Term 4 Exam 2

The nurse is counseling a woman who is caring for her 83-year-old father. The father has had mental changes and is becoming more confused. The father lives with the daughter in her home. The nurse knows the daughter understands the father's care needs when she states which of the following? a. "Dad will only need my help for a short time, and then he will get better." b. "I can leave dad alone during the day; I'll just deadbolt the door." c. "I can send dad to the adult daycare; that way I can work and care for him at night." d. "Dad misses mom since she passed; he will be okay in a few weeks."

"I can send dad to the adult daycare; that way I can work and care for him at night." The father will be cared for at the adult daycare, and it is a nice alternative for the daughter. She will be able to work and know that her father is safe during the day. The daughter thinking the father will be okay in a few days is not realistic, nor can she deadbolt the door and lock him in the house.

When teaching children, the nurse should include which concepts? (Select all that apply.) a. Exclude the children from teaching. b. Encourage parents or caregivers to be present. c. Use age-specific strategies. d. Consider the stages of development. e. Remember that parents are not the targets of the teaching.

-Encourage parents or caregivers to be present. -Use age-specific strategies. -Consider the stages of development. Patient education provided for children should be age specific. Effective patient education involving a child requires the presence of a parent or caregiver, who is likely the target of teaching.

The nurse recognizes which of the following to be a benefit of regular physical exercise? (Select all that apply.) a. Enhances the immune system. b. Decreases bone density. c. Limits joint mobility. d. Improves mental health. e. Helps to prevent type 2 diabetes

-Enhances the immune system. -Improves mental health. -Helps to prevent type 2 diabetes Exercise is essential for the prevention of illness and promotion of wellness. Physical exercise is any bodily activity or movement that enhances or maintains physical fitness levels and overall health.

The nurse identifies what decisional roles that are included in Mintzburg's description of management in terms of behavior? (Select all that apply.) a. Figurehead b. Spokesperson c. Entrepreneur d. Resource allocator e. Negotiator

-Entrepreneur -Resource allocator -Negotiator Mintzberg described management in terms of behaviors. Underlying his descriptions were two assumptions: much of a manager's time is spent in human relations, and managers are more reactive than proactive. These assumptions provided the basis for three categories of behaviors: interpersonal roles, informational roles, and decisional roles.

The community health nurse knows that which are standards of professional performance for home care nurses according to the ANA? (Select all that apply.) a. Collegiality b. Performance appraisal c. Ethical behavior d. Outcome identification e. Resource utilization

-Ethical behavior -Resource utilization The ANA's Public Health Nursing: Scope and Standards of Practice (2013) requires participation in research, responsible resource utilization, ethical behavior, leadership, and advocacy similar to the standards of practice for all nurses.

The student nurse learns the ANA's Scope and Standards of Practice for public health nursing include components? (Select all that apply.) a. Team membership b. Developing research c. Ethical behavior d. Responsible resource use e. Advocacy

-Ethical behavior -Responsible resource use -Advocacy The ANA's Scope and Standards of Practice for public health nursing requires participation in research, responsible resource utilization, ethical behavior, leadership, and advocacy like the standards of practice for all nurses. Team membership and developing one's own research are not included.

Interrelated concepts to professional nursing a nurse manager would consider when addressing concerns about the quality of health promotion include which concepts? (Select all that apply.) a. Culture b. Development c. Evidence d. Nutrition e. Health policy

-Evidence -Health policy The interrelated concepts to professional nursing include evidence, health care economics, health policy, and patient education. Culture is a patient attribute concept. Development is a patient attribute concept. Nutrition is a health and illness concept.

A nurse wants to create a community action plan for health problems related to air pollution from a nearby factory. Which stakeholders does the nurse consult as the priority? (Select all that apply.) a. Factory owners b. Stock shareholders c. Community residents d. Local health care providers e. Factory employees

-Factory owners -Community residents -Local health care providers Stakeholders have a significant interest in a topic. The priority stakeholders the nurse would want to consult for this project include the factory owners, community residents, and health care providers.

The nurse must provide patient education to a patient who has just been given the diagnosis of stage III cancer. The patient is complaining of chest and bone discomfort. Before providing the needed education, the nurse will complete which tasks? (Select all that apply.) a. Draw the curtain in the semi-private room. b. Medicate the patient to ease the pain. c. Place the patient in a private room if possible. d. Wait until later in the day. e. Attend to any other personal needs first.

-Medicate the patient to ease the pain. -Place the patient in a private room if possible. -Wait until later in the day. -Attend to any other personal needs first. The location of patient education influences the outcome. The setting should be quiet, and the session should have minimal interruptions. Providing privacy is difficult in settings such as emergency rooms, outpatient surgery centers, and semi-private inpatient rooms, but the nurse should make every effort to ensure confidentiality. Environmental considerations such as good lighting and the availability of resources should be explored to enhance the outcome ofpatient education. The nurse should examine the patient's situation and comfort level before beginning teaching.

A hospital organization is applying for Magnet© status to show excellence in nursing practice. What components would indicate that the hospital is meeting Magnet© principles? (Select all that apply.) a. The education budget for nursing has been cut to provide for new laboratory equipment. b. On average, 40% of new nurses are leaving within 1 year of hire. c. Nurses are active participants on all major hospital committees. d. Quality improvement projects are planned and evaluated by nurses. e. Patient care outcome data are reported in the annual executive board meeting.

-Nurses are active participants on all major hospital committees. -Quality improvement projects are planned and evaluated by nurses. To gain Magnet© status, an organization must show that nurses are active participants in the organization administrative structure, fully involved in quality improvement projects, and are recognized as a valuable resource.

The nurse identifies which components to be expected nursing documentation? (Select all that apply.) a. Nursing assessment b. The care plan c. Critique of the physician's care d. Interventions e. Patient responses to care

-Nursing assessment -The care plan -Interventions -Patient responses to care Expected nursing documentation includes a nursing assessment, the care plan, interventions, the patient's outcomes or response to care, and assessment of the patient's ability to manage after discharge. Documentation should be factual and nonjudgmental.

Many grandparents today are caring for grandchildren in place of a parent. Identify the reasons why this phenomenon is happening. (Select all that apply.) a. Children prefer living with their grandparents. b. Parents are incarcerated. c. Parents are deceased. d. Grandparents are better caregivers. e. Parents are mentally ill. f. Parents are substance abusers.

-Parents are incarcerated. -Parents are deceased. -Parents are mentally ill. -Parents are substance abusers. Grandparents are usually caring for children because the parents are deceased, in prison, substance abusers, or mentally ill and cannot care for the children. The fact that children prefer to live with the grandparents or the grandparents may be better caregivers is not a main reason for this phenomenon to happen.

The nursing student is learning about SBAR reporting. What statements about the patient are matched with the correct part of the report? (Select all that apply.) a. Patient is an 84-year-old female with a history of hypertension: S b. Patient's blood pressure has dropped from 142/92 to 98/48 mmHg: S c. Patient is hemorrhaging with four saturated dressings in an hour: A d. The patient took an overdose of antidepressants three days ago: B e. By policy, the patient needs transferred to the ICU; please come write the orders: R

-Patient's blood pressure has dropped from 142/92 to 98/48 mmHg: S -Patient is hemorrhaging with four saturated dressings in an hour: A -The patient took an overdose of antidepressants three days ago: B -By policy, the patient needs transferred to the ICU; please come write the orders: R SBAR stands for situation (what is happening the current time), background (circumstances leading up to this situation), assessment (what the nurse thinks the problem is), and recommendation (what needs to be done to correct the situation). A history of hypertension would be background (if it were related to the current issue).

The economic stability of individuals or families can determine whether they are willing to seek preventive care or screening examinations. The nurse knows which statements about screening examinations to be true? (Select all that apply.) a. Free or low-cost screening ensures patient screening. b. People may not screen due to fear of testing positive. c. Early screening ensures minimal treatment costs. d. Employment stability is enhanced by early screening. e. Treatment of disorders often means lost wages.

-People may not screen due to fear of testing positive. -Treatment of disorders often means lost wages. The economic stability of individuals or families can determine whether they are willing to seek preventive care or screening examinations. Even if screening is free or low cost, the patient or family members may decline because of the potential for testing positive for a disease.

When assigning tasks to other health care providers, the nurse understands that each task must be delegated using which guidelines? (Select all that apply.) a. The task must be within the scope of the person to whom it is being delegated. b. The task is one that can be delegated to other health care providers. c. The task can be delegated whenever assessments are required. d. The task may be re-delegated by the person to whom it was first delegated. e. The task may require the nurse to procure resources to complete the task.

-The task must be within the scope of the person to whom it is being delegated. -The task is one that can be delegated to other health care providers. -The task may require the nurse to procure resources to complete the task. Through quality improvement, the nurse appreciates the value of what each team member can do to improve patient care. When delegating to other health care providers, the nurse understands that the task must be within the scope and abilities of the person to whom it is being delegated. The nurse must know if the task is something that can be delegated.

The nurse has a question regarding scope of practice and delegation. Where should the nurse seek clarification? (Select all that apply.) a. The state's nurse practice act b. Theory X management c. Nurse's Code of Ethics d. The NCSBN website e. NCSBN journal articles

-The state's nurse practice act -The NCSBN website -NCSBN journal articles Nurses must have knowledge of the nurse practice act in the state where they are licensed. Each state's nurse practice act defines the RN scope of practice and discusses appropriate delegation. A second resource in delegation is the use of the organization's policy and procedure manual. Employers must have job descriptions for each job class that outline the responsibilities and limitations of each position.

The nurse knows that the Health Insurance Portability and Accountability Act (HIPAA) allows health information to be shared in which circumstances? (Select all that apply.) a. To provide treatment for the patient b. To determine billing and payment issues c. To enhance health care operations related to the patient d. In public areas such as the cafeteria or elevator e. Over the telephone with any family member

-To provide treatment for the patient -To determine billing and payment issues -To enhance health care operations related to the patient The Health Insurance Portability and Accountability Act (HIPAA), originally passed in 1996, created standards for the protection of personal health information, whether conveyed orally or recorded in any form or medium. The act clearly mandates that protected health information may be used only for treatment, payment, or health care operations.

The nurse is conducting a windshield survey. What items does the nurse assess? (Select all that apply.) a. Types of housing available b. Cars seen in parking lots c. Recreational facilities d. Health care facilities e. Places of worship

-Types of housing available -Recreational facilities -Health care facilities -Places of worship A windshield survey is a type of community health assessment. The nurse walks or drives through a neighborhood and notes the type of housing available, the presence and condition of recreational facilities, the presence of health care facilities, and places of worship among other items.

The nurse recognizes which skills that are needed to be an effective manager? (Select all that apply.) a. Understand the concepts of budgeting. b. Run a unit efficiently without regard to cost. c. Be able to staff the unit effectively. d. Be adept at information management. e. Achieve desired outcomes in any way possible.

-Understand the concepts of budgeting. -Be able to staff the unit effectively. -Be adept at information management. An effective manager must have business skills and a business sense. Part of quality care is ensuring that the care the patient receives is cost effective. The nurse manager must understand concepts of budgeting, staffing, marketing, and information management. An understanding of human resource management is equally important.

A nurse is assessing social determinants of health. Which does the nurse include in the assessment? (Select all that apply.) a. Vaccination compliance b. Family structure c. Communication patterns d. Roles for women e. Education

-Vaccination compliance -Family structure -Roles for women -Education Income, education, health literacy, where people live or work, early childhood development, social exclusion, family structure, the status and role of women, and vaccination adherence are just some of the social determinants of health recognized worldwide.

Which recommendations would the nurse identify as appropriate screening guidelines? (Select all that apply.) a. Women ages 21 to 29 should have a Pap test every 3 years. b. Self-breast exams should be addressed with male and female patients. c. Adolescent males should perform monthly self-testicular exams. d. Women ages 30 to 65 should receive Pap tests every 10 years. e. After a total hysterectomy, Pap testing should be more frequent.

-Women ages 21 to 29 should have a Pap test every 3 years. -Self-breast exams should be addressed with male and female patients. -Adolescent males should perform monthly self-testicular exams. All women should begin cervical cancer screening at the age of 21 years. Women between the ages of 21 and 29 years should have a Papanicolaou (Pap) test every 3 years. A priority assessment task for nurses in a variety of care settings is to ask female and male patients about breast self-examination.

The nurse identifies which patient would most likely need to have adjustments made to the education plan for discharge because of role function? a. A 67-year-old married female who lives with her retired husband b. A 32-year-old single mother of a toddler following hysterectomy c. A 13-year-old who lives at home with his parents after appendectomy d. A 50-year-old married mother with two children in college and teenager at home

A 32-year-old single mother of a toddler following hysterectomy Exploration of the patient's roles is an important task that must be done before development of a patient education plan. For example, a 32-year-old, single mother of five young children who has just undergone a hysterectomy may require a different perspective in her discharge instructions than that in the instructions of a 67-year-old female living with her husband who recently retired after 35 years as a family practice physician.

The nurse knows while leadership behaviors and management skills often complement each other they differ in which way? a. Managers focus on relationships. b. A manager may not possess leadership traits. c. Leadership focuses on coordinating and directing others. d. A manager is a visionary who sets the direction for a group.

A manager may not possess leadership traits. A manager may not possess leadership traits, and a leader may lack management skills. Management is the process of coordinating others and directing them toward a common goal.

The annual report for a hospital shows that external environment factors are affecting the amount of new staff hired. What is a likely factor contributing to this outcome? a. The recent implementation of becoming a not-for-profit institution b. The implementation of a hospital electronic medical record system c. A national recession that has been occurring for 3 years d. The closure of a hospital-based school of nursing due to lack of funding

A national recession that has been occurring for 3 years External environmental factors that affect organizations are conditions or events that occur outside the control of the agency, such as new health laws, governmental regulations, or economic trends. Internal environmental factors occur within the organizational structure and include such factors as technology issues, changes in personnel roles, or the implementation of new policies.

In which of the following answers is the hospital in compliance with the Consolidated Omnibus Budget Reconciliation Act and Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA)? a. The emergency department staff asks a patient to stay in the waiting room until the patients with insurance are treated. b. The emergency registration personnel explain to a patient that they must have proper identification to receive treatment. c. A patient with chest pain is triaged directly to a room for evaluation and registration information is obtained after the patient is stabilized. d. The emergency department physician discharges and instructs a patient who is actively suicidal to go the neighbor facility that has psychiatric services.

A patient with chest pain is triaged directly to a room for evaluation and registration information is obtained after the patient is stabilized. EMTALA requires that any hospital that operates an emergency department and receives Medicare funds provide an appropriate screening exam to anyone who presented and stabilize any emergency medical condition prior to transfer to another facility.

A student nurse is studying clinical judgment theories and is working with Tanner's Model of Clinical Judgment. How can the student nurse best generalize this model? a. A reflective process where the nurse notices, interprets, responds, and reflects in action b. One conceptual mechanism for critiquing ideas and establishing goal-oriented care c. Researching best practice literature to create care pathways for certain populations d. Assessing, diagnosing, implementing, and evaluating the nursing care plans

A reflective process where the nurse notices, interprets, responds, and reflects in action Looking across theories and definitions of clinical judgment, they all have in common the ability to reflect on data and choose actions. Reflection also considers evaluating the result of the actions to determine whether they were effective.

The nurse understands the need for accurate documentation due to which fact? a. Accurate documentation is needed for proper reimbursement. b. Accurate documentation must be electronically generated. c. Accurate documentation does not include e-mails or faxes. d. Accurate documentation is only accepted in court if written by hand.

Accurate documentation is needed for proper reimbursement. Accurate documentation is necessary for hospitals to be reimbursed according to diagnostic-related groups (DRGs). DRGs are a system used to classify hospital admissions. Health care documentation is any written or electronically generated information about a patient that describes the patient, the patient's health, and the care and services provided,including the dates of care.

A patient is diagnosed with pneumonia after an abrupt onset of fever, cough, and malaise. The patient is started on antibiotic therapy and is expected to improve in 2 to 3 weeks. Which statement by the nurse correctly identifies this illness? a. Acute b. Chronic c. Remission d. Exacerbation

Acute Acute illness is typically characterized by an abrupt onset and short duration (<6 months). Clinical manifestations of acute illness appear quickly. They may be severe or lethal, or they may soon resolve because they respond to treatment or are self-limiting.

The nurse is assisting a co-worker who is preparing to change a deep wound dressing on a patient's abdomen. Several of the patient's out-of-town friends are at the bedside watching a football game. Which action is most appropriate for the nurse to consider prior to the dressing change? a. Ask the friends to leave the room. b. Pull the curtain around the bed. c. Allow visitors to stay in the room during the procedure. d. Ask the patient to turn up the volume on the television.

Ask the friends to leave the room. It is appropriate for the nurse to ask visitors to leave a patient's room for a few minutes. Several factors affect the location appropriate for communication with patients. Privacy and confidentiality are critical during the interviewing and assessment process.

The nurse is caring for an older Chinese adult male who is grimacing and appears restless after abdominal surgery. What is the nurse's best action? a. Ask the patient if he is anxious about his hospital stay. b. Ask a translator to conduct a FACES pain scale assessment. c. Ask the patient about pain and assess vital signs. d. Ask the patient about any history of depression or anxiety.

Ask the patient about pain and assess vital signs. In the Chinese culture, elderly Chinese people believe that they must be stoic about pain and there is a stigma about talking about any mental health problems. The nurse should ask the patient about pain and also assess vital signs for physiological signs of pain, since the patient may not admit to any pain.

The admission personnel working to comply with the Patient Self Determination Act of 1991 would do which of the following? a. Request identification from the patient to complete the registration process. b. Ask the patient if they would like a private or semi-private room. c. Inquire about the patient's reason for their visit. d. Ask the patient or representative if the patient has an advanced directive and inform them of their right to participate in their medical decisions.

Ask the patient or representative if the patient has an advanced directive and inform them of their right to participate in their medical decisions. Inquiring about a patient's advanced directive is a requirement of the Patient Self Determination Act of 1991. Inquiring about identification, type of room requested, and reason for visit are not addressed by the Patient Self Determination Act.

Which action by the nurse working with a client best demonstrates respect for autonomy? a. Asks if the client has questions before signing a consent b. Gives the client accurate information when questioned c. Keeps the promises made to the client and family d. Treats the client fairly compared to other clients

Asks if the client has questions before signing a consent Autonomy is self-determination. The client should make decisions regarding care. When the nurse obtains a signature on the consent form, assessing if the client still has questions is vital, because without full information the client cannot practice autonomy. Giving accurate information is practicing with veracity.

During a shift report, the nurse briefly describes the history of a patient admitted with chronic gastrointestinal bleeding. In which SBAR topical area would this information be presented? a. Situation b. Background c. Assessment d. Recommendation

Background The "B" in SBAR stands for "Background," or what led up to the current situation. The "S" stands for Situation or what is happening right now. The "A" stands for "Assessment," or what is the identified problem, concern, or need. The "R" stands for "Recommendation," or what actions or interventions should be initiated to alleviate the problem.

Medical models coordinate medical services and were traditionally designed fulfill which function? a. Be patient specific. b. Be nursing oriented. c. Be diagnosis specific. d. Be community oriented.

Be diagnosis specific. Medical models focus on the patient's diagnosis. The medical model is not patient specific, nursing oriented, or community oriented.

A nurse is caring for a postoperative client on the surgical unit. The client's blood pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is best? a. Call the Rapid Response Team. b. Document and continue to monitor. c. Notify the primary care provider. d. Repeat blood pressure measurement in 15 minutes.

Call the Rapid Response Team. The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating before they suffer either respiratory or cardiac arrest. Since the client has manifested a significant change, the nurse should call the RRT.

A nurse wants to volunteer for a community group providing secondary prevention. What activity would the nurse attend? a. Stroke rehabilitation support group b. Blood pressure screening at the mall c. Bicycle safety class at the elementary school d. Drop by nutrition station at the grocery store

Blood pressure screening at the mall Secondary prevention activities are aimed at early diagnosis and prompt intervention. Blood pressure screening events are a good example. Stroke rehabilitation is tertiary prevention. Bicycle safety classes and nutrition education are examples of primary prevention.

During patient teaching led by the nurse with goals established through cooperation of the nurse and patient, the patient asks questions as needed and the nurse answers. The nurse understands that this is what type of teaching? a. Formal teaching b. Informal teaching c. Both formal and informal teaching d. Psychomotor teaching

Both formal and informal teaching Some patient education sessions have formal and informal elements, because the nurse and patient may set goals together before the nurse formulates and implements the plan of care, and the patient is free to ask questions that may direct the session.

A client is going to be admitted for a scheduled surgical procedure. Which action does the nurse explain is the most important thing the client can do to protect against errors? a. Bring a list of all medications and what they are for. b. Keep the doctor's phone number by the telephone. c. Make sure all providers wash hands before entering the room. d. Write down the name of each caregiver who comes in the room.

Bring a list of all medications and what they are for. Medication errors are the most common type of health care mistake. The Joint Commission's Speak Up campaign encourages clients to help ensure their safety. One recommendation is for clients to know all their medications and why they take them. This will help prevent medication errors.

The nurse manager of the emergency room believes that efficiency is the expected standard for the department and believes that efficiency lies in following established rules, policies, and guidelines. The only way to change procedures is to changes rules, policies, and guidelines. To run the emergency room with this philosophy, the nurse manager must take on which role? a. Laissez-faire leader b. Democratic leader c. Bureaucratic leader d. Autocratic leader

Bureaucratic leader Like the autocratic leader, the bureaucratic leader assumes that employees are motivated by external forces. This type of leader relies on policies and procedures to direct goals and work processes. The nurse using bureaucratic leadership tends to relate impersonally to staff and exercises power on the basis of established rules.

A home care nurse receives a physician order for a medication that the patient does not want to take because the patient has a history of side effects from this medication. The nurse carefully listens to the patient, considers it in light of the patient's condition, questions its appropriateness, and examines alternative treatments. What is the nurse's best action? a. Call the physician, explain rationale, and suggest a different medication. b. Consult an experienced nurse on whether there are other similar treatments. c. Hold the drug until the physician returns to the unit and can be questioned. d. Question other staff as to the physician's acceptance of nursing input.

Call the physician, explain rationale, and suggest a different medication. Determining how best to proceed on behalf of a patient's best health care outcomes may require clinical judgment. At the committed level of critical thinking, the nurse chooses an action after all possibilities have been examined. A home care nurse who is using good clinical judgment techniques should have confidence in their decision and may not have another nurse available as this is an autonomous setting.

Which is an example of the regulatory power to make law? a. Joint Commission establishing a medication reconciliation standard. b. Centers for Disease Control and Prevention (CDC) developing recommendations for childhood immunizations. c. Institute of Medicine (IOM) defining the approximate number of medication errors that result in significant patient harm or death. d. Centers for Medicare and Medicaid Services (CMS) enacting rules for restraint and seclusion for participating hospitals.

Centers for Medicare and Medicaid Services (CMS) enacting rules for restraint and seclusion for participating hospitals. The Centers for Medicare and Medicaid Services (CMS) enacting rules for restraint and seclusion for participating hospitals refers to the enactment of law, while the other answers discuss the development of standards and recommendations that do not have the authority of law.

The nursing instructor teaching students about charting explains that this type of charting records only abnormal or significant data? a. PIE b. SOAP c. Narrative d. Charting by exception

Charting by exception Charting by exception (CBE) is documentation that records only abnormal or significant data. A PIE note is used to document problem (P), intervention (I), and evaluation (E). A SOAP note is used to chart the subjective data (S), objective data (O), assessment (A), and plan (P).

The nurse understands that based on a patient's perception of professional competence and caring, the nurse should wear which item? a. Large, dangling, hoop earrings b. Bright, multicolored acrylic fingernails c. Clean, neatly pressed uniform d. Offensive tattoos that cannot be covered

Clean, neatly pressed uniform

The staff nurse who uses informatics in promoting quality patient care is most likely to access data in which domain? a. Certified clinical information systems (CIS) b. Clinical health care informatics c. Public health/population informatics d. Translational bioinformatics

Clinical health care informatics Clinical health care informatics and the subset, nursing informatics, provides for the development of direct approaches to patients and their families which can be used by the staff nurse to promote quality patient care. Certified CIS refers to the tools for achieving quality outcomes, including electronic health records, clinical data repositories, decision support programs, and handheld devices—not the data.

A nurse is wondering if home health care nursing is a good fit. What characteristic or ability does the experienced home health care nurse suggest is most important? a. Clinical reasoning b. Organization c. Assessment skills d. Time management

Clinical reasoning The role of the registered nurse in home health care is essentially autonomous in that the nurse must be highly proficient in health assessment (physical and psychosocial), be well versed in complex technical and clinical skills, possess strong critical-thinking and clinical reasoning abilities, and demonstrate excellent organizational skills.

Which are exemplars of the health informatics concept? a. Clinical research informatics b. Hardware and software c. Privacy and security d. Standard terminology

Clinical research informatics Exemplars of the health informatics concept include clinical health care informatics, clinical research informatics, public/population health informatics, and translational bioinformatics. Hardware and software, privacy and security, and standardized information systems and terminology are considered attributes related to the concept, not exemplars.

The nurse is implementing a patient teaching plan regarding diabetes mellitus. One of the short-term goals of the plan is that the patient will be able to verbalize three symptoms of hypoglycemia. The nurse recognizes that this is what type of teaching? a. Psychomotor teaching b. Cognitive teaching c. Affective teaching d. VARK teaching

Cognitive teaching Learners in the cognitive domain integrate new knowledge through first learning and then recalling the information. They then categorize and evaluate, making comparisons with previous knowledge that result in conclusions related to the new content.

Aspects of safety culture that contribute to a culture of safety in a health care organization include which component? a. Communication b. Fear of punishment c. Malpractice implications d. Team nursing

Communication Aspects that contribute to a culture of safety include leadership, teamwork, an evidence base, communication, learning, a just culture, and patient-centered care. Fear of professional or personal punishment and concern about malpractice implications are considered barriers to a culture of safety.

When the patient has had a fall while trying to climb out of bed, the nurse must carry out which task? a. Complete an incident report as a risk management document. b. Complete an incident report and add it to the medical record. c. Document that an incident report was completed in the medical record. d. Say nothing about the incident in the medical record.

Complete an incident report as a risk management document. Incident reports are objective, nonjudgmental, factual reports of the occurrence and its consequences. The incident report is not part of a medical record but is considered a risk management or quality-improvement document.

The nurse knows the World Health Organization defines health in which of the following terms? a. The absence of disease b. The lack of infirmity c. Complete well-being d. Being independent of fiscal responsibility

Complete well-being The World Health Organization offers a definition for health: "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." Nurses are responsible for helping patients reach their optimal levels of physiologic and mental health, but they also must provide health care in a system that requires cost containment and fiscal responsibility.

What interrelated constructs facilitate a nurse to become culturally competent? a. Cultural diversity, self-awareness, cultural skill, and cultural knowledge b. Cultural desire, self-awareness, cultural knowledge, and cultural identity c. Cultural desire, self-awareness, cultural knowledge, and cultural diversity d. Cultural desire, self-awareness, cultural knowledge, and cultural skill

Cultural desire, self-awareness, cultural knowledge, and cultural skill The process of cultural competence consists of four interrelated constructs: cultural desire, self-awareness, cultural knowledge, and cultural skill. Cultural diversity in the context of health care refers to achieving the highest level of health care for all people by addressing societal inequalities and historical and contemporary injustices.

The public health nurse volunteers for a missionary group caring for Ebola patients in Africa. The nurse is reviewing the data using analytic epidemiology methods. What information does the nurse collect as the priority? a. Cultural norms in burial practices b. Genetic variables in disease acquisition c. Statistics related to incidence and prevalence d. Autopsy data on direct cause of death

Cultural norms in burial practices Analytic epidemiology hypothesizes why a disease is occurring in a community and looks at cultural practices, nutrition, and extrinsic factors such as the environment for links. Genetic variables and direct cause of death data are more related to epidemiology.

A new graduate nurse is working with an experienced nurse to chart assessment findings. The new nurse notes that the physical therapist wrote on the chart that the patient is lazy and did not want to participate in assigned therapies this AM. The experienced nurse asks the new nurse what may be going on here. What is the best explanation for this statement? a. Data on the chart can sometimes be documented in a biased manner. b. Data on the chart changes as the patient's condition changes. c. Data on the chart is usually accurate and can be verified from the patient. d. Reading the chart is not a wise use of time as this can be time consuming and tedious.

Data on the chart can sometimes be documented in a biased manner. It is important that the nurse records only what is assessed, without adding judgments or interpretations to the record. Data do indeed change (and need to be charted) as the patient's condition changes, but this would not be the best answer to this question. Assessment data may at times be difficult to obtain, but that would not occur often enough to warrant a warning about the difficulty in charting it.

The nurse manager is considered a "great communicator." She can be found on the unit talking with staff, keeping them informed and asking their opinions. She believes that nurses are motivated by internal means and that they want to participate in making decisions about the unit although the final decision always rests with her. The nurses recognize that this nurse manager is what type of leader? a. Autocratic b. Democratic c. Bureaucratic d. Laissez-faire

Democratic The participative or democratic leader believes that employees are motivated by internal means and want to participate in decision making. The primary function of the leader in this situation is to foster communication and develop relationships with followers. The authoritarian or autocratic leader exercises strong control over subordinates.

The nurse is caring for a patient scheduled for a partial mastectomy resulting from advanced cancer. The patient tells the nurse, "I'm sure when the surgeon operates on me, he will not find any cancer in my breast. It looks just fine." The nurse recognizes that the patient is using which defense mechanism to cope with the medical diagnosis? a. Suppression b. Sublimation c. Displacement d. Denial

Denial The patient is refusing to admit that the breast has to be removed because of cancer. This inability to accept the truth is termed denial. Displacement is an unconscious defense mechanism used to avoid conflict and anxiety by transferring emotions from one object to another object that is less anxiety producing.

The nursing student has been assigned to help feed patients at lunch time. Which nursing intervention would be most effective when assisting a blind patient to eat a meal? a. Speak loudly to ensure that the patient understands. b. Describe the food arrangement using the numbers on a clock. c. Tell the patient what is on the plate since he has lost the sense of smell. d. Encourage the patient to eat faster so that the task will be done.

Describe the food arrangement using the numbers on a clock. An important factor to remember when caring for visually impaired or blind patients is that they are rarely hearing impaired. Typically, blind patients have heightened auditory and olfactory senses. Communication with blind patients can be characterized as anticipatory in nature, meaning that the nurse should alert visually impaired patients of potential hazards or object locations to provide necessary information and safe care.

To design and implement a decubitus ulcer risk management protocol in the electronic health record, the informatics nurse would first perform which action? a. Build the screens in the electronic health record. b. Determine evidence supporting decubitus ulcer risk management. c. Develop the training program for staff. d. Select the appropriate standardized language.

Determine evidence supporting decubitus ulcer risk management. Collecting the evidence related to the issue is the first step in addressing a problem (remember the nursing process, the foundation of nursing practice). Based on the evidence, an assessment tool or tools and data needed from a patient perspective would be identified.

A nurse has assessed a community and has found many areas in which health can be improved. As a result, the nurse has multiple ideas for programming. What action by the nurse is best?a. a. Determine what the community thinks is most important. b. Use vital statistics to determine which is most important. c. See what other communities are focusing programming on. d. Choose the easiest problem to address first.

Determine what the community thinks is most important. The nurse's priorities may be very different from the community's. For programming to be successful, there must be buy-in from members of the community. Unless programming addresses a need the community thinks is important, it is unlikely to be successful.

A nurse has designed an individualized nursing care plan for a patient, but the patient is not meeting goals. Further assessment reveals that the patient is not following through on many items. Which action by the nurse would be best for determining the cause of the problem? a. Assess whether the actions were too hard for the patient. b. Determine whether the patient agrees with the care plan. c. Question the patient's reasons for not following through. d. Reevaluate data to ensure the diagnoses are sound.

Determine whether the patient agrees with the care plan. Having patient and/or family provide input to the care plan is vital in order to gain support for the plan of action. The actions may have been too difficult for the patient, but this is a very narrow item to focus on. The nurse might want to find out the rationale for the patient not following through, but instead of directly questioning the patient, which can sound accusatory, it would be best to offer some possible motives.

When discussing the purposes of health care informatics with a nurse during orientation, the nurse educator would be concerned if the nurse orientee stated that which is one purpose of informatics? a. Develop a cognitive science. b. Improve disease tracking. c. Improve the health provider's work flow. d. Increase administrative efficiencies.

Develop a cognitive science. Cognitive science is one of the theories that play a role in the implementation of informatics. Its development is not a purpose, and the nurse educator would use this incorrect response of the orientee to plan additional teaching about the purposes of health care informatics.

A mother of a young child kicks a trashcan in anger and says to the nurse, "You just don't understand! Why can't the doctor find out what is wrong with my child?" The nurse understands that this behavior is most likely an example of which defense mechanism? a. Suppression b. Sublimation c. Displacement d. Rationalization

Displacement Displacement is an unconscious defense mechanism used to avoid conflict and anxiety by transferring emotions from one object to another object that is less anxiety-producing. The mother is upset that the health care team is not able to determine the cause of her child's illness and expresses her anger by kicking the trashcan.

The nurse recognizes which statement to be accurate regarding what should be documented? a. Document facts and subjective data from the patient. b. Document how he/she feels about the care being provided. c. Document in a "block" fashion once per shift. d. Double document as often as possible in order to not miss anything.

Document facts and subjective data from the patient. Nursing documentation is an important part of effective communication among nurses and with other health care providers. Documentation should be factual and nonjudgmental, with proper spelling and grammar. Subjective data from the patient should be included.

A student nurse asks the faculty to explain best practices when communicating with a person from the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community. What answer by the faculty is most accurate? a. Avoid embarrassing the client by asking questions. b. Don't make assumptions about their health needs. c. Most LGBTQ people do not want to share information. d. No differences exist in communicating with this population.

Don't make assumptions about their health needs. Many members of the LGBTQ community have faced discrimination from health care providers and may be reluctant to seek health care. The nurse should never make assumptions about the needs of members of this population. Rather, respectful questions are appropriate.

What action should the nurse take to correct an error in paper charting? a. Remove the sheet with the error and replace it with a new sheet with the correct entry. b. Scribble out the error and rewrite the entry correctly. c. Draw a single line through the error write "error" above or after the entry, along with the nurse's initials. d. Leave the entry as is and tell the charge nurse.

Draw a single line through the error write "error" above or after the entry, along with the nurse's initials. Documentation mistakes must be acknowledged. If an error is made in paper documentation, a line is drawn through the error and the word error is placed above or after the entry, along with the nurse's initials and followed by the correct entry. Notes should never be altered or obliterated. Documentation mistakes must be acknowledged.

The nurse is working with a diabetic patient and is attempting to teach psychomotor skills. This is occurring when the nurse has the patient complete what action? a. Verbally describe his feelings about diabetes. b. Answer three of five true-or-false questions about diabetes. c. Identify three positive lifestyle changes to manage blood sugar. d. Draw up and self-inject insulin correctly.

Draw up and self-inject insulin correctly. The psychomotor domain incorporates physical movement and the use of motor skills in learning. Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill.

The nurse understands ongoing evaluation of patient education occurs by which team member? a. Each member of the health care team who provides teaching b. The nurse who evaluates the patient's physical abilities c. The patient stating that he understands the instruction d. Not allowing review from the provider so the focus remains forward

Each member of the health care team who provides teaching Ongoing evaluation of patient education occurs by each member of the health care team who provides teaching according to the patient's teaching plan. Having the learner repeat what has been learned can help the nurse evaluate the teaching plan and adjust the plan for future patient education sessions.

The nurse is admitting a patient who has had several previous admissions. To obtain a knowledge base about the patient's medical history, the nurse would access which document? a. Electronic medical record (EMR) b. The computerized provider order entry (CPOE) c. Electronic health record (EHR) d. Primary provider's office notes

Electronic health record (EHR) The EHR is a longitudinal record of health that includes the information from inpatient and outpatient episodes of health care from one or more care settings. The EMR is a record of one episode of care, such as an inpatient stay or an outpatient appointment.

A nurse is orienting a new client and family to the inpatient unit. What information does the nurse provide to help the client promote his or her own safety? a. Encourage the client and family to be active partners. b. Have the client monitor hand hygiene in caregivers. c. Offer the family the opportunity to stay with the client. d. Tell the client to always wear his or her armband.

Encourage the client and family to be active partners. Each action could be important for the client or family to perform. However, encouraging the client to be active in his or her health care as a partner is the most critical. The other actions are very limited in scope and do not provide the broad protection that being active and involved does.

The nurse is preparing a teaching plan and is applying evidence-based practice. To promote involvement, the nurse must include which concept? a. Provide the latest professional literature to the patient. b. Ensure that the patient understands relevant information. c. Use only one teaching method to reduce confusion. d. Not review previously learned information.

Ensure that the patient understands relevant information. To promote involvement, nurses must ensure that patients understand the information relevant to their care. Nurses need to provide patients with easy-to-understand information and speak in a clear, distinct voice, using short sentences and understandable terminology.

A new nurse is working with a preceptor on an inpatient medical-surgical unit. The preceptor advises the student that which is the priority when working as a professional nurse? a. Attending to holistic client needs b. Ensuring client safety c. Not making medication errors d. Providing client-focused care

Ensuring client safety All actions are appropriate for the professional nurse. However, ensuring client safety is the priority. Up to 98,000 deaths result each year from errors in hospital care, according to the 2000 Institute of Medicine report. Many more clients have suffered injuries and less serious outcomes. Every nurse has the responsibility to guard the client's safety.

The nurse has implemented a community-wide immunization program for seasonal influenza. Once the program has ended, what action by the nurse is best? a. Begin planning for next year's program. b. Send mail surveys to participants. c. Determine financial gains or losses. d. Evaluate the program and outcomes.

Evaluate the program and outcomes. The last step of the nursing process is evaluation. The nurse should evaluate the program to see if interventions had the desired effect. Evaluation could include surveys or looking at financial outcomes, but those are only limited aspects of the process.

According to Fayol, controlling is a function of management. The nurse understands controlling compares to what phase of the nursing process? a. Evaluation b. Diagnosis c. Assessment d. Implementation

Evaluation The act of controlling involves comparing expected results of the planned work with the actual results. In the nursing process, evaluation is comparable to controlling. The planning function of a manager is comparable to the assessment, diagnosis, and planning portions of the nursing process.

Which branch of government is responsible for the execution of laws passed by legislatures? a. Legislative b. Judicial c. Executive d. Local

Executive The executive branch of federal and state governments is responsible for execution of laws passed. The legislative branch is responsible for passing laws. The judicial branch of government determines if rights are being upheld. Local governments are not considered a branch of the government.

A new nurse appears to be second-guessing herself and is constantly calling on the other nurses to double-check their plan of care or rehearse what they will say to the doctor before she call on the patient's behalf. This seems to be annoying some of the nurse's coworkers. What is the nurse manager's best response? a. Explain to coworkers that this is a characteristic of critical thinking and is important for the new nurse to improve reasoning skills. b. Agree with the staff and have someone follow and work more closely with a preceptor. c. Have a talk with the nurse and suggest asking fewer questions. d. Tell the staff that all new nurses go through this phase, and ignore their behavior.

Explain to coworkers that this is a characteristic of critical thinking and is important for the new nurse to improve reasoning skills. Reflection-on-action is critical for development of knowledge and improvement in reasoning. It is where learning from practice is incorporated into experience. Inquisitiveness is a characteristic of critical thinking and reflects a desire to learn even when the knowledge may not appear readily useful.

To promote safety, the nurse manager sensitive to point of care (sharp end) and systems level (blunt end) exemplars works closely with staff to address which point of care exemplar? a. Care coordination b. Documentation c. Electronic records d. Fall prevention

Fall prevention The most common safety issues at the sharp end include prevention of decubitus ulcers, medication administration, fall prevention, invasive procedures, diagnostic workup, recognition of/action on adverse events, and communication. These are the most common issues the staff nurse providing direct patient care encounters

A home health care nurse is working with the family of a patient who has Alzheimer disease and requires 24-hour care. What assessment by the nurse indicates the family is meeting an important goal for caregiver role stress? a. Family eats dinner together every night. b. Family uses respite care one night a week. c. Family investigates research trials for patient. d. Family verbalizes exhaustion from caregiving.

Family uses respite care one night a week. Caregiver role stress can occur when the caregiver(s) is unable to meet obligations or unable to take care of personal needs. Using a respite caregiver once a week gives the family a little time off to accomplish needed tasks.

The nurse needs to consider which approach when caring for patients with chronic illness? a. Help the patient face the reality that he will not get better. b. Emphasize to the patient that the illness is not his fault. c. Focus on improving quality of life through preventive behaviors. d. Acknowledge the limitations placed on the patient by his suffering.

Focus on improving quality of life through preventive behaviors. Nurses can help patients establish a daily routine of care by educating them about how to manage their care and the symptoms associated with the condition, including emergency or life-threatening situations. Emphasis is on improving quality of life through preventive behaviors.

Which tertiary prevention measure should be included in the health promotion plan of care for a patient newly diagnosed with diabetes? a. Avoiding carcinogens b. Foot screening techniques c. Glaucoma screening d. Seat belt use

Foot screening techniques Foot screening is considered a tertiary prevention measure, one that minimizes the problems with foot ulcers, an effect of diabetic disease and disability. Avoiding carcinogens is considered primary prevention—those strategies aimed at optimizing health and disease prevention in general and not linked to a single disease entity.

A quality improvement committee is reviewing discharge surveys. Results show that patients and their families have difficulty finding departments and areas of the hospital. What action by the committee would best address this concern for the organization? a. Continue to review future surveys to monitor the situation. b. Give additional training to the receptionists and switchboard personnel to give better directions. c. Form a multidisciplinary committee to identify options to help travel through the hospital. d. Send a work order to the maintenance department requesting that brighter lights be installed.

Form a multidisciplinary committee to identify options to help travel through the hospital. Successful organizations respect the input of all disciplines when searching for solutions for problems. Continuing to gather data delays solving a problem. There is no indication that verbal directions will solve the problem; additional measures may be required.

A nurse manager finds an unsigned note reporting that patient care standards are not consistently being followed. Within the organizational structure, what is the best action for the manager? a. Schedule a staff meeting to ask staff who left the note. b. Send an email reminder that all staff need to review the policy and procedure book. c. Wait for a staff member to come forward who is willing to be identified. d. Form a small group to explore why staff are not comfortable reporting errors.

Form a small group to explore why staff are not comfortable reporting errors. There are significant problems in an organization where staff are not willing to openly discuss problems, especially problems that affect patient care. A focus group can help identify what is preventing a sense of comfort to reveal problems.

The nurse has established a teaching plan including goals and identifies this type of education is termed by what term? a. Formal teaching b. Informal teaching c. Psychomotor teaching d. Affective teaching

Formal teaching Formal patient education is delivered throughout the community in the form of media, in a variety of educational and group settings, or in a planned, goal-directed, one-on-one session with a patient in the acute care setting. Informal education is usually learner or patient directed

Several nurses on a medical-surgical unit have been asked by the nurse manager to form a group and gather data regarding patient complaints of late meals. When the nurses meet and establish ground rules, this would be what phase of group development? a. Forming b. Storming c. Norming d. Performing

Forming Tuckerman's model of group performance includes forming, storming, norming, and performing. In the forming phase, there is little agreement on team goals other than those received from the leader, and there is a high dependence on the leader for guidance and direction.

The nurse is admitting a patient with a foul smelling leg wound. Which behavior by the nurse indicates an understanding of appropriate body language? a. Using hand gestures to enhance verbal communication b. Standing at the end of the bed with arms crossed c. Facial grimacing at the sight of the wound d. Gentle touching of the patient's shoulder

Gentle touching of the patient's shoulder

The nurse is caring for a patient with chronic lung disease. When the patient demands a cigarette after eating breakfast, the nurse responds, "If that was me, I wouldn't be asking for a cigarette. That is what has made you so sick in the first place." This nontherapeutic response is an example of what communication technique? a. Changing the subject b. Giving advice c. A stereotypical response d. Defensiveness

Giving advice Giving advice implies that the patient cannot make his or her own decisions and the nurse accepts the responsibility for the action. Changing the subject ignores the patient's concerns. Stereotypical or generalized responses such as, "Don't cry over spilled milk" may be judgmental.

The nurse identifies which statement to be accurate regarding the process of making a change-of-shift report (handoff)? a. Handoff is an uncommon occurrence of little importance. b. Handoff occurs only at change of shift and only to oncoming nurses. c. Handoff can lead to patient death if done incorrectly. d. Handoff does not allow for collaboration or problem solving.

Handoff can lead to patient death if done incorrectly. An ineffective handoff may lead to wrong treatments, wrong medications, or other life-threatening events, increasing the length of stay and causing patient injury or death. Improvement in the hand-off process can increase patient safety and promote positive patient outcomes.

A nurse has committed a serious medication error and has reported the error to the hospital's adverse medication error hotline as well as to the unit manager. The manager is a firm believer in developing critical thinking skills. From this standpoint, what action by the manager would best nurture this ability in the nurse who made the error? a. Have the nurse present an in-service related to the cause of the error. b. Instruct the nurse to write a paper on how to avoid this type of error. c. Let the nurse work with more experienced nurses when giving medications. d. Send the nurse to refresher courses on medication administration.

Have the nurse present an in-service related to the cause of the error. Nurturing critical thinking skills is done in part by turning errors into learning opportunities. If the nurse presents an in-service on the cause and prevention of the type of error committed, not only will the nurse learn something but many others nurses on the unit will learn from it to.

The nurse is preparing a patient teaching plan and is seeking a way to determine the patient's readiness and motivation to act regarding lifestyle changes to best manage diabetes mellitus. Which model would be useful for this nurse? a. Maslow's hierarchy of needs b. Holistic Health Model c. Health Promotion Model d. Health Belief Model

Health Belief Model The Health Belief Model was developed by psychologists Hochbaum, Rosenstock, and Kegels. It explores how patients' attitudes and beliefs predict health behavior.

The application of information processing that deals with the storage, retrieval sharing, and use of health care data, information, and knowledge for communication and decision making is the definition of which area? a. Computer science b. Health informatics c. Health information technology d. Nursing informatics

Health information technology This is the definition of health information technology. Computer science is a branch of engineering that studies computation and computer technology, hardware, software, and the theoretical foundations of information and computation techniques. Health informatics is a discipline in which health data are stored, analyzed, and disseminated through the application of information and communication technology.

The nurse understands the unique ability of the patient to understand and integrate health-related knowledge is known by which term? a. Health literacy b. Formal patient education c. Informal patient education d. Primary education

Health literacy The unique ability of a patient to understand and integrate health-related knowledge is known as health literacy. Formal patient education is delivered throughout the community in the form of media, in a variety of educational and group settings, or in a planned, goal-directed, one-on-one session with a patient in the acute care setting. Informal education is usually learner or patient directed.

The nurse recognizes that intentional behaviors to circumvent illness, detect it early, and maintain the best possible level of mental and physiologic function within the boundaries of illness is the definition of which term? a. Health promotion b. Self-actualization c. Health protection d. Self-transcendence

Health protection Health protection includes intentional behaviors aimed at circumventing illness, detecting it early, and maintaining the best possible level of mental and physiologic function within the boundaries of illness.

The nurse identifies which statement to be true regarding nursing documentation? a. Standards for documentation are established by a national commission. b. Medical records should be accessible to everyone. c. Documentation should not include the patient's diagnosis. d. High-quality nursing documentation reflects the nursing process.

High-quality nursing documentation reflects the nursing process. The ANA's model for high-quality nursing documentation reflects the nursing process and includes accessibility, accuracy, relevance, auditability, thoughtfulness, timeliness, and retrievability. Standards for documentation are established by each health care organization's policies and procedures.

The nurse caring for a patient with chronic pain uses guided imagery, therapeutic touch, and relaxation techniques as interventions for pain. The nurse is using what type of approach? a. Holistic b. Eastern holistic c. Risk factor reduction d. Health protection

Holistic Nurses participate in holistic care through the use of natural healing remedies and complementary interventions. These include the use of art and guided imagery, therapeutic touch, music therapy, relaxation techniques, and reminiscence.

Barriers to patient education the nurse considers in implementing a teaching plan include which factor? a. Family resources b. High school education c. Hunger and pain d. Need perceived by patient

Hunger and pain A patient who is hungry or in pain has limited ability to concentrate or learn. Family resources would be considered in developing a plan of care and could be an asset or a barrier to patient education. The patient's educational level would be considered in planning teaching strategies but would not be a barrier to education.

A patient presents to the clinic for illness, and the sick role is legitimized by the provider. The nurse recognizes this as what stage of illness according to Suchman's Model? a. I b. II c. III d. IV

III In stage III (Medical care contact), professional advice from health care providers is sought by the individual. A professional health care provider identifies and validates the illness and legitimizes the sick role. During stage II (Assumption of the sick role), the person decides that the illness is genuine and that care is necessary. This stage gives an individual permission to act sick and to be excused temporarily from typical social and personal obligations. During stage I (Symptom experience), a clinical manifestation of disease is experienced, and the person acknowledges that something is wrong and seeks a cure.

The nurse understands that as the health care community explores the concept of health literacy, many organizations recognize what concept? a. Consumers need to understand has no governmental support. b. Improvements are dependent on developing operational definitions. c. Low literacy and low health literacy are interchangeable terms. d. Interest in effective patient education is unique to the United States.

Improvements are dependent on developing operational definitions. As the health care community explores the concept of health literacy, many organizations recognize that before improvements can be made, operational definitions are imperative. The realization that consumers need to be able to understand the medical information delivered by health care providers has gained recognition at many governmental levels.

The nurse recognizes which concept that correctly completes the definition of the genetic vulnerability of an organism (risk of disease expression based on genotype)? a. It is involuntarily passed from biologic parents to offspring. b. It is totally unrelated to environmental factors. c. It is nonresponsive to alteration by way of lifestyle modification. d. It is not a factor in mental illness because it is behavioral.

It is involuntarily passed from biologic parents to offspring. The genetic vulnerability of an organism, or risk of disease expression based on genotype, is involuntarily passed from biologic parents to their offspring. Societal attitudes about testing and management of high-risk populations depend on the potential for expression of genetic disorders that may be triggered by environmental factors.

When planning to evaluate a patient's satisfaction with a teaching activity, what is the most appropriate strategy? a. Include a survey instrument. b. Observe for level of skill mastery. c. Present information more than one time. d. Provide for a return demonstration.

Include a survey instrument. A survey or questionnaires can be used to measure affective behavior change as well as patient satisfaction with the teaching experience. Observing for level of skill mastery would evaluate achievement of a psychomotor goal rather than satisfaction with the experience.

The nurse is assessing a patient's environment and its impact on outdoor activity and notes that the child rarely plays outside. Which is true regarding the indoor environment? a. Indoor environments protect the patient from toxics chemicals. b. Indoor activity is sometimes a result of unsafe outdoor conditions. c. Indoor activity decreases the risk of respiratory illness. d. Indoor lifestyles reduce the risk for sedentary behaviors.

Indoor activity is sometimes a result of unsafe outdoor conditions. Outdoor environments affect individual health in the areas of sanitation and waste disposal, water quality, air quality, and safety. Children living in areas where there are safety issues related to gang activity, sexual predators, or heavy traffic are less likely to engage in outdoor play activities.

A community was devastated by a tornado several months ago. What nursing diagnosis would be most appropriate for the nurse to consider? a. Social isolation b. Deficient community resources c. Ineffective community coping d. Deficient community health

Ineffective community coping This diagnosis considers those in a community who may be feeling helpless, hopeless, or frustrated because of an extraordinary event. Financial and physical resources may not be available for rebuilding. Social isolation refers to unacceptable social behavior.

The nurse is admitting a patient who has cystic fibrosis. During the admission interview, it is apparent that the patient is well versed in most aspects of his illness. When asked about where he learned so much, the patient responds, "I learned most of it myself. I looked things up on the Internet and read books. You have to know what's wrong with you to be sure that you're being treated right." The nurse knows this is an example of what type of education/learning? a. Formal education b. Psychomotor learning c. Informal education d. Affective learning

Informal education Informal education is usually learner or patient directed. Formal patient education is delivered throughout the community in the form of media, in a variety of educational and group settings, or in a planned, goal-directed, one-on-one session with a patient in the acute care setting. The psychomotor domain incorporates physical movement and the use of motor skills in learning.

Strategies to include in a teaching plan for an adult who has repeatedly not followed the written discharge instructions would include which information source? a. Individualized handout b. Instructional videos c. Internet resources d. Self-help books

Instructional videos An instructional video would provide a visual/auditory approach for discharge instructions. Repeatedly not following written instructions is a clue that the patient may not be able to read or understand the information. While assessing the literacy level of an adult patient can be challenging, the information that they have not been able to follow previous written instructions would suggest that the nurse use an alternate strategy that does not require a high degree of literacy.

The nurse manager would counsel the staff nurse for delegating which task to the UAP? a. Personal hygiene b. Assistance with eating breakfast c. Assistance with toileting d. Interpretation of abnormal vital signs

Interpretation of abnormal vital signs The RN must remember to delegate tasks that do not require nursing judgment. Interpretation of abnormal vital signs requires assessment skills possessed by the RN only. Only tasks that are routine and do not require variation from a standardized procedure, such as providing hygiene, assisting with eating, and toileting, should be delegated.

A nurse is a case manager for a home health care agency. The nurse often orders supplies for patients seen by the agency. What action by the nurse is best? a. Negotiate for cheaper prices from suppliers. b. Investigate what each patient's insurance will cover. c. Refer the patient to the closest supply source. d. Use the same supplier for all patients' needs.

Investigate what each patient's insurance will cover. The case manager in home health care must be a well-versed financial steward and understand what each patient's insurance will cover to maximize the patient's benefit. The home health care nurse serves as a case manager (coordinator) of client care, needed services, and needed supplies in the home setting.

When planning interventions for a community, what action by the nurse is best? a. Involve community leaders in planning. b. Create a plan of action addressing priorities. c. Determine what resources are available. d. Attempt to find funding for the plan.

Involve community leaders in planning. Stakeholders need to be involved in planning to ensure buy-in from the community. The stakeholders could be community or business leaders. The other actions are important, but if the community leaders are not committed to the plan, the plan is unlikely to work.

The patient asks the nurse to explain collaborative health care partnerships. The nurse gives a correct description when making which statement regarding collaborative care? a. Does not require participation of the patient. b. Is individual and cannot be mandated or legislated. c. Education needs are delegated to assistive personnel. d. Is designed to provide care to the patient as a whole.

Is designed to provide care to the patient as a whole. Collaborative health care partnerships are designed to deliver well-balanced care to the patient as a whole, rather than rendering fragmented care involving a single element of a disease process. Prevention is not solely the responsibility of the nurse; it involves active participation by the individual and the combined services of practitioners in a spectrum of health care disciplines as varied as nutrition, physical therapy, exercise physiology, and pharmacy.

The nurse identifies which true statement regarding the medical record? a. It serves as a major communication tool but is not a legal document. b. It cannot be used to assess quality of care issues. c. It is not used to determine reimbursement claims. d. It can be used as a tool for biomedical research and provide education.

It can be used as a tool for biomedical research and provide education. The medical record promotes continuity of care and ensures that patients receive appropriate health care services. The record can be used to assess quality-of-care measures, determine the medical necessity of health care services, support reimbursement claims, and protect health care providers, patients, and others in legal matters.

What is one of the major attributes of health care law? a. It defines the expected behavior of persons in the business of health care. b. The law or rule is easy to interpret and comply with. c. It is established by any health care authority. d. The creator must be an expert in health care.

It defines the expected behavior of persons in the business of health care. A health care law or rule defines expected behavior of persons in the business of health care or in health care relationships. Health care law is not easy to interpret or comply with and can only be established by organizations with legal authority for law making.

The nurse manager sends an e-mail to the nursing staff as a reminder for a scheduled monthly meeting. In doing so, the nurse manager understands that e-mail could result in which issue? a. It is usually slower than other methods of communication. b. It has the potential for miscommunication. c. It cannot be used to deliver vital information. d. It is especially effective because of the absence of nonverbal cues.

It has the potential for miscommunication. A message is the content transmitted during communication. Messages are transmitted through all forms of communication, including spoken, written, and nonverbal modalities. Electronic communication in the form of information referencing, e-mail, social networking, and blogging can quickly contribute to a person's knowledge, providing patients and health care professionals with vital information.

Which of the following components are included in health policy at the state level? a. Americans with Disabilities Act of 1990 b. Scope of nursing practice c. Health Insurance Portability and Accountability Act (HIPAA) of 1996 d. Patient Safety and Quality Improvement Act of 2005

Scope of nursing practice The scope of nursing practice is correct, because it is controlled at the state level by state boards of nursing. The Americans with Disabilities Act of 1990, the HIPAA of 1996, and the Patient Safety and Quality Improvement Act of 2005 are all regulated at the national level.

Nursing demonstrates dedication to improving public health through which avenue? a. Changing health care standards b. Legal regulations c. Scope of practice d. Technology

Scope of practice Through the scope of practice, specialized knowledge, and code of ethics, the discipline of nursing has demonstrated its dedication to improving public health. The changing health care environment is one of the challenges to nursing, not an indicator of dedication. Legal regulations are generally promulgated by legislators rather than nurses to protect the public.

When teaching a patient with a family history of hypertension about health promotion, the nurse describes blood pressure screening as which type of prevention? a. Illness b. Primary c. Secondary d. Tertiary

Secondary Blood pressure screening is considered secondary prevention. It is a measure designed to identify individuals in an early state of a disease process so that prompt treatment can be started. Illness prevention is considered primary prevention.

A 40-year-old patient presents to her provider for a yearly physical. The provider notes a family history of breast cancer in the patient's mother. The provider schedules the patient for a mammogram. The nurse recognizes this as what level of prevention? a. Tertiary b. Primary c. Secondary d. Holistic

Secondary Secondary prevention is undertaken in cases of latent (hidden) disease. Although the patient may be asymptomatic, the disease process can be detected by medical tests. Nurses may use screening tests to assess for latent disease in vulnerable populations. Examples of screening tests used as secondary prevention strategies include the purified protein derivative (PPD) skin test for tuberculosis, fecal occult blood test for colorectal cancer, and mammograms for breast cancer.

A hospital organization is working to improve a feeling of being valued and respected among all staff members. Which action by administration would reinforce the feeling of being valued? a. Create professional pathways that require advanced education for any advancement of staff. b. Seek staff input when planning a remodeling project of patient rooms. c. Form committees that consist of upper management to plan organizational goals. d. Consistently schedule required staff meetings at the same time each month.

Seek staff input when planning a remodeling project of patient rooms. Including staff at all levels of an organization in planning and projects demonstrates respect for the intelligence and creativity of the individual. Requiring advanced education for any advancement limits those with barriers to attending additional schooling; advancement should be available in a variety of ways to show the value of the individual.

Self-concept refers to the way in which individuals perceive unchanging aspects of themselves, such as social character, cognitive abilities, physical appearance, and body image. Which additional point does the nurse the nurse recognize as part of the definition of self-concept? a. If negative, self-concept will allow the patient to compensate for weaknesses. b. If positive, self-concept will cause the patient to see challenges as devastating. c. Self-concept is a concept that is derived from the patient internally. d. Self-concept depends on relationships with family and friends.

Self-concept depends on relationships with family and friends. Self-concept refers to the way in which individuals perceive unchanging aspects of themselves, such as social character, cognitive abilities, physical appearance, and body image. It is a mental image of self in relation to others and the surroundings.

The nurse educator would identify a need for further teaching when the student lists which example as a type of learning? a. Affective b. Cognitive c. Psychomotor d. Self-directed

Self-directed Self-directed is one approach to learning but is not considered a type or domain of learning. Self-directed would be a cognitive way of learning. Affective (feelings/attitude), cognitive (knowledge), and psychomotor (skills/performance) are the main domains of learning.

The nurse is preparing to teach a 90-year-old patient. In teaching an elderly patient, the nurse realizes what information? a. Most elderly patients are highly literate. b. Cognitive abilities always decline with age. c. Sensory alterations often occur with aging. d. Teaching methods are the same as for the middle aged.

Sensory alterations often occur with aging. Teaching should be tailored to elderly patients. Reports indicate that two-thirds of U.S. adults 66 years old and older have inadequate or marginal literacy skills, and 81% of patients 60 years old and older at a public hospital could not read or understand basic materials such as prescription labels.

The nurse is acting in the planning function as a manager. The nurse knows which stage should be completed first? a. Set the plan. b. Assess the situation and future trends. c. Convert plan into action statement. d. Set the goals.

Set the goals The planning function of a manager is comparable to the assessment, diagnosis, and planning portions of the nursing process. It includes four stages: (1) setting goals, (2) assessing the current situation and future trends, (3) setting the plan, and (4) converting the plan into an action statement

A nurse has been working with a patient for the entire shift. Which action by the nurse is unacceptable? a. Sharing a personal mobile phone number b. Touching the patient's hand during a painful procedure c. Standing 6 feet away from the patient when conversing d. Using the SBAR method of hand-off communication

Sharing a personal mobile phone number Professional role boundaries define the limits and responsibilities of nurses within a specific setting. It is unprofessional and unethical to share personal phone numbers or meet with patients outside of the health care setting. Therapeutic touch, such as holding the patient's hand or touching the patient's shoulder, can provide comfort and may alleviate pain.

A 60-year-old Italian immigrant presents for an annual physical. He is counseled about diagnostic testing including laboratory testing, colonoscopy, influenza vaccination, and pneumococcal vaccination. His reply is "If it ain't broke, don't try to fix it." When developing a plan of care, the nurse should consider which cultural orientation for this patient? a. Short term b. Long term c. Leisurely term d. Noncommittal

Short term Short-term cultural orientation focuses on the present or past and emphasizes quick results. Long-term cultural orientation focuses the future and long-term rewards. Long-term-oriented cultures favor thrift, perseverance, and adopting to changing circumstances. Leisurely term and noncommittal are undefined in cultural orientation.

Florence Nightingale, the first nurse informatician, sought hospital data for comparison purposes to compete which goal? a. Allow faster and accurate diagnosis. b. Better coordinate care. c. Improve the efficiency of care. d. Show people how their money was spent.

Show people how their money was spent. "They would show the subscribers how their money was being spent, what amount of good was really being done with it, or whether the money was not doing mischief rather than good" (Florence Nightingale, 1863).

The nurse is acting as a leader in the role of charge nurse and notes that the unlicensed assistive personnel (UAP) on the floor are stressed related to their increased workload. The nurse changes the original planned approach based on the presenting situation. Which theory of leadership is the nurse implementing with this action? a. Situational b. Transactional c. Transformational d. Autocratic

Situational Situational theories suggest that leaders change their approach depending on the situation. Transactional leaders use reward and punishment to gain the cooperation of followers. Transformational leaders use methods that inspire people to follow their lead.

For children and teens, which model includes school-based services? a. Social b. Integrated c. Medically-Oriented d. Nurse-Oriented

Social The social models focus on community-based services, and the other models do not.

The American Nurses' Association (ANA) outlines expectations of the nursing profession in which type of documentation? a. Gallup poll b. Goldman report c. Social Policy Statement d. Social identity theory

Social Policy Statement The ANA's Nursing's Social Policy Statement outlines expectations of nurses. The national Gallup poll has found nursing to be one of the most trusted professions for their honesty and ethical standards almost every year, but it does not outline expectations.

The scope of professional nursing practice is determined by the rules promulgated by which organization? a. American Nurses' Association (ANA) b. Institute of Medicine (IOM) c. State Board of Nursing d. State Nursing Association

State Board of Nursing Professional nursing practice is regulated by each state's Board of Nursing. The ANA is the professional organization of registered nursing in the United States and may influence, but it does not regulate. The IOM collaborated with the Robert Wood Johnson Foundation to improve the fractured health care system in the United States, and it makes recommendations, not rules.

Which level of government is responsible for the regulation of a nurse's license? a. Federal government b. State government c. Local government d. International coalition

State government State boards of nursing oversee the regulation of nursing practice. These agencies are established by legislatures to implement and enforce laws through a rule-making process. Federal, local, and international coalitions are not correct, because they do not have control of the state boards of nursing.

The nurse has made patient care assignments and expects all team members to set their own goals for the day and manage their time to meet their goals. The nurse is implementing what style of leadership? a. Autocratic b. Democratic c. Bureaucratic d. Laissez-faire

Laissez-faire Like the democratic leader, the permissive or laissez-faire leader thinks that employees are motivated by their own desire to do well. The laissez-faire leader provides little or no direction to followers, who develop their own goals and make their own decisions. The authoritarian or autocratic leader exercises strong control over subordinates.

Which of the following is false regarding state licensure laws? a. These laws establish the requirements for licensure to practice. b. Licensure is not necessary if the individual has completed training. c. The state regulatory agencies such as the state board of nursing are responsible for creating and enforcing these rules. d. The scope of practice defines what the professional can and cannot do within the scope of their licensure.

Licensure is not necessary if the individual has completed training. Licensure is required to practice after the completion of all required training for the profession. The state laws establish the requirements to practice and the state regulatory agencies are responsible for creating and enforcing the rules. The scope of practice defines what activities the professional is legally authorized to perform.

Which of the following is the intent of HIPAA? a. Release of patient information for purposes of insurance reimbursement. b. Prevent health care providers from billing for procedures done for the insured person. c. Protect patients from reviewing their own medical records. d. Limit the ability of health care providers to sell patient information to outside sources.

Limit the ability of health care providers to sell patient information to outside sources. The intent of HIPAA is to protect patient information and prevent it from being sold to outside agencies. The right of heath care providers to bill for services is necessary for patient payment is and not prohibited. Patients have the right to view their own patient information.

What fact is the nurse aware of when charting using electronic documentation? a. Errors can be corrected and totally removed from the record in the screen view. b. Log-on access to the electronic record identifies the person charting. c. Each entry requires the nurse to sign her/his name and credentials. d. Documenting significant changes in the electronic record ends the nurse's responsibility.

Log-on access to the electronic record identifies the person charting. Log-on access to the electronic record identifies the person charting or making a change. If an error is made in electronic documentation, it can be corrected on the screen view but the error and correction process remain in the permanent electronic record.

The patient is reportedly well educated and employed as an engineer but is struggling to comprehend terms found in health-related literature given to explain his disease process. The nurse recognizes that this is evidence of what issue? a. Low literacy b. Psychomotor dysfunction c. Affective domain deficiency d. Low health literacy

Low health literacy Although low literacy and low health literacy are related terms, they are not interchangeable. Low health literacy is content specific, meaning that the individual may not have difficulty reading and writing outside the health care arena.

Prior to preparing to administer medications to the patient, the nurse should compare the provider orders with what document? a. Flow sheet b. Kardex c. MAR d. Admission summary

MAR A medication administration record (MAR) is a list of ordered medications, along with dosages and times of administration, on which the nurse initials medications given or not given. A paper MAR usually includes a signature section in which the nurse is identified by linking the initials used with a full signature.`

The manager of the intensive care unit is accepting an award for excellence and efficiency in the provision of patient care. The manager accepts the award for the unit and cites the contributions of the staff since, without their expertise and dedication, the award may not have been achieved. The staff nurse recognizes the nurse manager is demonstrating which quality? a. Dedication b. Openness c. Magnanimity d. Creativity

Magnanimity Magnanimity means giving credit where credit is due. Good leaders reflect the work and success of accomplishing a goal by crediting those who helped reach it. Dedication is the ability to spend the time necessary to accomplish a task. Effective leaders persist in working toward accomplishment of a goal even when doing so is difficult.

The primary health care nurse would recommend screening based on known risk factors, because of which action? a. Eliminate the possibility of developing a condition. b. Identify appropriate treatment guidelines. c. Initiate treatment of a condition or disease. d. Make a substantial difference in morbidity and mortality.

Make a substantial difference in morbidity and mortality. Screenings are typically indicated and recommended if the effort makes a substantial difference in morbidity and/or mortality of conditions, and they are safe, cost effective, and accurate. Ideally a screening measure will accurately differentiate individuals who have a condition from those who do not have a condition 100% of the time; however, there may be a false-negative result, or the patient may develop a condition after the screening was conducted.

What is the most appropriate resource to include when planning to provide patient education related to a goal in the psychomotor domain? a. Diagnosis-related support groups b. Internet resources c. Manikin practice sessions d. Self-directed learning modules

Manikin practice sessions A teaching goal in the psychomotor domain should be matched with teaching strategies in the psychomotor domain, such as demonstration, practice sessions with a manikin, and return demonstrations.

The nurse is developing a plan of care for a patient with a hip fracture. Which model would the nurse use to prioritize the patient's care? a. The Health Belief Model b. Pender's Health Promotion Model c. Maslow's hierarchy of needs d. The Holistic Health Model

Maslow's hierarchy of needs Maslow's hierarchy of needs describes the relationships between the basic requirements for survival and the desires that drive personal growth and development. The Health Belief Model was developed by psychologists Hochbaum, Rosenstock, and Kegels. It explores how patients' attitudes and beliefs predict health behavior. The Health Promotion Model, developed by Pender and colleagues, defines health as a positive, dynamic state of well-being rather than the absence of disease in the physiologic state.

Several models exist that describe the relationship between health and wellness. Which model is used to understand the interrelationship between elements of basic requirements for survival and the desires that drive personal growth and development and is represented as a pyramid? a. Maslow's hierarchy of needs b. Health Belief Model c. Health Promotion Model d. Holistic Health Model

Maslow's hierarchy of needs Maslow's hierarchy of needs describes the relationships between the basic requirements for survival and the desires that drive personal growth and development. The model is most often presented as a pyramid consisting of five levels. The lowest level is related to physiologic needs, and the uppermost level is associated with self-actualization needs, specifically those related to purpose and identity.

Which is an essential element of a standard order set to verify a medication order? a. Volume only b. Number of tablets c. Metric dose/strength d. Hour of administration

Metric dose/strength The ISMP recommendations for standardized medication order sets include such elements as the drug name (generic followed by brand when appropriate), metric dose/strength, frequency and duration, route, and indication. Although a prescription may include volume or number of tablets, the essential component is dose or strength, because the volume or number of tablets may vary by manufacturer.

A nurse manager recognizes that systems theory identifies that there is a social component within an organization that affects the overall functioning of the system. What indicator would demonstrate to the nurse manager that the social needs of an organization are being met? a. Most employees from the organization attend an annual holiday celebration. b. Separate eating areas for each discipline are set up in the cafeteria. c. Nurse managers are planning to move to a centralized area away from the care units. d. The summer softball teams are canceled due to lack of interest.

Most employees from the organization attend an annual holiday celebration. Systems theory focuses on the needs and desires of people who work in the organization. Good attendance at a work-sponsored function indicates that staff enjoy interacting and are meeting social and relationship roles.

What nursing recommendations are published in the Institute of Medicine (IOM's) report The future of nursing: Leading change, advancing health? a. Teach, advocate, assess, and nurture. b. Should have a graduate degree to practice. c. Diagnose and recommend treatments. d. Must have continuing education.

Teach, advocate, assess, and nurture. Professional nurses teach, advocate, assess, and nurture. The IOM recommends that 80% of nurses have a minimum baccalaureate degree (not graduate degree) by 2020. Physicians diagnose and recommend treatments, and nurses provide the majority of these treatments.

Nurses work to serve the population, and they know that which priority population needs to be served by care coordination? a. Most vulnerable and the frail b. Uninsured and the very young c. Underinsured and the elderly population d. Whole population of the community

Most vulnerable and the frail The priority population is the most vulnerable and the frail, because they have the most health care needs. Other populations do need health care, but they do not always have immediate need of the health care system.

Interrelated concepts to the professional nursing role a nurse manager would consider when addressing concerns about the quality of patient education include which factor? a. Adherence b. Developmental level c. Motivation d. Technology

Technology The interrelated concepts to the professional role of a nurse include health promotion, leadership, technology/informatics, quality, collaboration, and communication. Adherence, culture, developmental level, family dynamics, and motivation are considered interrelated concepts to patient attributes and preference.

Many middle-aged adults are called the "sandwich" generation because they are caring for their children and their aging parents. What is the priority reason for aging parents needing care? a. Mental clarity b. Immobility c. Blindness d. Multiple chronic illnesses

Multiple chronic illnesses Multiple chronic illnesses come with the aging process. Middle-aged adults are becoming the caregivers for the generation before them and the one after them. Mental clarity is a positive aspect of aging and does not need care. Immobility and blindness do not always mean that the person needs direct care.

The nurse is collaborating with a patient to determine interventions to ensure compliance with medication administration after the pending discharge. The nurse understands that the goals and nursing interventions would be agreed upon in which phase of the nurse-patient relationship? a. Preinteraction phase b. Orientation phase c. Working phase d. Termination phase

Termination phase Termination phase involves alerting the patient to impending closure of the relationship, evaluating the outcomes achieved during the interaction, and concluding the relationship and transitioning patient care to another caregiver, as needed. In this case, the "new" caregiver is the patient.

When there is evidence that supports a screening for an individual patient but not for the general population, the nurse would expect the United States Preventive Services Task Force Grading to be what? a. No recommendation for or against b. Recommends c. Recommends against d. Strongly recommends

No recommendation for or against The United States Preventive Services Task Force Grading is an example of how evidence is used to make guidelines and determine priority. When there is evidence that supports a screening for an individual patient but not for the general population, there is no recommendation for or against screening the general population.

A nurse is interviewing at an agency owned by a national religious organization that serves homeless and uninsured patients. A large poster display shows a proposed addition that would add 16 beds to the facility that will be funded from profits of the previous 3 years of operation. The nurse recognizes that the agency is most likely what type of agency? a. For-profit b. Not-for-profit c. Publicly-owned d. Investor-owned

Not-for-profit Many religious organizations are privately owned and administer not-for-profit health facilities, where profits are returned into the facility for improvements or equipment. For-profit agencies distribute profits to shareholders.

When describing patient education approaches, the nurse educator would explain that informal teaching is an approach that involves which quality? a. Addresses group needs b. Follows formalized plans c. Has standardized content d. Often occurs one-to-one

Often occurs one-to-one Informal teaching is individualized one-on-one teaching which represents the majority of patient education done by nurses that occurs when an intervention is explained or a question is answered. Group needs are often the focus of formal patient education courses or classes. Informal teaching does not necessarily follow a specific formalized plan.

A patient has been admitted for a skin graft following third degree burns to the bilateral calves. The plan of care involves 3 days inpatient and 6 months outpatient treatment, to include home care and dressing changes. When should the nurse initiate the educational plan? a. After the operation and the patient is awake b. On admission, along with the initial assessment c. The day before the patient is to be discharged d. When narcotics are no longer needed routinely

On admission, along with the initial assessment Initial discharge planning begins upon admission. After the operation has been completed is too late to begin the discharge planning process. The day before discharge is too late for the nurse to gather all pertinent information and begin teaching and coordinating resources.

The nurse leader is conducting a staff meeting. During the meeting, staff members have verbalized dissatisfaction with the staffing pattern created by the nurse leader. The nurse listens intently as the staff come up with other options. The staff members recognize that the nurse leader is demonstrating which quality? a. Openness b. Integrity c. Dedication d. Magnanimity

Openness Openness refers to the leader's ability to listen to other points of view without prejudging or discouraging them. An effective leader considers others' opinions with an open mind because a wider variety of solutions to problems is offered. Openness by the nurse leader encourages creative solutions by providing an environment in which people feel comfortable "thinking outside the box."

The nurse knows that paper records are being replaced by other forms of record keeping for what reason? a. Paper is fragile and susceptible to damage. b. Paper records are always available to multiple people at a time. c. Paper records can be stored without difficulty and are easily retrievable. d. Paper records are permanent and last indefinitely.

Paper is fragile and susceptible to damage. Paper records have several potential problems. Paper is fragile, susceptible to damage, and can degrade over time. It may be difficult to locate a particular chart because it is being used by someone else, it is in a different department, or it is misfiled. Storage and control of paper records can be a major problem.

The nurse leader recognizes that to deliver quality care, focus needs to be placed on which participant? a. Patient b. Self c. Other staff members d. Health care provider

Patient It is important for nurse leaders to be focused on the patients rather than themselves to deliver good patient-focused care. Nurses must desire to improve the status quo to provide higher levels of quality in the care delivered. These qualities are also discussed in other works concerning effective managers

The nurse is conducting a presurgical screening interview with a patient at a local surgical center. When performing a health assessment, the nurse identifies which source should be the primary source of information? a. Spouse b. Medical record c. Close relative d. Patient

Patient The primary source from which data are collected is the patient. A secondary source would include a significant other, family members, caregivers, other members of the health team, and medical records.

The nurse who plans, organizes, delivers, and evaluates nursing care for patients is functioning in what role? a. Patient care provider b. Patient advocate c. Case manager d. Clinical nurse leader

Patient care provider A nurse does not have to be a manager to be a leader. Even at the bedside, nurses use leadership skills, although possibly in different ways than a nurse manager. The patient care provider must be able to plan, organize, deliver, and evaluate nursing care for patients. An advocate is someone who supports and promotes the interests of others.

A nurse is reported for taking prescribed patient medications for their personal use. Who has direct authority over deciding if the nurse may keep their professional license to continue practicing as a nurse? a. The hospital where the nurse is currently employed b. The American Nurses Association c. The National League for Nursing d. The State Board of Nursing who issued the license

The State Board of Nursing who issued the license Decisions related to practice are the responsibility of the licensing body, or State Board of Nursing, who is charged with protecting the public. The hospital does not determine who is eligible for a professional license. The National League for Nursing is active in nursing education standards.

Which delegation of tasks would require the nurse manager to intervene? a. The UAP re-delegates vital signs to the student nurse. b. The RN delegates assistance with bathing to the student nurse. c. The RN delegates monitoring of intake and output to the UAP. d. The RN delegates assistance with mobility to the UAP.

The UAP re-delegates vital signs to the student nurse. The person to whom the assignment was delegated cannot delegate that assignment to someone else. If the person cannot carry out the assignment, the individual needs to notify the delegating RN so that the task may be reassigned or completed by the RN.

The nurse is caring for patients on a unit that uses electronic health records (EHRs). What action by the nurse protects personal health information? a. The nurse should allow only nurses that he/she knows and trusts to use his/her verification code. b. The nurse should not worry about mistakes since the information cannot be tracked. c. The nurse should never share any password with anyone. d. The nurse should be aware that the EHR is sophisticated and immune to failure.

The nurse should never share any password with anyone. Access to an EHR is controlled through assignment of individual passwords and verification codes that identify people who have the right to enter the record. Passwords and verification codes should never be shared with anyone.

The nurse recognizes that nursing documentation is guided by what process? a. The nursing process b. NANDA-I, nursing diagnoses c. Nursing interventions classification d. Nursing Outcomes Classification

The nursing process Nursing documentation is guided by the five steps of the nursing process: assessment, diagnosis, planning, implementation, and evaluation. Standardized nursing terminologies such as the North American Nursing Diagnosis Association-International (NANDA-I) Nursing Diagnoses, nursing interventions classification (NIC), and Nursing Outcomes Classification (NOC) may be used in the documentation process.

If a verbal or phone order is necessary in an emergency, the nurse knows what action needs to be completed? a. The order must be taken by an RN or LPN. b. The order must be repeated verbatim to confirm accuracy. c. The order is documented as a written order. d. The order does not need further verification by the provider.

The order must be repeated verbatim to confirm accuracy. If a verbal or phone order is necessary in an emergency, the order must be taken by a registered nurse (RN) who repeats the order verbatim to confirm accuracy and then enters the order into the paper or electronic system, documenting it as a verbal or phone order and including the date, time, physician's name, and RN's signature.

The patient is asking about using the Internet for resources regarding lifestyle behaviors and benefits of modification. What is the best response that the nurse should provide the patient? a. Information on lifestyle behaviors is not available on the Internet. b. The patient should use websites that are easy to understand. c. Most websites are designed for health care providers only. d. Only negative outcomes are evaluated on the Internet.

The patient should use websites that are easy to understand. Information on lifestyle behaviors that lead to disease is available at research-sponsored websites that have peer-reviewed material and expert analyses. Website content should be easy to read and understandable for the general population.

According to the Health Belief Model, which of the following patients would be most likely to change health behavior? a. The person who perceives that he is at risk for colon cancer b. The person who recognizes that colon cancer is easily cured c. The person who believes that behavior can change outcomes d. The patient who faces multiple social barriers

The person who perceives that he is at risk for colon cancer In the three primary components of the Health Belief Model, six main constructs influence an individual's decision to take action about disease prevention, screening, and controlling illness.

Which of the following is true about health care legislation? a. The US Constitution addresses health care law specifically to give the federal government the ability to license professionals and institutions. b. The power of the US Constitution does not have a direct relationship to health care and reserves most of the power to the states. c. State laws are considered the highest source of health care law and trump the federal laws. d. The federal government asserts its power over health care legislation through the US Constitution.

The power of the US Constitution does not have a direct relationship to health care and reserves most of the power to the states. The power of the US Constitution does not have a direct relationship to health care and reserves most of the power to the states. The other statements are false. The US Constitution does not address health care specifically. Either state or federal laws can be considered the highest source of law depending on which law has the stricter regulation or rule.

When explaining delegation to student nurses, what statement by the nurse educator aligns to the ANA regarding delegation? a. A transfer of authority to a less-qualified individual b. The nurse transferring accountability to the delegate c. The transfer of tasks by the nurse while retaining accountability d. Transferring responsibility for assessments and planning

The transfer of tasks by the nurse while retaining accountability For patient care to be completed in a safe and timely manner, it is sometimes necessary for the nurse to delegate tasks to other health care providers. The National Council of State Boards of Nursing (NCSBN) offers support in this process.

What fact does the nurse know applies to PIE, APIE, SOAP, and SOAPIE documentation? a. They are chronologic. b. They are examples of problem-oriented charting. c. They are narrative charting. d. They are forms of "charting by exception."

They are examples of problem-oriented charting. The nurse's notes may be in a narrative format or in a problem-oriented structure such as the PIE, APIE, SOAP, SOAPIE, SOAPIER, DAR, or CBE format. Narrative charting is chronologic, charting by exception (CBE) is documentation that records only abnormal or significant data.

The nurse understands which statement about the use of electronic health records is true? a. They improve patient health status. b. They require a keyboard to enter data. c. They have not reduced medication errors. d. They require increased storage space.

They improve patient health status. Adoption of an EHR system produces major cost savings through gains in productivity and error reduction, which ultimately improves patient health status. The most common benefits of electronic records are increased delivery of guideline-based care, better monitoring, reduced medication errors, and decreased use of care.

The nurse is caring for a patient experiencing an allergic reaction to a bee sting who has an order for diphenhydramine (BenaDRYL). The only medication in the patient's medication bin is labeled BenaZEPRIL. The nurse contacts the pharmacy for the correct medication to avoid what type of error? a. Communication b. Diagnostic c. Preventive d. Treatment

Treatment The nurse avoided a treatment error, giving the wrong medication. Benazepril is an ace inhibitor used to treat blood pressure. According to Leape, treatment errors occur in the performance of an operation, procedure, or test; in administering a treatment; in the dose or method of administering a drug; or in avoidable delay in treatment or in responding to an abnormal test.

The nurse manager of a medical/surgical unit wants to increase the use of health care technology on the unit and is working with an ANA-certified informatics nurse to reduce which barriers to health information exchange? a. Basic informatics knowledge and skills b. Offering the best set of tools c. Privacy and security policies d. Unit-specific terminology

Unit-specific terminology Unit-specific terminology would be a barrier to sharing health information because there could be confusion about terms. Standardized terminology within the electronic health record is critical for communicating care to the interprofessional team and exchanging health information. Competency in informatics including basic informatics knowledge and skills could facilitate the use of informatics; lack of competency could be a barrier.

When the nurse is charting in the paper medical record, what action does the nurse carry out? a. Print his/her name since signatures are often not readable. b. Omit nursing credentials since only the nurses chart c. Skip a line between entries so that it looks neat. d. Use black ink unless the facility allows a different color.

Use black ink unless the facility allows a different color. Entries into paper medical records are traditionally made with black ink to enable copying or scanning, unless a facility requires or allows a different color. The date, time, and signature, with credentials of the person writing the entry, are included in the entry.

When the nurse is preparing to teach a 5-year-old child postoperative care that will be anticipated after a tonsillectomy, the nurse would incorporate what concept? a. Use pictures and simple words to describe care to the patient. b. Teach the parents alone to reduce fear in the patient. c. Exclude the parents to reduce parental anxiety. d. Use clear simple explanations to convey information.

Use pictures and simple words to describe care to the patient. Patient education provided for children should be age specific. Use pictures and simple words for young children. Use clear, simple explanations for school-age children. The patient's age directly affects the instructional methods and materials used. Effective patient education involving a child requires the presence of a parent or caregiver, who is likely the target of teaching.

The nurse in a newly opened community health clinic is developing a program for the individuals considered at greatest risk for poor health outcomes. How should the nurse consider this group? a. Global community b. Sedentary society c. Unmotivated population d. Vulnerable population

Vulnerable population Vulnerable populations refer to groups of individuals who are at greatest risk for poor health outcomes. The entire world is the global community. Sedentary refers to the lifestyles of people worldwide who have epidemic rates of obesity and many other related chronic diseases. Unmotivated population refers to the individuals who have not demonstrated interest in changing.

The nurse is performing an abdominal assessment on a postoperative surgical patient. The nurse notes that the dressing needs to be changed twice a day and discusses when the patient would like to have it done. The nurse then plans to change the dressing at that time. In which phase of the nurse-patient helping relationship would this process occur? a. Introductory phase b. Orientation phase c. Working phase d. Termination phase

Working phase In the working phase, there is the development of a contract or plan of care to achieve identified patient goals; implementation of the care plan or contract; collaborative work among the nurse, patient, and other health care providers, as needed; enhancement of trust and rapport between the nurse and the patient; reflection by the patient on emotional aspects of illness; and use of therapeutic communication by the nurse to keep interactions focused on the patient. In the orientation phase or introductory phase, introductions are made, establishing professional role boundaries (formally or informally) and expectations, and clarifying the role of the nurse.

The student studying community health nursing learns that vulnerable populations can be best assisted by which activity? a. Researching their genetic risk for health problems b. Working with the community to decrease health risks c. Studying vital statistics to determine their causes of death d. Making sure the population maintains immunizations

Working with the community to decrease health risks Vulnerable populations have some characteristic that puts them at higher risk for identified health problems. The nurse can best assist vulnerable populations by identifying and working with them to decrease their risks.

To promote a safety culture, the nurse manager preparing the staff schedule considers the anticipated census in planning the number and experience of staff on any given shift. Which is the human factor primarily addressed with this consideration? a. Available supplies b. Interdisciplinary communication c. Interruptions in work d. Workload fluctuations

Workload fluctuations Including an adequate number of staff members with experience caring for anticipated patients is a strategy to manage the workload and potential fluctuations. A safety culture requires organizational leadership (e.g., the nurse manager) that gives attention to human factors such as managing workload fluctuations.

The student learns that which is the best definition of a public health nurse? a. Works with the public. b. Works in public areas. c. Works with the greater community. d. Works with public funding.

Works with the greater community. A public health nurse works with communities as a larger whole and is concerned with specific target or vulnerable groups within that community. The other options are inaccurate.

A new registered nurse asks the registered nurse (RN) preceptor what could be done to become more professional. What is the preceptor's best response? a. "Attend nursing educational meetings." b. "Listen to other nurses." c. "Read the agency newsletter." d. "Pass the licensing exam."

"Attend nursing educational meetings." Knowledge and commitment are essential components of professionalism. Attending nursing educational meetings can promote collaborative learning with peers and maintenance of competence in an ever-changing health care environment.

The nurse is discussing care coordination with a patient. The patient asks the nurse to explain care coordination. What is the nurse's best response? a. "Care coordination is a cost effective method created by the community." b. "Care coordination forces the health care facilities in the community to work together." c. "Care coordination exists for the children and uninsured in the community." d. "Care coordination allows health care services to work together in the community."

"Care coordination allows health care services to work together in the community." Care coordination allows all health care/community services to work together so that patient and family needs can be met. Care coordination does not focus on cost methods. Cost coordination does not exist just for children or the uninsured.

A young wife is talking with the nurse about her husband who is returning from the military. The wife confides that her husband is physically okay but is behaving differently. What is the nurse's best response? a. "He is just trying to adjust to civilian life again; he'll be okay." b. "You should observe him closely, because he could attack you." c. "Many times people need care for emotional trauma." d. "Talk with your physician to get medication, and then put it in his food."

"Many times people need care for emotional trauma." The nurse is alerting the young wife to the fact that people who have experienced emotional trauma need care too. The nurse does not know how the husband is adjusting so the other options are incorrect.

A nursing instructor is talking about care coordination with nursing students. The instructor stresses which of the following to the students concerning care coordination? a. "A patient must ask for what they need in order to coordinate care." b. "The nurse does most of the work in care coordination." c. "Medical diagnoses are an integral part of care coordination." d. "Collaboration is a significant part of care coordination."

"Collaboration is a significant part of care coordination." Collaboration is a big part of care coordination. Without the collaboration, there would be no care coordination. Patients asking for their needs to be met does not collaborate care. Nurses do not do all the work in care collaboration.

Student nurses are being questioned by the nursing instructor about the health care coordination system. The instructor knows the students understand health care delivery when making which statement? a. "Health care is available for everyone at every time." b. "Health care needs are best met with a collaborative effort." c. "Health care is adequately meeting the needs of the homeless populations." d. "Health care needs are mostly in third world countries."

"Health care needs are best met with a collaborative effort." Health care needs many times are not met by one discipline. When a collaborative effort is used, the patient is better served. Health care is not available for everyone, nor is it meeting the needs of the homeless population. Health care needs are worldwide, not just in third world countries.

The new nurse correctly defines a law when stating which information? a. "Law is a fundamental concept for health care professionals." b. "Law's rule is developed by the employee's organization." c. "Law's rule is enacted by a government agency that defines what must be done in a given circumstance." d. "Law is a mandate from the Joint Commission or other accrediting agency."

"Law's rule is enacted by a government agency that defines what must be done in a given circumstance."

The nurse correctly defines leadership when making which statement? a. "Leadership is coordinating others toward a common goal." b. "Leadership is the ability to influence others." c. "Leadership focuses on the task at hand." d. "Leadership is based in formal authority."

"Leadership is the ability to influence others." Leaders have the ability influence and motivate others while maintaining relationships to accomplish a goal. Management is the process of coordinating others and directing them toward a common goal. Management is focused on the task at hand.

A mother is talking with the community-based nurse concerning her adult son. The son is mentally challenged and not able to live on his own. The mother is concerned about her son's welfare when she is no longer able to care for him. What is the best response by the nurse? a. "Let's look into the community resources that are available to assist you." b. "You have raised your son well, and he will be okay on his own." c. "Contact your distant relatives to see if anyone would take your son." d. "There are places for mentally challenged adults; let's place him there."

"Let's look into the community resources that are available to assist you." The mother, with the assistance of the nurse, can research resources in the community that will service and care for her son when she is no longer able to do so. How the son is raised does not mean that he will be okay on his own.

The nurse is preparing to discharge a patient home. In providing instruction about the patient's medications, the nurse should make which statement? a. "Before taking Metoprolol, you need to take your BP and rate." b. "MS should be taken only when needed for pain." c. "Take 1 baby aspirin by mouth every morning." d. "Take your water pill bid and you should be fine."

"Take 1 baby aspirin by mouth every morning." Do not use abbreviations or medical terminology when providing patients with instructions.

A patient with an inoperable brain tumor says to the nurse, "I just want to die now. It's going to happen soon anyway." Which would be the most appropriate response? a. "Don't worry about that right now. It'll be OK." b. "I disagree with what you just said!" c. "Honey, now don't you talk like that." d. "Tell me why you are saying that."

"Tell me why you are saying that." Using open-ended questions or comments gives the patient the opportunity to share freely on a subject, avoids interjection of feelings or assumptions by the nurse, and provides for patient elaboration on important topics when the nurse wants to collect a breadth of information. Giving false reassurance discounts the patient's feelings, cuts off conversation about legitimate concerns of the patient, and demonstrates a need by the nurse to "fix" somethingthat the patient just wants to discuss.

A staff nurse reports a medication error due to failure to administer a medication at the scheduled time. What is the charge nurse's best response? a. "We'll conduct a root cause analysis." b. "That means you'll have to do continuing education." c. "Why did you let that happen?" d. "You'll need to tell the patient and family."

"We'll conduct a root cause analysis." In a just culture the nurse is accountable for their actions and practice, but people are not punished for flawed systems. Through a strategy such as root cause analysis the reasons for errors in medication administration can be identified and strategies developed to minimize future occurrences.

Components of a professional identity in nursing include which attributes? (Select all that apply.) a. Accountability b. Advocacy c. Autonomy d. Competence e. Culture

-Accountability -Advocacy -Autonomy -Competence The scope of professional identity in nursing includes: autonomy, knowledge, competence, professionalism, accountability, advocacy, collaborative practice, and commitment. Cultural sensitivity is important to professional nursing; however, culture is an inherent quality of nurses and patients, not a component of the professional identity.

The nurse is to teach an 84-year-old Spanish-speaking patient newly diagnosed with diabetes how to self-administer insulin. The patient has hearing and visual impairments. To be effective as a teacher, the nurse should carry out which tasks? (Select all that apply.) a. Assess reading level and learning style. b. Determine readiness to learn. c. Use family members as interpreters. d. Provide written instruction in English. e. Place the patient in group classes.

-Assess reading level and learning style. -Determine readiness to learn. Before health care teaching sessions for adults, assess reading level, learning styles, and readiness to learn. Family members should not be used as interpreters of specific medical information to maintain the patient's right to privacy and to avoid possible misinterpretation of medical terminology.

In addressing patient education, the nurse recognizes that patient education is a process involving what components? (Select all that apply.) a. Assessment b. Diagnosis c. Planning d. Implementation and evaluation e. Reliance on evidence-based practice (EBP)

-Assessment -Diagnosis -Planning -Implementation and evaluation

In preparing to teach the patient, the nurse must consider which concepts? (Select all that apply.) a. Background b. Race c. Pain level d. Emotional status e. Readiness to learn

-Background -Pain level -Emotional status -Readiness to learn Consideration must be given to the patient's background, readiness to learn, and current condition before education can occur. A patient's ability to read, write, and comprehend health care materials enhances health literacy. Race, by itself, is not a factor.

The nurse understands that the nurse-patient relationship focuses on which areas? (Select all that apply.) a. Building trust b. Demonstrating sympathy c. Tearing down boundaries d. Developing a plan of care e. Applying cultural generalities

-Building trust -Tearing down boundaries -Developing a plan of care A helping relationship develops through ongoing, purposeful interaction between a nurse and a patient. The focal point of the nurse-patient helping relationship is the patient and the patient's needs and concerns. Nurse-patient relationships focus on five areas: (1) building trust, (2) demonstrating empathy, (3) establishing boundaries, (4) recognizing and respecting cultural influences, and (5) developing a comprehensive plan of care.

On completion of assessment, a nursing diagnosis relevant to the educational needs of the patient or caregiver can be determined. The nurse recognizes that diagnoses specifically related to patient education include which responses? (Select all that apply.) a. Deficient knowledge b. Readiness for enhanced knowledge c. Noncompliance d. Pain e. Alteration in elimination

-Deficient knowledge -Readiness for enhanced knowledge -Noncompliance On completion of assessment, a nursing diagnosis relevant to the educational needs of the patient or caregiver can be determined. Diagnoses specifically related to patient education include deficient knowledge, readiness for enhanced knowledge, and noncompliance.

A nurse is caring for a patient in a long-term care facility who has not been sleeping well. She notes that the patient is new to the facility, has been refusing therapy, and is also not eating well. The nurse interprets this to mean that the patient has been having trouble adjusting. The nurse decides to meet with the patient's care team. The team decides to assess the patient's willingness to participate in group recreational activities, The patient agrees to participate. After 1 week, the nurse reevaluates the plan of care and notes that the patient has been sleeping much better. Which of the following terms best describe processes used in the nurse's plan? (Select all that apply.) a. Clinical judgment b. Evidence-based practice c. The nursing process d. Collaborative care planning e. Positive reward process

-Clinical judgment -The nursing process -Collaborative care planning Clinical judgment is a reflective process by which the nurse notices, interprets, responds, and reflects in action. The nursing process is a process by which the nurse assesses, diagnoses, implements, and evaluates the nursing care plan. Consulting and gaining input from the healthcare team is collaborative care planning. Evidence-based practice refers to using interventions found in research studies.

When administering a bath to a hearing-impaired patient, what actions should the nurse carry out? (Select all that apply.) a. Speak very loudly into the patient's right ear. b. Control background noise as much as possible. c. Turn away when responding to a question. d. Adjust the lighting in the room. e. Be wary of consistent affirmative answers.

-Control background noise as much as possible. -Adjust the lighting in the room. -Be wary of consistent affirmative answers. When communicating with a hearing-impaired patient, the nurse should make sure that the area is well lit with as little background noise as possible. Hearing aids amplify all sounds, making noisy environments confusing and frustrating. Raising the voice level slightly, speaking clearly, and making sure that the patient can see the nurse's face helps to facilitate communication.

Care coordination models should be adopted in health care facilities. If models are not put into practice, the shortcomings of the health care system may display which of the following items? (Select all that apply.) a. Decrease in patients b. Fragmented services c. Low birth weight newborns d. Cost inefficiencies e. Poor health outcomes f. Increased pharmacy costs

-Fragmented services -Cost inefficiencies -Poor health outcomes Fragmented services, cost inefficiencies, and poor health outcomes may be some of the shortcomings seen in health care without the proper model in place to guide the health care delivery system.

Caregivers are often categorized by their relationship to the person being cared for. Which of the following are the roles? (Select all that apply.) a. Grandparent b. Spouse c. Parent d. Adult children e. Neighbor/friend f. Young children

-Grandparent -Spouse -Parent -Adult children -Neighbor/friend All of these options can provide care whether it is on a temporary or permanent basis. Young children do not provide care.

The nurse explains to the patient that which services will be covered under Medicare? (Select all that apply.) a. Infusion therapy b. Ostomy management c. Renal dialysis d. Chemotherapy e. Grocery shopping

-Infusion therapy -Ostomy management -Renal dialysis -Chemotherapy Medicare will reimburse for professionally rendered services provided by a licensed health care provider. Grocery shopping would not be covered. If homemaker services are provided to a patient also receiving skilled care, then they too are reimbursed.

A nursing student is preparing a care plan for an assigned patient. When accessing the electronic medical record, what is acceptable information to view? (Select all that apply.) a. Laboratory data of the assigned patient b. Admission diagnosis for a patient who is a former neighbor c. The patient's age, date of birth, and gender d. The history and physical of the assigned patient e. A classmate's brother's chest x-ray report

-Laboratory data of the assigned patient -The patient's age, date of birth, and gender -The history and physical of the assigned patient The laboratory data, age, date of birth, gender, history, and physical of an assigned patient are necessary for identification and care of the patient so it is acceptable to view this information in the electronic medical record.

Nurses can be health advocates in which of the following ways? (Select all that apply.) a. Supporting their professional nursing organization when discussing upcoming legislation b. Discussing the upcoming classes with a neighbor c. Rallying for coverage for childhood immunizations d. Arranging for a patient to meet with case management for home health care e. Discussing a patient they are concerned about with a fellow student in the public cafeteria

-Supporting their professional nursing organization when discussing upcoming legislation -Rallying for coverage for childhood immunizations -Arranging for a patient to meet with case management for home health care Supporting a professional nursing organization, rallying for coverage for childhood immunizations, and arranging for a patient to meet with case management are examples of how nurses can be a positive influence on health care policy.

The nursing student is writing a report on the use of nonverbal techniques to encourage therapeutic communication. Which examples would be included in the report? (Select all that apply.) a. Providing a backrub b. Remaining silent c. Refraining from distracting body movements d. Facing the patient e. Avoiding eye contact

-Providing a backrub -Remaining silent -Refraining from distracting body movements -Facing the patient Providing a backrub is considered therapeutic touch; additional examples include holding a patient's hand and gently touching a patient's arm. Silence refers to being present with a patient without verbal communication. Facing the patient and refraining from unusual body movements are active listening techniques. Avoiding eye contact does not facilitate communication.

The Joint Commission has compiled a list of do-not-use abbreviations, acronyms, and symbols to avoid the possibility of errors that may be life threatening. The nurse identifies which abbreviations to be unacceptable? (Select all that apply.) a. prn b. QD c. qod d. 0.X mg e. X mg

-QD -qod Nurses must be aware of the danger of using abbreviations that may be misunderstood and compromise patient safety. The Joint Commission (2018) has compiled a list of do-not-use abbreviations, acronyms, and symbols to avoid the possibility of errors that may be life threatening. QD, Q.D., qd, q.d. (daily), QOD, Q.O.D., qod, and q.o.d. (every other day) can be mistaken for each other. Periods after Q can be mistaken for I, and the O mistaken for I.

According to the Healthy People 2020 initiative, health information and the associated access issues have become more complicated. There are many considerations when determining whether an individual has proficient health literacy. The nurse acknowledges that the patient should be able to do what actions? (Select all that apply.) a. Read and identify credible health information. b. Recognize abnormalities on an x-ray. c. Navigate complex insurance programs. d. Evaluate EKG findings. e. Advocate for appropriate care.

-Read and identify credible health information. -Navigate complex insurance programs. -Advocate for appropriate care. The patient should be able to exhibit certain competencies such as reading and identifying credible health information, understanding numbers in the context of the patient's health care, making appointments, filling out forms, gathering health records and asking appropriate questions of physicians, advocating for appropriate care, navigating complex insurance programs (Medicare or Medicaid, and other financial assistance programs), and using technology to access information and services.

The home health care nurse educates patients on which goals of hospice care? (Select all that apply.) a. Relieve suffering. b. Support the patient and family. c. Provide grief support. d. Keep patients out of the hospital. e. Lower medical expenses.

-Relieve suffering. -Support the patient and family. -Provide grief support. The goals of hospice care include relief of suffering, supporting the family and patient, and providing grief support after the patient dies. Goals do not include keeping patients out of the hospital or lowering medical costs.

A nurse is studying intrinsic factors that influence the development of asthma in a community. What factors does the nurse assess? (Select all that apply.) a. Socioeconomic status b. Genetics c. Pollution in the area d. Water cleanliness e. Immunization status

-Socioeconomic status -Immunization status Host, or intrinsic factors are individual variables such as genetics, age, gender, ethnic group, immunization status, and human behavior that impact a person's health. The other options are all extrinsic factors, which pertain to environmental characteristics.

The nurse understands the use of standardized language in care planning is beneficial for what reasons? (Select all that apply.) a. Standardized language provides consistency. b. Standardized language improves communication among nurses. c. Standardized language increases the visibility of nursing interventions. d. Standardized language enhances data collection. Standardized language supports adherence to care standards.

-Standardized language provides consistency. -Standardized language improves --Standardized language increases the visibility of nursing interventions. -Standardized language enhances data collection. Standardized language supports adherence to care standards. Standardized nursing terminologies such as the North American Nursing Diagnosis Association-International (NANDA-I) Nursing diagnoses, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) may be used in the documentation process. Use of standardized language provides consistency, improves communication among nurses and with other health care providers, increases the visibility of nursing interventions, improves patient care, enhances data collection to evaluate nursing care outcomes, and supports adherence to care standards.

When charting is done using the DAR charting format, the nurse documents which components? (Select all that apply.) a. The patient problems b. Subjective data c. Any actions initiated d. Objective data e. The patient's response to interventions

-The patient problems -Any actions initiated -The patient's response to interventions A DAR note is used to chart the data (D) collected about the patient problems, the action (A) initiated, and the patient's response (R) to the actions. A SOAP note is used to chart the subjective data (S), objective data (O), assessment (A), and plan (P).

The nurse identifies what measurement to be an acceptable personal space distance for most English-speaking persons? a. 14 inches b. 18 inches c. 21 inches d. 24 inches

18 inches Proxemics refers to the amount of space or distance acceptable to two or more individuals based on cultural standards and personal preferences. Most English-speaking persons consider 18 inches to be an acceptable distance for communication. In general, intimate space is 0 to 1.5 feet; personal space is 1.5 to 4 feet; social space is 4 to 12 feet; and public space is 12 to 25 feet or more.

When considering factors influencing health and the impact of illness, specifically age, the nurse would correctly identify which patient as having the greatest risk? a. 10-year-old girl b. 23-year-old woman c. 47-year-old man d. 85-year-old woman

85-year-old woman Assessment of the patient begins with risk factors that take into account the person's age and the associated level of immune system function. The very young, especially neonates and infants born prematurely, are more susceptible to infections because of the immaturity of their immune systems.

To teach effectively, nurses must recognize which concept? a. Age and socioeconomic status play a large role in understanding. b. 90% of Americans possess rudimentary literary skills. c. The ability to comprehend is a very new concept in health care. d. Most health care teaching is effective and understood.

90% of Americans possess rudimentary literary skills. To teach effectively, nurses must recognize that patients of all ages come from diverse cultural and socioeconomic backgrounds. Each has a different ability to comprehend health care information. Results of the NAAL research indicate that among American adults, 30 million (14%) had below basic health literacy in English and 47 million (22%) had basic health literacy. This means that 77 million (36%) American adults possessed very rudimentary literacy skills that allowed them to read only short, simple printed and written materials.

A hospital is experiencing a drop in patient admissions, resulting in the implementation of a hiring freeze. What is a potential critical consequence of this internal organizational decision? a. A decrease in the availability of future nurses to hire b. A savings of salaries and benefits c. Increased scholarships to nursing students from the local high school d. Increased cross-training of current staff

A decrease in the availability of future nurses to hire In an economic climate where hospitals are not hiring, nursing schools may limit enrollment which will limit the availability of future nurses available to be hired when the current nurses retire or reduce their hours. Salary savings is minimal as the number of patients, staffing, and revenue are closely aligned.

A patient complains that several staff members entered the room during the morning bath without knocking. Which component of professional nursing communication has been violated in this scenario? a. Collaboration b. Advocacy c. Assertiveness d. Respect

Respect Respect for the patient includes providing privacy during procedures such as a bath. It is considered respectful to knock on a patient's door prior to entering the room.

The nurse is caring for a patient for the first time and needs background information such as history, medications taken at home, etc. What is the best central location for the nurse to obtain this information? a. Admission summary b. Discharge summary c. Flow sheet d. Kardex

Admission summary An admission summary includes the patient's history, a medication reconciliation, and an initial assessment that addresses the patient's problems, including identification of needs pertinent to discharge planning and formulation of a plan of care based on those needs.

The nurse is caring for a patient who is unable to take oral medications because of persistent nausea and vomiting. When the nurse decides to call the primary care physician and ask for a different medication administration route, this is a demonstration of what act? a. Collaboration b. Delegation c. Assertiveness d. Advocacy

Advocacy The nurse acts as a patient advocate by promoting what is best for the patient and ensuring that the patient's needs are met. Since the patient is unable to take medications by mouth, it is the nurse's responsibility to inform the physician and obtain alternative medication routes, as appropriate.

In determining patient goals, the nurse should complete which action? a. Allow patients to identify what is most important to them. b. Take the lead and determine what is best for the patient. c. Focus on health promotion and staying healthy. d. Explain the importance of avoiding complications.

Allow patients to identify what is most important to them. As health care educators, nurses should allow patients to identify what is most important to them. If a newly diagnosed diabetic patient is interested in learning techniques of care that will allow discharge to home rather than to an extended care facility, the patient is more likely to be receptive to learning about self-monitoring blood sugar levels.

A sentinel event refers to which situation? a. An event that could have harmed a patient, but serious harm didn't occur because of chance. b. An event that harms a patient as a result of underlying disease or condition. c. An event that harms a patient by omission or commission, not an underlying disease or condition. d. An event that signals the need for immediate investigation and response.

An event that signals the need for immediate investigation and response. A sentinel event is an unexpected occurrence involving death or serious physical or psychologic injury or the risk thereof called sentinel, because they signal the need for immediate investigation and response. A near-miss refers to an error or commission or omission that could have harmed the patient, but serious harm did not occur as a result of chance.

A nurse is orienting to a new job in a home health care agency and is told that most of her patients need tertiary prevention. What activity does the nurse plan to include in the daily routine? a. Household safety checks b. Well-baby checkups c. Antibiotic administration d. Monthly blood pressure assessments

Antibiotic administration Tertiary care is aimed at people who are already experiencing a health alteration, such as those with an infection who need antibiotics. The other options are secondary prevention.

The nurse is preparing to teach a patient for the first time and needs to evaluate the health literacy of the patient. The nurse uses the VARK assessment to gather what information? a. Assess the learning styles of the patient. b. Find the one method that the patient uses to learn. c. Be sure that the patient is a unimodal learner. d. Reduce the need for creating a collaborative learning plan.

Assess the learning styles of the patient. Tools have been developed to help health care workers evaluate the health literacy of their patients. One such tool is the VARK (verbal, aural, read/write, kinesthetic) assessment of learning styles of people who are having difficulty learning. Individuals typically learn through more than one method. For example, a patient's VARK assessment may indicatelearning through VAR or ARK.

A nurse is discharging a patient and is planning on what material to give the patient to take home. What action by the nurse is best? a. Assess the patient's ability to read and understand. b. Determine if the patient wants to take written material home. c. Give the patient the same material as other patients get. d. Ask the patient if he/she has a need for written material.

Assess the patient's ability to read and understand. Health literacy in an important concept in health. If the patient cannot read or comprehend written material, it will be of limited use. The nurse first assesses the patient's ability to read and comprehend written material before choosing the material with which to send him/her home.

A nurse wishes to provide client-centered care in all interactions. Which action by the nurse best demonstrates this concept? a. Assesses for cultural influences affecting health care b. Ensures that all the clients' basic needs are met c. Tells the client and family about all upcoming tests d. Thoroughly orients the client and family to the room

Assesses for cultural influences affecting health care Competency in client-focused care is demonstrated when the nurse focuses on communication, culture, respect, compassion, client education, and empowerment. By assessing the effect of the client's culture on health care, this nurse is practicing client-focused care.

Upon entering a patient's room, the nurse notes that the patient is unresponsive. The nurse takes control and begins to direct other members of the health care team during this crisis. The nurse is demonstrating characteristics of which type of nursing leadership? a. Autocratic b. Democratic c. Laissez-faire d. Bureaucratic

Autocratic The authoritarian or autocratic leader exercises strong control over subordinates. In this scenario, the nurse takes charge and gives directions that others will follow. The participative or democratic leader believes that employees are motivated by internal means and want to participate in decision making.

A patient is found unresponsive and pulseless. The nurse begins cardiopulmonary resuscitation (CPR) and calls for help. When help arrives, the nurse should take on which role? a. Autocratic leader b. Democratic leader c. Laissez-faire leader d. Bureaucratic leader

Autocratic leader Although autocratic leadership is a strict form of leadership, it is useful in crisis situations. A nurse may act as an autocratic leader when taking charge after a patient is found unresponsive. In this situation, it is helpful to have a leader who takes control and directs other members of the health care team.

A nurse is planning primary prevention activities. Which activity would the nurse include in this plan? a. Safer sex education for teens b. Mammogram screening c. Medication compliance d. Annual physical exams

Safer sex education for teens Primary prevention includes activities designed to prevent a disease or condition from occurring in the first place. Examples of primary prevention activities include vaccinations, wellness programs, good nutrition for health, and safer sex programs.

At the well-child clinic, how does the nurse correctly teach a mother about health promotion activities and describe immunizations? a. Unique for children b. Primary prevention c. Secondary prevention d. Tertiary prevention

Primary prevention Immunizations/vaccinations are considered primary prevention measures, those strategies aimed at optimizing health and disease prevention in general. Immunizations/vaccinations are primary prevention measures for individuals across the life span, not just children.

The nurse knows that use of seatbelts and airbags in automobiles is an example of which term? a. Secondary prevention b. Tertiary prevention c. Holistic care d. Primary prevention

Primary prevention Primary prevention is instituted before disease becomes established by removing the causes or increasing resistance. Examples include the use of seatbelts and airbags in automobiles, helmet use when riding bicycles or motorcycles, and the occupational use of mechanical devices when lifting heavy objects.

The qualities of leadership, clinical expertise and judgment, mentorship, and lifelong learning would best describe which type of nurse? a. Administrator b. Certified nurse specialist c. Practitioner d. Professional

Professional The qualities listed are those of a professional nurse. The other options are all nurses who may have these qualities, but the focus of their title includes qualities not essential for the professional nurse.

When the nurse is preparing to provide preoperative teaching to a deaf patient, what action by the nurse is best? a. Use printed materials. b. Provide recorded materials. c. Use a family member to interpret. d. Provide an interpreter.

Provide an interpreter Patients who are deaf or have low English proficiency are entitled to professional interpretation by federal law. Printed material may be helpful but not if the patient has low literacy/low health literacy. Recorded material may be an option is the patient has some hearing and the recordings are amplified. Family members are not used as interpreters.

When discussing immunizations for infants and children with new parents, the nurse should focus on which approach? a. Providing scientific evidence to parents b. Stressing that nonimmunization is a crime c. Acknowledging that immunizations are not needed d. Informing the parents that they have no choice

Providing scientific evidence to parents Parents need to have scientific, evidence-based information about immunizations and their consequences before choosing to accept or reject immunizations for their children. The parent's ability to make an informed decision is the primary goal for nurses educating people about childhood immunizations.

A definition of health policy includes which of the following elements? a. Funding for public education b. Appropriation of funds for roadwork c. Selection of congressional members of committees d. Public policy made to support health-related goals

Public policy made to support health-related goals Health policy is defined as public policies pertaining to health that are the result of an authoritative public decision-making process. Public education funding, appropriation of funding for roads, and selection of members of committees are not part of health care policy. They are under a different funding arm of the government.

A nurse is completing an OASIS assessment on a patient. What data would be most important for the nurse to assess? a. Presence of grocery stores nearby b. Safety concerns within the home c. Number and kind of pets d. Proximity to a health care facility

Safety concerns within the home OASIS (Outcomes and Assessment Information Set) is a data set of outcome measures for adult home health care clients that is used to track outcome-based quality improvement. Factors that could potentially affect patient safety in the home are particularly important.

The nurse observes a confused patient pacing back and forth in the dining room. The patient yells, "The doctor is going to make us all drink poison!" The most appropriate intervention by the nurse at this time would be to take what action? a. Ask the patient why he would say something like that. b. Change the subject to disrupt the patient's thought process. c. Tell the patient that he should probably think of something else. d. Quietly ask the patient to explain the statement.

Quietly ask the patient to explain the statement. Seeking clarification encourages the patient to expand on a topic that may be confusing or that seems contradictory. Asking "why" questions implies criticism, may make the patient defensive, tends to limit conversation, requires justification of actions, and focuses on a problem rather than a possible solution.

A patient calls the nurse to report the smell of cigarette smoke in the bathroom. The nurse recognizes that this component of the communication process is identified by which term? a. Channel b. Referent c. Message d. Feedback

Referent The elements of the communication process include a referent (i.e., event or thought initiating the communication), a sender (i.e., person who initiates and encodes the communication), a receiver (i.e., person who receives and decodes, or interprets, the communication), the message (i.e., information that is communicated), the channel (i.e., method of communication), and feedback (i.e., response of the receiver).

The nurse is caring for an adult patient with a recent below-the-knee amputation. During shift report, the nurse reports that the patient has urinated in the bed multiple times since the surgery. The nurse knows which defense mechanism best describes this behavior? a. Compensation b. Denial c. Rationalization d. Regression

Regression Regression is the return to an earlier developmental stage as a means of avoiding unpleasant or unacceptable thoughts. The adult patient recently lost a limb and reverted to bedwetting as a coping mechanism. Compensation refers to a strategy that uses a personal strength to counterbalance a weakness or a feeling of inadequacy.

A nurse is interested in epidemiology. What work activity would best fit this role? a. Studying census data to determine common causes of death b. Researching population variables that contribute to disease c. Developing sanitary measures to prevent foodborne illness d. Designing research to determine the connection between pollution and cancer

Researching population variables that contribute to disease The epidemiologist works to develop programs to prevent the development and spread of disease. Studying census data, researching population variables, and designing studies do not fall in this field.

A nurse has referred a patient to a community agency. When talking to the patient later, he states that he did not find the agency helpful. What action by the nurse is best? a. Determine what the patient would find helpful b. Review the agency's mission and scope. c. Make another appointment with the agency. d. Warn the patient that nonadherence affects payment.

Review the agency's mission and scope. One of the most important aspects of a community health nurse's role is to be familiar with referral agencies. Awareness of the scope of an agency's influence and services helps the community nurse to pinpoint which agencies are best able to address specific needs. The nurse may have sent this patient to an agency that did not meet his needs.

The nurse correctly recognizes which one of the following illnesses to trigger the broadest range of emotional and behavioral responses? a. Ear infection b. Mild concussion c. Rheumatoid arthritis d. Influenza

Rheumatoid arthritis Chronic, debilitating disease such as rheumatoid arthritis and severe illness can produce a broad range of emotional or behavioral responses in patients and their families. A short-term, self-limited illness that is not life threatening does not evoke emotions or actions that cause fundamental changes in daily lifestyle.

An overweight, sedentary middle-aged smoker with a family history of cardiac disease has noticed a steady rise in resting blood pressure over a 3- to 4-year period. The patient is concerned about his slightly elevated blood pressure and begins walking 20 to 30 minutes in the evenings with his wife and reduces his pack-a-day cigarette habit to ten cigarettes a day. The nurse identifies these actions are the initial step of which behavior? a. Risk factor reduction b. Self-actualization c. Self-transcendence d. Health promotion

Risk factor reduction Risk factor reduction is step-by-step improvement of individual health factors. These combined improvements lower the likelihood of developing a disease. Maslow considered self-actualization the highest level of optimal functioning and involves the integration of cognition, consciousness, and physiologic utility in a single entity.

Prior to drug administration the nurse reviews the seven rights, which include right patient, right medication, right time, right dose, right education, right documentation, and what other right? a. Room b. Route c. Physician d. Manufacturer

Route The right route (e.g., oral or intramuscular) is an essential component to verify prior to the administration of any drug. The patient does not need to be in a specific location. There may be a number of physicians caring for a patient who prescribe medications for any given patient. A similar drug may be made by a number of different companies, and checking the manufacturer is not considered one of the seven rights.

A female patient is admitted to the emergency department after being raped by a neighbor. The patient refuses to discuss the circumstances surrounding the event with the sexual assault nurse examiner. The nurse identifies that the patient is utilizing which defense mechanism? a. Suppression b. Sublimation c. Displacement d. Rationalization

Suppression Suppression is the conscious decision to conceal unacceptable or painful thoughts. The patient refuses to talk about the rape possibly because of the emotional and physical pain associated with the act. Sublimation is the rechanneling of unacceptable impulses into socially acceptable activities. Displacement is an unconscious defense mechanism used to avoid conflict and anxiety by transferring emotions from one object to another object that produces less anxiety.

The nurse recognizes the nursing goal for individuals and families seeking preventative care is to have those groups carry out which action? a. Take responsibility for their health and wellness. b. Abandon the use of electronic educational media. c. Make lifestyle changes after diseases occur. d. Use temporary changes until the danger has passed.

Take responsibility for their health and wellness. Nursing goals for all individuals and their families seeking preventive care are improvement of quality of life through positive lifestyle choices and taking responsibility for health and wellness.

The strategy to avoid medication errors endorsed by the Institute for Safe Medication Practices (ISMP) to differentiate products with look-alike names is referred to as which term? a. Automatic alerts b. Bar coding c. Computer order entry d. Tallman lettering

Tallman lettering Tallman lettering is a term coined by ISMP to describe the practice of using unique letter characteristics of similar drug names known to have been confused with one another. Tallman lettering is used to differentiate products with look-alike names such as BenaDRYL (antihistamine) and BenaZEPRIL (ace inhibitor).

The community health nurse is assessing a family who has a chronically ill child. The child needs special care, and the nurse has to coordinate the care for the home setting. What behavior will the nurse assess for to know that the family can care for the child? a. The family is willing to learn about the care and share the caregiving needs. b. The mother is going to care for the child and the family herself. c. The older siblings are going to care for the child while the parents are at work. d. An outside agency will be coming to the home three times a week to give care.

The family is willing to learn about the care and share the caregiving needs. The nurse will look for a family who is willing to provide care plus support each other in this need. Having a situation where just siblings or a mother or an outside agency give care puts an undue burden on the caregiver and brings disharmony to the family.

What fact is the nurse aware of when charting using paper nursing notes? a. Use red ink so the nursing entries stand out. b. When mistakes are made in documentation, the nurse should white out the entry. c. Only one nurse should document on a sheet so that it can be removed in case of error. d. The medical record, in any format, is the most reliable source of information in a legal action.

The medical record, in any format, is the most reliable source of information in a legal action. The medical record is seen as the most reliable source of information in any legal action related to care. When legal counsel is sought because of a negative outcome of care, the first action taken by an attorney is to acquire a copy of the medical record. Ink color is usually black, blue or other as designated by the facility.

Which of the following is an example of a nurse violating the Health Insurance Portability and Accountability Act (HIPAA) of 1996? a. The nurse asks the unit clerk to look up lab values for her relative recently admitted to the hospital. b. A group of fellow employees are discussing a patient's clinical status in a public place. The nurse manager requests that they step into private room to complete the discussion. c. After entering the progress notes on a patient's electronic medical record, the nurse logs off the computer to allow her coworker to use the terminal. d. As a family approaches the nursing desk, the nurse removes the patient census sheet from view on the counter.

The nurse asks the unit clerk to look up lab values for her relative recently admitted to the hospital. When the nurse asks the unit clerk to look up lab values for her relative recently admitted to the hospital, the nurse is accessing protected health information not required for the nurse to perform his or her job. This is a violation of privacy even if it is a relative. The other choices are all actions that are consistent with protecting a patient's privacy right as defined by HIPAA.

The nurse is implementing a plan of care for a patient newly diagnosed with type 2 diabetes mellitus. The plan includes educating the patient about diet choices. The patient states that they enjoy exercising and understand the need to diet; however, they can't see living without chocolate on a daily basis. Using the principles of responding in the Model of Clinical Judgment, how would the nurse proceed with the teaching? a. The nurse explains to the patient that chocolate has a high glycemic index. The nurse then focuses on foods that have low glycemic indexes and provides a list for the patient to choose from. b. The nurse explains that the patient may eat whatever they would like as long as the patient's glucose reading and A1c remain stable. c. The nurse derives a new nursing diagnosis of Knowledge Deficit and readjusts the plan of care to include additional sessions with the registered dietician. d. The nurse examines the patient's daily glucose log and incorporates the snack into the time of day that has the lowest readings. The nurse then follows up and evaluates the response in 1 week.

The nurse examines the patient's daily glucose log and incorporates the snack into the time of day that has the lowest readings. The nurse then follows up and evaluates the response in 1 week. Responding entails adjusting the plan of care to the particular patient issue through one or more nursing interventions. In this case, the nurse is working with the patient's wishes, knowing that the patient will most likely cheat. The patient will be allowed to "cheat." The plan will be evaluated to be sure the snack does not elevate the glucose excessively and be readjusted if warranted.

The nurse recognizes which leadership theory that assumes that leaders are born with certain leadership skill that few people possess? a. Trait theory b. Behavioral theory c. Situational theory d. Transformational theory

Trait theory Trait theories assume that leaders are born with the personality traits necessary for leadership, which few people are thought to possess. Behavioral theories assume that leaders learn certain behaviors. These theories focus on what leaders do, rather than on what characteristics they innately possess.

The unit charge nurse uses reward and punishment to gain the cooperation of the nurses assigned to the unit. What type of leader is this charge nurse?a. Transformation b. Autocratic c. Transactional d. Situational

Transactional Transactional leaders use reward and punishment to gain the cooperation of followers. Transformational leaders use methods that inspire people to follow their lead. Transformational leaders work toward transforming an organization with the help of others. The authoritarian or autocratic leader exercises strong control over subordinates. Situational theories suggest that leaders change their approach depending on the situation.

The nurse manager of a unit is sharing the most recent results of a patient satisfaction survey to motivate staff. This approach is a characteristic of what type of nursing leader? a. Transformational b. Transactional c. Situational d. Autocratic

Transformational Transformational leaders use methods that inspire people to follow their lead. Transformational leaders work toward transforming an organization with the help of others sharing survey results may work to inspire staff. Transactional leaders use reward and punishment to gain the cooperation of followers. The authoritarian or autocratic leader exercises strong control over subordinates.

Women who are given the job of caretaker for aging relatives are subject to caregiver strain due to a. feminine attributes. b. unequal gender. c. fixed gender roles. d. female inequality.

fixed gender roles. In cultures with more fixed gender roles, women are usually given the role of caretaker for aging relatives and may suffer the stresses of caregiver strain. Feminine attributes refers to harmonious relationships, modesty, and taking care of others.

The emphasis on understanding cultural influence on health care is important because of a. disability entitlements. b. HIPAA requirements. c. increasing global diversity. d. litigious society.

increasing global diversity. Culture is an essential aspect of health care because of increasing diversity. Disability entitlements refer to defined benefits for eligible mental or physically disabled beneficiaries in relation to housing, employment, and health care. HIPAA requirements refers to the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information;

When teaching an Asian patient with newly diagnosed diabetes, the nurse notes the patient nodding yes to everything that is being said. With a better understanding of cultural interdependence in self-concept, a nurse should immediately a. write everything down for the patient to refer to later. b. prompt further to elicit additional questions or concerns. c. call the recognized elder for this patient. d. call the oldest male relative for help with decision making.

prompt further to elicit additional questions or concerns. When a nurse provides nutritional education to a patient who is from a culture that values greater power distance, it might appear that the patient is willing to accept all that the nurse suggests, when further prompting would elicit additional questions or concerns.

Understanding cultural differences in health care is important because it will help the nurse to understand the manner in which people decide on obtaining treatments and medical care. In independent cultures an individual will a. put himself first. b. consult family members for advice. c. ask for a second opinion. d. travel great distances to receive the best care.

put himself first In independent cultures, an individual will put himself first in the case of a life-threatening illness, whereas even in dire circumstances, members of collectivist cultures may still consult other family members for the best course of action. In independent cultures, an individual will not consult with other family members, ask for a second opinion, or travel great distances to receive the best care.