226 Chapter 1 (Introduction to nursing) PREPU

The registered nurse communicates with the physical therapist that a client is now on strict bed rest due to bradycardia. Which statement best explains the standard exemplified by the nurse? The RN coordinates care delivery. The RN identifies outcomes. The RN analyzes client data. The RN collects client data.

The RN coordinates care delivery. Explanation: The standard exemplified by the nurse is 5a: Coordination of Care: The RN coordinates care delivery.

A registered nurse (RN) is caring for four clients on a medical-surgical unit. Which task is most appropriate for the nurse to delegate to the licensed practical nurse (LPN)?

administering bedside blood glucose testing Explanation: The LPN, under the Nurse Practice Act, is permitted to administer testing for bedside blood glucose. The nurse must recognize the scope of practice of the delegate, and remember that client needs and activities delegated must be matched to skill level. The RN would not delegate administration of blood products, intravenous push medication, or chemotherapy to the LPN, as these tasks are not covered under the LPN's nurse practice act (NPA).

The nurse is caring for a client with a new diagnosis of cancer, and allows the client to verbalize fears relating to how to tell the children. The nurse's intervention reflects which aspect of nursing?

Art of nursing Explanation: In this example, the nurse is utilizing a holistic approach to the provision of nursing care based on the knowledge of providing psychosocial interventions, such as allowing the client to verbalize feelings/fears. This application of knowledge is the art of nursing. The science of nursing is the knowledge base for the provision of care. Evidence-based practice and application of research are using research to make decisions on how to care for clients.

The nurse graduated several years ago from a 2-year nursing program at a community college near the home city. Recently, the nurse has considered moving from providing direct client care into an administrative role, but recognizes the need for further education to be considered for such a position. The nurse most likely possesses which nursing qualification?

Associate degree Explanation: An associate degree in nursing is typically a 2-year program that is offered at a community college or junior college. Such a degree allows a nurse to plan and provide care, but further education is often necessary for administrative positions. A diploma is often provided under the auspices of a hospital, while both baccalaureate and graduate degrees involve a minimum of 4 years of education; both degrees qualify a nurse to act in a supervisory role.

A student is choosing her educational path and desires a nursing degree with a track that contains community nursing and leadership, as well as liberal arts. The student would best be suited in which type of program?

Baccalaureate program Explanation: The baccalaureate degree in nursing offers students a full college or university education with a background in the liberal arts.

A nurse receives an x-ray report on a newly admitted client suspected of having a fractured tibia. The nurse contacts the physician to report the findings. What role is the nurse engaged in? Communicator Advocate Caregiver Researcher

Communicator Explanation: Nurses are communicators when they report findings to the health care team. Advocacy involves actions such as protecting the client's safety or rights. Administering care measures directly to the client demonstrates the caregiver role. Research involves collecting and analyzing data.

A nurse wishes to pursue a degree as a nurse practitioner. What is the minimal degree needed by the nurse?

Masters

In what time period did nursing care as we now know it begin?

18th to 19th century Explanation: From the middle of the 18th century to the 19th century, social reforms changed the roles of nurses and of women in general. It was during this time that nursing as we now know it began, based on the beliefs of Florence Nightingale.

Which of the following are the best examples of the role of the nurse as a communicator? Select all that apply.

-Telling a client their blood pressure -Calling a physician about a client's blood pressure -Informing the physical therapist that client's therapy was discontinued Explanation: When acting in the role of communicator, the nurse is using effective interpersonal and therapeutic communication skills to establish and maintain helping relationships for clients. Examples include telling a client their blood pressure, calling a physician regarding a client condition, and communication pertinent information with members of the allied discipline team, such as the physical therapist. Telling a friend something that happened to a client that day is not the role of the nurse as communicator, in fact it may be a violation of the client's privacy and confidentiality.

The nurse is evaluating client health. Which of the following clients should the nurse determine to be exhibiting the most signs of health?

A client with a leg amputation that performs activities of daily living with a prothesis Explanation: As defined by the World Health Organization, one's health includes physical, social, and mental components and is not merely the absence of disease or infirmity. Health is often a subjective state—a person may be medically diagnosed with an illness, but still consider himself or herself healthy. The client with an amputee is performing activities of daily living, thereby demonstrating healthy behaviors.

What type of nursing program would allow a student with a 4-year degree in psychology to enter and complete a baccalaureate degree in nursing, take the NCLEX examination, and transition into a Master of Science in nursing (MSN) program?

Graduate entry program Explanation: Graduate entry program students possess a baccalaureate degree in a field other than nursing. These students can track directly into a master's or doctorate in nursing program after successfully passing the NCLEX-RN.

A 32-year-old construction worker is admitted to the emergency department after suffering a heat stroke. Which of the following IV solutions would the nurse expect the physician would order? A solution of dextrose A solution of normal saline Blood products Total parenteral nutrition

A solution of normal saline Explanation: An isotonic solution is helpful for hypotension caused by hypovolemia in dehydration. Examples of an isotonic solution include normal saline (0.9% NaCl) and lactated Ringer's.

A registered nurse plans to return to the nursing profession after a long hiatus. Which statement about the trend in health care services would be most important for the nurse to keep in mind?

Clients enter the health care system acutely ill. Explanation: These days, clients enter the health care system acutely ill. Hospital stays are much shorter, not longer. Nurses in the past relied on intuition to make decisions. Today, they have specific knowledge developed through research and evidence-based practice. The health care delivery system is more, not less, controversial now.

Which is an appropriately stated nursing intervention? Ambulate in the hall. Stand at bedside with assistance. Ambulate 30 ft. twice a day with assistance of a walker. Ambulate with assistance of a walker.

Ambulate 30 ft. twice a day with assistance of a walker. Explanation: Correctly stated client outcomes are specific, measurable, and realistic. The other choices are poorly defined and do not specify when or how or by whom.

Which nursing action best exemplifies the nurse's role in promoting health?

Encouraging a group of junior high school students to engage in regular physical activity. Explanation: Health promotion involves encouraging individuals to be proactive in taking measures to foster their well-being and maximize optimal functioning. Exercise is one of the most common, and accessible, activities that can help achieve this. Support groups often focus on coping, while treating hypertension pharmacologically, and removing secretions that can threaten oxygenation, help to restore health and prevent illness.

A nurse manager is teaching staff how to use a new piece of hospital equipment. Which educational setting would be most appropriate for this process?

In-service education Explanation: In-service education is designed to increase the knowledge and skills of the nursing staff. Education about a new piece of hospital equipment would fall into this category. Continuing education is educational experiences designed to enrich the nurse's contribution to health. Many state nursing organizations require continuing education hours to maintain licensure. Undergraduate studies are the educational programs for pre-licensure in the field of nursing. For the nurse, this could be a diploma, associate degree, or baccalaureate in nursing. Graduate education would include the educational programs for the advanced practice nurse. This could be master's degree or doctoral preparation.

Which of the following is the best example of a nurse in the role of counselor?

A nurse allowing a crying client to verbalize their fears of death Explanation: When the nurse is acting as a counselor, the nurse uses therapeutic interpersonal skills to facilitate the client's problem-solving and decision-making skills. The best example is the nurse allowing the client to verbalize their feelings, as verbalizing feelings lets the client gain a better perspective of their situation for problem solving and for coming to terms with the situation. Telling the client about the side effects of a medication is a form of teaching. Providing test results to the physician is communication, and ensuring a client has follow-up care at a free clinic is advocacy.

The nurse is describing the role of the nurse entrepreneur. Which of the following statements best describe this role?

A nurse who manages a health-related business Explanation: The nurse entrepreneur usually has an advanced degree and manages a clinic or health-related business, conducts research, provides education, or serves as an adviser or consultant to institutions, political agencies, or businesses.

Which of the following is the best example of client-centered approach to care?

The nurse asks the client about his health goals. Explanation: Client-centered care is one of the quality and safety education requirements for nursing competencies (QSEN). The intent of client-centered care is to ensure that care is centered on the client, and not the needs of the nurse. An example of this is the nurse asking the client about his health goals so that they can be addressed on the client's plan of care. Helping the client ambulate and drawing a blood sample are examples of client care, but are not client-centered care.

A nurse is providing care for clients in a long-term care facility. Based on the definitions of nursing in the textbook, what should be the central focus of this care?

the client receiving the care Explanation: The client receiving the care is always the central focus of the nursing care provided. The central focus is not the nurse, the nursing actions, or nursing as a profession.