Chapter 36 & 47

The nurse manager is looking at models of clinical judgment to use as an employee assessment tool. The nurse manager wishes to use a model that can evaluate clinical competence in the workplace. Which is best suited for the job? a. Tanner's clinical judgment model b. Guided reflection c. Benner's skill acquisition model d. Lasater's clinical judgment rubric

c. Benner's skill acquisition model

Which is a reason for a private agency to develop health policy? a. To represent the interests of nurses only b. To represent the interests of healthcare providers only c. To represent the interests of healthcare organizations d. To represent the interest of nurse executives

c. To represent the interests of healthcare organizations

The nurse is caring for a young woman who is receiving antibiotics for a urinary tract infection. The patient returns to the clinic complaining of continued burning urination 4 days after starting the medication. The nurse looks at the patient's chart and notices that a urine culture was never performed. Which feature of Tanner's clinical judgment model is displayed here? a. Responding b. Interpreting c. Noticing d. Reflecting

d. Reflecting

The nurse is attending an orientation before starting work for the state health department. Over which department or organization does the state health department have jurisdiction? a. The Centers for Disease Control and Prevention (CDC) b. The National Institutes of Health (NIH) c. The Office of the Surgeon General d. Vital Statistics

d. Vital Statistics

Public health policies have powerful effects on....

healthcare delivery system, health of well being of U.S citizens, and professional nursing issues (scope of practice, staffing, funding, universal access to health insurance)

Health Policy

refers to actions taken by government bodies and other societal actors to attain specific health-related goals

A nurse is discussing the implementation of new laws based on health policy with colleagues. Which statement by the nurse is accurate? a. "If desired outcomes are not achieved, the government official will enact a new law." b. "The purpose of evaluation is to make sure that costs of implementing the law are as low as possible." c. "If the law requires major changes, the affected population will vote to modify the new law's regulations." d. "Implementation of the law does not end the cycle of policy analysis."

"Implementation of the law does not end the cycle of policy analysis."

Which nongovernmental organizations have an influence on health policy? a. Banks b. Teachers c. Children's groups d. Health professions associations

D. Health Professions associations

The nurse made a medication error while caring for a patient. Which statement by the nurse indicates that the nurse is interpreting the situation using guided reflection? a. "I should have remembered to check the patient's wristband even though I've been taking care of this patient for several days." b. "I was so busy giving medication that I misread the order and gave the wrong one to the wrong patient." c. "I had to tell the patient and doctor that I gave the wrong medication. It was very embarrassing." d. "The medication didn't harm the patient, but I need to be more careful whenever I give medication."

a. "I should have remembered to check the patient's wristband even though I've been taking care of this patient for several days."

When describing a Medigap policy to an older adult patient, which statement by the nurse is most accurate? a. "Medigap is a government policy that pays some of your medical bills. Medigap is purchased by you privately to cover costs not covered by Medicare." b. "Medicare is a government policy that pays some of your medical bills. Medicaid is purchased by you privately to cover costs not covered by Medicare." c. "Medicare is a government policy that pays some of your medical bills. A Medigap policy is purchased by you privately to cover costs not covered by Medicare." d. "Medicaid is a government policy that pays some of your medical bills. Medicare is purchased by you privately to cover costs not covered by Medicare."

a. "Medigap is a government policy that pays some of your medical bills. Medigap is purchased by you privately to cover costs not covered by Medicare."

The nurse researcher is preparing a webinar about the history of nursing research. Which statement should be included? a. "Membership in Sigma Theta Tau International is by invitation only to baccalaureate and graduate nursing students." b. "Membership in the National League for Nursing is by invitation only to baccalaureate and graduate nursing students." c. "Membership in the American Nurses Association is by invitation only to baccalaureate and graduate nursing students." d. "Membership in the American Association of Colleges of Nursing is by invitation only to baccalaureate and graduate nursing students."

a. "Membership in Sigma Theta Tau International is by invitation only to baccalaureate and graduate nursing students."

The nurse case manager is reviewing Medicare coverage rules with a patient. Which patient statement indicates correct understanding of the teaching? a. "Medicare covers the costs of long-term care." b. "Prescription drug coverage is available through Medicare." c. "Medicare covers my routine dental care." d. "Medicare covers the cost of hearing aids."

a. "Prescription drug coverage is available through Medicare."

The nurse is giving a presentation on the role and functions of specialty nursing practice organizations to a group of colleagues. Which statement is accurate for the nurse to include in the presentation regarding these organizations? a. "Specialty nursing practice organizations advance nursing practice in the affiliated specialty area." b. "Responsibilities of specialty nursing practice organizations include strengthening members' personal identities." c. "A small number of nursing specialties are supported by a professional specialty practice organization." d. "Examples of specialty nursing practice organizations include the American Nurses Association (ANA)."

a. "Specialty nursing practice organizations advance nursing practice in the affiliated specialty area."

A self-employed patient with a preexisting condition is applying for insurance and is concerned about being denied coverage. Which statement by the patient's insurance representative is correct? a. "Do not mention the preexisting condition on your insurance application." b. "A medical examination will not be required to determine your eligibility." c. "Your spouse and dependents will be covered by a self-employment-based health d. insurance plan." e. "You may find it difficult to purchase health insurance through private insurers."

a. "You may find it difficult to purchase health insurance through private insurers."

The nurse at a county health department receives a telephone call from a 22-year-old woman who is 7 months pregnant. The caller reports that they are unable to afford food and asks where they should go to enroll in the Women, Infants, and Children (WIC) supplemental nutrition program. Which response demonstrates that the nurse understands the services offered by government agencies? a. "You've contacted the correct agency. The county health department can enroll you in the WIC program." b. "We can connect you to the state health department, who can enroll you in the WIC program." c. "WIC is a federally administered program, so you'll need to contact the U.S. Department of Health and Human Services (DHHS) to enroll." d. "WIC is administered through the state offices of emergency medical services (OEMS), so you'll need to enroll through that department."

a. "You've contacted the correct agency. The county health department can enroll you in the WIC program."

The nurse is caring for a toddler who appears frightened by the nurse. To make the child more at ease, the nurse gives the toddler a disposable tape measure to play with. Which critical thinking concept is the nurse displaying? a. Concreteness b. Confidence c. Independence d. Creativity

a. Creativity

The nurse is caring for a patient with an electrolyte disturbance. The healthcare provider asks the nurse to draw an arterial blood gas (ABG), but the nurse has never performed the procedure and asks a more senior nurse to assist. Which critical thinking attitude is exemplified by the nurse's action? a. Perseverance b. Awareness of self-limits c. Differentiating fact from fiction d. Approaching situations objectively

a. Awareness of self-limits

The nurse working in the intensive care unit (ICU) has decided to attend a professional critical care conference. Which critical thinking attitude is exemplified by the nurse's actions? a. Awareness of self-limits b. Integrity c. Confidence d. Independence

a. Awareness of self-limits

A home health nurse is caring for a patient who requires an appointment with a specialty provider. The patient's health insurance is an employer-provided health maintenance organization (HMO). Based on the patient's insurance, which is the first step for the nurse to take to ensure that this patient is seen by the specialist? a. Calling the specialist directly to make an appointment b. Discussing the patient's options with the case manager c. Calling the primary healthcare provider for a referral to the specialist d. Discussing the patient's options with the insurance company

a. Calling the primary healthcare provider for a referral to the specialist

The community health nurse is designing a presentation about societal factors that influence health policy. Which statement should the nurse include in the presentation? a. Considerations include whether or not current policy benefits meets the population's needs. b. Population size does not influence the development of health policy. c. Level of support for the proposed policy is not an influencing factor. Population-specific needs are too complex to be taken into consideration.

a. Considerations include whether or not current policy benefits meets the population's needs.

The nurse has just been hired at a home care agency and is asked to choose an insurance plan. The nurse selects a consumer-driven healthcare plan (CDHP). Which statement describes this plan? a. Employer-sponsored coverage that combines a private insurance plan with a health savings account (HSA) or health reimbursement account (HRA) b. Insurance designed to supplement Medicare coverage c. An insurance plan that limits coverage to healthcare providers who contract with that specific health maintenance organization (HMO) d. A hybrid of a point-of-service (PPO) and a health maintenance organization (HMO)

a. Employer-sponsored coverage that combines a private insurance plan with a health savings account (HSA) or health reimbursement account (HRA)

The nurse is preparing to teach a class at the local community center about types of insurance coverage. When describing private insurance coverage, which item should be included? a. Group insurance coverage may be purchased through voluntary and membership associations. b. Employment-based private health insurance coverage may not be extended to include extended family members. c. Self-employment-based private insurance policies cover self-employed individuals and their family members. d. Direct-purchase private insurance plans are usually less expensive and less restrictive than group coverage.

a. Group insurance coverage may be purchased through voluntary and membership associations.

A 40-year-old patient with diabetes who is married and self-employed is searching for a new insurance plan. Which consideration about the different types of healthcare plans is most relevant to this patient? a. Individuals who are self-employed and have chronic health conditions may find it difficult to purchase health insurance through private insurers. b. Benefits of group health insurance may include lower premium costs and better coverage for eligible employees and their families. c. Self-employment-based health insurance coverage is available to self-employed individuals as well as their spouses/domestic partners and dependents. d. A Medigap policy is private health insurance designed to supplement Medicare coverage.

a. Individuals who are self-employed and have chronic health conditions may find it difficult to purchase health insurance through private insurers.

The nurse forgets to provide the patient with discharge papers. When speaking with a coworker, the nurse states, "I should have remembered to bring the papers into the patient's room, but I got distracted with another task." Which guided reflection task is the nurse demonstrating? a. Interpreting b. Observing c. Reflecting d. Responding

a. Interpreting

Which agency accredits all types of nursing education programs? a. The Commission on Collegiate Nursing Education (CCNE) b. The Accreditation Commission for Education in Nursing (ACEN) c. The Commission for Nursing Education Accreditation (CNEA) d. The Association of Specialized and Professional Accreditors (ASPA)

a. The Commission on Collegiate Nursing Education (CCNE)

A nurse is working for a local health department in the child care center sanitation program. On which heath-promotion programs should the nurse be expected to work? a. Poison control b. Bicycle safety c. Infant car seats d. Hand sanitation

a. Poison control

The nurse should recognize that which action is an example of continuous analysis and evaluation of results related to health policy? a. Reviewing evidence indicating whether or not the policy effectively benefits the people it was intended to serve b. Legislators or leaders in executive-branch health agencies committing to solve a problem c. Regulations describing how the executive-branch agency will carry out healthcare law d. Health professions raising awareness about the impact of a particular healthcare law and lobbying for a new policy

a. Reviewing evidence indicating whether or not the policy effectively benefits the people it was intended to serve

The nurse is preparing a presentation about Supplemental Security Income (SSI). Which statement regarding how SSI differs from Medicaid should the nurse include? a. SSI is a federal and state program for aged, blind, and disabled persons to help pay basic needs such as food, clothing, and housing. b. SSI is a state program for older adult patients that pays for their medical expenses. c. SSI is a federal program for blind and disabled persons to help pay for medical expenses. d. SSI is a federal and state program for lower income people to help pay for basic needs such as food and housing.

a. SSI is a federal and state program for aged, blind, and disabled persons to help pay basic needs such as food, clothing, and housing.

The nurse decides to take vital signs and draw morning blood work before the patient's family comes to visit. Which type of decision does the nurse's action reflect? a. Value decision b. Time-management decision c. Scheduling decision d. Priority decision

a. Scheduling decision

The nurse wants to join a professional organization that represents individual nurses. Which organization should the nurse consider? a. The National League for Nursing (NLN) b. Sigma Theta Tau International (STTI) c. The National Student Nurses Association (NSNA) d. The American Nurses Association (ANA)

a. Sigma Theta Tau International (STTI)

1. service about healthcare policies that have direct effects on the nation's health. Which content is appropriate for inclusion in the presentation? a. The Food and Drug Administration (FDA) is governed by the U.S. Department of Health and Human Services (DHHS). b. The Administration for Children and Families and the Administration on Aging are mainly responsible for addressing healthcare financing issues. c. The primary role of the Centers for Medicare and Medicaid Services (CMS) is to oversee services for individuals throughout the lifespan. d. The Centers for Disease Control and Prevention (CDC) is governed by the National Institutes of Health (NIH).

a. The Food and Drug Administration (FDA) is governed by the U.S. Department of Health and Human Services (DHHS).

Which statement describes the mission of the International Council of Nurses (ICN)? a. The ICN represents nursing worldwide, advancing the profession and influencing health policy. b. The ICN provides a code of conduct for nurses, advancing the profession and influencing health policy. c. The ICN advocates for nurses worldwide. d. The ICN provides legal assistance for nurses.

a. The ICN represents nursing worldwide, advancing the profession and influencing health policy.

1. American Nurses Association (ANA) write issue briefs? a. To express the association's opinion on how nurses feel about proposed federal rules b. To revoke laws c. To express the association's opinion on how federal or state laws or proposed federal rules affect nurses and patients d. To express the association's opinion on how nurses fit into the regulatory landscape

a. To express the association's opinion on how federal or state laws or proposed federal rules affect nurses and patients

The staff nurse asks the nursing supervisor, "Which regulatory agency requires hospitals to have personal protective equipment (PPE) ready for us to use when we need it?" Which response is correct? a. "The National Institutes of Health" b. "The Occupational Safety and Health Administration." c. "The Centers for Disease Control and Prevention" d. "The Agency for Healthcare Research and Quality"

b. "The Occupational Safety and Health Administration."

Which agency is responsible for administering a law once it has passed? a. A judicial branch agency of the federal or state government b. An executive branch agency of the federal or state government c. The federal or state senate d. The president

b. An executive branch agency of the federal or state government

The nurse is caring for a patient with a history of diabetes mellitus. The nurse notices an upward trend to the patient's daily fasting serum blood glucose and notifies the patient's healthcare provider. Which level best describes this nurse according to Benner's skill acquisition model? a. Novice b. Proficient c. Advanced beginner d. Competent

b. Proficient

A nurse is transferring from a county to a city health department. Which is a responsibility of a city health department? a. Sanitation b. Sexual health c. Retail food establishment safety d. Waste disposal

b. Sexual Health

Which independent organization significantly influences national quality and safety standards in healthcare institutions? a. The Centers for Disease Control and Prevention b. The Joint Commission c. The Department of Health and Human Services d. The World Health Organization

b. The Joint Commission

Which is the only international health agency with legal authority? a. The United Nations (UN) b. The World Health Organization (WHO) c. Project Hope d. Private voluntary organizations (PVOs)

b. The World Health Organization (WHO)

Which is the role of The Joint Commission in the creation of health policy? a. Monitors mortality and morbidity rates b. Leads infection prevention c. Influences the national quality and safety standards d. Oversees emergency services

c. Influences the national quality and safety standards

The nurse is caring for a neonate who requires nasogastric (NG) tube feedings due to prematurity. The NG tube frequently slips out of position, and the nurse tries different approaches to prevent this from happening. Which critical thinking skill is the nurse demonstrating? a. Intellect b. Reasoning c. Inquiry d. Reflection

c. Inquiry

The nurse auscultates a patient's breath sounds after the patient receives an albuterol nebulizer treatment secondary to wheezing. The nurse finds that the patient is still wheezing despite the therapy. Which aspect of Tanner's clinical judgment model is the nurse displaying? a. Interpreting b. Responding c. Noticing d. Reflecting

c. Noticing

A graduate nurse is applying for licensure. Which agency will issue the nursing license? a. Federal agency b. Local agency c. State agency d. County agency

c. State agency

The nurse is caring for a toddler who appears frightened by the nurse. To make the child more at ease, the nurse gives the toddler a disposable tape measure to play with. Which critical thinking concept is the nurse displaying? a. Concreteness b. Confidence c. Independence d. Creativity

d. Creativity

The nurse is working on the oncology floor of the hospital and notes that many of the patients request internet access so that they can communicate with loved ones more easily. Using this information, the nurse obtains a grant to purchase several laptops for the patients to share. Which type of reasoning did the nurse use to develop this protocol? a. Clinical reasoning b. Careful reasoning c. Deductive reasoning d. Inductive reasoning

d. Inductive reasoning

The nurse is looking at ways to help infants in the healthcare process. Which intervention is appropriate for this age group? a. Encourage the use of play therapy and toys in the treatment rooms. b. Provide simple options when appropriate. c. Allow for hands-on exploration of all equipment. d. Place cots for parents to stay over in all patient rooms.

d. Place cots for parents to stay over in all patient rooms.