Foundations Ch.1 : Introduction to nursing

A prospective nursing student desires a career that will allow him to provide client care and to assist professional nurses with routine technical procedures. The prospective student needs to be employed in a full-time position quickly due to economic hardship. What type of nursing program would best suit this student?

Licensed or vocational nursing program A licensed practical or vocational nursing program will allow the student to earn a technical certificate in 1 year and sit for the state board of nursing examination to be licensed as an LPN or LVN. An associate program will take 2 years and a baccalaureate program will take 4 years. There are very few diploma programs remaining in the U.S., and these programs typically take 3 years to complete.

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 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 registered nurse is teaching a community health class about illness prevention. Which of the following statements reflects understanding of this concept?

"It is important to enroll in a smoking cessation class."

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

18th to 19th century

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 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.

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 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 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 advanced nurse practitioner is best qualified to provide prenatal care for a pregnant client?

A nurse-midwife A nurse-midwife provides prenatal and postnatal care as well as delivers babies for women with uncomplicated pregnancies. A nurse anesthetist carries out preoperative visits and assessments; administers and monitors anesthesia during surgery; and evaluates postoperative status of clients. A clinical nurse specialist is considered to be an expert in a specialized area of nursing; carries out direct client care; consultation; teaching of client, families, and staff; and research. A nurse educator teaches in educational or clinical settings, theoretical knowledge and clinical skills, and conducts

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 normal saline 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.

Which is an appropriately stated nursing intervention?

Ambulate 30 ft. twice a day with assistance of a walker. 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.

A nurse mentoring second-year nursing students from a community college plans clinical experiences for them. These students will most likely graduate in which time frame?

At the end of the year Nursing students from a community college are most likely students attempting to obtain an associate degree, which is a 2-year program. Therefore, the nurse should plan clinical experiences for students who will most likely graduate at the end of the year, as this is their second year.

The Nurse Corps of the United States Army was established by whom?

Dorthea Dix

What is the best nursing intervention to promote health in a client at risk for heart disease?

Emphasizing a client's strengths to encourage weight loss Nurses promote health by identifying, analyzing, and maximizing each client's own individual strengths as components of preventing illness, restoring health, and facilitating coping with disability or death. Emphasizing the client's strengths to encourage weight loss will be the most effective weight to promote this client's health. Informing the client that they must lose weight will not help the client use his/her strengths to accomplish the goal. Low-sodium diets can prevent heart disease. Taking the pulse daily will not prevent heart disease.

A man age 61 years is distraught because he has just learned that his most recent computed tomography (CT) scan shows that his colon cancer has metastasized to his lungs. Which nursing aim should the nurse prioritize in the immediate care of this client?

Facilitating coping This client's care in the coming weeks or months will likely encompass all of the four foundational roles of the nurse. However, because the client has just recently received bad news and is emotionally distraught, helping the client cope is an appropriate priority in his immediate care.

A nurse is discussing the history of the profession with a client and describes that a shift in societal focus from religion to warfare had a negative impact on nursing due to which of the following?

Female criminals recruited as nurses As many Western societies shifted from a religious orientation to an emphasis on warfare, this led to a tremendous shortage of people to care for the sick. To meet this need, women who were convicted of crimes were recruited into nursing in lieu of serving jail sentences. In addition to having a poor reputation, nurses received low pay and worked long hours in unfavorable conditions.

The nurse is attempting to provide anticipatory guidance for the parents of an eighteen-month-old boy. Which of the following would be the best statement for the nurse to make?

Keep all medications in a locked cabinet." Anticipatory guidance provides the parent with information that the child will need as the child continues to grow and develop to promote his health. The best example of this is telling the parents to keep all medications in a locked cabinet, as the eighteen-month-old can climb and reach for medications that were placed high where the parents thought the child could not reach. This could prevent accidental medication overdose.

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

Masters

A nurse identifies a patient's health care needs and devises a plan of care to meet those needs. Which guideline is being followed in this case?

Nursing process Devising a plan of care is based on the nursing process. This process, identifies the client's healthcare needs and strengths, to establish and carry out a plan of care to meet those needs, and to evaluate the effectiveness of the plan to meet established outcomes. Nursing standards allow nurses to carry out professional roles, serving as protection for the nurse, the patient, and the institution where healthcare is given. Nurse practice acts are laws established in each state in the United States to regulate the practice of nursing. Nursing orders prescribe the nursing care to be given to assist the client to meet health goals.

The student nurse is changing the bed linens of a hospitalized patient. While placing the contaminated materials into the laundry bag, the outside of the bag is touched by the material. What should the student nurse do next?

Obtain another laundry bag and place the contaminated bag inside while in the patient's room. If the outside of the bag becomes contaminated, place that bag in another bag (double-bagging).A nurse is considering relocating to another state to practice nursing.

The nurse utilizing the nursing process includes which of the following steps? Select all that apply.

Plan Implement Assess Evaluate The nursing process consists of assessing the client, planning the client's care, implementing the planned interventions, and evaluating the effectiveness of those interventions. Prescribing is not a part of the nursing process.

Which nursing intervention would be most appropriate for a new mother that calls the nursery for help with breastfeeding?

Refer the mother for a home care visit.

The nurse is using the nursing process to care for a client and is in the process of making a nursing diagnosis for the client. Which of the following best reflects a nursing diagnosis?

Risk for falls Risk for falls is a nursing diagnosis. Hypertension, congestive heart failure, and pneumonia are medical diagnoses versus nursing diagnoses.

Which explanation differentiates the Registered Nurse (RN) from the Licensed Practical Nurse (LPN)?

The LPN should work under the supervision of an RN. LPNs are employed in hospitals, long-term care facilities, and rehabilitation centers and by health care providers such as physicians. LPNs differ from RNs in two areas: educational preparation and scope of practice. LPNs always practice under the supervision of an RN.

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 definition of implementation would include which of the following?

The action phase of the nursing process in which nursing care is provided.

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

The nurse asks the client about his health goals. 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.

The postoperative patient's plan of care contains an intervention to ambulate twice a day 200 feet with assistance of one member of the healthcare team. The intervention was not completed one morning due to his pain. Which of the following would be the appropriate way to document the missed event?

The patient reported his pain at a level of 8/10 at 30 minutes after dosing. The patient was returned to bed and the physician was notified of the uncontrolled pain level with the current medication order. This is the correctly stated evaluation because it indicates that goal was not met, with specific documentation providing what happened, patient's response, and what follow-up was done.

A registered nurse wishes to work as a nurse researcher. Which is true regarding nurse researchers?

They are responsible for the continued development and advancement of nursing. Nurse researchers are responsible for the continued development and refinement of nursing. They usually have advanced education in addition to a baccalaureate degree in nursing. Nurse administrators, not nurse researchers, serve as liaisons between staff members and directors of nursing. Nurse researchers tend to work in large teaching hospitals, research centers, and academic institutions, not community health centers and long-term care units.

The nurse working with an LPN understands which of the following about LPNs?

They must take a licensure exam. Schools for practical nursing programs are located in varied settings. Most programs are 1 year in length. Upon completion of the program, graduates can take the National Council Licensure Examination-Practical Nursing (NCLEX-PN) for licensure as an LPN. LPNs work under the direction of a physician or RN to give direct care to clients, focusing on meeting health care needs in hospitals, nursing homes, and home health agencies.

During the Reformation, what factor influenced the decline of nursing?

Women's subordination to men Women were viewed as subordinate to men and were expected to remain at home caring for children; this decreased the number of qualified women practicing nursing.

The RN is working with hospital administration to transform care at their facility. Which of the following nursing competencies will be critical for the nurse to utilize?

Work effectively in interdisciplinary teams The RN working with administration to transform care will need to be able to work effectively as part of an interdisciplinary team. The nurse will need to work as a team member with members of administration, as well as representatives from other health disciplines involved in the project. The ability to use and troubleshoot equipment and to navigate the electronic medical records are important to the nurse, but will not necessarily help when working with administration to transform care. Doing things the way they have always been done is a barrier to transformation of care.

The need for university-based nursing education programs was brought to light during which important historical time?

World War II

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 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).

A nurse is considering relocating to another state to practice nursing. Which of the following is the most appropriate action by the nurse to ensure ability to practice in the new state?

applying for a reciprocal license in the new state Nurses gain legal rights to practice nursing in another state by applying to that state's board of nursing and receiving reciprocal licensure.

Evidence-based practice and application of research

are using research to make decisions on how to care for clients.

A nurse anesthetist

carries out preoperative visits and assessments; administers and monitors anesthesia during surgery

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 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.

The nurse recognizes that immunizations are an example of:

illness prevention The aim of illness prevention activities is to reduce the risk for illness, to promote good health habits, and to maintain optimal functioning. Immunization administration is an example of illness prevention. Assisting with crutch-walking and teaching medication administration are examples of health restoration activities, which encompasses early detection of a disease to rehabilitation. Hospice care is an example of facilitating coping with disability and death.

A clinical nurse specialis

is considered to be an expert in a specialized area of nursing; carries out direct client care; consultation; teaching of client, families, and staff; and research.

he science of nursing

is the knowledge base for the provision of care

A nurse educator

teaches in educational or clinical settings, theoretical knowledge and clinical skills, and conducts

Which of the following is the best example of a nurse attending an inservice program?

Attending a hospital program on how to use a new IV pump nservice education are programs designed by hospitals and other healthcare agencies to provide education and training for their employees, such as a program on how to use a new IV pump. Continuing education programs, conferences, and online classes furthering one's education are not considered inservice programs.

A nurse is planning to continue her education in the hopes of becoming an expert in geriatric nursing who carries out direct care. For which of the following expanded career roles is the nurse preparing?

Clinical nurse specialist Clinical nurse specialists are nurses with an advanced degree who are considered experts in a specialized area of care. They also provide direct care, consultation, and education of clients, families, and staff. Nurse managers do not normally provide direct care. Nurse-midwives specialize in obstetrical care. Physician assistants are not nurses.

Which of the following is the best example of a nurse implementing care according to the ANA standards of practice?

Providing nutrition teaching to a client with diabetes According to the ANA standards of practice, standard 5 is implementation. This is when the registered nurse implements the identified plan, coordinates care delivery, and employs strategies to promote health and a safe environment. When providing nutrition education to a client with diabetes, the nurse is implementing the teaching plan. When the nurse is analyzing a client's blood glucose level or taking a pulse rate, the nurse is performing the standard related to assessment. When the nurse is determining that a client is at risk for falls, the nurse is implementing the standard relating to diagnosis.

Which nurse is demonstrating a type of nursing whose roots go back to the ancient Greek times when temples were the center of nursing care?

The nurse conducting a blood pressure screening at a local church

What is the primary purpose of standards of nursing practice?

to ensure knowledgeable, safe, comprehensive nursing care Each nurse is accountable for her own quality of practice and is responsible for using standards to ensure knowledgeable, safe, comprehensive care. Standards of practice do not provide the ability to safely perform skills, establish nursing as a profession and discipline, or enable nurses to have a voice in health care policy.

A nurse is demonstrating collegiality in professional practice. What behaviors practiced by the nurse correlate with this standard of practice? Select all that apply.

A nurse helps a colleague write a journal article. A nurse encourages a colleague to join the hospital journal club. A nurse encourages a colleague to join the American Nurses Association (ANA). The ANA standard of collegiality refers to the nurse interacting and contributing to the professional development of peers and colleagues. Examples include helping a colleague write a journal article, encouraging a colleague to join the hospital journal club, or to join a professional organization, such as the ANA. Helping a colleague quit smoking does not contribute to the colleague's professional development. Helping a colleague complete a client bed bath indicates teamwork and collaboration, but does not help contribute to the colleague's professional development.

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

Calling a physician about a client's blood pressure Informing the physical therapist that client's therapy was discontinued Telling a client their blood pressure 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 Quality and Safety Education for Nurses (QSEN) initiative has identified which key competencies for nurses? Select all that apply.

Client-centered care Teamwork and collaboration Evidence-based practice Quality improvement The QSEN has identified client-centered care, teamwork and collaboration, evidence-based practice, and quality improvement as a means for nurses to improve the quality and safety of client care wherever they work. Additional key competencies identified are safety and informatics.

During the course of any given day of work in the acute care setting, the nurse may need to perform which of the following roles? Select all that apply.

Communicator Teacher Counselor The roles and functions of the nurse are many and include: caregiver, communicator, teacher, counselor, leader, researcher, and advocate. Acting as financier and statistician are not the roles of the nurse.

Florence Nightingale introduced the concept of apprenticeship for nurses. Which of the following statements is an example of this?

Completing clinical hours supervised by a nursing instructor Florence Nightingale's concept of apprenticeship involved training student nurses in a hospital setting. Completing clinical hours is an example of this. The other choices do not reflect this concept.

The role of the nurse developed from the pre-civilization era, through the eras signifying the beginning of civilization, the beginning of the 16th century, the 18th and 19th centuries, and the World War II era to the present. Place the following roles of the nurse listed below in the correct chronologic order to follow this timeline.

Nurses were portrayed as a mother, caring for family and delivering physical care and health remedies. Nurses were viewed as slaves, carrying out menial tasks based on the orders of the priest. There was a shortage of nurses; criminals were recruited as nurses; nursing was viewed as disreputable. Florence Nightingale elevated nursing to a respected occupation and founded modern methods in nursing education. Efforts were made to upgrade nursing education, and women were more assertive and independent. Nursing was broadened in all areas and was practiced in a wide variety of settings; nursing was viewed as a profession.

What might a nurse need to do to ensure the continuation of his/her nursing license?

Obtain continuing education credits. In many states, continuing education is required for an RN to maintain licensure. These are defined as professional development experiences designed to enrich the nurse's contribution to health. Obtainment of an ongoing degree is not necessary to maintain licensure. While hospital in-services may provide continuing education, not all in-services are designed to do so.

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 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.

he nurse that has been in practice for 15 years is able to use intuition when providing care to clients and also utilizes resources and demands to attain specific goals. According to Author Patricia Benner, in From Novice to Expert (1984), what stage of practice is the nurse displaying?

expert nurse n From Novice to Expert, Patricia Benner (1984) discussed socialization and skill acquisition in nursing. A nurse passes through five levels of proficiency when acquiring and developing nursing skill: novice, advanced beginner, competent, proficient, and expert. Differences in each level reflect changes in three areas of skill performance. In the first area, the nurse moves from relying on abstract principles to using concrete experiences. The second area involves a change from seeing situations in parts to seeing them more conceptually, or as a whole. Finally, in the third area, the nurse is no longer outside the situation observing but is directly involved. This process takes 5 to 10 years after graduation.