VNSG 1304: Ch. 1 Prep U Questions

A nurse is evaluating clients in an outpatient clinic. Which client requires the nurse to include a secondary illness in the plan care?

Client with a history of chronic obstructive pulmonary disease (COPD) now had symptoms of right side heart failure.

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.

Which of the following statements accurately describes the formulation of a nursing diagnosis?

Collection of assessment data provides the basis for identifying nursing diagnoses

Trends in managed care have resulted in an increased focus on the care of clients by nurses in which settings?

Community Settings Health care is increasingly provided in community-based settings such as clinics, outpatient settings, and homes. The impetus for this change has largely been the implementation of a system of managed care to control and monitor health care services to minimize costs. Clients admitted to the critical care unit may need to progress to a floor and a long term setting after hospitalization.

The new nursing graduate is concerned related to some of the critical changes that will be occuring in nursing. What changes does the nurse anticipate will impact nursing care?

Difficulty for nurses to remain current in a rapidly changing medical and technology environment

The nurse is performing an extensive dressing change on a client with burns. The nurse explains each step as it is being performed. The nurse is acting in which role by providing each step?

Educator

What are healthy self-care practices that the nurse can utilize for herself? Select all that apply.

Engage in an activity, such as painting, that she enjoys. Practice meditation for 5 minutes on a regular basis. Attend a continuing education class on assertiveness. Schedule adequate time for hygiene and eating before attendance at work.

The registered nurse is performing a nutritional assessment to ensure that the client's diet is optimal for wound healing. The nurse's intervention can be traced back to which of nursing's key people's contributions to nursing?

Florence Nightingale

Which nurse posited a theory that can be practically applied to nursing as follows: "Nurses modify unhealthy aspects of the environment to put the client in the best condition for nature to act."

Florence Nightingale

Which description depicts the role of the nurse practitioner?

Functions independently, is skilled at doing nursing assessments, performing examinations, counseling, teaching, and treating health problems.

The director of nursing (DON) of a major hospital is seeking to hire a nurse with a strong technical background to care for clients on a busy surgical unit. The DON is most likely going to hire a nurse prepared at which level of nursing?

Associate Level Explanation: The ANA's 1965 resolution prompted the 1985 ANA statement adopting the titles of associate nurse (a nurse prepared in an associate degree program with an emphasis on technical practice) and professional nurse (a nurse possessing the baccalaureate degree in nursing) for these two levels. Master's and doctoral prepared nurses possess higher degrees and expertise.

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

The nurse pursed a degree in nursing by attending a a junior college for 2 years and successfully took the NCLEX-RN upon completion. Since getting his degree, the nurse has worked in an inpatient setting on a transplant floor for 17 years. Based on the information given, which degree does this nurse have?

Associate degree

Which description is consistent with the nurse's use of empathy during client care?

Intuitive awareness of what the client is experiencing

What was one barrier to the development of the nursing profession in the United States after the Civil War?

Lack of educational standards

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

Which trend in nursing is true?

More licensed nurses are earning master's and doctoral degrees.

The practice of nursing in each state is defined by

Nursing Practice Act

Teaching a woman about breast self-examination is an example of what broad aim of nursing?

Preventing illness

A post-surgical client required the reinsertion of a urinary catheter after retaining urine for several hours. The registered nurse had delegated this task to a practical nurse. What action shows that the RN applied the principle of right supervision and evaluation when delegating this task?

The RN confirmed that the catheter was inserted correctly after the LPN was finished the task Explanation: The principle of right supervision and evaluation dictates that nurses should validate that a task was completed correctly. Documentation and direct observation are not evidence of this principle. Correct completion of this task would not normally be followed up by removal of the catheter after one hour.

Which client is an example of "medically homeless"?

The client who goes to the emergency department for minor issues

The nurse studies Dorthea Dix, an individual who organized women volunteers to care for the Civil War troops. For which other healthcare reforms is this individual credited? (Select all that apply.)

improved health care for the mentally ill improved health care for the blind improved health care for the deaf improved health care for the homeless

The nurse is discussing entry level for professional nursing practices. Which is the most accurate statement by the nurse?

"BSN is the recommended entry level by national nursing organization."

The nurse is conducting a class for nursing assistants. One of the students asks the nurse why blood pressure, pulse, and temperature are called "vital signs". Which of the following explanations would the nurse offer the student?

"Because significant deviation from normal is not compatible with life."

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

18th to 19th century

Which nursing actions are appropriate when providing client care on a medical-surgical unit that implements functional nursing?

Administering medications to all assigned clients while a colleague provides all treatments, such as wound care to the same group of clients

Which social force significantly impacted the future supply and demand of nurses?

Aging

The first journal owned, operated, and published by nurses was:

American Journal of Nursing

Which organization has established standards that help the nurse determine which clinical actions fall under the scope of nursing practice?

American Nurses Association

Which organization is the best source of information when a nurse wishes to determine whether an action is within the scope of nursing practice?

American Nurses Association (ANA)

The client is admitted to the hospital. The nurse is using the nursing process to plan care for this client. Place in order the steps of the nursing process that the nurse would use for this client? Use all options.s

The nurse assesses the client is short of breath, coughing, and expectorating thick, yellow sputum. The nurse analyzes the data and determines the client is experiencing an oxygenation problem. The nurse plans to teach the client about deep breathing, coughing sputum into a tissue, and disposing of the tissue in an appropriate receptacle. The nurse administers an intravenous antibiotic every 12 hours. The nurse evaluates lung sounds and vital signs for effectiveness of treatment. Explanation: (ADPIE) Assess, Diagnose, Plan, Implement, and Evaluate The nurse assesses the client is short of breath, coughing, and expectorating thick, yellow sputum. The nurse analyzes the data and determines the client is experiencing an oxygenation problem. The nurse plans to teach the client about deep breathing, coughing sputum into a tissue, and disposing of the tissue in an appropriate receptacle. The nurse administers an intravenous antibiotic every 12 hours. The nurse evaluates lung sounds and vital signs for effectiveness of treatment.

During the Crimean War, which was fought between Russia and the alliance of England, Turkey, France, and Sardinia, what was the major achievement for nursing?

The nursing care resulted in a decrease of the death rate of soldiers to 1% from 60%.

A licensed practical nurse is planning a move to a new state and intends to begin practicing as soon as possible. The nurse should be aware that:

There may be differences in the scope of practice when a practical nurse relocates to a new state.

During the reformation, which factor influenced the decline in nursing?

Women's subordination to men

A client is confused about their new health insurance and asks the nurse, "My health insurance has changed and instead of having a network of physicians who discount their fees for service to choose from, I need to enroll in a managed care organization. What is the difference?" Which statement provides the most accurate information?

"This type of insurance plan offers medical care provided by a specific group of providers. Explanation: A managed care organization (MCO) offers medical care provided by a special group of providers verses a Preferred Provider Organizations (PPO) that has a network of a physicians who discount their fees for service in exchange for a supply of referred clients. For both types, the choice of care providers is limited to those listed in the network or group. Medicare is a federal program that finances healthcare costs of persons aged 65 years and older and permanently disabled workers of any age and their dependents. Prospective Payment System reimburses hospitals on a fixed rate basis based on the diagnostic-related group.

The nurse is providing education about reducing the risk of exposure to bloodborne pathogens during venipuncture. Which statements by a student indicates the need for additional education? Select all that apply.

"To reduce my chances of being stuck by a contaminated needle, I should recap the used needle promptly." "The only way to protect myself from hepatitis B infection is to observe standard precautions with every venipuncture." "I should always identify which patients have hepatitis B or HIV prior to any procedure that may expose me to their blood or body fluids." Explanation: When performing venipuncture, observe standard precautions to limit exposure to bloodborne pathogens, especially hepatitis B and HIV. Be sure your hepatitis B vaccinations are current. To avoid needlestick injuries, dispose of needles in appropriate biohazard containers, do not attempt to recap needles, and utilize self-retracting safety needles when performing venipuncture.

Which of the following are approved as nursing diagnoses?

- Impaired Skin Integrity - Caregiver Role Strain - Compromised Family Coping

The nurse is performing for a client in the end stage of cancer. How can the nurse facilitate the client and family's ability to cope?

- Refer to the client and family to hospice services - Assist the client and family with the preparation for end-of-life - Assist the client with activities of daily living (ADL)

Which of the following are examples of the Institute of Medicine's (IOM) recommendations for transforming the nursing profession? Select all that apply.

- The nurse is a graduate with an associate degree and enrolls in a program to obtain a bachelor's degree in nursing without taking any additional courses. - The nurse participates in a state-wide committee with other health professionals and legislators to address human trafficking. - The nurse notes an increase in hospitalized clients who have heart failure and implements a research study addressing this issue.

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

A nurse practitioner is caring for a couple who are the parents of an infant diagnosed with Down syndrome. The nurse makes referrals for a parent support group for the family. This is an example of which nursing role?

Counselor

Which description best summarizes the level of responsibility of the licensed nurse as related to assessment?

Identifies the information needed from individuals or groups to provide an appropriate nursing database Explanation: While assessing clients, the LPN/LVN gathers data by interviewing, observing, and performing a basic physical examination of people with common health problems with predictable outcomes. Option B is the description of the LPN/LVN's responsibility for implementing care. Option C is the associate degree nurses's responsibility level for assessment. Option D is the baccalaureate nurse's level of responsibility for assessment.

What factors are contributing to the nursing shortage? (Select all that apply.)

Increased aging population requiring health care Disappointing salaries for nurses with longevity employment Explanation Job dissatisfaction as a result of stress and the unrelenting rigor of working in health care Some factors contributing to the nursing shortage include the following: increased aging population requiring health care; disappointing salaries for nurses with longevity employment; job dissatisfaction as a result of stress and the unrelenting rigor of working in health care; heavier workloads and sicker clients; publicity about mandatory overtime; downsizing nursing staff from dwindling revenues and managed care policies; and negative stereotypes for traditionally female occupations like nursing.

An early example of the implementation of epidemiologic practices is seen by

Israelites' practice of sanitation and food inspection Explanation: The Israelites practiced principles of sanitation by using boiled water or filtered water and carefully inspecting meat for spoilage. This is an early example of epidemiologic practices in maintaining health.

A nurse who recently graduated with a baccalaureate degree is aware of demographic trends that have an impact on the profession. What is a major issues that will impact nursing in the future?

Many people will live with the effects of chronic illnesses

What guidelines do nurses follow to identify the client's health care 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 Process

What guidelines do nurses follow to identify the client's health care 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 process

Nurses must use multiple mechanical devices in the workplace to assess their patient. The data collected on these devices supply what type of information?

Objective (observable and measurable data)

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.

Due to the rising cost of health care services, many procedures and treatments are being delivered in what type of setting?

Outpatient Facility

A licensed practice nurse (LPN) is working as a staff nurse. What role do the LPNs working as staff nurses play?

Provide direct nursing care to the clients in the health care facility

Which nursing actions are appropriate when providing client care on a medical-surgical unit that implements primary nursing?

Providing personal hygiene, administering medications, educating the client, and providing emotional support

A nurse is providing care for an elderly client who was admitted to the hospital several days ago after she suffered a stroke. What action by the nurse best demonstrates the definition of nursing that was identified by Henderson and adopted by the International Council of Nurses?

Providing temporary assistance to maximize the client's recovery and rehabiliatation

During the Christian era, nursing care excluded which area?

Psychiatric services

The 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?

The communicator

The postoperative patient's plan of care contain 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 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.

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.

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

They must take a licensure exam

What is the primary purpose of standards of nursing practice?

To ensure knowledgeable, safe, comprehensive nursing care