ch 1 nursing foundations ml 4
A nurse is working with a client who has undergone a lower leg amputation. While conducting an assessment, the nurse notes the client has a downcast mood. Which statement by the nurse conveys empathy to the client? "If I had the type of life-altering experience you had, I would probably feel depressed. You are doing well under the circumstances." "It is not uncommon to be depressed after having such major surgery. Many of my clients feel sad." "I can see you are in need of extra comfort right now. Let me adjust your position and readjust your bed linens for you." "I notice you might be experiencing some feelings of sadness. Would you like to share how you are feeling with me?"
"I notice you might be experiencing some feelings of sadness. Would you like to share how you are feeling with me?" Because a client does not always communicate one's feelings to strangers, nurses use empathy (intuitive awareness of what the client is experiencing) to perceive the client's emotional state and need for support. This skill differs from sympathy (feeling as emotionally distraught as the client). Empathy helps the nurse become effective at providing for the client's needs while remaining compassionately detached. By stating an observational awareness of the client's emotional state based on the client's nonverbal cues, the nurse invites the client to engage in therapeutic communication. The nurse does not assume the client wants any help; therefore, the nurse asks if the client wants to engage in exploring one's experience. By telling the client that is common to be depressed, the nurse is making an assumption about the client's emotional experience. Not all sadness should be labeled as "depression." In addition, by telling the client that other people have had the same experience, it minimizes the client's unique and personal experience, which can threaten the nurse-client relationship and pose a barrier to therapeutic communication. The nurse should not share personal experiences or how the client's unique health experience would make the nurse feel if the nurse was in the same situation. Again, this statement serves to minimize the client's experience and undermines therapeutic communication. Although comforting skills are essential to nursing, assuming that adjusting the client's bed linens will address the client's emotional state is noncongruent and the incorrect intervention for what the nurse has observed.
In what time period did nursing care as we now know it begin? pre-civilization 16th to 17th century early civilization to 16th century 18th to 19th century
18th to 19th century
After hearing a presentation about the American Nurses Association (ANA), a nurse decides to join the organization based on the understanding that: ANA invites students showing excellence in scholarship to become members. membership is open to all nurses in the United States. ANA aims at fostering high standards of nursing in the United States. members include nurses, other health care providers, and lay people.
ANA aims at fostering high standards of nursing in America. Membership is not open to all nurses in America. Only registered nurses (RNs) can become members. Members of the National League for Nursing, not the ANA, include nurses, other healthcare providers, and lay people. ANA does not invite students showing excellence in scholarship to become members.
Which advancement in the nursing profession occurred immediately after World War II? Advanced nursing education was established. Care of clients in the hospital setting declined. Government funding supported minority nurses. National standards for nursing were developed.
Advanced nursing education was established. After the end of World War II, schools of nursing were based on educational objectives and were increasingly developed in university and college settings, leading to degrees in nursing for men, women, and minorities. National standards for nursing were already developed at this time. Following the war, care of clients in hospitals increased, not decreased. Government funding did not increase to support minority nurses at this time.
Which organization has established standards that help the nurse determine which clinical actions fall under the scope of nursing practice? International Council of Nurses National Council of State Boards of Nursing American Nurses Association National League for Nursing
American Nurses Association
The LPN has decided to move up the career ladder and is checking opportunities available through a local college. Which factor(s) should encourage the nurse to apply with an institution? Select all that apply. apply early to avoid waitlist related to limited seats being available Challenge opportunity: pass an exam to prove you know what you know verify your place of employment is a member of our clinical placement locations Online classes: work on your schedule to complete each class Pick the route that fits you: want to specialize, choose the path which best suites your goals
Challenge opportunity: pass an exam to prove you know what you know Online classes: work on your schedule to complete each class Some collegiate programs are now offering the opportunity to obtain credit by passing "challenge exam" initiations. Many also provide satellite or outreach programs to enable nurses who cannot go to school fulltime or travel long distances the opportunity to continue their education. An LPN to ADN/BSN may not be allowed to specialize; however, as the nurse moves up the ladder, specialization can then occur. Several factors lead to qualified applicants being rejected or waitlisted, including shortage of available faculty to teach the courses, lack of placements for clinical experience, lack of space in educational institutions, budget cuts to nursing programs, and intense competition for selective admissions. These factors could actually discourage someone from applying for the advanced training.
Which contributor to the nursing profession established two missions: sick nursing and health nursing? Dorothea Dix Florence Nightingale Lillian Wald Clara Barton
Florence Nightingale Nightingale established nursing as a profession with two missions. "Sick nursing" was helping clients use their own reparative processes to get well and "health nursing" was to prevent illness. Clara Barton founded the American Red Cross during the American Civil War. Lillian Wald advocated for human rights and founded American community nursing during the early 20th century. Dorothea Dix advocated on behalf of the mentally ill person in America and Europe during the 19th century.
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." Dorothea Orem Sister Callista Roy Florence Nightingale Virginia Henderson
Florence Nightingale The application to nursing practice of Florence Nightingale's theory is that nurses modify unhealthy aspects of the environment to put the client in the best condition for nature to act. Virginia Henderson's theory held that nurses assist in performing those activities that the client would perform if the person had the strength, will, and knowledge. Dorothea Orem posited that nurses assist clients with self-care to improve or to maintain health. Sister Callista Roy outlined that nurses assess biologic, psychological, and social factors interfering with health; alter the stimuli causing the maladaptation; and evaluate the effectiveness of the action taken.
A nurse explains the concept of health to a client when establishing health promotion goals with the client. Which statement by the client indicates that the nurse's teaching has been effective? Health is always an objective state. Health is an absence of illness. Health is a state of optimal functioning. Health is not determined by the client.
Health is a state of optimal functioning.
The nurse is performing care for a client in the end stage of cancer. How can the nurse best facilitate the client and family's ability to cope? Select all that apply. Refer the client and family to hospice services. Inform the family that there is nothing they can do for their loved one. Assist the client and family with the preparation for end-of-life. Assist the client with activities of daily living (ADLs). Encourage the family to leave and let the nurse take over care.
Refer 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 (ADLs).
A postsurgical client required the reinsertion of a urinary catheter after retaining urine for several hours. The insertion is delegated to the licensed practical nurse (LPN). The LPN expects the registered nurse (RN) to apply the principle of right supervision and evaluation. What action should the LPN expect the RN to take? The RN confirms that the catheter was inserted correctly after the LPN finished the task. The RN watches the LPN insert the catheter into the client's urethra. The RN removes the urinary catheter one hour after the catheter was inserted. The RN asks the LPN to document the catheter insertion in the client's medical record as soon as possible.
The RN confirms that the catheter was inserted correctly after the LPN finished the task. The principle of right supervision and evaluation dictates that the RN 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.
The nurse works in a unit where the staff nurses can pick their own work schedule in exchange for being on call at least one weekend in a month. However, once the staff nurse refuses to come in when called in to work, the staff nurse loses the flexibility to choose their work schedule for the next 2 months.
The institution implements a transactional leadership style as evidenced by the task and reward orientation The transactional leadership style makes use of the task-reward system. Individuals concur to a favorable work condition on the off chance that the institution too gets something in return. In the scenario, the nurses are given the option to choose their work schedule provided that they agree to be on call for a weekend. With transformational leadership, the provision of a stimulating and supportive environment foster professional and personal growth. The given scenario lack cues that promote transactional leadership. Autocratic leadership, otherwise referred to as directive or aurthoritarian leaadership, does not provide opportunity for its members to make independent decisions. The autocratic leadreship is not applicable in the scenario because the nurses were given the flexibility to choose their own schedule, although they are also expected to be on call one weekend in a month. In the provided scenario, the nurse was not offered the opportunity of shared decision making which is the foundation of the democratic leadership style. With this style of leadership, decisions and activities are shared, thereby creating a sense of equality among leadership and employees. The adoption of self scheduling methods indicates the organizations use of technology and ability to recognize its members as a collective being. This is an example of quantum leadership theory, which views the organization and its members as an interconnected, collaborative being that can prove useful when dealing with unpredictable events and changes.
The nurse works in a unit where the staff nurses can pick their own work schedule in exchange for being on call at least one weekend in a month. However, once the staff nurse refuses to come in when called in to work, the staff nurse loses the flexibility to choose their work schedule for the next 2 months.
The institution implements transactional leadership style as evidenced by the task and reward orientation
The charge nurse in the oncology unit is preparing the shift assignments. The unit is fully staffed: unlicensed assistive personnel (UAP), licensed practical nurse (LPN), and registered nurse (RN).
Unlicensed Assistive Personnel (UAP)-calculating the total intake and output for the entire shiftLicensed Practical Nurse (LPN)-administering a pain medication intramuscularlyRegistered Nurse (RN)-obtaining an admission assessment on a clientUnlicensed Assistive Personnel (UAP)-collecting a stool specimen for hemoccultRegistered Nurse (RN)-administering an intravesical chemotherapyLicensed Practical Nurse (LPN)-inserting an indwelling urinary catheter The unlicensed assistive personnel (UAP) can perform noninvasive, basic nursing activities such as computing for the intake and output and obtaining a stool specimen for hemoccult. The licensed practical nurse (LPN) can perform all the tasks the UAP can do plus basic nursing skills such as administering oral, intramuscular, subcutaneous, and intradermal medications that have standing prescriptions and inserting indwelling urinary catheters. The registered nurse (RN) is assigned tasks that require advanced training and education. Specialized nursing skills such as administering intravesical chemotherapy should be done by the RN. Tasks that require nursing judgment and assessment such as performing an admission assessment cannot be delegated; hence, should be done by the RN.
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%. The servicemen and their families recognized the importance of nursing. The funds collected from the war were used for opening the first training school for nurses. The nurses provided better living and sanitary conditions for the soldiers.
The nursing care resulted in a decrease of the death rate of soldiers to 1% from 60%. The significant achievement of nursing during the Crimean War was the decrease in the death rate of British soldiers, which went from being as high as 60% to becoming as low as 1%. This was possible due to the care given by the nurses under the guidance of Florence Nightingale. This was made possible by providing better living and sanitary conditions for the soldiers. This achievement of the nurses was appreciated by the servicemen and their families. The first training school for nurses was opened after the war and not during the war.
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? teacher/educator leader collaborator counselor
counselor
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? evidence-based practice science of nursing application of research art of nursing
art of nursing
Which of the following is a current trend affecting nursing education and practice? increase in length of hospital stay overabundance of graduating nurses increase in chronic health conditions office-based care delivery systems
increase in chronic health conditions Nursing changes continually in response to the needs and resources of society as a whole. It also changes in response to factors such as definitions of nursing, the aims of nursing, the educational preparation for nursing, and expanded practice roles. Some current trends affecting nursing include: nursing shortage, aging population, evidence-based practice, community-based nursing, decreased length of hospital stay, and increase in chronic health conditions.
Which description is consistent with the nurse's use of empathy during client care? intuitive awareness of what the client is experiencing providing stability and security during a health-related crisis feeling as emotionally distraught as the client managing transitional needs and ensuring continuity
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 nursing instructors lack of educational standards lack of candidates interested in taking up the nursing profession lack of clear distinction between nursing and medicine
lack of educational standards A lack of educational standards was one barrier to the development of the nursing profession after the Civil War. Other barriers included a male dominance of health care and the pervading belief that women were dependent on men.
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 supervise the work of charge nurses working in different units work only as care providers, team members, and communicators work only in long-term care facilities and at client's homes
provide direct nursing care to the clients in the health care facility LPNs working as staff nurses provide direct nursing care to the clients in the health care facility, under the supervision of a registered nurse. Where and how LPNs may work not limited as long as they can practice within their scope and have appropriate supervision. Staff nurses may work in hospitals, the community, clinics, long-term care facilities, or homes. LPNs do not work only as care providers, team members, and communicators but also as decision makers, client advocates, and educators. They do not supervise the work of charge nurses working in different units. Under their licensing and scope of practice, their work must be coordinated by the charge nurse or the team leader.
A nurse is providing care for an older adult 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? protecting the client's identity in order to benefit her physical health facilitating harmony between the client and her psychosocial environment providing temporary assistance to maximize the client's recovery and rehabilitation applying the principles of pharmacology to foster the client's health
providing temporary assistance to maximize the client's recovery and rehabilitation Henderson proposed that nursing involves temporarily meeting the client's health needs with knowledge and skills that neither the client nor family members can provide. Promoting harmony, applying pharmacology, and protecting the client's identity are appropriate actions for the nurse, but meeting the client's health needs is paramount. Henderson's theory focuses on the importance of increasing the patient's independence to hasten their progress in the hospital.
The nurse is utilizing knowledge about a blood pressure medication's actions and side effects to determine whether or not to give a client, whose blood pressure is low, the prescribed blood pressure medication. What best describes the aspect of nursing demonstrated? art of nursing quality improvement science of nursing conduction of research
science of nursing The science of nursing is the knowledge base for the care provided by the nurse. In this example, the nurse is using this knowledge base to decide how best to care for the client by giving or not giving the blood pressure medication. The art of nursing is the application of the knowledge. In this example, it would be demonstrated by the nurse actually giving or holding the medication. Quality improvement activities and the conduction of research influence the science and the art of nursing by helping build the body of knowledge that is the science of nursing.
What is the primary purpose of standards of nursing practice? to enable nurses to have a voice in health care policy to ensure knowledgeable, safe, comprehensive nursing care to establish nursing as a profession and a discipline to provide a method by which nurses perform skills safely
to ensure knowledgeable, safe, comprehensive nursing care
Although all of the following are nursing responsibilities, which one would be expected of a nurse with a baccalaureate degree? collaborating with other health care providers using research findings to improve practice providing direct physical care administering medications as prescribed
using research findings to improve practice Nurses with baccalaureate degrees are expected to use research findings to improve practice. Graduates from vocational, diploma, and associate degree programs do not have coursework in nursing research and are not expected to independently use it in clinical practice. Nurses from all levels of education provide direct care, administer medications, and collaborate with other health care providers.
The need for university-based nursing education programs was brought to light during which important historical time? Spanish-American War World War II World War I Korean War
world war II During the middle of the twentieth century, Esther Lucile Brown, in her report on nursing education published at that time, wrote that nursing education belonged in colleges and universities, not in hospitals. During the Spanish-American War, nursing was still in its earliest phase of development. Even with the input of Florence Nightingale and her followers after WWI, nursing continued to struggle. Professional nursing began during the period and crisis needs of WWII. Nursing continues to evolve today.
