Chapter 1 Health Care Delivery and Evidenced-Based Nursing Practice

When applying Maslow's hierarchy of needs to patient care, the nurse determines that the patient has reached the ultimate goal indicating integrated human functioning and health when which level is met?

Self-actualization

A Jewish patient, who adheres to the dietary laws of his faith, is in traction and confined to bed. He needs assistance with his evening meal of chicken, rice, beans, a roll, and a carton of milk. Choose the nursing approach that is most representative of promoting wellness. The nurse:

Prepares the environment and the over-bed table and inspects the contents of the dinner tray. The nurse asks the patient whether he would like to make any substitutions in the foods and fluids he has received.

The nurse is assisting with the development of a program to administer flu shots to a group of senior citizens. What type of prevention does this program reflect?

Primary prevention

According to Maslow, which category of needs represents the most basic on the hierarchy?

Physiologic needs

According to Maslow's hierarchy of needs, which of the following is the lowest-level need?

Physiological needs

A client is experiencing anorexia related to the adverse effects of cancer treatment. Using Maslow's hierarchy, the nurse identifies this need as reflecting which of the following?

Physiology

How should the registered nurse be responsive to the changing health care needs of society?

Place increasing emphasis on wellness, health promotion, and self-care, because the majority of Americans today suffer from chronic debilitative illness.

Nursing students are reviewing the changing patterns of disease. The students demonstrate a need for additional review when they identify which condition as being on the rise?

Pneumonia

After teaching nursing students about the health-illness continuum, the instructor determines that teaching was successful when the students state which of the following?

"A person can be both healthy and ill at the same time."

A student nurse observes a nurse case manager coordinating discharge for a patient diagnosed with congestive heart failure (CHF). Which statement made by the patient indicates to the student that the patient understands the role of the case manager?

"The nurse case manager contacted my insurance company and has arranged for the home health nurse and physical therapist to visit me as soon as I get home."

Continuous quality improvement (CQI) was identified in the 1990s as a system that would focus on improving quality of care by applying processes. Select all of the processes that apply to CQI.

- Analyzing similar clinical situations to identify repetitive tasks - Assessing the impact of financial parameters and reimbursement models on patient care delivery - Examining different processes that affect patient care

Which statement by the nurse shows an understanding of the focus of the quality assurance programs developed in the 1980s?

"The quality assurance programs focus on processes used to provide care and improving those processes."

A nurse is preparing a presentation for a local community group about health, wellness, and illness. When describing the concept of wellness, which of the following features would the nurse include? Select all that apply.

- Performing to one's best ability - Feeling that everything is together - Being able to adjust and adapt - Experiencing a feeling of well-being

An 83-year-old female demonstrating early-stage dementia has just had surgical repair to her fractured left hip. No family member is present at the discharge planning conference to discuss the next appropriate actions. Which members of the healthcare team will be instrumental in securing the client's placement in a rehabilitation center?

All of the responses are correct

Which is an element of nursing as defined by the American Nurses Association?

Alleviating suffering by diagnosing and treating human responses to health problems

Although nurse practice acts may vary state by state, all recognize several basic principles supporting the legal parameters for all registered nurses. Select the activity that falls under the scope of nursing practice.

Appraising and enhancing an individual's health-seeking perspective

Which element would be included as a goal of case management?

Appropriateness of services

The American Nurses Association's Code of Ethics provides practice guidelines, based on universal moral principles, for all nurses. Select the statement that reflects the nurse's primary commitment within this framework. The nurse is:

Committed to the patient, whether an individual, family, group or community, to promote health, safety and individual rights.

What is the first step in becoming culturally competent?

Exploring one's own cultural beliefs

A nursing instructor is describing to a class the various roles that nurses assume. The instructor determines that teaching has been effective when the students identify which of the following as the focus of the nursing researcher role?

Establishment of a scientific basis for action

Which is the most important reason that nurses utilize research in nursing practice?

Financial obligation

The nurse is providing a program at the local YMCA about stress-reduction techniques combined with a 1-mile walk around the indoor track once a week. What does this type of program address for the community?

Health promotion

The National Center for Health Statistics uses data from healthcare agencies to issue quarterly and annual reports on performance related to goals for improving the health of the U.S. population. Which initiative is targeted with improving the health of all Americans?

Healthy People 2020

Future healthcare policy in the United States will be significanly affected by a population that is:

aging and becoming more culturally diverse.

The Healthy People 2020 initiative targets the improvement of health for all. In addition to eliminating health disparities, what are the broad goals of this plan?

Increasing the quality and length of a healthy life

The nurse educator is planning a teaching session for nursing students related to the treatment and management of gestational diabetes. The nurse educator arranges for a dietitian, pharmacist, and physician assistant to participate in the lesson plan. Which professional nurse competency is the nurse educator demonstrating?

Interdisciplinary teamwork

The financial stability of health maintenance organizations (HMOs) is based on which factor?

Keeping patients healthy and out of the hospital through periodic screening, health education, and preventive services

Which of the following would NOT be categorized as a mid-level practitioner?

Nursing assistants

A nursing student is preparing for a class presentation addressing the collaborative practice model. Which of the following would the student expect to include?

Participation in decision making that is shared by all involved

A nurse, working in a health clinic, treats a variety of conditions on a daily basis. One disorder that is rapidly increasing and is the leading cause of secondary morbidity is:

Obesity

A nurse is preparing a presentation for a local community group addressing the influences on health care delivery. Which of the following would the nurse include in presentation when describing disease patterns?

Obesity along with conditions associated with it has become a major health concern.

The central figure in health care services is the:

Patient

A 54-year-old client on a fixed income has had an electrocardiogram (ECG) as part of an annual physical examination. The physician notes an abnormal Q wave on an otherwise unremarkable ECG. What legislation supports the focus on chronic disease prevention, health promotion, and quality, affordable health care for everyone?

Patient Protection and Affordable Care Act

According to Maslow's hierarchy of human needs, which of the following is the highest level of need(s)?

Self-actualization

The nurse is working at an institution that uses a collaborative practice model. Which of the following would most likely be reflected at this institution?

Shared accountability for care

Which tool is often used by case managers?

Standards of care

A nursing student overhears a patient talking with the rehabilitation nurse. The patient states, "I plan to recover from my stroke to the best of my ability. I know I will always have some limitations; however, I will not let the limitations slow me down." Which description of health does the patient exemplify with this statement?

The concept of health wellness-illness continuum

Which statement is true regarding population demographics?

The culturally diverse population is increasing.

A client comes to the clinic with the complaint that he has been ill for several weeks but does not have insurance and has delayed care. What does the nurse understand about the overall healthcare reform goals that will address issues such as this client?

The goal of healthcare reform is to provide affordable healthcare to more citizens.