Final (ch 1-16)

A shift in population growth is expected to place stress on nursing resources. Which age-group is expected to experience the greatest population growth in the next decade? a. Older than 85 years of age b. 75 to 85 years of age c. 35 to 65 years of age d. 18 to 35 years of age

A

In 2002 which major American corporation partnered with nursing to design a media campaign to promote the image of nursing? a. Johnson & Johnson b. Baxter c. Microsoft d. Wal-Mart

A

Respecting an elderly woman's decision to stay in her own home is based on a belief in the ethical principle of a. justice. b. autonomy. c. nonmaleficence. d. death with dignity.

ANS: B Feedback A "Justice" refers to the equality of the allocation of services. B Autonomy is based on the principle that patients have the right to determine their own course of action. C "Nonmaleficence" refers to the responsibility to do no harm. D Death with dignity is not an ethical principle.

Which of the following best describes a middle-range theory? a. They are very limited in scope and are confined to one to three concepts. b. They do not incorporate the elements of nursings metaparadigm in use. c. They usually blend nursing practice with nursing research. d. They do not borrow concepts from other disciplines.

ANS: C

Which of the following is a legitimate defense to a charge of assault and battery? a. Presence of a medical order b. Knowledge of what is best for the patient c. Informed consent d. Living will

ANS: C Feedback A The presence of a medical order does not negate the need for informed consent. B Even if the treatment is in the patient's best interest, without informed consent it cannot be done. C Informed consent is a viable defense against an accusation of assault and battery. D Having a living will does not replace the need for informed consent.

During the Great Depression, staffing of hospitals changed with an impact lasting to the current day. What was this change? a. The employment of graduate nurses in hospitals b. The need for increased private duty nurses and rural health nurses decreased the number of nurses seeking employment in hospitals c. The opening of more schools of nursing in hospitals d. The increased number of collegiate schools of nursing, which allowed hospitals to increase the educational requirements for the staff

A

Which of the following is true regarding the requirement that entry to nursing practice should require a bachelor's of science in nursing (BSN)? (Select all that apply.) a. With increased complexity in health care, this is being debated again. b. Many ADN nurses are returning to school to complete this degree c. The BSN will be required for practice in all 50 states by 2025. d. The master's of science in nursing (MSN) will replace the BSN for bedside nurses. e. The need for BSN-prepared nurses will decrease with increased unlicensed staff.

A & B

A patient recently lost a job as a salesperson. Which behaviors would indicate that the patient is experiencing stress? (Select all that apply.) a. Patient describes the desire to sleep a great deal due to fatigue. b. Patient states a decrease in participating in usual church activities. c. Patient seems to have difficulty selecting items from a menu. d. Patient is reading the newspaper and online job listings daily. e. Patient continues to spend time with her dog at the dog park.

A, B & C

A nurse has applied for a job and during the interview was told that the health care facility is a closed shop. What does that phrase mean to the nurse? a. The nurse must join a union to be employed there. b. The nurse can join the union if desired, but it is not required. c. This facility is closed to all union activities. d. The facility is negotiating with several unions for control of the employees.

ANS: A

A nurse has registered to vote, voted in primary and regular elections, and participated in public forums related to budget reductions that could result in the reduction of the numbers of school nurses. The nurse is known as a a. nurse citizen. b. nurse activist. c. nurse politician. d. nurse clinician.

ANS: A

A patient who had a broken neck in an automobile accident and was paralyzed, but eventually went back to college, obtained a law degree, and became a practicing lawyer could be said to be demonstrating a. adaptation. b. caring. c. self-care. d. homeostasis.

ANS: A

Which of the following is an effective method for the practicing nurse to achieve leadership skills? a. Becoming active in professional organizations b. Changing jobs frequently to improve skills c. Learning about collective bargaining d. Avoiding involvement in politics

ANS: A

Leiningers theory uses the sunrise model. What is the major premise of Leiningers theory? a. Nursing care should be culturally congruent. b. Nursing care is based on personal, interpersonal, and social systems. c. Nursing care is a deliberate action based on observation. d. Nursing care is only possible after scientific evaluation.

ANS: A Nursing care is focused on culture care preservation.

Which of the following are considered systems? (Select all that apply.) a. Automobile engine b. Person c. Rock d. Hospital e. Family

ANS: A, B, D, E Feedback Correct - An automobile engine, a person, a hospital and a family exhibit the components of a system: input, output, throughput, evaluation, and feedback. Incorrect - A rock does not have the characteristics of a system, such as input and output.

. A health care agency that uses its profits to better the institution rather than paying stockholders would be classified as a a. for-profit agency. b. not-for-profit agency. c. voluntary agency. d. private agency.

ANS: B

14. Which of the following is most important in order for a new staff nurse to communicate therapeutically with patients? a. Focusing interactions on educating patients about their treatments b. Becoming aware of own feelings about illness and death c. Sharing information about the intimate details of ones own life d. Presenting himself or herself as a knowledgeable and experienced clinician

ANS: B Feedback A Although education is important for patients, this does not help the nurse understand his or her feeling and responses. B Reflection will allow the nurse to develop self-awareness, which will help him or her become a better advocate for the patients. C Sharing intimate personal information is not therapeutic. D As a new nurse, knowledge and experience may be limited; portraying more knowledge and experience than one has is deceitful. DIF: Cognitive Level: Application REF: p. 175

4. Which of the following is not a necessary step in the research process? a. Review of the literature b. Review of best practice guidelines c. Design of the study d. Dissemination of results

ANS: B Feedback A Review of the literature is a primary step in the research process. B Review of best practice guidelines is not a step in the research process. C Design of the study is an essential step in the research process. D Dissemination is a step of the research process and a responsibility of the researcher. DIF: Cognitive Level: Comprehension REF: pp. 228-229

How can nurses contribute to a healthier environment? a. Supporting the purchase of polyvinyl chloride (PVC) products b. Teaching the benefits of using disposable diapers to new parents c. Recommending the purchase of nondisposable products when possible d. Leaving the computer on to reduce electrical use when rebooting

ANS: C Feedback A PVC products damage the environment. B The use of disposable diapers adds to solid waste, and they are not easily biodegradable. C The use of products that can be used again decreases the waste produced. D More energy is conserved by turning off computers.

Which of the following is a responsibility of many nurse executives (chief nursing officers)? a. Recruiting, hiring, and training new staff b. Managing day-to-day staff scheduling c. Managing budget for assigned unit d. Participating as a member of the board of directors

ANS: D

A major challenge to full autonomy for nurses is/are a. state nurse practice acts. b. lobbyists for the American Medical Association (AMA) and hospital associations. c. the status of nurses in hospital hierarchy. d. the view of physicians as the gatekeepers in health care.

B

According to the nurses Code of Ethics, the hallmark of nursing practice is a. autonomy. b. accountability. c. evidence-based practice. d. altruism.

B

Which statement about acute illness is true? a. Most people with acute illness develop chronic illness. b. Most people with acute illness return to their previous level of wellness. c. All people with an acute illness need medical care. d. Acute illnesses are usually catastrophic in nature.

B. Most people with acute illness return to their previous level of wellness.

A mother asks the nurse if her 5-year-old can visit his twin brother in the PICU after cardiac surgery. The nurse knows that hospital policy states that children younger than 12 years of age are not allowed to visit the PICU. The nurse grants the request. This illustrates which of Benners stages of nursing proficiency? a. Advanced beginner b. Competent practitioner c. Proficient practitioner d. Expert practitioner

C

Which of the following is an example of Orems self-care theory? a. Assuring proper fresh air and ventilation b. Demonstrating good handwashing techniques c. Assisting a disoriented patient with a bath d. Performing a visual screening exam

C

A 5-year-old with a twin brother is admitted to the PICU after cardiac surgery. Hospital policy does not allow individuals younger than 12 years of age to visit the PICU. The nurse recognizes the needs of the patient and his brother and suggests that the mother bring her son to visit his brother briefly in the afternoon when the unit is usually quiet. This illustrates which of Brenners stages of nursing proficiency? a. Advanced beginner b. Competent practitioner c. Proficient practitioner d. Expert practitioner

D

A barrier to professionalism attributed to nursings roots in altruism is illustrated when a nurse a. questions a medication order written by the physician. b. takes the time to listen to a patients fears about surgery. c. needs to seek approval from charge nurse to give a PRN medication. d. feels guilty for expecting to be paid well for work.

D

A nursing student asks, Since I work as a nurse technician in psychiatric nursing, may I spend part of my clinical rotation with a psychiatric home visiting nurse? In which stage of Cohens model of professional socialization is this student? a. Stage I: Unilateral dependence b. Stage II: Negativity/independence c. Stage III: Dependence/mutuality d. Stage IV: Interdependence

D

Despite the variety of work settings available to the RN, data from 2008 indicate that the primary work site for RNs is a. ambulatory care settings. b. community health settings. c. long-term care facilities. d. acute care hospitals.

D

Margaret Sanger, as a nurse and activist, worked on the Lower East Side of New York City in the early 1900s with immigrant women. What was the focus of her work? a. Sanitation to prevent disease transmission b. Health education for children c. Providing nursing care to underserved African-American families d. Safe contraception and family planning for women

D

NPs are advanced practice nurses who a. are required to have physician collaboration or supervision. b. function under a set of universal advanced practitioner laws. c. cannot receive direct reimbursement for their services. d. can diagnose and treat common and chronic conditions.

D

Which of the following trends in health care delivery that began in the second half of the twentieth century continues today? a. Widespread use of team nursing to address the nursing shortage b. Massive movement of nurses out of acute care and into home care c. Advent of primary care to replace specialized care d. Provision of care to the poor, elderly, and disabled through Medicare and Medicaid

D

Who was the first educated African-American professional nurse? a. Linda Richards b. Phoebe Pember c. Sojourner Truth d. Mary Eliza Mahoney

D

What is the primary difference between acute illness and chronic illness?

In acute illness, symptoms begin suddenly, progress quickly, and subside quickly.

Approximately what percentage of today's nurses belong to the ANA? a. 10% b. 20% c. 25% d. 30%

a. 10%

Why is the etiology of the nursing diagnosis statement important? a. If the etiology is incorrect, the nursing interventions are likely to be ineffective. b. The etiology will be the same each time the nursing diagnosis is identified. c. The etiology is necessary to identify the defining characteristics. d. The etiology determines whether the problem can be solved.

a. If the etiology is incorrect, the nursing interventions are likely to be ineffective.

Which illness has the characteristics of a chronic illness? a. Lupus b. Bronchitis c. Chickenpox d. Gastroenteritis

a. Lupus

A patient in whom metastatic cancer is diagnosed tells the nurse, "God has never let me down before. I'll pray for strength." This patient's illness behavior is being influenced by ___. a. resiliency b. sense of control c. spirituality d. depression

c. spirituality

Which of the following statements describes the purpose of the nursing process? a. Process of documentation designed to decrease liability b. Process designed to maximize reimbursement potential c. A sophisticated time-management strategy d. Process used to identify and solve patient problems

d. Process used to identify and solve patient problems

A contemporary view of the sick role includes ____.

patient as partner with the health care provider.

Which of the following best describes the difference between an occupation and a profession? a. A profession requires a duty to serve. b. A profession is defined by members average income. c. In a profession, action is based on intuition. d. In a profession, knowledge is handed down from generation to generation.

A

5. Dissemination of findings may involve which of the following activities? (Select all that apply.) a. Manuscript reviewed by peers b. Oral presentation of findings at annual conference of the Society of Pediatric Nurses c. Poster presentation at regional conference of Sigma Theta Tau International d. Publication of findings in Western Journal of Nursing Research e. PowerPoint slides developed showing charts and graphs of the statistical results

ANS: A, B, C, D Feedback Correct The dissemination of findings involves the publication and/or presentation of the results so that they are available to others. Incorrect A PowerPoint presentation may be part of preparation for publication or presentation, but it does not disseminate the findings in itself unless shown or discussed with other professionals. DIF: Cognitive Level: Comprehension REF: p. 235

The nurse who recognizes that the strict visiting hours policy that has existed on the pediatric unit is outmoded and begins to gather data to support a new policy liberalizing visiting hours based on evidence of better patient care is taking on the role of a. provider of care. b. patient advocate. c. counselor. d. educator.

ANS: B

The school health clinic treats common health problems, as well as conducting health promotion and illness prevention activities. The clinic provides which level of health care? a. Subacute care b. Primary care c. Secondary care d. Tertiary care

ANS: B

27. Using simple, clear words to explain the details of a colonoscopy procedure shows sensitivity to which successful communication criterion? a. Appropriateness b. Efficiency c. Feedback d. Flexibility

ANS: B Feedback A Appropriateness relates to whether the reply fits the circumstances and matches the message. B Efficiency means using simple, clear words that are timed at a pace suitable to the patient. C Feedback means the nurse seeks to clarify what the patient has said and gain understanding. D Flexibility means the message is based on the immediate situation and not preconceived expectations. DIF: Cognitive Level: Application REF: p. 179

Which nursing theorist is best known for her emphasis on interacting systems, including nurse and patient in goal setting and goal attainment? a. Watson b. Roy c. King d. Orem

ANS: C King focused on goal attainment for and by the patient. Kings interacting systems form a framework to view whole persons in their family and social contexts.

Which of the following best describes trends in nursing education? a.Numbers of RNs with bachelors and higher degrees are increasing. b.Numbers of RNs with associate degrees are decreasing. c.Foreign-born nurses practicing in the United States are seen as less knowledgeable because of their lesser educational preparation. d.Numbers of RNs with diploma educations are increasing.

A

For a nursing malpractice action, essential characteristics of negligence must be present. Which of the following constitute these essential characteristics? (Select all that apply.) a. The nurse assumed the responsibility for the patient's care. b. The nurse is found to have failed to meet the standard of care. c. The harm to the patient must be shown to have been caused by the failure to meet the standard of care. d. Harm to an individual has occurred. e. The nurse's action involves acts of commission.

ANS: A, B, C, D Feedback Correct - The nurse assuming the responsibility for the patients' care, the nurse failing to meet the standard of care, harm occurring to an individual, and the harm being shown to have been caused by the failure to meet the standard of care are the four elements that need to be present to support the charge of malpractice. Incorrect - Malpractice can involve acts of either commission or omission.

Which of the following is an example of diagnosis and treatment? a. Attending smoking cessation classes b. Computerized tomography (CT) scan to rule out gallbladder inflammation c. Screening in the workplace for tuberculosis d. Prenatal classes

ANS: B

Which of the following is not a public agency? a. National Institute of Nursing Research b. American Red Cross c. Centers for Disease Control and Prevention d. State board of nursing

ANS: B

Taking a pediatric patient to the playroom on a promised time and day is based on the belief in the ethical principle of a. autonomy. b. fidelity. c. justice. d. veracity.

ANS: B Feedback A Autonomy relates to the right of individuals to make their own decisions. B Fidelity is being faithful to commitments made to others. C "Justice" refers to the equal treatment of all. D Veracity is being truthful.

17. When nurses receive a patient assignment and accept reports on these patients, they are committed to providing care to those assigned to them. This is based on the ethical principle of a. beneficence. b. fidelity. c. justice. d. veracity.

ANS: B Feedback A Beneficence speaks to doing good. B Fidelity is being faithful or keeping commitments made to others. In accepting the assignment, the nurse has committed to caring for the patients assigned to her or him. C Justice is related to the equal treatment of all. D "Veracity" refers to one's truthfulness.

According to Kohlberg's theory of moral development, individuals who act "because it is the rule of society" are operating in which level of moral development? a. Preconventional b. Conventional c. Postconventional d. Developmental

ANS: B Feedback A In Kohlberg's preconventional level of moral development, the individual is inattentive to the norms of society and is self-centered. B In the conventional level, moral decisions conform to the norms of society. C In the postconventional level, the individual has a highly developed moral value system independent of group norms. D "Developmental" is not a level of moral development identified by Kohlberg.

The Patient Self-Determination Act of 1991, as implemented today, is known as providing a. informed consent. b. advance directives. c. patient bill of rights. d. HIPAA protections.

ANS: B Feedback A Informed consent assures patient autonomy. B Advance directives describe an individual's preferences in regard to medical intervention should the individual become incapacitated, which was the primary intent of the Patient Self-Determination Act of 1991. C The patient bill of rights assures patients certain basic rights unrelated to becoming incapacitated. D HIPAA protects medical records from disclosure.

An adult wears a helmet when riding a bicycle because he believes that his cycling skills might not prevent an accident, which could result in a head injury with serious consequences. Which component of the health beliefs model is this person demonstrating? a. Knowledge that cycling is good exercise and improves health b. Perception of vulnerability to head injury from a bicycle accident c. Concern about his cycling skills d. Belief that individuals should prevent injuries

ANS: B Feedback A Knowledge of practices to improve health is not part of the health beliefs model. B The health beliefs model has as one component the evaluation of one's vulnerability to a condition and the seriousness of that condition. C Concern about skills is not part of the health beliefs model. D The belief that individuals should prevent injuries is not part of the health beliefs model.

A nurse was appointed to a governing board of a governmental agency and then ran for an elective office. The nurse is known as a a. nurse citizen. b. nurse activist. c. nurse politician. d. nurse clinician.

ANS: C

A nurse who lobbies state legislators to support a change in the scope of practice in nursing is engaging in a. power sharing. b. setting policy. c. politics. d. legislative power.

ANS: C

An agency that treats temporary health dysfunction requiring intervention to prevent complications is providing which level of health care? a. Subacute care b. Primary care c. Secondary care d. Tertiary care

ANS: C

2. Quantitative research methods may be somewhat less useful in nursing because of which of the following? (Select all that apply.) a. Qualitative methods are the preferred method to study nursing phenomena. b. Nursing ethics require more stringent controls than are required by quantitative methods. c. Many phenomena of interest to nurses are not amenable to study in tightlyto statements that can be tested. d. The complexity of human beings makes it difficult to break problems in controlled circumstances. e. Patient perceptions of experiences may have significant effects on their health behaviors.

ANS: C, D, E Feedback Correct Nursing problems of interest cannot be studied in laboratory settings. The view of human beings as holistic makes it difficult to dissect them into problem statements to be tested.The meaning of the experience to the patient may be as significant to his or her response as the objective events that occurred. Incorrect Quantitative methods have had stature as the method of inquiry. However, both qualitative and quantitative methods have much to offer to the study of nursing phenomena. Quantitative methods are the most stringent but are not required to study all phenomena of interest to nursing. DIF: Cognitive Level: Comprehension REF: p. 224

Hospices that provide care to terminally ill patients and their families in hospitals, in the home, or in special hospice facilities provide which level of health care? a. Subacute care b. Primary care c. Secondary care d. Tertiary care

ANS: D

A new graduate nurse is in the fifth week of working on a busy surgical unit. The nurse tells a friend about witnessing some patient care that was appalling. What should the nurse do? a. Return to school to obtain a masters of science in nursing (MSN) and leave bedside nursing. b. Talk to the other nurses involved in the situation about the concerns. c. Report the behavior to the nurse manager of the unit. d. Accept that this is the reality of nursing in a busy unit.

B

A nursing student asks, Why do I have to go to clinical in obstetrics when I know Ill never work with women and children? In which stage of Cohens model of professional socialization is this student? a. Stage I: Unilateral dependence b. Stage II: Negativity/independence c. Stage III: Dependence/mutuality d. Stage IV: Interdependence

B

Which recommendation made by the 1965 American Nurses Association (ANA) position paper and other position papers of national nursing organizations is still an issue today? a. Education for nursing should take place in hospital-based programs. b. Minimum preparation for professional nursing practice should be the BSN degree. c. Minimum preparation for technical nursing practice should be the licensed practical/vocation nurse (LPN/LVN) diploma. d. Education for nursing must be evidence-based.

B

In 1900, the primary reason for hospital-based nursing education programs was to a. educate nurses to care for patients in hospitals. b. provide educational opportunities for women. c. staff the hospitals that operated the education programs. d. provide standardized preparation for nurses.

C

Which of the following is an example of formal socialization into the profession of nursing? a. Unplanned observation of a nurse comforting a child after a painful procedure b. Hearing two nurses discussing how to organize patient care more effectively c. Starting an intravenous (IV) line in the simulation laboratory under faculty guidance d. Participating in a student nurses association meeting

C

Which of the following is the primary distinction between licensure and certification? a. Certification is required to practice nursing. b. Licensure is granted automatically on completion of an accredited nursing program. c. Certification validates a high level of proficiency. d. Licensure is voluntary.

C

Which of the following nursing leaders, because of her work in the Henry Street Settlement, is considered the founder of public health nursing? a. Margaret Sanger b. Clara Barton c. Lillian Wald d. Lavinia Lloyd Dock

C

Which of the following recommendations resulting from the 1934 study Nursing Schools Today and Tomorrow still has relevance today? a. Nursing students should be trained on the job. b. Nursing students should be used to staff hospitals on the weekends. c. Nurses should be highly educated. d. Nurses with highly developed instincts do not require standards of practice.

C

A mother asks the nurse if her 5-year-old can visit his twin brother in the pediatric intensive care unit (PICU) after cardiac surgery. The nurse denies the request because hospital policy states that children younger than 12 years of age are not allowed to visit the PICU. This illustrates which of Benners stages of nursing proficiency? a. Novice b. Advanced beginner c. Competent practitioner d. Proficient practitioner

A

A nursing student says to the clinical faculty, I know I will be able to care for this patient given your directions. In which stage of Cohens model of professional socialization is this student? a. Stage I: Unilateral dependence b. Stage II: Negativity/independence c. Stage III: Dependence/mutuality d. Stage IV: Interdependence

A

Despite the caring efforts of early public health nurses in the Henry Street Settlement, racial disparity left many people underserved. Which of the following African-American public health nurses was instrumental in providing excellent nursing care to underserved families despite these social challenges? a. Jessie Sleet Scales b. Margaret Sanger c. Lavinia Lloyd Dock d. Anita M. McGee

A

One important advantage of clinical ladder programs for hospital-based RNs is that they a. allow career advancement for nurses who choose to remain at the bedside. b. encourage nurses to move into management positions in which they can influence patient care on a broader scale. c. encourage RNs to become politically active and guide the profession of nursing. d. provide training to staff nurses so they can move seamlessly across departments.

A

Similarities exist between various ideas about what constitutes a profession. Which of the following is believed to be a characteristic of a profession? a. Members have autonomy. b. Members are trained on the job. c. Members are motivated primarily by financial reward. d. The group lacks a code of ethics.

A

The clinical nurse leader (CNL) is a recently proposed role. The responsibilities of the person in this role include which of the following? a. Oversee and manage care delivery in specific settings. b. Manage and streamline operations in multiple nursing units. c. Replace the outdated CNS role. d. Provide daily care to a specific subset of patients with similar needs.

A

The earliest type of formal nursing education program was the a. diploma program. b. associate degree program. c. bachelors degree program. d. grandfathered acceptance as registered nurse (RN).

A

The process of professionalization of an occupation typically follows a pattern of developmental stages. One of the stages is collective identity. Which of the following is an example of collective identity? a. Legal right to practice profession to protect unique skills from outsiders b. Apprenticeship programs to develop skills c. A loose association of practitioners d. Definition of the professions mission related to full-time work

A

The purpose of mandatory continuing education for license renewal is to a. ensure that nurses remain up to date in knowledge. b. ensure that nurses remain competent in psychomotor skills. c. ensure that nurses attend regular staff development meetings. d. ensure consistency between states regarding continuing education requirements.

A

The racial and ethnic composition of the nursing profession will change to more accurately reflect the population as a whole when a.the increased numbers of racial and ethnic minorities enrolled in educational programs graduate and begin to practice. b.the number of Asians or Native Hawaiian-Pacific Islanders begins to increase. c.the percentage of African-American and Hispanic nurses decreases more than the percentage of white nurses. d.the nonwhite portion of the general population decreases.

A

To which early nursing leader is attributed the founding of the American Red Cross? a. Clara Barton b. Dorothea Dix c. Florence Nightingale d. Lavinia Lloyd Dock

A

What was the most significant impact on the profession of nursing made by Mary Breckenridge in her role as a frontier nurse? a. She demonstrated that nurses could provide primary care in rural settings. b. She demonstrated that female nurses could protect themselves in unsettled rural environments. c. She demonstrated that nurses were capable of teaching new mothers to care for babies. d. She demonstrated that nurses could provide care to many clients despite geographic boundaries.

A

Which of the following nursing roles is not considered an advanced practice role? a. Certified nurse-midwife (CNM) b. Community health nurse c. Certified nurse practitioner (CNP) d. Clinical nurse specialist (CNS)

B

What was the purpose of the Hill-Burton Act? a. It established funding for the construction of hospitals. b. It provided women in the service with military rank. c. It established and funded the Frontier Nursing Service. d. It created the Cadet Nurse Corps.

A

When surveyed, what is the primary reason given by men for entering nursing? a. To make a difference b. High salaries c. Flexible schedules d. Opportunity for travel

A

Which early nursing organization is credited with first recommending state registration for nurses? a. ICN b. NLN c. ANA d. National Association of Colored Graduate Nurses

A

Which of the following is a part of the history of doctoral education in nursing? a. The nurse scientist program was discontinued after more universities began offering doctoral programs in nursing. b. The first doctoral degree (PhD) was offered at the University of Pittsburgh. c. The number of doctoral programs in nursing has doubled since 1990. d. The largest numbers of doctoral programs are practice-focused.

A

Which of the following is a primary reason for the initial slow growth of bachelors degree nursing programs in the United States? a. Belief that hands-on training received in hospital-based diploma programs was superior to the theoretical-focused content in bachelors degree programs b. Belief that hospital-based diploma programs were more scientifically based c. Belief that students prepared in hospital-based diploma programs were more compassionate caregivers d. Belief that hospital-based education programs facilitated career mobility

A

Which of the following is an example of informal socialization into a profession? a. Nurses discussing a patient care issue in the presence of other nurses b. Taking an extra class for an elective c. Performing your first physical assessment in a client d. Teaching a patient about warfarin (Coumadin)

A

Which of the following is an important advantage of distance learning? a. It allows access to adult learners who are geographically unable to participate in a traditional classroom setting. b. It allows students to set their own learning objectives. c. It allows a student to take courses without clinical components. d. It allows universities to offer more classes with fewer faculty.

A

Which of the following statements explains why the school nurse of today is truly a community health nurse? a. The school nurse may be called on to care for a students family members in underserved areas. b. The school nurses primary responsibility is centered on the well child. c. The school nurses primary responsibility is to maintain immunization records. d. The school nurse must be certified in CHN.

A

Which of the following statements is correct about community health nursing (CHN)? a. Prevention and community education are the cornerstones of CHN. b. Nursing care is rapidly moving from the home setting to the institutional setting. c. High-tech care such as ventilators and total parenteral nutrition cannot be handled in the home. d. Assessment skills are less important in CHN because patients are not acutely ill.

A

Which of the following strategies may help to overcome reality shock in the novice nurse? a. Participating in a preceptorship b. Returning to school immediately after graduation c. Moving frequently from job to job d. Becoming emotionally involved with patients

A

Which of the following was recognized earliest as a true profession? a. Ministry b. Teaching c. Social work d. Engineering

A

What are the roles of the Occupational Safety and Health Administration (OSHA) in the workplace? (Select all that apply.) a. They provide protection for people who report workplace safety problems. b. They inspect all equipment to ensure it is safe before the staff uses it. c. The regulate workplace safety. d. They provide health screenings for all new employees. e. They administer the employee health program.

A & C

Which factors will lead to a continuing nursing shortage in the future? (Select all that apply.) a. Aging of the workforce b. Decreasing pay for nurses c. Increased unionization d. Increased need for nurses e. Recent economic downturn

A & D

What are some recommendations for self-care for nurses in the workplace? (Select all that apply.) a. Wash hands consistently. b. Use sharps disposal containers. c. Use adequate help or mechanical devices for lifting d. Demand mental health screening for all visitors and patients e. Reduce the need for working double shifts.

A, B & C

Which medical conditions can be linked to decreases in environmental quality? (Select all that apply.) a. Chronic respiratory diseases b. Allergies c. Cancers d. Mental illness e. Inflammatory bowel disease

A, B & C

Which of the following are including in the basic beliefs set forth in the ANA's Nursing's Agenda for the Future? (Select all that apply.) a. Health care is a basic human right. b. Health policies should be based on outcomes research. c. Government should be the only health care insurer. d. Health care should provide more balance by including preventive and community care. e. All people should have access to an all-inclusive package of health care.

A, B & D

Which questions will aid the nurse in planning culturally congruent care? (Select all that apply.) a. "What do smiles, nods, and hand gestures mean?" b. "How are you usually addressed?" c. "How many health care professionals have you seen?" d. "What is eaten when one is sick?" e. "Who is involved in making decisions about health care?"

A, B, D & E

. The purpose of continuous quality improvement (CQI) is to a. monitor processes involved in the provision of safe, effective care for patients. b. restructure hospital departments to initiate cost savings. c. provide an opportunity for staff members to participate in self-governance. d. deliver appropriate nursing care to patients.

ANS: A

An agency that provides inpatient care related to less complex conditions and does not require high-technology monitoring or complex diagnostic procedures is providing which level of care? a. Subacute care b. Primary care c. Secondary care d. Tertiary care

ANS: A

The nurse assists the patient with a bath in the morning because the patient has a cast on one hand and an intravenous line in the other. The nurse could be basing care on the philosophy of a. Henderson. b. Nightingale. c. Roy. d. Watson.

ANS: A

The nurse is caring for a young Hispanic patient after surgery. The patient hesitates when the nurse asks about meal selections from the menu. When the parents return, the nurse asks them what foods are eaten when one is ill. The nurse could be basing care on the theory of a. Leininger. b. Neuman. c. Orlando. d. Peplau.

ANS: A

The principles and values that govern actions directed at influencing and determining decisions, actions, and other matters are known as a. policy. b. politics. c. political power. d. power.

ANS: A

Which of the following is a characteristic of the team model of nursing care delivery? a. Each member of the team uses his or her abilities to the fullest in patient care. b. Communication among the team saves time, so the model is cost-efficient. c. Team nursing emphasizes holistic care for the patients and their families. d. This model increases continuity of care for the patients.

ANS: A

Which of the following is an example of health promotion and maintenance? a. Talking to a womens church group about having an annual mammogram b. Establishing an exercise program for postmenopausal women to reduce bone loss c. Providing colonoscopy examinations for high-risk individuals d. Talking to a state legislator about supporting a motorcycle helmet law

ANS: A

25. When a co-worker tells the nurse, I am not sure I will be able to give the right answers in the job interview, the nurse replies, I know what you mean. Interviews have always been a problem for me, too. This response can be evaluated as lacking a. appropriateness. b. efficiency. c. feedback. d. flexibility.

ANS: A Feedback A Appropriateness relates to whether the reply fits the circumstances and matches the message. The nurses response related to his own issue does not deal with the co-workers issue, which should be the focus of the interaction. B Efficiency means using simple, clear words that are timed at a pace suitable to the patient. C Feedback means the nurse seeks to clarify what the patient has said and gain understanding. D Flexibility means the message is based on the immediate situation and not preconceived expectations. DIF: Cognitive Level: Application REF: p. 178

38. Collaboration in health care settings involves a. professionals respected for their unique knowledge and abilities. b. professionals educated in a collaborative model of education. c. recognition of individual professional accomplishments. d. a multitiered system hierarchy.

ANS: A Feedback A Collaboration implies working jointly with other professionals, all of whom are respected for their unique knowledge and skills in the situation. B Currently most professionals are not educated in a collaborative model of education, although they are expected to work in collaboration. C In collaboration the accomplishments of the total group are recognized, not individuals. D Collaboration implies that everyone on the interdisciplinary team can make valuable contributions. DIF: Cognitive Level: Comprehension REF: p. 190

10. When should the preparation for the termination phase of the nurse-patient relationship begin? a. In the orientation phase b. During the working phase c. As part of the termination phase d. Right before termination

ANS: A Feedback A During the orientation phase, the nurse gives the patient an estimated time frame for their relationship. This begins the preparation for termination. B Preparation for termination of the nurse-patient relationship begins in the orientation phase. C Preparation for termination of the nurse-patient relationship begins in the orientation phase. D Preparation for termination of the nurse-patient relationship begins in the orientation phase. DIF: Cognitive Level: Knowledge REF: p. 171

33. Which of the following demonstrates giving information versus opinion? a. Mrs. Khan, lets practice together the breathing techniques you learned in Lamaze classes. That will help us to work together more effectively later when your labor is stronger. b. You learned breathing techniques in Lamaze classes. I really believe the breathing techniques make labor easier. c. Mrs. Khan, have you been practicing the breathing techniques you learned? It is very important to practice if you wish to use them effectively in labor. d. Using breathing techniques in labor is really to your benefit because you feel in control.

ANS: A Feedback A Saying Mrs. Khan, lets practice together the breathing techniques you learned in Lamaze classes. That will help us to work together more effectively later when your labor is stronger does not offer an opinion. B Saying You learned breathing techniques in Lamaze classes. I really believe the breathing techniques make labor easier offers the nurses opinion regarding the breathing techniques. C Saying Mrs. Khan, have you been practicing the breathing techniques you learned? It is very important to practice if you wish to use them effectively in labor offers the nurses opinion regarding the breathing techniques. D Saying Using breathing techniques in labor is really to your benefit because you feel in control offers the nurses opinion regarding the breathing techniques. DIF: Cognitive Level: Application REF: p. 181

36. A patient states, The harder I try to get along with my son, the more I feel he just wants to be left alone, and the nurse responds, I guess parents have to expect these problems as children get older. The nurses response is an example of a communication breakdown known as a. failing to see the uniqueness of the individual. b. failing to recognize levels of meaning. c. using value statements d. failing to clarify unclear messages.

ANS: A Feedback A The nurses response has put the patient into a group, parents, and therefore does not respond to the patient as a unique individual. B There is no meaning under the surface content in the patients remark. C There are no value statements in the nurses response. D The patients remark was not unclear. DIF: Cognitive Level: Application REF: p. 184

7. Which of the following suggests that a successful contract has been established between the nurse and patient in the orientation phase of the nurse-patient relationship? a. Patient has agreed to learn to change his colostomy bag. b. Patient ambulates in the hall without assistance. c. Patient allows the nurse to inject his daily insulin. d. Patient asks the charge nurse to verify that the staff nurses teaching is correct.

ANS: A Feedback A The successful completion of a planned intervention signifies the successful establishment of the therapeutic relationship. B The patient is acting independently of the nurses instructions. C The patient is not moving toward goals of independence. D Trust has not been established. DIF: Cognitive Level: Application REF: p. 171

21. A nurse is irrigating pressure ulcers on a patients coccyx. When the patient asks how they are healing, the nurse grimaces and says, Oh, theyre doing just fine. This is a. incongruence between verbal and nonverbal messages. b. a confirming statement. c. objectivity in responding to the question. d. the therapeutic use of humor.

ANS: A Feedback A The words say, Its OK, but the facial grimaces say it is not. B The verbal and nonverbal messages do not match. C Objectivity is not found in the statement. D There is no use of humor. DIF: Cognitive Level: Application REF: p. 176

2. Therapeutic use of self involves a. forming a relationship based on the nurses knowledge, attitudes, and skills to communicate effectively. b. providing a safe environment based on the use of environmental manipulation and verbal limit setting. c. evaluation of nurse-patient interactions and the creation of social alliances. d. determining whether it is necessary to listen to the patient and provide feedback.

ANS: A Feedback A Therapeutic use of self as defined by Peplau included using communication skills to help patients. B Therapeutic use of self does not involve the manipulation of the environment. C Therapeutic use of self does not involve the creation of social alliances. D Therapeutic use of self involves listening and providing feedback to the patient. DIF: Cognitive Level: Comprehension REF: p. 170

A specific organizational structure that makes clear connections between concepts is a a. conceptual model. b. metaparadigm. c. philosophy. d. theory.

ANS: A A conceptual model is a broadly defined concept in an organized system to provide a focus for the integration and interpretation of information.

Which nursing model is based on the assumption that people want to be in control of their lives? a. Orem b. King c. Roy d. Watson

ANS: A An underlying assumption of Orems model is that people want to be in control of their lives and to take care of themselves.--Self care

3. What is the most important information the nurse should share with the patient during the orientation phase? a. Name, credentials, extent of responsibility b. Plan for the day, times the nurse will be unavailable, how to contact the nurse c. Nurses name, physicians name, possible discharge date d. Plan for discharge, teaching needs, goals for the day

ANS: A Feedback A During the orientation phase the nurse shares his or her name, credentials, and extent of responsibilities. B Sharing information about the plan for the day, times the nurse will be unavailable and how to contact the nurse is not primary during the orientation phase. C Determining a discharge date would be the responsibility of the entire treatment team. D The nurse does not share the plan for discharge and teaching needs during the orientation phase. DIF: Cognitive Level: Knowledge REF: p. 170

9. Which research design has the goal of determining a cause-and-effect relationship? a. Experimental design b. Nonexperimental design c. Pure research d. Applied research

ANS: A Feedback A A true experimental design should prove a cause-and-effect relationship. B Nonexperimental studies do not necessarily include cause-and-effect controls. C Pure research is research conducted without regard for whether the information is immediately useful. D Applied research seeks to develop a practical use for research findings. DIF: Cognitive Level: Knowledge REF: pp. 230-231

15. What body has been established to protect participants of research? a. Institutional review board b. State board of nursing c. Nursing research board d. Peer review panel

ANS: A Feedback A An institutional review board has the purpose of protection of human subjects. B The state board of nursing has no jurisdiction over research. C The nursing research board is not a recognized entity. D The peer review process is not used to protect participants of research studies. DIF: Cognitive Level: Knowledge REF: p. 234

7. A nursing manager wants the unit staff to become more involved in research. The staff nurses say they are not qualified to conduct research. Which response by the manager is best? a. You need a basic understanding of the research process because you should be good consumers of research. b. At the staff nurse level, you can assist with clinical studies by doing data collection. c. A baccalaureate-prepared nurse should be able to design simple studies. d. If we all work on this together, we can design and implement good research studies.

ANS: A Feedback A Nurses at all levels of basic preparation become consumers of research when they enter practice, so they need a good understanding of the process. B Staff nurses might be asked to assist in data collection, but this option does not fully explain why they should be involved in research. C The masters-prepared nurse should be able to design replication studies. D Without the educational background that prepares a nurse to conduct research, even a team effort will probably not yield high quality studies. DIF: Cognitive Level: Application REF: p. 237

1. The discovery of oxygen would be called pure science because this information a. was obtained for the sake of obtaining new knowledge of the world. b. had an immediate use for humans. c. would be useful in curing, managing, or preventing disease. d. could direct further research at the bedside.

ANS: A Feedback A Pure science or pure research summarizes and explains the world without regard to whether this information is immediately useful. B Pure science does not address the immediate use of the information or its relationship to diseases or bedside research. C Pure science does not address the immediate use of the information or its relationship to diseases or bedside research. D Pure science does not address the immediate use of the information or its relationship to diseases or bedside research. DIF: Cognitive Level: Comprehension REF: p. 223

A nurse who advocates for a longer stay when a medically indigent patient is being prematurely discharged to reduce hospital cost is relying on which ethical principle? a. Justice b. Beneficence c. Autonomy d. Fidelity

ANS: A Feedback A "Justice" refers to the equal and fair allocation of services based on need. According to this principle, the patient should receive the same care as others in the same condition, regardless of ability to pay. B "Beneficence" simply refers to doing good. C Autonomy asserts that individuals have the right to make their own decisions. D "Fidelity" is an incomplete answer, because fidelity refers to faithfulness or honoring one's promises to patients.

A school nurse teaching school-aged children about water safety is an example of which ethical principle? a. Beneficence b. Justice c. Veracity d. Autonomy

ANS: A Feedback A Beneficence can be seen as "the doing of good." B "Justice" refers to the equal treatment of all. C Veracity is truth telling. D "Autonomy" refers to an individual's right to make his or her own decisions.

The quality of nursing care is judged by whether nursing actions meet the standard of care. Which of the following is an example of meeting the standard of care? a. Demonstrating the use of the nursing process when charting b. Following actions consistent with local practice c. Monitoring a patient more closely if the equipment has occasionally malfunctioned d. Bypassing medication checks to save time once the nurse is experienced

ANS: A Feedback A Charting that includes assessment, planning, intervention, and evaluation must be present in the patient's record. B National, not local, standards of practice should be used. C Nurses must use equipment properly and replace it when it is malfunctioning. D Proper medication safety checks are the standard of practice for all nurses, including those with experience.

Which of the following ethical theories is illustrated by the example of following the Golden Rule, "Do unto others as you wish them to do unto you"? a. Deontology b. Principlism c. Utilitarianism d. Virtue ethics

ANS: A Feedback A Deontology states that an act is moral if it originates from good will. B Principlism is the use of ethical principles in decision making. C Decisions are made based on what will do the greatest good for the greatest number of people. A main tenet of utilitarian ethics is that right or useful actions bring about the greatest good for the greatest number of people. D Virtue ethics refers to character traits of the decision maker, such as honesty, courage, kindness, and integrity.

Which of the following actions is acceptable as an exception to a nurse's obligation regarding confidentiality? a. Reporting certain diseases to public health authority b. Discussing a patient's care with someone who does not know the patient c. Leaving printouts of lab reports on the desk in the physicians' lounge as a convenience d. Discussing a patient's condition in a public place as long as the patient's name is not mentioned

ANS: A Feedback A Exceptions to confidentiality include reporting certain diseases to the appropriate public health authority. B It is inappropriate to discuss a patient with anyone outside of the treatment team. C Patient records must be kept private at all times. D Even if the patient's name is not mentioned, discussing a patient in public is a violation of privacy because someone listening may be able to determine the patient's identity from the discussion.

According to Kohlberg's theory of moral development, adolescents who shoplift are operating in which level of moral development? a. Preconventional b. Conventional c. Postconventional d. Developmental

ANS: A Feedback A In Kohlberg's preconventional level of moral development, the individual is inattentive to the norms of society and is self-centered. B In the conventional level, moral decisions conform to the norms of society. C In the postconventional level, the individual has a highly developed moral value system independent of group norms. D "Developmental" is not a level of moral development identified by Kohlberg.

A contributing factor to health care disparities may be a. genetic factors. b. provider bias. c. standard treatment options. d. diagnostic differences.

ANS: B

A nurse has been introduced to theory as a guide to research and practice. This nurse is prepared at which level of nursing education? a. Associate degree b. Bachelors degree c. Masters degree d. Doctoral degree

ANS: B

According to Kohlberg's theory, which of the following is true of moral development? a. Participating in decision making promotes moral reasoning. b. Intellectual development has no effect on moral development. c. Participating in debates on ethical issues decreases moral development. d. Holding people responsible for their actions does not improve moral development.

ANS: A Feedback A Kohlberg thought that certain conditions promote moral development, such as participating in decision making. B Kohlberg thought that intellectual development was necessary for advanced moral development. C Participating in debates on ethical issues does enhance moral development. D Taking responsibility for actions promotes moral development.

The nurse practice act of a state defines the scope and responsibilities of nursing practice in that state. Which of the following is true regarding nurse practice acts? a. They determine the educational requirements for licensure. b. They describe the process for gaining membership to a professional organization. c. They regulate how many professional nursing organizations may be formed. d. They define the practice of medicine in relation to nursing.

ANS: A Feedback A Nurse practice acts define the minimum educational qualifications and other requirements for licensure. B Nurse practice acts do not describe the process for admission to the state board of nursing. C Nurse practice acts do not regulate nursing organizations. D Nurse practice acts have no authority over medical practice issues.

A child is tested for genetic abnormalities. After the test results are delivered from the laboratory, a representative of the parents' medical insurance company calls the nurse's station and asks for the results of the tests. The nurse's best response to this request is to a. refuse to give the information. b. tell the representative the status of the tests is unknown. c. give the results as reported because the insurance company is paying for the tests. d. tell the representative that the test results will need to be obtained from the physician who ordered them.

ANS: A Feedback A On the basis of HIPAA guidelines, this information is for the patient and health care providers. B Nurses should not provide false information. C Giving the test results to the insurance company would violate the HIPAA guidelines. D Nurses should not provide false information.

Which of the following is believed about the concept of locus of control? a. Internally controlled people see themselves as responsible for their health and amenable to change. b. Externally controlled people believe health is controlled by what they do. c. Internally controlled people believe health is controlled by environmental factors. d. Externally controlled people are not likely to change their health behaviors.

ANS: A Feedback A People with internal locus of control believe that they control their health and have the ability to change their behaviors. B Externally controlled people believe they are controlled by external forces. C Internally controlled people believe that they control health. D Externally controlled people can change health behaviors, but the stimulus to do so will come from outside of themselves.

Which of the following falls under the jurisdiction of the state board of nursing? a. Approving or reject applications for new nursing education programs b. Expanding the provisions of the nurse practice act c. Reducing the provisions of the nurse practice act d. Right to suspend the need for licensure of registered nurses (RNs) in times of extreme shortage

ANS: A Feedback A Schools of nursing must have state approval from the state board of nursing to operate. B The state board of nursing can enforce the nurse practice act but cannot expand it. C The state board of nursing can enforce the nurse practice act but cannot reduce it. D The state board of nursing does not have the authority to suspend the licensure requirement for any reason.

Which of the following situations is an example of moral distress? a. You hear nurses in the lounge making off-color jokes about a patient. You are afraid to speak up for fear of retaliation. b. You have been late for work a couple of times in the last 2 weeks, and your co-workers are covering for you. c. You become romantically involved with a co-worker, which is against the unit policy, so you resign your position. d. You purposefully use vague language when explaining a patient's condition to the family. Staff expects that the patient may be brain-dead, but test results are not yet conclusive.

ANS: A Feedback A The definition of "moral distress" is distress that results from participating in a perceived moral wrongdoing due to situational constraints despite attempting to make a moral choice. B There is no breach of ethics in being late and having co-workers cover for you. C The person acts appropriately to the moral issue by resigning the position. D The person is acting appropriately under current circumstances.

A nurse is caring for a new mother from Southeast Asia. The nurse is concerned that except for breastfeeding, the mother allows her mother-in-law to provide all other care for the baby. The plan of care and patient teaching for this mother should include a. assessing the postpartum practices in her country of origin. b. assuming that the mother-in-law will care for the baby well since she is experienced. c. completing the teaching outlined for new mothers. d. asking the mother-in-law not to care for the baby so that the mother learns the care.

ANS: A Feedback A The information gained will assist the nurse to plan an individualized plan of care, including cultural beliefs. B The nurse does not know how long the mother-in-law will care for the baby and what this means for the future. C Completing the routine teaching may not be appropriate for this mother. D Asking the mother-in-law not to care for the baby may be in opposition to their cultural beliefs.

Analysis of cases of reported negligence from 1995 to 2001 demonstrated that the majority of cases occurred in which patient care setting? a. Acute care b. Psychiatric c. Nursing homes and long-term care facilities d. Home health

ANS: A Feedback A The majority of negligence cases (60%) occurred in acute care settings. B Psychiatric settings accounted for only 8% of the cases of negligence. C Nursing homes accounted for 18% of the cases of negligence. D Home health settings accounted for only 2% of the cases of negligence.

Family structures have experienced change in the second half of the 20th century. What is the most dramatic difference seen in families today? a. Increased incidence of single-parent families b. Reemergence of large, extended families c. Increased incidence of nuclear families d. Nuclear families moving closer to extended families

ANS: A Feedback A There are more single-parent families in the United States than ever before, and most are headed by women. B With increased mobility, large extended families are decreasing. C The number of nuclear families is also decreasing. D Nuclear families are moving away from extended families.

4. A nurse wants to examine the accuracy of child and parent perceptions of asthma symptoms and their decision making based on their understanding of the symptoms. What specific factors would identify participants? (Select all that apply.) a. Children 5 to 18 years of age b. Mothers of the children c. Children with a history of pneumonia d. Families living in rural areas e. Ethnicity

ANS: A, B Feedback Correct Children 5 to 18 years of age and their mothers address the participants identified in the problem. Incorrect There is no mention that the children needed to have had pneumonia. Although a researcher could limit participants based on geographic location and ethnicity, these are not mentioned in the description of the participants needed for this study. DIF: Cognitive Level: Application REF: p. 234

To whom does the nurse provide information when working in the role of educator? (Select all that apply.) a. Families about illnesses and treatments b. Community groups about injury prevention c. Student nurses about nursing standards and ideals d. Health care team members about the patient e. Physician assistants about invasive procedures

ANS: A, B, C, D

The nurse receives reports on the following patients at the beginning of the shift. Which of the following care activities could be delegated to a nursing assistant? (Select all that apply.) a. Ambulating a patient who had an emergency appendectomy 8 hours ago, has stable vital signs, and needs to ambulate for the second time b. Assisting a patient who was in an automobile accident and whose right arm and leg are in traction with bathing c. Feeding a patient recovering from a stroke resulting in difficulty holding a spoon d. Taking vital signs, including blood pressure, for a patient with newly diagnosed diabetes and a history of hypertension e. Measuring a bed-bound patient's pressure ulcer and assessing the patient's risk for skin breakdown when turning the patient

ANS: A, B, C, D Feedback Correct - Nursing assistants can assist with hygiene and activities of daily living, especially for patients in stable conditions. Incorrect - UAP cannot interpret data or assess patients, because assessment is part of the nursing process.

How can staff nurses play an important role in controlling health care costs? (Select all that apply.) a. Becoming aware of cost of supplies b. Questioning the need for unnecessary or repetitive tests c. Suggesting the use of brand-name medications to support the economy d. Handwashing to prevent infections e. Assuring that the payment method is identified on admission

ANS: A, B, D

The American Nurses Association (ANA) published a guide for state nurses associations seeking to revise their nurse practice acts. According the ANA, which of the following should be included in these revisions? (Select all that apply.) a. Differentiation between advanced and generalist nursing practice b. Authority for boards of nursing to oversee UAP c. Specified frequency of revisions to the nurse practice acts d. Authority for boards of nursing to regulate prescription writing by advanced practice nurses e. Nurses' responsibility for delegating to LPN/LVNs

ANS: A, B, D, E Feedback Correct - "Differentiation between advanced and generalist nursing practice," "authority for boards of nursing to oversee UAP," "specified frequency of revisions to the nurse practice acts," "authority for boards of nursing to regulate prescription writing by advanced practice nurses" and "nurses' responsibility for delegating to LPN/LVNs" are identified in the ANA's Model Practice Act published in 1996. Incorrect - The frequency of revision for the nurse practice acts is not addressed.

A variety of benefits result from membership in professional organizations, including (Select all that apply.) a. availability of practice guidelines to influence policy development. b. discount on licensure fees. c. continuing education opportunities. d. opportunities to develop personal leadership skills. e. increased pay and prestige in the work setting.

ANS: A, C, D

Which of the following areas experience serious disparities in health care access and outcomes for minorities? (Select all that apply.) a. Infant mortality b. Arthritis c. Cardiovascular disease d. Oral health e. Immunizations

ANS: A, C, E

MULTIPLE RESPONSE 1. Which behaviors foster active listening? (Select all that apply.) a. Encouraging the speaker by saying, Tell me more b. Limiting verbal ventilation because it is not focused c. Sitting in an open posture such as leaning forward d. Engagement in a task e. Good eye contact at eye level and nodding of the head

ANS: A, C, E Feedback Correct Active listening is a method of communicating interest and attention. Encouraging the speaker, using an open posture, eye contact, and nodding the head all communicate interest and attention. Incorrect Limiting verbal expression is likely to decrease the sharing of information by the patient. A task may serve as a distraction for the nurse and patient and may limit active listening. DIF: Cognitive Level: Comprehension REF: p. 180

3. Evidence-based nursing practice involves which of the following? (Select all that apply.) a. The use of the best evidence available supporting the interventions b. The use of randomized controlled trials only versus qualitative studies c. The expertise of the professional nurse d. Resources to identify practices that have traditionally been used in nursing practice e. The preferences of the individual patients and their families

ANS: A, C, E Feedback Correct Focusing on the evidence of the effectiveness of the intervention prevents the nurse from basing care on tradition or routine. Expertise of the nurse allows the nurse to question the best way to do something and to seek information to answer the question. Patient preference is still important if the intervention is to be successful. Incorrect Randomized controlled trials may be the gold standard for providing evidence of effectiveness, but they are not the only method to study patient problems. Resources should be used to find the best evidence to support nursing practice, not what nurses have done traditionally. DIF: Cognitive Level: Comprehension REF: p. 227

The central question in any charge of malpractice is whether the prevailing standard of care was met. Which of the following are considered part of the standard of nursing care? (Select all that apply.) a. Basic prudent nursing care is a standard. b. Health care providers determine standards of care in health care settings. c. Standards of care are never changing. d. Standards are based on the ethical principle of nonmaleficence. e. National standards of nursing practice are standards for all nurses.

ANS: A, D, E Feedback Correct - The standard of care reflects a basic minimum level of prudent care for the nurse based on the ethical principle of nonmaleficence or "to do no harm," and the national standards of nursing relevant to the situation at that time. Incorrect - Nurses, not other health care providers, are responsible for determining whether the standard of nursing care was met. As nursing practice develops, the standards of care change accordingly.

A nurse has held a media event to publicize the need for funding for immunizations and lobbied decision makers by providing pertinent statistical information about the risks and benefits of immunizations. The nurse is known as a a. nurse citizen. b. nurse activist. c. nurse politician. d. nurse clinician.

ANS: B

A nurse is contemplating a political leadership position and wonders if she/he has the desired characteristics to make a good leader. Which of the following traits is inconsistent with a good leader? a. Has a developed sense of systems thinking b. Solves problems methodically using a strict model c. Holds high moral and ethical standards d. Adapts quickly to new situations

ANS: B

A nursing case manager requests a meeting with the nursing staff after discovering variances from critical pathways related to timely discharge of patients having hip replacement. Patients are not being discharged on time because they are refusing their physical therapy as a result of poor pain control. Meeting with the staff to discuss potential improvements in pain management is an example of a. performance improvement. b. continuous quality improvement. c. team building. d. Joint Commission compliance.

ANS: B

An impact of health care cost-containment measures on nursing has been a. adding more registered nurses to the skill mix of the nursing team. b. the concern about the assurance of quality care. c. large annual salary increases for nurses. d. development of standards of nursing practice

ANS: B

An overriding principle of Nightingales writings on nursing dealt with which aspect of nursing? a. The relationship between nurses, physicians, and society b. The relationship between patients, health, and environment c. The relationship between illness and health practices d. The relationship between hospitals, nurses, and patients

ANS: B

Health promotion differs from illness prevention in that health promotion a. addresses identified health problems. b. occurs before the identification of disease risk factors. c. identifies and ameliorates a health problem. d. returns an individual to optimal functioning after an illness.

ANS: B

The area of philosophy that deals with the regulation and control of people living in society to preserve prosperity, defend rights, and augment resources is known as a. policy. b. politics. c. political power. d. power.

ANS: B

The most critical aspect of nurses becoming personally political is a. financially supporting political action committees (PACs). b. being informed of social and political issues. c. communicating with legislators. d. running for office.

ANS: B

The nurse adjusts the patients room to allow the patient to see the sunlight out the window and checks the patients diet tray to ensure a balanced diet. The nurse could be basing care on the philosophy of a. Henderson. b. Nightingale. c. Roy. d. Watson.

ANS: B

The nurse has established a relationship with a patient in whom asthma was recently diagnosed. Through their interactions, the nurse helps the patient understand the mechanism of asthma and develop the skills to use a spacer with the inhaler. The nurse could be basing care on the theory of a. Leininger. b. Peplau. c. Orlando. d. Neuman.

ANS: B

What service is covered by Medicare, part D? a. Home health care b. Prescription drug costs c. Inpatient hospital stays d. Physician office visits

ANS: B

Which contemporary nursing theorist is best known for her definition of nursing that describes the nurses role as a substitute for the patient and as a helper and partner to the patient? a. Orem b. Henderson c. Watson d. King

ANS: B

Which contemporary theorist is best known for her emphasis on the caring aspect of nursing? a. Orem b. Watson c. Henderson d. King

ANS: B

Which of the following best describes the meaning of the term theory? a. A set of beliefs about the nature of how things work and how the world should be viewed b. A group of related concepts, definitions, and statements that describe a certain view of nursing phenomena from which to describe or predict outcomes c. An organizational structure that outlines concrete connections between concepts d. Statements that describe linkages between concepts and propose a testable outcome

ANS: B

Which of the following patients is likely to benefit most from referral for case management? a. Child injured in a playground accident b. Elderly patient with total hip replacement c. A 49-year-old man in the emergency department with chest pain d. A 20-year-old with appendectomy

ANS: B

18. Using Hagerty and Patuskys theory of human relatedness (2003), the nurse-patient relationship has been reconceptualized by approaching a. each patient contact as one step in a lengthy relationship-building process. b. patients with a sense of the patients autonomy, choice, and participation. c. the relationship as one in which the nurse has the power. d. the nurse-patient contact as an opportunity to streamline caregiving.

ANS: B Feedback A Each contact should be approached as an opportunity for connection and goal achievement and not a lengthy process. B The relationship between the nurse and the patient is on a more equitable basis than the traditional nurse-patient relationship. C The relationship should be equitable. D The reconceptualization does not streamline caregiving. DIF: Cognitive Level: Comprehension REF: p. 175

22. Context is one of the five major elements of communication identified by Ruesch. Which of the following is part of the context of communication? a. Information about the sender b. Attitude of the receiver c. Response of the receiver d. Content of the message

ANS: B Feedback A Information about the sender is not part of the context of the communication. B Context refers to the environment in which the interaction occurs. This includes the mood and the relationship between the sender and receiver. C The response of the receiver is not part of the context of communication. D The content of the message is not part of the context of communication. DIF: Cognitive Level: Comprehension REF: p. 177

The nurse is caring for a postoperative patient who is unable to feed himself and complete basic activities of daily living. The nurse does catheter care and changes the surgical dressing, as well as assisting with feeding and hygiene. The nurse could be basing care on the conceptual model of a. Johnson. b. King. c. Orem. d. Roy.

ANS: C

23. A new mother says to the nurse, It really hurts me to breastfeed. I think I should wean my baby. The most appropriate response by the nurse is, a. It is good to wean the baby early because it is easier on you. b. If I understand you, it hurts when you breastfeed. Tell me how and when it hurts. c. It is your decision to make whether you breastfeed. d. You should continue to breastfeed because it is much better for the baby.

ANS: B Feedback A Saying It is good to wean the baby early because it is easier on you gives a response before the situation is clarified and closes off continued communication. B The nurse is gaining feedback that helps the nurse understand more about the situation from the patients perspective and keeps communication open. C Saying It is your decision to make whether you breastfeed gives a response before the situation is clarified and closes off continued communication. D Saying You should continue to breastfeed because it is much better for the baby gives a response before the situation is clarified and closes off continued communication. DIF: Cognitive Level: Application REF: p. 178

28. A 4-year-old child is going to have an abdominal x-ray examination. The child asks, Why do they have to do this? Will it hurt? Which of the following is the most appropriate response by the nurse? a. The doctor needs you to have the x-ray so she knows what is wrong with you. b. You will go to the x-ray department so they can take pictures of your tummy to find out why you have a tummy ache. The bed you lie on may be cool, but you will have a blanket to keep you warm. The test will not hurt. c. You will go downstairs on a stretcher. You will need to lie very still on a hard table while the x-ray machine goes over you. It will not take very long. d. X-rays do not hurt. The machine takes a picture but will not touch you.

ANS: B Feedback A Telling the child that he will need an x-ray to determine what is wrong with him does not provide a clear explanation that addresses the childs concerns. B The nurses response explains the procedure in clear and simple words that are suitable to a 4-year-old child. C Explaining the x-ray procedure in terms that may not be easy to understand for a 4-year-old does not provide a clear explanation that addresses the childs concerns. D Telling the child that x-rays do not hurt and that they take pictures does not provide a clear explanation that addresses the childs concerns. DIF: Cognitive Level: Application REF: p. 179

6. The nurse says to a newly diagnosed diabetic patient, I will be working with you during your 3-day stay to help you practice insulin injections and to review your new diet. Im wondering if we could find a time of day to begin the teaching sessions that is good for us. This conversation would occur in which phase of the nurse-patient relationship? a. Acquaintance phase b. Orientation phase c. Working phase d. Termination phase

ANS: B Feedback A The phases of the nurse-patient relationship do not include an acquaintance phase. B During the orientation phase the time frame of the relationship is established, the problems to be worked on are identified, and a time to meet is established. C The working phase is when the nurse and patient address the problems. D The termination phase is when the relationship is ending. DIF: Cognitive Level: Application REF: p. 170

13. Which of the following is an effective way to maintain safe professional boundaries? a. Never accepting small gifts from patients b. Finding ways to satisfy your needs through personal relationships outside of nursing c. Avoiding caring for patients who ask personal questions about you d. Sharing your personal stories so that patients will feel understood and trusting

ANS: B Feedback A There are many other possibilities for violating professional boundaries; gifts are only one small way and, on occasions when the gift is not valuable and can be shared with the entire staff, may be accepted. B Respecting professional boundaries means that the nurse recognizes the vulnerability of the patient and the power that comes from the nurses personal knowledge about the patient. Finding ways to satisfy personal needs outside of the professional relationship will prevent the nurse from becoming inappropriately involved with the patient. C Avoidance is not a helpful response to any nurse-patient problem. D The nurse should stay focused on the patient. DIF: Cognitive Level: Comprehension REF: p. 172

35. Within nurse-patient communication, the use of silence can a. block further therapeutic communication. b. allow the patient to not feel pressured to provide information. c. demonstrate trust. d. provide the nurse with an opportunity to complete the patients care.

ANS: B Feedback A Using silence actually encourages communication because it allows the patient to organize his or her thoughts. B Using silence means allowing periods of quiet thought during the nurse-patient interaction when the patient does not feel pressure to provide conversation. C Using silence does not relate to trust. D Using silence is not a requirement for completing patient care. DIF: Cognitive Level: Comprehension REF: p. 182

Which component of nursing theory describes a testable outcome? a. Conceptual model b. Proposition c. Framework d. Metaparadigm

ANS: B A proposition describes an outcome that is testable in research or practice.

11. Which research design should be used to determine whether there is a difference in the effectiveness of two preoperative preparation methods on length of stay? a. Survey design b. Experimental design c. Nonexperimental design d. Descriptive comparison design

ANS: B Feedback A A survey design will describe but not address differences. B Experimental designs will allow the researcher to look for differences between the outcomes of the two different preparation methods. C Nonexperimental designs will not allow the researcher to answer questions about differences between groups. D As a nonexperimental design, it addresses relationships among variables in groups. DIF: Cognitive Level: Comprehension REF: pp. 230-231

3. To build the body of knowledge of nursing, a problem amenable to study should be a. able to ensure participants that the intervention is a good idea. b. based on published research findings and fit logically with what is already known. c. an original area of study never researched previously. d. able to produce results that are applicable to a variety of situations.

ANS: B Feedback A An intervention being a good idea does not mean it will build the body of knowledge unless it relates to what we already know. B To build a body of knowledge, one needs to extend what one already knows. C Although original research is excellent, to build the body of knowledge, the foundational work must be expanded. D Not all problems occur in a variety of settings. DIF: Cognitive Level: Comprehension REF: p. 225

The nurse observes a patient pacing around the room. The patient expresses concern that being hospitalized will cause lost wages and create economic problems. The nurse infers that the patient is anxious, which the patient confirms. The nurse could be basing care on the theory of a. Leininger b. Neuman c. Orlando d. Peplau

ANS: C

10. Which research design would be used to determine the relationship between self-concept, physical fitness, and health habits in school-aged children? a. Experimental design b. Nonexperimental design c. Applied research design d. Pretest and posttest design

ANS: B Feedback A Experimental designs look for differences between groups on certain variables. B Nonexperimental designs will allow the researcher to look for relationships among the variables and are described as descriptive or exploratory. C Designs used in applied research take various forms, including experimental and nonexperimental. D An experimental design addresses differences, not relationships. DIF: Cognitive Level: Comprehension REF: pp. 230-231

16. What is the current name of the agency that serves as an important source of funding for nursing research? a. NIH b. National Institute of Nursing Research c. National Center for Nursing Research d. National Nursing Research Agenda

ANS: B Feedback A The National Institute of Nursing Research is the part of the NIH charged with nursing research. B The name of the agency that primarily funds nursing research is the National Institute of Nursing Research. C The National Center for Nursing Research was the original name for the National Institute of Nursing Research before 1992. D The National Nursing Research Agenda determines priorities for funding of nursing research but does not directly fund nursing research. DIF: Cognitive Level: Knowledge REF: p. 225

A nurse practitioner caring for a diabetic patient thinks the patient could gain better control of the diabetes if the patient lost weight. After assessing the patients perception of weight loss, role, stresses, and support systems, the nurse and patient establish the goal of losing 5 pounds in a month. The nurse could be basing care on the conceptual model of a. Johnson. b. King. c. Orem. d. Roy.

ANS: B King focused on goal attainment for and by the patient. Kings interacting systems form a framework to view whole persons in their family and social contexts.

Respecting the right of a patient with terminal cancer to refuse chemotherapy is based on a belief in the ethical principle of a. justice. b. autonomy. c. nonmaleficence. d. death with dignity.

ANS: B Feedback A "Justice" refers to the equality of the allocation of services. B Autonomy is based on the principle that patients have the right to determine their own course of action. C "Nonmaleficence" refers to the responsibility to do no harm. D Death with dignity is not an ethical principle.

Which of the following chart entries represents a pitfall in documentation? a. Restless and combative; SaO2 87% b. Patient demanding and difficult to please c. Discovered in bathroom; instructed to ask for assistance before ambulating d. Three-centimeter area of serosanguineous drainage noted on the dressing to the left hip

ANS: B Feedback A "Restless and combative; SaO2 87%" is an acceptable chart entry. B The chart entry is subjective and nonspecific. It also contains judgments about the patient which could be interpreted as bias. C "Discovered in bathroom; instructed to ask for assistance before ambulating" is an acceptable chart entry; it is accurate and concise. D "Three-centimeter area of serosanguineous drainage noted on the dressing to the left hip" is complete, accurate, and concise.

The nurse is interviewing the mother of a school-aged child. The mother states that their family consists of herself, her son, a female friend, and two foster children. One grandparent lives in another city, and one lives within two blocks of them. As the nurse works with this family, what implication is important to include? a. As a single parent, the mother has multiple roles to fill and will become stressed. b. As an extended family, all the children will receive attention from several adults. c. This child will lack male attention because he lives in a single-parent family. d. The quality of family life will be influenced because they are not a traditional family.

ANS: B Feedback A Although the mother does have multiple roles to fill, she seems to have a support system to help her manage her multiple roles successfully. B The children live in a household with two adults and have a grandparent within two blocks. C There is nothing to indicate that the children will not have a male presence, especially if the grandparents are men. D Quality of family life can be achieved in a variety of family structures.

Which of the following describes one of the five levels of human needs identified by Maslow? a. Equilibration b. Love and belonging c. Growth and development d. Adaptation

ANS: B Feedback A Equilibration is a stage of Carl Rogers's theory of personhood. B Love and belonging is the third level of Maslow's basic needs theory. C Growth and development is not a level of human needs according to Maslow. D Adaptation is from Carl Rogers's theory of personhood.

The RN delegates changing a sterile dressing over a central line to a licensed practical/vocational nurse (LPN/LVN). The LPN/LVN contaminated the site during the dressing change, and an infection developed in the patient. Which of the following statements is true? a. The LPN/LVN is guilty of malpractice. b. The RN is ultimately responsible for acts he or she delegates. c. The hospital cannot be held responsible for the acts of its employees. d. A malpractice suit cannot be brought as no harm came to the patient.

ANS: B Feedback A Guilt has to be determined in a court of law. The LPN/LVN can be held responsible for actions in relation to the LPN/LVN scope of practice in the state. B The RN is responsible for tasks delegated to both licensed and unlicensed personnel. C The hospital can be held responsible for employees not correctly following policies related to the standards of quality care. D The patient was harmed.

An 18-month-old child has been in three foster homes within the past 9 months. When the child is seen for a well-child visit, the nurse notices the child vigilantly watches everyone. This child may not have which of Maslow's basic needs met? a. Basic physiologic needs b. Safety needs c. Love and belonging needs d. Self-actualization

ANS: B Feedback A Maslow identified the first level of needs as those necessary for physiologic survival. The child appears to have these needs met. B Maslow identified the second level of needs as safety needs, which include physical and psychological safety, as well as security. The child does not appear to have these needs met. C Maslow identified the third level of needs as love and belonging. The safety needs must be met before a person attempts to meet higher level needs. D Maslow identified the fifth level of needs as self-actualization. The safety needs must be met before a person attempts to meet higher level needs.

A school-aged child with spina bifida uses a wheelchair, attends school, and is actively involved in Scouting and science club. This child is meeting which of Maslow's basic needs? a. Safety needs b. Love and belonging needs c. Esteem needs d. Self-actualization

ANS: B Feedback A Maslow identified the second level of needs as safety needs, which include physical and psychological safety, as well as security. B Maslow identified the third level of needs as love and belonging. This child has demonstrated the social relationships and group affiliations. C Maslow identified the fourth level of needs as the need for self-esteem. Lower order needs need to be fulfilled before meeting higher order needs. D Maslow identified the fifth level of needs as self-actualization. Lower order needs need to be fulfilled before meeting higher order needs.

Dynamic balance between systems and their parts is called a. synergy. b. homeostasis. c. inertia. d. suprasystems.

ANS: B Feedback A Synergy occurs when all parts of the system are working collaboratively. B The dynamic balance within and between open systems and their suprasystems is homeostasis. C "Inertia" is a term in physics that describes the tendency of matter to continue in its current state, whether moving or resting. D Suprasystems are the system and all of its subsystems.

What is the primary function of the National Council of State Boards of Nursing (NCSBN)? a. Overseeing decisions made by state boards of nursing b. Developing the NCLEX-RN® and NCLEX-PN® licensing examinations c. Administering the NCLEX examination at testing centers d. Overseeing granting licensure by endorsement

ANS: B Feedback A The NCSBN does not have the authority to oversee state boards of nursing. B The NCSBN develops the test plan and items for the NCLEX examination. C States, not the NCSBN, administer the NCLEX examination. D State boards of nursing, not the NCSBN, grant licensure through endorsement.

A nurse is assessing a patient's level of social support. How can the nurse best determine the adequacy of the patient's social support system? a. Noticing the number of visitors the patient has b. Asking for the patient's perception of support c. Counting the number of community groups with which the patient is involved d. Assessing the patient's family structure and roles

ANS: B Feedback A The adequacy of support can be determined only by the person himself or herself. Numbers alone do not indicate support or lack of support. B The adequacy of support can be determined only by the person himself or herself. C The number of community groups with which the patient is associated is not the best way to determine the patient's support. D Assessing family structure and roles will provide helpful information but is not the best way to assess the adequacy of the patient's support system.

A nurse is involved in an ethically challenging case. To use an ethical decision-making model, which step should the nurse perform first? a. Gather and examine all possible solutions. b. Identify the ethical dilemma in the case. c. Identify all parties who will be impacted by the decision. d. Gather all information important to the situation

ANS: B Feedback A The first step in many ethical decision-making models is to identify the ethical dilemma. Examining all possible solutions comes after this step and gathering information. B The first step in many ethical decision-making models is to identify the ethical dilemma. C The first step in many ethical decision-making models is to identify the ethical dilemma. Identifying parties affected is not a specific step but is part of identifying the dilemma. D The first step in many ethical decision-making models is to identify the ethical dilemma. The next step would be to gather all data related to the situation.

In which of the following situations should the legality of an informed consent be questioned? a. Patient with dementia; consent given by spouse b. Patient who received a preoperative dose of Demerol before giving consent c. Patient who is anxious and asks many questions of the physician d. Patient who expresses concern about the cost of the procedure

ANS: B Feedback A When the patient is incompetent, a spouse may give informed consent. B Patients cannot be sedated or impaired and legally give informed consent. C Patients have a right to ask questions of the health care team. D Questioning the cost does not negate the legality of the informed consent.

2. Which of the following are examples of open-ended questions? (Select all that apply.) a. Ms. Goode, did you have a productive therapy session? b. How are you? c. How do you feel about staying with your daughter? d. What would you like to discuss today while we take a walk? e. Are you having that problem with arthritis in your hand again?

ANS: B, C, D Feedback Correct The questions How are you? How do you feel about staying with your daughter? and What would you like to discuss today while we take a walk? require the patient to answer by providing data and not just a yes or no answer. Incorrect The statements Ms. Goode, did you have a productive therapy session?and Are you having that problem with arthritis in your hand again? do not require more than yes or no answers. DIF: Cognitive Level: Analysis REF: p. 181

Which of the following are activities in the ethical decision making process? (Select all that apply.) a. Avoid looking at legal cases or precedents related to the situation. b. Determine if the people who are affected by the dilemma have value conflicts. c. Brainstorm with others involved to identify all possible solutions. d. Evaluate the action taken to determine whether it accomplished its purpose. e. Discuss only acceptable solutions that are practical to implement.

ANS: B, C, D Feedback Correct - Determining who is affected by the dilemma and identifying possible value conflicts among them, identifying all possible solutions, and evaluating the action taken to determine whether it accomplished its purpose clarify the situation and determine whether the selected action achieved its goal. Incorrect - A variety of materials including legal documents may help clarify the situation or help identify possible actions. Ethical decision making is not done in isolation. It may involve others but especially must involve the patient and family. All possible solutions should be considered even if they are unusual, complex, or may be difficult to implement.

Governmental agencies differ from voluntary agencies in which way? a. Level of community served b. Administrative structure c. Funding source d. How the profits are used

ANS: C

The care delivery model in which a registered nurse provides direct care and also has 24-hour responsibility for updating the patients plan of care is known as a. functional care. b. team nursing. c. primary care. d. case management.

ANS: C

What is the relevance of the concepts of supply and demand, free market, and price sensitivity with regard to health care costs? a. The undersupply of available health care has driven up costs. b. In a free market, increased numbers of people are able to pay for health care. c. Consumer insensitivity to costs has increased demand for health care services. d. Third-party payers have demanded more health care services.

ANS: C

Which care delivery model uses critical pathways and continuous quality improvement to guide care practices? a. Managed care b. Primary care c. Case management d. Care redesign

ANS: C

Which of the following is a characteristic of the patient-centered care model of nursing care delivery? a. It is easily explained to patients because it is based on traditional models of nursing care. b. Communication among team members is not required to make the model work. c. A multidisciplinary team emphasizes continuum of care and focuses on the patients right to individualized care. d. It decreases the number of registered nurses required to provide care.

ANS: C

Which of the following is a responsibility of many health care agencies chief executive officers (CEOs)? a. Managing the budgets of each department in the agency b. Recruiting and hiring of staff c. Overall operation of the agency on a daily basis d. Establishing policies governing the operation for the agency

ANS: C

Which of the following is an example of rehabilitation and disease management? a. Prompt treatment for hypertension b. Attending weight loss classes c. Teaching patients with newly diagnosed diabetes the signs of hypoglycemia and hyperglycemia d. Taking an antibiotic for a sinus infection

ANS: C

Which of the following is not included as an overarching goal of Healthy People 2020? a. Eliminating health disparities b. Creating environments that promote good health c. Lengthening the average lifespan by a decade d. Attaining longer lives free of preventable diseases and injury

ANS: C

5. Which behaviors help patients develop trust in the nurse? a. Answering questions with authority b. Sharing personal information to indicate openness c. Conveying acceptance of the patient and a nonjudgmental attitude d. Meeting with the patient spontaneously because that indicates caring

ANS: C Feedback A Although answering questions as fully as possible and admitting the limits of knowledge facilitates trust, answering questions with authority implying that this is the entire answer does not help develop trust. B The sharing of personal information does not help develop trust. C Accepting the patients thoughts and feelings without judgment helps develop trust in the nurse. D Meeting at designated times helps the patient develop trust that the nurse will follow through with what is promised. DIF: Cognitive Level: Comprehension REF: p. 170

39. Collaboration among health care professionals most importantly results in a. the development of esprit de corps. b. benefits to the organization alone. c. positive patient outcomes. d. maintenance of employee satisfaction.

ANS: C Feedback A Although esprit de corps develops, the ultimate result is for positive patient outcomes. B Collaboration benefits the individuals involved, as well as the organization. C Making the most of collaborative opportunities enhances positive patient outcomes. D Employee satisfaction is greater with more collaboration, but the ultimate value of collaboration is positive patient outcomes. DIF: Cognitive Level: Comprehension REF: p. 190

24. A new mother says to the nurse, It really hurts me to breastfeed. I think I should wean my baby. The nurse responds, If I understand you, it hurts when you breastfeed. Tell me how and when it hurts. This response best represents which criterion of successful communication? a. Appropriateness b. Efficiency c. Feedback d. Flexibility

ANS: C Feedback A Appropriateness relates to whether the reply fits the circumstances and matches the message. B Efficiency means using simple, clear words that are timed at a pace suitable to the patient. C The nurse seeks to clarify the hurt before intervening further. D Flexibility means the message is based on the immediate situation and not preconceived expectations. DIF: Cognitive Level: Application REF: p. 178

11. The nurse and patient may experience sadness during the termination phase. How can the nurse help the patient be successful in the termination phase of the nurse-patient relationship? a. Providing personal contact information so the patient can contact the nurse if needed b. Visiting the patient at home during off-duty time to help the transition to self-care c. Emphasizing the achievements the patient has made, including the ability for self-care d. Exchanging goodbye gifts as a sign that the relationship is terminated

ANS: C Feedback A Nurses should not maintain personal communication with patients after discharge. B The nurse respects professional boundaries. C Emphasizing the patients achievement of goals and the reasons he or she does not need the nurse anymore is effective in the termination process. D Nurses should not exchange gifts with patients but should instead respect professional boundaries. DIF: Cognitive Level: Comprehension REF: p. 171

1. Which of the following best describes Peplaus theory on therapeutic use of self? a. Putting patients needs ahead of your own b. Providing excellent clinical skills to improve patients health status c. Using excellent interpersonal skills to help patients improve their health status d. Self-protection through avoidance of a relationship with the patient

ANS: C Feedback A Putting patients needs ahead of your own is not the best answer because although it is true that the patients needs, not the nurses, are met during the therapeutic relationship, nurses should not necessarily put all patient needs ahead of their own. B The theory focuses on therapeutic communication, not clinical skills. C Peplaus theory described using ones personality and communication skills to help patients improve their health status as therapeutic use of self. D The focus is the patient, not the nurse. DIF: Cognitive Level: Comprehension REF: p. 170

12. For data collection to be valid, what must occur? a. The tool must be thorough. b. The tool must be unbiased. c. The tool must measure what it is supposed to measure. d. The tool must be accurate all of the time.

ANS: C Feedback A Thoroughness of the tool does not make it valid. B A tool should be unbiased, but it will not make it valid. C For a tool to be valid, it must measure what it is supposed to measure. D The accuracy of the tool is referred to as reliability. DIF: Cognitive Level: Comprehension REF: p. 231

The first trained nurse in the United States graduated in 1873 and later became the supervisor of the Boston Training School. Who was this nurse? a. Mary Ann Bickerdyke b. Dorothea Dix c. Linda Richards d.Sallie Thompkins

C

32. In which of the following examples is the nurse demonstrating empathy for the postoperative mastectomy patient? a. With todays advanced reconstruction techniques, youll quickly forget you ever had surgery. b. Youll be back to your busy routine sooner than you think. c. This must be a very difficult time for you. d. I know how you feel; I also had breast cancer.

ANS: C Feedback A Saying With todays advanced reconstruction techniques, youll quickly forget you ever had surgery discounts the patients feelings and is false reassurance. B The nurse is making an assumption that the patient wants to return to a busy routine. This is false reassurance based on a faulty assumption about the patient. C The nurse acknowledges the patients feelings and uses an open-ended statement to encourage the patient to verbalize further. D The nurse should never assume to know how the patient feels. The focus should be on the patient, not the nurse. The nurses experience is not germane to the nurse-patient relationship. DIF: Cognitive Level: Application REF: p. 181

9. A patient demonstrates obvious regression in ability to perform self-care during the working phase. Which response by the nurse is most appropriate? a. Frustration because the patient does not appear to be motivated to achieve goals b. Persistence in demonstrating the importance of achieving goals c. Patience and understanding because regression is a defense mechanism d. Ignoring it because the nurse realizes the patient is exhibiting childlike behavior

ANS: C Feedback A The nurse needs to show patience and maturity, not frustration. B Regression may be a necessary defense mechanism against stress, and the nurse needs patience during this time. C Patience and understanding are necessary because the patients progress toward goal achievement may not be smooth. Regression is a defense mechanism that may precede positive outcomes. D Understanding of regression is needed during this time. DIF: Cognitive Level: Analysis REF: p. 171

17. Which of the following best illustrates nonjudgmental acceptance by the nurse? a. Using professional influence to change a patients morality to be more in keeping with societal norms b. Changing your assignment if you discover that you have negative feelings toward your patients lifestyle c. Demonstrating caring behavior in spite of negative feelings d. Avoiding all negative feelings about the patient

ANS: C Feedback A The nurse should not attempt to change a patients belief system or morality. B We cannot control our feelings but need to be able to control our behaviors. C Acceptance indicates neither approval nor disapproval of patients beliefs, behaviors, or lifestyles. D Prejudices are strong, and we may be unaware of them. It is impossible to control all negative feelings, but it is professional to acknowledge them and continue to provide safe and effective care. DIF: Cognitive Level: Analysis REF: p. 175

8. A newly diagnosed diabetic patient states I have very definite likes and dislikes when it comes to food. Am I going to have to eat only certain foods, or will I have some choice? The nurse responds, Why dont you give me a list of your likes and dislikes? I will consult with the dietitian about how to include your preferences and still come up with a good diet for you. What phase of the nurse-patient relationship is this? a. Relationship phase b. Orientation phase c. Working phase d. Termination phase

ANS: C Feedback A The phases of the nurse-patient relationship do not include a relationship phase. B The orientation phase is when the relationship is established, the problems to be worked on are identified, and a time to meet is established. C The working phase is when the nurse and patient address the problems that have been identified. D The termination phase is when the relationship is ending. DIF: Cognitive Level: Comprehension REF: p. 171

12. A patient is being discharged from the hospital. Which statement by the nurse is appropriate for the termination phase of the nurse-patient relationship? a. You must be happy to be going home. Here are the written diet and medication instructions. b. It has been wonderful getting to know you. The best of luck when you get home. c. During the past 3 days, you have learned how to inject insulin and how to make appropriate food choices. Remember that you have the unit telephone number if you have any questions. d. You have done well learning a lot of new material and should be able to do well at home.

ANS: C Feedback A This response does not summarize what has occurred, which is an important part of the termination phase. B This response does not include a summary of the progress the patient has made, which is an important part of the termination phase. C Summarizing the gains the patient has made is important during the termination phase. D This response gives false reassurance about success at home. DIF: Cognitive Level: Application REF: p. 171

30. The nurse plans to teach a patient about the care of her mastectomy site. The nurse finds the patient crying. The best response by the nurse is, a. It is time to discuss how to care for the surgical site. b. You seem upset. You should start looking forward to going home and being a wife and mother again. c. I see you are upset. Is there something on your mind youd like to talk about? d. Dr. Abrams said you can go home tomorrow, and we need to talk about the care of your surgical site.

ANS: C Feedback A This statement follows the established agenda and does not respond to the emotional state of the patient. B This statement follows the established agenda and does not respond to the emotional state of the patient. C The nurses response demonstrates flexibility. The response identifies the emotional state of the patient and requires deviation from the established agenda. D This statement follows the established agenda and does not respond to the emotional state of the patient. DIF: Cognitive Level: Application REF: p. 179

29. Which of the following examples illustrates the nurses failure to use flexibility effectively in professional communication? a. Asking on the admission assessment, You dont smoke, do you? b. When updating a family member on a patients condition stating, Your wifes ABG report indicates significant hypoxia. c. Continuing to follow the agenda in a staff meeting when people are obviously upset by a recent death on the unit d. Requiring nurses to read back phone orders to physicians

ANS: C Feedback A You dont smoke, do you? is an example of value judgment. B This is an example of poor communication, because the message is not geared to the receivers level of understanding. C Continuing to follow an established agenda when the emotional state of the group needs to be addressed indicates inflexibility on the part of the leader. D Requiring nurses to read back phone orders to physicians is an example of feedback. DIF: Cognitive Level: Analysis REF: p. 179

A broad, general view of nursing that clarifies values and answers broad disciplinary questions for nursing is known as a a. conceptual model. b. metaparadigm. c. philosophy. d. theory.

ANS: C A philosophy is a set of broad beliefs about the nature of how things work and how to view the world.

5. Which of the following are the three most common sources of research questions? a. Study of clinical problems, anecdotal stories, requests by the National Institutes of Health (NIH) b. Requests by drug companies, doctoral students, review of the literature c. Clinical problems, replication of prior research, testing nursing theory d.Review of existing research, NIH grants, request by state board of nursing

ANS: C Feedback A Clinical problems are a source of research, but anecdotal stories and NIH requests are not. B Drug companies conduct their own studies. C The three most common sources of research questions are clinical situations, the literature, and theory. D Most research questions do not come from the state board of nursing. DIF: Cognitive Level: Comprehension REF: p. 229

13. A data collection protocol calls for a questionnaire to be administered to patients having knee replacement surgery after the third physical therapy appointment. Errors can be introduced into the study by a. giving the questionnaire to all participants. b. reading the questionnaire to the participants with poor reading skills. c. giving the questionnaire to all participants when they arrive for their appointment. d. giving the questionnaire to the participants after the appointment to be completed while they have a snack.

ANS: C Feedback A Giving a questionnaire to all participants follows the timing of the protocol. B Reading the questionnaire to participants with poor reading skills follows the timing of the protocol. C Giving the questionnaire to all participants when they arrive for their appointment does not follow the protocol; the participant could fill out the questionnaire before experiencing the therapy session. D Giving the questionnaire to the participants after the appointment to be completed while they have a snack follows the timing of the protocol. DIF: Cognitive Level: Application REF: p. 231

Which nursing theorist is best known for her emphasis on inferences based on observation of patient behavior, confirmation by the patient, and results in effective care based on identified patient needs? a. Leininger b. Neuman c. Orlando d. Peplau

ANS: C Orlandos theory proposes how nurses process their observations of patient behavior and how they react to patients based on inferences from patients behavior.

Peplaus theory focuses on the therapeutic relationship as the key to successful nursing intervention. Which of the following is correct about Peplaus theory? a. It is a grand theory that demonstrates that defining nursing was more important than application to practice. b. Her theory developed from her work with oncology patients. c. The theory describes six key nursing roles that are flexibly used, depending on the practice setting. d. Her theory describes nursing roles as mother, technician, salesman, scholar, and advocate.

ANS: C Peplaus theory focuses on the therapeutic relationship between the nurse and patient. The nurses role is one of six that may change with the situation or practice setting.

Which nursing theorist based her model on the belief that adaptation to changes in the environment is the basis of health? a. Watson b. King c. Roy d. Peplau

ANS: C Roys model provides a comprehensive understanding of adaptation. When environmental demands are too high and patients adaptive mechanisms too low, behavioral responses for coping are ineffective.

Which of the following actions by the nurse constitutes professional malpractice? a. Administering a preoperative sedative in the patient holding area instead of in the patient's room b. Failing to notify the physician of a potassium level of 4 mEq/L c. Placing the head of the bed flat when a patient is receiving a tube feeding, causing the patient to aspirate the mixture d. Administering a routine medication 10 minutes late because of a unit emergency

ANS: C Feedback A Administering a preoperative sedative in the patient holding area instead of in the patient's room does no harm to the patient. B Failing to notify the physician of a potassium level of 4 mEq/L does not necessarily do harm to the patient. C The reasonable nurse would know that the head of the bed must be elevated when the patient is receiving a tube feeding. D No harm resulted from administering a routine medication 10 minutes late because of a unit emergency.

A nurse is turning a bedfast patient to prevent pressure ulcers. The patient complains that the process is painful. The nurse explains the reason for the turning schedule and completes the task. This is an example of the ethical principle of a. autonomy. b. fidelity. c. nonmaleficence. d. veracity.

ANS: C Feedback A Autonomy has to do with individuals being able to make their own decisions. B "Fidelity" refers to honoring one's commitments and promises. C "Nonmaleficence" is defined as the duty to do no harm. Although temporarily painful, not turning the patient would cause actual harm (physical damage), and so this nurse is acting on the principle of nonmaleficence. D "Veracity" refers to being truthful.

Which of the following is the best description of a code of ethics? a. A document that describes the correct course of action and does not change regardless of societal changes b. A document that all professions must have even if not representative of practice c. A document that permits others to know what principles guide professional decision making d. A document widely open to interpretation by professionals in various settings

ANS: C Feedback A Codes of ethics have been revised through the years to reflect changes in society. B Codes are useful only if upheld by members of the profession in their daily practice. C The Code of Ethics of nursing is an implied contract through which the profession informs society of the principles and rules by which it functions. D The Code of Ethics should be interpreted in a similar way regardless of practice setting.

An adult has difficulty initiating a conversation, and in working with others always agrees with them because "My opinion is not important." Which of Maslow's basic needs is not being met by this person? a. Basic physiologic needs b. Love and belonging needs c. Esteem needs d. Self-actualization

ANS: C Feedback A Maslow identified the first level of needs as those necessary for physiologic survival. There is no information that this person is not meeting these needs. B Maslow identified the third level of needs as love and belonging. There is no information that this person is not meeting these needs. C Maslow identified the fourth level of needs as the need for self-esteem. This individual does not demonstrate a sense of self-worth and self-respect. D Maslow identified the fifth level of needs as self-actualization. The lower order need of self-worth and self-respect must be met before attempting to meet the needs at this level.

A nursing student got a thank-you card from a patient's family and had another student take a photo of the student with the family. The student asks the nursing instructor if it would be alright to post the photo on Facebook. Which response by the instructor is best? a. "Yes, as long as you ask the family if that would be OK." b. "I think that would be OK, but you should check hospital policy." c. "No, posting pictures of patients and families on social media sites is not acceptable." d. "No, that could lead to a malpractice suit by the patient or family."

ANS: C Feedback A Confidentiality and Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations place severe restrictions on nurses' use of social media sites. The student should not post the photo. B The hospital probably has a policy regarding the use of social media sites, but the student should also be instructed to check the nursing school's policies as well. Most such policies prohibit or severely restrict what nurses and students can post. Even if there are no policies in place, the student should not post the photo due to ethical and HIPAA considerations. C The student would be wise to not post the photo on any social media site. Posts are neither "private" or inaccessible once deleted. D In order to prove a claim of malpractice, four elements are needed; duty, breach of duty, harm, and causation. This would most likely not be a case of malpractice.

Which of the following ethical theories is illustrated by the example of triage in disaster nursing? a. Deontology b. Principlism c. Utilitarianism d. Virtue ethics

ANS: C Feedback A Deontology states that an act is moral if it originates from good will. B Principlism is the use of ethical principles in decision making. C Triage in disasters requires decisions to be made on how to do the greatest good for the greatest number of people. A main tenet of utilitarian ethics is that right or useful actions bring about the greatest good for the greatest number of people. D Virtue ethics refers to character traits of the decision maker, such as honesty, courage, kindness, and integrity.

The current emphasis on eliminating racially based health disparities is based on which of the following ethical principles? a. Double effect b. Fidelity c. Justice d. Veracity

ANS: C Feedback A Double effect is the concept that justifies inflicting harm if the intent is to produce an overall good effect. B "Fidelity" refers to honoring one's promises to patients. C The principle of justice states that equals should be treated the same. D Veracity is telling the truth.

What is an advantage of the holistic view of health valued by nurses? a. Altering an individual's health beliefs to promote health b. Identifying a state of optimal role functioning c. Focusing on the interrelationship of all parts of a whole person d. Emphasizing the environment

ANS: C Feedback A Holism has nothing to do with altering health beliefs. B Holism is more than just optimal role functioning. C When viewing health holistically, individual health practices are taken into account along with other aspects of the individual. D Holism sees the environment as part of the person and contributing to his or her health.

Which one of the following guiding principles helps explain nursing's holistic approach? a. Nursing care can be provided in a variety of settings. b. Nursing care persists even in the absence of scientific research. c. Nursing care considers mind, body, and spirit. d. Nursing provides care regardless of a patient's belief systems or culture.

ANS: C Feedback A Holistic care can be provided in any setting. B "Nursing care persists even in the absence of scientific research" does not address the meaning of holism. C Holistic nursing considers the whole person: body, mind, and spirit. D Nursing care always strives to consider a person's culture and belief system.

Flight 93, hijacked on September 11, 2001, crashed into the Pennsylvania countryside because some of the passengers decided to try to take control of the plane and prevent it from being used as a weapon of mass destruction against structures in Washington, D.C. They decided to act despite grave danger to themselves. This is an example of which level of Kohlberg's theory of moral development? a. Preconventional b. Conventional c. Postconventional d. Conventional phase 4

ANS: C Feedback A In the preconventional level, the person's self-interest takes precedence over group norms. B In the conventional level, the person conforms to group norms. C People in the postconventional level of moral development may ignore self-interest and group norms when making decisions and may sacrifice themselves for the group. D Phase 4 of the conventional level follows group and cultural norms.

Which of the following is an important step in preventing legal action against the nurse? a. Never make a mistake. b. Deflect blame from yourself as much as possible. c. Develop caring, therapeutic relationships with patients. d. Avoid explaining care procedures to patients.

ANS: C Feedback A It is not reasonable to expect that nurses will never make a mistake. B Nurses must have accountability for errors. C Establishing and maintaining good communication and rapport with patients not only is an aspect of best practice but also protects the nurse from lawsuits. D Nurses should explain all procedures to patients.

Which of the following is the World Health Organization's definition of "health"? a. People in harmony with environment b. A state of optimum functioning for an individual in the performance of roles and tasks c. Physical, mental, and social well-being, not just the absence of disease or infirmity d. Functioning at maximum potential with the environment

ANS: C Feedback A Jan Christian Smuts introduced the theory of health as man in harmony with his environment. B "The state of optimum capacity of an individual for the effective performance of his roles and tasks" is Parson's definition of health. C The World Health Organization's definition of health is "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." D Functioning at maximum potential with the environment is Dunn's theory of health.

Gilligan's theory on moral development differed from Kohlberg's theory because Gilligan considered which population not addressed by Kohlberg? a. Children b. Men c. Women d. Adolescents

ANS: C Feedback A Kohlberg mostly tested his theory in men and boys. B Men were the focus of Kohlberg's theory. C Gilligan thought that Kohlberg's theory did not recognize the experience of women in moral development. D Gilligan's theory did not focus on adolescents.

Who is credited with developing the theory on systems? a. Rogers b. Maslow c. Rosenstock d. von Bertalanffy

ANS: D Feedback A Carl Rogers developed a theory of personhood. B Abraham Maslow developed a human needs theory. C I. M. Rosenstock developed a health belief model. D Ludwig von Bertalanffy developed the theory of systems.

The most common reason that nurses are disciplined by the state board of nursing is a. making medication errors. b. following unsafe nursing practice. c. practicing while impaired. d. abandoning patients.

ANS: C Feedback A Medication errors are not the most common cause of nurses having their licenses suspended. B Unsafe nursing practice is a reason to have a license suspended but not the most common reason. C The most common reason that the state board suspends a nurse's license is for practicing while impaired. D Abandoning patients is not the most common reason for suspending nursing licenses.

A patient's spouse and son were recently killed in an automobile accident, and the patient's position in a large company has been eliminated due to corporate reorganization. The patient states, "I do not think I can handle this." The nurse could safely make the assumption that a. the patient will soon develop clinical depression. b. the patient needs hospitalization to foster adaptation. c. environmental factors may have a negative impact on this person's health. d. self-care will assure the patient's ability to readjust.

ANS: C Feedback A Multiple changes in a person's environment do not always result in depression. B Adaptation can be fostered without hospitalization. C Multiple changes in a person's environment may affect health. D Self-care is important, but the patient may need further assistance.

Which patient rights are guaranteed by HIPAA? a. Patients are asked to sign a release of responsibility if their health care records inadvertently become a matter of public record. b. Patients sign a release protecting the health care provider and insurance company against computer file theft. c. Patients are protected against medical records being indiscriminately shared. d. Patients may receive a complete copy of their medical records at no cost.

ANS: C Feedback A Patients' health records are never to become a matter of public record. B Health care providers and insurance companies are not protected against computer theft. C HIPAA protects medical records: written, oral, and electronic. D Patients have access to their medical records through HIPAA, but they may be assessed a fee.

Which of the following puts the nurse at increased risk for legal action? a. Delegating a Foley catheter insertion to a LPN/LVN b. Documenting the exact words a patient uses when complaining c. Not assessing a patient who is complaining of pain d. Caring for a postoperative patient who has a pulmonary embolus while being transferred to the chair

ANS: C Feedback A Proper delegation does not increase risk for legal action. B Documenting in detail, including using direct quotations when appropriate, will protect the nurse from legal liability. C Failing to assess a patient constitutes an area of risk. D The embolus may have been unavoidable, and encouraging postoperative mobility meets the standard of care.

Which of the following is a nursing responsibility regarding informed consent? a. Canceling the procedure if the patient has questions b. Explaining the procedure, risks, and treatment alternatives c. Serving as a witness, ensuring that the patient does not feel coerced into a decision d. Ensuring that the physician has completely explained the costs of the procedure

ANS: C Feedback A The nurse does not have the responsibility to schedule or cancel medical procedures. B The physician has the responsibility of explaining the procedure, risks, and benefits. C The nurse can serve as a witness in informed consent. D The costs of the procedure are not required to be included in the physician's explanation.

The RN asked a nursing assistant to monitor several postoperative patients. Which of the following instructions to the nursing assistant demonstrate appropriate delegation? a. "Take vital signs every 2 hours, and report to me anything outside of the norms." b. "Assess pain using a 10-point scale, and record the score on the chart." c. "Record the urine output, and report to me if they have not voided within 4 hours." d. "Record the amount of drainage on the dressing on the bedside record."

ANS: C Feedback A The nursing assistant is told to report "anything outside of the norms." An RN should not assume that the nursing assistant knows the specific norms the RN is referring to. B The nursing assistant should know if there are specific scores that the RN wishes to know about. C This is the most appropriate instruction because the nursing assistant not only knows what to do but also what specific information to report. D The RN needs to know the amount of drainage to determine whether any further actions are needed.

A competent resident in a long-term care facility refuses an ordered antidepressant medication. The nurse believes the patient needs the medication because he is clearly showing signs of depression and dissolves the medication in juice without telling the patient. This illustrates negligence by failure to a. follow the standard of care. b. assess and monitor a patient. c. communicate with a patient. d. document.

ANS: C Feedback A The standard of care was followed as related to the giving of an ordered medication. B The nurse assessed the patient and determined he still needed the medication because he was showing signs of depression. C The nurse did not communicate with the patient to determine why he did not want to take the medication. Based on the information she gathered, further actions could have been taken. D There is no evidence that the nurse did not document the administration of the medication.

Bandura's theory of self-efficacy described people's response to health-related behaviors. Which of the following was a major premise of this theory? a. Patients will take responsibility for their health if they understand the risks and benefits. b. A "cue to action" is a powerful motivator for changing health behavior. c. Belief in self as having the ability to improve health is important in changing health behaviors. d. Health is genetically predetermined and cannot be influenced by an individual's actions or beliefs.

ANS: C Feedback A Understanding the risk does not always motivate patients to change their behavior. B A "cue to action" was described by Rosenstock as a motivating factor in changing behavior. C Bandura's theory of self-efficacy states that belief in one's self-efficacy leads to efforts to change. D Bandura believed that individuals could change their health practices if they believed they could.

Which of the following nursing responsibilities can never be delegated? a. Complex tasks b. Evaluation c. Medication administration d. Accountability

ANS: D Feedback A Complex tasks can be delegated if the person has been trained to perform the task. B While an unlicensed assistive personnel (UAP) is not qualified to evaluate results, if the nurse delegates something to another RN, the second RN is responsible for evaluating the results and acting appropriately. C Medication administration in some states can delegated (to a limited degree) to UAPs. D Professional accountability cannot be delegated.

MULTIPLE RESPONSE 1. Translational research/science will do which of the following? (Select all that apply.) a. Result in biomedical research becoming less flexible in response to the needs of society b. Limit interdisciplinary research because this does not enhance patient care c. Take laboratory findings for development for use with patients at the bedside d. Use clinical research findings to ask new questions for research in the laboratory e. Discover practical applications for scientific theories and laws.

ANS: C, D Feedback Correct Translational research serves as the conduit between the bench and the bedside. Incorrect Translational research will result in more flexibility in taking biomedical research findings to practical applications. Interdisciplinary research is expected to increase as multiple disciplines involved in clinical concerns can use the findings of the bench scientists. Discovering practical applications for scientific knowledge is applied science. DIF: Cognitive Level: Comprehension REF: p. 223

Nurses recognize which of the following about health? (Select all that apply.) a. Individuals desiring to change their behaviors are already motivated to change. b. The burden of change is borne by the individual. c. Health is relative and ever changing. d. Multiple interventions are necessary to change health behaviors. e. Unhealthy behaviors may persist in spite of increased knowledge.

ANS: C, D, E Feedback Correct - Nurses recognize that health is relative and ever changing, multiple interventions are necessary to change health behaviors, and that unhealthy behaviors may persist in spite of increased knowledge. Incorrect - Individuals may desire change but not have the knowledge, motivation, self-efficacy, or support to change. The burden of change is shared by the patient, health care providers, and population-focused entities.

A nurse caring for a preoperative patient is told by the patient, The doctor just had me sign a paper. I wish I knew what it was all about. The nurse goes to report this to the physician. The nursing role adopted by the nurse is a. provider of care. b. counselor. c. change agent. d. patient advocate.

ANS: D

A nurse conducts theory testing and theory development research to develop nursing science. This nurse is prepared at which level of nursing education? a. Associate degree b. Bachelors degree c. Masters degree d. Doctoral degree

ANS: D

A nurse places high priority on working with patients and families, including them in planning care and in establishing goals. Which nursing role has this nurse assumed? a. Patient advocate b. Provider of care c. Change agent d. Collaborator

ANS: D

Differences between treatment outcomes for different populations are known as a. health care outcomes. b. population variability. c. treatment choices. d. health care disparities.

ANS: D

Nursing theory provides a foundation for theory-based practice and curriculum development. Which is a primary reason for incorporating theory into education? a. Nursing theory helps nurses explain their practice to members of other disciplines. b. Nursing theory helps transmit knowledge to new professional nurses. c. Nursing theory contributes to professional autonomy, an important characteristic of all professions. d. Nursing theory is taught as a guide to nursing practice and to teach students care within the unique perspective of nursing.

ANS: D

The American Nurses Association (ANA) serves as the a. clearinghouse of standards set by clinical specialty organizations. b. regulatory agency setting the guidelines for the scope of practice. c. source of dissemination of nursing research. d. professional organization for all nurses regardless of practice setting or level of practice.

ANS: D

The nurse teaches the patient how to administer insulin. Before this the nurse and patient had developed a trusting relationship over several days, which included sharing feelings about having to take daily medication. The patient expressed confidence in the care provided by the nurse. The nurse could be basing care on the philosophy of a. Henderson. b. Nightingale. c. Roy. d. Watson.

ANS: D

Which of the following human needs was not included in Hendersons 14 basic needs of patients? a. Need for work b. Sleep and rest c. Spirituality d. Sexuality

ANS: D

Which of the following is an example of illness prevention? a. Viewing a program on television about the increased incidence of heart disease b. Speaking to a high school group about the value of exercise c. Encouraging women at a health fair to have an annual mammogram d. Counseling people recently experiencing death of a spouse about signs and symptoms of depression

ANS: D

Which of the following is characteristic of public agencies? a. They are supported by donations from the public. b. Most only provide primary care services. c. They are not involved in the education of health care providers. d. They provide health care services at the national, state, and local levels.

ANS: D

Which of the following is not recognized as part of the role of the nurse as a member of the health care team? a. Patient advocate and educator b. Collaborator and provider of care c. Manager of care and resources for a group of patients d. Performance of physician functions under direct supervision of a physician

ANS: D

Within a nursing shared governance model, the role of the clinical nursing staff is to a. determine the expectations and goals for the unit. b. manage the budget for the unit to be cost-effective. c. focus on the unit activities related to nurses only. d. adhere to standards and quality benchmarks to ensure professional practice.

ANS: D

34. How would a nurses use of the technique of reflection help a person? a. Showing an awareness of the persons feelings b. Causing the person to answer more fully than yes or no c. Showing knowledge the person is not expected to know d. Encouraging the person to think through problems for himself or herself

ANS: D Feedback A Reflection may involve the person becoming aware of his or her feelings but does not require the nurses awareness. B Reflection is not related to the answers provided by the patient. C Reflection is related to the insight the person gains, not information provided to him or her. D Reflection implies respect for the patient and his or her ability to solve his or her problems. DIF: Cognitive Level: Comprehension REF: p. 181

26. A new mother says, My baby is being kept in the nursery. Im really worried about him. Im also worried that the separation will interfere with breastfeeding. The most appropriate response by the nurse is, a. Well, thats not my territory. Youll have to deal with the nursery staff about breastfeeding. b. As a nurse on this unit, I can assure you that we will do all we can to help you. c. I can see youre upset about this, but to be honest with you, Im a new nurse here, and Im not sure how I can help you. d. I can see this is a problem for you. I will go to the nursery and see if I can get some answers for you.

ANS: D Feedback A Telling the mother that she will need to deal with the nursery staff does not address the concern of the mother. B Saying that the staff of the hospital will do all they can to help does not address the concern of the mother. C The nurse telling the mother that he is new and does not know how to help does not address the concern of the mother. D The nurses response fits the circumstances and matches the mothers message of being concerned about the separation and breastfeeding. DIF: Cognitive Level: Application REF: p. 178

4. One of the most important outcomes of the orientation phase of the nurse-patient relationship is the development of mutual a. communication. b. understanding. c. acceptance. d. trust.

ANS: D Feedback A The entire relationship requires excellent communication, not just the orientation phase. B All phases of the therapeutic relationship require understanding. C All phases require nonjudgmental acceptance. D The purpose of the orientation phase is to establish trust. DIF: Cognitive Level: Comprehension REF: p. 170

19. Which is true of verbal and nonverbal communication? a. Verbal messages are more important than nonverbal cues. b. Individuals can exercise more control over nonverbal communication. c. Verbal and nonverbal communication always match. d. The nonverbal communication may be a more reliable message.

ANS: D Feedback A The nonverbal message may tell much more than the verbal one. B Individuals can exercise more control over verbal communication than nonverbal communication. C Verbal and nonverbal communication are not always congruent. D Nonverbal communication includes gestures, posture, facial expressions, eye contact, and actions, among other things. Although the verbal message using words may be short, the nonverbal message can tell much more about the persons feelings. DIF: Cognitive Level: Comprehension REF: p. 176

37. A patient states, The thing that scares me the most about surgery is the spinal anesthesia. Im afraid itll leave me paralyzed, and the nurse responds, Everything will be fine. The anesthesiologists are very skilled in administering spinal anesthesia. The nurses response is an example of a communication breakdown known as a. failing to see the uniqueness of the individual. b. failing to recognize levels of meaning. c. using value statements. d. using false assurance.

ANS: D Feedback A The nurse does not fail to respond to the patient as a unique individual. B The nurse does not fail to take into account the meaning under the surface content. C The nurse does not use value statements. D The nurse offers false assurance. DIF: Cognitive Level: Application REF: p. 185

15. During report, a nurse complains about a 3-year-old boy, saying He sure knows when to pour on the tears. Theres nothing wrong until he sees you; then the tears start, but they stop as soon as you leave or his mother comes. Hes just spoiled because they have a nanny at home who waits on him hand and foot. This is an example of a. lack of understanding of child development. b. frustration that the mother is not present. c. assessment of the childs behavior. d. stereotyping because the child has a nanny.

ANS: D Feedback A The response does not reflect lack of knowledge about child development, assessment of the behavior, or a response to the mothers not being present. B The response does not reflect lack of knowledge about child development, assessment of the behavior, or a response to the mothers not being present. C The response does not reflect lack of knowledge about child development, assessment of the behavior, or a response to the mothers not being present. D Stereotypes are simplistic and illogical images used to describe groups of people. DIF: Cognitive Level: Analysis REF: p. 174

20. Which of the following could be considered congruent communication? a. The nurse manager states, Come by my office anytime. Then she keeps her door closed and does not answer phone calls. b. As a co-worker hurries down the hall, he asks, Is there anything you need help with? c. As she drops a stack of charts loudly on the desk, a co-worker states, This is going to be a wonderful day. d. The nurse manager sits with you in the nurses lounge and asks, Is there anything you would like to talk about?

ANS: D Feedback A The verbal message is that she is available, but the closed door indicates otherwise. B The verbal message is willingness to help; the nonverbal message is, I hope you do not ask. C The dropping of the charts loudly indicates frustration and is incongruent with the message This is going to be a wonderful day. Sarcasm is incongruent communication. D The nurse managers verbal message matches the nonverbal message. This is the definition of congruent communication. DIF: Cognitive Level: Application REF: p. 176

31. The patient says to the nurse, The staff treats me like Im a child. Everyone tells me what to do. No one ever asks my opinion. After all, it is my body. Which response by the nurse indicates active listening? a. Well, youre sick. Dont you think you should let us take care of you? b. I dont think I can help you with this. This is a personal matter between you and the rest of the staff. c. It makes you angry not to be included in your health care decisions. Lets talk about how you can vent your anger appropriately. d. Let me see if I understand. It bothers you not to be recognized for your abilities to handle your life. I can discuss this with the staff if you wish so that everyone involves you in planning your care.

ANS: D Feedback A This statement indicates a lack of interest in what the patient was saying and is paternalistic. B This statement indicates a lack of interest in what the patient was saying and an unwillingness to help the patient. C This statement shows an assumption by the nurse that should be verified. D The nurses response recognizes the patients feelings and concerns. The nurse verifies the patients feelings and suggests an action which gives the patient the desired control. DIF: Cognitive Level: Application REF: p. 175

16. A nurse comments in private about a patient: That lady with six kids is pregnant again! It makes me sick to see these people on welfare taking away from our tax dollars. I dont know how she can continue to do this. The best response by a nurse peer is to a. ignore the biased statements. b. accept the comments as self-disclosure. c. offer neutral responses. d. convey acceptance of the patient.

ANS: D Feedback A To ignore the statements will not help this nurse become aware of stereotypes. B These statements do not qualify as self-disclosure. C Offering neutral responses will not help the nurse become aware of stereotyping. D Acceptance conveys neither approval nor disapproval of personal beliefs. Nonjudgmental acceptance means that the nurse acknowledges that all people have rights to be different and to express their differences. Nurses should convey acceptance of people as they are even if they disagree with specific beliefs and/or practices. DIF: Cognitive Level: Application REF: p. 175

14. Which of the following must be included in the informed consent in research? a. Participants relinquish the right to privacy. b. Once participants agree to participate, they must complete the study. c. Participants need to know the funding source for the research. d. Participants must be informed of risks associated with participation.

ANS: D Feedback A Participants must be guaranteed privacy. B Participants may withdraw their consent at any time. C Participants do not need to know the funding source for the study. D Participants must be informed of any risk involved while participating. DIF: Cognitive Level: Knowledge REF: p. 234

A group of concepts and propositions that describe linkages between the concepts is a a. conceptual model. b. metaparadigm. c. philosophy. d. theory.

ANS: D A theory is a group of related concepts, definitions, and statements that propose a view of phenomena to describe, explain, or predict outcomes.

2. What is meant by the term evidence-based practice? a. Using nursing research findings to develop nursing theory b. Integrating the research process into nursing administration c. Studying research from the social sciences and applying it to practice d. Applying research findings; patient care data, preferences, and values; and nursing expertise to nursing practice

ANS: D Feedback A Evidence-based practice is for the purpose of clinical practice, not theory development. B The goal of evidence-based practice is to integrate research into clinical practice, not necessarily into nursing administration. C Research from nursing applied to practice is evidence-based practice. D Evidence based practice is defined as practice that integrates the best evidence from [research] studies and patient care data with clinician expertise and patient preferences and values. DIF: Cognitive Level: Knowledge REF: p. 227

6. Which of the following is an example of a research question based on a clinical problem? a. Published observations of a nurse who practiced many years in elder care b. Nursing intuition about what measures are most useful with anxious patients before surgery c. Stories of a flight nurses experiences with posttraumatic stress disorder d. Relationship between hours of bright light and irritability of preterm infants

ANS: D Feedback A Published observations about elder care do not meet the criteria of a research question. B Nursing intuition does not meet the criteria of a research question. C Stories of flight nurses experiences do not meet the criteria of a research question. D The relationship between hours of bright light and irritability in preterm infants is a research question based on a clinical problem that can be studied. DIF: Cognitive Level: Comprehension REF: p. 229

8. An intensive care unit (ICU) nurse notices that patients seem to have more normal vital signs when they are being visited by their family members, especially when the visitors seem to be more caring. However, the hospital has strict visiting hours of 10 minutes every other hour. What would be the most appropriate research question to ask at this time? a. What is patient and family satisfaction with visitation time? b. What is the relationship between length of visitation and vital signs? c. What are the vital signs of ICU patients when visited by caring visitors in comparison with when they are alone? d. Do ICU patients have vital signs in the normal range more frequently when they are being visited by family members?

ANS: D Feedback A Satisfaction is the issue the nurse is interested in. B At this point the length of visitation is similar and is not the issue. C Although this is an interesting question, the nurse needs to first discover whether the vital signs are in the normal range more often during family visitation. D The nurse has only subjective data and needs to determine whether the vital signs are truly more often in the normal range with visitation. DIF: Cognitive Level: Application REF: p. 230

A patient had a significant blood loss in surgery and now has a low hemoglobin level. The patient complains of fatigue. The nurse intervenes to facilitate adaptation by establishing periods of rest and scheduling activities throughout the day. The nurse could be basing care on the conceptual model of a. Johnson. b. King. c. Orem. d. Roy.

ANS: D Roy focused on the individual as a biopsychosocial adaptive system and described nursing as a humanistic discipline that emphasizes the persons adaptive abilities.

The nursing process is an example of which of the following branches of philosophy? a. Aesthetics b. Ethics c. Epistemology d. Logic

ANS: D Feedback A Aesthetics is the study of what is beautiful. B Ethics deals with standards of conduct. C Epistemology deals with the nature of knowledge itself. D The nursing process is an example of ordered thinking and reasoning known as logic and reasoning.

Answering a terminally ill child's questions about his or her condition honestly is based on a belief in the ethical principle of a. autonomy. b. fidelity. c. justice. d. veracity.

ANS: D Feedback A Autonomy relates to the right of an individual to make his or her own decisions. B "Fidelity" refers to being faithful to one's commitments. C "Justice" refers to the equal treatment of all. D "Veracity" is defined as telling the truth. Truthfulness is fundamental in the development and maintenance of trust in a relationship.

A father of four is admitted after an automobile accident in which two of the children were killed. Recognizing that he is in very serious condition, the nurse believes that it would be appropriate to avoid telling him about the death of his children unless he asks directly. This could be considered a violation of the ethical principle of a. beneficence. b. fidelity. c. justice. d. veracity.

ANS: D Feedback A Beneficence is the expectation of doing good. B "Fidelity" refers to keeping commitments and promises. C Justice is the treatment of all equally. D Veracity is truth telling. The nurse is not lying but is not forthcoming with the information about the children.

The nurse giving medications to a pediatric patient notes that an order for a medication is considerably larger than the usual dose. The nurse looks up the medication in a pharmacology book and finds the prescribed dose is too large. Which action should the nurse take? a. Documenting the findings in the chart after giving the medication b. Calling the nursing supervisor and ask what to do next c. Calling the pharmacist to obtain the usual dosage d. Notifying the physician of these findings before giving the medication

ANS: D Feedback A Documentation is important, but the order needs to be clarified before the medication is administered. B Although seeking advice from the supervisor is helpful, the nurse still needs to clarify the order with the physician who wrote it. C Although the pharmacist can check the dosage calculation and provide supportive information to the nurse, he or she is unable to change the order; only the physician can do that. D The nurse notifying the physician of her findings before giving the medication allows the physician to clarify the order if written incorrectly or to clarify his rationale for the increased amount.

Which of the following is the primary focus of Healthy People 2020? a. Improving the health of individuals b. Improving the health of children c. Improving the health of families d. Improving the health of communities

ANS: D Feedback A Improving the health of individuals is only a part of the primary focus of Healthy People 2020. B Improving the health of children is only a part of the primary focus of Healthy People 2020. C Improving the health of families is only a part of the primary focus of Healthy People 2020. D Healthy People 2020 shifted the focus from individuals to the health of communities.

A patient who is terminally ill is experiencing great pain. To relieve the patient's suffering, the nurse needs to administer larger doses of morphine. This relieves the pain but also inhibits respiration. Which principle justifies the risk of harm? a. Justice b. Fidelity c. Veracity d. Double effect

ANS: D Feedback A Justice relates to equal treatment of all. B Fidelity is faithfulness to one's commitments. C Veracity is being truthful. D The principle of double effect addresses actions that may result in a negative effect if the end result is good. The end point justifies the risk of harm.

Which of the following is true of open systems? a. They have very little interaction with the environment. b. Parts are independent of each other. c. Exchange of information is sporadic and intermittent. d. The whole is greater than the sum of all of its parts.

ANS: D Feedback A Open systems interact with the environment. B Parts of a system are interrelated. C The exchange of information is continuous and dynamic. D In systems the whole is greater than the sum of all of its parts.

Which of the following is true of Maslow's basic need of self-actualization? a. Once self-actualization is achieved, it is never lost. b. Elderly people outgrow the need for self-expression and self-development. c. Most people achieve self-actualization after all other needs are met. d. People use their abilities to the fullest extent possible and are true to their nature.

ANS: D Feedback A People do not stay in a state of self-actualization but may have peak experiences that last for some period of time. B Maslow felt that people never outgrew the innate need for self-expression and self-development, regardless of age. C Maslow believed that many people strive for self-actualization, but few consistently reach the level even if they have achieved the other levels. D Self-actualized people have realized their maximum potential.

Which of the following is an example of civil law? a. Possession of marijuana b. Assault and battery c. Giving alcohol to a minor d. Child custody case

ANS: D Feedback A Possession of marijuana is an example of a violation of criminal law: possession of an illegal substance. B Assault and battery comes under the purview of criminal law. C Giving alcohol to a minor is an example of a violation of criminal law. D Civil law recognizes and enforces the rights of individuals, such as disputes over legal rights or duties of individuals in relation to one another. A child custody case is an example of civil law.

Which statement by an obese individual could be assessed as perceiving self-efficacy? a. "I've never been able to lose weight on any diet." b. "It's better to maintain one's weight than lose weight and gain it all back." c. "I'll be all right as long as my spouse will stay on the diet with me." d. "I believe I can stay on this diet as long as necessary."

ANS: D Feedback A The person saying "I've never been able to lose weight on any diet" does not reflect the belief that one is able to change his or her own behaviors. B The person saying "It's better to maintain one's weight than lose weight and gain it all back" does not reflect the belief that one is able to change his or her own behaviors. C The person saying "I'll be all right as long as my spouse will stay on the diet with me" does not reflect the belief that one is able to change his or her own behaviors. D Self-efficacy is a person's belief that he or she has the ability to modify his or her own behavior to improve health.

The nurse forgets to give the patient a dose of antibiotic. Later in the shift, the patient goes into cardiac arrest and dies. What element is lacking to support malpractice? a. Duty of care b. Breach of duty c. Specific injury d. Proximate cause

ANS: D Feedback A There is nothing to support that the nurse did not assume the duty of care of the patient. B Although the nurse breached her duty by not administering the antibiotic, there also has to be support that this action caused the injury. C Although one might claim injury (cardiac arrest and death), the link to the nurse's action is not supported. D There is no support that failing to administer the antibiotic caused the cardiac arrest and death.

Which of the following nursing leaders is credited with being one of the earliest nursing educators in the world? a. Isabel Hampton Robb b. Mary Adelaide Nutting c. Melinda Anne Richards d. Annie W. Goodrich

B

A mother asks the nurse if her 5-year-old can visit his twin brother in the PICU after cardiac surgery. The nurse denies the request because hospital policy states that children younger than 12 years of age are not allowed to visit the PICU but suggests that the mother visit with the child in the visitors lounge and talk to him about what is happening with his brother. This illustrates which of Benners stages of nursing proficiency? a. Novice b. Advanced beginner c. Competent practitioner d. Proficient practitioner

B

A mother asks the nurse if her 5-year-old can visit his twin brother in the PICU after cardiac surgery. The nurse knows that hospital policy states that children younger than 12 years of age are not allowed to visit the PICU. After considering the needs of the patient and his brother, the nurse suggests that the brother can visit for 5 minutes. This illustrates which of Benners stages of nursing proficiency? a. Advanced beginner b. Competent practitioner c. Proficient practitioner d. Expert practitioner

B

Benner describes five stages of nursing proficiency as students develop into expert nurses. Which of the following is not a stage of development described by Benner? a. Novice b. Inexpert beginner c. Competent practitioner d. Expert practitioner

B

Biomedical technology involves the use of complex machines or devices in patient care situations. Because of the highly technological environment in which nurses work, it is important that nurses a. assume total responsibility for monitoring data generated by these devices. b. use human touch and words of reassurance frequently to convey caring. c. maintain the devices safety by assuring routine assessment by physicians. d. be careful not to frighten the patient and family with information about the device.

B

Florence Nightingale is often credited as being the first nurse researcher. This designation is based on a. her methods of reorganizing British hospitals. b. her use of data on the morbidity and mortality of soldiers in hospitals in Scutari. c. demonstration that trained nurses provided better nursing care. d. publication of Notes on Nursing, the first scholarly nursing publication.

B

In which practice area was the first clinical nurse specialist (CNS) role developed? a. Mother-baby b. Psychiatric nursing c. Intensive care nursing d. Emergency nursing

B

One important advantage of the evolution of nursing informatics is that a. it allows any RN to become a certified informatics nurse. b. informatics nurses are best able to design systems with the needs and skills of nurses who use them. c. informatics nurses will reduce the need for direct caregivers to document care. d. benefits of informatics advancements include improved patient safety and increased variability of care.

B

The document that provides professional standards and a framework for professional decision making that ensures decisions are made with the highest integrity is the a. Nurse Practice Act. b. Code of Ethics. c. Nursings Social Policy Statement. d. bylaws of the American Nurses Association (ANA).

B

What has been found about the outcomes of patients cared for in hospitals with a higher percentage of BSN-prepared nurses as compared to patients in hospitals with a lower percentage of BSN-prepared nurses? a. Patient outcomes are more dependent on nurse-patient ratios. b. Outcomes were better in hospitals with more BSN-prepared nurses. c. Outcomes were similar in both types of hospitals. d. Medical patients had better outcomes, but surgical patients fared the same.

B

What was the most important influence of war on nursing? a. It allowed for the development of hospitals. b. Nurses were able to perform medical procedures during war. c. Improved medical care increased soldiers survival rates. d. It provided for the creation of new technology to make work easier.

B

What were some of the application requirements of nursing education programs in the 1900s? a. Male, intelligent, strong b. Female, sensitive, subservient c. Female, docile, from poor background d. Male, high breeding, independent

B

Which early nursing leader founded the first training school for nurses that would later become a model for early nursing education? a. Dorothea Dix b. Florence Nightingale c. Clara Barton d. Mary Ann Bickerdyke

B

Which early nursing theorist defined nursing in interpersonal terms by stating that nursing is a significant, therapeutic, and interpersonal process? a. Virginia Henderson b. Hildegard Peplau c. Martha Rogers d. Dorothea Orem

B

Which of the following characteristics of a profession were listed in Flexners work on professions? a. Activities of professions are more physically than intellectually oriented. b. Activities of professions are based on their own body of knowledge. c. Beliefs of professions are more theoretical than practical. d. Beliefs and traditions are handed down from generation to generation.

B

Which of the following illustrates an effective strategy for a registered nurse student returning for a bachelors of science in nursing (BSN)? a. Get reacquainted with the library; expect to spend many hours there doing research. b. Be open to information that does not seem to be readily applicable to your current position. c. Start a program only if you have a great deal of free time to devote to classes on campus. d. Use your co-workers as a sounding board to relieve frustration.

B

Which of the following is most essential for the nurse entrepreneur to be successful? a. Ability to take direction well b. Excellent time-management skills c. Avoidance of risks d. A college degree in business

B

Which of the following is true about bachelors of science in nursing (BSN) education? a. Faculty must be BSN prepared. b. It is recommended by professional organizations as preparation for entry into practice. c. It requires 3 years to complete. d. Faculty are not given full faculty status in the university.

B

Which of the following statements best describes how the Chicago Worlds Fair of 1893 became a pivotal point in the history of nursing education in the United States? a. Florence Nightingales work on sanitation and its relationship to mortality rates was finally recognized. b. The organization today known as the NLN was formed to address issues in nursing education. c. The American Nurses Association (ANA) was formed to oversee nursing education in the United States. d. The International Council of Nurses (ICN) was formed to enhance collaboration between practicing nurses and educators.

B

Which of the following was an unsuccessful attempt by the American Medical Association (AMA) to alleviate the nursing shortage of the time? a. Creation of the nurse manager position b. Creation of the registered care technician c. Recruitment of RNs from English-speaking countries d. Redistribution of qualified nurses to certain geographic locations

B

Which type of basic nursing education program graduates the largest number of RNs in the United States today? a. Diploma programs b. Associate degree programs c. BSN programs d. Nurse practitioner programs

B

Which of the following are characteristic of compassion fatigue? (Select all that apply.) a. Increased energy b. Burnout c. Being prone to accidents d. Poor judgment e. Increased interest in reflection

B, C & D

A component that separates occupations from professions is commitment. Which of the following is the best way that nurses can show commitment to each other? a. Reporting substandard practice by unlicensed personnel b. Reading the professional literature c. Mentoring nursing students and novice nurses d. Making a financial donation to a professional organization

C

A nurse observes a new graduate nurse being harassed by co-workers when asking questions or requesting help. What action by the nurse is best? a. Do not intervene, because it will only invite more harassment. b. Ask the nursing manager to intervene on behalf of the new nurse. c. Respectfully confront the staff and explain that this behavior is not part of nursing. d. Teach the new nurse to stand up for himself or herself when harassed. This is bullying behavior by the staff, and often the new nurse cannot handle it alone. If the new nurse cannot manage this with mentoring of the seasoned nurse, the other nurse should help the new nurse report this behavior to the management staff.

C

A nursing student says, I can now see how developing care plans helps organize my thoughts and patient care. In which stage of Cohens model of professional socialization is this student? a. Stage I: Unilateral dependence b. Stage II: Negativity/independence c. Stage III: Dependence/mutuality d. Stage IV: Interdependence

C

A recent trend in nursing has been an increase in the number of men and women with degrees in other fields or other careers applying to nursing programs. What is the single most important reason for this trend? a. Nursing as a career has gained increased status and prestige. b. Nursing salaries have outpaced many other fields. c. A nursing career provides both job security and meaningful employment. d. Working conditions in nursing have improved.

C

All levels of nursing educational programs can be accredited by which organization? a. American Association of Colleges of Nursing (AACN) b. Commission on Collegiate Nursing Education (CCNE) c. National League for Nursing Accrediting Commission (NLNAC) d. National League for Nursing Councils of Education Programs (NLNCEP)

C

Black illustrates concepts of preventing burnout by using the example of a flight attendant instructing persons to put your own oxygen mask on first. What does this statement mean? a. Oxygen is the most important element of life. b. Airway is always a priority in patient care. c. Taking care of yourself will enable you to be a better nurse. d. Ask others for help if you feel overwhelmed by your first position as a nurse.

C

Faith community nursing (FCN) was founded on which of the following premises? a. Nurses faith beliefs do not play a part in healing. b. The spiritual aspect takes precedence over the physical body in healing. c. Spiritual health is central to a persons well-being. d. Faith community nurses must receive formal training as a minister or clergy.

C

In 2004, the AACN proposed a new doctoral degree, the doctor of nursing practice (DNP). What is the focus of the DNP degree in nursing? a. Nursing research b. Nursing quality improvement c. Advanced clinical practice d. Nursing theory development

C

One of the characteristics of a profession identified by Kelly was there is an organization (association) that encourages and supports high standards of practice. Which of the following illustrates a concern for nursing meeting this characteristic? a. The ANA has existed for more than 100 years. b. Nursing specialty organizations have greater power to influence practice than a more general nursing organization. c. The membership of the ANA is less than 10% of all nurses. d. The purpose of the ANA does not address the economic and general welfare of nurses.

C

Preparation is a component that separates occupations from professions. Which of the following is the best way that a nurse demonstrates preparation for the profession? a. Improves nursing practice through the use of trial and error methods b. Focuses on the skills needed for the practice setting c. Articulates the values of caring and compassion in patient-centered care d. Utilizes textbooks from college to support practice 5 years after graduation

C

The Goldmark Report focused on what aspect of nursing? a. Consistency in length of nursing education programs b. Consistency in theory content across diploma programs c. Desirability of establishing schools of nursing within academic settings d. Increasing numbers of physicians teaching in nursing programs

C

The nursing profession is responsible for improving its own image. The most effective avenue for changing the image of nursing is to a. write letters expressing concerns to those responsible for negative images on television and in films. b. have nurses as consultants to the media to ensure that the media producers have accurate information about nursing. c. have nurses appear and behave professionally and explain what nurses do in each patient interaction. d. support the Johnson & Johnson campaign by distributing their information about nursing to students interested in nursing.

C

What specialty of nursing was considered well suited for men at a time when other areas were excluding men from practicing? a. Obstetric nursing b. Pediatric nursing c. Psychiatric nursing d. Nurse educator

C

When surveyed, which profession was chosen by the general public as highest in honesty and ethics? a. Physician b. Pharmacist c. Nurse d. Attorney

C

Which of the following could eventually change the historical status of nursing as a female-dominated profession? a.More men graduating from baccalaureate and higher degree programs b.The proportion of men in nursing beginning to increase c.More male graduates of basic nursing programs entering the workplace d.Salary compensation increasing to attract more men

C

Which of the following is a correct statement about the registered nurse (RN) population? a.The racial/ethnic composition of RNs closely resembles that of the general population. b.The number of men entering nursing has decreased steadily over the last decade. c.The rate of aging of RNs has slowed for the first time in the past 30 years. d.The majority of employed RNs working full time must work a second position.

C

Who is credited with developing the model of associate degree nursing education? a. Esther Lucille Brown b. Annie W. Goodrich c. Mildred Montag d. National League for Nursing

C

The 1948 Brown Report recommended which of the following? a. Limit enrollment of men and minorities in nursing programs. b. Students admitted to nursing programs should not be required to meet admission requirements of the university. c. Schools of nursing should be associated with teaching hospitals. d. Schools of nursing should be located in institutions of higher learning.

D

The diversity of the population entering the health care system is a challenge for nurses because a. the portion of minorities in nursing is greater than the portion of minorities in the general population. b. educators are culturally competent leaders for nurses and students. c. lessons about culture and cultural differences are not part of progressive education programs. d. ethnic minority group nurses are approximately 12% of nurses.

D

The legal definition of nursing for any particular state can be found in the a. state legislatures official newsletter. b. state board of nursings bylaws. c. governors official papers. d. states nurse practice act.

D

The major benefit of serving as a military nurse is a. broader responsibilities and scope of practice than civilian nurses. b. working with entirely baccalaureate-prepared peers on active duty. c. serving as an officer on active duty or in the reserves. d. the financial support to seek advanced degrees

D

The nursing profession has experienced barriers to professionalism. Which of the following is the primary current barrier to nursings professionalism? a. Too many men in nursing b. Unquestioning obedience to doctors c. Limitations placed on practice by state legislators d. Variability of educational backgrounds of nurses

D

The single most important reason for the decline in the number of hospital-based diploma programs was a. shift in hospital occupancy from acute care to home care. b. increase in hospital-based medical residency programs competing for educational dollars. c. beginning of associate degree programs that were shorter in length. d. diploma educations position outside the mainstream of higher education.

D

What is the purpose of articulated models or systems for nursing education? a. Increasing curriculum similarities in nursing programs b. Allowing nurses to work in nursing as they gain additional education c. Increasing the numbers of nursing education programs d. Facilitating opportunities for nurses to move up the educational ladder with ease

D

Which American university opened the first nursing school as a separate department within the university? a. Harvard b. Teachers College c. Columbia d. Yale

D

Which early nursing theorist recognized therapeutic milieu, assessment skills, and a unique body of knowledge in her definition of nursing? a. Dorothea Orem b. Virginia Henderson c. Hildegard Peplau d. Florence Nightingale

D

Which of the following is an example of Hendersons definition of nursing? a. Performing a hearing screening in preschool children b. Interacting with depressed men to learn new strategies for reducing their symptoms c. Setting goals for weight loss with a patient d. Teaching a person with frequent constipation about high-fiber foods

D

Which one of the following events occurring during the first decade of the twentieth century brought sweeping changes to nursing? a. It was required that all practicing nurses be licensed. b. Permissive licensing laws allowed registered nurses (RNs) to practice without a license if they registered with the state. c. All states required a standardized licensing examination. d. Nurses had to pass a licensing examination to use the title RN.

D

A homeless man sleeps on a park bench and eats one meal a day at a shelter. Which is the lowest level of Maslow's basic needs he does not meet? a. Basic physiologic needs b. Safety needs c. Love and belonging needs d. Esteem needs

Feedback A Although he is getting food, oxygen, and rest, he does not have shelter. This is Maslow's lowest level of needs. B Maslow identified the second level of needs as safety needs, which include physical and psychological safety. Basic physiologic needs must be met before the person can meet higher order needs. C Maslow identified the third level of needs as love and belonging. Basic physiologic needs must be met before the person can meet higher order needs. D Maslow identified the fourth level of needs as the need for self-esteem. Basic physiologic needs must be met before the person can meet higher order needs.

According to Cooper, what is one important measure nurses can take to reduce burnout? a. Being aware of stressors and acting on them b. Refusing to work in a nonproductive environment c. Reporting bullying when it is noticed in the workplace d. Keeping a diary of unhealthy behaviors one indulges in

a. Being aware of stressors and acting on them

Critical thinking in nursing needs to include which of the following important variables? a. Consideration of ethics and responsible decision making b. Ability to act quickly, often on impulse c. Ability to determine the best nursing interventions regardless of patients values and beliefs d. Flexible thinking that rarely follows a pattern or considers standards

a. Consideration of ethics and responsible decision making

A patient with diabetes who refuses to change eating patterns may be in which stage of adjustment? a. Denial and disbelief b. Irritability and anger c. Attempting to gain control d. Acceptance and participation

a. Denial and disbelief

Several methods have been developed to assist nurses in organizing patient data. They include (Select all that apply.) a. Hendersons 14 nursing problems. b. Gordons 11 functional health patterns. c. Nightingales ecological framework. d. Abdellahs 21 nursing problems.

a. Hendersons 14 nursing problems. b. Gordons 11 functional health patterns. d. Abdellahs 21 nursing problems.

Developing sound clinical judgment is a professional responsibility of the nurse. Which statements indicate behaviors that improve clinical judgment? (Select all that apply.) a. I always assess before acting and make changes as needed. b. I work the shifts I am assigned. c. I look for research findings to support my nursing actions. d. I believe that every patient deserves my very best efforts. e. I have read the professional nursing standards.

a. I always assess before acting and make changes as needed. c. I look for research findings to support my nursing actions. d. I believe that every patient deserves my very best efforts. e. I have read the professional nursing standards.

Which of the following is a characteristic of an accomplished critical thinker? a. Inquisitiveness b. Narrow focus c. Unaffected by other arguments d. Quick decision making

a. Inquisitiveness

What is the most important action a nurse can take to help further the profession of nursing? a. Joining a professional organization like the ANA b. Running for political office and helping create health-related legislation c. Maintaining a sense of well-being and taking care of oneself in the workplace d. Developing leadership skills and increasing professional education

a. Joining a professional organization like the ANA

Which of the following statements has all of the necessary criteria for a well-written outcome? a. Patient will consume 50% of meals with no nausea and vomiting by 24 hours postsurgery. b. Therapist will report improvement in patients range of motion on a daily basis. c. Patient will ambulate in the halls a little today. d. Patients condition will improve before discharge.

a. Patient will consume 50% of meals with no nausea and vomiting by 24 hours postsurgery.

A tired, stressed nurse complains about being part of the "Sandwich Generation." What does that phrase mean? a. People who care for both children and aging parents b. Employees who are stuck in jobs they wish to quit c. A person who is tired and stressed from a job d. A group of people squeezed by the need for continued work

a. People who care for both children and aging parents

A well-cultivated critical thinker is an individual who does which of the following? (Select all that apply.) a. Raises questions b. Recognizes alternative ways to see problems c. Uses only logic to determine relevance of information d. Implements solutions to complex problems only as an individual e. Criticizes solutions and alternatives suggested by others

a. Raises questions b. Recognizes alternative ways to see problems

The nurse finds a patient sitting in bed, rocking back and forth, wringing her hands and repeating rapidly, "I can't breathe. My heart is pounding. I think I'm going to die." Her physician is called to the bedside and tells the nurse, "She is having an anxiety attack." What assessment can be made by the nurse? a. Severe anxiety is present in this patient. b. Cultural factors control anxiety levels. c. Focusing on discharge instruction will ease the anxiety. d. The level of anxiety cannot be determined at this point.

a. Severe anxiety is present in this patient.

Why is a basic understanding of ethnopharmacology part of being a culturally competent nurse? a. Significant differences among ethnic groups have been found in relation to the effects of medications. b. Ethnopharmacology is a new area of study important to all nurses. c. Nurses should know how medications may affect individual patients to properly administer the medication. d. Pharmacology is a significant aspect of nursing practice.

a. Significant differences among ethnic groups have been found in relation to the effects of medications.

Which of the following is an independent nursing intervention? a. Teaching a patient with congestive heart failure to weigh herself daily b. Recommending an extra dose of diuretic to the patient whose weight has increased 2 pounds overnight c. Changing the first surgical dressing on a patient after surgery d. Transferring a patient out of the intensive care unit 2 days after vascular surgery

a. Teaching a patient with congestive heart failure to weigh herself daily

The nurse is working in a busy emergency department, and is preparing to perform an interview and assessment on a patient with COPD exacerbation. Which factor(s) should the nurse expect to affect the patient interview? Select all that apply. a. The patient's shortness of breath. b. The weather outside. c. The presence of family members. d. The nurse's phone ringing. e. The physician walking into the room.

a. The patient's shortness of breath. c. The presence of family members. d. The nurse's phone ringing. e. The physician walking into the room

The nurse is admitting a patient for surgery. The patient is twisting a handkerchief over and over while saying, Im going to have a little mole removed. Im not worried. The surgery will take only an hour, and then I will go home. Ive never been sick a day in my life, so Ill be fine. The nurse finds the following during her physical assessment: blood pressure is 150/90; temperature is 98.6 F; pulse is 88 beats per minute; respiration is 20 breaths per minute; black, brown, and red pigmented pea-sized raised area on her shoulder. Which of the above information would be considered objective data? (Select all that apply.) a. Twisting handkerchief b. Blood pressure 150/90 c. Im having this little mole removed. d. Patient is worried. e. Patient is exhibiting denial.

a. Twisting handkerchief b. Blood pressure 150/90

The student nurse is discussing consultation as a means of gathering patient data with a clinical instructor. Which statement by the nurse indicates that teaching has been effective? a. "Consultation involves performing a physical assessment." b. "Nurses can use consultation to obtain patient data from other healthcare providers." c. "Consultation is used during the patient interview, and data is obtained from the patient." d. "Nurses cannot use consultation, as it is outside of the nurse's scope of practice."

b. "Nurses can use consultation to obtain patient data from other healthcare providers."

When planning for patient teaching, the nurse is aware that which of the following factors create(s) a barrier to learning? a. Mild anxiety b. Pain and fatigue c. Family presence d. Patient autonomy

b. Pain and fatigue

Which statement by the nurse indicates that further teaching is needed, based on the Paul-Elder critical thinking framework? a. "The critical thinker raises questions and problems and formulates them clearly and precisely." b. "The critical thinker is closed minded." c. "The critical thinker gathers and assesses relevant information, using abstract ideas for interpretation." d. "The critical thinker communicates effectively with others."

b. "The critical thinker is closed minded."

Which statement by the nursing student indicates that further teaching is needed on the nursing process? a. "The nursing process is a method of addressing clinical problems." b. "The nursing process is one area of nursing that has been without criticism." c. "The nursing process is a creative approach to thinking and decision making." d. "The nursing process is the cornerstone of nursing standards."

b. "The nursing process is one area of nursing that has been without criticism."

A new graduate medical-surgical nurse is interested in joining a professional organization. Which organization should the nurse's manager recommend? a. National Student Nurses Association (NSNA) b. American Nurses Association (ANA) c. The unit-based journal club d. A national political action committee

b. American Nurses Association (ANA)

The parents of a 4-year-old diabetic have become increasingly argumentative especially about whether the father helps enough with child care and housekeeping. He works two jobs which leaves little time to help his stay-at-home wife. Which nursing intervention is most appropriate for this family? a. Referring the parents to a marriage counselor b. Discussing with the parents the stresses they perceive in the situation c. Suggesting that the father give up one of his jobs d. Identifying a way to reallocate the child's diabetes care between the parents

b. Discussing with the parents the stresses they perceive in the situation

How could changes in world population affect health? a. Decreasing populations in third world countries frees up limited resources for the remaining population's needs. b. Feeding, immunizing, and providing clean water will become an overwhelming task. c. Massive population increases in some areas will lead to abundant health care in countries with smaller populations. d. More health care resources can be utilized fighting regional problems based on shifting population dynamics.

b. Feeding, immunizing, and providing clean water will become an overwhelming task.

A patient diagnosed with breast cancer responded by gathering information about treatment options and becoming involved in a self-help group. The nurse assesses that the patient is demonstrating which personality characteristic? a. Independence b. Hardiness c. Self-control d. Tolerance

b. Hardiness

The nurse is admitting a patient for surgery. The patient is twisting a handkerchief over and over while saying, Im going to have a little mole removed. Im not worried. The surgery will take only an hour, and then I will go home. Ive never been sick a day in my life, so Ill be fine. The nurse finds the following during her physical assessment: blood pressure is 150/90; temperature is 98.6 F; pulse is 88 beats per minute; respiration is 20 breaths per minute; black, brown, and red pigmented pea-sized raised area on her shoulder. Which of the above information would be considered subjective data? (Select all that apply.) a. Pigmented mole on shoulder b. I'm not worried I'll be fine. c. Patient is anxious. d. Heart rate is increased. e. The surgery will take only an hour and then I will go home.

b. I'm not worried I'll be fine. e. The surgery will take only an hour and then I will go home.

Which of the following patient problems is given the highest priority by the nurse? a. Anxiety related to hospitalization as manifested by hyperactive state b. Impaired tissue perfusion, cerebral, related to hypoxia as manifested by decreased level of consciousness c. Impaired skin integrity related to surgical incision d. Risk for fluid volume overload related to imbalance in antidiuretic hormone as manifested by peripheral edema and decreased sodium

b. Impaired tissue perfusion, cerebral, related to hypoxia as manifested by decreased level of consciousness

Which of the following patient problems is given the highest priority by the nurse using Maslows hierarchy of needs? a. Anxiety related to fear of the hospital b. Ineffective airway clearance related to retained secretions c. Fluid volume excess related to third spacing of fluid (edema) d. Ineffective thermoregulation related to fever

b. Ineffective airway clearance related to retained secretions

A patient states, "I am so upset that I need a knee replacement. I should have done those exercises that the physical therapist told me to do years ago." In which stage of illness is the patient? a. Disbelief and denial b. Irritability and anger c. Attempting to gain control d. Depression and despair

b. Irritability and anger

A patient has been diagnosed with angina. As he talks with the nurse, he asks several good questions about angina and seems able to concentrate on the explanations. He seems eager to learn how to manage his condition. What assessment can be made by the nurse? a. Severe anxiety is present. b. Mild anxiety is present. c. Moderate anxiety is present. d. The level of anxiety cannot be determined.

b. Mild anxiety is present.

The nurse is caring for a patient with chest pain. Which action should the nurse take to obtain objective data? a. Ask how the patient is feeling. b. Note that the patient is diaphoretic. c. Ask the patient to describe the symptoms. d. Ask what the patient believes is the problem.

b. Note that the patient is diaphoretic.

What is true about genetics and nursing practice? a. In the future, all drugs will be genetically based. b. Nurses will need competence in genetics. c. Genetic diseases will become more prevalent. d. All genetic conditions can be identified prenatally.

b. Nurses will need competence in genetics.

A nursing student asks a faculty member how to improve critical thinking. Which response by the faculty is best? a. Dont worry too much; it will come with time and experience. b. Pay close attention to how you solve problems; assess your own style of thinking. c. Spend time shadowing an experienced nurse to see how it is done. d. Use ethical standards to guide how you approach patient situations.

b. Pay close attention to how you solve problems; assess your own style of thinking.

A nurse sees an advertisement for work shoes that include a sexualizing image of a nurse wearing them. Which action by the nurse is best? a. Buying the shoes and complaining to the store manager b. Refusing to buy the shoes and writing a letter of complaint to the company c. Looking around to see if there are other shoes that fit and are appropriate for work d. Asking co-workers what they think about this advertisement campaign

b. Refusing to buy the shoes and writing a letter of complaint to the company

A patient is admitted with the diagnosis of bronchitis, congestive heart failure, and fever. The nurses assessment finds a temperature of 101 F, peripheral edema, and rhonchi. Which of the following is the best etiology to support the nursing diagnosis of ineffective airway clearance? a. Peripheral edema b. Retained secretions c. Bronchitis d. Congestive heart failure

b. Retained secretions

An English-speaking nurse gave a non-English-speaking Asian patient instructions about preparing an abdominal surgical site. The nurse showed the patient how the bottle of povidone-iodine was to be used in cleansing the area. The patient smiled and nodded throughout the instructions. The patient did not respond when asked if he had any questions. When the nurse left the room, the patient promptly drank the bottle of povidone-iodine. Which action would be most effective in preventing this error? a. Giving the patient written instructions in his language b. Using a medical interpreter to give the preoperative instructions c. Having the patient sign a statement that he understood the instructions d. Using illustrations to show the patient the procedure

b. Using a medical interpreter to give the preoperative instructions

A patient is in the intensive care unit after a myocardial infarction and refuses to stay in bed, saying, "I have to be up and walking around. When I stayed in bed after having my babies 40 years ago, I got so weak I could hardly move." This patient's illness behavior is being influenced by ___. a. hardiness b. past experiences c. culture d. role expectations

b. past experiences

The use of standardized plans of care for different patient populations has a. facilitated the use of critical paths as interdisciplinary plans of care. b. required the nurse to individualize the plan of care to the patient. c. eliminated the need for the nurse to develop a plan of care for an individual. d. increased the time the nurse has to document the plan of care.

b. required the nurse to individualize the plan of care to the patient.

The student nurse is listening to a lecture on methods of collecting patient data. Which statement indicates that more teaching is needed? a. "The physical environment can influence the quality of the interview." b. "The presence of family members can constrain the flow of information from the patient." c. "Internal factors related to the patient's condition rarely influence the type and amount of data obtained." d. "Patients may not speak freely in a semi-private room."

c. "Internal factors related to the patient's condition rarely influence the type and amount of data obtained."

A patient asks a nurse to explain pharmacogenetics. Which response by the nurse is best? a. "It is the effect of pharmaceutical agents on a person's genes." b. "It uses genetic information to determine if particular drugs will work in a person." c. "It is the science of using a person's genes to help create new medications." d. "It was the project that mapped and sequenced human genes."

c. "It is the science of using a person's genes to help create new medications."

A patient states, "I do not understand why I keep getting these headaches. I have seen a nurse practitioner and two specialists. I have taken several medications, but the headaches keep coming back." In which stage of illness is the patient? a. Disbelief and denial b. Irritability and anger c. Attempting to gain control d. Acceptance and participation

c. Attempting to gain control

What is the focus of the Truth About Nursing Campaign? a. Educating high school students about the nature of nursing b. Increasing interdisciplinary collaboration by highlighting nursing achievements c. Changing how the world thinks of nursing and protecting its image d. Defending nurses against malpractice by supplying expert witnesses at trial

c. Changing how the world thinks of nursing and protecting its image

Which action can the nurse take to demonstrate critical thinking skills? a. Educate the patient on how to perform wound care at home. b. Take extra patients on a busy day. c. Communicate effectively as solutions are being formulated. d. Orient a new nurse to the unit.

c. Communicate effectively as solutions are being formulated.

Which of the following is an appropriate intervention for the nursing diagnosis of spiritual distress? a. Never pray with patients or share readings that can have a religious connection. b. Inform patients of the prevalent religious beliefs that exist in the locale where they are being treated. c. Consider patients' religious beliefs when planning care. d. Reassure patients that they should not blame God for their illness.

c. Consider patients' religious beliefs when planning care.

Which of the following is a correctly stated nursing diagnosis? a. Fluid volume deficit b. Hypovolemia related to vomiting c. Fluid volume deficit related to vomiting as evidenced by increased heart rate and decreased urine output d. Hypovolemia related to nausea as evidenced by restlessness and anxiety

c. Fluid volume deficit related to vomiting as evidenced by increased heart rate and decreased urine output

A nursing manager has noticed increasing incidents of rudeness and lack of cooperation among co-workers. Which action by the manager is best? a. Holding a staff meeting and reminding the staff of policies regarding behavior b. Disciplining the "ringleaders" in order to make an example for the other staff c. Having informal meetings to solicit staff opinions on the workplace d. Announcing that raises will be withheld from staff members engaging in this behavior

c. Having informal meetings to solicit staff opinions on the workplace

What does the process of analysis of patient data directly result in? a. Validating actual problems or diagnoses b. Determining the nursing interventions of importance c. Identifying actual or potential problems amenable to nursing intervention d. Confirming the medical diagnosis

c. Identifying actual or potential problems amenable to nursing intervention

The nurse instructs the patient about incentive spirometry as preoperative teaching. Which phase of the nursing process does this illustrate? a. Assessment b. Planning c. Implementation d. Evaluation

c. Implementation

Which illness has the characteristics of an acute illness? a. Exercise-induced asthma b. Type 2 diabetes c. Influenza d. Cleft palate

c. Influenza

What is the primary method of obtaining patient data? a. Medical record b. Speaking with family c. Interview with patient d. Physical examination

c. Interview with patient

A nurse is admitting a non-English speaking patient to the hospital unit. Which is the best method of obtaining data from the patient? a. Asking the other family members to help interpret b. Performing a physical examination on the patient c. Interviewing the patient using a professional interpreter d. Attempting to obtain past medical records for this patient

c. Interviewing the patient using a professional interpreter

A nurse manager wants to cut costs and eliminate expensive latex-free gloves. Which response by the chief nursing officer (CNO) is best? a. Allowing the change because it will save substantial money b. Allowing the change because the manager is in charge of the unit's budget c. Not allowing the change because latex allergy is fairly common d. Not allowing the change until the next vendor bidding cycle occurs

c. Not allowing the change because latex allergy is fairly common

The nurse is caring for a patient who is well-known in the community. Which action should the nurse take to protect the patient's privacy? a. Share the information with only one of patient's family members. b. Make sure that social media accounts are set as private before sharing information. c. Only share information with health care providers directly involved in the care of the patient. d. Only have conversations about the patient in the staff break room.

c. Only share information with health care providers directly involved in the care of the patient.

Which of the following is an appropriate long-term goal to measure diabetes control for a patient in whom diabetes has been newly diagnosed? a. Patient will inject insulin twice daily. b. Patient will keep appointments with physician over the next 6 months. c. Patients A1c will be 5% at 1 year postdiagnosis. d. Patients recorded blood glucose will be between 60 and 120 mg/dL each day.

c. Patients A1c will be 5% at 1 year postdiagnosis.

A nurse reviewing a patients care plan notes a goal of Patient will ambulate 50 feet, three times in the hallway today. According to Bloom, what taxonomic category is this goal? a. Affective domain b. Physical domain c. Psychomotor domain d. Cognitive domain

c. Psychomotor domain

A nursing student is complaining about writing care plans. Which response by the faculty is best to help the student see the importance of this activity? a. Using the nursing process will help nurses get reimbursement for their services. b. You need a written plan of care so everyone is on the same page as you are. c. The nursing process is a way to systematically think about and use patient data. d. Most state nurse practice acts require them, so you need to learn how to do them.

c. The nursing process is a way to systematically think about and use patient data.

A patient is admitted with asthma. The nurses assessment finds a temperature of 99 F, wheezing, speaking in three-word phrases, and respiratory rate of 16 breaths per minute. Which of the following are the best defining characteristics to support the diagnosis of ineffective airway clearance related to inflammation and constriction of the bronchial tree? a.Elevated temperature and respiratory rate b. Diagnosis of asthma with wheezing c. Wheezing and speaking in three-word phrases d. Limited vocalization and fever

c. Wheezing and speaking in three-word phrases

The best definition of ethnocentrism is ___. a. a tendency to compare the behavior of others with your own cultural values. b. an astute awareness of your own personal biases regarding other cultures. c. a tendency to view your own culture as superior to others. d. the ability to incorporate patients' cultural beliefs and values into health teaching.

c. a tendency to view your own culture as superior to others.

A Caucasian nurse is caring for a Native American after a stroke. The nurse finds the patient sleeping while holding several small feathers bound by a beaded leather thong. The nurse should consider the possibility that this is ___. a. an interesting trinket to brighten the environment. b. a gift from his grandchildren to make him feel closer to the family. c. an important item used in native healing practices. d. an item that might introduce microorganisms into the hospital environment.

c. an important item used in native healing practices.

The nurse observes a patient lying rigidly in bed and taking shallow breaths. The patient reports a pain score of 4 out of 5 and says, My leg hurts. The nurse determines that the objective and subjective data are a. incongruent and require more assessment. b. insufficient to make any conclusions. c. congruent and support that the patient is in pain. d. unclear; the nurse needs to talk to the patients family for more information.

c. congruent and support that the patient is in pain.

Nurses can best help patients deal with stress by ___. a. helping patients eliminate all stress from their lives. b. helping patients communicate their stress better to friends and family. c. helping patients evaluate their lifestyles for areas of potential stress. d. intervening in the family system to reduce family stress.

c. helping patients evaluate their lifestyles for areas of potential stress.

What is meant by "workplace incivility"? a. A setting in which there are poor relationships among different professional specialties b. A setting in which different professions vie to take over the functions of other professional groups c. A setting in which the manager is unreceptive, hostile, and creates dissention d. A setting where colleagues bully, intimidate, or use aggression toward each other

d. A setting where colleagues bully, intimidate, or use aggression toward each other

A patient states, "I have knowledge about my diet and how to do my insulin injections, so I can get on with my life." In which stage of illness is this patient? a. Disbelief and denial b. Irritability and anger c. Attempting to gain control d. Acceptance and participation

d. Acceptance and participation

The nurse plans to obtain subjective data from the patient. Which action should the nurse take to obtain this information? a. Take the patient's blood pressure. b. Order a lab draw to check blood glucose. c. Ask the patient to stand and walk. d. Ask the patient to rate pain.

d. Ask the patient to rate pain.

Which of the following is considered objective data obtained from the patient? a. I cant catch my breath. b. Patient expresses concern about missing work. c. Patient nods, indicating an affirmative answer to a question. d. Blood pressure is 110/70 at 8 PM.

d. Blood pressure is 110/70 at 8 PM.

A patient tells the nurse, "I'll let you do whatever you think is best for me." The patient does very little independently without calling for assistance. The nurses conclude that the patient is demonstrating which personality characteristic? a. Acceptance b. Sense of control c. Coping d. Dependence

d. Dependence

A patient states, "There is no hope. They're going to keep me here until I die. Can't you give me my medication more often? I'm going to die anyway." In which stage of illness is this patient? a. Disbelief and denial b. Irritability and anger c. Attempting to gain control d. Depression and grief

d. Depression and grief

A young girl from a Middle Eastern country is in the process of dying. Her parents ask the nurses to allow her to be prepared for death by being dressed in a specific garment and headdress every day. The parents cannot be there every day to do this and ask the nurses to apply the attire. Which actions by the nurses demonstrate culturally competent care? a. Allowing the parents to dress the patient in the garment and headdress when they are by her side b. Consulting the chaplain as to the meaning of the ritual in the Middle East c. Informing the parents that hospital policy requires all patients to wear hospital garments d. Learning how to apply the garment and headdress properly

d. Learning how to apply the garment and headdress properly

Which of the following describes the primary difference between nursing diagnoses and medical diagnoses? a. Nursing diagnoses identify simple instead of complex problems. b. Nursing diagnoses must be verified by a physician. c. Nursing diagnoses, like medical diagnoses, identify medical diseases. d. Nursing diagnoses identify problems that can be treated with independent nursing actions.

d. Nursing diagnoses identify problems that can be treated with independent nursing actions.

Which of the following is considered subjective data in information gathering from the patient? a. Pulse and blood pressure measurements b. ECG pattern c. Diaphoresis d. Pain

d. Pain

Which of the following represents an interdependent nursing action? a. Giving the patient an ordered medication b. Bathing the patient c. Inserting a Foley catheter d. Participating in a code (cardiac arrest response)

d. Participating in a code (cardiac arrest response)

The identification of nursing diagnosis and goal setting should ideally be a collaborative process between the nurse and which other party? a. Physician b. Nurse manager c. Patients family d. Patient

d. Patient

A patient is in respiratory distress and placed on oxygen. Which is the most appropriate short-term goal? a. Nasal cannula remains in place. b. Patient completes morning care and eats breakfast. c. Patient verbalizes that he is breathing better after lunch. d. Patient maintains an oxygen saturation of 90% during the shift.

d. Patient maintains an oxygen saturation of 90% during the shift.

A new manager is hired and is reviewing unit records. The manager finds a list of accidents, errors, and interpersonal problems on the staff. Which action by the manager is best? a. Investigating the educational credentials and experience of the staff b. Hiring more registered nurses and assistive personnel c. Comparing this unit's records with similar units in the hospital d. Researching alternative staffing patterns and the effects of shift work

d. Researching alternative staffing patterns and the effects of shift work

A patient was diagnosed with ovarian cancer 5 years ago. She underwent chemotherapy and radiotherapy, but cancer returned 2 years ago with metastases to the bone and possibly the lung. She says the cancer is "no longer curable, but treatable." During this time the patient's daughter was critically injured in a car accident and now lives with a traumatic brain injury, needing round-the-clock care. Her husband had an affair. She continues to work and volunteers with various community groups. Which phenomenon is the patient demonstrating? a. Resourcefulness b. Independence c. Acceptance D. Resilience

d. Resilience

The nurse is planning short term goals for a patient. Which goal should be included? a. Quit smoking. b. Lose 50 pounds. c. Lower cholesterol by 30 points. d. Sleep 8 hours per night.

d. Sleep 8 hours per night.

In the nursing process, the evaluation phase is used to determine the a. value of the nursing intervention. b. accuracy of problem identification. c. the quality of the plan of care. d. degree of outcome achievement.

d. degree of outcome achievement.

A patient in whom cancer has just been diagnosed tells the nurse, "Just get out of here and leave me alone! Let me suffer alone. God is punishing me." The nurse determines that the most appropriate nursing diagnosis for this patient is ___. a. risk for loneliness b. powerlessness c. dysfunctional grieving d. spiritual distress

d. spiritual distress