Fundamentals: Chapter 1 - Nursing Today

Advanced practice registered nurses generally: 1. Function independently 2. Function as unit directors 3. Work in acute care settings 4. Work in the university setting

1. Function independently Advanced practice registered nurse functions independently as a clinician, educator, case manager, consultant, and researcher within his or her area of practice to plan or improve the quality of nursing care for the patient and family.

Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) 1. Caregiver 2. Autonomy and accountability 3. Patient advocate 4. Health promotion 5. Lobbyist

1. Caregiver 2. Autonomy and accountability 3. Patient advocate 4. Health promotion Each of these roles includes activities for the professional nurse. Each of these is used in direct care or is part of professionalism that guides nursing practice. Some nurses are lobbyists, but being a lobbyist is not expected of all professional nurses.

Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform? 1. Moving from an acute illness to a health promotion, illness prevention model 2. Moving from illness prevention to a health promotion model 3. Moving from an acute illness to a disease management model 4. Moving from a chronic care to an illness prevention model

1. Moving from an acute illness to a health promotion, illness prevention model Health care reform also affects how health care is delivered. There is greater emphasis on health promotion, disease prevention, and management of illness.

A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with the family. The nurse is acting as the patient's: 1. Educator 2. Advocate 3. Caregiver 4. Case manager

2. Advocate An advocate protects the patient's human and legal right to make choices about his or her care. An advocate may also provide additional information to help a patient decide whether or not to accept a treatment or find an interpreter to help family members communicate their concerns.

Which of the following nursing roles may have prescriptive authority in their practice? (Select all that apply.) 1. Critical care nurse 2. Nurse practitioner 3. Certified clinical nurse specialist 4. Charge nurse

2. Nurse practitioner Nurse practitioners and certified clinical nurse specialists encompass the role and preparation of the advanced practice registered nurse. According to the American Nurses Association standards of practice, prescriptive authority may be granted to these nurses

A nurse is caring for an older-adult couple in a community-based assisted living facility. During the family assessment he notes that the couple has many expired medications and multiple medications for their respective chronic illnesses. They note that they go to two different health care providers. The nurse begins to work with the couple to determine what they know about their medications and helps them decide on one care provider rather than two. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? 1. Patient-centered care 2. Safety 3. Teamwork and collaboration 4. Informatics

2. Safety Helping the patients understand the consequences and complications of multiple medications helps to build the competency in safety.

Evidence-based practice is defined as: 1. Nursing care based on tradition 2. Scholarly inquiry of nursing and biomedical research literature 3. A problem-solving approach that integrates best current evidence with clinical practice 4. Quality nursing care provided in an efficient and economically sound manner

3. A problem-solving approach that integrates best current evidence with clinical practice Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.

An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, auscultates her lung sounds, listens to her heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? 1. Diagnosis 2. Evaluation 3. Assessment 4. Implementation

3. Assessment Assessment is the collection of comprehensive data pertinent to the patient's health and/or the situation.

Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? 1. Continuing education 2. Graduate education 3. In-service education 4. Professional Registered Nurse Education

3. In-service education In-service education programs are instruction or training provided by a health care agency or institution. An in-service program is held in the institution and is designed to increase the knowledge, skills, and competencies of nurses and other health care professionals employed by the institution.

You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A nonnursing colleague asks about this code. Which of the following statements best describes this code? 1. Improves self-health care 2. Protects the patient's confidentiality 3. Ensures identical care to all patients 4. Defines the principles of right and wrong to provide patient care

4. Defines the principles of right and wrong to provide patient care When giving care, it is essential to provide a specified service according to standards of practice and to follow a code of ethics. The code of ethics is the philosophical ideals of right and wrong that define the principles you will use to provide care for your patients. The code serves as a guide for carrying out nursing responsibilities to provide quality nursing care and the ethical obligations of the profession.

A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed? 1. Planning 2. Evaluation 3. Assessment 4. Implementation

4. Implementation Implementation is completing coordinating care and the prescribed plan of care.

A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? 1. Patient-centered care 2. Safety 3. Teamwork and collaboration 4. Informatics

4. Informatics Using decision support systems is one example of using and gaining competency in informatics.

The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? 1. Clinical nurse specialist 2. Nurse administrator 3. Nurse educator 4. Nurse researcher

4. Nurse researcher The nurse researcher investigates problems to improve nursing care and to further define and expand the scope of nursing practice. He or she often works in an academic setting, hospital, or independent professional or community service agency.

The examination for registered nurse licensure is exactly the same in every state in the United States. This examination: 1. Guarantees safe nursing care for all patients 2. Ensures standard nursing care for all patients 3. Ensures that honest and ethical care is provided 4. Provides a minimal standard of knowledge for a registered nurse in practice

4. Provides a minimal standard of knowledge for a registered nurse in practice Registered nurse (RN) candidates must pass the NCLEX-RN® that the individual State Boards of Nursing administer. Regardless of educational preparation, the examination for RN licensure is exactly the same in every state in the United States. This provides a standardized minimum knowledge base for nurses.

A nurse is working with a young childbearing family who has one child with a congenital heart disease. The parents are trying to determine the risks of a second child being born with congenital heart disease. Describe why genomics information is important in assisting the parents in this decision.

Genomics can help identify possible genetic defects that the parents may pass on to their children.