Fundamentals Prep U Exam 3 Chapter 8, 9, 10, +

A nurse finds that a client has infiltration around the IV line that needs to be removed. What explanation should the nurse give to reduce the client's anxiety? a) "The infiltration is causing you pain and you will be relieved when I remove the IV line." b) "I know that you are anxious, but removal will be painless and the IV location needs to be changed." c) "You should relax and take deep breaths; the procedure is very minimal and will be over soon." d) "It will be a painless procedure and there is nothing to worry about; many clients experience this."

"I know that you are anxious, but removal will be painless and the IV location needs to be changed." Explanation: The nurse uses therapeutic communication by both acknowledging the client's anxiety and giving honest information that another IV line needs to be started. Telling the client that infiltration is causing pain that would be relieved when the IV line is removed does not address the client's anxiety and does not inform the client about restarting another IV line. Also, the nurse telling the client to take deep breaths, or saying that the procedure is very minimal and will be over soon, does not consider the client's anxiety. Finally, telling the client that many clients experience this is generalizing the client and is not appropriate. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 21: Communicator, p. 449-450.

The nurse has arranged to start an IV line for a client with pancreatitis. The nurse notes that the client appears anxious about the procedure. Which of the following is the most appropriate response by the nurse to decrease the client's anxiety? a) "I will start an IV that will add fluids directly to the blood stream." b) "I will start an IV, which should not cause you too much pain." c) "I will start an IV, which should not take much time." d) "I will start an IV with the number 18 catheters."

"I will start an IV that will add fluids directly to the blood stream." Explanation: The nurse should explain the procedure and its purpose. The nurse telling the client that it should not take much time does not convey the purpose of the procedure. It is unnecessary for the nurse to inform the client about the technical details of the catheter. Additionally, the nurse should not give false reassurance by telling the client that the procedure will not be painful. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 21: Communicator, p. 452-453.

A home healthcare nurse is discussing home healthcare during a presentation for a group of senior nursing students as part of a career day seminar. One of the students asks, "How is home healthcare different from care in a hospital?" Which response by the nurse would be most appropriate? a) "You need a graduate degree to specialize in home healthcare." b) "The client and family are in control of the setting, not the nurse." c) "Each team member works independently of other team members." d) "It requires that you have high-level critical care skils."

"The client and family are in control of the setting, not the nurse." Explanation: In home healthcare, the nurse is a "guest" in the client's home and on the client's turf. Thus the client and family retain the power and control that they give to providers in other settings such as an acute care facility. A generalist background and focus are useful as well as broad assessment skills and a knowledge base to provide clients with appropriate teaching to help them remain as independent as possible. Graduate degree and high-level critical care skills are not necessary. Collaboration among team members is essential. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 10: Home Healthcare, p. 176.

The nurse has entered a patient's room and observes that the patient is hunched over and appears to be breathing rapidly. What type of question should the nurse first implement in this interaction? a) A reflective question b) An open-ended question c) A directing question d) A yes/no question

A yes/no question Explanation: There are times when yes/no questions are appropriate. In this case, the nurse may want to ask, "Do you feel short of breath?" or something similar. Directing questions and reflective questions follow up on earlier communication. An open-ended question may elicit the necessary assessment data but a yes/no question accomplishes this goal more directly. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 21: Communicator, p. 456.

The nurse has entered a patient's room and observes that the patient is hunched over and appears to be breathing rapidly. What type of question should the nurse first implement in this interaction? a) A yes/no question b) An open-ended question c) A directing question d) A reflective question

A yes/no question Explanation: There are times when yes/no questions are appropriate. In this case, the nurse may want to ask, "Do you feel short of breath?" or something similar. Directing questions and reflective questions follow up on earlier communication. An open-ended question may elicit the necessary assessment data but a yes/no question accomplishes this goal more directly. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 21: Communicator, p. 456.

A 20-year-old pregnant patient is visibly distraught when the labor and delivery nurse tells her that she requires a urinary catheter. The patient is embarrassed by her anxiety and eventually tells the nurse that this is because of "what my father used to do to me." In addition to fulfilling any legal obligation to report the patient's statement, which of the nurse's following actions is most appropriate? a) Explore the matter in greater detail with the patient and encourage her to report this to the authorities. b) Thank the patient for her candor and explore the possibility of the nurse providing long-term counseling. c) Begin motivational counseling to help the patient overcome her difficult past. d) Acknowledge the significance of the patient's statement and facilitate a counseling referral.

Acknowledge the significance of the patient's statement and facilitate a counseling referral. Explanation: The gravity of the patient's statement indicates a need for professional counseling that is beyond the scope of the labor and delivery nurse. Acknowledgement of the patient's statement is necessary, and there is a legal responsibility for the nurse to report the matter in most jurisdictions; it would be inappropriate to place this onus solely on the patient. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 22: Teacher and Counselor, p. 490.

What type of practice was challenged by clients who want to be treated as whole persons, not just as a disease? a) Holistic care b) Altruistic medicine c) Homeopathic care d) Allopathic medicine

Allopathic medicine Explanation: Allopathic medicine was challenged by "patients who wanted to be treated as whole persons, not just as a disease". ... (more) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 28: Complementary and Alternative Therapies, p. 716.

During the initial visit to a patient's home, what information is it important to provide the patient and family with? a) Information on other patients in the area with similar health care needs b) The nurse's home address and phone number c) Dates and times of all scheduled home care visits d) Available community resources to meet their needs

Available community resources to meet their needs Explanation: The community-based nurse is responsible for informing the patient and family about the community resources available to meet their needs. During initial and subsequent home visits, the nurse helps the patient and family identify these community services and encourages them to contact the appropriate agencies. When appropriate, nurses may make the initial contact. The other answers are incorrect because it is inappropriate to ever provide information on other patients to a patient; it is equally inappropriate for a nurse to give her patient's her home address or phone number. Giving the patient the dates and times of their scheduled home visits is appropriate but it is more important to provide them with resources available within the community to meet their needs. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 10: Home Healthcare, p. 180.

A 20-year-old client reads the nutritional chart and follows it accurately. The nurse also notes that the client understands the need of a balanced diet and its relationship with a quick recovery. Which domain correctly identifies the client's learning style? a) Affective domain b) Psychomotor domain c) Cognitive domain d) Interpersonal domain

Cognitive domain Explanation: As the client is able to understand the need for a balanced diet after the session and follows the nutritional chart accurately, her learning style falls in the cognitive domain. The cognitive domain is a style of processing information by listening to or reading facts and descriptions. The affective domain is a style of processing that appeals to a person's feelings, beliefs, or values. The psychomotor domain is a style of processing that focuses on learning by doing. The interpersonal domain is a style of processing that focuses on learning through social relationships. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 22: Teacher and Counselor, p. 476.

An example of primary healthcare is a) A hearing screening in the school setting b) Care of the client on rehabilitation c) Diagnostic testing for HIV/AIDS d) Care of the client in the intensive care unit

Correct response: A hearing screening in the school setting Explanation: Primary prevention or primary healthcare involves the screening of clients in the prevention of disease. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 143.

In the provision of nursing care, it is most important to perform which of the following actions? a) Evaluation of client's responses b) Administration of prescribed medications c) Implementation of physician's orders d) Coordination of care with the healthcare team

Correct response: Coordination of care with the healthcare team Explanation: Nurses have moved from simply observing and giving prescribed medications to coordinating clinical information for the entire healthcare team. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 142.

Which qualities in a nurse help the nurse to become effective in providing for a client's needs while remaining compassionately detached? a) Kindness b) Commiseration c) Empathy d) Sympathy

Correct response: Empathy Explanation: Empathy refers to intuitive awareness of what the client is experiencing. It helps the nurse perform his or her activities and remain emotionally neutral. Sympathy means feeling as emotionally distraught as the client. If the nurse sympathizes with the client, the nurse may feel equally disturbed, and his or her performance may be affected. Kindness and commiseration also have an emotional component attached to them. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 21: Communicator, p. 451.

When a patient is admitted to the hospital, admissions personnel are required to determine if the patient has a document indicating advanced directives. If so, a copy is made for the patient's medical record. The advanced directive document indicates: a) that he refuses to have resuscitation measures or any life-prolonging care. b) that the patient has made his wishes for terminal care known. c) that the patient assigned a relative to act on their behalf. d) that an attorney has verified the living will papers.

Correct response: that the patient has made his wishes for terminal care known. Explanation: It is important to determine if the patient has advanced directives, which indicate what he wants should he become incompetent or dying. Advanced directives may be documented in a living will or durable power of attorney for healthcare document. A copy should be placed in the patient's hospital record. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 9: Continuity of Care, p. 159.

Choice Multiple question - Select all answer choices that apply. The nurse has just completed a patient's home visit and has scheduled another patient's visit immediately after. Which of the following measures should the nurse take in order to minimize risks of infection during home visits? Select all that apply. a) The nurse should implement standard precautions during home visits. b) The nurse should perform hand hygiene before and after patient contact. c) The nurse should wear gloves at all times while performing a home visit. d) Sterile gloves should be worn if blood or body fluid contact is anticipated. e) Consecutive home visits should be avoided whenever possible.

Correct response: • The nurse should perform hand hygiene before and after patient contact. • The nurse should implement standard precautions during home visits. Explanation: Hand hygiene is the most important infection control measure and is necessary before and after treating the patient. Nurses use standard precautions during home care visits, including wearing gloves when contacting blood, body fluids, secretions, excretions, and contaminated items. However, neither sterile gloves nor the wearing of gloves at all times are necessary to control infection. Performing consecutive home visits is an acceptable practice and any accompanying risk of infection can be controlled with conscientious infection control practices. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 10: Home Healthcare, p. 182.

A nursing student is caring for a client who is experiencing pain. In assessing for pain, the nursing student should use what skill in the provision of care? a) Evaluation b) Observational intervention c) Quantitative analysis d) Critical thinking

Critical thinking Explanation: Developing critical thinking skills enables the nursing student to place multiple factors into complex equations and arrive at appropriate conclusions. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 151.

A group of students is discussing theories related to aging with their clinical instructor. Which theory is best characterized by the concept that a chemical reaction produces damage to the DNA and cell death results? a) Free radical theory b) Immunity theory c) Genetic theory d) Cross-linkage theory

Cross-linkage theory Explanation: Cross-linkage is a chemical reaction that produces damage to the DNA and cell death. As one ages, cross-links accumulate, leading to essential molecules in the cell binding together and interfering with normal cell function. Free radical theory states that free radicals, formed during cellular metabolism, are molecules with separated high-energy electrons, which can have adverse effects on adjacent molecules. Lipids, proteins, and cell organelles are affected, and over time, irreversible damage results from the accumulated effects of this free radical damage. The immunity theory focuses on the functions of the immune system. The genetic theory of aging holds that life spans depend to a great extent on genetic factors. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 20: The Aging Adult, p. 408.

A nurse notices that a toddler is constantly snatching toys from the hands of other preschool children at the healthcare facility, placing the toddler and other children at risk for injury. Which of the following would be most effective method for teaching the toddler not to snatch toys? a) Enlist the aid of the toddler's parents in teaching b) Give the toddler another toy to play with c) Ask the children to play another game d) Tell the toddler that God punishes children who snatch

Enlist the aid of the toddler's parents in teaching Explanation: The nurse should inform the toddler's parents as to his or her behavior. Since toddlers and preschoolers are accustomed to learning from and communicating with their parents, the parents are usually the most effective teachers. Children learn through play, so using dolls or toys as models can enhance learning. Giving another toy to the toddler or asking the children to play another game may not solve the problem as the toddler would still want somebody else's toys. Telling the toddler that God punishes children who snatch is not correct because the nurse is indirectly trying to scare and threaten the toddler. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 22: Teacher and Counselor, p. 472.

A nurse is caring for a 72-year-old client with arthritis. Which action is the highest priority for the nurse when conducting the health teaching for the client? a) Find out what the client wants to know b) Divide information into manageable amounts c) Identify how long the teaching session will last d) Provide an environment that promotes learning

Find out what the client wants to know Explanation: Finding out what the client wants to know helps the nurse in showing personal interest, which facilitates better learning to an adult client. Dividing information into manageable amounts, providing an environment that promotes learning, and identifying how long the teaching session will last can be done only when the assessment of the client is completed. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 22: Teacher and Counselor, p. 477.

A patient has a complex medical history involving the consequences of type 1 diabetes. As a result of his diabetic nephropathy, he is now a patient of the local hospital's dialysis program and he has been referred to an ophthalmologist by his primary care physician following the onset of vision problems. In addition, he receives homecare nursing for the treatment of a foot ulcer that is slow to heal. This patient's situation characterizes which of the following phenomena? a) Fragmentation of care b) Case management c) Managed care d) Primary care

Fragmentation of care Explanation: Fragmentation of care occurs when multiple, specialized practitioners are involved in various aspects of a complex patient's care. This creates the potential for miscommunication and conflicting advice and treatment with the lack of a unified plan of care. This situation is not indicative of primary care and it is not necessarily a consequence or manifestation of case management and managed care. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 151.

The mind and body are connected in the provision of care. This statement describes a) Altruistic care b) Holistic care c) Homeopathic care d) Allopathic care

Holistic care Explanation: Holistic interventions focus on the interrelated needs of body, mind, emotions, and spirit. Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 28: Complementary and Alternative Therapies, p. 701.

The mind and body are connected in the provision of care. This statement describes a) Holistic care b) Allopathic care c) Altruistic care d) Homeopathic care

Holistic care Explanation: Holistic interventions focus on the interrelated needs of body, mind, emotions, and spirit. Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 28: Complementary and Alternative Therapies, p. 701.

Nurses who assist clients to deal holistically with their healthcare needs at the end of their lives work primarily in which healthcare delivery system? a) Hospice b) Rehabilitation c) Acute care d) Primary care

Hospice Explanation: The opportunity to help people maintain their ability to remain at home and deal holistically with their health and family needs at the end of their lives is home health hospice care. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 145.

You are the nurse admitting a patient to an ambulatory care facility. What is the most important nursing function at this time? a) Checking the admitting physician's orders. b) Identifying the immediate needs of the patient. c) Obtaining a baseline set of vital signs. d) Allowing the family to be with the patient.

Identifying the immediate needs of the patient. Explanation: Among the nurse's important functions in health care delivery is identifying the patient's immediate needs and working in concert with the patient to address them. The other nursing functions are important but they are not the most important function. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 9: Continuity of Care, p. 158.

One of the leading causes of death in the United States, particularly in southwestern states, is drowning. How can the nurse assist in lowering this statistic? a) Require fencing around all pools b) Begin swim lessons with toddlers c) Educate children in cardiopulmonary resuscitation d) Implement drowning-prevention strategies

Implement drowning-prevention strategies Explanation: The principles of injury control have interventions centered at three primary levels: the individual level, providing education about safety hazards and prevention strategies; the design phase, using engineering and environmental controls; and the regulatory level, creating, monitoring, and enforcing regulations to ensure safe products and environments among manufacturers, retailers, employers, workers, and product users. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 26: Safety, Security, and Emergency Preparedness, p. 621.

Which of the following statements should the nurse include in the teaching plan regarding safety issues that she is preparing for a group of adult clients? a) Environmental lead is a primary cause of death in adult clients b) Suicide is the leading cause of death in adults and adolescents c) Occupational safety controls for all workplace hazards d) In most age groups, motor vehicle accidents are major causes of death

In most age groups, motor vehicle accidents are major causes of death Explanation: Motor vehicles continue to be the major cause of deaths related to unintentional injuries for all age groups up to 80 years. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 26: Safety, Security, and Emergency Preparedness, p. 627.

Which of the following would be the least consistent as a reason for the use of complementary and alternative medicine (CAM)? a) Increasing numbers of acute conditions b) Difficulty meeting rising healthcare costs c) Growth of culturally diverse groups d) Dissatisfaction with conventional medicine

Increasing numbers of acute conditions Explanation: There are increasing numbers of people with chronic, incurable conditions. Reasons to use CAM include dissatisfaction with conventional medicine, difficulty meeting rising healthcare costs, and a growth of culturally diverse groups. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 28: Complementary and Alternative Therapies, p. 702.

The client is experiencing a cold and has sinus congestion. The client is prescribed a decongestant by his primary care provider. The client has a poor response to the decongestant and seeks to include acupuncture treatment. The nurse explains the use of a decongestant and acupuncture at the same time is called what type of therapy? a) Alternative b) Allopathic c) Holistic d) Integrative

Integrative Explanation: Integrative care is a combination of allopathic medicine and complementary therapies and/or alternative modalities. Allopathic medicine, also known as biomedicine, is conventional medical care and includes pharmacological and surgical interventions. Alternative modalities are those interventions that are not included in the scope of conventional medical care. Holistic care refers to the connection and interactions between parts of the whole. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 28: Complementary and Alternative Therapies, p. 699-701.

A nurse is preparing to provide care to a client who is receiving radiation therapy for cancer in which the radiation source will be kept in the client's room. Which of the following would be most important for the nurse to do? a) Wear an apron made of thick cotton material b) Dispose of linens immediately upon exposure c) Limit own exposure to radiation for the minimum time d) Ensure client is admitted to a semi-private room

Limit own exposure to radiation for the minimum time Explanation: The nurse should be aware that ionizing radiation can adversely affect the health. Consequently, the time of exposure should be minimized. Linens should be kept in the room until the radiation source is removed. They require special labeling and disposal. Nurses should use a lead apron, not one made of thick cotton. The client should be admitted to a private room with a private bath, not to a general unit, in order to prevent exposure of other clients. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 26: Safety, Security, and Emergency Preparedness, p. 642.

A nurse is discussing the benefits of smoking cessation with a patient. The nurse informs the patient that smoking cessation will reduce his risk for cancer, improve his respiratory status, and enhance the quality of his life. The nurse also shares her story of smoking cessation, provides information on other individuals who have successfully quit, and encourages the patient to attend a support group for smoking cessation. The patient discusses his feelings on smoking cessation and verbalizes a desire to quit smoking. What type of counseling did the nurse provide to this patient? a) Long-term counseling b) Motivational counseling c) Developmental counseling d) Situational counseling

Motivational counseling Explanation: Motivational counseling involves discussing feelings and incentives with the patient. Long-term counseling extends over a period of time. Developmental counseling occurs when a patient is going through a developmental stage or passage. Situational counseling occurs when a patient faces an event or situational crisis. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 22: Teacher and Counselor, p. 489.

A patient is experiencing difficulty in adjusting to a new prosthesis despite conscientious patient teaching by numerous members of the healthcare team. How should the team respond to the patient's lack of learning to this point? a) Scale back the scope and detail of patient teaching. b) Revise the teaching plan that has guided education. c) Explore alternatives to prosthesis. d) Refer the patient to outside sources of information.

Revise the teaching plan that has guided education. Explanation: If evaluation of patient teaching indicates that patient learning has not met outcomes, it is appropriate to revise the teaching plan. This does not necessarily entail reducing the detail or referring the patient to outside information sources. Exploring alternatives to prosthesis does not address the patient's learning needs. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 22: Teacher and Counselor, p. 472.

The U.S. system of healthcare is based on an ability to pay for care, which leaves millions of people uninsured or underinsured, with inadequate access to healthcare. Nurses are often presented with ethical dilemmas when caring for patients and families. Which of the following is an example of an ethical dilemma? Select all that apply. a) All patients are entitled to care, whether they can pay or not, because healthcare is a right. b) You may have to pay higher insurance premiums to cover the cost of care because you smoke. c) There are free clinics and health programs to serve the poor, they should receive healthcare there. d) Should the uninsured person, who cannot pay for healthcare, receive the same care and services as someone who works and pays for insurance?

Should the uninsured person, who cannot pay for healthcare, receive the same care and services as someone who works and pays for insurance? Explanation: Only D. suggests an ethical dilemma for which there is no easy answer. A. is an assumption that many have about health care, B. is a fact, that some health insurance programs charge more for those who smoke, and C. is an opinion, as although there are some clinics for the poor, healthcare access is limited. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 151.

You are the nurse employed in an acute care hospital. The head nurse states that you will be caring for 12 clients with the help of two nurse assistants. This is considered to be what type of nursing care delivery? a) Tertiary care b) Modular nursing c) Team nursing d) Primary care

Team nursing Explanation: Team nursing is the provision of care with a nurse supervising the work of one or more aides. Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 147.

Which of the following statements best describes palliative care? a) The goal is to prevent and relieve suffering by early assessment and treatment of pain and other physical, psychosocial, and spiritual needs. b) It commonly occurs in the home environment and involves primarily the skills of the nurse. c) It is the time of mourning experienced after a loss, and hospice will provide continuation of care for the family during this period of time. d) It is a related area of care that has evolved out of the hospice experience, and it is used later in the disease process.

The goal is to prevent and relieve suffering by early assessment and treatment of pain and other physical, psychosocial, and spiritual needs. Explanation: The goal of palliative care is to prevent and relieve suffering by early assessment and treatment of pain and other physical, psychosocial, and spiritual needs. It is a related area of care that has evolved out of the hospice experience but is used earlier in the disease process. Palliative care can be used in all healthcare settings, and it integrates the knowledge and skills of the multidisciplinary team. Bereavement is the time of mourning experienced after a loss, and hospice will provide continuation of care for the family during this period of time (bereavement care). (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 10: Home Healthcare, p. 176.

Nursing continues to recognize and participate in providing appropriate, uninterrupted care and facilitate patients' transitions between different settings and levels of care. What would be an example of this continuity of care? a) The nurse accompanying the physician on rounds b) The nurse attending an appointment with the patient in some place other than where the nurse works c) The nurse collaborating with other members of the healthcare team d) The nurse taking detailed notes on how each patient wants to continue care

The nurse collaborating with other members of the healthcare team Explanation: Continuity of care is a process by which healthcare providers give appropriate, uninterrupted care and facilitate a patient's transition between different settings and levels of care. To do this, the nurse must, along with other responsibilities, collaborate with other members of the healthcare team in meeting all the needs of each patient. The other answers are incorrect because they are not examples of the idea of the continuity of care. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 9: Continuity of Care, p. 156.

In order to provide effective nursing care, the nurse should engage in what type of communication with the patient and significant others? a) Therapeutic communication b) Intrapersonal communication c) Meta-communication d) Interpersonal communication

Therapeutic communication Explanation: Therapeutic communication facilitates interactions focused on the patient and the patient's concerns. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 21: Communicator, p. 445-449.

When caring for a client at a health care facility, the nurse discovers that the client is unable to read or write. Which of the following teaching approaches is most useful for the client? a) Teach the client to read and write. b) Keep the teaching session short. c) Involve the client in an active way. d) Use verbal and visual modes.

Use verbal and visual modes. Explanation: Using verbal and visual modes of instruction is most appropriate for a client who is unable to read or write. Teaching the client how to read and write is not within the scope of nurses' responsibilities. Keeping the session short and involving the client in an active way will not meet the special needs of the client who is unable to read or write. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 22: Teacher and Counselor, pp. 474-475.

Care provided to a patient following surgery and until discharge represents which phase of the helping relationship? a) Termination phase b) Evaluation phase c) Working phase d) Orientation phase

Working phase Explanation: During the working phase, the nurse and patient explore and develop solutions that are enacted and evaluated in subsequent interactions. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 21: Communicator, p. 448.

The nurse recognizes that discharge planning begins upon admission and the initial step in discharge planning is: a) teaching the patient self-care activities that are to be conducted in the home setting. b) establishing goals with the patient. c) collecting and organizing data about the patient. d) providing home healthcare referrals.

collecting and organizing data about the patient. Explanation: The initial step in discharge planning is collecting and organizing data about the patient, as this provides information on the patient's healthcare needs. Establishing goals, patient teaching, and providing home healthcare referrals are steps that will follow the collection and organization of data. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 9: Continuity of Care, p. 163.

You are employed in a large urban hospital. On your unit there is a nurse manager, a charge nurse, a nursing case manager, two team leaders, with nurses (RNs and LPNs) and auxiliary personnel who are assigned to provide care on each team. It is important for the nurse to understand the role of the case manager. The best description of the nursing case manager's role is to: a) provide expert nursing care to the most seriously ill patients. b) develop critical pathways to guide care and to reach patient outcomes in a specific time frame. c) review records of all incident reports in order to implement risk management measures. d) design care plans for each patient so that evidence-based nursing practice is provided.

develop critical pathways to guide care and to reach patient outcomes in a specific time frame. Explanation: It is the role of the nursing case manager to enhance continuity of care and effective use of resources by developing specific care protocols/critical pathways to reach patient outcomes in a specific time frame. Case managers do not provide direct patient care, write individual care plans, or review incident reports. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 139.

Nursing is the largest group of healthcare professionals. They have the potential to have an influence on healthcare reform. Healthy People 2020 suggests that nurses have an important role in: a) monitoring who receives care at a reasonable cost. b) improving access to quality care and cost of care. c) providing healthcare services to all citizens. d) challenging health reform that interferes with private insurance.

improving access to quality care and cost of care. Explanation: Healthy People 2020 emphasizes the importance of nursing's role in improving access to care, quality of care, and cost of care. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 151.

One of the newest concepts in providing long-term care is called "aging in place". The best description of this type of care is: a) patients move to an independent living apartment or home, then have access to increasing healthcare services as needed, provided within the healthcare community where they live. b) a long-term-care facility associated with a hospital, that provides acute care services as needed so the patient can return to long term care. c) patients are maintained in their own homes with home healthcare. d) patients move into the nursing home, and access more and more services as required in the same facility.

patients move to an independent living apartment or home, then have access to increasing healthcare services as needed, provided within the healthcare community where they live. Explanation: The best description of "aging in place" is the type of care where the patient moves into an independent living space, and then has access to more services, such as assisted living and/or skilled care, that are part of the healthcare community where they live. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 144.

In 1978, the World Health Organization (WHO) first conceived of the concept of decreasing illness and death by simple local measures with inexpensive solutions to health problems, often combined with social and economic development. This strategy led to the global health focus known as: a) primary care. b) global healthcare. c) primary healthcare. d) world healthcare.

primary healthcare. Explanation: Primary healthcare should not be confused with primary care. Primary healthcare emphasizes universal access and affordability of healthcare for the whole population. Primary care focuses on the individual, from initial contact, ongoing care and referrals by the provider. The other answers are incorrect. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 141.

Nurses work with various members of the health team. The nurse understands that the role of the hospitalist is best described as: a) the physician who manages the patient's care in emergency and intensive care units only. b) the specialist who admits the patient to hospital, and returns care to the primary physician for all other referrals and services. c) the doctor who notifies the primary physician that their patient has been admitted to the hospital, and transfers care to a the referral specialist. d) the doctor who admits the patient, assumes the management of the patient's care, and maintains communication with the primary physician while the patient is hospitalized.

the doctor who admits the patient, assumes the management of the patient's care, and maintains communication with the primary physician while the patient is hospitalized. Explanation: The hospitalist is a physician who provides care to the patient in the emergency room and after admission to the hospital. The hospitalist communicates with the patient's primary doctor, but manages the hospital care. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 148.

The nurse understands that planning for discharge actually begins at admission to the facility. The purpose of discharge planning is best described as: a) to ensure patient safety and health maintenance. b) to decrease stress for patient and family members. c) to provide continuity of care that is goal directed. d) to promote less dependence on others.

to provide continuity of care that is goal directed. Explanation: The purpose of discharge planning is to provide for continuity of care, so that the needs of patient and family are consistently met as the patient goes from hospital to home. The others may be additional goals. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 9: Continuity of Care, p. 164.

The nurse understands that planning for discharge actually begins at admission to the facility. The purpose of discharge planning is best described as: a) to ensure patient safety and health maintenance. b) to promote less dependence on others. c) to provide continuity of care that is goal directed. d) to decrease stress for patient and family members.

to provide continuity of care that is goal directed. Explanation: The purpose of discharge planning is to provide for continuity of care, so that the needs of patient and family are consistently met as the patient goes from hospital to home. The others may be additional goals. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 9: Continuity of Care, p. 164.

Choice Multiple question - Select all answer choices that apply. Which of the following are required for Medicare home healthcare reimbursement? Select all that apply. a) Client must require skilled nursing care intermittently. b) Client must be confined to the home. c) Client must require medical services. d) Client must require intermittent need for physical therapy. e) Client must require housekeeping services.

• Client must require skilled nursing care intermittently. • Client must require intermittent need for physical therapy. • Client must be confined to the home. Explanation: Eligibility requirements for Medicate reimbursement for home health services include: being confined to the home; under the care of a physician; receiving services under a plan of care established and periodically reviewed by a physician; having an intermittent need for skilled nursing care; and having an intermittent need for physical therapy, occupational therapy, or speech-language therapy. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 10: Home Healthcare, p. 175.

Choice Multiple question - Select all answer choices that apply. Healthcare is constantly changing and becoming more complex. Select the answers that describe patients as healthcare consumers today. Select all that apply. a) They prefer to control the decisions made about their own healthcare. b) They have helped develop patients' rights and cost-containment measures. c) They express concern regarding access to care and the quality of service. d) Most are less concerned about healthcare costs as long as they receive good care. e) They often have health information obtained from the Internet.

• They often have health information obtained from the Internet. • They prefer to control the decisions made about their own healthcare. • They express concern regarding access to care and the quality of service. • They have helped develop patients' rights and cost-containment measures. Explanation: Healthcare consumers are increasingly more knowledgeable about health, and prefer to control the decisions about their care. They express concern about access to services, and the cost and quality of care. They question duplication of services, and are actively engaged. They have helped to develop patient rights and cost-containment measures as protections for patients in healthcare settings. Today patients are surveyed regarding their experiences with doctors and nurses in hospitals. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery Systems, p. 150-151.

Choice Multiple question - Select all answer choices that apply. Healthcare costs are increasing with increases in technology and related services. Patients interact with many health care providers, such as RNs, LPNs, physicians, physical therapists, medical technologists, radiation technologists, specialists, and others employed in healthcare. As a result of the complexity of care and multiple providers, healthcare is becoming fragmented. The major results of fragmented care include: a) patients receive more specialized care. b) lack of continuity of care. c) less confusion for patients regarding treatment. d) increased medication errors.

• increased medication errors. • patients receive more specialized care. • lack of continuity of care. Explanation: Fragmented care increases healthcare costs and the number of providers/specialists seeing the patient. A lack of continuity of care often results, increasing the patient's confusion, and medication errors may increase. Although patients often receive specialized and care and services, there may be conflicting care plans. (less) Reference: Taylor et al. Fundamentals of Nursing, 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2011, Chapter 8: Healthcare Delivery System, p. 158.