Key Concepts, Chapter 1, Introduction to Nursing

The nurse offers a client two possible times to ambulate, as prescribed by the health care provider. The nurse is acting in which nursing role?

Manager and coordinator

The nurse going back to school for nurse midwifery can trace education for nurse midwifery to which nursing leader?

Mary Breckinridge

The nurse is discussing the recommended entry level for professional nursing practices. Which is the most accurate statement by the nurse?

"BSN is the recommended entry level by national nursing organizations."

Florence Nightingale

elevated the status of nursing to a respected occupation, improved the quality of nursing care, and founded modern nursing education. Defined nursing as both an art and a science, differentiated nursing from medicine, created freestanding nursing education; published books about nursing and health care; is regarded as the founder of modern nursing.

Which nursing action best exemplifies the nurse's role in promoting health?

encouraging a group of junior high school students to engage in regular physical activity

secondary traumatic stress:

feeling of despair caused by the transfer of emotional distress from a victim to a caregiver, which often develops suddenly

6. Identify current trends in nursing. (10)

•Changing demographics and increasing diversity •The technological explosion •The era of the educated consumer, alternative therapies, and genomic and palliative care •The shift to population-based care and the increasing complexity of patient care •The cost of health care and the challenge of managed care •The impact of health policy and regulation •The growing need for interdisciplinary education and collaborative practice •The current nursing shortage/opportunities for lifelong learning and workforce development •Significant advances in nursing science and research

The nurse is caring for a postoperative client. The health care provider has written a prescription for a pain medication, and the prescription gives a dosage range for the amount the nurse may give depending on the severity of the client's pain. This type of functioning within the health care team is called:

collaborative functioning.

4. Describe the various levels of educational preparation in nursing.

•Practical and vocational nursing education •Registered nursing education -Diploma in nursing -Associate degree in nursing -Baccalaureate in nursing •Graduate education in nursing •Continuing education •In-service education

Researcher

The participation in or conduct of research to increase knowledge in nursing and improve patient care

In what time period did nursing care as we now know it begin?

18th to 19th century

Attracting minorities to the profession of nursing is an important consideration for the future of nursing. Which key historical nursing figure set a precedent in this area?

Mary Eliza Mahoney

The nurse is documenting the client's response to a medication. This action reflects a practice that was started by which key figure in nursing's history?

Florence Nightingale

Which are approved as nursing diagnoses? Select all that apply.

Impaired Skin Integrity Caregiver Role Strain Compromised Family Coping

A person practicing nursing in the 1950s would most likely have been influenced by what trend?

Large numbers of women began to work outside the home, asserting their independence.

Who established the first public health service for the sick and poor?

Lillian Wald

A nurse identifies a client's health care needs and devises a plan of care to meet those needs. Which guideline is being followed in this case?

Nursing process

Which organization offers membership by invitation to students who demonstrate excellence in scholarship and to nurses in the community who demonstrate excellence in leadership?

Sigma Theta Tau International, Honor Society of Nursing

ANA Standards of Nursing Practice

Standard 1. Assessment Standard 2. Diagnosis Standard 3. Outcomes Identification Standard 4. Planning Standard 5. Implementation - 5a. Coordination of Care - 5b. Health Teaching and Health Promotion Standard 6. Evaluation

ANA Standards of Professional Performance

Standard 7. Ethics Standard 8. Culturally Congruent Practice Standard 9. Communication Standard 10. Collaboration Standard 11. Leadership Standard 12. Education Standard 13. Evidence-Based Practice and Research Standard 14. Quality of Practice Standard 15. Professional Practice Evaluation Standard 16. Resource Utilization Standard 17. Environmental Health

Leader

The assertive, self-confident practice of nursing when providing care, effecting change, and functioning with groups

The nurse is caring for a client after a stroke rendered the client's right side weaker than the left. The nurse coordinates the plan of care with the physical therapist. The nurse's interventions reflect which one of nursing's four broad goals?

To restore health

The nursing process is:

a critical thinking method used by nurses to provide nursing care that is individualized and holistic.

Critical challenges to nursing practice in the 21st century include

a growing population of hospitalized patients who are older and more acutely ill, increasing health care costs, and the need to stay current with rapid advances in medical knowledge and technology.

Nursing is recognized as a profession with

a unique body of knowledge, service orientation, code of ethics, autonomy, and self-regulation.

compassion fatigue:

loss of satisfaction from providing good patient care

In the role of entrepreneur, the nurse's primary responsibility is:

managing a health-related business.

Due to the rising cost of health care services, many procedures and treatments are being delivered in what type of setting?

outpatient facilities

reciprocity:

process allowing a nurse to apply for and be endorsed as a registered nurse by another state

nursing:

profession that focuses on the holistic person receiving health care services and provides a unique contribution to the prevention of illness and maintenance of health

A nurse must possess several characteristics to be successful in this profession. Secondary to critical thinking skills, which is of great value?

advocating for the client at all times

Which social force has most significantly impacted the future supply and demand of nurses?

aging

Counselor

The use of therapeutic interpersonal communication skills to provide information, make appropriate referrals, and facilitate the patient's problem-solving and decision-making skills

Which action by the nurse best represents the evaluative portion of the nursing process?

assessing a client's blood pressure after teaching stress reduction techniques

burnout:

(1) cumulative state of frustration with the work environment that develops over a long time; (2) behaviors exhibited as the result of prolonged occupational stress

The first nursing journal owned, operated, and published by nurses was:

American Journal of Nursing

Which organization has established standards that help the nurse determine which clinical actions fall under the scope of nursing practice?

American Nurses Association

The nurse is helping the unlicensed assistive personnel (UAP) bathe the client, who is experiencing a lot of pain when repositioned in bed. Which nursing responsibility is the nurse demonstrating?

Client advocate

A client is brought to the emergency department with a head injury following an all-terrain vehicle (ATV) accident. The nurse asks the family members to describe how the accident occurred. The nurse is implementing which ANA standard?

Collaboration

Florence Nightingale introduced the concept of apprenticeship for nurses. Which statement is an example of this?

Completing clinical hours supervised by a nursing instructor

Advocate

The protection of human or legal rights and the securing of care for all patients based on the belief that patients have the right to make informed decisions about their own health and lives

Caregiver

The provision of care to patients that combines both the art and the science of nursing in meeting physical, emotional, intellectual, sociocultural, and spiritual needs. As a caregiver, the nurse integrates the roles of communicator, teacher, counselor, leader, researcher, advocate, and collaborator to promote wellness through activities that prevent illness, restore health, and facilitate coping with disability or death. The role of caregiver is the primary role of the nurse.

Teacher/educator

The use of communication skills to assess, implement, and evaluate individualized teaching plans to meet learning needs of patients and their families

The need for university-based nursing education programs was brought to light during which important historical time?

World War II

Educational preparation for nursing practice involves several different types of programs that can lead to licensure as a registered nurse:

diploma, associate degree, baccalaureate, and newer alternative routes including entry-level master's programs, accelerated programs for graduates of nonnursing disciplines, community college--based baccalaureate programs, and RN completion programs for licensed practical nurses and other allied health providers. Graduate programs include master's degrees, doctor of nursing practice (DNP), doctor of nursing science (DNSc), and PhDs.

nursing process:

five-step systematic method for giving patient care; involves assessing, diagnosing, planning, implementing, and evaluating

A client asks an RN to prescribe a medication for pain. What is the best answer by the nurse?

"Only advanced practice registered nurses have prescriptive authority."

2. Explain the aims of nursing to facilitate optimum health and quality of life for patients.

*Promote health* -Identifying, analyzing, and maximizing each patient's individual strengths as components of preventing illness, restoring health, and facilitating coping with disability or death *Prevent illness Restore health Facilitate coping with disability or death*

To meet these aims, the nurse uses four blended competencies: *cognitive, technical, interpersonal, and ethical/legal*. More recently, these have been further specified as the

*Quality and Safety Education for Nursing (QSEN)* competencies: patient-centered care, teamwork and collaboration, quality improvement, safety, evidence-based practice, and informatics.

Which nursing actions demonstrate the aim of nursing to facilitate coping? Select all that apply.

- Teaching a client and her family how to live with diabetes - Providing counseling for the family of a teenager with an eating disorder - Assisting a client and his family to prepare for death

(7. Discuss the importance of self-care in relation to the demands of the nursing profession.)

-Compassion fatigue -Burnout -Secondary traumatic stress -Mindfulness -STOP

1. Describe the historical background of nursing, definitions of nursing, and the status of nursing as a profession and as a discipline.

EARLY CIVILIZATION - 16th CENTURY *Theory of animism* -Good spirits brought health; evil spirits brought sickness and death. -Roles of nurse and physician separate and distinct: physician as medicine man; nurse as caring mother. *Ancient Greek civilization* -Temples became center of medical care. -Nurses cared for the sick in the home and community; practiced as nurse-midwives. *Early Christian period* -Nursing has formal and more clearly defined role; deaconesses made visits to the sick. -Nursing developed purpose, direction, and leadership. *16th century* -Shift from a religious orientation to an emphasis on warfare, exploration, and expansion of knowledge -Nursing had a poor reputation; nurses received low pay and worked long hours in unfavorable conditions. 18th - 19th CENTURY *Social reforms changed the roles of nurses and of women in general.* *Nursing as we now know it began, based on many of the beliefs of Florence Nightingale.* -Nightingale challenged prejudices against women and elevated the status of all nurses. -She established the first training school for nurses, and wrote books about health care and nursing education. 19th - 21st CENTURY *Hospital schools organized to provide more easily controlled and less expensive staff for the hospital.* *Female nurses were under the control of male hospital administrators and physicians.* *World War II* -Large numbers of women worked outside the home and became more independent and assertive. -Explosion in medicine and technology broadened the role of nurses. -Growth of nursing as a professional discipline '50s - PRESENT *Nursing broadened in all areas* -Practice in a wide variety of health care settings -The development of a specific body of knowledge -The conduct and publication of nursing research -Recognition of the role of nursing in promoting health -Growth of nursing as a professional discipline DEFINITIONS of NURSING *Originated from the Latin word nutrix (to nourish)* *ICN definition—Promotion of health, prevention of illness, collaborative care* *ANA definition—Social policy statement* *Patient is central focus of all definitions* -Includes physical, emotional, social, and spiritual dimensions of the patient

A client is distraught because a recent computed tomography (CT) scan shows that the client's colon cancer has metastasized to the lungs. Which nursing aim should the nurse prioritize in the immediate care of this client?

Facilitating coping

The registered nurse is performing a nutritional assessment to ensure that the client's diet is optimal for wound healing. The nurse's intervention can be traced back to which key contributor to nursing?

Florence Nightingale

A nurse manager is teaching staff how to use a new piece of hospital equipment. Which educational setting would be most appropriate for this process?

In-service education

Which individual provided community-based care and founded public health nursing?

Lillian Wald

5. Discuss the effects on nursing practice of nursing organizations, standards of nursing practice, nurse practice acts, and the nursing process.

PROFESSIONAL NURSING ORGANIZATIONS •International Nursing Organizations •National Nursing Organizations -ANA -NLN -AACN -NSNA •Specialty Practice Organizations -Box 1-3 GUIDELINES FOR NURSING PRACTICE •Standards of Nursing Practice -Box 1-4 •Nurse Practice Acts and Licensure •Nursing Process NURSE PRACTICE ACTS •Define legal scope of nursing practice •Create a state board of nursing to make and enforce rules and regulations -Some states require continuing education units annually •Define important terms and activities in nursing, including legal requirements and titles for RNs and LPNs •Establish criteria for the education and licensure of nurses THE NURSING PROCESS •One of the major guidelines for nursing practice •Helps nurses implement their roles •Integrates art and science of nursing •Allows nurses to use critical thinking and clinical reasoning •Defines the areas of care that are within the domain of nursing

The nurse asks a client about his spiritual health. Which statement best explains the standard of care utilized by the nurse?

The RN collects comprehensive data.

Collaborator

The effective use of skills in organization, communication, and advocacy to facilitate the functions of all members of the health care team as they provide patient care

Which is the best example of a client-centered approach to care?

The nurse asks the client about health goals.

Communicator

The use of effective interpersonal and therapeutic communication skills to establish and maintain helping relationships with patients of all ages in a wide variety of health care settings

The nurse is caring for a client with a new diagnosis of cancer, and allows the client to verbalize fears relating to how to tell the children. The nurse's intervention reflects which aspect of nursing?

art of nursing

profession:

an occupation that meets specific criteria including a well-defined body of specific and unique knowledge, a code of ethics and standards, ongoing research, and autonomy

A nurse is discussing the history of the profession with a client and describes that a shift in societal focus from religion to warfare had a negative impact on nursing due to:

female criminals recruited as nurses.

mindfulness:

capacity to intentionally bring awareness to present-moment experience with an attitude of openness and curiosity; mindfulness promotes healing as you pause, focus on the present, and listen

During World War II, nurses were actively recruited and enlisted in the military. What effect did this have on the nursing profession?

caused a civilian nursing shortage

What was one barrier to the development of the nursing profession in the United States after the Civil War?

lack of educational standards

nurse practice act:

law established to regulate nursing practice

standards:

rules or guidelines that allow nurses to carry out professional roles, serving as protection for the nurse, the patient, and the institution where health care is given

Nursing controls and guarantees its practice through

standards of practice, nurse practice acts and licensure, and the use of the nursing process.

Which is the best example of a nurse demonstrating the role of caregiver?

starting an intravenous line in the client's arm

health:

state of optimal functioning or well-being

The American Nurses Association defines nursing as

the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities and populations.

Nursing's four broad aims are

to *promote health, prevent illness, restore health*, and *facilitate coping* with disability or death.

licensure:

to be given a license to practice nursing in a state or province after successfully meeting requirements

(3. Explain how nursing qualifies as a profession.)

•Well-defined body of specific and unique knowledge •Strong service orientation •Recognized authority by a professional group •Code of ethics •Professional organization that sets standards •Ongoing research •Autonomy and self-regulation