MED SURG CHAPTER 1
An advanced practice registered nurse (APRN) specializing in adult-gerontology has accepted a new position in a different state. Which governing body does the APRN need to consult to verify prescriptive authority in the new state?
The new state's boards of nursing
A home care nurse is preparing a presentation for a group of nursing students about the area of practice. Which statement would the nurse most likely include when describing this practice area
"Home care nurses need to have high-level assessment skills.
A nurse is describing her role as a home care nurse to students. A student asks, "Why do you need such high-level assessment and clinical decision-making skills in this practice?" Which response by the nurse would be most appropriate?
"No other health care professionals are around to confirm my observations."
Changes in population demographics over the next 40 years will significantly affect the delivery of health care services. Select the one change that will have the most impact on the practice of nursing.
The number of adults over age 65 will double in size.
A nurse is providing care to a client who speaks very little English. When communicating with this client, which action would be appropriate for the nurse to use to overcome the language barrier? Select all that apply.
Use short, simple sentences. Include gestures when speaking. Give instructions in a step-by-step fashion.
Which element would be included as a goal of case management?
Appropriateness of services
Which is a goal of case management?
Appropriateness of services
A client has been admitted in the emergency care unit with conditions of respiratory distress and pneumonia. The client's condition worsens and requires mechanical ventilation. While visiting this client in the hospital, the family observes members of the health care team washing their hands upon entering and leaving the room. By implementing recommended hand hygiene measures, which organization's goals is the health care team supporting?
The Joint Commission
The leadership of a private hospital have chosen to begin the process of accreditation in order to enhance the credibility and status of the hospital. The accreditation process and necessary performance improvements that the hospital will undertake will most likely occur under the auspices of what regulatory body?
The Joint Commission
In recent decades, the nurse's role has undergone significant change. Which of the following phenomena underlay the development of the advanced practitioner role, which first emerged in the 1960s?
A need for health care in geographically remote and underserved regions
An example of a dependent nursing action is:
Administering insulin, on a sliding scale, to a patient with diabetes. explanation: Administering a medication to a patient is a dependent nursing action, even though the dosage is altered based on blood sugar readings. The sliding dosage scale has been prescribed by the health care provider. All other choices are independent nursing actions.
A client is experiencing social isolation. Using Maslow's hierarchy of needs, identify the level that would correspond to this need?
Belonging and affection
Which of the following would least likely impact health care delivery and nursing?
Decline in genetic focus
A nursing instructor is describing to a class the various roles that nurses assume. The instructor determines that teaching has been effective when the students identify which of the following as the focus of the nursing researcher role?
Establishment of a scientific basis for action
After teaching a group of students about health, wellness and illness, a nursing instructor determines that additional instruction is necessary when the students identify which of the following as a component of wellness?
Feeling together about one part of life
A nurse who provides care in a postsurgical care unit of a hospital is aware that reimbursement to the hospital for Medicare patients is based on diagnosis-related groups (DRGs). How are DRGs used to determine reimbursement for Medicare patients?
Hospitals receive payment at a fixed rate for patients with diagnoses that fall into a specific DRG
The definition of nursing has evolved over time since Florence Nightingale first attempted, in 1859, to explain nursing's scope of practice. In 2003, the American Nurses' Association, in its Social Policy Statement, included which of the following activities as a significant role of nursing?
Identifying human responses to illness
Health care in the United States continues to be impacted by larger social trends and by factors in a variety of domains. Among these trends in the recent past and the foreseeable future are increases in:
Immigration and life expectancy
A nursing instructor is preparing a class on the changes that have occurred in health care over the past years. Which of the following would the instructor most likely include?
Increasing cultural diversity of the population Expanding consumer expectations Reductions in health care staffing Restructuring of health care institutions
The word leadership has a connotation of a position that brings with it a title that suggests leading large groups of people. What has nursing identified leadership as?
Inherent to all nursing positions
Which of the following would be categorized as a mid-level practitioner?
Nurse midwives
Economics have dictated many significant changes in the health care delivery system. What is one major effect that economic factors have had on the patient population?
Patients with high home-care needs are being discharged into the community.
A nurse working in a community-based health center is engaged in teaching a client about her medications. The nurse is acting as which of the following?
Practitioner
The nurse is practicing in a community-based setting. What outcomes may be achieved by the nurse's community interventions? (Select all that apply.)
Promote wellness. Reduce the spread of disease. Improve the health status of the community.
When functioning in the practitioner role, the nurse would be involved in which of the following? Select all that apply.
Providing direct care Collaborating with other disciplines Teaching clients and families
A nurse is interested in obtaining additional education to become a nurse practitioner and is reviewing various course programs. Which of the following would the nurse expect to find?
Provision of a broad range of direct care to clients
A nurse is caring for a patient who is experiencing fear, anxiety, and feelings of powerlessness after receiving a diagnosis of cancer. The nurse develops a teaching plan focusing on the patient's diagnosis and treatment options to promote the patient's sense of control over the situation. Using Maslow's Hierarchy of Human Needs, which of the following categories is the nurse attempting to meet?
Safety and security
The nurse working in the clinic has had several incidences of positive chlamydia cultures return in women with pelvic pain. The nurse understands that early diagnosis and treatment are essential measures in which to reduce contagion and limit the complications related to this infection. What type of prevention will the nurse use when these infections are treated?
Secondary prevention EXPLANATION: Secondary prevention is the early diagnosis and treatment to shorten the duration and severity of illness, reduce contagion, and limit complications. Tertiary prevention is healthcare to limit the degree of disability or promote rehabilitation in chronic, irreversible diseases. Prevalence is the number of cases of a disease in a specific population during a specific period. Primary prevention is the prevention of the development of disease in a susceptible or potentially susceptible population and includes health promotion and immunization.
The nurse is working at an institution that uses a collaborative practice model. Which of the following would most likely be reflected at this institution?
Shared accountability for care
Which tool is often used by case managers?
Standards of care
