Nursing 228 Test #1

Theory

helps explain an event by defining ideas or concepts, explaining relationships among the concepts, and predicting outcomes

concepts

ideas and mental images

Which type of health care setting predominantly provides cardiovascular rehabilitation, sports medicine and/or home care?

Resorative Care

Prospective payment system (PPS)

-established by Congress in 1983 -eliminated cost-based reimbursement

Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? 1. caregiver 2. Autonomy an accountability 3.Patient Advocate 4. Heath promotion 5. Lobbyist

1,2,3,4

Accountability

when a nurse is responsible professionally and legally for the type of quality of nursing care provided.

Nurse educator

works primarily in schools of using, staff development departments of health care agencies, and patient education departments-- educates students to become professional nurses

assumptions

"taken-for-granted" statements that explain the nature of the concepts, definitions, purpose, truths and are based on values and beliefs

Acute care

(aka secondary and tertiary care) pattern of heath care in which a patient is treated for an acute episode of illness, for the sequelae of an accident or other trauma, or during recovery from surgery

Discharge planning

*uses critical thinking skills and begins as soon as the patient is admitted* activities directed toward identifying future proposed therapy and the need for additional resources before and after returning home

Advanced Practice Registered Nurse (APRN)

-defined the scope of nursing and developed standards of practice and standards of professional performance most independently functioning nurse, has a master's degree in nursing, advanced education in pathophysiology, pharmacology, and physical assessment; and certification and expertise in a specialized area of practice Four roles: CNS. CNP, CNM, and CRNA

How many levels does a nurse pass through to develop specialized nursing skills according to Benner?

5 levels: -Novice -Advance Beginner -Competent -Proficient -Expert

The ANA defines nursing using which of the following phrases? (Select all that apply) a.The protection promotion and optimization of health and abilities. b.Prevention of illness and injury c.Alleviation of suffering through the diagnosis and treatment of human response. d.Advocacy in the care of individuals, families, communities and populations.

A. , B. , C., D

Differentiate between Associate degree RN programs and Baccalaureate degree RN programs. (Select all that apply) a.Associate degree programs are 2 years and Baccalaureate degree programs are 4 years. b.Associate degree students study social sciences, arts and humanities to support nursing theory. c.Both Assoc. and Bacc. Prepared students take the NCLEX-RN to be licensed. d. Bacc. Degree students study social sciences, arts and humanities to support nursing theory.

A., C., D.

Which of the following are outcomes of health care globalization? (Select all that apply) a. Patients are more knowledgeable b. Health care is more accessible c. Increased risk for the spread of communicable diseases d. Decreased discharge planning activities

A.,B.,C.

Government programs designed to control health care costs include: (Select all that apply) a. Managed Care b. Utilization Review Committees c. Prospective Payment Systems d. Diagnosis-related groups

A.,B.,C.,D.

Which of the following statements are true about Nurse Practice Acts (NPA)? (Select all that apply) a.Regulated by the State Boards of Nursing b.Shields the public from unqualified and unsafe nurses c.Protects public health, safety and welfare d.Each state defines its own scope of nursing practice

A.,B.,C.,D.

Which of the following statements are true about Florence Nightingale? (Select all that apply) a.She set the stage for using evidence to direct practice b.She established the first nursing philosophy based on health maintenance and restoration c.She founded the American Red Cross d.She was the first practicing nurse epidemiologist

A.,B.,D.

10. Which of the following statements is/are true about Nursing informatics and technological advancements? (Select all that apply) a. Makes the nurse's work easier b. Replaces the nurse's critical thinking and clinical judgment c. Changed where and how nurses provide patient care d. Allow for more up-to-date information to be available.

A.,C.D.

The Patient Protection and Affordable Care Act of 2010 provided which of the following (Select all that apply). a. Insurance industry reforms b. Decreased funding for community health centers c. Decreased primary care services d. Improved coverage for children

A.,D.

American Nurses Association (ANA)

An association that has defined the scope of nursing and developed Standards of Practice and Standard of Professional Performance since 1960

An 18 year old woman is in the emergency department with a fever and cough. The nurse obtains her vital signs listens to her lung and heart sounds, determines her level of comfort and collects blood samples. Which standard of practice is performed?

Assessment

Which activity performed by a nurse is related to maintaining competence in nursing practice?

Attending a review course in preparation for a certification examination

Select all the statements that correctly describe Lillian Wald and Mary Brewster's accomplishments. a.Founded the American Red Cross b.Founded the Henry Street Settlement c.Demonstrated autonomy d. Brought forth an awareness of cultural diversity

B.,C.

With managed care what is the focus of care of the organization? (Select all that apply) a. Individual Illness care b. Prevention c. Early Intervention d. Outpatient care

B.,C.,D.

Utilization review (UR ) committees

Physician-suprivised committees to review admissions, diagnostic testing, and treatments provide by physicians or heath care providers to patients

When providing nursing care, you need to make clinical judgments and decisions about your patients' health care needs based on knowledge, experience and standards of care. This is referred to as:

Critical Thinking

According to your text, who is the center of the nursing practice? A. The patient B. The family C. The community D. All of the Above

D.

Hospitals serving Medicare patients are only reimbursed a fixed amount based upon the patient's specific illness or problems. This type of cast control is known as:

Diagnosis-related group

________________________________ begins at admission to a health care facility and helps in the transition of a patient's care from one environment to another.

Discharge planning

Nurses are becoming less involved politically and as a result have a decreased influence on nursing health care policy and practice.

False

Professional nursing organizations do not deal with issues of concern to specialists groups within the nursing profession.

False

Which of the following Internet resources can help consumers compare quality care measures?

Hospital Compare and Hospital Consumer Assessment of Healthcare

The nurse gives the ordered medicated nebulizer treatment now and in four hours. Which standard of practice is preformed?

Implementation

Diagnoses-related groups

PPS created groups that had a fixed reimbursement amount with *adjustments based on case severity, rural/urban/regional costs, and teaching costs*

Which of the following indicated that nursing education needed increased financial support and that university schools of nursing receive the money?

The Goldmark Report

Describe a preferred professional organization? (PPO)

This is a fee-for-service plan in which you can choose any physician or hospital

Health care organizations are being evaluated on the basis of outcomes such as prevention of complications, patient's functional outcomes, and patient satisfaction.

True

Nursing standards provide the guidelines for implementing and evaluating nursing care.

True

paradigm

a pattern of beliefs used to describe the domain of a discipline: links concepts, theories, beliefs, values, and assumptions

Respite care

a service that provides short-term relief or "time-off" for people providing home care to an individual who is ill, disabled, or frail. Allows a person to run errands or have social time while another watch the ill person

Hospice

a system family-centered care that allows patients to live with comfort, independence, and dignity while easing the pains of terminal illness

Minimum Data Set

a uniform data set established by the Department of Health and Human Services, serves as the framework for any state-specified assessment instruments used to develop a written and comprehensive plan of care for newly admitted residents of nursing facilities

Quality and safety education for nurses (QSEN)

addresses the challenge to prepare Nurses with the competencies needed to continuously improve the quality of care in their work environments, encompasses the competencies of patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics

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 discuses the patents's wishes with them, The nurse is acting as the patient's

advocator

Conceptual framework

aka paradigm

nursing metaparadigm

allows nurses to understand and explain what nursing is, what nursing does and why nurses do what they do include 4 concepts: -person -health -environment/situation -nursing

Certified nurse-midwife (CNM)

an APRN who is also educated in midwifery and is certified by the American College of Nurse-midwives involves providing independent care for women during normal pregnancy, labor, and delivery and care for the newborn

Clinical nurse specialist (CNS)

an APRN who is an expert clinician in a specialized area of practice, the specialized area may be identified by: a population, setting, a disease special, type of care or type of problem

Nurse practitioner (NP)

an APRN who provides health care to a group of patients, usually in an outpatient, ambulatory care, or community-based setting-- more holistic approach

Certified registered anestheist (CRNA)

an APRN with advanced education from a nurse anesthesia-acredited program, requires one year of critical care or emergency experience, provide surgical anesthesia under the guidance and supervision of an anesthesiologist

Quality improvement

an approach to the continuous study of improvement of the processes of providing heath care services to meet the needs of patients and others and inform heath care policy

Assisted living

an attractive long-term care setting with an environment more like home and greater resident autonomy, residents require some help with daily activities but remain independent

Autonomy

an important part of nursing that involves making independent decisions without medical orders.

Performance improvement

an organization analyzes and evaluates current performance and uses the results to develop focused improvement actions

Another outcome of managed care is that organizations such as hospitals:

assume financial risk

Role of nurse as a communicator

be able to talk with patient, patient's families, the doctors, and the community to find the best care for the patient. In order to do this job sufficiently, a nurse must know the patient's strengths and weaknesses along with their needs to be able to communicate well

Vulnerable populations

children, women, and other adults most threatened by urbanization

Nursing theory

conceptualizes an aspect of nursing to describe, explain, predict, or prescribe nursing care

Burnout

condition that occurs when perceived demands outweigh perceived resources, physical and mental exhaustion

Nurse researcher

conducts evidence-based practice and research to prompter nursing care and further define and expand the scope of nursing practice

Professional organization

deals with the issues of concern to those processing in the profession-- seek to improve the standards of practice, expand nursing roles, and foster the welfare of nurses within the specialty area

Genomics

describes the study of all the genes in a person and interactions of those genes with one another and with that person's environment

The nurse spends time with the patient and family reviewing the dressing change procedure for the patient's wound. The patient's spouse demonstrates how to change the dressing. The nurse is acting in which professional role?

educator

Nursing (ICN definition)

encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well, and in all settings. It includes the promotion of health; prevention of illness; and the care of ill, disabled, and dying people. Advocacy, promotion of a safe environment, research participation, in shaping heath policy and in patient and heath systems management, and education

Medicare

federally funded national heath insurance programs in the United States for people over 65 years of age, administered in 2 parts

Professional standards review organizations (PSROs)

focuses on evaluation of nursing care provided in a heath care setting, the quality, effectiveness, and appropriateness of nursing care for the patient are the focus of evaluation

Primary Health care

focuses on improved heath outcomes for an entire population includes: primary care and heath education, proper nutrition, maternal/child health care, family planning, immunizations, and control of diseases

Work redesign

formal process used to analyze the work of a certain work group and change the actual structure of the jobs performed

Managed Care

heath care systems in which a providers or health care system receives a predetermined captivated payment for each patient enrolled in the program

Restorative care

help individuals regain maximal functional status and enhance the quality of life through promotion of independence and self care; emphasis on early discharge from hospitals

Caregiver

help patients maintain and regain health, manage disease and symptoms, and attain a maximal level of function and independence through the healing process, help patients set realistic goals and meet them

In-service education

instruction or training provided by a heath care agency or institution, designed to increase the knowledge, skills, and competencies of nurses and other heath care professionals employed by the institution, focused on new technologies

Continuing education

involves formal, organized educational programs offered by universities, hospitals, state nurses associations, professional nursing organizations, and educational and health care institutions

Phenomenon

label given to describe an idea or responses about an event, a situation, a process, a group of events, or a group of situations

Nurse administrator

manages patient care and delivery of specific nursing services within a heath care agency

Resource utilization groups

method of classification for health care reimbursement for long term-care facilities

Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform?

moving from an acute illness to a health promotion, illness prevention model

Skilled nursing facility

offers skilled care from a licensed nursing staff, often includes administration of IV fluids, wound care, long-term ventilator management, and physical rehabilitation

Nursing sensitive-outcomes

patient outcomes and nursing workforce characteristics that are directly related to nursing care such as changes in patients symptom experiences, functional status, safety, psychological distress, registered nurse job satisfaction, total nursing hours per patient day, and costs

Pay for Performance

programs and public reporting of hospital quality data are designed to promote quality, effective, and safe patient care by physicians and heath care organizations

Patient advocate

protect your patient's human and legal rights and provide assistance in asserting these rights if the need arises

Adult day care centers

provide a variety of health and social services to specific patient populations who live alone or with family in the community

The examination for RN licensure is exactly the same in every state in the United States. This examination:

provides a minimal standard of knowledge for an RN in practice

Extended care facility

provides intermediate medical, nursing, or custodial care for patients reoccurring from acute illness, or those with chronic illnesses, or disabilities

Patient-centered care

respect and dignity, sharing of info, participation in care and care decisions, and collaboration

Rehabilitation

restores a person to the fullest physical, mental, social, vocational, and economic potential possible

Medicaid

state medical assistance to people with low incomes, based on Title XIX of the Social Security Act. States receive matching federal funds to provide medical care and services to people meet categorical and income requirements

Heath

state of being that people define in relation to their own values, personality, and lifestyle *dynamic and continuing changing*

Compassion fatigue

term used to describe a state of burnout or secondary traumatic stress, occurs without warning and often results from giving high levels of energy and compassion over a prolonged period to those suffering

Globalization

the increasing connectedness of the world's economy, culture, and technology, is one of the forces reshaping the heath care delivery system

domain

the perspective or territory of a profession or discipline: it provides the subject, central concepts, values and beliefs, phenomena of interest , and central problems of a discipline

Code of ethics

the philosophical ideals of right and wrong that define the principals you will use to provide care to your patients *important to incorporate own values and ethics into your own practice*

content

the product and information obtained from the system

Nursing (ANA definition)

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

Capitation

the providers receive a fixed amount per patient or enrollee of a heath care plan, aims to build a payment plan for select fairness or surgical procedures for best care at lowest cost

Home Care

the provision of medically related professionals and paraprofessional services and equipment to patients and families in their homes for health maintenance, education, illness prevention, diagnosis and treatment of disease, palliation, and rehabilitation

Person

the recipient of nursing care, including individual patients, groups, cultures, families, and communities

Integrated delivery networks

used by large heath care systems that include a network of facilities, providers, and series organized to deliver a continuum of care to a population of patients at a captivated cost in a particular setting

Nursing Informatics

uses info and technology to communicate, manage knowledge, mitigate error, and support decision making