PrepU: Chapter 1

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

Advocating for the client at all times Nursing is caring, commitment, and dedication to meeting the health needs of all people. Nurses direct care to promote, maintain, and restore health in various settings. They are prepared to identify and to assist with the health care needs of individuals, families, communities, and populations. Advocating for the client is an essential skill needed. A RN does not need to have a masters degree to advocate. Any healthcare provider can delegate responsibilities. A nurse can learn to work with teams and team build as necessary.

The registered nurse is teaching a community health class about illness prevention. Which statement reflects understanding of this concept?

"It is important to enroll in a smoking cessation class." Enrolling in a smoking cessation class is an example of illness prevention. It will prevent conditions such as asthma and COPD. A hospice evaluation is for someone who is terminally ill. Hypertension is already a disease entity. An ambulance for injury does not denote illness prevention.

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 of nursing's key people's contributions to nursing?

Florence Nightingale Florence Nightingale's contributions to nursing included the recognition of the importance of nutrition to health. Clara Barton established the Red Cross. Dorothea Dix was a pioneer for reform of treatment for the mentally ill and founded The Nurse Corps of the United States Army. Linda Richards began the practice of keeping records and writing orders

A nurse applies for membership in a professional nursing organization that is operating in the United States. To which organizations might this nurse apply? Select all that apply. 1. ANO 2. AACN 3. ANA 4. NASN 5. NNO 6. ICN

2. AACN 3. ANA 6. ICN The American Nurses Association (ANA), International Council of Nurses (ICN), and American Association of Critical-Care Nurses (AACN) are three examples of organization to which a nurse might apply. The NNO, NASN and ANO are not professional nursing organizations.

Which of following are approved as nursing diagnoses? Select all that apply: 1. Abdominal Hernia 2. Congestive Heart Failure 3. Caregiver Role Strain 4. Compromised Family Coping 5. Impaired Skin Integrity

3. Caregiver Role Strain 4. Compromised Family Coping 5. Impaired Skin Integrity Both congestive heart failure and abdominal hernia are medical diagnoses.

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

A lack of educational standards was one barrier to the development of the nursing profession after the Civil War. Other barriers included a male dominance of health care and the pervading belief that women were dependent on men. The location of nursing schools, a lack of influence from nursing leaders, and independent nursing orders were not barriers to the development of the nursing profession after the Civil War.

A 32-year-old construction worker is admitted to the emergency department after suffering a heat stroke. Which of the following IV solutions would the nurse expect the physician would order?

A solution of normal saline An isotonic solution is helpful for hypotension caused by hypovolemia in dehydration. Examples of an isotonic solution include normal saline (0.9% NaCl) and lactated Ringer's.

A nurse is considering relocating to another state to practice nursing. Which of the following is the most appropriate action by the nurse to ensure ability to practice in the new state?

Applying for a reciprocal license in the new state Nurses gain legal rights to practice nursing in another state by applying to that state's board of nursing and receiving reciprocal licensure. The nurse does not need to retake the licensure exam. The nursing licenses are not transferable

The nurse is caring for a client who cannot meet health needs independently. Which action made by the nurse depicts concern and attachment?

Asking the client, "How are you today? I am really worried about you." Concern and attachment are the result of a close relationship of one human being with another. Thus, asking the client how the client is feeling and expressing concern exemplifies caring. Stability and security, communications and teaching, and organization and evaluation are physical care themes that are part of nursing care.

A nurse mentoring second-year nursing students from a community college plans clinical experiences for them. These students will most likely graduate in which time frame?

At the end of the year Nursing students from a community college are most likely students attempting to obtain an associate degree, which is a 2-year program. Therefore, the nurse should plan clinical experiences for students who will most likely graduate at the end of the year, as this is their second year

Which scenario is the best example of a nurse attending an in-service program?

Attending a hospital program on how to use a new IV pump In-service education is a program(s) designed by hospitals and other health care agencies to provide education and training for their employees, such as a program on how to use a new IV pump. Continuing education programs, conferences, and online classes furthering one's education are not considered in-service programs.

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

Completing clinical hours supervised by a nursing instructor Florence Nightingale's concept of apprenticeship involved training student nurses in a hospital setting. Completing clinical hours is an example of this. Passing the NCLEX exam is required to work as an RN. Participating in a paid internship is outside of the student nurse training supported by the apprenticeship model.

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

Lillian Wald Lillian Wald and Mary Brewster established the Henry Street Settlement, which was the first public health service for the sick and poor

The nurse is explaining the difference between macrodrip and microdrip IV tubing. Which of the following would the nurse include?

Microdrop tubing delivers solution at 60 drops/mL and is used for small volume administration

A registered nurse wishes to work as a nurse researcher. Which is true regarding nurse researchers?

Nurse researchers are responsible for the continued development and refinement of nursing. They usually have advanced education in addition to a baccalaureate degree in nursing. Nurse administrators, not nurse researchers, serve as liaisons between staff members and directors of nursing. Nurse researchers tend to work in large teaching hospitals, research centers, and academic institutions, not community health centers and long-term care units.

A nurse receives an x-ray report on a newly admitted client suspected of having a fractured tibia. The nurse contacts the physician to report the findings. What role is the nurse engaged in?

Nurses are communicators when they report findings to the health care team. Advocacy involves actions such as protecting the client's safety or rights. Administering care measures directly to the client demonstrates the caregiver role. Research involves collecting and analyzing data.

The student nurse is changing the bed linens of a hospitalized patient. While placing the contaminated materials into the laundry bag, the outside of the bag is touched by the material. What should the student nurse do next?

Obtain another laundry bag and place the contaminated bag inside while in the patient's room If the outside of the bag becomes contaminated, place that bag in another bag (double-bagging)

What might a nurse need to do to ensure the continuation of his/her nursing license?

Obtain continuing education credits In many states, continuing education is required for an RN to maintain licensure. These are defined as professional development experiences designed to enrich the nurse's contribution to health. Obtainment of an ongoing degree is not necessary to maintain licensure. While hospital in-services may provide continuing education, not all in-services are designed to do so.

The definition of implementation would include which of the following?

The action phase of the nursing process in which nursing care is provided

The nurse is performing an extensive dressing change on a client with burns. The nurse explains each step as it is being performed. The nurse is acting in which role by providing explanation of each step?

The nurse is acting in the role of educator by explaining each step. The act of changing the dressing and providing support is the caregiver role.

The postoperative patient's plan of care contains an intervention to ambulate twice a day 200 feet with assistance of one member of the healthcare team. The intervention was not completed one morning due to his pain. Which of the following would be the appropriate way to document the missed event?

The patient reported his pain at a level of 8/10 at 30 minutes after dosing. The patient was returned to bed and the physician was notified of the uncontrolled pain level with the current medication order. This is the correctly stated evaluation because it indicates that goal was not met, with specific documentation providing what happened, patient's response, and what follow-up was done.

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 four broad aims of nursing practice are to promote health, prevent illness, restore health, and facilitate coping with death and/or disability. In the example, the nurse is coordinating care with the other disciplines in an attempt regain some of the strength in the client's right side. This is an example of restoring a client's health. The nurse is not preventing the stroke or promoting health prior to the stroke. The nurse is not facilitating coping with the stroke.

The RN is working with hospital administrators to transform care at their facility. Which nursing competency will be critical for the nurse to utilize?

Work effectively in interdisciplinary teams The RN working with administrators to transform care will need to be able to work effectively as part of an interdisciplinary team. The nurse will need to work as a team member with members of the administration, as well as representatives from other health disciplines involved in the project. The ability to use and troubleshoot equipment and to navigate the electronic medical records are important to the nurse, but will not necessarily help when working with administration to transform care. Doing things the way they have always been done is a barrier to transformation of care.

The nurse is performing care for a client in the end stage of cancer. How can the nurse best facilitate the client and family's ability to cope? Select all that apply:

1. Assist the client and family with the preparation for end-of-life 2. Refer the client and family to hospice services 3. Assist the client with activities of daily living (ADL) Nurses facilitate client and family coping with altered function, life crisis, and death. Altered function decreases an individual's ability to carry out ADLs and expected roles, and it is appropriate for the nurse to assist in a previously independent client role. Nurses facilitate an optimal level of function through maximizing the person's strengths and potentials, through teaching, and through referral to community support systems such as hospice services. Nurses provide care to both clients and families at the end of life, and they do so in hospitals, long-term care facilities, hospices, and homes. Nurses are active in hospice programs, which assist clients and their families in multiple settings in preparing for death and in living as comfortably as possible until death occurs. Informing the family that there is nothing that they can do for their loved one creates further grieving and a feeling of loss and hopelessness.

The nursing process is:

A critical thinking method used by nurses to provide nursing care that is individualized and holistic The nursing process is a critical thinking method used by nurses to provide nursing care that is individualized and holistic. Continuing education and in-service education programs increase the knowledge and skill of the nurse. Evidence-based practice involves the identification and analysis of the best available scientific evidence for nursing care. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled, and dying individuals

After hearing a presentation about the American Nurses Association (ANA), a nurse decides to join the organization based on the understanding that:

ANA aims at fostering high standards of nursing in the United States. Membership is not open to all nurses in the U.S; only registered nurses (RNs) can become members. Members of the National League for Nursing, not the ANA, include nurses, other health care providers, and lay people. Sigma Theta Tau, not ANA, invites students showing excellence in scholarship to become members.

Which contributed to the advancement of the nursing profession after World War II?

Advanced nursing education was established. After the end of the war, nursing education was shortened to 2 years and relocated to vocational schools or community colleges. The graduate from this type of program would acquire an associate degree in nursing (ADN), and would be referred to as a technical nurse, and would not be expected to work in a management position. National standards for nursing were already developed at this time. Following the war, care of clients in hospitals increased, not decreased. Government funding did not increase to support minority nurses at this time

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

American Nurses Association The American Nurses Association (ANA) has established standards of clinical nursing practice that define the specific and unique activities of nurses. Standards serve as protection for the nurse, the client, and the institution where health care is given. The other organizations provide valuable services that differ from those of ANA. State Boards of Nursing also have the nurse practice act which define state specific guidelines for nurses to practice. The National League for Nursing is a national organization for faculty nurses and leaders in nurse education. The International Council of Nurses is a federation of more than 130 national nurses associations.

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 In this example, the nurse is utilizing a holistic approach to the provision of nursing care based on the knowledge of providing psychosocial interventions, such as allowing the client to verbalize feelings/fears. This application of knowledge is the art of nursing. The science of nursing is the knowledge base for the provision of care. Evidence-based practice and application of research are using research to make decisions on how to care for clients

The identity of the nursing profession was primarily shaped during which historical period?

Christian era While there are mentions of activities associated with nursing during ancient eras, the profession began to take form in the early Christian era

Nursing has evolved throughout the ages. Nurses in the 21st century face a variety of challenges, and technology is in the forefront of the profession. Which force affects the current nurse most?

Client privacy issues within the social media realm Technology allows nurses to connect to clients in new ways, but it also provides new challenges such as maintaining client privacy and developing human connections with clients we may never see face-to-face. Social media has few regulatory controls which prohibit the client of posting information about themselves on public sites. Nurses have been using electronic devices in health care including the electrocardiogram, vital sign machines, and bladder scanners. The computerized order entry system has reduced medication errors as the physician can use the keyboard for spelling and not having to decipher handwriting. Super bugs, such as MRSA, can be contained by effective hand-washing techniques which is not technologically sound

The nurse is caring for a postoperative client. The physician has written orders for a pain medication, and the order 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 Nurses manage collaborative problems using both nurse- and physician-prescribed interventions to reduce the risk of complication

The Nurse Corps of the United States Army was established by whom?

Dorothea Dix Chapter 1: Introduction to Nursing - Page 9

What type of nursing program would allow a student with a 4-year degree in psychology to enter and complete a baccalaureate degree in nursing, take the NCLEX examination, and transition into a Master of Science in nursing (MSN) program

Graduate entry program Graduate entry program students possess a baccalaureate degree in a field other than nursing. These students can track directly into a master's or doctorate in nursing program after successfully passing the NCLEX-RN

The nurse in a rehabilitative facility makes certain that her client is participating in group activities that are of interest to him. The nurse is ensuring which client need is met?

Love and belonging The nurse is responsible for making sure the needs of the client are met based on Maslow's hierarchy of needs. Attending a group activity helps meet the needs of love and belonging (the need to feel that one belongs and is loved to avoid loneliness and isolation). Self-actualization is the highest need and refers to realizing fully all of one's abilities and qualities. Safety and security refers to physical and psychological protection issues. Self-esteem indicates a feeling of self-worth.

The nurse is caring for a client who ascribes to the theory of animism. When attempting to explain this theory to other staff members, the nurse should state:

"Everything in nature is alive with invisible forces." The theory of animism attempts to explain the cause of mysterious changes in bodily functions. This theory was based on the belief that everything in nature was alive with invisible forces and endowed with power. Good spirits brought health; evil spirits brought sickness and death. In providing treatment, the roles of the physician and the nurse were separate and distinct. The physician was the medicine man who treated disease by chanting, inspiring fear, or opening the skull to release evil spirits (Dolan, Fitzpatrick, & Herrmann, 1983). The nurse usually was the mother who cared for her family during sickness by providing physical care and herbal remedies. Pets are not involved in the theory of animism.

The American Nurses Association (ANA) Standards of Professional Nursing Practice provides standard of care for all nurses. Which statement on the assessment of the nursing process is accurate?

The nurse collects comprehensive data pertinent to the client's health or situation The nursing process is used for all nurses as the standard of care. In the assessment phase, the RN collects comprehensive data pertinent to the client's health or situation. In the diagnosis, the RN analyzes the assessment data to determine the diagnoses or issues pertinent to the client. Next the RN identifies expected outcomes for a plan individualized to the client or the situation and develops a plan that prescribes strategies and alternatives to attain expected outcomes. The nurse does not dictate the plan. The RN implements the identified plan. This includes coordination of care, health teaching and health promotion, consultation, and prescriptive authority and treatment. Finally, in the evaluation phase, the RN evaluates progress toward attainment of outcomes. From the ethical standpoint, the nurse advocates for the client and makes sure that ethical standards are upheld but this is not part of the nursing process.

A registered nurse (RN) is caring for four clients on a medical-surgical unit. Which task is most appropriate for the nurse to delegate to the licensed practical nurse (LPN)?

Administering bedside blood glucose testing The LPN, under the Nurse Practice Act, is permitted to administer testing for bedside blood glucose. The nurse must recognize the scope of practice of the delegate, and remember that client needs and activities delegated must be matched to skill level. The RN would not delegate administration of blood products, intravenous push medication, or chemotherapy to the LPN, as these tasks are not covered under the LPN's nurse practice act (NPA).

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

Aging Social forces, such as aging and the retirement rate that exceeds replacement and attrition of aging faculty, significantly impacts the future supply/demand of nurses. Technology, economics, and science are not social forces that have impacted the future supply and demand of nurses.

A nurse is planning to continue their education in the hopes of becoming an expert in geriatric nursing who carries out direct care. For which of the following expanded career roles is the nurse preparing?

Clinical Nurse Specialist Clinical nurse specialists are nurses with an advanced degree who are considered experts in a specialized area of care. They also provide direct care, consultation, and education of clients, families, and staff. Nurse managers do not normally provide direct care. Nurse-midwives specialize in obstetrical care. Physician assistants are not nurses.

What is the best nursing intervention to promote health in a client at risk for heart disease? A. Emphasizing a client's strengths to encourage weight loss B. Informing the client that he/she must lose weight C.Instructing client to adhere to a high-sodium diet D. Taking the client's pulse rate daily

Emphasizing a client's strengths to encourage weight loss Nurses promote health by identifying, analyzing, and maximizing each client's own individual strengths as components of preventing illness, restoring health, and facilitating coping with disability or death. Emphasizing the client's strengths to encourage weight loss will be the most effective way to promote this client's health. Informing the client that he/she must lose weight will not help the client use his/her strengths to accomplish the goal. Low-sodium diets can prevent heart disease. Taking the pulse daily will not prevent heart disease

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 As many Western societies shifted from a religious orientation to an emphasis on warfare, this led to a tremendous shortage of people to care for the sick. To meet this need, women who were convicted of crimes were recruited into nursing in lieu of serving jail sentences. In addition to having a poor reputation, nurses received low pay and worked long hours in unfavorable conditions.

The nurse recognizes that immunizations are an example of:

Illness prevention The aim of illness prevention activities is to reduce the risk for illness, to promote good health habits, and to maintain optimal functioning. Immunization administration is an example of illness prevention. Assisting with crutch-walking and teaching medication administration are examples of health restoration activities, which encompasses early detection of a disease to rehabilitation. Hospice care is an example of facilitating coping with disability and death.

The client's plan of care is created by the nurse using which guideline for nursing practice?

Nursing process Nursing process is used to identify the client's strengths, limitations, and health care needs, to formulate a plan of care to address the health care needs, to implement that plan of care, and to evaluate the effectiveness of the plan to achieve established outcomes. The ANA Standards of Nursing Practice defines the activities of nurses that are specific and unique to nursing. Nurse practice acts are laws established by each state to regulate the practice of nursing. Nursing's Social Policy Statement describes the values and social responsibility of nursing, provides a definition and scope of practice for nursing and nursing's knowledge base, as well as the methods by which nursing is regulated

Nurses must use multiple mechanical devices in the workplace to assess their patients. The data collected from these devices supply what type of information?

Objective Measurement devices provide objective information for the evaluation of patient outcomes

Teaching a woman about breast self-examination is an example of what broad aim of nursing?

Preventing illness Nurses primarily prevent illness by teaching and personal example. Illness- prevention activities focus on avoiding illness or achieving early detection of an illness, such as breast cancer. Treating illness involves nursing interventions for people who have surgery or are ill. Facilitating coping is involved with easing transitions to new states of being.

Which scenario is the best example of a nurse implementing care according to the ANA standards of practice?

Providing nutrition teaching to a client with diabetes According to the ANA standards of practice, standard 5 is implementation. This is when the registered nurse implements the identified plan, coordinates care delivery, and employs strategies to promote health and a safe environment. When providing nutrition education to a client with diabetes, the nurse is implementing the teaching plan. When the nurse is analyzing a client's blood glucose level or taking a pulse rate, the nurse is performing the standard related to assessment. When the nurse is determining that a client is at risk for falls, the nurse is implementing the standard relating to diagnosis.

During the Christian era, nursing care excluded which area?

Psychiatric services During the Christian era nursing focused on many of the same areas that nursing focuses on today, but excluded psychiatric services. Areas of focus included nutrition, mobility, medication administration, personal counseling, hygiene, and comfort measures

The nurse is utilizing knowledge about a blood pressure medication's actions and side effects to determine whether or not to give a client, whose blood pressure is low, the prescribed blood pressure medication. What best describes the aspect of nursing demonstrated?

Science of nursing The science of nursing is the knowledge base for the care provided by the nurse. In this example, the nurse is using this knowledge base to decide how best to care for the client by giving or not giving the blood pressure medication. The art of nursing is the application of the knowledge. In this example it would be demonstrated by the nurse actually giving or holding the medication. Quality improvement activities and the conduction of research influence the science and the art of nursing by helping build the body of knowledge that is the science of nursing.

Florence Nightingale was a nursing pioneer who challenged prejudices against women and elevated the status of all nurses. Which statement accurately describes one of her accomplishments?

She promoted the publication of books about nursing and health care Florence Nightingale elevated the status of nursing to a respected occupation, improved the quality of nursing care, and founded modern nursing education. She promoted the publication of books about nursing education and health care. Her belief regarding nursing was that it was separate and distinct from the practice of medicine. She did not believe that nursing education should be a part of a medical degree. Clara Barton established the American Red Cross in 1882.

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. The standard being exemplified is Standard 1: Assessment: The RN collects comprehensive data. Spiritual assessment is part of the comprehensive assessment data collection. The RN may pray with a client and/or collaborate with spiritual healers, but it is not part of the standards of care. The RN typically does not provide spiritual counseling. Chapter 1: Introduction to Nursing - Page 18

The nurse conducts a home safety assessment for a client. Which statement best explains the standard of care being implemented?

The RN promotes a safe environment. The standard of care being exemplified is Standard 5b: Health teaching and Promotion: The RN employs strategies to promote health and a safe environment. Standard 3, which is outcomes Identification, the registered nurse identifies expected outcomes for a plan individualized to the healthcare consumer or the situation. Standard 12, is education, where the registered nurse seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. Standard 4, is planning, where the registered nurse develops a plan that prescribes strategies and alternatives to attain expected, measurable outcomes. Chapter 1: Introduction to Nursing - Page 18

A nurse is providing care for clients in a long-term care facility. Based on the definitions of nursing in the textbook, what should be the central focus of this care?

The client receiving the care The client receiving the care is always the central focus of the nursing care provided. The central focus is not the nurse, the nursing actions, or nursing as a profession.

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

World War II Explanation: Esther Lucille Brown, in her report on nursing education published at that time, wrote that nursing education belonged in colleges and universities, not in hospitals.

Which explanation differentiates the Registered Nurse (RN) from the Licensed Practical Nurse (LPN)?

LPNs are employed in hospitals, long-term care facilities, and rehabilitation centers and by health care providers such as physicians. LPNs differ from RNs in two areas: educational preparation and scope of practice. LPNs always practice under the supervision of an RN. LPN's have a scope of practice and the workload is not directed by the RN. RN's are not permitted to prescribe medications. Nurse practioners (NPs) can prescribe medications

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

1. Assisting a client and his family to prepare for death 2. Providing counseling for the family of a teenager with an eating disorder 3. Teaching a client and her family how to live with diabetes Coping is another important broad aim of nursing. Nurses facilitate client and family coping for those experiencing altered function, life crisis, and death. Examples of coping would be teaching a client and the client's family about how to live with diabetes. Another example would be assisting a client and the client's family to prepare for death. A third example would be providing counseling for the family of a teenager with an eating disorder. Changing bandages, starting an IV, or teaching a class on an expected health care issue or need would not be examples of the aim of facilitating coping with disability or death.

A graduate nurse applies for a nursing license in Pennsylvania. Which action does the jurisdiction of the licensing board have? Select all that apply: 1. Licensing nurses during the lifetime of the holder 2. Allowing graduates of approved schools of nursing to take the NCLEX 3. Protecting nurses from being suspended for professional misconduct 4. Authorizing nurses to practice nursing in any state 5. Issuing special licenses to nurses practicing in long-term care facilities as a priority 6. Denying licensing due to criminal actions

1. Licensing nurses during the lifetime of the holder 2. Allowing graduates of approved schools of nursing to take the NCLEX 6. Denying licensing due to criminal actions The jurisdiction of a licensing board could include allowing only graduates of approved schools of nursing to take the NCLEX exam, license nurses during the lifetime of the holder of the license, and deny licensing due to criminal actions. The jurisdiction of a state licensing board does not authorize nurses to practice nursing in any state other than the state of the board. The jurisdiction of a state licensing board does not protect nurses from being suspended for professional misconduct, nor can a board issue special licenses to nurses practicing in long-term care facilities as a priority.

The nurse is considering medical-surgical certification after working in a medical-surgical floor for the past five years. Nursing specialty certification is given by which of the following groups?

American Nurses Credentialing Center (ANCC) Nurses can choose to become certified in a nursing specialty. The American Nurses Credentialing Center (ANCC, 2014) states that certification validates nursing specialty knowledge. Also, it builds confidence in nurses as professionals, demonstrating that they meet nationally recognized standards in the specialty. Certification is a voluntary process to provide professional recognition of the knowledge, skills, and abilities of certified nurses. The American Nurses Association is a professional organization to advance and protect the profession of nursing. It started in 1896 as the Nurses Associated Alumnae and was renamed the American Nurses Association in 1911. The National League for Nursing is a national organization for faculty nurses and leaders in nurse education. The American Association of Colleges of Nursing (AACN) is the national voice for baccalaureate and graduate nursing education

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

BSN is the recommended entry level by national nursing organization National nursing organizations are recommending that the entry level for professional practice be at the baccalaureate level, not the associates degree (ADN) or diploma degree. They are not eliminating accelerated programs for graduates of non-nursing disciplines.

The nurse is caring for a postoperative client, and administers a pain medication prescribed on a p.r.n. basis by the physician. What best describes the type of intervention the nurse is demonstrating?

Collaborative intervention The administration of a p.r.n. medication requires a physician-prescribed intervention (the medication order) as well as a nurse-prescribed intervention (determining when the order should be carried out and proper administration of the medication); therefore, this action would be considered a collaborative intervention. Nurse-initiated interventions, such as turning and repositioning a client, are described as nurse-prescribed interventions. Physician-directed actions are described as physician-prescribed interventions. Client advocacy refers to communicating the needs and protecting the safety of the client. Interventions are not normally categorized as being independent or dependent.

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 Documentation is an example of maintaining accurate records, a practice that was initiated by Florence Nightingale. Linda Richards began the practice of keeping the records for a period of time. Clara Barton established the Red Cross. Lillian Wald was the founder of public health nursing

A student nurse understands that the primary aim of the Healthy People 2020 initiative is:

Health promotion Healthy People 2020 establishes health promotion guidelines for the nation as a whole. The guidelines contain 12 Leading Health Indicators, which are used to measure the health of the nation over a 10-year period. Illness prevention, health restoration, and coping with disability are components of the Healthy People 2020 guidelines, but are not considered as the primary goal of the initiative.

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

Mary Breckinridge The nurse can trace education for nurse midwifery back to Mary Breckinridge, who established one of the first midwifery schools in the United States. Sojourner Truth and Lavinia Dock worked for the women's movement. Margaret Sanger was the founder of Planned Parenthood

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 Mary Eliza Mahoney set a precedent for minorities in the profession of nursing by becoming the first African American nurse in the United States. Nora Livingston established the first 3-year hospital training in North America. Mary Agnes Snively was a founder of the Canadian Nurses Society. Mary Ann Bickerdyke organized diet kitchens, laundries, and ambulance services

A client asks 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 The best answer by the nurse is that only advanced practice registered nurses have prescriptive authority. The registered nurse who is not an advanced practice nurse should not prescribe medications, even over-the-counter medications such as ibuprofen and acetaminophen

Then nurse is providing flu shots to older adult clients at a nurse-managed wellness center. This is an example of which aim of nursing?

Preventing illness The objectives of illness prevention activities are to reduce the risk for illness, promote good health habits, and to maintain optimal functioning. The flu shot is reducing the risk of illness from the flu. Restoring health occurs after diagnosis or surgery and in a situation where the health of the individual was impaired. The question does not state that these older adult clients have a disability. Promoting health literacy would be based on improving a client's knowledge regarding a disease or preventing disease. A flu shot does not promote health literacy.

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

Starting an intravenous line in the client's arm In the role of caregiver, the nurse provides care to clients to meet their needs, such as when starting an intravenous line. The role of caregiver is the primary role of the nurse. Teaching a client about medication is the role of educator. Telling a doctor a lab value is the role of communicator. Securing a referral to the local clinic is the role of counselor. Assigning rooms is a management role

The registered nurse communicates with the physical therapist that a client is now on strict bed rest due to bradycardia. Which statement best explains the standard exemplified by the nurse?

The RN coordinates care delivery There are 12 Standards of Practice: Assessment, Diagnosis, Outcomes Identification, Planning, Implementation, Evaluation, ethics, Culturally Congruent Practice, Communication, Collaboration, Leadership, and Education. The standard exemplified by the nurse is 5a with the standard of implementation is the Coordination of Care where the RN coordinates care delivery. Standard 5b. Health Teaching and Health Promotion where the registered nurse employs strategies to promote health and a safe environment. The RN identifies outcomes is Standard 3. Outcomes Identification where the registered nurse identifies expected outcomes for a plan individualized to the healthcare consumer or the situation. Standard 2 Diagnosis is when the registered nurse analyzes the assessment data to determine the actual or potential diagnoses, problems, and issues. Standard 1 is Assessment where the registered nurse collects pertinent data and information relative to the healthcare consumer's health or the situation.

The nurse graduated several years ago from a 2-year nursing program at a community college near the home city. Recently, the nurse has considered moving from providing direct client care into an administrative role, but recognizes the need for further education to be considered for such a position. The nurse most likely possesses which nursing qualification?

Associate degree An associate degree in nursing is typically a 2-year program that is offered at a community college or junior college. Such a degree allows a nurse to plan and provide care, but further education is often necessary for administrative positions. A diploma is often provided under the auspices of a hospital, while both baccalaureate and graduate degrees involve a minimum of 4 years of education; both degrees qualify a nurse to act in a supervisory role.

A student is choosing her educational path and desires a nursing degree with a track that contains community nursing and leadership, as well as liberal arts. The student would best be suited in which type of program?

Baccalaureate program The baccalaureate degree in nursing offers students a full college or university education with a background in the liberal arts

The nurse is conducting a class for nursing assistants. One of the students asks the nurse why blood pressure, pulse, and temperature are called "vital signs". Which of the following explanations would the nurse offer the student?

Because significant deviation from normal is not compatible with life Temperature, pulse, respirations, and blood pressure are considered the vital signs because significant deviations from normal ranges are not compatible with life.

One of the role's that the nurse has in practice is that of a communicator. What attributes by the nurse demonstrate that is characteristic of this role?

Establishing and maintaining helping relationships with clients of all ages in a variety of settings The nurse acting in the role of communicator uses effective interpersonal and therapeutic communication skills to establish and maintain helping relationships with clients of all ages in a wide variety of health care settings. The nurse in the role of the teacher/educator uses communication skills to assess, implement, and evaluate individualized teaching plans to meet learning needs of patients and their families. The nurse in the role of counselor uses therapeutic interpersonal communication skills to provide information, make appropriate referrals, and facilitate the patient's problem-solving and decision-making skills. The nurse in the role of leader is assertive, self-confident practice of nursing when providing care, effecting change, and functioning with groups.

The nurse that has been in practice for 15 years is able to use intuition when providing care to clients and also utilizes resources and demands to attain specific goals. According to Author Patricia Benner, in From Novice to Expert (1984), what stage of practice is the nurse displaying?

Expert In From Novice to Expert, Patricia Benner (1984) discussed socialization and skill acquisition in nursing. A nurse passes through five levels of proficiency when acquiring and developing nursing skill: novice, advanced beginner, competent, proficient, and expert. Differences in each level reflect changes in three areas of skill performance. In the first area, the novice and advanced beginner nurse moves from relying on abstract principles to using concrete experiences. The second area involves a change from seeing situations in parts to seeing them more conceptually, or as a whole occurs with a competent and proficient nurse. Finally, in the third area, the nurse is no longer outside the situation observing but is directly involved and uses intuition. This process takes 5 to 10 years after graduation and is considered an expert. Chapter 1: Introduction to Nursing - Page 15

A prospective nursing student desires a career that will allow him to provide client care and to assist professional nurses with routine technical procedures. The prospective student needs to be employed in a full-time position quickly due to economic hardship. What type of nursing program would best suit this student?

Licensed or vocational nursing program A licensed practical or vocational nursing program will allow the student to earn a technical certificate in 1 year and sit for the state board of nursing examination to be licensed as an LPN or LVN. An associate program will take 2 years and a baccalaureate program will take 4 years. There are very few diploma programs remaining in the U.S., and these programs typically take 3 years to complete

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

Lillian Wald Lillian Wald established a neighborhood nursing service for the sick and poor in New York City and is considered the founder of public health nursing. The other women were important to the development of nursing, but not to public health nursing. Nutting helped to found a modern nursing program at the school. Sojourner Truth was an African-American abolitionist and women's rights activist who was a nurse. Clarissa "Clara" Harlowe Barton was a pioneering nurse who founded the American Red Cross Chapter 1: Introduction to Nursing - Page 9


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