weeks four and five CAQs
In what order should a nurse follow steps of risk management to identify potential hazards and to eliminate them before harm occurs? Analyzing the possible risks Identifying possible risks Evaluating the steps taken Acting to reduce the risks
1. Identifying possible risks 2. Analyzing the possible risks 3. Acting to reduce the risks 4. Evaluating the steps taken Rationale: To eliminate potential hazards before harm occurs, the nurse should first identify the possible risks. After this, the nurse should analyze the possible risks. Then the nurse should act to reduce risks. Finally, the nurse should evaluate the steps that have been taken.
A nurse is caring for a client who belongs to a different cultural community. The client is not very fluent in the language that the nurse is communicating. What would the nurse say to the client to initiate appropriate communication? Select all that apply. a. "Please tell me about the healthcare practices and beliefs of your community." b. "Let me bring in an interpreter to help you understand the medical procedures better." c. "I would like to know your personal beliefs regarding healthcare traditions and practices." d. "Please let me explain our traditions and cultural practices to help you understand our healthcare practices." e. "I have read up extensively about the healthcare practices of your community and have designed a care plan accordingly."
a. "Please tell me about the healthcare practices and beliefs of your community." b. "Let me bring in an interpreter to help you understand the medical procedures better." c. "I would like to know your personal beliefs regarding healthcare traditions and practices." Rationale:The nurse should try to understand the client's beliefs, traditions, and values and the effect of these dimensions on the client's healthcare beliefs and practices. If a language barrier exists, the nurse should engage the services of an interpreter to explain medical procedures. This action reduces the chances of accidental misinformation. The nurse should try to find out about the client's traditions, beliefs, and values in order to provide individualized care. The nurse should not discuss his or her personal beliefs with the client. The nurse should avoid stereotyping the client based on his or her culture by assuming that the client follows all the cultural practices of his or her community.
What is the difference between risk nursing diagnoses and actual nursing diagnoses? a. Actual nursing diagnoses have related factors; risk nursing diagnoses do not have related factors. b. Actual nursing diagnoses are present in NANDA-I classification; risk nursing diagnoses are absent in NANDA-I classification. c. Actual nursing diagnoses are associated with environmental and physiological factors; risk nursing diagnoses are not associated with these factors. d. Actual nursing diagnoses are least likely to be established in a vulnerable population; risk nursing diagnoses are established in vulnerable population.
a. Actual nursing diagnoses have related factors; risk nursing diagnoses do not have related factors. Rationale: Actual nursing diagnoses have related factors that show a causality relationship between the diagnosis and the etiology. Risk nursing diagnoses have a risk factor which may predispose a client to a disease. Both the types of diagnoses are mentioned in the NANDA-I classification. Both types of diagnoses may have associations with environmental and physiological factors. Both types of diagnoses can be established in vulnerable population.
A pregnant immigrant notices cultural differences in the way that pregnant women are cared for where she now lives. Which component of cultural competence is being demonstrated when the nurse motivates the immigrant to accept these differences? a. Cultural desire b. Cultural awareness c. Cultural knowledge d. Cultural encounters
a. Cultural desire The nurse is using cultural desire as a part of cultural competence. This component is related to motivation and commitment towards the care of an individual. Through this, an immigrant may become open to cultural differences and accept them. Cultural awareness is an in-depth self-examination of backgrounds and recognizing biases and prejudices. Cultural knowledge is a comparative study about the beliefs and care practices of other cultures. Cultural encounter is about transcultural interactions for effective communication and development.
A nurse leader of a state nurse's association (SNA) is advising legislators regarding health policy improvements. Which key idea is involved in this type of leadership power? a. Expert power b. Position power c. Connection power d. Information power
a. Expert power Rationale: A leader of an SNA can provide the expert knowledge needed to accurately inform the state legislators as they work to change public policy. Position power is involved when the leader possesses power by virtue of his/her position within an organization. Connection power is involved when there is association with other influential people. Information power is involved when a person is in possession of select information needed by others.
Which organization advocates nurses taking a prominent role in the healthcare arena? a. Institute of Medicine b. National Quality Forum c. Institute for Healthcare Improvement d. Agency for Healthcare Research and Quality
a. Institute of Medicine The Leading Change Advancing Health report (2010) from the Institute of Medicine focuses on nurse coalitions and their prominent role in the healthcare arena. The National Quality does not address the issues of nurses; it focuses on client protections and healthcare quality through measurement and public reporting. The Institute for Healthcare Improvement provides rapid-cycle change projects designed to improve care rapidly. It focuses on partnering with clients and healthcare professionals to test new models of care. The Agency for Healthcare Research and Quality Outcomes provides resources for nurses and is the source of Five Steps to Safer Health Care.
A nursing student is listing risk factors that affect the health and wellness of a client. Which risk factors listed by the nursing student are accurate? Select all that apply. a. Lifestyle b. Environment c. Spiritual factors d. Emotional factors e. Genetic and physiological factors
a. Lifestyle b. Environment e. Genetic and physiological factors Rationale: Lifestyle, environmental and genetic and physiological factors affect the health and wellness of the client. Spiritual and emotional factors are internal variables that influence health, health beliefs, and practices.
A nursing student is recalling the various stages of health behavior change. What are the characteristics of the preparation stage? Select all that apply. a. The client requires assistance to plan changes in health behavior. b. The client intends to make changes in health behavior in the next 6 months. c. The client becomes actively engaged in strategies to change health behavior. d. The client understands that the advantages of health behavior change exceed the disadvantages. e. The client makes small changes in health behavior in preparation for major changes in the next month.
a. The client requires assistance to plan changes in health behavior. d. The client understands that the advantages of health behavior change exceed the disadvantages. e. The client makes small changes in health behavior in preparation for major changes in the next month. In the preparation stage, the client may need assistance in planning for the health behavior change. At this stage, the client understands that advantages of health behavior change exceed the disadvantages. The client, therefore, makes small changes to prepare for major health behavior change in the next month. In the contemplation stage of health behavior change, the client intends to make changes in health behavior in the next 6 months. In the preparation stage, the client becomes actively engaged in strategies to change his or her health behavior.
Which feature is characteristic of a risk nursing diagnosis? a. The diagnosis does not have related factors. b. The diagnosis can be used in any health state. c. The defining characteristics support the diagnostic judgment. d. The defining characteristics are supported by a client's readiness
a. The diagnosis does not have related factors. Rationale: A risk nursing diagnosis describes human responses to health conditions that may develop in a vulnerable individual, family, or community. Risk diagnoses do not have related factors or defining characteristics because they have not occurred yet. A risk diagnosis has risk factors that help the nurse plan preventive measures. A health promotion nursing diagnosis can be applied to any individual with a desire to enhance health behaviors in any health state. An actual diagnosis is formed when the defining characteristics support the diagnostic judgment. There must be sufficient nursing assessment data to establish an actual diagnosis. A health promotion nursing diagnosis is a clinical judgment of an individual's readiness to increase well-being.
What does a community-based nurse do as a change agent? Select all that apply. a. The nurse empowers clients and their families to creatively solve problems. b. The nurse works with clients to solve problems and helps clients identify an alternative care facility. c. The nurse helps clients gain the skills and knowledge needed to provide self-care. d. The nurse empowers clients to become instrumental in creating change within a health care agency. e. The nurse does not make decisions but rather helps clients reach decisions that are best for them.
a. The nurse empowers clients and their families to creatively solve problems. b. The nurse works with clients to solve problems and helps clients identify an alternative care facility. d. The nurse empowers clients to become instrumental in creating change within a health care agency. Rationale: As a change agent, the nurse empowers clients and families to creatively solve problems. As a change agent, the nurse works with clients to solve problems and helps them identify an alternative care facility. As a change agent, the nurse empowers clients to become instrumental in creating change within a health care agency. As an educator, the nurse helps clients gain the skills and knowledge needed for self-care. As a counselor, the nurse does not make decisions, but rather helps clients reach decisions that are best for them.
A nurse is caring for a group of clients with diverse cultural backgrounds. Which nursing theory does the nurse use as a guide? a. Orem's theory b. Leininger's theory c. Henderson's theory d. Betty Neuman's theory
b. Leininger's theory Rationale: Leininger's theory guides the nurse to appropriately deal with clients from different cultural and ethnic groups. According to this theory, while caring for clients from different cultural backgrounds, the nurse should provide culturally specific nursing care. Dorothea Orem's self-care deficit theory focuses on the client's self-care needs. Henderson's theory involves working interdependently with other healthcare workers. Neuman's theory is based on stress and the client's reaction to the stressor.
A home health nurse is caring for school-aged children in a family that is economically deprived. Which characteristic is most common to those living in poverty? a. Open expression of anger b. Long-term feeling of powerlessness c. Willingness to postpone gratification d. Compliance with health recommendations
b. Long-term feeling of powerlessness Rationale: People living in poverty feel powerless because they do not have the buying power or social status to effect change. Their anger is covert and not direct; in addition, the anger rarely resolves their situation, resulting in feelings of powerlessness and hopelessness. Economically deprived people are less likely to postpone gratification because they focus on the present, not the future. Health recommendations may be misunderstood, confusing, or perceived as of little value and are frequently ignored
Which group benefits from Medicare? a. Self-insured employers b. People who are 65 years or older c. Members of low-income families d. Children who are not poor enough for Medicaid
b. People who are 65 years or older Rationale: Medicare is a health insurance program for people 65 years or older. The payment for the plan is deducted from monthly individual social security checks. A Preferred Provider Organization (PPO) plan is a contractual agreement between a set of providers and self-insured employers. It offers comprehensive health services at a discount to companies under contract. The Medicaid plan is a federally funded, state-run program that provides health insurance for low-income families. It finances a large portion of care for poor children, their parents, pregnant women, and disabled very poor adults. The State Children's Health Insurance Programs (SCHIP) is a federally funded, state-run program for children who are not poor enough for Medicaid.
What does "access to care" include according to the Picker Institute's eight dimensions of patient-centered care? Select all that apply. a. "Clients often need help to complete activities of daily living (ADL)." b. "Clients expect privacy and to have their cultural values respected." c. "Clients want to be able to see a specialist when a referral is made." d. "Clients want to schedule appointments at convenient times without trouble." e. "Clients need to be able to find conveyance when travelling to different healthcare settings."
c. "Clients want to be able to see a specialist when a referral is made." d. "Clients want to schedule appointments at convenient times without trouble." e. "Clients need to be able to find conveyance when travelling to different healthcare settings." According to the Picker Institute's eight dimensions of patient-centered care, "access to care" includes several features. Clients want to be able to see a professional when a referral is made. Clients want to schedule appointments at convenient times without trouble. Clients need to be able to find conveyance when travelling to different healthcare settings. According to the Picker Institute's eight dimensions of patient-centered care, "physical comfort" includes aspects such as clients requiring help to complete activities of daily living (ADL) and clients expecting privacy and respect towards their cultural values.
A daughter of a Chinese-speaking client approaches a nurse and asks multiple questions while maintaining direct eye contact. What culturally related concept does the daughter's behavior reflect? a. Prejudice b. Stereotyping c. Assimilation d. Ethnocentrism
c. Assimilation Rationale: Assimilation involves incorporating the behaviors of a dominant culture. Maintaining eye contact is characteristic of the American or Canadian culture and not of Asian cultures. Prejudice is a negative belief about another person or group and does not characterize this behavior. Stereotyping is the perception that all members of a group are alike. Ethnocentrism is the perception that one's beliefs are better than those of others.
What does the basic principle of advocacy provide to the nurse according to the American Nurses Association (ANA) code of ethics? a. The basic principle of advocacy helps the nurse remain competent in nursing practice. b. The basic principle of advocacy helps the nurse provide care on the basis of the client's specific needs. c. The basic principle of advocacy helps the nurse make a unique contribution to the understanding of the client's point of view. d. The basic principle of advocacy helps the nurse ensure that professional actions can be explained to clients and the employer.
c. The basic principle of advocacy helps the nurse make a unique contribution to the understanding of the client's point of view. The nurse advocates for the health, safety, and rights of clients along with their right to privacy. This helps the nurse to make a unique contribution to understanding the client's point of view. The basic principle of responsibility ensures that the nurse is responsible for his or her own actions and the actions of people to who tasks are delegated. In addition, this principle helps the nurse to remain competent in his or her practice. The nurse ensures that care is provided to clients only on the basis of their need. Accountability refers to ensuring that professional actions can be explained to the clients and the employer.
A nursing student is listing the steps that need to be followed to provide competent care for vulnerable populations. Which point listed by the nursing student is accurate? a. "Refrain from giving priority to cultural practices and values of the vulnerable populations." b. "Provide financial and legal advice to the vulnerable people as this may be more important to them." c. "Evaluate client's beliefs and values about health in terms of the nurse's own culture, beliefs, and values." d. "Understand the client's cultural beliefs, values, and practices to determine their specific needs and interventions."
d. "Understand the client's cultural beliefs, values, and practices to determine their specific needs and interventions." Rationale: The nurse should understand the client's cultural beliefs, values, and practices to determine their specific needs and interventions to provide competent care for vulnerable populations. The nurse should learn about the culture of the clients to understand cultural practices and values that influence their health care practices. The nurse should not provide financial and legal advice to the clients as clients should be connected with someone qualified to help them. The nurse should refrain from evaluating client's beliefs and values about health in terms of the nurse's own culture, beliefs, and values to provide competent care to vulnerable populations.
How does a nurse play the role of a "change agent" in a community-based nursing practice? a. By helping clients identify and clarify health problems b. By establishing relationships with community service organizations c. By establishing an appropriate plan of care, based on assessment of clients d. By identifying and implementing new and more effective approaches to problems
d. By identifying and implementing new and more effective approaches to problems. Rationale: The nurse acts as a change agent by identifying and implementing new and more effective approaches to problems. As a change agent, the nurse can empower individuals and their families to creatively solve problems or become instrumental in creating change within a health care agency. The nurse acts as a case manager when he or she asks clients to identify and clarify health problems. The nurse acts as an educator when he or she establishes relationships with community service organizations. The nurse acts as a counselor when he or she establishes an appropriate care plan based on the client's assessment.
According to which stage of Kohlberg's theory would a nurse ask a higher authority to reduce the treatment expenses of a low-income client? a. Social contract orientation b. Society-maintaining orientation c. Instrument relativist orientation d. Universal ethical principle orientation
d. Universal ethical principle orientation The universal ethical principle orientation stage of Kohlberg's theory states that an individual may not follow a law if it does not seem just. At this stage, the nurse may ask a higher authority to reduce the treatment expenses of a poorer client. According to the social contract orientation stage, a person follows a law even if it is not necessarily just. According to the society-maintaining orientation stage, an individual shows concern for and makes decisions in accordance to his or her society. During the instrument relativist orientation, a child recognizes that there is more than one correct view.
A nurse is explaining about healthcare plans to a patient. Which healthcare plan finances a large portion of care for low-income children, their parents, pregnant women, and disabled very poor adults? a. Medicare b. Medicaid c. Long-term care (LTC) insurance d. Private insurance
b. Medicaid Rationale: Medicaid finances a large portion of care for low-income children, their parents, pregnant women, and disabled very poor adults. Medicare covers services of nurse practitioners. LTC insurance is very expensive and is used for coverage of LTC services. Private insurance is typically expensive and clients have to meet deductibles before insurance pays.
A registered nurse educates a student nurse regarding the appropriate method of dealing with clients of different cultural backgrounds. Which statements by the student nurse indicate an understanding of various cultures? Select all that apply. a. "I should focus on understanding the traditions, beliefs, and values of the client's culture." b. "I should provide care strictly on the basis of the traditions, beliefs, and values of the client's community." c. "It is acceptable to provide generalized education and information to clients belonging to a different community." d. "I should understand that the cultural background of the client has no impact on his or her health, wellness, and illness." e. "I should be aware of my own cultural background and beliefs when attending to clients who belong to different cultures."
a. "I should focus on understanding the traditions, beliefs, and values of the client's culture." e. "I should be aware of my own cultural background and beliefs when attending to clients who belong to different cultures." Rationale: A nurse should refrain from assuming that every client follows the cultural practices and traditions of his or her community stringently. When educating a client about any illness or procedure, the nurse should understand that the client may have unique cultural perceptions regarding the cause of the illness and treatment and may need specific education and information. The nurse should understand that cultural background has an impact on a client's health care beliefs and that it affects his or her health, wellness, and illness. To provide individualized care to the client, the nurse should focus on his or her traditions, beliefs, and values. The nurse should be aware of his or her own cultural background and beliefs to ensure that stereotypes and prejudices do not get in the way of client care.
What is the most important nursing intervention for minority adolescents? a. Identifying individuals at risk for substance abuse b. Providing counseling to adolescents during rehabilitation c. Helping ensure improved access to appropriate healthcare d. Guiding minority adolescents to prevent injuries and accidental deaths
c. Helping ensure improved access to appropriate healthcare Minority adolescents experience a greater likelihood of health problems and barriers to healthcare. Hence, helping improve access to appropriate healthcare is the most important intervention for the nurse working with minority adolescents. Identifying individuals who are at risk for substance abuse, providing counseling to adolescents during rehabilitation, and guiding adolescents to help prevent injuries and accidental deaths are applicable to all adolescents.
What does the resources aspect of the American Nurses Association (ANA) standards of professional performance describe? a. When a nurse practices in an environmentally safe and healthy manner b. When a nurse attains knowledge and competency that reflects current nursing practices c. When a nurse demonstrates leadership in the professional practice setting and the profession d. When a nurse uses appropriate nursing services that are safe, effective, and financially responsible
d. When a nurse uses appropriate nursing services that are safe, effective, and financially responsible Rationale: Resources are the appropriate resources used by a nurse to plan and provide nursing services that are safe, effective, and financially responsible. Environmental health includes nurses practicing in an environmentally safe and healthy manner. Education is the attainment of knowledge and competency by the nurse that reflects current nursing practice. Leadership includes the demonstration of leadership in the professional practice setting and the profession.
What statements about culturally congruent care by the student nurse are correct? Select all that apply. a. "It is the main goal of transcultural nursing." b. "It is provided through cultural competence." c. "It is provided in accordance with set criteria." d. "It is bound to the professional health care system." e. "It depends on the patterns and needs of an individual."
a. "It is the main goal of transcultural nursing." b. "It is provided through cultural competence." e. "It depends on the patterns and needs of an individual." Rationale: Culturally congruent care is tailored to the needs of people themselves, not delivered in accordance with predetermined criteria. This care may be different from the values and meanings of the professional health care system. The main goal of transcultural nursing is to provide culturally congruent care. Cultural competence is applied to ensure the delivery of this care. Culturally congruent care is provided in accordance with people's life patterns, values, and beliefs.
A mother brings her 9-month-old infant to the clinic. The nurse is familiar with the mother's culture and knows that belly binding to prevent extrusion of the umbilicus is a common practice. The nurse accepts the mother's cultural beliefs but is concerned for the infant's safety. What variation of belly binding does the nurse discourage? a. Coin in the umbilicus b. Tight diaper over the umbilicus c. Binder that encircles the umbilicus d. Adhesive tape across the umbilicus
a. Coin in the umbilicus A coin may be dislodged, allowing the infant to put it in his or her the mouth, resulting in a safety issue. A diaper fastened tightly around the waist, a binder, or adhesive tape over the umbilicus will not endanger the infant. Cultural beliefs that do not place the infant at risk should not be discouraged.
What professional responsibility does the nurse display as a client's advocate? a.The nurse protects the client's human and legal rights and provides assistance in asserting said rights. b. The nurse actively collaborates with other healthcare professionals to follow the best treatment plan for a client. c. The nurse explains concepts and facts about health, describes the reason for routine care activities, and demonstrates procedures. d. The nurse establishes an environment for collaborative client-centered care to provide safe, quality care with positive client outcomes.
a.The nurse protects the client's human and legal rights and provides assistance in asserting said rights. Rationale: As a client's advocate, the nurse protects the client's human and legal rights and provides assistance in asserting these rights. Autonomy is an essential element of professional nursing that helps the nurse to actively collaborate with other healthcare professionals to follow the best treatment plan for a client. As an educator, the nurse explains concepts and facts about health, describes the reason for routine care activities, and demonstrates procedures to the client and family members. As a manager, the nurse establishes an environment for collaborative client-centered care to provide safe, quality care with positive client outcomes.
How should nurses provide effective nursing care to clients from different cultural backgrounds? a. By advising clients that some cultural practices may be harmful to health b. By providing care that fits the clients' cultural beliefs c. By strictly adhering to organization policies regarding nursing care d. By ignoring the cultural aspect and focusing on the medical aspect of care
b. By providing care that fits the clients' cultural beliefs Rationale: When providing care to clients from different cultural backgrounds, nurses should be careful to provide care that fits the client's cultural beliefs. It helps provide effective nursing care to the satisfaction of the client. Advising clients against their cultural practices may offend them and should be avoided. Organization policies should be made flexible to incorporate cultural aspects of care. Ignoring the cultural aspect of client care may result in ineffective nursing care.
A registered nurse is educating a nursing student about risk management methods to ensure that appropriate nursing care is provided to a client by identifying and eliminating potential hazards. What information should the registered nurse provide? Select all that apply. a. "If an incident occurs, document in the client's medical record that an occurrence report has been filed." b. "Ensure that the three principles of The Joint Commission's Universal Protocol are adhered to before starting a surgery on a client." c. "Refrain from depending on the use of electronic monitoring devices completely because they are not always reliable." d. "File an occurrence report in case of an error in technique when administering medication intravenously (IV)." e."Document that the healthcare provider was contacted, the information that was conveyed, and the response in the occurrence report.
b. "Ensure that the three principles of The Joint Commission's Universal Protocol are adhered to before starting a surgery on a client." c. "Refrain from depending on the use of electronic monitoring devices completely because they are not always reliable." d. "File an occurrence report in case of an error in technique when administering medication intravenously (IV)." Rationale: The nurse should ensure that the three principles of the protocol are adhered to before starting surgery. This is done to prevent an incorrect surgery. The nurse should not rely on electronic monitoring devices completely because they are not always reliable. Constant assessment of a client is essential to help document the accuracy of electronic monitoring. The nurse should file an occurrence report in case of an error in technique when administering medication intravenously (IV) to the client. This is done to prevent recurrence of the error and to alert hospital authorities about the situation. The nurse should never document in the client's medical record that an occurrence report has been filed, because this report is confidential and is kept separated from other medical records. The nurse should document that the healthcare provider was contacted, what information was conveyed and the healthcare provider's response. This helps to defend against a lawsuit. However, this information should not be documented in the occurrence report.
A registered nurse is educating a nursing student about community health nursing. Which point made by the student nurse needs correction? a. Community health nursing is focused on preserving, protecting, promoting, or maintaining health. b. Community health nursing emphasizes improving the quality of health and life within that community. c. Community health nursing does not provide direct or indirect care services to subpopulations in a community. d. Community health nursing is nursing practice in the community, with the primary focus being the health care of individuals, families, and groups in that community.
c. Community health nursing does not provide direct or indirect care services to subpopulations in a community. Rationale: Community health nursing provides direct care services to subpopulations within a community. Community health nursing is focused on preserving, protecting, promoting, or maintaining health. Community health nursing emphasizes improvement of the quality of health and life within that community. Community health nursing is nursing practice in the community, with the primary focus the health care of individuals, families, and groups in the community.
What does a public health nurse expect to encounter when working with families raised in a culture of poverty? a. Willingness to delay gratification b. Optimism about improving their lifestyle c. Shame because of their inadequacy as parents d. Powerlessness relative to changing their situation
d. Powerlessness relative to changing their situation Rationale: Powerlessness is a characteristic feeling among people in the culture of poverty, which tends to erode their hope for change. People in the culture of poverty usually require immediate gratification because they do not have enough faith in the future to delay gratification. Pessimism, not optimism, about changing a lifestyle is more common in these families. There is not sufficient evidence to indicate that poor people feel shame for their situation or that they are inadequate parents
