ch1 Nursing

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Which individual provided community-based care and founded public health nursing? Clara Barton Lillian Wald Mary Adelaide Nutting Sojourner Truth

Lillian Wald Explanation: 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. Reference: Chapter 1: Introduction to Nursing - Page 9

What might a nurse need to do to ensure the continuation of his or her nursing license? Obtain a baccalaureate degree. Attend hospital in-services. Obtain a master's degree. Obtain continuing education credits.

Obtain continuing education credits. Explanation: 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. Reference: Chapter 1: Introduction to Nursing - Page 14

Florence Nightingale introduced the concept of apprenticeship for nurses. Which statement is an example of this? -Completing clinical hours supervised by a nursing instructor -Passing the NCLEX exam -Participating in a paid internship -Taking an online class at a university

Completing clinical hours supervised by a nursing instructor Explanation: 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. Taking an online class at a university is not part of an apprenticeship model. Reference: Chapter 1: Introduction to Nursing - Page 7

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? Novice Proficient Competent Expert

Expert Explanation: 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. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019.

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. The patient was in too much pain to complete the morning ambulation. The patient complained of too much pain to ambulate and was returned to bed. The intervention was not completed due to patients severe pain level. The patient was assisted to standing but reported severe pain and begged to return to bed. Patient was assisted to bed.

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. Explanation: 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 need for university-based nursing education programs was brought to light during which important historical time? World War I World War II

World War II Explanation: During the middle of the twentieth century, Esther Lucile Brown, in her report on nursing education published at that time, wrote that nursing education belonged in colleges and universities, not in hospitals. During the Spanish-American War, nursing was still in its earliest phase of development. Even with the input of Florence Nightingale and her followers after WWI, nursing continued to struggle. Professional nursing began during the period and crisis needs of WWII. Nursing continues to evolve today. Reference: Chapter 1: Introduction to Nursing - Page 7-8

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. ANA NNO AACN ANO NASN ICN

ANA, ICN, AACN. Explanation: 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. Reference: Taylor, C.R. Fundamentals of Nursing, 8th ed., Philadelphia: Wolters Kluwer Health, 2015, Chapter 1: Introduction to Nursing, p. 17. Chapter 1: Introduction to Nursing - Page 17

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

Collaboration Explanation: According to the ANA Standard 13 - Collaboration, the registered nurse collaborates with the client, family, and others in the conduct of nursing practice. Standard 2 - Diagnosis states that the registered nurse analyzes the assessment data to determine the diagnoses or issues. Standard 6 - Evaluation states that the registered nurse evaluates progress toward attainment of outcomes. Standard 8 - Education pertains to the registered nurse attaining knowledge and competence that reflects current nursing practice. Reference: Chapter 1: Introduction to Nursing - Page 6-11-15

The diploma nurse is considering obtaining a baccalaureate degree. Which degree should the nurse investigate? -DNP -RN to BSN -MSN -Accelerated degree -SUBMIT ANSWER

RN to BSN Explanation: The diploma nurse considering obtaining a baccalaureate degree should investigate RN to BSN programs. This degree is designed for registered nurses with a diploma degree. The DNP is designed as the terminal degree (doctorate degree) for nursing practice. The accelerated degree is designed for people with a baccalaureate degree, currently not in nursing, to obtain their BSN in 1 to 2 years. The MSN is designed for nurses with a baccalaureate degree to obtain a master's degree in nursing. Reference: Chapter 1: Introduction to Nursing - Page 13-14

In the role of entrepreneur, the nurse's primary responsibility is: managing a health-related business. teaching in a clinical setting. administering resources. managing personnel involved in client care.

managing a health-related business. Explanation: A nurse entrepreneur is primarily concerned with organizing, developing, and managing a clinic or health-related business. Although a nurse entrepreneur may also administer resources, manage personnel, and teach, the primary responsibility of this role is managing a health-related business. A nurse administrator is primarily concerned with administering resources and managing personnel. A nurse educator is primarily concerned with teaching in a clinical setting. Reference: Chapter 1: Introduction to Nursing - Page 16

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: "Pets can help heal clients." "The nurse is the handmaiden of the physician." "Everything in nature is alive with invisible forces." "The physician is viewed as a god-like figure."

"Everything in nature is alive with invisible forces." Explanation: The theory of animism attempts to explain the cause of mysterious changes in bodily functions. This theory is based on the belief that everything in nature is alive with invisible forces and endowed with power. Good spirits bring health; evil spirits bring sickness and death. In cultures that ascribe to animism, the roles of the physician and the nurse are separate and distinct. The physician is the medicine man who treats disease by chanting, inspiring fear, or opening the skull to release evil spirits (Dolan, Fitzpatrick, & Herrmann, 1983). The nurse usually is the mother who cares for her family during sickness by providing physical care and herbal remedies. Pets are not involved in the theory of animism. Reference: Chapter 1: Introduction to Nursing - Page 7

The nurse is explaining to a nursing colleague why there should be only one entry into the profession. What is the best statement by the explaining nurse? "Increasingly, there is opportunity for educational advancement." "Multiple methods of preparation are confusing to consumers." "Multiple methods of preparation increase the number of nurses." "State laws recognize both the LPN and RN as nursing credentials."

"Multiple methods of preparation are confusing to consumers." Explanation: Educational preparation for the nurse has become a major issue in nursing; the multiple methods of preparation are confusing to employers, consumers of health care services, and nurses themselves. Proponents of multiple preparations for nurses have stated that it increases the number of nurses, which is important due to nursing shortages. State laws do recognize both the LPN and RN as nursing credentials, but this is confusing to consumers. Increased opportunity for educational advancement does not support the argument that there should be only one entry into the profession. Reference: Chapter 1: Introduction to Nursing - Page 13-14

A nurse is conducting an in-service on the early history of the education of nurses in the 19th century. Which statement made by the nurse demonstrates how far nursing has come as a profession from the 19th century? "The focus was on promoting nursing as a profession." "The focus was on students providing direct care to clients without pay." "Education was founded on theoretical knowledge behind interventions." "It occurred in the university setting."

"The focus was on students providing direct care to clients without pay." Explanation: In the early history of nursing education, training was based on an apprenticeship model. It was often hard to distinguish nursing service from nursing education. An example of this was students providing direct client care without pay. The setting for the training was in hospital-owned schools, not the university setting. Education was based on sound clinical medical evidence and the use of Florence Nightingale's influence. Early nursing education did not promote nursing as a profession. Reference: Chapter 1: Introduction to Nursing - Page 11

A nurse is demonstrating collegiality in professional practice. Which behaviors practiced by the nurse correlate with this standard of practice? Select all that apply. 1-A nurse helps a colleague complete a bed bath on a client. 2-A nurse encourages a colleague to join the American Nurses Association (ANA). 3-A nurse encourages a colleague to quit smoking. 4-A nurse helps a colleague write a journal article. 5-A nurse encourages a colleague to join the hospital journal club.

- 1, 2 , 4 Explanation: The ANA standard of collegiality refers to the nurse interacting with and contributing to the professional development of peers and colleagues. Examples include helping a colleague write a journal article, encouraging a colleague to join the hospital journal club, and encouraging a colleague to join a professional organization such as the ANA. Helping a colleague quit smoking does not contribute to the colleague's professional development. Helping a colleague complete a client bed bath indicates teamwork and collaboration, but does not help contribute to the colleague's professional development. Reference: Chapter 1: Introduction to Nursing - Page 10

Which scenario is the best example of a nurse attending an in-service program? Attending a conference on cultural diversity Attending a continuing education program given by a national organization Attending a hospital program on how to use a new IV pump Taking an online course at a local university

- Attending a hospital program on how to use a new IV pump Explanation: 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. Reference: Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2015, Chapter 1: Introduction to Nursing, p. 16. Chapter 1: Introduction to Nursing - Page 16

A nurse is planning to pursue further education in the hopes of becoming an expert in geriatric nursing who carries out direct care. For which expanded career role is the nurse preparing? -Clinical nurse specialist -Physician assistant -Nurse manager -Nurse-midwife

- Clinical nurse specialist Explanation: 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. Reference: Chapter 1: Introduction to Nursing - Page 16

The nursing process includes step(s)? Select all that apply. -Implement -Evaluate -Assess -Prescribe -Plan

- Implement - assess - Evaluate - plan The nursing process consists of assessing the client, planning the client's care, implementing the planned interventions, and evaluating the effectiveness of those interventions. Prescribing is not a part of the nursing process. Reference: Chapter 1: Introduction to Nursing - Page 11-18

A nurse educator is discussing the role of nursing based on the American Nurses Association (ANA). Which statement best describes this role? The essential components of professional nursing care are strength, endurance, and cure. It is the role of the physician, not the nurse, to assist clients in understanding their health problems. It is the role of nursing to provide a caring relationship that facilitates health and healing. Nursing is a profession dependent upon the medical community as a whole.

- It is the role of nursing to provide a caring relationship that facilitates health and healing. Explanation: The American Nurses Association (ANA) defines nursing as "the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations" (ANA, 2010). The ANA does not see nursing as dependent upon medicine. The ANA sees one of the roles of the nurse as assisting clients in understanding their health problems. The ANA does not address essential components of professional nursing care with terms such as strength, endurance, and cure. Reference: Chapter 1: Introduction to Nursing - Page 10

A nurse is providing care for clients in a long-term care facility. What should be the central focus of this care? -The nurse as the caregiver -Nursing as a profession -The client receiving the care -The nurse's actions

- The client receiving the care Explanation: 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. Reference: Chapter 1: Introduction to Nursing - Page 11

A registered nurse wishes to work as a nurse researcher. Which is true regarding nurse researchers? -They usually have a baccalaureate degree in nursing. -They are responsible for the continued development and advancement of nursing. -They tend to work in community health centers and long-term care units. -They serve as liaisons between staff members and directors of nursing.

- They are responsible for the continued development and advancement of nursing. Explanation: Nursing research requires extensive education and is a uniquely specialized field. Nurse researchers are responsible for the continued development and refinement of nursing. They usually have advanced education post baccalaureate degree in nursing and most often work in large teaching hospitals or research centers. Nurse administrators, not nurse researchers, serve as liaisons between staff members and directors of nursing, Nurse researchers may be found with a school of nursing at academic institutions, but not at community health centers and long-term care units. Reference: Chapter 1: Introduction to Nursing - Page 16

A nurse must possess several characteristics to be successful in this profession. Secondary to critical thinking skills, which is of great value? -delegation of responsibilities -advocating for the client at all times -good teamwork and team-building skills -educational attainment such as Master's of Nursing

- advocating for the client at all times Explanation: 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. Reference: Chapter 1: Introduction to Nursing - Page 8-17

Which standards are monitored by the Quality and Safety Education for Nurses (QSEN)? Select all that apply. -Client-centered care -Evidence-based practice -Quality improvement -Nursing certification -Informatics

- all exept Nursing Cetification Explanation: The Quality and Safety Education for Nurses (QSEN, 2014) initiative has identified key quality and safety competencies for nurses: client-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. These competencies support the responsibilities defined previously. Providing care focused on clients requires the nurse to balance client advocacy with safety. Effective management and coordination of care requires teamwork and collaboration. Evidence-based practice leads to safe and effective care. Nurses must continually evaluate and improve the quality of care. Competence in informatics allows nurses to use the latest technology in the provision, documentation, and evaluation of care. Nurses who achieve these competencies are able to improve the quality and safety of client care wherever they work. Nursing certification is not supported by QSEN. Reference: Chapter 1: Introduction to Nursing - Page 11-14

What is the primary purpose of standards of nursing practice? -to provide a method by which nurses perform skills safely -to establish nursing as a profession and a discipline -to ensure knowledgeable, safe, comprehensive nursing care -to enable nurses to have a voice in health care policy

- to ensure knowledgeable, safe, comprehensive nursing care Explanation: Each nurse is accountable for their own quality of practice and is responsible for using standards to ensure knowledgeable, safe, comprehensive care. Standards of practice do not provide the ability to safely perform skills, establish nursing as a profession and discipline, or enable nurses to have a voice in health care policy. Reference: Chapter 1: Introduction to Nursing - Page 17

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

----2.3,5 Explanation: Both congestive heart failure and abdominal hernia are medical diagnoses; the rest are nursing diagnoses. Reference: Chapter 1: Introduction to Nursing - Page 11

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-Inform the family that there is nothing they can do for their loved one. 2-Assist the client and family with the preparation for end-of-life. 3-Assist the client with activities of daily living (ADLs). 4-Encourage the family to leave and let the nurse take over care. 5-Refer the client and family to hospice services.

---2,3,5 Explanation: 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. Reference: Chapter 1: Introduction to Nursing - Page 13

A nurse is moving to another state and will be working at an acute care facility. Prior to beginning practice, what actions should the nurse take to be compliant with state guidelines for nursing practice? Select all that apply. 1-Locate the state nursing practice acts 2-Research the laws and regulations that govern nursing practice in the new state 3-Define the legal requirements and titles for registered nurses (RNs) and licensed practical nurses (LPNs) 4-Let the present state board of nursing know that the nurse is leaving the state 5-Visit the state board of nursing offices 6-Access educational resources related to nursing practice in another state

-1,3,5,6 Explanation: Prior to practicing in a new state, the nurse should understand that each state may have different rules and regulations even if it is a member of the compact. The nurse should research the laws and regulations that govern present practice to ensure adherence with any different practice laws, including the legal requirements and titles for RNs and LPNs. The nurse should locate the state nursing practice acts and refer to them often for any changes. The nurse should access educational resources related to nursing practice, such as the NCSBN. It is not necessary for the nurse to either visit the office of the new state board of nursing or let the past state know that the nurse will be practicing in another state, if it is in the compact. Reference: Chapter 1: Introduction to Nursing - Page 19

The nurse is evaluating client health. Which client should the nurse determine to be exhibiting the most signs of health? -A client with a leg amputation who performs activities of daily living with a prosthesis -A client with diabetes who is in denial of the diabetes and refuses to take insulin -A client in acute emotional distress due to spouse's death -A client with depression who refuses to get out of bed

-A client with a leg amputation who performs activities of daily living with a prosthesis Explanation: As defined by the World Health Organization, one's health includes physical, social, and mental components and is not merely the absence of disease or infirmity. Health is often a subjective state—a person may be medically diagnosed with an illness, but still consider himself or herself healthy. The client with an amputation is performing activities of daily living, thereby demonstrating healthy behaviors. A client with diabetes who is refusing to take insulin is in denial of the illness. A client in acute emotional distress related to the spouse's death is experiencing a normal pattern but not demonstrating a healthy behavior. A client with depression who will not get out of bed is also experiencing denial as opposed to a healthy behavior and coping. Reference: Chapter 1: Introduction to Nursing - Page 11

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 -Blood products -A solution of dextrose -Total parenteral nutrition

-A solution of normal saline Explanation: 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 documents on a client's electronic chart that the client has an advance directive, makes a copy of the advance directive, and immediately informs the client's physician. Which role is the nurse demonstrating? -Counselor -Researcher -Leader -Advocate

-Advocate Explanation: The nursing role that focuses on advocacy involves the protection of human or legal rights and the securing of care for all clients, based on the belief that clients have the right to make informed decisions about their own health. In this situation, the nurse recognizes the client's right to make end-of-life decisions and advocates for the client by documenting that the client has an advance directive. The nurse also demonstrates advocacy by communicating this information to the client's physician. Nurse counselors help clients identify goals and potential solutions to problems which cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavior change and optimal mental health. Nurse leaders work with an organization to lead nurses. A nurse researcher is a person who carries out academic or scientific research. Reference: Chapter 1: Introduction to Nursing - Page 11

Which nursing group provides a definition and scope of practice for nursing? -International Council of Nurses (ICN) -American Academy of Neurology (AAN) -American Nurses Association (ANA) -The Joint Commission

-American Nurses Association (ANA) Explanation: The ANA is a professional organization to advance and protect the profession of nursing. The ANA describes the values and social responsibility of nursing, provides a definition and scope of practice for nursing, discusses nursing's knowledge base, and describes the methods by which nursing is regulated within its Nursing's Social Policy Statement (2003). The Joint Commission is a United States-based nonprofit tax-exempt 501 organization that accredits more than 21,000 U.S. health care organizations and programs. The AAN is a professional society representing over 34,000 neurologists and neuroscientists. The ICN is an international federation of nursing organizations that works to ensure quality nursing care for all, sound health policies globally, the advancement of nursing knowledge, and the presence worldwide of a respected nursing profession and a competent and satisfied nursing workforce. Reference: Chapter 1: Introduction to Nursing - Page 10

During the course of any given day of work in the acute care setting, the nurse may need to perform which roles? Select all that apply. Communicator Counselor Teacher Financier Statistician

-Communicator -Counselor -Teacher Explanation: The roles and functions of the nurse are many and include caregiver, communicator, teacher, counselor, leader, researcher, and advocate. Acting as financier and statistician are not the roles of the nurse. Reference: Chapter 1: Introduction to Nursing - Page 11

The new nursing graduate is concerned about some of the critical changes that will be occurring in nursing. What changes does the nurse anticipate will impact nursing care? -Rapid growth of nurses and shortage of job opportunities -Decrease in health care costs -Difficulty for nurses to remain current in a rapidly changing medical and technology environment -Limitations that nurses have in the workforce

-Difficulty for nurses to remain current in a rapidly changing medical and technology environment Explanation: The National Advisory Council on Nurse Education and Practice (NACNEP) identifies critical challenges to nursing practice in the 21st century: a growing population of hospitalized clients who are older and more acutely ill, increasing health care costs, and the need to stay current with rapid advances in medical knowledge and technology. Nursing is limitless and, with opportunities for furthering education, there are many various ways nurses can practice. Health costs are rising and there are more citizens needing health care. There is a projected nursing shortage that may be severe and there are no shortages of jobs for nurses. Reference: Chapter 1: Introduction to Nursing - Page 19-24

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? -Educator -Caregiver -Decision-maker -Client advocate

-Educator Explanation: Under the overall umbrella of nursing process, the nurse in this situation is performing the implementation of the care plan interventions. The nurse is acting in the role of educator by explaining each step at a level, and to a degree that the client can process, ask questions if necessary, and understand. The act of changing the dressing is an aspect of the caregiver role. Once the nurse moves beyond the care plan interventions, it may become necessary to make a decision or advocate for the client as a result of the assessment of wound and client learning during the teaching of wound care occurring. Reference: Chapter 1: Introduction to Nursing - Page 11-16

Which action should the nurse implement when working with a medically homeless client? -Assist the client in finding a job. -Encourage client to utilize the free health care clinic. -Encourage the client to utilize the emergency room when ill. -Assist the client in finding housing.

-Encourage client to utilize the free health care clinic. Explanation: According to the Association of American Medical Colleges, many Americans are medically homeless and find it difficult to navigate the health care system. Encouraging the client to utilize the free health care clinic will help the client navigate the system and obtain access to health care. While utilizing the emergency room when needed is appropriate, the emergency room should not be utilized for all illnesses, as it increases the burden on the health care system. Assisting the client to find housing or a job will help the client, but is outside of the scope of nursing practice. Reference: Chapter 1: Introduction to Nursing - Page 19

Which national nursing organization serves as a primary source of research data about nursing education, and is the professional organization for nurse educators? American Association of Colleges of Nursing (AACN) National League for Nursing (NLN)

-National League for Nursing (NLN) Explanation: The NLN serves as the primary source of research data about nursing education, conducting annual surveys of schools and new RNs. The NLN's objective is to foster the development and improvement of nursing services and nursing education, and it serves as the professional nursing organization for nurse educators. The ANA is the professional organization for RNs in the United States, and it establishes standards of practice, encourages research to advance nursing practice, and represents nursing for legislative actions. Sigma Theta Tau International is the honor society for nursing. AACN is the national voice for baccalaureate and higher-degree nursing education programs and provides accreditation for collegiate nursing programs. Reference: Chapter 1: Introduction to Nursing - Page 17

What might a nurse need to do to ensure the continuation of his or her nursing license? -Attend hospital in-services. -Obtain continuing education credits. -Obtain a master's degree. -Obtain a baccalaureate degree.

-Obtain continuing education credits. Explanation: 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. Reference: Chapter 1: Introduction to Nursing - Page 14

The nurse is using the nursing process to care for a client and is in the process of making a nursing diagnosis. Which condition best reflects a nursing diagnosis? -Pneumonia -Hypertension -Congestive heart failure -Risk for falls

-Risk for falls Explanation: Risk for falls is a nursing diagnosis. Hypertension, congestive heart failure, and pneumonia are medical diagnoses rather than nursing diagnoses. Reference: Chapter 1: Introduction to Nursing - Page 325-326

Which explanation accurately differentiates the role of the registered nurse (RN) from that of the licensed practical/vocational nurse (LPN/LVN)? The RN directs the workload of an LPN/LVN. The LPN/LVN can only work in a long-term care facility. The RN is permitted to prescribe medications. The LPN/LVN should work under the supervision of an RN.

-The LPN/LVN should work under the supervision of an RN. Explanation: LPNs/LVNs are employed in hospitals, long-term care facilities, and rehabilitation centers and by health care providers such as physicians. LPNs/LVNs differ from RNs in two areas: educational preparation and scope of practice. LPNs always practice under the supervision of an RN. LPNs have a scope of practice and the workload is not directed by the RN. RNs are not permitted to prescribe medications. Nurse practitioners may prescribe medications. Reference: Chapter 1: Introduction to Nursing - Page 13-14

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. The RN collects client data. The RN analyzes client data. The RN identifies outcomes.

-The RN coordinates care delivery. Explanation: 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, implementation via coordination of care in which the RN coordinates care delivery. Standard 5b is health teaching and health promotion in which the registered nurse employs strategies to promote health and a safe environment. Standard 3 is outcomes identification, in which the registered nurse identifies expected outcomes for a plan individualized to the health care 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, in which the registered nurse collects pertinent data and information relative to the health care consumer's health or the situation. Reference: 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? Th RN identifies client outcomes. The RN develops a plan of care. The RN educates about preventing falls. The RN promotes a safe environment.

-The RN promotes a safe environment. Explanation: 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, involves the registered nurse identifying expected outcomes for a plan individualized to the health care consumer or the situation. Standard 12 is education, in which the registered nurse seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. Standard 4 is planning, in which the registered nurse develops a plan that prescribes strategies and alternatives to attain expected, measurable outcomes. Reference: Chapter 1: Introduction to Nursing - Page 8

Which is the best example of a client-centered approach to care? -The nurse asks the client about health goals. -The nurse draws a blood sample from a client. -The nurse helps a client ambulate. -The nurse asks the client what the client would like to order from the menu.

-The nurse asks the client about health goals. Explanation: Client-centered care is one of the quality and safety education requirements for nursing competencies (QSEN). The intent of client-centered care is to ensure that care is centered on the client, and not the needs of the nurse. An example of this is the nurse asking the client about personal health goals so that they can be addressed on the client's plan of care. Helping the client ambulate, asking the client what he or she would like from the menu, and drawing a blood sample are examples of client care, but are not client-centered care. Reference: Chapter 1: Introduction to Nursing - Page 11

The patient has just received a central venous catheter placed by the physician. Which of the following should the nurse anticipate next? The patient will become short of breath. The patient will develop an arrhythmia. The patient will have an X-ray to confirm placement of the device. The patient will have a stat order for lab tests.

-The patient will have an X-ray to confirm placement of the device. Explanation: Placement is confirmed by X-ray.

The registered nurse (RN) working with a licensed practical nurse (LPN) understands which about LPNs? -The program is 4 years in length. -They must take a licensure exam. -They have a higher degree than most RNs. -They may work independently.

-They must take a licensure exam. Explanation: Schools for practical nursing programs are located in varied settings. Most programs are 1 year in length. Upon completion of the program, graduates can take the National Council Licensure Examination for Practical Nurses (NCLEX-PN) for licensure as an LPN. LPNs work under the direction of a physician or RN to give direct care to clients, focusing on meeting health care needs in hospitals, nursing homes, and home health agencies. Reference: Chapter 1: Introduction to Nursing - Page 13-14

During the Reformation, which factor influenced the decline of nursing? -Women's subordination to men -Establishment of men in nursing -Advancement of medicine -Implementation of technolog

-Women's subordination to men Explanation: Women were viewed as subordinate to men and were expected to remain at home caring for children; this decreased the number of qualified women practicing nursing. Reference: Taylor, C., et al. Fundamentals of Nursing, 8th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015, p. 7. Chapter 1: Introduction to Nursing - Page 7

The RN is working with hospital administrators to transform care at their facility. Which nursing competency will be critical for the nurse to utilize? -Do things the way they have always been done -Work effectively in interdisciplinary teams -Navigate the electronic medical records system -Correctly utilize and troubleshoot high-tech equipment

-Work effectively in interdisciplinary teams Explanation: 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. Reference: Chapter 1: Introduction to Nursing - Page 6

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? application of research science of nursing evidence-based practice art of nursing

-art of nursing Explanation: 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. Reference: Chapter 1: Introduction to Nursing - Page 23

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

-collaborative functioning. Explanation: Nurses manage collaborative problems using both nurse- and health care provider-prescribed interventions to reduce the risk of complications. In this situation, the nurse is not operating authoritatively or independently, but within the parameters established by the health care provider. The nurse is not merely acting in an assistive capacity, as the nurse is performing interventions in the absence of the health care provider. Reference: Chapter 1: Introduction to Nursing - Page 8

A prospective nursing student desires a career that will allow the opportunity 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? -baccalaureate of science registered nursing program -licensed or vocational nursing program -diploma nursing program -associate of science registered nursing program

-licensed or vocational nursing program Explanation: 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. This would allow employment that will allow the graduate to provide client care and to assist professional nurses with routine technical procedures as desired. An associate program will take 2 years and a baccalaureate program will take 4 years; additionally these prepare new nurses to work in a more independent role than this person is seeking. There are very few diploma programs remaining in the U.S., and these programs typically take 3 years to complete. Reference: Chapter 1: Introduction to Nursing - Page 14

Which advanced nurse practitioner is specifically qualified to provide prenatal care for a pregnant client? -nurse anesthetist -clinical nurse specialist -nurse-midwife -nurse educator

-nurse-midwife Explanation: A nurse-midwife provides prenatal and postnatal care and also delivers newborns for clients with uncomplicated pregnancies. A nurse anesthetist carries out preoperative visits and assessments; administers and monitors anesthesia during surgery; and evaluates the postoperative status of clients. A clinical nurse specialist is considered to be an expert in a specialized area of nursing and carries out direct client care; consultation; teaching of client, families, and staff; and research. A nurse educator teaches in educational or clinical settings, teaches theoretical knowledge and clinical skills, and conducts research. Reference: Chapter 1: Introduction to Nursing - Page 16

A nurse has recently completed the administration of seasonal influenza vaccinations for the residents of a long-term care facility. Which aim of nursing has the nurse most clearly demonstrated? -promoting health -restoring health -facilitating coping -preventing illness

-preventing illness Explanation: Vaccinations are one of the most concrete measures that nurses take to prevent illness in clients, as the antibody production that is induced by vaccination actively prevents the recipient from developing the influenza. Promoting health includes preventing illness but also other concepts, such as optimizing health and well-being, and thus is not as accurate in this case as preventing illness. Restoring health is a return to a normal or healthy condition such as an acute illness. Coping is to face and deal with responsibilities, problems, or difficulties, especially successfully or in a calm or adequate manner. Reference: Chapter 1: Introduction to Nursing - Page 11-12

The nurse is caring for a client on the acute care unit. Which actions created in the plan of care would be considered cognitive interventions? Select all that apply. 1-Maintain equipment 2-Provide spiritual support 3-Reporting a change in vital signs 4-Providing feedback to the client after education of insulin injections 5-Educating the client regarding infection control procedures

1. 3 Explanation: Nurses carry out educational nursing interventions by applying general principles about the teaching and learning process. They develop teaching plans and provide instruction about health promotion or specific health care problems and their management. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019.

Which key figure was responsible for recruiting and equipping the army with a corps of nurses? Isabel Hampton Robb Dorothea Dix Lillian Wald Florence Nightingale

Dorothea Dix Explanation: Dorothea Dix served as superintendent of the Female Nurses of the Army during the Civil War and was given the authority and the responsibility for recruiting and equipping a corps of army nurses. 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. Florence Nightingale initiated major reforms in health care and nursing training that helped establish the modern profession of nursing. Isabel Hampton Robb was a leader in nursing and nursing education who established the nursing school at Johns Hopkins Hospital. Reference: Chapter 1: Introduction to Nursing - Page 9


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