Chapter 1: Introduction to Nursing (Part 2 )
The first nursing journal owned, operated, and published by nurses was: American Journal of Nursing Nurse Educator Nursing Research Standards of Clinical Nursing Practice
American Journal of Nursing Explanation: The American Journal of Nursing was first published in 1900 and was owned, operated, and published by nurses. It continues to provide information that may be of interest to nurses in all nursing specialties, and those who practice general nursing. Nurse Educator is a more recently developed journal which specializes in nursing education and targets nurse educators. Nursing Research is also a more recently developed nursing journal with a focus on nursing research and targets nurses interested in research. Standards of Clinical Nursing Practice are directives and guidelines that may be published as books available to nurses for purchase and review. It is not a nursing journal.
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.
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? Difficulty for nurses to remain current in a rapidly changing medical and technology environment Rapid growth of nurses and shortage of job opportunities Decrease in health care costs 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.
Which best exemplifies the role of the nurse as educator? Discussing side effects of a medication with a client Allowing a client to verbalize fears of death Researching the best way to provide care Referring a client to outpatient services
Discussing side effects of a medication with a client Explanation: In the role of educator, the nurse uses communication skills to assess, implement, and evaluate individualized education plans to meet the learning needs of clients, such as when discussing side effects of a medication. Allowing clients to verbalize feelings and referring them to outpatient services demonstrate the role of counselor. Researching the best way to provide care demonstrates the role of researcher.
What is the best nursing intervention to promote health in a client at risk for heart disease? Emphasizing a client's strengths to encourage weight loss Informing the client that the client must lose weight Instructing the client to adhere to a high-sodium diet Taking the client's pulse rate daily
Emphasizing a client's strengths to encourage weight loss Explanation: 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 is the most effective way to promote this client's health. Informing the client that the client must lose weight would not help the client use his or her strengths to accomplish the goal. Low-sodium diets can prevent heart disease. Taking the pulse daily would not prevent heart disease.
Which nursing actions are characteristic of the nurse's role as communicator? Assessing, implementing, and evaluating individual teaching plans to meet learning needs Establishing and maintaining helping relationships with clients of all ages in a variety of settings Facilitating clients' problem-solving and decision-making skills Effecting change within a group
Establishing and maintaining helping relationships with clients of all ages in a variety of settings Explanation: 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 learning needs, implement, and evaluate individualized teaching plans to meet those 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 and self-confident in the practice of nursing when providing care, effecting change, and functioning with groups.
A nurse manager is teaching staff how to use a new piece of hospital equipment. Which educational setting would be most appropriate for this process? Continuing education Graduate education In-service education Undergraduate studies
In-service education Explanation: In-service education is designed to increase the knowledge and skills of the nursing staff. Education about a new piece of hospital equipment would fall into this category. Continuing education is educational experiences designed to enrich the nurse's contribution to health. Many state nursing organizations require continuing education hours to maintain licensure. Undergraduate studies are the educational programs for pre-licensure in the field of nursing. For the nurse, this could be a diploma, associate degree, or baccalaureate in nursing. Graduate education would include the educational programs for the advanced practice nurse. This could be master's degree or doctoral preparation
For the nurse to become a nurse practitioner, what is the minimal degree the nurse will need to acquire? Diploma Associate's Master's Baccalaureate
Master's Explanation: A master's degree is the minimal degree for a nurse to become a nurse practitioner. Diploma, associate, and baccalaureate degrees are the minimal degree for an RN.
A nurse identifies a client's health care needs and devises a plan of care to meet those needs. Which guideline is being followed in this case? Nursing standards Nursing orders Nurse practice acts Nursing process
Nursing process Explanation: Devising a plan of care is based on the nursing process. This process identifies the client's health care needs and strengths to establish and carry out a plan of care to meet those needs, and to evaluate the effectiveness of the plan to meet established outcomes. Nursing standards allow nurses to carry out professional roles, serving as protection for the nurse, the client, and the institution where health care is given. Nurse practice acts are laws established in each state in the United States to regulate the practice of nursing. Nursing orders prescribe the nursing care to be given to assist the client to meet health goals.
What might a nurse need to do to ensure the continuation of his or her nursing license? Obtain a baccalaureate degree. Obtain a master's degree. Attend hospital in-services. 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.
The diploma nurse is considering obtaining a baccalaureate degree. Which degree should the nurse investigate? DNP RN to BSN Accelerated degree MSN
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.
Which nursing intervention would be most appropriate for a new mother that calls the nursery for help with breastfeeding? Refer the mother for a home care visit. Ask the mother to come to the emergency room. Email the mother a link for breastfeeding. Suggest that the mother bottle feed her infant.
Refer the mother for a home care visit. Explanation: It is the role of the nurse to encourage health promotion by providing information and referrals; therefore, the nurse should refer the mother for a home care visit, as this will enable the mother to receive all of the breastfeeding help that is needed. Emailing a link for breastfeeding provides information, but not the support that is needed if a mother is having difficulty with breastfeeding. Suggesting bottle feeding and/or going to the emergency room is inappropriate and does not encourage using available resources.
A nurse is providing care for clients in a long-term care facility. What should be the central focus of this care? The nurse's actions The client receiving the care The nurse as the caregiver Nursing as a profession
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
A registered nurse wishes to work as a nurse researcher. Which is true regarding nurse researchers? They are responsible for the continued development and advancement of nursing. They usually have a baccalaureate degree in nursing. They serve as liaisons between staff members and directors of nursing. They tend to work in community health centers and long-term care units.
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.
Why are nursing organizations important for the continued development and improvement of nursing as a whole? To provide socialization and networking for members To regulate work activities for members To set standards for nursing education and practice To provide information to nurses about legal requirements
To set standards for nursing education and practice Explanation: Professional organizations set educational and practice standards for nursing education and practice. They also are concerned with current issues in nursing and health care, and influence health care policy and legislation. Although professional organizations may provide outlets for networking, regulate work activities, and provide information about legal requirements, setting standards for education and practice is a primary focus.
The need for university-based nursing education programs was brought to light during which important historical time? Spanish-American War World War I World War II Korean War
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.
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 administering blood products administering intravenous push medication administering chemotherapy
administering bedside blood glucose testing Explanation: The LPN, under the nurse practice act (NPA), 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 NPA.
A nurse is considering relocating to another state to practice nursing. Which is the most appropriate action by the nurse to ensure ability to practice in the new state? asking the current state to transfer the license applying for a reciprocal license in the new state taking the new state's licensing exam No action is needed by the nurse.
applying for a reciprocal license in the new state Explanation: 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.
Which action by the nurse best represents the evaluative portion of the nursing process? assessing a client's blood pressure after giving a cup of coffee educating a client on how to take one's own blood pressure every morning assessing a client's blood pressure after teaching stress reduction techniques determining that a client is at risk for a fall while in the hospital
assessing a client's blood pressure after teaching stress reduction techniques Explanation: The nursing process consists of assessing, diagnosing, planning, implementing, and evaluating. Assessing the client's blood pressure after the nurse implements stress reduction techniques is an example of evaluation. Assessing a client's blood pressure after a cup of coffee is not an effective evaluation. Educating a client to take his or her blood pressure is an intervention. Determining a client is at risk for fall is part of the assessment process.
A novice nurse is excited to finally be able to put all the training to use on the inpatient unit. Which factor should the nurse be sure to prioritize when beginning to interact with clients? be an advocate for appropriate care ensure the families do not get sick ensure families are kept informed advise clients on the best plan of action
be an advocate for appropriate care Explanation: The American Nurses Association defines nursing as: protection, promotion and optimization of health and abilities; prevention of illness or injury; alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations. This would include being an advocate for the appropriate care for each client. The nurse should help prevent illness or injury, but alleviating illness in the families would not be possible. The nurse should only keep families informed if the client has given permission to share the information. For the nurse to share this information without authorization would be unethical and illegal. Nurses are responsible for educating clients concerning their situation and possible responses; however, the nurse must not advise the client on the best plan of action. The client needs to make that decision after having all the information to make an informed decision.
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.
Which nursing action best exemplifies the nurse's role in promoting health? encouraging a group of junior high school students to engage in regular physical activity facilitating a support group for the friends and families of clients affected by stroke performing deep suctioning on a client who has a tracheotomy and copious secretions administering a beta-adrenergic blocker and diuretic to a client who has a history of hypertension
encouraging a group of junior high school students to engage in regular physical activity Explanation: Health promotion involves encouraging individuals to be proactive in taking measures to foster their well-being and maximize optimal functioning. Exercise is one of the most common and accessible activities that can help achieve this. Facilitating support groups promotes coping with an existing condition. Treating hypertension pharmacologically and removing secretions that can threaten oxygenation help to restore health and prevent illness.
The primary aim of the Healthy People 2030 initiative is: health promotion. illness prevention. health restoration. coping with disability.
health promotion. Explanation: Healthy People 2030 establishes health promotion guidelines for the nation as a whole. The guidelines contain 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 2030 guidelines, but are not considered as the primary goal of the initiative.
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 physician is viewed as a god-like figure." "The nurse is the handmaiden of the physician." "Pets can help heal clients."
"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.
A nurse is working with a client who has undergone a lower leg amputation. While conducting an assessment, the nurse notes the client has a downcast mood. Which statement by the nurse conveys empathy to the client? "I notice you might be experiencing some feelings of sadness. Would you like to share how you are feeling with me?" "It is not uncommon to be depressed after having such major surgery. Many of my clients feel sad." "If I had the type of life-altering experience you had, I would probably feel depressed. You are doing well under the circumstances." "I can see you are in need of extra comfort right now. Let me adjust your position and readjust your bed linens for you."
"I notice you might be experiencing some feelings of sadness. Would you like to share how you are feeling with me?" Explanation: Because a client does not always communicate one's feelings to strangers, nurses use empathy (intuitive awareness of what the client is experiencing) to perceive the client's emotional state and need for support. This skill differs from sympathy (feeling as emotionally distraught as the client). Empathy helps the nurse become effective at providing for the client's needs while remaining compassionately detached. By stating an observational awareness of the client's emotional state based on the client's nonverbal cues, the nurse invites the client to engage in therapeutic communication. The nurse does not assume the client wants any help; therefore, the nurse asks if the client wants to engage in exploring one's experience. By telling the client that is common to be depressed, the nurse is making an assumption about the client's emotional experience. Not all sadness should be labeled as "depression." In addition, by telling the client that other people have had the same experience, it minimizes the client's unique and personal experience, which can threaten the nurse-client relationship and pose a barrier to therapeutic communication. The nurse should not share personal experiences or how the client's unique health experience would make the nurse feel if the nurse was in the same situation. Again, this statement serves to minimize the client's experience and undermines therapeutic communication. Although comforting skills are essential to nursing, assuming that adjusting the client's bed linens will address the client's emotional state is noncongruent and the incorrect intervention for what the nurse has observed.
Which scenario is the best example of a nurse in the role of counselor? A nurse allowing a crying client to verbalize fears of death A nurse telling a client the side effects of a medication A nurse providing the physician a client's test results A nurse ensuring that a client has follow-up care at a free clinic
A nurse allowing a crying client to verbalize fears of death Explanation: When acting as a counselor, the nurse uses therapeutic interpersonal skills to help develop the client's problem-solving and decision-making skills. The best example is the nurse allowing the client to verbalize feelings, as verbalizing feelings lets the client gain a better perspective of the situation for problem solving and for coming to terms with the situation. Telling the client about the side effects of a medication is a form of teaching. Providing test results to the physician is communication. Ensuring a client has follow-up care at a free clinic is advocacy.
A client is distraught because a recent computed tomography (CT) scan shows that the client's colon cancer has metastasized to the lungs. Which nursing aim should the nurse prioritize in the immediate care of this client? Facilitating coping Preventing illness Restoring health Promoting health
Facilitating coping Explanation: This client's care in the coming weeks or months will likely encompass all of the four foundational roles of the nurse. However, because the client has just recently received bad news and is emotionally distraught, helping the client cope is an appropriate priority in immediate care. Preventing illness is focused on preventing an infection or disease from occurring such as through immunizations, hand hygiene, exercising and diet. Restoring health would more appropriately occur after the client has accepted the disease and would involve taking medication and working to get back to baseline with the disease. Health promotion is the process of enabling people to increase control over, and to improve, their health.
A nurse educator is discussing the role of nursing based on the American Nurses Association (ANA). Which statement best describes this role? Nursing is a profession dependent upon the medical community as a whole. 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. The essential components of professional nursing care are strength, endurance, and cure. TAKE ANOTHER QUIZ
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.
Which is the best example of a client-centered approach to care? The nurse helps a client ambulate. The nurse asks the client about health goals. The nurse asks the client what the client would like to order from the menu. The nurse draws a blood sample from a client.
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.
Nursing is described in various ways. The focus of all nursing interventions should involve which factor(s)? Select all that apply. human experience and responses of individuals, families, and groups curing the illness in individuals birth, health, illness, and death of individuals pyschosocial dimension of the client use of evidence-based practice to ensure the best care
human experience and responses of individuals, families, and groups birth, health, illness, and death of individuals pyschosocial dimension of the client use of evidence-based practice to ensure the best care Explanation: The focus of all nursing interventions is on the human experience and responses of individuals, families, and groups to birth, health, illness, and death as well as utilizing evidence-based practice to provide the best possible care for each client. Focusing on curing each illness is not possible, as some illnesses cannot be cured. The nurse can assist the client's psychosocial needs as part of the holistic nursing process, as long as the physical aspect is also addressed.
When administering immunizations, the nurse is engaged in: health promotion. illness prevention. health restoration. coping facilitation.
illness prevention. Explanation: The aim of illness prevention activities is to reduce the risk for illness, to promote good health habits (health promotion), 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 encompass early detection of a disease and rehabilitation. Hospice care is an example of facilitating coping with disability and death.
In the role of entrepreneur, the nurse's primary responsibility is: managing a health-related business. administering resources. managing personnel involved in client care. teaching in a clinical setting.
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.