Foundations of Nursing, Chapter 1 Nursing Today Review Questions

2 Deep breathing exercises and chest physiotherapy are performed to prevent respiratory complications. The nurse does not need medical orders to prescribe breathing exercises in this case. The professional behavior shown here by the nurse is autonomy. Autonomy involves the initiation of independent nursing interventions without medical orders. Advocacy refers to protecting the patient's human and legal rights and providing assistance in asserting these rights when needed. Accountability means that the nurse is responsible, professionally and legally, for the type and quality of the nursing care provided. Collaboration refers to nurse interaction with interdisciplinary health professionals to provide the best possible care to the patient.

A 50-year-old patient is admitted with acute exacerbation of asthma. The patient is treated with bronchodilators and oxygen therapy. The patient is clinically stable and is planned for discharge. The nurse teaches the patient about deep breathing exercises. The nurse has initiated these exercises to improve the patient's lung capacity. Which professional behavior is the nurse showing? 1 Advocacy 2 Autonomy 3 Accountability 4 Collaboration

4 As a patient advocate, the nurse's duty is to provide information to help a patient and family members decide whether or not to accept a treatment. As a caregiver, the nurse's role is to help patients maintain and regain health, manage symptoms, and attain maximum functional independence. As nurse educator, the nurse is expected to teach a patient or group of patients about health and self-care activities. As a case manager, the nurse develops a care plan based on the assessment and coordinates other health care resources and services that could help the patient attain the outcome goals.

A patient has been advised to have a total knee replacement because of osteoarthritis. The patient is not willing to undergo the surgery, but family members want to get the surgery done to relieve the disability. The nurse explains the details of the surgery and the risks associated with it, and also discuss the patient's wishes with the family. Which nursing role is the nurse playing here? 1 Educator 2 Caregiver 3 Case manager 4 Advocate

1, 2 Certified nurse midwives (CNM) are nurses trained in providing care in pregnancy, conducting labor, and providing care to the newborn. The CNM does not have the authority to administer uterine relaxants. Performing a C-section exceeds the scope of practice for a CNM.

A patient in labor has been brought to the certified nurse midwife (CNM). Which interventions should the CNM undertake in this situation? Select all that apply. 1 Conduct the labor. 2 Provide care for the newborn. 3 Administer uterine relaxants and refer the patient to a tertiary center. 4 Perform C-section surgery. 5 Provide a physical presence until the patient has been transferred to tertiary care.

1, 2, 4 The nurse practitioner is well trained in managing acute and chronic illness so may provide direct medical care, provide comprehensive care, and establish a collaborative provider-patient relationship. Because such nurses are well trained in providing care for asthma, there is no need to refer the patient to the health care provider. Furthermore, nurse practitioners may take direct intervention steps without getting the opinion of the health care provider.

A patient with asthma approaches a primary care center for management of the illness. What is the role of the nurse practitioner during the patient's visit for primary care? Select all that apply. 1 Provide direct medical care. 2 Provide comprehensive care. 3 Refer the patient to a health care provider. 4 Establish a collaborative provider-patient relationship. 5 Perform preliminary laboratory tests and get the health care provider's opinion.

2, 3, 5 The primary role of the nurse is to manage the disease and symptoms, but as a caregiver, the nurse may deal with other issues, too. The nurse should motivate the patient and the family members to set goals and achieve them. The nurse should take steps to restore the patient's spiritual, emotional, and social well-being. The nurse cannot provide financial aid but can guide the patient to various assistive associations. The nurse may inquire about the patient's personal and family problems to evaluate and help sort out issues.

A patient with lung cancer is emotionally, economically, and socially disturbed. What is the role of the nurse as a caregiver? Select all that apply. 1 Provide financial aid. 2 Manage the disease and symptoms. 3 Help the patient establish and achieve goals. 4 Avoid the patient's personal and family problems. 5 Implement measures to restore emotional and social well-being.

1, 2, 4 Providing all-around care is an example of the nurse's caregiver role. Nursing interventions such as performing hygiene procedures for a patient do not require medical orders. This is an example of autonomy in nursing care. Accepting responsibility for the nursing care provided to a patient is an example of accountability in nursing care. The nurse educator teaches a patient or group of patients about health and self-care activities. The patient advocate provides information to help the patient and family members decide whether to accept a treatment and otherwise make health care-related decisions.

A registered nurse has recently started her nursing career by joining a cardiac care unit. The mentor explains the duties of the nurse. The mentor states that the nurse does not require any permission or orders to give routine hygiene care measures. The nurse's duty is to provide holistic care to the patient. Which aspects of nursing do these duties illustrate? Select all that apply. 1 Caregiving 2 Autonomy 3 Educating 4 Accountability 5 Patient advocating

4 The patient has been put on a potentially toxic drug. Because the patient is elderly, the nurse should act as an advocate and take measures to protect the patient's rights. Therefore, the nurse may provide information that will help the patient decide whether to take the treatment. The nurse should not give the drug in a low dose, because that may not serve the purpose of administering it. The nurse should obey the instructions by the health care providers only after ensuring that the patient's concerns are addressed. At times, in order to protect human rights, the nurse needs to speak out against policies.

An elderly patient has been put on a potentially toxic drug for treatment of arthritis. The patient and family have expressed concern about the drug. What is the role of the nurse in this particular situation? 1 Give the drug in a very low dose. 2 Obey the health care provider's instruction. 3 Do not speak out against policies or actions. 4 Provide information so the patient can decide whether to accept the treatment or refuse.

2, 4, 1, 3 Florence Nightingale is recognized as the primary founder of modern nursing. In 1860, Nightingale laid the foundation of professional nursing with the establishment of her nursing school at St. Thomas Hospital in London. It was the first secular nursing school in the world. Nightingale schools served as the basis for schools of nursing in the United States. Clara Barton founded the American Red Cross. Under her supervision, the American Red Cross provided health care services to soldiers during the Civil War (1860-1865). Lillian Wald and Mary Brewster contributed to the health needs of people living in slums in New York by opening the Henry Street Settlement in 1893. In 1896, the Nurses' Associated Alumnae of the United States and Canada was founded with the help of Isabel Hampton Robb.

Many women made significant contributions to the nursing profession. Arrange their names in the chronological order of their contributions. 1. Lillian Wald opened the Henry Street Settlement in New York. 2. Florence Nightingale founded St. Thomas Hospital in London. 3. Isabel Hampton Robb helped establish Nurses' Associated Alumnae of the United States and Canada. 4. Clara Barton founded the American Red Cross.

1, 2, 3, 4 Nursing is an art and a science. The practice of nursing incorporates elements including clinical practice, education, research, management, and administration, all of which directly or indirectly have prominence in providing safe, patient-centered health care. Helping a patient achieve the goals of the therapy and educating a patient are steps towards the mission. Interpreting clinical situations and making decisions that benefit patients are integral to nursing. Nursing practice involves collaborative care of individuals of all ages, families, groups, and communities, sick or well. Nursing practice incorporates ethical and social values with the knowledge of behavioral, biological, and physiological sciences.

Nursing is important in providing safe, patient-centered health care to the global community. Which statements are true about the nursing practice? Select all that apply. 1 Nursing practice helps shape health policy and health systems management. 2 Nursing practice involves collaborative care of sick individuals of all ages, families, groups, and communities. 3 Nursing practice involves helping a dying patient find relief from pain. 4 Nursing practice involves interpreting clinical situations and making complex decisions based on knowledge and experience. 5 Nursing practice does not incorporate ethical and social values but only knowledge of behavioral sciences.

2 Medically underserved people are those who lack the financial resources required for proper health care. Unemployment, low-paying jobs, and rising health care costs have all increased the population of medically underserved people in the United States. People not belonging to the dominant culture are not necessarily poor or unable to bear health care costs. People who prefer not to be treated and those who opt for alternate treatment methods are not categorized as medically underserved.

The community health nurse is conducting a program on health and fitness awareness for medically underserved people. Who would be categorized as medically underserved? 1 People belonging to a different culture 2 People of a poor socioeconomic status 3 People who are not willing to be treated for their illnesses 4 People who use complementary and alternative treatments for their illnesses

4 Registered nurse (RN) candidates must pass the NCLEX-RN® that the individual state boards of nursing administer. Regardless of educational preparation, the examination for RN licensure is exactly the same in every state in the United States. This provides a standardized minimum knowledge base for nurses. Successfully passing the NCLEX-RN does not guarantee safe, standard, nor ethical practice. These are evaluated by the employer

The examination for registered nurse licensure is exactly the same in every state in the United States. What should the public understand about this exam? 1 Guarantees safe nursing care for all patients 2 Ensures standard nursing care for all patients 3 Ensures that honest and ethical care is provided 4 Provides a minimum standard of knowledge for a registered nurse in practice

1, 3, 5 A master's degree is required for nursing careers as nurse educator, nursing researcher, or advanced practice registered nurse. the nurse with a baccalaureate nursing degree can pursue a career as a registered nurse after passing the nursing license exam. The certified nurse assistant must take a nurse assistant training program and pass a license exam.

The nurse educator is delivering a lecture on nursing as a profession to a group of nursing students who have recently joined the baccalaureate nursing degree course. The nurse educator is discussing nursing career options with the students. One of the students asks about the possible nursing careers that require a master's degree in nursing. Which career options should the nurse suggest? Select all that apply. 1 Nurse educator 2 Registered nurse 3 Nursing researcher 4 Certified nurse assistant 5 Advanced practice registered nurse

1, 3, 5 The nurse is responsible for collecting comprehensive data about the patient's health. The nurse records the body temperature after 2 hours to assess the effectiveness of the antipyretic medication. The nurse also asks the patient about the hygiene of the surrounding environment to assess the risk of acquiring infections caused by unhygienic surroundings. Nursing assessment also includes identifying the signs of a particular condition. Teaching a patient about the lifestyle changes required to reduce risks of ischemic heart disease is an example of the nursing process of implementation, not assessment. Asking the patient to demonstrate a technique after teaching it forms a part of the evaluation process, not the assessment process.

The nurse educator is delivering a lecture on nursing as a profession to a group of nursing students who have recently joined the baccalaureate nursing degree course. The nurse is explaining the nursing processes by giving examples. Which examples should the nurse give while explaining nursing assessment? Select all that apply. 1 Recording body temperature two hours after administering antipyretic medication. 2 Teaching the patient about the lifestyle changes required to reduce the risks of having coronary artery disease. 3 Asking the patient about hygiene and sanitation in the patient's community. 4 Asking the patient to demonstrate the technique of breast self-examination after teaching the technique. 5 Identifying the signs of respiratory distress in a hospitalized patient.

1, 2, 3 Nursing is a profession that involves administering quality patient-centered care in a safe and knowledgeable manner. The nurse provides a specific kind of health care to patients. The nurse is responsible for the care delivered to the patient and is accountable to the patients. Ethical health care delivery is a very important characteristic of the nursing profession. Nurses have the right to participate in the decision-making process for the patient, so they need not always rely on the prescription given by the health care provider for delivering care. Nursing education includes a theoretical body of knowledge leading to defined skills, abilities, and norms.

The nurse educator is delivering a lecture on nursing as a profession to a group of nursing students who have recently joined the baccalaureate nursing degree course. Which statements are true? Select all that apply. 1 "The nurse is responsible to provide specific health care to patients." 2 "The nurse is responsible and accountable to the patients." 3 "Nurses have to follow a specific code of ethics while delivering care." 4 "Care delivery by nurses is only based on orders given by the health care provider." 5 "Nursing education involves learning the caregiving techniques without any theoretical body of knowledge."

2, 3 A Certified Registered Nurse Anesthetist (CRNA) is an advanced practice registered nurse (APRN) and provides surgical anesthesia under supervision of the anesthesiologist. A CRNA does not manage medical care for healthy and chronically ill patients; these activities are performed by the Certified Nurse Practitioner (CNP). The Clinical Nurse Specialist (CNS) has a specialty area identified by a population as well as a disease. The Certified Nurse Midwife (CNM) provides routine gynaecological care. The CNP provides care for patients with complex problems using a more holistic approach.

The nurse educator is explaining different career opportunities in nursing. Which statements are true about a Certified Registered Nurse Anesthetist (CRNA)? Select all that apply. 1 CRNAs manage medical care for healthy individuals as well as those with chronic illnesses. 2 A CRNA is an advanced practice registered nurse (APRN). 3 CRNAs can provide surgical anesthesia under supervision. 4 CRNAs provide routine gynecological care. 5 CRNAs provide care for patients with complex problems using a more holistic approach.

2, 5 Preparing for community disasters is an important part of the nurse education curriculum. While teaching about nursing management interventions regarding bioterrorism, the nurse educator should speak on decontamination methods and vaccine research. Teaching the use of the defibrillator, stress management techniques, and anatomy of the human body is not pertinent to this situation.

The nurse educator is preparing to teach a group of nursing students about nursing interventions for managing bioterrorism. Which topics should the nurse include in the teaching plan? Select all that apply. 1 Defibrillator usage 2 Decontamination methods 3 Stress-management techniques 4 Anatomy of the human body 5 Evidence-based research on vaccines

2, 3, 5 Encouraging the patient to perform postoperative exercises is part of the nursing process and the nurse's responsibility as a caregiver. The nurse caregiver strives to meet all health care needs of the patient by providing measures that restore a patient's emotional, spiritual, and social well-being. In addition, the nurse assists in achieving the results with minimum possible financial cost. By reviewing information to help the health care provider make decisions, the nurse serves as an advocate; this is not a caregiver role. Responding to a patient's questions is a part of educating the patient, not giving care.

The nurse has many roles to perform. Which statements illustrate the nurse's role as a patient caregiver? Select all that apply. 1 Reviews information, so the health care provider can make a decision about treatment 2 Implements postoperative exercises for a patient who recently had surgery 3 Provides measures that restore a patient's emotional, spiritual, and social well-being 4 In a casual conversation, responds to patient questions regarding the need for an IV infusion 5 Assists the patient in meeting therapeutic goals with minimal financial cost, time, and energy

3 (and 1) The nurse educator is responsible for educational activities conducted in schools of nursing. If they are educators in clinical care institutions, they often participate in the development of nursing policies and procedures. In schools of nursing, the nurse educator imparts practical and theoretical knowledge to students. The nurse educator is not responsible for managing patient care, proving holistic care, or providing surgical anesthesia. The nurse administrator manages patient care. The nurse practitioner provides holistic care to patients. The certified registered nurse anesthetist provides surgical anesthesia.

The nurse is being appointed as nurse educator in a nursing school. What are the responsibilities of the nurse educator? Select all that apply. 1 Participate in the development of nursing policies and procedures. 2 Manage patient care and delivery of special nursing services. 3 Provide students with practical and theoretical knowledge. 4 Provide care to patients using a holistic approach. 5 Provide surgical anesthesia under the guidance and supervision of an anesthesiologist.

1, 3 Evidence-Based Practice refers to incorporating better quality interventions based on research. Referring to articles and systematic reviews to determine optimal care for a patient is an example of Evidence-Based Practice. Patient-Centered Care refers to providing care with respect to patients' needs, values, and preferences. Teamwork and Collaboration refers to work with a health care team to achieve the best quality of patient care. Safety refers to performing interventions that minimize risks.

The nurse is caring for a patient who has been admitted to the hospital with terminal leukemia. The patient has expressed a preference for nonpharmacological pain control. The nurse refers to articles and systematic reviews to learn the best possible nonpharmacological methods to treat cancer pain. How would the nurse's actions be categorized, according to the QSEN competencies? Select all that apply. 1 Patient-Centered Care 2 Teamwork and Collaboration 3 Evidence-Based Practice 4 Safety

2 In the United States, a student can take the NCLEX-RN® nursing licensure examination after completing either the associate or the baccalaureate degree program in nursing. An associate degree program is a 2-year program, whereas a baccalaureate program is a 4-year program. A master's in nursing degree is an advanced degree. The nurse must complete a master's in nursing program to become eligible for doctoral programs.

The nurse is caring for a patient whose daughter wishes to pursue a career in nursing. She wants to enroll in a program that is of short duration and makes her eligible to take the nursing licensure exam. Which educational program should the nurse recommend to this student? 1 Baccalaureate degree program in nursing 2 Associate degree program in nursing 3 Professional doctoral program in nursing 4 Master's degree in nursing

1, 2, 5 Health care reform will cause changes in the delivery of nursing care, and more services will be in community-based care settings. Revising practice standards will help to comply with the increasing focus on health promotion, disease prevention, and illness management. Changing nursing education will help nurses to be more efficient in dealing with the health care reform, because nurses are required to be more adept at assessing resources, service gaps, and how the patient adapts to returning to the community. Exploring new methods of providing care will enable nurses to provide care according to changing health care needs, because many nurses may need to work in community health centers, schools, and senior centers. Opposing current trends will not help improve the quality of nursing care, whereas accepting health care reform will be beneficial to all. Existing guidelines would be considered old and redundant under health care reform, and adopting new measures to suit the changes will help.

The nurse is learning about the effects of health care reform. Which type of actions should the nurse perform in response to health care reform? Select all that apply. 1 Revise practice standards. 2 Change nursing education. 3 Oppose current trends. 4 Continue with existing guidelines. 5 Explore new methods of providing care.

1, 3, 4, 5 Patient education will help in health promotion, disease prevention, and providing the required patient awareness regarding health care needs. Effective time management will ensure that work is efficiently completed in time, so a limited number of nurses can handle a large number of patients. Compassionate care is essential, because patients should get a positive image of nursing and a feeling that they received quality care. Therapeutic communication helps in promoting the emotional and physical well-being of the patient. Tactless nurturing will not help in a rapid-discharge and high-tech health care environment, because nurses need to relate to their patients on a human, caring level to ensure patient satisfaction.

The nurse is learning about the global nursing shortage that has led to fewer nurses in the workplace. Which essential skills should the nurse learn to ensure professional and efficient patient management? Select all that apply. 1 Patient education 2 Tactless nurturing 3 Time management 4 Compassionate care 5 Therapeutic communication

2, 4, 5 Implementation is when the nurse actually uses and performs particular actions or puts a strategy into use. Educating patients, using therapeutic knowledge, and providing consultation all provide opportunities for the nurse to implement skills. Developing strategies for patient care is a part of planning in nursing practice. Analyzing the assessment data is part of diagnosis in nursing practice.

The nurse is learning about the standards of nursing practice. Which activities are part of the practice of implementation? Select all that apply. 1 Developing strategies for patient care 2 Educating patients for health awareness 3 Analyzing assessment data for diagnosis 4 Using therapeutic procedures for patient care 5 Providing consultation to enhance patient care

4 The code of ethics identifies the philosophical ideals of right and wrong that define the principles that nurses follow when providing care for patients. The code serves as a guide for carrying out nursing responsibilities to provide quality nursing care and describes the ethical obligations of the profession. The code of ethics does not include methods to improve self-health care. Protecting the patient's confidentiality is a standard of care and is covered in the language of the Health Insurance Portability and Accountability Act (HIPAA). Care must be provided based on differing patient needs. When giving care, it is essential to provide a specified service according to standards of practice and to follow a code of ethics.

The nurse is participating in a clinical care coordination conference for a patient with terminal cancer. The nurse talks with colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A nonnursing colleague asks about this code. What does this code do? 1 Improves self-health care 2 Protects the patient's confidentiality 3 Ensures identical care to all patients 4 Defines the principles of right and wrong when providing patient care

3 The nurse practitioner has prescriptive authority and can call for investigative procedures such as chest x-rays to confirm the assessment findings. Assessment is the process of collecting data related to the health and illness of the patient. Nursing diagnosis involves analyzing the assessed data. Implementation is the process of delivering care according to the care plan.

The nurse practitioner is assessing a patient who has been admitted for congestive cardiac failure. The nurse suspects a pulmonary pathology and asks for a chest x-ray to confirm the findings. Which standard of practice is the nurse performing? 1 Assessment 2 Diagnosis 3 Prescriptive authority 4 Implementation

1 Communication is an important skill for nurses, so the mentor should help the student build communication skills. This student cannot be utilized for patient education, rehabilitation, or coordinating and managing patient care, because all these activities require good communication skills. Communication skills, not subject knowledge, ensure a good patient-nurse relationship.

The nursing mentor observes that a nursing student is deficient in communication skills but is good at understanding nursing theories. How should the mentor intervene with respect to this student? 1 Help the student build communication skills. 2 Utilize the student's services for patient education and rehabilitation. 3 Utilize the student's services for coordinating and managing patient care. 4 Consider the lack of communication skills unimportant, because sound knowledge ensures a good patient-nurse relationship.

1, 3, 4 A certified nurse midwife (CNM) is an advanced practice registered nurse who is also educated in midwifery and is certified by the American College of Nurse-Midwives. The duties of a certified nurse midwife involve conducting routine gynecological procedures such as Pap smears, performing normal deliveries, and caring for minor vaginal infections. A CNM assists the health care provider during hysterectomy surgery and in treating pregnancy-related emergencies such as eclampsia.

The registered nurse is planning to pursue a career as a certified nurse midwife. What are the duties of a certified nurse midwife? Select all that apply. 1 Perform Papanicolaou (Pap) smear tests. 2 Perform hysterectomies. 3 Perform normal delivery procedures. 4 Prescribe medications for minor vaginal infections. 5 Treat pregnancy-related emergencies such as abruptio placenta and eclampsia.

4, 5 The higher education opportunities available for the nurse with an associate degree include baccalaureate programs in nursing, such as Bachelor of Science in Nursing (BScN) and Bachelor in Nursing (BN). A Doctor of Nursing Practice (DNP) degree can be pursued only after a master's degree. A Doctor of Philosophy (PhD) in Nursing also requires a master's degree. The nurse must hold a baccalaureate degree before enrolling in a master's degree program.

The senior nurse is explaining to the nurse who holds an associate degree about immediate future options in advanced nursing education. Which educational options should be included? Select all that apply. 1 Doctor of Nursing Practice (DNP) 2 A master's degree in nursing 3 Doctor of Philosophy (PhD) in Nursing 4 Bachelor of Science in Nursing (BScN) 5 Bachelor in Nursing (BN)

D

A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? A. Patient-centered care B. Safety C. Teamwork and collaboration D. Informatics

B

A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with them. The nurse is acting as the patient's: A. Educator B. Advocate C. Caregiver D. Case manager

C

A nurse meets with the registered dietician and physical therapist to develop a plan of care that focuses on improving nutrition and mobility for a patient. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? A. Patient-centered care B. Safety C. Teamwork and collaboration Correct D. Informatics

1, 2, 3 The standards of practice are planning, diagnosis, and assessment. Planning refers to developing a plan that prescribes strategies and alternatives to attain the expected outcome. Diagnosis involves assessing the data to identify the nature and cause of the illness. Assessment involves collecting data pertaining to patient's health or situation. Collaboration and environmental health are care standards of professional performance. Collaboration is a process in which the nurse works jointly with a health care consumer, the family, and others. A registered nurse should adopt an environmentally healthy and safe approach.

A patient has a lung infection. Which nursing standards of practice should the nurse adopt while caring for this patient? Select all that apply. 1 Planning 2 Diagnosis 3 Assessment 4 Collaboration 5 Environmental health

3 Assessment is the collection of comprehensive data pertinent to the patient's health and/or the situation.

An 18-year-old patient is in the emergency department with fever and cough. The nurse obtains vital signs, auscultates lung sounds, listens to heart sounds, determines patient's level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? 1 Diagnosis 2 Evaluation 3 Assessment 4 Implementation

A

Expert clinician in a specialized area of practice such as adult diabetes care. A. Clinical nurse specialist B. Nurse anesthetist C. Nurse practitioner D. Nurse-midwife

C

Nurses in an acute care hospital are attending a unit based education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? A. Continuing education B. Graduate education C. In-service education D. Professional Registered Nurse Education

B

Provides care and services under the supervision of an anesthesiologist. A. Clinical nurse specialist B. Nurse anesthetist C. Nurse practitioner D. Nurse-midwife

C

Provides comprehensive care, usually in a primary care setting, directly managing the medical care of patients who are healthy or who have chronic conditions. A. Clinical nurse specialist B. Nurse anesthetist C. Nurse practitioner D. Nurse-midwife

1 In the nursing process, recording data from investigation reports is part of assessment. Nursing diagnosis involves analyzing the assessed data. Evaluation refers to testing the attainment of outcome goals. Implementation is the process of delivering care according to the care plan.

The nurse is recording the results of all the laboratory reports of a patient. Which standard of practice is the nurse performing? 1 Assessment 2 Diagnosis 3 Evaluation 4 Implementation

1 When the nurse teaches medical procedures, the teaching should always match the patient's capabilities, and complicated procedures should not be taught to the patient. The nurse should explain concepts and facts about health. The nurse should involve both the patient and family members when teaching. The teaching plan is about insulin injections, so facts about oral diabetic drugs should not be included.

The nurse is teaching a patient with diabetes how to self-administer subcutaneous insulin. Which key element should the nurse keep in mind before teaching the patient about health care principles? 1 Match the teaching with the patient's capabilities. 2 Limit discussion of concepts and facts about health. 3 Exclude family members from the teaching plan. 4 Include facts about oral medications for diabetes.

2 Genomics describes the study of all the genes in an individual and the interactions of these genes with one another and with that individual's environment. Genomic information allows health care providers to determine how genomic changes contribute to patient conditions and influence treatment decisions.

The nurse is working with a young childbearing family who has one child with a congenital heart disease. The parents are trying to determine the risks of a second child being born with congenital heart disease. Which information is important in assisting the parents in this decision? 1 Genetics 2 Genomics 3 Evidence-based practice 4 Safety

A

The nurse spends time with the patient and family reviewing the dressing change procedure for the patient's wound. The patient's spouse demonstrates how to change the dressing. The nurse is acting in which professional role? A. Educator B. Advocate C. Caregiver D. Case manager

3 Evidence-based practice integrates the best current evidence with clinical expertise, patient/family preferences, and values for delivery of optimal health care. It is based on research, not tradition. It is a patient care, not a type of literature. Quality care provided in an efficient and economically sound manner is a standard of nursing care.

What is evidence-based practice? 1 Nursing care based on tradition 2 Scholarly inquiry of nursing and biomedical research literature 3 Optimal patient care based on current research 4 Quality nursing care provided in an efficient and economically sound manner

2, 3 Nurse practitioners and certified clinical nurse specialists encompass the role and preparation of the advanced practice registered nurse. According to the American Nurses Association standards of practice, prescriptive authority may be granted to these nurses.

Which nursing roles may have prescriptive authority in their practice? Select all that apply. 1 Critical care nurse 2 Nurse practitioner 3 Certified clinical nurse specialist 4 Charge nurse 5 Orthopedic nurse

B D

Which of the following Internet resources available can assist consumers when comparing quality care measures? (Select all that apply.) A. WebMD B. Hospital Compare C. Magnet Recognition Program D. Hospital Consumer Assessment of Healthcare E. The American Hospital Association's webpage.

1, 2, 3, 4 Each of these roles includes activities for the professional nurse. Each is used in direct care or is part of the professionalism that guides nursing practice. Some nurses are lobbyists, but being a lobbyist is not expected of all professional nurses.

Which roles and responsibilities should every nurse be expected to fill? Select all that apply. 1 Caregiver 2 Autonomy and accountability 3 Patient advocate 4 Health promotion 5 Lobbyist

D

You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which of the following statements best describes this code? A. Improves self-health care B. Protects the patient's confidentiality C. Ensures identical care to all patients D. Defines the principles of right and wrong to provide patient care

4 Implementation is coordinating care and completing the prescribed plan of care.

A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed? 1 Planning 2 Evaluation 3 Assessment 4 Implementation

D

A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed? A. Planning B. Evaluation C. Assessment D. Implementation

1, 3 Because the patient is suffering from colon cancer before the age of 50, it is likely that the patient's siblings have a higher risk of developing colon cancer. Therefore, the nurse should motivate the twin brother to also get a colonoscopy or other screening test, as recommended by current guidelines for higher-risk patients. If the patient had developed colon cancer after age 50, screening for the brother would be less urgent. However, early onset in the patient means the risk of colon cancer is higher for the brother. The nurse is as responsible as the primary health care provider for screening for family members who are at risk of colon cancer. The nurse should provide care to both the patient and his brother.

A 40-year-old patient is diagnosed with colon cancer. While interacting with the patient, the nurse learns that he has a twin brother. Which nursing actions are appropriate for the patient's brother? Select all that apply. 1 Motivate the patient's brother to get a colonoscopy. 2 Conclude that the patient's brother does not require intervention. 3 Encourage the patient's brother to get an annual stool test. 4 Avoid doing anything, because that is a responsibility of the health care provider. 5 Avoid doing anything, because the nurse is responsible for the patient and not for the brother.

4 The nurse is delivering care to the patient; therefore the standard practiced by the nurse is implementation. Assessment is the process of collecting data related to the health and illness of the patient. Nursing diagnosis involves analyzing the assessed data. Evaluation refers to determining the effectiveness of the implemented patient care in meeting the patient goals.

A patient sprained her ankle. The nurse instructs the patient to keep the leg elevated and applies cold compresses on the affected ankle. Which standard of practice is the nurse performing? 1 Assessment 2 Diagnosis 3 Evaluation 4 Implementation

1, 3 The responsibilities of the nurse educator include explaining concepts and facts about health to patients. The nurse educator also plans teaching activities, such as teaching the patient to self-administer insulin injections. As a patient advocate, the nurse should protect the patient's human and legal rights and provide additional information to help a patient decide whether to accept a treatment. The nurse does not prescribe medications; however, the nurse is responsible for administering medications prescribed by the health care provider.

Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. What are the responsibilities of the nurse as a patient educator? Select all that apply. 1 Explain concepts and facts about health to patients. 2 Protect the patient's human and legal rights. 3 Teach the patient to self-administer insulin injections. 4 Provide adequate information to the patient to help make treatment decisions. 5 Prescribe appropriate medications.

A B C D

Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) A. Caregiver B. Autonomy and accountability C. Patient advocate D. Health promotion E. Lobbyist

1, 2, 5 The objective of the American Nurses Association (ANA) is to promote national associations of nurses, improve standards of nursing practice, seek a higher status for nurses, and provide an international power base for nurses. ANA is a part of International Council of Nurses (ICN). It lobbies at the federal level about practice-related issues. ANA successfully lobbied state legislatures to restrict the length of overtime for individual nurses. ANA is not involved in nursing education; the National League for Nursing (NLN) handles education. The Robert Wood Johnson Foundation sponsored the Quality and Safety Education for Nurses (QSEN) initiative to respond to reports about safety and quality patient care.

Implementation is when the nurse actually uses and performs particular actions or puts a strategy into use. Educating patients, using therapeutic knowledge, and providing consultation all provide opportunities for the nurse to implement skills. Developing strategies for patient care is a part of planning in nursing practice. Analyzing the assessment data is part of diagnosis in nursing practice.

2, 3 Nurses should learn time management skills and use patient contact time efficiently and professionally. They should not hurry through patient care, as studies have proven that hurrying does not save time in the long run and increases the possibility of errors. Nurses should not compromise the quality of care they deliver; in the long run, that will not save time.

In a hospital there is an acute shortage of nurses due to retirement. What should the remaining nurses do? Select all that apply. 1 Hurry through the patient care assignments. 2 Use patient contact time efficiently. 3 Utilize the patient contact time professionally. 4 Only treat the same number of patients as treated before the retirements. 5 Eliminate assessment aspects of patient care to make more time.

1, 3, 4 The nursing profession is accountable for the type and quality of care delivered to patients, so nurses should prepare by acquiring and updating knowledge, improving competencies, and acquiring technical skills. Avoiding documentation may generate more complications, such as legal issues. Nurses are given autonomy for various nursing practices, so they should be dependent only in aspects of care beyond their scope of practice.

Nurses are responsible for the quality of care provided to patients. Which will help nurses practice safe nursing? Select all that apply. 1 Acquiring knowledge 2 Minimizing documentation 3 Improving competencies 4 Acquiring technical skills 5 Exhibiting complete dependence

D

Provides independent care including pregnancy and gynecological services. A. Clinical nurse specialist B. Nurse anesthetist C. Nurse practitioner D. Nurse-midwife

4 Using decision support systems is an example of using and gaining competency in informatics.

The critical care nurse is using a computerized decision support system to correctly position ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? 1 Patient-centered care 2 Safety 3 Teamwork and collaboration 4 Informatics

1, 2, 3, 4 A master's degree can be pursued after a baccalaureate program. With a master's degree in nursing, a nurse can become a nurse educator, nurse administrator, advanced practice registered nurse (APRN), and researcher. A physical therapist earns a degree in physical therapy, not nursing.

The nurse is planning to obtain a master's degree in nursing. Which role can the nurse with a master's degree in nursing fulfill? Select all that apply. 1 Nurse educator 2 Nurse administrator 3 Advanced practice registered nurse 4 Nurse researcher 5 Physical therapist

3, 4 Mary Adelaide Nutting was instrumental in the affiliation of nursing education with universities and became the first professor of nursing at Columbia University Teachers College in 1906. Maitland Stewart founded the Frontier Nursing Service, which provided the first organized midwifery service in the United States. Lillian Wald founded the Henry Street Settlement in New York City and is considered the founder of community, or public health, nursing. Clara Barton was a Civil War nurse who used her experience on the battlefield to found the American Red Cross.

What did Mary Adelaide Nutting contribute to the development of nursing as a profession? Select all that apply. 1 Established the Frontier Nursing Service 2 Founded public health nursing in New York City 3 Ensured affiliation of nursing education with universities 4 Was the first professor of nursing at Columbia University Teachers College 5 Developed the American Red Cross while she was a Civil War nurse

1 An advanced practice registered nurse functions independently as a clinician, educator, case manager, consultant, and researcher within his or her area of practice to plan or improve the quality of nursing care for the patient and family.

What is true about the general practice of advance practice registered nurses? 1 Function independently 2 Function as unit directors 3 Work in acute care settings 4 Work in university settings

1 Quality Improvement is the Quality and Safety Education for Nurses (QSEN) competency that uses tools such as flowcharts and diagrams to make the care process explicit. The Patient-Centered Care competency involves family and friends in care and elicits the patient's values and preferences, providing care with respect for the diversity of the human experience. Evidence-Based Practice demonstrates knowledge of basic scientific methods, appreciates the strengths and weaknesses of scientific bases for practice, and recognizes the importance of regularly reading relevant journals. Teamwork and Collaboration recognizes the contributions of other health team members and the patient's family members and discusses effective strategies for communicating and resolving conflict.

While teaching about Quality and Safety Education for Nurses (QSEN) competencies, the nurse states, "This competency uses tools such as flowcharts and diagrams to make the process of care explicit." Which QSEN competency is the nurse referring to? 1 Quality Improvement 2 Patient-Centered Care 3 Evidence-Based Practice 4 Teamwork and Collaboration

2 Patient education is a major role of the nurse educator. The nurse educator is responsible for teaching the patient about the new prosthesis and the related postoperative care. The other types of nurses have different responsibilities. The staff nurse is responsible for providing basic care to a group of patients in a hospital setting based on standards of professional practice. The nurse administrator is responsible for managing the quality of patient care provided by the nurses. The nurse administrator also manages the different nursing services that are delivered within a health care establishment. The clinical nurse specialist is an expert clinician in a particular area and provides specialized care.

A 50-year-old patient is admitted with acute exacerbation of asthma. The patient is treated with bronchodilators and oxygen therapy. The patient is clinically stable and is planned for discharge. Who is responsible for teaching the patient about managing asthma at home? 1 The staff nurse 2 The nurse educator 3 The nurse administrator 4 The clinical nurse specialist

2 The nurse provides additional information and helps the patient decide whether to accept the treatment. Here, the nurse is acting as the patient's advocate, protecting human and legal rights and providing assistance in asserting these rights when needed. If the nurse explains concepts and facts about health, describes the reason for routine care activities, and demonstrates procedures such as self-care activities, the nurse is playing the role of an educator. As a caregiver, the nurse helps the patient and family set goals and assists them with meeting these goals using minimal financial cost, time, and energy. As a communicator, the nurse directly communicates strengths or weaknesses to the patient and the patient's family to give comfort and emotional support.

A patient with psychiatric illness is prescribed antipsychotic medications. The nurse helps the patient decide whether to accept the treatment. Which role does the nurse play in this situation? 1 Educator 2 Advocate 3 Caregiver 4 Communicator

C

An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, listens to her lung and heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? A. Diagnosis B. Evaluation C. Assessment Correct D. Implementation

A

Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform? A. Moving from an acute illness to a health promotion, illness prevention model B. Moving from illness prevention to a health promotion model C. Moving from an acute illness to a disease management model D. Moving from a chronic care to an illness prevention model

2, 4 Mary Mahoney was the first professionally trained African-American nurse. She was concerned with relationships between cultures and races. As a noted nursing leader, she initiated an awareness of cultural diversity and respect for the individual, regardless of background, race, color, or religion. Clara Barton was the founder of the American Red Cross. Florence Nightingale's concept of nursing was to promote health by modifying the patient's environment. In the late 19th century, Lillian Wald and Mary Brewster opened the Henry Street Settlement, which focused on the health needs of poor people who lived in the tenements in New York City.

Many nurses are known for their achievements. Which statements are true regarding Mary Mahoney? Select all that apply. 1 She was the founder of the American Red Cross. 2 She was the first professionally trained African-American nurse. 3 She proposed the concept of health promotion by modifying the patient's environment. 4 She focused on respecting an individual irrespective of color, race, or background. 5 She opened an establishment that focused on the health needs of poor people who lived in tenements in New York City.

3 Inservice education programs provide instruction or training by a health care agency or institution. An inservice program is held in the institution and is designed to increase the knowledge, skills, and competencies of nurses and other health care professionals employed by the institution. Prerequisite education is course work required prior to the nursing program. Graduate education is a formal program following a Bachelor of Science in Nursing (BSN) and professional registered nurse education is an undergraduate nursing education program.

Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for bed sores. This is an example of which type of education? 1 Continuing prerequisite education 2 Graduate education 3 Inservice education 4 Professional registered nurse education

D

The examination for registered nurse (RN) licensure is exactly the same in every state in the United States. This examination: A. Guarantees safe nursing care for all patients B. Ensures standard nursing care for all patients C. Ensures that honest and ethical care is provided D. Provides a minimal standard of knowledge for an RN in practice

3 A certified registered nurse anesthetist (CRNA) is trained at an anesthesia-accredited program. The nurse has the right to provide surgical anesthesia under the supervision of a primary health care provider with knowledge of surgical anesthesia. The CRNA should provide anesthesia only under the supervision of a primary health care provider. The CRNA can provide anesthesia even in a primary set-up, under supervision. CNRA services may be utilized even for surgical procedures.

The health care provider asks the certified registered nurse anesthetist (CRNA) to provide spinal anesthesia to a patient who is scheduled for a hernia operation. What is the CRNA's next step? 1 Provide the anesthesia under the supervision of a senior nurse. 2 Inform the health care provider that the CRNA has the right to provide spinal anesthesia only in a tertiary setup. 3 Provide the anesthesia under the supervision of a primary health care provider with knowledge of surgical anesthesia. 4 Inform the health care provider that the CRNA's services are restricted to nonsurgical procedures.

2 Helping patients understand the consequences and complications of multiple medications helps to build the competency in safety

The nurse is caring for an older-adult couple in a community-based assisted living facility. During the family assessment, the nurse notes that the couple has many expired medications and multiple medications for their respective chronic illnesses. They indicate that they go to two different health care providers. The nurse begins to work with the couple to determine what they know about their medications and helps them decide on one care provider rather than two. This is an example of which competency for QSEN? 1 Patient-centered care 2 Safety 3 Teamwork and collaboration 4 Informatics

1, 2, 4 The nurse caring for multiple patients at a time should understand that all patients are equally important. All should receive quality care, so they leave the health care setting with a positive image of nursing. Time management and a compassionate approach are keys to achieving these goals. However, the nurse should not cut down contact time with each patient; rather, the nurse should optimize contact time so all can be cared for and should deliver care in an organized manner, rather than in a hurried or rushed manner.

The nurse usually is assigned multiple patients at one time. What should the nurse do to ensure individual patient satisfaction? Select all that apply. 1 Provide quality care to each patient. 2 Ensure that patients leave with a positive image of nursing. 3 Provide quick and hurried treatment to the less needy. 4 Manage time and approach all patients with compassion. 5 Minimize contact time with each patient to ensure care for all.

1 According to Benner, the expert nurse has specialized skills and is capable of identifying both patient-centered problems and problems related to the health care system. The expert nurse passes through five levels of proficiency when acquiring or developing these skills. The proficient nurse perceives the clinical situation as a whole, is able to assess an entire situation, and readily transfers knowledge gained from multiple previous experiences. The competent nurse is able to anticipate nursing care and establish long-range goals. The advanced beginner nurse has some level of observational experience with the situation and is able to identify meaningful aspects or principles of nursing care.

The nurse with specialized nursing skills is capable of identifying both patient-centered problems and problems related to the health care system. According to Benner, which specialist nurse possesses such skills? 1 Expert nurse 2 Proficient nurse 3 Competent nurse 4 Advanced beginner nurse

4 The registered nurse implements the identified plan, which includes care coordination, health teaching, health promotion, consultation, prescriptive authority, and treatment. Health teaching and health promotion include strategies for promoting health and a safe environment for the patient. Planning is prescribing strategies and alternatives to attain expected outcome. Diagnosis is analyzing data to determine problems. Assessment is collecting comprehensive patient data

The registered nurse coordinates care delivery and uses strategies to promote health and a safe environment. Which American Nursing Association (ANA) standard of nursing practice is the registered nurse practicing? 1 Planning 2 Diagnosis 3 Assessment 4 Implementation

3 A certified nurse-midwife (CNM) is an advanced practice registered nurse (APRN) who provides independent care for women during normal pregnancy, labor, and delivery. The nurse practitioner (NP) is an APRN who provides health care to a group of patients, usually in an outpatient, ambulatory-care, or community-based setting. The clinical nurse specialist (CNS) is an APRN who is an expert clinician in a specialized area of practice, such as geriatrics. The certified registered nurse anesthetist (CRNA) assists with anesthesia during surgeries.

A pregnant patient is diagnosed with a minor vaginal infection. Which nursing domain involves providing independent care for women during normal pregnancy, including labor, delivery, and care for the newborn? 1 Nurse practitioner (NP) 2 Clinical nurse specialist (CNS) 3 Certified nurse-midwife (CNM) 4 Certified registered nurse anesthetist (CRNA)

D

The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? A. Clinical nurse specialist B. Nurse administrator C. Nurse educator D. Nurse researcher

4 The nurse researcher investigates problems to improve nursing care and to further define and expand the scope of nursing practice. The nurse researcher often works in an academic setting, hospital, or independent professional or community service agency.

The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. The nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Which career does the nurse consultant exemplify? 1 Clinical nurse specialist 2 Nurse administrator 3 Nurse educator 4 Nurse researcher

1, 2, 5 Multiple external forces affect nursing. Bioterrorism could be a reality in the near future, and nurses should have the adequate knowledge and education to handle a disaster associated with bioterrorism. The Affordable Care Act is an external influence on health care. Medically underserved people also influence nursing practice. In order to serve this population, nurses may need to promote health and disease prevention to the homeless, mentally ill, and other people who do not have adequate access to health care services. Health insurance policies do not influence nursing practices, nor do static demographics.

Which external forces influence current nursing practices? Select all that apply. 1 Bioterrorism 2 Affordable Care Act 3 Health insurance policies 4 Static demographic factors 5 Medically underserved people