Kozier and Erb's chapter 1 study questions

A client tells the nurse about research information on the Internet to learn more about a new health problem. What should the nurse respond to this client? 1. "Information from the Internet isn't always accurate." 2. "It's best to check this information with your physician." 3. "Bring your information to the clinic so we can go through it together." 4. "I'd prefer you rely on information you haven't received from our office."

Answer : 3 Rationale: Nurses may need to interpret Internet sources of information to clients and their families. Although not all Internet-based information is accurate, some may be high quality and valid. Nurses need to become information brokers so they, not just the physician, can help clients access and evaluate information to determine its usefulness.

A client wishes to discontinue cancer treatment. If acting as the client advocate, which statement should the nurse make to the client's physician? 1. "The client is making his own decision." 2. "The client would benefit from additional information about treatment options." 3. "The family must be involved in this decision." 4. "Let's educate the family about the consequences of this decision."

Answer: 1 Rationale: A client advocate acts to protect the client and may represent the client's needs and wishes to other health professionals, such as relaying the client's wishes for information to the physician. Providing additional information to the client about treatment options and bringing the family into the decision-making process would be examples of the nurse acting as teacher or counselor.

The ANA's proposal for entry level for professional practice initiated debate among nurses. Which nurse would be at greatest risk if the ANA proposal were implemented? 1. An RN with an associate degree who has a head nurse position 2. An RN with a BSN who is a staff nurse 3. An RN with a diploma who works overtime 4. An RN with an associate degree who is currently in school

Answer: 1 Rationale: According to the ANA's proposal, only the baccalaureate graduate would be licensed under the legal title registered nurse. The graduate with an associate degree or diploma would be considered an associate nurse. If the ANA proposal were implemented, nurses who are currently licensed and educated in associate degree or diploma programs would have to be considered under a grandfather clause, provided that their performance met established standards. If an institution required a minimum of a baccalaureate degree for the position of head nurse, an RN who was currently employed as a head nurse but who did not hold a baccalaureate degree would have no guarantee of retaining that position.

The staff nurse is considering membership in the National League for Nurses. What should the nurse expect as a member of this organization? 1. Members that are non-nurses 2. Assistance with getting into graduate school 3. Opportunities to be awarded scholarships 4. Assistance with finding employment

Answer: 1 Rationale: The NLN is an organization of both individuals and agencies. Its objective is to foster the development and improvement of all nursing services and nursing education. People who are not nurses but have an interest in nursing services can be members of the league.

A registered nurse is supervising several LPNs who provide patient care. Which responsibility should the registered nurse expect to complete? 1. Evaluating the care provided to the client 2. Administering intramuscular (IM) medications 3. Performing dressing changes 4. Delegating appropriate tasks to unlicensed client care providers (such as a nurse's aide)

Answer: 1 Rationale: The RN has the knowledge and skill to make more sophisticated nursing judgments, and is responsible for assessing the client's condition, planning care, and evaluating the effect of the care provided.

The nurse ensures that a patient is covered during a bath. In which nursing role is the nurse functioning? 1. Caregiver 2. Communicator 3. Teacher 4. Client advocate

Answer: 1 Rationale: The caregiver role includes those activities that assist the client physically and psychologically while preserving the client's dignity. As a communicator, the nurse identifies client problems, then communicates these verbally or in writing to other members of the health team. As a teacher, the nurse helps clients learn about their health and the health care procedures they need to perform to maintain or restore their health. A client advocate acts to protect clients and represents their needs and wishes to other health professionals.

The nurse has accepted a position as a case manager. What should the nurse expect to perform when functioning in this role? 1. Managing a client's hospital stay 2. Delegating activities to other nurses 3. Evaluating the performance of ancillary workers 4. Identifying areas of client concern or problems

Answer: 1 Rationale: The case manager oversees the care of a specific caseload or may act as the primary nurse to provide some level of direct care to the client and family. Responsibilities may vary from managing acute hospitalizations to managing high-cost clients or case types. Delegating activities to other nurses and evaluating the performance of ancillary workers are responsibilities of the nurse manager. Identifying areas of researchable problems would fall to the research consumer.

The nurse is planning to apply to graduate school to earn a master's degree in nursing. On what should the nurse expect the program's curriculum to focus? 1. An advanced leadership role 2. Case manager 3. Wound care specialist 4. Intravenous therapy specialist

Answer: 1 Rationale: The emphasis of master's degree programs is on preparing nurses for advanced leadership roles in administration, clinical, or teaching.

The nurse is scheduled to attend a continuing education program to learn about the latest urinary catheterization care. Which type of credential should the nurse expect to earn after attending this program? 1. None because this program is designed to enhance a skill 2. Advanced degree 3. Certification as a renal nurse 4. Credit hours toward an advanced degree

Answer: 1 Rationale: The term continuing education (CE) refers to formalized experiences designed to enhance the knowledge or skills of practicing professionals. Compared to advanced educational programs, which result in an academic degree, CE courses tend to be more specific and shorter. Participants may receive certificates of completion or specialization.

While a nurse is conducting a health assessment, the individual asks why the term "patient" is being used. What should the nurse explain about the implication of the term "patient"? 1. The person is seeking assistance because of illness. 2. The individual is proactive in his or her health care needs. 3. The person is a collaborator in his or her care. 4. The individual is using a service or commodity.

Answer: 1 Rationale: The word patient comes from a Latin word meaning "to suffer" or "to bear." Usually, people become patients when they seek assistance because of illness or for surgery. Some nurses believe that the wordpatient implies passive acceptance of the decisions and care of health professionals, which would be opposite of being proactive in one's health care needs. The term client presents the recipient of health care as a collaborator in that care, along with the people who are providing service. A consumer is an individual, a group of people, or a community that uses a service or commodity.

The nursing instructor is explaining the present economic challenges in health care to students in a community health course. What should the instructor emphasize as being important for the students to be aware of? 1. Passage of the Affordable Care Act 2. Consumer presence on the boards of nursing associations and regulatory agencies 3. Diagnostic-related groups (DRGs) 4. Advances in science and technology

Answer: 1 Rationale: With the passage of the Affordable Care Act (ACA) in 2010, health care delivery shifted in focus from acute care to primary preventive care and treatment of chronic conditions using health care teams and information technology. Other forces include consumer demands, family structure, and science and technology. DRGs are a classification system that categorically establishes pretreatment billing based on diagnosis. Although this is an aspect of economic factors affecting nursing, it is not the underlying cause of more personnel being employed in community-based settings.

The nurse is interested in specializing in forensics. What should the nurse expect to learn prior to assuming the role of a forensics nurse? Standard Text: Select all that apply. 1. Knowledge about the legal system 2. Approaches to collecting evidence 3. Budgeting, staffing, and planning programs 4. Information necessary when providing testimony in court 5. Training in identification, evaluation, and documentation of injuries

Answer: 1, 2, 4, 5 Rationale 1: The forensic nurse provides specialized care for individuals who are victims and/or perpetrators of trauma. Forensic nurses have knowledge of the legal system and skills in injury identification, evaluation, and documentation. After tending to the client's medical needs, the forensic nurse collects evidence, provides medical testimony in court, and consults with legal authorities. Rationale 2: The forensic nurse provides specialized care for individuals who are victims and/or perpetrators of trauma. Forensic nurses have knowledge of the legal system and skills in injury identification, evaluation, and documentation. After tending to the client's medical needs, the forensic nurse collects evidence, provides medical testimony in court, and consults with legal authorities. Rationale 4: The forensic nurse provides specialized care for individuals who are victims and/or perpetrators of trauma. Forensic nurses have knowledge of the legal system and skills in injury identification, evaluation, and documentation. After tending to the client's medical needs, the forensic nurse collects evidence, provides medical testimony in court, and consults with legal authorities. Rationale 5: The forensic nurse provides specialized care for individuals who are victims and/or perpetrators of trauma. Forensic nurses have knowledge of the legal system and skills in injury identification, evaluation, and documentation. After tending to the client's medical needs, the forensic nurse collects evidence, provides medical testimony in court, and consults with legal authorities.

The nurse is explaining the definition of being a nurse to a new nursing assistant. Which themes should the nurse include when talking with the assistant? Standard Text: Select all that apply. 1. Adaptive 2. Client-centered 3. Goal-directed according to the needs of the client 4. Diagnosis and treatment of disease 5. An art 6. A science

Answer: 1, 2, 5, 6 Rationale 1: Adaptive; client-centered; art; science; holistic; caring; concerned with health promotion, health maintenance, and health restoration; and a helping profession are themes that are common to many definitions formulated about nursing. In 1973, the American Nurses Association (ANA) described nursing practice as goal-oriented and adaptable to the needs of the individual, the family, and the community (not just the client). In 1980, the ANA's definition was changed to "Nursing is the diagnosis and treatment of the human responses to actual or potential health problems." Diagnosis and treatment of disease is a definition of the medical model. Rationale 2: Adaptive; client-centered; art; science; holistic; caring; concerned with health promotion, health maintenance, and health restoration; and a helping profession are themes that are common to many definitions formulated about nursing. In 1973, the American Nurses Association (ANA) described nursing practice as goal-oriented and adaptable to the needs of the individual, the family, and the community (not just the client). In 1980, the ANA's definition was changed to "Nursing is the diagnosis and treatment of the human responses to actual or potential health problems." Diagnosis and treatment of disease is a definition of the medical model. Rationale 5: Adaptive; client-centered; art; science; holistic; caring; concerned with health promotion, health maintenance, and health restoration; and a helping profession are themes that are common to many definitions formulated about nursing. In 1973, the American Nurses Association (ANA) described nursing practice as goal-oriented and adaptable to the needs of the individual, the family, and the community (not just the client). In 1980, the ANA's definition was changed to "Nursing is the diagnosis and treatment of the human responses to actual or potential health problems." Diagnosis and treatment of disease is a definition of the medical model. Rationale 6: Adaptive; client-centered; art; science; holistic; caring; concerned with health promotion, health maintenance, and health restoration; and a helping profession are themes that are common to many definitions formulated about nursing. In 1973, the American Nurses Association (ANA) described nursing practice as goal-oriented and adaptable to the needs of the individual, the family, and the community (not just the client). In 1980, the ANA's definition was changed to "Nursing is the diagnosis and treatment of the human responses to actual or potential health problems." Diagnosis and treatment of disease is a definition of the medical model.

The nurse is caring for a nurse who provided care to soldiers during the Vietnam War. What information in this patient's history should the nurse use to understand the patient's nursing career? 1. The patient was still a student when serving in the war. 2. The patient's first patient care experiences were during a time of war. 3. The patient decided to leave the profession after serving in the war. 4. The patient contracted long-term illnesses from being overseas in a war.

Answer: 2 Rationale: During the Vietnam War, approximately 11,000 American military women stationed in Vietnam were nurses. Most of them volunteered to go to Vietnam right after they graduated from nursing school, making them the youngest group of medical personnel ever to serve in wartime.

The nurse has been asked to participate on the hospital's Shared Governance Committee. To which nurse leader should the nurse attribute the ability for nurses to control the profession? 1. Mary Breckinridge 2. Lavinia Dock 3. Margaret Higgins Sanger 4. Virginia Henderson

Answer: 2 Rationale: Lavinia Dock was a feminist, writer, and activist. She participated in protest movements for women's rights that resulted in passage of the 19th Amendment, which allowed women the right to vote. In addition, Dock campaigned for legislation to allow nurses, rather than physicians, to control their profession

The manager identifies that a nurse is practicing professionalism. What did the manager observe to come to this conclusion? 1. Recognizing characteristics considered to be professional 2. Maintaining specific character and spirit 3. Learning about the influences of Florence Nightingale 4. Promising to uphold the standards of the profession

Answer: 2 Rationale: Professionalism refers to professional character, spirit, or methods. It is a set of attributes and a way of life that implies responsibility and commitment. Florence Nightingale influenced nursing professionalism a great deal, but simply learning about her influence does not constitute professionalism because professionalism refers to a way of life. Professionalization is the process of becoming professional, which is acquiring characteristics considered to be professional and upholding the standards of a profession.

The student nurse contacts a number of other students to create a study group. What behavior is the student nurse demonstrating? 1. Governance 2. Socialization 3. Service orientation 4. Specialized education

Answer: 2 Rationale: Socialization involves learning to behave, feel, and see the world in a manner similar to other persons occupying the same role. The goal is to instill in others the norms, values, attitudes, and behaviors deemed essential. One of the most powerful mechanisms of professional socialization is interacting with fellow students and becoming bound together by feelings of mutual cooperation, support, and solidarity.

A high school graduate is considering entering a nursing program that offers a baccalaureate degree. What organization accreditation should the nurse use to help select a nursing program? 1. NLN (National League for Nursing) 2. CCNE (Commission on Collegiate Nursing Education) 3. NCLEX® (National Council Licensure Examination) 4. NCSBN (National Council of State Boards of Nursing)

Answer: 2 Rationale: The CCNE accredits baccalaureate- and graduate-degree nursing programs. The NLN accredits nursing programs at all levels, including LVN and LPN. Both of these offer voluntary accreditation. The NCLEX® is the licensure examination administered by each state, and the NCSBN is the council to which all state boards of nursing belong.

The nurse is consulting other professionals as well as educating, supporting, and managing a client's chemotherapy regimen. In which role is this nurse functioning? 1. Nurse practitioner 2. Clinical nurse specialist 3. Nurse educator 4. Nurse entrepreneur

Answer: 2 Rationale: A clinical nurse specialist has an advanced degree or expertise and is considered to be an expert in a specialized area of practice (oncology in this case). The nurse provides direct client care, educates others, consults, conducts research, and manages care. A nurse practitioner has an advanced education, is a graduate of a nurse practitioner program, and usually deals with nonemergency acute or chronic illness and provides primary ambulatory care. The nurse educator is responsible for classroom and often clinical teaching. A nurse entrepreneur usually has an advanced degree, manages a health-related business, and may be involved in education, consultation, or research.

The nurse is caring for several acutely ill patients. What nursing action demonstrates professional autonomy? 1. Delivering medications and prescribed treatments in a timely manner 2. Prioritizing client according to client needs 3. Communicating with peers when help is needed 4. Informing the supervisor about high acuity level and staff-to-client ratio

Answer: 2 Rationale: Autonomy in nursing means independence at work, responsibility, and accountability for one's actions. Making decisions about which client requires care according to needs is an example of autonomy. Carrying out physician orders would be an example of nursing care, but not independence. Communication is important in any profession, as is making concerns known to supervisors, but these are not examples of controlling activity—a hallmark of autonomy.

The nurse is reviewing historic events in nursing for a presentation to be provided to new nursing students. In which chronological order should the nurse present these events? Begin with the earliest (1) and end with the most recent (5). Standard Text: Click and drag the options below to move them up or down. Choice 1. The Order of Deaconesses opens a small hospital in Kaiserswerth, Germany. Choice 2. The Knights of St. Lazarus dedicate themselves to the care of people with leprosy, syphilis, and chronic skin conditions. Choice 3. Harriet Tubman provides care to slaves fleeing on the Underground Railroad. Choice 4. The Cadet Nurse Corps is established. Choice 5. Florence Nightingale administers to soldiers during the Crimean War.

Answer: 2, 1, 5, 3, 4 Rationale 1: In 1836, Theodore Fliedner reinstituted the Order of Deaconesses and opened a small hospital and training school in Kaiserswerth, Germany, where Florence Nightingale received her training. Rationale 2: Religion played a significant role in the development of nursing. The crusades saw the formation of several orders of knights who provided care to the sick and injured, including the Knights of St. Lazarus. Rationale 3: During the American Civil War (1861-1865), Harriet Tubman (among other nurses) administered to the care of slaves and injured soldiers. Rationale 4: World War II casualties created an acute shortage of care, and the Cadet Nurse Corps was established in response to the shortage of nurses. Rationale 5: During the Crimean War (1854-1856), Ms. Nightingale administered to the solders following a request by Sir Sidney Herbert of the British War Department.

The student nurse is reviewing the code of ethics prior to beginning a clinical assignment. On what areas should the nurse focus when providing client care? Standard Text: Select all that apply. 1. Support lifelong learning. 2. Ensure the safety of all clients. 3. Maintain client confidentiality. 4. Provide care in a professional manner. 5. Collaborate with students and faculty.

Answer: 2, 3, 4 Rationale 2: When providing care, the student nurse should focus on client safety. Rationale 3: When providing care, the student nurse should focus on client confidentiality. Rationale 4: When providing care, the student should ensure professionalism.

A seasoned nurse is a mentor for a new graduate. Which of the standards of professional performance is the seasoned nurse practicing? 1. Collaboration 2. Leadership 3. Collegiality 4. Evaluation

Answer: 3 Rationale: Collegiality describes interaction with and contributions to the professional development of peers and colleagues, which is what a mentoring relationship would involve. Collaboration involves working with the client, the family, and others in the conduct of nursing practice. Leadership provides direction in a professional practice setting, and evaluation involves a comparison between one's own nursing practice and professional practice standards.

The nurse is offering free occult blood screening at a community health fair. Which level of practice is the nurse providing? 1. Promoting health and wellness 2. Illness prevention 3. Restoring health 4. Rehabilitation

Answer: 3 Rationale: Restoring health focuses on the ill client, and it extends from early detection (such as checking for occult blood in feces) through helping the client during the recovery period. Health promotion and wellness activities enhance the quality of life and maximize personal potential. Rehabilitation is an activity of health restoration.

A staff nurse is serving as a preceptor for nursing students. In which level of Benner's proficiency is this nurse practicing? 1. Stage II 2. Stage III 3. Stage IV 4. Stage V

Answer: 3 Rationale: Stage IV is a proficiency stage. The person has 3 to 5 years of experience and has a holistic understanding of the client, which improves decision making and focuses on long-term goals. Stage II is advanced beginner. The person demonstrates marginally acceptable performance. Stage III is competent. The nurse has 2 or 3 years of experience and demonstrates organizational/planning abilities. Stage V is considered expert. Performance is fluid, flexible, and highly proficient. The expert nurse no longer requires rules, guidelines, or maxims to connect an understanding of the situation to appropriate action. This person has highly intuitive and analytic abilities in new situations.

A faculty member is speaking to prospective students interested in enrolling in the BSN program at the university. What should the faculty member emphasize as a major incentive for students to select a BSN program over an ADN program? 1. Ability to work in critical care areas 2. Easier transition to graduate school 3. Better opportunity for career advancement 4. Liberal arts education

Answer: 3 Rationale: The nurse who holds a baccalaureate degree enjoys greater autonomy, responsibility, participation in institutional decision making, and career advancement.

A nurse is considering additional education to become a nurse researcher. To prepare for this role the nurse is reviewing the evolution of research in nursing. In which order should the nurse review this information? Put these events in chronological order, starting with the earliest (1) and proceeding to the most recent (4): Standard Text: Click and drag the options below to move them up or down. Choice 1. Centers for nursing research established Choice 2. Research focused on the study of nursing education Choice 3. Early stage of development Choice 4. Studies focused on the knowledge behind nursing practice Choice 5. Research focused on practice-related issues

Answer: 3, 1, 2, 4, 5 Rationale 1: Increasing research in nursing is contributing to nursing practice. In the 1940s, nursing research was at a very early stage of development. In the 1950s, increased federal funding and professional support helped establish centers for nursing research. Most early research was directed at the study of nursing education. In the 1960s, studies were often related to the nature of the knowledge base underlying nursing practice. Since the 1970s, nursing research has focused on practice-related issues. Rationale 2: Increasing research in nursing is contributing to nursing practice. In the 1940s, nursing research was at a very early stage of development. In the 1950s, increased federal funding and professional support helped establish centers for nursing research. Most early research was directed at the study of nursing education. In the 1960s, studies were often related to the nature of the knowledge base underlying nursing practice. Since the 1970s, nursing research has focused on practice-related issues. Rationale 3: Increasing research in nursing is contributing to nursing practice. In the 1940s, nursing research was at a very early stage of development. In the 1950s, increased federal funding and professional support helped establish centers for nursing research. Most early research was directed at the study of nursing education. In the 1960s, studies were often related to the nature of the knowledge base underlying nursing practice. Since the 1970s, nursing research has focused on practice-related issues. Rationale 4: Increasing research in nursing is contributing to nursing practice. In the 1940s, nursing research was at a very early stage of development. In the 1950s, increased federal funding and professional support helped establish centers for nursing research. Most early research was directed at the study of nursing education. In the 1960s, studies were often related to the nature of the knowledge base underlying nursing practice. Since the 1970s, nursing research has focused on practice-related issues. Rationale 5: Increasing research in nursing is contributing to nursing practice. In the 1940s, nursing research was at a very early stage of development. In the 1950s, increased federal funding and professional support helped establish centers for nursing research. Most early research was directed at the study of nursing education. In the 1960s, studies were often related to the nature of the knowledge base underlying nursing practice. Since the 1970s, nursing research has focused on practice-related issues.

The nurse practitioner is working with a staff nurse to change the plan of care for a client with a terminal illness. In which areas of nursing practice are these nurses functioning? 1. Promoting health and wellness 2. Preventing illness 3. Restoring health 4. Caring for the dying

Answer: 4 Rationale: Caring for the dying involves comforting and caring for people of all ages who are dying. It includes helping clients be as comfortable as possible until death and helping support persons cope with death.

The nurse is reviewing public health and health promotion roles for available for nurses. To which leader should the nurse attribute the development of these roles? 1. Clara Barton 2. Lillian Wald 3. Mary Brewster 4. Florence Nightingale

Answer: 4 Rationale: Florence Nightingale's vision of nursing included public health and health promotion roles for nurses, but it was only partly addressed in the early days of nursing. Her focus tended to be on developing the profession within the hospitals. Clara Barton is noted for establishing the American Red Cross. She persuaded Congress to ratify the Treaty of Geneva in 1882 so that the Red Cross could perform humanitarian efforts in times of peace. Lillian Wald is considered the founder of public health nursing. She and Mary Brewster were the first to offer trained nursing services to the poor in the New York slums and developed the Visiting Nurse Service, along with the Henry Street Settlement.

The nurse has starting working in a state other than the one in which the nursing education program was located. Which of the following should the nurse consult in order to understand the implications of this change of venue? 1. American Nurses Association (ANA) 2. National League for Nursing (NLN) 3. National Council of State Boards of Nursing (NCSBN) 4. Nurse State Practice Act

Answer: 4 Rationale: Nurse practice acts regulate the practice of nursing in the United States and Canada. Each state and each province has its own act. Nurses are responsible for knowing their state's nurse practice act, as it governs their practice. The ANA is the professional organization of nursing, the NLN is responsible for accrediting schools of nursing, and the NCSBN handles licensure of professional nurses

The community health nurse is caring for teenage mothers and their children. For what should the nurse assess these patients when determining their degree of vulnerability? 1. Distance separation from their nuclear families 2. Increased levels of poverty 3. Raising children without the support of family 4. The normal difficulties of adolescence

Answer: 4 Rationale: Teenage mothers have the normal needs of teenagers as well as those of new mothers, with motherhood compounding the difficulties of adolescence. Although many teenage mothers are raising children alone, without the support of the baby's father or perhaps their own families, and many live in poverty, all are vulnerable because of their age.

The nurse is creating a community education program on health promotion and wellness. Which topic should the nurse use for this program? 1. Prenatal and infant care 2. Prevention of sexually transmitted disease 3. Exercise class for clients who have had a stroke 4. Home accident prevention

Answer: 4 Rationale: Wellness is a process that engages in activities and behaviors that enhance quality of life and maximize personal potential. This involves individual and community activities to enhance healthy lifestyles, such as improving nutrition and physical fitness, preventing drug and alcohol misuse, restricting smoking, and preventing accidents in the home and workplace. The goal of illness prevention is to maintain optimal health by preventing disease, which would include immunization, prenatal and infant care, and prevention of sexually transmitted disease. Teaching clients about recovery activities, such as exercises that accelerate recovery after a stroke, would focus on health restoration.