PrepU Quizzes Post Midterm

In what way can a nurse differentiate strong research from poor research? a) By conducting the research b) Through the nurse's own informal investigation c) By critiquing the study d) Through author dialogue

By critiquing the study Correct Explanation: Nurses must have a working knowledge of research methods, and a beginning ability to read for application and to critique research.

The quality of nursing care is a major factor in reaching patient outcomes. Medicare has published a list of preventable errors for which hospitals will no longer be reimbursed. Which scenario describes an in-hospital situation for which the care is not reimbursed? a) A cancer patient receiving multiple and repeated IV injections of medications who develops signs of infection from the central venous line. b) A patient recovering from coronary artery bypass graft surgery who develops post-operative bleeding. c) A patient who returns from the operating room with a urinary catheter, abdominal dressing, and anti-embolism stockings. On the third post-operative day, the patient develops urinary retention and the catheter is reinserted. The urine culture and sensitivity results are negative. d) An elderly client admitted for debridement and grafting of a leg ulcer.

A cancer patient receiving multiple and repeated IV injections of medications who develops signs of infection from the central venous line. Correct Explanation: Non-reimbursed preventable errors include infections of vascular lines. The other situations do not describe non-reimbursable and preventable errors such as pressure ulcers, injuries from falls, infections form indwelling urinary catheters, infections of the mediastinum after coronary bypass graft surgery, reactions from incompatible blood, or sponges/instruments left inside a patient

After many years of advanced practice nursing, a nurse has recently enrolled in a nurse practitioner program. This nurse has been attracted to the program by the potential to provide primary care for clients after graduation, an opportunity that is most likely to exist in which of the following settings? a) A university hospital b) A rural health center c) A long-term care facility d) A community hospital

A rural health center Correct Explanation: Many rural health centers employ few health care providers, and primary care is often provided by a nurse practitioner (NP). A nurse practitioner may provide care in a long-term care facility or hospital, but in these settings, the NP is less likely to be the provider of primary care to clients.

A nursing student is reading a research article from a nursing journal. The student is aware that the opening paragraph summarizing the article (and the findings of the research) is a good place to start. What part of the article is the nursing student reading? a) Review of the literature b) Abstract c) Conclusions d) Results

Abstract Correct Explanation: The abstract is located at the beginning of the article, and it summarizes the entire article and usually provides the purpose of the study, a description of the subjects, data collection and data analysis, and a summary of important findings. The review of literature discusses relevant studies that have been conducted in the area of this study, and it is included in the introduction. The results are the findings of the study and are often presented both in words and charts, tables, or graphs. The conclusions are the discussions of the results and suggestions for further study.

Which of the following factors is the primary criterion for eligibility in the federally funded Medicare program? a) Lack of enrollment in a group health plan b) Diagnosis with more than one chronic health condition c) Age greater than 65 d) Low income

Age greater than 65 Correct Explanation: Medicare is available to those over age 65 and to those under 65 who are disabled or who require dialysis. Many recipients have multiple chronic health problems, a low income, or are not enrolled in a group health plan; however, these factors do not determine eligibility.

A nurse in a walk-in health care setting provides technical services (e.g., administering medications), determines the priority of care needs, and provides client teaching on all aspects of care. Which of the following terms best describes this type of health care setting? a) Ambulatory center b) Hospital c) Long-term care d) Physician's office

Ambulatory center Correct Explanation: Nurses in ambulatory care centers (walk-in clinics) provide technical services (e.g., administering medications), determine the priority of care needs, and provide teaching about all aspects of care. Nurses employed in hospitals have many roles, including manager of other members of the health care team providing client care, administrator, nurse practitioner, clinical nurse specialist, patient educator, in-service educator, and researcher. In physician's offices, advanced practice registered nurses (APRNs), nurse practitioners, midwives, or clinical nurse specialists work independently or collaboratively with physicians to make assessments and care for clients who require health maintenance or health promotion activities. Long-term care provides medical and nonmedical care for people with chronic illnesses or disabilities.

What nursing organization first legitimized the use of the nursing process? a) State Board of Nursing b) National League for Nursing c) International Council of Nursing d) American Nurses Association

American Nurses Association Correct Explanation: Although the term "nursing process" was first used by Lydia Hall in 1955 and nursing theorists delineated specific steps in a process approach to nursing, use of the nursing process was legitimized in 1973, when the American Nurses Association's Congress for Nursing Practice developed Standards of Practice to guide nursing performance.

A client comes to the emergency department complaining of severe chest pain. The nurse asks the client questions and takes vital signs. Which step of the nursing process is the nurse demonstrating? a) Assessing b) Diagnosing c) Planning d) Implementing

Assessing Correct Explanation: Assessing is the step in which nurses assess the client to determine the need for nursing care. When assessing, the nurse systematically collects client data.

The home care nurse asks the client and family about their socioeconomic status, culture, and beliefs. This occurs during which phase of care? a) Assessment b) Implementation c) Outcome criteria d) Nursing diagnosis

Assessment Correct Explanation: During the assessment phase of a home care visit, the nurse collects subjective information on how the person normally manages at home, what the home is like, and what family and community support is available. The nurse explores the client's beliefs and culture, competencies, capabilities, concerns, deficits, and limitations to understand how the client manages at home and what she or he desires. Nursing diagnosis, outcome criteria, and implementation occur later in the nursing process as a result of assessment data.

Then nurse is making morning rounds after receiving reports on clients. The nurse takes the opportunity to greet the clients and do an initial observation. The nurse is actually accomplishing which step of the nursing process? a) Planning b) Implementation c) Assessment d) Evaluation

Assessment Correct Explanation: The nursing process is a systematic method used by the nurse and client. Assessment is the first step to determine the needs for client care.

Nurses make decisions in their practice every day. Which of the following are potential errors in this decision-making process? Select all that apply. a) Avoiding information contrary to one's opinion b) Being predisposed to multiple solutions c) Placing emphasis on the last data received d) Prioritizing problems in order of importance e) Selecting alternatives to maintain status quo

Avoiding information contrary to one's opinion • Selecting alternatives to maintain status quo Correct Explanation: Potential errors in decision making include bias: placing emphasis on the first data received, avoiding information contrary to one's opinion, selecting alternatives to maintain status quo, and being predisposed to a single solution. Failure to prioritize problems in order of importance is failure to consider the total situation. Failure to use appropriate resources is impatience. All these actions can lead to errors in decision making (Lipe & Beasley, 2004.)

Which ethical principle refers to the obligation to do good? a) Nonmaleficence b) Fidelity c) Veracity d) Beneficence

Beneficence Correct Explanation: Beneficence is the duty to do good and the active promotion of benevolent acts. Fidelity refers to the duty to be faithful to one's commitments. Veracity is the obligation to tell the truth. Nonmaleficence is the duty not to inflict, as well as to prevent and remove, harm; it is more binding than beneficence.

A nurse is caring for a woman 28 years of age who has delivered a baby by Cesarean section. She describes her pain as a 9. The nurse medicates her for pain. This is an example of which of the following ethical frameworks? a) Beneficence b) Nonmaleficence c) Fidelity d) Justice

Beneficence Correct Explanation: Beneficence means doing or promoting good. The treatment of the client's pain is the nurse's act of doing good.

Nursing practice is based on different models of care, each aiming to enhance the effectiveness of nursing care. In which of the following models of care does the nurse coordinate many resources to maximize the opportunity for people to manage their own healthcare at home? a) Case management b) Functional care model c) Hospital management d) Nursing administration

Case management Correct Explanation: In case management, the nurses coordinate many resources to maximize the opportunity for people to manage their own healthcare at home. The nurses make decisions specific to each individual client to promote independence for as long as possible. In a functional model of care, each nurse is assigned a specific task to perform and the head nurse is responsible for making decisions. Hospital management is a vast field involving all aspects of care. Nursing administration involves managing the nursing resources according to the policies of the healthcare facility.

The client with end-stage cancer wishes to use hospice services and die at home. The client's family wants everything done for the client and are trying to convince the client to go to the hospital. The home health nurse speaks with the family about the client's wishes. Which role is the home health nurse fulfilling? a) Caregiver b) Client advocate c) Family educator d) Coordinator of services

Client advocate Correct Explanation: The home health nurse is being a client advocate by supporting the client's rights to choose to die at home.

A nurse provides client care within a philosophy of ethical decision making and professional expectations. What is the nurse using as a framework for practice? a) Standards of Care b) Values Clarification c) Definition of Nursing d) Code of Ethics

Code of Ethics Correct Explanation: A professional code of ethics provides a framework for making ethical decisions and sets forth professional expectations. Codes of ethics inform both nurses and society of the primary goals and values of the profession.

Nurses who are employed in home care have a variety of responsibilities. Which of the following is one of those responsibilities? a) Provide all care and services b) Collaborate with other care providers c) Advise clients on financial matters d) Maintain a clean home environment

Collaborate with other care providers Correct Explanation: Nurses who provide care in the home make assessments, provide physical care, administer medications, teach, and support family members. They also collaborate with other health care providers in providing care and services. Home care nurses do not provide all care and services, maintain a clean home environment, or advise clients on financial matters.

A nurse is working in a public school as the school nurse. This nurse is considered to be working in which role? a) Ambulatory care b) Rehabilitation facility c) Community health d) Inpatient facility

Community health Correct Explanation: A nursing employed as a school nurse is considered to working in community-based care.

When the nurse researcher informs the participant that his or her identity will not be linked with the information that is collected, the researcher is ensuring the participant's a) Confidentiality b) Anonymity c) Protection from harm d) Ability to withdraw

Confidentiality Correct Explanation: Confidentiality ensures that the subjects' identities will not be linked with the information they provide and will not be publicly divulged.

Information is collected for analysis in both quantitative and qualitative research. What is the information called? a) Data b) Interviews c) Surveys d) Answers

Data Correct Explanation: Data are information the researcher collects from subjects in the study. Data are collected through answers on instruments (such as surveys, rating scales, or biologic measurements) or verbal interviews.

Which of the following is a responsibility of an institutional review board (IRB)? a) Secure funding for institutional research b) Review written accuracy of research proposals c) Secure informed consent for researchers d) Determine risk status of all studies

Determine risk status of all studies Explanation: Federal regulations require that institutions receiving federal funding, or conducting studies of drugs or medical devices regulated by the Food and Drug Administration establish IRBs. The IRB reviews all studies conducted in the institution to determine risk status and to ensure that ethical principles are followed. The IRB does not secure informed consent, review the accuracy of proposals, or secure funding.

Which step of the nursing process is the nurse performing when analyzing client data to identify client strengths and health problems that independent nursing interventions can prevent or resolve? a) Diagnosing b) Assessing c) Implementing d) Evaluating

Diagnosing Correct Explanation: Analysis of client data to identify client strengths and health problems that independent nursing interventions can prevent or resolve is a function of the diagnosis step of the nursing process. Assessing involves collection, validation, and communication of client data. Implementation is carrying out the plan of care. Evaluating is measuring the extent to which the client has achieved the outcomes specified in the plan of care.

A nurse is making a visit to a client in the home. As a home health care nurse you may be expected to accomplish which of the following? a) Complete an assessment on each visit. b) Administer treatments and medications. c) Provide support to the client and family. d) Communicate and collaborate with other members of the health team. e) Document actions regarding patient, activities, and progress.

Document actions regarding patient, activities, and progress. • Communicate and collaborate with other members of the health team. • Provide support to the client and family. • Complete an assessment on each visit. • Administer treatments and medications. Correct Explanation: All of the above. Home health care nurses may provide all of these activities in the home setting.

Which of the following are involved in the implementation step in the nursing process? a) Documenting the plan of care b) Selecting nursing interventions c) Identifying measurable outcomes d) Documenting the nursing care and client responses

Documenting the nursing care and client responses Explanation: The implementation step in the nursing process involves documenting the nursing care and client responses. Planning involves selecting nursing interventions, documenting the plan of care, and identifying measurable outcomes.

What population do hospice nurses provide with care? a) Those requiring care to improve health b) Dying persons and their loved ones c) Children with chronic illnesses d) Older adults requiring long-term care

Dying persons and their loved ones Correct Explanation: Hospice is a program of palliative and supportive services providing physical, psychological, social, and spiritual care for dying persons, their families, and other loved ones. Hospice nurses do not implement care to improve health, focus on children with chronic illnesses, or care for older adults in long-term care.

The growth in home health care is largely attributed to which of the following? a) The nursing shortage in hospitals b) Nurses' desire to work in the community c) The inability of hospitals to care for an increasing numbers of clients d) Early discharge of clients from the hospital setting

Early discharge of clients from the hospital setting Correct Explanation: Home health care is one of the most rapidly growing areas of the health care system. The prospective payment system of reimbursement encourages early discharge from the hospital and has created a new, acutely ill population that needs skilled nursing care at home.

You are assessing a new patient and their home environment. What is a responsibility that you, as a community-based nurse, have at this initial visit? a) Encourage the patient and their family to contact their church as a resource. b) Encourage the patient and their family to use local stores to support their community. c) Encourage the patient and their family to use the internet to find local resources. d) Encourage the patient and their family to contact appropriate community resources.

Encourage the patient and their family to contact appropriate community resources. Correct Explanation: During initial and subsequent home visits, the nurse helps the patient and family identify these community services and encourages them to contact the appropriate agencies. When appropriate, nurses may make the initial contact. The other answers are incorrect because a home-health nurse would not encourage the patient to support the community; they would not necessarily encourage the patient to use their church as a resource or to use the internet to find their own local resources. They would provide the patient with the applicable local resources.

A nurse has an elderly home care client who lives alone with no family nearby. On a recent visit, the nurse notices that his clothes are very loose, and he has difficulty letting the nurse leave when the visit is ending. After talking with him, the nurse learns that he has not been cooking for himself and he can't get to the grocery store easily. What service could the nurse suggest as an immediate response until a long-term plan can be formed? a) Have the social worker counsel him. b) Suggest he go to an assisted living facility. c) Enroll the client in Meals on Wheels. d) Refer him to the dietician.

Enroll the client in Meals on Wheels. Correct Explanation: The best option that can be arranged quickly is to enroll the client in Meals on Wheels, a voluntary agency. The other responses may be helpful in later planning for a long-term situation.

When looking at a model for evidence-based practice, what is the final step of the process? a) Formulating a clinical question b) Searching the literature c) Evaluating practice change d) Appraising evidence

Evaluating practice change Correct Explanation: The fifth and final step in the process of implementing evidence-based practice is to evaluate and critically appraise the change in practice. Formulating a clinical question and searching and appraising the literature precede this step.

Which phase of the nursing process enables the nurse to compare the actual outcomes with the expected outcomes? a) Implementation b) Planning c) Assessment d) Evaluation

Evaluation Correct Explanation: Evaluation is assessment and review of the quality and suitability of the care given, and the client's responses to that care. Assessment is careful observation and evaluation of a client's health status. Planning involves setting priorities, defining expected and desired outcomes (goals), determining specific nursing interventions, and recording the plan of care. Implementation means carrying out the written plan of care, performing interventions, monitoring the client's status, and assessing and reassessing the client before, during, and after treatments

Once the nurse has administered pain medication, it is the nurse's responsibility to determine its effect and any other results. When accomplishing this followup with the client, the nurse is utilizing which step of the nursing process? a) Implementation b) Evaluation c) Planning d) Assessment

Evaluation Correct Explanation: Evaluation is the step of the nursing process when the nurse evaluates the results of a nursing action. The nurse needs to determine if the client's pain has been relieved and monitor for any untoward effects.

Before developing a procedure, a nurse reviews all current research-based literature on insertion of a nasogastric tube. What type of nursing will be practiced based on this review? a) Factual-based nursing b) Authoritative nursing c) Institutional practice d) Evidence-based nursing

Evidence-based nursing Correct Explanation: Evidence-based nursing practice (EBNP) is the conscientious, explicit, and judicious use of research-based information in making decisions about the delivery of care. EBNP does not include institutional practice, authoritative nursing, or factual-based nursing.

The nurse understands that research has demonstrated that a common source of hospital-acquired infections in clients with IV infusions is the hub on the IV tubing. Which Quality and Safety Education for Nurses (QSEN) competency is displayed when health care institutions recommend that health care providers always wash hands and wear gloves when accessing the hubs of IV tubing? a) Person-centered care b) Informatics c) Evidence-based practice d) Teamwork and collaboration

Evidence-based practice Correct Explanation: Evidence-based practice as defined by QSEN indicates the need to value evidence-based practice findings to ensure the best clinical practice is provided for clients. When health care institutions change their policies based on research, this is reflective of the significance of this QSEN competency.

A nurse researcher is examining the cause-and-effect relationship between the consumption of tap water containing minimal amounts of bleach, and the incidence of cancer in rats. The research is taking place in a laboratory setting. What type of quantitative research is being used based upon this description? a) Descriptive research b) Quasi-experimental research c) Experimental research d) Correlational research

Experimental research Correct Explanation: Experimental research examines the cause-and-effect relationships between variables under highly controlled conditions. Experimental research studies often occur in a laboratory setting. Descriptive research explores and describes events in a real-life situation to identify relationships between, and among, events. Correlational research examines the type and degree of relationships between two or more variables. Quasi-experimental research examines the cause-and-effect relationships between selected variables and is typically situated outside of a laboratory setting.

A nurse states to the client that she will keep her free of pain. However, her family wishes to try a treatment to prolong her life that may necessitate withholding pain medication. This factor will cause an ethical dilemma for the nurse in relation to which ethical principle? a) Autonomy b) Veracity c) Fidelity d) Justice

Fidelity Correct Explanation: Fidelity means being faithful to one's commitments and promises.

One of the primary focuses of nursing research is to do what? a) Quantify outcomes related to patients b) Prevent further disease and death c) Determine outcomes for patients d) Generate knowledge to guide practice

Generate knowledge to guide practice Correct Explanation: One of the major reasons for conducting research is to expand a profession's knowledge base.

A male client 79 years of age who is postoperative Day 3 following hip replacement surgery has been approached by a nurse researcher and asked to participate in a research study. This study will test a new rehabilitation strategy. What aspect of the nursing research process addresses the client's understanding of the potential risks and benefits of this study? a) Going through the informed consent process with the client b) Meeting with the hospital's institutional review board (IRB) c) Giving the client the opportunity to ask questions about the study d) Obtaining the client's signature on a permission document

Going through the informed consent process with the client Correct Explanation: Informed consent is a process in which the details of the study and the client's rights are explained and discussed in detail. This goes beyond simply obtaining the client's signature or allowing him to ask questions. Meeting with the IRB is a necessary step in the research process but this does not directly affect the client's understanding of risks and benefits.

What is the goal of nurses who provide home health care? a) Helping clients achieve maximum independence and health b) Minimizing the manifestations of disease processes c) Collaborating with other health care providers and services d) Encouraging clients' dependence on family members

Helping clients achieve maximum independence and health Correct Explanation: The essential components of home health care include the client, the family, and health care professionals from various disciplines. The goal of nursing care in the home is to help clients reach maximum independence and health. Although nurses collaborate with other health care providers, they do so to meet this goal. Home health care is not provided to minimize disease manifestations or to encourage clients' dependence on family members.

Nurse researchers have predicted that a newly created mentorship program will result in decreased absenteeism, increased retention, and decreased attrition among a hospital's nursing staff. Which of the following does this predicted relationship represent? a) Dependent variable b) Hypothesis c) Methodology d) Abstract

Hypothesis Correct Explanation: A hypothesis is an expected statement of the relationship between variables in a study. In this study, the dependent variables are absenteeism, retention, and attrition while the independent variable is the mentorship program. The methodology of a study is the logistical framework that guides the planning and execution of the study. An abstract is a summary of a research study published in a journal.

As you are completing your nursing rounds, you notice the patient has slumped down in bed. You assist him up in bed and settle him more comfortably, but he grimaces and tenses his body. You do a complete pain assessment, check the time of his last analgesic, and prepare the medication. As you give him the medication, you are accomplishing which step of the nursing process? a) Implementation b) Assessment c) Planning d) Evaluation

Implementation Correct Explanation: Implementation is the step of the nursing process that carries out the nursing care, administering medication to relieve the patient's pain.

When the nurse is administering Lasix 20 mg to a client in congestive heart failure, what phase of the nursing process does this represent? a) Assessment b) Implementation c) Evaluation d) Planning

Implementation Correct Explanation: Implementation refers to the action phase of the nursing process, in which nursing care is provided.

A nurse manager notes an increase in the frequency of client falls during the last month. To promote a positive working environment, how would the nurse manager most effectively deal with this problem? a) Reprimand the nursing personnel responsible for the clients when the falls occurred b) Determine if client falls have increased on other nursing units in the hospital c) Institute a new policy on the prevention of client falls on the unit d) Investigate the circumstances that contributed to client falls

Investigate the circumstances that contributed to client falls Correct Explanation: The most effective method to address the increased frequency of client falls and to promote a positive working environment would be to determine the circumstances that contributed to the clients' falls. Attempting to identify and reprimand individual nurses does not lead to an atmosphere of openness and honesty in determining the causes. Instituting a new policy to prevent falls is premature before identifying why the falls are occurring. It may be relevant later to determine if other nursing units are having the same problem, but it is not necessary at this time.

A nursing instructor is describing the nursing process to a class. Which of the following would the instructor include as a characteristic of the nursing process? a) It can be used in hospital settings. b) It is a framework for providing care. c) It involves general care for all clients. d) It is independent of other disciplines.

It is a framework for providing care. Correct Explanation: The nursing process is a framework for providing care. The process is not independent of other disciplines, but is interdependent with other disciplines such as medicine, physiotherapy, surgery, etc. The nursing process can be used in all settings and is not limited to hospital settings. The nursing process aims to provide specific care to clients based on individual needs.

Which of the following is a true statement regarding critical thinking in nursing? a) It is a systemic way of thinking b) It supplies validation for reimbursement c) It shows trend and patterns in client status d) It makes judgment based on conjecture

It is a systemic way of thinking Correct Explanation: Critical thinking is a systemic way of thinking that involves purposeful, outcome-directed thinking. Critical thinking makes judgment based on evidence rather than conjecture. Providing a foundation for evaluation and quality improvement and showing trends and patterns in client status are functions served by documentation.

A nurse working in a long-term care facility has an elderly male client who is very confused. What ethical dilemma is posed when using restraints in a long-term care setting? a) It increases confusion. b) It limits personal safety. c) It prevents self-directed care. d) It threatens autonomy.

It threatens autonomy. Correct Explanation: Because there are safety risks involved when using restraints on elderly confused clients, this is a common ethical problem in long-term care settings, as well as other health care settings. Restraints limit the individual's autonomy because they are perceived as imprisonment. Restraints should not limit personal safety. Often, restraints increase confusion, and they prevent self-directed care.

A student is conducting a literature review to identify a problem area for his research paper. Which of the following should the student remember when conducting a literature review? a) Indexes are rarely found on the Internet b) Books are a primary source for up-to-date informaton c) Abstracts provide detailed information about a topic d) Journal reference lists provide sources for original articles

Journal reference lists provide sources for original articles Correct Explanation: Bibliographies in books and reference lists in articles are valuable because they provide sources for original articles. Books provide overviews of topics or deal with a specific detailed topic but become dated almost as soon as they are published. The Internet is a source for hundreds of nursing sites with numerous online databases. Abstracts are not detailed but do provide a good starting point.

What is the ultimate goal of expanding nursing knowledge through nursing research? a) Learn improved ways to promote and maintain health. b) Become full-fledged partners with other care providers. c) Apply knowledge to become independent practitioners. d) Develop technology to provide hands-on nursing care.

Learn improved ways to promote and maintain health. Correct Explanation: The ultimate goal of expanding nursing's body of knowledge through nursing research is to learn improved ways to promote and maintain health. Ongoing practice-based research reflects the nursing profession's commitment to meet the ever-changing demands of health care consumers. While doing research also facilitates the development of technology, helps produce independent practitioners, and provides partnerships with other providers of care, those are not the ultimate goals of nursing research.

Which health care setting provides care with activities of daily living for people of any age who are physically or mentally unable to care for themselves independently? a) Rural health centers b) Long-term care facilities c) Ambulatory care centers d) Homeless shelters

Long-term care facilities Correct Explanation: Long-term care facilities provide health care and help with daily living for people of any age who are physically or mentally unable to care for themselves independently. This care may extend for periods ranging from days to years. Rural and ambulatory care centers provide primary care services, while homeless shelters provide housing for people who do not have regular shelter

The nurse caring for a client formulates client outcomes based on the understanding that the outcomes should be which of the following? a) Not bound to time b) Abstract in nature c) General in scope d) Measurable

Measurable Correct Explanation: The nurse should keep in mind that client outcomes should be measurable, realistic, time bound, and specific to the client. The outcomes are not general, but are specific to the client based on the individual client's problems. The outcomes are realistic and measurable, not abstract. The outcome establishes a definite time frame for achievement.

Which of the following health care insurance programs is most suitable for a client 68 years of age? a) Medicare b) AmeriCare c) Medicaid d) Capitation

Medicare Correct Explanation: Medicare is a federal program that finances health care costs of persons 65 years and older, permanently disabled workers of any age and their dependents, and those with end-stage renal disease. The system is funded primarily through withholdings from an employed person's income. Capitation is a reimbursement strategy in managed care organizations. AmeriCare is a type of private insurance. Capitation and AmeriCare are not the preferred providers for the client, considering the client's old age. Medicaid is a federal program that is operated by the states, and each state decides who is eligible and the scope of health services offered. In Medicaid, eligibility may be decided by the state, which is not the case in Medicare.

Which of the following is the largest single source of reimbursement for home health care services? a) Medicaid b) Client's self-pay c) Private insurance d) Medicare

Medicare Correct Explanation: Medicare is the largest single source of reimbursement for home health care services. Other sources of reimbursement may include Medicaid, private insurance, self-pay, and other public funding.

A student nurse is anticipating graduation and is aware of the changing nature of healthcare and nursing practice. Which of the following statements most accurately describes an aspect of contemporary nursing practice in the United States? a) Most nurses work in long-term care facilities. b) Most nurses now provide care in outpatient settings. c) Most nurses provide home healthcare. d) Most nurses are still employed in hospitals.

Most nurses are still employed in hospitals. Correct Explanation: While the percentage of nurses who are employed in hospitals is in decline, 59% of nurses are still employed in a hospital setting.

What is a systematic inquiry into the problems encountered in nursing practice and into the modalities of patient care? a) Nursing research b) Evidence-based practice c) Scientific inquiry d) Outcome criteria

Nursing research Correct Explanation: Nursing research is defined as a systematic inquiry into the problems encountered in nursing practice and into the modalities of patient care, such as support and comfort, prevention of trauma, promotion of recovery, health education, health appraisal, and coordination of healthcare. Evidence-based practice supports nursing care given to patients by emphasizing decision making based on the best available evidence and the use of outcome studies to guide decisions.

Nurses on the unit were reviewing results of the national study conducted by the American Association of Critical-Care Nurses (AACN). Which of the following statements is true of the findings from the study? a) Most physicians report that they confront colleagues regarding their concerns of compromised client care b) Most physicians and nurses have seen coworkers taking shortcuts that could be dangerous to patients c) Few physicians and nurses have seen clinical care providers showing poor clinical judgement. d) Health care providers who confront compromised client care find no change in unit behaviors.

Most physicians and nurses have seen coworkers taking shortcuts that could be dangerous to patients Correct Explanation: Most physicians and nurses have seen coworkers taking shortcuts that could be dangerous to patients (greater than 80% of physicians and greater than 60% of nurses). Most clinical care providers had seen poor judgement utilized by care providers, most physicians do not confront their colleagues but those that do find improved conditions in the facilities.

Which of the following groups developed standard language to increase the visibility of nursing's contribution to client care by continuing to develop, refine, and classify phenomena of concern to nurses? a) NIC b) NOC c) NANDA d) HHCC (now CCC)

NANDA Correct Explanation: The North American Nursing Diagnosis Association (NANDA) International increased the visibility of nursing's contribution to client care by continuing to develop, refine, and classify phenomena of concern to nurses. The Nursing Interventions Classification (NIC) works to identify, label, validate, and classify actions nurses perform, including direct and indirect care interventions. The Nursing-Sensitive Outcomes Classification (NOC) identifies, validates, and classifies nursing-sensitive client outcomes and indicators to evaluate the validity and usefulness of the classification. Home Health Care Classification (HHCC, now known as Clinical Care Classification (CCC) system) provides a structure for documenting and classifying home health and ambulatory care.

A home health nurse who performs a careful safety assessment of the home of a frail elderly patient to prevent harm to the patient is acting in accord with which of the following, a principle of bioethics? a) Values b) Nonmaleficence c) Morals d) Advocacy

Nonmaleficence Correct Explanation: Nonmaleficence is a principle of bioethics and is defined as the obligation to prevent harm. Advocacy, morals, and values are not principles of bioethics.

A healthcare team consists of members from all disciplines of healthcare. Which of the following healthcare professionals physically assess clients, consult with various team members, design plans of care, and implement interventions? a) Physicians b) Physical therapists c) Nurses d) Social workers

Nurses Correct Explanation: Nurses are the healthcare professionals who physically assess clients, consult with various team members, design plans of care, and implement plans. Physicians are responsible for advising treatment of the client. Social workers work for a social cause. Physical therapists are responsible for instituting physical therapy when referred by the physician or the nurse.

The nursing staff on a hospital unit are using peer review to improve professional performance. Who performs the review? a) Visitors b) Clients c) Nurses d) Unit manager

Nurses Correct Explanation: Peer review is the evaluation of one staff member by another staff member on the same level of the hierarchy of the organization. Peer review is not done by the unit manager, clients, or visitors.

What is the best explanation for the way evidence based practice (EBP) has changed the way nursing care is delivered? a) Nurses now have to take part in research. b) Nursing care now incorporates research studies into client care. c) Nurses now spend time looking up the best way to give nursing care. d) Nursing care now uses EBP as a means of ensuring quality care.

Nursing care now uses EBP as a means of ensuring quality care. Correct Explanation: The facilitation of EBP involves identifying and evaluating current literature and research, as well as incorporating the findings into client care as a means of ensuring quality care. The other answers are incorrect; they were used even before EBP became a major force in the delivery of nursing care

Staff nurses in an ICU setting have noticed that their patients required less interventions for pain when the ICU was quiet. They passed their observations on to a nurse researcher and asked the researcher to design a study about the effects of noise on the pain levels of hospitalized patients. How does this demonstrate the ultimate goal of expanding the nursing body of knowledge? a) Nursing research helps improve ways to promote and maintain health b) Nursing research involves patients in their care while hospitalized c) Nursing research draws conclusions about the quality of patient care d) Nursing research explains ongoing medical studies to patients and asks for participation

Nursing research helps improve ways to promote and maintain health Correct Explanation: Nursing research expands knowledge to learn improved ways to promote and maintain health. The other answers are incorrect because they are not the primary purpose of nursing research.

One step in implementing evidence-based practice is to ask a question about a clinical area of interest or an intervention. The most common method is the PICO format. Which of the following accurately defines the letters in the PICO acronym? a) O = output b) C = compromise c) P = population d) I = institution

P = population Correct Explanation: P = patient, population, or problem of interest, I = intervention of interest, C = comparison of interest, and O = outcome of interest

An elderly woman has total care of her husband, who suffers from debilitative rheumatoid arthritis. The couple voices concern over the pain and stress associated with the condition. What type of care might the nurse suggest to help the couple? a) Respite care b) Primary care c) Palliative care d) Bereavement care

Palliative care Correct Explanation: The goal of palliative care is relief from the symptoms, pain, and stress of a serious illness, and to improve the quality of life for both the client and the family. The main purpose of respite care is to give the primary caregiver some time away from the responsibilities of day-to-day care. Primary care is found in acute care settings and physicians' offices. Bereavement care is provided to families following the death of a family member.

The home healthcare nurse is providing information to a patient and family on medication changes. What role is the nurse performing? a) Caregiver b) Patient advocate c) Patient and family educator d) Coordinator of services

Patient and family educator Correct Explanation: Nurses providing home healthcare teach patients and families about all the aspects of care in the home, including the disease process or treatment, nutrition, medications, or treatment of care of wounds. As a caregiver, the nurse develops and implements a plan of care. As a patient advocate, the nurse protects and supports the rights of another person. As a coordinator of services, the nurse must use effective communication skills with other healthcare providers while coordinating services for the patient.

Which of the following principles underlies the ethical conduction of research in a hospital setting? a) Any interventions must be approved by the Food and Drug Administration (FDA). b) Patients must grant informed consent if they are to participate. c) Descriptive studies are more ethical than experimental studies. d) The patient must directly and personally benefit from the research.

Patients must grant informed consent if they are to participate. Correct Explanation: Informed consent is an absolute prerequisite for patients who are asked to participate as subjects in a research study. Many interventions in healthcare settings lie beyond the scope of the FDA. The risks and benefits of research are considered carefully in light of ethical principles, but this does not necessarily mean that every participant in a study stands to benefit from it. Ethical standards are applicable and achievable in every type of research, and descriptive studies are not necessarily more ethical than experiments.

A nursing instructor would like to study the effect peer tutoring has on student success. What is the independent variable? a) Nursing student b) Student success c) Peer tutoring d) Nursing education

Peer tutoring Correct Explanation: The independent variable is the presumed cause or influence on the dependent variable.

A home health nurse reviews the nursing care with the client and family and then mutually discusses the expected outcomes of the nursing care to be provided. Which step of the nursing process is the nurse illustrating? a) Diagnosing b) Implementing c) Evaluating d) Planning

Planning Correct Explanation: During the planning step, the nurse identifies expected outcomes of the plan of care. The plan of care should be holistic and individualized, specify desired client goals and related outcomes, and identify the nursing interventions most likely to meet those expected outcomes.

Which step of the nursing process involves setting long-term goals and short-term expectations? a) Implementation b) Planning c) Evaluation d) Assessment

Planning Correct Explanation: Planning involves setting priorities, defining expected (desired) outcomes (goals), determining specific nursing interventions, and recording the plan of care. Assessment is careful observation and evaluation of a client's health status. Implementation means carrying out the written plan of care, performing interventions, monitoring the client's status, and assessing and reassessing the client before, during, and after treatments. Evaluation is assessment and review of the quality and suitability of the care given and the client's responses to that care.

A person receiving health care insurance from his employer knows that he should check the approved list of contracted health care providers before seeking services, in order to receive them at a lower cost. What type of insurance is most likely involved? a) Medicaid b) Health maintenance organization c) Preferred provider organization d) Long-term care insurance

Preferred provider organization Correct Explanation: Preferred provider organizations (PPOs) allow a third-party payer (agencies that pay health care providers for services provided to individuals, such as a health insurance company) to contract with a group of health care providers to provide services at a lower fee in return for prompt payment and a guaranteed volume of clients and services. Although clients are encouraged to use specific providers, they may also seek care outside the panel without referral by paying additional out-of-pocket expenses.

In the 1980s, the nursing care delivery model shifted from a team nursing model to a a) Clinical specialist model b) Managed care model c) Modular care model d) Primary nursing model

Primary nursing model Correct Explanation: In primary nursing, registered nurses provide most of the client care.

The nurse researcher would like to gather data on the attitudes of young adults on spirituality and health care. What is the most effective form of research on this topic? a) A Delphi study b) Quantitative research c) Methodologic survey d) Qualitative research

Qualitative research Correct Explanation: Attitudes on spirituality and health care require the nurse to interview patients or informants to obtain qualitative research. Qualitative research involves the systematic collection and analysis of more subjective, narrative materials using procedures in which there tends to be a minimum of researcher-imposed control

Which of the following agencies has as its primary goal to "prepare nurses with the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of their healthcare systems"? a) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) b) American Association of Critical-Care Nurses (AACN) c) Quality and Safety Education for Nurses (QSEN) d) Peer review

Quality and Safety Education for Nurses (QSEN) Correct Explanation: The statement to prepare nurses with the KSAs necessary to continuously improve the quality and safety of their healthcare systems is the overall goal of QSEN. Peer review is a process by which one nurse evaluates the performance of another in an effort to improve their professional performance. AACN strives to provide safe work environments, and HCAHPS measures client satisfaction with health care.

The Joint Commission is conducting an accreditation visit at the hospital. What is the focus of the evaluation being conducted? a) Quality improvement b) Magnet status c) Quality assurance d) Peer review

Quality assurance Correct Explanation: Accreditation by the Joint Commission evaluates quality assurance. Quality assurance is an externally driven process, demonstrating nursing excellence by meeting professional standards of care. Quality improvement is an internally driven continuous process, focusing on the processes of client care. Peer review is a process whereby individual nurses improve their professional performance through the evaluation of one staff member by another staff member on the same level of the hierarchy. Magnet status is awarded by the American Nurses Credentialing Center, recognizing health care organizations for their excellence in nursing.

A nurse researcher is collecting nominal data. What type of research is being conducted? a) Quantitative research b) Experimental research c) Interval research d) Qualitative research

Quantitative research Correct Explanation: Quantitative research involves the systematic collection of numeric information. Nominal data is of a numeric nature.

Which of the following skills is foundational for a nursing student's participation in the evidence-based practice process? a) Become involved in evidence-based practice research. b) Read and understand a research article. c) Critically analyze research articles and the findings. d) Publish an article on evidence-based practice findings.

Read and understand a research article. Correct Explanation: The use of evidence-based research requires critical analysis and extensive, systematic reviews of research articles and findings. However, a beginning nursing student has not acquired the knowledge to complete that task nor to conduct and publish new research. The first stop for a student is to be able to read and understand a research article.

A client with a diagnosis of colorectal cancer has been presented with her treatment options, but wishes to defer any decisions to her uncle, who acts in the role of a family patriarch within the client's culture. By which of the following is the client's right to self-determination best protected? a) Revisiting the decision when the uncle is not present at the bedside b) Teaching the client about her right to autonomy c) Respecting the client's desire to have the uncle make choices on her behalf d) Holding a family meeting and encouraging the client to speak on her own behalf

Respecting the client's desire to have the uncle make choices on her behalf Correct Explanation: The right to self-determination (autonomy) means that it should never be forced on anyone. The client has the autonomous right to defer her decision-making to another individual if she freely chooses to do so.

As part of a class assignment, a beginning professional nursing student is to prepare a research paper. Which of the following would be most appropriate to do when identifying a problem area? a) Express a relationship between the operationalized concepts b) Identify a direction that the research project will take c) Analyze the results to confirm what the problem was d) Review scientific literature to develop a research idea

Review scientific literature to develop a research idea Correct Explanation: When identifying a problem area, the student may review scientific literature to develop a research idea. When formulating the problem statement, not when identifying the problem area, the student can identify a direction that the research project will take and express a relationship between the operationalized concepts. An analysis of the results is not done during problem area identification. It is done when the results of the research are available.

The shift to community health nursing is due in part to which of the following factors? a) Increased need for health team members b) Decreased accessibility to healthcare c) The psychosocial needs of clients d) Rising healthcare costs

Rising healthcare costs Correct Explanation: The shift to community-based care is related to "rising consumerism," or the public's desire to participate actively in healthcare decisions, issues, and choices

A client has just been admitted to the clinical unit. The nurse is providing her with the expectations she may have of the health care she will receive. She is told that she will not be harmed by any errors that might be made and she can expect to be safe in the facility. This assurance represents which expectation of the health care environment? a) Safety b) Individualization c) Control d) Transparency

Safety Correct Explanation: Safety is represented by the expectation that the client won't be harmed by any errors and they will be safe in the facility. The other choices represent expectations of the health care environment but do not define safety.

A nurse is caring for a client in the ER who was injured in a snowmobile accident. The nurse documents the following client data: uncontrollable shivering, weakness, pale and cold skin. Th nurse suspects the client is experiencing hypothermia. Upon further assessment, the nurse notes a heart rate of 53 BPM and core internal temperature of 90°F, which confirms the initial diagnosis. The nurse then devises a plan of care and continues to monitor the client to evaluate the outcomes. This nurse is using which of the following types of problem solving in her care of this client? a) Intuitive b) Critical thinking c) Scientific d) Trial-and-error

Scientific Explanation: Scientific problem solving is a systematic, seven-step, problem-solving process that involves (1) problem identification, (2) data collection, (3) hypothesis formulation, (4) plan of action, (5) hypothesis testing, (6) interpretation of results, and (7) evaluation, resulting in conclusion or revision of the study. This method is used most correctly in a controlled laboratory setting but is closely related to the more general problem-solving processes commonly used by health care professionals as they work with clients, such as the nursing process.

After reviewing several research articles, the clinical nurse specialist on a medical surgical unit rewrites the procedure on assessing placement of a nasogastric tube. What source of nursing knowledge did the nurse use in this situation? a) Authoritative knowledge b) Scientific knowledge c) Philosophical knowledge d) Traditional knowledge

Scientific knowledge Correct Explanation: The clinical nurse specialist utilized scientific knowledge, which is gained through the research-based scientific method. Philosophical knowledge is not a source of nursing knowledge, but is a type of general knowledge. Authoritative knowledge comes from an expert and is accepted as truth based upon the person's perceived expertise. Traditional knowledge is that part of nursing practice passed down from generation to generation and is not based upon scientific inquiry.

After completing an assessment of a client, the nurse uses critical thinking and clinical reasoning to prioritize the client's problems. Which of the following would the nurse determine is the highest priority? a) History of asthma b) Diabetes c) Severe bleeding from a wound d) Lack of family support

Severe bleeding from a wound Correct Explanation: The client's problem is considered to be of high priority if it is life threatening, requires more intervention time, and has serious consequences. The severe bleeding from a wound would be the highest priority. The client's history of asthma, diabetes, and lack of family support may be important but the bleeding is the priority.

Hospice nurses provide care in a variety of settings, including clients' homes, long-term-care facilities, and hospice residences. After the client dies, what happens next? a) Nurses assist the family to work through their grief during the period of mourning. b) The hospice services continue for family and friends during the bereavement period, up to one month after the death. c) The hospice nurse continues to care for the client's family for up to one year. d) The hospice services are provided to the families of the former residence clients only.

The hospice nurse continues to care for the client's family for up to one year. Explanation: After the death of the patient, the hospice nurse continues to care for the client's family during the bereavement period for up to one year. Nurses help the family to work through their loss.

Which nurse is using criteria to determine expected standards of performance? a) The nurse seeks information from the unlicensed nursing personnel regarding the family's response to the nurse's education. b) The nurse manager provides the staff nurse feedback regarding job performance for the previous year. c) The nurse preceptor provides feedback to the new graduate nurse after six weeks of orientation. d) The new graduate nurse consults the policies and procedures of the institution prior to skill implementation.

The new graduate nurse consults the policies and procedures of the institution prior to skill implementation. Correct Explanation: Standards are the levels of performance accepted and expected by the nursing staff and other health team members, such as institutional policies and procedures. The nurse preceptor providing feedback to the new graduate nurse after six weeks of orientation is an example of peer review. The nurse manager providing the staff nurse feedback regarding job performance for the previous year is typical of an annual employee review.

A group of nurse researchers has proposed a study to examine the efficacy of a new wound care product. Which of the following aspects of the methodology demonstrates that the nurses are attempting to maintain the ethical principle of nonmaleficence? a) The nurses have completed a literature review that suggests the new treatment may result in decreased wound healing time. b) The nurses have given multiple opportunities for potential participants to ask questions, and have been following the informed consent process systematically. c) The nurses have organized the study in such a way that the foreseeable risks and benefits are distributed as fairly as possible. d) The nurses are taking every reasonable measure to ensure that no participants experience impaired wound healing as a result of the study intervention.

The nurses are taking every reasonable measure to ensure that no participants experience impaired wound healing as a result of the study intervention. Correct Explanation: The principle of nonmaleficence dictates that nurses avoid causing harm. In this study, this may appear in the form of taking measures to ensure that the intervention will not cause more harm than good. The principle of justice addresses the distribution of risks and benefits, and the informed consent process demonstrates that autonomy is being protected. Preliminary indications of the therapeutic value of the intervention show a respect for the principle of beneficence.

Why are quality-assurance programs important in nursing? a) They enable nursing to be accountable for the quality of care. b) They allow increased retention of qualified nurses. c) They facilitate increased enrollment in educational programs. d) They specify how resources are used or not used.

They enable nursing to be accountable for the quality of care. Correct Explanation: Quality-assurance (QA) programs enable nursing to be accountable to society for the quality of nursing care. They are a response to the public mandate for professional accountability. QA programs do not facilitate increased enrollment, specify how resources are to be used, or increase retention of nurses.

Members of the staff on a hospital unit are critical of a client's family, who has different cultural beliefs about health and illness. A student assigned to the patient does not agree, based on her care of the client and family. What critical thinking attitude is the student demonstrating? a) Demonstrating confidence b) Being creative c) Thinking independently d) Being curious and persevering

Thinking independently Correct Explanation: Although all the attitudes listed are components of critical thinking, the student is thinking independently. Nurses who are independent thinkers are careful not to let the status quo or a persuasive individual control their thinking.

What is the term for the beliefs held by the individual about what matters? a) Ethics b) Values c) Morals d) Bioethics

Values Correct Explanation: Values are ideals and beliefs held by an individual or group; values act as a standard to guide one's behavior. Ethics are moral principles and values that guide the behavior of honorable people. A moral is a standard for right and wrong. Bioethics is related to ethical questions surrounding life and death and questions and concerns regarding quality of life as it relates to advanced technology.

The orderly progression of steps of the nursing process is: a) planning, assessment, diagnosis, evaluation, and implementation. b) assessment, diagnosis, planning, implementation, and evaluation. c) implementation, planning, evaluation, assessment, and diagnosis. d) diagnosis, implementation, assessment, evaluation, and planning.

assessment, diagnosis, planning, implementation, and evaluation. Correct Explanation: The nursing process is a systematic method that directs the nurse and patient and includes the following sequential steps: assessment, diagnosis, planning, implementation, and evaluation.

What phrase best describes the science of nursing? a) art of individualized nursing b) application of clinical skills c) body of nursing knowledge d) holistic patient care

body of nursing knowledge Correct Explanation: The body of knowledge, called a knowledge base or the science of nursing, provides the rationale for nursing interventions in clinical nursing practice. The science of nursing provides the nurse with the knowledge and skills to provide individualized and holistic patient care.

The nurse is providing care for a pediatric client on night shift. At 0400, the nurse notes that the child has a high fever but does not have an order for an antipyretic. What nursing action represents a good example of teamwork and collaboration as defined by the Quality and Safety Education for Nurses (QSEN) competencies? The nurse: a) reports to the oncoming nurse at 0700 that the child has a fever so that when the healthcare provider comes in, she can obtain an order for an antipyretic. b) gives the child a common over-the-counter antipyretic based on dosing recommendations and reports this to the oncoming nurse. c) requests that the child's mother give the child something for the fever that she brought from home. d) calls the health care practitioner, reports her findings, and requests an order for an antipyretic.

calls the health care practitioner, reports her findings, and requests an order for an antipyretic. Correct Explanation: Teamwork and collaboration as defined by QSEN indicates the need to recognize practice boundaries at the same time as functioning within the inter-professional team to accomplish shared decision making. It is the nurses responsibility to report altered client status that may require collaborative interventions, irregardless of time of day. For the nurse to administer a medication, there must be a written order for the medication, and it is outside of the scope of practice to prescribe medications. Waiting to report the assessment to an oncoming nurse may delay client care and effect client outcomes. It would be inappropriate to require the mother take care of this with medications brought from home.

Which of the following is a trend to watch in healthcare delivery? a) lower costs of healthcare b) current nursing shortage c) uneducated consumers d) decreasing diversity

current nursing shortage Correct Explanation: Trends to watch in healthcare include changing demographics, increasing diversity, technology explosion, globalization of economy and society, educated consumers, increasing complexity of patient care, costs of healthcare, effect of health policy and regulation, and current nursing shortage.

When admitting the elderly patient to the hospital for surgery, it is the nurse's responsibility to do a complete assessment and document the patient's condition. A priority reason for this responsibility is that the nurse knows that the hospital will not be reimbursed for: a) confusion b) fat embolism c) wound infection d) decubitus ulcer

decubitus ulcer Correct Explanation: Medicare will no longer reimburse hospitals for conditions that result from preventable errors, such as pressure ulcers (decubitus ulcers). You must document condition of skin on admission. Preventable errors include air embolism (not fat embolism); the others are not included on the list of preventable errors.

Which agency focuses on the epidemiology, prevention, control, and treatment of communicable diseases? a) National Institutes of Health b) Indian Health Services c) Centers for Disease Control and Prevention d) Veterans Administration

enters for Disease Control and Prevention Correct Explanation: The Centers for Disease Control and Prevention (CDC) in Atlanta focuses on the epidemiology, prevention, control, and treatment of communicable diseases. The National Institutes of Health engages in funding and conducting various health research activities. The Veterans Administration provides health care to veterans. Indian Health Services is the principal source of support of Native American health care.

A nurse uses the process of quantitative research to study the incidence and causes of hospital-acquired pneumonia in her hospital. The statement of what the researcher expects to find in these studies is called the: a) data b) hypothesis c) instrument d) variable

hypothesis Correct Explanation: The hypothesis is the statement of relationships between the independent and dependent variables that the researcher expects to find. A variable is something that varies and has different values that can be measured. Data is information the researcher collects from subjects in the study (expressed in numbers). Instruments are devices used to collect and record the data such as rating scales, pencil and paper tests, biologic measurements.

Nursing is the largest group of healthcare professionals. They have the potential to have an influence on healthcare reform. Healthy People 2020 suggests that nurses have an important role in: a) improving access to quality care and cost of care. b) providing healthcare services to all citizens. c) monitoring who receives care at a reasonable cost. d) challenging health reform that interferes with private insurance.

improving access to quality care and cost of care. Correct Explanation: Healthy People 2020 emphasizes the importance of nursing's role in improving access to care, quality of care, and cost of care.

Which of the following group of terms best describes the nursing process? a) family-centered, single point in time, intuitive b) nurse-centered, single focus, blended skills c) patient-centered, systematic, outcomes-oriented d) nursing goals, medical terminology, linear

patient-centered, systematic, outcomes-oriented Correct Explanation: The nursing process is a patient-centered, systematic, outcomes-oriented method of caring that provides a framework for nursing practice. It is nursing practice in action.

Select the best description of how the nurse applies the nursing process in caring for patients. The nurse: a) applies intuition and routine care for patients. b) uses critical thinking to direct care for the individual patent. c) uses scientific problem solving to meet patient problems. d) employs communication to meet the patient's needs.

uses critical thinking to direct care for the individual patent. Correct Explanation: The nursing process requires blended skills and critical thinking. Critical thinkers think systematically about the nursing process and apply it for the individual patient. Communication is important but not sufficient to meet patient needs, and scientific problem solving is used in the laboratory setting, not nursing.

Which of the following terms are part of quantitative research? a) concept b) ethnography c) process d) variable

variable Correct Explanation: Quantitative research analyzes numbers to examine the relationship or effects between and among variables (something that varies and has different values that can be measured). Process, concept, and ethnography are associated with qualitative research.

Which of the following is an essential feature of professional nursing? Select all that apply. a) Attention to a range of human experiences and responses to health and illness b) Use of objective data to negate the client's subjective experience c) Providing a caring relationship to facilitate health and healing d) Advancement of professional nursing knowledge through scholarly inquiry e) Use of judgment and critical thinking to form a medical diagnosis

• Advancement of professional nursing knowledge through scholarly inquiry • Providing a caring relationship to facilitate health and healing • Attention to a range of human experiences and responses to health and illness Correct Explanation: As the role has changed, definitions of nursing have evolved to acknowledge the following essential features of professional nursing: (1) providing a caring relationship that facilitates health and healing, (2) attention to the range of human experiences and responses to health and illness within the physical and social environments, (3) integration of objective data with knowledge gained from an appreciation of the client's or group's subjective experience, (4) application of scientific knowledge to the processes of diagnosis and treatment through the use of judgment and critical thinking, (5) advancement of professional nursing knowledge through scholarly inquiry, and (6) influence on social and public policy to promote social justice.

Nurses apply critical thinking to clinical reasoning and judgment in their nursing practice every day. Which of the following are characteristics of this practice? Select all that apply. a) It is driven by the nurse's need to document competent, efficient care. b) It carefully identifies the key problems, issues, and risks involved. c) It is based on principles of nursing process, problem solving, and the scientific method. d) It is guided by standards, policies and procedures, ethics codes, and laws. e) It calls for strategies that make the most of human potential.

• It is guided by standards, policies and procedures, ethics codes, and laws. • It is based on principles of nursing process, problem solving, and the scientific method. • It calls for strategies that make the most of human potential. • It carefully identifies the key problems, issues, and risks involved. Correct Explanation: Critical thinking is guided by standards, policies and procedures, ethics codes, and laws; is based on principles of nursing process, problem solving, and the scientific method; and carefully identifies the key problems, issues, and risks involved. It is driven by client, family, and community needs, as well as nurses' needs to give competent, efficient care (e.g., streamlining paperwork to free nurses for client care). It calls for strategies that make the most of human potential and compensate for problems created by human nature. It is constantly re-evaluating, self-correcting, and striving to improve