Roles / Contemporary Nursing Test 1

The Nurse Training Act

$250,000,000 was allocated for nursing education

Campaign for Nursing's Future

$50,000,000 to focus enhancing the image of nursing

Nurse Reinvestment Act

Faculty Loan cancellations

Patient Protection and Affordable Care Act

Increased limits for nursing student loans

Maria Ortiz - 4 Jennifer Moreno - 1 Florence Nightengale Edith Cavell

4 - Died in a clinic bombing in Baghdad, Iraq 1 - Won a bronze medal for action in Afghanistan 3 - Patient advocate for Crimean soldiers 2 - Executed by Germany during World War I

A widely used approach to encouraging team training in the health care professions is the use of: A. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). B. SBAR (Situation; Background; Assessment; Recommendation). C. the Robert Wood Johnson Pilot School Collaboration. D. Quality and Safety Education for Nurses (QSEN).

A A widely used team training approach for health care teams is TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety). TeamSTEPPS acknowledges that team training and enhanced communication are among the essential components of a comprehensive patient safety system. The SBAR technique provides a succinct, structured framework for communication among members of the health care team about a patient's condition. QSEN is a national program with the goal of preparing future nurses with the knowledge, skills, and attitudes (KSA) necessary to continually improve the quality and safety of the health care systems in which they work. The Robert Wood Johnson Foundation supported the Pilot School Collaborative to model how faculty could include the six competencies in prelicensure programs.

In order to best ensure client safety, which of the following questions should a staff nurse ask first when determining whether to accept a client assignment that is made when several staff members have reported off sick? A. "Do I have the experience and knowledge to care for these patients?" B. "Is this a staffing crisis or a result of typical staffing patterns?" C. "Can I expect to be mandated to stay an additional shift?" D. "How long will it be before I get additional help?"

A Although all these questions can help the staff nurse think critically about accepting the assignment, initially the important question is whether the nurse possesses the experience, skills, and knowledge necessary to safely provide appropriate care for the clients she is asked to care for.

Based on current trends, which nursing care environment has the greatest employment potential for new nurses? A. Long-term care facilities B. Hospital emergency departments C. Pre- and postsurgical departments D. Primary health care provider practices

A Employment will not grow at the same rate in every setting—hospital employment will grow more slowly because many procedures and care are shifting to outpatient and home health settings, more sophisticated procedures can safely be done outside the hospital, and home health and long-term care facilities will see employment growth due to the aging population. The other options are more traditional environments and so are not as likely to show increased employment growth.

The most likely reason a 9-year-old child cries and refuses to cooperate with an injection is: A. the child's past experiences with injections. B. the environment the child finds himself in, such as a hospital emergency room. C. the precipitating event, such as a fall that resulted in the need for a local anesthetic. D. the nurse's verbal and nonverbal communication with the child about the injection.

A Previous experiences with injections are likely to have the greatest impact on the way a child will interpret any communication about an injection.

Which hospital-wide policy would best address the nurse's negative view of job satisfaction? A. Making it possible to earn additional personal leave time based on their absentee records B. Providing a dedicated parking area close to the hospital for nursing staff C. Instituting biannual staff recognition days that include a free meal in the cafeteria D. Providing security backup when there is a perceived sense of workplace violence

A RNs are generally satisfied with their jobs when hospital administrators emphasize quality of patient care; recognize the importance of their personal and family lives; and provide nurses with satisfying salary and benefits, high job security, and positive relationships with other nurses and with management. The other policies may appeal to groups of nurses, but they are not directed towards any of the major job satisfaction indicators.

Nursing's primary concern related to the appropriate use of social media is to preserve: A. confidentiality. B. professionalism. C. cultural sensitivity. D. effective communication.

A The nurse must be acutely aware of the need to preserve the client's privacy and the confidentiality regarding client information. The nurse must also be aware of the consequences of failing to do so effectively. The other options may be affected by social media posting but the client issue of primary concern is confidentiality.

Which of the following activities engaged in by a nurse manager would be expected to have the greatest impact on patient care? A. Role modeling effective communication between all levels of staff B. Conducting a survey to identify factors affecting staff job satisfaction C. Providing all nursing staff with opportunities to influence unit policies D. Providing all staff members with written copies of organizational policies

A Positive role modeling is an effective tool the nurse can use to create a positive team spirit and promote high-quality patient care. Positive role modeling simply means that the nurse performs the job in such a way that he or she demonstrates ideal performance as a professional nurse; others hopefully will follow the example. The other options are more related to the working climate and control of staff performance.

Which intervention is associated with a focus of The Institute of Medicine's The Future of Nursing report? (Select all that apply.) a. Preparing more nurses with advanced nursing degrees b. Facilitating nurses in practicing to the full scope of their educational preparation c. Supporting the nursing role in the interdisciplinary health care team d. Impacting the image of professional nursing in a direct manner e. Improving data collection to support nursing workforce planning

A, B, C, E The Institute of Medicine (2010) issued a landmark report, the Future of Nursing that has significantly impacted the image and future of nursing. This report included four main recommendations: (1) higher levels of nursing education (80% BSN by 2020 and doubling the number of doctorates) through seamless academic progression; (2) removal of practice barriers to enable nurses to practice to their full scope of practice based on their educational preparation; (3) inclusion of nurses as full partners with physicians and other professionals in redesigning the U.S. health care system; and (4) improved data collection and information infrastructure to facilitate more effective workforce planning and information infrastructure.

What patient care area is addressed by QSEN Competencies? (Select all that apply.) A. Team work B. Informatics C. Quality Improvement D. Nursing Professionalism E. Evidence-based practice

A, B, C, E The QSEN competencies at both the prelicensure (2007) and graduate level (2012) assess the knowledge, skills, and attitudes of nurses within six areas: patient centered care, teamwork and collaboration, evidence based practice, quality improvement, safety, and informatics. Nursing professionalism is not an addressed area.

What interventions will a nurse manager implement when coaching a newly licensed nurse regarding the way a patient's complaint was handled? (Select all that apply.) A. Asks, "What will you do differently the next time this situation occurs?" B. Begin the discussion with a personal interpretation of the situation C. Focus on how to achieve the "ideal situation" D. Approach the conversation in a nonjudgmental fashion E. Use close ended questions to help focus the conversation on the situation

A, B, D Effective coaching includes discussing situations in a neutral way—avoid judgmental language that will put the other person on the defensive, encouraging the other person to provide his or her perspective about the situation and to reflect on his or her performance through open-ended questions. Being realistic by focusing on what is actually achievable.

nterprofessional care requires improvement in respect to which patient care area? (Select all that apply.) A. Safety B. Patient-centered focus C. Economics D. Efficiency E. Impartiality

A, B, D, E In response to the paradigm shift to interprofessional care, and providing care following the IOM's six aims for improvement; safe, effective, patient centered, timely, efficient, and equitable (impartial). Economics is not an area that is considered.

Which statement accurately describes elements concerning the play Miss Ever's Boys? (Select all that apply.) a. Dramatizes an ethical nursing dilemma b. Focuses on the infamous Tuskegee experiment Correct c. The treatment of military personnel d. Involved the administration of penicillin as a treatment modality Correct e. Treatment of syphilis

A, B, D, E The play tells the true story of Nurse Rivers, who was hired to recruit and retain young black men into the infamous Tuskegee experiment designed to describe the long-term effects of untreated syphilis. Although the study began in 1932, penicillin became the treatment of choice for syphilis in 1947 in the civilian population. When subjects asked Nurse Evers to obtain the new treatment of penicillin for them and she sought to do so, the physician investigators required her to discourage them from treatment. The play introduces non-nurses to the dilemmas of nursing practice during that era and the consequences of misplaced faith and trust in other health care disciplines.

Which characteristics are expected to be represented in a health care facility's mission statement? (Select all that apply.) A. Commitment to professional excellence B. Providing the most economic health care services C. Ethical treatment of all patients and staff D. Teamwork to deliver quality care E. Utilization of innovated service delivery methods

A, C, D, E Appropriate philosophies and values include commitment to professional and individual excellence, with support for personal and professional growth, ethical and fair treatment for all through a commitment to relationships based on fairness and trust with our patients and our employees. Teamwork is consistently demonstrated as we work together to provide ever-improving quality care. Compassion is our highest priority; we will always provide care and comfort to people in need with respectful and dignified treatment at all times. Innovation in service delivery is accomplished by investing in the development of new and better ways to deliver health care.

Which skill is most important for a nurse to possess when attempting to exercise or earn informal power within an organization? A. Ability to persuade others B. Expert level nursing knowledge C. Understanding of management goals D. Willingness to compromise with everyone on the team

A. Informal leadership is exercised by the person who has no official or appointed authority to act, but is able to persuade and influence others. The informal leader may have considerable power in the work group and can influence the group's attitude and significantly affect the efficiency and effectiveness of workflow, goal setting, and problem solving. The other options represent skills that either relate to actual nursing care (expert nursing knowledge and cooperation) or management (goals).

The nursing faculty incorporates which practice-based learning activity in order to meet the students' need to learn about the sociodemographics currently present among today's population? A. Inclusion of a geriatric experience as a clinical requirement of all nursing students B. Participation in a panel discussion on the political agendas of several national nursing organizations C. Creation of a poster that compares and contrasts Medicaid and private insurance health care coverage D. Preparing a care plan that addresses the needs of an immigrant client with limited English language skills

A. The sociodemographics of a population includes descriptions of the sociological and statistical information represented among a population. Age-related information would be included and thus bring attention to the growing population of older adults in the United States and their health needs. The political agenda of nursing organizations and health care delivery systems are considered political and economic rather that sociodemographic in nature. Language barriers would be considered cultural in nature.

1. A researcher is using data collected by the government on the use of prescription drugs by older adults. The new research question, "Why do older adults adhere to a prescription drug regimen?" was based on data from the previous study. The researcher is participating in which type of research? A. Meta-analysis B. Secondary data analysis C. Quasi-experimental D. Pilot study

ANS : B Rationale: B is correct because secondary data analysis allows the researcher to ask new questions based on data previously collected from a completed study. A is incorrect because a meta-analysis is the systematic analysis of several studies to increase the power and confidence level. C is incorrect because in quasi-experimental research, one component of the research design, such as randomization, a control group, or manipulation of one or more variables, is missing. D is incorrect because a pilot study is a small-scale study conducted to determine the feasibility of a larger study. Level of Difficulty: Application

1. A charge nurse has asked for the upcoming holiday off. The nurse manager calls her into the office and states, "The unit must be covered. Do you have any suggestions on how to cover it?" The charge nurse assumes her boss is upset with her for asking for the day off because she never asks her opinion on staffing. Which of the following elements most likely influenced the communication process? A. Interpretation B Filtration C. Closed communication D. Blocking

ANS: A Rationale: A is correct because interpretation of information can be influenced by such factors as context, precipitating events, preconceived ideas, personal perceptions, style of transmission, and past experiences that may cause the sender's message to mean to the receiver something that was entirely unplanned by the sender. B is incorrect because filtration is the unconscious exclusion of extraneous stimuli that affect the communication process. C is incorrect because closed communication is a type of communication that uses yes or no questions or closed body language such as crossed arms, which was not implied in this situation. D is incorrect because blocking is a type of negative communication in which the receiver responds with noncommittal or generalized answers. Level of Difficulty: Application

1. During a public talk, a nurse is asked, "Who ensures that foreign nurses are properly trained and competent to practice as an RN?" The nurse responds that monitoring of foreign nurses' knowledge base and competencies is the jurisdiction of the: A. Commission of Graduates of Foreign Nursing Schools B. Employment and Training Administration C. Center for American Nurses D. U.S. Department of Labor

ANS: A Rationale: A is correct because the Commission on Graduates of Foreign Nursing Schools is responsible for verification of the foreign nurse's knowledge base and practice competencies. B is incorrect because this organization administers federal government training, including worker dislocation programs and unemployment insurance benefits. C is incorrect because the Center for American Nurses addresses the needs of individual nurses that are not represented by collective bargaining. D is incorrect because the U.S. Department of Labor oversees the employment of foreign nurses by ensuring fair working conditions.

While making patient rounds, the charge nurse is told that a staff nurse sat in the room with the family and watched television, causing the patient's medications to be late. When communicating with the staff nurse, the charge nurse states, "I will not tolerate lazy disorganized nurses on my unit. Either join my team or leave, and I don't want to hear any of your excuses." Which type of communication did the manager use? A. Straw man B. Aggressive C. Assertive D. Passive

ANS: B Rationale: B is correct because aggressive communication conveys dominance and limits the focus on or understanding of the opinions, values, or beliefs of others. A is incorrect because with straw man, a person's position on a topic is misrepresented, and in this situation, the manager is very clear about her position. C is incorrect because with assertive communication, the sender states his or her basic rights without violating the rights of others; the manager was clearly violating the rights of the staff nurse in this situation. D is incorrect because passive communication includes the use of apologetic words with hidden meanings and failure to say what is meant. Level of Difficulty: Application

Which of the following would have the greatest influence on the success of a health care organization? A. Effective protocols B. Clear goals and objectives C. A transactional nurse manager D. Human skills

ANS: B Rationale: B is correct because clearly stated goals and objectives that are measurable, observable, and realistic are necessary to achieve the strategic plan and contribute to the success of the organization. A is incorrect because although effective protocols increase efficiency and effectiveness, the goal and objectives must first be established so team members realize what they are working to meet. C is incorrect because the transactional leader who is committed to the day-to-day operations of the organization must be able to clearly identify the organization's goals and objectives to be successful. D is incorrect because human skills represent the ability to work with people in an effective leadership role; although human skills are important to the success of any organization, leaders must first be able to conceptualize the organization's goals and objectives if they are to work effectively with people. Level of Difficulty: Application

The hospital's nursing administration wants to implement a policy that all wound care be implemented and monitored by the hospital's certified enterostomal nurse because of a high rate of hospital-acquired wound infections. The nursing administrator refuses to hire an outside consultant suggested by the nurse managers, stating, "We can do this ourselves; no one needs to know our problems." The nursing administrator is adhering to which management theory? A. Open systems B. Closed systems C. Chaos theory D. Participative theory

ANS: B Rationale: B is correct because closed system theory incorporates the belief that the organization should not be contaminated by outside influences. A is incorrect because with an open system, internal and external forces are mutually influential, resulting in change. C is incorrect because chaos theory is based on the belief that because of the complexity of health care systems, expected variations occur and have to be managed; however, in this case, the administrator is not considering appropriate options for managing an undesirable variation. D is incorrect because participative theory encourages staff input in decision making, and in this case, the administrator is making all decisions. Level of Difficulty: Application

2. An RN received a diploma as entry into professional nursing. The RN was able to progress to an academic degree by completing an RN-to-BSN program. This progression from diploma preparation to an academic degree is known as: A. Performance-based assessment B. Educational mobility C. Practice-based competency D. Continuing education

ANS: B Rationale: B is correct because educational mobility is the progressive advancement from one type or level of education to another, as in the instance of moving from a diploma program to a bachelor's degree program. A is incorrect because performance-based assessment consists of evaluation of the performance of skills or tasks rather than the assessment of level of knowledge. C is incorrect because practice-based competencies, which are learning experiences that are focused on core practice competency outcomes, may be incorporated into the curriculum for RNs, with a diploma progressing toward a bachelor's degree, but it is only one component of the degree. D is incorrect because continuing education is a method by which RNs can remain current and competent in today's dynamic health care environment, but participants are not awarded college credit. Level of Difficulty: Comprehension

2. A patient who is 1 day postop following a right knee replacement is complaining of a pain level of 8 (on a 10-point scale) after having received his pain medication 2 hours ago. The pain medicine is ordered every 4 hours. The nurse calls the physician and provides the following information: "Dr. Michaels, this is Jane Stallings, RN at Fairview General. I am calling about Mr. Stuart Phillips. Mr. Phillips is 1-day postop right knee replacement and is reporting a pain level of 8 after receiving morphine 1 mg 2 hours ago. The medication is ordered to be given every 4 hours. His blood pressure is 148/86; pulse 104; respirations 24; temperature 98.6. The dressing on the right knee is clean and dry and 4+ pedal pulse. He may need a higher dose of morphine to control the pain. How would you like to change his orders?" What form of standardized communication is the nurse using? A. Critical language B. SBAR (situation background assessment recommendation) C. Check-back D. Hand-off

ANS: B Rationale: B is correct because the nurse is providing information in a structured format to be very clear to the physician about the patient's situation. SBAR communication addresses each of the following areas in a concise and clear manner: Situation: patient information and brief sentence of what is happening now; Background: diagnosis, relevant lab and assessment data, chief complaints; Assessment: analysis of the problem, what is of concern; and Recommendation: form as a question of what may be a solution or request for help. A is incorrect because there is no indication to stop and there was no evidence of language such as "I am concerned" to indicate a concern. C is incorrect because the nurse was not repeating what was heard for the team. D is incorrect because the patient is not being transferred to another unit or provider at this time. DIFF: Application

1. A nurse is preparing to talk at a community meeting about current trends that affect nursing and nursing education. Which of the following should be included in this discussion? A. Citizens are living longer, resulting in a shift in nursing practice from community-based care to the acute care setting. B. As our population is becoming more diverse in ethnicity, sexual preference, and how family is defined, ethical decisions are less clear because the values and preferences of the individual who is seeking care must be taken into consideration. C. Fewer individuals are choosing and entering nursing, which is causing a near-crisis situation in terms of the nursing shortage. D. The focus of caring for individuals suffering from domestic violence continues to decrease, with an increase in the need to be competent in biochemical containments in the event of terrorist acts.

ANS: B Rationale: B is correct because we have an increasing multicultural, multiethnic population, whose values are very different and must be considered when care is planned, implemented, and delivered. A is incorrect because as the population ages and chronic illness become more common, care will be delivered in the community setting. C is incorrect because applicants to nursing schools have increased; however, the shortage and aging of nursing faculty have limited the acceptance of applicants into programs. D is incorrect because nurses continue to care for an increasing number of victims of domestic violence and must also be competent to provide care in the event of a terrorist attack. Level of Difficulty: Application

2. An RN suspects that an employer hires nursing students at a higher rate of pay and allows them to perform certain procedures that require the skills of an RN. The nursing students enjoy the autonomy and extra pay. Before the RN participates in whistle-blowing, he or she should: A. File a formal complaint to The Joint Commission to initiate an investigation and receive protection from retaliation by the employer. B. Collect adequate documentation and, if possible, consult with the state nurses association before reporting to the state agency responsible for regulation of the employer. C. Remember that protection from retaliation by the employer is provided until unethical or illegal actions are reported in writing. D. Confront the individual suspected of wrongdoing and request that he or she stop the behavior.

ANS: B Rationale: B is correct because whistle-blowing requires that suspicions be documented and reported to the national or state agency responsible for regulation of the employing agency. Nurses are also advised to seek guidance from their state nurses association if possible. A is incorrect because private groups such as The Joint Commission do not confer protection. C is incorrect because protection from retaliation is provided only after the nurse blows the whistle. D is incorrect because those involved in unethical or illegal actions will not welcome your interference and may retaliate. Level of Difficulty: Application

2. What company invested 30 million dollars in a campaign to reduce the nursing shortage? A. Pfizer B. Merck C. Johnson and Johnson D. Kellogg

ANS: C Rationale: Answer C is correct because the Johnson and Johnson company invested 30 million dollars in a media campaign to increase awareness of nursing as a desirable rewarding career choice. Answer B is incorrect because Merck is a pharmaceutical company that has not been involved in a campaign to promote nursing as a career. Answer D is incorrect because Kellogg is a cereal company that has not been involved in a campaign to promote nursing as a career. Level of Difficulty: Knowledge

2. The advantage of meta-analysis is that multiple studies are statistically analyzed, enhancing the power of the results. The disadvantage is that: A Generalizability is limited B. Confidence is small C. The findings are only as reliable and valid as the original studies D. The results are expressed qualitatively

ANS: C Rationale: C is correct because a meta-analysis reviews the findings of prior studies so that the reliability and the validity of the original studies can enhance the value of the findings. A is incorrect because analysis of multiple studies allows a greater confidence level. B is incorrect because through increased power and multiple studies, generalization is increased. D is incorrect because meta-analyses produce quantitative data. Level of Difficulty: Comprehension

1. While one is visiting Arlington National Cemetery, a large limestone statue, the Spirit of Nursing, can be seen. This statue honors: A. Florence Nightingale's accomplishments in public health. B. Nurse Rivers, who advocated for victims of the Tuskegee experiment. C. Clara Maass, who found the cure for yellow fever during World War II. D. All military nurses for their bravery and compassion.

ANS: D Rationale: D is correct because the Spirit of Nursing statue was placed in Arlington National Cemetery to honor all military nurses. A is incorrect because the Spirit of Nursing statue pays tribute to all nurses who have served in the military, and although Florence Nightingale provided care to the soldiers in the Crimean War, she did not actually serve in the military. B is incorrect because although Nurse Rivers advocated in the end for participants in the study, she followed orders, and it is questioned whether she thought an unethical situation had occurred. C is incorrect because Clara Maas did indeed die of yellow fever, and she has been honored with a postal stamp. Level of Difficulty: Comprehension

Which activity demonstrates the organizational Chaos Theory? A. Preparing the yearly unit budget B. Planning for unexpected staffing shortages C. Preparing a rubric to guide staff performance reviews D. Setting unit goals related to quality control of client care

B The Chaos Theory suggests that a degree of order can be attained by viewing complicated behaviors and unpredictable situations as predictable by planning for them. The other options are not considered unpredictable.

Increasing professional and personal responsibility has been identified as an issue influencing the education of today's nursing professional. Which of the following has the greatest impact on client safety in the acute care setting? A. Requiring all nurse managers to possess at least a Bachelor's degree in nursing (BSN) B. Scheduling mandatory competency assessments on all shifts to facilitate compliance C. Offering monetary incentives to nursing staff who earn appropriate certifications D. Providing nursing staff with classes that focus on effective communication skills

B Although all the options contribute to safe nursing care, regular, rigorous assessment of clinical skills has the greatest impact on client safety.

In order to best address workplace satisfaction among its nursing staff, a hospital's administration provides: A. a yearly salary raise. B. tuition reimbursement. C. additional vacation time. D. an extra 15-minute break per shift.

B Areas that have been identified as affecting nursing satisfaction include: 1) opportunities to influence decisions about workplace organization; 2) recognition of accomplishments and work well done; 3) opportunities for professional development and advancement; and 4) opportunities to influence decisions about patient care. Tuition reimbursement would meet the interest in professional development of many nurses. Although the other options are considered favorable gestures, they do not address the identified factors.

To best provide patient-centered care (PCC), especially when working with diverse populations, the nurse must initially: A. survey the individual client regarding his or her needs. B. engage in self-reflection about personal values and beliefs. C. share the principles of patient-centered care with the client. D. encourage all members of the health care team to engage in PCC.

B Because patient-centered care respects the diversity of the human experience, nurses must examine their own attitudes about working with individuals and groups whose values differ from their own. Although the other options are appropriate, they are effective only after the nurse has reflected on personal beliefs and values.

According to the definition, which word best describes leadership? A. Allocate B. Influence C. Evaluate D. Control

B Leadership is the ability to guide or influence others. The other words are more applicable to the supervision of resources.

To best address safety issues (sentinel events) that can negatively impact client health and recovery, the individual nurse must initially: A. thoroughly assess each client for possible safety risks. B. be well aware of the various types and sources of sentinel events. C. encourage all members of the client's health care team to be aware of potential risks. D. educate clients about the possible safety risks that can affect their health and recovery

B Nurses must first increase their awareness of the issues in quality and safety and apply lessons from other industries on how to identify, report, and systematically participate in analysis of a near miss or sentinel event. Although the other options may be helpful, the initial action is to become knowledgeable about the possibility of sentinel events occurring.

Which of the following is the best example of a situation where a nurse could demonstrate workforce advocacy? A. A client wishes to become an organ donor in spite of family opposition. B. A client feels pressured by a health care provider into agreeing to a specific medical procedure. C. A nurse volunteers time to participate in a fund raiser to provide toys for a hospital's pediatric unit. D. Staff on a particular unit feel that the nurse manager is showing favoritism when granting vacation time.

B Nurses' strong concern and commitment to patient care and their role as patient advocates often place them in direct conflict with those who have more control, such as physicians and health care administrators. How a nurse reacts to such conflicts within the workplace and continues to advocate to improve patient care is a necessary focus for the profession—a focus called workforce advocacy. Volunteering time to provide funds for toys shows an interest in the client's welfare but is not as strongly related to client care. Advocacy for a client wishing to become an organ donor is an example of patient advocacy. The issue of fair management in this situation does not involve client care.

If a nursing research project strives to discover new information concerning client care practices, this project is said to be a model of: A. quantitative design. B. qualitative design. C. a pilot study. D. triangulation.

B Qualitative research is designed for discovery rather than verification. It is used to explore little-known or ambiguous phenomena. The most common intent of quantitative study is to apply or generalize knowledge from a smaller sample of subjects to a larger population. A pilot study is a small-scale study used to identify the strengths and weaknesses of a planned large-scale study. Triangulation is the use of various research methods or different data collection techniques in the same study.

Which educational intervention demonstrates the most acceptable application of technology as a trend that is currently influencing nursing education as well as client safety? A. Scheduling an orientation session on computer-based documentation for each freshman nursing student B. Providing a list of acceptable Internet sites to use as resources for medication administration C. Requiring each student to have access to a personal laptop computer installed with all required software D. Allowing pre- and postclinical written assignments to be submitted electronically

B The ever-expanding need for rapid, accurate information has presented a problem for both faculty and student. Appropriate Internet sites can serve as effective sources of information when faculty plays a role in identifying these sites. Such faculty involvement also helps ensure client safety because this information is used to provide client care. Scheduling time for the students to become familiar with computer-based documentation systems is helpful but is not as safety oriented as is the correct option. Requiring personal computers for classroom work and testing and allowing electronic submission of written assignments is student focused rather than client focused.

The primary reason nurses engage in research is to: a. achieve equal status with other health care sciences. b. provide the most appropriate evidence-based client care. c. advance the profession of nursing in the eyes of the public. d. collaborate with other members of the science community.

B The main outcome of a research activity for a nurse is to put the knowledge gained to work in health care delivery. Although engaging in research may achieve the other outcomes, they are not the primary reason behind nursing research.

A nurse manager recognizes which of the following as an example of a desirable practice-based competency outcome for a recently licensed registered nurse? The novice nurse: A. demonstrates excellent communication and interpersonal skills. B. meets orientation expectations 1 week ahead of schedule. C. has no absences during the required probationary employment period. D. asks for a work schedule that supports enrollment in an advanced nursing program.

B The outcomes of practice-based competency relate to clinical practice. Demonstrating the ability to achieve the goals of the facility's orientation program 1 week ahead of schedule shows clinical expertise and professional confidence, both reflective of practice-based competency. An excellent attendance record and an interest in earning an advanced nursing degree reflect professionalism, and although effective communication and interpersonal skills are desirable, they are not considered among the necessary clinical care skills.

The most important concept to remember when using both verbal and nonverbal communication is that: A. people are more likely to accept verbal messages than nonverbal ones. B. nonverbal messages are accepted as true more often than verbal ones. C. touch as a nonverbal form of communication should be avoided. D. avoiding eye contact is viewed as being untruthful by all cultures.

B An important concept to remember is that when the verbal message and the nonverbal message do not agree, the receiver is more likely to believe the nonverbal message since body language is often the most trusted indicator for conveying feelings, attitudes, and emotions. Touch is appropriate and useful when accepted by the client. In some cultures, avoiding eye contact is viewed as being respectful.

When a client expresses doubt whether a complicated procedure will actually help his condition, the nurse best avoids blocking the communication by responding: A. "I can understand your concern. We can talk more about it whenever you want." Incorrect B. "Your physician has performed this procedure many times and with great success." C. "What makes you doubt that your condition will benefit from having the procedure done?" D. "Would you like me to arrange for someone who has had the procedure talk to you about it?"

C By opening the communication up to further discuss the client's concerns, the nurse has validated the client's feelings, acknowledged his concerns, and provided the opportunity for further communication. The other options, while providing support and encouragement, do not open communication for further information gathering.

How can a nurse manager best foster high-quality and safe nursing care among the nursing staff? A. Praise the staff's efforts to provide care that is both safe and of high quality B. Offer incentives to those providing specific interventions that are safety and quality focused C. Create a unit culture where asking questions about health care interventions is encouraged D. Place great emphasis on how important safe, high-quality nursing care is to the client's health

C Health care organizations focusing on quality and safety encourage inquiry, making it okay to ask questions and providing resources to access information needed through various means, including informatics. Although praise and incentives are appropriate, they are not effective if the unit culture is not accepting. Placing emphasis on such interventions alone will not be successful if not supported by nursing managers and leaders.

A nurse manager will likely have which of the following types of power? A. Referent B. Informal C. Legitimate D. Connection

C Legitimate power is based on an official position in the organization. Through legitimate power, the manager has the right to influence staff members, and staff members have an obligation to accept that influence. Although a manager may have the other types of power, they are not a result of the management position alone.

When researching an aspect of human grief response, the nurse researcher will likely select which method of qualitative design? A. Ethnography B. Meta-analysis C. Phenomenology D. Needs assessment

C Phenomenology is designed to provide understanding of the participants' "lived experience." This method is a valuable approach for studying intangible experiences, such as grief, hope, and risk taking. Ethnography is a method used to study phenomena from a cultural perspective. Ethnographers spend time in the cultural setting with the research participants to observe and better understand their experience. Meta-analysis synthesizes quantitative data from multiple similar studies, thus enlarging the power of the results and allowing more confident generalizations than a single study. Needs assessments is a quantitative design used to determine what is most beneficial to a specific aggregate group. This design can be used by organizations, communities, or groups to establish priorities for their respective client groups

Regarding nursing research, the role of the clinical nurse specialist (CNS) is best utilized when: A. recruiting participants for specific studies. B. identifying clinical care problems. C. designing research studies. D. collecting research data.

C The CNS is in an ideal position to link research to practice by assessing an agency's readiness for research utilization, consulting with staff to identify clinical problems, and helping staff to discover, implement, and evaluate findings that improve health care delivery. The other roles are those assumed by a clinical nurse researcher who is a doctorally prepared nurse with clinical and research experience.

The primary goals of good relationship building and client care are best achieved when all members of the interprofessional care team: A. have identified the team's leader. B. are experts in their field of care. C. have developed a trusting relationship. D. recognize their role in the client's care.

C The need for trust in the health care setting is not limited to the nurse-patient relationship but rather pervades all working relationships. Care is more effective when the nursing team and the interprofessional team share the essential element of trust. Although the other options are factors in relationship building and client care, they would all be affected by a lack of trust among team members.

Which situations have been identified as positive factors in achieving job satisfaction among nurses? (Select all that apply.) A. Having policy and practice decisions made by administration B. Managers taking care not to interfere when a patient focused crisis occurs C. Professional development opportunities made available at the facility D. Attention is paid to fostering excellent nurse-physician relationships E. Respect is given to and expected by all members of the health care team

C, D, E Nursing job satisfaction depends on attention being paid to professional development and advancement opportunities, support for good nurse-physician cooperation and a pleasant respectful work environment. A lack of collaborative decision making and a management team uninvolved in the daily function of the nursing units serve as negative factors.

A nurse can find guidance in managing ethical nursing issues in the ANA's _________________.

Code of Ethics for Nurses with Interpretive Statements The American Nurses Association's Code of Ethics for Nurses with Interpretive Statements (2001) provides a succinct statement of the ethical obligations and duties of every individual who enters the nursing profession. REF: p. 49

When considering the philosophy and values of a health care facility, _____________________ is the highest priority.

Compassion Compassion is the highest priority when providing care and comfort to people in need with respectful and dignified treatment at all times. REF: p. 303, Box 17-4

Which statement made by a nurse demonstrates the appropriate attitude regarding the implementation of evidence-based practice (EBP)? A. "I've asked other nurses and they tell me this is how it's done here at this facility." B. "I'll ask the client how he feels this particular health issue should be best handled." C. "The client's general health has improved so much since the team has addressed her care." D. "I lack direct experience with this type of problem, so I'll bring it up at the team meeting."

D Acknowledging one's own limitations in knowledge and clinical expertise before determining when to deviate from evidence-based best practice demonstrates good nursing practice. Discussing care with team members, especially when addressing EBP, is demonstrating sound judgment. Relying only on how things were done in the past is not necessarily reflective of EBP. Although including the client in decisions regarding care is appropriate, there are limits to the value of the client's input, particularly when it comes to treatment-related issues regarding aspects of which they have no expertise.

A social issue that is currently having a very negative impact on the learning environment in classrooms can be best minimized by initially: a. presenting information using a variety of methods so that all learning styles will be addressed. b. requiring that electronic devices be turned off when entering a classroom or other learning environment. Incorrect c. presenting information on the proper use of social media by nursing students as it impacts client confidentiality. d. defining behaviors that will not be tolerated in the classroom since they do not demonstrate respect or civility.

D The decline of respectful, civil interpersonal behavior is a social problem that impacts even the learning environment. The initial defining of unacceptable behaviors is most effective in setting expectations of classroom etiquette. While the other options may represent reasonable requests, they are not as directed towards the primary issue of effective learning environments.

The nursing profession viewed the television series _________ as a negative portrayal of nurses based on the exploits of the program's nurses and physicians.

M*A*S*H The nursing profession viewed M*A*S*H as professionally destructive because of the negative portrayal of Hot Lips Hoolihan and the nurses of the 4077th Army MASH (Mobile Army Surgical Hospital) unit in Korea. The sexual exploits of nurses and physicians and the uncaring Margaret provided few positive images. REF: p. 26

The __________________ management style encourages staff involvement in the decision-making process.

The Democratic/Participative manager encourages staff participation in decision making. Involves staff in planning and developing new ideas and programs while believing in the best in people. This manager communicates effectively, and provides regular feedback and so builds responsibility in people. Works well with competent, highly motivated people. REF: p. 300, Box 17-3

The ability to maintain appropriate professional boundaries and preserve nurse-client confidences has been most severely impacted by: a. the misuse of social media forums by nurses. b. the hesitation of state board of nursing to discipline offenders. c. the courts' reluctance to uphold legal decisions involving professional boundaries. d. the nursing profession's inability to adequately define unacceptable behaviors.

a. the misuse of social media forums by nurses. The ramifications of inappropriate posting of information by nursing professionals as well as nursing students via the various forms of social media has created serious problems affecting confidentiality and professional boundaries. State board of nursing take these breaches of nursing practice seriously, revoking nurses' license to practice and expelling students from nursing programs. Currently the courts have upheld legal decisions involving such actions.

A staff nurse routinely finds it difficult to receive clarification on prescriptions and orders written by a particular member of the medical staff. When numerous attempts to deal directly with the physician fail, the nurse most appropriately manages the problem by: a. making it known to the nurse manager that they will no longer accept the physician's clients as patients. b. documenting the problem in terms of client safety concerns and forwarding the information to both the nursing manager and chief of medical staff. c. informing the clients that any dissatisfaction with their care should be directed toward their physician for resolution. d. presenting the issues to the unit's entire nursing staff so that a unified plan can be developed to ensure the safety of the physician's clients.

b. documenting the problem in terms of client safety concerns and forwarding the information to both the nursing manager and chief of medical staff. The problem will best be addressed as a medical staff problem with appropriate documentation of the problem as it affects client safety being forwarded to both nursing and medical staff administration. Refusing to treat a particular physician's clients or discussing the situation with the clients themselves is not professional behavior and so not a viable option. Involving the entire nursing staff may seem effective but it merely identifies the situation as a nursing problem rather than what it truly is—a medical problem.

The image that best serves today's profession of nursing is one that portrays: a. skill and caring. b. trust and belief. c. honesty and loyalty. d. dependability and charity.

b. trust and belief The image most important to today's nursing professional is one that supports the public's need to trust and believe in the nurse caring for them. The individual actually providing the care often changes with each shift change and so the perception of the profession as a whole is vitally important. Although the other options represent positive traits, they all seem to be embodied in the image of trust and belief in the public's collective mind.

The play Miss Evers' Boys was one of the first literary presentations that depicted nurses as: a. trained professionals. b. caring and charitable. c. client advocates. d. self-sacrificing.

c. client advocates The play and eventual television movie Miss Evers' Boys tells the story of the now-infamous Tuskegee experiment that focused on the treatment of syphilis among black men between 1932 and 1972. Miss Evers was the nurse in charge of recruiting subjects. The play describes how her request for the inclusion of penicillin into the treatment plan was denied, even though penicillin was the treatment of choice for the disease after 1947.

A new nurse manager is concerned about the workforce diversity in the unit. A staff survey is created to assess the opinion of those who work on the unit about their perceptions. Which of the following questions should be added to the survey? a. Do you find the income potential adequate for the nurse on the unit? b. Do you find the work to be routine and boring? c. Do you experience a lack of professional autonomy while working on the unit? d. Do you have the perception that nursing is a female profession?

d. Do you have the perception that nursing is a female profession? Nursing continues to be viewed as a female profession although the number of males entering the profession is steadily increasing. The public views nursing as an interesting and meaningful profession that provides good job security but does not provide job independence. The perception of job independence affects both male and females equally.

Which of the current perceptions of nursing most likely accounts for the lagging numbers of males in the profession? a. Poor income potential b. Work is routine and boring c. Lack of professional autonomy d. Viewed as a female profession

d. viewed as a female profession Nursing continues to be viewed as a female profession although the number of males entering the profession is steadily increasing. The public views nursing as an interesting and meaningful profession that provides good job security but does not provide job independence. The perception of job independence affects both male and females equally.

When clinical settings are limited, faculty can best assess competence associated with entry level clinical skills by implementing ___________________ assessments.

simulation (Standardized Patient) The use of standardized patients as a competency-based summative assessment allows faculty to assess mastery of entry level clinical skills, some of which student may not have access to in the clinical setting. REF: p. 44-45