Test 1 (PART 1)
After a new handwashing protocol is instituted, patients are asked to complete surveys about whether or not providers performed hand hygiene before and aftercare is provided. Which term best describes this action? a. Process measurement b. Peer-reviewed research c. Experimental study d. Outcomes research
A
How will the hospital be reimbursed by Medicare for an elderly patient admitted with pneumonia? a. Based upon the DRG for pneumonia b. Based upon the cost of the patient's care c. Based upon the patient's length of stay d. Based upon the types of therapies required
A
Which action by the nurse demonstrates implementation of Florence Nightingale's original theories about nursing care? a. The patient is gently bathed and given fresh linens after giving birth. b. The nurse forms a close therapeutic relationship with the patient. c. The nurse helps the patient conserve energy for healing processes. d. The nurse views the patient as a unique, ever-changing energy field.
A
Which action by the patient reflects a cultural influence on health practices? a. The patient uses seaside purification rituals to ease arthritis pain. b. The patient refuses to take blood pressure medicine due to the side effects. c. The patient has annual mammograms to screen for breast cancer. d. The patient avoids eating red meat due to a family history of heart disease.
A
Which form of insurance is appropriate for a single mother who is unable to work and her three children? a. State Medicaid b. Federal Medicare c. Private insurance d. Managed care program
A
Which is an example of an environmental risk factor? a. The patient's drinking water contains high levels of lead. b. The patient has a strong family history of autoimmune diseases. c. The patient carefully follows a lactose-free, gluten-free diet. d. The patient drinks one glass of red wine every night before bed.
A
Which program is appropriate for a nurse who wishes to become an expert in ostomy and wound care? a. Specialty certification b. Master of Science program c. Doctoral degree program d. Continuing education program
A
Which statement indicates the patient's perception of susceptibility to illness as described by the Health Belief Model? a. "I am never going to get lung cancer so I refuse to stop smoking." b. "Cancer is no big deal with all of the new treatments available now." c. "I have been smoking for so many years that I will never be able to quit." d. "I cannot afford the nicotine patches so I might as well keep on smoking."
A
Which health care professionals will participate in discharge planning for the patient? (Select all that apply.) a. Registered nurse b. Radiology technician c. Social worker d. Physical therapist e. Laboratory technician
A,C,D
The nurse is researching the use of music therapy for patients with dementia and finds that many research articles have been published about the topic. Which single source will provide the best evidence for the nurse? a. The opinion of an expert committee b. Meta-analysis of randomized control trials c. One well-designed randomized control trial d. Systematic review of qualitative nursing studies
B
Which action by the patient best represents primary prevention? a. The patient utilizes a cane when walking to prevent falls. b. The patient receives the influenza vaccination every year. c. The patient participates in physical therapy after having a stroke. d. The patient takes prescribed blood pressure medication every morning.
B
Which assessment finding indicates that the patient's body image has been altered due to illness? a. The patient developed a strong dislike for any kind of spicy foods. b. The patient feels uncomfortable wearing a swimsuit after colostomy surgery. c. The patient refuses to take antihypertensive medications due to the side effects. d. The patient drinks six glasses of cranberry juice daily to prevent bladder infections.
B
Which feature of the hospital enables it to qualify for Magnet Recognition Program? a. The hospital cafeteria is open 24 hours to accommodate staff on every shift. b. The nurses utilize evidence-based practice and flexible staffing plans. c. The hospital radiology technicians have received additional certifications. d. The hospital physicians provide mentoring services for interns and residents.
B
Which is an example of a patient-centered medical home team? a. Occupational and physical therapists come to the patient's home to provide rehabilitation services. b. The patient's primary care physician coordinates care with the patient's social worker and respiratory therapist. c. The nurse assesses the patient's home environment for irritants that can worsen the patient's respiratory status. d. A home care company is employed to provide the patient with a nebulizer and supplemental oxygen equipment.
B
A new central line care protocol to prevent site infection is instituted after it has been shown to be significantly more effective than previous approaches. Which term best describes this action? a. Inductive reasoning b. Qualitative research c. Evidence-based practice d. Process measurement
C
A researcher tests a new fall prevention protocol on a nursing unit with patients who are at very low risk of falling. Which term describes the problem with this study? a. This type of study is better suited for qualitative research. b. The subjects are at risk of being harmed by participating in the study. c. The study is biased because the subjects are already at low risk of falling. d. The study results will be inaccurate due to placebo effects on the subjects.
C
Which is an example of a tertiary health care provider? a. An outpatient rehabilitation center b. A nurse-managed urgent care clinic c. A university-based research hospital d. A community center offering adult day care services
C
Which professional nursing organization ensures that nursing programs adequately prepare students to enter the nursing profession? a. Federal Nurses Association (FNA) b. International Council of Nurses (ICN) c. National League for Nursing (NLN) d. National Student Nurses Association (NSNA)
C
Which is an example of a sentinel event? a. The patient suffers a fatal air embolism after a central line is removed incorrectly. b. The nurse identifies a patient's urinary tract infection before symptoms develop. c. The unit's urinary tract infection rate is 5% lower than the national average. d. The pilot study indicates potential effectiveness of a new oral care protocol.
A
The diabetic patient sees the podiatrist regularly to prevent development of ulcers in the feet. Which term best describes this action of the patient? a. Health promotion b. Primary prevention c. Secondary prevention d. Tertiary prevention
C
Which type of patient is an appropriate candidate for restorative care services? a. A patient who uses supplemental oxygen for emphysema b. A patient who is actively dying of metastatic cancer c. A patient with right-sided hemiplegia after a recent stroke d. A patient with depression who tried to commit suicide
C
Researchers conduct a study to determine if the use of chlorhexidine mouthwash is more effective than the use of normal saline for oral care to reduce the incidence of ventilator-associated pneumonia. Which action by the researchers makes the study a randomized controlled trial? a. The researchers do not know which patients will be treated with saline and which patients will be treated with chlorhexidine. b. The researchers do not know which treatment will be more effective before the interventions are tested. c. The researchers randomly select nurses at several local health care facilities to implement the mouth-care protocols. d. The researchers do not know which statistical tests will be used to evaluate the effectiveness of the oral care protocols.
A
The nurse has taught the patient about how to perform sterile dressing changes. Which action by the nurse best assesses whether or not the patient's discharge teaching was effective? a. The nurse watches the patient perform the sterile dressing change and provides feedback as needed. b. The nurse provides additional written instructions as a reminder of how to correctly perform the procedure. c. The nurse includes the patient's spouse when teaching the patient how to perform the sterile procedure. d. The nurse asks the patient and spouse if they have any further questions about how to perform the procedure.
A
The nurse is researching oral care protocols to reduce the incidence of ventilator-associated pneumonia on the unit. Which section allows the nurse to quickly determine if the study is relevant without having to read the entire article? a. Abstract b. Literature review c. Data collection method d. Theoretical framework
A
The patient is nauseated and vomiting when the nurse attempts to provide discharge teaching. Which is the most appropriate action of the nurse? a. Administer antinausea medication and provide discharge teaching later. b. Provide written materials to the patient to read when the nausea has subsided. c. Provide discharge teaching to the family members while the patient rests. d. Assist the patient with mouth care and proceed with the discharge teaching.
A
Which action by the nurse helps to achieve the goals of the Hospital Readmissions Reduction Program? a. The nurse ensures that the patient understands how to take prescribed medications correctly. b. The nurse develops a close therapeutic relationship with the patient and provides privacy when care is provided. c. The nurse uses therapeutic touch to promote relaxation, reduce anxiety, and promote healing. d. The nurse elevates the head of the patient's bed and administers oxygen when the patient feels short of breath.
A
Which action of the nurse demonstrates the concept of the Holistic Health Model? a. The nurse incorporates the patient's religious restrictions, economic status and personal preferences when developing the nutrition plan. b. The nurse has the patient demonstrate how to perform a sterile dressing change after teaching about the procedure. c. The nurse consistently uses a 0-10 objective pain rating scale to achieve consistent pain management for the patient. d. The nurse assists the patient to sit up slowly when getting out of bed to avoid fainting from orthostatic hypotension.
A
Which assessment finding is an example of an internal variable that influences the patient's health beliefs? a. The patient's spiritual beliefs prohibit the use of blood transfusions. b. The patient's family is homeless after being evicted from their apartment. c. The patient relies on a pharmacy assistance program to pay for medications. d. The patient and community prefer natural medicines over prescription drugs.
A
Which assessment question allows an administrator to determine the level of patient satisfaction after hospitalization? a. "Did the nursing staff treat you with respect and maintain your privacy?" b. "Were you able to keep the follow-up appointment with your physician?" c. "Did you have any difficulty filling your prescriptions after discharge?" d. "Has the occupational therapist come to your home to start therapy yet?"
A
Which information is included in the Minimum Data Set? a. The patient has a history of gout and macular degeneration. b. The average length of stay for pneumonia is 3 days in the hospital. c. The hospital has a 14% nosocomial urinary tract infection rate. d. Approximately 40% of American adults exercise at least 30 minutes daily.
A
Which is an example of a Healthy People 2020 goal? a. Women and men will receive equally aggressive care for suspected heart attack. b. The patient will participate in a physical therapy program after suffering a stroke. c. The nurse will identify and address stressors unique to multicultural families. d. The nurse will organize mobile mammograms for female patients in the local area.
A
Which is an example of health care disparity? a. The physician treats cardiac patients with insurance more aggressively than noninsured patients. b. The patient takes longer to recover from surgery due to a history of aggressive rheumatoid arthritis. c. The nurse prioritizes care so that additional time is spent with patients who require more intensive interventions. d. The registered nurse is able perform more advanced interventions than the licensed practical nurse.
A
Which is an example of respite care? a. A patient with dementia attends an adult daycare center so that the patient's family can go to work. b. The respiratory therapist comes to the patient's house to ensure that the oxygen equipment is functioning correctly. c. The nurse teaches the patient's spouse how to check blood sugar levels and administer insulin to the patient. d. The patient is seen in an urgent care clinic for stitches and wound care after being bitten by a dog.
A
Which patient assessment finding must be addressed first according to Maslow's hierarchy of needs? a. The patient is cyanotic and feels short of breath. b. The patient refuses to participate in physical therapy. c. The patient verbalizes anxiety about upcoming surgery. d. The patient is unable to reposition in bed without assistance.
A
Which patient is the highest priority for the discharge planner? a. A patient who will require home IV antibiotics for the next 6 weeks b. A patient who will be taking antihypertensive medications after discharge c. A patient who will be discharged after routine tonsillectomy surgery d. A patient who will be returning to a local skilled nursing facility
A
Which type of program is appropriate to educate staff about new fall prevention protocols that are to be implemented on the nursing unit? a. In-service education b. Advanced education c. Continuing education d. Certification education
A
Which type of research study is most appropriate to determine if premedication with diphenhydramine is more effective than acetaminophen to reduce the incidence of aseptic meningitis after intravenous globulin infusion? a. Randomized trial b. Qualitative study c. Historical review d. Descriptive report
A
Which actions of the nurse demonstrate the nursing role of leader? (Select all that apply.) a. The nurse implements a new skin-care protocol to reduce decubitus ulcers. b. The nurse develops a therapeutic relationship with the patient's family members. c. The nurse ensures that the patient assignments are created fairly for each shift. d. The nurse works to meet the patient's cultural preferences for personal care. e. The nurse clearly communicates expected standards of care for the patients.
A, C, E
Which sources may be found in the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database? (Select all that apply.) a. Literature review about complementary therapies for rheumatoid arthritis b. Randomized trial to study the use of honey to treat decubitus ulcers c. Satirical article about the risk of dihydrogen monoxide exposure to humans d. Blog written by a patient recently diagnosed with myasthenia gravis e. Meta-analysis to analyze coffee intake with risk of developing dementia
A,B,E
Using the Health Promotion Model while rendering care enables a nurse to do which of the following: (Select all that apply.) a. Help the patient attain better health b. Detect the presence of illness c. Promote health behaviors in a patient d. Assess a family's response to illness e. Stimulate relational transcendence
A,C
Which goals are appropriate for a patient in a restorative care agency? (Select all that apply.) a. The patient will be able to transfer to the wheelchair with one person assist. b. The patient's family will verbalize understanding of the dying process. c. The patient will be able to eat independently using specially molded utensils. d. The patient will be transferred to a trauma hospital within 1 hour of arrival. e. The patient's family will verbalize feeling of relief from strains of caregiving.
A,C
Which statements are examples of hypotheses? (Select all that apply.) a. Hospitals staffed with primarily bachelor-prepared nurses will have lower mortality rates than hospitals staffed with primarily associates-prepared nurses. b. More than 80% of the patients with catheter-associated urinary tract infections did not have any signs or symptoms of infection. c. Patients who receive ondansetron preoperatively will experience lower rates of nausea and vomiting than patients who do are not premedicated. d. The greatest risk factor for developing ventilator-associated pneumonia was the length of time that the patient was intubated. e. Ultraviolet light disinfection of equipment is a nontoxic, effective method for prevention of Clostridium difficile infection.
A,C
Which actions of the nurse demonstrate the nursing role of educator? (Select all that apply.) a. The nurse teaches the patient's family how to perform sterile dressing changes. b. The nurse includes the patient in clinical decision making whenever possible. c. The nurse provides written teaching materials in the patient's preferred language. d. The nurse speaks about diabetes management at a professional conference. e. The nurse assesses for adequate protein intake for a patient on a vegetarian diet.
A,C,D
A single mother with three children uses the public health department services in the county to immunize her children. Which level of health care did the mother use? a. Continuing care b. Preventative care c. Secondary acute care d. Restorative care
B
After a careful literature review, the nurse manager creates a new fall prevention protocol to reduce patient fall rates on the unit. What is the nurse manager's logical next step? a. Discuss the protocol with the patients and families on the unit. b. Present the protocol to the nursing policy and procedure committee. c. Post an entry about the protocol on the agency's social networking page. d. Submit an article about the protocol to be published in the agency newsletter.
B
The nurse feels that an assigned duty is outside the scope of nursing practice. Which document is the best source to answer the nurse's concern? a. ANA Code of Ethics b. State Nurse Practice Act c. QSEN Initiative Act d. Nurse's Bill of Rights
B
The nurse is caring for a patient who suddenly becomes acutely short of breath. The nurse elevates the head of the patient's bed, checks the patient's pulse oximetry, and administers 2 L of oxygen before notifying the patient's physician. Which term best describes the actions of the nurse? a. Accountability b. Autonomy c. Licensure d. Certification
B
The nurse manager will use evidence-based practice to address a recent increase in catheter-associated urinary tract infections on the unit. Which type of trigger did the nurse manager use? a. Literature-focused b. Problem-focused c. Knowledge-focused d. Expectations-focused
B
The patient uses a special telephone connection to allow the cardiologist to assess the patient's pacemaker function while the patient stays at home. Which term is used to describe this type of health care? a. Capitation b. Telemedicine c. Magnet Recognition Program d. Utilization review
B
Where is the best place for the nurse to obtain the latest information about prevention of catheter-associated urinary tract infections? a. Online information b. Peer-reviewed nursing journal c. Latest edition of a nursing textbook d. Most recent edition of a popular magazine
B
Which action by the nurse demonstrates the use of evidence-based practice to positively impact the quality and cost of health care? a. The nurse performs decubitus ulcer dressing changes the way they have always been done at the agency. b. The nurse pioneers a new oral care protocol that has been demonstrated to reduce the risk of ventilator-associated pneumonia. c. The nurse enters the physician's orders into the computer system because the physician refuses to learn how to do it. d. The nurse works on a medical-surgical unit for 4 years before becoming certified in critical care nursing.
B
Which action by the nurse helps to meet the aesthetic needs of the patient as described by Maslow? a. The nurse uses a drawsheet to carefully reposition the patient in bed. b. The nurse puts a beautiful handmade quilt on the bed for the patient to enjoy. c. The nurse collaborates with the health care team when scheduling care activities. d. The nurse assesses the patient's readiness to learn before beginning teaching.
B
Which action by the nurse helps to meet the cognitive needs of the patient as described by Maslow? a. Encouraging early ambulation after surgery to prevent formation of blood clots. b. Providing a calm environment when the patient becomes agitated and confused. c. Teaching the patient's family how to perform sterile dressing changes. d. Performing careful perineal care to avoid development of a urinary tract infection.
B
Which action of the nurse addresses Maslow's need for love and belongingness? a. The nurse uses a gait belt and assists the patient to use a walker for ambulation. b. The nurse encourages a widowed patient to join a bereavement support group. c. The nurse plans daily care to allow for rest periods for the patient as needed. d. The nurse reorients the patient to time and place during periods of acute confusion.
B
Which action of the nurse demonstrates coordination of care for the patient? a. The nurse creates a warm, therapeutic relationship with the patient by actively listening to what the patient has to say. b. The nurse works with the physical therapist to determine how to best transfer the patient from the bed to the chair. c. The nurse educates the patient about energy conservation techniques to increase activity tolerance. d. The nurse uses clear and objective language when documenting assessment findings in the patient's medical record.
B
Which assessment finding is a modifiable risk factor for disease? a. The patient has a family history of breast cancer. b. The patient smokes two packs of cigarettes every day. c. The patient was born with a congenital heart defect. d. The patient's childhood home contained high levels of radon.
B
Which is an example of a Bundled Payment for Care Improvement? a. The insurance company combines services for several patients into one single payment. b. The hospital is paid a predetermined lump sum for all costs related to the patient's open-heart surgery. c. The hospital is paid an additional bonus if the patient's surgical outcome exceeds national standards. d. The insurance company will withhold all payments for the patient until accreditation is achieved.
B
Which is an example of a qualitative research question? a. Will a school hand-hygiene program reduce the frequency of head lice outbreaks? b. What are the experiences of young children diagnosed with type 1 diabetes? c. How does crossing the legs affect the accuracy of blood pressure measurement? d. What is the incidence of side effects after administration of the influenza vaccine?
B
Which is an example of how a psychosocial variable affects the patient's health beliefs? a. The patient was diagnosed with rheumatoid arthritis as a young child. b. The patient has always been terrified of needles and so never goes to the doctor. c. The patient's neighborhood has few opportunities to buy fresh fruits or vegetables. d. The patient requires three antihypertensive medications to control blood pressure.
B
Which is the expected action of the nurse who is caring for a patient in a hospice agency? a. The nurse teaches the patient how to administer home IV antibiotics through an intravenous line. b. The nurse educates the patient's family about what to expect as the patient progresses through the dying process. c. The nurse reviews the patient's daily laboratory results before preparing to administer the next dose of chemotherapy. d. The nurse teaches the patient about the importance of swallow precautions to avoid the development of aspiration pneumonia.
B
Which patient will be treated in a Critical Access Hospital (CAH)? a. The cancer patient who requires a bone marrow transplant b. The victim of a serious car accident that occurred in a remote area c. The pregnant patient whose baby will require neonatal intensive care d. The patient who requires minimally invasive heart valve replacement
B
Which nursing actions incorporate informatics into nursing practice? (Select all that apply.) a. The nurse uses written materials to teach a patient who is hard of hearing. b. The nurse uses an online database to learn more about the patient's disease. c. The nurse uses a bar-code scanner to prevent medication administration errors. d. The nurse teaches the patient's family how to perform range of motion. e. The nurse checks the electronic record to review the patient's medical history.
B,C,E
Which action of the nurse demonstrates patient-centered care? (Select all that apply.) a. The nurse elevates the head of the bed when the patient becomes short of breath. b. The nurse and patient work together to determine the patient's health goals. c. The nurse checks the patient's name and birth date before giving medications. d. The nurse maintains privacy when conversing with the patient and providing care. e. The nurse respects the patient's choice to refuse transfusion of blood products.
B,D,E
After careful research, the nursing staff have implemented a new fall prevention protocol on the unit. Which is the logical next step of the staff? a. Review the available literature. b. Encourage abstract thinking. c. Measure the patient fall rate. d. Execute the theoretical framework.
C
After the implementation of a new protocol, the nursing unit had a central line site infection rate of 3%. This rate is well below the agency's expected standard of 5%. Which term best describes this evaluation? a. Research bias b. Control group c. Benchmarking d. Descriptive research
C
The nurse is mandated by the state to complete 25 contact hours of nursing education before the nursing license may be renewed. Which term best describes this requirement? a. In-service education b. Advanced education c. Continuing education d. Certification education
C
Which agency would be most appropriate for a patient who requires rehabilitation services for right-sided hemiplegia after a stroke? a. Respite center b. Primary care center c. Restorative care center d. Assisted-living center
C
Which assessment finding indicates that the family processes were interrupted by the patient's illness? a. The patient must now follow a gluten-free, low-carbohydrate diet. b. The patient must use a walker for ambulation to prevent a fall or injury. c. The patient's spouse had to return to work to maintain the family's income. d. The patient must take three antihypertensive drugs to control high blood pressure
C
Which is an example of a PICO question? a. How does the agency's monthly catheter-associated urinary tract infection rate compare with the national average? b. Which types of topical antibiotic irrigation solutions may be used to reduce healing time for stage 4 decubitus pressure injuries? c. Does oral care with chlorhexidine solution more effectively reduce the incidence of ventilator-associated pneumonia in intubated patients than saline solution? d. Which emotions are commonly felt by patients upon learning that they were diagnosed with a terminal illness?
C
Which statement by the nurse will help the patient progress to the preparation stage for smoking cessation? a. "You will die of emphysema or lung cancer if you do not stop smoking." b. "Research has shown that smoking causes emphysema and lung cancer." c. "The physician will give you nicotine patches to help you start to quit smoking." d. "You need to avoid people who smoke so you will not be tempted to start again."
C
Which type of health care agency is appropriate for a patient who sustained a back injury while at work? a. Respite care center b. Skilled nursing facility c. Occupational health clinic d. Outpatient surgical center
C
Which type of study is appropriate to investigate patients' perceptions about quality of life after a diagnosis of liver cancer? a. Quantitative study b. Randomized trial c. Qualitative study d. Case control study
C
After the implementation of a well-researched fall prevention protocol, patients at the agency have a lower incidence of falls than the national average. Which term will the nurse use to describe this finding? a. Sentinel event b. Qualitative research c. Manuscript narrative d. Nursing-sensitive outcome
D
Which is a responsibility of the Centers for Medicare and Medicaid (CMS)? a. Create teaching materials to educate health care professionals. b. Research evidenced-based practices to improve health care for patients. c. Accredit and certify hospitals in order to ensure safe health care for patients. d. Manage health insurance coverage for elderly, disabled, and low-income patients.
D
Which is an example of a diagnosis-related group (DRG)? a. Patients recovering from orthopedic surgery are placed on the same nursing unit. b. Specialty hospitals are utilized to treat patients with life-threatening illnesses. c. The speech therapist is consulted to see every patient admitted with dysphagia. d. Hospitals will be paid $4500 to care for patients with uncomplicated pneumonia
D
Which is an example of an acute illness? a. Type 2 diabetes b. Multiple sclerosis c. Alcohol addiction d. Bacterial meningitis
D
Which is an example of capitation in health care? a. The patient's rheumatologist is reimbursed for services provided at each consultation appointment with the patient. b. The discharge planner arranges for a home respiratory care company to deliver home oxygen supplies before the patient leaves the hospital. c. The patient's care is managed by a nurse practitioner rather than an attending physician. d. The patient's primary care physician is paid a flat monthly fee no matter how many appointments are scheduled with the patient.
D
Which is an example of tertiary care? a. The patient has annual mammograms to screen for breast cancer. b. The patient sees the podiatrist monthly to prevent diabetic foot ulcers. c. The patient is seen at an urgent care clinic to treat a badly sprained wrist. d. The patient is treated in the intensive care unit following a gunshot injury.
D
Which patient action demonstrates the concept of health promotion? a. The patient receives the influenza vaccination every year. b. The patient participates in cardiac rehabilitation after a heart attack. c. The patient has yearly mammograms to screen for breast cancer. d. The patient follows a macrobiotic, vegetarian diet with organic foods.
D
Which patient is appropriate for an assisted-living agency? a. A patient who requires tube feeding and frequent tracheostomy suctioning after a massive stroke b. A patient with dementia who requires supervision during the day when family members are at work c. A patient with severe depression who has made three suicide attempts in the last 6 months d. A patient who can perform activities of daily living independently but requires assistance with daily medications
D
Which statement by the patient indicates to the nurse that the patient is in the preparation stage of smoking cessation? a. "I don't ever want to quit smoking." b. "I hope to quit smoking sometime before I die." c. "I am really working hard to stop smoking." d. "I stocked up on nicotine patches and gum."
D