Chapter 1: Introduction to Nursing PrepU
During the course of any given day of work in the acute care setting, the nurse may need to perform which roles? Select all that apply. -Communicator -Statistician -Teacher -Counselor -Financier
-Communicator -Counselor -Teacher The roles and functions of the nurse are many and include caregiver, communicator, teacher, counselor, leader, researcher, and advocate. Acting as financier and statistician are not the roles of the nurse.
The first nursing journal owned, operated, and published by nurses was: -Standards of Clinical Nursing Practice -Nurse Educator -Nursing Research -American Journal of Nursing
American Journal of Nursing The American Journal of Nursing was first published in 1900 and was owned, operated, and published by nurses. It continues to provide information that may be of interest to nurses in all nursing specialties, and those who practice general nursing. Nurse Educator is a more recently developed journal which specializes in nursing education and targets nurse educators. Nursing Research is also a more recently developed nursing journal with a focus on nursing research and targets nurses interested in research. Standards of Clinical Nursing Practice are directives and guidelines that may be published as books available to nurses for purchase and review. It is not a nursing journal.
Florence Nightingale introduced the concept of apprenticeship for nurses. Which statement is an example of this? -Passing the NCLEX exam -Taking an online class at a university -Completing clinical hours supervised by a nursing instructor -Participating in a paid internship
Completing clinical hours supervised by a nursing instructor Florence Nightingale's concept of apprenticeship involved training student nurses in a hospital setting. Completing clinical hours is an example of this. Passing the NCLEX exam is required to work as an RN. Participating in a paid internship is outside of the student nurse training supported by the apprenticeship model. Taking an online class at a university is not part of an apprenticeship model.
What might a nurse need to do to ensure the continuation of his or her nursing license? -Obtain a baccalaureate degree. -Attend hospital in-services. -Obtain a master's degree. -Obtain continuing education credits.
Obtain continuing education credits. In many states, continuing education is required for an RN to maintain licensure. These are defined as professional development experiences designed to enrich the nurse's contribution to health. Obtainment of an ongoing degree is not necessary to maintain licensure. While hospital in-services may provide continuing education, not all in-services are designed to do so.
Which nursing intervention would be most appropriate for a new mother that calls the nursery for help with breastfeeding? -Email the mother a link for breastfeeding. -Ask the mother to come to the emergency room. -Suggest that the mother bottle feed her infant. -Refer the mother for a home care visit.
Refer the mother for a home care visit. It is the role of the nurse to encourage health promotion by providing information and referrals; therefore, the nurse should refer the mother for a home care visit, as this will enable the mother to receive all of the breastfeeding help that is needed. Emailing a link for breastfeeding provides information, but not the support that is needed if a mother is having difficulty with breastfeeding. Suggesting bottle feeding and/or going to the emergency room is inappropriate and does not encourage using available resources.
A nurse is providing care for clients in a long-term care facility. What should be the central focus of this care? -The client receiving the care -The nurse as the caregiver -Nursing as a profession -The nurse's actions
The client receiving the care The client receiving the care is always the central focus of the nursing care provided. The central focus is not the nurse, the nursing actions, or nursing as a profession.
A registered nurse (RN) is caring for four clients on a medical-surgical unit. Which task is most appropriate for the nurse to delegate to the licensed practical nurse (LPN)? -administering bedside blood glucose testing -administering blood products -administering chemotherapy -administering intravenous push medication
administering bedside blood glucose testing The LPN, under the nurse practice act (NPA), is permitted to administer testing for bedside blood glucose. The nurse must recognize the scope of practice of the delegate, and remember that client needs and activities delegated must be matched to skill level. The RN would not delegate administration of blood products, intravenous push medication, or chemotherapy to the LPN, as these tasks are not covered under the LPN's NPA.
In what time period did nursing care as we now know it begin? -early civilization to 16th century -18th to 19th century -16th to 17th century -pre-civilization
18th to 19th century From the middle of the 18th century to the 19th century, social reforms changed the roles of nurses and of women in general. It was during this time that nursing as we now know it began, based on the beliefs of Florence Nightingale.
Which scenario is the best example of the nurse implementing the ANA standard relating to diagnosis? -Determining a client is at risk for falls -Assessing a client's apical pulse rate -Evaluating a client's laboratory results -Teaching a diabetic client to inject insulin
Determining a client is at risk for falls When the nurse is implementing the ANA standards relating to diagnosis, the nurse analyzes the assessment data (e.g., lab results, apical pulse) to determine a nursing diagnosis or issue to be addressed by nursing. Determining a client is at risk for falls is an example of the nurse identifying/diagnosing a nursing issue. Assessing a client's apical pulse is assessment. Evaluating a client's laboratory results is part of analysis. Teaching a diabetic client to inject insulin is an intervention.
Which action should the nurse implement when working with a medically homeless client? -Assist the client in finding housing. -Assist the client in finding a job. -Encourage client to utilize the free health care clinic. -Encourage the client to utilize the emergency room when ill.
Encourage client to utilize the free health care clinic. According to the Association of American Medical Colleges, many Americans are medically homeless and find it difficult to navigate the health care system. Encouraging the client to utilize the free health care clinic will help the client navigate the system and obtain access to health care. While utilizing the emergency room when needed is appropriate, the emergency room should not be utilized for all illnesses, as it increases the burden on the health care system. Assisting the client to find housing or a job will help the client, but is outside of the scope of nursing practice.
The registered nurse communicates with the physical therapist that a client is now on strict bed rest due to bradycardia. Which statement best explains the standard exemplified by the nurse? -The RN coordinates care delivery. -The RN analyzes client data. -The RN identifies outcomes. -The RN collects client data.
The RN coordinates care delivery. There are 12 Standards of Practice: assessment, diagnosis, outcomes identification, planning, implementation, evaluation, ethics, culturally congruent practice, communication, collaboration, leadership, and education. The standard exemplified by the nurse is 5a, implementation via coordination of care in which the RN coordinates care delivery. Standard 5b is health teaching and health promotion in which the registered nurse employs strategies to promote health and a safe environment. Standard 3 is outcomes identification, in which the registered nurse identifies expected outcomes for a plan individualized to the health care consumer or the situation. Standard 2, diagnosis, is when the registered nurse analyzes the assessment data to determine the actual or potential diagnoses, problems, and issues. Standard 1 is assessment, in which the registered nurse collects pertinent data and information relative to the health care consumer's health or the situation.
The need for university-based nursing education programs was brought to light during which important historical time? -World War I -World War II -Spanish-American War -Korean War
World War II During the middle of the twentieth century, Esther Lucile Brown, in her report on nursing education published at that time, wrote that nursing education belonged in colleges and universities, not in hospitals. During the Spanish-American War, nursing was still in its earliest phase of development. Even with the input of Florence Nightingale and her followers after WWI, nursing continued to struggle. Professional nursing began during the period and crisis needs of WWII. Nursing continues to evolve today.
The nurse is caring for a client who ascribes to the theory of animism. When attempting to explain this theory to other staff members, the nurse should state: -"Everything in nature is alive with invisible forces." -"Pets can help heal clients." -"The nurse is the handmaiden of the physician." -"The physician is viewed as a god-like figure."
"Everything in nature is alive with invisible forces." The theory of animism attempts to explain the cause of mysterious changes in bodily functions. This theory is based on the belief that everything in nature is alive with invisible forces and endowed with power. Good spirits bring health; evil spirits bring sickness and death. In cultures that ascribe to animism, the roles of the physician and the nurse are separate and distinct. The physician is the medicine man who treats disease by chanting, inspiring fear, or opening the skull to release evil spirits (Dolan, Fitzpatrick, & Herrmann, 1983). The nurse usually is the mother who cares for her family during sickness by providing physical care and herbal remedies. Pets are not involved in the theory of animism.
A nurse is working with a client who has undergone a lower leg amputation. While conducting an assessment, the nurse notes the client has a downcast mood. Which statement by the nurse conveys empathy to the client? -"I can see you are in need of extra comfort right now. Let me adjust your position and readjust your bed linens for you." -"If I had the type of life-altering experience you had, I would probably feel depressed. You are doing well under the circumstances." -"I notice you might be experiencing some feelings of sadness. Would you like to share how you are feeling with me?" -"It is not uncommon to be depressed after having such major surgery. Many of my clients feel sad."
"I notice you might be experiencing some feelings of sadness. Would you like to share how you are feeling with me?" Because a client does not always communicate one's feelings to strangers, nurses use empathy (intuitive awareness of what the client is experiencing) to perceive the client's emotional state and need for support. This skill differs from sympathy (feeling as emotionally distraught as the client). Empathy helps the nurse become effective at providing for the client's needs while remaining compassionately detached. By stating an observational awareness of the client's emotional state based on the client's nonverbal cues, the nurse invites the client to engage in therapeutic communication. The nurse does not assume the client wants any help; therefore, the nurse asks if the client wants to engage in exploring one's experience. By telling the client that is common to be depressed, the nurse is making an assumption about the client's emotional experience. Not all sadness should be labeled as "depression." In addition, by telling the client that other people have had the same experience, it minimizes the client's unique and personal experience, which can threaten the nurse-client relationship and pose a barrier to therapeutic communication. The nurse should not share personal experiences or how the client's unique health experience would make the nurse feel if the nurse was in the same situation. Again, this statement serves to minimize the client's experience and undermines therapeutic communication. Although comforting skills are essential to nursing, assuming that adjusting the client's bed linens will address the client's emotional state is noncongruent and the incorrect intervention for what the nurse has observed.
The nurse is evaluating client health. Which client should the nurse determine to be exhibiting the most signs of health? -A client in acute emotional distress due to spouse's death -A client with depression who refuses to get out of bed -A client with diabetes who is in denial of the diabetes and refuses to take insulin -A client with a leg amputation who performs activities of daily living with a prosthesis
A client with a leg amputation who performs activities of daily living with a prosthesis As defined by the World Health Organization, one's health includes physical, social, and mental components and is not merely the absence of disease or infirmity. Health is often a subjective state—a person may be medically diagnosed with an illness, but still consider himself or herself healthy. The client with an amputation is performing activities of daily living, thereby demonstrating healthy behaviors. A client with diabetes who is refusing to take insulin is in denial of the illness. A client in acute emotional distress related to the spouse's death is experiencing a normal pattern but not demonstrating a healthy behavior. A client with depression who will not get out of bed is also experiencing denial as opposed to a healthy behavior and coping.
Which scenario is the best example of the nurse in the role of teacher/educator? -Communicating discharge status to a home care agency -Teaching a first-grader to read -Conducting research on dressing changes -Assessing whether the client is able to perform a dressing change
Assessing whether the client is able to perform a dressing change When in the role of teacher/educator, the nurse uses communication skills to assess, implement, and evaluate teaching plans to meet the learning needs of clients and their families. The nurse assessing whether a client is able to perform a dressing change is assessing the need for education on how to perform the dressing change. Teaching a first-grader to read is not within the scope of nursing practice. Communication of discharge status is an example of the nurse as a communicator. Conducting research is an example of the role of the nurse as a researcher.
A nurse manager is teaching staff how to use a new piece of hospital equipment. Which educational setting would be most appropriate for this process? -Undergraduate studies -Graduate education -In-service education -Continuing education
In-service education In-service education is designed to increase the knowledge and skills of the nursing staff. Education about a new piece of hospital equipment would fall into this category. Continuing education is educational experiences designed to enrich the nurse's contribution to health. Many state nursing organizations require continuing education hours to maintain licensure. Undergraduate studies are the educational programs for pre-licensure in the field of nursing. For the nurse, this could be a diploma, associate degree, or baccalaureate in nursing. Graduate education would include the educational programs for the advanced practice nurse. This could be master's degree or doctoral preparation.
A registered nurse wishes to work as a nurse researcher. Which is true regarding nurse researchers? -They usually have a baccalaureate degree in nursing. -They serve as liaisons between staff members and directors of nursing. -They are responsible for the continued development and advancement of nursing. -They tend to work in community health centers and long-term care units.
They are responsible for the continued development and advancement of nursing. Nursing research requires extensive education and is a uniquely specialized field. Nurse researchers are responsible for the continued development and refinement of nursing. They usually have advanced education post baccalaureate degree in nursing and most often work in large teaching hospitals or research centers. Nurse administrators, not nurse researchers, serve as liaisons between staff members and directors of nursing, Nurse researchers may be found with a school of nursing at academic institutions, but not at community health centers and long-term care units.
The nurse is caring for a client after a stroke rendered the client's right side weaker than the left. The nurse coordinates the plan of care with the physical therapist. The nurse's interventions reflect which one of nursing's four broad goals? -To facilitate coping -To promote health -To prevent illness -To restore health
To restore health The four broad aims of nursing practice are to promote health, prevent illness, restore health, and facilitate coping with death and/or disability. In the example, the nurse is coordinating care with the other disciplines in an attempt regain some of the strength in the client's right side. This is an example of restoring a client's health. The nurse is not preventing the stroke or promoting health prior to the stroke. The nurse is not facilitating coping with the stroke.
The RN is working with hospital administrators to transform care at their facility. Which nursing competency will be critical for the nurse to utilize? -Work effectively in interdisciplinary teams -Do things the way they have always been done -Correctly utilize and troubleshoot high-tech equipment -Navigate the electronic medical records system
Work effectively in interdisciplinary teams The RN working with administrators to transform care will need to be able to work effectively as part of an interdisciplinary team. The nurse will need to work as a team member with members of the administration, as well as representatives from other health disciplines involved in the project. The ability to use and troubleshoot equipment and to navigate the electronic medical records are important to the nurse, but will not necessarily help when working with administration to transform care. Doing things the way they have always been done is a barrier to transformation of care.
The primary aim of the Healthy People 2020 initiative is: -coping with disability. -health restoration. -health promotion. -illness prevention.
health promotion. Healthy People 2020 establishes health promotion guidelines for the nation as a whole. The guidelines contain Leading Health Indicators, which are used to measure the health of the nation over a 10-year period. Illness prevention, health restoration, and coping with disability are components of the Healthy People 2030 guidelines, but are not considered as the primary goal of the initiative.
The primary aim of the Healthy People 2030 initiative is: -coping with disability. -illness prevention. -health promotion. -health restoration.
health promotion. Healthy People 2030 establishes health promotion guidelines for the nation as a whole. The guidelines contain Leading Health Indicators, which are used to measure the health of the nation over a 10-year period. Illness prevention, health restoration, and coping with disability are components of the Healthy People 2030 guidelines, but are not considered as the primary goal of the initiative.
