CHAPTER 1 - THE PROFESSION OF NURSING

Which of the following nursing groups provides a definition and scope of practice for nursing? AAN ICN The Joint Commission ANA

ANA p. 10 Rationale: The American Nurses Association (ANA) describes the values and social responsibility of nursing, provides a definition and scope of practice for nursing, discusses nursing's knowledge base, and describes the methods by which nursing is regulated within its Nursing's Social Policy Statement (2003).

During the clinical rotation, a nurse documents the vital signs of a client on the bedside chart. What role is the nurse playing in such a situation? Communicator Coordinator Decision-maker Client advocate

Communicator p. 12 Rationale: The nurse is providing, in written form, the client's vital signs to the health care provider checking the bedside chart during clinical rounds, so the nurse acts as a communicator. The nurse is not making any decisions here, so the role is not that of a decision-maker. The nurse is not playing the role of a coordinator or a client advocate. When the nurse coordinates services offered by a variety of health care professionals, the nurse acts as a coordinator. As a client advocate, the nurse should protect the client, understanding the client's needs and concerns.

A nurse is gathering information about a person's culture and beliefs related to health and how these beliefs influence the person. The nurse is evaluating which functional health pattern? Cognition and perception Health perception and health management Sleep and rest Coping and stress tolerance

Health perception and health management p. 15 Rationale: The health perception/health management pattern focuses on health values and beliefs and the resources in the community that are available to meet health needs. Success in meeting human needs in this pattern relies heavily on culture, societal beliefs, personal expectations, and one's own health. The cognitive/perceptual pattern examines the extent of the client's awareness of human needs, which ties in with the health perception/health management pattern. Sleep and rest relate to sleep and rest patterns that develop at birth and change throughout life. Coping and stress tolerance reflect a person's adaptive psychological function.

The nurse recognizes that immunizations are an example of: - Health promotion - Facilitating coping with disability and death - Illness prevention - Health restoration

Illness prevention p. 24-25 Rationale: The aim of illness prevention activities is to reduce the risk for illness, to promote good health habits, and to maintain optimal functioning. Immunization administration is an example of illness prevention. Assisting with crutch-walking and teaching medication administration are examples of health restoration activities, which encompasses early detection of a disease to rehabilitation. Hospice care is an example of facilitating coping with disability and death.

Amy Jones, a high school senior, wants to become a geriatric nurse practitioner. What nursing degree will she need to attain this goal? Associate degree Baccalaureate degree Licensed Practical Nurse Master's degree

Master's degree p. 7 Rationale: A nurse must have an advanced degree (master's in nursing) to become a nurse practitioner. The other levels of preparation do not provide adequate advanced knowledge and skills for the responsibilities of a nurse practitioner.

What might a nurse need to do to ensure the continuation of his/her nursing license? Attend hospital in-services. Obtain continuing education credits. Obtain a master's degree. Obtain a baccalaureate degree.

Obtain continuing education credits p. 7 Rationale: 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.

Oxygen, food, water, and rest are all examples of what type of human need as described by Maslow? Self-actualization Safety Esteem Physiologic

Physiologic p. 14 Rationale: Oxygen, food, water, and rest are all examples of physiologic need according to Maslow's hierarchy of human needs. Physiologic need is the most fundamental and essential need for existence.

The nurse is administering an antibiotic to a client with community-acquired pneumonia. This activity encompasses which aim of nursing? Preventing illness Restoring health Promoting health Facilitating coping

Restoring health p. 11 Rationale: Treating an existing illness is an example of restoring health. The object of illness-prevention activities is to reduce the risk for illness through educational programs, resources that encourage healthy lifestyles, and information on good health habits. Promoting health focuses on health-related activities, health awareness, and a client's self-awareness. Facilitating coping with disability and death assists the client and family in dealing with altered function, life crisis, and death.

The nurse conducts a home safety assessment for a client. Which statement best explains the standard of care being implemented? The RN develops a plan of care. The RN promotes a safe environment. The RN identifies client outcomes. The RN educates about preventing falls.

The RN promotes a safe environment p. 9, 11 Rationale: The standard of care being exemplified is Standard 5b: Health teaching and Promotion: The RN employs strategies to promote health and a safe environment.

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 restore health To prevent illness To faciliate coping To promote health

To restore health p. 11 Rationale: 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.

Which age group in the population is expanding most rapidly, resulting in changes in the delivery of health care? school-age children young adults newborns older adults

older adults p. 17-18 Rationale: The older adult population is expanding more rapidly than any other age group. As a result, older adults will consume more health care services and will require individualized interventions that differ from those designed for younger populations.

A man age 61 years is distraught because he has just learned that his most recent computed tomography (CT) scan shows that his colon cancer has metastasized to his lungs. Which nursing aim should the nurse prioritize in the immediate care of this client? - Restoring health - Facilitating coping - Promoting health - Preventing illness

- Facilitating coping P. 11 Rationale: This client's care in the coming weeks or months will likely encompass all of the four foundational roles of the nurse. However, because the client has just recently received bad news and is emotionally distraught, helping the client cope is an appropriate priority in his immediate care.

The nurse graduated several years ago from a 2-year nursing program at a community college near the home city. Recently, the nurse has considered moving from providing direct client care into an administrative role, but recognizes the need for further education to be considered for such a position. The nurse most likely possesses which nursing qualification? Associate degree Graduate degree Diploma Baccalaureate

Associate degree p. 7 Rationale: An associate degree in nursing is typically a 2-year program that is offered at a community college or junior college. Such a degree allows a nurse to plan and provide care, but further education is often necessary for administrative positions. A diploma is often provided under the auspices of a hospital, while both baccalaureate and graduate degrees involve a minimum of 4 years of education; both degrees qualify a nurse to act in a supervisory role.

Which national nursing organization serves as a primary source of research data about nursing education, and is the professional organization for nurse educators? - American Nurses Association (ANA) - American Association of Colleges of Nursing (AACN) - National League for Nursing (NLN) - Sigma Theta Tau International

National League for Nursing (NLN) p. 10 Rationale: The NLN serves as the primary source of research data about nursing education, conducting annual surveys of schools and new RNs. The NLN's objective is to foster the development and improvement of nursing services and nursing education, and it serves as the professional nursing organization for nurse educators. The ANA is the professional organization for RNs in the United States, and it establishes standards of practice, encourages research to advance nursing practice, and represents nursing for legislative actions. Sigma Theta Tau International is the honor society for nursing. AACN is the national voice for baccalaureate and higher-degree nursing education programs and provides accreditation for collegiate nursing programs.

Which explanation differentiates the Registered Nurse (RN) from the Licensed Practical Nurse (LPN)? The LPN can only work in a long-term facility. The RN is permitted to prescribed medications. The LPN should work under the supervision of an RN. The RN directs the workload of an LPN.

The LPN should work under the supervision of an RN p. 6 Rationale: LPNs are employed in hospitals, long-term care facilities, and rehabilitation centers and by health care providers such as physicians. LPNs differ from RNs in two areas: educational preparation and scope of practice. LPNs always practice under the supervision of an RN.

A nurse is providing care for clients in a long-term care facility. Based on the definitions of nursing in the textbook, what should be the central focus of this care? - the client receiving the care - nursing as a profession - the nursing actions provided by the nurse - the nurse as the caregiver

the client receiving the care p. 2 Rationale: 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.

In what time period did nursing care as we now know it begin? - Early civilization to 16th century - Pre-civilization - 18th to 19th century - 16th to 17th century

- 18th to 19th century p. 3, Table 1-1 Rationale: 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 nursing action would be considered an ethical/legal skill? - A nurse obtains a urine sample for a urinalysis. - A nurse explains the rationale for a client's plan of care. - A nurse holds the hand of a woman whose baby died at birth. - A nurse helps a client prepare a living will.

- A nurse helps a client prepare a living will. p. 9, text and Box 1-2 Rationale: Ethical and legal skills include being trusted to act in ways that advance the interests of clients; being accountable for their practice to themselves, the clients they serve, the caregiving team, and society; acting as effective client advocates; mediating ethical conflicts among the client, significant others, the health care team, and other interested parties; practicing nursing faithful to the tenets of professional codes of ethics and appropriate standards of practice; and using legal safeguards that reduce the risk of litigation. Obtaining a urine sample is an example of the caregiver role. Explaining care is within the role of communicator, and holding the client's hand is providing supportive care.

Which organization is the best source of information when a nurse wishes to determine whether an action is within the scope of nursing practice? - American Association of Colleges in Nursing (AACN) - International Council of Nurses (ICN) - American Nurses Association (ANA) - National League for Nursing (NLN)

- American Nurses Association (ANA) p. 9 Rationale: The ANA produced the 2015 Nursing: Scope and Standards of Practice, which defines the activities specific and unique to nursing. The AACN addresses educational standards, while the NLN promotes and fosters various aspects of nursing. The ICN provides a venue for national nursing organizations to collaborate, but does not define standards and scope of practice.

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? - Graduate education - In-service education - Continuing education - Undergraduate studies

- In-service education p. 9 Rationale: 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 client has come to a health care facility for a routine Pap smear. Who is qualified to perform the smear? - Nurse midwife - Nurse educator - Nurse administrator - Nurse anesthetist

- Nurse midwife p. 8 Rationale: A nurse midwife is qualified to perform a routine Pap smear. The nurse anesthetist, nurse administrator, and nurse educator do not perform routine Pap smears. A nurse anesthetist assists an anesthesiologist in providing general anesthesia during surgery. A nurse administrator works as a liaison between the staff members and directors. A nurse educator is a nurse who teaches in nursing programs

Which nursing intervention would be most appropriate for a new mother that calls the nursery for help with breastfeeding? - Ask the mother to come to the emergency room. - Refer the mother for a home care visit. - Suggest that the mother bottle feed her infant. - Email the mother a link for breastfeeding.

- Refer the mother for a home care visit. p. 11-12 Rationale: 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.

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. p. 9, Box 1-2 Rationale: The standard exemplified by the nurse is 5a: Coordination of Care: The RN coordinates care delivery.

Which of the following is the best example of client-centered approach to care? - The nurse drawing a blood sample from a client. - The nurse helps a client ambulate. - The nurse asks the client about his health goals. - The nurse asks the client what he would like to order from menu.

- The nurse asks the client about his health goals. p. 12 Rationale: Client-centered care is one of the quality and safety education requirements for nursing competencies (QSEN). The intent of client-centered care is to ensure that care is centered on the client, and not the needs of the nurse. An example of this is the nurse asking the client about his health goals so that they can be addressed on the client's plan of care. Helping the client ambulate and drawing a blood sample are examples of client care, but are not client-centered care.

A nursing instructor is preparing a presentation for a group of incoming nursing students. What would the instructor need to keep in mind when developing the presentation? - Many of the students will be single parents. - The student population is likely to be widely diverse. - A few students may have obtained degrees in other areas. - The majority of students will be recent high school graduates.

- The student population is likely to be widely diverse. p. 18 Rationale: Fifty years ago, most nurses were young women who entered hospital-based programs right after graduation from high school. Today's students reflect a much more diverse population. Some still enter their programs immediately after high school, but many more have pursued other paths before choosing nursing as a career. Consequently, nursing students must find ways to balance the demands of being an adult learner with the responsibilities of adult life. Many have children, partners, and other employment demands. These learners must balance family, finances, and career development.

A registered nurse wishes to work as a nurse researcher. Which is true regarding nurse researchers? - They are responsible for the continued development and advancement of nursing. - They serve as liaisons between staff members and directors of nursing. - They tend to work in community health centers and long-term care units. - They usually have a baccalaureate degree in nursing.

- They are responsible for the continued development and advancement of nursing. p. 8-9 Rationale: Nurse researchers are responsible for the continued development and refinement of nursing. They usually have advanced education in addition to a baccalaureate degree in nursing. Nurse administrators, not nurse researchers, serve as liaisons between staff members and directors of nursing. Nurse researchers tend to work in large teaching hospitals, research centers, and academic institutions, not community health centers and long-term care units.

The nurse working with an LPN understands which of the following about LPNs? - They must take a licensure exam. - They have a higher degree than most RNs. - They may work independently. - The program is 4 years in length.

- They must take a licensure exam. p. 6 Rationale: Schools for practical nursing programs are located in varied settings. Most programs are 1 year in length. Upon completion of the program, graduates can take the National Council Licensure Examination-Practical Nursing (NCLEX-PN) for licensure as an LPN. LPNs work under the direction of a physician or RN to give direct care to clients, focusing on meeting health care needs in hospitals, nursing homes, and home health agencies.

Which description depicts the role of the nurse practitioner? - is responsible for the continued development and refinement of nursing knowledge and practice through the investigation of nursing problems. - functions independently, is skilled at doing nursing assessments, performing physical examinations, counseling, teaching, and treating health problems. - provides general anesthesia for clients undergoing surgery. - manages and controls client care while being responsible for specific nursing units.

- functions independently, is skilled at doing nursing assessments, performing physical examinations, counseling, teaching, and treating health problems. p. 8 Rationale: The nurse practitioner functions independently, is skilled at doing nursing assessments, performing physical examinations, counseling, teaching, and treating health problems. The nurse researcher is responsible for the continued development and refinement of nursing knowledge and practice through the investigation of nursing problems. The nurse anesthetist provides general anesthesia for clients undergoing surgery. The nurse administrator manages and controls client care while being responsible for specific nursing units.

What is the primary purpose of standards of nursing practice? - to ensure knowledgeable, safe, comprehensive nursing care - to provide a method by which nurses perform skills safely - to establish nursing as a profession and a discipline - to enable nurses to have a voice in health care policy

- to ensure knowledgeable, safe, comprehensive nursing care p. 9-10 Rationale: Each nurse is accountable for her own quality of practice and is responsible for using standards to ensure knowledgeable, safe, comprehensive care. Standards of practice do not provide the ability to safely perform skills, establish nursing as a profession and discipline, or enable nurses to have a voice in health care policy.

A nurse applies for membership in a professional nursing organization that is operating in the United States. To which organizations might this nurse apply? Select all that apply. ANA NASN ANO NNO ICN AACN

ANA AACN ICN p. 10-11 Rationale: The American Nurses Association (ANA), International Council of Nurses (ICN), and American Association of Critical-Care Nurses (AACN) are three examples of organization to which a nurse might apply. The NNO, NASN and ANO are not professional nursing organizations.

A client admitted to the telemetry floor informs the nurse that he has an advance directive and does not wish to be resuscitated if his heart stops beating. The client takes a copy of the advance directive from his wallet and hands it to the nurse. The nurse documents on the electronic chart that the client has an advance directive, makes a copy of the advance directive, and immediately informs the client's physician. In this situation, what is the nursing role demonstrated by the nurse? Researcher Leader Counselor Advocate

Advocate p. 11 Rationale: The nursing role that focuses on advocacy involves the protection of human or legal rights and the securing of care for all clients, based on the belief that clients have the right to make informed decisions about their own health. In this situation, the nurse recognizes the client's right to make end-of-life decisions and advocates for the client by documenting that the client has an advance directive. The nurse also demonstrates advocacy by communicating this information to the client's physician.

The nurse is caring for a client who cannot meet health needs independently. Which action made by the nurse depicts concern and attachment? Telling the client, "I will be back in 15 minutes to change your dressing." Organizing the work for the day and evaluating how the day went Asking the client, "How are you today? I am really worried about you." Talking about diabetes and teaching the client how to do foot care

Asking the client, "How are you today? I am really worried about you." p. 91-92 Rationale: Concern and attachment are the result of a close relationship of one human being with another. Thus, asking the client how the client is feeling and expressing concern exemplifies caring. Stability and security, communications and teaching, and organization and evaluation are physical care themes that are part of nursing care.

A nurse is assigned the care of a client who has been admitted to the health care facility with high fever. Which nursing skill should be put into practice at the first contact with the client? Comforting Caring Assessment Counseling

Assessment p. 9, Box 1-2 Rationale: On admission of the client to a health care facility, the nurse would be required to conduct an initial assessment of the client. Therefore, the nurse would implement her nursing skills in this case. This can be done by interviewing, observing, and examining the client. Caring skills are put into practice once the nursing needs are determined. Comforting and counseling skills may not have a major role in assessing client problems.

There are various levels of preparation for nursing practice. Which degree program will best prepare a nurse to work as a nurse researcher? Doctoral Baccalaureate Master's Diploma

Doctoral p. 8-9 Rationale: Nurses with doctoral degrees meet requirements for academic advancement and are prepared to carry out research necessary to advance nursing theory and practice. A master's degree prepares advanced practice nurses to function in educational settings, managerial roles, as clinical specialists, and in various advanced practice areas. Baccalaureate programs provide a general educational base and incorporate the sciences and humanities. Graduates of a diploma program have a strong emphasis on clinical experiences in direct client care and are prepared to work in acute, long-term, and ambulatory care facilities.

A new graduate is working with a registered nurse. The registered nurse demonstrates the use of intuition to focus on a client's problem. The registered nurse is functioning at which level of proficiency? Expert Novice Competent Proficient

Expert p. 6, Table 1-2. Rationale: The nurse is functioning at the level of the expert nurse. The expert nurse, with an enormous background of experience, has an intuitive grasp of the situation and zeroes in on the problem. Competence is reflected by the nurse who has been on the same job for 2 or 3 years and who consciously and deliberately plans nursing care in terms of long-range goals. The novice nurse is a beginning nursing student or any nurse entering a situation in which no previous experience has been attained. Behavior is governed by established rules and is limited and inflexible. The proficient nurse perceives situations as a whole rather than in terms of aspects, and manages nursing care rather than performing tasks.

The nurse asks a client about his spiritual health. Which statement best explains the standard of care utilized by the nurse? The RN collects comprehensive data. The RN collaborates with spiritual healers. The RN prays with clients. The RN provides spiritual counseling.

The RN collects comprehensive data. p. 9, Box 1-2 Rationale: The standard being exemplified is Standard 1: Assessment: The RN collects comprehensive data. Spiritual assessment is part of the comprehensive assessment data collection. The RN may pray with a client and/or collaborate with spiritual healers, but it is not part of the standards of care. The RN typically does not provide spiritual counseling.

Which of the following best exemplifies the role of the nurse as educator? - a nurse discussing side effects of a medication with a client - a nurse researching the best way to provide care - a nurse allowing a client to verbalize fears of death - a nurse referring a client to outpatient services

a nurse discussing side effects of a medication with a client p. 11 Rationale: When the nurse is in the role of educator, the nurse uses communication skills to assess, implement, and evaluate individualized education plans to meet the learning needs of clients, such as when discussing side effects of a medication. Allowing the client to verbalize feelings and/or referring them to outpatient services demonstrates the role of counselor. Researching the best way to provide care demonstrates the role of researcher.

Which social force significantly impacted the future supply and demand of nurses? - technology - aging - economics - science

aging p. 6 Rationale: Social forces, such as aging and the retirement rate that exceeds replacement and attrition of aging faculty, significantly impacts the future supply/demand of nurses. Technology, economics, and science are not social forces that have impacted the future supply and demand of nurses.

A nurse is considering relocating to another state to practice nursing. Which of the following is the most appropriate action by the nurse to ensure ability to practice in the new state? No action is needed by the nurse. taking the new state's licensing exam asking the current state to transfer the license applying for a reciprocal license in the new state

applying for a reciprocal license in the new state p. 10 Rationale: Nurses gain legal rights to practice nursing in another state by applying to that state's board of nursing and receiving reciprocal licensure.

A nurse is evaluating clients in an outpatient clinic. Which client requires the nurse to include a secondary illness in the plan care? - client with a history of premature atrial contractions (PVCs) who is experiencing heart palpitations while jogging - client with a history of chronic obstructive pulmonary disease (COPD) now had symptoms of right side heart failure - client who woke up this morning with a fever and sore throat - client with chronic asthma who is experiencing shortness of breath and wheezing

client with a history of chronic obstructive pulmonary disease (COPD) now had symptoms of right side heart failure Rationale: A secondary illness is a disorder that develops from a preexisting condition. The client with COPD already has a pulmonary disease as a primary illness. If heart failure occurs as a consequence of damaged lung tissue, it is considered a secondary problem. All of the other clients are experiencing symptoms associated with primary problems or acute problems.