PCCI Exam 2 Ch Quizzes

8. Ethnicity is evident in customs of particular groups. Which of the following statements accurately reflect the definitions of culture, values and value orientation? (select all that apply) A. Culture refers to patterns of human behavior that include language, communication, customs and beliefs. B. Ethnicity is shaped by values, beliefs, norms, and practices that are shared by members of the same group. C. Health care beliefs and attitudes among ethnic groups are congruent with health care providers. D. Values are beliefs about the worth of something and serve as standards that influence behavior. E. Value orientations reflect the personality type of a particular society.

A. Culture refers to patterns of human behavior that include language, communication, customs and beliefs. D. Values are beliefs about the worth of something and serve as standards that influence behavior. E. Value orientations reflect the personality type of a particular society.

5. A nurse mentor is explaining the benefits of collaborative practice to a nurse new to a facility. Which of the following research-based benefits is the nurse likely to identify as positive outcomes of collaboration? (Select all that apply): A. Decreased length of stay for patients. B. Decreased staff resignations. C. Decreased use of pain medications. D. Increased reimbursement from insurance carriers. E. Increased patient follow-up appointments after discharge. F. Increased job satisfaction of the staff.

A. Decreased length of stay for patients. B. Decreased staff resignations. F. Increased job satisfaction of the staff. Rationale Documented positive outcomes from collaboration include a shortened length of stay, increased job retention and decreased staff turnover, increased job satisfaction for registered nurses, and improved problem-solving skills. Identified research has not demonstrated less use of pain medication, increased reimbursement, or better follow-up by patients after discharge.

3. The nurse is assessing a patient's ability to perform basic activities of daily living (BADLs). Which of the following activities are considered in the BADLs assessment? (Select all that apply): A. Feeding oneself. B. Preparing a meal. C. Balancing a checkbook. D. Walking. E. Toileting. F. Grocery shopping.

A. Feeding oneself. D. Walking. E. Toileting. Rationale BADLs include feeding oneself, ambulation, and toileting. Instrumental activities of daily living (IADLs) include shopping, meal preparation, housekeeping, doing laundry, managing finances, taking medications, and using transportation.

9. What biological risk factors may be an issue when working with families? (select all that apply) A. Genetic inheritance B. Stress and anxiety C. Congenital malformation D. Mental retardation E. Water pollution

A. Genetic inheritance C. Congenital malformation D. Mental retardation Rationale Family risk factors can be inferred from: lifestyle; biological factors; environmental factors; social, psychological, cultural, and spiritual dimensions; and the health care system. Lifestyle habits such as overeating, drug dependency, high sugar and cholesterol intake, and smoking influence health outcomes. Biological risk factors may include the elements of genetic inheritance, congenital malformation, and mental retardation. Social and psychological dimensions such as crowding, isolation, or rapid and accelerated rates of change are areas to consider when assessing family risk factors. Environmental risk factors that influence family function include work pressures, peer pressure, stress, anxieties, tensions, and air, noise, or water pollution. Reference: p. 153

8. Which interventions are independent nursing actions? (Select all that apply.) A. IV reinsertion B. Assessing lung sounds C. Medication administration D. First postoperative dressing change E. Obtaining informed consent from the patient

A. IV reinsertion B. Assessing lung sounds Rationale Independent nursing actions are those that a nurse is legally able to order or begin independently (e.g., turn every two hours, monitor for complications). Dependent interventions are physician-initiated. Medication administration is collaborative care as the health care provider must order the medication. Surgeons usually do the first postoperative dressing change. The health care provider legally must obtain informed consent from the patient, although the nurse may witness the consent.

8. What are the four types of nursing interventions used in health-promotion and disease-prevention planning for the family? (select four correct answers) A. Increasing knowledge and skills B. Increasing strengths C. Decreasing exposure to risks D. Decreasing susceptibility E. Decreasing interdependence

A. Increasing knowledge and skills B. Increasing strengths C. Decreasing exposure to risks D. Decreasing susceptibility Rationale In health promotion and disease prevention, nurses assist families to improve their capacity to act on their own behalf. Health promotion and disease prevention may not have been part of the family's life experiences, giving the nurse the educational task to try to change attitudes and values expanding the options for families to consider health promotion. Four types of nursing interventions appear in health- promotion and disease-prevention planning: increasing knowledge and skills; increasing strengths; decreasing exposure; and decreasing susceptibility. Increasing knowledge and skills to improve family capacity for health-promotion and disease-prevention behavior may be the primary strategy. Increasing strengths is accomplished through education and learning of new skills. Decreasing exposure to risk factors may include enhancing parents' ability to assess and adjust their behavior to their child's temperament. Decreasing susceptibility means educating families about prevention principles. Reference: p. 171

1. Which techniques would be most appropriate to enhance patient learning? (Select all that apply.) A. Obtain frequent feedback. B. Have a quiet environment. C. Explain information in great detail. D. Involve the patient and caregiver in the process. E. Emphasize relevancy of the information to the patient's lifestyle.

A. Obtain frequent feedback. B. Have a quiet environment. D. Involve the patient and caregiver in the process. E. Emphasize relevancy of the information to the patient's lifestyle. Rationale Asking for frequent feedback, involving the patient and caregiver, and emphasizing relevancy of the information to the patient's lifestyle are all appropriate techniques. The nurse would want to avoid giving great detail to patients. Starting simple is best.

4. Which of the following interventions should be included in a plan of care for a patient who had a stroke 30 days ago and is now in home care rehabilitation? (Select all that apply). A. Promoting independence and encouraging patient participation in activities of daily living (ADLs). B. Promoting rest and sleep. C. Promoting a diet rich in protein. D. Promoting exercise and ambulation. E. Assisting the patient with ADLs. F. Limiting visitors and social contacts.

A. Promoting independence and encouraging patient participation in activities of daily living (ADLs). B. Promoting rest and sleep. D. Promoting exercise and ambulation. Rationale It is important to promote independence in ADLs early in the plan of care to increase independence in general. Promoting rest and sleep will promote well-being. Ambulation and exercise promote well-being and increase healing by circulating oxygen to the brain. Protein promotes healing in postsurgical patients but is not a main focus in stroke patients. Assisting the patient does not promote independence. Limiting visitors will isolate the patient, which can lead to depression.

10. Nurses caring for the Black/African American population need to maintain an awareness of which of the following health-related cultural aspects of care? (select two that apply) A. Severe high blood pressure is more common for African Americans. B. Cancer and mortality rates for African Americans is higher than that for White Americans. C. African Americans are less likely to be diagnosed with diabetes. D. African Americans have the highest percentage of women with low or no prenatal care in the first trimester.

A. Severe high blood pressure is more common for African Americans. B. Cancer and mortality rates for African Americans is higher than that for White Americans.

10. Improvement of which five of the following habits would substantially reduce mortality rates? (select all that apply) A. Smoking B. Stress C. Poor diet D. Alcohol abuse E. Medication use F. Lack of exercise G. Emergency room visits

A. Smoking B. Stress C. Poor diet D. Alcohol abuse F. Lack of exercise Rationale At least 7 of the 10 leading causes of death listed in the Healthy People 2020 report might be substantially reduced if the family improves only five habits: poor diet, smoking, lack of exercise, alcohol abuse, and stress. Reference: p. 153

7. Nurses have a responsibility to ensure health literacy when providing health education. What are some strategies that nurses can use to promote health literacy? (select all that apply) A. Speak clearly and distinctly. B. Speak louder than usual. C. Use medical terminology. D. Face the person when speaking. E. Conclude with a summary of key points.

A. Speak clearly and distinctly. D. Face the person when speaking. E. Conclude with a summary of key points. Rationale The ability to communicate clearly with people from all literacy levels is an important component of patient-centered quality and safety in health education. The following strategies can have a significant impact on patient outcomes: speak clearly and distinctly, face the person when speaking, avoid the use of medical terminology, use plain language, and conclude with a summary of key points. It is not necessary to increase the volume of speaking, or change your tone when providing health education. Reference: p. 217

7. The patient says she prefers to watch how things are done rather than to read the information or instructions to learn about how to take care of herself. Which teaching strategy would be best for this patient? A. Watch a DVD. B. Read the pamphlet. C. Talk about it with the nurse. D. Use the Internet to read about it.

A. Watch a DVD. Rationale This patient has a visual or audio learning style and prefers not to learn by reading. The DVD would be the best teaching strategy. The nurse could also demonstrate how to do a skill with this patient.

10. Major goals in assessing each person's functional pattern are to determine: (select all that apply) A. ability to manage health-promoting activities. B. herbal medications that promote health. C. knowledge of health promotion. D. the need for physician referral for illness care. E. the value that the person ascribes to health promotion.

A. ability to manage health-promoting activities. C. knowledge of health promotion. E. the value that the person ascribes to health promotion. Rationale A major goal in assessing each pattern is to determine the individual's knowledge of health promotion, the ability to manage health-promoting activities, and the value that the individual ascribes to health promotion. The assessment of herbal medications is important to determine potential for interactions with other prescribed medications, and adverse effects produced by the herbal medications. Referral to the physician for illness care would not be part of the assessment of functional health patterns. Reference: p. 130

2. The nurse incorporates cultural considerations into the health teaching plan by: A. assessing a person's beliefs. B. using medical terminology. C. presenting evidence-based information. D. explaining that universal health practices are the best.

A. assessing a person's beliefs. Rationale The health professional must take the time to assess cultural beliefs that influence social and health practices, and must make every effort to analyze educational interventions that are acceptable and satisfying to the individual. Nurses should recognize that a person's or group's background, beliefs, and knowledge may differ significantly from their own and seek to understand and show respect for these differences. Nurses should endeavor to provide culturally sensitive client education. Using medical terminology may be confusing and thus interpreted in different ways, and should only be used when the meaning can be made clear. Nurses should present evidence-based information to all clients regardless of their cultural background. Universal health practices, which are based upon research, should be presented regardless of cultural background. Reference: p. 221

6. The nurse's role with the family with older adults includes serving as a counselor of: A. bereavement. B. menopause. C. family planning. D. sexually transmittable diseases.

A. bereavement. Rationale The nurse's role in the family with older adults would include the counselor of bereavement. The counselor of menopause would be part of the nurse's role with the family with young or middle-aged adults. The nurse's role with the family with adolescents would be the counselor of family planning. Reference: p. 173

5. Nurses play an active role in __________individuals to make their own informed decisions about health care. A. empowering B. coercing C. persuading D. directing

A. empowering Rationale Applying principles of respect, autonomy, justice, and beneficence, nurses have an active role as advocates in empowering individuals to make their own informed decisions about their health and care. The nurse works as partner, facilitator, and resource for the care recipient and family. Choices about health care practices belong to individuals, not health care providers. All competent individuals have the right to autonomous choice. Nurses should respect decisions made by persons and families, even when the choice is not what the nurse might do or suggest, or is considered "unhealthy," and avoid labeling them as noncompliant. Reference: p. 220

10. Nurses provide health education to people to assist them in achieving a goal of: (select all that apply) A. enhanced wellness. B. physician-directed care. C. management of a chronic condition. D. admission to tertiary-care facilities. E. wisely handling daily health care decisions. F. fostering successful changes in health behaviors.

A. enhanced wellness. C. management of a chronic condition. E. wisely handling daily health care decisions. F. fostering successful changes in health behaviors. Rationale The goal of health education is to assist individuals, families, and communities achieve, through their own actions and initiative, optimal states of health, and therefore enhanced wellness. Other goals of health education are for the detection of illness, treatment, rehabilitation, and long-term care. Health education encourages positive, informed changes in lifestyle behaviors that prevent acute and chronic disease, decrease disability, and enhance wellness. Health education fosters successful changes in health behavior, which then empowers the individual. People who believe that their behaviors will make a difference in their health and who are involved in the decision making are more likely to make changes. Health education enables the individual to wisely handle daily decisions and to manage a chronic illness. Reference: pp. 217-219

3. A nurse is providing care for a patient who had transurethral resection of his prostate this morning. The patient is receiving continuous bladder irrigation, but his urinary catheter is now occluded. The nurse is now planning to phone the patient's health care provider and communicate using the SBAR (Situation-Background-Assessment-Recommendation) format. Which statement is a component of communication using SBAR? A. "What do you think could be causing this occlusion?" B. "I think that we should manually irrigate his catheter." C. "What do you know about this patient and his history?" D. "Could you please provide some direction for his care?"

B. "I think that we should manually irrigate his catheter." Rationale Proposing a recommendation is a component of the "R" component of SBAR communication. Asking the health care provider for possible contributing factors to the problem or for general direction may be appropriate in some circumstances, but these are not explicit components of SBAR. The nurse should briefly identify the patient and his circumstances, not ask an open-ended question regarding the physician's familiarity.

3. The three elements of nursing competency described in the Quality and Safety for Nurses (QSEN) initiative are knowledge, skill, and A. Accountability. B. Attitude. C. Education. D. Value.

B. Attitude. Rationale The Robert Wood Johnson Foundation funded the national initiative called Quality and Safety for Nurses (QSEN), which builds on the work of the Institute of Medicine (IOM), defines safety, and outlines the necessary elements of knowledge, skill, and attitude to demonstrate safety in one's practice. Accountability is a critical aspect of a culture of safety; recognizing and acknowledging one's actions is a trademark of professional behavior and is incorporated into, but not considered one of the three major elements, of QSEN.

5. Which of the following concepts would a nurse think has the strongest link to safety? (Select all that apply): A. Cognition. B. Communication. C. Quality. D. Regulation. E. Teamwork.

B. Communication. C. Quality. D. Regulation. E. Teamwork. Rationale Communication, quality, regulation, and teamwork are the concepts with the strongest links to safety and include processes that are essential for the nurse to consider related to safety. Safety refers to the prevention of injuries or freedom from accidents. Quality and safety are interrelated, overlapping concepts, and it is difficult to achieve outcomes in one without working on the other. Regulation refers to the mandates that have been credited with many of the improvements in health care systems, such as those from the Joint Commission, and to the oversight for the safety of the public provided by state boards of nursing. Teamwork and the ability of health care professionals to work together account for as much as 70% of health care errors. Cognition dependent on an optimally functioning brain could affect vigilance but would not be considered a concept that has one of the strongest links to safety.

9. Which of the following statements are true about cultural competency in health care? (select all that apply) A. Recognizing and accepting cultural diversity achieves cultural competency. B. Cultural competency is a major element in eliminating health disparities. C. There is no association between the care recipient's cultural background and the health care providers' cultural beliefs. D. Health care services are to be provided that are respectful of and responsive to the diverse health beliefs of the care recipient. E. Health care providers must be aware of how people interpret their health issues or illnesses.

B. Cultural competency is a major element in eliminating health disparities. D. Health care services are to be provided that are respectful of and responsive to the diverse health beliefs of the care recipient. E. Health care providers must be aware of how people interpret their health issues or illnesses.

6. The nurse is preparing education on prevention of urinary tract infections. A principle emphasized in the teaching plan would be: A. Decreasing oral intake facilitates urinary dilution. B. Empty the bladder at the first sensation of fullness. C. Frequency is a common symptom that can be ignored. D. Increasing time between urinations decreases the risk of infection.

B. Empty the bladder at the first sensation of fullness. Rationale The nurse uses evidence-based practice to guide his or her practice. Emptying the bladder as soon as bladder sensation of fullness occurs is a practice that decreases the time the urine remains in the bladder, thus decreasing the chance for bacterial growth to occur. Decreasing oral intake will cause the urine to become concentrated. Urinary frequency is a symptom seen with urinary tract infections. Research indicates that delayed time between urinations is associated with increased incidence of urinary tract infection. Reference: p. 134

6. What two groups comprise emerging populations in the United States? (select two that apply) A. Older Americans B. Ethnic minorities C. Homeless D. Baby boomers

B. Ethnic minorities C. Homeless

9. Telehealth includes using devices to provide which types of care for the patient? (Select all that apply.) A. Administering medications B. Evaluation of weight loss C. Video assessment of wounds D. Monitoring peak flow meter results E. Real-time blood pressure assessment

B. Evaluation of weight loss C. Video assessment of wounds D. Monitoring peak flow meter results E. Real-time blood pressure assessment Rationale Telehealth enables the nurse to provide distance assessment, planning, intervention, and evaluation of outcomes of nursing care using technologies such as the Internet, digital assessment tools, and telemonitoring equipment.

1. The increasing number of ethnic groups in the United States has been influenced by what? A. Communicable diseases in disadvantaged countries B. Increasing immigration C. Homelessness D. Healthcare reform

B. Increasing immigration

3. Which assessment technique will elicit the best information on the quality of life from individuals and families in a target population? A. Collect information on infant mortality. B. Involve the people in a self-study. C. Analyze health care coverage statistics. D. Review the epidemiological data of the people.

B. Involve the people in a self-study. Rationale The nurse evaluates the quality of life in a population by analyzing their social, economic, communication, or spiritual patterns, concerns, and problems. Involving the people in a self-study of their needs and aspirations is the best way to accomplish this task. Relating a health problem to social problems helps the nurse and the clients expand the rationale or justification of the health education project. The nurse collects data by analyzing infant mortality rates, health care coverage, and the population's demographic information. These are assessment techniques used to collect demographic information in order to formulate the intervention plans for the population. Active involvement in a self-study secures participation in the interventions, leading to positive outcomes. Reference: pp. 216-217

2. The nurse is assessing a patient's ability to perform instrumental activities of daily living (IADLs). Which of the following activities are considered in the IADLs assessment? (Select all that apply): A. Feeding oneself. B. Preparing a meal. C. Balancing a checkbook. D. Walking. E. Toileting. F. Grocery shopping.

B. Preparing a meal. C. Balancing a checkbook. F. Grocery shopping. Rationale IADLs include shopping, meal preparation, housekeeping, doing laundry, managing finances, taking medications, and using transportation. The other activities listed are activities of daily living (ADLs) related to self-care.

7. Nurses deliver patient-centered care in collaboration with the interdisciplinary health care team within the framework of a care delivery model. In which care delivery model does the nurse plan and coordinate the aspects of patient care with other disciplines with a focus on continuity of care and interdisciplinary collaboration even when the nurse is absent? A. Team nursing model B. Primary nursing model C. Total patient care model D. Case management nursing model

B. Primary nursing model Rationale Primary nursing model includes planning the patient's care, coordinating and communicating all aspects of care with other disciplines and those providing care in the nurse's absence. The focus is on continuity of care and interdisciplinary collaboration. Team nursing uses the RN as the team leader to organize and manage the care for a group of patients with other ancillary workers. The RN has authority and accountability for the quality of care delivered by the team only during the work period. In a total patient care model, the nurse is accountable for the complete care of the patient during the assigned shift. Case management is not a model of care delivery, but a collaborative process that involves assessing, planning, facilitating, and advocating for health services with a variety of resources to promote cost-effective outcomes.

1. The nurse is performing an initial antepartal assessment on a woman who has missed two periods. Assessment of this woman for alcohol consumption is best determined by the: A. CAGE test. B. T-ACE test. C. non-stress test. D. protein dipstick test.

B. T-ACE test. Rationale The T-ACE test provides a much more sensitive measure of alcohol intake patterns than that derived from the CAGE test. The T-ACE test considers the following assessment criteria: How many drinks does it Take to make you feel high? Have you ever been Annoyed by people criticizing your drinking? Have you ever felt you ought to Cut down your drinking? Have you ever had a drink first thing in the morning (Eye Opener) to steady your nerves or get rid of a hangover? The CAGE test considers data collected from the client on Cutting down on drinking, being Annoyed by criticism of drinking, feeling Guilty about drinking, and using alcohol as an Eye opener. The non-stress test evaluates the fetal heart rate response to fetal movement, which is assessed after the fetus is 20 weeks or more. The protein dipstick is performed at each prenatal visit and measures the amount of protein in the client's urine. Proteinuria is a symptom seen with pre-eclampsia. Reference: p. 128

4. The nurse notes that a male patient regularly asks about the purpose and potential side effects of each oral medication that he has received during his time in the hospital. How should the nurse best interpret the patient's questions? A. The patient has an auditory learning style. B. The patient is identifying his learning needs. C. The patient is exhibiting a high level of health literacy. D. The patient is experiencing anxiety related to his diagnosis and treatment.

B. The patient is identifying his learning needs. Rationale The patient most likely is revealing his learning needs related to his medication regimen. It would be inaccurate to conclude that he has an auditory learning style, and concluding that he is experiencing anxiety would be premature. It would be incorrect to conclude that because he has numerous questions about an aspect of his care that he necessarily has a high level of health literacy.

1. Instruments such as the Functional Activities Questionnaire (FAQ) for postoperative patients who are at home, the Minimum Data Set for Nursing Facility Resident Assessment and Care Screening (MDS) for nursing home patients, the Functional Status Scale (FSS) for children, and the Edmonton Functional Assessment Tool for cancer patients are used to assess activities of daily living (ADLs). The nurse needs to remember that a disadvantage of these instruments includes A. The efficacy and reliability of the instruments. B. The variations in assessments and responses may be subjective because of self-reporting of functional activities. C. The instruments do not show a true measure of ability because of a lack of interactivity during the assessments. D. The information contained in the instruments is insufficient to make a determination about functional status in these populations.

B. The variations in assessments and responses may be subjective because of self-reporting of functional activities. Rationale A disadvantage of many of the ADLs and instrumental activities of daily living (IADLs) scales is the self-reporting of functional activities. Efficacy and reliability are not measured when assessing ADLs and IADLs. Interaction with the patient is necessary to complete the ADL and IADL assessments. The FAQ and FSS are comprehensive tools that can help the nurse determine functional status.

4. A nurse is explaining why collaboration is valued to a new nurse during her orientation to the unit. Which of the following outcomes is a key patient care outcome that occurs when collaboration is correctly used? A. Governmental accrediting agencies give more favorable reviews to the agency. B. There are fewer errors that occur in patient care. C. Agencies can offer higher salaries due to the cross-training of staff. D. Ongoing education is not needed, because other specialties contribute to care decisions.

B. There are fewer errors that occur in patient care. Rationale Collaboration results in fewer errors in patient care due to the interactions between health providers of all disciplines and patient involvement in planning. A positive accreditation review benefits the agency directly and the patient only indirectly. Collaboration is not the same as cross-training, and ongoing education is an expectation of all professions.

8. Which teaching strategy would be best to offer to a 20-year-old patient? A. Lecture or books B. Websites or podcasts C. Television or pamphlets D. Role play or support group

B. Websites or podcasts Rationale The 20-year-old patient is likely to be a multitasker who prefers interactive and virtual environments and has a short attention span. Internet and websites and podcasts or video game systems are recommended to teach Millenials health behaviors. Veterans (born before 1946) prefer lecture and book strategies. Baby Boomers (born 1946-1964) prefer lecture and discussion, educational TV, or printed materials. Generation X (born 1965-1980) prefer group teaching, support groups, role playing, and Internet-based education materials.

9. Which of the following statements accurately describe the five stages of health-related behavior change according to the Transtheoretical Model (TTM)? (select all that apply) A. Sustained change over time occurs in the contemplation phase. B. When a person is considering the adoption of a change within the next 6 months, she or he is said to be in the precontemplation phase. C. Small, sporadic changes occur in the planning phase, as the individual is seriously thinking about making a change within the next month. D. In the action phase, the person has made behavior change which has persisted for 30 days. E. Maintenance begins 6 months after the action has started, and continues indefinitely.

B. When a person is considering the adoption of a change within the next 6 months, she or he is said to be in the precontemplation phase. C. Small, sporadic changes occur in the planning phase, as the individual is seriously thinking about making a change within the next month. E. Maintenance begins 6 months after the action has started, and continues indefinitely. Rationale The Transtheoretical Model (TTM), or the stages of change model, is useful for determining where a person is in relation to making a behavior change. The TTM proposes that behavior change progresses through 5 stages regardless of whether the person is quitting or adopting a behavior. The five stages are: Precontemplation: A person is not thinking about or considering quitting or adopting a behavior change within the next 6 months (not intending to make changes). Contemplation: A person is seriously considering making a specific behavior change within the next 6 months (considering a change). Planning or Preparation: A person who has made a behavior change is seriously thinking about making a change within the next month (making small or sporadic changes). Action: The person has made a behavior change and it has persisted for a period of 6 months (actively engaged in behavior change). Maintenance: The period beginning 6 months after action has started and continuing indefinitely (sustaining the change over time).

7. A person reports his exercise pattern is one golf game per week. The nurse evaluates this pattern and teaches the individual that: A. exercise should include jogging. B. exercises should be repetitive. C. golfing one time per week is adequate. D. weekly workouts at the gym should be included.

B. exercises should be repetitive. Rationale Exercise is a type of physical activity that is planned, structured, and repetitive, and performed to improve or maintain physical fitness. Active social activities such as backyard softball or golf would be considered physical activity. Activities such as jogging, walking, or gym workouts would be considered exercise. Sedentary social activities such as bingo, reading, knitting, stamp collection, cards, or participation in discussion groups would not be considered physical activity. Reference: p. 135

4. The communication of health information in a manner which is clear and understandable is known as: A. empowerment. B. health literacy. C. health disparities. D. health education

B. health literacy. Rationale Health literacy is defined as "the degree to which individuals have the capacity to obtain, process, and understand health information and services needed to make appropriate health decisions" (Selden, Zorn, Ratzen, & Parker, 2000). Health literacy includes the ability to read, write, speak, listen, compute, and comprehend, and to apply those skills to health situations. Empowerment is a goal of health education where successful change is fostered in people to promote healthful changes. Health disparities are health differences that adversely affect socially disadvantaged groups. Health education is a process of teaching and learning that encompasses ensuring the understanding of the information delivered. Reference: p. 217

4. The nurse teaches parents that the most important factor in the child's physical, emotional, and cognitive development is: A. parental maturity. B. parental influence. C. experiences with children. D. how they were nurtured as children.

B. parental influence. Rationale Couples who find satisfaction in parenthood seem to realize that parental influence begins at birth and is the single most important factor in the child's physical, emotional, and cognitive development. The parent's ability to assume responsibility depends on a complex array of factors, some of which are their own maturity; how they were nurtured as children; their values and philosophy of life; their conceptions about self, culture, social class, and religion; and their perceptions of and experiences with children and other adults. Reference: p. 167

2. The nurse recognizes that a minority group is perceived as: A. capturing biological variations within human populations. B. people who receive less than their share of wealth, power, or social status. C. people set apart on the basis of cultural or national origin characteristics. D. socially organized groups with salient differences with respect to other groups in society.

B. people who receive less than their share of wealth, power, or social status.

2. The nurse, teaching a class on primary prevention at a women's health club, emphasizes participation in: A. physician visits during illness. B. recommended immunization schedules. C. taking antibiotics at the first sign of symptoms. D. water aerobics to develop muscle building.

B. recommended immunization schedules. Rationale Primary prevention is a concept central to nursing and includes generalized health promotion and specific protection from disease. Health promotion connotes an active process involving specific protections, including immunizations, occupational safety, and environmental control, along with a set of behaviors that enhances health. Physician visits that promote health promotion focus on screening and wellness visits that include teaching on preventative health practices. Antibiotics should only be taken when there is evidence of an infection. Water aerobics focuses on flexibility, not muscle building. Reference: p. 129

5. The nurse is caring for an 85-year-old woman 6 weeks following a hysterectomy secondary to ovarian cancer. The patient will need chemotherapy and irradiation on an outpatient basis. Which of the following priorities would be seen as a barrier to healing and need to be considered when planning care for this patient? (Select all that apply): A. Can feed herself and prepare meals but cannot drive to the store. B. Lives on a fixed income and can balance her checkbook. C. Has stress incontinence. D. Was active at the senior center and now cannot participate in activities. E. Lives alone and has no nearby relatives. F. Has no transportation to the oncology clinic.

C. Has stress incontinence. E. Lives alone and has no nearby relatives. F. Has no transportation to the oncology clinic. Rationale The patient will not be able to get treatment if she has no transportation or no relatives that live nearby who can help her with recovery. Stress incontinence increases the risk of falls because of urgency and rushing to get to the bathroom. Income and social abilities are lower priorities during this phase of recovery.

2. In an agency with a culture of safety, when an error or patient safety issue is identified, the individual who reports the problem A. Is disciplined according to established protocols. B. Must communicate the problem to the patient. C. Knows that near misses are used to improve care. D. Shares details to locate the individual at fault.

C. Knows that near misses are used to improve care. Rationale In an agency with a culture of safety, a nurse knows that near misses are used to improve care. Individual people are not punished for flawed systems, and there are no protocols for discipline. Consequences are individualized to improve the system and minimize the opportunity for future problems. Telling the patient is part of the transparency and the sharing and disclosure among stakeholders but is generally the responsibility of the risk management staff, not the staff nurse. Through a strategy such as root cause analysis, the reasons for errors in medication administration can be identified and strategies developed to minimize future occurrences, not to point a finger at a certain person.

3. Which of the following behaviors by a nurse indicates the effective use of collaboration with other professionals? A. Strongly defends own professional role. B. Avoids conflict. C. Negotiates with others. D. Aggressively presents a personal view of a situation.

C. Negotiates with others. Rationale Conflicts may arise during collaboration, requiring the skill of negotiation. Strongly defending the professional role does not allow for input from other disciplines. Avoiding conflict does not allow proper representation of the nursing role. Collaboration should be based on professional roles, not personal views.

8. What are some of the components of the health belief model that can assist nurses in determining the probability of an individual to make change? (select all that apply) A. External pressure to change B. The value of health as determined by significant others C. Perceived susceptibility to a health problem, disease, or complications D. Perceived seriousness of disease E. Risk factors of disease attributed to heredity, race, or culture

C. Perceived susceptibility to a health problem, disease, or complications D. Perceived seriousness of disease E. Risk factors of disease attributed to heredity, race, or culture Rationale The health belief model is a paradigm used to predict and explain health behavior. It can assist the nurse in formulating an action plan that meets the needs and capabilities of the individual making health behavior changes. Nurses utilize the following guidelines to analyze the probability of a person making an appropriate plan of action: Individual perceptions or readiness for change The value of health to the individual compared with other aspects of living Perceived susceptibility to a health problem, disease, or complications Perceived seriousness of the disease level threatening the achievement of certain goals or aims Risk factors to a disease attributed to heredity, race or culture, medical history, or other causes Perceived benefits and barriers of health action

6. A registered nurse (RN) has delegated the administration of IV medications to a licensed practical/vocational nurse (LPN/LVN). Which statement accurately describes delegation? A. The RN should first teach the LPN how to administer IV medications. B. Ultimate responsibility for the execution of the task now lies with the LPN. C. The RN is still accountable for the quality of care and procedures that the patient receives. D. The RN is responsible for observing and evaluating the administration of IV medications by the LPN.

C. The RN is still accountable for the quality of care and procedures that the patient receives. Rationale Delegation entails a redistribution of nursing work, but the RN remains ultimately responsible and accountable for the execution of the task. It would be inappropriate to delegate if the LPN was unfamiliar with the task. The RN is not obliged to observe the LPN's execution of the task.

10. Based on adult learning principles, which situation indicates that the patient is ready to learn about taking enoxaparin (Lovenox) injections at home? A. The patient is requesting pain medication. B. The patient is too tired to stay awake to watch the teaching DVD. C. The patient wants to practice before actually injecting himself with the needle. D. The patient is nervous and says he cannot do it when he picks up the bottle of medication.

C. The patient wants to practice before actually injecting himself with the needle. Rationale The patient wanting to practice before injecting himself is demonstrating the learner's orientation to learning by seeking out a resource for this stage of learning. The patient requesting pain medication and the tired patient demonstrate they do not have readiness to learn. The nervous, unconfident patient demonstrates that the learner's self-concept is in need of encouragement and more teaching is needed. Other adult learning principles include the learner's need to know, prior experiences, and motivation to learn.

3. Which of the following diseases are Arab Americans at the highest risk for? A. colon cancer. B. hypertension. C. adult-onset diabetes. D. end-stage renal disease.

C. adult-onset diabetes

2. The nurse assesses a family's coping-stress tolerance pattern by exploring their: A. cultural beliefs. B. traditions and practices. C. dysfunctional adaptive strategies. D. expectations of marriage and parenthood.

C. dysfunctional adaptive strategies. Rationale The coping-stress tolerance pattern helps to depict the family's adaptation to both internal and external pressure. Assessments include the kinds of dysfunctional adaptive strategies that are used. The remaining options are assessments for the values-beliefs pattern. Reference: p. 164

1. Any combination of planned experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire the information and skills needed to make quality health decisions is known as: A. health promotion. B. health counseling. C. health education. D. health knowledge.

C. health education. Rationale Any combination of planned experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire the information and skills needed to make quality health decisions is known as health education. This process involves several key components including the use of teaching-learning strategies. Reference: p. 216

4. In assessing the nutritional-metabolic pattern, the nurse performs an examination of: A. attention span. B. blood pressure. C. mucous membranes. D. urine color.

C. mucous membranes. Rationale Assessment of the mucous membranes determines hydration status, which is part of the nutrition-metabolic pattern. Other specific assessment findings for the nutritional-metabolic pattern may point to an individual who is overweight, underweight, overly hydrated, dehydrated, or experiencing difficulties in skin integrity, such as skin breakdown or delayed healing. The attention span is part of the self-perception-self-concept pattern. Measurement of blood pressure is part of the activity-exercise pattern. Urine color is part of the elimination pattern. Reference: p. 134

9. The nurse is preparing a class on wellness and health promotion for a group of middle school students. Developmental tasks of early adolescence include a learning focus emphasis on: A. coping with life events and problems. B. economic responsibility. C. risk taking and its consequences. D. social responsibility for self and others.

C. risk taking and its consequences. Rationale Early adolescence developmental focus is on industry verses inferiority as identified by Erikson. The wellness tasks identified include: learning that health is an important value. learning self-regulation of physiological needs—sleep, rest, food, drink, and exercise. learning risk taking and its consequences (injury prevention). The other three options define adolescent (identity verses role confusion) wellness developmental tasks, which include learning to cope with life events and problems, learning economic responsibility, and learning social responsibility for self and others. Reference: p. 139

5. A 44-year-old female patient with a long-standing history of type 1 diabetes has brought a number of printouts from websites to her most recent visit with her primary care provider. What direction should the nurse provide to the patient regarding health information on the Internet? A. "It is best to make sure that you avoid websites that are not associated with a government agency." B. "You may have some good information there, but it is best to focus only on the information the doctor provides to you." C. "There is a great deal of misinformation on the Internet, so it is best to focus on printed material rather than electronic sources." D. "I encourage you to find websites that are credible and reliable, and I can give you some information on making those decisions if you like."

D. "I encourage you to find websites that are credible and reliable, and I can give you some information on making those decisions if you like." Rationale The Internet can be a valid and useful source of health information. Patients may require instruction in determining which sites are of highest value. It would be inappropriate to dissuade the patient from using any electronic-based resources or to instruct her not to bring any such information to a visit with her physician. Nurses and patients alike should ensure that sources are credible, but these sources are not necessarily limited to government websites.

9. Which question elicits additional information to evaluate the patient's understanding? A. "Can you show me how to change your dressing?" B. "Do you understand how to change your dressing?" C. "Do you think you can change your dressing at home?" D. "What will you do if the dressing has excess drainage?"

D. "What will you do if the dressing has excess drainage?" Rationale Open-ended questions provide more information about the patient's understanding than closed-ended questions that only require a "yes" or "no" response.

5. Priority nursing assessments of Latino/Hispanic Americans should focus on what disease process, because of its higher incidence in this population? A. Cancer B. Stroke C. Diabetes D. Cardiovascular

D. Cardiovascular

1. When the nurse encourages a patient with heart failure to alternate rest and activity periods to reduce cardiac workload, what phase of the nursing process is being used? A. Planning B. Diagnosis C. Evaluation D. Implementation

D. Implementation Rationale Carrying out a specific, individualized plan constitutes the implementation phase of the nursing process. The nurse's action of encouragement and instruction to the patient is part of carrying out a plan of action.

2. A nurse working in a free clinic has recognized that health promotion for teenagers who are pregnant is needed. The nurse works to develop a team of health care experts in several disciplines from across the region to work toward improving the nutrition of pregnant teenagers. This is an example of what type of collaboration? A. Nurse-patient collaboration. B. Nurse-nurse collaboration. C. Intraprofessional collaboration. D. Interorganizational collaboration.

D. Interorganizational collaboration. Rationale Interorganizational collaboration occurs between regional, national, or international organizations to achieve a common goal. Nurse-patient collaboration occurs when a nurse is working directly with a patient. Nurse-nurse collaboration occurs between nurses and among professionals in nursing management projects. Intraprofessional collaboration occurs among members of a professional discipline.

2. To address administrative concerns about the effectiveness of staff nurses related to patient education, the nurse manager would first A. Assign one nurse to teach patients. B. Organize patient teaching resources. C. Post a teaching outline in the lounge. D. Survey nurses about patient teaching.

D. Survey nurses about patient teaching. Rationale The first step in addressing any concern is assessment, or determining what the issues are, so conducting a verbal or written survey would be the most appropriate first step. Education of patients is integral to professional nursing practice; it would not be appropriate, or even possible, to assign one nurse to teach patients, because much patient education is informal, spontaneous, and takes place during treatments or when a nurse is responding to patient questions. There is no information to support a problem with the organization of patient teaching resources. Posting a teaching outline in the lounge could be an appropriate strategy if a need related to a specific area was identified; however, a needs assessment must first be completed.

5. When a patient tells the nurse about plans to do research about the patient's diagnosis and potential treatment on the Internet, the nurse's most appropriate initial response is to A. Discount the reliability of the Internet. B. Evaluate the patient's computer competency. C. Provide a list of recommended sources. D. Teach about evaluation of Internet resources.

D. Teach about evaluation of Internet resources. Rationale Evaluation of resources is an essential component of gathering information from the Internet, and the nurse would want to be sure the patient finds valid and reliable information. A majority of adults in the United States use the Internet to find information on many aspects of life, and this use of technology expands the role of the nurse in patient education to include teaching on how to evaluate Internet sources. Discounting the reliability of the Internet would not support the positive behavior and motivation of the patient to learn. The nurse would want to evaluate what the patient learns from the Internet rather than the patient's computer competency. Providing a list of recommended sources would be appropriate and support the patient's motivation, but it would not be the first thing the nurse would do.

1. A student nurse receives an order for Valium to be given intravenously. Valium tablets are available. The student nurse crushes a tablet and mixes it with sterile water for injection. The instructor notes that the solution is cloudy and asks to see the medication vial. When the student produces the vial of sterile water for injection and the instructor stops the medication from being given, what type of error is prevented? A. Communication error. B. Diagnostic error. C. Preventive error. D. Treatment error.

D. Treatment error. Rationale The nurse avoided a treatment error; she was prevented from giving the wrong type of medication. Valium for intravenous administration is clear and comes prepared in a vial labeled for intravenous administration. According to Leape, treatment errors occur in the performance of an operation, procedure, or test; in administering a treatment; in the dose or method of administering a drug; or in an avoidable delay in treatment or in responding to an abnormal test. A communication error results from a failure to communicate. Diagnostic errors are the result of a delay in diagnosis, a failure to employ indicated tests, the use of outmoded tests, or a failure to act on results of monitoring or testing. Preventive errors occur when there is a failure to provide prophylactic treatment when monitoring is inadequate, or when follow-up of treatment is inadequate.

5. When teaching about proper nutrition to a person with congestive heart failure, which affective component should be included in the educational plan? A. Eating with someone B. Food preparation techniques C. Knowledge of dietary restrictions D. Values of adhering to the diet

D. Values of adhering to the diet Rationale The affective component of education addresses the attitudes and values the person believes regarding the education and how it will apply to his or her life beliefs. If the person values the education, it will be more likely to be followed as opposed to if the person finds that the education is not congruent with his or her values. Even when the person possesses the knowledge base, assessment of whether the individual also values the importance of adhering to the modifications in lifestyle is vital. Reference: p. 132

5. The nurse's educational role reflecting health promotion and disease prevention during the couple stage of family development is the: A. teacher of risk factors to health. B. coordinator with pediatric services. C. teacher of first aid and emergency measures. D. coordinator for genetic counseling.

D. coordinator for genetic counseling. Rationale The coordinator for genetic counseling is identified as a possible nursing role for the couple stage. The coordinator with pediatric services is part of the nurse's role for the childbearing family. The teacher of first aid and emergency measures is addressed in the family with preschool or school-aged children. The teacher of risk factors to health is part of the role for the family with adolescents. Reference: p. 173

1. The cognitive-perceptual pattern assessment includes: A. who decides when children go to sleep. B. what types of daily activities include physical exercise. C. what kinds of feelings family members have for each other. D. how the family makes decisions about health promotion and disease prevention.

D. how the family makes decisions about health promotion and disease prevention. Rationale How the family makes decisions about health promotion and disease prevention is part of the cognitive-perceptual pattern. Deciding when children go to sleep is an assessment included in the sleep-rest pattern. Physical exercise activities fall within the realm of the activity-exercise pattern. Feelings are included in the self-perception-self-concept pattern. Reference: p. 157

3. The nurse uses developmental theory by evaluating the family's: A. analysis of baseline data. B. rigid and permeable boundaries. C. structural and functional components. D. prospective tasks and progression through cycles.

D. prospective tasks and progression through cycles. Rationale Developmental theory approaches families from the perspective of tasks and progression through cycles. The nurse analyzes data for cues to identify the stages of the family life cycle and tasks to accomplish for successful family function. The systems approach determines both the structural and functional components of the family as a system. The stages of family development guide the analysis of the baseline data. Reference: p. 166

6. A hospital creates a Facebook page for the bariatric surgery program. The owner of the site posts healthy recipes, lifestyle information, and information about upcoming workshops. This is an example of: A. health literacy. B. coercive advertising. C. a teaching plan. D. social marketing.

D. social marketing. Rationale Social marketing is the use of technology to change behavior while targeting a specific group. When an organization wants to offer an ongoing health education program for a target population, social marketing provides a strategy for reaching members of the group and implementing a service that will satisfy these members as consumers. Principles of social marketing and health education strategies are combined to promote population-based changes in behavior to improve health. Social marketers create information in a manner that is appealing to the target audience and at a literacy level that is understandable. The teaching plan would be created after the planning for the seminar or courses are underway. This type of marketing would not be considered coercive because it is up to the individual to respond to the information. Reference: p. 222

6. The nursing student is assigned to use motivational interviewing to motivate the patient to change dietary eating behaviors. Which statement shows the use of this technique? A. "Tell me about the concerns you have about changing your diet." B. "You have a big weakness for ice cream; we will need to change that." C. "I feel sorry for you, but you must change your diet if you plan to feel better." D. "I would not want to change my diet, but I would sure do it instead of getting sicker."

A. "Tell me about the concerns you have about changing your diet." Rationale Motivational interviewing uses nonconfrontational interpersonal communication techniques to motivate patients to change behavior. Key aspects include listening instead of telling, adjusting to rather than opposing patient resistance, expressing empathy through reflective listening, focusing on the positive without criticizing the patient, gently persuading with the understanding that change is up to the patient, focusing on patient strengths, avoiding argument and direct confrontation, and helping the patient recognize the "gap" between where the patient is and where the patient hopes to be.

7. What are some of the benefits of assessing a family through the use of an ecomap and genogram? (select all that apply) A. A genogram allows a visual display of family health conditions. B. Family histories provide the nurse with a unique perspective of family risk for inherited diseases. C. Slashed lines on an ecomap are used to signify death. D. The ecomap uses a structural approach to the assessment of family roles and function. E. The ecomap is useful in determining environmental hazards related to geography.

A. A genogram allows a visual display of family health conditions. B. Family histories provide the nurse with a unique perspective of family risk for inherited diseases. Rationale A genogram, or family diagram, represents the family based on identification data that depicts each member of the family with connections between the generations. This useful technique gathers data on at least three generations, including the current one, their parents, grandparents, aunts, uncles, and their children. The family genogram explores clues within family histories contributing to health problems. The ecomap, which is similar to the genogram, uses pictorial techniques to document family organizational patterns with visual clarity. A genogram is constructed for a family or household. It begins with a circle in the center of the page. Outside the circle, smaller circles are drawn and labeled with the names of significant people, agencies, and institutions in the family's social environment. Lines are drawn from the family-household to each circle. Solid lines indicate strong relationships. Dotted lines reflect fragile or tenuous connections. Slashed lines signify stressful relationships. The ecomap uses a functional rather than a structural approach to the assessment of family roles and function. Both the genogram and the ecomap provide useful information and can be incorporated into family assessment. Reference: p. 160

3. Formal patient education courses or classes would be the most appropriate strategy to A. Address needs common to a group. B. Explain self-directed learning. C. Describe nursing interventions. D. Respond to questions of a patient's family.

A. Address needs common to a group. Rationale Group needs are often the focus of formal patient education courses or classes. Self-directed learning refers to an educational activity completed independently from the nurse or other health care providers. Describing nursing interventions with formal patient education courses or classes is not the most appropriate strategy, because most patient education is done by nurses during the explanation of an intervention, and that is a spontaneous, one-to-one activity. Formal courses or classes are not the most appropriate strategy to address a patient's or a family's questions; from a time perspective, it is not appropriate to have the patient or family wait for a class.

4. Interrelated concepts regarding patient attributes and preferences that a nurse would consider when addressing patient education include A. Adherence. B. Health promotion. C. Quality. D. Technology.

A. Adherence. Rationale Adherence, culture, developmental level, family dynamics, and motivation are considered interrelated concepts regarding patient attributes and preferences. Interrelated concepts regarding the professional role of a nurse include health promotion, leadership, technology and informatics, quality, collaboration, and communication.

4. What factor has been most clearly identified as an influence on the future of nursing practice? A. Aging of the American population and increases in chronic illnesses B. Increasing birth rates coupled with decreased average life expectancy C. Increased awareness of determinants of health and improved self-care D. Apathy around health behaviors and the relationship of lifestyle to health

A. Aging of the American population and increases in chronic illnesses Rationale The American population is aging at the same time that the incidence of chronic health conditions is increasing. There is no noted increase in the overall awareness of the determinants of health, but at the same time, observers have not identified apathy as a predominant attitude. Life expectancy is increasing, not decreasing.

1. When planning the evaluation of a teaching activity that has the goal of educating a patient and family about the long-term effects of diabetes, it would be most appropriate for the nurse to include an opportunity for the patient to A. Ask questions. B. Inject insulin. C. Meet exercise goals. D. Prepare a menu.

A. Ask questions. Rationale The evaluation should match the goal. In this scenario, the goal is related to long-term effects, so providing an opportunity for the patient and family to ask questions gives the nurse information about their understanding of the content and allows the nurse to evaluate the cognitive and affective impacts of the teaching. Opportunities to inject insulin, meet exercise goals, and prepare a menu would be strategies to assess psychomotor domain learning, and this is not the goal of the teaching activity.

3. Which actions best demonstrate the nurses' awareness of learning styles and the role that they play in patient and caregiver teaching? (Select all that apply.) A. Assess patients' learning styles prior to teaching. B. Use materials that appeal to a variety of learning styles. C. Prioritize the learning style with which he or she is most familiar and comfortable. D. Provide written instructions to younger patients while using visual and audio aids when teaching older patients. E. Provide visual and audio aids to younger patients while using written instructions when teaching older patients.

A. Assess patients' learning styles prior to teaching. B. Use materials that appeal to a variety of learning styles. Rationale Assessing patients' learning styles and using a variety of materials that appeal to different learning styles are sound teaching strategies. It would be simplistic to choose materials solely based on patients' ages or to limit teaching to his or her own learning preference.

4. Priority nursing assessments of Asian Americans/Pacific Islanders should be on which disease process? A. COPD B. Hypertension C. Diabetes mellitus D. Breast cancer

A. COPD

4. To promote safety, the nurse manager sensitive to point-of-care (sharp-end) and systems-level (blunt-end) exemplars works closely with administrators to address organizational system exemplars, such as A. Care coordination. B. Communication. C. Diagnostic workup. D. Fall prevention.

A. Care coordination. Rationale The most common safety issues at the blunt end include documentation/electronic records, team systems, environmental systems, error reporting/analysis systems, and regulatory systems. Each of the other options is classified as a point-of-care, sharp-end exemplar.

2. When planning care for a patient, the nurse may use a visual diagram of patient problems and interventions to illustrate the relationships among pertinent clinical data. What is this format called? A. Concept map B. Critical pathway C. Clinical pathway D. Nursing care plan

A. Concept map Rationale A concept map is another method of recording a nursing care plan. In a concept map, the nursing process is recorded in a visual diagram of patient problems and interventions. A clinical (critical) pathway is a prewritten plan that directs the entire health care team in the daily care goals for select health care problems.

5. A group of nurses have a plan to implement evidence-based practice (EBP) for care of patients with pressure ulcers. What will this change in practice encompass? (Select all that apply.) A. Consulting with the wound care and ostomy nurse B. The preferences of patients and their particular circumstances C. Nurses' expertise and their bodies of experience and knowledge D. The traditions that surround pressure ulcer practices on the unit E. Journal articles that address the care of patients with pressure ulcers

A. Consulting with the wound care and ostomy nurse B. The preferences of patients and their particular circumstances C. Nurses' expertise and their bodies of experience and knowledge E. Journal articles that address the care of patients with pressure ulcers Rationale EBP draws on research, data from local quality improvement, professional organization standards, patient preferences, and clinical expertise. The particular traditions on the nursing unit are not part of EBP.

8. When assessing the older adult for sleep quality, the nurse expects to find that the person will state: A. "I continue to be a night owl." B. "I experience difficulty returning to sleep." C. "I experience a night of deep sleep." D. "I rarely wake up during the night."

B. "I experience difficulty returning to sleep." Rationale Most difficulties associated with sleep are amenable to nursing therapies. Frequent awakenings do not necessarily imply sleep interruption. Many individuals may awaken numerous times during the night but return to sleep within seconds. This may be especially true of older adults who generally spend most of the night in stages of light sleep. Their normal developmental pattern does not include deep sleep; therefore, awakenings may not affect the sleep cycles and resultant feelings after awakening in the morning. More commonly, older adult individuals experience difficulty returning to sleep because they experience discomfort, fears, or other variables. Reference: p. 137

2. What would be one method of individualizing learning for a patient's unique needs? A. Use prepackaged learning materials. B. Only teach the patient "need-to-know" information. C. Have the patient arrange topic cards in order of priority. D. Have the patient watch a video and then read a pamphlet.

C. Have the patient arrange topic cards in order of priority. Rationale By allowing a patient to prioritize his or her own learning needs, the nurse can begin with the patient's most important needs and end with the least important. The other choices may be appropriate teaching strategies, but they do not individualize the learning needs.

1. Which of the following statements by a nursing student demonstrates an understanding of collaboration? A. "Collaboration is a new way of interacting with physicians." B. "Collaboration means that the care team can make all of the decisions for the patient." C. "Collaboration with patients has been used by nurses throughout the history of nursing." D. "Collaboration is an outdated concept that has been replaced by managed care."

C. "Collaboration with patients has been used by nurses throughout the history of nursing." Rationale History shows that from the time of Florence Nightingale, nurses have worked with patients to assess their needs and wants. Collaboration with fellow care providers such as physicians is not a new concept; it is becoming more prevalent. To correctly use collaboration, the team does not make decisions without including the patient.

7. Which of the following statements accurately describe race and ethnic categories in the United States as defined by the Office of Management and Budget? (select all that apply) A. Race and ethnicity have the same definition. B. Ethnicity is associated with power and indexes the history or ongoing imposition of one group's authority above another. C. Ethnicity focuses on differences in meaning, values, and ways of living. D. Ethnicity refers to commonalities in language, history, nation, or region of origin. E. A minority group consists of people living in society that is usually disadvantaged.

C. Ethnicity focuses on differences in meaning, values, and ways of living. D. Ethnicity refers to commonalities in language, history, nation, or region of origin. E. A minority group consists of people living in society that is usually disadvantaged.

3. The individual's perceived health and well-being and how health is managed describes the: A. cognitive-perceptual pattern. B. coping-stress tolerance pattern. C. health perception-health management pattern. D. self-perception-self-concept pattern.

C. health perception-health management pattern. Rationale The health perception-health management pattern provides an overview of the individual's health status and the health practices that are used to reach the current level of health or wellness. The focus is on perceived health status and the meaning of health, along with the individual's level of commitment to maintaining health. The cognitive-perceptual pattern focuses on sensory perceptual and cognitive patterns. The coping-stress tolerance pattern identifies the general coping pattern and effectiveness on stress tolerance. The self-perception-self-concept pattern describes the individual's perception of self to include body comfort, body image, and feeling state as well as self-conception and self-esteem. Reference: p. 131