PNVN 1111 Exam Study guide

How should an LPN/LVN explain the term accountability to a student nurse? - "Accountability is assuming personal responsibility for one's nursing actions." - "Accountability is the transfer of responsibility for wrong actions." - "Accountability is giving up responsibility when the situation dictates." - "Accountability is shared responsibility with the physician for wrongdoing."

"Accountability is assuming personal responsibility for one's nursing actions." Accountability means that one is answerable for one's actions. The other options do not correctly reflect the meaning of accountability.

Which question should be asked by a nursing student who is developing a plan to increase his critical thinking ability so as to achieve higher grades? "Someone needs to check my conclusions." "I wonder how to improve my overall efficiency." "I'll have to learn from my mistakes." "Do I comprehend information from textbooks and classes?"

"Do I comprehend information from textbooks and classes?" This question deals with an important aspect of using critical thinking in nursing. One must comprehend the information and then be able to recall and apply it. "I wonder how to improve my overall efficiency" is a diffuse question and does not lend itself to planning without first being narrowed and better focused. The other two options are not questions.

Which statement best explains the "entry into practice" controversy? - Nursing shortages would be relieved if all nurses entered into practice as LPN/LVNs. - After graduation, all professional and vocational nurses should enter practice by serving a 1-year internship in a hospital setting. - "Entry into practice" refers to discerning the educational level most appropriate for entry into the practice of nursing: ADN, BSN, MSN. - The return to self-proclaimed nurses would save scarce health care dollars.

"Entry into practice" refers to discerning the educational level most appropriate for entry into the practice of nursing: ADN, BSN, MSN. "Entry into practice," originally advanced by the ANA, refers to the movement to establish two levels of nursing. More recently it has become a question of determining the most appropriate entry into practice for professional nurses: the ADN, BSN, or master's level of preparation. The other options are not related to entry into practice.

A student nurse asks, "What's the difference between laws and ethics?" Which response best explains the difference between nursing laws and ethics? - "Ethics are specific to individual agencies, but laws are state specific." - "Ethics are derived from laws, whereas laws are enacted by nonnurse legislators." - "Ethics refer to expected behavior of nurses, but laws require mandatory observance by nurses." - "Nursing ethics are formalized by statutes, whereas laws are permissive codes."

"Ethics refer to expected behavior of nurses, but laws require mandatory observance by nurses." Ethics refers to behaviors nurses "ought" to observe. Laws refer to statutes that must be observed.

A patient asks the nurse, "What do health maintenance organizations (HMOs) do to reduce health care costs?" The response giving the best example of an HMO cost-containment method would be: - "HMOs pool individual contributions for use in catastrophic illness." - "HMOs use a retrospective payment system." - "HMOs provide services aimed at keeping members healthy." - "HMOs provide supplemental coverage for items not covered by Medicare."

"HMOs provide services aimed at keeping members healthy." HMOs attempt to reduce costs by providing services aimed at keeping members healthy, such as smoking cessation classes and weight loss programs. The other options are not factual statements.

The instructor tells a student nurse, "You have functioned at a substandard level of clinical performance recently. Now you have a chance to redeem yourself. I'm assigning you to a complex nursing situation. I expect you to function without asking for assistance." The most appropriate response from the student nurse would be - "Is this your way of asking for my resignation from the program?" - "I'll try my best, but I will need someone on staff to answer my questions." - "I cannot accept the assignment. Complex nursing situations are beyond my abilities." - "You'd better remember that if anything goes wrong, the hospital will hold you responsible."

"I cannot accept the assignment. Complex nursing situations are beyond my abilities." The student nurse is obligated to refuse an assignment that is clearly beyond the scope of his or her abilities rather than jeopardize patient safety. Placing a student in a complex nursing situation without access to supervision is totally inappropriate.

Which remark by a nurse demonstrates the use of critical thinking? - "My mind is made up. Why listen further?" - "I just let my thoughts flow." - "I think about what other information I need before proceeding." - "I play and replay a situation, like using instant replay."

"I think about what other information I need before proceeding." Critical thinking requires the individual to have access to all necessary information. This is accomplished by collecting and verifying data in an organized way, arranging data in an organized way, looking for gaps in information, and then proceeding with data analysis.

How should the nurse accurately describe a nurse practitioner to a student nurse? - "The nurse practitioner is a student nurse who is near graduation from a basic program." - "The nurse practitioner is a registered nurse with a master's degree in nursing and specialty certification." - "The nurse practitioner is a registered nurse with doctoral preparation in research methodology." - "The nurse practitioner is a nurse who practices exclusively in a university medical center."

"The nurse practitioner is a registered nurse with a master's degree in nursing and specialty certification." The nurse practitioner has a minimum of a master's degree in nursing and certification in an area of specialization, such as primary care, geriatrics, pediatrics, and so on. The other options do not accurately describe the nurse practitioner's education or role.

When the nurse is asked by a patient, "Why is it necessary to have deductibles and copayments when I already have health insurance?" The best response would be: - "They are part of the incremental changes designed to provide more universal care." - "They were developed to save health care dollars at the time Medicare introduced DRGs." - "They are a way to improve the margin of profit in the fee-for-service method of paying for health care." - "They prevent health care agencies from having huge deficits associated with uncompensated care."

"They are a way to improve the margin of profit in the fee-for-service method of paying for health care." Deductibles and copayments require the patient to pay an increased share of the cost of treatment, thus improving the profit margin for the insurer. They benefit the insurer more than the agency. Deductibles and copayments were not developed to save health care dollars at the time Medicare introduced DRGs. Deductibles and copayments are not part of the incremental changes designed to provide more universal care.

The case method of care delivery is used on the surgical unit. The LPN/LVN asks what this means regarding work assignments. The best answer would be: - "You will be assigned to perform specific nursing tasks for a number of patients, such as taking vital signs, doing simple dressings, and so on." - "You will receive cross-training to be assigned as unit secretary, venipuncturist, or to nursing duties." - "You will be assigned to provide care for two or three relatively stable patients with predictable care outcomes." - "You will be assigned to provide daily total care for several patients from admission to discharge."

"You will be assigned to provide care for two or three relatively stable patients with predictable care outcomes." Case method calls for a nurse to provide complete care to several patients. Stable patients are generally assigned to LPN/LVNs. Performance of specific nursing tasks for a number of patients, such as taking vital signs, doing simple dressings, and so on, describes the team method of care delivery. Provision of daily total care for several patients from admission to discharge describes primary care nursing that uses only RN staff. Cross-training to be assigned as unit secretary, venipuncturist, or to nursing duties describes patient-focused nursing.

Which statements would the nurse evaluate as suggesting that the patient's decision has not been autonomous? (Select all that apply.) - "I thought through all the alternatives." - "I am going to refuse to take the treatment because it will prolong life." - "I wish I knew for sure that I had all the facts about the treatment." - "My son told me emphatically what he thought would be best for the family."

- "I wish I knew for sure that I had all the facts about the treatment." - "My son told me emphatically what he thought would be best for the family." Autonomy means being free to choose. The statement, "I wish I knew for sure that I had all the facts about the treatment," suggests that the patient may not have had all the relevant facts. The statement, "My son told me emphatically what he thought would be best for the family," suggests undue influence from the family. Thinking through all the facts is part of autonomous decision making, as is acting on one's personal decision.

During a performance evaluation, the evaluator describes several behaviors of the nurse. Select the observations that indicate the nurse uses critical thinking. (Select all that apply.) - "You tailor interventions to the circumstances." - "I have noted that you base care on patient needs." - "You use professional standards as guidelines." - "Your caregiving is guided by identified outcomes."

- "You tailor interventions to the circumstances." - "I have noted that you base care on patient needs." - "You use professional standards as guidelines." - "Your caregiving is guided by identified outcomes." Each behavior is consistent with the advanced way of thinking known as critical thinking and with use of clinical judgment.

A student nurse asked to identify the types of services currently provided in the U.S. health care delivery system should mention which of the following? (Select all that apply.) - Seamless systems - Alliances and networks - Diagnosis and treatment - Health promotion - Illness prevention - Restructuring

- Diagnosis and treatment - Health promotion - Illness prevention Of the options listed, those considered to be health care services are health promotion, diagnosis and treatment, and illness prevention. The other options are terms used in this chapter.

Nursing management and executive roles include which of the following? (Select all that apply.) - Director - Nurse manager - Supervisor - Charge nurse - Chief nursing officer

- Director - Nurse manager - Supervisor - Chief nursing officer The four levels of nursing management include supervisor, nurse manager, director, and chief nursing officer (CNO). Charge nurse is not considered a level of nursing management.

The LPN/LVN charge nurse has been designated to participate in the orientation of a new LPN/LVN by explaining cost-containment measures. Measures the charge nurse should mention include which of the following? (Select all that apply.) - Document patient care according to the policy for reimbursement. - Use time management principles to work efficiently. - Charge patients for all supplies used in their care. - Advise insured patients to select higher tiers whenever possible. - Use supplies carefully to avoid waste. - Implement measures to prevent complications.

- Document patient care according to the policy for reimbursement. - Use time management principles to work efficiently. - Charge patients for all supplies used in their care. - Use supplies carefully to avoid waste. - Implement measures to prevent complications. The correct options result in cost containment. Advising insured patients to select higher tiers whenever possible would not conserve health care dollars, because higher tier care and medications are more costly than those offered in lower tiers.

Which of the following are major concerns associated with the present nursing shortage? (Select all that apply.) - High patient acuity - High stress among nurses - High nurse-to-patient ratios - High recruitment incentives - Patient safety

- High patient acuity - High stress among nurses - High nurse-to-patient ratios - Patient safety Patient safety is a concern, because errors are more common when nurse-to-patient ratios are high. Patients in hospitals now are sicker than they were previously. High patient acuity requires increasingly skilled nurses, and the high-acuity patient requires more nursing time; neither may be available during a nursing shortage. Errors increase when one nurse has a patient load that is so large that care is rushed. Nurses leave the workforce as a result of high stress; this worsens the shortage. High recruitment incentives are not considered major concerns associated with the shortage of nurses.

Which statements are accurate with regard to a living will? (Select all that apply.) - Living wills are recognized as legal documents in Canada. - Living wills are recognized as legal documents in 47 states in the United States, the District of Columbia, and Guam. - The living will is filled out by the individual and witnessed by a person who will benefit by the death of that individual. - A living will is a legal document that describes the kind of medical or life-sustaining treatments the person would want if seriously or terminally ill. - An attorney is required to draft a living will. - A living will does not let the person select someone to make decisions for them.

- Living wills are recognized as legal documents in 47 states in the United States, the District of Columbia, and Guam. - A living will is a legal document that describes the kind of medical or life-sustaining treatments the person would want if seriously or terminally ill. - A living will does not let the person select someone to make decisions for them. An attorney is not required to draft a living will. Living wills are not recognized as legal documents in Canada. A living will does not let the person select someone to make decisions for them. Living wills are recognized as legal documents in 47 states in the United States, the District of Columbia, and Guam. The living will is filled out by the individual and witnessed by a person who will not benefit by the death of that individual. A living will is a legal document that describes the kinds of medical treatments or life-sustaining treatments the person would want if seriously or terminally ill.

What actions should be taken by the nurse to increase the possibility of doing no harm while caring for a patient? (Select all that apply.) - Make sure the patient has agreed to the procedure verbally or in writing. - Never participate in any action that will deliberately harm the patient. - Question how to do the least amount of harm when doing something that is expected to result in good. - Perform new procedures without seeking supervision. - Become aware of side effects of commonly administered medications.

- Make sure the patient has agreed to the procedure verbally or in writing. - Never participate in any action that will deliberately harm the patient. - Question how to do the least amount of harm when doing something that is expected to result in good. - Become aware of side effects of commonly administered medications. Each of these measures, except option D, would increase the potential for nonmaleficence in practice. Performing new procedures without seeking supervision has an increased potential for doing harm.

Select the person or persons who may be included on the physical therapy team. (Select all that apply.) - LPN/LVN - Physical therapy assistants - RN - Physical therapists

- Physical therapy assistants - Physical therapists Strictly speaking, the physical therapy team includes only those individuals who have education in physical therapy. Nurses may assist the patient to perform exercises to provide continuity of care when members of the physical therapy team are not present.

Which nursing actions are examples of use of the ethical principle of beneficence? (Select all that apply.) - The LPN/LVN tells a patient to ask for a second doctor's opinion. - The LPN/LVN places the bed in a low position before leaving the room. - The LPN/LVN provides emotional support when the patient cries. - The LPN/LVN provides report for the staff of the oncoming shift. - The LPN/LVN places medication the patient brought from home at the nurses' station.

- The LPN/LVN places the bed in a low position before leaving the room. - The LPN/LVN provides emotional support when the patient cries. - The LPN/LVN places medication the patient brought from home at the nurses' station. Beneficence means to do good. It also involves preventing harm, removing harm, and putting the patient's interests first.

Individual A has worked as an LPN/LVN for a year. The agency where she works discovers that the registration document she presented at the time she was hired was altered to remove the name of the rightful registrant and show her name instead. What are the possible outcomes of this situation? (Select all that apply.) - The individual will be arrested for misrepresentation. - The agency will notify all patients for whom the individual cared to determine injury. - The agency will terminate the employment of the individual. - The state board of nursing, when notified, will charge the nurse with fraud and deceit. - The individual's license to practice will be revoked.

- The agency will terminate the employment of the individual. - The state board of nursing, when notified, will charge the nurse with fraud and deceit. Obtaining the registration of license document and changing the name on the document so that one may represent herself as a nurse when she is not is fraudulent behavior. The agency will terminate the individual's employment, because she cannot continue to work as an LPN/LVN. The agency would not notify all patients for whom the individual cared to determine injury. Arrest would occur only if criminal charges are filed. The individual does not hold licensure, so revocation cannot occur.

In the following list, identify the instances of possible malpractice. (Select all that apply.) - The nurse discusses a patient's condition in a disparaging way in a hospital elevator and is overheard by the patient's husband. - The nurse notes the patient's poor capillary return distal to a cast, becomes busy and does not report it, and the patient later loses limb function. - The nurse runs a red light en route to work and causes an auto accident in which three people are seriously injured and one dies. - The nurse accidentally administers an excessively large dose of a prescribed medication, and the patient becomes comatose.

- The nurse notes the patient's poor capillary return distal to a cast, becomes busy and does not report it, and the patient later loses limb function. - The nurse accidentally administers an excessively large dose of a prescribed medication, and the patient becomes comatose. Medication errors and failure to communicate important information, resulting in harm to the patient, are common sources of malpractice. Running a red light en route to work and causing an auto accident in which three people are seriously injured and one dies would be considered negligence, because the nurse is not engaged in the practice of the profession while driving to work. Discussing a patient's condition in a disparaging way in a hospital elevator and being overheard by the patient's husband would be considered slander.

The event that had the greatest influence on the role of practical nurses in modern hospital nursing was - the U.S. Civil War. - World War II. - the Industrial Revolution. - the Crusades.

- World War II. World War II and the shortage of nurses it created greatly expanded the practice sites available to practical nurses. In the face of the nursing shortage, hospitals gradually increased the responsibilities designated for the practical nurse. The other options had a lesser impact on modern hospital nursing.

The nurse is asked to explain the meaning of ethics to a patient. The nurse should correctly state, "Ethics is a system of standards that refer to ideas and actions in terms of being (Select all that apply.): - like and dislike." - moral and immoral." - ought and ought not." - good and bad." - legal and illegal." - rights and duties." - right and wrong."

- moral and immoral." - ought and ought not." - good and bad." - rights and duties." - right and wrong." Ethics is concerned with all of the options except "legal and illegal" and "like and dislike." Ethics and legalities are not the entirely the same, although some ethical principles may be enacted into law. "Like and dislike" refer to values.

The National Council of State Boards of Nursing (NCSBN) performs a job analysis every ________ years to determine the scope of practice of LPN/LVNs.

3 three The National Council of State Boards of Nursing performs a job analysis every 3 years to measure the scope of practice for LPN/LVNs.

What role is the nurse who diligently works for the protection of patients' interests playing? - Health care administrator - Health care evaluator - Caregiver - Advocate

Advocate A nurse accepts the role of advocate when, in addition to general care, the nurse protects the patient's interests. Caregiver, health care administrator, and health care evaluator are not terms for the nurse who diligently works for the protection of patients.

The role of the LPN/LVN can best be described as which of the following? - Initiates all health teaching - Initiates all phases of the nursing process - Assists with all phases of the nursing process - Works in an independent role

Assists with all phases of the nursing process Initiating health teaching, working in an independent role, and initiating all phases of the nursing process are roles of the RN. An RN initiates all health teaching; an LPN/LVN initiates health teaching for basic health habits and reinforces the health teaching of the RN in other areas. An RN works in an independent role; an LPN/LVN identifies possible new nursing problems and reports them to the RN. An RN initiates all phases of the nursing process and formulates nursing diagnoses; an LPN/LVN assists with all phases of the nursing process and works with established nursing diagnoses.

What organization, established during World War II, provided nursing education and training? - Public health department - Frontier Nursing Service - Nightingale school - Cadet Nurse Corps

Cadet Nurse Corps The Cadet Nurse Corps was established during World War II to provide nursing education and training. The Nightingale school, public health department, and Frontier Nursing Service are not organizations established during World War II to provide nursing education and training.

The first chapter of the American Red Cross was established by - Clara Barton. - Sairy Gamp. - Dorothea Lynde Dix. - Florence Nightingale.

Clara Barton. Clara Barton established the first chapter of the American Red Cross. Sairy Gamp was a fictional character in Charles Dickens' novel Martin Chuzzlewit. Dorothea Lynde Dix was appointed superintendent of nurses and organized a corps of female nurses during the Civil War. Florence Nightingale nursed wounded soldiers during the Crimean War.

Which factor that influences critical thinking provides the best rationale for using a team meeting to plan care for a patient? - Collaboration - Moral development - Self-confidence - Maturity

Collaboration Collaborative effort promotes critical thinking skills; thus, care planning by a knowledgeable group is likely to result in creative solutions to problems. The other options do not provide a rationale for using team planning sessions.

A nursing student demonstrates the ability to basically understand information, recall it, and identify examples of that information. This is an example of what cognitive level? - Knowledge - Analysis - Application - Comprehension

Comprehension Knowledge refers to the ability to recall and repeat information one has memorized. Comprehension refers to the ability to very basically understand information, recall it, and identify examples of that information. Application means being able to use learned material in new situations. Analysis means to be able to break down complex information into its basic parts and relate those parts to the whole picture.

What score does the graduate practical nurse require to be issued a license upon completion of the computerized examination? - Designated as "pass" - Within the 75th percentile - 70% or better - This is defined and set by each state

Designated as "pass" Currently graduates of an approved vocational school are eligible to take the licensing examination and be awarded a license with a score of "pass" that is recognized by all states.

Clinical judgments about patients that result from critical thinking have what as their basis? - Assumptions - Ethical principles - Evidence - Personal preference of the nurse

Evidence Judgments should be made on the basis of facts or evidence, rather than assumptions or the nurse's preference. Ethical principles influence decisions, with the nurse choosing to do the right thing for the patient.

Whose influence on nursing practice in the 19th century was related to improvement of patient environment as a method of health promotion? - Florence Nightingale - Linda Richards - Dorothea Dix - Clara Barton

Florence Nightingale The influence of Florence Nightingale was highly significant in the 19th century as she fought for sanitary conditions, fresh air, and general improvement in the patient environment. Clara Barton developed the American Red Cross in 1881. Linda Richards is known as the first trained nurse in America, was responsible for the development of the first nursing and hospital records, and is credited with the development of our present-day documentation system. Dorothea Dix was the pioneer crusader for elevation of standards of care for the mentally ill and superintendent of female nurses of the Union Army.

The emergence of modern nursing is usually attributed to the influence of - Florence Nightingale. - Clara Barton. - Lillian Wald. - Sairy Gamp.

Florence Nightingale. Miss Nightingale's insistence that nurses be women of good character helped nursing emerge from its "Dark Ages" and elevated it to a respectable vocation. In addition, she established a school for nurse training and wrote several books on nursing. Although Barton and Wald are positive examples in nursing history, neither influenced nursing to the extent that Nightingale did. Sairy Gamp is a negative character associated with nursing history.

Which care delivery method has the greatest potential for fragmenting patient care? - Functional method - Primary nursing - Patient-focused care - Case method

Functional method The functional method of care delivery assigns various nursing team members to provide specific aspects of care to the patient. The RN might give medications and provide health teaching, the unlicensed assistive personnel (UAP) might provide hygiene, the LPN/LVN might take vital signs and change a dressing, lab personnel might draw blood specimens, and so on. Primary nursing provides the least fragmentation. With the case method, one nurse is responsible for most of the patient care. Patient-focused care attempts to limit fragmentation by using cross-trained personnel.

The "first real school of nursing" was located in - Israel. - Greece. - Italy. - Germany.

Germany. The first real school of nursing was founded by the Lutheran Order of Deaconesses under the supervision of a German pastor, Theodor Fleidner, in Kaiserswerth, Germany. The other options are incorrect. |

What ethical principle underlies the statement in the National Federation of Licensed Practical Nurses (NFLPN) Code for Licensed Practical/Vocational Nurses, "The practical nurse provides health care to all patients regardless of race, creed, cultural background, disease, or lifestyle"? - Justice - Confidentiality - Beneficence - Autonomy

Justice Justice means treating all patients fairly according to their needs; that is, with dignity and respect. The other principles listed in the options do not fit the scenario. Autonomy is having control over personal decisions. Confidentiality means avoiding sharing patient information with anyone not directly involved in care without the patient's permission. Beneficence means to "do good" with your nursing actions.

A nursing student demonstrates the ability to recall and repeat memorized information but does not understand the information. This is an example of what cognitive level? - Analysis - Knowledge - Application - Comprehension

Knowledge Knowledge refers to the ability to recall and repeat information one has memorized. Comprehension refers to the ability to very basically understand information, recall it, and identify examples of that information. Application means being able to use learned material in new situations. Analysis means to be able to break down complex information into its basic parts and relate those parts to the whole picture.

Which is a nursing care error that violates the Health Insurance Portability and Accountability Act (HIPAA)? - Refusing to give a patient's daughter information over the phone - Administering a stronger dose of drug than was ordered - Informing the patient's medical power of attorney of a medication change - Leaving a copy of the patient's history and physical in the photocopier

Leaving a copy of the patient's history and physical in the photocopier Leaving the document in the photocopier could expose it to the public. Inappropriate drug administration is possible malpractice. Sharing information with the power of attorney is legal. Refusing to give a patient's daughter information over the phone is appropriate practice.

Which individuals made significant contributions to nursing? (Select all that apply.) - Lillian Wald - Linda Richards - Sairy Gamp - Betsy Prig - Mary Mahoney

Lillian Wald Linda Richards Mary Mahoney Wald organized the first visiting nurse service for the poor. Linda Richards was America's first professionally trained nurse; she organized other training schools. Mary Mahoney was the first African-American graduate nurse. Gamp and Prigg were Dickens characters who portrayed nurses as scoundrels and women of ill repute.

A nurse fails to irrigate a feeding tube as ordered, resulting in harm to the patient. This nurse could be found guilty of: - failure to follow the nurse practice act. - harm to the patient. - negligence. - malpractice.

Malpractice The nurse can be held liable for malpractice for acts of omission. Failure to meet a legal duty, thus causing harm to another, is malpractice. The nurse practice act has general guidelines that can support the charge of malpractice.

What official agency exists exclusively for LPN/LVN membership and promotes standards for the LPN/LVN? - NAPNES - NLN - NFLPN - ANA

NFLPN The NFLPN exists solely for the LPN/LVN. The other options have membership that includes RNs and the lay public.

What document identifies the roles and responsibilities of the LPN/LVN? - NLN Accreditation Standards - Nurse Practice Act - NAPNE Code - American Nurses' Association Code

Nurse Practice Act The LPN/LVN functions under the Nurse Practice Act. NLN Accreditation Standards, the NAPNE Code, and the American Nurses' Association Code do not identify the roles and responsibilities of the LPN/LVN.

To function within the scope of the law, the nurse must know that the legal duties and functions of the nurse in a given state are determined by the - Nurse Practice Act of the state. - U.S. Constitution. - Bill of Rights. - bylaws of the professional organization.

Nurse Practice Act of the state. The Nurse Practice Act of each state determines the scope of practice of RNs and LPN/LVNs in that state. The U.S. Constitution and the Bill of Rights are incorrect answers, because matters dealing with the health and welfare of its citizens are states' rights. Professional organizations may issue position papers, but these do not have the force of law.

An LPN/LVN is asked by the RN to administer an IV chemotherapeutic agent to a patient in the acute care setting. What law should this nurse refer to before initiating this intervention? - Standards of care - American Nurses' Association Code - Regulation of practice - Nurse practice act

Nurse practice act It is the nurse's responsibility to know the nurse practice act in his or her state. Standards of care, regulation of practice, and the American Nurses' code are not laws that the nurse should refer to before initiating this treatment.

The nurse caring for a patient in the acute care setting assumes responsibility for a patient's care. What is this legally binding situation? - Nurse-patient relationship - Standard of care - Advocacy - Accountability

Nurse-patient relationship When the nurse assumes responsibility for a patient's care, the nurse-patient relationship is formed. This is a legally binding "contract" for which the nurse must take responsibility. Accountability is being responsible for one's own actions. An advocate is one who defends or pleads a cause or issue on behalf of another. Standards of care define acts whose performance is required, permitted, or prohibited.

What is the title of the American Hospital Association's 1972 document that outlines the patient's expectations to be treated with dignity and compassion? - OBRA - Advance directives - Code of Ethics - Patient's Bill of Rights

Patient's Bill of Rights Patient expectations are outlined by the Patient's Bill of Rights. Patient expectations are not outlined in the Code of Ethics, OBRA, or advance directives.

Select the method of delivering nursing care that facilitates continuity of care, individualizes care, and fosters 24-hour accountability for patient care. - Case nursing - Primary care nursing - Team nursing - Functional nursing

Primary care nursing This care delivery method uses RNs only. Each primary nurse cares for six patients from admission to discharge, developing the nursing diagnoses and plans of care and assuming ultimate responsibility for 24-hour care, although associate nurses may actually provide care when the primary nurse is not on duty.

Which program offers an incentive to hospitals to discharge patients as quickly as possible? - Private insurance plans in effect for under 1 year - Prospective payment system - Retrospective payment system - Seamless system

Prospective payment system The prospective payment system tells the hospital what it will pay for specific health care in advance. This fixed payment does not change regardless of the number of days the patient is hospitalized. Thus, early discharge can result in a profit for the hospital, creating an incentive.

What is the purpose of licensing laws for LPN/LVNs? - To limit the number of LPN/LVNs - To increase revenue for the state board of nursing - Protection of the public from unqualified people - Prevention of malpractice

Protection of the public from unqualified people The purpose of licensing laws for LPN/LVNs is to protect the public from unqualified health care providers. Licensing laws' purpose is not to limit the number of LPNs/LVNs, prevent malpractice, or increase revenue for the state board of nursing.

What is the best way for a nurse to avoid a lawsuit? - Spend time with the patient. - Answer all call lights quickly. - Carry malpractice insurance. - Provide compassionate, competent care.

Provide compassionate, competent care. The best defense against a lawsuit is to provide compassionate and competent nursing care. Carrying malpractice insurance is prudent, but it will not avoid a lawsuit. Spending time with patients and answering call lights quickly will not necessarily help avoid a lawsuit.

Which groups are members of a nursing team? - RNs, LPN/LVNs, nursing assistants - Radiologists, dietitians, respiratory therapists - Occupational therapists, physical therapists, pharmacists - Physicians, pharmacists, dietitians, physical therapists

RNs, LPN/LVNs, nursing assistants RNs, LPN/LVNs, and nursing assistants are members of the nursing team who have been cross-trained to perform selected nursing tasks. The groups listed in the other options are not considered part of the nursing team.

Which member of the health care team is responsible for initially teaching a patient about medication side effects? - Registered nurse - LPN/LVN - Occupational therapist - Patient care technician

Registered nurse The RN initiates all health teaching. This would include education about medication effects and side effects. The LPN/LVN is able to initiate health teaching only for basic health habits, such as cleanliness. Occupational therapists and patient care technicians are not qualified to undertake medication teaching.

An older adult is admitted to the hospital with numerous bodily bruises, and the nurse suspects elder abuse. What is the best nursing action? - Ask the patient if anyone has hit her. - Take photographs of the bruises. - Cover the bruises with bandages. - Report the bruises to the charge nurse.

Report the bruises to the charge nurse/ The law stipulates that the health care professional is required to report certain information to the appropriate authorities. The report should be given to a supervisor or directly to the police, according to agency policy. When acting in good faith to report mandated information (e.g., certain communicable diseases or gunshot wounds), the health care professional is protected from liability.

Which of the following is an example of breach of duty? - The LPN/LVN delegates duties to unlicensed assistive personnel. - The LPN/LVN resigns from the position. - The LPN/LVN does not perform duties according to the standard of care. - The LPN/LVN walks off the unit during the shift.

The LPN/LVN does not perform duties according to the standard of care. Breach of duty means the nurse did not adhere to the nursing standard of care. Walking off the unit during the shift refers to abandonment. Resigning from the position is a right of the nurse. Delegating duties according to the standard of care is not a breach of duty if it is permitted by the state Nurse Practice Act and is correctly performed.

The instructor tells an SP/VN, "You have functioned at a substandard level of clinical performance recently. Now you have a chance to redeem yourself. I'm assigning you to a complex nursing situation. I expect you to function without asking for assistance." What is the most accurate assessment of the instructor's action? - The action will enable the instructor to determine whether the student should pass or fail the course. - The instructor is accountable for making an unsafe patient care assignment. - It is an acceptable teaching practice to challenge students to higher levels of performance. - The instructor should be investigated for fraud by the state board of nursing.

The instructor is accountable for making an unsafe patient care assignment. Assigning an SP/VN to a complex nursing situation shows poor judgment. A complex nursing situation involves a patient whose clinical condition is unpredictable. Nursing care expectations are beyond what the LPN/LVN has learned during the educational program. An instructor is expected to make patient assignments based on student knowledge and ability to give safe nursing care and is expected to provide necessary supervision.

A new LPN/LVN passes the NCLEX-PN examination and obtains licensure in state X. The LPN/LVN wishes to work in a state other than state X but is unsure of how to proceed. Which statement provides sound advice in this situation? - The effect of current national licensure allows a nurse licensed in one state to work in any other state for a maximum of 2 years without applying for endorsement. - The nurse can work legally in any state that borders state X without applying for endorsement. - The nurse should contact the state board of nursing of the state in which she wishes to work to determine whether they have multistate licensure with state X. - The nurse should apply to take the NCLEX-PN examination in the state in which she wishes to work.

The nurse should contact the state board of nursing of the state in which she wishes to work to determine whether they have multistate licensure with state X. The state board of nursing of the state in which the LPN/LVN wishes to work can provide the essential information. Eighteen states have mutual recognition compacts, and Minnesota has a border recognition agreement. National licensure does not exist. A nurse working legally in any state that borders state X without applying for endorsement describes a border recognition agreement, such as the one in existence in Minnesota. It is unnecessary for a nurse to apply to take the NCLEX-PN examination; nurses can obtain endorsement without retaking the NCLEX-PN examination.

A nurse is found liable for battery. What does this mean? - The nurse, without consent, touched the patient in a way that caused harm. - The nurse incorrectly performed a procedure that is within her scope of practice. - The nurse threatened the patient, causing fear of bodily harm. - The nurse detained the patient against his will.

The nurse, without consent, touched the patient in a way that caused harm. Battery is touch that causes actual physical harm to someone. Threatening a patient, causing fear of bodily harm, is assault. Detaining a patient against his will is false imprisonment. Incorrectly performing a procedure that is within the nurse's scope of practice is malpractice.

Which statement best describes the relationship between the student nurse assigned to a hospital unit for clinical experience and the unit staff? - The student applies classroom learning under the supervision of faculty members during clinical training. - Students are on the clinical unit to give service to the hospital as they care for patients. - The student is under direct supervision of the nurse manager of the unit at all times. - Practical nursing students form a nursing team of their own and are not a part of the larger unit team.

The student applies classroom learning under the supervision of faculty members during clinical training. Student nurses are not counted as clinical staff when receiving clinical experience on a unit. They are supervised by instructors, and their objective is to apply classroom theory in selected clinical situations. It is not an expectation that a student be under direct supervision of the nurse manager. Students are not unit employees. It is not a usual practice for practical nursing students to form a nursing team of their own and not be a part of the larger unit team on the clinical unit.

How may a newly licensed LPN/LVN practice? - Independently in a hospital setting - Under the supervision of a health care provider or RN - As a sole health care provider in a clinic setting - With an experienced LPN/LVN

Under the supervision of a health care provider or RN An LPN/LVN practices under the supervision of a health care provider, dentist, OD, or RN.

When permitted by the state Nurse Practice Act, under what conditions can the LPN/LVN perform complex nursing skills not taught in the basic educational program? - When ordered to do so by the attending physician - When the task is delegated to a competent LPN/LVN by a supervising RN - When the LPN/LVN has graduated from a nursing program accredited by the National League for Nursing - When the state of practice has declared a severe nursing shortage

When the task is delegated to a competent LPN/LVN by a supervising RN Delegation, if allowed by the Nurse Practice Act of the state, can take place if the RN teaches the skill, observes a return demonstration, documents the teaching/learning process in the LPN/LVN's file, and provides ongoing direct supervision. LPN/LVNs are under the direct supervision of professional nurses. Accreditation of the school does not confer the right to accept delegation. Nursing shortages cannot dictate the acceptability of delegation.

The nurse is assisting a patient to clarify values by encouraging the expression of feelings and thoughts related to the situation. What is the most appropriate action for the nurse? - Withhold an opinion. - Give advice. - Compare values with those of the patient. - Make a judgment.

Withhold an opinion. The nurse can assist the patient in values clarification without giving an opinion.

The cognitive levels used on the NCLEX-PN examination are knowledge, comprehension, application, and _______________.

analysis The NCLEX-PN includes items that require various levels of thinking to answer a test item. These various levels are called cognitive levels. The cognitive levels used on the NCLEX-PN examina

The nursing student has learned the principles of determining and recording intake and output. When the student cares for a patient who has had a liquid breakfast and has voided twice and vomited once, the student documents intake and output in the patient's chart using the cognitive level known as - knowledge. - analysis. - application. - comprehension.

application. Knowledge refers to recalling memorized information. Comprehension refers to repeating information in one's own words or identifying an example. Analysis refers to breaking down complex information and relating the parts to the whole picture. Application calls for being able to use learned material in new situations. Because the student documents the intake and output, he is using information learned.

Encouraging a patient to be involved in planning and carrying out his or her own care is a nursing action that supports the ethical principle of - justice. - privacy. - confidentiality. - autonomy.

autonomy Autonomy means being free to choose. Possible patient choices include identifying goals and care measures compatible with one's culture, religion, and personal values. Confidentiality means avoiding sharing patient information with anyone not directly involved in care without the patient's permission. Privacy is the patient's right to choose care based on personal beliefs, feelings, or attitudes. Justice means the nurse must deliver fair and equal treatment to all patients, recognizing and avoiding personal bias.

The nurse discusses the patient's condition on the phone with the patient's brother. On learning this, the patient is upset, saying he has not spoken with his brother for years and does not want his brother to know anything about his condition. The nurse has - breached confidentiality. - assaulted the patient. - committed a felony. - slandered the patient.

breached confidentiality. Confidentiality and privacy are the issues. HIPAA provides for only limited disclosure of patient health care information. Patient consent is required to disclose. Disclosure of information is not necessarily slander unless the nurse speaks of the patient in a derogatory way. A felony is a major crime. Assault involves threatening the patient.

A set monthly fee charged by the provider of health care services for each member of the insurance group for a specific set of services is known as - fee-for-service. - inflation. - capitation. - gross domestic product.

capitation Capitation is an alternative to the traditional fee-for-service method of payment. Capitation involves a set monthly fee charged by the provider of health care services for each member of the insurance group for a specific set of services. Inflation is a general rise in prices, usually persisting over several years. Fee-for-service is the traditional method of paying health care bills in which physicians are paid a fee by the patient for each service they provide. Gross domestic product is the combination of all goods and services produced in a nation's economy.

A resident asks an LPN/LVN, "What is meant by the practical/vocational nurse's standard of care in a long-term care agency?" The LPN/LVN should respond, "The practical/vocational nurse who provides care for residents in a long-term care agency must implement care that is consistent with - shortcuts acceptable to the agency that allow nurses to assume larger and more complex patient assignments." - care that an ordinary, prudent LPN/LVN with the same education and experience would perform in similar circumstances." - the minimum competency necessary to function as a health care giver in the state in which the nurse resides." - customs of the agency in which the nurse is employed."

care that an ordinary, prudent LPN/LVN with the same education and experience would perform in similar circumstances." This is the standard used by the courts, and it is the same regardless of the type of agency in which the nurse is employed. The other options do not define the nurse's standard of care.

A lumbar puncture was performed on a patient without a signed informed consent form. This patient might sue for: - assault. - civil battery. - punitive damages. - nothing; no violation has occurred.

civil battery Civil battery charges can be brought against someone performing an invasive procedure without the patient's informed consent legally documented. This patient could not sue for punitive damages or an assault.

A method of financing health care costs in which physicians are paid a fee by the patient for each service they provide is known as - capitation. - inflation. - fee-for-service. - gross domestic product.

fee-for-service. Fee-for-service is the traditional method of paying health care bills in which physicians are paid a fee by the patient for each service they provide. Inflation is a general rise in prices, usually persisting over several years. Capitation is an alternative to the traditional fee-for-service method of payment. Capitation involves a set monthly fee charged by the provider of health care services for each member of the insurance group for a specific set of services. Gross domestic product is the combination of all goods and services produced in a nation's economy.

A mother and her three children often seek medical services at the emergency room. The nurse realizes that they have no insurance and are unable to pay for services. The action the nurse should take that would provide the greatest assistance to the family would be to - advise them to use urgent care centers where fees are lower. - leave the newspaper classified ads in a visible place. - advise the mother to seek work at the hospital personnel office. - contact a social worker to discuss Medicaid with the mother.

contact a social worker to discuss Medicaid with the mother. The social worker would be able to help the family explore whether they might qualify for Medicaid or the Children's Health Insurance Program. Advising the family to use urgent care centers might be considered a form of refusal of services. Leaving the newspaper classified ads in a visible place and advising the mother to seek work at the hospital personnel office assume that the uninsured mother is not working, when in fact she may have a job that does not provide the benefit of health care.

Diagnosis-related groups (DRGs) and prospective payment systems are most clearly the reason for - critical pathways and managed care. - Medicare and Medicaid. - group health insurance and centralization. - a shortage of nurses and unlicensed assistive personnel.

critical pathways and managed care. Both DRGs and prospective payment systems have resulted in cost-containment efforts by health care agencies. Managed care and critical pathways are responses to the need to contain costs. DRGs originated with Medicare. Group health insurance existed prior to DRGs and prospective payment systems. The reason for personnel shortages in health care is not as simplistic as a shortage of nurses and unlicensed assistive personnel.

A first-postoperative-day patient received pain medication 6 hours ago. He states he is not experiencing pain but refuses to deep breathe and ambulate as ordered. The nursing student caring for him consults her instructor, asking whether it might be advisable to administer pain medication. The student is using - the right brain hemisphere. - the intrapersonal learning style. - linguistic memory. - critical thinking.

critical thinking. The student has questioned the reason for the patient's refusal to deep breathe and ambulate and has suggested that a possible cause may be the presence of discomfort that could be relieved by medication. This qualifies as critical thinking. The action described is not a good example of right brain hemisphere use or use of the intrapersonal learning style, and it is not related to linguistics.

The yearly amount an insured person must spend out-of-pocket for health care services before a health insurance policy will begin to pay its share is known as the - premium. - coinsurance. - deductible. - copayment.

deductible. The deductible is the yearly amount an insured person must spend out-of-pocket for health care services before a health insurance policy will begin to pay its share. The premium is the monthly fee a person must pay for health care insurance coverage. The copayment is the amount an insured person must pay at the time of an office visit, when picking up a prescription, or before a hospital service. Coinsurance is the percentage of the total bill paid by the insured person after a deductible has been met. The remainder is paid by the insurance company.

An example of a criminal action committed by a nurse is - releasing information without the patient's consent. - restraining a patient without a physician's order. - making a medication error. - discontinuing a ventilator without a physician's order.

discontinuing a ventilator without a physician's order. Commission of a felony, such as murder, is clearly a criminal act. The other options represent examples of torts, or matters of civil concern.

A way of practicing fidelity to a patient would be to - document the patient's expression of feelings and wishes. - develop the care plan without patient input. - categorize the patient as a "down-and-out alcoholic." - discuss the patient with friends at a social gathering.

document the patient's expression of feelings and wishes. The nurse who documents the patient's expression of feelings or wishes without subjective interpretation is demonstrating fidelity (being true) to the patient. The other options demonstrate lack of fidelity.

Patient A, who has Alzheimer's disease, wanders and is often noisy and intrusive. The patient has a prn order for haloperidol (Haldol) IM for assaultive behavior. At report, the LPN/LVN charge nurse explains that staffing is poor and she is unable to provide the supervision the patient needs. She directs the medication nurse to administer the patient's prn haloperidol q4h during the shift. This action constitutes - assault. - false imprisonment. - negligence. - libel.

false imprisonment. This is false imprisonment, an intentional tort. Chemical restraint is a means of detaining a person against his or her will. Negligence is an unintentional tort. Libel is a type of defamation. Assault refers to threatening behavior.

A major change in medical ethics that affected nursing occurred when the Western secular belief system shifted emphasis from duties to - the cost-effectiveness of care. - nonmaleficence. - individual autonomy and rights. - satisfying Medicare regulations.

individual autonomy and rights. Freedom of choice (autonomy) and the ability to assert one's individual rights have become the major operative beliefs of the Western secular belief system affecting medical ethics today. These beliefs, in turn, affect the way nurses interact with patients. Satisfying Medicare regulations and the cost-effectiveness of care are not aspects of the Western secular belief system. The remaining option is an ethical principle that has always been important in medical ethics.

The aspect of functioning that distinguishes RNs from LPN/LVNs is that only RNs - provide health information to patients and families. - initiate independent nursing actions based on nursing diagnoses. - plan and organize daily care for groups of patients. - implement measures ordered to prevent complications.

initiate independent nursing actions based on nursing diagnoses. LPN/LVNs function interdependently rather than independently. The LPN/LVN functions under the supervision of the RN. The LPN/LVN is able to perform the remaining options.

Civil law is concerned with - decision making based on the nursing process. - intentional and unintentional torts. - guilt associated with criminal behavior. - acts that threaten society.

intentional and unintentional torts. Torts are civil wrongs and may be intentional (intended to cause harm) or unintentional (did not mean to do harm to the patient). Acts that threaten society are considered criminal acts. Civil law is not directly concerned with the nursing process. Civil law is concerned with liability rather than guilt.

The role of the LPN/LVN in the health care team is best described as ______________________.

interdependent

An LPN/LVN offers input to the RN about the effectiveness of the patient's care plan. By doing this, the LPN/LVN is functioning in an - interdependent role. - independent role. - expanded role. - entrepreneurial role.

interdependent role. Interdependence calls for the LPN/LVN to provide input and feedback to the RN planning and evaluating care for a specific patient.

A major reason for LPN/LVN graduates to join nursing organizations is that membership - provides an opportunity to draft legislation for health care workers. - enhances one's standing among registered nurses. - keeps one updated on issues that affect practical nursing. - encourages practical nurses to expand their social horizons.

keeps one updated on issues that affect practical nursing. Membership in a nursing organization provides access to information relevant to the standing, as well as the practice, of nursing. Proposed changes in the Nurse Practice Act can be disseminated and the organization can use its collective power to support or call for defeat of such measures. The greater the membership in an organization, the greater the political power the group has. The other options are not considered major reasons for belonging to a nursing organization.

The student reads a definition of a nursing term and is asked to state whether the sentence is true or false. The cognitive level of this exercise is - analysis. - application. - comprehension. - knowledge.

knowledge. Knowledge refers to the ability to recall and repeat memorized information. The other options are higher cognitive levels—comprehension: the ability to basically understand information, recall it, and identify examples; application: the ability to use learned material in new situations; analysis: to break down complex information into its basic parts and relate those parts to the whole picture.

A nurse damages a physician's reputation through false written communication without the physician's permission. This is an example of - libel. - slander. - battery. - assault.

libel Libel is defamation through written communication or pictures. Assault is an unjustified attempt or threat to touch someone. Battery means to cause physical harm to someone. When a patient refuses a treatment or medication, forcing the patient to take medication could result in an assault and battery charge. Slander is defamation by verbalizing untrue or private information (gossip) to a third party.

A nurse is performing routine vital signs on patients. The nurse has obtained vital signs many times before and is able to do so without much conscious thought. This is an example of - directed thinking. - negative thinking. - ruminative thinking. - nonfocused thinking.

nonfocused thinking. Directed thinking is purposeful and outcome oriented. Negative thinking occurs when the mind is stuck on negative thoughts and blocks worthwhile thinking. Ruminative thinking occurs when the same situation or scene is replayed in the mind over and over, without reaching an outcome. Nonfocused thinking occurs when the brain is engaged out of habit, without much conscious thought.

When a student nurse prepares diligently for a clinical assignment, the ethical principle being observed is - fear of punishment. - justice. - autonomy. - nonmaleficence.

nonmaleficence Being prepared to provide skillful nursing care, anticipating problems that may occur, and thinking through alternative solutions qualifies as observing the principle of doing no harm. Autonomy and justice are not principles that apply. Fear of punishment is not an ethical principle.

Legally, student practical/vocational nurses are held to the level of performance - described in the job description for nursing assistants. - of the LPN/LVN instructor. - described in the outline/syllabus of the course in which the student is enrolled. - of the LPN/LVN.

of the LPN/LVN. The standard of practice for the SP/VN is that of the LPN/LVN. Beginning practitioners are not held to a lesser standard. SP/VNs are not held to the same level of performance as nursing assistants. Holding the student practical/vocational nurse to the level of performance described in the outline/syllabus of the course in which the student is enrolled may not correspond to the Nurse Practice Act (although it should!). The instructor would be held to the standard for RNs.

Which of the following constitutes a problem that affects data collected by the nurse interviewing a chronically ill older adult patient? Many older adults who are covered only by Medicare Parts A and B find it difficult to pay the cost of - prescription drugs while living at home. - hospital care for an acute short-term illness. - doctor's office visits, Pap smears, and mammography. - post-hospitalization rehabilitation services in a skilled nursing facility.

prescription drugs while living at home. Data collection should include medications prescribed for the patient and whether the patient is medication compliant. Often patients are without medication when funds are limited. The other costs mentioned in the remaining options are covered by Medicare Parts A and B.

A 70-year-old patient tells the nurse, "I can't go to the hospital for treatment because I have no hospital insurance. My Social Security and my pension pay my living expenses, but I don't have any savings." The nurse's response should be focused on - investigating which hospitals provide free care for indigent patients. - providing information about Medicare. - exploring the patient's ability to purchase group health insurance. - explaining the provisions of Medicaid.

providing information about Medicare. It is important to provide information that older adults, regardless of income, can receive federal payment for hospital and physician services through Medicare. There is not a clear need to provide information about Medicaid. It's too late to secure group health insurance for this identified health care need. In addition, health insurance companies often refuse payment for treatment of preexisting conditions. Exploring the patient's ability to purchase group health insurance should not be the initial focus.

When documenting patient behavior, the LPN/LVN should - record subjective interpretations of patient behavior. - avoid mentioning communicating with supervisors to report changes in condition. - record all interventions performed and patient instruction given. - Use white-out to erase errors in documentation.

record all interventions performed and patient instruction given. The nurse should record all interventions and instructions given to the patient. Legally, if it is not documented, it cannot be proved that the care was given. Documentation should be objective. All patient-related communication with supervisors or physicians should be documented. Flow sheets must be marked appropriately.

What fundamental principle must the nurse first observe when confronted with an ethical decision? - Nonmaleficence - Respect for people - Beneficence - Autonomy

respect for people The first fundamental principle is respect for people. Autonomy, beneficence, and nonmaleficence are not the first fundamental principles to observe when confronted with an ethical decision.

The member of the health care team responsible for performing treatments to assist the patient to breathe more efficiently and effectively is the - respiratory therapist. - physical therapist. - psychotherapist. - occupational therapist.

respiratory therapist. Respiratory therapists are responsible for evaluating patient respiratory status and suggesting treatment to prevent or treat respiratory problems. The health care team members mentioned in the other options do not focus on patient breathing.

The goal of the health care team is best described as - preventing communicable diseases. - restoring optimal physical, emotional, and spiritual health to patients. - selecting health care professionals who serve people with health care needs. - attaining personal satisfaction of the need to help others.

restoring optimal physical, emotional, and spiritual health to patients. Restoring optimal physical, emotional, and spiritual health to patients is a frequently used statement that describes the goal of health care. Prevention of communicable diseases is a narrow statement and does not best describe the goal of the health care team. The remaining options are not goals of the health care team.

A patient tells the nursing student, "I keep thinking of the mistake I made that led to the accident. I can't get it out of my mind. Now my son has a broken leg." The nursing student correctly identifies this as - random thinking. - habitual thinking. - ruminative thinking. - directed thinking.

ruminative thinking. Ruminative thinking replays the same situation repeatedly without reaching an outcome. Random thinking involves many thoughts or scenes running aimlessly through the mind. Habitual thinking involves routines performed as if on automatic pilot. Directed thinking is purposeful and outcome oriented.

The event that had the most profound influence in changing practical/vocational nursing was - the first computer-adaptive test for practical/vocational nursing graduates. - the American Medical Association (AMA) proposal to develop registered care technicians as new health care workers. - the depression of the 1930s, when nurses worked for room and board in lieu of salary. - the post-World War II movement of practical/vocational nurses into hospital positions.

the post-World War II movement of practical/vocational nurses into hospital positions. The nursing shortage following World War II was responsible for hospitals hiring practical/vocational nurses and for the gradual expansion of the role of the practical/vocational nurse. None of the other options offered had the same degree of influence as World War II and the subsequent nursing shortage.

The most important reason for a student nurse to prepare adequately before providing patient care is - to be able to give the same safe care as a nurse. - to avoid arousing the anger of the instructor. - to maintain self-esteem by performing well. - to make a favorable impression on unit staff.

to be able to give the same safe care as a nurse. Student nurses are legally and ethically responsible for giving the same safe nursing care that nurses provide. Avoidance of arousing the anger of the instructor is not a valid reason. The remaining options are not the most important reasons.

The nurse is caring for a patient with a do-not-resuscitate (DNR) order. Although the nurse may disagree with this order, what is his or her legal obligation? - To seek advice from the family - To question the health care provider - To discuss it with the patient - To follow the order

to follow the order When a DNR order is written in the chart, the nurse has a duty to follow the order. Questioning the health care provider, seeking advice from the family, and discussing it with the patient are not legal obligations of the nurse.

The best reason for studying nursing history is - to prepare for the NCLEX-PN examination. - to help nurses adapt to change. - to make nurses more professional. - to learn from nursing's past mistakes.

to help nurses adapt to change. Knowledge of the changes that have occurred in nursing prepares one to better understand and adapt to continuing changes. The other options have lesser degrees of validity.