Professionalism Test bank

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7. A nurse works in the medical-surgical unit of a suburban hospital and is taking care of a client who has many complex physiologic processes going on at the same time. The nurse exhibits flexibility, inquisitiveness, and open mindedness in caring for the client as their condition changes from day-to-day. The nurse is primarily exhibiting which type of thinking? A) critical thinking B) creative thinking C) reflective thinking D) independent thinking

1. A grandfather who is in the hospital has his grandchildren come to see him for visiting hours because he misses them so much. He believes that with his health deteriorating, he may not see them again if something happens. What is the term that best represents the definition of what most likely will happen with the future being primarily a mirror to the present with little or no actual change? A) preferable future B) probable future C) plausible future D) possible future

10. A nurse attends a wound-healing conference and brings back information about a change in practice that he or she believes needs to occur on the unit. The nurse manager encourages the nurse to empower colleagues to provide their thoughts on the changes the nurse believes are in the best interests of the clients on the unit. Which term best describes an avenue for participatory decision making? A) team decision making B) consensus decision making C) individual decision making D) autocratic decision making

10. A student nurse graduates from a university with a bachelor's degree in nursing. After successfully passing the state boards, the nurse decides to pursue employment at a local hospital on medical-surgical unit. There are many openings due to the current nursing shortage. Which factor is contributing to the current global nursing shortage? A) low turnover rates so that jobs are hard to find B) nursing faculty shortage limiting the number of students accepted into nursing school C) overstaffing in acute- and extended-care settings D) reduced number of persons entering the profession

10. At the end of a third 12-hour shift in a row, a nurse assists in the transfer of an obese client. Which universal skill did the nurse need in order to perform this task? A) problem solving B) physical stamina C) leadership and/or persuasion D) frequent contact with the public

13. On admission, the nurse obtains the client's history and begin discussing the plans outlined to prepare the client for their upcoming surgical intervention. The nurse also asks the client what they want to achieve with this experience. According to Northouse and Northouse, which phase of the nurse-client relationship are the client and nurse experiencing? A) trust formation B) initiation C) resolution D) rapport

13. When trying to identify how to write conclusions and implications regarding their research study, a nurse researcher discusses with the mentor the factors involved with the project. Which factor best describes differences related to quantitative and qualitative research findings when writing conclusions for the written thesis? A) The quantitative approach utilizes more statistical analysis than do qualitative studies. B) The quantitative approach utilizes a theoretical approach; the qualitative approach uses development of new nursing knowledge. C) Qualitative studies provide a foundation for future hypothesis testing; quantitative studies do not. D) Qualitative studies have more generalizations than do quantitative studies.

14. A nurse is working with a morbidly obese client who doesn't want to bath or get out of bed. Which statement by the nurse reveals her passion for helping others achieve a high quality of health? A) "Let's just get the bath done and over with for the day." B) "Let's see if you can walk one more step today than yesterday." C) "Do you want me to call your health care provider and explain why you didn't get a bath today?" D) "I know you must hurt all over, so I'll let you rest some more."

16. The health care provider (along with the nurse) has just informed a client that she has uterine cancer and will need a total hysterectomy. The client is all alone and very tearful. She expresses concern about telling her family "the news." The nurse tries help this client process the new information. This nurse's belief in helping people through mutual goal-setting is best illustrated using which nursing theory? A) Susan Leddy's Human Energy Model B) Imogene King's Systems Interaction Model C) Martha Rogers Science of Unitary Human Beings D) Rosemarie Parse's Human Becoming Theory

19. A nurse is caring for a client with diabetes who is homeless. The client has had multiple admissions in the past year related to diabetic ketoacidosis. When questioned, the client simply states, "I can't afford insulin." Which is considered a responsibility of a nurse when it comes to advocating for safe care for their assigned clients? A) Research possible treatments for their current health status. B) Ensure clients have access to appropriate services to meet their health needs. C) Provide mechanisms for clients to control how their body responds to treatment regimens. D) Take control over appointing other disciplines to work with the client to get them to a higher level of wellness.

19. A nurse is utilizing Rogers' Diffusion of Innovations theory to study the use of "slick sheet" system to assist nurses in turning immobile clients. The nurse is visiting with their colleagues asking further opinions about trying the "slick sheet" for one month. The nurse is in which stage of the Rogers' theory of Diffusion of Innovations process? A) Stage 1—Knowledge B) Stage 2—Persuasion C) Stage 3—Decision D) Stage 5—Confirmation

19. A nursing unit assigns their RN staff to plan individualized care for each client and actually implement the plan, along with providing health education for their assigned group of clients/families. What type of nursing care delivery model is being practiced on this nursing unit? A) team nursing B) primary nursing C) progressive client care D) skilled nursing

3. A newly diagnosed breast cancer client is discussing her feelings about changes in her breast following surgery and the hair loss expected after chemotherapy. She and her nurse discuss her support system, coping mechanisms, options to get haircut before losing hair, shopping for wigs, etc. Utilizing Roy's Adaptation Model, which adaptive mode is the nurse focusing on with this interaction? A) physiologic mode B) self-concept mode C) role function mode D) interdependent relations

3. A nurse is interested in pursuing further education in nursing informatics. While researching the educational programs from various universities, the nurse finds that a degree in informatics nurse specialist will require which type of schooling? Which degree does the informatics nurse specialist hold as the minimum requirement? A) associate's degree B) master's degree C) baccalaureate degree D) doctorate degree

4. During chart review, a local hospital noticed a large amount of ventilator-acquired pneumonias. The hospital devised an educational program to try to reduce the number of pneumonias and implemented interventions to reduce the rate. Data was collected after 6 months to see if the changes were successful, and the hospital realized a reduction in ventilator-acquired pneumonia rates by 25%. Whose quality improvement approach did this hospital implement? A) Joseph Juran B) W. Edwards Deming C) Philip Crosby D) Toyota

4. The president of a local chapter of a nursing professional organization determines that there is a need for a change in the alignment of the chapter. Which Covey's role of a leader looks at inspiring trust? A) aligning B) modeling C) empowering D) path finding

5. A client visits his primary care health care provider and is seen initially by the nurse to take vital signs followed by a request from the administrative assistant to complete insurance paperwork. The primary care provider then comes in to perform a history and physical and diagnoses the client with an upper respiratory infection. Which individual represents the external customer? A) health care provider B) client C) nurse D) administrative assistant

5. A nurse instructs a client, originally from India, to call the health care provider's office if the client develops signs of infection such as a fever of 101°F (38.3°C), redness, swelling at the incision site, and any drainage from the incision site. While giving these directions, the client does not look at the nurse. What cultural difference may have caused this perceived barrier to nonverbal communication in this scenario? A) proximity B) eye contact C) silence D) touch

8. A nursing education department in the hospital supports and encourages clinical research of its nurses. What motivating factors may best facilitate research utilization by the nursing staff? A) change in values related to research by administration B) promotions or salary increases for use of research in practice C) increased time to participate in research utilization activities D) provision of time for nurses to read research reports while off duty

16. Nurses are educated with regard to physical disabilities that arise in the aging population. Nurses working with geriatric clients should be prepared to care for an increase in which clinical issues as a result of aging population? Select all that apply. A) Increase in the number of smoking cessation programs. B) Prevention of HIV exposure due to decrease in condom use. C) Supportive care services available for loved ones in their homes. D) Rise in liver disease and alcoholism related to socialization in establishments that sale liquor. E) Obesity resulting from natural decrease in activity and increase in fast-food meal consumption.

B, C

10. A nursing professor has asked the students in research class to compare research utilization with that of evidence-based practice (EBP). The students have incorporated which key elements as part of evidence-based nursing practice? Select all that apply. A) scientifically based B) utilization of more than one type of data C) used more frequently in hospital setting D) evidence-based nursing outcomes are better than research utilization outcomes E) EBP is more cost effective for the employer

B,C

15. A nurse in the busy orthopedic unit develops symptoms of stress related to staff shortages and employer's frequent requests to work extra shifts. Which symptoms are indications that the nurse is under stress? Select all that apply. A) increased ability to concentrate B) increased smoking C) sleep disturbances D) overeating E) increased gossiping with peers

B,C,D

1. A nurse, after several years of medical-surgical experience, decides to specialize in another aspect of nursing care. The nurse looks to set up a career vision statement that will begin the process of finding the ideal nursing position that incorporates their nursing-related passions. Which human life transition may cause revisions in the career vision statement based on a mental health status change? A) reduced child care responsibilities B) position that requires less physical exertion C) re-enter clinical practice because of a change in marital status D) leave a position to stay home with children

11. A nurse in a rural area comes to work to find that he/she is the only nurse for the shift to care for 12 clients. The nurse believes this is too many clients to care for on a busy night in the medical-surgical area and calls the supervisor. Which form of accountability is best illustrated in this example? A) accountability to the profession B) accountability to the agency C) accountability to self D) accountability to third-party payer

13. A client's parent is dying from heart failure and has just been transferred to skilled nursing facility for end-of-life care. What kind of care is the client's parent receiving when receiving care for end-of-life issues? A) primary care B) secondary care C) tertiary care D) quaternary care

15. When the nurse truly empowers the client, positive outcomes can be the result. Which prerequisite to empowerment encompasses turning to higher powers without the need for social prominence? A) power by purpose B) power by reflection C) power by gestalt D) power by giving

5. A graduate nursing student has been researching whether administering IV antibiotics through the upper access port or the lower port closest to the insertion site makes a difference in clients' antibiotic therapeutic blood levels. This student is primarily utilizing which type of knowledge that is verifiable for accurate findings? A) personal knowledge B) aesthetic knowledge C) empirical knowledge D) ethical knowledge

6. In reviewing the history of the nursing profession, how can students and nurses alike utilize the past to assist in solving future nursing issues? A) Utilize strategies that have been unsuccessful in the past to support nursing professionalism B) Work alone in solving nursing issues with nursing colleagues not taking account of past history C) Collaborate with other professionals to assist in solving current nursing issues D) Reinvent nursing from a philosophical standpoint

10. A nurse is working on a busy medical-surgical unit. They are caring for 6 clients with the help of an LPN. The nurse is behind schedule for giving medication. The nurse begins to hand an IV push medication to the LPN for them to administer. But then the nurse recognizes this is outside the scope of practice for LPNs. This is an example of which trait possessed by RNs to be accountable to standards of practice? A) ethical B) autonomy C) authority D) competence

5. A health promotion program attempts to help smokers quit. Which strategy for changing lifestyle behaviors would be a priority for clients with this addiction? A) conditioning B) medication C) psychotherapy D) stimulus control

6. A busy nurse manager on a medical-surgical unit has just read The Seven Habits of Highly Effective People. Which habit of effective leaders was added to the other seven and incorporates periodic analysis of values and beliefs? A) blending voices to develop shared vision B) empowering others to use their talents C) empowering others to live out passions D) hearing one's own voice and inspiring others to find theirs

6. A nurse is studying the ethical practices of a research project focusing on resilience following spousal abuse. Which principle of research ethics protects the human rights of participants? A) process of approval by IRB B) truth in research reporting C) anonymity of participants D) informed consent signature

6. Which assessment characteristic will the nurse need to know when taking care of an Asian client? A) advanced hair graying B) hair usually silky, black, and curly C) pallor appears as corn color D) areola and genitalia are darker

9. The nurse is performing a cultural assessment on a client. Which question would a nurse use to obtain data about social life? A) How do you spend your free time? B) Who lives in your home with you? C) What support systems do you have outside the home? D) Do you have any rituals or habits that we need to be aware of while you are in the hospital?

1. A colleague approaches a nurse on the unit and asks about a specific client. The nurse assumes the colleague knows this client outside the hospital setting. According to Ceccio and Ceccio, what is the purpose of the colleague's communication? A) inform B) inquire C) persuade D) entertain

13. Which document provides evidence for meeting the criteria of a promotion? A) reference list B) nursing portfolio C) cover letter D) résumé

3. The research study on the use of untrained nursing personnel in the early 20th century parallels the use of what kind of worker in the 1990s? A) Student Nurse Personnel (SNs) B) Unlicensed Assistive Personnel (UAPs) C) Certified Nurse Aides (CNAs) D) Licensed Practical Nurses (LPNs)

5. There are many parallels throughout nursing history that relate to current nursing practice. Which can be seen today in nursing education? A) informal training programs B) formal training programs C) decrease in scholarships D) decrease in student diversity

14. A client is very motivated to lose weight. They plan on starting an exercise program. This client is displaying which model for motivational readiness for lifestyle behavior change? A) Revised Pender model B) Health belief model C) The transtheoretical model D) The stages-of-change model

2. A client has just turned 50 and is persuaded by the spouse to have a complete physical examination. The client makes an appointment with the family doctor to determine their current state of health. What level of care is this client seeking? A) primary care B) secondary care C) tertiary care D) quaternary care

4. A political action committee is formed by a business, and a nurse is asked to be on the committee. What is the major purpose of a political action committee? A) financing campaigns for political office B) advising politicians on campaign issues C) lobbying key politicians for pieces of legislation D) creating jobs for political staffers

19. A graduate nurse (GN) has his/her first job interview tomorrow. What activities should the GN implement prior to going to the interview? Select all that apply. A) Look up the organizations mission and philosophy today to get a feel for their overall goals. B) Be prepared to talk about one's person strengths and examples of problem-solving skills. C) Put on your best pair of scrubs that are clean and ironed and make sure your shoes are clean. D) Avoid interjecting general examples of how you would handle certain situations so HIPPA is not violated. E) Ask a classmate to go to the interview and be available so you can discuss the process afterwards.

A,B

11. A nurse with 5 years of experience in the field has recently decided to pursue a teaching career in a university setting. The nurse currently has a baccalaureate degree. What is the next level of education that this nurse must obtain in order to reach her goal? A) certification B) graduate nursing education C) specialized nursing experience D) RN degree

15. The Kingdon model for political processes identifies streams that affect agenda development and policy formation. Which stream aims at creating a political culture in elected bodies that support tackling the problem? A) political B) policy C) procedure D) problem

19. A victim of a motor vehicle accident who is seen in the emergency room of a rural hospital can receive consultation from a trauma team at a larger urban trauma center by way of video technology. This is an example of which type of consumer health informatics services? A) Telemedicine B) Telehealth C) Telemonitoring D) Education informatics

4. As a nurse who promotes health and wellness in the community, what characteristics would the nurse use to define wellness when teaching to a group of parents at the YMCA? A) state of perceived well-being B) minimally functional but able to care for self C) maladaptive with environment but needs minimal assistance D) subjectively states functionality

6. A 45-year-old individual has been transferred to Japan for work and has elected to utilize Japan's national health service model as insurance. Where does the national health service model get funding? A) general tax revenues B) nonprofit insurance funds C) individual purchase D) income tax revenues

8. A nurse in graduate school is focusing their research on community nursing. Which perspective best represents the individual as the basic unit of the community; that is, the community is a number of separate individuals? A) aggregate perspective B) human system perspective C) unitary perspective D) human field perspective

8. The nurse, is caring for Client A, who is scheduled for surgery the next day and has a bowel prep prescribed, beginning tonight. The nurse discusses the bowel prep with the client as one step in getting ready for surgery. The prep was delivered, and by 6 AM the next morning, both the nurse and the client feel they have met the physiological and psychological readiness for surgery. Which term best describes this scenario? A) mutuality B) respect C) reciprocity D) helper relationship

18. While providing nursing care in Turkey in the 1850s, Florence Nightingale implemented which measures, still in practice today, which lowered the mortality rate of 40% to 2%. Select all that apply. A) proper room ventilation B) applying herbs on open wounds C) nutritious meals D) cleaning of the facility [rooms] E) incorporation of prayer and meditation at the bedside

A,C,D

14. A nurse working in the emergency department is designing a research topic related to workplace hazards. Which professional associations/ governmental agencies conducts ongoing studies related to workplace hazards for nurses and may provide a wealth of knowledge for this nurse researcher? A) Oncology Nursing Society B) American Nurses Association C) American Association of Critical Care Nurses D) National Institute for Nursing Research

13. Which geographical area was instrumental in food inspection techniques, vital statistics, and infectious disease quarantine procedures? A) Greece B) East C) Palestine D) Assyria

1. A local hospital performed an in-service to assess its level of client quality. The clients commented on the lack of contact that they had with their nurses. Which indicator of quality service for nurses does the hospital need to address? A) lack of time with clients B) educational information C) assistance with resources D) availability of supplies

1. A nurse arrives to the unit and receives report from the night shift nurse. The nurse identifies what medications are necessary for the client before going to the client's room. Upon entering the room, the nurse introduces themselves and takes a blood pressure and then listens to the client lungs, heart, and abdomen before checking pedal pulses and inquiring about pain. Which step in the nursing process has the nurse just performed? A) assessment B) diagnosis C) planning D) implementation

10. "Patterning nursing processes use energy to enhance health and well-being" is what the student reads in the textbook. As the student inquired as to what theories use patterning, the student began to read about appraisal and deliberative phases. Which theory highlights these concepts and is considered a patterning process? A) Rogers' science of unitary human beings B) Parse's human becoming theory C) Paterson and Zderad's humanistic theory D) Peplau's interpersonal relations model

13. After a nursing student does poorly on a test, the student's professor requests a conference to discuss the matter. During the discussion, the student comments, "I didn't have time to read all those chapters." While discussing strategies to help with reading effectiveness, the professor suggests that after reading a passage, the student should take a break and do which activity? A) Paraphrase the major concepts they just read. B) Listen to classical music. C) Visit with their peers about their study habits. D) Get a caffeinated beverage.

16. A nurse is admitting a client to the unit and collects relevant regarding the client's personal habits, communication styles, and cultural influences to provide individualized care. Which step in the nursing process is the nurse implementing? A) assessment B) diagnosis C) planning D) implementation

2. A nurse prefers to view the future in the present, making a point to dream about what the future will bring. Which term describes the definition that proposes the desired state for the future? A) Preferable future B) Probable future C) Plausible future D) Possible future

20. An elderly client has multiple disease processes. They see a cardiologist for HF management, a nephrologist for impaired renal function, a rheumatologist for advanced arthritis, etc. The primary role of the nurse managing their care revolves around which concept? A) Ensure safety across the continuum of care, esp. regarding their medications. B) Ability to get the client to each scheduled healthcare provider appointment on time. C) Arrange for client to participate in activity enhancement classes at the local senior citizen center at least three times/week. D) Provide opportunities for their socialization needs by encouraging them to attend community activities.

1. A Filipino nurse practices nursing in a hospital in the United States. In looking at the definition of cultural competence, a life-long journey that requires the elimination of ethnocentrism (belief that one's way is best) and an unconditional acceptance of cultural diversity, the nurse is moved to provide an in-service on cultural factors to enhance nursing care. Which step to acquire cultural competence involves learning how to read verbal and nonverbal messages? A) becoming culturally aware B) learning specific communication strategies C) identifying biases in one's own self D) interacting with different cultures

12. A client returns to the unit following surgery. The nurse admits the client to the room and describes how to use the call light. After the shift is over, the nurse gives report to the next shift RN and reviews the client's care plan that has been written to identify the necessary plans for the client throughout the next shift. What step of the nursing process identifies nursing interventions to be implemented in the oncoming shift? A) assessment B) planning C) implementation D) evaluation

15. A nurse educator attends a conference focused on teaching nursing models specifically related to culturally diverse groups of populations. This educator got into a discussion with other attendees about development of a deep self-awareness of personal existence, feelings, ideas, and emotions while not allowing these to influence actions/interventions when working with persons from other cultures. This discussion group is primarily talking about which transcultural nursing theory? A) Leininger's sunrise model and theory of culture care diversity and universality B) Purnell's model for cultural competence C) Spector's model of heritage consistency D) Giger and Davidhizar's transcultural assessment model

2. A health care provider writes an order for a client on the unit to have a diuretic due to the medical diagnosis of congestive heart failure. As congestive heart failure is a disease to the client, which terminology defines "disease" as a part of the interrelated cause-effect in the treatment regime? A) dysfunction of the mind B) dysfunction of the body C) dysfunction treated by medication D) dysfunction treated by rest

20. Which scenario would be considered a breach of a common ethical principle for nurses? A) Keeping clients' gender identity confidential. B) Deciding to forego renewal of CPR certification when one's card expires since "nothing ever changes." C) Attending nursing standards committee meeting and relaying information back to the nursing unit. D) Pulling drapes around a client and their family to give them privacy to make a decision about their care.

5. A nurse has been assigned to care for an African American male following their abdominal surgery. When assessing the African American male, the nurse is aware of differences in this population. Which assessment finding would lead the nurse to suspect the client is hemorrhaging into their abdomen? A) Development of petechiae on both arms. B) Skin is ashen or slightly gray in color. C) Inflammation is more detectable by visual means. D) Skin is warm and dry to touch.

6. A client comes to the hospital for a surgical procedure. On day 2, the client experienced a fever and required antibiotic therapy. The client was originally supposed to go home on day 2 but as a result of the fever stayed an extra day and then went home with oral antibiotics. As a result of accurate documentation, what would be the positive outcome to the facility? A) client's fever was treated B) reimbursement by third-party payer C) family reunited with loved one D) nurse satisfaction with resolution of fever

7. A worker in Brazil utilizes the mandated health insurance model for health care insurance. When describing the mandated health insurance model to an American friend, the worker will discuss the funding occurs through which revenue source? A) income tax revenues B) nonprofit insurance funds C) individual purchase D) general tax revenues

9. A lobbyist for the ANA has contacted many nurses to find out their opinions on health care reform. Following receipt of the information, the lobbyists put together information in aggregate form. In addition, the lobbyist requested that all nurses write their elected officials. What is the most effective weapon for the lobbyist? A) letter writing B) constituent pressure C) personal visit D) e-mail

9. Career development is an iterative and continuous process combining linear and nonlinear approaches. A model has been suggested for use that has five phases of career planning. Which phase relates to self-assessments? A) scanning the environment B) periodic reality checks C) incongruence forces alternative career path D) decision to stay or make a change

17. A nurse manager is working on their annual departmental budget. They notice a variance in actual versus projected salary expenses. The manager will build in overtime hours for which potential scenario? Select all that apply. A) A nurse with a newborn calls in several times in a row when the child is placed in daycare and becomes ill. B) Medical emergency with one of the clients happens at shift change. C) Unit has received multiple, unexpected admissions within a short time frame. D) Many of the nurses have volunteered to be on hospital-wide committees that meet at least once/week. E) The unit is short two unlicensed assistive personnel and nurses are doing primary care.

B,C

17. A nurse is sharing with their next-door neighbor that she/he no longer cares if the clients get better or not. They try to give them the best care, but administration keeps piling more 'busy' work on the staff. The neighbor has been a recent client at this same hospital. Which behaviors observed by the neighbor would be classified as noncaring from their personal experience? Select all that apply. A) Staff primarily are at the client's bedside interacting with them. B) Staff acting as if they are being "bothered" when a client asks for pain medication. C) Overhearing staff arguing among themselves as to whose turn it was to "float" to another nursing unit. D) Staff verbalizing their frustration with the "new" electronic medication dispensing equipment that they did not get in-serviced on how to use. E) Big celebration with food and cupcakes for one of the nurses 50th birthday.

B,C,D

1. The nurse in a health care provider's office looks at the charts for the next day to determine who is coming to the health care provider's office to plan for the day. The nurse begins to think about one particular individual who recently lost their spouse. The nurse is looking forward to visiting with this person about how they are handling the loss. When thinking about this person, how would the nurse best define this person as an individual? A) two or more individuals who depend on one another B) groups of people with common interest with open communication C) recipient of nursing care unique and continuously evolving D) a person progressing through life

10. A client is interested in pursuing a test to determine if there is a predisposition to breast cancer since it is in the family history. Which technology relates to ethical and legal concerns regarding right to privacy issues when specific innovative testing is performed? A) stem cell research B) electronic medical record C) genetic testing D) HIPPA violations

10. A nurse enters the room of a client and teaches about pain medication while simultaneously relieving stress with therapeutic massage. The nurse is also able to determine what theories pertain to the nursing actions. Which type of thinking is the nurse exhibiting when he/she processes caring for the pain of this client? A) independent thinking B) critical thinking C) reflective thinking D) creative thinking

10. A nurse identifies that a client lacks motivation and wants to explore ways to improve the client's ability to engage in learning. The nurse demonstrates proper technique to changing the dressing. Which motivational strategy best indicates a meaningful relationship has taken place between the client and the nurse? A) The teacher assumes and expects that the student can learn. B) The teacher is sensitive to the student's individual needs. C) The student and the teacher trust and respect each other. D) The teacher feels comfortable making mistakes to see if the student can identify it.

10. A nursing doctoral student is researching self-efficacy of managing type 2 diabetes in a defined population using a valid Likert-type scale, Diabetes management Self-Efficacy Scale (DMSES). The findings demonstrated that the participants who reported a moderately high level of self-efficacy in managing their diabetes had better glycemic control [glycosylated hemoglobin levels]. This is an example of utilizing which type of theory that explains and predicts certain relationships among key concepts? A) Self-care deficit nursing theory B) Systems model C) Middle-range theory D) Interpersonal theory

10. A nursing faculty member is hired in a community college setting with a BSN degree. The nursing faculty member is required to finish the master's degree within the first year of employment in order to continue teaching at the college. Once employed, faculty members closely follow a tenure track program with specific criteria for advancement. What type of career path is this scenario defining? A) circular career path B) noncircular career path C) linear career path D) nonlinear career path

11. A nurse writes a letter to assigned congressperson about an issue involving health care. In order to be effective with writing a letter to an elected official, a nurse should include what in the first paragraph? A) Greet the official according to his or her title in the salutation. B) Add personal experiences and views eliminating the tone of a form letter. C) Identify yourself as a constituent, health care expert, and credible source on the issue. D) Provide contact information as legislators monitor letters from their constituents.

11. Nurses on the floor of a general medical-surgical unit do not get along, and the clients on the floor have noticed. Customer satisfaction reports have been low, and the nurse manager has asked all members of the unit to participate in the upcoming staff meeting. The nurse manager will begin by addressing the observations and then present communication strategies to assist staff to engage in meaningful conversations. Which communication strategy is the nurse manager utilizing by having a safe place for the team members to foster collaborative learning and to share and listen to the thinking of others? A) listening B) advocacy C) intention D) silence

11. Nurses routinely check the telemetry monitors while at the desk looking for abnormal arrhythmias on the monitor. A nurse looks at the strip in Room 1030 and has a feeling to check the client. She does so, and notes the client is cyanotic and having difficulty breathing. What term best identifies the feeling that the nurse had to go assess the client? A) critical thinking B) negative thinking C) intuition D) reflection

12. A consumer of health care has just been laid off by their employer, thereby losing health care coverage for themselves and family members. In this situation, which key factor will contribute to this consumer not being able to afford health care? A) Access to care B) Quality to care C) Cost of care D) Continuity of care

13. A professional nurse decides to volunteer to teach women at a local church about self-breast examinations. Which type of outpatient nursing opportunities is the nurse utilizing? A) cardiac rehabilitation B) community health center C) community education D) managed care companies

17. A group of nursing students have been assigned to work on a group project. Every student has different working schedules making it difficult to meet in person. One student has volunteered to organize a timeline and edit the final project for consistent writing style. This student is fulfilling which role in the group? A) helper B) recorder C) leader D) gatekeeper

10. During a graduate research and theories class, the professor discusses the integration worldview. Which nursing view has integrated this integration worldview into their nursing practice? A) The client is not necessarily responsible for their health since many times their genetic makeup supersedes their choices. B) Environmental factors play a significant part in one's overall health. C) Not only the client, but all friends and family members are responsible for the client's current state of health. D) The nurse helps the client focus on their strengths while getting them to acknowledge factors impeding growth to maximal health.

4. A client chooses to use a certified nurse-midwife (CNM) to deliver her child. After reviewing the credentials required to practice as a CNM, which degree program would the nurse anticipate the CNM's diploma to contain? A) licensed practical nurse degree B) generalist nurse C) certification program D) advanced practice nursing degree

4. A health care provider states that a client will be going home in 3 days and that education is needed regarding home administration of oxygen. The nurse evaluates the client and determines that the client is having anxiety about going home because of their "inability to breathe well." The nurse listens to the client's concerns and determines that teaching will need to occur the next day after these concerns are discussed. The nurse in this situation was real, open, honest, and caring to the client. Which communication concept was used by the nurse? A) respect B) mutuality C) empathy D) genuineness

4. A nurse is working on the unit with a diverse group of colleagues. Although the nurse recognizes that there may be biases regarding different cultures, the nurse makes an attempt to become culturally competent. Which strategy deals with communication ineffectiveness? A) Deal with biases openly to dispel incorrect assumptions. B) Recruit culturally competent nurses to diversify the workforce. C) Promote psychological comfort to colleagues of different cultures. D) Have direct caregivers repeat instructions back to validate understanding.

4. A nurse working in the outclient clinic identifies a concern regarding a community suburb when the health care provider mentions to the nurse that this was the fifth case of Lyme disease seen from this community suburb. Which theory demonstrates the conceptual model that best fits when the nurse thinks of the community as being in need or the recipient of care? A) geopolitical model B) perception as community model from a human becoming perspective C) human field-environment model D) systems model of community as client

4. The Religious Sisters of Mercy in the 1830s devised a system of nursing that included "physical care and emotional consolation provided from a spiritual perspective." What was this form of nursing called? A) public health nursing B) civil War nursing C) home health nursing D) careful nursing

5. A 25-year-old adult graduates from college and obtains a job working for a bank that offers a good salary, good hours, and medical and dental benefits. Which type of health care funding model would best describe the medical benefits provided by the employee and employer? A) The national health service model B) The mandated insurance model C) The Medicaid insurance model D) The entrepreneurial insurance model

5. A client was prescribed digoxin for a cardiac arrhythmia in the hospital setting by a nursing health care professional. Which type of advanced practice nurse did this client likely encounter? A) clinical nurse specialist B) certified registered nurse anesthetist C) certified nurse-midwife D) nurse practitioner

5. A nurse on a busy cardiac unit experiences their first code (cardiac arrest), and the client is sent to the coronary care intensive care unit for further care. The nurse feels their participation in the code could have been performed in a more efficient manner. The next time, the nurse will perform essential actions faster with more confidence. What type of thinking was utilized in this scenario? A) critical thinking B) negative thinking C) intuition D) reflection

6. A nurse is talking to a client about the client's history of abuse as a child. The nurse is engaged in the conversation and nonverbally supporting the client as they share this information. This interaction allows the nurse to develop a helping relationship with the client and would be classified as displaying which principle of communication? A) Getting client to relax. B) Helping the client to move on to more positive interactions. C) Encouraging the client to make a profound change from within. D) Displaying empathy by trying to understand and accept the client's feelings.

6. A nurse who has worked on the medical-surgical unit for 25 years discusses with a colleague the way learning took place in nursing school. There is a new policy that has been implemented, and the nurse is having difficulty adjusting to the new procedure. Which type of nursing-based practice is the nurse themselves performing at this time? A) conceptual practice B) theoretical practice C) stereotypical practice D) rote practice

7. A nurse is interested in becoming a traveling nurse. Which nursing professional organization can provide career trends as a result of an Internet search? A) United States Department of Labor B) The United States Bureau of Statistics C) Healthy People 2020 D) The American Association of Colleges of Nursing

7. A nurse working in the hospice area has recently noticed that it is taking longer amounts of time to complete simple nursing tasks, is irritable and moody at work and at home, is having difficulty getting a good nights' sleep, and has made some medication errors recently. When stepping back and looking at the big picture, the nurse will likely recognize that he or she is experiencing which work-related problem? A) decrease in energy B) crisis C) role overload D) burnout

7. A practice manager working for a busy pediatric orthopedic practice is worried that the wait time for the clients is becoming far too long. The manager decides to do some research about similar practices regarding standard waiting room time to see how practices compare. What best describes what is occurring? A) consumer satisfaction B) financial performance C) system integration D) benchmarking

7. An ICU nurse has been asked to testify in court related to the death of a client on a ventilator who died as a result of a clogged endotracheal tube. The nurse testifies in court that standards of practice drive the nursing profession and that a client's care was substandard since there was no suction tubing available on the unit which delayed treatment by at least 5 minutes. What type of knowledge is the nurse using for this testimony? A) personal knowledge B) aesthetic knowledge C) empirical knowledge D) ethical knowledge

7. When dealing with an ethical decision regarding a complex client care issue, the nurse uses a traditional approach instead of a theoretical approach to assist in decision making. Which concept is used frequently in the traditional approach to ethical decision making that focuses on bringing about the greatest good? A) contextualism B) principalism C) deontology D) utilitarianism

8. A 60-year-old client arrives at the hospital for a knee replacement. A nursing professional greets the client at the room, takes the client's history, and performs a preoperative assessment. Then the client is taken to surgery and the same nursing professional assists in the surgery and even closes the incision. What type of nursing professional did the client encounter today? A) nurse practitioner B) certified registered nurse anesthetist C) clinical nurse specialist D) registered nurse first assistant

8. The mother of visiting nursing, Phoebe, highlighted which movement in the history of nursing that corresponds to home health nursing today? A) Careful nursing movement B) Women's liberation movement C) Religious order movement D) Deaconess movement

9. A 75-year-old client comes to the clinic to be examined for a decreased sensation in their right foot. The client is an insulin-dependent diabetic and was diagnosed with the condition 15 years ago. Which contextual element applies to this client and affects nursing practice? A) subcultural elements B) economic elements C) cultural elements D) demographic elements

9. A case manager is working for an insurance company and is doing research on ethical considerations from a payer's view. Which technology involves ethical concerns regarding access issues relating to items for which the insurance company does not pay? A) use of technology 24/7 B) stem cell therapy and research C) use of robotics in health care D) genetically designed medications

9. A client has been diagnosed with cancer and is alone (without family) when receiving the diagnosis. After the healthcare provider leaves, the nurse sits down at the client's bedside and engages in therapeutic communication. What is the most effective therapeutic communication technique to effectively use in this situation? A) authenticity B) empathy C) clarification D) listening

9. A community is in need of a program that looks at the development of goals to improve single mothers' quality of life. A focus group has been developed involving 20 single mothers. A nurse working in the community is leading the focus group and has asked for input on setting the goals for the program. Which theory can be most closely related to this scenario? A) Susan Leddy's human energy model B) Margaret Newman's theory of health as expanding consciousness C) Rosemarie Parse's human becoming theory D) Imogene King's theory of goal attainment

12. Which philosophical approach to the development of knowledge is highlighted by the goal of science to predict, explain, and control world events, situations, and occurrences? A) logical empiricism B) historicism C) postmodernism D) rationalism

3. The common purpose of quantitative and qualitative approaches to research is to gain an understanding. Which category does the researcher, using the quantitative approach, view as necessary to objectively distance himself or herself from subjects? A) view of truth B) view of reality C) view of relationships D) view of nursing

19. A young female nurse has decided to embark on an international nursing experience by accepting a very lucrative offer to work in a hospital in Saudi Arabia for one year. Once she arrives in Saudi Arabia, where is the first place this nurse should visit? A) hospital employment office B) hotel where she is assigned to live C) U. S. consulate or embassy D) postal office to register her nursing license

12. While working on a busy medical unit, an assistant nurse manager has noted an increase in the number of falling incidents. After reviewing the documentation, it appears most falls occur soon before lunch when clients are going to the bathroom. The nurse shares this information with the UAP and asks them to assist clients more at this time. Which domain in the Professional Nurse Contributions model does this represent? A) cognitive B) behavioral C) affective D) psychomotor

13. A nurse practitioner who works in the hospital of a large suburban city is accountable for a health care practice involving 30 clients. A student nurse asks the practitioner "Which professional organization set up practice standards for service, practice, and education?" Which agency would be a correct response to this question? A) The American Nurses Association (ANA) B) Institute of Medicine (IOM) C) The National Council of State Boards of Nursing (NCSBN) D) The Joint Commission

1. A nurse is caring for five clients. One client is having acute pain as the nurse walks into the client's room, the client states his/her pain level is a 5 out of 10 and is requesting more pain medication. The nurse retrieves the pain medication, but on the way to the client's room, the nurse is called by another nurse who needs help with an emergency situation. The first client does not receive the pain medication for another 30 minutes, at which point is in acute pain: 8 out of 10 on a 10-point pain scale. Which term best indicates the nurse's commitment to the first client? A) accountable to B) autonomous with C) authority over D) responsible for

1. A nurse who practices on the floor utilizes the theory concerned with elements and interactions among all the factors (variables) in a situation. A cardiac client with heart failure is experiencing coldness in their lower extremities. Their pedal pulses are also very weak due to decrease in blood supply to the tissues. Which theory is the nurse using in the assessment of this client? A) systems theory B) stress/adaptation theory C) caring theory D) complexity theory

1. A conference is presented on world views of health, and the first breakout session discusses the human being conceptualized as a whole comprised of parts who interacts with a physically separate environment. The environment exerts stressors on people to which they must react. There is a belief in linear, predictable, and quantifiable cause-and-effect relationships. What world view is depicted by this scenario? A) interaction worldview B) integration worldview C) partiality worldview D) simultaneity worldview

1. A nurse in a busy orthopedic health care provider's office looks for ways to improve client education and begins investigating the concepts of teaching and learning. What is the rationale for identifying clients as "experts" in the client education process? A) The client is an expert on how issues affect him or her. B) The client is an expert on what he or she needs to know. C) The client is an expert on alterations in health. D) The client is an expert on how to learn.

1. The nursing director attends a workshop and is presenting information on the ANA's seven essential features in Nursing's Social Policy Statement (2010). Which one of the seven essential features of nursing is included in the publication? A) Application of professional judgment and critical thinking to assess and implement treatment based on human responses and experiences. B) Use public policy of current legislature to shape the future of the nursing profession. C) Use scientific knowledge to ration care to those individuals with noncomplex diagnoses and simple treatment options. D) Use assessment as the guide in order to treat the full range of human responses "within the physical environment."

10. A client's caregiver opens the door to the client's home, and the home health nurse enters to find the older adult client sitting up in a chair. The client states, "I have not been myself lately and I am hearing things that frighten me." The nurse assesses the client and discusses the new medication that may be the cause of these symptoms. The caregiver states, "She was like this before being put on the medicine." As the nurse charts the assessment findings, the nurse comments on the lovely flowers the client has received and states that they are just beautiful. Which communication technique has the nurse just utilized? A) changing the subject B) exhibiting judgmental behaviors C) stereotyping the individual D) failing to listen

10. A medical-surgical nurse is discharging a client in 3 days. When looking at how this client interacts with their environment to determine their health, how does discharge teaching for this client differ from that of teaching to families and communities? A) Focus is on the individual. B) Focus is on the family as participants of care. C) Focus is on the community in which they live. D) Focus is on all three of the aspects for the individual.

10. A nurse is caring for a homeless client with a history of diabetes who has a large foot wound. The health care provider prescribes sterile dressing changes and other treatments to prevent progression of the wound. Which contextual element may apply to this client's ability to obtain supplies and to have access to health care to prevent future amputation? A) economic elements B) cultural elements C) demographic elements D) subcultural elements

10. An Asian American nurse practitioner is working in an urban area with a large percentage of the population being of middle eastern decent. One client has chronic pain from a back injury. In addition to giving medications, this healthcare provider suggests the use of meditation and acupressure. This is an example of which concept that is included in Purnell's model for cultural competence? A) Acculturation, taking the best of both cultures and blending them into one. B) Assimilating, adoption of group culture by members of a different culture. C) Diversity, differences within the groups. D) Empathy, expressive concern and the ability to see experiences as the client sees them

10. An effectively written letter to an elected official regarding a health care issue that affects nursing can provide a voice in the political process. The nurse begins by writing a brief summary background of the issue. Following this summary, the nurse should also include which data to highlight the reason for the letter? A) Be brief and specific about the desired action on the part of the elected official. B) Be detailed and lengthy when presenting key information using as many examples as possible. C) Limit each letter or e-mail message to four pages or less, if possible. D) Focus on all the issues that concerns healthcare for this letter.

11. A nurse arrives to the unit and learns that a colleague has called out sick so the nurse will be responsible for at least 10 clients for the shift. Several clients have returned from surgery and require close monitoring. Several other clients are older adults and in need of dressing changes and treatments. All clients have IVs and IV medications to be administered throughout the shift. What is the most prevalent ethical dilemma this nurse is facing, in light of the responsibility that the nurse needs to undertake? A) safety of all the clients B) enough time to complete responsibilities C) enough help to do a good job D) prioritization of needs based on situation

11. A nurse, working on a doctorate degree, has begun collecting articles related to the research topic. Today, they took a step back and realized there was a "gap" in the nursing literature that could become his or her research topic. What phrase best describes this gap in the literature? A) research critique B) comprehensive literature review C) research collection D) defining variables

11. A student wishing to pursue an education in nursing identifies that the nursing program does not meet the student's needs. The student searches for other programs that may do so. Which characteristic of ideal nursing education programs outlined by Ironside and Valiga would provide an opportunity for improved satisfaction of nursing students? A) An open, flexible curriculum that responds to individualized student learning needs. B) Students and faculty learn with each other in courses designed to use role-playing as the delivery method. C) Provide extra clinical hours in areas that the student chooses based on individual interests. D) Student selection of courses based on individual interest and have the ability to test out of other required courses.

11. A wellness class is taught by a nurse in the outpatient clinic of a large suburban hospital. In discussing the clinical model related to health, what factor would the nurse say contributes to individual variability in wellness? A) physiological interrelatedness B) psychological standards C) social influence D) self-actualization

12. A client has been admitted to the coronary care unit (CCU) following myocardial infarction (MI). Which environmental element will affect the nurse and the client when care is being providing in the CCU? A) frequent interruptions B) insurance coverage C) age of onset D) health condition

12. A client's regulatory systems operate by way of compensation, and the nurse who uses this theoretical framework recognizes that any change in the internal environment automatically initiates a response to minimize or counteract the change. What theoretical framework is this nurse using in this clinical situation? A) adaptation framework B) systems framework C) complexity framework D) caring framework

12. An individual has anorexia nervosa and is in a partial hospitalization program. The individual tells friends about the illness. On learning of their hospitalization, friends condone this individuals dependent behaviors that were unacceptable prior to the hospitalization for anorexia nervosa. What is the best term that describes this individual? A) sickness B) well-being C) illness D) disease

14. A client receives their breakfast tray, which was delivered to the unit by the nursing bot while nursing staff perform other more important clinical duties. In addition, a surgeon performs surgery on a client at another hospital while manipulating the instruments from the urban hospital where the surgeon works. Which technology best describes the use of machines to assist health care workers in the care of clients? A) robotics B) stem cell C) genome D) physical therapy

14. A nurse practitioner (NP) has views regarding their ability to safely prescribe narcotics. They are informing fellow NPs to write their legislative representatives voicing their opinion that the state law needs to be changed. According to Cohen, Mason, Kovner, et al. (1996), this is an example of which stage of political activism? A) buying in B) self-interest C) political sophistication D) leading the way

14. A nurse working on an oncology unit has administered a high dose of narcotics to a terminally ill client with pancreatic cancer metastasized to the brain, liver, and bone. Shortly after the administration of the narcotic, the client passes away. During discussions with the hospital's ethics committee, the nurse notes that this decision was the lesser of two evils. Which ethical decision-making principle is the nurse using in this situation? A) double effect B) client advocacy C) principalism D) beneficence

14. A nursing student attends a lecture on the central concepts of nursing. Which answer represents the concept of health? A) well-being and illness B) alive or inanimate C) an individual nurse or client, a family, a group, or a community D) all the interactions among the nurse, client, and the environment in the pursuit of health; as well as what nurses do

14. As a nursing student begins to think about their potential job after graduation, what should be considered the best place to begin the planning process? A) Perform a self-assessment and set career goals. B) Visit nursing units that one hasn't visited while in clinical to see what type of care they provide. C) Ask the nurse recruiter where most new graduate nurses begin their nursing career. D) Visit a nursing staff in the lunch room to get some advice as to how they got their first job.

15. A client is being sent to interventional radiology to have their hemodialysis access re-opened. As the nurse transporting the client to radiology, they give an overview of the client's history, especially related to their current fluid and electrolyte status. Utilizing SBAR as the method to report critical information to other staff, the nurse has just provided which piece of information to the radiology nurse? A) situation B) before admission C) assessment D) recommendation

15. A graduate nurse (GN) is working on a busy medical floor. Her personal goal is to save lives and help clients be an attribute to their society. The experienced nurses express their opinions that reality of the day-to-day work will soon change this GN attitude. The GN is primarily wanting to practice which type of philosophy that views nursing as a means for forming authentic and caring relationships with others? A) idealistic philosophy B) pragmatic philosophy C) existentialist philosophy D) realistic philosophy

15. A nurse is working on a busy rehab unit caring for an immobile older adult client who has 3rd degree decubital ulcers on the sacral area. The health care provider has ordered the wound packed with a sugar/betadine paste "like in the old days." The RN recognizes this practice as not being based on research and not considered an appropriate treatment for this type of wound. What is the next step/intervention the RN should make? A) Research and find solid knowledge on current evidence-based practice (EBP) treatment options. B) Confront the health care provider at the nurse's station and refuse to carry out their order. C) Ask a peer to perform the treatment since the RN has never seen this done before. D) Document in the medical records the rationale as to why the prescribed order was not implemented.

15. A nursing research is working with a group of clients who have elevated blood glucose levels despite medication. The researcher is varying the percentage of carbohydrates comparing a low-carb with a high-carb diet. Throughout the study, blood glucose levels are monitored and recorded. Which perspective/paradigm is being utilized in this study since it has definable properties (carbs) that can be isolated and measured? A) Particulate-deterministic perspective B) Interactive-integrative perspective C) Unitary-transformative perspective D) Unitary-deterministic perspective

15. Many issues confront the nursing profession as it works to maintain numbers to meet the needs of society. From the preferred future perspective, which statement below is representative of that viewpoint? A) Strong research projects form a source of information to enable cost-effective and clinically effective client care. B) Nursing licensure fees greatly increase as a result of having compact licensure rather than applying and maintaining licensure in more than one state. C) Nursing workforce continues to age with associate degree nurses exceeding baccalaureate nursing graduates with focus on technical aspects of nursing practice. D) Federal and private funding for nursing students prove to be unsuccessful in attracting persons to enter nursing programs as their profession.

15. Research utilization model is a term that a nurse was trying to define, but the nurse could not come to grips with what it meant to the profession of nursing. In trying to determine the importance of the concept, the nurse came across a model where a five-phase, critical-thinking and decision-making process assists the individual practitioner in using published research. Which model uses published research? A) Stetler's research utilization model B) Theory of diffusion of innovations C) Iowa model D) Thunder project by AACN

16. During a discussion with a group of newly-employed graduate nurses (GNs), the educational staff began a discussion on technological devices that have the potential of enhancing or distracting from the delivery of care to clients at the bedside. Which statement below is an example of an "enhancing" technologic device? A) Implementation of a bar-coding medication delivery system. B) Increasing the amount and expectations for documentation on client culture. C) Placing metal-detecting devices at all entrances of the hospital. D) Review of proper handwashing practices on all clinical units.

3. A nurse discusses a client's request to use an alternative therapy for a skin rash. While visiting with this client, the telephone rings, the nurse's pager goes off, and a code blue is called in another client's room on the floor. Which describes the use of the client being aware of their medical care and alternative therapies? A) technology B) safety C) consumerism D) global community

16. In giving a lecture to nursing students at a university, a professor discusses goals from the measurement category of general health status as part of the Healthy People 2020 objectives. Which overarching goal best addresses the measurement category of general health status? A) Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death B) Achieve health equality, eliminate disparities, and improve the health of all groups C) Create social and physical environments that promote good health for all D) Promote quality of life, healthy development, and healthy behaviors across all life stages

16. Which client scenario best displays the meaning of "unpredictability that is conceptualized as chaos"? A) An ICU nurse implementing "proning" for ventilator clients as a "new" mechanism to prevent pneumonia. B) Ensuring every unresponsive client is turned every 2 hours as prescribed. C) Assisting the UAP with their morning rounds and checking blood glucose levels before breakfast. D) Calling security to assist with an "overdose" client who will not following orders to stay in their room.

17. A nurse is working a night shift on an oncology unit. One of their clients is experiencing excruciating pain unrelieved with medication. The nurse, who practices therapeutic touch, asks the client if they are open to this holistic care. The nurse believes human beings are "a unitary energy field that continuously interacts with an environmental universal essence field." The nurse is primarily utilizing which nurse theorist's model? A) Susan Leddy's Human Energy Model B) Rosemarie Parse's Human Becoming Theory C) Jean Watson's Human Science and Human Care Theory D) Margaret Newman's Theory of Health as Expanding Consciousness

17. Following an extremely difficult semester where several students earned failing grades in clinical, a faculty member has decided to start their own business. Which initial step would be the best place to start as they begin to plan their future employment opportunity? A) Discover an idea for a viable business while practicing professional nursing. B) Gather more information about an idea to provide solid foundation for a new business concept. C) Develop the business concept by verifying the idea through the gathering of more information. D) Consult with someone to navigate the legal aspects of developing and running a business.

17. In current nursing times, when a client has a fever, nurses usually remove blankets, keep room temperature lower and force fluids. These same concepts were developed by which ancient health care provider in Greece? A) Aretaeus B) Hippocrates C) Galen D) Herophilos

18. A nurse has developed a research study on her clinical unit. They are anxious to get started. However, before they can begin the actual data collection, what step in the research design must occur? A) Obtain approval from the institution and obtain client informed consent. B) Develop a data gathering instrument from scratch ensuring it is specific to the hypothesis. C) Seek counsel with risk management to review any critical incident they anticipate might occur. D) Find someone to collect data from the clients so objectivity can be maintained.

18. A nurse is trying to figure out why a certain COPD client keeps having exacerbations about the same time every month which requires admission to the hospital for IV steroids. This is an example of which aspect of intuitive judgment? A) pattern recognition B) commonsense understanding C) skilled know-how D) deliberative rationality

18. A recent MI client that required stent placement located a blog talking about the research of Dr. Dean Ornish. He is currently refusing to take his statin medication and his ACE-inhibitor. He quoted the research stating "these people didn't have to take medication. I can control my disease with diet and exercise." The nurse researches the study and finds the details: less than 10% diet contains fats; vegetarian diet; 1 hour of meditation/day; at least 1 hour of cardio exercise/day. The client is unwilling to become a vegetarian and does not have time for all the exercise and refuses to meditate. This is an example of the nurse performing which role related to their professionalism? A) working collaboratively with empowered clients B) being accountable for decisions made by their clients C) providing the clients with the defeatist opinion on their lack of knowledge D) delivering reasonable care to this client in the form of "education"

18. Home health nurses are working with a child born premature who is now dependent on a ventilator for breathing. The nurse caring for the child has researched the topic of technology-dependent children and what effects this may have on both the child and their parents. Which statement best describes the nurses findings? A) Maternal depression symptoms were significantly reduced when the child is no longer dependent on technology. B) Normalization of family function did not improve when the child is no longer dependent on technology. C) An increase in maternal depressive symptoms occurred when the child remained dependent on technology for an extended period. D) The child began demonstrating depressive symptoms when they remained dependent on technology for an extended period

19. A client has a fractured tibia/fibula that required insertion of pins and external traction. The client shares with their peers that they are concerned about getting a complication since "no one ever checks my lower leg for circulation and sensation." In legal terms, the staff is deviating from approved policies/procedures/standards and therefore at risk for being accused of which type of legal action? A) malpractice B) accountability C) incompetence D) battery

19. A student nurse gathers a client's medication and administers them without notifying the clinical faculty. In doing so, the student did not utilize the electronic scan prior to giving the client their medications. When the student does scan the medications under supervision of the faculty, the device elicits an "Error....Wrong Client" warning. The faculty will likely document that the student violated which ethical principle? A) nonmaleficence B) beneficence C) autonomy D) justice

19. A teenager who is morbidly obese arrived in the ED after falling and breaking their leg (fibula fracture). Which nursing diagnosis would be considered the priority for this client prior to discharge home? A) Impaired physical mobility related to fractured leg requiring crutches to walk. B) Risk for constipation related to decreased mobility requiring use of laxatives. C) Obesity related to BMI of 45 resulting in difficulty moving from chair to bed. D) Risk for skin breakdown related to prolonged sitting due to broken leg.

20. A nurse is trying to influence a client diagnosed with lung cancer to change their high-risk behavior of smoking cigarettes. Which example would be considered a "coercion" form of influence? A) Nurse focuses the teaching on threat of job loss and death if they continue to smoke. B) Nurse focuses on cost savings if the client stops smoking which could be enough for a family vacation. C) Nurse reviews statistical odds of recurrent cancer which the client internalizes to make the decision. D) Nurse appeals to client's minister to discuss smoking cessation with client and pray he has the will-power to succeed

20. Two college students committed suicide the week before final exams. It appears that the students were not doing very well and knew they were going to lose their scholarships. The professional nurse for the college is developing a program to increase awareness of resources and services available to students, free of charge, to help them resolve the problems. This is an example of which type of preventive strategy? A) primary B) secondary C) tertiary D) acute crisis

3. A 65-year-old client recently had a hip replacement and had a straight catheter placed following surgery to empty the bladder. Forty-eight hours after the catheter was placed, the client developed symptoms of a urinary tract infection (UTI). The nurse manager approached the nurse who placed the catheter, blaming the nurse for the cause of the UTI. Which quality approach did the nurse manager utilize? A) quality assurance techniques B) total quality management techniques C) continuous quality improvement techniques D) continuous quality management techniques

3. A graduate nurse is looking at a large urban hospitals employment opportunities. Since the nurse recently graduated with a bachelor's degree in nursing, which of the available employment opportunities would they be qualified to apply for the position? A) A staff nurse position working on a medical unit at a hospital. B) A nurse position working in the neonatal intensive care unit (NICU). C) A nurse practitioner working in a private practice clinic. D) A forensic nurse who works in the emergency room and morgue.

3. A group of students in their second year of nursing school joins the Student Nurses' Association. The chairperson of the group discusses the need for volunteers to help out at the health fair. This group of students have open communication networks between the structure and function of the organization working towards the greater good of the societal systems? Which word best describes this relationship of the organization? A) community B) individual C) family D) system

3. A nurse approaches a client who is from another country, and the client backs away. The nurse realizes that the client may have space issues that make the client uncomfortable when the nurse gets too close. When giving report to the oncoming team, the nurse will utilize which term to convey the client's uncomfortable expression when someone gets too close? A) proxemics B) kinesics C) object association D) tactile stimulation

4. A nurse applies for a position on the cardiac care unit of a major suburban hospital. The nurse shares with the manager their nursing philosophy stating that, "A client is a human being in need of care while in the hospital. It is my hope that I can provide quality nursing care with attention to the body, mind, and spirit of the individual, moving him or her on a continuum to a state of health, and working with the environment to accomplish this task." What four elements are included in the nurse's philosophy? A) person, health, nursing, and environment B) personal knowledge, empirics, aesthetics, and ethics C) individual, environment, mission, and reflective thinking D) health, empirics, environment, and personal knowledge

4. A nurse attends a conference and learns about the area of nursing informatics. The nurse has always been interested in helping to develop a nursing assessment program that would more clearly allow for detailed documentation of clinical practice. Which degree does the informatics innovator hold as the minimum requirement? A) doctorate degree B) master's degree C) baccalaureate degree D) associate's degree

4. A nurse is working on a doctorate degree in nursing. The nurse's employer has recently hired a group of nurses from the Philippines to help with their nursing shortage. This nurse has designed a quantitative research study looking at how foreign-born nurses view their role as "care provider". This is an example of what emphasis on quantitative research nursing practice focuses on? A) demonstrating an empirical, analytical emphasis B) demonstrating a human, science emphasis C) demonstrating an empirical, science emphasis D) demonstrating a human, analytical emphasis

4. A nursing professor who teaches pharmacology to undergraduate nursing students begins a discussion on genetic testing/research as the way of the future to find new treatments and ways to prevent illness from occurring. What impact may this new direction of pharmaceutical companies have on the nurse's role related to educating clients about their medications? A) Nurses assume the key role of helping persons understand the results of genetic testing. B) Genetic testing will be performed only with voluntary consent. C) Pharmaceutical companies use human genetic research to find treatments for illness. D) All persons with familial tendencies for particular diseases will be offered genetic testing.

5. A client comes to the hospital and is being treated for breast cancer. The client's sister visits and is interested in her sister's history after she left home. The client's sister doesn't know much the client's life in the last 10 years because she moved away to a city in another state. The client had an abortion in the past and has never told anyone. When working with families, what ethical issue can best describe a violation of the client's privacy if information is presented to a family member without the client's permission? A) confidentiality and privacy of one's health care information B) family needs over individual client's needs C) individual client's needs over family needs D) adding family stressors to situation

5. A client, who is dying of cancer, wishes to have hospital personnel provide only comfort measures. Respecting the client's request, the nurse is implementing which moral principle central to nursing? A) beneficence (to do good) B) compassion (caring) C) double effect (lesser evil) D) principalism (orientation)

5. A hospice nurse manager is presenting a new outlook to the hospice team and uses an example from Covey's work on habits of an effective leader. The term trim-tab is used to delineate the small rudder that turns the larger rudder of a ship. Which habit by Covey is suggestive of the trim-tab concept? A) inspiring others B) modeling character and competence C) instilling trust D) aligning goals and systems to achieve results

5. A nurse decides to do some research on models for political action and how nurses can be utilized more in the process. The nurse becomes aware of some deplorable conditions in certain nursing homes. This starts the nurse on a research path where all nursing home facilities were visited and conditions recorded. According to the Kingdon Model for Political Processes, which key stream has developed from this nurse's research project? A) problem stream B) policy stream C) political stream \ D) politician stream

5. A nurse utilizes the nursing process to take care of clients in a busy ICU surgical unit in a suburban hospital. The nurse uses bedside and handheld monitors to collect a variety of information, including blood glucose level, clotting time, electrocardiograph rhythm, cardiac output, blood pressure, oxygen saturation of hemoglobin, and temperature. For which part of the nursing process does the nurse use the above technology? A) Assessment B) Planning C) Implementation D) Evaluation

5. A professional organization has called for abstracts for a conference where the theme is "theory in practice." The nurse sends in the abstract using a model in which the purpose of nursing is to facilitate the harmonious pattern of the essence fields of both client and nurse. Which theory is inclusive of this concept of nursing? A) Susan Leddy's human energy model B) Margaret Newman's theory of health as expanding consciousness C) Rosemarie Parse's human becoming theory D) Jean Watson's human science and human care theory

6. A hospital wants to improve quality with its customers. It sends out a questionnaire to all clients who have stayed in the hospital in the last year and asks about their needs and how well they were met. Which aspect of the Six Sigma process is the questionnaire going to provide data for? A) define B) analyze C) improve D) control

6. A new graduate nurse enters the profession and begins the work of developing a personal nursing philosophy. The efforts they make to intellectually and effectively grow in this arena involves self-discovery. According to Carper as one of the patterns of knowing, which characteristic will this nurse continue to develop over time? A) personal knowledge B) values C) beliefs D) feelings

6. A nurse relies on R. Leddy's theories to assist with client education. Which health-patterning strategy, suggested by R. Leddy can be used in the clinical setting to promote health and healing by specifically restoring energy field harmony? A) prayer B) self-massage C) aromatherapy D) Tai Chi

7. A 55-year-old male recently suffered a myocardial infarction and has been prescribed cardiac rehabilitation. The client works three times a week with a nurse who monitors the client's exercise with a monitor, periodic pulse, and blood pressure measurements. Which education level is the minimum that this nurse must have obtained to work in the cardiac rehabilitation setting? A) education of general practice nurse B) education of a licensed practical nurse C) education of advanced practice nurse D) education at the postgraduate level

7. A nurse educator who has been teaching for a period of time uses the traditional teaching-learning process. On a busy cardiac unit, the nurse reviews the clients history and selects the priority assessments to make (cardiac, respiratory), then sorts and categorizes the data before reaching a nursing diagnosis of "impaired tissue perfusion." Which step in the teaching process is this nurse functioning in? A) assessment B) planning C) implementation D) evaluation

7. During post-conference, the clinical instructor reviews theories that utilize the nursing process and how they differ in their approach to the nursing process. Which theory includes perception, communication, and interaction of the nurse and the client in the definition of the assessment phase? A) King's theory of goal attainment B) Paterson and Zderad's humanistic theory C) Newman's theory of health as expanding consciousness D) Parse's human becoming theory

7. When the nurse analyzes accountability to themselves, which question provides a self-assessment of professional accountability? A) Should I seek additional preparation (education) for that role? B) If I am not satisfied with that job description, am I seeking appropriate ways to change it? C) Am I working in accordance with the policies and procedures of the institution? D) Am I complying with the ethical code of the profession?

8. A nurse educator watches a student nurse walk across the stage to receive their diploma. After the program, the nurse educator discusses with the student about their plans for work. The student expresses uncertainty, but definitely does not wish to work in the obstetrical area. The student nurse is using which type of knowledge to make this decision? A) personal knowledge B) aesthetic knowledge C) empirical knowledge D) ethical knowledge

8. A nursing student is in the senior semester of nursing school. In addition to going to clinical sessions, didactic lectures, and applying for nursing position, the student is reviewing for the NCLEX exam. Which of these intellectual characteristics of a nursing student is involved with licensure? A) specialized education B) body of knowledge C) the ability to think critically D) the ability to manage colleagues

8. A successful career map was shared during a presentation at a nursing conference. The presenter listed key strategies for building successful career maps. What are the key strategies for building successful career maps? A) networking and mentoring B) creating career maps and marketing C) networking and marketing D) mentoring and creating career maps

9. A Canadian student is seen by a health care provider for a routine screening before going to college. The student's family is covered by the Canadian plan. Which principle of the Canadian health care system is evident for this student? A) Each insurance plan covers all residents for uniform services. B) A public for-profit authority administers the plan. C) Canadians do not have coverage when they travel across provinces. D) Care can be denied for inability to pay for coverage

9. A client has been empowered by the nurse to learn to exercise and eat healthy when discharged to home from the hospital. Which best describes empowered caring in the caregiver's role as it relates to behavioral changes in the client compared to the use of traditional approaches? A) behavioral changes occur from empowering situations B) behavioral changes are not as genuine C) behavioral changes are less realistic D) long-lasting habits are the goal but not the outcome

9. A nurse is beginning to plan the teaching activities for a client who is learning how to care of his wound at home. Which piece of information highlights the identification of the client's perspective of their need to learn? A) how the client perceives the health situation B) physical, cultural, linguistic, or psychological limitations that may impede learning C) intended learning outcomes D) client's conscious intentions and desires regarding health behaviors

9. A nurse is gathering information from research studies and evidence-based nursing practice on wound healing around colostomy pouches. The nurse has noticed that clients on the unit who utilize a specific product do better with wound healing than those who do not use this product when changing colostomy pouches. Which source of information is provided as evidence-based practice in this scenario? A) clinical experience data B) chart audit data C) benchmarking data D) quality improvement data

9. A nursing student attends a capstone lecture related to the central concepts of nursing. Following the lecture, the student's preceptor asks what was learned. Which answer represents the four major concepts of nursing central to work of the profession? A) human being, environment, health, and nursing B) human being, theory, health, and environment C) theory, health, environment, and nursing D) environment, health, theory, and nursing

9. A recent graduate of an accredited RN program decides to further their education by applying for a 2-year program that involves extensive studies in anatomy, physiology, chemistry, and pathophysiology along with other studies involving sedation. The education also requires 90 hours of learning specific to this field. Which program is this recent graduate applying to? A) certified registered nurse anesthetist \ B) clinical nurse specialist C) registered nurse first assist D) nurse practitioner

9. In planning for the nursing shortage, nursing can have an impact on the profession through a mutual recognition model for professional nurse registration. Which advantage best identifies nursing shortage issues? A) allows nurses to cross bordering states to practice without additional licensing B) increases cost effectiveness of licensure programs across the United States C) enhances interstate commerce and allows for more freedom for employment D) simplifies the nursing licensure process for the profession

9. When the nurse analyzes accountability to the agency, which question best provides a self-assessment of professional accountability? A) Am I seeking to ensure that I am practicing under safe, if not optimal, conditions? B) Am I incorporating what I know of nursing theory and research into my practice in this situation? C) Am I complying with the ethical code of the profession? D) Am I acting in accordance with my own ethical code and that of the profession?

18. Nurses have been voicing concern about the number of obese or morbidly obese clientele. Of the following scenarios related to obesity, which would be considered a plausible future view? Select all that apply. A) Affluent citizens in developed nations continue to gain weight. They have unlimited access to food. B) Wealthy individuals engage in sedentary jobs, fail to exercise, and find comfort in passive entertainment. C) Scientists discover ways to turn off the "thrifty gene" that makes humans conserve calories, block the chemicals responsible for hunger, and develop an effective weight loss pill that has few and insignificant adverse effects. D) Government support for weight reduction in obese and overweight citizens includes prescription drugs for weight loss, memberships to health clubs. E) Employers reduce employee contributions to health care insurance for maintaining a healthy weight, provide incentives for employees to exercise more, and even provides them with free gym memberships.

A, B

14. When looking at the key concept of using special expertise to foster the best possible care across the care continuum for consumers, which content would be addressed in the Institute of Medicine (IOM) recommendations? Select all that apply. A) Work on interdisciplinary teams encouraged. B) Workers need to adapt to constant change. C) Nurse executive is the leader that provides effective coordination of nursing care. D) Environment is focused on learning and not placing blame on individuals. E) Nurses communicate and function as effective teams among themselves.

A,B,D

17. A pediatric nurse practitioner (NP) has been asked by parents of a 16-year old male to assess him for possible illicit drug abuse. They have noticed his grades are dropping, he seems to "hang" with a different peer group, he disobeys curfew rules, etc. If the NP uses Parse human becoming as their model for nursing practice, which interventions would they implement? Select all that apply. A) The NP would expend energy with the teen to uncover the meaning that underlies the behaviors changes the parents have identified. B) The NP would truly be present with the family as they express concerns that would ultimately reveal the meaning behind the teen's changes of behavior. C) The NP would intervene to facilitate re-patterning the family into a higher level of consciousness. D) The NP would focus on understanding all mechanisms that affect the life process of the teen, one of which is the family. E) The nurse would consider the drug problem to affect the entire school community so they would plan and execute an education program for students/staff/faculty.

A,B

20. When discussing "Obamacare" in a classroom discussion, many students identified which outcomes as being positive following implementation of the Affordable Care Act (ACA)? Select all that apply. A) Young adults (ages 19 to 26 years) were able to stay on the health insurance policy of their parents. B) Availability of more free-standing specialty outclient surgery centers resulted in decreased health care costs. C) All 50 states expanded Medicaid coverage for persons with incomes up to 400% of the federal poverty level. D) Closing smaller healthcare organizations resulting in consolidation of care that was financially better for their out-of-pocket expenses. E) No changes were made to the choice of health care providers the client could choose to go to for care

A,B

17. Which examples demonstrate the implementation of motivational strategies for learning when working with a female client who had a left radical mastectomy and primarily speaks Spanish? Select all that apply. A) Asking the client how they plan on increasing the flexibility of their left arm. B) Providing literature in Spanish related to nutritional needs to help promote wound healing. C) Waiting for family to arrive before removing their dressing so all can see the wound. D) Placing reading materials in the room quietly so as not to wake up the resting client. E) Providing a list of medications and time they need to take them as there are being discharged off the unit.

A,B,

16. When visiting with a cancer client and their family, the nurse realizes they are doing extensive research on the internet. The nurse shares with them how to find legitimate sources of information on their disease process. Which computer site evaluation tips should they share in terms of how to spot an unsuitable source? Select all that apply. A) Product declares "shark cartilage" will slow the process of cancer replication. B) Site was placed 10 years prior but has no updates since then posted. C) Site has lots of testimonials declaring the product is beneficial but no way to follow-up with clientele. D) Website was located on a governmental source funded by National Cancer Institute. E) Site is run by a nonprofit organization that only discusses one disease (i.e. American Cancer Society).

A,B,C

21. A nurse is caring for a client who was newly diagnosed with diabetes. The client is insulin-dependent and due to be discharged in 2 days. Prior to educating them about insulin administration, the nurse should assess which factors? Select all that apply. A) Ability to read teaching materials. B) Ability to perform find-motor hand coordination. C) Amount of anxiety expressed concerning giving themselves a "shot." D) Expressions of remorse about their consumption of too many carbohydrates. E) Ability to adjust their prescribed insulin dose depending on their glucose level.

A,B,C

16. A nurse who has worked on a medical-surgical unit for over 20 years has agreed to mentor a graduate nurse. However, the first week didn't go so well. The GN was late for all 3 days, slipped away to check her Facebook throughout the day, and didn't look up any of her medications since "I'm done with nursing school and books!" The mentor discusses this with the manager saying he/she would prefer someone else mentor this student since which requirements of successful mentoring were lacking? Select all that apply. A) punctuality and proper timing of medication/skills B) attitude of openness to learning C) complementary personalities D) being prepared with a firm knowledge base E) similar goals for nursing care of clients

A,B,C,D

8. A nurse has lobbied the state legislator frequently regarding a bill that is to come to the floor in the coming months. In addition to electronic media as a vehicle to contact officials, what more traditional modes of communication might the nurse also try? Select all that apply. A) Letters that are concise, well-organized, and easy to read. B) Town hall meetings. C) Telephone calls with yourself and other colleagues who have similar interests. D) Personal visits that are scheduled through their assistants. E) Standing in parking lots to flag them down as these are leaving for the day.

A,B,C,D

19. An elderly client fell off a cart parked in the hallway of radiology. The client had completed a CT of the brain for changes in mentation. They needed to go to the bathroom. Root cause analysis identified that they client had been waiting for over 2 hours to return to their room due to a shortage of help that could return them to their room. Looking at the LEAN categories of waste, which categories pertain to the example? Select all that apply. A) waste from transportation B) waste from poor utilization of resources C) waste from unnecessary waiting D) waste from defects in quality control E) waste from process inefficiency

A,B,C,E

3. When the nurse analyzes accountability to a client, which question best provides a self-assessment of this type of accountability? A) Am I willing to help other nurses in my work setting? B) Am I acting as a community resource in the areas of health and nursing? C) Am I providing the best care of which I am capable? D) Am I seeking to improve health and nursing care?

18. A nurse is considering running for a legislative position to bring their expertise on health and safety issues to the forefront. To be an effective lobbyist, the nurse should evaluate which characteristics as beneficial to fulfill the duties of the job? Select all that apply. A) Ability to convey answers to questions in an honest, accurate manner to the best of their ability. B) Ability to research and collect valid data on topics that affect their constituents. C) Ability to "Wing it" when asked a question that they are not prepared to answer until time permits for further research. D) Ability to listen to what the candidates running for higher offices are saying about health issues. E) Being forceful when trying to get a point across about the "reality" of health in the area.

A,B,D

7. Lobbyists and political action committees (PAC) each perform key roles in the political process. A lobbyist for the American Nurses Association (ANA) tries to paint a picture when persuading legislature members to vote a certain way. When talking to nursing students about this, which advantages can been seen when statistical data is used effectively? Select all that apply. A) Take the numbers and put them in "human" terms. B) Report the numbers in simple terms like "1 out of 3 clients" rather than 33% of the population. C) Make sure to bring copies of charts and graphs that are color-coded. D) As much as possible, use national, state, and local statistics since most representatives are concerned about their local constituents. E) Always manipulate the statistics to show how vital it is for the population.

A,B,D

9. A nurse practitioner is caring for an elderly client who has developed renal failure. Which actions demonstrate the practitioner's belief in practicing patient-and family-centered care (PFCC)? Select all that apply. A) Listen to the client and family members during the visit as they express changes in activity levels. B) Nurse practitioner discusses lab value results and explains in simple terms what the results mean. C) Nurse practitioner determines that the client is not telling the truth about their ability to care for self so they order home health aide to visit 3 times/week. D) Meets with client and family to discuss jointly type of care they want provided towards end-of-life. E) Informs family that the client qualifies for nursing home care and placing client there would be best for all involved.

A,B,D

18. A nurse is discharging a client following inclient care for a stroke. The client and his significant other are able to verbalize side effects of new medications and the signs/symptoms of a stroke. However, they insist they will not pay for an ambulance ride to the hospital if they have another "episode." How can this nurse intervene for the safety of this client? Select all that apply. A) Contact immediate family to let them know that transporting a client with symptoms of a stroke could have life-threatening consequences. B) Notify their home health nurse so they can reinforce the information about call 911 when first notice symptoms of a stroke. C) Deny their discharge and notify the nursing supervisor to come help intervene with this family teaching. D) Refer the client and significant other to a community-based stroke education program which will reinforce teachings. E) Re-teach this material and then document client's verbal statements.

A,B,D,E

17. A group of nurses who graduated from nursing school together are meeting to discuss their views on today's health care environment. They develop some strategies to remain viable in today's employment market. Which strategies would be considered most beneficial in the current health care environment? Select all that apply. A) Maintain a current up-to-date resume. B) Develop some interview questions and call on a buddy to bounce questions/answers back and forth with one another. C) Research for a list of the top paying nursing jobs in the U. S. D) Sending out resume randomly to various hospitals to get a feel for the job market E) Attend professional meetings and conventions to network with others in the profession.

A,B,E

20. With the national shortage of primary care health care providers, many states do not want to recognize a need for Doctor of Nursing Practice (DNP) as the terminal degree for APRN practice. A nurse exploring further schooling options to become a nurse practitioner may identify which effect the increased time needed to complete a DNP program could have on the public seeking care? Select all that apply. A) increase in amount of time to get an appointment B) increase in health care costs C) overall, lower standard of care for the average person seeking health care D) increase in overall prescriptions written for narcotics E) increase usage of health care provider assistants as a cost-effective alternative

A,B,E

16. A Capstone (senior) nursing class has invited a member of their local state nursing league, who is also an ANA delegate, to discuss the current legislative and regulatory initiatives being discussed Congress. Examples of the 115th Congress session might include which topics being presented to this senior class? Select all that apply. A) Working on promoting safe, ethical work environments to protect client safety. B) Seeking full scope of practice doctorial prepared nurse educators. C) Allow APRNs to certify clients for home health services. D) Encourage all levels of nurses to be able to refer clients to outclient therapies. E) Helping cut cost of health care by encouraging APRNs to order older, cheaper medications.

A,C

16. When caring for an individual of Japanese culture who speaks primarily Japanese, what should the nurse due prior to performing the initial physical assessment? Select all that apply. A) Ask the client for permission to touch them. B) Call their American-raised children and ask if there is anything you (the nurse) should know before during a complete head-to-toe assessment. C) Contact an interpreter to attend the first assessment so factual information about their signs/symptoms can be shared. D) Rely on the unlicensed assistant personnel (UAP), who is also of Asian descent, to help you perform the assessment for the first time. E) Ask family members who know ESL to translate word-for-word what information you (the nurse) are trying to obtain

A,C

18. The nurses working in a highly stressful neurotrauma ICU had a meeting about the importance of developing support among themselves. Which actions by team members demonstrate their commitment to building a supportive work environment and should be encouraged to continue? Select all that apply. A) Verbally give praise when one observes their peer giving comfort to a distraught family member. B) Refer a colleague to the manager for reprimand when one observes them being rude to a visitor who gets in their way of providing care. C) Invite new nurses into one of your rooms to observe while you are assisting in performing a skill that is rarely done in the unit. D) Demonstrate to peers how to stop a family from pressing the call light for minor things like water or food. E) Ignore peer requests for help when you are tired and just want a break

A,C

9. The nurse who has been having difficulty sleeping has investigated techniques to assist in consistently getting a good night's sleep as a method of taking care of oneself. Which strategy will help with sleep? Select all that apply. A) Keeping a regular sleep schedule consisting of 7 to 8 hours per night. B) Avoiding eating any fast food. C) Providing a bedroom with optimal darkness before bedtime. D) Exercise right before bedtime so you will fall asleep quicker. E) A cocktail right before bedtime helps one relax and fall asleep faster.

A,C

15. Some nurse managers have enrolled in a healthcare financial class at a local college. These nurses were asked to prepare a presentation on healthcare cost. The group decided to divide topics among themselves. Which topics would be appropriate to include in this presentation? Select all that apply. A) Percentage of rise in healthcare cost when compared to rate of inflation. B) Impact of limited choice of health care providers willing to see clients with certain healthcare plans. C) Disproportion of health insurance cost from entry level worker making low wages compared to those in upper management. D) Workers with no health insurance ignoring manifestation of disease until it becomes life-threatening. E) Increase use of alternative medical practices rather than seeking care from a health care provider because of cost differences.

A,C,D

16. Which clients would the RN consider delegating the task of assisting with feeding to the UAP? Select all that apply. A) Client with mobility problems related to a sacral spinal cord injury many years ago. B) Client with new onset right-sided CVA with paralysis on left side and some speech difficulties. C) Client with Multiple Sclerosis who is confined to a wheelchair for mobility. D) Client with terminal lung cancer with metastasis to liver and bone having difficultly controlling their bowel/bladder. E) Client admitted in acute respiratory failure who is on 40% oxygen via venti-mask who is struggling to breathe and maintain oxygen saturation levels.

A,C,D

17. A student nursing organization would like to lobby for more services for their homeless teenager population in the local area. They are discussing the pros and cons related to email campaigns. Which would be considered a con (disadvantage) of bombarding their local representative with emails? Select all that apply. A) The impact of the problem can be watered down by sheer numbers. B) Access to computers is readily available in the student population. C) Possibility of multiple messages by one representative may get sent to "spam." D) Message is too short and concise so staffers don't consider it a worthy topic. E) Sender doesn't mention the fact that they are a constituent, so email is moved to wastebasket.

A,C,E

20. A graduate nurse (GN) has made an appointment to talk with their nurse manager about feelings of distress. They are actually thinking about quitting and leaving the nursing profession. Which issues encountered would be considered outside the nurse manager ability to intervene in order make a more positive experience for this GN? Select all that apply. A) Lack of self-confidence about their nursing abilities and judgment. B) Unrealistic expectations from the staff who think once a student graduates, they should know the basics for caring for a client. C) Imbalance between individual efforts and rewards from work. D) Horizontal violence by other nurses who are assigning the most difficult clients to the GN. E) Inability to organize tasks needed for effective nursing care in a timely manner.

A,C,E

16. Nurses working in a small healthcare hospital are exploring options for personal health record programs (PEHR). The nursing administrator knows that which behaviors are required of their health care consumers in order for a smooth, successful PEHR adoption? Select all that apply. A) Willingness to observe and try the new system. B) Have family members available to help their loved one us the technology so they can "get better (healthier). C) Willingness to go to the library a couple times/week to use the computer where they can get help from technicians is needed. D) Have diabetes (a chronic disease) that they prefer to self-manage and engage in collaboration negotiation with their healthcare provider. E) Get a better handle on their bipolar tendencies (chronic condition) so they can communicate with the healthcare providers when they decide to discontinue taking their medications

A,D

16. The 2004 IOM report, Keeping Patients Safe: Transforming the Work Environment of Nurses, focused on keeping clients safe. Which recommendation was partly brought about as a result of this report? Select all that apply. A) Re-evaluation of nurse-client staffing levels. B) Instructing nursing administrators to review nursing standards and update regularly. C) Request nursing staff to submit EBP articles for nursing administrators to review prior to implementation. D) Establish interdisciplinary committees for various nursing units to discuss ways to increase quality of care at bedside. E) Encourage nurses to verify client identification prior to administering medications.

A,D,E

16. Which the following traits of a nurse in charge of a busy ICU would be viewed primarily as a "leader" rather than a "manager" role? Select all that apply. A) Looking forward to creating a vision for the unit over the next 15 years. B) Ensuring the unit has all supplies they need to provide quality care. C) Efficiently looking at resource expenditures focusing especially on high-dollar items. D) Encouraging the nursing staff to engage in EBP research projects that may be considered unconventional. E) Working with passion to find a human connection with each member of the nursing staff.

A,D,E

12. A client wants to get washed before breakfast, but the nurse has a critical situation to attend to immediately. The nurse instructs the client to call the Unlicensed Assistive Personnel, but the client did not appreciate the unwillingness of the nurse to assist. What term describes the tension state resulting from the negative appraisal of the client in this communication process? A) apprehension B) anxiety C) defensiveness D) depression

1. A client is seen in an urgent care clinic for a broken leg which was splinted and client sent home. The client called their primary care health care provider to find out what should be done after the injury. The doctor directed the client to the emergency room where an orthopedic surgeon was consulted and performed surgery to place a pin in the leg. What kind of care was provided to this client when care was transferred from the emergency room health care provider to the orthopedic surgeon? A) primary care B) secondary care C) tertiary care D) quaternary care

1. A nurse attends the American Association of Colleges of Nursing's (AACN) educational conference and reports back to the hospital about the conference. When presenting the information to the nurse manager, the nurse discusses the recommended generalist nurse's abilities that the AACN proposes for nursing. Which ability should the generalist nurse be able to perform with technology? A) participate in decisions regarding the use of demographic data B) use technology to advance client education at the bedside C) use appropriate technologies to assess and monitor hospital practices D) adapt the use of technologies to meet the nurse's needs

1. A nurse is taking a class on nursing research. The student is preparing to defend their thesis and thinks about all the contributions that can be made to the nursing profession. Which contribution can a baccalaureate nurse provide to research in the profession of nursing? A) participating in nursing education projects B) suggesting nursing research questions C) using nursing research findings for discussion D) promoting a sense of encouragement for colleagues

1. A nurse manager interviews several qualified applicants for a position on the unit. The applicant being interviewed today has previously worked as a supervisor in a long-term care facility. Which universal job skill relates to the supervisory experience? A) problem solving/creativity B) leadership/persuasion C) frequent contact with the public D) manual dexterity

1. Scientific theory and the organization and development of human knowledge began in ancient times. What was the predominant belief during this era? A) Math and logic were important. B) Internal and external forces ruled. C) Internal forces ruled solely. D) Uncertainty was accepted

10. A client in the medical-surgical unit of a hospital asks the nurse how long it will take to psychologically feel well after her hysterectomy. The nurse replies that in some studies in the nursing literature, women feel their best 6 to 8 weeks postoperatively. Which type of nursing practice has the nurse displayed? A) stereotypical-based nursing practice B) theoretically based nursing practice C) rote-based nursing practice D) typical-based nursing practice

10. A nurse theorist is looking at concepts that apply to the future of nursing. In looking at the futures model outlined, which strategy for the preferred future for nursing best identifies the importance of nursing to the public? A) cohesion in the profession amongst colleagues B) nursing is valued by society and other disciplines C) provision of solid evidence for contributions made to health care D) standard level of minimum education

11. A client gives permission to have the hospital bill the insurance company for surgery that the client is undergoing. A friend works at this hospital and the client wonders if the friend would print off a report. Which provides the best answer regarding ethical concerns relating to the misuse of client information? A) Electronic Medical Record (EMR) B) HIPPA violations C) Data security issues D) Documentation issues

11. A nurse utilizing a theory to base practice engages the client in a conversation about energetic patterning. The nurse is discussing how working together, they can reestablish the clients "free flow of energy." Which nursing theorist included this concept as part of the nursing interventions to facilitate a better health pattern to promote healing? A) Margaret Newman B) Susan Leddy C) Callista Roy D) Dorothea Orem

11. A staff nurse is providing education to the unlicensed assistive personnel (UAP) on the unit about safe gowning and gloving when caring for clients with MRSA. Which role will the staff nurse undertake when providing this education? A) caregiver B) teacher C) coordinator D) counselor

11. In doing a project for graduate school, a nurse investigates values to determine what career goals might look like in the future. When a nurse values comfort and peace in the dying process, rather than preserving life at all costs, what area of nursing might the nurse be employed in? A) geriatric nursing B) hospice nursing C) nurse researchers or theorists D) critical care or emergency department

12. A nurse manager attends a conference on leadership skills and contemplates how to be a better leader. One of the staff members on the unit recently stated that the manager did not empower the members of the staff and was extremely picky about everything. What would be the criteria for effective leadership that deals with empowerment? A) Is the leader aware of issues encountered by nurses engaged in client care activities? B) Does the leader effectively delegate tasks to others, or does he or she micromanage everything? C) Does the leader provide the needed resources to provide quality nursing services? D) Does the leader demonstrate sensitivity to the impact of self on others, leading to effective use of self?

12. When the nurse analyzes accountability to the public, which question best provides a self-assessment of professional accountability? A) Am I seeking to ensure that I am practicing under safe, if not optimal, conditions? B) Am I speaking out against abuses I see in health and nursing care? C) Am I satisfied with my chosen profession? D) Should I seek additional preparation for that role?

13. A client with end-stage renal disease has decided to discontinue dialysis treatment. They have discussed this wish with their family. Which ethical principle is this client exercising? A) benevolence B) autonomy C) authority D) independence

13. A nurse, who is contemplating going back to school, is looking at their individual values and the types of nursing programs available. The nurse enjoyed the theorist work in undergraduate school and decides to pursue education and research. What role in nursing scholarship best describes the impact that research will have on the future of the nursing profession and health care? A) prediction of nursing outcomes through development of theories B) participation in nursing and multidisciplinary research efforts to improve outcomes C) continued support from professional nurses and policy makers D) continued validation of models and theories for nursing care

13. During the first lecture in the [Nursing] Professional Developmental class, the faculty discuss the 2015 National Workforce Survey of Registered Nurses. One student who was of Hispanic nationality asked, "I know lots of Hispanic/Latino people living in this area. How many licensed nurses are currently working as an RN in the U. S.? What is the most accurate answer the faculty can give to this question? A) Less than 1% of the nursing workforce is of Hispanic/Latino decent. B) About 3% of the national workforce of RNs are Hispanic/Latino. C) Black/African Americans are the largest ethnic group of nurses. D) Sadly, this ethnic culture rarely go to college let alone nursing school.

14. A nurse believes that nursing is a pattern of the whole, health is a pattern of the evolving whole with caring as a moral imperative. Which nursing theory is inclusive of this concept of nursing? A) Susan Leddy's human energy model B) Margaret Newman's theory of health as expanding consciousness C) Rosemarie Parse's human becoming theory D) Jean Watson's human science and human care theory

14. A nurse manager is working on ways to maximize client satisfaction. Which skill of a nurse manager requires management of maximizing client satisfaction? A) budgeting B) marketing C) staffing D) strategic planning

15. A 25-year-old woman recently applied for insurance coverage through a national company. After submitting the application, the woman receives a phone call from the company's nurse case manager to review medical records and certify insurance coverage. Which level of educational experience has the nurse case manager earned in order to certify insurance coverage at an insurance company? A) licensed practical nursing education B) general nursing practice education C) certification by a professional organization D) advanced practice nursing education

15. A graduate nurse is working on a busy inpatient medical floor. The nurse has been taught to do a central catheter dressing change one way but cannot handle changing the procedure to accommodate the supplies that are readily available. In addition, the nurse will not go to lunch until all charting is complete since, "Those are the rules." According to Benner's Novice-to-Expert Model, in which stage of the model is the nurse currently performing? A) expert practitioner B) novice practitioner C) advanced beginner D) Competent practitioner

15. A nurse attends a conference in a different state and develops friendships with those at the conference. On the last day of the conference, the nurse looks in the notebook and finds all the names and addresses of the conference attendees provided by the sponsor. Which strategy best provides information to others in the nursing community based on projects of interest? A) business card distribution B) active collaboration C) willingness to call others D) a genuine desire to help others

16. When a client is in pain and extremely uncomfortable, some nurses may read to them stories the client enjoys, recite calming hymns, or sing/play musical instruments to help distract the clients focus on their pain. Looking back in history, which ancient civilization began these holistic nursing practices? A) Egypt B) India C) Babylonia D) Persia

16. Which student would be ideal to work in a surgery unit that limits direct communication with clients and families? A) Student who likes to focus on client education prior to discharge. B) Quiet student who is very meticulous about maintaining sterile fields during procedures. C) Student who excels in group activities and primarily takes the leader role. D) Reserved student who enjoys visiting with elderly clients and utilizes reminiscing.

17. A nurse is working on a unit that primarily cares for clients with alcohol and substance abuse withdrawal. Which statement by the nurse would be considered an example that they are experiencing compassion fatigue? A) "I just know that after a few days, this client will see the benefits of changing their addictive behaviors." B) "I go home and think about these clients all the time and I get angry because they are doing this to themselves." C) "Helping these clients to slowly withdraw from these substances is my way of making the world a better place to live." D) "I go to the gym at least 4 to 5 times every week so I can relieve my stress and refocus on my job to help my fellow mankind."

17. A nurse researcher has developed a hypothesis. Now they are evaluating the type of research design suitable for the study. They basically want to manipulate two specific variables on other variables. In consultation with their faculty advisor, which research design would be best for the proposed research hypothesis? A) a descriptive design B) an experimental design C) an historical design D) ethnographic research

17. Health care providers (including nurses) have been voicing concern on the topic of natural disasters. Of the following scenarios related to natural disasters, which would be considered a plausible/preferable future view? A) expansion of residential areas without regard for wildlife or plant survival B) work being done collaboratively to reduce greenhouse gas emissions C) increase building along coastlines with sea levels rising enough to threaten human life D) sea levels increase combined with decreasing temperatures to the point that life cannot exist in the deep freeze environment

17. Some area APRNs expressed their feelings at a local conference. They voiced a concern that some health care providers viewed them as competitors rather than collaborators. On literature review, which national report suggested that nurses should be full partners in terms of redesigning healthcare in the U. S.? A) The Institute for Healthcare Improvement report. B) The Institute of Medicine report. C) The National Registered Nurses Sample Survey. D) The National Quality Forum article

17. When asked by a foreign exchange student why health care costs are so high when compared to their small country, the parents of the American student identifies which sources to be responsible for the higher cost of health care? A) American nurses demand higher pay than the nurses in their small country. B) The increased use of highly technical equipment and expensive medications fuels rising costs. C) The internet is utilized by many clients who ultimately demand the most expensive diagnostic tests, meals, and medications. D) Overall, the U. S. just takes better care of their people than most other countries.

17. Which nursing diagnosis would be considered the priority for a client who was brought to the ED following a bee sting which has resulted in a severe reaction? A) Risk for activity intolerance related to difficulty breathing from bee stings. B) Ineffective breathing pattern related to edema of tissues in response to allergic reaction. C) Risk for aspiration due to excessive fluid in tissues making it difficult to swallow liquids. D) Anxiety related to feelings of impending doom due to fear of bees

18. A nurse is working with a client recovering from a heart attack. The client is concerned they may not be able to work again since they have a stressful, labor intensive job. The nurse is describing their beliefs that health is a continuum with wellness on one end and illness on the other. The nurse beliefs that the client will gradually reach a level of wellness where they can function within their heart's capacity. This nurse is practicing which theorist's view of "health?" A) Susan Leddy B) Margaret Newman C) Dorothea Orem D) Jean Watson

19. A high school nurse is suspicious that one student is anorexic. The student has sunken eyes, pale skin color, and is wearing "baggy" clothing to conceal weight loss. If this nurse practice is based on Orem's self-care deficit theory, what interventions would the nurse implement? A) Offer education about eating disorders. B) Assess the student and family for their ability to access physical and mental health services independently. C) Work to build trust and rapport with the family unit and collaborate with the family to set goals. D) See that the health status of the student was a manifestation of the pattern of the whole.

19. A nurse works in an ICU where the primary client population is cardiac. The nurse visits with a classmate from nursing school who works in a generic ICU that cares for clients with all medical problems. This classmate shares that the nurses never feel like they are providing the best care because they focus on so many disease entities daily. The classmate shares that many peers are planning on transferring to a different unit. When thinking about this conversation, the nurse draws comparisons to the research by Sacco, Ciurzynski, Harvey & Ingersoll, 2015. Which anticipated results can be drawn in regards to compassion satisfaction? A) Male nurses in the generic medical ICU will experience significantly higher compassion satisfaction scores than female counterparts. B) Nurses working in an ICU that has a single specialty will have higher compassion satisfaction scores than their classmate's peers working in ICUs with multiple specialties. C) Any recent (less than 1 year) managerial change in the ICU that cares for generic medical clients will bring about higher compassion satisfaction scores. D) Nurses with BSN degrees, no matter what the ICU client population of clients are will experience higher compassion satisfaction when compared to nurses with associate's degrees working in the same environment.

2. A nurse educator sets out to write a mission statement as an example for class. In doing so, the nurse educator realizes of being unaware of just what a mission statement is. Which is the best description of a mission statement? A) to outline specific services that the nurse wants to perform B) to specify the meaning and purpose behind work C) to specify how visions can materialize D) to create meaning behind a written statement that comes from the heart

2. The nurse receives a phone report on a client being transferred to the intensive care unit. This nurse will take care of the client for the rest of the shift. Upon arriving to the unit, the nurse follows a series of steps to get the client admitted. What kind of thinking does the nurse exhibit if the nurse recognizes the interconnectedness of the results of the admission process, getting the client a food tray for dinner, and administering medications once the client is admitted? A) whole-systems thinking B) relational thinking C) quantum science thinking D) holistic thinking

20. A nurse currently working in an ICU is studying to obtain certification in critical care. When looking at further one's education, the nurse should also consider obtaining which collegial degree if the nurse wants to impact client outcomes? A) Associate degree in Nursing (ADN) B) Bachelor degree in Nursing (BSN) C) Master's degree in Nursing (MSN) D) Doctorate in Nursing Practice (DNP)

20. A nursing is assigned a team of 6 clients. Each client has multiple medications due at the same time. Throughout the medical pass, the nurse was interrupted several times by clients asking for hygiene measures. Frustrated by the interruptions, the nurse researched the topic and located articles that revealed which findings regarding interruptions during medication administration? A) Most of the time, interruptions were for emergent needs. B) Having UAPs available during scheduled medication times help nurses administer medications in a more timely fashion. C) Clients who were off the unit during medication time received their medications promptly on return to the unit. D) Frequently, nurses went into isolation rooms without putting on PPE if they were just putting the "cup of pills" on the bedside table.

20. The nurse is caring for a medical-surgical client who has a history of COPD and is recovering from a thoracotomy due to lung cancer. As the nurse enters the room to give medications, they note the client is cyanotic with dyspnea and a respiratory rate of 38. The nurse increases the oxygen to 4 l pm and calls respiratory therapy (RT) to intervene. The client does not respond to the interventions and is transferred to ICU. Which action below corresponds to the final step to take when utilizing the clinical judgment model described by Tanner (2006)? A) Documents all details of the experience include RT actions. B) Reflects on actions taken as a learning process. C) Calls RT department to report inadequate care and treatment. D) Leave the unit for a short break to decrease anxiety.

21. When a newly appointed nursing manager focuses on setting a priority for the unit to develop and build an outstanding nursing team. Which "Habit" from Covey is being utilized in this goal? A) Seek first to understand, then to be understood. B) Put first things first. C) Have a balanced, systematic program for self-renewal. D) Find your own voice and inspire others to find theirs.

3. A client asks the nurse to teach her some ways to hold her baby when she breast-feeds since the baby is not latching on appropriately. The client is frustrated and appears snappy to the nurse. The nurse replies that she will have to come back in 10 minutes and will bring some information that will be helpful to the client. In 10 minutes, the nurse returns with a booklet and some materials to teach the client. The client appears more relaxed and is able to listen to the suggestions that the nurse makes. What major communication concept involves the feelings of self-worth that come with a successful teaching-learning process? A) mutuality B) respect C) genuineness D) empathy

3. A health care legislation bill is set to go to the state legislature for a vote within a few months. A nurse decides to begin visiting with elected officials in the hopes of influencing their action on the piece of pending legislation. What is the correct term for the nurse's role in this situation? A) member of a political action committee (PAC) B) lobbyist C) campaign donor D) political strategist

3. Galileo and Sir Isaac Newton were able to utilize the scientific method in the 1600s as a result of beliefs in the principles of determinism, quantity, continuity, and impersonality. Which principle is concerned with the transition from one state to another and expresses that nature transforms gradually? A) determinism B) continuity C) quantity D) impersonality

4. A 95-year-old client is admitted to the hospital with dehydration secondary to a fall that occurred 3 days prior to admission. The client's adult child found the client on the floor. The client was unable to reach a phone to call for help. At the hospital, health care providers stated that the client was not a candidate for surgery due to the client's age and anticipated quality of life. Which challenge of the health care delivery system correlates with the situation? A) allowing consumer participation in the provision of health care services B) determining the optimal balance between illness treatment and quality of life C) providing both preventive and curative services D) attaining an effective system using governmental support and private resources

4. A nurse and a client engage in communication about the client's length of stay as a result of having open heart surgery. The unit uses day-by-day specific instructions for nursing care on a form that is at the client's bedside. What is the cognitive tool that is used in this specific instance that has reduced variation of nursing care received by clients with the same clinical problem, streamlined care to reduce costs, reduced care errors and oversights, and decreased the time nurses spend in documentation? A) critical thinking B) client care paths C) nursing outcomes classification D) nursing interventions classification

4. A student nurse, who is in the second semester of nursing school, is experiencing an unsettled feeling. The nurse notes a lack of confidence in knowing how to act or what questions to ask. According to Bridges' Managing Transitions theory, what phase of transition is this student experiencing? A) new beginning B) neutral zone C) transition one D) letting go

5. A nurse documents a Foley catheter insertions by clean technique since they were told by administration to decrease expenses like use of sterile gloves to a minimum. Who is liable if the client develops urinary tract infections (UTIs) that extend their hospital stay by 2 days and upsets the family to the point of "contacting a lawyer"? A) the nurse administrator B) the nurse performing the procedure C) the healthcare provider D) the chief financial officer

5. A nurse is working on their thesis as part of their Master's degree requirements. After a long day of research, the nurse shared with their faculty advisor, "I just want to study this topic. Why do I have to read everyone else's' study on this topic?" Which is the best response by the faculty advisor as to the purpose of the initial review of the literature? A) to raise more questions about the topic B) to help the researcher develop a strong knowledge base C) to describe how others define the subject D) to develop preconceived ideas about the topic

5. Mentoring involves the process of enlisting an experienced guide or trusted adviser who assumes responsibility for the professional growth and advancement of a less experienced person, called the protégé. When a nurse mentors another nurse, how does the mentoring process best enhance career opportunities for the protégé? A) The protégé can receive an accurate reference from a mentor if looking to make a change. B) The protégé learns from a mentor who role models a career path. C) The protégé becomes a trusted assistant to the mentor by sharing career goals. D) The protégé is guided by a mentor when specialty practice changes to assist in the transition.

6. A nurse educator discusses mutuality with the class and outlines Henson's processes of mutuality as being characterized by three senses. Which sense is created as a result of this process? A) relief B) satisfaction C) moving forward D) gain

6. A nurse enters a client's room and is concerned about the client's statement, "I feel funny but I can't explain why." The nurse assesses the client but cannot determine an actual scientific problem. However, the nurse calls the resident who comes to see the client and while being examined the client goes into cardiac arrest. The nurse utilized which type of knowledge in this situation? A) personal knowledge B) aesthetic knowledge C) empirical knowledge D) ethical knowledge

6. A nurse preceptor is reviewing the nursing process during the first day together with a new preceptee. The preceptor stresses that the process has the advantage of keeping nurses organized and provides structure for problem solving. While strengths were listed, what is one of the weaknesses of the nursing process that has been discussed in the literature? A) The nursing process is time efficient. B) The nursing process is inconsistent with real-world practice. C) The nursing process focuses on a client's strengths, not problems. D) The nursing process is controversial for beginning nursing practice.

6. The characteristics of a profession are many, and nursing is delineated as an emerging profession because of the absence of what characteristic? A) use of a specialized database B) standardized educational entry C) specialized competencies D) autonomy and control over work

7. A client returns to the hospital room from surgery following a cervical fusion for a herniated disc. When the nurse receives report and attends to the client following surgery, the nurse assumes the role of caregiver as the client cannot take care of himself at this time. As the nurse begins discharge planning, they collect data about the client's job, lifting requirements and assistance at home. This is an example of which helping role the nurse is providing to promote independence as they heal from surgery? A) leader B) counselor C) resource person D) change agent

7. A nurse is conducting a research study and has some difficulties during the project. Which is a barrier to research utilization in nursing? A) positive beliefs and attitudes toward nursing research by the clinician B) difficulty determining if studies are well designed and scientifically sound C) professional characteristics of clinicians such as openness D) postgraduate education level concentrating on research design

7. In looking at the presented future scenario of Hard Times, what is the major nursing implication in regards to universal health care and the effect it will have on consumers based on the possible future perspective? A) increase in the amount of documentation health care providers need to complete B) frugal benefits package; care coverage not as extensive and may refuse to pay providers of costs incurred from all preventable hospital-acquired complications. C) heroic measures once used to prolong life are limited for clients who are younger D) cost containment reduces the amount of federal funding for all forms of health care research

8. A nurse is involved in an ethical decision-making process involving a client who does not wish to receive blood products for religious reasons. The client's laboratory values are dangerously low and without the blood, the client likely will to go into shock. The nurse at the ethics committee meeting states that "The client should have the blood regardless of personal reasons as without it the client may die. The committee should recommend disregarding the client's wishes as they do not know what is best for them." This example represents what kind of fallacy? A) Arguing that because everybody does something, that something must be good. B) Making someone accept the conclusion of another based on force alone. C) Appealing to inappropriate authority to justify a decision. D) Refusing to allow evidence to be shared if it contradicts one's personal position.

8. A nurse presents information to a group of staff nurses on the traditional teaching-learning process. In discussing the topic to be taught, the educator focuses is developing objectives revolving around what to teach and how to evaluate learning. Which part of the traditional teaching-learning process does this refer to? A) assessment B) planning C) implementation D) evaluation

8. A nurse recognizes the signs and symptoms of burnout and enrolls in a class that teaches health-enhancing techniques. Which emotive, health-enhancing technique will help the nurse develop resilience so they can "bounce back" to their usual self? A) stress-management techniques like meditation B) refuting irrational ideas C) utilizing behavior modification techniques D) values clarification

8. An administrator reviews the nursing-sensitive outcomes report for the hospital. Which nursing-sensitive outcome would be a concern for the administrator regarding employee satisfaction as it relates to nursing? A) nurse turnover rate of 1% B) job satisfaction rate of 30% C) BSN/RN education level rate of 60% D) RN intention to stay in job rate of 80%

8. The nurse is performing a cultural assessment on a client. Which question would a nurse use to obtain data about values orientation? A) Do you speak more than one language? B) What things in life matter the most to you? C) What are your beliefs about health and illness? D) What are your attitudes about food and time?

9. Nursing research in the postmodern era of nursing has discovered which entity plays a key role in health and healing? A) consilience B) spirituality C) alternative interventions D) complementary therapy

11. In looking through the history of nursing, which geographical area was noted for paving the way for sanitation and public hygiene? A) East B) China C) Egypt D) Babylon

18. To improve test results by decreasing anxiety, a faculty member may recommend which strategies to assist with anxiety on the actual test day? Select all that apply. A) Re-read all notes taken from the textbook and classroom lectures the a few hours before the actual test. B) Arrive at the test site early. C) Practice relaxation techniques like deep-breathing. D) Quiz fellow nursing students on concepts one has learned. E) Light an incense burner in the room to evoke calmness among all students. F) Keep room lights off and direct peers to meditate using a powerful mantra to chant.

B, C

18. A nurse has been working on an oncology unit for many years. The nurse is experiencing some "burnout" attitudes. They have visited with the palliative care and parish nurses seeking guidance. Which recommended healing modalities may assist this nurse in rekindling a passion for working with cancer clients? Select all that apply. A) Keeping a humor log about clients and "funny" things one observed clients doing. B) Reviewing their diet to incorporate "healthy" food choices whenever possible. C) Attending a tai chi class when offered on the unit. D) When time permits, touching clients in a therapeutic, healing manner. E) Incorporate more sleep into their day to allow renewal from negative thoughts.

B,C,D

18. A nurse who is not happy in his/her current position has decided to explore different job opportunities. The nurse is trying to develop a resume but doesn't have the time to research it on the internet so they hand it to a friend to proofread. Which items on the resume would be considered inappropriate to include? Select all that apply. A) Name with current mailing address along with preferred email to receive information. B) Current position held and number of years one has worked for current employer. C) Timeline as to when one would be available to start work. D) Explanation for looking for new nursing position. E) A statement that references are available on request.

B,C,D

20. A new client who is being discharged following a myocardial infarction treated with a stent is visiting the cardiac rehab unit per healthcare providers order. While visiting with the cardiac rehab nurse, which statements by the client would be considered "Barriers" to changing their previous behaviors? Select all that apply. A) "My heart has been fixed with a stent so I don't need to change any of my exercise or eating habits." B) "I know everyone in my family wants me to come to rehab so I'll give it a try." C) "I guess I can go to work earlier so I can get off at a decent time and be able to do this rehab after work." D) "I work and live a long way away from your rehab unit so since you don't have a facility near my home, I will have to decline rehab." E) "I enjoyed exercise when I was younger so I'm willing to give it a try if it will help prevent further heart attacks."

B,C,E

13. In giving a presentation to graduate students at the university, a professor discusses goals from the United Nations millennium development program as well as Healthy People 2020 objectives. Which goals are considered missions of Healthy People 2020? Select all that apply. A) Identify priorities for world health improvement B) Identify and provide measurable and applicable goals and objectives for all levels of government C) Engage single sector nurses of society to improve policies and practices to use the best available knowledge and evidence for health promotion D) Identify the critical areas for data collection, research, and evaluation.

B,D

14. A nurse is studying anthropology in the humanities class to fulfill a general education requirement. In the student's nursing studies, the student is learning about Culture-Specific and Culturally Congruent Care as it applies to nursing. Which example below would be considered a culturally congruent care? Select all that apply. A) Having the Native American tribes spiritual leader (shaman) perform a specific healing ceremony immediately following surgery. B) Serving "hot" and "cold" foods and beverages to a Chinese woman who is hospitalized for brachytherapy to treat cervical cancer. C) Turning on soft music to drown out the noise at the nursing station for an elderly Puerto Rican client. D) Allowing the family of an Eastern Indian client to bring in remedies made from vegetables following amputation for gangrene of the foot.

B,D

14. The nurse is reflecting on how the first month in community health could have been improved pertaining to documenting the visits. Which tools could help the nurse to develop skills in reflection? Select all that apply. A) write a biography about a nursing leader B) keep professional logs C) audit the mentor's performance D) construct criteria for role model profiles E) ask nurse manager for daily feedback

B,D

16. A family has relocated and is looking for a health care provider in their area. The family consists of a single mother with 3 children. The mother is searching for a provider who will care for the entire family and focus on maintaining their health. If a health care provider practices The Friedman family assessment model, which statements accurately represent their practice model? Select all that apply. A) Assessing and meeting the emotional needs of the client is the priority. B) The client is seen as an individual within the family context that has a need for nursing care. C) The incorporation of social events will improve "moods" for both that client and their caretakers. D) The family as a whole equal's one unit of care focused on positive outcomes. E) The client's coping mechanisms may irritate the family members caring for them.

B,D

19. Which client scenario would meet the federal-funded core measures concerning core client documented education of the Centers for Medicare and Medicaid Services (CMS)? Select all that apply. A) Bonding measures observed on a new mother who delivered twins less than 12 hours ago. B) Smoking cessation education provider to client recovering from myocardial infarction. C) Infection control measures to implement at home following conversion of HIV status. D) Encouraging a heart failure client to weigh themselves daily to monitor effective management of current prescribed medications. E) Reviewing possible side effects when client are discharged with new "home" medication prescriptions.

B,D,E

3. A nurse reviews nursing models specifically related to culturally diverse groups of client populations as a part of their journal study project. Which model indicates socialization is the focus to care for culturally diverse groups? A) Leininger's sunrise model and theory of culture care diversity and universality B) Purnell's model for cultural competence C) Spector's model of heritage consistency D) Giger and Davidhizar's transcultural assessment model

12. A client recovering from a bariatric surgery is assisted by the multidisciplinary health care team. As the client watches the nurse take care of medication administration, treatment, and the coordination of care, the client perception of the nurse as the bedside caregiver is pronounced. Which can assist nurses to improve the scholarly nursing research image of professional nursing? A) Improve relations with other disciplines who value practice, not research. B) Focus awareness on the public's image of the practice nurse. C) Communicate nursing research's improvements to health outcomes. D) Identify opportunities to teach others the value of the practicing nurse.

19. A nursing student (NS) is reading a research article entitled, "Changing the model of care delivery: This NS is considering working for an organization after graduation that will allow them to deliver holistic care so the care the client receives will be coordinated and not fragmented. Which delivery model is this NS looking for? A) functional nursing B) team nursing C) total patient care nursing D) modular nursing

1. A nurse is running for office on the platform of health care reform. The strategies that this nurse wants to incorporate into public policy are a maximum of one nurse to six clients per shift and access to health care for everyone. Which term best describes formalized procedures that are followed by persons responsible for delivering governmental or institutional services? A) policy enforcement B) public procedures C) public policies D) laws

10. A nursing unit is gathering data related to pressure ulcer development of their clients. Which part of the cycle of their quality improvement program that utilizes W. Edward Deming's cycle involves using statistical data to determine progress? A) plan B) do C) check D) act

11. A nurse in the geriatric area of a hospital sits with a client and discusses teaching on how to keep the Groshong port clean when the client goes home. The nurse takes the time to talk about port care and is able to present the data in terms the client can understand (laymen terms). What strategy for controlling environmental constraints should the nurse keep in mind when working with clients who are geriatric? A) Try to arrange learning experiences when the learner feels relatively healthy. B) The nurse should have a sufficient grasp of the subject matter so that they can use various terminology as needed to get the point across. C) Make sure expectations and standards are clear. D) Provide time for learning when family members can attend so they can monitor the client performing the care at home.

11. A nurse manager working on a doctorate has been asked to present information on theoretical frameworks to a group of nursing students who are attending the college nearby. Which characteristic would the nurse use in a description of theoretical frameworks? A) narrower than a theory B) more local than global C) not validated through scientific testing D) simple rather than complex

12. A faculty member in a community college setting identifies several concerns with the curriculum and wants to improve the way in which the curriculum is taught. The faculty member forms a committee to look at this, and an ideal nursing curriculum is identified and compared to the one that is currently in place. Which characteristic of ideal nursing education programs outlined by Ironside and Valiga would best provide an opportunity for improved satisfaction of nursing faculty? A) smarter, not harder, work habits of faculty B) visible thinking of faculty when interacting with students C) faculty teaching assignments that support their passion D) clinical practice in all courses

12. A nurse has been working for 20 years in a fast-paced emergency department. The nurse decides a change of pace is needed and begins looking for a new career in a setting that allows the ability to establish long-term relationships with clients. Which job opportunity could be what this nurse is looking for? A) A nurse in a cardiac rehabilitation center. B) A nurse in an outpatient clinic. C) A nurse in a long-term care setting. D) A nurse in a surgery center.

12. A nurse schedules an appointment with a local representative. When outlining a plan to visit the elected official, how much time should the nurse plan for the actual meeting? A) 5 to 10 minutes B) 10 to 15 minutes C) 15 to 30 minutes D) 30 to 45 minutes

12. A quality improvement team sends out satisfaction surveys to learn what areas of the hospital may need further improvement. Which group of people is the most instrumental in helping to improve health care delivery processes? A) nurses B) doctors C) consumers D) lab personnel

12. Which scenario best describes one of the hazards of using electronic health records (EHR)? A) Every item documented utilizes the same standard terminology. B) Increase usage of paper since the majority of nurse's print off computerized reports to help with organizing their day. C) During a weather power outage, the nurses document simplified noted on assessment findings which may be entered into HER later. D) Nurses receive multiple reminders of care regarding procedures they have missed or are late in providing.

13. A nurse in graduate school takes a class on political science as an elective. The nurse was able to identify strategies to stay abreast of current legislative and public policy issues. What is the easiest way to stay abreast of current legislative and public policy issues? A) printed materials of political bills B) electronic media of political decisions C) website review of publications D) receipt of periodic legislative reports

13. A nursing department dean is hired to lead a major university initiative that encompasses leadership strategies. Which role that Covey has listed as the most effective for leadership has to do with getting others to internally unleash their human potential for the dean? A) aligning B) modeling C) empowering D) path finding

13. A strategy best used as a strategic improvement in health care has been implemented at a neighboring hospital. They are looking for ways to decrease worker injury that occurs when moving morbidly obese clients. They are looking how the work process is designed following principle of body mechanics to promote worker health and well-being. Whose quality management strategy theory is based on looking at how work is constructed and how work can be improved and errors reduced? A) Juran B) Six Sigma C) Toyota's Lean operations D) Deming's cycle

13. The nurse in the intensive care unit (ICU) has a client with multiple IVs for several different medications that the client has been prescribed. For which part of the nursing process does the nurse use the technology of computerized IV pumps to help calculate mcg/kg/min for a vasopressor drug prior to hanging the medication? A) assessment B) planning C) implementation D) evaluation

13. What prevention strategies can be applied by the nurse using tertiary prevention when an outbreak of measles occurs within the public school community? A) facilitating people to do self-screening and report abnormal findings B) increasing the public's awareness of health problems C) lobbying for adequate services and resources through the legislature D) facilitating people to do referrals when issues arise

14. A professional nurse is trying to locate information about a disease process and is evaluating online information. Which question should the nurse ask to identify the authority of the online information? A) "Is the information error free and consistent?" B) "Does the information conflict with known scientific information?" C) "Is there a way to contact the author(s)?" D) "Are the initial posting dates and updates present?"

14. Noting a rise in infection rates on a postsurgical unit, the staff is asked to observe handwashing techniques, not only of themselves but other hospital personnel as well. The goal is to increase percentage of personnel washing hands to lower infection rates. Which key principle from the TeamSTEPPS® 2.0 program will the staff be practicing? A) team structure B) leadership C) situation monitoring D) mutual support

14. When looking at the future of nursing, a group of nursing students believes they will have long-term employment due to the health care field always expanding. Several other students focus on what may occur based on current trends that may be combined to describe a range of potential futures. They have been researching what impact global warming will have of the health of the population. What term refers to the latter group's view of the future? A) preferable future B) probable future C) plausible future D) possible future

15. Of the following goals for keeping clients safe, which was identified by The Joint Commission's 2016 National Patient Safety Goals for Hospitals? A) Increase amount of details documented in medical records. B) 100% of narcotic waste doses are witnessed by a RN. C) Screen all high-risk clients for potential suicide risk. D) 90% of clients receiving blood will have a nurse witness the ID process.

16. A nurse has gone back to school to complete a Master's degree in nursing education and is currently taking a research class. Since the nurse works on an orthopedic unit, they have an extreme interest in studying music therapy as a way to decrease pain. Which step in the research would be the next item to address? A) Financial cost of hiring a music therapist. B) Identify resources (type of music) available for implementation. C) Perform a literature review to provide general background and see if this topic has been studied. D) Establish tentative hypotheses for the focus of the research.

17. A hospital infectious disease department has noted a sharp rise in ventilator acquired pneumonia (VAP). The Infectious disease nurses spent some time monitoring the ICU areas observing hand hygiene and suctioning techniques of the staff. After several weeks, a trend was noted related to noncompliance with proper handwashing and poor sterile technique when suctioning ventilated clients. Education was provided to all staff. Evaluation was initiated and overall compliance with policy resulted in decrease in VAP. This is an example of which type of accountability? A) peer review B) Code of Ethics C) safe nursing practice D) cooperative teamwork

17. A male graduate student is carrying on a discussion with his peer female students. He is "black and white" oriented and believes client choices are either right or wrong, there is no "gray" area. He also believes that their nurse manager passes on information that is always truthful and that the manager's subordinates, the nursing staff should be passive. Which concept is he demonstrating? A) full relativism B) relative subordinate position C) basic dualism D) constructed knowledge

17. An elderly Chinese man reporting chest pain was brought to the Emergency Department by family. As the female RN started to lift his shirt to place a stethoscope on his chest, he grabbed her arm and stopped her. The nurse should perform which step next in order to provide safe, effective care to this client? A) Ask a male nurse working in the ED to help with the assessment. B) Assess the client for mental changes that may indicate a stroke. C) Apologize and call for an approved language interpreting service to have them explain what interventions she wants to provide with his cooperation. D) Find family members and ask if the person can speak English and Chinese. If so, ask them to interpret what you are going to assess.

18. A client was admitted through the ED with hyperglycemia. They have been diagnosed with new onset diabetes. In addition to developing priority nursing diagnoses, the nurse will identify diagnoses for enhancing client wellness and prevention of potential complications. Which diagnosis would be considered a "wellness" nursing diagnosis? A) imbalanced nutrition: more than body requirements B) risk for infection. C) readiness for enhanced knowledge D) risk for disturbed sensory perception

18. A middle-aged NP is looking to change their career path. They would like to have an academic schedule so that they can be home during the summer months to supervise their teenaged children. They would like to teach clinical skills with students. Which academic program will best meet this NPs goals? A) faculty position in a large research university B) pharmacy professor for NP program C) community college program which focuses on technical nursing D) staff position in urban hospital teaching competency skills to UAPs

18. A nurse is explaining to a client about standardized methods for managing their COPD. The client is not "on board" since they think that more expensive treatment and medications would make them "better." Every day this nurse maps out expected interventions along with discharge planning and instructions. Once the client has reached the "desired outcome," this nurse recommends discharge to home. Which hospital department has this client been working with? A) social services B) risk management C) case management D) legal department

18. A nurse on a busy medical-surgical unit notices that when a particular UAP works on their team, several delegated items are not completed. The nurse has decided to "write up" the UAP with a warning. After the written warning, the UAP completes the tasks delegated to them in a timely fashion. Which change strategy did the nurse utilize in this scenario? A) empirical--rational strategies B) normative--re-educative strategies C) power--coercive strategies D) facilitative strategies

18. A public health nurse is considering offering an educational program for a fairly large group of Hispanic members of the community. This group speaks Spanish primarily. While researching and planning the program, the nurse will need to consider which contextual elements about this Hispanic group? A) Money, they have available for healthcare and their ability to access healthcare. B) Limited work opportunities impacting their ability to purchase food and medicine. C) Biophysiologic variations related to specific health problems and medication metabolism of this ethnic group. D) How worried the group is when it comes to no social security available for retirement since they are immigrants.

18. Which item below would be the best example of the use of QSEN Competencies for informatics that relates to applying technology/information management to promote safe nursing care? A) Printing off client care educational sheets about their new medications so they can read them at home at their leisure. B) Making notes during morning rounding on clients so the nurse can document assessments later in the day. C) Stopping to verify right client/right medication prior to administering the medication when a computerized warning flashes after their wrist band ID is scanned. D) Using the information generated from the information management tools available to track response to various wound care products.

19. A client is really struggling to accept their disability following an automobile accident that left them a paraplegic. The nurse caring for this client believes the role of nursing is to use true presence to facilitate the becoming of the participant (client). The nurse is trying to help the client accept their change as a process of "becoming." This nurse is practicing which theorist's view of nursing? A) Dorothea Orem B) Jean Watson C) Rosemarie Parse D) Martha Rogers

19. A nurse is working on a unit caring for neurologic clients. The nurse notices one of the clients is struggling to feed themselves and immediately intervenes by providing a weighted utensil with a good grip. Since the nurse was able to look at the whole situation and intervene without the need for step-by-step plans of action, this nurse is functioning at which level of Benner's Novice-to-Expert Model? A) novice B) advanced Beginner C) proficient D) expert

19. A nurse practitioner (NP) is opening a clinic practice in a rural community that lacks health care providers. They are required to file paperwork with various agencies. What qualifications will the NP have to have before they can receive third party reimbursement? A) unencumbered status with State Board of Nursing B) financial plan showing enough funds to maintain practice for at least 6 months C) certification through a national organization D) required number of CEUs depending on state where they practice

2. A caregiver brings a 2-year-old child to a clinic for a well-child visit. The nurse notes the child can follow simple directions like, "What is under your chair?" It is also observed that the child uses 2- to 3-word sentences when conversing with the mother. The nurse documents which assessments from this observation? A) The child is displaying language skills normally expected of 3 to 4 years old. B) The child's culture has limited their ability to develop English language skills. C) The child is meeting the cognitive developmental tasks of a toddler. D) The child is functioning at the 12-month range for language skills

2. A family is in crisis from an automobile accident that has seriously injured three of the family members. A nurse who works in rehab uses which of the following to best describe the definition of families from Artinian's perspective? A) a group of people with a common interest with open communication B) a combination of people who work in the same area C) an organized whole; individuals are parts of the system and are interdependent D) a recipient of nursing care who is unique and continuously evolving

2. A hospital administrator was making rounds on the "off" (night) shift and noted a nurse who they considered to be culturally competent. What quality did this nurse display that lead the administrator to categorize them a being a culturally competent nurse? A) attempting to provide privacy when culture dictates it B) greeting clients the first time they meet C) making clients and colleagues feel cared for and appreciated D) passively listening to those whom the nurse does not understand

2. A manager of a busy surgical care center is working on the annual budget. Nursing has suggested a need for a new blanket warmer for clients when they arrive to the operating room. The last budget meeting required a 10% reduction in proposed items. The manager elects to keep the blanket warmer in the budget. What major task of the manager best describes the review and purchase of budgeted items that the surgery center needs? A) ability to work with people B) assuring smooth workflow processes C) efficiently using resources D) communicating clearly

2. A nurse is monitoring an elderly client with heart failure. After listening to the client's lungs, the nurse hears decreased breath sounds on the left side. Since this is a change in the client's previous assessment, the nurse notifies the health care provider for further instruction. Which universal job skill did the nurse utilize in this situation? A) helping or instructing other health care personnel B) physical stamina C) problem solving D) manual dexterity

2. A nurse practitioner works in a small, rural community. In addition to traditional practices, the practitioner at times discusses the use of herbal supplements with clients. The nurse visits with them about a holistic approach to health rather than just reliance of medications to treat many ailments. Occasionally, the clients ask when the practice of holistic health began. The best answer would be which era of scientific thought brought about a holistic approach to health? A) ancient times B) 1500s C) 20th century D) Current times

2. There were many historical eras in which society was involved in nursing care. Which era involved the appointment of Dorothea Dix as superintendent of female nurses? A) Victorian era B) Colonial American era C) Civil War era D) Renaissance

20. A group of nurses in a graduate level trends and issues class are discussing the need for national standards to ensure client safety is addressed as the priority. According to Senate bill 1132 and House of Representative Act of 2015 (114th Congressional Legislative Session), the nurses are enthusiastic when which topic related to client safety is considered the priority? A) Increase use of restraints when clients become combative. B) Ability to perform CPR without a health care provider's order. C) Setting of national standards related to direct care RN-to-client ratios. D) Expanding the role of UAP to include medication administration after training.

20. A woman is admitted to the postpartum area in premature labor. The client, who is a practicing Jehovah Witness, progresses to active labor and delivers a premature infant. The client begins to hemorrhage and does not respond to IV Pitocin or fundal massage. Sadly, the client dies having refused blood products for religious reasons. This is an example of a clash with which major contextual element of professional nursing practice? A) demographic elements B) economic elements C) cultural elements D) environmental elements

20. The educational staff in a large hospital group is developing some interview questions prior to accepting applications from a nursing school close by. They also develop some case studies and questions to get an overview of the nature, scope, and sources of knowledge the senior level nursing students have as a foundation. This form of planning closely mimics which tenet of intermodernism? A) empiricism B) reality C) epistemology D) romanticism

21. A nurse in a busy cardiac surgery intensive care unit has been working for the past 7 hours without a break. The nurse notices the assistant nurse manager sitting in the nursing station visiting with other nurses who are not as busy as this nurse. Which statement by the nurse is an example of a claiming (clarifying role/concerns/issues) affirmation statement? A) "I can't believe my peers are sitting around visiting when they see how busy I have been." B) "My peers are not treating me as a valid team member when they ignore my needs. I need to report this." C) "I am going to talk with the assistant manager about my need for a break so that I can provide better care to my clients." D) "I am going to inform the assistant nurse manager that I am going to terminate my employment since no one ever offers me coverage for breaks."

3. A client arrives from surgery and the nurse assesses the client vital signs, pain level, and bleeding status. Following the assessment, the nurse writes, "acute pain related to surgery as evidenced by moaning, verbalization of pain being 10 on a scale of 1 to 10, and elevated blood pressure." What portion of the nursing process has the nurse utilized? A) assessment B) planning C) diagnosis D) evaluation

3. A customer purchases a plane ticket and flies overseas to Germany. While in Germany, the individual becomes ill and travels back to the United States to be seen by primary care health care provider. Once seen by the primary health care provider, the client is placed in isolation at a nearby hospital. Which challenge of the health care delivery system correlates with this situation? A) ensuring access to care for all human beings B) providing both preventive and curative services C) responding to actual and future epidemics D) enabling optimal health essential to high quality of life

4. A nurse is responsible for the evening shift at a busy maternity unit. The unit is full, and the nurse has had to call several other nurses in to manage the load. A client with broken membranes has requested no external or internal monitors. The nurse explains to the client that they will accommodate her requests to a point, but occasionally they will be listening to the FHR throughout the labor. Which answer represents the best positive outcome for the client when both the nurse and the client work together to meet the client's needs as long as safety is maintained? A) autonomy for the client B) family-centered care C) customer satisfaction D) reduced liability

4. A nurse is working in a rehabilitation center, and in defining the concept of environment, they go beyond just the physical environment but also incorporate chemical, biologic, and social contexts. Given this, the nurse recognizes this facility uses which nursing theorist in their definition for environment? A) Jean Watson B) Martha Rogers C) Dorothea Orem D) Martha Newman

4. An infant is taken to its parents for the first time, and the mother holds the baby. The mother caresses the baby's cheek and observes the baby sleeping. The nurse watching this exchange understands that the most primitive sensory process developed by humans is which of the following? A) apprehensiveness B) verbal communication C) tactile stimulation D) listening for audible cues

4. When professional nurses network, a variety of learning experiences takes place. Which learning activity would create a way of benchmarking across the United States? A) expansion of professional networks B) becoming aware of career opportunities C) learning about nursing care practice variances across settings D) supporting each other in various ways

4. Which philosophical approach to the development of knowledge is highlighted by a concern for "context rather than universality, specificity rather than generalization, uniqueness rather than sameness, and relativism rather than absolutism"? A) logical empiricism B) historicism C) postmodernism D) rationalism

5. A nurse returns to school to complete an advanced nursing degree and is finding it difficult to meet all expectations of her life. The nurse is a new parent, a student, a spouse, and a full-time employee. The nurse is experiencing what type of issue? A) value conflict B) behavioral conflict C) role conflict D) attitude conflict

5. A nursing class has changed the topic for the day in light of a horrendous attack on a train station in eastern Europe. The students want to discuss what their role would be if they lived in that environment. In addition to addressing disaster planning, the faculty also using this scenario to discuss plausible futures in accordance to The United Nations reports? A) economic considerations take priority over preservation principles B) actions everyone should implement for energy conservation and environmental preservation C) nurses will need to prepare a global response plan to chemical and biological attacks D) continue focusing on ones surroundings looking for potential terrorists within ones community

5. When looking at the definition of mutuality in the teaching-learning process, what is the major characteristic that takes place in order for the dynamic process to occur? A) connection with or relation to another B) empowerment with and understanding of another C) connection with or understanding of another D) relation to and empowerment with another

6. A Hispanic client comes to the hospital in pain and is admitted to the ER due to cholecystitis. The client does not speak any English. An interpreter had been used during the course of treatment, and now the client is ready to be discharged. Which technology best assists the nurse in client teaching during the discharge process for a client such as this? A) care plans generated by software programs based on nursing diagnosis B) computerized documentation through the use of handheld computers C) software that translates client educational materials into multiple languages D) software allowing access to x-rays in digital format to be read by radiologists

6. A hospital is looking to fill a vacant staff nurse position in the inclient unit. After interviewing many qualified applicants, they decide to offer the job to a nurse who is best utilized during regional and seasonal shortages. What type of nurse might the nurse manager consider hiring? A) A nurse who works in a rehabilitation center. B) A nurse who works in the operating room. C) A travel nurse with 10 years' experience. D) A long-term care nurse with no experience.

6. A nurse in an occupational work setting notices unusual behavior from a worker who has been "ill" for several weeks. After returning to work, the nurse notices bruising to the face and a broken arm, for which the employee states, "It was just an accident." The nurse suspects abuse but does not confront the client at the time. One month later, the client is on life support due to a traumatic brain injury. Which nursing specialty would be best prepared to handle this case if something like this were to happen again? A) Armed Forces nursing B) school nursing C) forensic nursing D) nursing the Incarcerated

6. A nurse in the operating room has grown weary of the hours and would like to spend more time with the family. The nurse sets sights on meeting with a career counselor who suggests working on a career map. The nurse has never heard of one before. What is the first step in working on a career map? A) envisioning a future B) creation of a blueprint C) identification of values D) determining the importance of each value

6. A senior level nursing class is discussing what the future could hold if scientists find a way to turn off the "thrifty gene" that makes humans conserve calories. Which impact could this finding have on health care workers responsible for educating the public about obesity? A) Reduced need for secondary health care services if clients are compliant with prescribed regime. B) Tax increase for those who are diagnosed as obese which will help to defray health care costs C) Nutritional counseling will need to be based on individual genetic profiles. D) Government support (financially) will need to increase for obese and overweight citizens to reduce weight.

6. Some senior level BSN students were discussing with their faculty some flaws and gaps in the health care delivery system. They ask the faculty if nurses can influence policy changes. The faculty response was positive but they also shared the fact that this rarely happens because of which factor? A) Pharmaceutical firms have the most influence in the legislature. B) No legislator member wants to address the needs of clients. C) Financial resources are lacking for nurse-driven health policy. D) Big tobacco firms always pay large amounts to reserve a seat at the negotiating table.

7. A nurse working on the medical-surgical unit uses the change/stability models of nursing as their main practice philosophy. Which model would this nurse be using if they believe that the family is a social system made up of a group of interacting individuals focusing on goal attainment? A) Parse's human becoming model B) Newman's theory of health as expanding consciousness C) King's systems interaction model D) Neuman's health care systems model

7. As part of the admission assessment procedure at a local rehabilitation center, the nurse begins collecting data related to a client's "stressors." They explore the client's feelings about being in a rehab center following surgery for a fractured hip, what their role expectations are; usual support system they have available, financial concerns from lost wages, etc. This rehab center is utilizing which nursing system model as they gather this data? A) Callista Roy's adaptation model B) Rosemarie Parse's human becoming theory C) Betty Neuman's health care systems model D) Jean Watson's human science and human care theory

7. Professional nurses assume leadership roles when coordinating care and making recommendations to interprofessional team members. What best describes the feminist approach to leadership? A) concept of mutuality B) concept of empowerment C) concept of "power with" D) concept of transformation

7. The nurse is caring for six clients. All the clients need medication passed at 0900. The nurse relies on which technology to prevent making a medication error? A) Personal digital assistant (PDA) B) Handheld computers C) Computerized medication-dispensing stations (CMDS) D) Pharmaceutical software programs

8. A nursing student is reviewing the history of the American health care system. He reads about the scientific advancements in the mid-to-late 1800s and is impressed with the use of the thermometer, laryngoscope, and the ophthalmoscope in the 1860s. What other scientific advancement occurred during this timeframe that advanced the health care providers diagnostic ability? A) anesthesia B) antisepsis C) x-ray D) hospital hygiene

8. Leaders choose how they use power based on their philosophical beliefs while considering specific situations. According to Covey, what describes the overall real test of interpersonal skills in transformational leadership? A) to permit others to validate themselves B) alignment of goals benefits members C) mutual learning, mutual influence, mutual benefits D) to make all contributors accountable

8. The political team for a campaign asks a nurse to help the candidate with the health care issues affecting the city. In preparation for the task of presenting to the team and the candidate, the nurse investigates issues that affect nursing's future. Which issue would the nurse present to the committee to assist in informing the government of the nurse's needs and desires? A) need for changes in the health care delivery system to meet the needs of the population B) recognition that positive outcomes of client care are improved when professional nurses provide care C) determine a means to disseminate nursing research findings to the public D) support interprofessional learning experiences that result in long-lasting effects

8. When the nurse analyzes accountability to the profession, which question best provides a self-assessment of professional accountability? A) In areas where I am dissatisfied, am I seeking alternative modes of action or thought? B) Should I withdraw from that role until I receive additional preparation? C) Am I working within the profession to improve practice, education, or research? D) Am I working in accordance with the policies and procedures of the institution?

9. A client who is quadriplegic who has been on the unit for more than 30 days. They have developed a pressure ulcer and are complaining of pain. The nurse manager develops a pressure ulcer in-service to assist in the management of this client as well as other clients on the unit. Which nursing-sensitive outcome would be important to the nurse manager and the nurses on this unit? A) self-care B) functional status of the client C) reduced rates of institutionally acquired pressure ulcers D) satisfaction with health care received

9. A nurse enters a client's room and introduces themselves as the nurse who will be taking care of them today. The client informs the nurse they have been sick to stomach for the last several hours. After discussing the client's nausea, the nurse and the client decide that medication might be helpful to alleviate the client symptoms. Which nursing theorist focuses on the interpersonal relationship between the client to facilitate useful transformation of the client's energy or anxiety? A) Parse's human becoming theory B) Paterson and Zderad's humanistic theory C) Peplau's interpersonal relations model D) Newman's theory of health as expanding consciousness

9. In order to attain professional status, which nursing role will nursing personnel need to be performing on a regular basis? A) Work individually to showcase contributions to society. B) Maintain three levels of education for nurses collectively. C) Work together to collaborate through professional organizations. D) Ethically maintain standards of care for clients.

12. Which nurses influenced the reform of health care and nursing and, in 1893, opened a nurses' settlement house in New York City using the term "public health nurse" to describe the trained nurses who responded to nursing needs outside the hospital? Select all that apply. A) Dorothea Dix B) Florence Nightingale C) Mary Brewster D) Lillian Wald

C, D

18. A nurse is working for a large urban hospital which has adopted a "just culture" for managing errors. Which error below may result in a suspension of duties or firing of the personnel? Select all that apply. A) Client un-intentionally was harmed when lab did not notify the nursing staff of a critical PTT result which they placed in the "routine" lab results. B) Healthcare provider, who had little rest over past 24 hours, prescribed a second anticoagulant for a client admitted over night for a mini-stroke. C) Co-worker was called and asked to work overtime due to staff shortages. Co-worker accepted the assignment even though they had just consumed 4 alcoholic beverages at a part. D) RN had a busy work day with 2 clients requiring transfer to ICUs. RN told everyone they would not stay and document because they were too tired and just didn't care. E) Admitting health care provider ordered one set of medications and hospitalist orders a second set of medication. Both health care providers ordered ACE-I, beta-blocker, and aspirin for this client. The nurse implemented all prescribed orders which resulted in client having a critical drop in BP and pulse rate

C,D

19. During a discussion on trends/issues in nursing, students were asked to identify some topics that were passed in the legislature with nursing backing the program. Of the topics students want to explore for their class presentation, which would the faculty ask the students to reconsider and change to a different focus? Select all that apply. A) client safety needs B) HIV virus funding programs C) reasonable percentage of tax to be placed on nicotine products D) direct Medicare reimbursement to APRNs E) minimum salary for nurse educators

C,E

1. A nurse arrives on the unit having a prescribed set of values and beliefs and begins the assessment on the assigned client. These values and beliefs influence thoughts, feelings, and which quality of the nurse provides care to the client? A) ideas B) views C) communication D) perception

1. A nurse educator in a college setting has developed leadership skills as a result of attaining further education and sharing positive change within the department. When looking at leadership in the contemporary sense, what leadership trait is characteristic of transformational leaders? A) influencing others B) guiding others C) directing others D) empowering others

1. A nurse who has been practicing since the late 19th century has experienced many societal reforms that have contributed to the establishment of nursing as a profession. What societal reforms would be considered instrumental in leading to a reform in nursing? A) war and educational reform B) educational and hospital reform C) war and government reform D) prison and hospital reform

10. The implementation of the use of clinical pathways in hospitals had what effect on current nursing practice? A) decreased the autonomy of nurses in practice B) increased the variance of care in nursing practice C) increased the complexity of nursing care D) decreased the individualization of nursing care plans

11. A hospice nurse is caring for a terminally ill client who is requesting minimal pain medication be administered while their family is visiting. Which ethical principle is designed to avoid using fallacies in ethical decision making? A) Not allowing the client to share in the health care decision. B) Serving the client in a manner that promotes harm. C) Devaluing the client's self-determination. D) Respecting the client's rights and treatment options

11. A new graduate nurse has accepted a job on a nursing unit in a busy orthopedic unit and has been working for the last 6 months developing skills. The nurse has worked with many colleagues and has seen many instances where the manager has been accessible, communicated well, and has supported the staff. The nurse determines that the leader on the unit is an exceptional nursing leader. What remaining criteria for evaluating effective leaders does McCauley and Van Velsor list that would relate to accountability? A) Does the leader use effective verbal and nonverbal communication skills? B) Can the leader effectively modify his or her behavior and that of others? C) Is the leader willing to help others grow as professional nurses? D) Does the leader set high standards and hold others and self to the standards?

11. A nurse who uses a conceptual model as a framework begins to think differently about the nursing process. When using a conceptual model as a framework for clients, what is the major advantage of applying an individual model to the family and the community as client model? A) The model is the road map; need buy in by the user to incorporate it effectively. B) The model changes by virtue of the client and expands, creating more variables. C) The model becomes multidimensional, which may be difficult to apply. D) The model is familiar; the impact of an individual's health-related change affects a family system and communities.

11. A nursing student originally born in the Philippines enters a nursing program in the United States to become an RN. Three semesters later, the student wants to quit the program. The student's advisor has observed this student eating alone in the cafeteria (classmates are all eating at a different table); studying alone in the library where classmates have joined various study groups; spends little time visiting with nurses on the clinical unit when their clients are sleeping. What term best describes what this student is experiencing? A) cultural diffusion B) cultural blindness C) cultural identity D) culture shock

11. In looking to expand its quality improvement initiatives, a hospital's administrator and a multidisciplinary team of health care workers are looking at processes to coordinate their quality improvement goals. What method can be used to improve health care by finding out what key customers want and need followed by implementation of initiatives to fulfill customer expectations? A) total quality management B) continuous quality improvement C) plan, do, check, act D) Six Sigma

12. A client learns how to bathe her baby and shares with the nurse her hesitation of a return demonstration stating that she is afraid when she gets him wet he will slip and get hurt. The nurse replies that with the bassinet under the baby, there should be no time that the baby is not safe. The client performs the bath and the nurse congratulates her on a great job. Which correlates that this behavioral change was well integrated? A) The client understands the educational material. B) The client has mastered a particular health care skill. C) The client uses the new information or skill effectively. D) The client must be validated by persons significant to the client.

12. A nurse practitioner is providing end-of-life care for a terminally ill cancer client. As the client begins to exhibit signs that death is nearing, the nurse practitioner notices they are focusing more on the families need than that of the clients dying. Which best describes this nurse practitioners belief in client and/or family care? A) Focus should always remain on the client with family needs after those of the client. B) Pain control measures always supersede other nursing problems. C) To keep expenses low, the NP should focus on giving older medication that has been around a while for pain. D) The NP views the family as the unit of care for this client.

12. During nursing fundamentals class, the professor begins by stating the most recent data from U.S. Census Bureau (2011) related to growth of various ethnic groups. The students are asked to vote for which group represents the fastest growth rate of ethnic groups (thereby leading to rise of this minority nursing population)? Which groups of students correctly answered this question? A) Group 1 voted American Indian/Alaskan Native. B) Group 2 voted Black/African American. C) Group 3 voted Hispanic/Latino. D) Group 4 voted Asian or Native Hawaiian/Pacific Islander

12. Which senior-level nursing student should be encouraged to apply for a position in a cardiac critical care unit? A) student with passion for working with elderly clients B) student who finds their greatest desire to work with mentally challenged individuals C) student who finds great reward helping individuals die with dignity D) student who spends extra time in skills lab practicing on the more complex skills like trach care

13. A client receives feedback on her breast-feeding technique by the lactation consultant. Constructive feedback such as this causes what to occur in learners? A) Learners present more questions. B) Learners learn faster. C) Learners identify barriers. D) Learners want to learn more.

13. A client with chronic pain has started practicing subconscious mind power techniques like visualization and hypnosis. They are also working on resolving negative mental and emotional patterns to release stress to free up healing energy. What is the theme of scientific thought this client is practicing that is a manifestation of current times? A) reduction of humans into separate psyche and soma B) machine ruled by the same laws as all of nature C) comfortable with uncertainty and work toward processes D) reflection of body-mind-soul

13. A nurse documents a desired client outcome for the client as "food selections staying within predetermined daily caloric limit when eating out or participating in social gatherings." The nurse suggests the client place these goals on the refrigerator in clear view. All the nursing interventions for the client are computer coded and the client is being charged for the specific nursing interventions the nurse has done for this desired outcome. Which best describes the nurse's actions they should document in the clients electronic medical record?' A) Critical thinking B) Client care paths C) Nursing-sensitive outcomes classification D) Nursing intervention classification

13. When reviewing the literature for model theories, the nurse comes across several specific theories. Which best describes Jean Watson's human science and human care theory? A) Nursing is helping to attain, maintain, or restore health, and the action necessary is goal setting B) Caring for client as a whole in a given situation C) Interaction of the client from a systems standpoint, not a goal attainment standpoint D) Incorporates caring philosophies that include the past, present, and future influences on an individual

14. A family recently experienced deaths of two of their children in a car accident. The parents, following in the vehicle behind their children's car, witnessed their children's car being hit by a truck. Which conceptual model identifies the family as it focuses on this unexpected event that is disruptive to its overall health? A) family assessment and intervention model B) Friedman family assessment model C) family systems model D) family stress model

14. A nurse and client require effective communication in the client education process. A nurse who is trying to improve communication skills identifies three concepts that facilitate teaching-learning. Which concept looks at the perceiving each other as real and as genuinely human, open, honest, and caring in their responses to each other and will generate effective educational plans as a result? A) respect B) empathy C) mutuality D) genuineness

14. Peer review activities are monthly occurrences on the medical-surgical unit of the local hospital. Which statement best describes the primary outcome for peer reviews? A) awareness of personnel concerns B) improved quality of client care C) awareness of practice concerns D) increased employee professionalism

14. When reviewing the history of the Civil Rights Movement in a history class, the nursing students identified which positive belief that encouraged the government to become more involved in health care? A) Anesthesia was introduced as a form of pain management following riots. B) Blood transfusions were discovered as a way to treat blood loss. C) Vaccines were proven unsafe and discouraged, especially marching in the Civil Rights Movement. D) Equal health care should become a basic right among all people.

14. Which practice can be traced back to the Chinese and is used in the current practice of nursing? A) Bathing and bandaging wounds B) Obstetrical care C) Medication administration D) Physical examination

15. A nurse compares the nursing interventions presented in an article in a nursing magazine to the nursing interventions implemented on the assigned client to improve skin integrity with second-degree decubitus ulcers. What part of the nursing process is the nurse participating? A) assessment B) planning C) implementation D) evaluation

15. A nurse has developed a relationship with a long-term oncology client. As they discuss health, the nurse shares with the client that they view health as a nonlinear entity that is a constantly changing the process of "becoming." The nurses goal is to be "present in the moment" with the client so they can enhance their quality of life. Which theorist is the foundation of this nurse's practice? A) Susan Leddy B) Martha Rogers C) Callista Roy D) Rosemarie Parse

15. A nurse in the family-centered care unit uses the family system as an energy field that serves as the focus of study and interaction in caring for clients and families. The nurse views the family as only a backdrop for individuals. Which model is the nurse basing practice on? A) Orem's self-care deficit model B) Watson's human science and human care model C) Peplau's interpersonal relations model D) Rogers' science of unitary human beings

15. A student nurse takes a test and is relieved when receiving a perfect score for her test on theories and models in nursing. Which model uses the central concern as the communicative understandings of meanings given by people who live within the situation? A) Watson's model of nursing B) Bruner's learning models C) Benner's novice-to-expert model D) Diekelmann's phenomenological model of curriculum

15. Palestinians developed sick houses that were connected to rest houses that cared for travelers and the destitute that are the equivalent to what types of current facilities? A) Places of worship B) Hospitals C) Surgical centers D) Long-term care facilities

15. When researchers (Piscotty, et al, 2015) utilized a descriptive study to identify the perceived impact of health information technology on clinical nursing practice, which statement most accurately identifies their findings? A) If a nurse perceived the health information technology affected their clinical care, it actually did affect the care in a negative way. B) Older, more experienced nurses who didn't want to use the mandated technology continued to give the same care as before the study. C) Nurses who perceived that health information technology affected care had an increase in the number of care items they missed because they relied too heavily on electronic reminders. D) Nurses who perceived that health information technology affected their clinical practice reported fewer incidents of missed nursing care.

16. A nurse is admitting a client who has multiple complaints primarily centering around their abdominal region following laparoscopic removal of their gallbladder four days previously. The nurse notes an elevation in liver enzymes and development of a jaundice color on skin. They notify the health care provider about these assessments. Which helping role best defines the actions this nurse has just taken? A) teacher B) resource person C) leader D) critical thinker

16. A nurse researcher is completing a dissertation by looking at and comparing various wound care systems for individuals with diabetes who have draining wounds on their lower limbs. The researcher makes direct observations of the wounds twice weekly along with measurements and estimates of drainage. This type of research method coincides with which form of nursing knowledge development? A) postmodernism B) historicism C) logical empiricism D) intermodernism

16. While attending a high school career fair, a nurse is asked "Why does no one want to be a nurse anymore?" Which would be the best reply, based on the health care workforce 2015 report? A) "Not true. There are thousands of nurses in the U. S." B) "The shortage relates only to the fact that more people are living longer and have more chronic diseases." C) "Today's nurses don't want to work the usual 40 hour/week." D) "There is not enough people interested in the profession so we attend events like this career fair to encourage you to considered nursing."

17. A nurse working in a busy ED is assessing a female who has injuries consistent with spousal abuse. Having just returned from an in-service, the nurse is struggling to provide the knowledge and courage to take action in this situation. The nurse encourages the woman to go to a shelter for battered women and seek legal counsel. However, the woman refuses help and plans to return home with her spouse. This nurse is trying to implement which concept related to ethical decision making? A) deontology B) principalism C) utilitarianism D) ethical competence

17. Which scenario would be considered an example of research in nursing informatics, a sub-specialty area of nursing informatics? A) Nursing unit performs a review of all narcotics removed from the dispensary compared with the doses documented as being given to actual clients on the unit. B) Educational program outlining the steps required prior to administering insulin injection. C) Development of a pamphlet about the dangers of unprotected sex to provide for local high school students. D) Public health department sets up an electronic system to identify clients who received the flu vaccine in relation to those who contracted the actual flu.

18. A nurse who is a devout Roman Catholic is assigned to care for an older adult client from Brazil. The client became ill while vising family in the United States. The ED diagnosed pancreatic cancer with metastasis throughout the client's body. Upon entry into the room, the nurse notes the client's eyes are closed but is moving her lips while touching beads. What action by the nurse would be appropriate at this time? A) Withdraw from the room and give the client plenty of time to say her prayers. B) Ask the hospital chaplain (not a priest) to come handle this situation since you are too busy to stay with the client. C) Let the staff know to keep the noise low outside this client's room. D) Stay with the client, sitting close by the bed, being with the client. If comfortable, ask permission and say prayers with her

19. A school nurse seems to be overwhelmed with students coming to the office with sudden onset of headache, nausea and vomiting within an hour after lunch. As the situation increases, in the nurses mind, they take a step back to look at the situation overall from a global perspective. The nurse is seeing a correlation between lunch and the student's current symptoms. The nurse is detecting significant client pattern changes utilizing which form of "knowing?" A) personal knowing B) aesthetic knowing C) esoteric knowing D) satellite knowing

19. The findings from the Human Genome Project are having profound effects on society. Taking this to the next step, which scenario would be considered a plausible future view as it relates to advances in genetics? A) Individuals receive genetic testing at birth to determine their future lives. The state selects the profession, education, and genetic composition for all citizens. B) Persons become able to provide a bit of saliva and send it to a lab for a comprehensive report on their genome. C) Marriage is no longer needed because new human life is created using artificial insemination in women genetically designed to thrive during pregnancy. D) People undergo genetic testing at birth and for those with a genetic predisposition to cancer, screenings begin earlier in life than would be recommended for the general population.

19. The nurse manager is working on "team building" among their nursing staff. Basically, the managers want their team to communicate effectively so that all members share their concerns about any given client situation. Which technique may provide the staff the best opportunities to master essential communication skills? A) Write a memo to the entire staff and place it in the "communication" notebook on the unit. B) Ask every team member to report an incident where they felt like communication could have been more effective. C) Ask peers to give feedback to their co-workers about "good" communication they have observed and examples when they felt their co-workers could have done better. D) Borrow a clinical simulation mannequin and provide opportunities for the team to practice communication and team building skills through role play

2. A client requests pain medication as a result of incisional pain following a Cesarean birth. The client's pain level is 5 on a 10-point scale with 10 being the worst pain the client has ever had. Thirty minutes after receiving the pain medication, the client states her pain is a 2 on the 10-point scale. What is the name of this portion of the nursing process? A) diagnosis B) planning C) implementation D) evaluation

2. A nurse has noted what he or she thinks is a "better," more efficient way to perform central-line dressing changes. They are thinking about putting a scientific study together for research. Given this, which is the first step the nurse should take to begin the research process? A) collecting data about how other nurses change central-line dressings B) reviewing the literature on central line dressing changes C) defining variables that can be controlled during the dressing change D) raising questions about how to streamline central-line dressing changes

2. A nurse in an outpatient surgery center looks for ways to improve client education at discharge and explores the concepts of teaching and learning. What is the rationale for identifying nurses as "experts" in the client education process? A) Nurses help clients to teach. B) Nurses are experts in assessing clients. C) Nurses are experts on how issues affect clients so that mistakes won't occur. D) Nurses can help clients learn new action and problem-solving skills.

2. A nurse practitioner is working with a client who has multiple chronic disease processes. They ask the client, "What health goals would you like to improve to maintain or improve your overall health?" Which systems theory is the nurse utilizing that focuses on being able to help people attain, maintain, or restore health, primarily by mutual goal setting? A) Dorothea Orem's self-care deficit theory B) Betty Neuman's health care systems model C) Jean Watson's human science and human care theory D) Imogene King's systems interaction model (theory of goal attainment

2. A nurse who has worked for 15 years in the hospital has an opportunity to attend an RN-to-BSN program in her local community, and the hospital will pay for the cost of tuition if the nurse agrees to work there for 2 years following graduation. The nurse has accepted and is in the first term at the local college. If the nurse wants to work on her critical and reflective thinking skills, which activity should she/he focus on developing? A) Reading a chapter on "Care of the Cardiac Patient. B) Speaking to the nurses on the clinical unit. C) Listening to family as they share the client's story. D) Writing a paper on nursing for the palliative client.

2. A nurse who works in the hospice area receives a call regarding a client who is having trouble with pain control. The nurse discusses with the family the medication regimen that the family has been using. The nurse realizes that the family has not been medicating the client appropriately, and further discussion reveals that the family "did not want to kill the client with medication and wanted their family member to be able to interact with him." The nurse explains to the family about maintaining therapeutic blood levels and sets up a schedule for the administration of pain medication around the clock with instructions to call (the nurse) if the family needs to do so. Which term best describes the functioning of the nurse? A) accountability B) responsibility C) authority D) autonomy

2. A nursing faculty member allows students to bring handheld computers for managing daily tasks, keeping calendars, calculating medication dosages, performing other complex clinical math calculations, and consulting references such as medication information, medical terminology, disease references, and various medical calculation software programs. Which describes this device? A) electronic calendars B) electronic textbooks C) electronic documentation app D) hospital provided computer tablet

2. A political rally occurs in the evening and the nurse leaving work attends at the request of a friend. Which term best describes the science and art of political government? A) public policies B) political competence lobbyist C) political action committee D) politics

2. Before administering a heparin injection, the nurse confirms the six rights of medication administration with the client. Which is the best hallmark of quality health care that the nurse demonstrated? A) effectiveness B) client-centeredness C) efficiency D) safety

20. A nurse has developed a research project utilizing a "Sleek Sheet" system looking for ways to decrease nurses' back strain when repositioning immobile clients. This nurse is using the "Stetler Model of Evidence-Based Practice." After gathering data for 2 months, analysis of data is performed. At this phase, the manager wants to extend the pilot study to other nursing units. Which phase in the Stetler Model of Evidence-Based Practice has the research project reached? A) Phase II—Validation. B) Phase III—Comparative Evaluation C) Phase IV—Translation/application D) Phase V—Evaluation

20. A nurse in the ICU spends much of the time in front of the computer monitoring their clients. An ECG alarm goes off that looks like ventricular tachycardia. The nurse goes into the room and gives the client a precordial thump (that results in a fractured sternum). The client screams. Later on, the family is overheard discussing legal actions. Which best describes what happened in this incident that could be avoided in the future? A) Nurse should have called a "code blue" before the precordial thump. B) Nurse should have administered epinephrine 1 mg per IV prior to the thump. C) Nurse should have watched the monitor for at least 30 seconds prior to any intervention. D) Nurse should have performed an assessment of the client rather than focus solely on the machinery.

20. A nurse is listening to one of her peers talk about her beliefs related to the human race. This peer basically believes the mind, body, soul, and environment unite with souls not confined to the physical world but exist following actual physical death. The nurse recognizes that their peer is practicing the concepts from which nursing theorists? A) Jean Watson B) Rosemarie Parse C) Callista Roy D) Dorothea Orem

20. A nurse is suspicious that a co-worker may be stealing and using narcotics from their clients. This co-worker has begun calling in frequently. When they do work, they disappear for hours and then return acting "intoxicated." The best action the nurse can do prior to confronting or reporting suspicions of illegal drug use would include which intervention? A) Following the nurse and watching to see if they take narcotics frequently from the medication dispensing system. B) Ask the UAP to keep an eye out and let you know if this nurse starts acting different. C) Ask the unit secretary to print the log for controlled medication variances in the computerized dispensing system. D) Document in a written log the dates and times the suspicious behaviors occurred.

20. A nurse working at an in-patient psychiatric unit has developed a good nurse-client relationship with a client diagnosed with bipolar disease who needs their medications adjusted. They are assisting the client to formulate new goals and career plans that incorporate the client's ability to act more independently. This level of interaction would be seen in which phase of Peplau's nurse-client relationship? A) Orientation Phase B) Identification Phase C) Exploitation Phase D) Resolution Phase

20. An adjunct clinical faculty member is meeting with her fellow peers during the lunch hour. The faculty member is concerned about one of their students who is of Asian culture. The faculty expresses concern that the student's outward appearance is "cold and distant" since the student will not make eye contact with the faculty nor supervising RN. Which bit of information might help the faculty interpret this students actions? A) Give the student a written warning related to lack of interpersonal skills and ask them to explain their behavior. B) Ask other students if this student has a problems with making eye contact or if this is just normal for her. C) Suggest supervising RN staff write down their observations and share them with this student. D) Listen as other faculty share that this is the Asian way of conveying respect to those in authority.

20. Taking into account future scenarios for health care delivery, which scenario would be considered the preferred future perspective? A) As unemployment increases, citizens pressure the federal government to create a universal health care plan. B) Heroic measures once used to prolong life are limited to clients who are younger, have something to offer society, or can pay for them. C) The business-as-usual scenario, assumes continued technologic ingenuity, proliferation of new pharmaceuticals where most Americans are better off. D) The focus is on "healing the body, mind, and spirit of individuals and communities" which incorporates neighbors looking out for each other.

3. A chief nursing officer in a busy, downtown, urban hospital has a major collaborative vision regarding nursing and would like to see the vision become reality by the year 2020. The chief nursing officer creates a plan to communicate the vision and to empower individual nurses to help meet the goals and objectives that accompany it. This is an example of which key to empowering people within an organization? A) assisting in releasing motivation employees possess B) creating autonomy through boundaries C) replacing the traditional hierarchy with self-directed teams D) sharing information

3. A neighbor of a nurse comes to the clinic complaining of fever, malaise, cough, and night sweats. The neighbor is given directions to rest, drink plenty of fluids, and take medication to relieve the fever. The neighbor complains to the nurse over the backyard fence of still not feeling their best and asks whether they should go back to the clinic next week. Which description of illness best covers how this neighbor is feeling? A) subjective feeling of needing assistance B) objective observation of abnormality C) objective observation of normalcy D) subjective feeling of being unhealthy

3. A nurse gets done with work and heads to son's baseball game. While sitting in the stands, the nurse strikes up a conversation with one of the other parents on the son's team. Which networking location is best for expanding their knowledge outside of nursing? A) work (health care-related) B) school C) professional organizational meetings D) community service activities

3. A nurse in the long-term care facility has decided to return to nursing school to earn a higher degree. The nurse is full of positive thoughts and energy when contemplates all the new things to learn. According to Shane's returning-to-school syndrome, which phase is this nurse experiencing? A) conflict phase B) reintegration phase C) integration phase D) honeymoon phase

3. A senior-level Trends & Issues class has read the IOM report on The Aging American Population. Utilizing Henchley's ways to approach the future while discussing the change in society's values regarding life and the elderly, which worst-case scenario topic will likely be addressed when looking at a "possible future"? A) elderly have no value; focus more on pediatrics B) disparities in coverage for elderly due to cessation of social security C) new obligation of the elderly to die D) legalization of euthanasia and assisted suicide

7. A nurse reviews nursing models specifically related to culturally diverse groups of client populations as a journal study project. This nurse is looking for an organized, systematic approach for assessing culturally diverse clients similar to how they perform physical assessments on their clients. Which model best provides this systematic approach? A) Leininger's sunrise model and theory of culture care diversity and universality B) Purnell's model for cultural competence C) Spector's model of heritage consistency D) Giger and Davidhizar's transcultural assessment model

7. Which technique is from the era of primitive man that utilized a form of massage to heal? A) twisting B) starving C) purging D) pummeling

8. A graduate nurse (GN) has been taking note how quickly the experienced nurse is able to process data and make clinical decisions. The GN recognizes that they still go step-by-step through the nursing process but the experienced nurse bypass some steps. Which model should the GN review to get a better understanding of what they (GN) are experiencing? A) Peplau's interpersonal relations model B) Paterson and Zderad's humanistic theory C) Tanner's model of clinical judgment D) Benner's novice-to-expert model

8. A nurse manager has been asked to relate a particular theory to the care given on the unit. The nurse manager states, "I'm not sure we utilize a single model but a variety of many models." What is a potential weakness this nurse manager verbalized as to models being utilized in nursing practice? A) Agreement exists about how professional nursing is described. B) The nursing profession has a cohesive approach to use one model. C) More models are needed to determine a unified approach. D) There is a failure to use models in nursing research that then can be related to practice.

8. A nurse works only when needed on a hospital floor (prn) and is frustrated by the constant in-services they have to attend relating to equipment. The nurse has several children and lives at least 1 hour away from work. What is the challenge of technology in the workplace that this nurse is experiencing? A) balancing technology with life B) ethical decisions regarding technology C) accessing information D) struggling to stay abreast of new technologies

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