RNSG 1309 JARVIS ADAPTIVE QUIZZING CH 1,2,4,5,6,7,33,34 EXAM 1

Which action is an example of caring touch? 1. Holding the patient's hand 2. Touching the forehead to assess warm skin 3. Holding the arm to start an intravenous (IV) line 4. Holding the patient to avoid a fall

1. Holding the patient's hand Rationale Caring touch, such as holding a patient's hand, is an extremely important aspect of nursing. The nurse should participate in the conversation and help the patient to feel better. Touching the forehead to assess temperature does not indicate caring touch. Holding the arm to start an IV line does not indicate caring touch. Holding the patient to avoid a fall does not indicate caring touch. p. 87

Which theory would help the nurse in developing strategies to help a young adult with congenital heart disease deal with chronic uncertainty? 1. Grand 2. Mishel's 3. Peplau's 4. Descriptive

2. Mishel's Rationale The nurse would use Mishel's theory. Mishel's theory on uncertainty focuses on dealing with uncertainty in disease processes such as congenital heart disease. A grand theory does not guide strategies or nursing interventions but does provide a structural framework for broad, abstract ideas about nursing. Grand theories are extremely comprehensive. Peplau's theory focuses on the nurse-patient interpersonal relationship, not on chronic uncertainty. Descriptive theories are helpful in explaining patient assessments and concepts like stress and coping, but are not useful for guiding nursing actions or strategies. p.49

The nurse is teaching a patient with diabetes how to self-administer subcutaneous insulin. Which key element would the nurse keep in mind before teaching the patient about health care principIes? 1. Match the teaching with the patient's capabilities. 2. Limit the discussion to concepts and facts about health. 3. Exclude family members from the teaching plan. 4. Include facts about oral medications for diabetes.

Rationale When the nurse teaches medical procedures, the teaching should always match the patient's capabilities, and complicated procedures should not be taught to the patient. The nurse should explain concepts and facts about health. The nurse should involve both the patient and family members when teaching. The teaching plan is about insulin injections, so facts about oral diabetic drugs should not be included. pp. 3-4

Which stage of behavioral change is a patient exhibiting when he or she joins a fitness club and attends aerobics class three nights a week? 1. Precontemplation 2. Contemplation 3. Preparation 4. Action

4. Action Rationale The patient is in the action stage of behavioral change because the patient is actively engaged in strategies to change behavior. In precontemplation, the patient is not considering a change in behavior within the next 6 months. This patient is actively exercising. In contemplation, the patient is considering a change in 6 months; and in preparation, the patient makes small changes in anticipation of change that will occur in the next month. The patient is past both of these stages because he or she is actively engaged in strategies to change behavior. pp. 75-76

Which database offers free access to journal articles? 1. Agency for Healthcare Research and Quality (AHRQ) 2. Cumulative Index of Nursing and Allied Health Literature (Cl NAHL) 3. EMBASE 4. PubMed

4. PubMed Rationale PubMed offers free access to journal articles. AHRQ includes clinical guidelines and evidence summaries. CINAHL includes studies in nursing, allied health, and biomedicine. The EM BASE database includes biomedical and pharmaceutical studies. p.55

Which nursing action would be included in Swanson's theory of caring? Select all that apply. One, some, or all responses may be correct. 1. Being emotionally present to the patient 2. Forming an altruistic relationship with the patient 3. Doing for the patient as the patient would do for self if at all possible 4. Striving to understand an event as it has meaning in the life of the patient 5. Allowing for spiritual forces to provide a better understanding of nurse and patient

1. Being emotionally present to the patient 3. Doing for the patient as the patient would do for self if at all possible 4. Striving to understand an event as it has meaning in the life of the patient Rationale When practicing Swanson's theory of caring, the nurse should be emotionally present to the patient and provide the same care the nurse would want. This approach will help the nurse anticipate the patient's needs, protect and comfort the patient, and perform nursing care skillfully. It will also help the nurse to share feelings without burdening the patient. The nurse should strive to understand an event as it has meaning in the life of the patient. This helps the nurse to avoid assumptions and assess thoroughly by seeking clues from the patient. Forming an altruistic value system and allowing for spiritual forces are components of Watson's 10 carative factors. Test-Taking Tip: Look for answers that focus on the patient or are directed toward feelings. pp.84-85

Which physical sign often indicates the possibility of sexual abuse in children? 1. Chronic pain 2. Excessive masturbating 3. Vomiting or abdominal tenderness 4. Trauma to the labia, vagina, cervix, or anus

1. Chronic pain Rationale Children who have been victims of sexual abuse often experience chronic pain. Excessive masturbating is a behavioral sign that the child is a victim of sexual abuse, not a physical sign. Vomiting or abdominal tenderness and trauma to the labia, vagina, cervix, or anus are physical signs more common in adults who have been victims of sexual abuse. p. 709

Which element does the C stand for in a PICOT question? 1. Comparison of interest 2. Client who is admitted 3. Care provided 4. Current diagnosis

1. Comparison of interest Rationale The C stands for comparison of interest. There are five elements of a PICOT question. P stands for patient identified by age, gender, ethnicity, and disease or health problem. / stands for intervention of interest. C stands for comparison of interest. 0 stands for outcomes, and T stands for time. C does not stand for client, care, or current diagnosis. p. 54

As a science, which component does nursing rely on? 1. Current research 2. Experience of the nurse 3. Unique caring relationships 4. Clinical knowledge

1. Current research Rationale As a science, the field of nursing relies on knowledge gained through current research. Nursing is both a science and an art. The experience of the nurse, the unique caring relationships, and clinical knowledge are components of the art of nursing, not the science of nursing. p.43

Which health model is described when the nurse routinely asks patients if they take any vitamins or herbal medications, encourages family members to reminisce, and frequently suggests the use of therapeutic touch? 1. Holistic 2. Health belief 3. Transtheoretical 4. Health promotion

1. Holistic Rationale The nurse is using a holistic health model of care that considers the relationship among body, mind, and spirit. Holistic measures include herbs, reminiscence, and therapeutic touch. The health belief model addresses the relationship between a person's beliefs and behaviors; this approach was not used in the question. The transtheoretical theory assesses an individual's readiness to change, which was not performed in this scenario. While the nurse is promoting health, the nurse in this situation did not use the health promotion model in which the person commits to or changes a behavior. p. 70

Which nursing theorist used anthropology to form a theory of universality? 1. Madeleine Leininger 2. Callista Roy 3. Imogene King 4. Dorothea Orem

1. Madeleine Leininger Rationale Leininger used her background in anthropology to form her theory of cultural care diversity and universality. Roy identified types of demands placed on the patient, assessed adaptation to demands, and helped the patient with adaptation; she did not focus on anthropology and universality. King used goal attainment to view a patient as a unique personal system that is constantly interacting/transacting with other systems; she did not use anthropology or universality. Orem promoted patient care and helped the patient fully attain selfcare; she did not use anthropology or universality. pp. 46-47

Which theory explains a patient newly diagnosed with diabetes who becomes stressed and eats more carbohydrates? 1. Neuman's 2. Orem's 3. Peplau's 4. Leininger's

1. Neuman's Rationale The theory is Neu man's. This patient is newly diagnosed with diabetes and is under stress. The patient responds to stress by eating too many carbohydrates. This process is explained by Neuman's theory, which focuses on stress and the reaction of patients to that stress. Unlike Neuman Systems Model, Orem's theory, Peplau's theory, and Leininger's theory do not specifically explain the relationship between the stressor and the stress-related behavior. Orem's theory focuses on the self-care needs of the patient. According to Orem's theory, the patient should be able to self-manage the diabetes. Peplau's theory focuses on the nurse-patient interpersonal relationship. Leininger's theory focuses on providing culturally competent care to all types of patients. p.48

The nurse educator is delivering a lecture on nursing as a profession to a group of nursing students who have recently joined the baccalaureate nursing degree course. The nurse educator is discussing nursing career options with the students. One of the students asks about the possible nursing careers that require a master's degree in nursing. Which career option should the nurse suggest? Select all that apply. One, some, or all responses may be correct . 1. Nurse educator 2. Registered nurse 3. Nursing researcher 4. Certified nurse assistant 5. Advanced practice registered nurse

1. Nurse educator 3. Nursing researcher 5. Advanced practice registered nurse Rationale A master's degree is required for nursing careers as a nurse educator, nursing researcher, or advanced practice registered nurse. The nurse with a baccalaureate nursing degree can pursue a career as a registered nurse after passing the nursing license exam. The certified nurse assistant must take a nurse assistant training program and pass a license exam.

Which lifestyle factor increases the risk of developing cardiovascular disease? Select all that apply. One, some, or all responses may be correct . 1. Unhealthy diet 2. Obesity 3. Excessive sun exposure 4. Texting while driving 5. Lack of immunizations

1. Unhealthy diet 2. Obesity Rationale An unhealthy diet and obesity could increase the risk of cardiovascular disease. Excessive sun exposure can cause skin cancer, not cardiovascular disease. Texting while driving can lead to unintentional injuries and death but not cardiovascular disease. A lack of immunizations may leave one susceptible to diseases such as influenza and hepatitis, not cardiovascular disease. p. 75

A patient who is quadriplegic complains of being cold and asks for an extra blanket. The nurse covers the patient and draws the room's curtains. Which process did the nurse follow? 1. Knowing 2. Doing for 3. Being with 4. Maintaining belief

2. Doing for Rationale Doing for is the process in which the nurse carries out tasks for patients as they would do for themselves if possible. The quadriplegic patient is unable to cover himself; hence, the nurse does the task. Knowing is getting to know the patient. Being with refers to being present emotionally for the patient. Maintaining belief is instilling hope and faith in the patient. pp. 84-85

Which type of reimbursement system categorizes hospitalized Medicare patients into diagnosis-related groups? 1. Fee-for-service 2. Inpatient prospective payment 3. Purposeful rounding 4. Evidence-based practice

2. Inpatient prospective payment Rationale The inpatient prospective payment system categorizes hospitalized Medicare patients into diagnosis-related groups. Fee-for-service pays for each service performed; it does not place hospitalized Medicare patients into categorized groups. Purposeful rounding is a technique nurses use for hand-off reporting and to improve the patient experience; it is not a type of reimbursement system. Evidence-based practice is a technique to improve quality in patient care that may affect funding, but it is not a reimbursement system. p.23

Which component is included in the PLISSIT model of assessment? Select all that apply.One, some, or all responses may be correct. 1. Palliation 2. Permission 3. Limited information 4. Specific suggestions 5. Intravenous therapy

2. Permission 3. Limited information 4. Specific suggestions Rationale The PLISSIT model is used for sexual assessment of the patient. P stands for permission from the patient to discuss sexual history. LI stands for limited information regarding sexual health problems. SS stands for specific suggestions made when the nurse is clear about the problem. IT stands for intensive therapy by a professional. Palliation and intravenous therapy are not part of the PLISSIT model. p. 714

In planning nursing care for an 85-year-old man, which basic need is the most important to be met? 1. Assurance of sexual intimacy 2. Preservation of self-esteem 3. Expanded socialization 4. Increase in monthly income

2. Preservation of self-esteem Rationale Self-esteem is essential for physical and psychological health across the life span. The other aspects are also important but not as basic or vital as preserving the patient's self-esteem. p.696

Which level of need according to Maslow is being addressed when the nurse discusses with the elderly couple about removing the throw rugs and low footstool and improving the lighting in the home? 1. Physiological 2. Safety and security 3. Love and belonging 4. Self-actualization

2. Safety and security Rationale The nurse is addressing the need for safety and security. Throw rugs, low lighting, and low footstool are hazards that can cause falls in the elderly. Preventing falls is a priority safety issue for older adults. Physiological needs refer to the need for food, fluid, elimination, and so forth, not removing throw rugs. Love and belonging refers to the need for relationships, not for improving the lighting in the home. Selfactualization is the need to feel fulfilled in life, not about removing a low footstool. pp. 69-71

While caring for a pregnant patient who is in the first trimester of pregnancy, the nurse discusses sexual activity during pregnancy with the patient. During which trimester are pregnant women most likely to experience increased libido? 1. First trimester 2. Second trimester 3. Third trimester 4. Libido is unaffected during pregnancy

2. Second trimester Rationale During the second trimester of pregnancy, patients are most likely to experience an increased libido because of an increased blood supply to the pelvic area to nourish the placenta. In the first trimester, there is usually a decrease in libido because of nausea and vomiting. In the third trimester a comfortable position for sex is difficult. Therefore sexual desire is usually unequal during all trimesters of pregnancy. p. 710

Which holistic intervention would the nurse suggest to the patient with a headache to attain a good outcome? Select all that apply. One, some, or all responses may be correct. 1. Drug therapy 2.Music therapy 3. Therapeutic touch 4. Relaxation therapy 5. Radiation therapy

2.Music therapy 3. Therapeutic touch 4. Relaxation therapy Rationale Holistic interventions include music therapy, therapeutic touch, and relaxation therapy. Music therapy helps provide a soothing environment. Therapeutic touch helps in relieving anxiety. Relaxation therapy helps relax the body and mind. Drug therapy and radiation therapy are not holistic interventions; they are medical interventions.

The nurse at a community health center is teaching a group of menopausal women about normal changes in the female sexual response that occur with aging. Which statement by one of the women indicates that the information is understood? 1. "It's normal for me to take longer to reach an orgasm." 2. "I might experience chest pain or shortness of breath during intercourse." 3. "It's normal for me to lose interest in sexual relationships." 4. "I won't need to be concerned about contraception or sexually transmitted infections because of my age.

1. "It's normal for me to take longer to reach an orgasm." Rationale Normal changes in the female sexual response include a decrease in sex hormone levels, decrease in vaginal lubrication, longer time to reach orgasm, and longer refractory times. Many factors such as chronic illness, medications, stress, or loss of partner can influence the older adult's sexual activity. Older adults may not be comfortable using barrier methods such as condoms and therefore are at increased risk of sexually transmitted infections. p. 708

Which statement made by the nurse demonstrates patient-centered care while focusing on alleviating the patient's fear and anxiety? 1. "Let's talk about the concerns you have about going home." 2. "I'll get the medication prescriptions for you before discharge." 3. "I'll be back in 30 minutes to help you get ready." 4. "Let me make a referral to the mental health counselor for you."

1. "Let's talk about the concerns you have about going home." Rationale The nurse would say, "Let's talk about the concerns you have about going home." Interventions that focus on the alleviation of fear and anxiety is one example of patient-centered care. The statement about getting the medication prescriptions does nothing to alleviate the patient's fears and anxiety and does not demonstrate patient-centered care. The statement about coming back in 30 minutes belittles the patient's feelings and would not demonstrate patient-centered care. Although making a referral can be patient-centered, in this case, the nurse would manage this type of problem, not pass the responsibility onto another team member. Also, experiencing fear and anxiety does not mean the patient needs mental health counseling. Test-Taking Tip: Look for answers that focus on the patient or are directed toward feelings. p. 26

Which nonverbal or behavioral sign often indicates the possibility of sexual abuse in an aduIt? 1. Depression 2. Physical aggression 3. Excessive masturbating 4. Running away from home

1. Depression Rationale Adults who have been victims of sexual abuse often exhibit depression. Physical aggression, excessive masturbating, and running away from home are behavioral signs of possible sexual abuse more common among child victims. Test-Taking Tip: Be alert for details about what you are being asked to do. In this question type, you are asked to select all options that apply to a given situation or patient. All options likely relate to the situation, but only some of the options may relate directly to the situation. p. 709

The nurse educator is delivering a lecture on nursing as a profession to a group of nursing students who have recently joined the baccalaureate nursing degree course. Which statement is true? Select all that apply. One, some, or all responses may be correct. 1. "The nurse is responsible to provide specific health care to patients." 2. "The nurse is responsible and accountable to the patients." 3. "Nurses have to follow a specific code of ethics while delivering care." 4. "Care delivery by nurses is only based on prescriptions given by the health care provider." 5. "Nursing education involves learning the caregiving techniques without any theoretical body of knowledge."

1. "The nurse is responsible to provide specific health care to patients." 2. "The nurse is responsible and accountable to the patients." 3. "Nurses have to follow a specific code of ethics while delivering care." Rationale Nursing is a profession that involves administering quality patient-centered care in a safe and knowledgeable manner. The nurse provides a specific kind of health care to patients. The nurse is responsible for the care delivered to the patient and is accountable to the patients. Ethical health care delivery is a very important characteristic of the nursing profession. Nurses have the right to participate in the decision-making process for the patient, so they need not always rely on the prescription given by the health care provider for delivering care. Nursing education includes a theoretical body of knowledge leading to defined skills, abilities, and norms. Test-Taking Tip: Sometimes eliminating the incorrect responses is easier than confirming the correct ones on first reading. Notice that one of the choices contains an absolute word, only. Words such as only, always, never, and all in the choices are frequently evidence of a wrong response. p. 3

Which activity represents secondary prevention? 1. A home health care nurse visits a patient's home to change a wound dressing. 2. A college-bound healthy student obtains the meningococcal vaccine before living in a dormitory. 3. The school health nurse provides a program to the first-year students on healthy eating. 4. A patient attends cardiac rehabilitation sessions weekly.

1. A home health care nurse visits a patient's home to change a wound dressing. Rationale The home health nurse changing the wound dressing is an activity that is focused on preventing complications ( secondary prevention). Secondary prevention focuses on individuals who are experiencing health problems or illnesses and who are at risk of developing complications or worsening conditions. The meningococcal vaccine and educational programs for healthy eating are examples of primary preventive measures, not secondary. Attending cardiac rehabilitation sessions is tertiary prevention, not secondary. p. 74

Which section of an evidence-based article includes a brief summary about the major themes or findings and the implications for nursing practice? 1. Abstract 2. Introduction 3. Literature review 4. Manuscript narrative

1. Abstract Rationale An abstract is a brief summary that quickly tells whether the study is research-based or clinically based, and it includes the major themes or findings and the implications for nursing practice. The introduction contains more information about the purpose of the article but is not a brief summary. The literature review offers background about the topic that led the author to conduct the study or report, but is not a brief summary about the major themes. The manuscript narrative is the middle section, which differs according to the type of evidence-based article it is (i.e., a clinical article or a research article); it is not a brief summary about the research. p. 57

Nurses are responsible for the quality of care provided to patients. Which will help nurses practice safe nursing? Select all that apply. One, some, or all responses may be correct . 1. Acquiring knowledge 2. Minimizing documentation 3. Improving competencies 4. Acquiring technical skills 5. Exhibiting complete dependence

1. Acquiring knowledge 3. Improving competencies 4. Acquiring technical skills Rationale The nursing profession is accountable for the type and quality of care delivered to patients, so nurses should prepare by acquiring and updating knowledge, improving competencies, and acquiring technical skills. Minimizing documentation may generate more complications, such as legal issues. Nurses are given autonomy for various nursing practices, so they should be dependent only in aspects of care beyond their scope of practice. p.3

Which organization established the Magnet Recognition Program to recognize health care organizations that achieve excellence in nursing practice? 1. American Nurses Credentialing Center (ANCC) 2. Centers for Medicare and Medicaid Services (CMS) 3. Quality and Safety Education for Nurses (QSEN) 4. Hospital Consumer of Assessment of Healthcare Providers and Systems (HCAH PS)

1. American Nurses Credentialing Center (ANCC) Rationale The ANCC established the Magnet Recognition Program to recognize health care organizations that achieve excellence in nursing practice. CMS regulates Medicare and Medicaid services and payments for those services; it is not involved in the Magnet Recognition Program. QSEN focuses on quality and safety competencies for nurses so that they have the knowledge, skills, and attitudes to meet the challenges in today's health care settings; it is not involved in the Magnet Recognition program. HCAHPS measures patients' perceptions of their hospital experience; it is not the organization that established the Magnet Recognition Program.

In which order would the nurse proceed to reach a clinical decision through evidence-based practice (EB P)? 1. Ask a clinical question . 2. Collect evidence from databases . 3. Critically appraise the evidence . 4. Evaluate the practice decision.

1. Ask a clinical question . 2. Collect evidence from databases . 3. Critically appraise the evidence . 4. Evaluate the practice decision. Rationale The sequence is as follows: (1) ask a clinical question, (2) collect evidence from databases, (3) critically appraise the evidence, and (4) evaluate the practice decision. EBP is a step-by-step approach that helps the nurse make logical decisions based on the available evidence. An EBP promotes achievement and incorporation of the best practices into nursing. p.54

Which role and responsibility should every nurse be expected to fill? Select all that apply. One, some, or all responses may be correct . 1. Caregiver 2. Autonomy and accountability 3. Patient advocate 4. Health promotion 5. Lobbyist

1. Caregiver 2. Autonomy and accountability 3. Patient advocate 4. Health promotion Rationale Caregiver and patient advocate are two roles of the professional nurse, and autonomy, accountability, and health promotion are responsibilities of the professional nurse. Each role and responsibility is used in direct care or is part of the professionalism that guides nursing practice. Some nurses are lobbyists, but being a lobbyist is not expected of all professional nurses. Test-Taking Tip: This question asks for both roles AND responsibilities. If you only think of one of them, you would miss some correct answers. Be sure to (1) read the question carefully, noticing any key terms; (2) read all choices carefully; (3) make your decision; and then (4) reread the question to confirm your choices. pp.3-4

The nurse gently touches the shoulder of a patient lying with his eyes closed. When the patient opens his eyes, the nurse smiles and asks how he is feeling. Which kind of touch is this? 1. Caring 2. Protective 3. Task-oriented 4. Healing touch

1. Caring Rationale In this scenario, the nurse practices caring touch. Caring touch is a form of nonverbal communication. It helps improve a patient's comfort and security, enhances self-esteem, increases confidence in the caregivers, and improves mental well-being. Protective touch is used to protect the patient from any harm. Task-oriented touch occurs when the nurse is performing nursing duties. Healing touch is a type of energy therapy used for healing certain diseases. p. 87

Which phrase is closely aligned with Leininger's theory? 1. Caring for patients from unique cultures 2. Understanding the humanistic aspects of life 3. Understanding variables affecting a patient's response to a stressor 4. Caring for patients who cannot adapt to internal and external environmental demands

1. Caring for patients from unique cultures Rationale Caring for patients from unique cultures is closely aligned with Leininger's theory. Leininger's theory of transcultural nursing focuses on the patient's culture and the effect of cultural heritage on health care needs and interventions. Maslow (not Leininger) focused on the humanistic aspects of life. Neuman, not Leininger, focused on understanding variables affecting a patient's response to a stressor. Roy focused on adaptation and Neuman focused on the internal and external environment; however, Leininger focused on culture, not adaptation and internal and external environmental demands. pp. 46-47

The hospice nurse sits at the bedside of a male patient in the final stages of cancer. Whenever she enters the room or approaches the patient to give care, she touches his shoulder and tells him that she is present. Which type of touch is this? 1. Caring touch 2. Protective touch 3. Task-oriented touch 4. Interpersonal touch

1. Caring touch Rationale Caring touch is a form of nonverbal communication used to connect with the patient physically and emotionally to enhance a patient's comfort and security, self-esteem, confidence in the caregivers, and mental well-being. Protective touch protects the nurse and/or the patient to prevent physical or emotional harm. Nurses use task-oriented touch when performing a task or procedure. Touch can enhance interpersonal relationships, but there is no category of touch called interpersonal touch. p. 87

Which factor can affect body image in a 15-year-old female patient? Select all that apply. One, some, or all responses may be correct . 1. Cognitive and physical growth 2. Cultural and societal attitudes 3. Role performance 4. Fulfillment of role expectations 5. Achievement of identit

1. Cognitive and physical growth 2. Cultural and societal attitudes Rationale An altered body image can lead to a negative self-concept. Cognitive and physical growth during adolescence and aging can affect the body image. The hormonal changes during adolescence and puberty affect the way one perceives oneself. The cultural and societal attitudes and values may also affect body image. Some cultures consider aging to be a normal growth process, whereas other cultures are more youth oriented. Role performance and fulfillment of role expectations do not affect body image but have an effect on self-concept. Achievement of identity does not affect body image. p.694

A patient in labor has been brought to the certified nurse midwife (CNM). Which intervention would the CNM undertake in this situation? Select all that apply. One, some, or all responses may be correct. 1. Conduct the labor. 2. Provide care for the newborn. 3. Administer uterine relaxants and refer the patient to a tertiary center. 4. Perform C-section surgery. 5. Provide a physical presence until the patient has been transferred to tertiary care.

1. Conduct the labor. 2. Provide care for the newborn. Rationale CNMs are nurses trained in providing care in pregnancy, conducting labor, and providing care to the newborn. The CNM does not have the authority to administer uterine relaxants. Performing a C-section exceeds the scope of practice for a CNM. A registered nurse, not a CNM, would provide a physical presence until the patient has been transferred to tertiary care. p.5

Which primary prevention intervention would the nurse suggest to a patient who is a smoker, allergic to milk and seafood, and supposed to walk to decrease effects of peripheral vascular disease? Select all that apply. One, some, or all responses may be correct. 1. Counseling for smoking cessation 2. Taking narcotic drugs for pain relief 3. Encouraging the patient to exercise regularly 4. Advising the patient to avoid milk products 5. Instructing about a high-fiber diet to prevent colon cancer

1. Counseling for smoking cessation 4. Advising the patient to avoid milk products 5. Instructing about a high-fiber diet to prevent colon cancer Rationale Primary prevention interventions include counseling for smoking cessation, advising the patient to avoid milk products, and instructing about a high-fiber diet to prevent colon cancer. In primary prevention, measures are taken before the occurrence of disease or dysfunction. In this case, activities for primary prevention include counseling for smoking cessation, advising the patient to avoid milk products, and instructing about a high fiber diet. Taking narcotics for pain relief is a secondary (not primary) prevention, which is done after diagnosis. Encouraging the patient to exercise is a tertiary (not primary) prevention against effects of peripheral vascular disease

Which explanation describes input as it relates to the nursing process as a system? 1. Data entering the system 2. The end product 3. Data related to system functioning 4. The product and information obtained from the system

1. Data entering the system Rationale Input is data entering the system. Input for the nursing process is the data or information that comes from a patient's assessment (i.e., how the patient interacts with the environment and the patient's physiological function). The end product is output, not input. Data related to system functioning is feedback, not input. The product and information obtained from the system is content, not input. pp. 45-46

A 40-year-old man is diagnosed with colon cancer. While interacting with the patient, the nurse learns that he has a twin brother. Which nursing action is appropriate for the patient's brother? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected 1. Educate the patient's brother on reasons to get a colonoscopy. 2. Conclude that the patient's brother does not require intervention . 3. Encourage the patient's brother to get an annual stool test. 4. Avoid doing anything because that is a responsibility of the health care provider. 5. Avoid doing anything because the nurse is responsible for the patient and not for the brother.

1. Educate the patient's brother on reasons to get a colonoscopy. 3. Encourage the patient's brother to get an annual stool test. Rationale Because the patient was diagnosed with colon cancer before the age of 50, it is likely that the patient's siblings have a higher risk of developing colon cancer. Therefore, the nurse should educate the twin brother to also get a colonoscopy or other screening test, as recommended by current guidelines for higher-risk patients. If the patient had developed colon cancer after age 50, screening for the brother would be less urgent. However, early onset in the patient means the risk of colon cancer is higher for the brother. The nurse is as responsible as the health care provider for screening for family members who are at risk of colon cancer. The nurse should provide care to both the patient and his brother.

Decreased levels of which hormone may result in painful sexual intercourse? 1. Estrogen 2. Testosterone 3. Growth hormone 4. Follicle-stimulating hormone (FSH)

1. Estrogen Rationale Decreased estrogen levels result in decreased vaginal lubrication and vaginal tissue thinning. These changes can result in painful sexual intercourse. Testosterone, growth hormone, and FSH do not affect the vaginal tissues and do not cause painful intercourse when their levels decrease. Testosterone is responsible for sexual growth and development in men. Growth hormone is responsible for overall growth and development in an individual. FSH promotes sexual growth in women. p. 706

Which type of research study represents the nurse designing and conducting an informational health campaign and then measuring the outcomes of the campaign? 1. Evaluation 2. Descriptive 3. Exploratory 4. Experimental

1. Evaluation Rationale This is a type of evaluation research. Evaluation research tests how well a program, practice, or policy is working. The nurse is conducting an informational health campaign and measuring the outcomes of the campaign, which indicates that the nurse is engaged in evaluation. Descriptive research measures the characteristics of either people, situations, or groups, and the frequency with which certain events or characteristics occur, not how well the program is working. Exploratory research is designed to develop or refine the dimensions of phenomena or to develop or refine a hypothesis about the relationships among phenomena, not how well a project is working. In experimental research, the investigator controls the study variables and randomly assigns participants to different conditions to test each variable; the nurse did not split the people in the health campaign but rather wanted to see how well the program worked. pp. 61-62

Which nursing intervention is considered primary prevention for school children younger than 10 years old? 1. Explaining the importance of a nutritious diet 2. Supplying a nutritious diet to children with malnutrition 3. Teaching disabled children to use their capacities to the fullest 4. Conducting health examinations to identify children with malnutrition

1. Explaining the importance of a nutritious diet Rationale Explaining the importance of a nutritious diet is primary prevention. Primary prevention interventions are done before the development of a disease or disorder. Interventions can take the form of health education or nursing interventions such as immunizations. Primary prevention also includes a nutritious diet to maintain health and prevent illness. Supplying a nutritious diet to children with malnutrition is secondary prevention, not primary, because a disease (malnutrition) is already present. Teaching disabled children to use their capacities to the fullest would be considered tertiary (not primary) prevention, because disability has already occurred. Conducting health examinations to identify children with malnutrition and supplying nutritious diets to children with malnutrition would be considered secondary (not primary) prevention, because thesemeasures are directed toward managing a disease that has already manifested. pp. 73-74

Which example is classified as an external variable? Select all that apply. One, some, or all responses may be correct. 1. Family practices 2. Socioeconomic factors 3. Developmental stages 4. Cultural beliefs 5. Spiritual factors

1. Family practices 2. Socioeconomic factors 4. Cultural beliefs

The nurse is educating a couple about sexually transmitted infections. Which sexual infection cannot be cured? Select all that apply. One, some, or all responses may be correct. 1. Herpes 2. Syphilis 3. Chlamydia 4. Gonorrhea 5. Human papillomavirus infection

1. Herpes 5. Human papillomavirus infection Rationale Sexually transmitted infections that cannot be cured include herpes and human papillomavirus. Syphilis, chlamydia, and gonorrhea are sexually transmitted infections caused by bacteria; they can be cured by antibiotics. Syphilis is caused by the bacteria Treponema pallidum. Chlamydia is caused by the bacteria Chlamydia trachomatis. Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. p. 711

The nurse obtains a patient's complete history and assesses him thoroughly. Which process of Swanson's theory is the nurse using? 1. Enabling 2. Knowing 3. Doing for 4. Being with

2. Knowing Rationale Knowing the patient means understanding the patient and the patient's background. Hence, obtaining the health history and assessment relates to knowing the patient. Enabling refers to helping the patient through life transitions. Doing for is performing tasks for the patient. Being with is giving emotional support to the patient. pp.84-85

Many women made significant contributions to the nursing profession. Arrange their names in the chronological order of their contributions . 1. Florence Nightingale founded St. Thomas Hospital in London . 2. Lillian Wald opened the Henry Street Settlement in New York . 3. Clara Barton founded the American Red Cross . 4. Isabel Hampton Robb helped establish Nurses' Associated Alumnae of the United States and Canada.

1. Florence Nightingale founded St. Thomas Hospital in London. 3. Clara Barton founded the American Red Cross . 2. Lillian Wald opened the Henry Street Settlement in New York . 4. Isabel Hampton Robb helped establish Nurses' Associated Alumnae of the United States and Canada. Rationale Florence Nightingale is recognized as the primary founder of modern nursing. In 1860, Nightingale laid the foundation of professional nursing with the establishment of her nursing school at St. Thomas Hospital in London. It was the first secular nursing school in the world. Nightingale schools served as the basis for schools of nursing in the United States. Clara Barton founded the American Red Cross. Under her supervision, the American Red Cross provided health care services to soldiers during the Civil War (1860-65). Lillian Wald and Mary Brewster contributed to the health needs of people living in slums in New York by opening the Henry Street Settlement in 1893. In 1896, the Nurses' Associated Alumnae of the United States and Canada was founded with the help of Isabel Hampton Robb. Test-Taking Tip: For this type of question, if you are unsure of the order, try what you first think is the correct order. If it does not seem correct, rearrange it and check if that seems better. However, be sure to keep track of the first sequence because usually your first impression is correct. p. 6

When developing an appropriate outcome for a 15-year-old girl, which primary developmental task of adolescence should the nurse consider? 1. Forming a sense of identity 2. Creating intimate relationships 3. Separating from parents and living independently 4. Achieving positive self-esteem through experimentation

1. Forming a sense of identity Rationale Understanding developmental tasks across the life span is essential in designing nursing care. Adolescents are focused on establishing their identities outside of their families and should be supported in meeting this developmental task. The remaining options are not developmental tasks of adolescents. STUDY TIP: Think of individuals you know for each developmental stage. Ask yourself if they have accomplished the developmental task for that stage. Considering the stages and tasks in relation to the individuals you know helps anchor the stages and tasks in your mind. p.692

Which role is true about the general practice of advanced practice registered nurses? 1. Function independently 2. Function as unit directors 3. Work in acute care settings 4. Work in university settings

1. Function independently Rationale An advanced practice registered nurse (APRN) functions independently as a clinician, educator, case manager, consultant, and researcher within his or her area of practice to plan or improve the quality of nursing care for the patient and family. Registered nurses without an APRN license can function as unit directors and work in acute care settings and university settings, but they cannot practice independent of a primary care provider. Test-Taking Tip: After you have eliminated one or more choices, you may discover that two of the options are very similar. This can be very helpful because it may mean that one of these look-alike answers is the best choice and the other is a very good distractor. Test both of these options against the question. The option that best answers the question is the one you should choose. Here, too, pause for a few seconds, give your brain time to reflect, and recall the correct answer. p. 4

Which type of nursing theory answers the question, "What is nursing?" 1. Grand theories 2. Practice theories 3. Descriptive theories 4. Prescriptive theories

1. Grand theories Rationale Grand theories are broad theories that aim to answer the question, 11What is nursing? 11 Practice theories are situation-specific and guide nursing care, but they do not answer the broad question of what nursing is. Descriptive theories describe phenomena. Prescriptive theories do not answer the question, "What is nursing? 11 but instead guide practice change and address nursing interventions. p.44

Which statement about human immunodeficiency virus (HIV) is appropriate? Select all that apply.One, some, or all responses may be correct . 1. HIV is a bloodborne pathogen. 2. HIV spreads through oral-genital sex. 3. HIV is not found in bodily fluids. 4. HIV causes ectopic pregnancy. 5. The risk of contracting HIV can be reduced by the use of condoms.

1. HIV is a bloodborne pathogen. 2. HIV spreads through oral-genital sex. 5. The risk of contracting HIV can be reduced by the use of condoms. Rationale HIV is primarily a bloodborne pathogen. It spreads through vaginal and anal intercourse and through oralgenital sex. The use of condoms reduces the incidence of HIV infection, whereas unprotected sex increases the risk of HIV transmission. Bodily fluids contain HIV, and any exchange of body fluids can result in HIV transmission. Unlike chlamydia, HIV infection is not known to cause ectopic pregnancy. pp. 711, 719

Which parameter would the nurse focus on when using the Transtheoretical Model of Change to help treat a patient? 1. Health behaviors 2. Disease condition 3. Medication strengths 4. Pathology of the disease

1. Health behaviors Rationale The focus is on health behaviors. The nurse tries to change the negative health behaviors to positive ones using the Transtheoretical Model of Change. The nurse applies the model by focusing on the patient's health behaviors, strengths, and capabilities. Understanding the disease condition is not part of the Transtheoretical Model of Change. Strength of the medicine and pathology of the disease are also not part of the Transtheoretical Model of Change, which focuses on an individual's health-damaging or health-promoting behaviors. pp. 75-76

Which activity is included in primary prevention? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected 1. Health education programs 2. Protection from occupational hazards 3. Physical fitness activities 4. Screening tests 5. Drug therapy

1. Health education programs 2. Protection from occupational hazards 3. Physical fitness activities Rationale Health education programs, protection from occupational hazards, and physical fitness activities aim at preventing illness and promoting health; thus these are primary prevention. Screening tests and drug therapy are secondary, not primary prevention, and are performed when disease is already present. pp. 73-74

The nurse is teaching a 10-year-old patient about personal hygiene. Which observation would indicate that the child has not reached an age-appropriate developmental stage? 1. His inability to understand and master brushing technique 2. The inability to accept age-related body changes 3. An inability to assess life goals 4. His inability to decide on a future career

1. His inability to understand and master brushing technique Rationale As per Erikson's developmental stages, a 10-year-old child should be able to understand and reinforce information provided and master new skills, such as the basic hygiene tasks the nurse discusses. A person starts to accept age-related body changes and begins to establish goals in adolescence but may not do so as young as 10 years of age. The assessment of life goals is not expected until adulthood. Setting goals for the future, such as deciding which school to attend or what career to pursue, is a developmental behavior for children 12 to 18 years old. STUDY TIP: This question is a good example of how your knowledge builds upon what you have already learned. Knowing the tasks for Erikson's developmental stages helps you understand what would build selfconcept for those stages and what signs would indicate not reaching age-appropriate development as well. As you study for the examination, remember to review material learned earlier; it may come in handy!

In assessing a patient for self-concept and self-esteem, on which component would the nurse focus? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected 1. Identity 2. Body image 3. Role performance 4. Physical condition 5. Medical condition

1. Identity 2. Body image 3. Role performance Rationale When assessing a patient's self-esteem, the nurse should focus on assessing individual components such as identity, body image, and role performance. This helps the nurse determine which factor is affecting the selfconcept. The physical and medical conditions are not components of self-concept. p.694

A patient with heart disease asks the nurse if medications for heart disease can cause erectile dysfunction. Which drugs can cause erectile dysfunction? Select all that apply.One, some, or all responses may be correct. Some correct answers were not selected 1. Illicit drugs 2. Ant id i a betics 3. Diuretic agents 4. Antiplatelet drugs 5. Anti hypertensives

1. Illicit drugs 3. Diuretic agents 5. Anti hypertensives Rationale Drugs that have been associated with erectile dysfunction include illicit drugs, diuretic agents, and antihypertensive medications. Antidiabetic and anti platelet drugs are not associated with erectile dysfunction but are associated with minor side effects such as nausea, diarrhea, and itchy skin. p. 712

Based on knowledge of the developmental tasks of Erikson's industry versus inferiority stage, the nurse emphasizes proper technique for use of an inhaler with a 10-year-old boy. Why does the nurse do this? 1. Increase the patient's self-esteem with the mastery of a new skill. 2. Help him accept changes in his appearance and physical endurance. 3. Allow him to experience success in role transitions and increased responsibilities. 4. Assist him in appreciating his body appearance and function.

1. Increase the patient's self-esteem with the mastery of a new skill. Rationale The developmental stage of industry versus inferiority (ages 8 to 12) is focused on incorporating feedback from peers and teachers, increasing self-esteem with the mastery of new skills, and promoting awareness of strengths and limitations. Accepting changes in his appearance occurs in the identity versus role confusion stage. Allowing him to experience success in role transitions occurs in the intimacy versus isolation stage. Assisting him in appreciating his body appearance and function occurs in the autonomy versus shame and doubt stage. STUDY TIP: Role play with your study group to memorize Erikson's stages. Pick an age-group, but don't tell the group what it is. Then make statements consistent with the stage and have your study group guess the stage. For instance, if you were pretending to be an 8-year-old, you could say, "I had a great time playing with my friends today, and the teacher gave me a gold star when I finished my work!" p.692

As a system, which component will the nursing process include? Select all that apply. One, some, or all responses may be correct. 1. Input 2. Output 3. Feedback 4. Delivery 5. Rejection

1. Input 2. Output 3. Feedback Rationale The components include input, output, and feedback. The nursing process as a system consists of input, output, feedback, and content. Input is the information that is obtained from patient assessment. Output is the result of the nursing care, such as whether the patient's condition has improved, is stable, or has worsened. Feedback is the response of the patient to nursing interventions and response of family members and health care providers to the patient's health condition. Content is the information and production obtained from the system, such as the nursing process. Delivery and rejection are not parts of the nursing process when viewed as a system. Although the nursing process helps deliver care, delivery is not a component of a system and neither is rejection.

Which explanation defines middle-range theory? 1. It addresses specific phenomena and reflects practice. 2. It describes a phenomenon and is the first level in theory development. 3. It provides a structural framework for broad concepts about nursing. 4. It is linked to outcomes (consequences of specific nursing interventions).

1. It addresses specific phenomena and reflects practice. Rationale Middle-range theory addresses specific phenomena and reflects practice. A middle-range theory focuses on a specific field or phenomenon rather than the broad scope of nursing. A descriptive theory (not middle-range theory) is the first level of theory development and describes the phenomena under study. A grand theory (not a middle-range theory) is systematic and broad in scope and provides a structural framework for nursing practice. A prescriptive theory (not a middle-range theory) details nursing interventions for a specific phenomenon and the expected outcome of the care and helps guide research. p. 45

Which option is an appropriate goal for restorative care? 1. Patient will walk 200 feet without shortness of breath. 2. Patient will receive the flu vaccination before flu season. 3. Patient will express concerns related to returning home. 4. Patient will identify strategies to improve sleep habits.

1. Patient will walk 200 feet without shortness of breath. Rationale The goal for restorative care is the patient will walk 200 feet without shortness of breath. Restorative interventions focus on returning a patient to his or her previous level of functioning or reaching a new level of function limited by his or her illness or disability. The goal of restorative care is to help individuals regain maximal functional status and enhance quality of life by promoting independence. Receiving the flu vaccination is preventive care, not restorative care. Expressing concerns related to returning home is discharge planning in an acute care hospital, not restorative care. Improving sleep habits is not restorative care. Test-Taking Tip: Be sure goals are measurable! pp. 19-20

Which description is true of spiritual caring? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected 1. Mobilizes hope for the patient and the nurse 2. Focuses on treatment by conventional means 3. Recognizes that caring relationships connect humans to each other 4. Helps cure the patient without using any social or emotional resources 5. Helps the patient understand the illness, symptoms, or emotions

1. Mobilizes hope for the patient and the nurse 3. Recognizes that caring relationships connect humans to each other 5. Helps the patient understand the illness, symptoms, or emotions Rationale Spiritual health occurs when individuals find a balance between their own life values, goals, and belief systems and those of others, especially as research shows a link between spirit, mind, and body. The approach helps in mobilizing hope for the nurse and the patient in a caring relationship. The patient and the nurse realize that caring relationships connect humans. The spiritual approach also helps establish an understanding of illness, symptoms, or emotions that is acceptable to the patient. The approach helps the nurse to look beyond the conventional methods of treatment and helps the patient in getting cured by using social, emotional, and spiritual resources. p.89

Nursing is important in providing safe, patient-centered health care to the global community. Which statement is true about the nursing practice? Select all that apply. One, some, or all responses may be correct. 1. Nursing practice helps shape health policy and health systems management. 2. Nursing practice involves collaborative care of sick individuals of all ages, families, groups, and communities. 3. Nursing practice involves helping a dying patient find relief from pain. 4. Nursing practice involves interpreting clinical situations and making complex decisions based on knowledge and experience. 5. Nursing practice does not incorporate ethical and social values but only knowledge of behavioral sciences.

1. Nursing practice helps shape health policy and health systems management. 2. Nursing practice involves collaborative care of sick individuals of all ages, families, groups, and communities. 3. Nursing practice involves helping a dying patient find relief from pain. 4. Nursing practice involves interpreting clinical situations and making complex decisions based on knowledge and experience. Rationale Nursing is an art and a science. The practice of nursing incorporates elements including clinical practice, education, research, management, and administration, all of which directly or indirectly have prominence in providing safe, patient-centered health care. Helping a patient achieve the goals of the therapy and educating a patient are steps toward that mission. Interpreting clinical situations and making decisions that benefit patients are integral to nursing. Nursing practice involves collaborative care of individuals of all ages, families, groups, and communities, sick or well. Nursing practice incorporates ethical and social values with the knowledge of behavioral, biological, and physiological sciences.

Which term is referred to as the pattern of beliefs that describe the domain of a discipline? 1. Paradigm 2. Phenomena 3. Content 4. Assumption

1. Paradigm Rationale Paradigm is the term used to describe the pattern of beliefs that explain the domain of a particular discipline such as nursing. A paradigm links the concepts, theories, beliefs, values, and assumptions accepted and applied by the discipline. Phenomenon is the term, description, or label used to describe an idea or responses about an event, a situation, a process, a group of events, or a group of situations; it is not a pattern of beliefs. Content is the product and information obtained from the system; it is not a pattern of beliefs. Although an assumption is a part of a paradigm, it is not the term used to refer to the pattern of beliefs that describe the domain of a discipline. p.43

Which sequence is correct when conducting a randomized controlled trial (RCT)? 1. Participants are randomly assigned to either the control or treatment group . 2. The treatment group receives the experimental intervention, and the control group receives the standard of care . 3. The researchers measure both groups for the same outcomes to see if there is a difference . 4. The researchers determine if the intervention leads to better outcomes than the standard of care.

1. Participants are randomly assigned to either the control or treatment group . 2. The treatment group receives the experimental intervention, and the control group receives the standard of care . 3. The researchers measure both groups for the same outcomes to see if there is a difference . 4. The researchers determine if the intervention leads to better outcomes than the standard of care. Rationale The sequence is as follows: (1) participants are randomly assigned to either the control or treatment group; (2) the treatment group receives the experimental intervention, and the control group receives the standard of care; (3) the researchers measure both groups for the same outcomes to see if there is a difference; and (4) the researchers determine if the intervention leads to better outcomes than the standard of care. An RCT is performed to test an intervention against the standard of care. Test-Taking Tip: In this question type, you are asked to prioritize (put in order) the options presented. For example, you might be asked to put the steps of performing a nursing action or skill such as those involved in medication administration in the correct order. Be sure to read the question completely and follow the directions. p.55

The nurse is caring for a patient who has been admitted to the hospital with terminal leukemia. The patient has expressed a preference for non-pharmacological pain control. The nurse refers to articles and systematic reviews to learn the best possible non-pharmacological methods to treat cancer pain. How would the nurse's actions be categorized, according to the Quality and Safety Education for Nurses (QSEN) competencies? Select all that apply. One, some, or all responses may be correct. 1. Patient-centered care 2. Teamwork and collaboration 3. Evidence-based practice 4. Safety

1. Patient-centered care 3. Evidence-based practice Rationale Evidence-based practice refers to incorporating better quality interventions based on research. Referring to articles and systematic reviews to determine optimal care for a patient is an example of evidence-based practice. Patient-centered care refers to providing care with respect to patients' needs, values, and preferences. Teamwork and collaboration refers to work with a health care team to achieve the best quality of patient care. Safety refers to performing interventions that minimize risks. p.8

Arrange the needs starting from the most basic to the highest according to Maslow's hierarchy of needs . 1. Physiological 2. Safety and security 3. Love and belonging 4. Self-esteem 5. Self-actualization

1. Physiological 2. Safety and security 3. Love and belonging 4. Self-esteem 5. Self-actualization Rationale The sequence is as follows: physiological, safety and security, love and belonging, self-esteem, and selfactualization. Maslow's hierarchy of needs includes five levels of priority. The nurse would take care of the patient to fulfill physiological needs first. The nurse then would make sure the patient is safe and secure. It is then important to fulfill the patient's love and belonging needs by helping to maintain social relationships. After the patient recovers, the nurse would help patients restore self-confidence and self-esteem. Last, the patient might need help with self-actualization, which involves becoming the best one can be. p. 47

Which action would demonstrate a caring touch? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected 1. Positioning the patient comfortably 2. Inserting an intravenous line 3. Comforting the patient and holding the patient's hands 4. Engaging in a conversation with the patient 5. Holding the patient to prevent a fall

1. Positioning the patient comfortably 3. Comforting the patient and holding the patient's hands 4. Engaging in a conversation with the patient Rationale Caring touch is a way of communicating. It enables the patient to feel comfortable and cared for. Positioning the patient, holding the patient's hands, and engaging in a conversation are part of this caring touch. Establishing an intravenous line is a task-oriented touch. Holding the patient to prevent a fall is a protective touch. p. 87

Arrange the stages of change that a patient with stress goes through, resulting in finally attending a relaxation class . 1. Precontemplation 2. Contemplation 3. Preparation 4. Action

1. Precontemplation 2. Contemplation 3. Preparation 4. Action Rationale The order is precontemplation, contemplation, preparation, and action. The precontemplation stage is the first stage, in which the patient has no intention of making any change. The next stage is the contemplation stage, in which the patient considers change in the next few months. The third stage is the preparation stage, in which the patient starts making small changes in behavior. The fourth stage is the action stage, in which the patient has taken active measures in changing the behavior. p. 76

Which level of prevention describes the nurse participating at a health fair in the local mall by administering influenza vaccines to senior citizens? 1. Primary 2. Secondary 3. Tertiary 4. Quaternary

1. Primary Rationale The level of prevention is primary. Primary prevention is aimed at health promotion and includes health education programs, immunizations, and physical and nutritional fitness activities. It can be provided to an individual and includes activities that focus on maintaining or improving the general health of individuals, families, and communities. It also includes specific protections, such as immunization for influenza. Secondary prevention is diagnosing and treating an illness and limiting disabilities; it does not include giving vaccines. Tertiary prevention includes restoration and rehabilitation; it does not focus on vaccine administration. There are only three levels of prevention; the quaternary level does not exist. pp. 73-74

Which concept describes the nurse providing information to a group of healthy adolescents about contraception and the risk of human immunodeficiency virus (HIV) infection? 1. Primary prevention 2. Secondary prevention 3. The health belief model 4. The holistic approach model

1. Primary prevention Rationale The concept is primary prevention. The nurse is teaching adolescents the measures that should be taken to prevent HIV infection and unplanned pregnancy. When providing secondary prevention, the nurse educates the patient about screening techniques available for specific diseases, not about the risks of HIV to healthy adolescents. Neither the health belief model nor the holistic approach model is considered preventive (primary prevention) care. pp. 73-74

Which risk factor for cerebrovascular disease is considered modifiable? Select all that apply. One, some, or all responses may be correct . 1. Smoking five times a day 2. Sedentary lifestyle 3. History of insulin dependent diabetes 4. Thromboembolic disease 5. Eating pizza for dinner every night

1. Smoking five times a day 2. Sedentary lifestyle 5. Eating pizza for dinner every night Rationale Smoking five times a day, sedentary lifestyle, and eating pizza for dinner every night are modifiable risk factors. Modifiable risk factors for a disease are in the patient's ability to control and/or change. Tobacco use is modifiable. A sedentary lifestyle also increases the risk of cerebrovascular disease, and it is modifiable. Eating foods with poor nutritional value frequently increases risk of cerebrovascular disease, and it is modifiable. A history of insulin dependent diabetes is a genetic and physiological factor, so is a non modifiable risk factor. Likewise, a patient with thromboembolic disease has a physiological factor that is non modifiable, not modifiable. p. 75

The nurse usually is assigned multiple patients at one time. Which action would the nurse take to ensure individual patient satisfaction? Select all that apply. One, some, or all responses may be correct. 1. Provide quality care to each patient. 2. Ensure that patients leave with a positive image of nursing. 3. Provide quick and hurried treatment to the less needy patients. 4. Manage time, and approach all patients with compassion. 5. Minimize contact time with each patient to ensure care for all.

1. Provide quality care to each patient. 2. Ensure that patients leave with a positive image of nursing. 4. Manage time, and approach all patients with compassion. Rationale The nurse caring for multiple patients at a time should understand that all patients are equally important. All patients should receive quality care so they leave the health care setting with a positive image of nursing. Time management and a compassionate approach are keys to achieving these goals. However, the nurse should not cut down contact time with each patient; rather, the nurse should optimize contact time so all can be cared for and should deliver care in an organized manner, rather than in a hurried or rushed manner. Test-Taking Tip: On multiple response questions, be sure to examine each choice individually and decide if each one is true or false before indicating your responses. p. 9

While teaching about Quality and Safety Education for Nurses (QSEN) competencies, the nurse states, 11This competency uses tools such as flowcharts and diagrams to make the process of care explicit." Which QSEN competency is the nurse referring to? 1. Quality improvement 2. Patient-centered care 3. Evidence-based practice 4. Teamwork and collaboration

1. Quality improvement Rationale Quality improvement is the QSEN competency that uses tools such as flowcharts and diagrams to make the care process explicit. The patient-centered care competency involves family and friends in care and elicits the patient's values and preferences, providing care with respect for the diversity of the human experience. Evidence-based practice demonstrates knowledge of basic scientific methods, appreciates the strengths and weaknesses of scientific bases for practice, and recognizes the importance of regularly reading relevant journals. Teamwork and collaboration recognizes the contributions of other health team members and the patient's family members and discusses effective strategies for communicating and resolving conflict. p.8

According to systems theory, which information is considered input from the patient with a urinary tract infection? 1. Reports difficulty with urination 2. Voids normally after treatment 3. Thanks the nurses for their help 4. Is given a diuretic to assist with urination

1. Reports difficulty with urination Rationale Reporting difficulty with urination is input data. Input is the data that are obtained after examining the patient. Output (not input) is the result, and hence, voiding normally after treatment is considered output data. The patient thanking the nurses for their help is feedback, not the input. The information that a diuretic is given is content, not input. p.45

Which theory states that the patient adapts to changes in physiological needs, self-concept, and interdependent domains during health and illness? 1. Roy's 2. Orem's 3. Peplau's 4. Henderson's

1. Roy's Rationale Roy's theory explains the adaptation model and considers the patient to be an adaptive system. According to Roy's theory, the patient adapts to changes in physiological needs, self-concept, and interdependent domains during health and illness. Orem's theory mainly focuses on self-care. The goal of Orem's theory is to help the patient perform self-care and manage his or her own health problems, not adapt to the different domains: physiological needs, self-concept, and interdependence. Peplau's theory focuses on the interpersonal relations between the nurse, the patient, and the patient's family members. It helps to develop the nurse-patient relationship, not adapt to changes in the physiological needs, self-concept, and interdependent domains. Henderson's theory states that nursing aids in assisting sick or well individuals in the performance of activities that will contribute to health, recovery, or a peaceful death, not on adaptation to the different domains. p.48

Which research topic is probable for a group of researchers conducting a study on patients with diabetes based on Orem's theory? 1. Self-administration of insulin 2. Effective nurse-patient communication 3. Pathological process in diabetes 4. Medications for diabetes

1. Self-administration of insulin Rationale Self-administration of insulin is the probable topic. Orem's theory focuses on the patient's self-care needs. Evidence gained by the research based on insulin self-administration would help facilitate self-care in patients with diabetes. Research based on effective strategies to improve nurse-patient communication would be based on Peplau's theory, not Orem's. Studies based on pathological processes in diabetes would help to improve the descriptive and biomedical (not Orem's) theories based on diabetes. Research focused on medications for diabetes is useful for improving prescriptive and practice theories (not Orem's). p.46

According to Orem's theory, which goal is appropriate for the patient? 1. Self-care 2. Adaptation 3. Synergy 4. Transitions

1. Self-care Rationale Self-care is the goal. Orem's theory focuses on patient self-care needs, and its goal is to care for and help the patient attain complete self-care. Helping a person adapt to changes (adaptation) is the goal of Roy's theory, not Orem's. According to the American Association of Critical Care Nurses' theory (not Orem's), synergy is the goal. Transitions are the goals of Meleis, Sawyer, Im, Messias, and Schumacher's theory, not Orem's. p.46

Which element influences the achievement of identity in a person? Select all that apply. One, some, or all responses may be correct. 1. Sexuality 2. Gender 3. Ethnicity 4. Place of birth 5. Physical appearance

1. Sexuality 2. Gender 3. Ethnicity Rationale Identity is the individual's sense of individuality. Sexuality and gender are essential components of identity. Ethnicity or racial differences are integral to a person's identity because they identify a person within an established set of values, traditions, customs, and rituals. The place of birth and physical appearance do not necessarily influence identity. p.692

Which type of theory would be helpful to the nurse when gaining knowledge about the underlying pathology of a disease? 1. Grand 2. Educational 3. Biomedical 4. Prescriptive

3. Biomedical Rationale Biomedical theory would be helpful when gaining knowledge about disease pathology. Biomedical theory explains causes of disease and principles related to physiology. Grand theories are extremely comprehensive and provide a structural framework for broad and abstract ideas of nursing; it does not focus on disease pathology. Educational theories focus on the teaching-learning process, not disease pathology. Prescriptive theories address the nursing interventions for a phenomenon to anticipate outcomes; it does not focus on disease pathology. p. 47

Arrange the stages in the order in which they occur in the process of changing health behavior in a person . 1. The person has no intention of changing the behavior . 2. The person considers making a change in behavior . 3. The person makes small changes in behavior . 4. The person actively engages in strategies to change behavior . 5. The person maintains a changed behavior.

1. The person has no intention of changing the behavior . 2. The person considers making a change in behavior . 3. The person makes small changes in behavior . 4. The person actively engages in strategies to change behavior . 5. The person maintains a changed behavior. Rationale The sequence is as follows: (1) the person has no intention of changing the behavior: precontemplation stage; (2) the person considers making a change in behavior: contemplation stage; (3) the person makes small changes in behavior: preparation stage;(4) the person actively engages in strategies to change behavior: action stage; and (5) the person maintains a changed behavior: maintenance stage. According to the Transtheoretical Model of Change, change in health behavior goes through a series of five stages. p. 76

Which theory describes the life processes of an older adult facing chronic illness? 1. Systems 2. Developmental 3. Human needs 4. Educational

2. Developmental Rationale Developmental theories describe and predict behavior and development at various phases of the life continuum, as in the phase of older adulthood. Systems theory focuses on input, output, feedback, and content; it does not focus on older adults. Human needs theory focuses on the five levels of priority, not life processes of an older adult. Educational theory focuses on the teaching-learning process by examining behavioral, cognitive, and adult learning principles; it does not focus on life processes of an older adult. STUDY TIP: You have a great resource in your classmates. We all have different learning styles, strengths, and perspectives on the material. Participating in a study group can be a valuable addition to your nursing school experience. p. 47

Which situation is an example of feedback? 1. The wife of a husband suffering asthma thanked the nurse for her husband's recovery. 2. The nurse learned that scheduled positioning changes help reduce the risk of pressure injuries. 3. A patient who had an ischemic heart attack was stable after continued nursing care. 4. During assessment of a patient, the nurse noticed that the patient was unable to walk properly.

1. The wife of a husband suffering asthma thanked the nurse for her husband's recovery. Rationale The wife's thanking the nurse for her husband's improving condition is considered feedback. Feedback is the response of the family members and other health care providers to the patient's health condition. The knowledge that scheduled positioning changes help in reducing the risk of pressure injuries is an example of nursing content, not feedback. The stable condition of the patient who had an ischemic heart attack is an example of nursing output, not feedback. Noticing the inability to walk is an example of nursing input, not feedback. Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items with four options. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses. pp. 45-46

Which response would the nurse make to help a patient move through the stages of change when the patient states, "I've noticed how many people are out walking in my neighborhood. Is walking good for you?" 1. "Walking is okay, but I really think running is better because it burns more calories." 2. "Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" 3. "Yes, I want you to begin walking. Walk for 30 minutes every day, and eat more fruits and vegetables." 4. "They probably aren't walking fast enough or far enough. You need to spend at least 45 minutes walking if you are going to do any good."

2. "Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" Rationale The nurse would say, "Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" The patient's response indicates that the patient is in the contemplative stage, possibly intending to make a behavior change within the next 6 months. The nurse's statement reinforces a behavior and provides a specific goal for the patient to begin a walking plan. Telling the patient to start running before walking would not help the patient to change behavior. Although eating fruits and vegetables is good, this adds another change behavior other than just walking, which could postpone change in the patient. Stating that they are not walking fast enough or far enough is inappropriate; the nurse needs to focus on the possibility that the patient wants to change a behavior (walking). pp. 75-76

Which statement is related to the perception of susceptibility to an illness according to the health belief model? 1. "I don't have time to exercise because I have to work after school every night." 2. ''I'm worried about becoming overweight and getting diabetes because my father has diabetes." 3. "The statistics of how many teenagers are overweight is scary." 4. "I've decided to start a walking club at school for interested students."

2. ''I'm worried about becoming overweight and getting diabetes because my father has diabetes." Rationale The statement "I'm worried about becoming overweight and getting diabetes because my father has diabetes" indicates that the individual is concerned about developing diabetes and believes there is a risk or susceptibility based on recognition of a familial link for the disease. Once this link is recognized, the individual may perceive the personal risk of diabetes. None of the other options recognizes a risk factor or susceptibility. p.69

The nurse is a part of a campaign on cervical cancer that involves administering the human papillomavirus (HPV) vaccine. For which age-group is the HPV vaccine most effective? 1. 20 to 50 years of age 2. 11 to 26 years of age 3. 20 to 30 years of age 4. 25 to 35 years of age

2. 11 to 26 years of age Rationale The H PV vaccine is most effective when given before first sexual exposure in the age-group of 11 to 26 years. Individuals in the age-groups of 20 to 50 years, 20 to 30 years, and 25 to 35 years are usually already sexually active and may already be infected with the HPV virus. Therefore the vaccine may not be as effective in these age-groups as in the younger age-group. p. 712

Which factor would influence an 80-year-old patient's current self-concept? Select all that apply. One, some, or all responses may be correct. 1. Living conditions 2. Adjustment to a role change 3. Adjustment to the loss of a spouse 4. Assurance of sexual intimacy 5. Behaviors of relatives providing care

2. Adjustment to a role change 3. Adjustment to the loss of a spouse Rationale An 80-year-old patient's self-concept is likely to be altered by changes in the role in the family and by the loss of the spouse. Living conditions do not influence self-concept at this age. Sexual intimacy is generally not desired at this age because the production of sexual hormones lowers. The behavior of relatives providing care is not a significant factor for altering self-concept at this age. p.695

The nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risks and benefits of the surgery to the family and discusses the patient's wishes with the family. Which role is the nurse playing for the patient? 1. Educator 2. Advocate 3. Caregiver 4. Manager

2. Advocate Rationale An advocate protects the patient's human and legal right to make choices about care. An advocate may also provide additional information to help a patient decide whether or not to accept a treatment or find an interpreter to help family members communicate their concerns. As an educator, the nurse explains concepts and facts about health, describes the reason for routine care activities, demonstrates procedures such as selfcare activities, reinforces learning or patient behavior, and evaluates the patient's progress in learning. As a caregiver, the nurse helps patients maintain and regain health, manage disease and symptoms, and attain a maximal level of function and independence through the healing process. A manager coordinates the activities of members of the nursing staff in delivering nursing care and has personnel, policy, and budgetary responsibility for a specific nursing unit or agency. STUDY TIP: Familiarize yourself with the definitions of different types of nurses (nurse educator, case manager, etc.) and roles of the nurse (advocate, caregiver, etc.) so the answers to these types of questions are crystal clear. p.3

A patient with a psychiatric illness is prescribed antipsychotic medications. The nurse helps the patient decide whether to accept the treatment. Which role does the nurse play in this situation? 1. Educator 2. Advocate 3. Caregiver 4. Communicator

2. Advocate Rationale The nurse provides additional information and helps the patient decide whether to accept the treatment. Here, the nurse is acting as the patient's advocate, protecting human and legal rights and providing assistance in asserting these rights when needed. If the nurse explains concepts and facts about health, describes the reason for routine care activities, and demonstrates procedures such as self-care activities, the nurse is playing the role of an educator. As a caregiver, the nurse helps the patient and family set goals and assists them with meeting these goals using minimal financial cost, time, and energy. As a communicator, the nurse directly communicates strengths or weaknesses to the patient and the patient's family to give comfort and emotional support. p.3

Self-esteem stressors vary with developmental stages. In children, which stressor affects self-esteem and self-worth? Select all that apply. One, some, or all responses may be correct. 1. Unsuccessful relationships 2. An inability to meet parents' expectations 3. Sibling rivalry 4. Late onset of education 5. Loss of companionship

2. An inability to meet parents' expectations 3. Sibling rivalry Rationale In children, the inability to meet the expectations of parents and sibling rivalry can decrease the level of selfesteem and self-worth. An unsuccessful relationship is a stressor that affects the self-esteem of an adult. Late onset of education has a limited effect, if any, on a child's self-esteem. The loss of a companion or a spouse can affect the self-concept of an older adult. p. 695

The nurse is caring for a patient whose daughter wishes to pursue a career in nursing. The daughter wants to enroll in a program that is of short duration and makes her eligible to take the nursing licensure examination. Which educational program would the nurse recommend to this student? 1. Baccalaureate degree program in nursing 2. Associate degree program in nursing 3. Professional doctoral program in nursing 4. Master's degree in nursing

2. Associate degree program in nursing Rationale In the United States, a student can take the National Council Licensure Examinations (NCLEX)-RN® after completing either the associate or the baccalaureate degree program in nursing. An associate degree program is a 2-year program, whereas a baccalaureate program is a 4-year program. A master's degree in nursing is an advanced degree. The nurse must complete a master's in nursing program to become eligible for doctoral programs. p. 10

A 50-year-old patient is admitted with acute exacerbation of asthma. The patient is treated with bronchodilators and oxygen therapy. The patient is clinically stable and is planned for discharge. The nurse teaches the patient about deep-breathing exercises. The nurse has initiated these exercises to improve the patient's lung capacity. Which professional behavior is the nurse showing? 1. Advocacy 2. Autonomy 3. Accountability 4. Collaboration

2. Autonomy Rationale Deep-breathing exercises and chest physiotherapy are performed to prevent respiratory complications. The nurse does not need medical orders to prescribe breathing exercises in this case. The professional behavior shown here by the nurse is autonomy. Autonomy involves the initiation of independent nursing interventions without medical orders. Advocacy refers to protecting the patient's human and legal rights and providing assistance in asserting these rights when needed. Accountability means that the nurse is responsible, professionally and legally, for the type and quality of the nursing care provided. Collaboration refers to nurse interaction with interprofessional health providers to provide the best possible care to the patient. p. 3

According to Maslow's hierarchy of needs, which need is the priority for an elderly woman with a fever who lives in a high-crime area? 1. Esteem and self-esteem 2. Basic physiological 3. Safety and security 4. Self-actualization

2. Basic physiological Rationale The priority is basic physiological needs because of the fever. Lower basic needs must be met before higher needs. The patient is admitted to the hospital now and not in her home environment where safety is a priority, so the priority need now is physiological because of the fever. At home, the patient's priority is likely safety followed by self-esteem and then self-actualization. Test-Taking Tip: For questions concerning Maslow's hierarchy of needs, recall the needs in order of highest priority first. Is there any indication that basic physiological needs are not being met? Yes, the fever. Ah-ha! The question offers the clue about the patient having a fever, and so you have the answer-basic physiological. p. 47

According to the World Health Organization (WHO), what is the definition of health? 1. Being free from illness or injury 2. Complete physical, mental, and social well-being 3. Absence of signs and symptoms with normal laboratory reports 4. Total absence of all diseases, disorders, and syndromes

2. Complete physical, mental, and social well-being Rationale Complete physical, mental, and social well-being defines health. The WHO defines health as a "state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." Health is not just the state of being free from illness or injury or the absence of signs and symptoms. Health does not refer to the state of total absence of all diseases, disorders, and syndromes but also includes components of mental health and spiritual health. p.69

The nurse is learning about the standards of nursing practice. Which activity is part of the practice of implementation? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected 1. Developing strategies for patient care 2. Educating patients for health awareness 3. Analyzing assessment data for diagnosis 4. Using therapeutic procedures for patient care 5. Providing consultation to enhance patient care

2. Educating patients for health awareness 4. Using therapeutic procedures for patient care 5. Providing consultation to enhance patient care Rationale Implementation is when the nurse actually uses and performs particular actions or puts a strategy into use. Educating patients, using therapeutic knowledge, and providing consultation all provide opportunities for the nurse to implement skills. Developing strategies for patient care is a part of planning in nursing practice. Analyzing the assessment data is part of diagnosis in nursing practice. Test-Taking Tip: Recall which activities are specific to each stage of the nursing process. If the activity applies to a stage other than implementation, it does not answer this question. p.2

Helping a new mother through the birthing experience demonstrates which component of Swanson's five caring processes? 1. Knowing 2. Enabling 3. Doing for 4. Being with

2. Enabling Rationale The caring behavior of enabling facilitates the other person's passage through life transitions (e.g., birth, death) and unfamiliar events. When the nurse practices enabling, the patient and nurse work together to identify alternatives and resources. Knowing the patient helps the nurse select caring approaches that are most appropriate to the patient's needs. Doing for requires the nurse to do for the patient as he or she would do if it were possible. Being with involves the nurse giving of the self, which means being available and at a patient's disposal. pp. 84-85

Which process will help health care organizations provide quality care? Select all that apply. One, some, or all responses may be correct. 1. Restoring the physical hospital environment 2. Establishing protocols 3. Following national accrediting standards 4. Using evidence-based practice findings 5. Remodeling the ancillary areas

2. Establishing protocols 3. Following national accrediting standards 4. Using evidence-based practice findings Rationale Establishing protocols, following national accrediting standards, and using evidence-based practice findings help health care organizations provide quality care. Although restoring the physical hospital environment and remodeling the ancillary areas may make these areas more appealing, it will not affect the quality of care patients receive. p. 27

Which purpose does a theory fulfill? 1. Formulates legislation 2. Explains a phenomenon 3. Measures nursing functions 4. Reflects the domain of nursing practice

2. Explains a phenomenon Rationale Theories are designed to explain a phenomenon such as self-care or caring. A theory is a way of seeing through a set of concepts and propositions that describe or link the concepts to the phenomenon. Theory does not formulate legislation, measure nursing functions, or reflect the domain of nursing practice. Laws and bills help formulate legislation. Operational definitions state how concepts are measured. The domain is the perspective or territory of a profession or discipline that provides both a practical and theoretical aspect of the discipline. p.43

Which outcome is the desired behavioral goal of the health promotion model (H PM)? 1. Healthy People 2020 2. Health-promoting behavior 3. Perceived self-efficacy 4. Activity-related affect

2. Health-promoting behavior Rationale Health-promoting behavior is the desired behavioral outcome and the end point in the HPM. Healthy People 2020 is a health initiative, not the desired behavioral goal of the HPM. Perceived self-efficacy and activityrelated affect are behavior-specific cognitions and affect; they are not the behavioral outcome. The nurse is addressing the need for safety and security. Throw rugs, low lighting, and low footstool are hazards that can cause falls in the elderly. Preventing falls is a priority safety issue for older adults. Physiological needs refer to the need for food, fluid, elimination, and so forth, not removing throw rugs. Love and belonging refers to the need for relationships, not for improving the lighting in the home. Self-actualization is the need to feel fulfilled in life, not about removing a low footstool. pp. 69, 71

Which chief factor determines the self-concept of an individual? Select all that apply. One, some, or all responses may be correct. 1. Age 2. Identity 3. Body image 4. Gender 5. Role performance

2. Identity 3. Body image 5. Role performance Rationale The way an individual identifies him- or herself, how the person perceives his or her body image, and the person's role performance determine the self-concept in the individual. Age and gender affect the self-concept of a person, but they are not the main components. STUDY TIP: To memorize the chief factors that influence self-concept ( Identity, Body image, and Role performance), make up a mnemonic, such as IBiRp, then a silly sentence using the sounds of IBiRp, such as, " I may burp (IBiRp), but I have a healthy self-concept!" Learning does not have to be entirely serious. If you can remember concepts more easily using humor, use it! p.690

Which term describes people reacting in different ways because of attitudes about illness? 1. Health belief 2. Illness behavior 3. Health promotion 4. 11n1e ss prevention

2. Illness behavior Rationale The term illness behavior describes people reacting in different ways because of attitudes about illness. Illness behavior affects how people monitor their bodies, define and interpret their symptoms, take remedial actions, and use health care resources. Health beliefs are a person's ideas, convictions, and attitudes about health and illness, not behaviors when ill. Health promotion involves activities related to maintaining, attaining, or regaining good health and preventing illness, not describing behaviors when ill. Illness prevention motivates people to avoid a decline in health or functional levels, and are not behaviors people exhibit when ill. p. 77

Which statement is true regarding the nursing process? 1. It is the end product of a system . 2. It is the product and information obtained from a system. 3. It is the information that comes from a patient's assessment. 4. It is the information provided to a system about its functions.

2. It is the product and information obtained from a system. Rationale The nursing process includes the product and information obtained from the system, also called content. Output is the end product of a system or the patient's health status on returning to an environment, not the nursing process itself. Input is the information that comes from a patient's assessment, not the nursing process itself. Feedback serves to provide information to a system about its functions or the patient successfully or unsuccessfully functioning in an environment, not the nursing process itself. pp. 45-46

Which process is included in Swanson's theory of caring? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected 1. Touching 2. Knowing 3. Being with 4. Enabling 5. Maintaining belief

2. Knowing 3. Being with 4. Enabling 5. Maintaining belief Rationale Swanson's theory of caring includes five processes of care: knowing, being with, doing for, enabling, and maintaining belief. Knowing refers to striving to understand an event as it has meaning in the life of the patient. Being with means that the nurse is emotionally present for the patient. Doing for is performing for others as they would do for themselves if it were possible. Enabling refers to the activities that facilitate the patient's passage through changes in life. Maintaining belief means keeping faith in the other person's ability to get through an event. Touch is a caring behavior, but it is not included in Swanson's theory of caring STUDY TIP: Make a mnemonic to memorize the Swanson 5: knowing, being with, doing for, enabling, and maintaining belief. If you take the first letters of each of the five processes, you could use them for the first letters of a silly sentence, such as II Knock before entering dangerous mansions," but the mnemonic you create will be more beneficial for your memory than the one you just read. pp. 84-85

Which caring process would be included in Swanson's theory? Select all that apply. One, some, or all responses may be correct. 1. Bias 2. Knowing 3. Doing for 4. Being with 5. Randomization

2. Knowing 3. Doing for 4. Being with Rationale The caring processes of Swanson's theory of caring include knowing, doing for, and being with. Knowing helps understand an event and adds meaning to life. Doing for a patient is comforting to the patient. Being with a patient provides emotional support to the patient. Bias and randomization are not parts of Swanson's theory. Test-Taking Tip: Practicing a few relaxation techniques may prove helpful on the day of an examination. Relaxation techniques such as deep breathing, imagery, head rolling, shoulder shrugging, rotating and stretching of the neck, leg lifts, and heel lifts with feet flat on the floor can effectively reduce tension while causing little or no distraction to those around you. Practice one or two of these techniques intermittently to avoid becoming tense. pp. 84-85

Which primary developmental task would the nurse consider for a 9-year-old patient? 1. Communication of likes and dislikes 2. Mastery of new skill 3. Acceptance of body changes 4. Distinguishing self from environment

2. Mastery of new skill Rationale Based on Erikson's theory of development, during the ages of 6 to 12 years, the primary developmental task is to increase self-esteem. This is achieved through mastery of new skills such as reading, math, music, and sports. Communication of likes and dislikes is exhibited between 3 and 6 years of life. During the ages of 12 to 20 years, body changes and maturation are accepted. Between the ages of 1 and 3 years, the person distinguishes the self from the environment. p.692

Which nursing role has prescriptive authority in their practice? Select all that apply. One, some, or all responses may be correct. 1. Critical care nurse 2. Nurse practitioner 3. Certified clinical nurse specialist 4. Charge nurse 5. Orthopedic nurse

2. Nurse practitioner 3. Certified clinical nurse specialist Rationale Nurse practitioners and certified clinical nurse specialists encompass the role and preparation of the advanced practice registered nurse. According to the American Nurses Association standards of practice, prescriptive authority may be granted to these nurses. Critical care nurses, charge nurses, and orthopedic nurses are positions held by registered nurses who do not have prescriptive authority in their scope of practice. Test-Taking Tip: Read the question carefully before looking at the answers: (1) determine what the question is really asking by looking for key words; (2) read each answer thoroughly and see if it completely covers the material asked by the question; and (3) narrow the choices by immediately eliminating answers you know are incorrect

Which nursing theory is useful in promoting self-management for a patient with diabetes taking insuIin? 1. Neuman's 2. Orem's 3. Roy's 4. Peplau's

2. Orem's Rationale Orem's theory of self-care provides a solid theoretical background for self-management for a variety of diseases. This theory shows the nurse how to direct the patient toward self-management to meet physical, psychological, sociological, and developmental needs. Neu man's theory focuses on the patient as an open system exchanging energy with internal and external environments; it does not focus on self-management. Roy's theory focuses on adaptation, not self-management. Peplau's theory focuses on interpersonal relationships, not self-management. STUDY TIP: Have each member of a study group write what they think is the focus of Orem's, Leininger's, Peplau's, and other's theories. Compare your responses and summarize each theory on a notecard for review. p.46

The community health nurse is conducting a program on health and fitness awareness for medically underserved people. Who would be categorized as medically underserved? 1. People belonging to a different culture 2. People of a poor socioeconomic status 3. People who are not willing to be treated for their illnesses 4. People who use complementary and alternative treatments for their illnesses

2. People of a poor socioeconomic status Rationale Medically underserved people are those who lack the financial resources required for proper health care. Unemployment, low-paying jobs, and rising health care costs have all increased the population of medically underserved people in the United States. People not belonging to the dominant culture are not necessarily poor or unable to bear health care costs. People who prefer not to be treated and those who opt for alternative treatment methods are not categorized as medically underserved. p.8

Using Maslow's hierarchy of needs, which patient need is an immediate priority? 1. Self-actualization 2. Physiological 3. Safety and security 4. Self-esteem

2. Physiological Rationale The immediate priority is physiological needs, like air, water, and nutrition. The physiological needs are basic to life and are the immediate priority. Self-actualization is the highest need and is not a priority. Safety and security is a level above physiological needs, so it is not an immediate priority. Self-esteem is a higher need and is not an immediate priority. p. 47

A patient loses balance, and the nurse holds the patient to avoid a fall. Which kind of touch is this? 1. Caring 2. Protective 3. Noncontact 4. Task oriented

2. Protective Rationale Holding a patient to avoid a fall is an example of protective touch. The use of touch is often a comforting approach while dealing with patients. Touch is classified into different categories based on the type of touch. Protective touch is used to protect the patient or the nurse. Caring touch helps comfort the patient and establish a personal connection between the nurse and the patient. Noncontact touch mainly involves eye contact, not physical touch. Task-oriented touch is the touch that takes place while the nurse is performing a nursing task or procedure. p. 87

The nurse is being appointed as nurse educator in a nursing school. Which responsibilities fall under the role of the nurse educator? 1. Manage patient care and delivery of special nursing services . 2. Provide students with practical and theoretical knowledge. 3. Provide care to patients using a holistic approach. 4. Provide surgical anesthesia under the guidance and supervision of an anesthesiologist.

2. Provide students with practical and theoretical knowledge. Rationale Nurse educators are responsible for educational activities conducted in schools of nursing. If they are educators in clinical care institutions, they often participate in the development of nursing policies and procedures. In schools of nursing, the nurse educator imparts practical and theoretical knowledge to students. The nurse educator is not responsible for managing patient care, proving holistic care, or providing surgical anesthesia. The nurse administrator manages patient care. The nurse practitioner provides holistic care to patients. The certified registered nurse anesthetist provides surgical anesthesia. Test-Taking Tip: Do not read information into questions, and avoid speculating. Reading into questions creates errors in judgment. p. 3-4

Which service would the nurse suggest to a patient's caregiver who wants to know if there are support services that allow time off from caregiving? 1. Hospice 2. Respite care 3. Nursing clinics 4. Assisted living

2. Respite care Rationale Respite care is a service that gives time off to the caregivers of patients. Professionals and others take care of the patient while the caregiver completes chores or handles other responsibilities. Hospice is a service in which terminally ill patients receive palliative care in their homes, but it does not provide time off for caregivers of patients. Nursing clinics diagnose and treat medical conditions but do not provide time off for caregivers. Assisted living is associated with long-term care facilities where patients live with other individuals in a homelike surrounding, but it does not provide time off for caregivers of patients. p. 16

The nurse is caring for an older-adult couple in a community-based assisted-living agency. During the family assessment, the nurse notes that the couple has many expired medications and multiple medications for their respective chronic illnesses. They indicate that they go to two different health care providers. The nurse begins to work with the couple to determine what they know about their medications and helps them decide on one care provider rather than two. Which Quality and Safety Education for Nurses (QSEN) competency is this an example of? 1. Patient-centered care 2. Safety 3. Teamwork and collaboration 4. Informatics

2. Safety Rationale Helping patients understand the consequences and complications of multiple medications helps build the competency of safety. Recognizing the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and needs describes patient-centered care. Functioning effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care describes teamwork and collaboration. Using decision support systems is an example of using and gaining competency in informatics. p.8

Which level of Maslow's hierarchy of needs is being addressed when the nurse teaches the parents of a school-age child about the risks of physical and sexual abuse and methods necessary to educate the child about them? 1. Self-esteem 2. Safety and security 3. Love and belonging 4. Physiological needs

2. Safety and security Rationale The nurse is addressing the safety and security level of Maslow's hierarchy of needs. The nurse is instructing the parents to teach the child about physical and sexual abuse to ensure the child's physical and psychological safety. The nurse addresses self-esteem when parents are instructed to praise the child, not talk about physical and sexual abuse. The nurse addresses the child's need to feel love and belonging when instructing the parents to love and include the child in family outings and meals, not about physical and sexual abuse. The nurse addresses the physiological needs of Maslow's hierarchy when instructing the parents to provide proper nutrition, fluids, and basic needs, not about physical and sexual abuse. pp. 69-71

Which level of prevention describes an obese patient who follows a healthy low-calorie diet and after 6 months the patient has lost weight? 1. Primary 2. Secondary 3. Tertiary 4. Specific

2. Secondary Rationale This situation describes secondary prevention. Patients with health problems or who are at risk of developing complications need medical interventions. Early diagnosis and treatment can limit further damage and help patients recover. Primary prevention occurs before development of a medical problem; the patient is currently obese. Tertiary prevention is required for patients who need rehabilitation for a permanent or irreversible defect or disability; obesity is not permanent or irreversible. While the focus is specific for diet, it is not classified as specific prevention. p. 74

Which term describes how one thinks of oneself? 1. Self-awareness 2. Self-concept 3. Self-esteem 4. Self-expression

2. Self-concept Rationale Self-concept is how one thinks of oneself. It is subjective and is a mixture of conscious and unconscious thoughts, attitudes, and perceptions. Self-awareness is having knowledge about one's feelings, thoughts, and attitudes. Self-esteem is how one feels about oneself. Self-expression is expressing one's own character, feelings, thoughts, and mindsets. p. 690

The nurse asks the patient, "How do you feel about yourself?11 Which aspect is the nurse assessing? 1. Identity 2. Self-esteem 3. Body image 4. Role performance

2. Self-esteem Rationale Self-esteem is how a person feels about him- or herself. Asking open-ended questions about self-esteem is important during the nursing assessment. The nurse would not be assessing identity, body image, or role performance by asking the patient "How do you feel about yourself?" p.690

Which step would a group of nurses take next after implementing an evidence-based practice (EBP) change and evaluating the effectiveness of the change? 1. Search the literature . 2. Share the findings with others. 3. Conduct a statistical analysis. 4. Create a well-defined PICOT question.

2. Share the findings with others. Rationale The next step is to share the findings with others. After completing an EBP project and evaluating its effectiveness, the next step is to communicate the results with others. Searching the literature, conducting statistical analysis, and creating a well-defined PICOT question come before (not after) implementing an EBP change. pp. 58-59

Many nurses are known for their achievements. Which statement is true regarding Mary Mahoney? Select all that apply. One, some, or all responses may be correct. 1. She was the founder of the American Red Cross. 2. She was the first professionally trained African American nurse. 3. She proposed the concept of health promotion by modifying the patient's environment. 4. She focused on respecting an individual irrespective of color, race, or background. 5. She opened an establishment that focused on the health needs of low-income people who lived in tenements in New York City.

2. She was the first professionally trained African American nurse. 4. She focused on respecting an individual irrespective of color, race, or background. Rationale Mary Mahoney was the first professionally trained African American nurse. She was concerned with relationships between cultures and races. As a noted nursing leader, she initiated an awareness of cultural diversity and respect for the individual, regardless of background, race, color, or religion. Clara Barton was the founder of the American Red Cross. Florence Nightingale's concept of nursing was to promote health by modifying the patient's environment. In the late 19th century, Lillian Wald and Mary Brewster opened the Henry Street Settlement, which focused on the health needs of low-income people who lived in the tenements in New York City. p. 6

Arrange the behavioral changes seen in the patient who was paralyzed from an automobile accident, starting with the first change to the last. 1. Acknowledgment 2. Shock 3. Withdrawal 4. Acceptance 5. Rehabilitation

2. Shock 3. Withdrawal 1. Acknowledgment 4. Acceptance 5. Rehabilitation Rationale The sequence is as follows: (1) shock, (2) withdrawal, (3) acknowledgment, (4) acceptance, and (5) rehabilitation. Initially, when the patient becomes aware of the paralysis, the sudden impairment causes shock. This is followed by a stage of withdrawal in which the patient realizes the reality and often withdraws and refuses discussion. This is also a way of coping with the situation. The third stage is acknowledgment, in which the patient moves through a period of grieving to the next stage of accepting the impairment. The fifth stage is rehabilitation, in which the patient tries to learn new ways of coping with the impairment. p. 78

Which action by the nurse best describes knowing according to Swanson's theory? 1. Sustaining faith in one's capacity to get through a situation 2. Striving to understand an event's meaning for another person 3. Being emotionally there for another person 4. Providing for others as they would do for themselves

2. Striving to understand an event's meaning for another person Rationale Swanson's theory describes knowing as striving to understand an event as it has meaning in the life of the patient. This theory supports the claim that caring is a central nursing phenomenon but not necessarily unique to nursing practice. Sustaining faith in one's capacity to get through a situation is maintaining belief. Being emotionally there for another person is being there. Providing for others as they would do for themselves is doing for. STUDY TIP: Record the information you find to be most difficult to remember on 3 x 5-inch cards and carry them with you in your pocket or purse. When you are waiting in traffic or for an appointment, just pull out the cards and review them again. This found time may add points to your test scores that you have lost in the past. For theories, you can write the name of the theory on one side of the card and its guiding principles on the other. To study, read the name of the theory and try to recall the specifics of it. Or start by flipping the cards over, reading the specifics, and trying to recall the theory name. pp. 84-85

Which sexual disease is caused by bacteria? Select all that apply.One, some, or all responses may be correct. Some correct answers were not selected 1. Herpes 2. Syphilis 3. Chlamydia 4. Gonorrhea 5. Genital warts

2. Syphilis 3. Chlamydia 4. Gonorrhea Rationale Sexually transmitted infections (STls) caused by bacteria include syphilis, chlamydia, and gonorrhea. Herpes and genital warts are sexually transmitted but are caused by viruses. Herpes is caused by the herpes simplex virus, and genital warts are caused by the human papillomavirus. STUDY TIP: Notice that bacterial STls are treatable with antibiotics and curable. Remembering that herpes and genital warts are not curable may help you remember that they are viruses. p. 711

Which action would the nurse take to provide patient-centered care that is focused on continuity and transition? 1. Ask the patient which family member should have access to patient information . 2. Teach the patient how to change the wound dressing at home. 3. Respond promptly to the patient's request for pain medication. 4. Schedule the patient's diagnostic scan after the physical therapy session.

2. Teach the patient how to change the wound dressing at home. Rationale The nurse would teach the patient how to change the wound dressing at home. Nursing interventions focused on continuity and transition provide patients with information, support, and resources to care for themselves after discharge or receive the assistance they need. Asking the patient which family member should have access to patient information is focused on respect for patients' values, preferences, and expressed needs and involvement of family and friends, not continuity and transition. Responding promptly to the patient's request for pain medication focuses on physical comfort, not continuity and transition. Scheduling the patient's diagnostic scan after the physical therapy session focuses on coordination and integration of care, not continuity and transition.

Which phrase accurately describes output? 1. Data entering the system 2. The end product 3. Data related to system functioning 4. The product and information obtained from the system

2. The end product Rationale Output is the end product. A system functions on its content, input, output, and feedback. Data entering the system is input, not output. Data related to system functioning is feedback, not output. The product and information obtained from the system is content, not output. p. 45

Which phrase accurately describes output? 1. Data entering the system 2. The end product 3. Data related to system functioning 4. The product and information obtained from the system

2. The end product Rationale Output is the end product. A system functions on its content, input, output, and feedback. Data entering the system is input, not output. Data related to system functioning is feedback, not output. The product and information obtained from the system is content, not output. p.45

Several staff members complain about a patient's constant questions such as "Should I have a cup of coffee or a cup of tea?" and "Should I take a shower now or wait until later?" Which interpretation of the patient's behavior helps the nurses provide optimal care? 1. Asking questions is attention-seeking behavior . 2. The inability to make decisions reflects a self-concept issue. 3. A dependence on staff must be stopped immediately. 4. Indecisiveness is aimed at testing how the staff reacts.

2. The inability to make decisions reflects a self-concept issue. Rationale Patients with deficits in self-concept often have difficulty making decisions. It is essential for the nurse to remain accepting of the patient and to support him or her in decision-making. Asking questions is not necessarily attention-seeking behavior, and the nurse should remain accepting of the patient's questions. A dependence on staff should not be stopped, and the nurse should support the patient. By asking multiple questions, the patient is not testing how the staff reacts, and the nurse should remain accepting of the patient. p. 691

A 50-year-old patient is admitted with acute exacerbation of asthma. The patient is treated with bronchodilators and oxygen therapy. The patient is clinically stable and is planned for discharge. Who is responsible for teaching the patient about managing asthma at home? 1. The staff nurse 2. The nurse educator 3. The nurse administrator 4. The clinical nurse specialist

2. The nurse educator Rationale Patient education is a major role of the nurse educator. The other types of nurses have different responsibilities. The staff nurse is responsible for providing basic care to a group of patients in a hospital setting based on standards of professional practice. The nurse administrator is responsible for managing the quality of patient care provided by the nurses. The nurse administrator also manages the different nursing services that are delivered within a health care establishment. The clinical nurse specialist is an expert clinician in a particular area and provides specialized care. STUDY TIP: A helpful method for decreasing test stress is to practice self-affirmation. After you have adequately studied and really know the material, start looking in the mirror each time you pass one and say to yourself-preferably out loud- 11 1 know this material, and I will do well on the test." After several times of watching and hearing yourself reaffirm your knowledge, you will gain inner confidence and be able to perform better during the test period. This technique really works for students who are adventurous enough to use it. It may feel silly at first, but if it works, who cares? It will work for performing skills in clinicals as well, as long as you have practiced the skill sufficiently. Make the statements once you are certain you know the material. p. 5

Which goal is typical of Watson's theory? 1. To develop interaction between the nurse and patient 2. To promote self-healing using carative factors 3. To focus on unitary beings by expanding consciousness 4. To facilitate the reparative processes of the body by manipulating the patient's environment

2. To promote self-healing using carative factors Rationale Watson's theory is to promote self-healing using ca rative factors. Developing a nurse-patient relationship is the main goal of Peplau's theory, not Watson's. Focusing on unitary beings by expanding consciousness is the main goal of Rogers, Parse, and Newman, not Watson. Facilitating the reparative processes of the body by manipulating the patient's environment is a goal of Nightingale's theory, not Watson's theory. p.48

In a hospital, there is an acute shortage of nurses because of retirements. Which action would the remaining nurses take? Select all that apply. One, some, or all responses may be correct. 1. Hurry through the patient care assignments. 2. Use patient contact time efficiently. 3. Use the patient contact time professionally. 4. Only treat the same number of patients as treated before the retirements. 5. Eliminate assessment aspects of patient care to make more time.

2. Use patient contact time efficiently. 3. Use the patient contact time professionally. Rationale Nurses should learn time management skills and use patient contact time efficiently and professionally. They should not hurry through patient care, because studies have proven that hurrying does not save time in the long run and increases the possibility of errors. Nurses should not compromise the quality of care they deliver because it will not save time. pp.5-6

A male patient approaches the nurse for advice on permanent methods of contraception. Which option would the nurse suggest to the patient? 1. Tubal ligation 2. Vasectomy 3. Subdermal implants 4. Transdermal skin patches

2. Vasectomy Rationale Vasectomy is a permanent method of contraception in men. In the procedure, the vas deferens, which carries the sperm away from the testicles, is cut and tied. Tubal ligation is a surgical procedure done in women that involves cutting the fallopian tube. Subdermal implants and transdermal skin patches are hormonal methods for temporary contraception. p. 710

Which type of physical sign is often seen in adult victims of sexual abuse? 1. Unusual odor in the genital area 2. Vomiting or abdominal tenderness 3. Torn, stained, or bloody underclothing 4. Wounds that match the patient's "story"

2. Vomiting or abdominal tenderness Rationale Vomiting and abdominal tenderness are often seen in adult victims of sexual abuse. Child victims of sexual abuse may have an unusual odor in the genital area or torn, stained, or bloody underclothing. Adult victims of sexual abuse often have wounds that do not match their stories. It is not a physical sign of sexual abuse. Test-Taking Tip: Be alert for details about what you are being asked to do. In this question type, you are asked to select all options that apply to a given situation or patient. All options likely relate to the situation, but only some of the options may relate directly to the situation. p. 709

A pregnant patient is diagnosed with a minor vaginal infection. Which nursing domain involves providing independent care for women during normal pregnancy, including labor, delivery, and care for the newborn? 1. Nurse practitioner (NP) 2. Clinical nurse specialist (CNS) 3. Certified nurse midwife (CNM) 4. Certified registered nurse anesthetist (CRNA)

3. Certified nurse midwife (CNM) Rationale A CNM is an advanced practice registered nurse (APRN) who provides independent care for women during normal pregnancy, labor, and delivery. The NP is an APRN who provides health care to a group of patients, usually in an outpatient, ambulatory-care, or community-based setting. The CNS is an APRN who is an expert clinician in a specialized area of practice such as geriatrics. The CRNA assists with anesthesia during surgeries. p. 5

Which statement by a patient supports the nurse's conclusion that the patient follows a holistic approach of healing? 1. "I am implementing changes in my behavior for better health." 2. "I am following a perfect regimen of diet and exercise every day." 3. "I am also using guided imagery and music therapy for treatment." 4. "I am taking prescribed medications to lower the risk of heart attack."

3. "I am also using guided imagery and music therapy for treatment." Rationale The patient following a holistic approach would say, 11 1 am also using guided imagery and music therapy for treatment." A patient who follows a holistic approach to healing recognizes the natural healing abilities of the body and may prefer guided imagery and music therapy. Implementing changes in behavior for better health is not a holistic approach. While diet and exercise are healthy choices, they do not include the body, mind, and spirit; they are not holistic approaches. Taking prescribed medications is not a holistic approach, it is a medical approach.

Based on the Transtheoretical Model of Change, which response would a nurse make to a patient who states, "Me, exercise? I haven't done that since junior high gym class, and I hated it then"? 1. "I don't exercise either because I hate it, too, and I don't think it's helpful." 2. "I want you to walk 3 miles four times a week, and I'll see you in 1 month." 3. "I understand. Can you think of one reason why being more active would be helpful for you?" 4. "I would like you to ride your bike three times this week and then four times by next week."

3. "I understand. Can you think of one reason why being more active would be helpful for you?" Rationale The nurse would say, "I understand. Can you think of one reason why being more active would be helpful for you ?11 The patient's response indicates that the patient is in the precontem plation stage and does not intend to change behavior in the next 6 months. Asking a question may stimulate the patient to identify a reason to change behavior. Saying, "I don't exercise either because I hate it, too, and I don't think it's helpful" is inappropriate and inaccurate. In this stage the patient is not interested in information about the behavior and may be defensive when confronted with it; therefore, telling a patient to walk 3 miles or ride a bike three times this week is inappropriate. Nurses are challenged to motivate and facilitate change in health behavior when working with individuals, not to dictate what the patient should do.

How is a self-concept stressor defined? 1. The inability of an individual to distinguish self-concept from self-esteem. 2. An individual's belief that establishes that he or she is unworthy 3. A real or perceived change that threatens a person's identity and body image. 4. The inability of an individual to reach an age-appropriate developmental stage.

3. A real or perceived change that threatens a person's identity and body image. Rationale Any real or perceived change in a person's life that would threaten or alter the person's identity, body image, or role performance is identified as a self-concept stressor. The ability to distinguish between self-concept and self-esteem does not alter a person's level of self-concept. A person's belief that he or she is unworthy indicates a low level of self-concept but is not necessarily a stressor. A person's inability to reach an ageappropriate developmental stage is not considered a self-concept stressor. p.694

Which intervention is classified as an active strategy of health promotion? 1. Fortification of milk with vitamin D 2. Fluoridation of municipal drinking water 3. A weight reduction program for obese people 4. Fortification of cereals with vitamin A

3. A weight reduction program for obese people Rationale A weight reduction program for obese people is an active strategy. Active strategies of health promotion require a person to be actively involved in the measures taken to improve a condition and reduce the risk of disease. In passive strategies of health promotion, individuals gain from the activities of others without acting themselves. Interventions such as fortification of milk with vitamin D, fluoridation of municipal drinking water, and fortification of cereals with vitamin A are classified as passive strategies, not active. p. 73

Which nursing activity is an example of tertiary care? 1. Administering influenza immunizations at the senior independent living agency 2. Providing well-baby care in a clinic run by the local community health department 3. Admitting a patient to the cardiovascular intensive care unit after open heart surgery 4. Working the triage desk in the emergency department

3. Admitting a patient to the cardiovascular intensive care unit after open heart surgery Rationale Admitting a patient to the cardiovascular intensive care unit after open heart surgery is an example of tertiary care. Tertiary care is focused on highly specialized treatment of disease and illness. Administering influenza immunizations is an example of preventive care, not tertiary care. Providing well-baby care in a clinic is an example of primary care, not tertiary care. Working the triage desk in the emergency department is an example of secondary care, not tertiary care. p. 15

An 18-year-old patient is in the emergency department with fever and cough. The nurse obtains vital signs, auscultates lung sounds, listens to heart sounds, determines patient's level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? 1. Diagnosis 2. Evaluation 3. Assessment 4. Implementation

3. Assessment Rationale Assessment is the collection of comprehensive data pertinent to the patient's health and/or the situation. A nursing diagnosis is a clinical judgment made by a nurse to describe a patient's response or vulnerability to health conditions or life events that a nurse is licensed and competent to treat. Evaluation determines whether a patient's condition or well-being improved after nursing interventions were delivered. Implementation involves the performance of nursing and collaborative interventions necessary to achieve the goals and expected outcomes needed to support or improve a patient's health status.

The nurse attentively listens and touches a patient gently. Which component of Swanson's theory does this action fulfiII? 1. Enabling 2. Doing for 3. Being with 4. Maintaining belief

3. Being with Rationale Touch signifies that the nurse understands the patient's concerns. It means being with the patient and listening to the patient whenever needed. Enabling is facilitating the patient's passage through life stages. Doing for is performing for the patient as the patient would do for himself or herself if possible. Maintaining belief is sustaining faith. pp. 84-85

Which type of research explores the interrelationships among variables of interest without any active intervention by the researcher? 1. Exploratory 2. Evaluation 3. Correlational 4. Experimental

3. Correlational Rationale Correlational research explores the interrelationships among variables of interest without any active intervention by the researcher. Exploratory, evaluation, and experimental research involve active intervention by the researcher. Exploratory research develops or refines the dimensions of facts or events, such as in a pilot study. Evaluation research tests how well a program, practice, or policy is working. In experimental research, an investigator controls the study variables and randomly assigns participants to different conditions to test the variable. p. 61

Which strategy for creating work environments enables nurses to demonstrate caring behaviors? 1. Increasing the working hours of the staff 2. Decreasing salary benefits of the staff 3. Creating a setting that allows flexibility and autonomy for staff 4. Encouraging increased input concerning nursing functions from physicians

3. Creating a setting that allows flexibility and autonomy for staff Rationale Encouraging flexibility and autonomy increases nursing satisfaction. When nurses' job satisfaction is high, they have a greater connectedness with their patients and believe that caring practices are part of the nursing culture. Increasing the working hours of staff usually decreases nursing satisfaction. Decreasing salary benefits usually decreases job satisfaction. Encouraging increased input concerning nursing functions from physicians decreases nursing autonomy and thus decreases nursing satisfaction. p.90

Which factor is considered an external variable influencing illness and illness behavior? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected 1. Coping skills 2. Locus of control 3. Cultural background 4. Employment status 5. Visibility of symptoms

3. Cultural background 4. Employment status 5. Visibility of symptoms Rationale External variables influencing illness and illness behavior include cultural background, employment status, and visibility of symptoms. Internal (not external) variables include coping skills and locus of control. p. 77

Which phrase accurately describes feedback as it relates to the nursing process as a system? 1. Data entering the system 2. The end product 3. Data related to system functioning 4. The product and information obtained from the system

3. Data related to system functioning Rationale Feedback is the data related to system functioning. Feedback serves to inform a system about how it functions. A system functions on its content, input, output, and feedback. Data entering the system are input, not feedback. The end product is output, not feedback. The product and information obtained from the system is content, not feedback. pp. 45-46

Which factor is a possible cause of dyspareunia? 1. Diminished sexual desire 2. Diabetes and hypertension 3. Diminished vaginal lubrication 4. Increased vaginal elasticity

3. Diminished vaginal lubrication Rationale Dyspareunia is painful sexual intercourse. In perimenopausal women, estrogen secretion decreases and leads to diminished vaginal lubrication and elasticity. These changes may cause dyspareunia. Diminished sexual desire could be because of low estrogen but does not lead to dyspareunia. Diabetes and hypertension do not cause dyspareunia. p. 706

What did Mary Adelaide Nutting contribute to the development of nursing as a profession? Select all that apply. One, some, or all responses may be correct. 1. Established the Frontier Nursing Service 2. Founded public health nursing in New York City 3. Ensured affiliation of nursing education with universities 4. Was the first professor of nursing at Teachers College, Columbia University 5. Developed the American Red Cross while she was a Civil War nurse

3. Ensured affiliation of nursing education with universities 4. Was the first professor of nursing at Teachers College, Columbia University Rationale Mary Adelaide Nutting was instrumental in the affiliation of nursing education with universities and became the first professor of nursing at Teachers College, Columbia University in 1906. Maitland Stewart founded the Frontier Nursing Service, which provided the first organized midwifery service in the United States. Lillian Wald founded the Henry Street Settlement in New York City and is considered the founder of community, or public health, nursing. Clara Barton was a Civil War nurse who used her experience on the battlefield to found the American Red Cross.

Of the five caring processes described by Swanson, which action describes knowing the patient? 1. Anticipating a patient's cultural preferences 2. Determining which physician a patient prefers 3. Establishing an understanding of a specific patient 4. Gathering task-oriented information during assessment

3. Establishing an understanding of a specific patient Rationale Knowing the context of a patient's illness helps the nurse choose and individualize interventions that will actually help the patient. The nurse should strive to understand an event as it has meaning in the life of the patient. Knowing the patient is essential when providing patient-centered care. Two elements that facilitate knowing are continuity of care and clinical expertise. Anticipating cultural and physician preferences and gathering task-oriented information are not part of knowing the patient according to Swanson's five caring processes. pp. 84-85

According to Maslow's hierarchy of needs, which patient need is most basic? Select all that apply. One, some, or all responses may be correct. 1. Reassuring the patient 2. Allowing family members to visit 3. Feeding the patient 4. Ensuring adequate fluid intake 5. Assisting with bladder or bowel elimination

3. Feeding the patient 4. Ensuring adequate fluid intake 5. Assisting with bladder or bowel elimination Rationale Feeding the patient, ensuring adequate fluid intake, and assisting with bladder or bowel elimination are most basic. According to Maslow's hierarchy of needs, some human needs are more basic than other needs and should be met before other needs are met. Food, water, and elimination are basic needs and should be given priority over others. Reassurance helps make the patient feel emotionally secure, but it is not a most basic need. Allowing family members to visit is appropriate, but it is not one of the most basic needs; visits by family members make the patient feel loved, a higher need, not a basic need. Test-Taking Tip: Consider how you would feel if you were the patient and one type of care was offered before another. For instance, would you want a visit from a family member if you needed help with elimination at that time?

A patient diagnosed with major depressive disorder has long-term low self-esteem related to a negative view of the self. Which action would be the most appropriate cognitive intervention by the nurse? 1. Promote active socialization with other patients. 2. Role play to increase assertiveness skills . 3. Focus on identifying strengths and accomplishments. 4. Encourage journaling of underlying feelings.

3. Focus on identifying strengths and accomplishments. Rationale Focusing on strengths and accomplishments to minimize the emphasis on failures assists the patient in altering distorted and negative thinking. The other interventions are important, but they are not designed to affect thoughts. p. 702

Which group or organization is directly affected by pay for performance reimbursement programs? 1. Low-income families 2. Quality and Safety Education for Nurses (QSEN) 3. Health care providers 4. National Academy, Health and Medicine Division

3. Health care providers Rationale Health care providers are directly affected by pay for performance programs. Health care providers are compensated only if they meet certain benchmarks for quality and efficiency. Low-income families are not directly affected by pay for performance reimbursement programs. QSEN focuses on quality and safety competencies for nurses so that they have the knowledge, skills, and attitudes to meet the challenges of today's health care settings; it is not involved in pay for performance programs. The National Academy, Health and Medicine Division focuses on safe, effective, patient-centered, timely, efficient, and equitable health care delivery; it is not directly affected by pay for performance programs. p.23

Which health model describes a nurse allowing a stressed patient to meditate and do breathing exercises for 15 minutes in the evening? 1. Health promotion 2. Health belief 3. Holistic health 4. Transtheoretical

3. Holistic health Rationale Using meditation and breathing exercises are examples of the holistic health model. The holistic health model emphasizes the relationship between body, mind, and spirit; therefore, the approach used in this case comes under the holistic health model. The health promotion model focuses on individual characteristics and experiences, behavior-specific knowledge and affect, and behavioral outcomes, not meditation and breathing exercises. The health belief model addresses the relationship between a person's beliefs and behavior, including susceptibility to an illness, perception of the seriousness of the illness, and the likelihood for preventive action, not meditation and breathing exercises for stress. The Transtheoretical Model of Change is a series of five stages a person goes through before making a change, not relaxation and breathing exercises. p. 70

Which complication from untreated sexually transmitted infections (STls) is most serious in women? 1. Genital discharge and dyspareunia 2. Painful menstrual cycles 3. Infertility and pelvic inflammatory disease 4. Genital warts

3. Infertility and pelvic inflammatory disease Rationale STls can certainly cause discharge, discomfort, and genital warts; however, the most serious complications from untreated bacterial STls are damage to the reproductive organs and increased risks of pelvic inflammatory disease, ectopic pregnancy, and infertility. p. 712

Which option is another term for shared theory? 1. Paradigm 2. Practice theory 3. Interdisciplinary theory 4. Content

3. Interdisciplinary theory Rationale The other term for shared theory is interdisciplinary theory or borrowed theory. Paradigm is not another term for shared theory. Paradigm is a pattern of beliefs used to describe the domain of a discipline. Practice theory is another term for situation-specific theory, not for shared theory. Content is not another word for shared theory; content is the product and information obtained from the system. p.45

Which information does the registered nurse understand about the intrauterine device (IUD)? 1. The IUD is a round, rubber dome that has a flexible spring around the edge. 2. The device needs to be refitted in case of significant change in weight or pregnancy . 3. It contains either copper or progesterone that stops the sperm from fertilizing an egg. 4. This method is the most effective contraception method and is considered a permanent procedure.

3. It contains either copper or progesterone that stops the sperm from fertilizing an egg. Rationale IUDs contain either copper or progesterone that prevents sperm from fertilizing an egg. An IUD is a plastic device inserted by a health care provider into the uterus through the cervical opening, and a diaphragm is a round, rubber dome that has a flexible spring around the edge. Diaphragms need to be refitted in case of significant change in weight or pregnancy. Sterilization is the most effective contraception method and is considered permanent. p. 710

In compliance with Leininger's theory, which action would the nurse take when told by some villagers that they are willing to take vaccines only in the presence of the pastor of their church, who has gone to another village and will return in a day? 1. Explain to the villagers that the vaccinations can be given safely even in the absence of the pastor. 2. Give the vaccine to the people on the scheduled day . 3. Listen to the villagers and give them the vaccines the next day in the presence of the pastor. 4. Contact the pastor and ask him to come back because the people from the village need his presence during the vaccinations.

3. Listen to the villagers and give them the vaccines the next day in the presence of the pastor. Rationale In this scenario, the nurse would respect the villagers' faith and listen to them. The nurse can give them the vaccine the next day in the presence of the pastor. The major concept of Leininger's theory is cultural diversity, and the goal of nursing care is to provide the patient with culturally specific nursing care. The nurse would not try to explain or convince them to take the vaccinations in the absence of the pastor because it is against their wishes. To incorporate culture, according to Leininger, the nurse would comply with the villagers and would not give the vaccine to the people on the scheduled day. Contacting the pastor and asking him to come back

Which aspect is the primary contraceptive action of an intrauterine device (1 U D)? 1. Prevents ovulation 2. Acts as a physical barrier 3. Prevents fertilization 4. Kills sperm cells

3. Prevents fertilization Rationale The primary action of an IUD is to prevent fertilization of the ovum. It has no effect on ovulation, does not act as a physical barrier, and has no effect on the sperm. Hormonal contraception (e.g., use of oral contraceptive pills) prevents ovulation. Condoms and diaphragms act as physical barriers to contraception. Spermicidal products, such as spermicidal creams and jellies, kill sperm cells. Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items with four options. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses. p. 710

Which finding is a nursing-sensitive outcome that can be measured? 1. Incidence of asthma among children of parents who smoke 2. Frequency of episodes of low blood sugar in children at a local school 3. Number of patients who fall and experience subsequent injury on the evening shift 4. Percentage of sexually active adolescent girls who attend the nurses' teaching sessions for birth control

3. Number of patients who fall and experience subsequent injury on the evening shift Rationale The number of patients who fall and subsequently experience injury on the evening shift is a nursing-sensitive outcome that can be measured. Nursing-sensitive outcomes are those that are directly related to nursing care. The number of patients who fall and experience injury on the evening shift can be directly correlated to nursing care and can be quantified in relation to measures taken by nursing staff. The incidence of asthma among children of parents who smoke, frequency of low blood sugar in children at a local school, and percentage of sexually active adolescent girls who attend the nurses' teaching sessions for birth control are not directly related to nursing care. pp.60,64

What is evidence-based practice? 1. Nursing care based on tradition 2. Scholarly inquiry of nursing and biomedical research literature 3. Optimal patient care based on current research 4. Quality nursing care provided in an efficient and economically sound manner

3. Optimal patient care based on current research Rationale Evidence-based practice integrates the best current evidence with clinical expertise, patient/family preferences, and values for delivery of optimal health care. It is based on research, not tradition. It is a patient care, not a type of literature. Quality care provided in an efficient and economically sound manner is a standard of nursing care. p.8

Which statement about Orem's theory is correct? Select all that apply. One, some, or all responses may be correct. 1. The goal of nursing care is to provide culturally competent care. 2. Orem's theory focuses on interpersonal relations between the nurse and the patient. 3. Orem's theory focuses on the patient's self-care needs. 4. The goal is to help the patient perform self-care and manage health problems. 5. Nursing care aims to increase the patient's ability to independently meet his or her own needs

3. Orem's theory focuses on the patient's self-care needs. 4. The goal is to help the patient perform self-care and manage health problems. 5. Nursing care aims to increase the patient's ability to independently meet his or her own needs Rationale True statements include the following: Orem's theory focuses on the patient's self-care needs; the goal is to help the patient perform self-care and manage health problems; and nursing care aims to increase the patient's ability to independently meet his or her own needs. The goal of Leininger's theory (not Orem's) is to provide culturally competent care. Peplau's, not Orem's, theory focuses on interpersonal relations between the nu rse and the patient. STUDY TIP: Have each member of a study group write what they think is the focus of Orem's, Leininger's, Peplau's, and other's theories. Compare your responses and summarize each theory on a notecard for review. p.46

A person tries to meet the strenuous demands of employment while taking care of a family of six and manages to fulfill these responsibilities with great difficulty. Which role performance stressor is affecting this person? 1. Conflict 2. Ambiguity 3. Overload 4. Strain

3. Overload Rationale When the expectations and responsibilities of a role are unmanageable, it is referred to as role overload. A person may experience role overload when trying to meet employment demands and caring for a family. Role conflict happens when a person has to assume two or more inconsistent and mutually exclusive roles. Role ambiguity occurs when a person is confused and not sure of his or her role. Role strain results from role conflict and role ambiguity combined. STUDY TIP: In case you are experiencing role overload with studying and other tasks, enhance your timemanagement abilities by designing a study program that best suits your needs and current daily routines. Consider issues such as the following: (1) amount of time needed, (2) amount of time available, (3) the best time to study, and (4) time for emergencies and relaxation.

Which theory is useful for developing interpersonal relationships? 1. Leininger's 2. Roy's 3. Peplau's 4. Nightingale's

3. Peplau's Rationale Peplau's theory focuses on developing interpersonal relationships among the nurse, the patient, and the patient's family. Following this theory, the nurse acts as a counselor, a resource person, and a surrogate. Thus the nurse helps the patient reduce the anxiety related to health care problems. Leininger's theory focuses on cultural diversity and providing culturally specific health care, not on developing interpersonal relationships. Roy's theory deals with helping the patient adapt to changes, and Nightingale's theory focuses on environmental factors influencing the patient's health status; Roy and Nightingale do not focus on developing interpersonal relationships. STUDY TIP: Have each member of a study group write what they think is the focus of Orem's, Leininger's, Peplau's, and other's theories. Compare your responses and summarize each theory on a notecard for review.

Which behavioral symptom is often found in children who have been victims of sexual abuse? 1. Depression 2. Facial grimacing 3. Physical aggression 4. Strong peer relationships

3. Physical aggression Rationale Physical aggression is common in children who have been victims of sexual abuse. Depression and facial grimacing are symptoms more commonly found in adults who have been victims of sexual abuse. Children who have been victims of sexual abuse often have poor peer relationships, not strong ones. Test-Taking Tip: Be alert for details about what you are being asked to do. In this question type, you are asked to select all options that apply to a given situation or patient. All options likely relate to the situation, but only some of the options may relate directly to the situation. p. 709

The nurse is assessing a patient who has been admitted for congestive heart failure. The nurse practitioner suspects a pulmonary pathology and asks for a chest x-ray to confirm the findings. Which standard of practice is the nurse practitioner performing? 1. Assessment 2. Diagnosis 3. Prescriptive authority 4. Implementation

3. Prescriptive authority Rationale The nurse practitioner has prescriptive authority and can call for investigative procedures such as chest x-rays to confirm the assessment findings. Assessment is the process of collecting data related to the health and illness of the patient. Nursing diagnosis involves analyzing the assessed data. Implementation is the process of delivering care according to the care plan. pp.4-5

The health care provider asks the certified registered nurse anesthetist (CRNA) to provide spinal anesthesia to a patient who is scheduled for a hernia operation. What is the CRNA's next step? 1. Provide the anesthesia under the supervision of a senior nurse. 2. Inform the health care provider that the CRNA has the right to provide spinal anesthesia only in a tertiary setup . 3. Provide the anesthesia under the supervision of a health care provider with knowledge of surgical anesthesia. 4. Inform the health care provider that the CRNA's services are restricted to nonsurgical procedures.

3. Provide the anesthesia under the supervision of a health care provider with knowledge of surgical anesthesia. Rationale A CRNA receives training at an anesthesia-accredited program. The nurse has the right to provide surgical anesthesia under the supervision of a health care provider with knowledge of surgical anesthesia. The CRNA should provide anesthesia only under the supervision of a health care provider. The CRNA can provide anesthesia, even in a primary setup, under supervision. The CRNA's services may be used for surgical procedures. p. 5

Which feature is true about grand theory? 1. Addresses specific phenomena and reflects practice 2. Is the first level in theory development and describes a phenomenon 3. Provides a structural framework for broad concepts about nursing 4. Links outcomes to specific nursing interventions

3. Provides a structural framework for broad concepts about nursing Rationale A grand theory provides a structural framework for broad concepts about nursing. A middle-range theory focuses on a specific field or phenomenon rather than the broad scope of a grand theory. A descriptive theory (not a grand theory) is the first level of theory development and describes the phenomena under study. A prescriptive theory (not grand theory) details nursing interventions for a specific phenomenon and the expected outcome of care and helps guide research. Test-Taking Tip: If you are unfamiliar with the term in the question, review the responses and look for similar terms in the responses to match those in the question. In this case, the question asks about grand theory. You know grand can mean large or expansive, and the correct answer includes the term broad. p.44

Which type of research design determines the percentage of women who are diagnosed with rheumatoid arthritis between the ages of 50 and 70 years? 1. Phenomenology 2. Qualitative 3. Quantitative 4. Evaluation

3. Quantitative Rationale Quantitative research involves analysis of numbers, such as the percentage of women diagnosed with rheumatoid arthritis and what age groups the women belong to. Phenomenology is a type of qualitative research that deals with perceptions, not percentages, numbers, or statistics. Qualitative research describes information in a non-numerical form and focuses on perceptions. Evaluation research determines how well a program, practice, or policy is working, not percentages of women diagnosed with a certain disease at a certain age. p. 61

How can a nurse establish trust and encourage patient disclosure about sexuality? 1. Ask how often the patient has sexual intercourse. 2. Ask the patient to disrobe in preparation for the physical assessment. 3. Request permission to discuss sexual issues. 4. Request specific examples of sexual practices and problems.

3. Request permission to discuss sexual issues. Rationale According to the Permission, Limited Information, Specific Suggestions, and Intensive Therapy (PLISSIT) assessment of sexuality, the nurse should first ask for permission to discuss sexual issues with the patient, followed by open-ended questions to determine the patient's concerns. The other options do not establish trust or encourage patient disclosures about sexuality. p. 714

In the pyramid of Maslow's hierarchy of needs, which need of the patient is placed at the highest level? 1. Food 2. Love 3. Self-actualization 4. Physical safety

3. Self-actualization Rationale Self-actualization is placed at the highest level. Self-actualization is considered the highest expression of one's individual potential, and it allows for the continual discovery of self. Maslow's model of the hierarchy of needs is used to understand the interrelationships of basic human needs. According to this model, basic needs are at the bottom and self-actualization is at the top. Food is considered a basic need and is thus placed at the bottom, not the top. The need for love comes after the need for physical safety; however, both are below the highest level. pp. 69-71

The nurse explains a procedure to a patient and uses task-oriented touch. Which action by the nurse would be considered task-oriented touch? 1. Listening to the patient's concerns 2. Making good eye contact with the patient 3. Skillfully inserting the tube and positioning it 4. Holding the patient's hand and comforting the patient

3. Skillfully inserting the tube and positioning it Rationale Task-oriented touch is the touch that the nurse uses while performing nursing procedures. In this scenario, inserting the tube skillfully is task-oriented touch. Listening to the patient's concerns and making good eye contact ensure the patient's comfort but are not task-oriented touch. Holding the patient's hand is an example of caring touch. p. 87

Which definition describes the knowing component of Swanson's theory of caring? 1. Being emotionally present for the patient 2. Facilitating the patient's passage through changes in life 3. Striving to understand an event as it has meaning in the life of the patient 4. Caring for the patient as the nurse would have done for himself or herself

3. Striving to understand an event as it has meaning in the life of the patient Rationale Swanson's theory of caring comprises five caring processes. Knowing is striving to understand an event as it has meaning in the life of the patient. Being with refers to being emotionally present for the patient. Enabling is facilitating the patient's passage through changes in life. Doing for is caring for another person as that person would have done if it were possible. Maintaining belief is sustaining faith in the other person's ability to get through an event. Test-Taking Tip: Have confidence in your initial response to an item because it more than likely is the correct answer. pp. 84-85

The nurse skillfully inserts a Foley catheter in a patient. Which type of touch is this? 1. Caring touch 2. Protective touch 3. Task-oriented touch 4. Interpersonal touch

3. Task-oriented touch Rationale Nurses use task-orientated touch when performing a task or procedure. An expert nurse learns that any procedure is more effective when administered carefully and in consideration of any patient concern. Caring touch is holding a patient's hand, giving a back massage, gently positioning a patient, or participating in a conversation to enhance a patient's comfort and security, self-esteem, confidence in the caregivers, and mental well-being. Protective touch protects the nurse and/or the patient to prevent physical or emotional harm. Touch can enhance interpersonal relationships, but there is no category of touch labeled interpersonal touch. p. 87

Which level of prevention describes a patient who experienced a myocardial infarction (heart attack) 4 weeks ago and is currently participating in the daily cardiac rehabilitation sessions at the local fitness center? 1. Primary 2. Secondary 3. Tertiary 4. Quaternary

3. Tertiary Rationale Tertiary prevention is being described. Tertiary prevention involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration after a disease (myocardial infarction). Tertiary prevention activities are directed at restoration and rehabilitation (cardiac rehabilitation sessions). Care at this level aims to help patients achieve as high a level of functioning as possible despite the limitations caused by illness or impairment. Primary prevention is aimed at health promotion and includes health education programs, immunizations, and physical and nutritional fitness activities before an illness occurs, not after. Secondary prevention includes diagnosing and treating an illness and limiting disabilities, not attending cardiac rehabilitation sessions. There are only three levels of prevision; the quaternary level does not exist. p. 74

Which parameter indicates a high quality of nursing care provided in the care unit? 1. The high number of patient falls 2. The high number of patients developing pressure injuries 3. The low rate of hospital-acquired infections 4. The low rate of patient admissions

3. The low rate of hospital-acquired infections Rationale A low rate of hospital-acquired infections indicates that the quality of nursing care is high. A high number of patient falls and high number of patients developing pressure injuries indicate subpar nursing care, not a high quality of nursing care. The low rate of patient admissions is not related to the quality of nursing care provided, but is more medical-focused than nursing-focused. p.23

A couple is diagnosed as positive for the human immunodeficiency virus (HIV). Which information would the nurse include when educating this couple about HIV? 1. They should not engage in sexual intercourse. 2. Their children will also be HIV positive . 3. Their duration of survival would increase with treatment. 4. They can be cured by highly active antiretroviral therapy (HAART).

3. Their duration of survival would increase with treatment. Rationale Individuals infected with HIV can survive for about 10 years if left untreated. Because they are already infected, they may have sexual intercourse with each other. Their children are at risk, but not all children born to mothers with HIV test positive for HIV. HAART greatly increases the longevity of infected individuals but does not cure the disease. p. 711

Which model that consists of five stages of health behavior change would the nurse use to manage a patient who needs to exercise? 1. Health belief model 2. Holistic health model 3. Transtheoretical model 4. Maslow's hierarchy of needs

3. Transtheoretical model Rationale The Transtheoretical Model of Change describes the five stages of health behavior change that a patient undergoes while trying to change a behavior (in this case, exercising). The health belief model helps the nurse understand the patient's beliefs, behaviors, and perceptions of illness and plans to provide an appropriate intervention; it does not have five stages. While the holistic health model is an approach in which the nurse creates conditions to promote the patient's fitness and well-being, it does not have five stages. Maslow's hierarchy of needs helps nurses understand the importance of and relationships among basic human needs; it does not focus on changing health behaviors. pp. 75-76

Which health care service is provided in secondary care? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected 1. Assisted living 2. Intensive care 3. Urgent care 4. Outpatient surgery 5. Ambulatory care

3. Urgent care 4. Outpatient surgery 5. Ambulatory care Rationale Secondary health care services include urgent care, outpatient surgery, and ambulatory care. The aim of these services is to diagnose and treat illness. Assisted living is an example of continuing care, not secondary care. Intensive care is a part of tertiary care, which is more sophisticated care provided at specialized health care centers; it is not a type of secondary care. p. 15

The terms diagnosis of breast cancer and roles of the family are examples of which elements in the research question, "What is the effect of the diagnosis of breast cancer on the roles of the family?" 1. Surveys 2. The sample 3. Variables 4. Data collection

3. Variables Rationale These terms are examples of the variables. Variables are concepts, characteristics, or traits that vary within or among patients. Surveys are methods of collecting data about the variables, but they are not the variables. The sample is the group of individuals surveyed for the information, not the diagnosis of breast cancer and roles of the family. These terms are not data collection; there are many methods for data collection, such as surveys, questionnaires, physiological measures, interviews, or observations. p. 57

The nurse has long conversations with a patient about the patient's health, family, and religious and cultural practices. Which likely effect will such a conversation have on the healing relationship? 1. May distract the nurse from important nursing tasks 2. Will have no effect on the patient's healing 3. Will help to assist the patient in using social resources 4. Will make the patient uncomfortable to reveal personal information

3. Will help to assist the patient in using social resources Rationale Having long conversations helps the nurse provide the patient with social, emotional, and spiritual resources. Such conversations will not necessarily distract the nurse from important tasks because conversation can be held while the nurse performs routine care tasks. These conversations extend the healing relationship so that the patient's recovery will be faster, and it may build the patient's confidence in the nurse. Usually, patients are happy to reveal personal information to professionals involved in providing health care. p.89

Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk of bed sores. This is an example of which type of education? 1. Continuing prerequisite education 2. Graduate education 3. lnservice education 4. Professional registered nurse education

3. lnservice education Rationale lnservice education programs provide instruction or training by a health care agency or institution. An inservice program is held in the institution and is designed to increase the knowledge, skills, and competencies of nurses and other health care professionals employed by the institution. Prerequisite education is course work required prior to the nursing program. Graduate education is a formal program that follows a Bachelor of Science in Nursing (BSN), and professional registered nurse education is an undergraduate nursing education program. p. 10

Which statement made by a young adult patient with an amputation indicates a problem with body image? 1. "I just don't have any energy to get out of bed in the morning." 2. "I've been attending church regularly with my wife since I got out of the hospital." 3. "My wife has taken over paying the bills since I've been in the hospital." 4. "I don't go out very much because everyone stares at me."

4. "I don't go out very much because everyone stares at me." Rationale The statement, "I don't go out very much because everyone stares at me" indicates a problem with body image. The amputation resulted in a change in physical appearance that caused a change in body image. Not having the energy to get out of bed indicates a problem with fatigue or depression, not a problem with body image. Attending church indicates a positive adjustment to the amputation, not a problem with body image. Having the wife pay the bills is an impact of the amputation on the family roles and dynamics that can occur from an illness or amputation, but it does not indicate a problem with body image. pp. 77-78

The nurse understands that any weight change necessitates a resizing of the diaphragm. A loss or gain of how much weight would be significant? 1. 4 pounds 2. 6 pounds 3. 8 pounds 4. 10 pounds

4. 10 pounds Rationale A diaphragm is a round, rubber dome that is fitted into the cervical opening to provide contraception. It must be used with a contraceptive cream or jelly. It must be refitted if the patient has a weight gain or loss of 10 pounds. Weight changes of 4, 6, or 8 pounds have no adverse effect on the placement of the diaphragm and thus do not require the patient to be refitted. p. 710

Which service is provided at an occupational health center? 1. Coverage to pay the bills of workers who get ill or injured 2. Healthy nutrition education through a school curriculum 3. Care for older patients or those unable to leave their homes 4. Accident/disease prevention in the workplace

4. Accident/disease prevention in the workplace Rationale Occupational health centers provide services for accident/disease prevention in the workplace. A type of health insurance (not the occupational health center) pays a portion of the bills of workers who get ill or injured. School health is a program that includes healthy nutrition education through the school curriculum; an occupational health center does not work through a school curriculum. Block and parish nursing and home health nurses provide services to older patients or those unable to leave their homes; occupational health centers focus on care at the workplace, not the home. p. 16

A patient has been advised to have a total knee replacement because of osteoarthritis. The patient is not willing to undergo the surgery, but family members want to get the surgery done to relieve the disability. The nurse explains the details of the surgery and the risks associated with it, and also discusses the patient's wishes with the family. Which nursing role is the nurse playing here? 1. Educator 2. Caregiver 3. Case manager 4. Advocate

4. Advocate Rationale As a patient advocate, the nurse's duty is to provide information to help a patient and family members decide whether or not to accept a treatment. As a caregiver, the nurse's role is to help patients maintain and regain health, manage symptoms, and attain maximum functional independence. As nurse educator, the nurse is expected to teach a patient or group of patients about health and self-care activities. As a case manager, the nurse develops a care plan based on the assessment and coordinates other health care resources and services that could help the patient attain the outcome goals. p.3

Which activity is classified as tertiary prevention? 1. Attending to personal hygiene 2. Taking measures to shorten a period of disability 3. Providing services to limit disability and prevent death 4. Aiding with rehabilitation for physically handicapped people

4. Aiding with rehabilitation for physically handicapped people Rationale Aiding with rehabilitation for physically handicapped people is tertiary prevention. Tertiary preventive measures are taken when permanent, irreversible damage has occurred as a result of a medical problem or accident. Attending to personal hygiene is a primary preventive measure, not tertiary. Taking measures to shorten the period of disability comes under secondary prevention, not tertiary. Providing services to limit disability and prevent death is a secondary preventive measure, not tertiary. p. 74

Which nursing behavior is considered important to patients' well-being by families of acutely ill patients? 1. Making health care decisions for patients 2. Having family members provide total personal hygiene care for the patient 3. Injecting the nurse's perceptions about the level of care provided 4. Asking permission before performing a procedure on a patient

4. Asking permission before performing a procedure on a patient Rationale To care for a family, the nurse takes into consideration the context of the patient's illness and the stress it imposes on all family members. Making health care decisions for patients, having family members provide hygiene care for the patient, and injecting the nurse's perceptions about the level of care provided are inappropriate behaviors. p. 89

Which bacterial sexually transmitted infection (STI) is most commonly reported in the United States? 1. Syphilis 2. Gonorrhea 3. Genital herpes 4. Chlamydia

4. Chlamydia Rationale Syphilis, gonorrhea, genital herpes, and chlamydia! infections are all commonly reported; however infection with Chlamydia organisms is the most common bacterial STI in the United States. Other STls include syphilis, gonorrhea, and genital herpes. Syphilis is caused by Treponema pallidum. Gonorrhea is caused by Neisseria gonorrhoeae. Genital herpes is caused by the herpes simplex virus. p. 712

In which stage of the Transtheoretical Model of Change would a patient have mixed feelings about quitting smoking? 1. Action 2. Preparation 3. Maintenance 4. Contemplation

4. Contemplation Rationale Mixed feelings (ambivalence) about a behavior change are characteristic of the contemplation stage. In the action stage, the patient actively engages in strategies to quit smoking and does not have mixed feelings about quitting. In the preparation stage, the person understands the advantages and plans how to make small changes; the patient does not have mixed feeling about quitting. The maintenance stage involves integrating positive behavioral changes into the patient's long-term lifestyle to prevent relapse; the patient does not have mixed feelings regarding quitting smoking. p. 76

A nurse talks with colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. Which purpose does this code serve? 1. Improves self-health care 2. Protects the patient's confidentiality 3. Ensures identical care to all patients 4. Defines the principles of right and wrong when providing patient care

4. Defines the principles of right and wrong when providing patient care Rationale The code of ethics identifies the philosophical ideals of right and wrong that define the principles that nurses follow when providing care for patients. The code serves as a guide for carrying out nursing responsibilities to provide quality nursing care and describes the ethical obligations of the profession. The code of ethics does not include methods to improve self-health care. Protecting the patient's confidentiality is a standard of care and is covered in the language of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Care must be provided based on differing patient needs. When giving care, it is essential to provide a specified service according to standards of practice and to follow a code of ethics. Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer. For this question, it would be unethical and incorrect to give all patients identical care.

Which interpretation would the nurse make about a patient who smokes and is in the precontemplation stage to quit smoking? 1. Intends to quit smoking in the next 6 months 2. Has started making small lifestyle changes 3. Is actively taking measures to quit smoking 4. Does not intend to quit smoking in the next 6 months

4. Does not intend to quit smoking in the next 6 months Rationale The patient does not intend to quit smoking in the next 6 months when in the precontemplation stage. According to the Transtheoretical Model of Change, there are five stages in health behavior change that a person may go through while trying to change habits. These stages include precontemplation, contemplation, preparation, action, and maintenance. In the contemplation stage, the patient intends to quit smoking in the next 6 months; the patient is in the precontemplation stage. The patient starts making small lifestyle changes in the preparation stage, not the precontemplation stage. In the action (not precontemplation) stage the patient actively takes measures to quit smoking. p. 76

Which nursing intervention indicates a protective touch for a patient with a major injury after an accident? 1. Shaking the patient's hand while meeting for the first time 2. Touching the patient's shoulder while explaining a medication 3. Holding the patient's hand while starting an intravenous catheter 4. Holding the patient while assisting with walking

4. Holding the patient while assisting with walking Rationale The risk of falls is high in patients with injuries from an accident. Therefore, the nurse holds the patient while walking and protects the patient from falling. This indicates that the nurse is using a protective touch. Shaking the patient's hand when being introduced or while greeting indicates a professional touch. The nurse touches the patient's shoulder while talking to provide comfort or to convey his or her presence to the patient. Holding the patient's hand while completing a procedure indicates a task-oriented touch. p. 87

A patient has been diagnosed with cervical cancer. Which infection would be responsible for this malignancy? 1. Chlamydia infection 2. Gonorrhea infection 3. Herpes simplex infection 4. Human papillomavirus infection

4. Human papillomavirus infection Rationale Human papillomavirus causes cervical cancer in women and anogenital cancers and warts in both men and women. Chlamydia trachomatis infection does not cause malignancies but can cause urinary and pelvic symptoms. Neisseria gonorrhoeae infection causes urethritis and does not lead to any malignancy. Herpes simplex causes recurrent genital lesions. p. 711

A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the prescribed medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed? 1. Planning 2. Evaluation 3. Assessment 4. Implementation

4. Implementation Rationale Implementation is coordinating care and completing the prescribed plan of care. Assessment is the collection of comprehensive data pertinent to the patient's health and/or the situation. Evaluation determines whether a patient's condition or well-being improved after nursing interventions were delivered. Planning involves setting priorities based on patient diagnoses and collaborative problems, identifying patient-centered goals and expected outcomes, and prescribing nursing interventions appropriate for each diagnosis. p.2

A patient has a sprained ankle. The nurse instructs the patient to keep the leg elevated and applies cold compresses on the affected ankle. Which standard of practice is the nurse performing? 1. Assessment 2. Diagnosis 3. Evaluation 4. Implementation

4. Implementation Rationale The nurse is delivering care to the patient; therefore, the standard practiced by the nurse is implementation. Assessment is the process of collecting data related to the health and illness of the patient. Nursing diagnosis involves analyzing the assessed data. Evaluation refers to determining the effectiveness of the implemented patient care in meeting the patient goals. p.2

The registered nurse coordinates care delivery and uses strategies to promote health and a safe environment. Which American Nursing Association (ANA) standard of nursing practice is the registered nurse practicing? 1. Planning 2. Diagnosis 3. Assessment 4. Implementation

4. Implementation Rationale The registered nurse implements the identified plan, which includes care coordination, health teaching, health promotion, consultation, prescriptive authority, and treatment. Health teaching and health promotion include strategies for promoting health and a safe environment for the patient. Planning is prescribing strategies and alternatives to attain an expected outcome. Diagnosis is analyzing data to determine problems. Assessment is collecting comprehensive patient data. p.2

The critical care nurse is using a computerized decision support system to correctly position ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. Which Quality and Safety Education of Nurses (QSEN) competency is this an example of? 1. Patient-centered care 2. Safety 3. Teamwork and collaboration 4. Informatics

4. Informatics Rationale Using decision support systems is an example of using and gaining competency in informatics. Recognizing the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and needs describes patient-centered care. Minimizing risk of harm to patients and providers through both system effectiveness and individual performance describes safety. Functioning effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care describes teamwork and collaboration. p.8

Which element is described when the researcher provides complete information about the purpose of the study and gives patients the choice to participate or not participate in the study? 1. Bias 2. Anonymity 3. Confidentiality 4. Informed consent

4. Informed consent Rationale The element described is informed consent. The process of informed consent includes providing potential research patients full disclosure about the study and the opportunity to participate or not participate in the study. Bias is opinion by a researcher that will influence the results of research; it does not deal with allowing patients to participate or not. Anonymity guarantees that any information a participant provides will not be reported in any manner that identifies the participant and will not be accessible to anyone, including the research team; anonymity does not focus on full disclosure of the experiment. Confidentiality guarantees that any information a participant provides will not be reported in any manner that identifies the participant and will not be accessible to people outside the research team; it does not deal with providing information about the study to participants. p. 63

Which system was created by the federal government to test new payment and service delivery models and advance best practices? 1. Medicare 2. Medicaid 3. Magnet Recognition Program 4. Innovation Center

4. Innovation Center Rationale The federal government created the Innovation Center to test new payment and service delivery models and advance best practices. Although Medicare and Medicaid are funded by the federal government, they are government insurance programs; they do not test new payment and service delivery models. The Magnet Recognition Program was developed by the American Nurses Credentialing Center, not the federal government. p. 24

Which statement about theory-based nursing practice is correct? 1. It contributes to advancement of the medical profession. 2. It provides a systematic process for delivering nursing care. 3. It is not linked to nursing outcomes. 4. It defines the uniqueness of nursing practice from other disciplines

4. It defines the uniqueness of nursing practice from other disciplines Rationale Theory-based nursing practice defines the uniqueness of nursing practice from other disciplines. Theory based nursing practice contributes to the advancement of the nursing profession, not the medical profession. The nursing process provides a systematic process for delivering nursing care; it is not a theory. Theory-based nursing practice is linked to nursing outcomes. For example, prescriptive theories address specific nursing interventions and predict the patient response. p.45

The examination for registered nurse licensure is the same in every state in the United States. Which understanding about this examination should the public have? 1. It guarantees safe nursing care for all patients 2. It ensures standard nursing care for all patients 3. It ensures that honest and ethical care is provided 4. It provides a minimum standard of knowledge for a registered nurse in practice

4. It provides a minimum standard of knowledge for a registered nurse in practice Rationale Registered nurse (RN) candidates must pass the National Council Licensure Examinations (NCLEX)-RN® that the individual state boards of nursing administer. Regardless of educational preparation, the examination for RN licensure is exactly the same in every state in the United States. This provides a standardized minimum knowledge base for nurses. Successfully passing the NCLEX-RN® does not guarantee safe, standard, nor ethical practice. These are evaluated by the employer. Test-Taking Tip: Key words or phrases in the question such as.first, primary, early, or best are important. Similarly, words such as only, always, never, and all in the answer options are frequently evidence of a wrong response. As in life, no real absolutes exist in nursing; every rule has its exceptions, so answer with care. For this question, you will notice that two of the choices seem unlikely because of the word all; furthermore, when you examine the remaining choices, you realize that it would be impossible to ensure ethical care through an examination, thus giving you the answer. You can recheck the remaining answer choice against the question and confirm it is correct! p. 11

Which statement is true regarding Magnet status recognition for a hospital? 1. Nursing is run by a Magnet manager who makes decisions for the nursing units. 2. Nurses in Magnet hospitals make all of the decisions on the clinical units. 3. Magnet is a term used to describe hospitals that are able to hire the nurses they need . 4. Magnet is a special designation for hospitals that achieve excellence in nursing practice.

4. Magnet is a special designation for hospitals that achieve excellence in nursing practice. Rationale Magnet is a special designation for hospitals that achieve excellence in nursing practice. The designation is given by the American Nurses Credentialing Center and focuses on demonstration of quality patient care, nursing excellence, and innovations in professional practice. The manager does not obtain Magnet status; the hospital receives the recognition. The nurses contribute to making decisions but do not make all of the decisions. Magnet does not mean hospitals are able to hire the nurses they need; however, Magnet recognition can help recruit nurses. Test-Taking Tip: If you are not certain of an answer, make an educated guess. p. 26

A 50-year-old patient is admitted with acute exacerbation of asthma. The patient is treated by a clinical nurse specialist. The patient expresses thanks to the clinical nurse specialist for the care that all the nurses have provided. What are the minimal educational qualifications to become a clinical nurse specialist? 1. Basic nurse education 2. Registered nurse licensure 3. Doctoral degree in nursing 4. Master's degree in nursing

4. Master's degree in nursing Rationale A master's degree in nursing is the educational requirement for a clinical nurse specialist (CNS). Basic nursing education is not a graduate degree. Registered nurse (RN) licensure is not an educational qualification. A doctoral degree exceeds the qualifications for a CNS. STUDY TIP: Consider what additional education you may want after you complete your basic nurse education. Research what additional opportunities would be available to you with an advanced degree. p.4

When preparing a research project, which level of evidence is highest for a scientific study? 1. Single non-experimental cohort study 2. Controlled trial without randomization 3. Systematic review of a qualitative study 4. Meta-analysis of a randomized clinical trial

4. Meta-analysis of a randomized clinical trial Rationale The Level 1 meta-analysis of a randomized clinical trial is the highest level of evidence available to a researcher. The single non-experimental cohort study is a Level 4 in the pyramid indicating levels of evidence. The controlled trial is a Level 3. The systemic review of a qualitative study is a Level 5. All other levels are less reliable than a Level 1 type of evidence. Test-Taking Tip: Avoid looking for an answer pattern or code. There may be times when four or five consecutive questions have the same letter or number for the correct answer. p.55

When preparing a research project, which level of evidence is highest for a scientific study? 1. Single nonexperimental cohort study 2. Controlled trial without randomization 3. Systematic review of a qualitative study 4. Meta-analysis of a randomized clinical trial

4. Meta-analysis of a randomized clinical trial Rationale The Level 1 meta-analysis of a randomized clinical trial is the highest level of evidence available to a researcher. The single nonexperimental cohort study is a Level 4 in the pyramid indicating levels of evidence. The controlled trial is a Level 3. The systemic review of a qualitative study is a Level 5. All other levels are less reliable than a Level 1 type of evidence. Test-Taking Tip: Avoid looking for an answer pattern or code. There may be times when four or five consecutive questions have the same letter or number for the correct answer. p.55

The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. The nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Which career does the nurse consultant exemplify? 1. Clinical nurse specialist 2. Nurse administrator 3. Nurse educator 4. Nurse researcher

4. Nurse researcher Rationale The nurse researcher investigates problems to improve nursing care and to further define and expand the scope of nursing practice. The nurse researcher often works in an academic setting, hospital, or independent professional or community service agency. A clinical nurse specialist (CNS) is an advanced practice registered nurse who is an expert clinician in a specialized area of practice. A nurse administrator manages patient care and the delivery of specific nursing services within a health care agency. A nurse educator works primarily in schools of nursing, staff development departments of health care agencies, and patient education departments. p. 5

Which phase of the health belief model (HBM) describes a female patient who is concerned about getting diabetes mellitus because both her grandfather and father have the disease? 1. Perceived threat of the disease 2. Likelihood of taking preventive health action 3. Analysis of perceived benefits of preventive action 4. Perceived susceptibility to the disease

4. Perceived susceptibility to the disease Rationale The patient is in the phase of perceived susceptibility to the disease. In this phase, the patient recognizes the familial link to the disease. The HBM addresses the relationship between a person's beliefs and behaviors. Perceived threat of the disease is the second phase of the individual's perception of the seriousness of the illness, and this patient is not at that stage; the patient is just recognizing susceptibility. Likelihood of taking preventive health action is the third phase of the HBM, in which the person does or does not take preventive actions; this patient is not at that phase. Analysis of perceived benefits of preventive action occurs in the fourth phase, and this patient is not at that level. p.69

In which stage of the Transtheoretical Model of Change does a patient display defensive behavior when the nurse provides information regarding the benefits of quitting excessive alcohol drinking? 1. Action 2. Preparation 3. Contemplation 4. Precontemplation

4. Precontemplation Rationale In the precontemplation stage, a patient is not interested in the information provided and may exhibit defensive behaviors when the nurse tries to explain the benefits of a behavioral change (quitting excessive alcohol drinking). In the action stage, the patient actively takes measures to stop drinking for at least 6 months; the patient would not become defensive in the action stage. In the preparation stage, the patient understands the advantages of making the change and begins to make small changes; the patient does not become defensive. In the contemplation stage, the patient considers quitting excessive alcohol drinking within the next 6 months; the patient would not become defensive about the change. p. 76

Which type of theory would the nurse consider to find the effectiveness of breathing exercises for patients with asthma? 1. Grand 2. Middle-range 3. Descriptive 4. Prescriptive

4. Prescriptive Rationale Prescriptive theories detail nursing interventions for a specific phenomenon and the expected outcome of the interventions. Thus the nurse would refer to prescriptive theories to find the efficacy of an intervention. Grand theories do not provide guidance for specific nursing interventions; they provide a broad abstract framework for general ideas about nursing. Middle-range theory tends to focus on a specific field of nursing rather than reflect on a wide variety of nursing care situations. Descriptive theories explain why a phenomenon occurs; they do not guide nursing interventions. pp. 44-45

An elderly patient has been put on a potentially toxic drug for treatment of arthritis. The patient and family have expressed concern about the drug. What is the nurse's responsibility in this particular situation? 1. Give the drug in a very low dose. 2. Obey the health care provider's instruction. 3. Do not speak out against policies or actions . 4. Provide information so the patient can decide whether to accept or refuse the treatment.

4. Provide information so the patient can decide whether to accept or refuse the treatment. Rationale The patient has been put on a potentially toxic drug. Because the patient is elderly, the nurse should act as an advocate and take measures to protect the patient's rights. Therefore, the nurse may provide information that will help the patient decide whether to take the treatment. The nurse should not give the drug in a low dose because that may not serve the purpose of administering it. The nurse should obey the instructions by the health care providers only after ensuring that the patient's concerns are addressed. At times, to protect human rights, the nurse needs to speak out against policies. pp. 3-4

Which type of shared theory focuses on explanations or predictions of human responses within the physiological, psychological, sociocultural, developmental, and spiritual domains? 1. Systems 2. Biomedical 3. Developmental 4. Psychosocial

4. Psychosocial Rationale Theoretical models that explain or predict patient responses related to any physiological, psychological, sociocultural, developmental, and spiritual domain come under psychosocial theories. Systems theory explains the components of a theory that are interrelated to form a whole, such as the nursing process, not for explanation or predictions of human responses within the physiological, psychological, sociocultural, developmental, and spiritual domains. A biomedical theory explains causes of disease, not human responses within the physiological, psychological, sociocultural, developmental, and spiritual domains. Developmental theories explain the processes that start with conception and continue until death and the common pattern of growth and development, not human responses within the physiological, psychological, sociocultural, developmental, and spiritual domains. p. 47

Which type of research study describes when the nurse researcher randomly assigns 100 patients who smoke and attend a wellness clinic into two groups and plans to compare the effectiveness of the standard treatment with the educational program? 1. Qualitative 2. Descriptive 3. Correlational 4. Randomized controlled trial

4. Randomized controlled trial Rationale This is a randomized controlled trial because patients are randomly assigned into either the control or treatment group. The researcher will measure the effectiveness of the standard treatment with the educational program, which is a quantitative measure, not qualitative. This research is also not descriptive, which measures people, situations, or groups and the frequency with which certain events or characteristics occur. Correlational research explores interrelationships among variables of interest without any active intervention by the researcher; the researcher in this study provided an active intervention (educational program). p. 61

Which activity regarding the research process would the nurse conduct to determine what has already been studied about the research problem of interest? 1. Construct a theoretical framework. 2. Identify variables. 3. Formulate a hypothesis . 4. Review the literature.

4. Review the literature. Rationale The nurse would review the literature. A literature review provides information on what has already been studied about the research problem of interest. Constructing a theoretical framework will not help determine what has already been studied. Variables are concepts in the study that are expected to change or differ from one person or time to another, but identifying variables will not help determine what has already been studied. Formulating a hypothesis does not help determine what has already been studied about the problem. A hypothesis is a prediction that should be based on previous research, so it is developed after conducting a review of the literature p.57

Which action would the nurse take when having difficulty communicating with the patient, a young boy, and his father who are both from Greece? 1. Care for the boy using hand gestures as if he were from the local community. 2. Ask the manager to talk with the father and keep him out of the unit. 3. Have another nurse care for the boy because maybe that nurse will do better with the father . 4. Search for help with language interpretation while recognizing cultural differences.

4. Search for help with language interpretation while recognizing cultural differences. Rationale The nurse would search for help with language interpretation while recognizing cultural differences. The nurse needs to understand how Greek culture influences the father's health beliefs and communication with health care providers. Cultural background influences beliefs, values, and customs. It influences the approach to the health care system, the health practices, and the nurse-patient relationship. Utilizing hand gestures is not a genuine way to communicate with a patient from another culture. Parents are integral components in the health and healing of their children, and it is not appropriate to ask the manager to talk with the father and keep him out of the unit. It is not appropriate to pass the child to another nurse. p. 72

While comforting a patient who is in severe pain, which nursing intervention is beneficial? 1. Stepping back to give the patient space 2. Speaking to the patient in a loud and cheerful voice 3. Smiling and writing notes while listening to the patient 4. Sitting beside the patient and holding the patient's hand

4. Sitting beside the patient and holding the patient's hand Rationale The patient is in pain, so holding the patient's hand and sitting beside the patient will reduce the patient's pain and provide comfort, demonstrating the comforting approach. Stepping back to give the patient space would facilitate a protective approach and ensure that the patient does not come to harm, but it would not provide comfort. Speaking in a loud voice may startle the patient and increase the patient's pain, so that is not a comforting intervention. Smiling while communicating does not reduce the patient's pain, is not as beneficial as holding the patient's hand, and is not an example of the comforting approach. p. 87

Which topic is best suited for quantitative research? 1. The perception of a patient with chronic back pain on quality of life 2. The parent's perception of nursing care on a pediatric unit 3. The caregiver's perception of stress while caring for patients with dementia 4. The different types of dressings to measure the extent of surgical wound healing

4. The different types of dressings to measure the extent of surgical wound healing Rationale "The different types of dressings to measure the extent of surgical wound healing" is best suited for quantitative research. Quantitative research involves analysis of numbers and measurements. This type of research offers precise measurements and quantifications. The perception of a patient with chronic back pain on quality of life, the parent's perception of nursing care on a pediatric unit, and the caregiver's perception of stress while caring for patients with dementia are all types of qualitative, not quantitative, research. Qualitative research involves verbal analysis, and the information is obtained in a nonnumerical form. Test-Taking Tip: Notice that all three incorrect responses have the word perception in them. Perceptions are a qualitative component; that is, they are not reliably measured. The correct choice for this question about quantitative research includes a description of something that can be accurately measured (i.e., extent of healing). p. 61

Which phrase accurately describes content? 1. Data entering the system 2. The end product 3. Data related to system functioning 4. The product and information obtained from the system

4. The product and information obtained from the system Rationale Content is the product and information obtained from the system. Data entering the system is input, not content. The end product is output, not content. Data related to system functioning is feed back, not content. p.46

Which statement about touching patients is accurate? 1. Touching is reserved for times when procedures are being done. 2. Touch is a type of verbal communication. 3. There is never a problem with using touch . 4. Touch forms a connection between nurse and patient.

4. Touch forms a connection between nurse and patient. Rationale Touch is relational and leads to a connection between the nurse and patient. It involves contact and noncontact touch. Contact touch involves obvious skin-to-skin contact, whereas noncontact touch refers to eye contact. Before implementing touch, the nurse should be aware of the patient's cultural practices and past experiences. Although comforting to some, for others touch may be perceived as invasive or threatening. p. 87

A couple does not desire to have any more children. Which contraceptive method would the nurse suggest? 1. Skin patch 2. Intrauterine device 3. Abstinence 4. Vasectomy

4. Vasectomy Rationale Because the couple does not wish to have any more children, it is advisable for them to opt for permanent contraception. Vasectomy is usually a permanent sterilization procedure for men and involves tying and cutting of the vas deferens. Skin patches and intrauterine devices are not as effective and do not offer permanent contraception. Abstinence from sex is difficult to maintain for most couples. STUDY TIP: The contraceptive methods that are permanent are also referred to as sterilization. These include vasectomy for the man and tubal ligation for the woman. Both can rarely be surgically reversed, so vasectomy and tubal ligation are usually permanent. Be sure you are ready for questions on sterilization as well as contraception. p. 710

In Neuman System Model of nursing, how many components, including the physical, interact with each other to represent the patient as a system? Record your answer using a whole number.

5 Rationale This theory has five components that represent the patient as a system: the physical, psychological, sociocultural, developmental, and spiritual. Neuman's theory is based on stress and the patient's reaction to it. p.48