Unit 5 revision

Which of the following is the best description of managed care? a. Care Coordination b. Cost containment systems directing the utilization of patient care c. System d. A system of providers

B managed care focuses on a cost containment system directing utilization of health care towards eligible reimbursement

2. As a nurse, you are aware that Medicare is a: a. health insurance program for people aged 65 and older or under age 65 with certain disabilities or any age with end-stage renal disease b. health insurance program for age 66 and older c. joint federal and state assistance program designed to pay for medical long-term care assistance for individuals and families with low income and limited resources d. state assistance program designed to pay for medical long-term care assistance for individuals and families with low income and limited resources

a. health insurance program for people aged 65 and older or under age 65 with certain disabilities or any age with end-stage renal disease

A hospital has begun to expand home health services to its clients. Which reason is the most likely cause for the expansion of these services? a) Changes to the structure of Medicare and Medicaid b) The increase in the incidence and prevalence of infectious diseases c) The change to shorter hospital stays d) The need for decreased financial expenditures

c) The change to shorter hospital stays

5. You are completing the discharge plan for a patient who has Medicare Part B. You will inform the patient that this part of her Medicare coverage plan pays for: a. prescription medication b. a new ramp for her wheelchair access c. surgical procedures as an outpatient d. durable medical equipment

d. durable medical equipment

A community center is presenting a nurse-led program on the Patient Protection and Affordable Care Act. Which statement made by a participant indicates a need for further teaching? 1. "My small company will now have to offer the 75 employees health insurance or pay a penalty." 2. "As long as my son is a full-time student in college, I will be able to keep him on my health insurance until he is 26 years old." 3. "I signed up for the state health insurance exchange before the designated deadline to make sure I had health insurance." 4. "Since I have now been diagnosed with diabetes, my health insurance plan cannot charge me higher premiums."

2

A factor that strongly influences the success of a primary health care system is: A) Participation of the community members in the design, implementation, and evaluation of the initiative. B) Assurance of access to care for every woman and child from pregnancy through childhood. C) Each entity's sense of urgency regarding the evaluation of indicators. D) Cure orientation of the private sector of health care delivery in the United States.

A

The nurse is assigned to an interdisciplinary team caring for a patient. Which is a role the nurse is expected to fulfill in this team? Taking full responsibility for providing direct care to the patient Prescribing medications that are appropriate for the patient's care Attending team meetings to discuss the patient's care Making independent decisions regarding the patient's medical care

Attending team meetings to discuss the patient's care

A nurse is caring for patients in a primary care center. What is the most likely role of this nurse based on the setting? a. Assisting with major surgery b. Performing a health assessment c. Maintaining patients' function and independence d. Keeping student immunization records up to date

B

Community service organizations partnered with healthcare services work to accomplish all of the following EXCEPT: A) Reduce the number of unnecessary emergency room visits B) Encourage vulnerable patients to leave the hospital as soon as possible C) Reduce the number of preventable hospital readmissions D) Provide home care, transportation services, shelters, chemical dependency programs, meal delivery services, and reduced cost medication programs.

B

Which activities should the nurse recognize as supporting the building of skills for successful collaboration of interprofessional healthcare​ teams? (Select all that​ apply.) A.Focusing care delivery on individual groups B.Advocating for policy change with local legislation C.Role playing scenarios to practice communication skills D.Encouraging clinical problem solving through group work E.Practicing with additional credentials to increase nursing authority

B,C,D,E Rationale: Nursing collaboration is supported by working in groups and having a voice in the community on health policy through​ advocacy, professional communication​ skills, and increased authority and accountability. Focusing care is an individual task.

A nurse manager recognizes that an individual can affect health policy. Which of the following actions by the nurse indicates the step of agenda setting in affecting health policy? A. Planning a fund-raising campaign to raise money for a nutrition program B. Identifying increased malnutrition in preschool children C. Evaluating daycare meal plans D. Implementing a home meal plan for preschool children

B. Identifying increased malnutrition in preschool children

The nurse is planning to participate in a community dialogue regarding healthcare resource allocation. Which discussion activity would be the most appropriate choice for this nurse? Talking with cancer survivors Collaborating with legislators Networking with healthcare providers Speaking with the hospital administration

Collaborating with legislators

Which activity should the nurse understand is a key competency to effective nursing care? Being able to interact with healthcare providers Knowledge of hospital rules and regulations Medication administration Communication

Communication Communication is a key competency of effective nursing care and means for promoting collaboration. Miscommunication among healthcare providers can lead to serious consequences. This is important for all members of the collaborative healthcare team, including the healthcare provider. Administering medications is required as prescribed by the healthcare provider. Understanding the rules and regulations of a hospital would be necessary if employed in an inpatient facility.

A patient is given information about the same medication from different members of the healthcare team. Which term should the nurse use to describe this collaboration? Parallel communication Information exchange Parallel functioning Coordination and consultation

Parallel communication

Which outcome should the nurse understand is an adverse organizational outcome that may occur because of negativity or incivility? Increased reports of incivility Decreased absenteeism Staff turnover Decreased patient errors

Staff turnover

The nurse is assessing the birth rates and death rates of the local municipality and comparing these rates to those of the nation and the world. Which type of nursing is this nurse practicing? a) Research nursing b) Home health nursing c) Community health nursing d) Parish nursing

c) Community health nursing

The nurse provides information about Medicare to a 65-year-old patient who is on Medicaid. Which patient statement indicates that further information is needed? "I have an appointment with a social worker to help me apply for Medicare." "I understand that Medicare will not cover everything." "I don't want to pay a premium for Medicare every month." "I know I can use the health department for routine care until my Medicare comes through."

"I don't want to pay a premium for Medicare every month." While Medicare Part B does have a monthly premium, a patient who is eligible for Medicaid does not pay a monthly premium. The local health department can provide some services for the patient until the gap in coverage is closed. A social worker can assist the patient with obtaining benefits. Medicare does not cover all services.

The nurse is working at a facility that utilizes primary care nursing as the model for delivering nursing care. Which statement by the nurse best demonstrates an understanding of the role of the primary care nurse? "I have 24/7 authority and responsibility for the patients assigned to my group." "I will be delegating tasks to others, and they will be responsible for the tasks." "I will be providing all the care for my patients and delegate tasks if necessary." "I am responsible for the care of the patients assigned to my team."

"I have 24/7 authority and responsibility for the patients assigned to my group." The statement that best describes the nursing orientees' understanding of primary care nursing is, "I understand that I have 24/7 authority and responsibility for the patients assigned to my group." The primary nurse (PN) cares for the assigned patients during their shift from the time of admission through discharge. The registered nurse who serves as the team leader is accountable for the care provided to the patients assigned to the team. The team leader retains responsibility and authority for the patients' overall well-being but delegates some tasks to unlicensed assistive personnel (UAPs). The statement, "I understand I am responsible for the care of the patients assigned to my team," reflects the model of team nursing.

The nurse manager is providing training on collaboration to a group of nurses. Which comment by a group member indicates that teaching was​ effective? ​"The charge nurse asked me to be on the infection control​ committee, but I​ don't have​ time." ​"The physician keeps ordering physical therapy for my​ client, who ambulates in the hall every​ day." ​"I need to teach my client how important it is to adhere to her treatment​ regimen." ​"I've done my job the same way for 20​ years, and it works well for​ me."

"I need to teach my client how important it is to adhere to her treatment​ regimen." Teaching the client the importance of following the treatment regimen engages the client in​ client-centered care and can lead to improved adherence with the treatment regimen. Effective collaboration eliminates duplication of effort and unnecessary expenses. The nurse needs to inform the physician about the​ client's progress so that the need for physical therapy can be reevaluated. Serving on a committee can improve client outcomes and reduce healthcare​ costs, while improving communication among members. The nurse may find that serving on a committee fosters improved relationships with peers and increased job satisfaction. Performing​ one's job the same way for 20 years overlooks the opportunity to update practice based on the latest​ evidence-based research, which can improve both quality and cost of care.

An older adult patient with some memory difficulty receives care from her daughter. Upon receiving conflicting information about the healthcare provider's visit from the patient and the nurse, the caregiver gets angry and shouts at the nurse. Which response by the nurse will help to diffuse the situation? "You should call the healthcare provider to follow up." "Let's get the healthcare provider on the phone so you can speak with them directly." "You know your mother has memory issues and should not be trusted." "I need you to listen to me. I was present when the healthcare provider saw your mother."

"Let's get the healthcare provider on the phone so you can speak with them directly." By offering to call the healthcare provider, the nurse allows the caregiver to hear directly from the provider for a report. This addresses the issue immediately and considers the caregiver's point of view. The other answer options direct the caregiver, rather than allowing her to collaborate, which may place her on the defensive.

A patient has been prescribed both physical and occupational therapy. The patient asks the nurse,"Why do I need two types of therapy?" Which response by the nurse explains how a physical therapist may complement the activity of the occupational therapist? "Physical therapy addresses your independence and activities of daily living, while occupational therapy aims to treat the injury." "Occupational therapy focuses on independence and activities of daily living, while physical therapy treats the injury." "Your healthcare provider must have made a mistake. You do not need two therapies." "Occupational therapy will help you get back to work faster, while physical therapy focuses on helping you to walk again."

"Occupational therapy focuses on independence and activities of daily living, while physical therapy treats the injury."

A patient has been prescribed both physical and occupational therapy. The patient asks the nurse, "Why do I need two types of therapy?" Which response by the nurse explains how a physical therapist may complement the activity of the occupational therapist? "Occupational therapy focuses on independence and activities of daily living, while physical therapy treats the injury." "Your healthcare provider must have made a mistake. You do not need two therapies." "Occupational therapy will help you get back to work faster, while physical therapy focuses on helping you to walk again." "Physical therapy addresses your independence and activities of daily living, while occupational therapy aims to treat the injury."

"Occupational therapy focuses on independence and activities of daily living, while physical therapy treats the injury." Both physical therapy and occupational therapy offer many benefits to patients, including maintaining independence, maximizing their function, and leading a healthy and active life. While occupational therapy focuses more on helping people get back their independence and successfully carry out activities of daily living, physical therapy treats the injury itself and helps prevent future injuries.

The nursing student is giving a presentation on the roles of citizens and government in shaping health policy. Which statements should be included in the​ presentation? ​(Select all that​ apply.) "One role of government officials is hearing citizens​' concerns." "Citizens will evaluate the outcomes of newly implemented laws." "The citizen who reports the concern is responsible for choosing the best solution." "The citizen​'s responsibilities include evaluating safety concerns of proposed solutions." "The government official is responsible for identifying political considerations related to each solution."

"One role of government officials is hearing citizens​' concerns." "The government official is responsible for identifying political considerations related to each solution."

The nurse case manager is reviewing Medicare coverage rules with a client. Which client statement indicates correct understanding of the​ teaching? "Medicare covers my routine dental care." "Medicare covers the costs of​ long-term care." "The cost of my hearing aids is covered by Medicare." "Prescription drug coverage is available through Medicare.

"Prescription drug coverage is available through Medicare.

The nurse is caring for a patient who has managed care insurance. The patient states, "I am not too sure about this new insurance. I have never had this type of coverage before." Which statement by the nurse provides the patient with an accurate response? "The insurance you have allows you to go wherever you want to receive care." "This type of coverage by design promotes receiving high-quality, cost-effective care." "Your new insurance is excellent in decreasing your out-of-pocket expenses." "You will receive patient-focused care with your insurance plan."

"This type of coverage by design promotes receiving high-quality, cost-effective care." The statement made by the nurse that provides the patient with an accurate response is, "This type of coverage by design promotes receiving high-quality, cost-effective care." Managed care is designed to improve outcomes for groups of patients and its framework can be adapted across all healthcare settings. The statement, "Your new insurance is excellent at decreasing your out-of-pocket expenses," is not necessarily accurate. Managed care consists of a HMO or a PPO, with the PPO's direct cost to the patient being higher. The patient may go wherever they choose for care, but in order for the care to be covered, the patient must use the designated healthcare providers and facilities identified by the insurance company. Patient-focused care is not part of managed care, it is a model of care.

A client is enrolled in an HMO, while their previous experience with healthcare coverage was with a PPO. The client asks the occupational health nurse to explain the difference between the HMO and PPO. The best response by the nurse is: "Both the HMO and PPO are covered by your employer, so it's really not your concern." "You really should be happy about the HMO. You'll pay little, if any, out-of-pocket expense." "Your PPO offered you a choice in your healthcare provider as well as services. Now, you will choose a primary care provider who will evaluate your health and will coordinate all of your care." "You'll have good healthcare benefits, so don't worry."

"Your PPO offered you a choice in your healthcare provider as well as services. Now, you will choose a primary care provider who will evaluate your health and will coordinate all of your care." Rationale: HMO plans emphasize wellness, and members choose a primary care provider who evaluates their health status and coordinates their care. Clients are limited in their ability to select healthcare providers and services, but available services are at minimal and predetermined cost to the client. PPOs consist of a group of physicians that provides an insurance company or employer with health services at a discounted rate. One advantage of the PPO is that it provides clients with a choice of healthcare providers and services. Telling the client not to worry does not address the client's request, which is to explain the difference. Even though explaining that the client will have little out-of-pocket expense may be truthful, it doesn't answer the request. Nursing Process: Implementation Client Need: Safe, Effective Care Environment Cognitive Level: Applying

A nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is an appropriate goal for restorative care? 1. Patient will be able to walk 200 feet without shortness of breath. 2. Wound will heal without signs of infection. 3. Patient will express concerns related to return to home. 4. Patient will identify strategies to improve sleep habits.

1

Nurses on a nursing unit are discussing the processes that led up to a near-miss error on the clinical unit. They are outlining strategies that will prevent this in the future. This is an example of nurses working on what issue in the health care system? 1. Patient safety 2. Evidence-based practice 3. Patient satisfaction 4. Maintenance of competency

1

A charge nurse has made client assignments for the shift and learns that two of the nurses are arguing over who is really going to care for one particular client. One nurse was directed by the nurse manager to care for the client because the client's family requested that nurse. The other nurse was assigned care of the client by the charge nurse. The cause of this conflict is: Receiving directions from two or more "bosses." Inadequate action plan Lack of trust Inadequate communication

Inadequate communication Rationale: The ultimate cause of this conflict is the lack of communication between the nurse manager and the charge nurse. Receiving directions from two bosses would create an individual conflict. Inadequate action plan is not relevant to this situation because there is no plan in place. Lack of trust implies that the nurses do not trust the charge nurse, which is not in evidence here. Nursing Process: Implementation Client Need: Safe, Effective Care Environment Cognitive Level: Applying

The nurse is analyzing the staffing needs of several clinics. Which healthcare trend does the nurse identify that will increase the demand for healthcare​ expertise? (Select all that​ apply.) Lack of specialized practitioners Increased ethnic diversity Increase in​ long-term illness Decreased access to healthcare Lack of primary care providers

Increase in​ long-term illness Lack of primary care providers The increase in long​ term-illness and lack of primary care providers are expected to produce an increased demand for healthcare expertise. Increasing ethnic​ diversity, decreased access to​ healthcare, and lack of specialized practitioners do not contribute to the increased demand for healthcare expertise.

The client asks the​ nurse, "Why am I receiving this​ medication?" Which action should the nurse take if not familiar with the​ medication? 1) Looking up information on the medication and telling the client the reason it is being given 2) Holding the medication and documenting that the client refused 3) Leaving the​ client's oral medication at the bedside and allowing the client to decide whether to take it 4) Instructing the client to tell the nurse the reason why the client thinks the medication is being given

1) Looking up information on the medication and telling the client the reason it is being given Rationale: The nurse should urge the client to question any medication administered about which the client is unsure. The nurse also should be familiar with medications before administering them to a client. With this​ action, the new nurse is acting as a client advocate in preventing medication errors. Asking the client to tell the nurse the reason why the client thinks the medication is being given is inappropriate—many clients will not be able to do​ this, and this is the responsibility of the nurse. Leaving a medication at the​ client's bedside is never appropriate. Holding the​ client's medication because the client is asking about it is also inappropriate and does not improve the safety of medication administration.

All clients have the right to be cared for by a competent and safe nurse according to which guideline for nursing​ care? 1) Standards of practice 2) Code of ethics 3) Nurse practice acts 4) Licensing process

1) Standards of practice ​Rationale: Standards of practice describe the competency level of nursing care as described by the American Nurses Association​ (ANA), which outlines the rights of a client to have competent and safe nursing care. Nurse practice acts regulate the licensing and practice of nursing by describing the scope of practice but does not cover the​ client's rights to competent and safe nursing care. The licensing process establishes an assessment for a minimum knowledge base relevant to the client population that the nurse serves but does not cover the rights of clients. A code of ethics is a guide for carrying out nursing responsibilities while maintaining moral principles but is not associated with the right of clients to have competent and safe nursing care.

The nursing staff is developing a quality program. Which of the following are nursing-sensitive indicators from the National Database of Nursing Quality Indicators (NDNQI) that the nurses can use to measure patient safety and quality for the unit? (Select all that apply.) 1. Use of physical restraints 2. Pain assessment, intervention, and reassessment 3. Patient satisfaction with food preparation 4. Registered nurse (RN) education and certification 5. Number of outpatient surgical cases per year

1, 2, 4

A 73 year old client is being discharged following knee replacement surgery. The home health care nurse is forming an interdisciplinary collaborative team to provide care for the client. What would be some characteristics of this team? (Select all that apply.) The physical therapist would be the leader. A physician will make all the treatment decisions. There is limited communication among team members. Individual members of the team participate in the overall treatment planning. Decisions are made by the treatment team.

Individual members of the team participate in the overall treatment planning. Decisions are made by the treatment team. Rationale: Members of the multidisciplinary team set goals and develop client treatment plans in a more autonomous fashion. In a multidisciplinary team approach, a single team member-usually a physician-makes the treatment decisions. While the physician interacts with each member of the multidisciplinary team, there is little communication between the other individual professionals on the team. As opposed to placing emphasis on each individual team member's area of professional expertise, interdisciplinary collaboration emphasizes each individual's contribution to the joint planning. On an interdisciplinary or interprofessional team, decisions are made by the group. Nursing Process: Implementation Client Need: Management of Care Cognitive Level: Applying

Which of the following are examples of a nurse participating in primary care activities? (Select all that apply.) 1. Providing prenatal teaching on nutrition to a pregnant woman during the first trimester 2. Assessing the nutritional status of older adults who come to the community center for lunch 3. Working with patients in a cardiac rehabilitation program 4. Providing home wound care to a patient 5. Teaching a class to parents at the local grade school about the importance of immunizations

1, 2, 5

The nurse has ideas on how to streamline charting in the electronic medical record. Which interprofessional team member should the nurse​ consult? Information technology expert Complementary healthcare provider Unlicensed assistive personnel Paramedical technologist

Information technology expert The information technology expert would be the collaborative partner to explore changes and to enhance the electronic medical record.The paramedical technologist would be consulted for laboratory and imaging issues.The unlicensed assistive personnel can help with delegated tasks of hands on care.The complementary healthcare provider would be consulted for complementary medical therapies such as acupuncture.

Which of the following are characteristics of managed care systems? (Select all that apply.) 1. Provider receives a predetermined payment for each patient in the program. 2. Payment is based on a set fee for each service provided. 3. System includes a voluntary prescription drug program for an additional cost. 4. System tries to reduce costs while keeping patients healthy. 5. Focus of care is on prevention and early intervention.

1, 4, 5

Which activity performed by a nurse is related to maintaining competency in nursing practice? 1. Asking another nurse about how to change the settings on a medication pump 2. Regularly attending unit staff meetings 3. Participating as a member of the professional nursing council 4. Attending a review course in preparation for a certification examination

4

A nurse caring for patients in a primary care setting submits paperwork for reimbursement from managed care plans for services performed. Which purpose best describes managed care as a framework for health care? a. A design to control the cost of care while maintaining the quality of care b. Care coordination to maximize positive outcomes to contain costs c. The delivery of services from initial contact through ongoing care d. Based on a philosophy of ensuring death in comfort and dignity

A

Primary health care differs from primary care in which of the following ways? A) Primary health care encourages community participation. B) Primary health care focuses on prevention and cure. C) Primary health care is defined more narrowly. D) Primary health care is the primary method of health care delivery in the United States.

A

The nurse attended a class about preventing horizontal violence in the workplace. Which action by the nurse indicates that learning​ occurred? A.Teaching others through unit presentations about the ramifications of workplace violence B.Encouraging gossip about peers and other staff members C.Allowing nurses who have been victims to approach and humiliate their abusers D.Ignoring negative statements of others about nurses on the unit

A Rationale: Each nurse and nurse manager has a responsibility to act to prevent workplace bullying. One way to prevent this form of aggression and violence is to educate others about the ramifications of bullying. Condoning or encouraging​ gossip, ignoring negative​ comments, and allowing humiliating or hostile behaviors are actions that​ promote, rather than​ discourage, bullying in the workplace.

The nurse wants to provide collaborative care for a client who has terminal cancer. Which action should the nurse​ include? A.Consulting an​ oncology-certified nurse when planning care B.Providing comfort interventions C.Assessing the​ client's preferences regarding care D.Giving the physician priority when delivering care

A Rationale: Seeking expertise from an​ oncology-certified nurse when planning care for the client with terminal cancer is consistent with providing collaborative care. Assessing the​ client's preferences regarding care and providing comfort interventions are nursing responsibilities that the nurse is required to​ meet, regardless of the care setting or the type of care being provided. It is not appropriate for the nurse to give one team member priority over another when delivering care.

The nurse is involved in a situation of hostility with a​ co-worker that is escalating in an open area.Which action should the nurse take to best address the​ situation? A.Taking the interaction to a private place B.Walking away from the employee and ignoring the situation C.Calling for​ upper-level administration to assist D.Continuing the interaction in the current location

A ​Rationale: Conflict should not take place in open areas. It is best to move the conflict to a private area.​ Upper-level administration may be involved if members of supervision are involved in the conflict. Walking away to establish boundaries may be done if the conflict cannot be moved to a private area but not with the intention of ignoring the situation.

Which statement by the nurse describes the difference between a nutritionist and a dietitian? A dietitian primarily prescribes therapeutic diets and a nutritionist recommends healthy diets and advisory services. A dietitian recommends vitamins and exercises for weight loss and the nutritionist works in the community to promote healthy diets. A nutritionist helps patients with therapeutic diets and a dietitian recommends healthy diets and advisory services. A nutritionist recommends vitamins and exercises for weight loss and a dietitian suggests diets to accommodate diseases.

A dietitian primarily prescribes therapeutic diets and a nutritionist recommends healthy diets and advisory services. A dietitian is someone who primarily works in a hospital and helps patients with therapeutic diets and a nutritionist is one who works in a community setting and recommends healthy diets and broad advisory services. This statement best explains the difference between a dietitian and a nutritionist. A dietitian has special knowledge about the diets required to maintain health and treat disease but does not work in a community setting. A nutritionist is one who has special knowledge about nutrition and food and works in a community setting.

Which recommendation should the nurse expect a nutritionist to make? Vitamin and mineral supplements A healthy diet for a pregnant woman Herbal supplements Special diets for hospitalized patients

A healthy diet for a pregnant woman

Which recommendation should the nurse expect a nutritionist to make? Herbal supplements Vitamin and mineral supplements Special diets for hospitalized patients A healthy diet for a pregnant woman

A healthy diet for a pregnant woman A nutritionist is one who has special knowledge about nutrition and food. They promote health and prevent disease by advising families about balanced diets for growing children and pregnant women. They work in a community setting and recommend healthy diets. They also offer broader services about the purchase and selection of foods but not the recommendation of vitamin, mineral, or herbal supplements. A dietitian recommends special diets for hospitalized patients.

Which situation reflects primary sources of​ conflict? (Select all that​ apply.) A nurse who is gossiping about a coworker A nurse assistant who communicates assessment findings with the healthcare provider A nurse and a physical therapist who are collaborating to provide care to an elderly client A physician who does not believe that a nurse practitioner can provide​ "on-call" care to clients A nurse who places blame on the respiratory therapist for not administering a medication on time

A nurse assistant who communicates assessment findings with the healthcare provider A nurse and a physical therapist who are collaborating to provide care to an elderly client A nurse who places blame on the respiratory therapist for not administering a medication on time Primary sources of conflict include role boundary issues like scope of practice and accountability issues. A nursing assistant who communicates nursing assessment findings to the healthcare provider is experiencing role boundary issues. A physician who does not believe a nurse practitioner can provide care to a client is having​ scope-of-practice issues. A nurse who blames a respiratory therapist for not being able to administer a medication on time is having accountability issues. A nurse and physical therapist who collaborate on care are not experiencing conflict. A nurse who is gossiping about a coworker is contributing to horizontal​ violence, which is not a primary source of conflict. Next Question

A nurse is forming an intradisciplinary team to help implement electronic records. Who might be requested to join the team? (Select all that apply.) A hospital records supervisor A nurse supervisor A nurse anesthesiologist An orthopedic surgeon A hospital administrator

A nurse supervisor A nurse anesthesiologist Rationale: Intradisciplinary teams are formed by members of the same profession who work toward achieving a common goal. Only nurses would be part of an intra disciplinary nursing team. A nurse anesthesiologist might be requested to join an intradisciplinary nursing team. A nurse supervisor might be requested to join an intradisciplinary nursing team. Nursing Process: Planning Client Need: Management of Care Cognitive Level: Applying

D.Self-care/management.

A nurse works in a free clinic for uninsured low-wage employees in the community. The free clinic setting operates in a primary health care (PHC) strategy. The nurse would most likely focus on: A.Incidence of the disease. B.Physician orders for the individual. C.Pathophysiology of the disease. D.Self-care/management.

Which situation should the recognize as an indication of interpersonal conflict on the hospital unit? -A registered nurse and an unlicensed assistive personnel (UAP) arguing over who should ambulate patients -An unlicensed assistive personnel (UAP) turning down a job at the nursing home for more money -The nurse complaining to the nurse manager about healthcare provider orders -The registered nurses on the unit complaining to management about their wages

A registered nurse and an unlicensed assistive personnel (UAP) arguing over who should ambulate patients

Which situation should the recognize as an indication of interpersonal conflict on the hospital unit? An unlicensed assistive personnel (UAP) turning down a job at the nursing home for more money The nurse complaining to the nurse manager about healthcare provider orders The registered nurses on the unit complaining to management about their wages A registered nurse and an unlicensed assistive personnel (UAP) arguing over who should ambulate patients

A registered nurse and an unlicensed assistive personnel (UAP) arguing over who should ambulate patients Interpersonal conflict is conflict between two or more individuals due to differences and/or personalities, or due to competition or concern over territory, roles, or responsibilities. The nurse can delegate the duty of taking patients to the bathroom to the UAP; the AP should not argue about the role responsibility. A group of nurses complaining to management about wages and a nurse questioning healthcare provider orders are examples of intergroup conflict. A UAP who decides to take a job for more money may experience intrapersonal conflict.

Which of the following is an example of covert conflict? A) Complaining to a friend about an assigned job task B) Yelling at a coworker who has insulted another coworker C) Telling a manager that you think she is being unnecessarily harsh D) Warning a client that inappropriate contact and comments will not be tolerated

A) Complaining to a friend about an assigned job task

A nurse is working as the designated leader of a group of healthcare providers in a community clinic setting. The team members are working to decrease the number of adolescent pregnancies in the community. They have defined the problem and are now focusing on objectives and considering various viewpoints presented by the group. The nurse is tasked with helping the team stay focused in order to address the defined problem. Which of the competencies of collaboration does this describe? A) Decision making B) Mutual respect C) Trust D) Communication

A) Decision making

A staff nurse learns before reporting to work that a close family member has been diagnosed with terminal cancer. When receiving the shift report, the nurse finds that this family member has been assigned as a client. The nurse who cared for this individual on the outgoing shift states that the client is very demanding and complains a lot. Which action by the staff nurse who is assigned care for the oncoming shift is appropriate? A) Discuss the situation with the charge nurse. B) Resolve to refrain from reacting negatively to the client. C) Tell the client to change the behavior. D) Ask the healthcare provider to help control the client.

A) Discuss the situation with the charge nurse.

An experienced nurse is delivering a presentation to a group of nursing students about the importance of collaboration in the healthcare environment. The nurse wants to use evidence from the literature to support her argument. Which of the following are documented benefits of collaboration that the nurse should discuss in her presentation? Select all that apply. A) Improved client outcomes B) Reduction in duplication of healthcare services C) Increased overall cost of healthcare services D) Decreased client morbidity and mortality E) Higher level of job satisfaction

A) Improved client outcomes B) Reduction in duplication of healthcare services D) Decreased client morbidity and mortality E) Higher level of job satisfaction

A community hospital wants to implement a labor—delivery—recovery—postpartum unit to replace the labor and delivery and mother/baby units. The nurses who work on the mother/baby unit are concerned they will not be able to care for laboring mothers and may lose their jobs. The nurse manager for both units supports the plan for an integrated unit, reports that jobs will not be lost, and involves the team members in the planning process, which includes cross-training all nursing staff. Based on the information presented, what causes of conflict may occur despite the nurse manager's effort for a smooth transition? Select all that apply. A) Mistrust B) Miscommunication C) Ambiguous role expectations D) Resistance to change E) Ineffective leadership

A) Mistrust D) Resistance to change

Nurse leaders in a local hospital created a neurotrauma (NT) unit healthcare team focused on improving outcomes for stroke clients. This team includes acute care nurses, physicians, other care partners (e.g., physical therapists, social workers, case managers, dietitians), and representatives from the NT outpatient clinic. The team is led by a physician who makes treatment decisions based on the treatment plans developed by individual team members who each communicate with the clients, asking the same or similar questions to obtain data needed for the treatment plan. Which type of communication and action is represented in this scenario? A) Parallel communication B) Parallel functioning C) Information exchange D) Coordination and consultation E) Co-management and referral

A) Parallel communication

In arranging community services for a client who is diagnosed with schizophrenia, the nurse case manager discusses options with the assertive community treatment (ACT) team. Which team disciplines should the nurse expect will be part of the client's ACT interdisciplinary team? A) Psychiatrists, nurses, social workers, employment counselors B) Speech pathologists, occupational therapists, nurses, physicians C) Teachers, school administrators, psychiatrists, nurses D) Transportation providers, nurses, physicians, social workers

A) Psychiatrists, nurses, social workers, employment counselors

The nurse wants to provide collaborative care for a client who has terminal cancer. Which action should the nurse​ include? A.) Consulting an​ oncology-certified nurse when planning care B.) Providing comfort interventions C.) Assessing the​ client's preferences regarding care D.) Giving the physician priority when delivering care

A, "Consulting an​ oncology-certified nurse when planning care." Seeking expertise from an​ oncology-certified nurse when planning care for the client with terminal cancer is consistent with providing collaborative care. Assessing the​ client's preferences regarding care and providing comfort interventions are nursing responsibilities that the nurse is required to​ meet, regardless of the care setting or the type of care being provided. It is not appropriate for the nurse to give one team member priority over another when delivering care.

An organization has goals to promote mutual respect within the inter-professional team and to improve client outcomes. Which action by the organization supports mutual​ respect? A.) Implementing inter-professional rounding B.) Promoting verbal acknowledgment of mutual respect C.) Placing physician leaders for each hospital department D.) Upholding the tradition of patriarchal​ nurse-physician relationships

A, "Implementing inter-professional rounding." Inter-professional rounding promotes mutual respect through collaboration on​ client-centered care. Verbal acknowledgement is not meaningful without nonverbal support. Physician leadership should have nursing counterparts to promote mutual understanding of authority. The traditional​ nurse-physician relationship must change to allow for mutual trust in collaboration.

The clinical nursing instructor is preparing a presentation about societal factors that influence health policy. Which factor should be​ included? (Select all that​ apply.) A.) Level of support for the proposed policy B.) Population-specific needs C.) Degree to which the​ population's current needs are met D.) Size of a given population E.) Ability of the population to finance the proposed policy

A, B, C, D. Societal factors that influence health policy include the​ population's size and specific​ needs, the level of support for the proposed​ policy, and the degree to which current policy meets the​ population's needs. The target population is not required to finance the health policy.

A family with children has utilized the same healthcare provider for many years. Which outcome is expected as a result of having a usual source of medical​ care? (Select all that​ apply.) A.) Enhanced communication B.) Improved health outcomes C.) Decreased costs D.) Fewer health disparities E.) Fewer instances of cold and flu

A, B, C, D. The benefits of having a usual source of medical care include decreased​ cost, fewer health​ disparities, enhanced​ communication, and improved health outcomes. Having a usual source of medical care does not result in fewer instances of cold and flu.

The nurse is designing activities to promote skill building for nursing collaboration. Which activity should be​ included? (Select all that​ apply.) A.) Reviewing scope of practice for nurses B.) Performing a​ self-assessment of strengths C.) Analyzing different communication styles D.) Explaining how authority impacts care delivery E.) Acknowledging that barriers to team building will never change

A, B, C, D. QSEN​ (Quality and Safety Education for​ Nurses) identified characteristics related to teamwork and collaboration that support skill building for the nurse. The nurse should review scope of​ practice, self-assess​ strengths, analyze different communication​ skills, and understand how authority impacts care delivery. Barriers exist to team​ building, but they should not be viewed as insurmountable.

A community that experienced a damaging tornado activated the community emergency response plan. Which activity constitutes the emergency response​ phase? (Select all that​ apply.) A.) Repairing utilities B.) Establishing critical care services C.) Opening shelters D.) Establishing emergency operations centers E.) Implementing warning systems

A, B, C. Opening​ shelters, repairing​ utilities, and establishing critical care services constitute the emergency response phase. Implementing a warning system and establishing an emergency operations center occur during the mitigation phase of a community emergency response plan.

The nurse is caring for clients in the community and frequently refers them to the public health department for healthcare. Which benefit does a client who utilizes the public health department for care​ receive? (Select all that​ apply.) A.) Care offered includes preventive health services. B.) The facility has a history of service to the community. C.) Professional staff is already available to provide care. D.) The facility has an available inventory of​ low-cost medications. E.) Potential clients are aware of the many services.

A, B, C. The benefits to clients who utilize the public health department for care include the fact that preventative services are offered. The public health department has a history of service to the​ community, and professional staff is already available to provide care. Many clients are unaware of the services available at the public health​ department, and the facilities do not have an available inventory of​ low-cost medications.

The nurse is comparing the similarities of the roles of the case manager and the primary nurse in the rehabilitation facility and the acute care facility. Which statement is accurate regarding the similarities between these two roles? (Select all that apply.) A.) Both support continuity of care. B.) Both plan for meeting the family's needs. C.) Both plan for meeting client's needs. D.) Both lead a multidisciplinary team. E.) Both follow the clients across care settings.

A, B, C. The similarities between a case manager and primary nurse include the fact that they both support continuity of care and meet the needs of clients and families. Only the case manager follows clients across care settings or leads a multidisciplinary team.

The nursing administrator is planning an​ in-service for nurses about Medicare coverage. Which content should be​ included? (Select all that​ apply.) A.) Younger individuals with disabilities are eligible for Medicare coverage. B.) Medicare is a form of public health insurance. C.) All individuals ages 62 and older are eligible for Medicare coverage. D.) Medicare is a federally funded program. E.) Medicare coverage includes individuals with​ end-stage renal disease.

A, B, D, E. Medicare is a federally funded public health insurance program that is available to people age 65 or​ older, younger people with​ disabilities, and people with​ end-stage renal disease.

Nurses provide care to patients as collaborative members of the health care team. Which roles may be performed by the advanced practice registered nurse? Select all that apply. a. Primary care provider b. Hospitalist c. Physical therapist d. Anesthetist e. Midwife f. Pharmacist

A, D, E

A nurse researcher keeps current on the trends to watch in health care delivery. What trends are likely included? Select all that apply. a. Globalization of the economy and society b. Slowdown in technology development c. Decreasing diversity d. Increasing complexity of patient care e. Changing demographics f. Shortages of key health care professionals and educators

A, D, E, F

A client with a history of multiple cardiac defect repairs now requires a heart transplant. Which factor will be taken into consideration when selecting a donor match for the​ client? (Select all that​ apply.) A.) Medical urgency B.) Cardiac birth defect C.) Previous successful operations D.) Size of the heart E.) Length of time on waiting list

A, D, E. In selecting an organ match for the​ client, the size of the​ heart, medical​ urgency, and length of time on the waiting list are all taken into consideration. Birth defects or previous successful operations are not taken into consideration when selecting a donor match for the client.

The nurse at a community​ center's health fair is assessing a client who presents with high blood pressure and states that he has not seen a healthcare provider in over a decade. Which referral is the most appropriate for this client based on the result of the​ screening? A.) Primary Care Provider B.) Urgent Care Clinic C.) Cardiologist D.) Emergency Department

A, Primary Care Provider. The elevated blood pressure obtained during the screening requires a​ follow-up with a primary care provider. The result of the​ client's blood pressure does not warrant a referral to a​ cardiologist, urgent care​ clinic, or the emergency department. The​ client's elevated blood pressure has most likely occurred over a long period of time because there is no indication of a sudden change in his health​ status, and has gone unnoticed and untreated due to the​ client's lack of healthcare.

The nurse is examining role expectations and boundary issues causing primary sources of conflict within a healthcare unit. Which issue should be addressed by the nursing​ staff? (Select all that​ apply.) A.Resistance to change B.Lack of understanding C.Inaccurate information D.Consistent cooperation E.Effective communication

A,B,C ​Rationale: Role expectations and boundary issues are a primary source of conflict within a healthcare unit. They may arise from a lack of understanding or awareness of which task each team member is to perform due to​ miscommunication, inaccurate​ information, and resistance of some members to change. Cooperation and effective communication often lead to conflict resolution.

The nurse is designing activities to promote skill building for nursing collaboration. Which activity should be​ included? (Select all that​ apply.) A.Reviewing scope of practice for nurses B.Performinga​ self-assessment of strengths C.Analyzing different communication styles D.Explaining how authority impacts care delivery E.Acknowledging that barriers to team building will never change

A,B,C,D Rationale: QSEN​ (Quality and Safety Education for​ Nurses) identified characteristics related to teamwork and collaboration that support skill building for the nurse. The nurse should review scope of​ practice, self-assess​ strengths, analyze different communication​ skills, and understand how authority impacts care delivery. Barriers exist to team​ building, but they should not be viewed as insurmountable.

A nurse is planning to teach a class about preventing workplace bullying. Which behavior should the nurse​ include? (Select all that​ apply.) A.Encouraging nonthreatening reporting B.Developing acceptable codes of conduct C.Isolating the victim to provide a safe environment D.Educating others about the ramifications of bullying E.Talking about the abuser to make the victim feel better

A,B,D Rationale: Nonthreatening reporting that is taken​ seriously, developing acceptable codes of​ conduct, and education on the impact of bullying all support the prevention of bullying in the workplace. The victim may already feel isolated and should be made to feel part of a supported team. Talking about the abuser does not promote professional behaviors.

A nurse is explaining the various levels of health care services to a group of newly licensed nurses. Which of the following examples of care or care settings should the nurse classify as tertiary care? SATA A. Intensive care Unit B. Oncology treatment center C. Burn Center D. Cardiac Rehabilitation E. Home health care

A. CORRECT Tertiary health care involves the provision of specialized and highly technical care, such as the care nurses deliver at intensive care units. B. CORRECT. Tertiary health care involves the provision of highly specialized and highly technical care, such as the Oncology treatment Center. C. CORRECT. Tertiary health care involves the provision of highly specialized and highly technical care, such as the care nurses deliver in burn centers. D. This is an example of restorative care and tertiary prevention, but not of tertiary care. E. This is an example of restorative care.

A nurse manager is developing strategies to care for the increasing number of clients who have obesity. Which of the following actions should the nurse include as a primary health care strategy? A. Collaborating with providers to perform obesity screenings during routine office visits. B. Ensuring the availability of specified beds in rehabilitation centers for clients who have obesity. C. Providing specialized intraoperative training regarding surgical treatments for obesity. D. Educating acute care nurses on postoperative complications related to obesity.

A. CORRECT The nurse should identify obesity screenings at office visits as an example of primary health care. Primary health care emphasizes health promotion and disease control, is often delivered through office visits, and includes screenings. B. The nurse should identify care that is provided in a rehabilitation center as an example of restorative health care. C. The nurse should identify specialized and highly technical care as an example of tertiary health care. D. The nurse should identify acute care of clients as an example of secondary health care.

The nurse plans to discuss strategies to recognize and manage conflict. Which strategy should be​ included? (Select all that​ apply.) Calling in sick during conflict Addressing issues as they arise Ignoring each other when angry Treating each other with respect Acknowledging each​ other's accomplishments

Addressing issues as they arise Treating each other with respect Acknowledging each​ other's accomplishments Strategies that may help prevent or reduce conflict include addressing issues when they​ arise, avoiding destructive​ criticism, treating others with​ respect, defusing​ arguments, listening and considering each​ other's point of​ view, fairly allocating​ resources, defining role​ expectations, encouraging​ feedback, and acknowledging each​ other's professional and personal accomplishments and achievements. Ignoring the conflict or calling in sick are not appropriate strategies to manage conflict.

Which activities should the nurse recognize as supporting the building of skills for successful collaboration of interprofessional healthcare​ teams? (Select all that​ apply.) Focusing care delivery on individual groups Advocating for policy change with local legislation Role playing scenarios to practice communication skills Encouraging clinical problem solving through group work Practicing with additional credentials to increase nursing authority

Advocating for policy change with local legislation Role playing scenarios to practice communication skills Encouraging clinical problem solving through group work Practicing with additional credentials to increase nursing authority Nursing collaboration is supported by working in groups and having a voice in the community on health policy through​ advocacy, professional communication​ skills, and increased authority and accountability. Focusing care is an individual task.

The nurse is part of an interdisciplinary team caring for a patient who was prescribed physical therapy, occupational therapy, and a special diet. Which task should the nurse perform in collaboration with the physical therapist of the team? Implementing swallowing precautions Evaluating the diet Ambulating the patient Assessing the home

Ambulating the patient

The nurse is part of an interdisciplinary team caring for a patient who was prescribed physical therapy, occupational therapy, and a special diet. Which task should the nurse perform in collaboration with the physical therapist of the team? Assessing the home Ambulating the patient Evaluating the diet Implementing swallowing precautions

Ambulating the patient The physical therapist will assess the patient and recommend hip precautions and ambulation guidelines in collaboration with the nursing staff. There is no indication for the services of a speech therapist to provide swallowing guidelines. A dietitian will perform a dietary assessment with the input of the nursing staff. The discharge planner or home health agency will assess the patient's postdischarge needs in the home.

4) Which of the following statements about case management and case managers is not true? A) Case managers can only be licensed professional nurses who have extensive patient care experience. B) The collection of baseline data for conditions or diagnoses that will be managed is an essential component of case management. C) Case managers usually do not provide direct client care; instead, they coordinate and monitor others providing direct client care. D) A case manager's typical caseload is 10-15 clients, mostly representing high-volume, high-cost, and high-risk diagnoses for the hospital.

Answer: A Explanation: A) Although case managers are often licensed professional nurses with advanced degrees and extensive patient care experience, social workers, nurses without advanced degrees, and other healthcare-related professionals also serve in this role. Case managers typically do not provide direct patient care, but are responsible for a caseload of 10-15 clients for whom they will coordinate care during the clients' hospitalization while also assisting with discharge planning. It is critical to collect and document baseline data for those conditions in the client population selected by the facility for case management.

5) A nurse is working as the designated leader of a group of healthcare providers in a community clinic setting. The team members are working to decrease the number of teenage pregnancies in the community. They have defined the problem and are now focusing on objectives and considering various viewpoints presented by the group. The nurse is tasked with helping the team to stay focused in order to address the defined problem. Which of the competencies of collaboration does this describe? A) Decision making B) Mutual respect C) Trust D) Communication

Answer: A Explanation: A) Decision making involves shared responsibility for the outcome. The team must follow specific steps of the decision-making process, beginning with a clear definition of the problem. Team decision making must be directed at the objectives of the effort and requires full consideration and respect for various and diverse viewpoints, and often requires guidance and direction from a group leader. Mutual respect occurs when two or more people show or feel honor or esteem toward one another. Trust occurs when an individual is confident in the actions of another individual. Both mutual respect and trust imply mutual process and outcome and may be expressed verbally or nonverbally. Communication is necessary in effective collaboration; it occurs only if the involved parties are committed to understanding each other's professional roles and appreciating each other as individuals.

1) A young female surfer is admitted with traumatic amputation of the lower left arm secondary to shark attack. The nurse realizes that many different types of healthcare professionals will be needed to help the client survive the injury and regain as much upper extremity function as possible. The nurse advises that a healthcare team be assembled based on which description? A) Healthcare teams utilize collaborative delivery of high-quality, interdisciplinary health services in a shared leadership role, where accountability is both individual and mutual in nature. B) Healthcare teams are made up of members of the same profession who work under one leader to achieve one goal. C) Healthcare teams exist only to make decisions for clients. D) Healthcare teams are assembled only to manage the care of extremely ill clients.

Answer: A Explanation: A) Healthcare teams are made up of professionals from different areas of expertise, each with equal input and accountability, with the shared goal of delivering comprehensive, high-quality care to clients. Healthcare groups are made up of members of the same profession, and have one leader. Clients and families are included in the healthcare team's decision-making process. Healthcare teams are utilized anywhere in health care where multiple areas of expertise are needed, and not only for extremely ill clients.

3) A staff nurse learns before reporting to work that a close family member has been diagnosed with terminal cancer. The nurse is receiving the shift report and finds the family member has been assigned as a client. The nurse reporting off duty states that the client is very demanding and complains a lot. What is the appropriate next action by the oncoming nurse? A) Discuss the situation with the charge nurse. B) Resolve to refrain from reacting negatively to the client. C) Tell the client to change the behavior. D) Ask the doctor to help control the client.

Answer: A Explanation: A) The best action to prevent conflict would be to explain the personal situation to the charge nurse and ask for a reassignment. The nurse can resolve to not react to the client, but the nurse should have the presence of mind to understand that personal ability to cope is impaired. It would not be appropriate to confront the client at this time. The nurse should not ask anyone other than the charge nurse to intervene and help control the client.

8) Nurse leaders in a local hospital created a neurotrauma (NT) unit healthcare team focused on improving outcomes for their stroke clients. This team includes acute care nurses, physicians, other care partners (e.g., physical therapists, social workers, case managers, dieticians), and representatives from the NT outpatient clinic. This team is led by a physician who makes treatment decisions based on the treatment plans developed by individual team members who each communicate with the clients, asking the same or similar questions to obtain data needed for their treatment plan. What type of communication and action is represented in the scenario described? A) Parallel communication B) Parallel functioning C) Information exchange D) Coordination and consultation E) Co-management and referral

Answer: A Explanation: A) The type of communication and action used by this healthcare team is parallel communication. It is at the lowest level along the continuum of communication and collaboration among health team members and is characterized by each professional communicating with the client independently, asking the same or similar questions needed to develop their plan of care. The next level up on the continuum of communication and collaboration, but not described in this scenario, is parallel functioning. Here, communication is more coordinated, but each professional still develops separate interventions and care plans. In parallel functioning, the exchange of information among team members is more structured and planned, but decision making is unilateral and does not involve much collegiality. The actions of this NT team do not demonstrate coordination and consultation or co-management and referral, the two highest levels of communication and collaborative action. The higher levels of communication and collaboration characterize interdisciplinary and interprofessional teams; the lower level of communication characterizes multidisciplinary teams.

7) The hospital's nurse case manager has been extensively involved with a shooting victim and his family in coordinating care of providers from many disciplines as the client progressed from the Emergency Department (ED) to the intensive care unit (ICU) and then onto the unit. After 3 weeks of hospitalization, the case manager is helping to prepare him for discharge to a rehabilitation center where he will continue treatment for his injury. Which outcomes have been documented in the literature as benefits of such collaboration? Select all that apply. A) Improved client outcomes B) Reduction in duplication of healthcare services C) Increased overall cost of health care services D) Decreased client morbidity and mortality E) Diminished sense of autonomy felt by nurses F) Higher level of job satisfaction

Answer: A, B, D, F Explanation: A) Research findings suggest that collaboration in health care among clients, family members, caregivers, and communities leads to improved client outcomes, a reduction in duplicated healthcare services, and a decrease in client morbidity and mortality. Collaborative efforts have also been found to decrease, rather than increase, the overall cost of healthcare services, and to contribute to an enhanced, rather than diminished, sense of autonomy. This increase in sense of autonomy has been linked to nurses' greater job satisfaction.

6) Years after the practice of having newborns "room in" with mothers was widely established in this country, some the nurses on the labor and delivery unit and on the newborn nursery unit at a rural community hospital strongly resisted the implementation of an integrated mother/baby unit. The nurses were concerned that after years of experience in working with only birthing mothers or only with newborns, they might not be able to adequately care for pairs of mothers and infants. Many felt that they had a limited skill set in the area where they had not previously worked and did not want this change. They also felt that if they spoke up about their opposition they might lose their jobs. Others felt the units were "behind the times," were eager for the transition, and were angry at the other nurses' hostility toward the head nurse promoting the change. The head nurse pushing for the integrated unit clearly stated her expectations, reported that jobs would not be lost, involved the team members in planning, posted frequent updates about the planning process, and discussed her plan for how nurses in each unit would be cross-trained for the other unit. Based on the information presented, what were the likely causes of the conflict that occurred in spite of the head nurse's efforts for this transition? Select all that apply. A) Mistrust B) Miscommunication C) Ambiguous role expectations D) Resistance to change E) Ineffective leadership F) Inadequate project planning

Answer: A, D Explanation: A) The likely sources of conflict in this scenario are mistrust and resistance to change. From the information presented, the head nurse applied several principles of effective management to avoid conflict among her staff, yet some nurses continued to resist the change and demonstrated mistrust. Miscommunication, ambiguous role expectations, ineffective leadership, and inadequate project planning appear not to have been issues because the head nurse took several actions to smooth the transition and reassure the staff. These included involving them in planning, reassuring them that they would retain employment, explaining the cross-training they would be provided, as well as a number of other activities to avoid conflict.

8) Which statement is a primary and historical barrier to effective nurse-physician collaboration that has tended to persist over time? A) The view among the general population that that nurses' contributions to clients' care is less important to their health and well-being compared to the contribution of physicians B) The nurses' and physicians' perceptions of inequity in their roles, with nurses assuming a subservient role and physicians assuming leadership and superior role in healthcare settings C) A general lack of education provided in schools for health professionals about the benefits on healthcare quality linked to nurse-physician collaboration D) A lack of published evidence about the effectiveness of collaborative efforts among and between nurses and physicians E) The lack support at the federal level for efforts to improve health care among the general population through increased nurse-physician-client collaboration.

Answer: B Explanation: A) A primary and historical barrier to effective nurse-physician collaboration has been nurses' and physicians' perceptions of inequity in their roles, with nurses assuming a subservient role and medical providers perceiving their role to be superior in the provision of healthcare services. Evidence does not suggest that the general population views nurses' contributions to the care of clients as less important, thus this is not considered a primary barrier to nurse-physician collaboration. Likewise, because health professional students are in fact educated about the benefits of collaborative practice and published evidence has documented the effectiveness of collaboration in improving client outcomes, these are not barriers to collaboration. In addition, the federal government, as evidenced in particular by the Healthy People initiative, has promoted collaborative efforts among clients, nurses, physicians, other healthcare providers, and the larger community to improve the health of the U.S. population.

7) The Chief Nursing Officer and Chief Medical Officer in an urban teaching hospital are leading a series of meetings with nurses, physicians, hospital lawyers, and risk managers to review and update hospital privileging procedures and requirements for advanced practice RNs and physicians new to the hospital. This is an example of what type of collaborative team? A) Intradisciplinary B) Interdisciplinary C) Multidisciplinary D) Complementary

Answer: B Explanation: A) A team comprised of members from different disciplines that is focused on achieving a common goal is an interdisciplinary team. Their varying professional backgrounds helps to ensure that other perspectives are represented as the issue is considered. Intradisciplinary teams are comprised of members of the same profession working to achieve a common goal, and multidisciplinary teams are more commonly teams whose members work more autonomously toward the common goal. Complementary is not a type of team, although team members' efforts can be complementary and provide a broader perspective of issues.

4) A group of nurses are in a staff meeting on a medical-surgical unit headed by the new unit nurse manager. The manager announces that nurses should not criticize and make fun of other nurses or there will be repercussions. Several nurses at the meeting tell the manager that this type of situation should be handled by the individual nurses. Which statement describes how the new manager could best develop an understanding of the group's dynamic? A) Insist that this is an appropriate new policy. B) Recognize that the group has already defined behavioral norms. C) Discipline the staff nurses who spoke out. D) Request a transfer to another unit.

Answer: B Explanation: A) Behavioral norms are established by the group or the leader of the group. In this case, the manager should recognize that the group does not see this as an issue because it has already established behavioral norms for it. The new manager should simply offer support for any nurse who is unable to resolve such interpersonal conflicts. Insisting on initiating the new policy could be harmful to the goals of the group as a whole. Rather than transfer, the manager could observe the dynamics of the group and adapt to the findings. Disciplining those who spoke out would negatively affect the cohesiveness of the entire group.

2) A client who has been in the intensive care unit (ICU) for 2 days is placed on a care map for extended care following a coronary artery bypass. Which statement by the client indicates to the nurse that there is understanding of the care map? A) "I cannot alter the care map plan." B) "The chosen care map can be altered to meet my needs." C) "My insurance plan can deny payment if I do not meet goals." D) "I must be able to meet goals that are set for me."

Answer: B Explanation: A) Care maps, or critical pathways, are flexible enough to be adjusted and tailored to the client's needs and wishes. The client is included in the discussion of meeting goals. It is possible to have variances in a critical pathway that, if documented properly, should be paid for by insurance. The case manager monitors and works with the client to alter the pathway as needed during the recovery process.

1) A home health nurse manager is planning care for a male client being discharged after hospitalization for complications of diabetes mellitus. This client requires an extensive dressing change twice a day, help with activities of daily living, and comprehensive education. The nurse manager is planning visits from home health nurses, aides, and therapists. The nurse manager is working within the context of which of the following? A) Health education B) Case management C) Collaboration D) Health promotion

Answer: B Explanation: A) Collaboration means a collegial working relationship with other healthcare providers to supply client care. Collaborative practice requires the discussion of diagnoses and management in the delivery of care. Case management involves one or more individuals overseeing the needs and requirements of a particular individual's health. Health promotion activities include disease prevention and healthy lifestyle interventions. Health education would be included in this particular situation, but collaboration is a more inclusive definition of what is occurring with these individuals and the care they require.

4) A 10-year-old boy is in the intensive care unit (ICU), unconscious and with multiple traumatic injuries, after a skateboard accident that included closed head injury. Many health professionals are involved in his care and the scene is chaotic. The parents are extremely anxious and want to know what's happening. The nurse case manager realizes that an interdisciplinary team meeting would be of great benefit in managing the client's care, based upon which of the following statements? A) An interdisciplinary team would not be needed for a multiple-trauma patient. Each healthcare professional should practice independently. B) An interdisciplinary team could more efficiently share and evaluate information for care planning and implementation, and prevent priority conflicts, redundancy, and omissions in care. C) The team should be multidisciplinary, with one physician making all of the decisions. D) Forming an interdisciplinary team would prevent the parents from trying to change the plan of care.

Answer: B Explanation: A) Interdisciplinary collaboration engages each professional's contribution to joint care planning, implementation, and accomplishment of client goals, with possibly less redundancy, more efficiency, and fewer care omissions. The parents of a minor child should be involved in all aspects of care and decision making.

1) A client with type 1 diabetes mellitus has developed an open sore on the shin and is having trouble meeting daily goals for exercising. After the client spends a week in the hospital receiving wound care and antibiotics, the nurse decides to notify which of the following healthcare team members for follow-up care? A) The pharmacy B) The case manager C) The occupational therapist D) The physical therapist

Answer: B Explanation: A) The client's needs and progress have changed. The nurse notifies the case manager to coordinate changes in care needed after discharge. A physical therapist may be needed, but the nurse would coordinate care best by notifying the case manager. The pharmacy is not needed as part of the team at this time. The occupational therapist mainly deals with the upper body areas needing rehabilitation. This client's exercise program needs to be revamped, and the case manager is the individual to coordinate this change.

2) The nurse case manager assembles a team of healthcare professionals, including the client's physician, physical therapist, and social worker, for the purpose of collaborative discharge planning and decision making. What type of team does this represent? Select all that apply. A) Intradisciplinary team B) Interdisciplinary team C) Interprofessional team D) Management team

Answer: B, C Explanation: A) Interdisciplinary teams include professionals of varied backgrounds who share decision making. The terms interprofessional team and interdisciplinary team are synonymous. Intradisciplinary teams include members of the same profession. Multidisciplinary teams include members of varied backgrounds, but treatment decisions are made by one team member-usually the physician. Management teams are executive-level teams that run the day-to-day operations of a corporation.

5) The nurses in the Emergency Department (ED) and the staff nurses on the neurological unit are experiencing conflict. The ED nurses are concerned that individuals discharged from the ED with orders for admission to the neurological unit are experiencing prolonged wait times as they wait for the neurological unit's admitting nurse to come down to the ED to receive a face-to-face report about the client and to then assist with the client's transfer to the floor. The neurological unit is currently short-staffed, and the nurses want to make sure that their patients are adequately cared for before they leave the unit to go to the ED. The neurological unit nurses also have said that once they arrive in the ED after being called to come down for the report and transfer, required paperwork isn't always completed, and the nurse ends up having to wait while this task is finished. What type of conflict are the nurses in these two service areas experiencing? A) Intrapersonal conflict B) Interpersonal conflict C) Intergroup conflict D) Interorganizational conflict E) Covert conflict

Answer: C Explanation: A) Because the inter-unit conflict described is occurring between two teams of nurses, this scenario is describing intergroup conflict. It is likely driven by each team's wish to provide quality care for their patients in a context of limited resources or lack of role clarity. Intrapersonal conflict describes stress or tension within the individual that results from real or perceived pressure associated with incompatible expectations. Interpersonal conflict is characterized by conflict between individuals (rather than service areas as in this situation). Interorganizational conflict typically involves competition between two organizations existing in one market. Without a further description of how the conflict is being manifested and managed by the two teams, the conflict can't be identified as covert (or overt) at this time.

7) A group of nurses were having lunch together at a community table in the hospital cafeteria. One individual made an unflattering comment in front of several other nurses about one a nurse on the unit who was off that day. The nursing director present quietly said to the offending nurse, "This behavior isn't OK, especially in a hospital like ours with a 'zero-tolerance policy.' Please take your issue directly to him and have a discussion if there is something that is bothering you. If you'd like me to help you with this, please let me know, and the three of us can meet." This nursing director was modeling appropriate behavior for addressing which work-related issue? A) Workplace stress B) Sexual harassment C) Horizontal violence D) Intrapersonal conflict

Answer: C Explanation: A) In quietly and respectfully calling out the nurse about her disparaging comments directed at an absent coworker, the nursing director modeled strategies to address horizontal violence (HV), a form of workplace bullying. HV is described as aggressive acts committed against a nurse by one or more nursing colleagues and can be verbal or physical. The director's positive steps to address HV included: reminding the nurse about the hospital's "zero-tolerance" attitude toward bullying; reinforcing the code of conduct that identified the nurses' behavior as bullying; demonstrating to other nurses that she took the issue of bullying seriously; and offering to help the nurse appropriately address with her colleague the behavior that had prompted the disparaging comment. There is not enough information presented to know if workplace stress or sexual harassment were issues, and intrapersonal conflict refers to conflict within an individual, which is not necessarily evident in this scenario.

2) The nurse and physician are discussing follow-up care with a client who is being discharged home and the client's family. The client and family cross their arms and state angrily that the team's suggestions are not acceptable. What is the best response by the nurse? A) "We will leave you alone to discuss your options." B) "We only want what's best for you." C) "Let's discuss other options that might work well for you and your family." D) "Perhaps you did not understand the recommendations."

Answer: C Explanation: A) The client is the center of the team, and the goal is to facilitate healing. There are always other options to consider to reach that goal. The nurse would discuss other options with the client, which will most likely increase cooperation by the client, who will feel in control as the decision is made. By leaving the room, the nurse and doctor have turned their backs on the client. The client may not understand the recommendations, but pointing that out can be seen as demeaning. Telling the client that the doctor only wants what is best sends the message that the client does not know what is best, when, in fact, a well-informed client does know what is best and should be able to make the correct choice.

1) A nurse is discussing the plan of care with a client who is preparing for discharge. The client has a strong objection to portions of the plan of care. The nurse recognizes that there is a conflict. Which response by the nurse indicates an understanding of the client's position and a willingness to collaborate regarding the discharge plan? A) "You are not being cooperative in your plan of care." B) "This plan of care was ordered by the physician." C) "Let's talk about what your objections are and possible solutions or alternatives." D) "I will ask your family to convince you that this plan of care is best."

Answer: C Explanation: A) The nurse attempts to resolve the conflict with the client by listening to the client's concerns and then negotiating with the client. This action helps build the client's trust in the medical team. Telling the client that these orders were made by the physician continues the conflict and brings the physician into it. The nurse would not want to include the client's family in the conflict and cause problems between family members. The nurse might consult with the physician after a resolution has been reached with the client, but the conflict is the nurse's to solve.

3) The nurse and physician are preparing a client for discharge who will be requiring physical therapy (PT) to rehabilitate after a total knee replacement. After reading the physician order for PT, which would be the nurse's initial action? A) Set up appointments according to the order with the hospital PT department. B) Call home health and schedule a therapist to visit the home for therapy. C) Discuss the various types of settings for therapy and have the client choose the venue. D) Teach the family the exercises needed for the client.

Answer: C Explanation: A) The nurse best exhibits the characteristic that the client has a right to self-determination by presenting the methods available for PT and answering the client's questions about each so the client can make an informed decision. The nurse would not refer the client for outpatient therapy unless the client requests that form of therapy. Scheduling home PT is leaving the client out of the decision-making process. The therapy that the client requires must be performed by a professional physical therapist. To teach the family exercises encroaches upon the expertise of the professional who will be performing the service.

6) An 86-year-old client has been referred for home health nurse case management. The nurse realizes that an outpatient interdisciplinary team may best serve the client's needs in terms of planning for increased mobility, socialization, transportation, and home-based care. The nurse knows that the elderly client may best be supported by which interdisciplinary teams? Select all that apply. A) Assertive Community Treatment (ACT) B) YMCA C) Programs of All-Inclusive Care for the Elderly (PACE) D) Outpatient clinic E) Meals on Wheels

Answer: C, D Explanation: A) Interdisciplinary teams are used in many settings outside the hospital, including schools, the workplace, and long-term care facilities. PACE supports and facilitates the provision of all services and care for the elderly. Outpatient clinics coordinate medical care, supplies, and social services referrals. ACT is a mental health support and treatment program. The YMCA is a fitness facility. Meals on Wheels provides a service but is not an interdisciplinary program.

5) Identify the primary purpose of critical pathways used by nurse case managers. A) evaluate care provided to clients with certain medical conditions. B) direct care provided to clients with certain medical conditions. C) track care provided to clients with certain medical conditions. D) direct, track, and evaluate care provided to clients with certain medical conditions.

Answer: D Explanation: A) Critical pathways are a disease-specific or diagnosis-specific tool used by case managers to direct, track, and evaluate expected client outcomes and care strategies.

2) The nurse caring for an adult client in the intensive care unit (ICU) is given a verbal order by a first-year medical resident. The nurse determines that the best course of action is to check with the attending physician before implementing the order. Which of the following statements best describes the nurse's Rationale for her decision? A) The resident seems unsure of the order. B) The nurse only takes orders from attending physicians. C) The nurse does not like first-year residents. D) The nurse may not trust the resident to make the best care decisions.

Answer: D Explanation: A) This type of conflict is most likely caused by a lack of trust in the resident on the part of the nurse. Nurses who work in critical care learn to validate orders given by a resident because a mistake can mean the client's life. The nurse may not like residents, but that is not a reason to question their orders. There is no evidence here that the resident is unsure of the order given. Residents can give orders, preferably written, but the nurse is wise to confirm the order with the managing physician.

The nurse is assigned to an interdisciplinary team caring for a patient. Which is a role the nurse is expected to fulfill in this team? Attending team meetings to discuss the patient's care Prescribing medications that are appropriate for the patient's care Taking full responsibility for providing direct care to the patient Making independent decisions regarding the patient's medical care

Attending team meetings to discuss the patient's care In an interdisciplinary team, decisions are made by the group, and the members collaborate to set patient goals and carry out the treatment plan. The novice nurse would anticipate attending team meetings to discuss the patient's care. It would not be appropriate for the nurse to take full responsibility for providing direct care to the patient as a member of an interdisciplinary team. This occurs with primary nursing. Prescribing medication and making independent decisions regarding medical care is outside the nurse's scope of practice. The nurse can dispense medications and implement orders prescribed by the physician.

The nurse wants to improve collaborative​ decision-making skills. Which action promotes collaboration between nurses and the interprofessional​ team? A. Delaying feedback on results to ensure that all collected data were reviewed by the team first B. Sharing responsibility of the outcome of the decision C. Depending on physician leadership to ultimately make the decision for the team D. Removing the client from the​ decision-making process

B Rationale: Collaboration in decision making results in shared responsibility of the outcome of the decision. The client should be involved in decision making. The physician should hold a​ collaborative, not​ supervisory, position within the team. Feedback should be prompt to evaluate and make changes as needed.

An organization has goals to promote mutual respect within the interprofessional team and to improve client outcomes. Which action by the organization supports mutual​ respect? A.Promoting verbal acknowledgment of mutual respect B.Implementing interprofessional rounding C.Placing physician leaders for each hospital department D.Upholding the tradition of patriarchal​ nurse?physician relationships

B ​Rationale: Interprofessional rounding promotes mutual respect through collaboration on​ client-centered care. Verbal acknowledgement is not meaningful without nonverbal support. Physician leadership should have nursing counterparts to promote mutual understanding of authority. The traditional​ nurse?physician relationship must change to allow for mutual trust in collaboration.

A home health nurse is planning care for an adult client who is being discharged from the hospital after experiencing complications of diabetes mellitus. The client requires an extensive dressing change twice per day, help with activities of daily living, and comprehensive education. To ensure these needs are met, the nurse is coordinating home visits from aides and therapists. Which role is the nurse assuming by coordinating this client's care? A) Health educator B) Case manager C) Client advocate D) Health promoter

B) Case manager

A local health system has implemented a number of health promotion policies and plans to prioritize health problems. The system must now evaluate the effectiveness of the interventions. Which groups are stakeholders in this initiative and would be involved in this process? A) Only consumers who were directly affected by the services provided B) Consumers, community leaders, and politicians C) Only hospital and clinic personnel who administered healthcare needs D) Healthcare providers employed by other health systems

B) Community leaders, politicians, and consumers all would be stakeholders and would be included in the evaluation process. Healthcare providers employed by other health systems would not be stakeholders in this initiative and would not need to be included in the evaluation process. Because policy changes are made by the health system, the hospital and clinic personnel employed there would not evaluate the effectiveness of policy without participation by the community. Consumers are part of the process, but would not be the only evaluation group.

A case manager assembles a team of healthcare professionals, including a client's primary healthcare provider, physical therapist, and social worker, for the purpose of collaborative discharge planning and decision making. Which type of team did the case manager assemble? A) Intradisciplinary team B) Interdisciplinary team C) Interorganizational team D) Management team

B) Interdisciplinary team

Which of the following is a primary barrier to effective nurse-physician collaboration that has persisted over time? A) The view among the general population that nurses' contributions to client care are less important to health and well-being than physicians' contributions B) Nurses' and physicians' perceptions of inequity in their roles, with nurses assuming a subservient role and physicians assuming leadership and a superior role in healthcare settings C) A general lack of education among health professionals about the ways in which nurse—physician collaboration improves healthcare quality D) A lack of published evidence regarding the effectiveness of collaborative efforts among and between nurses and physicians E) A lack of support at the federal level for efforts to improve healthcare among the general population through increased nurse-physician-client collaboration

B) Nurses' and physicians' perceptions of inequity in their roles, with nurses assuming a subservient role and physicians assuming leadership and a superior role in healthcare settings

What action can a nursing student take to comply with nurse practice acts and remain accountable for knowing the legal nursing scope of practice in their state? A) Become engaged in organizational quality improvement projects. B) Obtain current licensure. C) Join the American Nurses Association (ANA). D) Become accredited.

B) Obtain current licensure.

A student nurse is completing a community assessment with a group of fellow students. The student must research the location of the main healthcare facilities and the number of health professionals in the community. Which would be the best source for this information? A) Police department B) Local health department C) State census data D) City health planning board

B) The local health department would be able to supply information about location of health facilities, occupational health programs, numbers of health professionals, numbers of welfare recipients, and so on. The police department has statistics regarding incidence of crime, vandalism, and drug addiction. The city health planning board has information about health needs and practices. The state census data describe population composition and characteristics.

A school-age client is admitted to the pediatric intensive care unit (PICU), unconscious and with multiple traumatic injuries, after a skateboard accident that included a closed head injury. Many health professionals are involved in the client's care, and the scene is chaotic. The client's parents are extremely anxious and want to know what is happening. The case manager asks for an interdisciplinary team meeting to speak with the client's parents. Which is the rationale for this meeting? A) To allow for each specialty to practice independently B) To share and evaluate information for care planning and implementation, and to prevent priority conflicts, redundancy, and omissions in care C) To allow the primary healthcare provider to make all decisions regarding the client's care D) To prevent the client's parents from trying to change the plan of care

B) To share and evaluate information for care planning and implementation, and to prevent priority conflicts, redundancy, and omissions in care

The nurse manager is presenting an​ in-service for staff nurses about Medicaid insurance coverage. Which statement is appropriate for the nurse manager to include during the​ in-service? A.) "While Medicaid covers hospital​ services, it does not cover outpatient​ care." B.) ​"Individuals with disabilities who meet federal and state eligibility requirements may be covered by​ Medicaid." C.) "Transportation costs to healthcare appointments are not covered by​ Medicaid." D.) "Medicaid provides qualified individuals with cash for basic needs such as​ food, housing, and​ clothing."

B, "Individuals with disabilities who meet federal and state eligibility requirements may be covered by medicaid." Medicaid is available to certain​ lower-income individuals and​ families, older adult​ clients, and people with disabilities who meet the eligibility requirements set by federal and state law. Each state sets its own guidelines regarding Medicaid eligibility and covered services.​ However, federal law requires Medicaid to cover certain services including healthcare provider​ services, inpatient and outpatient hospital​ care, home health​ services, and transportation to medical care. Supplemental Security Income​ (SSI) provides cash for basic needs such as​ food, housing, and clothing.

The nurse is discussing Medicaid health coverage with a client. Which information should be​ included? A.) Medicaid coverage does not include the​ client's home health services. B.) Medicaid is available to eligible​ individuals, families, older adult​ clients, and individuals with disabilities. C.) Medicaid provides cash for basic​ needs, such as​ food, housing, and clothing. D.) Medicaid reimbursement does not cover costs related to transportation to medical care.

B, "Medicaid is available to eligible individuals, families, older adult clients, and individuals with disabilities." Medicaid is a​ state-administered program that is available to certain​ lower-income individuals and​ families, older adult​ clients, and individuals with disabilities who meet the eligibility requirements set by federal and state law. Federal laws require Medicaid to cover certain​ services, including healthcare provider​ services, inpatient and outpatient hospital​ care, home health​ services, and transportation to medical care. Supplemental Security Income​ (SSI) provides cash for basic needs such as​ food, housing, and clothing.

A client asks the nurse to explain how Medicare works. Which item should the nurse​ include? (Select all that​ apply.) A.) Individuals with​ end-stage renal disease are not eligible for Medicare coverage. B.) There are four types of Medicare coverage. C.) Both hospital and medical insurance are offered by Medicare. D.) Medicare is a federally funded health insurance program. E.) Routine eye care is not covered by Medicare.

B, C, D, E. Medicare is a federally funded health insurance program that is available to people age 65 or​ older, younger people with​ disabilities, and people with​ end-stage renal disease. Certain​ services, including routine eye​ care, are not covered by Medicare. There are four types of Medicare​ coverage: Part A​ (hospital insurance), Part B​ (medical insurance), Part C​ (Medicare Advantage Plans like an HMO or​ PPO), and Part D​ (Medicare prescription drug​ coverage).

The nurse is planning care for a client following a surgical procedure. Which collaborative action should the nurse​ include? (Select all that​ apply.) A.) Changing the medication order after speaking with the client about adverse effects B.) Informing the dietitian that the client is on a special diet and needs reteaching about the diet C.) Consulting the pharmacist regarding interactions between medications the client is prescribed D.) Informing the pharmacist that the​ client's blood pressure​ (BP) is low and to hold the BP medication E.) Updating the physical therapist regarding the​ client's physical activity and tolerance earlier in the day

B, C, E. Collaborative actions that are client centered lead to improved client outcomes. Consulting the​ pharmacist, updating the physical​ therapist, and informing the dietitian are all appropriate collaborative actions for the nurse to take. Telling the pharmacist to hold the​ client's medications without consulting the prescribing provider is outside the scope of practice of the​ nurse, as is changing the medication order. The nurse would report adverse effects or changes in the​ client's condition to the prescribing​ provider, who would be responsible for changing the medication order.

A nurse is providing health care to patients in a health care facility. Which of these patients are receiving secondary health care? Select all that apply. a. A patient enters a community clinic with signs of strep throat. b. A patient is admitted to the hospital following a myocardial infarction. c. A mother brings her son to the emergency department following a seizure. d. A patient with osteogenesis imperfecta is being treated in a medical center. e. A mother brings her son to a specialist to correct a congenital heart defect. f. A woman has a hernia repair in an ambulatory care center.

B, C, F

The nurse is planning care for a client following a surgical procedure. Which collaborative action should the nurse​ include? (Select all that​ apply.) A. Changing the medication order after speaking with the client about adverse effects B. Informing the dietician that the client is on a special diet and needs reteaching about the diet C. Consulting the pharmacist regarding interactions between medications the client is prescribed D. Informing the pharmacist that the​ client's blood pressure​ (BP) is low and to hold the BP medication E. Updating the physical therapist regarding the​ client's physical activity and tolerance earlier in the day

B,C,E Rationale: Collaborative actions that are client centered lead to improved client outcomes. Consulting the​ pharmacist, updating the physical​ therapist, and informing the dietician are all appropriate collaborative actions for the nurse to take. Telling the pharmacist to hold the​ client's medications without consulting the prescribing provider is outside the scope of practice of the​ nurse, as is changing the medication order. The nurse would report adverse effects or changes in the​ client's condition to the prescribing​ provider, who would be responsible for changing the medication order.

Which situation reflects primary sources of​ conflict? (Select all that​ apply.) A. A nurse who is gossiping about a coworker B. A nurse assistant who communicates assessment findings with the healthcare provider C. A nurse and a physical therapist who are collaborating to provide care to an elderly client D. A physician who does not believe that a nurse practitioner can provide​ "on-call" care to clients E. A nurse who places blame on the respiratory therapist for not administering a medication on time

B,D,E ​Rationale: Primary sources of conflict include role boundary issues like scope of practice and accountability issues. A nursing assistant who communicates nursing assessment findings to the healthcare provider is experiencing role boundary issues. A physician who does not believe a nurse practitioner can provide care to a client is having​ scope-of-practice issues. A nurse who blames a respiratory therapist for not being able to administer a medication on time is having accountability issues. A nurse and physical therapist who collaborate on care are not experiencing conflict. A nurse who is gossiping about a coworker is contributing to horizontal​ violence, which is not a primary source of conflict.

The nurse plans to discuss strategies to recognize and manage conflict. Which strategy should be​ included? (Select all that​ apply.) A.Calling in sick during conflict B.Addressing issues as they arise C.Ignoring each other when angry D.Treating each other with respect E.Acknowledging each​ other's accomplishments

B,D,E ​Rationale: Strategies that may help prevent or reduce conflict include addressing issues when they​ arise, avoiding destructive​ criticism, treating others with​ respect, defusing​ arguments, listening and considering each​ other's point of​ view, fairly allocating​ resources, defining role​ expectations, encouraging​ feedback, and acknowledging each​ other's professional and personal accomplishments and achievements. Ignoring the conflict or calling in sick are not appropriate strategies to manage conflict.

A nurse is discussing the purpose of regulatory agencies during a staff meeting. Which of the following tasks should the nurse identify as the responsibility of state licensing boards? A. Monitoring evidence-based practice for clients who have a specific diagnosis. B. Ensuring that health care providers comply with regulations. C. Setting quality standards for accreditation of health care facilities. D. Determining if medications are safe for administration to clients.

B. CORRECT The nurse should identify the state licensing boards are responsible for ensuring that health care providers and agencies are compliant with state regulations. A. The nurse should identify the utilization review committees have the responsibility of monitoring for appropriate medical diagnosis and treatment according to evidence-based practice for diagnosis and treatment of hospitalized clients. C. The nurse should identify that the Joint Commission has the responsibility of setting quality standards for accreditation of health care standards. D. The nurse should identify that the U.S. Food and Drug Administration has the responsibility of determining if medications are safe for administration of clients.

A nurse is explaining the various types of health care coverage clients might have to a group of nursing students. Which of the health care financing mechanisms are federally funded? A. Preferred provider organization B. Medicare C. Long-term insurance D. Exclusive Preferred Organization E. Medicaid

B. Medicare CORRECT Medicare is federally funded E. Medicaid CORRECT Medicaid is a federal funded program. A. PPO's are privately funded. C. Long-term care is privately funded. D. EPO's are privately funded.

Which should the nurse use to explain mindsight? Behaving disruptively in the workplace, manifesting as aggression, bullying, and violence Being self-aware of one's triggers to stress that can result in conflict Using skills to resolve conflicts in a positive manner Using a collaborative approach for gaining insight to the perspectives of others

Being self-aware of one's triggers to stress that can result in conflict Mindsight is a term that describes being self-aware of one's triggers to stress that can result in conflict and purposefully "retraining" the brain to respond differently. Conflict competence includes skills to resolve conflicts in a positive manner. Incivility or disruptive behavior in the workplace can manifest as aggression, bullying, and violence. Collaboration is a collaborative approach that involves gaining insight to the perspectives of others.

The client asks the nurse to explain how Medicare works. Which items should the nurse include in the teaching​ session? ​(Select all that​ apply.) Both hospital and medical insurance are offered by Medicare. Individuals with​ end-stage renal disease are not eligible for Medicare coverage. There are four types of Medicare coverage. Routine eye care is not covered by Medicare. Medicare is a federally funded health insurance program.

Both hospital and medical insurance are offered by Medicare. There are four types of Medicare coverage. Routine eye care is not covered by Medicare. Medicare is a federally funded health insurance program. Learning Objective Describe various types of healthcare reimbursement. Rationale Medicare is a federally funded health insurance program available to people age 65 or​ older, younger people with​ disabilities, and people with​ end-stage renal disease. Certain​ services, including routine eye​ care, are not covered by Medicare. There are four types of Medicare​ coverage: Part A​ (hospital insurance), Part B​ (medical insurance), Part C​ (Medicare advantage plans like an HMO or​ PPO), and Part D​ (Medicare prescription drug​ coverage).

The nurse educator is comparing the roles of the case manager and the primary nurse with a group of students. The educator wants to review similarities of these roles in the rehabilitation facility and in the acute care facility. Which student statements are accurate regarding the similarities between these two​ roles? ​(Select all that​ apply.) Both roles support continuity of care Both roles plan for meeting families​' needs Both roles lead a multidisciplinary team Both roles follow the clients across care settings Both roles plan for meeting clients​' needs

Both roles support continuity of care Both roles plan for meeting families​' needs Both roles plan for meeting clients​' needs Learning Objective Contrast the different frameworks for providing care. Rationale The similarities between a case manager and a primary nurse are that they both support continuity of care and plan for meeting the needs of clients and families. Only the case manager follows clients across care settings or leads a multidisciplinary team.

When healthcare providers in the community refuse to accept Medicare clients, this implies reduced access to care, potential decreases in acceptable quality of services offered, and a form of health care rationing. Health care rationing becomes a public health and nursing issue because: A. Medicare reimbursement needs to be higher. B. proactive primary prevention orientation is cost effective. C. public health systems and nurses must ensure that essential clinical services are available. D. sufficient resources are available in the public health system to meet the unmet need.

C

The collaborative team treating a client includes the​ cardiologist, dietician, social​ services, and a nurse case manager. The team works together to establish a plan of care based on the​ client's goals. Which outcome is likely to result from this type of collaboration for the​ client? A.Decreased adherence with the plan of care B.Increased healthcare costs C.Enhanced continuity of care D.Improved relationship between the physician and the client

C ​Rationale: When effective collaboration​ occurs, quality of care​ improves; effective collaboration directly impacts client outcomes and enhanced continuity of care results. An​ increase, not a​ decrease, in adherence with the care plan is an outcome of collaboration. Healthcare costs will​ decrease, not​ increase, with collaboration. An improved physician-client relationship is not an outcome of​ collaboration; however, improved relationships do occur within the healthcare team as a result of collaboration.

The nurse is discussing follow-up care with a client who is being discharged. The client and his family cross their arms and state angrily that the care team's suggestions are not acceptable. Which response by the nurse is appropriate? A) "We will leave you alone to discuss your options." B) "We only want what's best for you." C) "Let's discuss other options that might work well for you and your family." D) "Perhaps you did not understand the recommendations."

C) "Let's discuss other options that might work well for you and your family."

An older adult client experiences an extended hospitalization due to a chronic illness. The client states to the nurse, "I don't know how I can pay for this hospital stay and afford all of the new medication that I have been prescribed." Which response by the nurse is the most appropriate? A) "I'll have someone from the business office come and talk to you about your bill." B) "You need to focus on recovering and stop worrying about money." C) "Much of your care will be covered by Medicare." D) "Don't worry. I'm sure everything will work out okay."

C) "Much of your care will be covered by Medicare."

A nurse manager overhears two staff nurses talking about a third nurse, who has the day off. The two nurses are making unflattering comments regarding the third nurse in front of several other nurses who work on the unit. The nurse manager discreetly asks to speak to the two nurses in private and states, "This behavior isn't OK, especially in a hospital like ours with a 'zero-tolerance policy.' If you have an issue with another nurse, please deal with that nurse directly. If you'd like me to help you with this, please let me know, and the four of us can meet." The nurse manager's behavior modeled strategies for dealing with which type of workplace conflict? A) Intergroup conflict B) Sexual harassment C) Horizontal violence D) Intrapersonal conflict

C) Horizontal violence

The nurses in the emergency department (ED) and the staff nurses on the neurology unit are experiencing conflict. The ED nurses are not pleased with the amount of time it takes for the neurology unit's admitting nurse to receive face-to-face handoff communication for clients who are being admitted to that unit. Which type of conflict is being experienced by these nurses? A) Intrapersonal conflict B) Interpersonal conflict C) Intergroup conflict D) Interorganizational conflict

C) Intergroup conflict

________ occurs when two or more individuals show or feel honor or esteem toward one another, and it is an important element of successful collaborative practice. A) Trust B) Conflict management C) Mutual respect D) Effective communication

C) Mutual respect

A home healthcare nurse is planning care for an older adult client. Which interdisciplinary program would best support the needs of an older adult client within the community? Select all that apply. A) Assertive community treatment (ACT) B) YMCA C) Programs of All-Inclusive Care for the Elderly (PACE) D) Outpatient clinic E) Meals on Wheels

C) Programs of All-Inclusive Care for the Elderly (PACE) D) Outpatient clinic

A 67-year-old client has experienced an extended hospitalization due to a chronic illness. The client asks the nurse how he will afford to pay for the hospitalization plus all the extremely expensive drugs he now has to take. What is the most appropriate response by the nurse? A) "I'll have someone from the business office come and talk to you about your bill." B) "You need to focus on recovering and stop worrying about money." C) "Much of your care will be covered by Medicare." D) "Don't worry. I'm sure everything will work out okay."

C) The Medicare amendment to the Social Security Act provided a national and state health insurance program for older adults. By the mid-1970s, virtually everyone over 65 years of age was protected by hospital insurance under Part A. In 1988, Congress expanded Medicare to include extremely expensive hospital care, "catastrophic care," and expensive drugs. Ignoring the client's concerns by telling him not to worry is not therapeutic communication and does little, if anything, to confront the client's concerns. Giving the concern to the business office is merely "passing the buck." Nurses should have some knowledge about the payment sources of their clients, especially those who have automatic coverage with Medicare because of their age.

The collaborative team treating a client includes the​ cardiologist, dietitian, social​ services, and a nurse case manager. The team works together to establish a plan of care based on the​ client's goals. Which outcome is likely to result from this type of collaboration for the​ client? A.) Increased healthcare costs B.) Improved relationship between the physician and the client C.) Enhanced continuity of care D.) Decreased adherence with the plan of care

C, "Enhanced continuity of care." When effective collaboration​ occurs, quality of care​ improves; effective collaboration directly impacts client outcomes and enhanced continuity of care results. An​ increase, not a​ decrease, in adherence with the care plan is an outcome of collaboration. Healthcare costs will​ decrease, not​ increase, with collaboration. An improved physician-client relationship is not an outcome of​ collaboration; however, improved relationships do occur within the healthcare team as a result of collaboration.

The nurse wants to improve collaborative​ decision-making skills. Which action promotes collaboration between nurses and the inter-professional​ team? A.) Delaying feedback on results to ensure that all collected data were reviewed by the team first B.) Depending on physician leadership to ultimately make the decision for the team C.) Sharing responsibility of the outcome of the decision D.) Removing the client from the​ decision-making process

C, "Sharing responsibility of the outcome of the decision." Collaboration in decision making results in shared responsibility of the outcome of the decision. The client should be involved in decision making. The physician should hold a​ collaborative, not​ supervisory, position within the team. Feedback should be prompt to evaluate and make changes as needed.

A client tells the nurse that the pain medication is ineffective and causes too many side effects. Which inter-professional team member should the nurse​ consult? (Select all that​ apply.) A.) Dentist B.) Dietitian C.) Physician D.) Pharmacist E.) Complementary healthcare provider

C, D, E. The physician ordering pain medication is one inter-professional team member to​ involve, as they are aware of the ineffectiveness and adverse effects of the current medication ordered.The pharmacist is another inter-professional team member to assess interaction of all medications currently prescribed and recommend untried therapies.The complementary healthcare provider can provide adjunct therapies for pain like massage and reflexology. A dentist would be consulted for issues of the​ teeth, gums, and oral cavity. A dietitian would be consulted for nutrition needs.

The nursing student is giving a presentation on the roles of citizens and government in shaping health policy. Which statement should be included in the​ presentation? (Select all that​ apply.) A.) "The citizen who reports the concern is responsible for choosing the best​ solution." B.) ​"The citizens' responsibilities include evaluating safety concerns of proposed​ solutions." C.) "The government official is responsible for identifying political considerations related to each​ solution." D.) "One role of government officials is hearing​ citizens' concerns." E.) "Citizens will evaluate the outcomes of newly implemented​ laws."

C, D. Government​ officials' roles include hearing​ citizens' concerns about healthcare​ needs, evaluating safety concerns related to potential​ solutions, identifying political considerations related to each​ solution, and choosing the best solution. Federal agencies or departments who are responsible for implementing the new law will evaluate outcomes.

The nurse is coordinating care for a client with no significant health history who will be scheduled for the removal of an uncomplicated skin nodule. Which setting will provide the most cost-effective care based on the current health of the client. A.) Urgent care clinic B.) Surgical Center C.) Dermatologist's Office D.) Emergency Department

C, Dermatologist's office. This minor procedure can be performed in the office of a dermatologist. A surgical setting is costlier. An urgent care clinic and the emergency department are inappropriate settings to perform the procedure.

Nursing students are reviewing information about health care delivery systems in preparation for a quiz the next day. Which statements describe current U.S. health care delivery practices? Select all that apply. a. Access to care depends only on the ability to pay, not the availability of services. b. The Patient Protection and Affordable Care Act provides private health care insurance to underserved populations. c. Every health insurance plan in the Health Insurance Marketplace offers comprehensive coverage, from doctors to medications to hospital visits. d. The uninsured pay for more than one third of their care out of pocket and are usually charged lower amounts for their care than the insured pay. e. Fifty years ago, half of the doctors in the United States practiced primary care, but today fewer than one in three do. f. Quality of care can be defined as the right care for the right person at the right time.

C, E, F

A client who had the option to receive an influenza vaccine in an open clinic opted to call the primary healthcare​ provider's office to schedule a visit to receive the vaccine. Which barrier to healthcare access does the​ client's behavior​ exemplify? A.) Uneven distribution of services B.) Lack of a usual source of care C.) Perception of need D.) Lack of healthcare insurance

C, Perception of Need. The​ client's behavior exemplifies perception of need. Healthcare​ insurance, uneven distribution of​ services, and lack of a usual source of care are not factors in the choice of the client to wait to receive the vaccine.

The nurse is planning a discussion on a topic related to tertiary prevention for clients with type 2 diabetes. Which information will the nurse include? A.) A demonstration of proper hand-washing techniques. B.) Screening for coronary artery disease. C.) The effects of exercise and blood glucose control. D.) Smoking cessation.

C, The effects of exercise and blood glucose control. A topic that addresses tertiary prevention for a client with type 2 diabetes is the effects of exercise and blood glucose control. Hyperglycemia is a complication of diabetes. Tertiary prevention begins after a condition is treated and stabilized or recognized as incurable. It includes the restoration of function and decrease of complications of an established disease. Smoking cessation and hand washing are primary preventative measures. Screening for coronary artery disease is a secondary preventative measure.

A client tells the nurse that the pain medication is ineffective and causes too many side effects. Which interprofessional team member should the nurse​ consult? (Select all that​ apply.) A.Dentist B.Dietician C.Physician D.Pharmacist E.Complementary healthcare provider

C,D,E ​Rationale: The physician ordering pain medication is one interprofessional team member to​ involve, as they are aware of the ineffectiveness and adverse effects of the current medication ordered.The pharmacist is another interprofessional team member to assess interaction of all medications currently prescribed and recommend untried therapies.The complementary healthcare provider can provide adjunct therapies for pain like massage and reflexology. A dentist would be consulted for issues of the​ teeth, gums, and oral cavity. A dietician would be consulted for nutrition needs.

A patient who is visually impaired and has Parkinson disease is assigned a nurse to coordinate care from a number of specialists. Which type of framework does this care coordination indicate? Managed care Case management Patient-focused care Team nursing

Case management This type of framework in care coordination is an example of case management. Managed care focuses on a group level, not on an individual level. Patient-focused care is a type of care that identifies the patient as the decision maker. Team nursing is model of nursing used in the hospital setting.

A patient requires skilled nursing care after discharge from an acute care hospital. Which member of the collaborative healthcare team should the nurse anticipate will coordinate the discharge? Case manager Social worker Nurse Discharge planner

Case manager The case manager's role is to ensure that patients receive fiscally sound, appropriate care in the best setting. The role is often filled by the member of the healthcare team who is most involved in the patient's care. Depending on the nature of the patient's concerns, the case manager may be a nurse, a social worker, or any other member of the healthcare team. A social worker counsels patients and their support people regarding problems such as finances, marital difficulties, and adoption of children. The nurse is responsible for reporting the patient's needs to the collaborative healthcare team. The discharge planner coordinates the movement of patients between a hospital or skilled nursing facility and a home care or hospice arrangement.

The home health nurse has made a visit to a client who is receiving several therapies by health team members in the home for arthritis and postoperative care. Upon return to the home health office, the nurse plans to: Report to the manager. Communicate the client's status to the rest of the team. Review the cases for the next day. Call the client to reinforce teaching.

Communicate the client's status to the rest of the team. Rationale: Since the client is receiving several therapies, the nurse would communicate with team members regarding the client's current status and progress in collaboration. Reviewing the cases for the next day may or may not be necessary. It is not necessary to report to the manager unless there is a system problem. Calling the client is probably not necessary since the nurse would evaluate client understanding of teaching before leaving the home. Nursing Process: Evaluation Client Need: Safe, Effective Care Environment Cognitive Level: Applying

Which activity should the nurse understand is a key competency to effective nursing care? Medication administration Knowledge of hospital rules and regulations Communication Being able to interact with healthcare providers

Communication

Nurses are utilizing an approach that involves addressing an issue of conflict with a resolution that satisfies both parties. Which approach is being​ used? Competing Compromising Accommodating Avoiding

Compromising Compromising involves addressing the conflict with a solution that satisfies all parties. Avoiding is purposely not addressing the​ conflict, sometimes done to collect more information. Competing involves an assertive presentation of​ one's side of the issue. Accommodating neglects the desires of one side to allow the other party satisfactory resolution.

The nurse is attending a team meeting regarding the care of a client. During the​ meeting, the nurse has a heated discussion with a peer. Which factors would be likely to impede effective communication and collaboration in this​ situation? ​(Select all that​ apply.) Confusing roles among team members Understanding cultural differences with the peer Trusting the peer to make the right decision Having a lack of respect for the peer Providing feedback to the peer

Confusing roles among team members Having a lack of respect for the peer A lack of respect and role confusion can impede communication and collaboration. Understanding cultural differences enhances communication and collaboration. Trust is an essential aspect of communication and collaboration. Providing feedback enhances communication and collaboration.

Which act should the nurse recognize as horizontal​ violence? A.Battery of a client by a nurse B.Maltreatment of a housekeeper by the nurse C.Physical threats by a nurse against a nursing assistant D.Gossiping by one nurse against another nurse

D Rationale: Horizontal violence involves​ acts, like​ gossiping, by one nurse against another nurse. Battery of a client is criminal abuse. Maltreatment and threats to other team members or insubordinates is bullying.

Two hospitals in a small town are trying to increase their nursing staff. In the hopes of attracting more​ applicants, one is offering​ sign-on bonuses to entice​ BSN-prepared staff members to join their team. Which type of conflict could occur in this​ situation? A.Interpersonal conflict B.Intrapersonal conflict C.Intergroup conflict D.Interorganizational conflict

D ​Rationale: Interorganizational conflict occurs when one organization within the same market is in direct competition with another. If one organization is able to offer​ sign-on bonuses and other benefits that create a competitive​ advantage, this may alter the ability of other organizations to recruit and retain​ staff, creating conflict. Intergroup conflict is conflict between teams that are in competition for rewards or resources. Intrapersonal conflict is conflict that occurs within an individual that causes stress from real or perceived pressure generated by incompatible expectations or goals. Interpersonal conflict is conflict between two or more individuals due to differences​ and/or personalities or due to competition or concern over​ territory, roles, or responsibilities.

The nurse experiences workplace bullying. Which action should the nurse anticipate from the administration to support steps toward successful resolution of this​ issue? A.Ignoring the report of bullying until it is reported more than once B.Encouraging the employee to transfer out of the department C.Asking the nurse to provide at least three witnesses to the event D.Obtaining details of the event before taking action

D ​Rationale: The nurse manager would obtain details on who was​ involved, when the event​ occurred, and details of the event before taking action to resolve the bullying issue. Witnesses would be encouraged to come forward but are not required. The manager would support resolution of the​ bullying, not encourage the employee to change roles or ignore the report.

The nurse is working for a healthcare organization that is going through the reaccreditation process. What action can the nurse take to help the organization be successful in the reaccreditation process? A) Write position statements related to current events that affect the nursing profession. B) Influence change by working with public officials at the local, community, state, and national levels. C) Understand how healthcare policy affects patients, their own practice, and their organization. D) Facilitate the use of nursing procedures that are current and evidence-based.

D) Facilitate the use of nursing procedures that are current and evidence-based.

A nurse educator is discussing the changes in the healthcare system with a group of nursing students. The students ask why the cost of health care has increased so much in recent years. What is the best response by the nurse? A) "There are not enough technological advances." B) "There is an increased use of alternative medicine." C) "There is a decrease in chronic disease." D) "Many people are forced to seek routine health care in the Emergency Department."

D) Many people in the United States do not have healthcare insurance. As a result, they seek routine health care in the Emergency Department, contributing to the increase in the cost of health care. Use of alternative medicine does not increase healthcare costs. Chronic disease is on the rise. There are many technological advances in medicine, and they have increased the cost of health care.

The nurse is caring for a client with rheumatoid arthritis who expresses the desire to remain active as long as possible. In order for the client to meet this goal, what should the nurse prepare to do? A) Teach the client about nutrition and joint exercises. B) Ask the client about the reasons for this goal. C) Tell the client that activity limitations are inevitable with rheumatoid arthritis. D) Provide referrals to other professionals who can help the client meet this goal.

D) Provide referrals to other professionals who can help the client meet this goal.

A nurse who is caring for an adult client in the intensive care unit (ICU) is given a verbal prescription by a first-year medical resident. The nurse determines that the best course of action is to check with the attending healthcare provider before implementing the prescription. What is the most likely reason why the nurse is experiencing conflict regarding this situation? A) The resident seems unsure of the prescription. B) The nurse only takes prescription orders from attending healthcare providers. C) The nurse does not like first-year residents. D) The nurse may not trust the resident to make the best care decisions.

D) The nurse may not trust the resident to make the best care decisions.

Nurses who demonstrate mindsight are able to A) focus on being "in the moment" so that they can dedicate their full attention to the events and emotions they are currently experiencing. B) predict events that will occur in the future with reasonable certainty. C) interpret events and emotions from another person's perspective. D) recognize their personal triggers to stress that result in conflict, then retrain their brain to respond differently.

D) recognize their personal triggers to stress that result in conflict, then retrain their brain to respond differently.

The nurse manager wants to promote communication skills for successful collaboration among the nursing staff. Which communication style should the nurse​ use? A.) Parallel communication B.) Dominance in conversation C.) Status-based communication D.) Active listening

D, "Active Listening." Active listening is attentive communication that decreases miscommunication. Parallel communication is the lowest level of communication and does not support collaboration like higher levels of information exchange or consultation.​ Status-based communication does not support​ collaboration, but​ team-centered communication does support collaboration. Dominance and argumentative styles of communication do not promote collaboration.

A community health nurse is preparing to meet with the state representative to discuss the unmet needs of military families whose loved ones are deployed. Which statement demonstrates that the nurse understands the process of developing health policy in the United​ States? A.) "I understand that meeting with citizens about healthcare issues is not part of your​ role, so I really appreciate your​ time." B.) "I realize that you are the person who decides whether or not a healthcare solution becomes a​ law." C.) "Along with a description of the healthcare​ issue, I've also included a list of political considerations related to​ it." D.) "In addition to other​ considerations, I'm aware that a proposed​ solution's anticipated effectiveness must be​ evaluated."

D, "In addition to other​ considerations, I'm aware that a proposed​ solution's anticipated effectiveness must be​ evaluated." Government officials evaluate proposed solutions based on several​ factors, including costs and​ benefits, anticipated​ effectiveness, efficiency, and safety. Government​ officials' roles include hearing​ citizens' concerns about healthcare​ needs, as well as gathering information about reported issues. Government officials are also responsible for identifying political considerations associated with each healthcare issue and proposed solution. Passage of proposed healthcare solutions into law is not the government​ official's choice; it is a process that requires collaboration between lawmakers and government officials and adherence to procedures.

The nurse has ideas on how to streamline charting in the electronic medical record. Which inter-professional team member should the nurse​ consult? A.) Complementary healthcare provider B.) Paramedical technologist C.) Unlicensed assistive personnel D.) Information technology expert

D, "Information Technology Expert." The information technology expert would be the collaborative partner to explore changes and to enhance the electronic medical record.The paramedical technologist would be consulted for laboratory and imaging issues. The unlicensed assistive personnel can help with delegated tasks of hands on care.The complementary healthcare provider would be consulted for complementary medical therapies such as acupuncture.

The nurse is working with an older adult client to understand Medicare. Which plan is designed to supplement Medicare​ coverage? A.) Medicaid B.) Medicare Part D C.) Preferred provider organization D.) Medigap policy

D, "Medigap Policy." ​Rationale: A Medigap policy​ (that is, Medicare supplemental​ insurance) is private health insurance designed to supplement Medicare coverage. Medicaid is coverage for lower income individuals and families. Medicare Part D is prescription coverage within Medicare. A preferred provider organization is a network of providers.

A county health department nurse is creating a brochure that describes the​ agency's role. Which activity should be​ included? A.) Regulating child care centers B.) Overseeing the construction of new medical facilities C.) Enrolling clients in Medicaid D.) Providing community disease monitoring

D, "Providing community disease monitoring." Providing community disease monitoring is a function of a county health department. Enrolling clients in Medicaid typically is the responsibility of local departments of social services. Regulation of child care centers and overseeing the construction of new medical facilities are​ state-level regulatory functions.

The nurse is analyzing the staffing needs of several clinics. Which healthcare trend does the nurse identify that will increase the demand for healthcare​ expertise? (Select all that​ apply.) A.) Increased ethnic diversity B.) Decreased access to healthcare C.) Lack of specialized practitioners D.) Increase in long-term illness E.) Lack of primary care providers

D, E. The increase in long​ term-illness and lack of primary care providers are expected to produce an increased demand for healthcare expertise. Increasing ethnic​ diversity, decreased access to​ healthcare, and lack of specialized practitioners do not contribute to the increased demand for healthcare expertise.

The nurse is assigned to administer medications to all client on the unit. Which nursing care delivery model is being utilized? A.) Primary B.) Team C.) Secondary D.) Functional

D, Functional. The nurse who is assigned as the medication nurse is being assigned a task. The functional nursing model utilizes a task-oriented approach to the care of clients. The model of team nursing utilizes a registered nurse (RN) as the team leader for a group of clients. The primary nursing model designates one nurse who has 24/7 authority and responsibility for the care of an assigned group of clients. Secondary nursing is not a model for the delivery of nursing care.

The nurse who is participating in emergency training activities is interested in helping the local community increase its surge capacity in the event of an emergency. Which action best addresses an increase in surge​ capacity? A.) Satisfying the need for current recovery operations B.) Opening​ off-site operating rooms for emergencies C.) Assisting shelters to house more evacuated individuals D.) Meeting increased demand for qualified personnel

D, Meeting increased demand for qualified personnel. The action that best addresses an increase in surge capacity is meeting the increased demand for qualified personnel needed for an emergency. Increasing the surge capacity does not address satisfying the need for current recovery​ operations, assisting shelters to house more evacuated​ individuals, or opening​ off-site operating rooms.

The nurse is coordinating care for a client who requires the removal of an uncomplicated basal cell carcinoma. Based on the robust health of this​ client, which setting would provide the most​ cost-effective care? Emergency department Surgical center Urgent care clinic Dermatologist​'s office

Dermatologist​'s office Learning Objective ​Discuss factors that affect the delivery of health care. Rationale A dermatologist can handle a minor surgical procedure under local anesthesia in the office. A surgical center is a more expensive setting than an office. It would usually not be appropriate to do the procedure in the ED or urgent care clinic.

The primary care physician has recommended to the nurse that the client be discharged to a rehabilitation center for further care. The nurse discusses the recommendation with the family and client, who decide that this is not what they want to do. The nurse's next action is to: Tell the family that this is the physician's order. Discuss available acceptable options with the family. Notify the case manager that the family is noncompliant. Notify the physician about the family's decision.

Discuss available acceptable options with the family. Rationale: The family and client are a part of the collaborative team. If the family does not favor a recommendation, the nurse explores other options open to the client, such as home health care, and then communicates the client's wishes to the team. It is not appropriate to tell the family that this is the doctor's order because clients have a voice in care decisions. The case manager can be notified to help the nurse present other options but not that the family is noncompliant. The physician may be notified of the need for other options as part of the team. Nursing Process: Implementation Client Need: Safe, Effective Care Environment Cognitive Level: Applying

A nurse is reported to the charge nurse by a physician for ignoring an order that the physician gave regarding patient care. The charge nurse investigates the issue and finds that it appears as if the nurse did ignore the order. The charge nurse would: Ask another nurse to go get the nurse in question. Ask the client if the task was performed. Go to the nurse and request an explanation. Discuss the situation with the nurse in an office.

Discuss the situation with the nurse in an office. Rationale: The best approach would be to ask the nurse in question to describe the conflict in the privacy of the office. It is entirely possible that there is an easy solution to the problem, but the discussion should take place in private. The request for an explanation should not be conducted in the client care setting. The charge nurse would not ask the client about the incident unless there is a complaint by the client. The charge nurse does not involve another nurse in the conflict since this would be a breach of the first nurse's right to confidentiality. Nursing Process: Implementation Client Need: Safe, Effective Care Environment Cognitive Level: Applying

The charge nurse is preparing to discuss plans to improve the unit with the staff. Based on the concept of peer​ collaboration, which plan will she​ discuss? ​(Select all that​ apply.) Discussing starting a journal club for interested staff members to discuss new​ evidence-based practice findings Allowing nurses to volunteer to prepare brief presentations on clinical topics seen on the unit Asking for volunteers to go from the day shift to night shift to cover a temporary staff shortage Encouraging nurses to eat meals at their desks so they will be more accessible to physicians Implementing open visitation hours for families to increase client satisfaction

Discussing starting a journal club for interested staff members to discuss new​ evidence-based practice findings. Allowing nurses to volunteer to prepare brief presentations on clinical topics seen on the unit. Asking for volunteers to go from the day shift to night shift to cover a temporary staff shortage. Encouraging nurses to share their expertise on commonly encountered health topics allows more experienced nurses to share their knowledge and experience with others in order to ensure​ high-quality client care. Allowing staff to participate in schedule changes on a volunteer basis shows mutual respect and may foster improved relationships. A journal club gives interested individuals a chance to improve their clinical knowledge and share with their peers. Open visitation does not address the principles of peer collaboration. Eating at the desk does not foster collaboration and may violate infection control policies.

Which reason describes why a team member may not report incivility in the workplace? Passive personality Lack of resources An aggressive personality Fear of retribution

Fear of retribution

What are some of the benefits of interdisciplinary teams? (Select all that apply.) Physician satisfaction Redundancy Fewer omissions Greater effectiveness Greater emphasis on individual expertise

Fewer omissions Greater effectiveness Rationale: Less redundancy is a benefit of interdisciplinary teams. Some physicians may be opposed to interdisciplinary collaboration and prefer physician led treatment. Interdisciplinary teams emphasize each individual's contribution to the joint planning and accomplishment of client goals, as opposed to placing emphasis on each individual team member's area of professional expertise. Studies suggest that interdisciplinary teams can manage care with less redundancy, more efficiency, and fewer omissions. Nursing Process: Analysis Client Need: Management of Care Cognitive Level: Analyzing

Which description should the nurse use to describe team-centered communication? Provides the team with status reports in order to direct patient care outcomes Focuses on individual responsibilities Supports cultural bias between members Focuses on what "we" can do to work with the patient toward successful outcomes

Focuses on what "we" can do to work with the patient toward successful outcomes

Which description should the nurse use to describe team-centered communication? Focuses on what "we" can do to work with the patient toward successful outcomes Provides the team with status reports in order to direct patient care outcomes Supports cultural bias between members Focuses on individual responsibilities

Focuses on what "we" can do to work with the patient toward successful outcomes Team-centered communication focuses on shared, not individual, responsibilities. Identifying and preventing any potential cultural and language barriers is also critical to ensuring successful collaboration. Status reporting communication is a one-sided approach that is task oriented, such as "give this" or "do that."

Which nursing care model for delivery can be the most cost effective? Functional nursing Team nursing Positive nursing Primary nursing

Functional nursing Functional nursing is the most cost-effective choice. Functional nursing assigns staff to tasks, rather than to patients, and is effective for budgetary constraints. Team nursing and primary nursing require a greater number of nursing staff, which is costlier. A positive nursing system is not a nursing model.

A nurse who is being pulled from one unit to another for a shift is being introduced to the nursing staff. Some of the labels that the nurse hears are open double quote"medication ​nurse,close double quote" open double quote"dressing change ​nurse,close double quote" open double quote"I and O ​aide,close double quote" and open double quote"vital signs aide.close double quote" Based on these​ comments, which nursing care delivery system can the nurse expect to participate in for this​ shift? Functional nursing Team nursing Secondary nursing Primary nursing

Functional nursing Learning Objective Contrast the different frameworks for providing care. Rationale The labels the nurse hears are indicating tasks assigned to that person. This is functional nursing. Team nursing has clients assigned to a group of staff. Primary nursing has clients assigned to one main staff person. There is no secondary nursing system.

A nurse works at a hospital that provides services in all specialty areas (medical, surgical, pediatrics, obstetrics). This hospital is classified as: General hospital Long-term care hospital Specialty hospital Short-term care hospital

General hospital Rationale: Hospitals are classified by the services they provide as well as by their ownership. General hospitals admit clients requiring a variety of services such as medical, surgical, obstetric, pediatric, and psychiatric services. Some hospitals offer only specialty services such as psychiatric or pediatric. Hospitals can also be classified as acute care or chronic care. Acute care hospitals provide assistance to clients whose illness and need for hospitalization are relatively short term, such as several days. Long-term care hospitals provide services for longer periods—sometimes years or for the remainder of the client's life. Nursing Process: Assessment Client Need: Safe, Effective Care Environment Cognitive Level: Applying

Which act should the nurse recognize as horizontal​ violence? Maltreatment of a housekeeper by the nurse Battery of a client by a nurse Physical threats by a nurse against a nursing assistant Gossiping by one nurse against another nurse

Gossiping by one nurse against another nurse Horizontal violence involves​ acts, like​ gossiping, by one nurse against another nurse. Battery of a client is criminal abuse. Maltreatment and threats to other team members or insubordinates is bullying.

Which should the nurse identify as an effect of interprofessional collaboration? Increased absenteeism Greater sense of autonomy Increased turnover Greater risk of interpersonal conflict

Greater sense of autonomy

Which should the nurse identify as an effect of interprofessional collaboration? Greater risk of interpersonal conflict Greater sense of autonomy Increased turnover Increased absenteeism

Greater sense of autonomy Interprofessional collaboration has positive psychologic and professional effects. Both patients and nurses perceive a greater sense of autonomy when collaborative strategies are applied. The ability to enact one's professional role contributes to career satisfaction, decreased absenteeism, decreased turnover, and career retention.

The nurse is working in a busy pediatric ICU. Several of the nurses on the unit are interested, at the request of parents, in changing the rules to allow families to be present in a code situation for their child. The nurses are afraid to speak their minds openly because some of the doctors do not support the change and the nurses do not want to cause hard feelings. The nurse manager suggests a meeting of all concerned and might use which of the following to help with decision making? Present both sides of the argument to the group members. Ask the nurses to present their changes. Ask the members to be open minded. Have group members present concerns and questions on paper.

Have group members present concerns and questions on paper. Rationale: Nurses and doctors have to function as a team for the benefit of the client. Using the nominal group technique has the benefit of members submitting their ideas privately, which can help decrease friction in the group as a whole. The nurse manager would not want to take over the meeting since this would discourage dialogue within the group. If the nurses present their changes themselves, there is the chance that those nurses may be subject to the censorship of the group as a whole. This issue is an emotional one and asking group members to be open-minded may not happen since emotions may be high. It is best, to begin with, present concerns anonymously. Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Applying

The nurse is planning care for a client following a surgical procedure. Which collaborative action should the nurse​ include? (Select all that​ apply.) Changing the medication order after speaking with the client about adverse effects Informing the dietician that the client is on a special diet and needs reteaching about the diet Consulting the pharmacist regarding interactions between medications the client is prescribed Informing the pharmacist that the​ client's blood pressure​ (BP) is low and to hold the BP medication Updating the physical therapist regarding the​ client's physical activity and tolerance earlier in the day

Informing the dietician that the client is on a special diet and needs reteaching about the diet Consulting the pharmacist regarding interactions between medications the client is prescribed Updating the physical therapist regarding the​ client's physical activity and tolerance earlier in the day Collaborative actions that are client centered lead to improved client outcomes. Consulting the​ pharmacist, updating the physical​ therapist, and informing the dietician are all appropriate collaborative actions for the nurse to take. Telling the pharmacist to hold the​ client's medications without consulting the prescribing provider is outside the scope of practice of the​ nurse, as is changing the medication order. The nurse would report adverse effects or changes in the​ client's condition to the prescribing​ provider, who would be responsible for changing the medication order.

Two hospitals in a small town are trying to increase their nursing staff. In the hopes of attracting more​ applicants, one is offering​ sign-on bonuses to entice​ BSN-prepared staff members to join their team. Which type of conflict could occur in this​ situation? Interpersonal conflict Intrapersonal conflict Intergroup conflict Interorganizational conflict

Interorganizational conflict Interorganizational conflict occurs when one organization within the same market is in direct competition with another. If one organization is able to offer​ sign-on bonuses and other benefits that create a competitive​ advantage, this may alter the ability of other organizations to recruit and retain​ staff, creating conflict. Intergroup conflict is conflict between teams that are in competition for rewards or resources. Intrapersonal conflict is conflict that occurs within an individual that causes stress from real or perceived pressure generated by incompatible expectations or goals. Interpersonal conflict is conflict between two or more individuals due to differences​ and/or personalities or due to competition or concern over​ territory, roles, or responsibilities.

The nurse manager is preparing a report of staffing needs. What demographic trends could the nurse describe that are expected to produce a high demand for healthcare​ expertise? ​(Select all that​ apply.) Lack of primary care providers Increasing ethnic diversity Lack of specialists More​ long-term illnesses Increasing racial diversity

Lack of primary care providers More​ long-term illnesses Learning Objective ​Discuss factors that affect the delivery of health care. Rationale More​ long-term illnesses and lack of primary care providers are expected to produce a high demand for healthcare expertise. Although increasing racial and ethnic diversity is​ expected, those factors do not affect the demand for healthcare expertise. There is no predicted lack of specialists.

Which agency would sponsor a program that would meet the needs of a community group deficient in health promotion education ? Local health department Local hospital State health department Federal government

Local health department Rationale: The local health department is responsible for developing programs to meet the health needs of the people. State health organizations are responsible for assisting the local health departments. The U.S. Department of Health and Human Services is a federal agency whose functions include: conducting research and providing training in the health field, providing assistance to communities in planning and developing health facilities, and assisting states and local communities through financing and provision of trained personnel. Local hospitals provide the majority of acute care services in a community. Nursing Process: Implementation Client Need: Safe, Effective Care Environment Cognitive Level: Applying

The nurse manager is presenting an​ in-service for staff nurses about Medicaid insurance coverage. Which statements are appropriate for the nurse manager to include during the​ in-service? ​(Select all that​ apply.) "For the client who qualifies for​ Medicaid, home health services are typically covered." "Transportation costs to healthcare appointments are not covered by Medicaid." "Individuals with disabilities who meet federal and state eligibility requirements may be covered by Medicaid." "While Medicaid covers inpatient hospital​ services, it does not cover outpatient care." "Medicaid provides qualified individuals with cash for basic​ needs, such as​ food, housing, and clothing"

"For the client who qualifies for​ Medicaid, home health services are typically covered." "Individuals with disabilities who meet federal and state eligibility requirements may be covered by Medicaid."

The nurse has integrated the six principles of the Joint Principles of the Patient-Centered Medical Home into practice. Which statement defines the goal when providing this type of practice? Healthcare is a partnership with the patient and the patient's family. Patient-centered care is delivered in the home setting. The cost of the care provided to the patient using this model is moderate. A team of healthcare providers will be available to care for the patient.

Healthcare is a partnership with the patient and the patient's family. The factor that constitutes a biological agent to be categorized as the highest priority by the CDC includes the fact that the biological agent can cause public panic. Not all biological agents can be eradicated by a vaccine, but some can be treated with antibiotics. Biological agents that have a significant impact on public health or are easily transmitted are factors that place the agents in the highest category by the CDC.

Which statement describes horizontal violence? Horizontal violence is long-term behavior that lasts a minimum of 6 months. Horizontal violence refers to aggressive acts committed against a nurse by one or more nursing colleagues. Horizontal violence is an attack made when a person is in the horizontal recumbent position. Horizontal violence is chronic violence perpetrated by a workplace bully.

Horizontal violence refers to aggressive acts committed against a nurse by one or more nursing colleagues. Horizontal violence is a term used to describe aggressive acts that are committed against a nurse by one or more nursing colleagues. Workplace bullying is long-term behavior that lasts a minimum of 6 months and plays out in a series of verbal attacks, refusal to help or assist others, speaking negatively, or taunting.

An organization has goals to promote mutual respect within the interprofessional team and to improve client outcomes. Which action by the organization supports mutual​ respect? Placing physician leaders for each hospital department Upholding the tradition of patriarchal​ nurse physician relationships Implementing interprofessional rounding Promoting verbal acknowledgment of mutual respect

Implementing interprofessional rounding Interprofessional rounding promotes mutual respect through collaboration on​ client-centered care. Verbal acknowledgement is not meaningful without nonverbal support. Physician leadership should have nursing counterparts to promote mutual understanding of authority. The traditional​ nurse physician relationship must change to allow for mutual trust in collaboration.

The nurse should understand that which outcome is the major advantage of interprofessional collaboration? Working in partnership with other team members Meeting new colleagues Presenting a united front to the patient Improving patient outcomes

Improving patient outcomes According to the World Health Organization (WHO), professional collaboration has system-wide effects, including improvement of patient outcomes and patient safety indicators. The collaborative team does involve colleagues from other teams, but the most important benefits are always patient focused.

A client with a history of multiple cardiac defect repairs now requires a heart transplant. Which factor will be taken into consideration when selecting a donor match for the​ client? (Select all that​ apply.) Medical urgency Previous successful operations Length of time on waiting list Size of the heart Cardiac birth defect

Medical urgency Length of time on waiting list Size of the heart In selecting an organ match for the​ client, the size of the​ heart, medical​ urgency, and length of time on the waiting list are all taken into consideration. Birth defects or previous successful operations are not taken into consideration when selecting a donor match for the client.

Which term should the nurse use that describes being self-aware of one's triggers to stress that may result in conflict? Mindsight Conflict competence Incivility Collaboration

Mindsight

The nurse experiences workplace bullying. Which action should the nurse anticipate from the administration to support steps toward successful resolution of this​ issue? Asking the nurse to provide at least three witnesses to the event Encouraging the employee to transfer out of the department Ignoring the report of bullying until it is reported more than once Obtaining details of the event before taking action

Obtaining details of the event before taking action The nurse manager would obtain details on who was​ involved, when the event​ occurred, and details of the event before taking action to resolve the bullying issue. Witnesses would be encouraged to come forward but are not required. The manager would support resolution of the​ bullying, not encourage the employee to change roles or ignore the report.

Which of the following is in alignment with one of the Healthy People 2010 primary prevention goals? Providing free screening to children Opening a wellness clinic Creating new pharmacological treatments Developing better insurance controls

Opening a wellness clinic Rationale: The two primary prevention goals of Healthy People 2010 are to (1) increase quality and years of healthy life and (2) eliminate health disparities. Opening a wellness clinic, which is aimed at primary prevention, focuses on bettering health; this is in line with the primary goal. Free screening to children occurs in most states and is secondary prevention aimed at early detection. Pharmacological treatments are considered tertiary goals. Developing insurance controls was a goal of health care reform during the Clinton administration. Nursing Process: Assessment Client Need: Safe, Effective Care Environment Cognitive Level: Applying

The nurse is caring for a confused patient whose family states they do not know what the healthcare provider is planning. They state they left several messages without a response. Which response by the nurse is appropriate? Reiterating the plan of care that was communicated at the shift change Paging the healthcare provider to come and speak with the family Reminding the family that the healthcare provider is busy but will call when time allows Advising the family to call again and stress that they need to speak immediately to the healthcare provider

Paging the healthcare provider to come and speak with the family

A client who had the option to receive an influenza vaccine in an open clinic opted to call the primary healthcare​ provider's office to schedule a visit to receive the vaccine. Which barrier to healthcare access does the​ client's behavior​ exemplify? Lack of healthcare insurance Uneven distribution of services Lack of a usual source of care Perception of need

Perception of need The​ client's behavior exemplifies perception of need. Healthcare​ insurance, uneven distribution of​ services, and lack of a usual source of care are not factors in the choice of the client to wait to receive the vaccine.

A client diagnosed with Alzheimer's disease, whose memory is rapidly declining, has a spouse who must continue to work full time.- Which solution should the nurse recommend? That the spouse consider early retirement Increasing the client's medications to slow the progress of the disease Long-term care placement for the client Placing the client in an adult day-care environment

Placing the client in an adult day-care environment Rationale: Due to economics and the increasing age of the adult population, means other than hospitalization are needed to care for clients who cannot be cared for in the home. Day-care centers provide care and nutrition for adults who cannot be left at home alone but do not need to be in an institution. Moving a client from an independent home situation to long-term care would be more detrimental than a gradual progression of care. Telling the spouse to consider early retirement is neither therapeutic nor realistic. Increasing medications is a decision that needs to be made by the client's primary caregiver, not the nurse. Nursing Process: Implementation Client Need: Safe, Effective Care Environment Cognitive Level: Analyzing

The nurse case manager is reviewing Medicare coverage rules with a client. Which client statement indicates correct understanding of the​ teaching? The cost of my hearing aids is covered by Medicare Medicare covers my routine dental care. Prescription drug coverage is available through Medicare Medicare covers the costs of​ long-term care.

Prescription drug coverage is available through Medicare Learning Objective Describe various types of healthcare reimbursement. Rationale Medicare Part D offers prescription drug coverage. Services that are not covered by Medicare include​ long-term care, routine dental​ care, and hearing aids and the exams for fitting them.

The nurse at a community​ center's health fair is assessing a client who presents with high blood pressure and states that he has not seen a healthcare provider in over a decade. Which referral is the most appropriate for this client based on the result of the​ screening? Emergency department Urgent care clinic Cardiologist Primary care provider

Primary care provider The elevated blood pressure obtained during the screening requires a​ follow-up with a primary care provider. The result of the​ client's blood pressure does not warrant a referral to a​ cardiologist, urgent care​ clinic, or the emergency department. The​ client's elevated blood pressure has most likely occurred over a long period of time because there is no indication of a sudden change in his health​ status, and has gone unnoticed and untreated due to the​ client's lack of healthcare.

The nurse is caring for clients in the community and frequently refers them to the public health department for healthcare. Which benefit does a client who utilizes the public health department for care​ receive? (Select all that​ apply.) Professional staff is already available to provide care. Care offered includes preventive health services. The facility has a history of service to the community. Potential clients are aware of the many services. The facility has an available inventory of​ low-cost medications

Professional staff is already available to provide care. Care offered includes preventive health services. The facility has a history of service to the community. The benefits to clients who utilize the public health department for care include the fact that preventative services are offered. The public health department has a history of service to the​ community, and professional staff is already available to provide care. Many clients are unaware of the services available at the public health​ department, and the facilities do not have an available inventory of​ low-cost medications.

A nurse is a member of a community team formed to support and treat individuals with serious mental illnesses. Who might also be part of this team? (Select all that apply.) Physical therapist Psychiatrist Paralegal Speech therapist Employment specialist

Psychiatrist Employment specialist Rationale: Although some individuals may require speech services, physical therapy, or paralegal consultation, these are not services expected as a regular part of a community support team for clients with mental illness. Employment specialists can provide vocational guidance and placement services. A psychiatrist can provide medication management to the team's efforts. Nursing Process: Planning Client Need: Management of Care Cognitive Level: Applying

When performing collaborative health care, the nurse must implement which of the following? Rely on the expertise of other health care team members. Assume a leadership role in directing the health care team. Be physically present for the implementation of all aspects of the care plan. Delegate decision-making authority to each health care provider.

Rely on the expertise of other health care team members. Rationale: In collaboration, each member of the team, including the client, participates in sharing ideas and reaching consensus on the best plan of care. The team is generally led by the health care professional most skilled in the client's specific areas of need. Once the plan is established, it may be implemented by any member of the team or a designate at an appropriate time or place. It is not necessarily delegated by the nurse. Nursing Process: Planning Client Need: Safe, Effective Care Environment Cognitive Level: Understanding

A coworker yells obscenities at a nurse colleague when unhappy. The nurse colleague asks the coworker to stop the behavior, but it continues. Which action should the nurse colleague take to remedy the situation? Ask a colleague to intervene. Wait to see if the coworker stops the behavior. Report the behavior to the immediate supervisor. Do nothing.

Report the behavior to the immediate supervisor. Verbal abuse in the workplace should be reported immediately. Victims of bullying experience adverse emotional effects, including anxiety, depression, and a sense of isolation. Asking another colleague to intervene or doing nothing will not address the situation.

A 73-year-old client is in the hospital for pneumonia for the third time in 6 months. During the nursing history, the nurse discovers that the client has few financial resources, lives alone, and has not received needed immunizations. To provide excellence in care, the nurse should: Tell the client of the need to move to long-term care. Request consultations with other disciplines. Recommend that the client remain in the hospital until well. Request an order from the physician for long-term care.

Request consultations with other disciplines. Rationale: Many older adults choose to remain in their own homes to care for themselves. In today's world, the nurse recognizes that with the proper resources, this is a possibility. The nurse might request a social worker and a nutritionist to help the client with home care resources, and might also ask the physician for the appropriate immunizations. Considering the cost of health care, the client can recuperate at home with the appropriate resources. The client may not want or need long-term care and should be consulted prior to making that decision. The nurse might discuss the advantages of long-term care with the client, but would not tell the client to move to it. Nursing Process: Implementation Client Need: Health Promotion and Maintenance Cognitive Level: Analyzing

The nurse is examining role expectations and boundary issues causing primary sources of conflict within a healthcare unit. Which issue should be addressed by the nursing​ staff? (Select all that​ apply.) Resistance to change Lack of understanding Inaccurate information Consistent cooperation Effective communication

Resistance to change Lack of understanding Inaccurate information Role expectations and boundary issues are a primary source of conflict within a healthcare unit. They may arise from a lack of understanding or awareness of which task each team member is to perform due to​ miscommunication, inaccurate​ information, and resistance of some members to change. Cooperation and effective communication often lead to conflict resolution.

The nurse is designing activities to promote skill building for nursing collaboration. Which activity should be​ included? (Select all that​ apply.) Reviewing scope of practice for nurses Performing a​ self-assessment of strengths Analyzing different communication styles Explaining how authority impacts care delivery Acknowledging that barriers to team building will never change

Reviewing scope of practice for nurses Performing a​ self-assessment of strengths Analyzing different communication styles Explaining how authority impacts care delivery QSEN​ (Quality and Safety Education for​ Nurses) identified characteristics related to teamwork and collaboration that support skill building for the nurse. The nurse should review scope of​ practice, self-assess​ strengths, analyze different communication​ skills, and understand how authority impacts care delivery. Barriers exist to team​ building, but they should not be viewed as insurmountable.

Which factors should the nurse consider a major source of conflict in the healthcare setting? Role boundary issues and accountability Accountability and miscommunication Accountability and cultural issues Miscommunication and role boundary issues

Role boundary issues and accountability Within the healthcare setting, researchers have identified role boundary issues and accountability as the two primary causes of conflict. Miscommunication can cause a problem but has not been identified as a source of conflict. Cultural differences can cause conflicts but they are not the primary cause.

A nurse is caring for three clients who all demand that the nurse meet expectations immediately. The charge nurse asks the nurse to set up a room and take a new admission from the emergency department. The nurse is experiencing: Intergroup conflict Organizational conflict Interpersonal conflict Role conflict

Role conflict Feedback Rationale: The nurse who is overwhelmed on a tour of duty by many obligations that are due simultaneously is experiencing individual or role conflict. Interpersonal conflict is conflict between people. Organizational conflict refers to conflicts that may occur between departments or perhaps agencies. Intergroup conflict is another name for organizational conflict. Nursing Process: Evaluation Client Need: Safe, Effective Care Environment Cognitive Level: Understanding

The client asks the nurse to explain how Medicare works. Which items should the nurse include in the teaching​ session? ​(Select all that​ apply.) Routine eye care is not covered by Medicare. Medicare is a federally funded health insurance program. Individuals with​ end-stage renal disease are not eligible for Medicare coverage. Both hospital and medical insurance are offered by Medicare. There are four types of Medicare coverage.

Routine eye care is not covered by Medicare. Medicare is a federally funded health insurance program. Both hospital and medical insurance are offered by Medicare. There are four types of Medicare coverage.

The nurse is teaching an adolescent patient how to perform a thorough breast self-examination using a realistic model of the breast. Which type of prevention activity is the nurse performing with this patient? Primary prevention Secondary prevention Palliative prevention Tertiary prevention

Secondary prevention Secondary prevention is used to detect and then treat identified injuries and diseases early so that they can be cured or their associated symptoms and complications can be prevented or limited. Breast self-examination is a screening tool for breast cancer. Palliative prevention is not an activity for prevention.

The nurse wants to improve collaborative​ decision-making skills. Which action promotes collaboration between nurses and the interprofessional​ team? Delaying feedback on results to ensure that all collected data were reviewed by the team first Removing the client from the​ decision-making process Sharing responsibility of the outcome of the decision Depending on physician leadership to ultimately make the decision for the team

Sharing responsibility of the outcome of the decision Collaboration in decision making results in shared responsibility of the outcome of the decision. The client should be involved in decision making. The physician should hold a​ collaborative, not​ supervisory, position within the team. Feedback should be prompt to evaluate and make changes as needed.

A nurse is forming a team responsible for school based care. Identify some of the disciplines that might be appropriate for this team. (Select all that apply.) Social worker School bus driver Teacher School secretary Nurse Cafeteria supervisor

Social worker Teacher Nurse Rationale: Although information provided by those who have regular contact with students, such as school secretaries, cafeteria supervisors and bus drivers, may be useful in team planning, they do not bring expertise that contributes to a team's planning and treatment process. Social workers can contribute case management and mental health skills to the interdisciplinary team. Teachers can contribute perspective and knowledge about a student's cognitive and social functioning. School nurses can contribute knowledge and skills on physical and mental health issues. Nursing Process: Planning Client Need: Management of Care Cognitive Level: Applying

Which outcome should the nurse understand is an adverse organizational outcome that may occur because of negativity or incivility? Staff turnover Decreased patient errors Increased reports of incivility Decreased absenteeism

Staff turnover Studies on incivility indicate that such negativity can lead to adverse organizational outcomes. This includes staff turnover and decreased job satisfaction, leading to absenteeism, loss of productivity, and patient errors with the potential for adverse outcomes and associated costs.

The home health nurse is visiting an 86-year-old client who weighs 96 pounds to assess the client's postoperative progress. The nurse observes the aide giving a bath and notes that the aide puts powder in the folds of the perineal area. To promote a collaborative setting, the nurse would: Report the aide to the agency. Ask the family to request another aide. Report the aide to the physician. Take the aide aside and teach the appropriate skin care.

Take the aide aside and teach the appropriate skin care. Rationale: The role of the nurse in this instance is one of a teacher. The nurse cannot assume that the aide was or was not taught appropriately, and would take the aide aside and gently explain appropriate care for this client. This action puts the client in the center of the team and promotes collaboration. Telling the family to request another aide is not appropriate and could decrease the family's trust level; it also victimizes the family. If the aide continues with inappropriate care, the nurse would report the aide after informing the aide of the nurse's intentions. There is no reason to involve other team members, including the physician. Nursing Process: Evaluation Client Need: Physiological Integrity Cognitive Level: Applying

The nurse is involved in a situation of hostility with a​ co-worker that is escalating in an open area. Which action should the nurse take to best address the​ situation? Walking away from the employee and ignoring the situation Continuing the interaction in the current location Calling for​ upper-level administration to assist Taking the interaction to a private place

Taking the interaction to a private place Conflict should not take place in open areas. It is best to move the conflict to a private area.​ Upper-level administration may be involved if members of supervision are involved in the conflict. Walking away to establish boundaries may be done if the conflict cannot be moved to a private area but not with the intention of ignoring the situation.

The nurse attended a class about preventing horizontal violence in the workplace. Which action by the nurse indicates that learning​ occurred? Teaching others through unit presentations about the ramifications of workplace violence Ignoring negative statements of others about nurses on the unit Allowing nurses who have been victims to approach and humiliate their abusers Encouraging gossip about peers and other staff members

Teaching others through unit presentations about the ramifications of workplace violence Each nurse and nurse manager has a responsibility to act to prevent workplace bullying. One way to prevent this form of aggression and violence is to educate others about the ramifications of bullying. Condoning or encouraging​ gossip, ignoring negative​ comments, and allowing humiliating or hostile behaviors are actions that​ promote, rather than​ discourage, bullying in the workplace.

A nurse educator is explaining the difference between groups and teams. What are some of the specific characteristics of teams that the nurse identifies. (Select all that apply.) Task completion is delegated to individuals. Team members are only individually accountable. Team members have a variety of goals Teams have a flexible hierarchy. A team is a specialized type of group.

Teams have a flexible hierarchy. A team is a specialized type of group. Rationale: In a team, task completion and product creation are collaborative in nature, as opposed to being delegated to individuals. A team comprises individuals who agree to work in tandem to accomplish a common goal. Accountability among team members is both individual and mutual in nature. A team's hierarchy is more flexible than that of a group; members of a team often share the leadership role. In simplest terms, a team comprises individuals who agree to work in tandem to accomplish a common goal. Nursing Process: Analysis Client Need: Management of Care Cognitive Level: Applying

Which statements are true regarding the nurse as a​ collaborator? ​(Select all that ​apply). The ability to independently set goals and objectives for client care The ability to recognize the contributions of team members by virtue of experience The ability to share and receive clinical expertise with other nurses The ability to participate in policy formation to increase knowledge of a clinical problem The ability to seek opportunities to work with and within professional organizations

The ability to recognize the contributions of team members by virtue of experience. The ability to share and receive clinical expertise with other nurses. The ability to seek opportunities to work with and within professional organizations. The nurse helps clients set mutually​ agreed-upon goals and objectives for health​ care, ensuring the​ client's involvement in healthcare decisions. The nurse does not set goals independently without client input. The nurse shares clinical expertise with other nurses and elicits the expertise of others to ensure​ high-quality client care. The nurse participates in collaborative interdisciplinary research to increase knowledge of a clinical problem or situation. The nurse participates in policy formation in order to offer expert opinions on legislative issues related to health care. The nurse would participate in​ health-related research to increase knowledge of a clinical problem. The nurse recognizes the contributions of team members by virtue of experience and view of the situation. The nurse also seeks opportunities to work with and within professional organizations

The nurse is working with a client who will be discharged home in the next few days. The nurse notes that the client has orders for home health and physical therapy after discharge. The nurse plans to notify: The home health agency The physical therapy department The nurse manager The case manager

The case manager Rationale: The case manager is responsible for coordinating the care of the client from admission through discharge. When the client has orders for services beyond the hospital setting, the case manager arranges the care so that continuity of care is maintained. The nurse is no longer responsible for notifying the home health agency or physical therapy, but is responsible for collaborating with the case manager to assure that the services will be in place when the client is discharged. The nurse manager does not need to be notified unless a situation arises that would need a manager's expertise. Nursing Process: Planning Client Need: Safe, Effective Care Environment Cognitive Level: Applying

The collaborative care team for a​ 44-year-old client admitted two days ago following a diagnosis of diabetic ketoacidosis is reviewing the client​'s progress since admission. The nurse on the team requests a consultation with the dietician for the client. Which is an expected outcome of the​ consultation? The client will have many questions about insulin. The client will have to eat foods she does not like. The client will be more likely to adhere to her treatment regimen. The client will become an informed consumer.

The client will become an informed consumer. Care that is client centered and client directed results in a client who is a more informed healthcare​ consumer, leading to better client outcomes. The client will not necessarily have to eat foods that she does not like following dietary​ teaching: She will learn to choose from a variety of foods that are appropriate. There is no way to predict whether or not the client will be any more or less likely to follow her treatment regimen following the dietary consultation. While the client may have questions about her​ insulin, this not the focus of a dietary consultation.

The nurse is planning a discussion on a topic related to tertiary prevention for clients with type 2 diabetes. Which information will the nurse​ include? Screening for coronary artery disease The effects of exercise and blood glucose control A demonstration of proper​ hand-washing techniques Smoking cessation

The effects of exercise and blood glucose control A topic that addresses tertiary prevention for a client with type 2 diabetes is the effects of exercise and blood glucose control. Hyperglycemia is a complication of diabetes. Tertiary prevention begins after a condition is treated and stabilized or recognized as incurable. It includes the restoration of function and decrease of complications of an established disease. Smoking cessation and hand washing are primary preventive measures. Screening for coronary artery disease is a secondary preventative measure.

The nursing student is giving a presentation on the roles of citizens and government in shaping health policy. Which statements should be included in the​ presentation? ​(Select all that​ apply.) The citizen who reports the concern is responsible for choosing the best solution. The government official is responsible for identifying political considerations related to each solution. The citizen​'s responsibilities include evaluating safety concerns of proposed solutions. Citizens will evaluate the outcomes of newly implemented laws. One role of government officials is hearing citizens​' concerns.

The government official is responsible for identifying political considerations related to each solution. One role of government officials is hearing citizens​' concerns. Learning Objective Identify societal and governmental influences of the development of health policy. Rationale Government​ officials' roles include hearing​ citizens' concerns about healthcare​ needs, evaluating safety concerns related to potential​ solutions, identifying political considerations related to each​ solution, and choosing the best solution. Federal agencies or departments who are responsible for implementing the new law will evaluate outcomes.

The nurse manager for the acute care wing of an assisted living center has several meetings with different groups of people. Which group would be considered an intradisciplinary​ team? The​ respiratory, occupational,​ speech, and physical therapy managers The facility physician and pharmacy manager The social worker and the nurse manager for the chronic care wing The nurse managers for the memory care wing and the chronic care wing.

The nurse managers for the memory care wing and the chronic care wing. Intradisciplinary teams are made up of members of the SAME profession. The therapy​ managers, physician, pharmacy​ manager, and social worker all are from different professions. Meetings with them would be considered interdisciplinary.

Two events occurred on the nursing unit. The first involves a nurse who consistently does not accept the team leader's patient assignment and insists on choosing their own patient. The second event involves a nurse who was physically attacked by a coworker. Which nurse is experiencing horizontal violence? Neither The nurse who wants to choose their assignment The nurse who was physically attacked The team leader

The nurse who was physically attacked

The unit nurse manager is preparing to give a performance review to a new nurse who has performed below expectations in multiple areas. Which factor does the nurse manager anticipate will impact the way that this employee receives the​ feedback? The nurse​'s ​self-esteem The nurse​'s lack of time management skills The nurse​'s lack of experience The nurse​'s religious beliefs

The nurse​'s ​self-esteem ​Self-esteem is one factor that affects how an individual perceives feedback. If the nurse has low​ self-esteem, a poor review can cause feelings of failure in other areas of​ life, not just on the job. While the​ nurse's lack of job experience can impact​ performance, it does not influence how well or how poorly the nurse receives feedback. The​ nurse's religious beliefs are not a factor in determining how feedback is received. Poor time management skills can adversely affect job​ performance, but are not a factor in how effectively feedback is received.

The nurse is caring for an older adult patient who takes many medications due to complex healthcare needs. Which statement describes the risk for the patient for prescription drug expenses when hitting the "donut hole" of Medicare? The patient is able to get a free year's worth of drugs to use before the next calendar year. The patient can only qualify for generic medications using Medicare payment. The patient is given low-cost medications paid for with government funding. The patient may be forced to purchase fewer prescription drugs.

The patient may be forced to purchase fewer prescription drugs. The government rations healthcare resources, such as inclusion of the coverage gap in Medicare Plan D (known as the "donut hole") that sometimes forces beneficiaries to purchase fewer prescriptions. The "donut hole" means that the patient pays a higher price for a time, until drug expenses hit a preset higher level. There are no Medicare drug discounts or free medications, and the patient is not restricted to generic medications.

A patient tells the nurse, "I work full-time at a large company but I do not have any health insurance." Which statement best describes the nurse's understanding of why the patient may have no health insurance? The patient does not understand the importance of caring for health. The patient may not be able to get insurance due to preexisting conditions. The employer may not offer health insurance due to the employee's job description. The patient may not be able to afford the health insurance the employer offers.

The patient may not be able to afford the health insurance the employer offers. The patient may not be able to afford the health insurance the employer offers. A job description does not exclude a full-time employee from obtaining health insurance benefits. The Affordable Care Act prevents insurance companies from denying individuals insurance coverage based on preexisting conditions. The patient understands the importance of care for their health, because the patient presents to the clinic with concerns about high blood sugar levels.

The nurse is caring for a patient who lives 50 miles from the clinic and is often unable to obtain transportation for follow-up care. Which barrier to healthcare is most likely responsible for the patient's noncompliance with follow-up clinic visits? Uneven distribution of services Perception of need Lack of a usual source of care Lack of healthcare insurance

Uneven distribution of services The barrier to healthcare that is most likely responsible for the patient's noncompliance with follow-up care in the clinic is the uneven distribution of services (for example, the nearest clinic is 50 miles away). The perception of need, lack of healthcare insurance, or lack of a usual source of care are not identified as primary factors for the noncompliance in care.

A.Immunization clinics B.Health education C.Family planning services

What are some examples of programs which may be provided at the local health department level? Select all that apply. A.Immunization clinics B.Health education C.Family planning services D.Licensing of health care professionals E.Quality and safety data

Which situation is representative of workplace bullying? The public health nurse's role is to educate the public on sexually transmitted infections. When assignments are posted, a nurse loudly insists on choosing their own patients. The young nurse loves to talk about personal life quite often. The nurse who works in a long-term care facility is eager to help teammates.

When assignments are posted, a nurse loudly insists on choosing their own patients. Workplace bullying is long-term behavior that lasts a minimum of 6 months and plays out in a series of verbal attacks, refusal to help or assist others, speaking negatively, or taunting. Each day, the nurse insisting on choosing their own patients indicates bullying of the team leader and undermining the team leader's authority. This is not fair to the rest of the team. Although it may be annoying, a coworker talking about personal life is not a form of bullying. A helpful nurse and one who provides education about sexually transmitted infections are not bullies.

The nurse manager is establishing a team of nurses to explore ways to reduce sharps exposure among staff on the unit. Which is an example of using collaboration when coaching staff members on the​ unit? Designating a single team leader Working toward a common goal Following a stringent chain of command Delegating tasks to specific individuals

Working toward a common goal. Individuals on a team work together toward a common goal. Teams complete tasks in a collaborative​ manner, not by delegating to individuals. Team members often share leadership roles. Teams have a flexible hierarchy or chain of command.

The nurse is discussing care with an adult client. Which action by the nurse is the most appropriate for providing collaborative​ care? Asking the​ client's husband to wait outside Working with the client to determine care objectives Your answer is correct. Encouraging the client to request more aggressive treatment Sharing the​ physician's treatment goals with the client

Working with the client to determine care objectives. Setting​ mutually-agreed upon goals and objectives illustrates collaborative care. Asking the​ client's husband to wait outside is not collaborative and is only appropriate if the client requests it. Sharing the​ physician's treatment goals with the client does not indicate collaboration. Encouraging the client to request more aggressive treatment is considered to be offering advice and is not indicative of collaborative care.

A nurse caring for patients in a primary care setting submits paperwork for reimbursement from managed care plans for services performed. Which purpose best describes managed care as a framework for health care? a) A design to control the cost of care while maintaining the quality of care b) Care coordination to maximize positive outcomes to contain costs c) The delivery of services from initial contact through ongoing care d) Based on a philosophy of ensuring death in comfort and dignity

a Managed care is a way of providing care designed to control costs while maintaining the quality of care

The home care nurse asks the client and family about their socioeconomic status, culture, and beliefs. This occurs during which phase of care? a) Assessment b) Nursing diagnosis c) Outcome criteria d) Implementation

a) Assessment

Which is the primary goal of continuity of care? a) Ensuring a smooth and safe transition between different health care settings b) Increasing clients' knowledge base and improving their health maintenance behaviors c) Minimizing nurses' legal liability during client transitions between health care institutions d) Controlling costs and maximizing client outcomes after discharge from the hospital

a) Ensuring a smooth and safe transition between different health care settings

A client is having an increasing amount of difficulty caring for oneself in the home alone. The client states to the nurse, "I need more help. What am I going to do?" Which action would be the most appropriate for the nurse to take? a) Have the social worker visit the client to discuss care options. b) Have the physical therapist help the client with rehabilitation. c) Have the home health aide increase visits for bathing the client. d) Have the occupational therapist assess for the client's need for adaptive devices.

a) Have the social worker visit the client to discuss care options.

The nurse is planning discharge of the client who had surgery for a left hip replacement. The client is being discharged from the hospital to the home and requires home medical services. Which item would be provided by home medical services? a) High-rise toilet seat b) Intravenous therapy c) Pain management d) Homemaking

a) High-rise toilet seat

Which type of home healthcare agency is a local health department? a) Official or public agency b) Private not-for-profit agency c) Private, proprietary agency d) Institution-based agency

a) Official or public agency

Which measure should a home health care nurse integrate into routine practice to minimize the potential for lawsuits? a) Perform thorough, accurate, and timely documentation. b) Apply more conservative interventions than those used in a hospital setting. c) Integrate the client's learning needs and goals into plans of care. d) Have the client sign a waiver prior to the entry phase of a visit.

a) Perform thorough, accurate, and timely documentation.

The nurse is admitting a client for outpatient surgery. When the nurse asks what the client has been told about self-care following discharge, the client says, "No one has told me anything." Which nursing intervention is indicated? a) Provide the teaching. b) Notify the surgeon. c) Alert the charge nurse in surgery. d) Advise the client to delay the surgery.

a) Provide the teaching.

In preparation for discharge, the nurse is reviewing information related to new dietary guidelines with the client. This is an example of which step in discharge planning? a) Providing client education b) Assessing the client's needs and identifying problems c) Developing goals with the client d) Making home health care referrals

a) Providing client education

The client is being discharged to the home setting following a stroke. Which activity would the occupational therapist assist the client with? a) Relearning how to cook safely b) Improving oral communication c) Gait training with a walker d) Improving the ability to swallow

a) Relearning how to cook safely

An 82-year-old client is being discharged from the hospital following a bowel resection. The client lives alone and the client's family is out of town. Which factor will have the greatest effect on the client's home care management? a) Support system b) Medication management c) Transportation d) Psychosocial needs

a) Support system

A client is admitted to the acute care facility for the treatment of pneumonia. What exemplifies the nurse-managed care approach? a) The case manager identifies dates when oxygen should be discontinued, bronchodilators changed to self-administered inhalers, and antibiotics changed from intravenous to oral treatment. b) A nurse manager ensures that the client navigates the health care system with a maximum of efficiency and a minimum of frustration to avoid causing the client to feel isolated or abandoned. c) The primary nurse delegates client care to other health care professionals but is consulted when new problems develop or the plan of care requires modifications. d) A nurse practitioner monitors the client's care and makes referrals for consultation and additional testing.

a) The case manager identifies dates when oxygen should be discontinued, bronchodilators changed to self-administered inhalers, and antibiotics changed from intravenous to oral treatment.

The nurse is preparing to begin the discharge planning process with a client whose pulmonary embolism has recently resolved. Which factor should the nurse prioritize during this process? a) The client's identified needs and goals b) The nurse's knowledge base and experience level c) The client's potential for recurrence d) The NANDA diagnoses relevant to the client's condition

a) The client's identified needs and goals

When a multidisciplinary team is involved in meeting the home care needs of a client, who is the person responsible for the coordination of the care provided? a) The registered nurse b) The social worker c) The chaplain or minister d) The home health care aide

a) The registered nurse

Which are recommended guidelines to prevent the spread of infection in the home care setting? Select all that apply. a) Wearing gloves when contacting body fluids b) Using standard precautions c) Performing hand hygiene after reaching into the bag for supplies d) Using sterile technique when reaching into the bag for supplies e) Placing the bag on a liner before setting it down in the client's home

a) Wearing gloves when contacting body fluids b) Using standard precautions e) Placing the bag on a liner before setting it down in the client's home

A 16-year-old client has been injured in an accident and is receiving home care due to fractures and multiple trauma-related injuries. The client states, "I don't know why I survived and not my best friend." It is most important for the home care nurse to encourage the client to: a) communicate these feelings to family and friends. b) allow a religious leader in the client's life to visit. c) be certain that the client's educational needs are being met. d) increase the client's activity to assist in coping.

a) communicate these feelings to family and friends.

A nurse researcher keeps current on the trends to watch in healthcare delivery. What trends are likely included? Select all that apply. a) Globalization of economy and society b) Slowdown in technology development c) Decreasing diversity d) Increasing complexity of patient care e) Changing demographics f) Shortages of key health care professionals and educators

a, d, e, f Trends to watch in health care delivery include: globalization of the economy and society, increasing complexity of patient care, changing demographics, shortages of key health care professionals and educators, technology explosion, and increasing diversity.

1. As a nurse, you are aware that The World Heath Organization defines "health" as: a. a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity b. a state of well-being with absence of disease c. a state of well-being d. absence of disease or infirmity

a. a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

6. Your patient is being transferred to a subacute facility tomorrow. In planning for this transfer, you are aware that subacute care would provide services for patients with the following conditions: a. long-term ventilator dependency b. newly diagnosed cancer requiring chemo c. a condition in which the patient will die within 2 weeks d. breastfeeding difficulty for a first-time mother

a. long-term ventilator dependency

7. One type of health care delivery system is a health maintenance organization (HMO). You are aware that: a. this type of a system delivers comprehensive health maintenance and treatment services for a group of enrolled individuals b. there is only one independent model of HMO c. there is only a group model where practitioners employed by the insurer spend all their time caring for their patients of that particular HMO d. HMOs are part of Medicare Part C

a. this type of a system delivers comprehensive health maintenance and treatment services for a group of enrolled individuals

A nurse is caring for patients in a primary care center. What is the most likely role of this nurse based on the setting? a) Assisting with major surgery b) Performing a health assessment c) Maintaining patients' function and independence d) Keeping student immunization records up to date

b Performing patient assessments is a common role of the nurse in a primary care center. Assisting with major surgery is a role of the nurse in the hospital setting. Maintaining patients' function and independence is a role of the nurse in an extended-care facility, and keeping student immunization records up to date is a role of the school nurse.

Which circumstance likely requires the most documentation and communication on the part of the nurse? a) A client is being discharged home following a laparoscopic appendectomy 2 days earlier. b) A geriatric client is being transferred from a subacute medical unit to a new long-term care facility following recovery from pneumonia. c) A client is being transferred from one medical unit of the hospital to another to accommodate a client on isolation precautions. d) A client is returning to an assisted-living facility following a colonoscopy earlier that day.

b) A geriatric client is being transferred from a subacute medical unit to a new long-term care facility following recovery from pneumonia.

A nurse is covering all aspects of admission procedures for a client who is receiving home health services. The nurse explains what procedures will be covered during the nurse's visits. Which aspect of the admission process does this represent? a) Establishing rapport and showing willingness to listen b) Clearly defining the purpose and expectations of the admission c) Documenting the procedure d) Assisting in participation of the care-related decisions

b) Clearly defining the purpose and expectations of the admission

Which action must the nurse perform on discharge of a client from an acute care facility? a) Writing a discharge order for the client b) Coordinating future care for the client c) Writing any orders for future home visits that may be necessary for the client d) Sending the client's records to the attending physician

b) Coordinating future care for the client

A successful discharge includes effective planning. Identifying and meeting client needs beyond the acute care facility reduce readmissions. Which nursing role is of great importance to this success? a) Caregiver b) Coordinator c) Nurse practitioner d) Clinician

b) Coordinator

The nurse is working with a client's family and social worker to select a home health care agency. Which question does the nurse state should be the family's priority when interviewing potential home health agencies? a) Is the facility listed as a government-approved facility with no infractions? b) Does the agency meet uniform standards for licensing, certification, and accreditation by state agencies and/or federal programs? c) Does the agency provide care to facilitate transition to a hospital? d) How does the agency train employees for accountability and do they require a background check?

b) Does the agency meet uniform standards for licensing, certification, and accreditation by state agencies and/or federal programs?

A nurse is preparing a room for client admission. Which actions follow recommended guidelines for this process? Select all that apply. a) Always open and position the bed in the highest position. b) Fold back the top bed linens. c) Assemble the necessary equipment and supplies, including a hospital admission pack. d) Do not supply pajamas or hospital gowns until it is determined whether the client will wear the client's own. e) Ask the physician to assemble special equipment needed by the client (such as oxygen, cardiac monitors, or suction equipment). f) Adjust the physical environment of the room, including lighting and temperature.

b) Fold back the top bed linens. c) Assemble the necessary equipment and supplies, including a hospital admission pack. f) Adjust the physical environment of the room, including lighting and temperature.

Which is the largest single source of reimbursement for home health care services? a) Client's self-pay b) Medicare c) Private insurance d) Medicaid

b) Medicare

The home care nurse is providing care and education to a client who is pregnant for the first time. The client states, "I have no money or food. I don't know what I should do. I want to provide for my unborn child." The nurse refers the woman to the WIC program and a local food bank. This is an example of what aspect of community-based nursing? a) Assessment b) Planning c) Restoration d) Evaluation

b) Planning

It is important for home health care nurses to remember which point? a) The nurse is the primary caregiver. b) The nurse is the guest in the client's home. c) Rehabilitation is the major client goal. d) The nurse should act as a counselor and advisor.

b) The nurse is the guest in the client's home.

A nurse is preparing for handoff communication for a client who is being discharged from the hospital to home health care. Which example is not an action performed during this process? a) The nurse determines who should be involved in the handoff communication. b) The nurse prepares the new room for the client. c) The nurse asks the other health care professionals if they have any questions. d) The nurse uses the SBAR technique during the handoff.

b) The nurse prepares the new room for the client.

The nurse is met in the staff lounge by the nurse who has been caring for the client team on this shift. The off-going nurse says, "Sorry, but I have to get out of here." The nurse then gives a quick overview of each client on the team and says, "All the rest is in the chart if you need anything." Which essential part of the handoff is missing? a) The chance for the oncoming nurse to assess the clients b) The opportunity for the oncoming nurse to ask questions c) The oncoming nurse's chance to check intravenous (IV) sites and fluids d) The oncoming nurse's opportunity to meet new clients

b) The opportunity for the oncoming nurse to ask questions

Continuity of care is an important concept for quality nursing practice. The responsible nurse understands the best description of the process of continuity of care is to: a) manage the individual care needs of the client throughout the hospital stay. b) coordinate uninterrupted care and facilitate transfer between units and levels of care. c) assist the client to focus on health goals and reach outcomes. d) teach the client self-care regarding medications and plan of care.

b) coordinate uninterrupted care and facilitate transfer between units and levels of care.

When educating clients in the community on health promotion and prevention of disease, it is important to stress: a) strenuous exercise is necessary for health. b) health education can benefit individuals and groups. c) the ideal location for education is in a health care institution. d) health promotion may not be possible for many of the older members of a community.

b) health education can benefit individuals and groups.

The nurse is caring for a client who would benefit from home health care services. In preparing for discharge, the nurse is aware that home health care can only be initiated if the: a) appropriate transfer forms are completed. b) physician writes an order for home care. c) social worker assesses the need and Medicare agrees to pay for home health care services. d) home health care agency evaluates the client and determines the need for services.

b) physician writes an order for home care.

When preparing to transfer an older adult client back to the long-term care facility where the client has been for several years, it is the primary responsibility of the nurse to: a) ensure that the current health state of the client is maintained. b) provide for the coordination and continuity of care by the health care providers. c) communicate to the next of kin so they are aware of the transfer. d) discuss the return to familiar surroundings with the client.

b) provide for the coordination and continuity of care by the health care providers.

The nurse understands that planning for discharge actually begins at admission to the facility. The purpose of discharge planning is best described as: a) decreasing stress for client and family members. b) providing continuity of care that is goal directed. c) ensuring client safety and health maintenance. d) promoting less dependence on others.

b) providing continuity of care that is goal directed.

A nurse is providing secondary health care to patients in a health care facility. Which patients are receiving this level of care? Select all that apply. a) A patient enters a community clinic with signs of strep throat. b) A patient is admitted to the hospital following a myocardial infarction. c) A mother brings her son to the emergency department following a seizure. d) A patient with osteogenesis imperfecta is being treated in a medical center. e) A mother brings her son to a specialist to correct a congenital heart defect. f) A woman has a hernia repair in an ambulatory care center

b, c, f Secondary health care treats problems that require specialized clinical expertise, such as an MI, a seizure, and a hernia repair. Treating strep throat is primary health care.Tertiary health care involves management of rare and complex disorders, such as osteogenesis imperfecta and congenital heart malformations.

10. A chronic hemodialysis patient would have his bills paid for by: a. Medicare Part A b. Medicare Part B c. Medicare Parts A and B d. Medicare Part C

b. Medicare Part B

You are the nurse caring for a 54 yr old woman who has just been diagnosed with end-stage pancreatic cancer. Along with the social worker, you are discussing hospice programs with her. Which of the following will be explained to the patient? a. hospice programs are hospital based only b. hospice programs allow patients to die with dignity at home or in a facility c. hospice programs are for adults over the age of 66 only d. hospice programs are for those patients who will die within 1 year of diagnosis

b. hospice programs allow patients to die with dignity at home or in a facility

3. When questioned by a patient about Medicaid benefits, as a nurse you are aware that Medicaid is a: a. health insurance program for people aged 65 and older or under age 65 with certain disabilities or any age with end-stage renal disease b. joint federal and state assistance program designed to pay for medical long-term care assistance for individuals and families with low income and limited resources c. health insurance program for age 66 and older d. joint federal and state assistance program designed to pay for medical long-term care assistance for individuals and families regardless of income

b. joint federal and state assistance program designed to pay for medical long-term care assistance for individuals and families with low income and limited resources

The nurse case manager is reviewing Medicare coverage rules with a client. Which client statement indicates correct understanding of the​ teaching? a "Medicare covers my routine dental care ." b "The cost of my hearing aids is covered by Medicare. " c "Prescription drug coverage is available through Medicare. " d "Medicare covers the costs of​ long-term care. "

c

A home health care nurse is explaining to an emergency room nurse how nursing care in the home setting differs from that in the hospital setting. Which statement by the home health care nurse would be most appropriate? a) "You need a graduate degree to specialize in home health care." b) "It requires that you have high-level critical care skills." c) "The client and family are in control of the setting, not the nurse." d) "Each team member works independently of other team members."

c) "The client and family are in control of the setting, not the nurse."

A client's son says, "Mom can come and live with me, but I will need help. I am going to call a home health agency to see about having someone come out to my house." Which nursing response is indicated? a) "I can get the telephone numbers of several home health agencies for you." b) "Home health is very expensive. You might wish to check into an individual sitter instead." c) "Your mother's primary health care provider will have to write a prescription for home health." d) "Home health can only help you for 60 days."

c) "Your mother's primary health care provider will have to write a prescription for home health."

One significant change in the health care delivery system in recent years is earlier hospital discharges. What is one result of earlier hospital discharges? a) Clients are in the hospital for a longer period of time. b) Clients are locked into prenegotiated payment rates that have remained unchanged. c) Clients with high home care needs are being discharged into the community. d) Client use of ambulatory care has decreased.

c) Clients with high home care needs are being discharged into the community.

A single parent age 17 years, with one child and pregnant with a second, has the mental age of a 12-year-old. The home care nurse's greatest concern in caring for this client should be the client's ability to do which? a) Bond with the children b) Receive financial aid c) Cognitively understand how to care for the children d) Physically perform care needed by the children

c) Cognitively understand how to care for the children

In anticipation of discharge, a nurse is teaching the daughter of an older adult client how to change the dressing on the client's venous ulcer. Which teaching strategy is most likely to be effective? a) Use a multimedia strategy that combines animation with narration. b) Explain the procedure clearly and slowly while providing multiple opportunities for the daughter to ask questions. c) Demonstrate and explain the procedure and then have the daughter perform it. d) Provide explicit written and verbal instructions and ask the daughter to explain back to the nurse how to perform the procedure.

c) Demonstrate and explain the procedure and then have the daughter perform it.

Which role is the home health nurse exhibiting when demonstrating how to suction the oropharynx of the client? a) Caregiver b) Advocate c) Educator d) Care coordinator

c) Educator

A registered nurse is providing community-based health care for a client diagnosed with early onset dementia. Which strategy is best for the nurse to employ to facilitate the family participating in the client's care? a) Reinforce the care plan to the family if it is determined the client is not properly cared for. b) Provide referrals for health care professionals to perform the client's activities of daily living (ADLs). c) Encourage active participation of the client and family in health care decisions. d) Create a care plan based on the client's requests and inform the family of the client's wishes.

c) Encourage active participation of the client and family in health care decisions.

Which is the primary goal of continuity of care? a) Increasing clients' knowledge base and improving their health maintenance behaviors b) Minimizing nurses' legal liability during client transitions between health care institutions c) Ensuring a smooth and safe transition between different health care settings d) Controlling costs and maximizing client outcomes after discharge from the hospital

c) Ensuring a smooth and safe transition between different health care settings

The nurse is assigned to care for a middle-aged client who is agitated and wants to go home. The client states that the client does not have time to waste in the hospital, and no one is doing anything anyway. Which action by the nurse is most appropriate if the client insists on leaving the hospital against medical advice (AMA)? a) Have the client sign the discharge form. b) Obtain a copy of the client's care plan. c) Have the client sign the AMA form. d) Have the client sign a consent form.

c) Have the client sign the AMA form.

A client living alone has degenerative joint disease, hypertension, and neuropathy. It is difficult for the client to bathe, and the client's blood pressure is unstable. Which type of care would this client benefit from most? a) Acute care b) Ambulatory care c) Home care d) Respite care

c) Home care

The client is being discharged to the home setting following a stroke. The client requires assistance in relearning how to cook safely. To which home health care team member should the nurse refer the client? a) Social worker b) Home health aide c) Occupational therapist d) Physical therapist

c) Occupational therapist

What is the priority nursing responsibility when transferring a client from one unit in the hospital to another? a) Bring all of the client's belongings to the new unit. b) Transport the completed client chart to the receiving unit. c) Provide a verbal report of the client's status to the admitting nurse. d) Help the client become familiar with the new unit.

c) Provide a verbal report of the client's status to the admitting nurse.

Continuity of care for a particular client is most important to prevent: a) multiple providers. b) infection. c) fragmentation of services. d) rising health care costs.

c) fragmentation of services.

A new client arrived on the unit while the nurse was obtaining the end-of-shift report from the night nurse. This client is admitted walking and is here for a cardiac workup; the client is assigned to the nurse. The nursing assistant has settled the client in the room and oriented the client to the surroundings, call system, bathroom, bedside supplies, and where to place clothes. The priority nursing action is to: a) obtain the physician's orders. b) call the dietary department to get breakfast for the client. c) gather information and complete the admission database. d) ask the nursing assistant to obtain vital signs.

c) gather information and complete the admission database.

On admission to the hospital, each client is asked whether the client has a living will or a durable power of attorney. If not, the admitting staff person provides a sample form to the client if wanted. The purpose of this inquiry is to determine: a) what the client wants to have happen during the hospitalization. b) how the client feels about being resuscitated and maintained on life support if this is necessary. c) whether the client has a document describing wishes for care when the client is no longer able to make decisions. d) previous decisions made regarding whom to contact should the client die in the hospital.

c) whether the client has a document describing wishes for care when the client is no longer able to make decisions.

Nursing students are reviewing information about health care delivery systems in preparation for a quiz the next day. Which statements describe current U.S. health care delivery practices? Select all that apply. a) Access to care depends only on the ability to pay, not the availability of services. b) The Patient Protection and Affordable Care Act provides private health care insurance to the underserved populations. c) Every health insurance plan in the Marketplace offers comprehensive coverage, from doctors to medications to hospital visits. d) The uninsured pay for more than one-third of their care out of pocket and are usually charged lower amounts for their care than the insured pay. e) Fifty years ago, half of the doctors in America practiced primary care, but today fewer than one in three do. f) Quality of care can be defined as the right care for the right person at the right time.

c, e, f The Marketplace is designed to help people more easily find health insurance that fits their budget. Every health insurance plan in the Marketplace offers comprehensive coverage, from doctors to medications to hospital visits. Fifty years ago, half of the doctors in America practiced primary care, but today fewer than one in three do. Quality is the right care for the right person at the right time. Access to care depends on both the ability to pay and the availability of services. The Patient Protection and Affordable Care Act provides Medicaid or subsidized coverage to qualifying people with incomes up to 400% of poverty. The uninsured pay for more than one-third of their care out of pocket and are often charged higher amounts for their care than the insured pay.

9. You are caring for an adolescent who has sustained a severe spinal cord injury and is paralyzed from the waist down. The physician has written an order for transfer to a rehab facility. Along with the case manager, you will inform the patient and the family that the: a. family is responsible for full payment for the rehab facility b. patient and family will be given the name of one facility only c. family can visit the facility before transfer d. choice of facility is up to the physician

c. family can visit the facility before transfer

A nurse is evaluating a patient diagnosed with renal disease for treatment in a Hospital at Home program. Which statement accurately describes a step in this program? a) The patient is evaluated upon hospital admission and is given daily nursing care in the home after discharge for as long as necessary. b) Any urgent or emergent situation requires an ambulance trip from the home to the hospital. c) Patients are transported to physicians' offices from the home for weekly evaluations. d) The clinicians use care pathways, clinical outcome evaluations, and specific discharge criteria.

d In the Hospital at Home program, the clinicians use care pathways including illness-specific care maps, clinical outcome evaluations, and specific discharge criteria. A patient requiring admission for one of the target illnesses is identified in the emergency department or ambulatory site. Staff assess whether the patient is a good candidate for the program using validated criteria. If the patient is eligible and consents to participate, the Hospital at Home physician evaluates the patient, who is then transported home, usually by ambulance. Nurses are available 24 hours a day/7 days a week for any urgent or emergent situations. The patient is evaluated daily in the home by the Hospital at Home physician, who completes an assessment and continues to implement appropriate diagnostic and therapeutic measures

The home health nurse is making a home visit for an older adult client recently discharged from the hospital after suffering a stroke. Which finding would most concern the nurse? a) The client is living with an adult child's family. b) The client's home has a basement with small staircase. c) Medication bottles are on the counter without safety caps. d) Area rugs are present in multiple areas throughout the house.

d) Area rugs are present in multiple areas throughout the house.

The nursing student asks the home health nurse what data is required for a Medicare home plan of care. Which item would be incorrect for the nurse to include when responding to the student? a) Types of services and equipment required b) Medications and treatments c) Functional limitations d) Documented need for a speech pathologist

d) Documented need for a speech pathologist

The community-based nurse is assessing a new client and the home environment. What is a responsibility of the community-based nurse at this initial visit? a) Encourage the client and family to use local stores to support their community. b) Encourage the client and family to contact their religious group as a resource. c) Encourage the client and family to use the internet to find local resources. d) Encourage the client and family to contact appropriate community resources.

d) Encourage the client and family to contact appropriate community resources.

During the entry phase of a home visit, the nurse is most likely to perform which task? a) Makes calls to establish initial contact with the client and schedule a visit b) Gathers supplies and equipment needed for the first visit c) Obtains directions to the client's home d) Establishes nursing diagnoses based on client needs

d) Establishes nursing diagnoses based on client needs

When doing discharge planning for an older adult client who had a stroke, what is the nursing priority? a) Involve the family in discussing when the client will go home. b) Help the client after discharge to establish goals. c) Realize that goals may not be met after discharge. d) Plan reachable goals with the client and family.

d) Plan reachable goals with the client and family.

A client with severe congestive heart failure (CHF) has been referred to a long-term care facility. The nurse is transferring care from the hospital setting to a long-term care facility. Which action is a priority to ensure continuity of care for this client? a) Notifying all departments of the room change. b) Discussing the move with both client and his or her family. c) Asking family members to meet with the social worker at the receiving facility prior to the client's arrival. d) Providing accurate and complete communication to the new facility.

d) Providing accurate and complete communication to the new facility.

A client is receiving home health services after having a stroke and being hospitalized. After a thorough assessment of the home environment and the client, what would indicate to the nurse that there is an impairment in the client's home management? a) The client reports having slipped in the restroom the first night in the hospital. b) The client refuses to allow the caregiver to help the client sit up in bed. c) The home care nurse has to reschedule an appointment with the client. d) The client's caregiver is absent whenever the nurse visits and the client is alone.

d) The client's caregiver is absent whenever the nurse visits and the client is alone.

One of the fastest growing venues of practice for the nurse is home health care. What is the basis for the growth in this health care setting? a) The chronic nursing shortage b) The focus on treatment of disease c) The preference of nurses to work during the day instead of evening or night shifts d) The discharge home of clients who are more critically ill

d) The discharge home of clients who are more critically ill

A nurse is caring for a client who decides to leave the hospital against medical advice (AMA). The nurse knows that the client must sign a form before leaving. What is the purpose of the AMA form? a) To ensure that the client knows that the client must still pay the bill b) To let the cafeteria staff know a meal will no longer be required c) To have relevant information all in one place in case the client is readmitted d) To release the physician and the institution from any legal responsibility

d) To release the physician and the institution from any legal responsibility

Prior to the discharge of a client who is recovering from a stroke from an acute care facility, the nursing case manager has the nursing staff, client, client's family, physical therapist, and home health nurse meet. The most likely purpose of this meeting is to: a) provide client education. b) evaluate the effectiveness of the hospitalization. c) determine hospital-based services needed by the client. d) prepare the client for home care.

d) prepare the client for home care.

Public health nursing is the branch of nursing that: a) provides primary care to individuals. b) assesses individuals for community care. c) administers care for a defined geographic community. d) provides health care for the community.

d) provides health care for the community.

A nursing instructor is teaching students about the utilization of health care services and how the U.S. health care dollar is spent. Place the following care areas in order from the highest percentage of health care money spent to the lowest. a) Physician/clinical services b) Home health care c) Long-term care facility services d) Retail prescription drugs e) Government administration f) Hospital care

f, a, d, c, b, e The national health expenditures in 2010 were hospital care 31%, physician/clinical services 20%, retail prescription drugs 10%, long-term care facility services 5%, home health care 3%, and government administration 1%.

The nurse should understand that which outcome is the major advantage of interprofessional collaboration? Meeting new colleagues Presenting a united front to the patient Working in partnership with other team members Improving patient outcomes

improving pt outcomes

A coworker yells obscenities at a nurse colleague when unhappy. The nurse colleague asks the coworker to stop the behavior, but it continues. Which action should the nurse colleague take to remedy the situation? Wait to see if the coworker stops the behavior. Ask a colleague to intervene. Do nothing. Report the behavior to the immediate supervisor.

report behavior

The nurse is comparing the similarities of the roles of the case manager and the primary nurse in the rehabilitation facility and the acute care facility. Which statement is accurate regarding the similarities between these two​ roles? (Select all that​ apply.) ​"Both plan for meeting the​ family's needs." ​"Both lead a multidisciplinary​ team." ​"Both plan for meeting​ clients' needs." ​"Both follow the clients across care​ settings." ​"Both support continuity of​ care."

​"Both plan for meeting the​ family's needs." ​"Both plan for meeting​ clients' needs." ​"Both support continuity of​ care." The similarities between a case manager and a primary nurse include the fact that they both support continuity of care and meet the needs of clients and families. Only the case manager follows clients across care settings or leads a multidisciplinary team.

The nurse is coordinating care for a client with no significant health history who will be scheduled for the removal of an uncomplicated skin nodule. Which setting will provide the most​ cost-effective care based on the current health of the​ client? Emergency department Surgical center ​Dermatologist's office Urgent care clinic

​Dermatologist's office This minor procedure can be performed in the office of a dermatologist. A surgical setting is costlier. An urgent care clinic and the emergency department are inappropriate settings to perform the procedure.

The nurse is caring for a client who has been placed on a critical pathway for care following hip surgery. The client asks the nurse why there is a need for this type of care model. The best response by the nurse is: "Critical pathways ensure that you will get well." "Critical pathways make you adhere to the program of care." "Critical pathways give direction to the team caring for you." "Critical pathway is just a new term for the nursing care plan."

"Critical pathways make you adhere to the program of care."

The nurse is preparing to provide the parents of a child that is being seen for a well visit some general education. Which statement by the nurse reflects secondary prevention education? "Your child should be seen by the dentist every 6 months." "You child is due for another immunization in 1 year." "It is important to include fresh fruits and vegetables in your child's diet." "It is important that your child get exercise for at least 20 minutes a day."

"Your child should be seen by the dentist every 6 months." The statement made by the nurse that is reflective of secondary care is, "Your child should be seen by the dentist every 6 months." Secondary prevention focuses on the detection and then treatment of identified injuries and diseases early so that they can be cured or their associated symptoms and complications can be prevented or limited. Exercise, immunizations, and nutritional intake reflect primary preventative care.

The client asks the nurse to explain how Medicare works. Which items should the nurse include in the teaching​ session? ​(Select all that​ apply.) a Medicare is a federally funded health insurance program. b Individuals with​ end-stage renal disease are not eligible for Medicare coverage. c Routine eye care is not covered by Medicare. d There are four types of Medicare coverage. e Both hospital and medical insurance are offered by Medicare

.a,c,d,e

A patient tells a nurse that she is enrolled in a preferred provider organization (PPO) but does not understand what this is. What is the nurse's best explanation of a PPO? 1. This health plan is for people who cannot afford their own health insurance. 2. This health plan is operated by the government to provide health care to older adults. 3. This health plan gives you a list of physicians and hospitals from which you can choose. 4. This is a fee-for-service plan in which you can choose any physician or hospital.

3

A nurse is using the Plan-Do-Study-Act (PDSA) strategy to do a quality improvement project to decrease patient falls on a nursing unit. Place the steps in the correct sequence for PDSA. 1. Bedside change of shift report is piloted on two medical-surgical units. 2. Patient satisfaction levels after implementation of the bedside report are compared to patient satisfaction levels before the change. 3. The nursing council develops a strategy for bedside change of shift report. 4. After modifications are made in the shift report elements, bedside shift report is implemented on all nursing units.

3, 1, 2, 4

Which of the following nursing activities is provided in a secondary health care environment? (Select All That Apply) 1. Conducting blood pressure screenings for older adults at the Senior Center 2. Teaching a clinic patient with chronic obstructive pulmonary disease purse-lipped breathing techniques 3. Changing the postoperative dressing for a patient on a medical-surgical unit 4. Doing endotracheal suctioning for a patient on a ventilator in the medical intensive care unit

3, 4

Which type of health insurance plan requires the participant to select a primary care provider? A) Health maintenance organization (HMO) B) Preferred-provider organization (PPO) C) Point-of-service (POS) D) Indemnity

A) Health maintenance organization (HMO)

The American health care system will continue to evolve and change. Which of the following groupings of health care trends will have the greatest influence on the health care transformation process at the present time? Select all that apply. A) Aging of the population, globalization, and medical technology advances. B) Funding levels, political structure, and professional licensure requirements. C) Longevity, population diversity, and funding sources. D) Managed care, workforce shortages, and level of education of the population.

A,C

The most important features of the Affordable Health Care for America Act of 2010 that the community-oriented nurse needs to understand to provide resource information to clients are that the Act: A) Transforms the health care system from a sick care system to health care system. B) Uses piecemeal approach to strengthen the safety net. C) Replaces the rational equitable health care system. D) Provides insurance reform. E) Increases access to affordable health care insurance.

A,D,E

A nurse is discussing restorative healthcare with a newly licensed nurse. Which of the following examples should the nurse include in the teaching? SATA A. Home health care B. Rehabilitation facilities C. Diagnostic centers D. Skilled nursing facilities E. Oncology centers

A. CORRECT Restorative health care involves immediate follow-up care for restoring health and promoting self-care Home health care is a type of restorative health care. B. CORRECT See first sentence above. Rehabilitation facilities is a type of restorative care. D. CORRECT Skilled nursing facilities are a type of restorative health care. C. Secondary health care includes the diagnosis and treatment of acute injury or illness. Diagnostic centers are a type of secondary health care. E. Tertiary healthcare is specialized and highly technical care. An oncology center is a type of tertiary healthcare.

The nurse manager wants to promote communication skills for successful collaboration among the nursing staff. Which communication style should the nurse​ use? Active listening Parallel communication Dominance in conversation ​Status-based communication

Active listening Active listening is attentive communication that decreases miscommunication. Parallel communication is the lowest level of communication and does not support collaboration like higher levels of information exchange or consultation.​ Status-based communication does not support​ collaboration, but​ team-centered communication does support collaboration. Dominance and argumentative styles of communication do not promote collaboration.

5) In arranging community services for a client who is schizophrenic, the nurse case manager discusses options with the Assertive Community Treatment (ACT) team. Which team disciplines should the nurse expect will be part of the client's ACT interdisciplinary team? A) Psychiatrists, nurses, social workers, employment specialists, substance abuse specialists B) Speech pathology, occupational therapy C) Teachers, school administrators D) Handi-Cab drivers

Answer: A Explanation: A) The ACT program supports and treats individuals with serious mental illnesses and provides psychiatrists, nurses, social workers, employment specialists, and substance abuse specialists. The schizophrenic patient would not require speech pathology remediation or occupational therapy. The schizophrenic patient would not require teacher assistance or school administration intervention. Handi-Cab drivers may be utilized for transportation, but are not part of the healthcare team.

3) The client's nurse case manager, diabetes educator, and nutritionist met to discuss the client's needs in preparation for discharge to home. The client's physician arrived and stated that he would be making all decisions regarding the client's discharge care. With the physician's decision to lead the team, the dynamic has shifted between what two types of teams? A) Intradisciplinary to interdisciplinary team B) Multidisciplinary to intradisciplinary team C) Interdisciplinary to multidisciplinary team D) Interprofessional to interdisciplinary team

Answer: C Explanation: A) Interdisciplinary teams include professionals of varied backgrounds who share in decision making. Multidisciplinary teams include members of varied backgrounds, but treatment decisions are made by one member-usually the physician. Intradisciplinary teams include members of the same profession. The term interprofessional team is synonymous with interdisciplinary team.

9) What does research reveal about the greatest benefit of engaging an interdisciplinary team in planning and implementing client care? A) Team members feel a greater sense of commitment and contribution to the organization. B) Team members report feeling more respected and valued within and across professional disciplines. C) Pooling resources and ideas results in greater efficiency in providing care to clients. D) Organizations can report greater compliance with the 2010 Patient Protection and Affordable Care Act.

Answer: C Explanation: A) The greatest benefit of increased interdisciplinary collaboration among health team members is greater efficiency in providing care to clients from pooling resources and ideas to help clients meet their healthcare goals.

3) The nurse case manager has interviewed an elderly client with a recent hip replacement and her family. The case manager began the process for discharge planning soon after the client's admission to the orthopedic floor for planned surgery and has followed her progress through the client's hospitalization. A joint decision has been made that the client will not be able to return to her apartment until her rehabilitation is completed. Toward this end, the case manager has worked with the hospital nursing staff, the rehabilitation center, family members, and other care providers to assist with a smooth transition. Which is the primary goal of the care management model described here? A) To provide greater peace of mind for the client and his or her family members B) To help manage concerns that are related to the client's medical care and treatment regimen only C) To track a client's progress to ensure that appropriate care is provided until the time of discharge D) To provide a continuum of clinical services in order to help contain costs and improve client outcomes

Answer: D Explanation: A) Case managers coordinate client care to help ensure that a continuum of clinical services is provided. The goal of case management is to improve client outcomes and to help contain costs. Toward this end, case managers not only with help to coordinate care and treatment during hospitalization, but also assist with planning for care following discharge. Their focus includes not only medical care, but issues related to health promotion and disease prevention, the cost of health care received, and planning for the efficient use of resources. Although the involvement of case managers in care typically provides greater peace of mind for clients and family members, this is not the primary goal of this service.

4) The nurse is caring for a client with rheumatoid arthritis who expresses the desire to remain active as long as possible. In order for the client to meet this goal, what should the nurse prepare to do? A) Teach the client nutrition and joint exercises. B) Ask the client the reason for the decision. C) Tell the client there is no hope. D) Refer the client to the appropriate professionals.

Answer: D Explanation: A) The number of clients with chronic diseases with healthcare needs is increasing rapidly, and nurses and physicians cannot meet all of these clients' needs. When a client expresses the desire to live as normally as possible, the nurse should refer the client to professionals who can help the client meet that goal. The nurse can teach some nutrition and exercise but cannot go into the depth that this client would need. The client with a chronic disease should not be told there is no hope but should be helped toward reaching desired goals. Asking the client the reason for the decision is irrelevant to the situation.

What is the definition of microallocation? A) occurs at the societal level and includes decisions about how to allocate funds across a range of public goods B) involve bedside decisions about whether an individual patient will or will not receive a scarce medical resource C) there is no such thing as microallocation

B

Which of the following conflict-related communication styles involves attempting to satisfy the concerns of others while neglecting the self? A) Compromising B) Accommodating C) Avoiding D) Competing

B) Accommodating

A local health system implemented a number of health promotion policies and plans to prioritize health problems. The system must now evaluate the effectiveness of the interventions. Which groups are stakeholders in this initiative and would be involved in the evaluation process? A) Only consumers who were directly affected by the services provided B) Consumers, community leaders, and politicians C) Only hospital and clinic personnel who administered healthcare needs D) Healthcare providers employed by other health systems

B) Consumers, community leaders, and politicians

Which of the following individuals would be included on an interdisciplinary healthcare team but not on an interprofessional healthcare team? A) Nurse practitioner B) Laboratory technologist C) Pharmacist D) Physical therapist

B) Laboratory technologist

A group of nurses are in a staff meeting on a medical-surgical unit headed by the new unit nurse manager. The manager announces that nurses should not criticize and make fun of other nurses or there will be repercussions. Several nurses at the meeting suggest that the nurse manager talk to the individual nurses who are exhibiting this behavior. When assessing the staff's group dynamics, which action by the nurse manager is appropriate? A) Insist that this is an appropriate new policy. B) Recognize that the group already has defined behavioral norms. C) Discipline the staff nurses who spoke out. D) Request a transfer to another unit.

B) Recognize that the group already has defined behavioral norms.

A client with type 1 diabetes mellitus has developed an open sore on the shin and is having trouble meeting daily goals for exercise. The client is scheduled for discharge in a couple of days. When planning for this client's continued care, who will the nurse notify regarding the client's postdischarge needs? A) The pharmacy B) The case manager C) The occupational therapist D) The physical therapist

B) The case manager

Which activities should the nurse recognize as supporting the building of skills for successful collaboration of inter-professional healthcare​ teams? (Select all that​ apply.) A.) Focusing care delivery on individual groups B.) Advocating for policy change with local legislation C.) Role playing scenarios to practice communication skills D.) Encouraging clinical problem solving through group work E.) Practicing with additional credentials to increase nursing authority

B, C, D, E. Nursing collaboration is supported by working in groups and having a voice in the community on health policy through​ advocacy, professional communication​ skills, and increased authority and accountability. Focusing care is an individual task.

A nurse working in a pediatric clinic provides codes for a patient's services to a third-party payer who pays all or most of the care. This is an example of what mode of health care payment? a. Out-of-pocket payment b. Individual private insurance c. Employer-based group private insurance d. Government financing

B.

A nurse is answering questions about health care at a community health fair. An elderly visitor asks why health care is so expensive. Which of the following is the best response by the nurse? A. "There are a decreasing number of patients needing long-term health care, so there are fewer health care providers." B. "Patients without health care coverage use emergency departments, where it is more expensive to provide care." C. "We are not developing equipment and technology fast enough to keep medical costs down." D. "Many patients are only using nonprescription medications, so the cost of other cares has gone up."

B. "Patients without health care coverage use emergency departments, where it is more expensive to provide care."

Which should the nurse use to explain mindsight? Behaving disruptively in the workplace, manifesting as aggression, bullying, and violence Being self-aware of one's triggers to stress that can result in conflict Using a collaborative approach for gaining insight to the perspectives of others Using skills to resolve conflicts in a positive manner

Being self-aware of one's triggers to stress that can result in conflict

As a new nurse you are easily influenced by those around you. You have a seasoned nurse who is quick to have a snide comment regarding another nurse who has opted out of a surgery she did not agree with. As a new graduate which of these are the most important thing to remember? A: You must respect your elders and agree with them B: You never judge anyone!! C: No matter whether you have differing beliefs you are a professional and must remain professional and respectful D: All of the above

C

The local nurse-managed clinic/center initiative is providing community-based primary and preventive care as well as specialty care, community screenings, local health assessments, health education, and health care coordination, targeted to medically uninsured individuals regardless of ability to pay. This initiative best describes a system of: A) Managed care. B) Primary care. C) Primary health care. D) Private health care.

C

Nurses are utilizing an approach that involves addressing an issue of conflict with a resolution that satisfies both parties. Which approach is being​ used? A.Accommodating B.Competing C.Compromising D.Avoiding

C ​Rationale: Compromising involves addressing the conflict with a solution that satisfies all parties. Avoiding is purposely not addressing the​ conflict, sometimes done to collect more information. Competing involves an assertive presentation of​ one's side of the issue. Accommodating neglects the desires of one side to allow the other party satisfactory resolution.

A nurse is discussing the plan of care with a client who is preparing for discharge. The client has a strong objection to portions of the plan of care. The nurse recognizes that there is a conflict. Which response by the nurse indicates an understanding of the client's position and a willingness to collaborate regarding the discharge plan? A) "You are not being cooperative in your plan of care." B) "This plan of care was ordered by the physician." C) "Let's talk about your objections and possible solutions or alternatives." D) "I will ask your family to help convince you that this plan of care is best."

C) "Let's talk about your objections and possible solutions or alternatives."

The nurse is preparing for the discharge of a client who will require physical therapy (PT) for rehabilitation following a total knee replacement. After reading the healthcare provider's order for PT, what should the nurse do next? A) Set up outpatient appointments for the client with the hospital's PT department B) Call home health and schedule a therapist to visit the client's home for PT C) Inform the client about the settings in which PT may occur and have the client choose the venue D) Teach the client's family the exercises that will be included in the client's PT regimen Answer: C

C) Inform the client about the settings in which PT may occur and have the client choose the venue

The nurse managers in a community hospital have been charged with reviewing the job descriptions of unlicensed assistive personnel (UAP), and they have questions about the delegation of certain client care activities to UAP by nurses. To which group, organization, or individual would the committee members direct their questions to obtain definitive answers about the parameters of nurse delegation to UAP? A) The hospital's Chief Nursing Officer B) The hospital's Chief Executive Officer C) The state board of nursing D) The American Nurses Association

C) The state board of nursing

A home health nurse is caring for a client who requires an appointment with a specialty provider. The client​'s health insurance is an​ employer-provided HMO. Based on the client​'s ​insurance, what is the first step for the nurse to take to ensure this client is seen by the​ specialist? Discuss the client​'s options with the insurance company Call the specialist directly to make an appointment Call the primary care provider for a referral to the specialist Discuss the client​'s options with the case manager

Call the primary care provider for a referral to the specialist

A patient requires skilled nursing care after discharge from an acute care hospital. Which member of the collaborative healthcare team should the nurse anticipate will coordinate the discharge? Nurse Discharge planner Social worker Case manager

Case manager

Which technique should the nurse use to prevent and resolve conflicts? Collaboration Avoidance Communication Competition

Communication Communication is the key for preventing and resolving conflict. Five different communication styles have been identified to use during a conflict. They are competing, collaborating, compromising, avoiding, and accommodating.

The community health nurse is designing a presentation about societal factors that influence health policy. Which statement should the nurse include in the​ presentation? Level of support for the proposed policy is not an influencing factor. ​Population-specific needs are too complex to be taken into consideration. Considerations include whether or not current policy meets the population​'s needs. Population size does not influence the development of health policy.

Considerations include whether or not current policy meets the population​'s needs.

The nurse wants to provide collaborative care for a client who has terminal cancer. Which action should the nurse​ include? Providing comfort interventions Assessing the​ client's preferences regarding care Consulting an​ oncology-certified nurse when planning care Giving the physician priority when delivering care

Consulting an​ oncology-certified nurse when planning care Seeking expertise from an​ oncology-certified nurse when planning care for the client with terminal cancer is consistent with providing collaborative care. Assessing the​ client's preferences regarding care and providing comfort interventions are nursing responsibilities that the nurse is required to​ meet, regardless of the care setting or the type of care being provided. It is not appropriate for the nurse to give one team member priority over another when delivering care.

A member of the American Nurses Association​ (ANA) is giving a presentation about the ANA​'s primary methods of advancing the nursing profession. Which activities are appropriate to include in the​ presentation? ​(Select all that​ apply.) Implementing nurse educator faculty development programs Cultivating high standards of nursing practice Advocating for nurses​' rights in and away from the workplace Assisting deans with implementing quality nursing education standards Fostering a positive and realistic view of nursing

Cultivating high standards of nursing practice Fostering a positive and realistic view of nursing

Accreditation refers to one of the following: a. making assessment b. meeting predetermined standards c. making care cost effective d. ensuring quality

D

An older adult client with limited financial recourses is being treated for a stroke. Which factor should the nurse consider that may impact this client's care and recovery? A. The client may need to pay out-of-pocket for rehabilitation B. The client will have limited options for long-term care facilities C. The client will not be eligible for rehabilitation D. The client may be eligible for a new care coordination model that includes home-based care

D

The clinical nursing instructor is preparing a presentation about societal factors that influence health policy. Which factors should be​ included? ​(Select all that​ apply.) Degree to which the population​'s current needs are met Level of support for the proposed policy Ability of the population to finance the proposed policy ​Population-specific needs Size of a given population

Degree to which the population​'s current needs are met Level of support for the proposed policy ​Population-specific needs Size of a given population

A nurse is planning to teach a class about preventing workplace bullying. Which behavior should the nurse​ include? (Select all that​ apply.) Encouraging nonthreatening reporting Developing acceptable codes of conduct Isolating the victim to provide a safe environment Educating others about the ramifications of bullying Talking about the abuser to make the victim feel better

Encouraging nonthreatening reporting Developing acceptable codes of conduct Educating others about the ramifications of bullying Nonthreatening reporting that is taken​ seriously, developing acceptable codes of​ conduct, and education on the impact of bullying all support the prevention of bullying in the workplace. The victim may already feel isolated and should be made to feel part of a supported team. Talking about the abuser does not promote professional behaviors.

A family with children has utilized the same healthcare provider for many years. Which outcome is expected as a result of having a usual source of medical​ care? (Select all that​ apply.) Enhanced communication Improved health outcomes Fewer health disparities Decreased costs Fewer instances of cold and flu

Enhanced communication Improved health outcomes Fewer health disparities Decreased costs The benefits of having a usual source of medical care include decreased​ cost, fewer health​ disparities, enhanced​ communication, and improved health outcomes. Having a usual source of medical care does not result in fewer instances of cold and flu.

The collaborative team treating a client includes the​ cardiologist, dietician, social​ services, and a nurse case manager. The team works together to establish a plan of care based on the​ client's goals. Which outcome is likely to result from this type of collaboration for the​ client? Decreased adherence with the plan of care Increased healthcare costs Improved relationship between the physician and the client Enhanced continuity of care

Enhanced continuity of care When effective collaboration​ occurs, quality of care​ improves; effective collaboration directly impacts client outcomes and enhanced continuity of care results. An​ increase, not a​ decrease, in adherence with the care plan is an outcome of collaboration. Healthcare costs will​ decrease, not​ increase, with collaboration. An improved physician-client relationship is not an outcome of​ collaboration; however, improved relationships do occur within the healthcare team as a result of collaboration.

The nurse is assigned to administer medications to all clients on the unit. Which nursing care delivery model is being​ utilized? Secondary Team Functional Primary

Functional The nurse who is assigned as the medication nurse is being assigned a task. The functional nursing model utilizes a​ task-oriented approach to the care of clients. The model of team nursing utilizes a registered nurse​ (RN) as the team leader for a group of clients. The primary nursing model designates one nurse who has​ 24/7 authority and responsibility for the care of an assigned group of clients. Secondary nursing is not a model for the delivery of nursing care.

The nursing instructor is preparing a class for nursing students about types of insurance coverage. When describing private insurance​ coverage, which item should be​ included? Group insurance coverage may be purchased through voluntary and membership​ associations, such as professional and trade groups. ​Direct-purchase private insurance plans are usually less expensive and less restrictive than group coverage. ​Employment-based private health insurance coverage may not be extended to include extended family members. ​Self-employment-based private insurance policies cover​ self-employed individuals and their family members.

Group insurance coverage may be purchased through voluntary and membership​ associations, such as professional and trade groups.

Which statement describes horizontal violence? Horizontal violence is long-term behavior that lasts a minimum of 6 months. Horizontal violence is an attack made when a person is in the horizontal recumbent position. Horizontal violence refers to aggressive acts committed against a nurse by one or more nursing colleagues. Horizontal violence is chronic violence perpetrated by a workplace bully.

Horizontal violence refers to aggressive acts committed against a nurse by one or more nursing colleagues.

A.Primary prevention

Implementing a community-level program, such as walking for exercise, to assist citizens in improving health behaviors is an example of which level of prevention? A.Primary prevention B.Secondary prevention C.Tertiary prevention D.Disease promotion

The nurse explains to a group of clients some of the healthcare policy changes that have been made to improve healthcare to clients. The nurse includes which policy change in the explanation? Meals on Wheels Nursing diagnoses Mandatory wheelchair ramps at health facilities Flu shots given at pharmacies.

Mandatory wheelchair ramps at health facilities Rationale: One factor influencing changes in national policy is access to healthcare. Government agencies and health care agencies are required to provide increased access by installing wheelchair ramps for the handicapped. Meals on Wheels is not part of the healthcare system. Urging clients to get flu shots is a government policy; however, it is not policy to get the shots at pharmacies. Nursing diagnoses are required but not by the government as policy. Nursing Process: Implementation Client Need: Safe, Effective Care Environment Cognitive Level: Analyzing

The nurse is discussing Medicaid health coverage with a client. Which information should be​ included? Medicaid coverage does not include the client​'s home health services. Medicaid is available to eligible​ individuals, families, the​ elderly, and individuals with disabilities. Medicaid provides cash for basic​ needs, such as​ food, housing, and clothing. Medicaid reimbursement does not cover costs related to transportation to medical care.

Medicaid is available to eligible​ individuals, families, the​ elderly, and individuals with disabilities.

The nursing administrator is planning an​ in-service for nurses about Medicare coverage. Which content should be​ included? ​(Select all that​ apply.) All individuals ages 62 and older are eligible for Medicare coverage. Medicare is a federally funded program. Younger individuals with disabilities are eligible for Medicare coverage. Medicare is a form of public health insurance. Medicare coverage includes individuals with​ end-stage renal disease.

Medicare is a federally funded program. Younger individuals with disabilities are eligible for Medicare coverage. Medicare is a form of public health insurance. Medicare coverage includes individuals with​ end-stage renal disease.

Which term should the nurse use that describes being self-aware of one's triggers to stress that may result in conflict? Collaboration Incivility Mindsight Conflict competence

Mindsight Mindsight is a term that describes being self-aware of one's triggers to stress that can result in conflict and purposefully "retraining" the brain to respond differently. Conflict competence includes skills to resolve conflicts in a positive manner. Incivility or disruptive behavior in the workplace can manifest as aggression, bullying, and violence. Collaboration is a collaborative approach that involves gaining insight to the perspectives of others.

Two coworkers feel esteem for one another. The nurse should recognize that the coworkers are demonstrating which behavior? Trust Collaboration Nonverbal communication Mutual respect

Mutual respect

Two coworkers feel esteem for one another. The nurse should recognize that the coworkers are demonstrating which behavior? Mutual respect Trust Collaboration Nonverbal communication

Mutual respect Mutual respect occurs when two or more individuals feel honor or esteem for one another. Trust occurs when an individual is confident in the actions of another individual. Nonverbal communication is not related to esteem. Collaboration is working together in a group that benefits the patient. Members who collaborate may or may not have esteem for each other.

The nurse is caring for a confused patient whose family states they do not know what the healthcare provider is planning. They state they left several messages without a response. Which response by the nurse is appropriate? Paging the healthcare provider to come and speak with the family Advising the family to call again and stress that they need to speak immediately to the healthcare provider Reminding the family that the healthcare provider is busy but will call when time allows Reiterating the plan of care that was communicated at the shift change

Paging the healthcare provider to come and speak with the family By paging the healthcare provider, the nurse is advocating for the family and patient and handling the issue immediately. This portrays the nurse's understanding of effective communication. The other answer options direct the family, rather than allow them to collaborate, which may place them on the defensive.

A patient is given information about the same medication from different members of the healthcare team. Which term should the nurse use to describe this collaboration? Coordination and consultation Parallel functioning Parallel communication Information exchange

Parallel communication Parallel communication occurs when each professional communicates with the patient independently and asks the same or similar questions. This is the lowest level of communication and can cause gaps in communication or wrong information to be conveyed. Parallel functioning occurs when communication may be more coordinated, but each professional has a separate intervention and a separate plan of care. Information exchange involves planned communication, but decision making is unilateral, involving little, if any, congeniality. Coordination and consultation represent a midrange level of collaboration that seeks to maximize the efficiency of resources.

The manager of a small clinic has cross-trained the nurses to perform ECG testing, phlebotomy, and some respiratory therapy interventions. This clinic is an example of which delivery model? Case management Managed care Critical pathways Patient-focused care

Patient-focused care Feedback Rationale: Patient-focused care is a delivery model that brings all services and care providers to the client. Activities provided by auxiliary personnel are moved close to the client, thereby decreasing the number of personnel involved and the number of steps to get the work done. Managed care focuses on cost-effective, quality care which results in decreased costs and improved outcomes. Case management is a way to integrate health care services for individuals or groups and involves multidisciplinary teams that assume collaborative responsibility for planning, assessing, coordinating, implementing, and evaluating care. Critical pathways are used to track the client's progress in case management. Nursing Process: Assessment Client Need: Safe, Effective Care Environment Cognitive Level: Applying

A client tells the nurse that the pain medication is ineffective and causes too many side effects. Which interprofessional team member should the nurse​ consult? (Select all that​ apply.) Dentist Dietician Physician Pharmacist Complementary healthcare provider

Physician Pharmacist Complementary healthcare provider The physician ordering pain medication is one interprofessional team member to​ involve, as they are aware of the ineffectiveness and adverse effects of the current medication ordered.The pharmacist is another interprofessional team member to assess interaction of all medications currently prescribed and recommend untried therapies.The complementary healthcare provider can provide adjunct therapies for pain like massage and reflexology. A dentist would be consulted for issues of the​ teeth, gums, and oral cavity. A dietician would be consulted for nutrition needs.

The novice nurse is trying to remember the different benefits of primary​ prevention, primary​ care, primary​ insurance, and primary nursing. Which two of these activities would the nurse identify as increasing the continuity of​ care? Primary prevention and primary care Primary prevention and primary nursing Primary care and primary nursing Primary prevention and primary insurance

Primary care and primary nursing Learning Objective Identify various types of healthcare agencies and services provided. Rationale Primary care and primary nursing have the benefit of increasing the continuity of care. Primary prevention is about​ wellness, not continuity. Primary insurance happens when the client has more than one insurer.

B.Primary care is provided within the context of family and community. D.Primary care provides first-contact, continuous, comprehensive, and coordinated care.

Primary care refers to personal health care for the most common needs of members of a community. Which of the following statements also differentiates primary care from primary health care? Select all that apply. A.Primary care consists of a multidisciplinary team. B.Primary care is provided within the context of family and community. C.Primary care encourages self-care and self-management. D.Primary care provides first-contact, continuous, comprehensive, and coordinated care. E.Primary care provides preventive, curative, and rehabilitative services.

A county health department nurse is creating a brochure that describes the agency​'s role. Which activity should be​ included? Overseeing the construction of new medical facilities Providing community disease monitoring and surveillance Regulating child care centers Enrolling clients in Medicaid

Providing community disease monitoring and surveillance

Which factors should the nurse consider a major source of conflict in the healthcare setting? Role boundary issues and accountability Accountability and miscommunication Accountability and cultural issues Miscommunication and role boundary issues

Role boundary issues and accountability (these are the 2 primary)

The nurse leading the​ clinic-based support group for individuals with chronic diseases was pleased with the number of individuals who showed up for a lecture on open double quote"Living with Type 2 Diabetes.close double quote" Due to time​ constraints, the nurse planned to limit the talk to describing tertiary prevention activities. Which activities could the nurse​ include? Discussing smoking cessation tips to help smokers quit the habit Talking about the role of exercise to maintain blood sugar control Showing a video on hand washing techniques to prevent infection Encouraging a healthy diet to prevent onset of a diabetic condition

Talking about the role of exercise to maintain blood sugar control Learning Objective Identify various types of healthcare agencies and services provided. Rationale Talking about the role of exercise to maintain blood sugar control is tertiary​ prevention, meant to avoid complications of uncontrolled hyperglycemia. Wellness advice on topics of a healthy​ diet, smoking​ cessation, and hand washing is primary prevention.

The nurse caring for a patient who is newly diagnosed with diabetes requests a dietary consult. Which type of care is the nurse implementing? Secondary prevention Primary prevention Case management Tertiary prevention

Tertiary prevention The nurse is implementing tertiary prevention in the care for the diabetic patient that requires a dietary consult to help manage the disease. Secondary preventative measures are aimed at detecting and identifying injuries or diseases early. Primary prevention is used to prevent a future disease or illness. Case management is a method of delivering care.

Karalynn​ Templeton, a community health​ nurse, is preparing to meet with her state representative to discuss the unmet needs of military families whose loved ones are deployed. During the​ meeting, which statement demonstrates Karalynn understands the process of developing health policy in the​ U.S.? ​"Along with a description of the healthcare​ issue, I've also included a list of political considerations related to​ it." ​"I realize that you are the person who decides whether or not a healthcare solution becomes a​ law." ​"I understand that meeting with citizens about healthcare issues is not part of your​ role, so I really appreciate your​ time." ​"In addition to other​ considerations, I'm aware that a proposed​ solution's anticipated effectiveness must be​ evaluated."

​"In addition to other​ considerations, I'm aware that a proposed​ solution's anticipated effectiveness must be​ evaluated."