1050 STUDY SET 1
the goals of restorative care
to help individuals regain maximal functional status and enhance quality of life through promotion of independence and self-care
private ins
traditional fee-for service plan
Task oriented touch
used when performing nursing interventions
Values
Enduring ideas about what a person considers is the good, the best, and the "right" thing to do and their opposites-the bad, worst, and wrong things to do-and about what is desirable or has worth in life
Educator role of the nurse
Ensures patient's receive sufficient information on which to base consent for care and related treatment. Asses learning needs, evaluate the effectiveness of teaching.
How does the (ANA) American Nursing Association define health?
"A dynamic state of being in which the developmental and behavioral potential of an individual is realized to the fullest extent possible".
prospective payment system
establishe by congress in 1983 eliminated cost-based reimbursment
State children health ins programs
federally funded, state operated program to provide ins for children
Five components to nurse presence
Individual nurse characteristics, individual patient characteristics, shared characteristics, environmental characteristics reflective of relational work, nurses intentional decision to engage in practice
Significant non-nursing theories
Maslows Hierarchy of needs, Erickson's psychosocial theory, Lewins Change Theory, Paul's critical thinking theory, and Rosenstocks health belief model
Clara Barton
Practiced nursing in the Civil War and established the American Red Cross in the 1880s.
Secondary prevention
Undertaken in cases of latent (hidden) disease
poverty is still deadlier than
any disease and the most frequent reason for death around the world.
Holistic health models
based on the philosophy that a synergistic relationship exists between the body and the environment
nurses gain or use information when
they organize, structure, or interpret data
fastest growing age group uninsured
19-34
Stage 2 of the illness model
Assumption of the sick role; the person decides that the illness is genuine and that care is necessary
A label that describes key ideas shared by study participants is described as a: a. Phenomenon b. Theme c. Constant comparison d. Theoretical sample
B
A new nurse is completing an assessment on an 80-year-old patient who is alert and oriented. The patient's daughter is present in the room. Which action by the nurse will require follow-up by the charge nurse? a. The nurse makes eye contact with the patient. b. The nurse speaks only to the patient's daughter. c. The nurse leans forward while talking with the patient. d. The nurse nods periodically while the patient is speaking.
B
opportunistic infection
Caused by harmless organisms that become pathogenic and illness from the spread of community acquired disease.
Self efficacy definition
Confidence in ones ability to take action
Set core competencies for APNR
Direct clinical practice, collaboration, expert coaching and guidance, research, ethical decision making, consultation, leadership
After determining a nursing diagnosis of acute pain, the nurse develops the following appropriate client-centered goal: A. Encourage client to implement guided imagery when pain begins. B. Determine effect of pain intensity on client function. C. Administer analgesic 30 minutes before physical therapy treatment. D. Pain intensity reported as a 3 or less during hospital stay.
D. Pain intensity reported as a 3 or less during hospital stay.
A patient exhibits the following symptoms. Tachycardia, increased thirst, headache, decreased urine output it, and increased body temperature. The nurse analyzes the data. Which nursing diagnosis will the nurse assign to the patient?
Deficient fluid volume
During what step is education very important?
Discharge, so that patients will be prepared for their own needs at home
Code of Ethics for Nurses
Ethics is the standards of right and wrong behavior. The ICN and the ANA each have developed a code of ethics for nurses
The nurse is reviewing a patient's plan of care, which includes the nursing diagnostic statement, impaired physical mobility related to tibial fracture as evidenced by patient inability to ambulate. Which part of the diagnostic statement does the nurse need to revise?
Etiology
The nurse is caring for an adult client who is diagnosed with insomnia. Which assessment finding supports this diagnosis? Decreased irritability Fatigued feeling during sedentary activities Reported average sleep each night of 8 hours Increased concentration at work
Fatigued feeling during sedentary activities
Symptoms of compassion fatigue
Feeling vulnerable, anxiety, depression, and anger
Metaparadigm of Nursing
Focused on the concepts of person, environment, health, and nursing.
Hildegard Peplau's theory of interpersonal relations (1952)
Focuses on the roles played by the nurse and the interpersonal process between a nurse and a patient. This process happens in overlapping phases: orientation, working (identification and exploitation), and resolution.
Which health care service represents the primary level of prevention? Immunizations Breast self-examination Home care for high risk pregnancies Blood pressure screening
Immunizations
A nurse develops a nursing diagnostic statement for a patient with a medical diagnosis of pneumonia with chest x-ray results of the lower lobe infiltrates. Which nursing diagnosis did the nurse write?
Impaired gas exchange related to Alveolar capillary membrane changes
Benner's stages of nursing proficiency
Novice: no previous experience Advanced beginner: critical thinking Competent: confident 2-3 years experience Proficient: using past experience for decisions Expert: no longer relies on anything, most experience
Manger role of the nurse
Nurse manages all of the activities and treatments for patients. Promoting, restoring, and maintaining patient health requires coordinating all of the health care providers services
Nurse's role
Nurse works with people not for them
Paul's critical thinking theory
Nurses analyze data; develop, implement, and evaluate a care plan
Stage 5 of the illness model
Perceived recovery; the patient abandons the sick role and resumes usual tasks and roles to the greatest degree possible
Remission
Periods of wellness
Collaboration
Process by which two or more people work together toward a common goal. In nursing, inter-professional collaboration (including all levels of providers) occurs when the team interacts productively to provide high quality patient care
humanistic approach
Promotion of human welfare
Cues to Action Change Strategies
Provide how to information, promote awareness, and use reminder systems
Altruism
Public service over personal gain
Providing treatment and rehabilitation for people who have developed disease is part of: Primary preventive care Secondary preventive care Tertiary preventive care Primordial preventive care
Tertiary preventive care
According to Shawnee's Philosophy, what does the educational experience do?
The educational experience develops communication processes, clinical reasoning and judgment, analytical inquiry, creativity, and ethical comportment preparing the graduate for the complexities and challenges in nursing practice.
Advocate role of the nurse
The nurse interprets information, accepts and respects patients decisions, communicates to other health care providers, speaking up for patients when they can't because of circumstances such as general anesthesia or coma.
Caregiver
The nurses primary professional responsibility is to people requiring nursing care
Lewins change theory
Three step process: unfreezing, moving or change, refreezing (Nurse must be willing to change)
What are the characteristics of sleep?
Variable levels of consciousness Changes in the body's physiological processes Minimal physical activity A decrease in responsiveness to external stimuli
primary care
prenatal, well visits, family planning
What are the 7 areas of wellness?
-Environmental -Occupational -intellectual -Spiritual -Physical -Emotional -Social
Key to health promotion
-Modify risk factors
The nurse is assigned to a client who experiences major depression and anxiety. Which steps are part of the planning stage of the nursing process? Select All That Apply. 1. Stating that the client will report feeling less distress at social gatherings 2. Selecting the best antidepressant for the client 3. Recommending a cognitive behavioral therapist for the client 4. Taking the client's vital signs with special attention paid to blood pressure
1. Stating that the client will report feeling less distress at social gatherings 2. Selecting the best antidepressant for the client 3. Recommending a cognitive behavioral therapist for the client
Match the stage of development with the normal sleep pattern.
16 to 18 hours per day Newborns 14 to 15 hours per day Infants Normal biological sleep patterns shift to both sleeping later and waking up later Adolescents Usually awaken 1.3 hours earlier and go to bed approximately 1 hour earlier Older Adults
The nurse researcher is developing a research proposal and is in the process of selecting an instrument to measure anxiety. The nurse is in which part of the research process? 1 Analyzing the data 2 Designing the study 3 Conducting the study 4 Identifying the problem
2 Designing the study During study design, the researcher selects instruments to measure variables. Identifying the problem comes first in the research process, after which the researcher will design the study. Once the study has been designed, the researcher will conduct the study, and then analyze the data collected.
Of what is communication among family members an indication? 1 Hardiness or resiliency 2 Functioning 3 Structure 4 Development
2 Functioning Communication is a component of family functioning, whether that is setting goals, coping, or establishing discipline. Family functioning is what the family does, and communication is an important component of function. Structure is based on the multiple relationships and makeup of the family. Communication is not an example of hardiness or resiliency.
a Critical Access Hospital provides
25 inpatient beds for providing temp care for 96 hours or less to pts needing stabilization before transfer to a larger hospital
A large, blended family is in the process of converting a study into a bedroom for an adult child who is moving home following a job loss. The family is in the process of distributing household chores.When you talk to members of the family, they all think that their family can adjust to lifestyle changes. Of what is this an example? 1 Diversity 2 Durability 3 Resiliency 4 Configuration
3 Resiliency Resiliency is the ability of the family to cope with the unexpected. In this scenario, the family used resources to provide some short-term solutions for the adult child's return home.
A nurse is developing a care plan for a patient with a pelvic fracture on bed rest. Which goal statement is realistic for the nurse to assign to this patient? a. Patient will increase activity level this shift. b. Patient will turn side to back to side with assistance every 2 hours. c. Patient will use the walker correctly to ambulate to the bathroom as needed. d. Patient will use a sliding board correctly to transfer to the bedside commode as needed.
A
A researcher finds that a 0.8 correlation between the number of hours one sleeps before an exam and the exam grade earned. The best interpretation of this information is: a.There is a strong positive relationship between hours slept and the grade earned b. There is a weak relationship between slept and the grade earned c. There is a strong negative relationship between hours slept and the grade earned d. The more hours you sleep before an exam the more likely you are to earn a poor grade.
A
After data collection is completed, member checking is done by sharing the analysis with individual participants to validate that the participants agree with the findings which are true to their own experiences. What aspect of the study does this support? a.The study's credibility b. The study's auditability c. The study's transferability d. The study's fittingness
A
Contact information for the institutional review board (IRB) office. a.Required on a consent form b. Not required on a consent form
A
Information regarding possible risks and benefits of participating in the study. a.Required on a consent form b. Not required on a consent form
A
The foal of the project is to improve organizational processes and productivity. a. More characteristic of quality improvement b. More characteristic of research
A
The nurse is interviewing a patient with a hearing deficit. Which area should the nurse use to conduct this interview? a. The patient's room with the door closed b. The waiting area with the television turned off c. The patient's room before administration of pain medication d. The waiting room while the occupational therapist is working on leg exercises
A
The nurse is using critical thinking skills during the first phase of the nursing process. Which action indicates the nurse is in the first phase? a. Completes a comprehensive database b. Identifies pertinent nursing diagnoses c. Intervenes based on priorities of patient care d. Determines whether outcomes have been achieved
A
The nurse researcher understands that inclusion and exclusion criteria should include: a.Who is in and who is out b. Should be two side of the same coin c. Only emotionally stable patients d. Payment for their services
A
There is evidence to support that early ambulation, use of SCDs and prophylactic Lovenox may reduce the number of VTEs in hospitalized patients. Which of the following is a recommendation for hospital staff to aid in the prevention of VTEs? a. All staff members should participate in continuing education programs about VTEs. b. Give Lovenox, even if the patient refuses the medication. c. Encourage strenuous activity immediately following arrival to hospital floor. d. Restrain patients who attempt to remove SCDs.
A
What personal factors facilitate nurses that are successful CEO's of large health systems? a. Case study b. Phenomenology c. Grounded theory d. Ethnographic method
A
When critiquing a report of a qualitative research study, the nurse asks "where did the interviews take place and how long did the interviews last?" This question is critiquing what section of the report? a. Data collection b. Data analysis c. Statement of the phenomenon of interest d. Conclusions, implications, and recommendations
A
Which method is best to use when confirming initial placement of a gastric tube? a. Radiographic examination b. Air installment c. Measuring pH of gastric aspirate d. All of the above
A
Which of the following is the highest level of evidence for recommended practice for obtaining blood cultures to reduce risk of contamination? a. Use alcohol or chlorhexidine alcohol to thoroughly clean the skin and allow to dry prior to venipuncture for blood culture draw b. Braw blood off of an existing IV regardless of length of time since placement to minimize patient discomfort c. Draw blood into anaerobic container before aerobic container d. Use a new needlestick site for every container needed for cultures (4 in total for 5 minute serial cultures)
A
Which of the following organizations is not a good source for clinical practice guidelines? a. The institutional review board (IRB) b. Pubmed database c. The world health organization (WHO) d. The centers for disease control (CDC)
A
A goal for a patient with diabetes is to demonstrate effective coping skills. Which patient behavior will indicate to the nurse achievement of this outcome? a. States feels better after talking with family and friends b. Consumes high-carbohydrate foods when stressed c. Dislikes the support group meetings d. Spends most of the day in bed
A (Evaluative data that show signs of effective coping will help the nurse determine whether the patient has met the outcome. Talking to family and friends is the only positive option. During evaluation, you perform evaluative measures that allow you to compare clinical data, patient behavior measures, and patient self-report measures collected before implementation with the evaluation findings gathered after administering nursing care. Next, you evaluate whether the results of care match the expected outcomes and goals set for a patient. Consuming high-carbohydrate foods (patient is a diabetic), disliking support group, and spending the day in bed indicate unsuccessful progress toward meeting the patient's goal.)
The study of nursing requires ______?
A broad base of knowledge from the physical and behavioral sciences, humanities, nursing theories, and related nonnursing theories
A family consists of a mother and her 3-year-old daughter. This is an example of which kind of family? 1 A nuclear family 2 A blended family 3 An extended family 4 A single-parent family
A single-parent family is one in which one parent takes care of the child or children. A nuclear family consists of the husband, wife, and their children. A blended family is formed when parents bring children from previous relationships into a new, joint living setting. An extended family includes a nuclear family and relatives.
Active listening
A specific communication technique in which one fully concentrates on what the other is saying in a conscious effort to fully understand the other. Uses all senses
A nurse is planning care for a patient with a nursing diagnosis of Impaired skin integrity. The patient needs many nursing interventions, including a dressing change, several intravenous antibiotics, and a walk. Which factors does the nurse consider when prioritizing interventions? (Select all that apply.) a. Rank all the patient's nursing diagnoses in order of priority. b. Do not change priorities once they've been established. c. Set priorities based solely on physiological factors. d. Consider time as an influencing factor. e. Utilize critical thinking.
A,D,E
The nursing care plan is: A. A written guideline for implementation and evaluation. B. A documentation of client care. C. A projection of potential alterations in client behaviors D. A tool to set goals and project outcomes.
A. A written guideline for implementation and evaluation.
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? A. Patient safety B. Evidence-based practice C. Patient satisfaction D. Maintenance of competency
A. Near-miss events are events that could have caused a problem with patient safety had they not been stopped before patient harm occurred. Nurses who investigate ways to prevent near-miss events work on issues surrounding patient safety.
Which of the following is an example of the principle of patient-centered care focused on continuity and transition? A. The nurse asks the patient who in the family should have access to patient information B. The nurse is teaching the patient how to change the wound dressing at home C. The nurse responds promptly to the patient's request for pain medication D. The nurse schedules the patient's diagnostic scan following the physical therapy session
A. Nursing interventions focused on transition and continuity provide patients with information about medications to take, dietary or treatment plans to follow, and danger signals for which to look after hospitalization or treatment. These interventions also provide patients and families with health care resources after discharge.
The agent-host-environment model of health and illness is based on what concept? A. Risk factors B. Demographic variables C. Behaviors to promote health D. Stages of illness
A. Risk factors
Empathy
Ability to understand or share the feelings of another
How do adolescents react to trauma and loss?
Agitation, sleeping/eating disturbances, increased conflicts, physical complaints, delinquent behavior, and poor concentration
Age-Related Guidelines for Pap Smears
All women should have a screening at 21 years of age. Between 21-29, every 3 years. Between 30-65, get a screening plus HPV test. Women 65 and older who had normal, negative screenings, no longer need to be tested. Women who have had a total hysterectomy should not be tested, unless surgery was done as a treatment for cervical cancer or precancer
Arrange the steps of the research process in correct order. 1. Identify areas of interest or a clinical problem. 2. Design the study protocol. 3. Obtain necessary approvals. 4. Formulate recommendations for further research. 5. Analyze the results of the study.
Arrange the steps of the research process in correct order. 1. Identify areas of interest or a clinical problem. 2. Design the study protocol. 3. Obtain necessary approvals. 5. Analyze the results of the study. 4. Formulate recommendations for further research The research process is an orderly series of steps that allow a researcher to move from asking a research question to finding the answer. The initial step in the research process is identifying areas of interest or a clinical problem. The next step is designing a study protocol. Then the researcher should obtain necessary approvals to conduct the study. Finally, the researcher analyzes the results of the study and formulates recommendations for further research.
A nurse administrator is searching for the best evidence on how to get nurses to wash their hands effectively to prevent disease transmission. Based on the work of Dr. Elaine Larson, the nurse would: a.choose a program that includes a short-term intervention that involves penalties for not using appropriate precautions b. recognize that a feedback model that involves staff and long-term goals would be the best approach c. eliminate the use of hand sanitizers at the hospital d. implement the use of latex gloves for all nursing care
B
A nurse has already set the agenda during a patient-centered interview. What will the nurse do next? a. Begin with introductions. b. Ask about the chief concerns or problems. c. Explain that the interview will be over in a few minutes. d. Tell the patient "I will be back to administer medications in 1 hour."
B
A nurse is completing a care plan. Which intervention is most appropriate for the nursing diagnostic statementImpaired skin integrity related to shearing forces? a. Administer pain medication every 4 hours as needed. b. Turn the patient every 2 hours, even hours. c. Monitor vital signs, especially rhythm. d. Keep the bed side rails up at all times.
B
A nurse is conducting a nursing health history. Which component will the nurse address? a. Nurse's concerns b. Patient expectations c. Current treatment orders d. Nurse's goals for the patient
B
A researcher reports that "the average level of pain recorded on the Johnson fatigue scale was 5". This is an example of a: a.Mode b. Mean c. Median d. Standard deviation
B
During the project, the ream is careful to use reliable and valid instruments. a.More characteristic of quality improvement b. More characteristic of research
B
When developing a plan of care for a hospitalized patient that wants to quit smoking, the nurse should; a. Tell the patient, "You are killing yourself, stop smoking," and then leave the room. b. Develop a person-centered tobacco intervention plan with the client. c. Recommend that patients bring their cigarettes from home to prevent withdrawals. d. Discuss with the HCP to allow patients to smoke while in the hospital.
B
Which action indicates the nurse is using a PICOT question to improve care for a patient? a. Practices nursing based on the evidence presented in court b. Implements interventions based on scientific research c. Uses standardized care plans for all patients. d. Plans care based on tradition
B
Which of the following types of data would be appropriate to include in a qualitative study? a.Survey with closed ended questions b. Documents including newspapers and photos c. Height, weight, and BMI measures d. Hemoglobin A1c and fasting glucose levels
B
While completing an admission database, the nurse is interviewing a patient who states "I am allergic to latex." Which action will the nurse take first? a. Immediately place the patient in isolation. b. Ask the patient to describe the type of reaction. c. Proceed to the termination phase of the interview. d. Document the latex allergy on the medication administration record.
B
Which method of qualitative research was developed by the discipline of anthropology? A. Historical B. Ethnography C. Grounded theory D. Phenomenology
B Ethnography was developed by the discipline of anthropology and is used to examine issues of culture of interest to nursing
A new nurse is confused about using evaluative measures when caring for patients and asks the charge nurse for an explanation. Which response by the charge nurse is most accurate? a. "Evaluative measures are multiple-page documents used to evaluate nurse performance." b. "Evaluative measures include assessment data used to determine whether patients have met their expected outcomes and goals." c. "Evaluative measures are used by quality assurance nurses to determine the progress a nurse is making from novice to expert nurse." d. "Evaluative measures are objective views for completion of nursing interventions."
B (You conduct evaluative measures to determine if your patients met expected outcomes, not if nursing interventions were completed. Evaluative measures are assessment skills and techniques. Evaluative measures are not multiple-page documents, and they are used to assess the patient's status, not the nurse's performance or progress from novice to expert.)
The RN has received her client assignment for the day-shift. After making the initial rounds and assessing the clients, which client would the RN need to develop a care plan first? A. A client who is ambulatory. B. A client, who has a fever, is diaphoretic and restless. C. A client scheduled for OT at 1300. D. A client who just had an appendectomy and has just received pain medication.
B. A client, who has a fever, is diaphoretic and restless.
Health promotion activities may occur on a primary, secondary, or tertiary level. Which activities are considered tertiary health promotions? Select all that apply. A. A nurse runs and immunization clinic in the inner city B. A nurse teaches a patient with an amputation how to care for the residual limb C. A nurse provides range-of-motion exercises for a paralyzed patient D. A nurse teaches parents of toddlers how to childproof their homes E. A school nurse provides screening for scoliosis for the students F. A nurse teaches new parents how to choose and use an infant car seat
B. A nurse teaches a patient with an amputation how to care for the residual limb C. A nurse provides range-of-motion exercises for a paralyzed patient
Diane is a hospice nurse who is caring for the Robinson family. This family is providing end-of-life care for their grandmother, who has terminal breast cancer. When Diane visits the home 3 times a week, she focuses on symptom management for the grandmother and assists the family with coping skills. Diane's approach is an example of which of the following?
B. Family as patient: When the family as patient is the approach, family processes and relationships (e.g., parenting or family caregiving) are the primary focuses of nursing care.
Communication among family members is an example of family:
B. Function: Communication is a component of family functioning, whether that be setting goals, coping, or establishing discipline. Family functioning is what the family does, and communication is an important component of function.
A nurse assesses patients in a physician's office who are experiencing different levels of health and illness. Which statements best define the concepts of health and illness? Select all that apply. A. Health and illness are the same for all people B. Health and illness are individually defined by each person C. People with acute illnesses are actually healthy D. People with chronic illnesses have poor health beliefs E. Health is more than the absence of illness F. Illness is the response of a person to a disease
B. Health and illness are individually defined by each person E. Health is more than the absence of illness F. Illness is the response of a person to a disease
The most common reason grandparents are called on to raise their grandchildren is because of: single parenthood legal interventions dual-income families increased divorce rate
B. Legal Intervention: This new parenting responsibility is caused by a number of societal factors: the increase in the divorce rate, dual-income families, and single parenthood. But most often it is a consequence of legal intervention when parents are unfit or renounce their parental obligations.
perceived susceptibility definition
Beliefs about the chances of getting a condition or disease
Perceived benefits definition
Beliefs about the effectiveness of taking action to reduce risk or seriousness
Perceived barriers definition
Beliefs about the material and psychological costs of taking action
According to Shawnee's Philosophy, the client is influenced by what?
By cultural, biological, psychological, social, spiritual and environmental dynamics that create the human experience.
. Which information indicates a nurse has a good understanding of a goal? a. It is a statement describing the patient's accomplishments without a time restriction. b. It is a realistic statement predicting any negative responses to treatments. c. It is a broad statement describing a desired change in a patient's behavior. d. It is a measurable change in a patient's physical state.
C
A charge nurse is reviewing outcome statements using the SMART approach. Which patient outcome statement will the charge nurse praise to the new nurse? a. The patient will ambulate in hallways. b. The nurse will monitor the patient's heart rhythm continuously this shift. c. The patient will feed self at all mealtimes today without reports of shortness of breath. d. The nurse will administer pain medication every 4 hours to keep the patient free from discomfort.
C
A nurse is gathering information about a patient's habits and lifestyle patterns. Which method of data collection will the nurse use that will best obtain this information? a. Carefully review lab results. b. Conduct the physical assessment. c. Perform a thorough nursing health history. d. Prolong the termination phase of the interview.
C
A nurse overhears a researcher using coercion to make a patient agree to participate in a research study. What should the nurse do? a.Notify patient of concerns b. Document suspicions in the patient's medical record c. Contact the appropriate institutional review board d. Secretly tape-record the researcher's interaction with a potential subject
C
A patient expresses fear of going home and being alone. Vital signs are stable and the incision is nearly completely healed. What can the nurse infer from the subjective data? a. The patient can now perform the dressing changes without help. b. The patient can begin retaking all of the previous medications. c. The patient is apprehensive about discharge. d. The patient's surgery was not successful.
C
A patient verbalizes a low pain level of 2 out of 10 but exhibits extreme facial grimacing while moving around in bed. What is the nurse's initial action in response to these observations? a. Proceed to the next patient's room to make rounds. b. Determine the patient does not want any pain medicine. c. Ask the patient about the facial grimacing with movement. d. Administer the pain medication ordered for moderate to severe pain.
C
A researcher reports that the mean temperature of participants in the study is 100.6oF. What level of measurement is temperature? a. Nominal b. Ordinal c. Interval d. Ratio
C
After reviewing the database, the nurse discovers that the patient's vital signs have not been recorded by the nursing assistive personnel (NAP). Which clinical decision should the nurse make? a. Administer scheduled medications assuming that the NAP would have reported abnormal vital signs. b. Have the patient transported to the radiology department for a scheduled x-ray, and review vital signs c. Ask the NAP to record the patient's vital signs before administering medications. d. Omit the vital signs because the patient is presently in no distress.
C
The American Nurses Association's priority in promoting research is to: a. Demonstrate the best wat to foster to physician communication b. Examine the role of simulation in the undergraduate nursing curriculum c. Identify the contribution of nursing to high quality and safe patient care d. Examine the impact of doctoral prepared nurses in clinical settings
C
When conducting quantitative research, the researcher collects information to support a hypothesis. This information would be identified as: A. The subject B. Variables C. Data D. The instrument
C Data refers to information the researcher collects from subjects in the study
After assessing the client, the nurse formulates the following diagnoses. Place them in order of priority, with the most important (classified as high) listed first. A. Constipation B. Anticipated grieving C. Ineffective airway clearance D. Ineffective tissue perfusion.
C, D, A, B.
A nurse is teaching the staff about the benefits of Nursing Outcomes Classification. Which information should the nurse include in the teaching session? (Select all that apply.) a. Includes seven domains for level 1 b. Uses an easy 3-point Likert scale c. Adds objectivity to judging a patient's progress d. Allows choice in which interventions to choose e. Measures nursing care on a national and international level
C,E
When a nurse uses information and technology to communicate, locate and use knowledge, reduce and eliminate errors, and help make decisions, the nurse is working in which area? A. Integrated delivery system B. Health care patient system C. Nursing informatics D. Computerized nursing network
C. Nursing informatics is the use of information, data, and technology to communicate, manage knowledge, mitigate errors, and support decision making. It requires knowledge, skills, and attitudes from the nurse to be able to effectively use information and technology. Nursing informatics is focused on the organization, analysis, and dissemination of information.
A nurse research who is considering whether to use a qualitative research design should be aware that the focus of qualitative research is best described as: a.Measuring one or more human characteristics using survey instruments. b. Controlling variables that interfere with the phenomenon being studied c. A way to test interventions and associated patient outcomes d. Studying human experiences that occur within a person's natural setting
D
A patient comes from a close-knit family. The patient's family functions as context. You will need to evaluate: A. Attainment of patient needs. B. Family attainment of developmental tasks. C. Individual family members caring about one another. D. Family satisfaction with its new level of functioning.
D
A patient has reduced muscle strength following a left-sided stroke and is at risk for falling. Which intervention is most appropriate for the nursing diagnostic statement Risk for falls? a. Keep all side rails down at all times. b. Encourage patient to remain in bed most of the shift. c. Place patient in room away from the nurses' station if possible. d. Assist patient into and out of bed every 4 hours or as tolerated.
D
A patient's plan of care includes the goal of increasing mobility this shift. As the patient is ambulating to the bathroom at the beginning of the shift, the patient suffers a fall. Which initial action will the nurse take next to revise the plan of care? a. Consult physical therapy. b. Establish a new plan of care. c. Set new priorities for the patient. d. Assess the patient.
D
A patient's son decides to stay at the bedside while his father is confused. When developing the plan of care for this patient, what should the nurse do? a. Individualize the care plan only according to the patient's needs. b. Request that the son leave at bedtime, so the patient can rest. c. Suggest that a female member of the family stay with the patient. d. Involve the son in the plan of care as much as possible.
D
A registered nurse administers pain medication to a patient suffering from fractured ribs. Which type of nursing intervention is this nurse implementing? a. Collaborative b. Independent c. Interdependent d. Dependent
D
All of the following are appropriate ways to prevent a central line- associated bloodstream infection (CLABSI) EXCEPT: a. Chlorohexidine baths daily b. Change the dressing as needed c. Assess the site regularly for signs of infection d. Central lines never get infected
D
Evidence has shown that there are multiple risk factors related to falls. Which of the following is NOT a risk for falls? a. Decreased muscle strength b. Poor footwear c. Taking multiple medications d. Clutter-free environment
D
The nurse begins a shift assessment by examining a surgical dressing that is saturated with serosanguineous drainage on a patient who had open abdominal surgery yesterday (or 1 day ago). Which type of assessment approach is the nurse using? a. Gordon's Functional Health Patterns b. Activity-exercise pattern assessment c. General to specific assessment d. Problem-oriented assessment
D
The nurse is critiquing a qualitative research study. Which question would be appropriate for the nurse to ask when critiquing the study's credibility? a. Is the strategy used for analysis compatible with the purpose of the study? b. Are the results meaningful to nursing and individuals not involved in the research? c. Does the investigator document the research process? d. Do the participants recognize the experience as their own?
D
When reading the results section of a quantitative research article you are most likely to see: a. A description of the theoretical model b. Previous research done by the author c. A discussion of the clinical implications of the study d. Tables and figures that summarize the results of the statistical tests
D
Which of the following is not recommended as an intervention for adults with ventilator acquired pneumonia? a. HOB elevated 30-45 degrees b. Performing oral care with a chlorhexidine solution c. Using a mechanical toothbrush d. Performing oropharyngeal suctioning once a week
D
A nurse is evaluating goals and expected outcomes for a confused patient. Which finding indicates positive progress toward resolving the confusion? a. Patient wanders halls at night. b. Patient's side rails are up with bed alarm activated. c. Patient denies pain while ambulating with assistance. d. Patient correctly states names of family members in the room.
D (The goal for this patient would address a decrease or absence of confusion. Thus, one possible sign that a patient's confusion is improving is seen when a patient can correctly state the names of family members in the room. You examine the results of care by using evaluative measures that relate to goals and expected outcomes. Keeping the side rails up and using a bed alarm are interventions to promote patient safety and prevent falls. The patient's denying pain indicates positive progress toward resolving pain. The patient's wandering the halls is a sign of confusion.)
Which of the following statements is true regarding Magnet status recognition for a hospital? A. Nursing is run by a Magnet manager who makes decisions for the nursing units B. Nurses in Magnet hospitals make all of the decisions on the clinical units C. Magnet is a term that is used to describe hospitals that are able to hire the nurses they need D. Magnet is a special designation for hospitals that achieve excellence in nursing practice
D. Magnet status is a process and review in which hospitals participate that shows achievement of excellence in nursing practice. The designation is given by the American Nurses Credentialing Center and focuses on demonstration of quality patient care, nursing excellence, and innovations in professional practice.
After evaluating a patient's external variables, the nurse concludes that health beliefs and practices can be influenced by A.) Emotional factors B.) Intellectual background C.) Developmental stage D.) Socioeconomic factors
D.) socioeconomic factors
A charge nurse is evaluating a new nurses plan of care. Which finding the charge nurse to follow up?
Developing nursing diagnoses before completing the database
Which factor negatively affects the ability to sleep? Regular nighttime schedule Not doing homework 1 hour before bed Avoidance of office work 1 hour after waking up Exercise late in the day
Exercise late in the day
A college health clinic nurse is working with a homesick freshman from a large extended family. The client has come into the clinic several times in the first semester with injuries. Which characteristic of the client's developmental level is a possible factor? Declining physical abilities Lack of defenses against disease Increased number of falls Exhibition of risk-taking behavior
Exhibition of risk-taking behavior
Perceived benefits change strategy
Explain how, where, and when to take action and describe likely positive results
National League for Nursing (NLN) competencies
Human flourishing, nursing judgment, professional identity, spirit of inquiry
Self efficacy change strategy
Provide training and guidance in performing action. Use progressive goal setting. Give verbal reinforcement. Demonstrate desired behaviors.
Leader role of the nurse
Provides direction and purpose, builds sense of commitment toward common goals, communicates effectively, and assists with addressing challenges that arise in patient care.
The nurse is conducting an oral health history during the nursing assessment. Which considerations will be included in this portion of the assessment?
Self-care abilities Past oral problems Hygiene practices Frequency of dental visits
Wellness
a process of self-care achieved by making choices leading to a healthy life
International Council of Nurses (ICN)
based in Switzerland, represents nursing world wide
the health care industry is shifting from managing illness to
managing health of a community and the environment
the focus of nursing informatics is
not on the technology or computer but rather on the organization, analysis, and dissemination of info
knowledge developes when
nurses combine and identify relationships between different pieces of info
risk factor reduction
step-by-step improvement of individual health factors
Lenah Higbee
superintendent of the U.S. Navy Nurse Corps, was awarded the Navy Cross in 1918.
Who is responsible for publishing standards for patient and family education to improve outcomes in health care facilities?
The Joint Commission
managed care organization (MCO)
staff model- physicians are salaried employees of the MCO group model- MCO contracts with single group practice network model- MCO contracts with multiple group practices
globalization
health care providers have to make their services more accessible
managed care
health care systems in which the provider or health care system receives a predetermined capitated payment for each pt enrolled in the program
continuing care describes
health, personal, and social services over a prolonged period of time
the values of the nursing profession are rooted in
helping people to regain, maintain, or improve health. prevent illness, and find comfort and dignity
pay for performance
programs and public reporting of hospital quality data are designed to promote quality, effective and safe pt are by physicians and health care organizations
extended care facilities
provides intermediate medical, nursing, or custodial care, for pts recovering from an acute illness or those with chronic illnesses or disabilities
home care is
provision of medically related professional and paraprofessional services and equipment to pts and families in their homes for health maintenance, education, illness prevention, diagnosis, an treatment of disease, palliation and rehabilitation
nursing sensitive outcomes
pt outcomes ans select nursing workforce characteristics that are directly related to nursing care such as changes in pts symptoms, functional status, safety, psych, RN job satisfaction and total nursing hours per pt day.
respite care
service that provides short-term relief or time off for people providing home care to ill, disabled, or frail adult medicare does not cover
QSEN ifentified informatics as a
competency for nurses
Virginia Henderson's definition of nursing
" The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or it's recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible.
The nurse is caring for a 5-year-old girl who is living with her family. The family includes her mother and a grandmother who is 65 years old. Her father is in the military. The girl's parents divorced a year before. Her mother works in a store, and the grandmother takes care of the girl. What societal factors have led to this new parenting responsibility for grandparents? Select all that apply. 1 Single parenthood 2 Both parents working 3 Rich grandparents 4 Increased rates of divorce 5 Blended family
1 Single parenthood 2 Both parents working 4 Increased rates of divorce Many grandparents are raising their grandchildren due to high divorce rates and because the current state of the economy has resulted in both parents having to work. Thus single parenthood, both parents working, and increased rates of divorce are societal factors leading to new parenting responsibilities for grandparents. The grandparents' wealth does not influence whether or not they care for their grandchildren. A blended family is formed when parents bring unrelated children from prior adoptive or foster parenting relationships into a new, joint living situation.
Which of the following are major public health problems com- monly affecting older adults? (Select all that apply.) 1. Substance abuse2. Confusional states3. Financial limitations 4. Communicable diseases 5. Acute and chronic physical illnesses
1, 2, 3, 5
Which describes components of implementation in the nursing process? Select all that apply. 1. Doing 2. Deciding 3. Delegating 4. Documenting 5. Caring
1. Doing 3. Delegating 4. Documenting
Which type of data should be included in the discharge planning? Select All That Apply. 1. Functional and self-care limitations 2. Emotional stability and ability to learn 3. Family or other caregivers available 4. Use of community services before admission 5. Medical diagnosis
1. Functional and self-care limitations 2. Emotional stability and ability to learn 3. Family or other caregivers available 4. Use of community services before admission
Timeline of Florence Nightingale
1850s: cared for injured in the Crimean War 1860s: she established the Nightingale Training school and published her book "Notes on Nursing" 1880s: Nightingale journal was published 1930s: the Florence Nightingale Foundation was established
Place the stages of the sleep cycle in the correct order.
1st The first three stages of NREM are passed through in 20-30 minutes. 2nd Stage IV of NREM cycle lasts 30 minutes 3rd Stage III and IV are passed back through over 20 minutes 4th The first REM stage occurs, lasts about 10 minutes
A family includes a mother, stepfather, two teenage biological daughters of the mother, and a biological daughter of the father. Of what type of family is this an example? 1 A nuclear family 2 A blended family 3 An extended family 4 An alternative family
2 A blended family Blended families result when two people who have children from a previous marriage or relationship marry.
Which type of assessment is performed to obtain data about an actual, potential, or possible problem that has been identified or is suspected? 1. Initial assessment 2. Focused assessment 3. Global assessment 4. Special needs assessment
2. Focused assessment
major health care reform came in
2010 with the patient protection and affordable care act
Compassion fatigue
An extreme state of distress experienced as the progressive and cumulative result of exposure to stress in the therapeutic use of self in caring for others.
How many stages are in the stages of illness model?
5
A charge nurse meets with staff to outline a plan to provide transcultural nursing care for patients in their health care facility. Which theorist promoted this type of caring as the central theme of nursing care, knowledge, and practice? A. Madeline Leininger B. Jean Watson C. Dorothy E. Johnson D. Betty Newman
A
You read the following statement in a research study "Cronbach's alpha for an instrument to measure pain scale was .95" and you correctly conclude: a.This instrument has a high degree of internal consistency (reliability) b. This instrument has a high level of validity c. The instrument is stable over several different situations d. The instrument is not a good choice for measuring pain
A
A nurse add the following diagnoses to a patient care plan. Constipation related to decreased gastrointestinal motility secondary to pain medication administration as evidenced by patient reporting no bowel movement in seven days abdominal distention and abdominal pain. Which element did the nurse write as the defining characteristic?
Abdominal distinction
The nurse is caring for an older adult client who exhibits sundown syndrome. Which assessment findings would the nurse expect for this client to exhibit while providing care in the late afternoon? Tachycardia Eupnea Sleepiness Agitation
Agitation
Jean Watson's theory of caring (1988)
Based on caring, with nurses dedicated to health and healing. The nurse functions to preserve the dignity and wholeness of humans in health or while peacefully dying. The caring process in a nurse-patient relationship is known as transpersonal caring and includes carative factors that satisfy human needs. The practice of nursing focuses on goals of growth, meaning, and self-healing
A nurse is completing an assessment. Which findings will the nurse report as subjective data? (Select all that apply.) a. Patient's temperature b. Patient's wound appearance c. Patient describing excitement about discharge d. Patient pacing the floor while awaiting test results e. Patient's expression of fear regarding upcoming surgery
C,E
When did nursing begin?
In religious and military services in the Middle Ages, particularly during the crusades
Some nurses are collecting data to determine how many adoles- cents attempt suicide in a community. This is an example of what type of community assessment data?
Incident rates
Stage 3 of the illness model
Medical care contact; professional advice from health care providers is sought by the individual. A PCP identifies and validates the illness and legitimizes the sick role
The nurse is administering medications to a group of clients on a medical-surgical unit. Which medication is most likely to cause a client to experience frequent awakenings during the nighttime hours? Morphine Propranolol Tylenol Trazodone
Morphine
According to Shawnee's Philosophy, Nursing is what?
Nursing is a profession that creatively uses knowledge from the sciences and humanities to plan, provide, and evaluate interventions grounded in evidence to compassionately meet the unique healthcare needs of the client. Nursing is an evolving science that integrates concepts, ideas, and theories through critical inquiry to develop an understanding of client responses to interventions. Nurses identify clinical problems and participate in the generation of new knowledge. Nurses assume leadership roles to identify and implement changes affecting the human experience.
self-concept
Refers to the way in which individuals perceive unchanging aspects of themselves, such as social character, cognitive abilities, physical appearance, and body image
Which of the following demonstrate family resiliency? (Select all that apply.)
Resuming full-time work when spouse loses job Developing hobbies when children leave home Family resiliency is the ability to cope with expected and unexpected stressors. Resiliency helps to evaluate healthy responses when individuals and families are experiencing stressful events
Which nerve fiber is involved in the sleep-wake cycle? Pineal gland Serotonin Reticular activating system Neurons
Reticular activating system
The nurse is providing care to a client participating in a sleep study. The nurse documents eye rolling from side to side, decreased respiratory and heart rate, and being able to easily arouse the client. Which stage of NREM sleep is the client experiencing? Stage IV Stage III Stage I Stage II
Stage I
Who accredits SSU's ADN program?
The National League of Nursing Accrediting Commission (NLNAC) and the Accreditation Commission for Education of Nursing
Who accredits SSU's RN-BSN program?
The National League of Nursing Accrediting Commission (NLNAC) and the Accreditation Commission for Education of Nursing
Metaparadigm
The most abstract level of knowledge, defined as a global set of concepts that identify and describe the central phenomena of the discipline and explain the relationship between those concepts.
When did the BSN program start at Shawnee?
The first class started in 2012 after an assessment was taken in 2009 that revealed the need for more baccalaureate prepared nurses.
Compassion
The force that impels and empowers one to recognize, acknowledge, and act to alleviate human suffering.
Nursing theory
The fourth level of nursing knowledge. This represents an group of concepts that can be tested in practice and can be derived from a conceptual model.
A large number of health care disparities can be traced to what?
The health beliefs of either patients or health care providers
Touch
The intentional contact between two or more people
Holistic care focuses on what?
The interrelatedness of body and mind and is an approach to applying healing therapies
Change agent role of the nurse
The nurse works with patients to address their health concerns and with staff members to address change in an organization or within a community. Sometimes this role is extended to bringing change to legislation on health policy issues
Sympathy
To have pity for another's situation
evidence based practice is
a problem solving approach to clinical practice that involves the conscientious use of current best evidence, along with clinical expertise and pt preferences.
Which title suggests an ethnographic study? Select one: a. The phenomenon of breast self-examination in among African American women b. The challenge of retaining femininity after mastectomy c. The lived experience of breast cancer in postmenopausal women d. The experience of teens and parents receiving cancer prevention patient education materials
a. The phenomenon of breast self-examination in among African American women
Two nurses, one newly graduated and the other an experienced mentor, are discussing improving documentation of the nursing process. Which statement by the new graduate should be corrected by the mentor? "Nursing process is influenced by the preceding step." "Nursing process is a linear five-step method." Your answer is correct. "Nursing process operates as a feedback loop." "Nursing process is influenced by the following step."
"Nursing process is a linear five-step method." Your answer is correct. "Nursing process operates as a feedback loop."
intensity of care has increased in restorative care settings because
pts leave hospitals early
Following a community assessment that focused on adolescent health behaviors, a nurse determines that a large number of ado- lescents smoke and designs a smoking cessation program at the youth community center. This is an example of which nursing role: 1. Educator2. Counselor3. Collaborator4. Case manager
2
American Nurses Association (ANA) definition of nursing
"....... nurse work tirelessly to identify and protect the needs of the individual. Beyond the time-honored reputation for compassion and dedication lies a highly specialized profession, which is constantly evolving to address the needs of society. From ensuring the most accurate diagnoses to the ongoing education of the public about critical health issues; nurses are indispensable in safeguarding public health."
On the basis of an assessment, the nurse identifies an increase in the immigrant population group in the community. How would the nurse determine the health needs of this population? (Select all that apply.) 1. Identify what the immigrant population views as the two most important health needs. 2. Apply information from Healthy People 2020. 3. Determine how the population uses available health care resources. 4. Determine which health care agencies will accept immigrant populations. 5. Identify perceived barriers for health care.
1, 2, 3, 5
Which nursing interventions are considered direct-care interventions? Select All That Apply. 1. Physical care 2. Emotional support 3. Client education 4. Making a referral 5. Managing the environment
1. Physical care 2. Emotional support 3. Client education
Perceived severity definition
Beliefs about the seriousness of a condition and it's consequences
By what is a family's access to adequate health care, opportunity for education, sound nutrition, and decreased stress affected? 1 Development 2 Family function 3 Family structure 4 Economic stability
4 Economic stability
Which type of medication is associated with nightmares? Hypnotics Tranquilizers Beta-blockers Antidepressants
Beta-blockers
A student nurse interacting with patients on a cardiac unit recognizes the four concepts in nursing theory that determine nursing practice. Of these four, which is most important? A. Person B. Environment C. Health D. Nursing
A Of the four concepts, the most important is the person. The focus of nursing, regardless of definite or theory, is the person
A nurse manager schedules a clinic for the staff to address common nursing interventions used in the facility and to explore how they can be preformed more effectively. What is the term for this type of theory affecting change in clinical nursing practice? A. Prescriptive theory B. Descriptive theory C. Developmental theory D. General systems theory
A Prescriptive theories address nursing interventions and are designed to control, promote, and change clinical nursing practice.
Belief
A mental representation of reality or a persons perceptions about what is right (correct), true, or real, or what the person expects to happen in a given situation
value clarification
A therapeutic process that allows individuals to consider, clarify, and prioritize their personal values.
For clients to participate in goal setting, they should be: A. Alert and have some degree of independence. B. Ambulatory and mobile. C. Able to speak and write. D. Able to read and write.
A. Alert and have some degree of independence.
Once a nurse assesses a client's condition and identifies appropriate nursing diagnoses, a: A. Plan is developed for nursing care. B. Physical assessment begins C. List of priorities is determined. D. Review of the assessment is conducted with other team members.
A. Plan is developed for nursing care.
13. Which initial intervention is most appropriate for a patient who has a new onset of chest pain? a.Reassess the patient. b.Notify the health care provider. c.Administer a prn medication for pain. d.Call radiology for a portable chest x-ray.
ANS: A Preparation for implementation ensures efficient, safe, and effective nursing care; the first activity is reassessment. The cause of the patient's chest pain is unknown, so the patient needs to be reassessed before pain medication is administered or a chest x-ray is obtained. The nurse then notifies the patient's health care provider of the patient's current condition in anticipation of receiving further orders. The patient's chest pain could be due to muscular injury or a pulmonary issue. The nurse needs to reassess first.
18. The nurse is intervening for a family member with role strain. Which direct care nursing intervention is most appropriate? a.Assisting with activities of daily living b.Counseling about respite care options c.Teaching range-of-motion exercises d.Consulting with a social worker
ANS: B Family caregivers need assistance in adjusting to the physical and emotional demands of caregiving. Sometimes they need respite (i.e., a break from providing care). Counseling is an example of a direct care nursing intervention. The other options do not address the identified problem of role strain (activities of daily living and range-of-motion exercises). Consulting is an indirect care nursing intervention.
10. A new nurse is working in a unit that uses interdisciplinary collaboration. Which action will the nurse take? a.Act as a leader of the health care team. b.Develop good communication skills. c.Work solely with nurses. d.Avoid conflict.
ANS: B Good communication between other health care providers builds trust and is related to the acceptance of your role in the health care team. As a beginning nurse, you will not be considered a leader of the health care team, but your input as an interdisciplinary team member is critical. Interdisciplinary involves other health care providers, not just nurses. Organizational culture includes leadership, communication processes, shared beliefs about the quality of clinical guidelines, and conflict resolution.
12. Vital signs for a patient reveal a high blood pressure of 187/100. Orders state to notify the health care provider for diastolic blood pressure greater than 90. What is the nurse's first action? a.Follow the clinical protocol for a stroke. b.Review the most recent lab results for the patient's potassium level. c.Assess the patient for other symptoms or problems, and then notify the health care provider. d.Administer an antihypertensive medication from the stock supply, and then notify the health care provider.
ANS: C Communication to other health care professionals must be timely, accurate, and relevant to a patient's clinical situation. The best answer is to reassess the patient for other symptoms or problems, and then notify the health care provider according to the orders. Reviewing the potassium level does not address the problem of high blood pressure. The nurse does not follow the protocol since the order says to notify the health care provider. The orders read to notify the health care provider, not administer medications.
1. A nurse is providing nursing care to patients after completing a care plan from nursing diagnoses. In which step of the nursing process is the nurse? a.Assessment b.Planning c.Implementation d.Evaluation
ANS: C Implementation, the fourth step of the nursing process, formally begins after a nurse develops a plan of care. With a care plan based on clear and relevant nursing diagnoses, a nurse initiates interventions that are designed to assist the patient in achieving the goals and expected outcomes needed to support or improve the patient's health status. The nurse gathers data during the assessment phase and mutually sets goals and prioritizes care during the planning phase. During the evaluation phase, the nurse determines the achievement of goals and effectiveness of interventions.
6. A patient recovering from a leg fracture after a fall reports having dull pain in the affected leg and rates it as a 7 on a 0 to 10 scale. The patient is not able to walk around in the room with crutches because of leg discomfort. Which nursing intervention is priority? a.Assist the patient to walk in the room with crutches. b.Obtain a walker for the patient. c.Consult physical therapy. d.Administer pain medication.
ANS: D The patient's pain is a 7, indicating the priority is pain relief (administer pain medication). Acute pain is the priority because the nurse can address the problem of immobility after the patient receives adequate pain relief. Assisting the patient to walk or obtaining a walker will not address the pain the patient is experiencing.
A nurse administers an antihypertensive medication to a patient at the scheduled time of 900. The nursing assistive personnel then reports to the nurse at the patient's blood pressure was low when it was taking at 08 30. The NAP states she was busy and had not had a chance to tell the nurse. The patient begins to complain of dizziness and light headed. The blood pressure is rechecked and it has dropped even lower. In which phase of the nursing process did the nurse first make an error?
Assessment
What Belmont Report Principle states the research study benefits should outweigh the risks? a.Justice b. Beneficence c. Confidentiality d. Respect for persons
B
What are effective teaching methods for a patient with poor asthma control? (SELECT ALL THAT APPLY) a. Inform the patient to self-research asthma control b. Observe the patient while they demonstrate the proper technique of an inhaler c. UAP verbalization of how to use an inhaler and medication schedule d. Review with the patient the goals of management on asthma prior teaching e. Patient verbalization of understanding of when they should seek help during an asthma exacerbation.
B/D/E
Sister Callisto Roy adaptation model (1970)
Based on human being as an adaptive open system. The person adapts by meeting physiological-physical needs, developing a positive self-concept-group identity, performing social role functions, and balancing dependence and independence. Stressors result in illness by disrupting the equilibrium. Nursing care is directed at altering stimuli that are stressors to the patient. The nurse helps patients strengthen their abilities to adapt to their illnesses or helps them develop adaptive behaviors.
Erikson's Psychosocial Theory
Based on the individuals interacting and learning about their world
How did Madeleine Leininger define nursing?
Both an art and a science that provides culture specific care to individual patients and groups to promote or maintain health behaviors or recovery from illness
A clinical research nurse, working with patients enrolled in a randomized control study, is concerned that research misconduct has taken place. Which situation below is not research misconduct? a.Reporting fabricated research findings b. Manipulating results so that the research is not accurately represented c. Differing opinions between two researchers d. Using another's ideas or words without giving proper credit
C
Which of the following nursing activities is found in a tertiary health care environment? A. Administering influenza immunizations at the senior independent living facility B. Providing well-baby care in the clinic run by the local community health department C. Admitting a patient following open heart surgery to the cardiovascular intensive care unit D. Working the triage desk in the emergency department
C. Tertiary health care is focused on treatment of disease and illness. Tertiary health care takes place in intensive care and subacute care units. Emergency departments are part of secondary acute care. Preventive and health-promotion activities are part of primary care.
Which clinic patient is most likely to have annual breast examinations and mammograms based on the physical human dimension? A. Jane, whose best friend had a benign beast lump removed B. Sarah, who lives in a low-income neighborhood C. Tricia, who has a family history of breast cancer D. Nancy, whose family encourages regular physical examinations
C. Tricia, who has a family history of breast cancer
The client is reporting difficulty sleeping. Which assessment findings may be causing this client's sleeping difficulties? Cigarette smoking A cup of coffee after dinner each night Financial stability Several glasses of wine in the evening Recent weight loss
Cigarette smoking A cup of coffee after dinner each night Several glasses of wine in the evening
A nursing assessment for a patient with a spinal cord injury leads to several pertinent nursing diagnoses. Which nursing diagnosis is the highest priority for this patient? a. Risk for impaired skin integrity b. Risk for infection c. Spiritual distress d. Reflex urinary incontinence
D
The nurse is reviewing a patient database for significant changes and discovers that the patient has not voided in over eight hours. The patients kidney function lab results are abnormal and the patient's oral intake has significantly decreased since previous shift. Which step of the nursing process should the nurse proceed to after this review?
Diagnosis
A nurse is using assessment data gathered about a patient in combining critical thinking to develop a nursing diagnosis. What is the nurse doing?
Diagnostic reasoning
Which of the following contribute to family hardiness? (Select all that apply.)
Family meetings Establishing family roles Willingness to change in time of stress
Higher order beliefs
Generalizations or ideas that are derived from first-order beliefs and reasoning
When was Shawnee state officially named Shawnee State University?
In 1986
In addition to managing a team of patients, the nurse may be the manager of a unit in a hospital. What are their responsibilities?
In addition to managing patients, they will oversee the staff that are providing patient care while managing the budget and resources required for necessary functions
When did the Rn-BsN program start at Shawnee?
In fall of 1998.
The Future of Nursing: Leading Change, Advancing Health identifies what nursing goals?
Nurses should practice to the full extent of their education and training, nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression, nurses should be full partners with physicians and other health care professionals in redesigning health care in the U.S., effective workforce planning and policy making required better data collection and an improved infrastructure.
Which best defines family caregiving? (Select all that apply.)
Providing physical and emotional care for a family member Establishing a safe physical environment for a family Monitoring for side effects of illness and treatments Family caregiving involves the routine provision of services and personal care activities for a family member by spouses, siblings, or parents. Caregiving activities include finding resources, personal care (bathing, feeding, or grooming), monitoring for complications or side effects of illness and treatments, providing instrumental activities of daily living (shopping or housekeeping), and the ongoing emotional support and decision making that is necessary.
A nurse working in the sleep lab teaches her clients the clinical changes of NREM sleep. Which assessment findings represent the changes in Stage II of NREM sleep?
Pulse rate slows Respiratory rate slows Body temperature decreases
Dorothea Orem's Self-Care Deficit Theory (1971)
Three interrelated theories of self care, self care deficit, and nursing systems constitute this theory. A self care deficit exists when patients are unable to meet their self care needs. Nursing systems care for patients who require assistance in one of three categories: wholly compensatory, partly compensatory, or supportive-educative. The goal of nursing care is to help patients perform self care by increasing their independence.
Advanced Practice Registered Nurse (APRN)
a designation for an RN who has met advanced educational and clinical practice requirements at a minimum of a master's degree level and provides at least some level of direct care to patient populations
A nurse researcher is interested in estimating how reliably data can be used to generalize the findings of a study. In order for this to occur, the researcher should use: Select one: a. Inferential statistics b. Mathematical statistics c. Descriptive statistics d. Nonparametric statistics
a. Inferential statistics
A dependent variable is: Select one: a. What the is measured to determine if there is a change during the research study b. A variable that has an effect on another variable c. Manipulated by the researchers d. An intervention
a. What the is measured to determine if there is a change during the research study
Which ethical principle is maintained when the subject's identity cannot be linked, even by the researcher, with his or her individual responses in a research study? Select one: a. Justice b. Confidentiality c. Beneficence d. Nonmalfecence
b. Confidentiality
A husband brings his children in to visit their mother in the hospital. The nurse asks how the family is getting along at home without their mom around. The husband states, "None of her jobs are getting done, and I don't do those jobs, so the house and the kids are falling apart." The nurse suspects that this family structure is a. Very flexible. b. Quite rigid. c. Extremely open. d. Hardy.
b. Quite rigid. A rigid structure specifically dictates who is able to accomplish a task and may limit the number of people outside the immediate family who assume these tasks. An extremely open or very flexible structure also presents problems for the family in that consistent patterns of behavior do not exist, and enactment of roles is overly flexible. Hardiness is the internal strength and durability of the family unit characterized by a sense of control over the outcome of life and an active rather than passive orientation in adapting to stressful events.
Which of the following research topics would most likely be studied through a qualitative design? Select one: a. Is there a change in measures of hope and coping in adults over 65 after completing rehabilitation from a hip fracture? b. What is the meaning of health and health promotion among low-income, Southern, rural women? c. What are the effects of exercise on fatigue rate and level of emotional distress in patients undergoing radiation therapy for breast cancer? d. What is the relationship between perceived risk and willingness to interact with individuals with HIV/AIDS in older adults diagnosed with HIV/AIDS?
b. What is the meaning of health and health promotion among low-income, Southern, rural women?
True or False: The article by Brand et al. (2013) is an example of a secondary source. Select one: a. True b. False
b. false
The nurse develops a nursing diagnosis of ineffective health maintenance related to low motivation based on the finding that the diabetic patient a) does not perform capillary blood glucose tests as directed. b) occasionally forgets to take the daily prescribed medication. c) says that dietary intake does not seem to impact fatigue level. d) cannot identify signs or symptoms of high and low blood glucose.
c) says that dietary intake does not seem to impact fatigue level.
What is the independent variable in this study based on the following research question: What is the effect of deep breathing on nursing student exam scores and anxiety levels? Select one: a. Anxiety levels b. Exam scores c. Deep breathing d. Nursing students
c. deep breathing
restorative care
cardiovascular, pulmonary rehabilitation, sports medicine, spinal cord injury, home care
The roles of the nurse
care provider, educator, advocate, leader, change agent, manager, researcher, collaborator, delegator
Balanced Budget Act of 1997
changed the designation for rural hospitals to critical access hospital if certain criteria were met.
Chronic illness
characterized by a loss or abnormality of body function that lasts longer than 6 months and requires ongoing long-term care
When initiating the care of families, one factor that helps organize the family approach to the nursing process is that the nurse a. Views all patients as unique individuals. b. Realizes that families have little impact on individuals. c. Understands that individuals have little impact on families. d. Realizes that individuals have an impact on families.
d. Realizes that individuals have an impact on families. When initiating the care of families, three factors organize the family approach to the nursing process: (1) that the nurse views all individuals within their family context, (2) that families have an impact on individuals, and (3) that individuals have an impact on families.
Health Promotion Model
defines health as a positive, dynamic state of well-being rather than the absence of disease in the physiologic state
Quality Health care is the
degree to which health services for pts and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge
Which of the following is not a typical component of a research article? Select one: a. Background (or Introduction) b. Methods c. Abstract d. Results e. Practice f. Conclusions
e. Practice
diagnosis-related groups (DRG's)
each group has a fixed amount with adjustments based on case severity, rural/urban/regional costs, and teaching costs. Hospitals receive a set dollar amount for each pt regardless of the pts length of stay or use of service
As a nurse utilizing clinical practice guidelines in developing PICOT questions, you understand policies are referring to: a.Resources for evidence based clinical practice guidelines set by the national guideline clearinghouse b. practice standard set by academic institutions related to clinical practice c. evidence of local regional needs to develop policy and procedures d. policy and procedures setback agency clinical units
A
In differentiating a quality improvement (QI) from a research project, which of the following is true? a.Research projects may impose some risks to participants b. Research project findings typically get implemented into practice immediately c. QI projects consistently use valid and reliable data collection d. QI projects generate new knowledge that can be generalized
A
The National Nurses' Health Study is an example of a: a.Prospective cohort study b. Retrospective case study analysis c. Randomized control experiment d. Quasi-experimental study
A
The PICOT format is most helpful in: a.identifying clinical problems that can be addressed through clinical research b. providing a theoretical framework for understanding health behavior c. examining the findings of qualitative research studies d. testing new devices that increase clinical efficiency
A
The nurse is critiquing a qualitative research study. Which question would be appropriate for the nurse to ask when critiquing the study's sample selections? a.Are the targeted informants appropriate to inform the research? b. If a particular approach is used to guide the inquiry, does the researcher complete the study according to the processes described? c. Does the researcher address the credibility, auditability, and fittingness of the data? d. Does the researcher place the report in the context of what is already known about the phenomenon (e.g., the existing literature)?
A
The nurse researcher is planning a research study that will use human subjects and their choice to participate in a specific treatment. What basic human right describes a prospective subject's freedom to choose whether or not to participate in the research study is what? a.Right to self-determination b. Right to anonymity and confidentiality c. Right to fair treatment d. Right to protection from discomfort and harm
A
When critiquing a report of a qualitative research study, the nurse reads that a study used a computer software program to manage the data. This statement is critiquing what section of the report? a.Data analysis b. Data collection c. Statement of the phenomenon of interest d. Conclusions, implications, and recommendations
A
When is it ethical to select a population of only prisoners for a study sample? a.The study is relevant to issues important in the prison population b. Prisoners have extra to participate in the study c. Retention rates are higher when studying prison populations in research d. Prisoners are more likely to agree to participate in research
A
A nurse on a medical-surgical floor, you are asked to complete a search for a literature review on prevention of falls. What is the best first step to begin your literature search? a.Begin the search using the search term "falls" b. Develop a PICO question that clearly defines your interest c. Review the patient education materials on the unit d. Begin brainstorming falls prevention interventions for the unit
A/B
The framework a nurse researcher creates to strengthen the study should include the research question or hypothesis, theoretical framework, literature review, and: a.randomization b. reliable instruments or tools c. mediating variables d. study design
A/B/D
When reviewing research studies, the nurse understands that bias: a.Can influence or distort the study's theoretical framework b. Must strengthen the study results c. Can affect the validity of the study d. All of the above
A/C
The work of Dr. Barbara Reigal has been used most frequently to: a. Advocate for better nurse to patient staffing ratios b. Improve self care in patients with heart failure c. Improve working conditions for new nurses d. Increase funding for prevention of medication errors
B
What is the best interpretation of the following statistical statement "The 95% confidence interval for the mean score of 34 was 29-38"? a.There is a 95% chance that the mean score is 34 b. There is a 95% chance that the mean score is between 29-38 c. The researcher is confident that the mean score cannot be determined d. There is a 5% chance that the mean score is 34
B
What is the lived experience of a woman undergoing radiation treatment for breast cancer? a.Case study b. Phenomenology c. Grounded theory d. Ethnographic
B
Which of the following is the researcher trying to disprove or reject? a)H0 b) H1 c) Hypothesis d) Null hypothesis a. A&C b. A&D c. B&C d. B&D
B
Which of the following statements describes the emic view? a.The outsider's interpretation of a different culture b. The insiders view of the wat members of a culture view their own world c. The research design that is used to study and understand different cultures d. The way that researchers study their own cultures
B
Writing a research question best corresponds to what step of the nursing process a.Assessment b. Nursing diagnosis c. Planning d. Evaluation
B
You are reading a meta-analysis related to the use of a wound treatment on the closure of wounds. A meta0analysis would be most likely to include: a. 1-2 individual studies on the topic that have larger samples b. A statistical analysis where small studies are combined for increased power c. A heterogeneous sample of articles with different outcome measures d. The development of a new theoretical model to study wound care
B
in a double-blind placebo/control drug trial: a.The investigator knows who is getting the drug but the patient does not b. Neither the patient not the investigator knows who is getting the real drug c. Both the investigator and the patient know who is getting the drug d. Family members know who is getting the drug so they can monitor side effects
B
A client's wound is not healing and appears to be worsening with the current treatment. The nurse first considers: A. Notifying the physician. B. Calling the wound care nurse C. Changing the wound care treatment. D. Consulting with another nurse.
B. Calling the wound care nurse
The nurse is reviewing the critical paths of the clients on the nursing unit. In performing a variance analysis, which of the following would indicate the need for further action and analysis? A. A client's family attending a diabetic teaching session. B. Canceling physical therapy sessions on the weekend. C. Normal VS and absence of wound infection in a post-op client. D. A client demonstrating accurate medication administration following teaching.
B. Canceling physical therapy sessions on the weekend.
The following statement appears on the nursing care plan for an immunosuppressed client: The client will remain free from infection throughout hospitalization. This statement is an example of a (an): A. Nursing diagnosis B. Short-term goal C. Long-term goal D. Expected outcome
B. Short-term goal
Non-experimental study design includes: a. cause and effect studies b. pre-test and post test observational studies c. descriptive studies d. quasi-experimental studies
C
Which factor in a research report indicates that the study used a qualitative design? a.Hypotheses are stated b. Participants were randomly assigned to an intervention and control group c. The participants were part of a purposive sample d. Participants completed a questionnaire to measure their understanding of the topic
C
Which is considered an essential element of the informed consent form for a research study? a.Witnessing signature of the researcher's supervisor b. Listing all institutional review board members that approved the study c. Assuring anonymity and confidentiality d. Listing of physical risks only due to the potential upsetting nature of described psychological risks
C
Which statement is true about the impact factor of journals? a.It is a referred source b. The lower the impact, the more it is accessed c. The higher the impact, the higher it is cited d. It determines the strength of the study design
C
Which of the following nursing interventions are written correctly? Select all that apply. A. Apply continuous passive motion machine during day. B. Perform neurovascular checks. C. Elevate head of bed 30 degrees before meals. D. Change dressing once a shift.
C. Elevate head of bed 30 degrees before meals.
Based on Patricia Benner's Novice to Expert Theory, a nursing administrator would be most likely to support: a.Evidence- based seminars on current research topics b. Better work schedules to improve nurse satisfaction c. More nurses in clinical settings d. An evidence-based internship for new graduates
D
The major difference that is usually found when comparing an experimental study to a quasi-experimental design is that: a.there is no manipulation of the independent variable in a quasi-experimental study b. there is no baseline measure in a quasi-experimental study c. there is no intervention in a quasi-experimental study d. there is no randomization in a quasi-experimental study
D
The nurse understands that key elements of a systematic review include what? a. Clearly stated problems b. Funding agencies cited c. Evidence tables d. All of the above
D
The nurse wants to eliminate a bias where people say what they think you want them to hear. This type of bias is: a. Sample bias b. Recall bias c. Selection bias d. Social acceptability bias
D
The ultimate goal if evidence based practice is to: a.Identify new questions b. Disseminate educational facts c. Obtain a large sample size d. Utilize findings into practice
D
What is it like to be a Latino youth seeking health care services in a rural community in the U.S? a.Case study b. Phenomenology c. Grounded theory d. Ethnographic method
D
What is the KEY term associated with Clinical Practice Guidelines? a.Uniformity b. Variability c. Assessment d. Standardization
D
Which concept cannot be measured using statistics due to the fact that it comes from the research process itself? a. Random sampling error b. Margin of error c. Causality d. Bias
D
Well formulated, client-centered goals should: A. Meet immediate client needs. B. Include preventative health care. C. Include rehabilitation needs. D. All of the above.
D. All of the above.
The primary nurse asked a clinical nurse specialist (CNS) to consult on a difficult nursing problem. The primary nurse is obligated to: A. Implement the specialist's recommendations. B. Report the recommendations to the primary physician. C. Clarify the suggestions with the client and family members. D. Discuss and review advised strategies with CNS.
D. Discuss and review advised strategies with CNS.
Collaborative interventions are therapies that require: A. Physician and nurse interventions. B. Nurse and client interventions. C. Client and Physician intervention. D. Multiple health care professionals.
D. Multiple health care professionals.
The International Council of Nurses (ICN) definition of nursing
"Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups, and communities, sick or well, and in all settings. Nursing includes the promotion of health; prevention of illness; and the care of ill, disabled, and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles."
After collecting detailed assessment data, a nurse verbally summarizes the data aloud. What are the reasons that the nurse takes this approach? (Select all that apply.) Client has an opportunity to validate the data Client gains social support Client becomes more aware of the need for behavioral change Client develops increased health literacy Client avoids illness behavior
-Client has an opportunity to validate the data -Client becomes more aware of the need for behavioral change
What are they aspects of wellness ?
-Self-responsibility -ultimate goal -dynamic growing process -daily decision making in areas of nutrition -Stress management -physical fitness -preventive health care -emotional health
A geriatric nurse is explaining the concept of the illness-wellness continuum to an older couple who have become homebound. Which of the following could the nurse tell them is true about their situation? (Select all that apply.) Their perception of each other's health is important. . They can expect to die prematurely. They will have good days and bad days. They can expect to fully recover mobility. Their perception of their own health is important.
-Their perception of each other's health is important. -They will have good days and bad days. -Their perception of their own health is important.
Which part of an evidence-based article includes the major themes or findings and the implications for nursing practice? 1 Abstract 2 Introduction 3 Literature review 4 Manuscript narrative
1 Abstract An abstract is a brief summary that quickly tells whether the study is research-based or clinically based. This part of the evidence-based article includes the major themes or findings and the implications for nursing practice. The introduction contains more information about the purpose of the article. The literature review offers an argument about what led the author to conduct the study or report. The manuscript narrative is the middle section, which differs according to the type of evidence-based article it is (that is, a clinical article or a research article).
The nurse caring for patients in an inpatient unit asks a clinical question using a PICOT format. What does C stand for in a PICOT question? 1 Comparison of interest 2 Client who is admitted 3 Care provided 4 Current diagnosis
1 Comparison of interest There are five elements of a PICOT question. P stands for the patient identified by age, gender, ethnicity, and disease or health problem. I stands for intervention of interest. C stands for comparison of interest. O stands for outcomes, and T stands for time. C does not stand for client, care, or current diagnosis.
A patient reports difficulty seeing objects at a distance after a cerebrovascular accident. What would the nurse anticipate? 1 Risk of falls 2 Anxiety related to fear of falling 3 Unilateral neglect due to brain injury 4 Impaired physical mobility on one side of the body
1 Risk of falls The nursing diagnosis for a patient who experiences a cerebrovascular accident and reports difficulty seeing objects at a distance will be at elevated risk of falls. If a patient is worried about falling and health status, the nurse may identify anxiety related to fear of falling. If the nurse finds that the patient does not eat food on one side of the plate, it may indicate unilateral neglect due to brain injury. If a patient has difficulty performing fine and gross motor skills on one side of the body, it indicates impaired physical mobility on one side of the body.
The nurse is caring for a 70-year-old patient who lives with her children and grandchildren in an extended family. The patient is suffering from chronic bronchitis and does not want to be admitted to the hospital. The family has decided to take care of her at home. The patient's 35-year-old daughter takes care of the patient. What questions should the nurse ask to assess the coping process of the family? Select all that apply. 1 "How did your family solve their previous problems?" 2 "How does your family celebrate different festivals?" 3 "Does your family give equal importance to all members?" 4 "How does your family solve financial problems?" 5 "Do your family members suffer from any addictions?"
1 "How did your family solve their previous problems?"3 4 "How does your family solve financial problems?" 5 "Do your family members suffer from any addictions?
The nurse is teaching a family about the caregiver's role. What changes in a caregiver should the family learn to identify as signs of caregiver role strain? Select all that apply. 1 The caregiver has a change in appetite. 2 The caregiver is socially withdrawn. 3 The caregiver is fearful of learning new therapies. 4 The caregiver experiences anger and irritability. 5 The caregiver takes an interest in his or her personal appearance.
1 The caregiver has a change in appetite. 2 The caregiver is socially withdrawn. 3 The caregiver is fearful of learning new therapies. 4 The caregiver experiences anger and irritability. When a caregiver experiences role strain, there will be a change in the caregiver's appetite or weight. The caregiver is socially withdrawn due to limited opportunities for socialization. The caregiver will be fearful of learning new therapies or administering new medication to the patient due to stress. Role strain also brings behavioral changes such as anger and irritability. A caregiver who experiences role strain is too stressed to care about his or her personal appearance.
The public health nurse is working with the county health depart- ment on a task force to fully integrate the goals of Healthy People 2020. In the immigrant community most of the population does not have a primary care provider, nor do they participate in health promotion activities; the unemployment rate in the community is 25%. How does the nurse determine which goals need to be included or updated? (Select all that apply.) 1. Assess the health care resources within the community.2. Assess the existing health care programs offered by the county health department. 3. Compare existing resources and programs with Healthy People 2020 goals. 4. Initiate new programs to meet Healthy People 2020 goals.5. Implement educational sessions in the schools to focus on nutritional needs of the children.
1, 2, 3
The nurse in a new community-based clinic is requested to com- plete a community assessment. Order the steps for completing this assessment.1. Structure or locale2. Social systems3. Population
1, 3, 2
Which is the best explanation of the difference between a medical diagnosis and a nursing diagnosis? 1. A medical diagnosis defines an illness or disease with a certain pathology, while a nursing diagnosis is geared toward the client's health status and how a nurse can help independently. 2. A medical diagnosis is made by a physician, and a nursing diagnosis is created by a nurse. 3. A medical diagnosis involves interventions and medical treatment, and a nursing diagnosis involves client comfort and activities of daily living. 4. A medical diagnosis determines the nursing diagnosis, while the nursing diagnosis has no bearing on the medical diagnosis.
1. A medical diagnosis defines an illness or disease with a certain pathology, while a nursing diagnosis is geared toward the client's health status and how a nurse can help independently.
When working with a postoperative bariatric client, how can the nurse promote client participation and adherence to the nursing plan? Select All That Apply. 1. Ensure the client feels comfortable asking questions. 2. Keep the instructions simple, clear, and as specific as possible. 3. Determine if the client's goals for weight loss are the same as those in the nursing plan. 4. Help the client set realistic goals. 5. Carry out goal implementation and interventions even when client doesn't "feel like it."
1. Ensure the client feels comfortable asking questions. 2. Keep the instructions simple, clear, and as specific as possible. 3. Determine if the client's goals for weight loss are the same as those in the nursing plan. 4. Help the client set realistic goals.
A patient is worried about her 76-year-old grandmother who is in very good health and wants to live at home. The patient's con- cerns are related to her grandmother's safety. The neighborhood does not have a lot of crime. Using this scenario, which of the following are the most relevant to assess for safety?1. Crime rate, locks, lighting, neighborhood traffic2. Lighting, locks, clutter, medications3. Crime rate, medications, support system, clutter4. Locks, lighting, neighborhood traffic, crime rate
2
The nurse is explaining family structure to a group of nursing students. Which type of family structures need to be modified? Select all that apply. 1 Open structure 2 Very rigid structure 3 Blended family 4 Extremely open structure 5 Adaptable family structure
2 Very rigid structure 4 Extremely open structure A very rigid structure dictates the ability of one family member to do a task. The family faces difficulty when the member is unable to do the specified task. Extremely open structure may lead to inconsistent behavior patterns, which can confuse the family members. An open structure can promote healthy family relationships as the family can adjust to sudden changes. The adaptable family structure makes it easy for family members to adapt during a crisis or sudden changes and still maintain healthy relationships. A blended family is not a type of family structure.
A 55-year-old patient is diagnosed with lung cancer and has a history of smoking. To find the association between smoking and lung cancer, the nurse decides to use a case-control study. Before proceeding to implementation, the nurse should obtain informed consent from the study subjects. Which are involved in informed consent? Select all that apply. 1 The patient and a family member should sign the consent form. 2 The patient should be capable of understanding the research procedure. 3 Once the patient has signed the forms, the patient must participate until the end of the research. 4 Informed consent ensures the patient that all the information of the study will be confidential. 5 The patient has the right to refuse to participate at any point of time in the research.
2, 4, 5 Informed consent means that the research subjects are given full and complete information about the study, including the purpose of the study, procedures, data collection, potential harm and benefits, and alternative methods of treatment. An informed consent implies that the information rendered by the patient will be kept confidential. The patient has the right to withdraw from the study at any point in time. If the patient is participating in the study, the family members are not required to sign the consent form. Signing a consent form does not mean that the patient has to participate until the end of the research. The patient can withdraw at any time.
A nursing student is giving a presentation to a group of other nursing students about the needs of patients with mental illnesses in the community. The nursing professor needs to clarify the student's presentation when the student states: 1. "Many patients with mental illness do not have a permanent home." 2. "Unemployment is a common problem experienced by people with a mental illness." 3. "The majority of patients with mental illnesses live in long- term care settings." 4. "Patients with mental illnesses are often at a higher risk for abuse and assault."
3
A nurse has created a plan of care that involves assisting a client with ambulation. She attempts to get the client out of bed, but the client is obese and unable to move without pain. What action should the nurse take? 1. Change the outcome goals. 2. Document the attempt to ambulate the client. 3. Request assistance with ambulating the client. 4. Amend the nursing diagnosis and interventions.
3. Request assistance with ambulating the client.
A community nurse in a diverse community is working with health care professionals to provide prenatal care for underem- ployed and underinsured South African women. Which overall goal of Healthy People 2020 does this represent? 1. Assess the health care needs of individuals, families, or communities. 2. Develop and implement public health policies and improve access to care. 3. Gather information on incident rates of certain diseases and social problems. 4. Increase life expectancy and quality of life and to eliminate health disparities.
4
Vulnerable populations of patients are those who are more likely to develop health problems as a result of: 1. Chronic diseases, homelessness, and poverty 2. Poverty and limits in access to health care services 3. Lack of transportation, dependence on others for care, and homelessness 4. Excess risks, limits in access to health care services, and depen- dency on others for care
4
The nurse understands the evidence-based articles and is critiquing the available evidence. Which characteristic feature should the nurse look for in a well-written literature review? 1 It mentions the purpose of the article. 2 It includes a short summary that contains brief information about the study. 3 It explains a new therapy or new technology. 4 It includes an argument about what led the author to conduct a study or report on a clinical topic.
4 A well-written literature review offers an argument about what led the author to conduct a study or report on a clinical topic. The literature review also provides a detailed background of the level of science or clinical information that exists about the research study. An abstract is a short summary that contains brief information about the study. An introduction contains more information about the purpose of the article. A manuscript narrative provides information regarding new therapy or new technology.
Which activity regarding the research process should the nurse conduct to determine what has already been studied about the research problem of interest? 1 Construct a theoretical framework. 2 Identify variables. 3 Formulate a hypothesis. 4 Review the literature.
4 Review the literature. A literature review provides a logical but abstract structure that suggests the relationship among the variables in a research study, allowing for the organization and explanation of all the information in the study. All available literature related to the nurse's research problem should be reviewed to provide a theoretical framework as a foundation for the research study. Variables are concepts in the study that are expected to change or differ from one person or time to another. A hypothesis is a prediction that should be based on previous research, so it is developed after conducting a review of the literature.
A nurse is preparing to make a consult. In which order, beginning with the first step, will the nurse take? 1. Identify the problem. 2. Discuss the findings and recommendation. 3. Provide the consultant with relevant information about the problem. 4. Contact the right professional, with the appropriate knowledge and expertise. 5. Avoid bias by not providing a lot of information based on opinion to the consultant. a. 1, 4, 3, 5, 2 b. 4, 1, 3, 2, 5 c. 1, 4, 5, 3, 2 d. 4, 3, 1, 5, 2
A
A group of elderly patients are enrolled in an intervention to increase the distance they walk every day. The researcher wants to compare the distance they walked before and after the intervention. The statistical test that would be most appropriate for this analysis us: a.T-test b. Odds ratio c. Chi square d. Correlation coefficients
A
A group of researchers are trying to develop a new screening test for the EBOLA virus. For this to be an effective test it should have: a.High specificity/high sensitivity b.high specificity/low sensitivity c.low specificity/high sensitivity d.low specificity/low sensitivity
A
A nurse is developing a care plan. Which intervention is most appropriate for the nursing diagnostic statement Risk for loneliness related to impaired verbal communication? a. Provide the patient with a writing board each shift. b. Obtain an interpreter for the patient as soon as possible. c. Assist the patient in performing swallowing exercises each shift. d. Ask the family to provide a sitter to remain with the patient at all times.
A
A research nurse is helping with recruitment for a qualitative study. Which statement below shows that the nurse understands the recruitment procedure and number of subjects for participation in a qualitative study? a.Data are collected from new subjects until data saturation is reached b. The number of subjects is the number available at the specific location on a random day c. The number of subjects depends on the number of willing participants within the researcher's specified time frame d. A power analysis of data collected in a pilot study is used to determine the number needed
A
Which scenario best illustrates the nurse using data validation when making a nursing clinical decision for a patient? a. The nurse determines to remove a wound dressing when the patient reveals the time of the last dressing change and notices old and new drainage. b. The nurse administers pain medicine due at 1700 at 1600 because the patient reports increased pain and wants something done. c. The nurse immediately asks the health care provider for an order of potassium when a patient reports leg c d. The nurse elevates a leg cast when the patient reports decreased mobility.
A
While interviewing an older female patient of Asian descent, the nurse notices that the patient looks at the ground when answering questions. What should the nurse do? a. Consider cultural differences during this assessment. b. Ask the patient to make eye contact to determine her affect. c. Continue with the interview and document that the patient is depressed. d. Notify the health care provider to recommend a psychological evaluation.
A
A nurse identifies a fall risk when assessing a patient upon admission. The nurse and the patient agree that the goal is for the patient to remain free from falls. However, the patient fell just before shift change. Which action is the nurse's priority when evaluating the patient? a. Identify factors interfering with goal achievement. b. Counsel the nursing assistive personnel on duty when the patient fell. c. Remove the fall risk sign from the patient's door because the patient has suffered a fall. d. Request that the more experienced charge nurse complete the documentation about the fall.
A ( When goals and outcomes are not met, you identify the factors that interfere with their achievement. The nurse identifies factors that interfered with goal achievement to determine the cause of the fall. The fall may not have been due to an error by the nursing assistive personnel; therefore, counseling should be reserved until after the cause has been determined. The patient remains a fall risk, so the fall risk sign should remain on the door. The nurse witnessing the fall or the nurse assigned to the patient needs to complete the documentation. The charge nurse can be consulted to review the documentation.)
Normal lines of defense in the systems model
A person's normal response to stress. A flexible line defends against unusual stress.
Prejudice
A preformed opinion, usually an unfavorable one, about an entire group based on insufficient knowledge, irrational feelings, or inaccurate stereotypes
Socialization
A process that involves learning the theory and skills necessary for the role of the nurse.
The nurse wants to care for a patient using Swanson's theory of caring. Which of the following are processes included in Swanson's theory of caring? Select all that apply. 1. The researchers measure both groups for the same outcomes to see if there is a difference. 2. The researcher determines if the intervention leads to better outcomes than the standard of care. 3. Subjects are randomly assigned to either the control or treatment group. 4. The treatment group receives the experimental intervention, and the control group receives the usual standard of care.
A randomized controlled trial (RCT) is performed to test an intervention against the standard of care. The subjects are randomized to the treatment or the control group. The treatment group receives the experimental intervention, and the control group receives the usual standard of care. The researcher observes both groups to determine the outcome. On completion, the researcher will determine if the experimental intervention leads to better outcomes when compared to the standard of care.
What is a discipline?
A specific field of study or branch of instruction or learning. Nursing leaders believe nursing needs a theoretical base that reflects its practice.
health
A state of complete physical, mental, and social well being and not merely the absences of disease or infirmity
Illness
A state of health characterized by decreased or impaired abilities to engage in physical or mental functioning that was previously experienced
What is wellness?
A state of well being.
A nurse follows accepted guidelines for a healthy lifestyle. How cant his promote health in others? A. By being a role model for healthy behaviors B. By not requiring sick days from work C. By never exposing others to any type of illness D. By spending less money on food
A. By being a role model for healthy behaviors
The student nurse learns that illnesses are classified as either acute or chronic. Which are examples examples of chronic illnesses? Select all that apply. A. Diabetes mellitus B. Bronchial pneumonia C. Rheumatoid arthritis D. Cystic fibrosis E. Fractured hip F. Otitis media
A. Diabetes mellitus C. Rheumatoid arthritis D. Cystic fibrosis
Which statement made by the nurse is an example of applying the principle of patient-centered care while focusing on alleviation of a patient's fear and anxiety? A. "Let's talk about the concerns that you have about going home." B. "I'll get the medication prescriptions for you before discharge" C. "I'll be back in 30 minutes to help you get cleaned up" D. "I'll make a referral to the home health nurse for you"
A. Interventions that focus on alleviation of fear and anxiety are related to allowing the patient and family time to express fears and concerns, understand the impact that illness will have on the patient's ability to care for himself or herself, and often express worries about ability to pay for medical care. Identifying staff that can help with payment plans alleviates fear and anxiety.
19. The nurse is intervening for a patient that has a risk for a urinary infection. Which direct care nursing intervention is most appropriate? a.Teaches proper handwashing technique b.Properly cleans the patient's toilet c.Transports urine specimen to the lab d.Informs the oncoming nurse during hand-off
ANS: A Teaching proper handwashing technique is a direct care nursing intervention. All the rest are indirect nursing care: cleaning the toilet, transporting specimens, and performing hand-off reports.
7. The nurse is caring for a patient who requires a complex dressing change. While in the patient's room, the nurse decides to change the dressing. Which action will the nurse take just before changing the dressing? a.Gathers and organizes needed supplies b.Decides on goals and outcomes for the patient c.Assesses the patient's readiness for the procedure d.Calls for assistance from another nursing staff member
ANS: C Always be sure a patient is physically and psychologically ready for any interventions or procedures. After determining the patient's readiness for the dressing change, the nurse gathers needed supplies. The nurse establishes goals and outcomes before intervening. The nurse needs to ask another staff member to help if necessary after determining readiness of the patient.
16. The nurse inserts an intravenous (IV) catheter using the correct technique and following the recommended steps according to standards of care and hospital policy. Which type of implementation skill is the nurse using? a.Cognitive b.Interpersonal c.Psychomotor d.Judgmental
ANS: C Nursing practice includes cognitive, interpersonal, and psychomotor skills. Psychomotor skill requires the integration of cognitive and motor abilities. The nurse in this example displayed the psychomotor skill of inserting an intravenous catheter while following standards of care and integrating knowledge of anatomy and physiology. Cognitive involves the application of critical thinking and use of good judgment in making sound clinical decisions. Interpersonal skills involve developing trusting relationships with patients, conveying caring and compassion, and communicating clearly.
11. Which action should the nurse take first during the initial phase of implementation? a.Determine patient outcomes and goals. b.Prioritize patient's nursing diagnoses. c.Evaluate interventions. d.Reassess the patient.
ANS: D Assessment is a continuous process that occurs each time the nurse interacts with a patient. During the initial phase of implementation, reassess the patient. Determining the patient's goals and prioritizing diagnoses take place in the planning phase before choosing interventions. Evaluation is the last step of the nursing process.
What are the main concepts of nursing ethics?
Accountability, advocacy, autonomy(be independent and self motivated), beneficence (acting in best patient interest), confidentiality, fidelity (keep promises), justice (relate to others with fairness and equality), nonmaleficence (do not harm), responsibility, veracity (be truthful).
A patient presents to the emergency department following a motor vehicle crash and suffers a right femur fracture. The leg is stabilized and a full leg cast. Otherwise the patient has no major injuries, is in good health, and reports only moderate discomfort. Which is the most pertinent nursing diagnosis the nurse will include in the plan of care?
Acute pain
Which diagnosis will the nurse document in a patient's care plan that is NANDA approved?
Acute pain
tertiary prevention
Also known as the treatment or rehabilitation stage of preventive care, is implemented when a condition or illness is permanent and irreversible
Linda Richards
America's first trained nurse. She graduated from Boston's Women's Hospital in 1873.
According to Shawnee's Philosophy, the client is who?
An individual, family, group, community, or population and an integrated whole that is unique, adapts and grows, deserves respect, and has the right to make both independent and collaborative choices regarding health care.
What is a profession?
An occupation that requires a specialized body of knowledge and training
Behavioral Risk Factor Surveillance System
An ongoing, state based, random digit dialed telephone survey of the noninstitutionalized U.S population older than 18 year of age. This collects data on health risk behaviors and preventive health services related to the leading causes of death
A researcher is examining the relationship between exercise and heart disease in a sample of women at a senior citizen center. She plans to collect data on their daily activities at one point in time. There is no manipulation of the independent variable. Correct terms that can be used to describe the study are: a.Randomized control experiment b. Correlational, cross-sectional, non-experimental c. Quasi-experimental, retrospective d. Retrospective, cohort, comparative
B
A self-report tool that asks cardiac patients to write a paragraph about three things that increase their fatigue would be described as: a.Subjective, closed-ended b. Subjective, open-ended c. Objective, open-ended d. Objective, closed-ended
B
According to evidence, which of the following situations would be most appropriate to use behavioral pain scales rather than vital signs or number scales alone? a. A 26-year-old male in a cardiac ICU, with no communication limitations or alterations in level of consciousness b. A 72-year-old female who experienced an intracranial hemorrhage. She is intubated and in an induced coma in the neuro ICU c. A 7-year-old child with an asthma exacerbation in the pediatric stepdown unit d. A 42-year-old male with COPD on a medical-surgical floor
B
During a literature review prior to a qualitative study investigating pediatric perceptions of pain after peripheral IV insertion, the researcher finds very little information regarding previous research with this patient population. The researcher's next step should be: a.Begin the study without further literature review b. Review literature on a similar population such as adolescents c. Develop an instrument to identify pain in pediatric patients d. Cancel the study due to limited information and increased risk for harm to patients
B
The FDA has recommendations for performing proper oral care on intubated patients. Which statement made by the nurse indicates an appropriate understanding of performing oral care on a ventilated patient? a. I will use a power toothbrush to brush my patients teeth in the morning, after each meal, and before bed b. I will brush and rinse my patients mouth with chlorohexidine gluconate twice a day and provide oral and lip moisturizing evert 2-4 hours c. I will rinse my patients mouth with alcohol-free mouthwash, brush their teeth, and apply Vaseline every shift d. I will provide oral care and lip moisturizing every 6 hours, avoiding chlorohexidine gluconate because its routine use is only recommended for nonintubated patients
B
The nurse is attempting to prompt the patient to elaborate on the reports of daytime fatigue. Which question should the nurse ask? a. "Is there anything that you are stressed about right now that I should know?" b. "What reasons do you think are contributing to your fatigue?" c. "What are your normal work hours?" d. "Are you sleeping 8 hours a night?"
B
The nurse realizes that qualitative research involves: a. Direct interviewing of participants without IRB approval to collect data b. Prolonged contact with participants c. A more closed-ended question or deductive inductive approach d. All of the above
B
Which action will the nurse take after the plan of care for a patient is developed? a. Place the original copy in the chart, so it cannot be tampered with or revised. b. Communicate the plan to all health care professionals involved in the patient's care. c. File the plan of care in the administration office for legal examination. d. Send the plan of care to quality assurance for review.
B
A nurse is using general systems theory to describe the role of nursing to provide health promotion and patient teaching. Which statements reflect key points of this theory? Select all that apply. A. A system is a set of individual elements that rarely interact with each other B. The whole system is always greater than its parts C. Boundaries separate systems from each other and their environments D. A change in one subsystem will not affect other subsystems E. To survive, open systems maintain balance through feedback F. A closed system allows input form and to the environment
B, C, E
A nurse's neighbor tells the nurse, "I have a high temperature, feel awful, and I am not going to work." What state of illness behavior is the neighbor exhibiting? A. Experiencing symptoms B. Assuming the sick role C. Assuming a dependent role D. Achieving recover and rehabilitation
B. Assuming the sick role
When and where did Shawnee's ADN program start?
Began in 1969 at the Ohio university Portsmouth campus under direction of Ms. Gladys Scott.
Which of the following is the recommended time to change a sterile gauze dressing and a transparent dressing? a. Sterile gauze dressing should be changed in 7 days and transparent dressing should be changed in 2 days. b. Sterile gauze dressing should be changed in 3 days and transparent dressing should be changed in 6 days. c. Sterile gauze dressing should be changed in 2 days and transparent dressing should be changed in 7 days. d. Sterile gauze dressing should be changed in 7 days and transparent dressing should be changed in 10 days.
C
Which statement by a nurse indicates a good understanding about the differences between data validation and data interpretation? a. "Data interpretation occurs before data validation." b. "Validation involves looking for patterns in professional standards." c. "Validation involves comparing data with other sources for accuracy." d. "Data interpretation involves discovering patterns in professional standards."
C
The database that is most closely focused on articles published in nursing journals is: a. Medline b. The Cochrane collaboration c. CINAHL d. Dynamed
C
The nurse completes a thorough assessment of a patient and analyzes the data to identify nursing diagnoses. Which step will the nurse take next in the nursing process? a. Assessment b. Diagnosis c. Planning d. Implementation
C
The nurse is gathering data on a patient. Which data will the nurse report as objective data? a. States "doesn't feel good" b. Reports a headache c. Respirations 16 d. Nauseated
C
The nurse performs an intervention for a collaborative problem. Which type of intervention did the nurse perform? a. Dependent b. Independent c. Interdependent d. Physician-initiated
C
Theoretical frameworks: a.Always have a high level of predictability for the phenomenon studied b. Can only be developed after randomized controlled trials are conducted c. Are dynamic and need to be revised as additional studies are conducted d. Are most effective when they explain a very narrowly defined phenomenon
C
A nurse has volunteered to give influenza immunizations at a local clinic. What level of care is the nurse demonstrating? A. Tertiary B. Secondary C. Primary D. Promotive
C. Primary
Which of the following are included in a family function assessment? (Select all that apply.)
Cultural practice Decision making Rituals and Celebrations cultural practices help identify culturally related health practices, diets, and religious practices. Decision making provides information as to how the family copes and meets challenges related to changes in family life or dynamics. Rituals and celebrations address how a family celebrates accomplishments and how they deal with challenges. Neighborhood crime data are relevant for community assessment, but they do not give sufficient information about family function.
The new nurse is caring for six patients in this shift. After completing their assessments, the nurse asks where to begin in developing care plans for these patients. Which statement is an appropriate suggestion by another nurse? a. "Choose all the interventions and perform them in order of time needed for each one." b. "Make sure you identify the scientific rationale for each intervention first." c. "Decide on goals and outcomes you have chosen for the patients." d. "Begin with the highest priority diagnoses, then select appropriate interventions."
D
Which of the following is true regarding family presence during resuscitation and invasive procedures? a. Family presence improves medical decision making and patient care b. There were no adverse psychological effects reported among family members who remained at the bedside compared to families who did not c. Policies and procedures should include criteria and contraindications to ensure uninterrupted patient care d. All of the above
D
While the patient's lower extremity, which is in a cast, is assessed, the patient tells the nurse about an inability to rest at night. The nurse disregards this information, thinking that no correlation has been noted between having a leg cast and developing restless sleep. Which action would have been best for the nurse to take? a. Tell the patient to just focus on the leg and cast right now. b. Document the sleep patterns and information in the patient's chart. c. Explain that a more thorough assessment will be needed next shift. d. Ask the patient about usual sleep patterns and the onset of having difficulty resting.
D
A nurse is formulating a clinical question in PICO format. What does the letter "P" represent? A. Comparison to another similar treatment B. Clearly defined, focused literature review C. Specific identification of the desired outcome D. Explicit descriptions of the population of interest
D The "P" in PICO format represents an explicit description of the patient population of interests. "I" represents the intervention, "C" represents the comparison, and "O" stands for the outcome
Karen Johnson is a single mother of a school-age daughter. Linda Brown is also a single mother of two teenage daughters. Karen and Linda are active professionals, have busy social lives, and date occasionally. Three years ago they decided to share a house and housing costs, living expenses, and child care responsibilities. The children consider one another as their family. This family form is considered a(n):
D. Alternative Family relationship: This relationship includes multiadult households, "skip-generation" families, communal groups with children, "nonfamilies," cohabitating partners, and homosexual couples.
When providing health promotion classes, a nurse uses concepts from models of health. What do both the health-illness continuum and the high-level wellness models demonstrate? A. Illness as a fixed point in time B. The importance of family C. Wellness as a passive state D. Health as a constantly changing state
D. Health as a constantly changing state
When nurses view the family as context, their primary focus is on the:
D. Health needs of an individual member: When you view the family as context, the primary focus is on the health and development of an individual member existing within a specific environment (i.e., the patient's family). Although the focus is on the individual's health status, assess how much the family provides the individual's basic needs.
Which activity performed by the nurse is related to maintaining competency in nursing practice? A. Asking another nurse about how to change the settings on a medication pump B. Regularly attending unit staff meetings C. Participating as a member of the professional nursing council D. Attending a review course in preparation for the certification examination
D. Maintaining ongoing competency is a nurse's responsibility. Earning certification in a specialty area is one mechanism that demonstrates competency. Specialty certification has been shown to be positively related to patient safety.
because of Managed Care, the number of days pts can stay in the hospital is limited based on their
DRG's
A nurse adds a nursing diagnosis to a patient care plan. Which information did the nurse document?
Decreased cardiac output it related to altered myocardial contractility
The patient database reviews that a patient has decreased oral take, decreased oxygen saturation when ambulating, reports shortness of breath when getting out of bed, and a productive cough. Which elements will the nurse identify as defining characteristics for the diagnostic label of activity intolerance?
Decreased oxygen saturation when ambulating and reports of shortness of breath when you getting out of bed
perceived susceptibility change strategy
Define the populations at risk. Tailor risk information to the individuals characteristics or behaviors. Help the individual develop an accurate perception of his or her own risk
stage 4 of illness model
Dependent patient role; the person, who is designated as the patient, undergoes treatment
Healthy People 2020
Designed to track, over 10-yr increments, the risk factors and personal behaviors related to physical activity, access to health services, tobacco use, substance use, responsible sexual behavior, mental heath, immunizations, and injury and violence prevention
A nurse performs an assessment on a patient. Which assessment data will the nurse use as an etiology for acute pain?
Disruption of tissue integrity
A nurse assesses a patient has not going did in six hours. Which question should the nurse asked to assist in establishing a nursing diagnosis?
Do you feel like you need to go to the bathroom?
Who is by far the hottest Nursing student at lsue? (Hint not Ruby)
Dougie Fresh
Funding sources for research include: a.NIH b. NINR c. Private Foundations d. A and B e. All of the above
E
secondary acute care
ED, acute med-surg, asymptomatic,
David Singer is a single parent of a 3-year-old boy, Kevin. Kevin has well-managed asthma and misses day care infrequently. David is in school studying to be an information technology professional. His income and time are limited, and he admits to going to fast-food restaurants frequently for dinner. However, he and his son spend a lot of time together. David receives state-supported health care for his son, but he does not have health insurance or a personal physician. He has his son enrolled in a government-assisted day care program. Which of the following are risks to this family's level of health? (Select all that apply.) economic status chronic illness underinsured government-assisted day care frequency of fast food dinners state-supported housing
Economic Status Underinsured economic status is stretched. He has multiple resources for his son, but he is not insured. Thus, as a result, there is a potential that David does not follow through with personal health promotion activities. Although asthma is a chronic illness, this is well managed, and there is adequate health care for his son.
Cues to action definition
Factors that activate readiness to change
Which of the following are possible outcomes with clear family communication? (Select all that apply.) family goals increased socialization decision making methods of discipline improved education impaired coping
Family goals Decision making Methods of Discipline
Licensure
Granting of a license that provides legal permission to practice
National patient safety goals by TJC
Improve the accuracy of patient identification, improve the effectiveness of communication among caregivers, improve safety of using medications, reduce harm Assisi aged with clinical alarm systems, reduce the risk of health care associated infections. The hospital must identify safety risks inherent in its patient population.
A patient with a spinal cord injury is seeking to enhance urinary elimination abilities by learning self catheterization versus assisted catheterization by home health nurses and family members. The nurse adds readiness for enhanced urinary elimination in the care plan. Which type of diagnosis did the nurse write
Health promotion
According to Shawnee's Philosophy, what is the environment and how does the client affect it?
It is cultural, spiritual, social, economic, political, and physical surroundings affecting the clients safety and quality of the client's health. Client can alter the environment to enchanted or diminish his/her ability to achieve a desired level of well-being
A new nurse writes the following diagnoses on a patient care plan. Which nursing diagnosis will close to the nurse manager to intervene?
Hemorrhage
Florence Nightingale's environmental theory
Her concept of the environment emphasized illness prevention, clean air, water, and housing. Her theoretical work discussed environmental adaption with appropriate noise levels, hygiene, light, comfort, socialization, hope, nutrition, and conservation of patient energy. Theory states that the imbalance between the patient and the environment decreases the capacity for health and does not allow for conservation of energy.
Which theory has been used widely in psychiatric nursing and enchanted the understanding of changing aspects regarding the goals and roles in the nurse-patient relationship?
Hildegard peplau theory of interpersonal relations
Which question would be most appropriate for a nurse to ask a patient to assist in establishing a nursing diagnosis of diarrhea?
How many bowel movement a day have you had?
Martha Roger's Theory of Unitary Human Beings (1970)
Human beings and their environments are interacting in continuous motion as infinite energy fields. The model includes four dimensions (energy fields, openness, patterns and organizations, and dimensionality). The dimensions are used in developing the three principles of resonancy (continuous change from higher to lower frequency), helicy (increasing diversity), and integrality (continuous process of human and environment fields). The resultant well-being of pattern and organization includes and symphonic interactions between the patient and the environment.
what is the most expensive health care delivery site because each nurse usually cares for one or two pts at a time?
ICU
Betty Neuman's Systems Model (1972)
Includes holistic concept and an open-system approach. Model identifies energy resources that provide for basic survival, with lines of resistance that are activated when a stressor occurs. Stressors May be interpersonal, interpersonal, or extra personal. Three environments (internal, external, and created) are defined, and nursing actions involve three levels of prevention (primary, secondary, and tertiary.) the nurses goal is to assist in maximum wellness, focus on patient reaction to stressors, and strengthen their line of defense.
Imogene King's General systems framework (1971)
Incorporates three levels of systems: individual/personal, group/interpersonal, and society/social. The theory of goal attainment discusses the importance of interaction, perception, communication, transaction, self, role, stress, growth and development, time, and personal space. In this theory, the nurse and the patient work together to achieve the goals in the continuous adjustment to stressors.
What is low health literacy associated with?
Increased hospitalization, greater emergency care use, lower use of mammography, and lower receipt of influenza vaccine
What are other characteristics of a leader?
Integrity, creativity, interpersonal skills, the ability to think critically, and problem solve. Nurse leaders should ALWAYS motivate others toward common goals
A nurse is caring for a client who is postoperative from an open appendectomy. The client uses an overhead trapeze bar to transfer position in bed. Which type of exercise is demonstrated with this action? Isotonic Isokinetic Isodynamic Isometric
Isotonic
What does a conceptional model address?
It addresses the four concepts of nursing metaparadigm: optimal functioning of the person or patient, how people interact with the environment, illness and health promotion, and nursing roles.
Five processes that characterize caring
Knowing, being with, doing for, enabling, maintaining belief
According to Shawnee's Philosophy, what is learning?
Learning is a continuous process involving cognitive, affective, and psychomotor skills. Self-discovery and personal growth in the learning process are enhanced and encouraged in an environment of professional collaboration.
Diversity consideration that influence health
Lifespan, gender, disability, morphology
A client was recently diagnosed with type 2 diabetes. This diagnosis led to changes in diet, recommended activity level, and frequent glucose monitoring during waking hours. What kind of changes is the client experiencing? Lifestyle changes Emotional changes Body image changes Self-concept changes
Lifestyle changes
A nurse working in a pulmonary rehabilitation clinic is conducting an exercise session for a group of clients with chronic obstructive pulmonary disease (COPD). Which exercises will the nurse include because they are most beneficial for clients with COPD? Stationary arm bicycle Lunges Squats Bicep curls Stair climbing
Lunges Squats Stair climbing
American Nurses Credentialing Center established
Magnet recognition program to recognize health care organizations that achieve excellence in nursing practice
Collaborator role of the nurse
Make sure that all goals are met, and is responsible for ensuring that all patient care orders are carried out and for communicating with the entire team
Starndards
Minimum set of criteria
Middle Range theory
Moderately abstract and has a limited number of variables. These theories are more concrete and narrowly focused on a specific condition or population than grand theories.
Rosemarie Rizzo Parse's Human Becoming Theory (1981)
Modernly called the Human Becoming School Of Thought, this theory was created by combining concepts from Martha Rogers' Science of Unitary Human Beings with existential-phenomenological thought. This theory looks at the person as a constantly changing being and at nursing as a human science
How does the WHO (World Health Organization) define health?
More holistic to view of health. It defines health as a "state of complete physical, mental, and social well being, and merely the absence of disease or infirmity."
Zero order beliefs
Most of which are unconscious such as object permanence
The scientific process that nurses use to care for their patients is the multi step attach called the nursing process. What is followed as a care provider?
Nurses assess patient data, prioritize nursing diagnoses, plan the care of the patient, and implement the appropriate interventions, and evaluate care in an ongoing cycle
Researcher role of the nurse
Nurses critique research studies and apply research to practice. Nurses determine care concerns and ask questions about them. Problems in nursing become the basis of research. By incorporating research into their practice, nurses are involved in evidence based practice.
Values conflict
Occurs when there is an actual or perceived difference between two or more belief systems
Perceived barriers change strategy
Offer reassurance, incentives, and assistance; Forrest misinformation or allegations
Caring
Often considered to be synonymous with nursing, is a fundamental value for nurses in both their personal and professional lives
self-efficacy
One's belief in his or her own ability to perform a task
What two theories were developed from Betty Neuman's Systems Model?
Optimal patient stability and prevention as intervention
Many older homes in a neighborhood are undergoing a lot of restoration. Lead paint was used. The community clinic in the neighborhood is initiating a lead screening program. This activity is based on which social determinant of health?
Physical environment
What are the seven dimensions of optimal health?
Physical, emotional, social, intellectual, spiritual, environmental, and occupational
Maslow's Hierarchy of Needs theory
Physiological, safety/security, love/belonging, self-esteem, self actualization
How do elementary school children react to trauma and loss?
Poor concentration, irritability, aggressiveness, clinging to parents, nightmares, school avoidance, and withdrawal from friends and activities
Nurse practice acts
Provide the scope of practice defined by each state or jurisdiction and set forth the legal limits of nursing practice
A nurse is caring for an older adult who complains of dry mouth. The client states, open double quote"Food just doesn't taste the same anymore.close double quote" The nurse understands that the client's dry mouth may be the cause of the client's altered taste. Which statement is true regarding saliva and taste?
Saliva liquefies food chemicals so that they can be tasted, so a decrease in saliva will decrease taste
What is Florence Nightingale known for?
She is considered the founder of modern nursing and is known for her care of the sick in the Crimean War. Her contributions influences developments in the field of epidemiology by connecting poor sanitation to cholera and dysentery. Her role in nursing included establishing nursing as a respected profession for nursing that was distinct from other medical professions. She is also known for founding a nursing school and stressing the need for university based and continuing education for nursing
A nurse is caring for a newborn with a congenital malformation of the oral soft palate. The nurse understands that if this malformation is not surgically repaired, the newborn will have future problems. Which problems will this client be at risk for developing in the future if the malformation is not repaired?
Swallowing problems because the soft palate closes off the esophagus when swallowing Swallowing problems because the soft palate includes the uvula, which aids in swallowing
Stage 1 of illness model
Symptom experience; a clinical manifestation of disease is experienced, and the person acknowledges that something is wrong and seeks a cure
The nurse is caring for a 70-year-old patient who lives with her children and grandchildren in an extended family. The patient is suffering from chronic bronchitis and does not want to be admitted to the hospital. The family has decided to take care of the patient at home. The patient's 35-year-old daughter takes care of the patient. What interventions should the nurse suggest to manage the caregiver's role strain? Select all that apply. 1 Set alternating schedules to give the caregiver some rest. 2 Arrange a support system to provide groceries, meals, and housekeeping for the caregiver. 3 Identify community resources such as support groups. 4 Suggest that the patient be hospitalized. 5 Educate and provide training to the caregiver for effective caregiving.
The nurse is caring for a 70-year-old patient who lives with her children and grandchildren in an extended family
A community health nurse is providing education to a group of adults about the types of exercise that promote health. Which statements will the nurse include in the teaching?
The talk test may be easier to use than the heart rate calculation for determining effort in aerobic exercise. An example of an anaerobic exercise is weight lifting. Isotonic exercises are also known as dynamic exercises.
A nurse is performing an oral health nursing assessment on an adult client. The nurse notes the presence of pyorrhea. What does this finding indicate? The presence of periodontal disease The presence of stomatitis The presence of fungal disease The presence of glossitis
The presence of periodontal disease
Delegation
The process of entrusting or transferring the responsibility for certain tasks to other personnel, including UAP, LVNs, and LPNs.
Joyce Travelbee: Human-to-Human Relationship Model
The purpose of nursing is achieved though human to human contact. Model describes steps toward "compassionate" and "empathetic" care, which is not included in other theories, making it as relevant today as it was when the theory was developed
conceptual framework or model
The third level of knowledge. This is a collection of interrelated concepts that provides direction for nursing practice, research, and education.
Maslow's Hierarchy of Needs describes what?
The relationships between the basic requirements for survival and the desires that drive personal growth
In 1860, Florence Nightingale said what in her "Notes on Nursing"?
The role of nursing: "to put the patient in the best condition for nature to act upon him"
Professional Standards review organization (PSRO)
created by the federal government, to review the quality, quantity, and cost of hospital care
How do preschoolers react to trauma and loss?
Thumb sucking, clinging to parents, bed wetting, sleep disturbances, fear of the dark, loss of appetite, regression in behavior, and routine withdrawal
Why is it important to teach the parents of newborn and infant clients to place infants to sleep on their backs? To decrease the risk of SIDS To decrease the risk of aspiration To increase REM sleep To increase light sleep
To decrease the risk of SIDS
After assessing a patient, a nurse develops a standard formal nursing diagnosis. What is the rationale for the nurses actions?
To distinguish the nurses role from the physicians role
A nurse is caring for a client in a primary care clinic who has osteoporosis but is in otherwise good health. Which statement made by the nurse is most appropriate when teaching this client about the benefits of exercise? Non-weight-bearing exercise is most beneficial in your condition. Weight-bearing exercise increases the number of osteoblasts of the bone Swimming is most beneficial for your condition. Walking is an excellent choice of exercise for your condition.
Walking is an excellent choice of exercise for your condition.
Dorothea Dix
Was the head of the U.S. Sanitary Commision, which was a forerunner of the Army Nurse Corps. She was also the Superintendent of Women Nurses for the Union Army during the Civil War and was an advocate for the mentally ill in the 1860s.
Stereotypes
When generalizations are treated as if they are always true. This is a conceptualized depiction of a person, a group, or an event that is thought to be typical of all others in that category.
First-order beliefs
Which are conscious, typically relating to direct experiences
health promotion
behavior motivated by the desire to increase well-being and optimize health status
what is the National Priorities Partnership?
a group of 28 organizations from a variety of health care disciplines that have joined together to work toward transforming healthcare
larger health care systems have integrated delivery networks that include
a set of providers and services organized to deliver a continuum of care to a population of patients at a captivated cost in a particular setting.
Values system
a set of somewhat consistent values and measures that are organized hierarchically into a belief system on a continuum of relative importance
hospice
a system of family centered care that allows pts to live and remain at home with comfort and dignity while easing the pains of terminal treatment
How should a nurse researcher expect a sample to differ from a population? Select one: a. A sample is a representative segment of a defined population. b. A population has a narrow set of defining characteristics, and a sample has a broad set of defining characteristics. c. A sample can mean objectives or events, and a population refers to individuals or groups. d. A well-designed sampling method will ensure that the sample has a different set of characteristics from a population.
a. A sample is a representative segment of a defined population.
A nurse researcher is planning to write a proposal for a research study using a quantitative design. Which of the following would be likely to reduce control in the study? Select one: a. Encourage the researcher's family members to participate in the study. b. Standardize data collection processes. c. Use trained data collectors. d. Use psychometric tools with established reliability and validity.
a. Encourage the researcher's family members to participate in the study.
The following is an example of what type of data collection tool? "How satisfied are you with your care while you were in the hospital?" 1 Very satisfied 2 Moderately satisfied 3 Undecided 4 Moderately dissatisfied 5 Very dissatisfied Select one: a. This is a Likert scale used on a questionnaire or survey. b. This is biometric data. c. This is observational data, used to establish interrater agreement. d. This is an example of using a focus group.
a. This is a Likert scale used on a questionnaire or survey.
What is the overall purpose of the research design in a quantitative study? Select one: a. To provide the plan for answering the research questions. b. To assist the researcher in identifying gaps in the scientific knowledge base. c. To identify the problem statement. d. To determine the sample size for the study.
a. To provide the plan for answering the research questions
assisted living
an attractive long term care setting with an environment more like home.
continuing care
assisted living, psych and older adult day care, disease management is most common and expensive
What is an example of a primary source in a literature review? Select one: a. An edited textbook on nursing research b. A journal article written by a researcher describing the study they conducted c. A review of theoretical frameworks used in nursing research d. A critique of a nursing research study
b. A journal article written by a researcher describing the study they conducted
preventative care
blood pressure and cancer screening, immunizations, mental health counseling
The nurse plans to teach a client about good skin hygiene (daily bathing schedule dependent on age and use of lotions). In this case, the nursing action is considered to be a) A nursing action that requires a physician order to implement b) cooperative. c) a nursing action focused on health promotion, illness prevention, and patient advocacy. d) A nursing action where the nurse is responsible primarily for monitoring for complications of acute illness or providing care to prevent or treat complications.
c) a nursing action focused on health promotion, illness prevention, and patient advocacy.
Which of the following study designs indicates the highest level of evidence? Select one: a. A randomized controlled trial (RCT) b. A case study c. A meta-analysis d. A quasi-experimental study
c. A meta-analysis
Holistic
concerned with the whole: (physical, mental, emotional, spiritual, and social)
Grand theory
consists of a global conceptual framework that defines broad perspectives for nursing practice and provides ways of looking at nursing phenomena from a distinct nursing perspective. This defines key concepts and principles of the discipline in an abstract way
systems of managed care focus on
containing or reducing costs, increasing pt satisfaction, and improving the health or functional status of individuals
The nurse researcher designed a study examining anxiety among elementary school children. If a widely publicized murder of a child occurred in the city during the time frame of the study, what type of threat to internal validity would the murder represent? Select one: a. Instrumentation b. Maturation c. Selection bias d. Historical
d. Historical
What is the dependent variable in the following research question: "How does maternal employment among health care professionals affect infant health during the first 6 months of life?" Select one: a. Maternal employment b. Health care professionals c. First 6 months of life d. Infant health
d. Infant health
Which of the following is an example of nominal level data? Select one: a. Educational level b. Test scores c. Weight d. Marital status
d. Marital status
The researcher's data set contains extremes of both high and low scores. The measure of central tendency that should be used in order to be least affected by extremes of high and low scores is: Select one: a. Percentile b. Mode c. Median d. Mean
d. Mean
Which qualitative approach would be most appropriate for a nurse researcher to use when studying the daily experience of women undergoing radiation treatment for breast cancer? Select one: a. Grounded theory b. Ethnography c. Case Study d. Phenomenology
d. Phenomenology
A nurse researcher would choose to use a correlational study of multiple variables for which purpose? Select one: a. To test whether one variable causes another variable b. To distinguish how different one variable is from another variable c. To identify the independent variable d. To example the relationship between or among variables
d. To example the relationship between or among variables
Which term represents the most frequent score in a frequency distribution? Select one: a. Median b. Mean c. Percentile d. mode
d. mode
all caregivers who care for a pt wit a health problem participate in
discharge planning
the US health care system has 5 levels of care for which heal care providers offer services
disease prevention, health promotion, primary, secondary, and tertiary health care
medicare
federally administrated program by the commonwealth funf for people 65 and older Part A- basic protection for medical, surgical and psych Part B- voluntary medical insurance covers physician Part C- managed care provision that provides a choice of three ins. plans Part D- prescription drug coverage- voluntary
medicaid
federally funded, state operated, health ins for low income, disabilities, supplemental coverage and LTC assistance to older adult beneficiaries
primary health care
focuses on improved health outcomes for an entire population
Generalizations
general statements or ideas about people or things
Primary prevention
instituted before disease becomes established by removing the causes or increasing resistance
Tertiary care
intensive care, subacute care, disease present
Preventive Action
involves lifestyle change and information gathering about a health topic that leads to a change in behavior
population-based health care services provide the basis for preventative services. these services provide
primary, secondary, and tertiary healthcare
Nursing center is now the appropriate term for
nursing home
skilled nursing facility
offers care from a licensed nursing staff
National Priorities Partnership has set what national priorities?
patient and family engagement- pt centered care population health- focus on wellness and prevention safety- eliminating errors care- pt centered care palliative care- care for advanced illness overuse- reducing waste/costs
minumum data set (MDS)
resident assessment protocols, and utilization guidelines of each state.
8 dimensions of patient centered care
respect values, preferences and expressed needs coordination and integration of care information, communication, and education physical comfort emotional support and relief of fear and anxiety involvement of family and friends transition and continuity access to care
pts and families are more likely to comply with treatment plans and achieve optimal functioning when they are involved in
restorative care
rehab
restores a person to the fullest physical, metal , social, vocational and economic potential possible
health literacy
the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions
the focus in hospitals is to provide
the highest quality of health care possible to the pts are discharged early but safely to home or another health care facilities
the patient protection and affordable care act focuses on
the major goal of increasing access to health care services for all, reducing health care costs, and improving health care quality.
ideally when does rehabilitation begin?
the moment a pt enters a health care facility
discharge planning begins when?
the moment a pt is admitted to a health care facility
health promotion programs lower
the overall health care by reducing the incidence of disease, minimizing complications, and this reducing the need to use more expensive health care resources
uninsured pt present a challenge to healthcare because why?
they are more likely to skip or delay treatment for acute and chronic illnesses and die prematurely
magnet model has 5 components that are affected by global issues that are challenging nursing today
transformational leadership, structural empowerment, exemplary professional practice, new knowledge, innovation, and improvements, and empirical quality results
Preferred provider organization (PPO)
type of managed care place that limits an enrollees choice to list of preferred hospitals, and providers
Acute illness
typically characterized by an abrupt onset and short duration (<6 months)
what is an increasing problem in health care
uninsured individuals
Caring touch
used as a valuable means of nonverbal communication
children, women, and older adults are
vulnerable populations
people who do not have health ins often
wait longer before presenting for treatment, thus they are usually sicker and need more health care as a result, end up being more costly
Exacerbation
worsening of clinical manifestations
Nursing presence
Defined as the shared perception of human connectedness between a nurse and a patient
What is the definition of health?
Defined in terms of the presence or absence of disease
The nurse is learning about the types of families. Which types of families would the nurse classify as crisis-proof families? Select all that apply. 1 Families with a flexible structure 2 Families who exhibit control over their environment 3 Families lacking control over their environment 4 Families who accept help from outside the family system 5 Families with a rigid structure without any adaptability
1 Families with a flexible structure 2 Families who exhibit control over their environment 4 Families who accept help from outside the family system A crisis-proof family, also known as an effective family, has a flexible structure and allows adaptable performance of tasks. This family has control over their environment and influences the immediate environment of home, neighborhood, and school. They accept help from outside of the family system. Families lacking control over their environment or having a rigid structure without any adaptability are ineffective and crisis-prone. Be alert for conflicting choices in multiple-response questions as they can help you eliminate choices. In this question, "Families who exhibit control over their environment" and "Families lacking control over their environment" oppose each other; only one of the choices is correct. Similarly, "Families with a flexible structure" and "Families with a rigid structure without any adaptability" are opposites, and only one of them is correct.
Which options contribute to family hardiness? Select all that apply. 1 Family meetings 2 Established family roles 3 Willingness to change in times of stress 4 Passive orientation to life 5 Positive perceptions of self
1 Family meetings 2 Established family roles 3 Willingness to change in times of stress Family hardiness is the internal strengths and durability of the family unit. It includes a sense of control over the outcome of life, a view of change as beneficial and essential for growth, and an active orientation (such as family meetings) rather than a passive orientation in adapting to stressful events. Family meetings, understanding of roles, and the adaptation to stressors along with a willingness to change affect family hardiness.
Which is an example of a nurse using subjective data to clarify objective data? 1. The nurse palpates the client's knee after the client complains of pain and swelling. 2. The nurse notes the client has a rash and asks the client if the rash is itching. 3. The nurse notices a mole with an irregular border and documents this finding. 4. The nurse notices the client has a cough and checks the medical record to see if the client is a smoker.
2. The nurse notes the client has a rash and asks the client if the rash is itching.
A research study is investigating the question, "What is the effect of the diagnosis of breast cancer on the roles of the family?" In this study the terms diagnosis of breast cancer and family roles are examples of what? 1 Surveys 2 The sample 3 Variables 4 Data collection points
3 Variables Variables are concepts, characteristics, or traits that vary within or among subjects. Surveys are a method of collecting data collection points, and the sample is the group of individuals surveyed for the information.
Which statement correctly identifies an outcome goal from the nursing diagnosis of "potential for skin breakdown related to immobility"? 1. The client will have increased mobility. 2. The client will understand strategies for preventing skin breakdown. 3. The client will be moved periodically throughout the shift. 4. The client's skin will remain intact and healthy.
4. The client's skin will remain intact and healthy.
According to Shawnee's Philosophy, how is health defined?
A state of wholeness which exists on a continuum across life span. It is the result of cultural, biological, psychological, social, spiritual, and environmental dynamics interacting on different levels with varying emphases at different times.
When a nurse completes the nursing data on a client, to complete the admission and develop a plan of care, the nurse will need to: A. Test the family unit's ability to cope. B. Evaluate communication patterns. C. Identify family unit form and attitudes. D. Gather health data from all family members.
C
What are the different health models using the nursing process?
Basic Human Needs Model (Maslows), health belief model, health promotion model, and holistic health models
The nurse writes an expected outcome statement in measurable terms. An example is: A. Client will have less pain. B. Client will be pain free. C. Client will report pain acuity less than 4 on a scale of 0-10. D. Client will take pain medication every 4 hours around the clock.
C. Client will report pain acuity less than 4 on a scale of 0-10.
A client complains to the nurse, open double quote"I feel that there is nothing that I can control about my health.close double quote" The empathetic nurse realizes that the client is totally focused on internal variables. For which factors is the client's complaint correct? (Select all that apply.) Culture Genes Sex Nutrition Age
Culture Genes Sex Age
When you ask an experienced nurse why it is necessary to change the patient's bed every day, the nurse says, "I guess we have just always done it that way." This answer is an example of what type of knowledge? A. Instinctive knowledge B. Scientific knowledge C. Authoritative knowledge D. Traditional knowledge
D Traditional knowledge is the part of nursing practice passed down from generation to generation, often without research data to support it
A Chamber of Commerce wants to partner their business members with local government to produce visible efforts to improve health. At a Chamber meeting, what kind of health promotion activities could the members propose? (Select all that apply.) Health fairs Immunization awareness efforts Recycling efforts Methadone clinics Fitness programs
Health fairs Immunization awareness efforts Recycling efforts Fitness programs
What happened at Shawnee in 1975?
Ohio-University Portsmouth campus merged with Scioto Technical college and resulted in the creation of Shawnee state general and technical college. Two years later, this became Shawnee State Community College.
genetic vulnerability
Risk of disease expression based on genotype, is involuntarily passes from biological parents to their offspring
Perceived severity change strategy
Specify the consequences of a condition and recommend action or intervention
A nurse is discussing the leading health indicators of Healthy People 2020 with colleagues. What does the nurse answer when asked open double quote"What does the open double quote"2020close double quote" in the title refer to?close double quote" Corrected vision of 20/20 Number of leading health indicators Number of topic areas Target year for accomplishment
Target year for accomplishment
Philosophy
The next level of knowledge after metaparadigm. This is a statement about the beliefs and values of nursing in relation to a specific phenomenon such as health.
Health Belief Model
This explores how patients attitudes and beliefs predict health behavior. When applied to the nursing process, it is used as a measure for determining the patient's readiness and motivation to act
Which of the following is a dependent variable in the Brand et al. (2013) article? Select one: a. Anxiety b. Hand massage c. Ambulatory surgery patients d. Music therapy
a. Anxiety
Jean Watson 10 Carative Factors
includes expressing all positive and negative feelings, instilling faith and hope, developing a trusting relationship between the nurse and the patient, forming a human value system, cultivating sensitivity to others, using creative problem-solving processes, promoting transpersonal teaching-learning, providing for a supportive and spiritual environment, meeting human needs, and allowing for existential spiritual forces.
Health protection
includes intentional behaviors aimed at circumventing illness, detecting it early, and maintaining the best possible level of mental and physiologic function within the boundaries of illness
nursing informatics
uses info and technology to communicate, managae knowledge, mitigate error, and support decision making
The nurse is referring to various research articles in order to acquire information about a PICOT question for which no pilot study has been done. After studying the references, the nurse finds that the evidence is not strong enough to apply in practice. What should the nurse do to investigate the PICOT question? Choose the best answer. 1 Conduct a pilot study. 2 Conduct a systematic review. 3 Conduct a randomized controlled trial. 4 Implement the change that the nurse predicts in clinical settings.
1 If the evidence acquired through varied research is not strong enough to apply in practice, the next option for the nurse is to conduct a pilot study. A pilot study is research done on a small scale. Conducting systematic reviews or randomized controlled trials involves tedious processes and takes a long time to obtain results. Even though these methods provide high quality evidence, they are less likely to be performed by the nurse working in a clinical setting. The nurse does not apply the predicted results of research in clinical settings without suitable evidence.
The registered nurse is teaching a group of student nurses about quantitative nursing research. Which statement made by a student indicates effective learning? 1 "It focuses on statistical analysis." 2 "It focuses on nonnumeric data." 3 "It includes research methods such as grounded theory." 4 "It provides an opportunity for patients to share their experiences."
1 Quantitative nursing research is the study of nursing phenomena that offers precise measurement and quantification. It focuses on numerical data, statistical analysis, and controls to eliminate bias in findings. Qualitative research focuses on nonnumeric data. Qualitative research methods include ethnography, phenomenology, and grounded theory. Qualitative research provides an opportunity for patients to share their experiences.
During a visit to a family clinic, the nurse teaches the mother about immunizations, car seat use, and home safety for an infant and toddler. Which type of nursing interventions are these? 1 Health promotion activities 2 Acute care activities 3 Restorative care activities 4 Growth and development care activities
1 Health promotion activities Health promotion activities focus on interventions designed to maintain the physical, social, emotional, and spiritual health of the family unit. They can include information about specific health behaviors, family coping techniques, and growth and development.
The nurse researcher decides to complete a study to evaluate how Florence Nightingale improved patient outcomes in the Crimean War. This is an example of which type of research? 1 Historical 2 Evaluation 3 Exploratory 4 Experimental
1 Historical Historical studies establish facts concerning past events. Evaluation research tests how well a program, practice, or policy is working. Exploratory research is designed to develop or refine the dimensions of phenomena or to develop or refine a hypothesis about the relationship among phenomena. Experimental research involves studies in which the researcher controls the study variable and randomly assigns subjects to different conditions to test the variable.
Which care intervention would reduce the risk of sudden infant death syndrome (SIDS)? 1 Immunizing the infant 2 Using snug-fitting sheets 3 Using large soft toys without small hard pieces 4 Avoiding leaving the baby unattended on the changing table
1 Immunizing the infant Immunizing the infant will reduce the risk of SIDS. The use of a snug-fitting sheet would prevent suffocation, strangulation, or entrapment. Small parts of toys may become dislodged and the infant may choke on them; therefore, the use of large, soft toys without small parts, such as buttons, would prevent choking and aspiration. Not leaving an infant unattended on the changing table prevents falls, not SIDS.
The nurse is teaching a family whose caretakers are in the "sandwich generation" of taking care of older parents while raising adolescents and adopting some young children. Which instruction does the nurse recommend for the further development of family status? Select all that apply. 1 "Take up the parental roles." 2 "Develop intimate peer relationships." 3 "Adjust the marital system to make space for children." 4 "Begin a shift toward concern for the older generation." 5 "Realign relationships as parenting and grandparenting roles."
1 "Take up the parental roles." 3 "Adjust the marital system to make space for children." 5 "Realign relationships as parenting and grandparenting roles." The nurse teaches the family about the changes that are required to promote its future development. The nurse will insist that the parents accept their parenting roles to find a more comfortable and balanced way of living. The nurse requests changes in the marital system that will promote space for the children. The nurse also will teach about the realignment of relationships that include parenting and grandparenting. This promotes growth and a deeper sense of connectedness with all members of the family. The nurse should instruct an unattached young adult to develop intimate peer relationships to promote high energy in day-to-day activities. In a family with adolescents, the nurse teaches about a shift toward concerns for older adults. This is because the "sandwich generation" is more prone to stressors due to taking a dual-caretaker role in taking care of both children and aging parents.
The nurse is teaching a group of teenagers about adolescent pregnancy. Which information should the nurse include? Select all that apply. 1 Adolescent mothers may lack support. 2 Adolescent mothers may be unable to complete their education. 3 Adolescent mothers may find motherhood stressful. 4 Adolescent mothers are prepared for a parenting role. 5 Adolescent mothers are well informed about motherhood.
1 Adolescent mothers may lack support. 2 Adolescent mothers may be unable to complete their education. 3 Adolescent mothers may find motherhood stressful. Adolescent mothers may not be very well accepted in their families and may lack support from the partner's side. Due to the responsibilities of motherhood, adolescent mothers may have to stop their education, which may lead to poor job prospects. Inadequate job skills, financial burdens, and inadequate health care resources can make motherhood stressful for adolescent mothers. Adolescent or teenage mothers are often psychologically and physically unprepared for a parenting role. They often lack adequate knowledge and understanding of the responsibilities involved in motherhood.
A patient with prostate cancer is in the terminal stage of the disease and wishes to have home care. How can the nurse help the family achieve optimal end-of-life care? Select all that apply. 1 Advise the family members to apply for hospice care. 2 Provide grief support measures. 3 Motivate family members to consider euthanasia. 4 Leave the patient alone at the time of death. 5 Educate the family about the dying process.
1 Advise the family members to apply for hospice care. 2 Provide grief support measures. 5 Educate the family about the dying process. The nurse should help the family members obtain hospice care for the last days of the patient's life. Providing grief support to the family helps them to cope better with the anticipated loss. Educating the family members about the dying process helps them become mentally prepared for the loss. Euthanasia is not an ethically acceptable part of end-of-life care and is not legal in many countries. The nurse should arrange to provide privacy for the patient at the time of death but should not leave the patient alone.
While assessing a patient and her family, the nurse observes that the patient's daughter is stressed with her multiple responsibilities of caring for her mother, her own family, and doing her job. What advice should the nurse give her to reduce this stress? Select all that apply. 1 Explore additional resources such as respite care. 2 Quit her job and take care of her mother. 3 Accept her limits and ask for additional help. 4 Continue doing things the way she has been. 5 Take time off or ask her boss for a more flexible work schedule.
1 Explore additional resources such as respite care. 3 Accept her limits and ask for additional help 5 Take time off or ask her boss for a more flexible work schedule.
A family has children who are on the verge of entering adolescence. How can the nurse help the family have good relationships with the adolescent children? Select all that apply. 1 Help the parents redefine their relationships with their adolescent children. 2 Help the adolescent children refocus on midlife material and career issues. 3 Help the family adjust to a reduction in family size. 4 Help the adolescent children initiate concern for the older generation. 5 Help the adolescent children differentiate their own personalities.
1 Help the parents redefine their relationships with their adolescent children. 4 Help the adolescent children initiate concern for the older generation.
The community health nurse performs an assessment of families and categorizes them under different family forms. Which groups would the nurse identify as alternative family forms? Select all that apply. 1 Multi-adult household 2 Communal groups with children 3 Husband and wife caring for children 4 Grandparents caring for grandchildren 5 Single parent caring for an adopted child
1 Multi-adult household 2 Communal groups with children 4 Grandparents caring for grandchildren Alternative family types include family situations that are different from traditional family types, but share personal ties similar to a traditional family. Communal groups with children are an alternative family type but have a set of relationships between the groups. Grandparents caring for grandchildren is a type of alternative family, even though there is a relationship. A husband and wife caring for children is a nuclear family. A single parent caring for an adopted child is a single-parent family.
The nurse is conducting research on the effect of imagery on pain perception. Which actions should the nurse perform when searching the scientific databases for evidence? Select all that apply. 1 Seek the assistance of a medical librarian. 2 Enter and manipulate different key words. 3 Be prepared for some confusion with the evidence obtained. 4 Refer to agency policies and procedures manuals. 5 Refer to existing clinical practice guidelines.
1, 2, 3 Scientific databases are appropriate for searching evidence on a research question. A medical librarian may help by suggesting the type of databases appropriate to the question and different key words for refining the search. Different combinations of key words should be checked to find studies relevant to the subject. If the key words do not match the words used in the research studies, the results of the search may cause some confusion. Agency policies and procedures manuals and clinical practice guidelines are good sources of information, but they do not help in searching scientific databases.
A nursing student in the last semester of a baccalaureate nursing program is beginning the community health practicum and will be working in a clinic with a focus on asthma and allergies. What is the primary focus of the community health nurse in this clinic setting? (Select all that apply.) 1. Decrease the incidence of asthma attacks in the community 2. Increase patients' ability to self-manage their asthma 3. Treat acute asthma attack in the hospital 4. Provide asthma education programs for the teachers in the local schools 5. Provide scheduled immunizations to people who come to the clinic
1, 2, 4
The nurse caring for a Bosnian community identifies that the children are undervaccinated and the community is unaware of resources. The nurse assesses the community and determines that there is a health clinic within a 5-mile radius. The nurse meets with the community leaders and explains the need for immuniza- tions, the location of the clinic, and the process of accessing health care resources. Which of the following practices is the nurse pro- viding? (Select all that apply.) 1. Providing community resources for the children 2. Teaching the community about health promotion and illness prevention 3. Promoting autonomy in decision-making about health practices 4. Improving the health care of the community's children 5. Participating in professional development activities to main- tain nursing competency
1, 2, 4
The author of an article reports that "the highest value in the sample distribution was 102 and the lowest value was 40." This is an example of the: a.Standard deviation b. Mode c. Central tendency d. Range
D
A 50-year-old patient complains of hair loss. A scraping of the patient's scalp shows a candida infection. The hair loss decreased with the use of a medicated shampoo and herbal oil. The nurse has developed a PICOT question and starts to search for the evidence. The nurse has reviewed many books and searched for information on the Internet. The nurse also consulted other health care professionals and found that herbal oils have an antifungal medicinal value. Which should be the nurse do next? Select all that apply. 1 Recommend a protocol if the evidence supports the use of herbal oil. 2 Conduct a pilot study if the evidence is not strong enough to support the use of herbal oils. 3 Keep all the data of the study confidential and share outcomes with staff who are affected by the results. 4 Conduct the research study even if the PICOT question goes unanswered after the study. 5 Avoid recommending any changes in the protocol, even if the study supports the use of herbal oil.
1, 2, 4 Once the nurse finds information supporting the use of herbal oils, the nurse should take steps to implement this change in practice and evaluate the outcomes. Following the evaluation, the nurse can recommend a related protocol. If the evidence is not strong enough, the nurse can conduct a pilot study to test the use of herbal oils in hair loss. If the PICOT question remains unanswered after evaluation, then a research study can be conducted. Following the outcome evaluation, the results should be shared with the staff to promote evidence-based practice. If the evaluation of the study shows that herbal oil is useful, then the nurse is allowed to recommend this change in protocol.
Using Healthy People 2020 as a guide, which of the following would improve delivery of care to a community? (Select all that apply.)1. Community assessment 2. Implementation of public health policies 3. Home safety assessment4. Increased access to care5. Determining rates of specific illnesses
1, 2, 4, 5
A nurse in a community health clinic noticed an increase in the number of positive tuberculosis (TB) skin tests from students in a local high school during the most recent academic year. After comparing these numbers to the previous years, 10% increase in positive tests was found. The nurse contacts the school nurse and the director of the health department. Together they begin to expand their assessment to all students and employees of the school district. The community nurse was acting in which nursing role(s)? (Select all that apply.)1. Epidemiologist2. Counselor3. Collaborator4. Case manager5. Caregiver
1, 3
A 55-year-old patient is diagnosed with lung cancer and has a history of smoking. To find the association between smoking and lung cancer, the nurse decides to use a case-control study. Which are the requirements of a case-control study? Select all that apply. 1 Two groups are required. 2 Hospital records are sufficient for evidence. 3 One of the groups should have lung cancer. 4 One of the groups should not have lung cancer. 5 Two groups with different genders are required.
1, 3, 4 A case-control study requires two groups. One of the groups must have lung cancer, and the other should not have the disease. The hospital records are not sufficient for obtaining the evidence. It is not necessary that two groups should have different genders. Each group can have a mix of genders.
The nurse helps a researcher to conduct a study on human subjects. The researcher obtains approvals from an institutional review board (IRB). An IRB ensures that researchers follow ethical principles, including respecting the rights of human subjects. The nurse verifies that the subject has signed the informed consent. Which criteria regarding the informed consent will the nurse explain to the subject? Select all that apply. 1 Consent is voluntary. 2 The subject cannot refuse to participate in the research. 3 The subject understands how the researcher maintains confidentiality. 4 The subject is allowed to choose the treatment modality. 5 The subject can withdraw from the study at any time.
1, 3, 5 Informed consent is needed to ensure that the subject is given sufficient information about the research to enable the subject to either consent voluntarily to participate or decline to participate. The subject should understand the confidentiality of the data obtained. The subject has the right to withdraw from the study when desired. Informed consent does not limit the subject's ability to decline participation; the subject can decline participation anytime in the course of the study. The informed consent does not allow the subject to choose his or her own treatment.
The nurse understands that using a PICOT format for clinical questions helps in refining the search for evidence. Which are the best reasons to follow the PICOT format? Select all that apply. 1 It helps to ask a more focused question. 2 It is necessary to follow the sequence of PICOT. 3 It prevents wandering when searching for evidence. 4 It allows the researcher to ask questions that are focused on theory. 5 It helps to identify knowledge gaps within a clinical situation.
1, 3, 5 The PICOT (Patient, Intervention, Comparison, Outcome, Time) format is used when asking a clinical question and looking for related evidence. The PICOT format helps to refine the focus of the question by dividing the question into different components of PICOT. The evidence can be searched through key words of a PICOT question, which helps to refine the search and to identify gaps in the clinical situation in terms of missing evidence. It is not necessary to follow the sequence of PICOT; the components can be used in any order. The PICOT format allows the nurse to ask questions that are focused on intervention, rather than theory.
A 55-year-old patient is diagnosed with lung cancer and has a history of smoking. Which type of study would be initiated to find the association between smoking and lung cancer,? Select all that apply. 1 Case-control study 2 Randomized controlled trial 3 Historical research 4 Retrospective study 5 Descriptive research
1, 4 A case-control study is performed to find out the cause for a disease. A retrospective study looks back in time to evaluate the available data and find the variables in a disease. Although randomized controlled trials can be used for investigating cause and effect, they are more suitable for exploring drug therapies. Historical studies are performed to confirm facts and relationships about a past event. Descriptive studies help to measure characteristics of persons, situations, or groups and the frequency with which certain events or characteristics occur.
Which statement shows the steps of the research process in the correct order? 1 Review the literature, state the research problem, and develop a theoretical construct. 2 Review the literature, state the research problem, and select the research strategy. 3 Select the research strategy, collect data, and analyze data. 4 State the research problem, review the literature, and clarify operational definitions.
4 The first step of the research process is to state the research problem. The correct order of steps is to state the research problem, review the literature, develop a theoretical construct, identify variables, and then clarify operational definitions.
A professor is explaining the importance of the scientific method of research to a group of nursing students. Which statement by a student suggests that the student requires further explanation? Select all that apply. 1 "The scientific method is without fault." 2 "The scientific method is the foundation of research." 3 "Aspects of the scientific method help in conducting research." 4 "The scientific method may influence the opinions of the researcher in the final outcome." 5 "The scientific method is an advanced, objective means of acquiring and testing knowledge."
1, 4 Systematic, orderly procedures characterize the scientific method to limit the possibility for error, although it is not without fault. The scientific method minimizes the chance that bias or opinion by a researcher will influence the results of research and thus the knowledge gained. The scientific method is the foundation of research and is the most reliable and objective of all methods of gaining knowledge. Aspects of the scientific method help in conducting research. The scientific method is an advanced, objective means of acquiring and testing knowledge.
The nursing student has posed a PICOT clinical question for a research study. The question that has been posed is, "How do patients with cervical cancer rate their quality of life?" Which PICOT elements does this question contain? Select all that apply. 1 Patient population of interest 2 Intervention of interest 3 Comparison of interest 4 Outcome 5 Time
1, 4 Using the PICOT format helps to ask a focused clinical question. P stands for population of interest, I stands for intervention of interest, C stands for comparison of interest, O stands for outcome, and T stands for time. Patients with cervical cancer represent the population of interest, and rating the quality of life represents the outcome. The question does not contain the other three elements: intervention of interest, comparison of interest, and time.
Which are examples of cue clusters for a nursing diagnosis? Select All That Apply. 1. Hard, painful bowel movement approximately every 3 to 4 days; sedentary lifestyle; low dietary fiber intake; dry skin 2. Pain and limited range of motion in knees, use of walker, medical diagnosis of osteoarthritis 3. Sore throat, fever, inability to ambulate, medical diagnosis of depression 4. Dry skin, painful urination, epistaxis 5. Urinary incontinence, lower abdominal pain, bladder spasm
1. Hard, painful bowel movement approximately every 3 to 4 days; sedentary lifestyle; low dietary fiber intake; dry skin 2. Pain and limited range of motion in knees, use of walker, medical diagnosis of osteoarthritis 5. Urinary incontinence, lower abdominal pain, bladder spasm
When creating a nursing diagnosis for a client with renal failure, what questions should the nurse ask during the assessment process? Select All That Apply. 1. Is the client still producing urine? 2. What is the client's oral intake? 3. Does the client exhibit signs of edema? 4. Can the client ambulate without assistance? 5. Can the client engage in activities of daily living?
1. Is the client still producing urine? 2. What is the client's oral intake? 3. Does the client exhibit signs of edema? 5. Can the client engage in activities of daily living?
The nurse finds topics for research studies in different scientific literature databases. Which source is described correctly? 1 MEDLINE provides only biomedical and pharmaceutical studies. 2 AHRQ gives clinical guidelines and evidence summaries. 3 CINAHL offers free access to journal articles. 4 EMBASE includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health.
2 AHRQ stands for Agency for Healthcare Research and Quality and provides clinical guidelines and evidence summaries. MEDLINE includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health. CINAHL stands for Cumulative Index of Nursing and Allied Health Literature; it includes studies in nursing, allied health, and biomedicine at a cost. EMBASE provides biomedical and pharmaceutical studies.
A group of nurses have implemented an evidence-based practice (EBP) change and have evaluated the effectiveness of the change. What is their next step? 1 Conduct a literature review. 2 Share the findings with others. 3 Conduct a statistical analysis. 4 Create a well-defined PICOT question.
2 After completing an evidence-based practice (EBP) project and evaluating its effectiveness, the next step is to communicate the results with others. Conducting a literature review and statistical analysis, and creating a well-defined PICOT question, come before evaluation and sharing findings.
The student nurse is documenting the similarities and differences among evidence-based practice, research, and quality improvement. Which datum documented by the student nurse is accurate? 1 Datum 1 2 Datum 2 3 Datum 3 4 Datum 4
2 Quality improvement sometimes requires IRB (institutional review board) approval. Therefore, datum 2 is accurate. Researchers may or may not be employed by the health care agency and usually are not a part of the clinical health care team, so datum 1 is inaccurate. Funding sources for evidence-based practice are usually internal, from the health care agency, so datum 3 is inaccurate. The purpose of evidence-based practice is to determine safe and effective nursing care with the goal of improving patient care and outcomes, so datum 4 is inaccurate.
The nurse is studying the process of nursing research. Which research should the nurse classify as qualitative research? 1 Effectiveness of aspirin to reduce fever in patients with viral infections 2 Effectiveness of psychological counseling on the perception of stress in patients with chronic illness 3 Effectiveness of relaxation techniques in decreasing pain severity in cancer patients 4 Effectiveness of loop diuretics in increasing urine output in patients with chronic renal failure
2 The effectiveness of psychological counseling on the perception of stress in patients with chronic illness is the outcome variable. This variable cannot be measured; thus the study is a qualitative study. In the statement regarding the effectiveness of aspirin to reduce fever in patients with viral infections, fever is the main outcome variable. Changes in temperature can be measured; thus this study is an example of quantitative research. In the statement regarding the effectiveness of relaxation techniques in decreasing pain severity in cancer patients, pain severity is the main outcome variable. Changes in pain severity can be measured using the visual analogue scale; thus this study is an example of quantitative research. In the statement regarding the effectiveness of loop diuretics in increasing urine output in patients with chronic renal failure, urine output is the main outcome variable. The change in urine output can be measured; thus this study is an example of quantitative research.
The Cleric family, which includes a mother, stepfather, two teenage biological daughters of the mother, and a biological daughter of the father is an example of a(n):
B. Blended families result when two people who have children from a previous marriage/relationship marry.
A group of staff educators are reading a research study together at a journal club meeting. While reviewing the study, one nurse states that the study evaluates whether newly graduated nurses progress through orientation more effectively when they participate in patient simulation exercises. Which part of the research process is reflected in this nurse's statement? 1 Introduction 2 Purpose statement 3 Methods 4 Results
2 The purpose statement includes research questions or hypotheses—predictions made about the relationship or difference among study variables (concepts, characteristics, or traits that vary within or among subjects). The introduction lays the basics of the questions the researcher is asking and lays the groundwork of the study. Methods describe the steps taken to gather knowledge and test the variables. Results describe the findings of the research.
The nurse is helping a researcher conduct a randomized controlled trial (RCT). Which characteristic differentiates the RCT from other types of studies? 1 Researchers will test a new drug with the usual standard of care. 2 When completed, researchers will know if the intervention leads to better outcomes than the standard of care. 3 Researchers will study two groups of subjects—one with the disease and another without the disease. 4 When completed, researchers will determine if there is an association between one or more predictor variables and the condition.
2 When a randomized controlled trial (RCT) is completed, the researcher will know if the intervention leads to better outcomes than the standard of care. In a case control study, the researchers determine if there is an association between a predictor variable and a condition. A case control study is one in which researchers study one group of subjects with a certain condition at the same time as another group of subjects who do not have the condition.
Diane is a hospice nurse who is caring for the Robinson family. This family is providing end-of-life care for their grandmother, who has terminal breast cancer. When Diane visits the home 3 times a week, she focuses on symptom management for the grandmother and assists the family with coping skills. Of what is Diane's approach an example? 1 Family as context 2 Family as patient 3 Family as system 4 Family as structure
2 Family as patient When the family as patient is the approach, family processes and relationships (e.g., parenting or family caregiving) are the primary focuses of nursing care. The family as a context approach focuses primarily on an individual member, whereas the family as a system is caring for the family as context plus the family as patient. Family structure is an attribute of families and is based on complex relationships of the family members.
A patient is in the terminal stages of cancer. The nurse learns that the patient's caregiver is extremely stressed and has not been able to take time for a personal life. How can the nurse provide relief to the caregiver? 1 Ask the caregiver to withhold caregiving activities. 2 Help the caregiver set a regular time for respite. 3 Explain the need to focus more on the patient now and less on the caregiver's personal life. 4 Encourage the caregiver by praising his or her actions.
2 Help the caregiver set a regular time for respite. The nurse may provide relief to the caregiver without compromising the patient's care by helping him or her set a regular time for rest and personal time. Withholding care would hamper the patient's situation. Even though the patient needs the caregiver's help, the caregiver's personal life is also important. Expressing appreciation about the caregiver's work is nice, but it is not necessarily helpful in providing relief to the caregiver.
A group of nurses have implemented an evidence-based practice (EBP) change and have evaluated the effectiveness of the change. What is their next step? 1 Conduct a literature review. 2 Share the findings with others. 3 Conduct a statistical analysis. 4 Create a well-defined PICOT question.
2 Share the findings with others. After completing an evidence-based practice (EBP) project and evaluating its effectiveness, the next step is to communicate the results with others. Conducting a literature review and statistical analysis, and creating a well-defined PICOT question, come before evaluation and sharing findings.
A patient who was admitted to the hospital receives a red-color wristband for identification purposes. What is the significance of the wristband? 1 The patient has allergies. 2 The patient is at risk for falling. 3 The patient should be treated immediately. 4 The patient is not indicated for resuscitation
2 The patient is at risk for falling. The American Hospital Association issued an advisory recommendation that hospitals use standardized wristband colors. Red wristbands indicate patient allergies. Yellow wristbands are for patients who are at a risk for falling. There is no wristband for immediate treatment of patients. Purple wristbands are given to patients who have do-not-resuscitate orders.
The nurse is speaking to a family that has limited financial resources and no insurance. How can the nurse help this family obtain financial and health care resources? Select all that apply. 1 Promote the dependence of the family. 2 Identify resources that would help them pay the energy bills. 3 Identify resources that would help them provide school supplies. 4 Identify resources that would help them pay for their dental care and health care bills. 5 Encourage them to take insurance even if it is not affordable.
2 Identify resources that would help them pay the energy bills. 3 Identify resources that would help them provide school supplies. 4 Identify resources that would help them pay for their dental care and health care bills. Numerous resources are available for poor families with uninsured children. These include assistance with energy bills, assistance with school supplies, and assistance with health care. The nurse should promote measures to make the family independent. The nurse should not encourage the family to get insurance they cannot afford.
Which best defines family caregiving? Select all that apply. 1 Designing a nurturing family to raise children 2 Providing physical and emotional care for a family member 3 Establishing a safe physical environment for a family 4 Monitoring for side effects of illness and treatments 5 Providing an environment conducive to spirituality
2 Providing physical and emotional care for a family member 3 Establishing a safe physical environment for a family 4 Monitoring for side effects of illness and treatments Family caregiving by spouses, siblings, or parents involves routinely providing services and personal care activities for a family member. Caregiving activities include finding resources, personal care (bathing, feeding, or grooming), monitoring for complications or side effects of illness and treatments, providing instrumental activities of daily living (shopping or housekeeping), and the ongoing emotional support and decision making that are necessary. Developing a nurturing family to raise children and providing a spiritual environment are important but are not part of the caregiver's role.
The nurse is teaching a family about achieving family goals. Which processes should the nurse teach the families to adopt? Select all that apply. 1 Neglecting problems 2 Setting goals for the family 3 Communicating with family members 4 Resolving conflicts among family members 5 Avoiding discussions with family members
2 Setting goals for the family 3 Communicating with family members 4 Resolving conflicts among family members Goal setting is one of the processes used by a family to achieve its goals. Having clear and direct communication with family members makes achievement of family goals more successful. Resolving conflicts among family members helps members respect each other and work cooperatively towards family goals. Neglecting the problems leaves those problems unidentified and will not help the family achieve their goals. Avoiding discussions may leave the problem unidentified, while clear communication helps resolve problems.
The nursing student is collecting useful information for a research project. The student has collected more than 100 articles and needs to sort the articles that are similar to the project's PICOT question. Which advice should the professor give the student? Select all that apply. 1 "Read all the articles in detail." 2 "Read abstracts of the articles." 3 "Read the introductions to the articles." 4 "Read literature reviews about the articles." 5 "Read manuscript narratives of the articles."
2, 3 An abstract is a short summary of a study or an article that highlights the main features of the article, including the objective of the article, methods used, results obtained, and conclusions made. The introduction explains the purpose of the article and the evidence to support it. The abstract and introduction together would indicate whether the article is relevant to the PICOT question being researched. Reading the article in detail is time-consuming. Literature reviews involve thorough search of the relevant scientific studies done in the past to consolidate the purpose of the present study. Reading manuscript narratives is time-consuming and unnecessary if the article is not relevant to the PICOT question.
A 50-year-old woman complains of hair loss. When going through the medical records, the nurse finds that the patient underwent chemotherapy for breast cancer a few years ago. To determine a relationship between hair loss and chemotherapy, the nurse formulates a PICOT question. Which points should the nurse keep in mind when developing a PICOT question? Select all that apply. 1 The sequence of P, I, C, O, and T should be followed. 2 The I in PICOT refers to intervention of interest. 3 PICOT helps to ask an intervention-focused question. 4 The elements P and O can be skipped. 5 PICOT helps to identify knowledge gaps within a given clinical situation.
2, 3, 5 A well-focused question makes it easy to gather evidence. A PICOT question is very useful for evidence-based practice. The I in PICOT refers to intervention of interest. A well-framed PICOT question helps to keep the research question focused on intervention. A well-formed PICOT questions also helps to question the existing routines and identify knowledge gaps within a given clinical situation. The sequence of P, I, C, O, and T is not mandatory in developing the PICOT question. The components I, C, and T may not be suitable to be used in every PICOT question, so they can be skipped accordingly.
The nurse assesses the following risk factors for coronary artery disease (CAD) in a male patient. Which factors are classified as genetic or physiological? Select all that apply. 1 Sedentary lifestyle 2 Father died from CAD at age 50 3 History of hypertension 4 Diet high in sodium 5 Elevated cholesterol level 6 Age of 44 years
2, 3, 5 Genetic risk factors are related to heredity and the genetic predisposition to an illness; physiological factors involve the physical functioning of the body. Certain physical conditions such as being pregnant or overweight place increased stress on physiological systems (e.g., the circulatory system), increasing susceptibility to illness in these areas. A person with a family history of coronary artery disease is at risk for developing the disease later in life because of a hereditary and genetic predisposition to the disease. Age, diet and lifestyle are not genetic or physiological risk factors.
The nurse finds topics for research studies in different scientific literature databases. Which sources are correct for their respective database? Select all that apply. 1 MEDLINE contains biomedical and pharmaceutical studies. 2 AHRQ contains clinical guidelines and evidence summaries. 3 CINAHL contains studies in nursing, allied health, and biomedicine. 4 EMBASE includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health. 5 PubMed offers free access to journal articles
2, 3, 5 The Agency for Healthcare Research and Quality (AHRQ) database includes clinical guidelines and evidence summaries. Cumulative Index of Nursing and Allied Health Literature (CINAHL) includes studies in nursing, allied health, and biomedicine. PubMed is the health science library at the National Library of Medicine and offers free access to journal articles. MEDLINE includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health. EMBASE includes biomedical and pharmaceutical studies.
Which type of research design would be helpful to determine the percentage of women who are diagnosed with an acute myocardial infarction between the ages of 40 and 60 years? 1 Survey 2 Qualitative research 3 Quantitative research 4 Evaluation research
3 Quantitative research involves analysis of numbers, such as the percentage of women diagnosed with acute myocardial infarction and what age groups the women belong to. The survey design examines opinions, attributes, behaviors, or characteristics of a population. Qualitative research describes information in a nonnumeric form. Evaluation research determines how well a program, practice, or policy is working.
The nurse wants to determine the effectiveness of a behavioral therapy intervention in adolescents with conduct disorder. Which type of research should the nurse conduct in order to acquire the most reliable evidence? 1 Descriptive study 2 Case control study 3 Randomized controlled trials 4 Controlled trial without randomization
3 Randomized control studies are the most precise form of experimental studies and the gold standard of research. These studies provide the most reliable evidence. A descriptive study, case control study, and controlled trial without randomization are much lower in the hierarchy of evidence.
A nurse is evaluating an expected outcome for a patient that states heart rate will be less than 80 beats/min by 12/3. Which finding will alert the nurse that the goal has been met? a. Heart rate 78 beats/min on 12/3 b. Heart rate 78 beats/min on 12/4 c. Heart rate 80 beats/min on 12/3 d. Heart rate 80 beats/min on 12/4
A (Heart rate 78 beats/min on 12/3 indicates the goal has been met. Comparing expected and actual findings allows you to interpret and judge a patient's condition and whether predicted changes have occurred. Expected outcome states less than 80, not 80. The date is by 12/3, not 12/4.)
The nurse has conducted field research and is now writing a manuscript about the study. Which information should the nurse include in the section following the conclusion? 1 The statistical analysis of the data obtained in the research 2 The procedure or design of the research 3 The explanation of the application of the results in clinical settings 4 The explanation of the relationships predicted between various variables of the study
3 The clinical implication section follows the conclusion section and gives the information regarding the application of the research results in the clinical settings. The results section includes the information about the statistical analysis of the data acquired through research. The methods or design section of the research explains the process by which the research was carried out. The purpose statement of the research article provides information regarding relationships predicted between various variables of the study.
The nurse is developing the protocol for a research study. The nurse is referencing various research articles to develop the procedures for the study. To which section of the research articles should the nurse refer? 1 Abstract 2 Introduction 3 Methods 4 Results
3 The nurse refers to the methods or design section of relevant research to develop methodologies for new research. The methods or design section of the research explains the process by which research is carried out. The abstract provides a brief overview of the entire research and does not specifically give detailed information about the procedures followed. The introduction states the purpose of the study and provides brief supporting evidence that explains the importance of the topic. This section does not provide detail about the procedures followed. The results section includes the statistical analysis that provides a detailed explanation of whether the research question was answered. This section does not give any information about the procedures followed by the researchers.
The nurse is assessing the family status of a patient. Which question should the nurse include to assess the health process of the family? 1 "How does your family resolve conflicts?" 2 "Does your family hug, cry, or laugh together?" 3 "What type of health care provider does your family have?" 4 "What are your family's beliefs about health and illness or end-of-life care?
3 "What type of health care provider does your family have?" Asking the patient about the type of health care provider his family has helps in assessing the family's health process. Asking how the family resolves conflicts and whether they cry, laugh, or hug together helps to assess the interactive process of the family. Asking the family about their beliefs on health and illness helps to assess the integrity process of the family.
A nursing student is learning about the different types of families. What could be an example of a blended family? 1 A woman raising her son alone after her husband's death 2 A homosexual couple raising a daughter on their own 3 A woman bringing her adopted son into a new family when she remarries 4 A grandfather taking care of his granddaughter after his daughter's demise
3 A woman bringing her adopted son into a new family when she remarries A blended family is formed when parents bring children who may or may not be biologically related to them into a new, joint-living situation. Hence, a woman bringing her adopted son into a new family when she remarries is an example of blended family. A woman raising her son alone after her husband's death is an example of single-parent family. A homosexual couple raising a daughter on their own is an example of an alternative family. A grandfather taking care of his granddaughter after his daughter's demise is also an example of an alternative family.
A family consists of a man, his parents, his wife, and their two sons. This is an example of which kind of family? 1 Nuclear family 2 Blended family 3 Extended family 4 Alternative family
3 Extended family An extended family includes the nuclear family plus relatives. A nuclear family consists of the husband, the wife, and their children. A blended family is formed when parents bring children from previous relationships into a new, joint living setting. An alternative family can be a skipped-generation household, multiadult household, or household led by a homosexual couple.
A group of nurses on the research council of a local hospital are measuring nursing-sensitive outcomes. Which is a nursing-sensitive outcome that the nurses should consider measuring? 1 Incidence of asthma among children of parents who smoke 2 Frequency of episodes of low blood sugar in children at a local school 3 Number of patients who fall and experience subsequent injury on the evening shift 4 Number of sexually active adolescent girls who attend the community-based clinic for birth control
3 Number of patients who fall and experience subsequent injury on the evening shift Nursing-sensitive outcomes are outcomes that are directly related to nursing care. The number of patients who fall and experience injury on the evening shift can be directly correlated to nursing care, and can be measured in accordance to the measures taken by nursing staff. The incidence of asthma among children of parents who smoke, frequency of low blood sugar in children at a local school, and number of sexually active adolescent girls who attend the community clinic for birth control are not directly related to nursing care.
The nurse is explaining family assessment to a group of nursing students. The nurse discusses the ability of a family to cope with expected and unexpected stressors. What is this ability? 1 Love 2 Integrity 3 Resiliency 4 Hardiness
3 Resiliency Resiliency is the ability of a family to cope with expected and unexpected stressors. It is an important factor to consider when assessing a family. Love is the feeling of attachment towards family and other people. Family integrity is the feeling of oneness among family members. Family hardiness is the internal strengths and durability of the family. STUDY TIP: Resiliency is the bounce-back ability. Think of resiliency as a reset button. It is a great trait to develop in an individual as well as a family.
Many grandparents have taken on the responsibility of raising grandchildren, which creates a new parenting responsibility within the home. Which factors does the nurse suspect to be the result of this? Select all that apply. 1 Homelessness 2 Family violence 3 Single parenthood 4 Dual-family incomes 5 An increase in the divorce rate
3 Single parenthood 4 Dual-family incomes 5 An increase in the divorce rate A number of factors affect the new parenting responsibility when grandparents raise grandchildren. The factors include single parenthood due to death, divorce, or desertion; dual-family incomes, with both spouses maintaining different careers; or an increase in the divorce rate. Homelessness is a major public health issue that causes changes in the structure and roles of family members. This is not a sole or direct factor affecting the new parenting responsibility. Family violence is described as emotional, physical, social, or sexual abuse. This is not a factor responsible for the new parenting culture.
When recruiting subjects to participate in a study about the effects of an exercise program on balance, the researcher provides full and complete information about the purpose of the study and gives the subjects the choice to participate or not participate in the study. Of what is this an example? 1 Bias 2 Anonymity 3 Confidentiality 4 Informed consent
4 The process of informed consent includes providing research subjects full disclosure about the study and the opportunity to participate or not to participate in the study. Bias is opinion by a researcher that will influence the results of research. Confidentiality guarantees that any information a subject provides will not be reported in any manner that identifies the subject and will not be accessible to people outside the research team. Anonymity guarantees that any information a subject provides will not be reported in any manner than identifies the subject and will not be accessible by anyone, including the research team.
The nurse is providing care to a patient who is experiencing major abdominal trauma following a car accident. The patient is losing blood quickly and needs a blood transfusion. The nurse finds out that the patient is a Jehovah's Witness and cannot have blood transfusions because of religious beliefs. The nurse notifies the patient's health care provider and receives an order to give the patient an alternative to blood products. Of what is this an example? 1 A quality improvement study 2 A change in practice based on evidence 3 A time when calling the hospital's ethics committee is essential 4 Consideration of patient preferences and values while providing care
4 This example illustrates a situation in which the health care providers take the patient's values and beliefs into consideration while providing care. This is not an example of a quality improvement study or change in practice based on evidence. Although ethics is a critical consideration in this instance if the patient's life is in danger and the patient refuses treatment, the provider orders an alternative to blood products, which in itself is not an ethical dilemma.
The nurse researcher conducts a study that randomly assigns 100 patients who smoke and attend a wellness clinic into two groups. One group receives the standard smoking cessation handouts; the other group takes part in a new educational program that includes a smoking cessation support group. The nurse plans to compare the effectiveness of the standard treatment with the educational program. Which type of research study is this? 1 Qualitative 2 Descriptive 3 Correlational 4 Randomized controlled trial
4 This is a randomized controlled trial because patients are randomly assigned into the control or treatment group. The researcher will measure the effectiveness of the standard treatment with the educational program, which is a quantitative measure, not qualitative. This research is also not descriptive, which measures people, situations, or groups and the frequency with which certain events or characteristics occur. Correlational research explores the interrelationships among variables of interest without any active intervention by the researcher.
Karen is a single mother of a school-age daughter. Linda is a single mother of two teenage daughters. Karen and Linda are active professionals, have busy social lives, and date each other occasionally. Three years ago, they decided to share a house and housing costs, living expenses, and child care responsibilities. The children consider one another as their family. What family form is this? 1 A diverse family relationship 2 A blended family relationship 3 An extended family relationship 4 An alternative family relationship
4 An alternative family relationship This alternative family includes two single parents (a multiadult household), cohabitating partners who are homosexual and living with the children of both mothers. A blended family is formed when parents bring unrelated children from prior adoptive or foster parenting relationships into a new, joint living situation. Diverse and extended family relationships are not considered family forms in this context.
Which database offers free access to journal articles? 1 AHRQ 2 CINAHL 3 EMBASE 4 PubMed
4 PubMed PubMed offers free access to journal articles. The Agency for Healthcare Research and Quality (AHRQ) includes clinical guidelines and evidence summaries. The Cumulative Index of Nursing and Allied Health Literature (CINAHL) includes studies in nursing, allied health, and biomedicine. The EMBASE database includes biomedical and pharmaceutical studies.
The nurse researcher conducts a study that randomly assigns 100 patients who smoke and attend a wellness clinic into two groups. One group receives the standard smoking cessation handouts; the other group takes part in a new educational program that includes a smoking cessation support group. The nurse plans to compare the effectiveness of the standard treatment with the educational program. Which type of research study is this? 1 Qualitative 2 Descriptive 3 Correlational 4 Randomized controlled trial
4 Randomized controlled trial This is a randomized controlled trial because patients are randomly assigned into the control or treatment group. The researcher will measure the effectiveness of the standard treatment with the educational program, which is a quantitative measure, not qualitative. This research is also not descriptive, which measures people, situations, or groups and the frequency with which certain events or characteristics occur. Correlational research explores the interrelationships among variables of interest without any active intervention by the researcher.
Which topic is best suited for quantitative research? 1 The perception of a patient diagnosed with cancer 2 The patient's perception of the nurse's care in a palliative unit 3 The perception of stress by family members of critically ill patients 4 The percentage of cardiac illness in men between 40 and 60 years of age
4 The percentage of cardiac illness in men between 40 and 60 years of age Quantitative research involves analysis of numbers, such as percentages and ages. This type of research offers precise measurements and quantifications. Determining the percentage of cardiac illness in men between 40 and 60 years of age is an example of quantitative research. Qualitative research involves verbal analysis, and the information is obtained in a nonnumerical form. Determining the patient's perception of the nurse's care in a palliative unit or the perception of stress by family members of critically ill patients are examples of qualitative research.
You will use the concept of primary prevention when instructing a patient to: A.) get a flu shot every year B.) take a blood pressure reading everyday C.) explore hiring a patient with a known disability D.) undergo physical therapy following a cerebrovascular accident
A.) get a flu shot every year
A nurse is discharging a heart failure patient. The nurse knows that several interventions are placed to reduce readmission rates. These interventions include: (SELECT ALL THAT APPLY) a. Home visiting programs b. Telephone support c. A speedy discharge d. Nurse led clinics
A/B/D
The nurse is assessing a family that is grieving the loss of a family member. How does the nurse evaluate the coping process of the family? Select all that apply. 1 By assessing the family's culture and practices 2 By assessing the social support of the family 3 By evaluating the family's health issues and the impact of these issues 4 By evaluating the coping strategies of the family and the effectiveness of those strategies 5 By evaluating the family's problem-solving strategies
4 By evaluating the coping strategies of the family and the effectiveness of those strategies 5 By evaluating the family's problem-solving strategies In order to evaluate the coping processes of the family, the nurse should study the behaviors adopted by the family to deal with stress, such as exercise, overeating, and arguing. The nurse should also evaluate the family's approach to solving problems. Assessing family culture and practices is helpful in evaluating the integrity process of the family. Assessment of social support is helpful in assessing the interactive process of the family. Evaluating health issues and how they affect the family helps the nurse assess the family's developmental process.
A hospital's wound nurse consultant made a recommendation for nurses on the unit about how to care for the patient's dressing changes. Which action should the nurses take next? a. Include dressing change instructions and frequency in the care plan. b. Assume that the wound nurse will perform all dressing changes. c. Request that the health care provider look at the wound. d. Encourage the patient to perform the dressing changes.
A
A nurse is caring for a patient with a nursing diagnosis of Constipation related to slowed gastrointestinal motility secondary to pain medications. Which outcome is most appropriate for the nurse to include in the plan of care? a. Patient will have one soft, formed bowel movement by end of shift. b. Patient will walk unassisted to bathroom by the end of shift. c. Patient will be offered laxatives or stool softeners this shift. d. Patient will not take any pain medications this shift.
A
A nurse researcher includes peer-reviewed or refereed journals in the literature review because: a.The articles are critiqued by a panel of external reviewers b. The articles selected for publication are related to a specific field of knowledge c. the journals encourage competition among authors to have their articles published d. The journals publish only articles that are primary sources of research findings
A
According to the National Data Base of Nursing Quality Indicators (NDNQI), which of the following is considered an indicator of the quality of nursing care at a hospital? a.The number of patients that reexperience falls and injuries b. The number of side effects from medications c. The surgical infection rate d. Readmission rates of medical patients
A
An Institutional Review Board (IRB) reviews research for: a. humans as participants b. animals as research subjects c. private sector organizations d. Both A and B
A
An example of an evidence-based health policy that has had a very positive effect on population health in the united states is: a.Seat belt laws that require adults and children to use seat belts b. Dietary guidelines written by the American Diet Association c. The American heart Association Guidelines related to physical activity d. The American Nurses Association Code of Ethics
A
As a new graduate, you want to work on a unit that supports evidence-based practice. Which piece of data would provide the best assurance of a commitment to evidence-based practice? a.The job description for your position includes an expectation that nurses will use evidence and participate in a unit-based quality committee b. The nurse manager shows you their annual report which includes positive patient outcomes c. The hospital received full accreditation during the last joint commission visit d. The nurse manager tells you that the highest retention rate of nurses in the hospital
A
As a nurse on a behavioral health unit, you are asked to complete a search for evidence on best practices to prevent the use of restraints. When you enter the term, you get 1,000 hits. Which of the following is the best set of limiters to narrow your result? a.Last 5 years, English, Peer Reviewed Journals b. Last 10 years, English & Spanish, New reports c. Last 5 years, English, Professional Association Publications d. English, Conducted in the US
A
Our Laupus library health sciences librarians spoke about the 3-legged stool components for improved patient outcomes. These include all except: a. Theory based interventions b. Best available clinical evidence c. Provider clinical expertise d. Patients value and expectations
A
The following statements are on a patient's nursing care plan. Which statement will the nurse use as an outcome for a goal of care? a. The patient will verbalize a decreased pain level less than 3 on a 0 to 10 scale by the end of this shift. b. The patient will demonstrate increased tolerance to activity over the next month. c. The patient will understand needed dietary changes by discharge. d. The patient will demonstrate increased mobility in 2 days.
A
Which of the following is an example of a correlational research question? a.Is there a relationship between anxiety and pain level in patients receiving chemotherapy? b. Do patients who participate in an anxiety intervention have lower pain levels than patients that receive usual care c. What is the experience of mothers with young children who are receiving chemotherapy? d. Is there a difference in pain levels between patients on chemotherapy that experience nausea and those without nausea?
A
Which research study characteristic would be inappropriate for qualitative methods? a.Testing an intervention b. Using field notes to collect data c. Coding transcripts d. Developing a theory
A
You read the following statement in a research article "all individuals that came to the clinic that had stage 3 heart failure and were over 70 years old were asked to participate in this cross-sectional, descriptive study." The type of sample in this study would be best described as: a.Purposive b. Snowball c. Simple random sampling d. Maximum representative
A
A researcher is examining the test retest reliability of an instrument to measure depression. The researcher administers the scale and then administered it to the same people the next day. The correlation between the two readings is .89. The researcher concludes with the instrument is: a.a valid instrument of the concept of depression b. a stable instrument with good test retest reliability c. a poor measure of depression d. an unstable instrument that does not meet the criteria for good reliability
B
A nurse has instituted a turn schedule for a patient to prevent skin breakdown. Upon evaluation, the nurse finds that the patient has a stage II pressure ulcer on the buttocks. Which action will the nurse take next? a. Reassess the patient and situation. b. Revise the turning schedule to increase the frequency. c. Delegate turning to the nursing assistive personnel. d. Apply medication to the area of skin that is broken down.
A (If a nursing diagnosis is unresolved or if you determine that a new problem has perhaps developed, reassessment is necessary. A complete reassessment of patient factors relating to an existing nursing diagnosis and etiology is necessary when modifying a plan. The nurse must assess before revising, delegating and applying medication. The breakdown may be a result of inadequate nutritional intake and medication cannot be applied unless there is an order.)
The nurse is providing care to an older adult client who was recently diagnosed with early osteoporosis. Which intervention is most appropriate for the nurse to implement with this client? A) Instituting an exercise plan that includes weight-bearing activities B) Increasing the amount of calcium in the client's diet C) Protecting the client's bones with strict bed rest D) Providing the client with assisted range of motion exercising twice daily
A) Instituting an exercise plan that includes weight-bearing activities
A nurse is caring for a group of patients. Which evaluative measures will the nurse use to determine a patient's responses to nursing care? (Select all that apply.) a. Observations of wound healing b. Daily blood pressure measurements c. Findings of respiratory rate and depth d. Completion of nursing interventions e. Patient's subjective report of feelings about a new diagnosis of cancer
A, B, C, E (You examine the results of care by using evaluative measures, which are assessment skills and techniques (e.g., observations, physiological measurements, use of measurement scales, and patient interview). Examples of evaluative measures include assessment of wound healing and respiratory status, blood pressure measurement, and assessment of patient feelings. You conduct evaluative measures to determine if your patients met expected outcomes, not if nursing interventions were completed.)
Which of the following activities performed by the nurse is/are focused on the patient-centered care principle of physical comfort? (Select all that apply.) A. Asking the patient what a tolerable level of pain is for him or her following surgery B. Providing a back rub at bedtime C. Offering the patient a warm washcloth for his or her hands before eating D. Teaching the patient about the new antihypertensive medication ordered E. Scheduling the patient's follow-up appointments on discharge F. Changing the bed linens for a patient who is experiencing diaphoresis
A, B, C, F Interventions for the patient-centered care principle of physical comfort are focused on care that increases the comfort of the patient. Responding to patients need for pain medications and using nursing interventions that increase comfort are important. Teaching is focused on the principle of continuity and transition; scheduling appointments is an intervention for access to care
Which of the following is/are characteristics of managed care systems? (Select all that apply.) A. Provider receives a predetermined payment for each patient in the program. B. Payment is based on a set fee for each service provided. C. System includes a voluntary prescription drug program for an additional cost. D. System tries to reduce costs while keeping patients healthy. E. Focus of care is on prevention and early intervention.
A, D, E Managed care programs have administrative control over primary health care services for a defined patient population. The provider or health care system receives a predetermined capitated payment for each patient enrolled in the program. In this case the managed care organization assumes financial risk in addition to providing patient care. The focus of care of the organization shifts from individual illness care to prevention, early intervention, and outpatient care. If people stay healthy, the cost of medical care declines. Systems of managed care focus on containing or reducing costs, increasing patient satisfaction, and improving the health or functional status of the individual
During a visit to a family clinic the nurse teaches the mother about immunizations, car seat use, and home safety for an infant and toddler. Which type of nursing interventions are these?
A. Health promotional activities: Health promotion activities focus on interventions designed to maintain the physical, social, emotional, and spiritual health of the family unit. They can include information about specific health behaviors, family coping techniques, and growth and development.
To initiate an intervention the nurse must be competent in three areas, which include: A. Knowledge, function, and specific skills B. Experience, advanced education, and skills. C. Skills, finances, and leadership. D. Leadership, autonomy, and skills.
A. Knowledge, function, and specific skills
When calling the nurse consultant about a difficult client-centered problem, the primary nurse is sure to report the following: A. Length of time the current treatment has been in place. B. The spouse's reaction to the client's dressing change. C. Client's concern about the current treatment. D. Physician's reluctance to change the current treatment plan.
A. Length of time the current treatment has been in place.
Which of the following is an example of the nurse participating in primary care activities? A. Providing prenatal teaching on nutrition to a pregnant woman during the first trimester B. Working with patients in a cardiac rehabilitation program C. Assessing a patient at an emergent care facility D. Providing home wound care to a patient
A. Primary care activities are focused on health promotion. Health-promotion programs contribute to quality health care by helping patients acquire healthier lifestyles. Health-promotion activities keep people healthy through exercise, good nutrition, rest, and adopting positive health attitudes.
The 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? A. Patient will be able to walk 200 feet without shortness of breath B. Wound will heal without signs of infection C. Patient will express concerns related to return to home D. Patient will identify strategies to improve sleep habits
A. Restorative interventions focus on returning a patient to his or her previous level of function or a new level of function limited by his or her illness or disability. The goal of restorative care is to help individuals regain maximal functional status and enhance quality of life by promoting independence.
Caring
Defines as having concern or regard for another and is conceptualized as a human trait, a moral imperative, an affect, the nurse-patient, interpersonal relationship, and therapeutic intervention
3. The standing orders for a patient include acetaminophen 650 mg every 4 hours prn for headache. After assessing the patient, the nurse identifies the need for headache relief and determines that the patient has not had acetaminophen in the past 4 hours. Which action will the nurse take next? a.Administer the acetaminophen. b.Notify the health care provider to obtain a verbal order. c.Direct the nursing assistive personnel to give the acetaminophen. d.Perform a pain assessment only after administering the acetaminophen.
ANS: A A standing order is a preprinted document containing orders for the conduct of routine therapies, monitoring guidelines, and/or diagnostic procedures for specific patients with identified clinical problems. The nurse will administer the medication. Notifying the health care provider is not necessary if a standing order exists. The nursing assistive personnel are not licensed to administer medications; therefore, medication administration should not be delegated to this person. A pain assessment should be performed before and after pain medication administration to assess the need for and effectiveness of the medication.
4. Which action indicates a nurse is using critical thinking for implementation of nursing care to patients? a.Determines whether an intervention is correct and appropriate for the given situation b.Reads over the steps and performs a procedure despite lack of clinical competency c.Establishes goals for a particular patient without assessment d.Evaluates the effectiveness of interventions
ANS: A As you implement interventions, use critical thinking to confirm whether the interventions are correct and still appropriate for a patient's clinical situation. You are responsible for having the necessary knowledge and clinical competency to perform interventions for your patients safely and effectively. The nurse needs to recognize the safety hazards of performing an intervention without clinical competency and seek assistance from another nurse. The nurse cannot evaluate interventions until they are implemented. Patients need ongoing assessment before establishing goals because patient conditions can change very rapidly.
20. The nurse is revising the care plan. In which order will the nurse perform the tasks, beginning with the first step? 1. Revise specific interventions. 2. Revise the assessment column. 3. Choose the evaluation method. 4. Delete irrelevant nursing diagnoses. a.2, 4, 1, 3 b.4, 2, 1, 3 c.3, 4, 2, 1 d.4, 2, 3, 1
ANS: A Modification of an existing written care plan includes four steps: 1. Revise data in the assessment column to reflect the patient's current status. Date any new data to inform other members of the health care team of the time that the change occurred. 2. Revise the nursing diagnoses. Delete nursing diagnoses that are no longer relevant and add and date any new diagnoses. Revise related factors and the patient's goals, outcomes, and priorities. Date any revisions. 3. Revise specific interventions that correspond to the new nursing diagnoses and goals. Be sure that revisions reflect the patient's present status. 4. Choose the method of evaluation for determining whether you achieved patient outcomes.
17. A staff development nurse is providing an inservice for other nurses to educate them about the Nursing Interventions Classification (NIC) system. During the inservice, which statement made by one of the nurses in the room requires the staff development nurse to clarify the information provided? a."This system can help medical students determine the cost of the care they provide to patients." b."If the nursing department uses this system, communication among nurses who work throughout the hospital may be enhanced." c."We could use this system to help organize orientation for new nursing employees because we can better explain the nursing interventions we use most frequently on our unit." d."The NIC system provides one way to improve safe and effective documentation in the hospital's electronic health record."
ANS: A NIC does not help determine the cost of services provided by nurses. The staff development nurse would need to correct this misconception. Because this system is specific to nursing practice, it would not help medical students determine the costs of care. The NIC system developed by the University of Iowa differentiates nursing practice from that of other health care disciplines. All the other statements are true. Benefits of using NIC include enhancing communication among nursing staff and documentation, especially within health information systems such as an electronic documentation system. NIC also helps nurses identify the nursing interventions they implement most frequently. Units that identify routine nursing interventions can use this information to develop checklists for orientation.
2. A nurse is providing nursing care to a group of patients. Which actions are direct care interventions? (Select all that apply.) a.Ambulating a patient b.Inserting a feeding tube c.Performing resuscitation d.Documenting wound care e.Teaching about medications
ANS: A, B, C, E All of the interventions listed (ambulating, inserting a feeding tube, performing resuscitation, and teaching) are direct care interventions involving patient and nurse interaction, except documenting wound care. Documenting wound care is an example of an indirect intervention.
4. Which interventions are appropriate for a patient with diabetes and poor wound healing? (Select all that apply.) a.Perform dressing changes twice a day as ordered. b.Teach the patient about signs and symptoms of infection. c.Instruct the family about how to perform dressing changes. d.Gently refocus patient from discussing body image changes. e.Administer medications to control the patient's blood sugar as ordered.
ANS: A, B, C, E Nursing priorities include interventions directed at enhancing wound healing. Teaching the patient about signs and symptoms of infection will help the patient identify signs of appropriate wound healing and know when the need for calling the health care provider arises. Performing dressing changes, controlling blood sugars through administration of medications, and instructing the family in dressing changes all contribute to wound healing. As long as a patient is stable and alert, it is appropriate to allow family to assist with care. The patient should be allowed to discuss body image changes.
3. A nurse is preparing to carry out interventions. Which resources will the nurse make sure are available? (Select all that apply.) a.Equipment b.Safe environment c.Confidence d.Assistive personnel e.Creativity
ANS: A, B, D A nurse will organize time and resources in preparation for implementing nursing care. Most nursing procedures require some equipment or supplies. Before performing an intervention, decide which supplies you need and determine their availability. Patient care staff (assistive personnel) work together as patients' needs demand it. A patient's care environment needs to be safe and conducive to implementing therapies. Confidence and creativity are needed to provide safe and effective patient care; however, these are critical thinking attitudes, not resources.
LTC ins
supplemental ins for coverage of LTC services. provides set amount of r2 years
2. The nurse is teaching a new nurse about protocols. Which information from the new nurse indicates a correct understanding of the teaching? a.Protocols are guidelines to follow that replace the nursing care plan. b.Protocols assist the clinician in making decisions and choosing interventions for specific health care problems or conditions. c.Protocols are policies designating each nurse's duty according to standards of care and a code of ethics. d.Protocols are prescriptive order forms that help individualize the plan of care.
ANS: B A clinical practice guideline or protocol is a systematically developed set of statements that helps nurses, physicians, and other health care providers make decisions about appropriate health care for specific clinical situations. This guideline establishes interventions for specific health care problems or conditions. The protocol does not replace the nursing care plan. Evidence-based guidelines from protocols can be incorporated into an individualized plan of care. A clinical guideline is not the same as a hospital policy. Standing orders contain orders for the care of a specific group of patients. A protocol is not a prescriptive order form like a standing order.
8. A patient visiting with family members in the waiting area tells the nurse "I don't feel good, especially in the stomach." What should the nurse do? a.Request that the family leave, so the patient can rest. b.Ask the patient to return to the room, so the nurse can inspect the abdomen. c.Ask the patient when the last bowel movement was and to lie down on the sofa. d.Tell the patient that the dinner tray will be ready in 15 minutes and that may help the stomach feel better.
ANS: B In this case, the environment needs to be conducive to completing a thorough assessment. A patient's care environment needs to be safe and conducive to implementing therapies. When you need to expose a patient's body parts, do so privately by closing room doors or curtains because the patient will then be more relaxed; the patient needs to return to the room for an abdominal assessment for privacy and comfort. The family can remain in the waiting area while the nurse assists the patient back to the room. Beginning the assessment in the waiting area (lie down on the sofa) in the presence of family and other visitors does not promote privacy and patient comfort. Telling the patient that the dinner tray is almost ready is making an assumption that the abdominal discomfort is due to not eating. The nurse needs to perform an assessment first.
15. The nurse establishes trust and talks with a school-aged patient before administering an injection. Which type of implementation skill is the nurse using? a.Cognitive b.Interpersonal c.Psychomotor d.Judgmental
ANS: B Nursing practice includes cognitive, interpersonal, and psychomotor skills. Interpersonal skills involve developing trusting relationships with patients, conveying caring and compassion, and communicating clearly. Cognitive skills include critical thinking and decision-making skills. Psychomotor skill requires the integration of cognitive and motor abilities, such as administering the injection. Being judgmental is not appropriate in nursing; nurses are nonjudgmental.
9. A newly admitted patient who is morbidly obese asks the nurse for assistance to the bathroom for the first time. Which action should the nurse take initially? a.Ask for at least two other assistive personnel to come to the room. b.Medicate the patient to alleviate discomfort while ambulating. c.Review the patient's activity orders. d.Offer the patient a walker.
ANS: C Before beginning care, review the plan to determine the need for assistance and the type required. Before intervening, the nurse must check the patient's orders. For example, if the patient is on bed rest, the nurse will need to explain the use of a bedpan rather than helping the patient get out of bed to go to the bathroom. Asking for assistive personnel is appropriate after making sure the patient can get out of bed. If the patient is obese, the nurse will likely need assistance in getting the patient to the bathroom. Medicating the patient before checking the orders is not advised in this situation. Before medicating for pain, the nurse needs to perform a pain assessment. Offering the patient a walker is a premature intervention until the orders are verified.
5. A nurse is reviewing a patient's care plan. Which information will the nurse identify as a nursing intervention? a.The patient will ambulate in the hallway twice this shift using crutches correctly. b.Impaired physical mobility related to inability to bear weight on right leg. c.Provide assistance while the patient walks in the hallway twice this shift with crutches. d.The patient is unable to bear weight on right lower extremity.
ANS: C Providing assistance to a patient who is ambulating is a nursing intervention. The statement, "The patient will ambulate in the hallway twice this shift using crutches correctly" is a patient outcome. Impaired physical mobility is a nursing diagnosis. The statement that the patient is unable to bear weight and ambulate can be included with assessment data and is a defining characteristic for the diagnosis of Impaired physical mobility.
14. A nurse is making initial rounds on patients. Which intervention for a patient with poor wound healing should the nurse perform first? a.Reinforce the wound dressing as needed with 4 × 4 gauze. b.Perform the ordered dressing change twice daily. c.Observe wound appearance and edges. d.Document wound characteristics.
ANS: C The most appropriate initial intervention is to assess the wound (observe wound appearance and edges). The nurse must assess the wound first before the findings can be documented, reinforcement of the dressing, and the actual skill of dressing changes.
1. A nurse is implementing interventions for a group of patients. Which actions are nursing interventions? (Select all that apply.) a.Order chest x-ray for suspected arm fracture. b.Prescribe antibiotics for a wound infection. c.Reposition a patient who is on bed rest. d.Teach a patient preoperative exercises. e.Transfer a patient to another hospital unit.
ANS: C, D, E A nursing intervention is any treatment based on clinical judgment and knowledge that a nurse performs to enhance patient outcomes. Repositioning, teaching, and transferring a patient are examples of nursing interventions. Ordering a chest x-ray and prescribing antibiotics are examples of medical interventions performed by a health care provider.
A nurse is using the problem-oriented approach to data collection. Which action will the nurse take first? a. Complete the questions in chronological order. b. Focus on the patient's presenting situation. c. Make accurate interpretations of the data. d. Conduct an observational overview.
B
Evidence based practice suggests that oral temperature measurement is the best non-invasive option for temperature assessment, however, in some situations oral may not be used. In what types of patients would oral temperature NOT be suggested? a. Adult patients b. Unconscious patients c. Elderly patients d. Patients on droplet precautions
B
Experimental studies should incorporate allocation concealment. Which statement describes the concept of allocation concealment? a.the researcher uses a random number table b. opaque envelopes are used to assign participants to be experimental and control group c. The investigator does not know who was in the experimental and control group d. the person completing the outcome measure does not know who is in the experimental and control group
B
If a hospital wants to achieve American Nurses' Credentialing Center (ANCC) Magnet Status, it must demonstrate: a.Hiring of only BSN prepared nurses b. Participating in research and use of evidence-based practice by staff c. Assuming unit leaders are prepared at least with a master's degree d. Paying nurses above the mean level of salary in the region
B
In a cohort study of women being followed for breast cancer, the researcher reports that the relative risk for developing breast cancer is 4.2 if you have a BMI of 40 compared to a women with a normal BMI. This means that: a. Obesity is a protective factor for breast cancer b. If a woman is obese she is about 4 times as likely to develop breast cancer compared to woman with a normal weight c. Obesity causes breast cancer d. If a woman is obese she is about 4 times less likely to develop breast cancer compared to a woman with is of normal weight
B
Personal privacy may be more difficult for nurse researchers to protect in qualitative studies that in quantitative studies due to: a.Participants may be related to each other b. The researcher meets face to face with most participants c. Participants are not asked to sign an informed consent statement d. Verbatim quotations from participants may reveal personal information
B
The nurse at the ambulatory care clinic is counseling a client about how to begin an exercise program using Pender's Health Promotion Model as a guide. Which question/statement during the assessment best indicates the use of the model? a.What is your BMI? b. Tell me about the types of exercises you like and don't like c. Do you want to try to use a FITBIT to monitor your exercise? d. Weight loss is difficult, but you can be successful if you make it a priority
B
The nurse has created the following clinical question: "In older patients with chronic obstructive pulmonary disease, what is the effect of aerobic exercise compared to anaerobic exercise on perceived tolerance to activities of daily living?" When using the PICOT model, what is the outcome of this clinical question? a.Older patients with chronic obstructive pulmonary disease b. Perceived tolerance of activities of daily living c. Anaerobic exercise d. Aerobic exercise
B
What information in the report of a qualitative research study indicates that the research meets the criterion of "fittingness"? a. The study's participants recognize the experience described as their own b. The results are meaningful to nursing and others not in the study c. The researcher allowed adequate time to understand the phenomenon d. The researcher documented steps of analysis and how the data lead to the conclusions
B
What is the null hypothesis? a.A prediction made to test a theory based on an observation in experimental designed studies b. A statement proposing no effect or relationships between a phenomena or population c. A set of ideas that drive an area of research to test to negative effect d. A set of related statements that explain a variety of occurrences
B
Which cluster of concepts is critical for developing an evidence-based practice model? a. Clinical expertise and best research evidence b. Clinical expertise, best research evidence, patient needs and values c. Patient needs and values and best research evidence d. Best research evidence, clinical practice guidelines, and hospital policy
B
You are a nurse researcher in a rural clinic for underserved pregnant women needing prenatal care. With regard to research in the patient population of pregnant women, you understand: a. Pregnant women are not allowed in studies due to being vulnerable subjects b. Special precautions must be taken to safeguard pregnant women participating in research c. Research is not approved for pregnant women due to potential risks to the unborn fetus d. Pregnant women are not considered a vulnerable population with no additional precautions needed.
B
The nurse is caring for a patient who has an order to change a dressing twice a day, at 0600 and 1800. At 1400, the nurse notices that the dressing is saturated and leaking. What is the nurse's next action? a. Wait and change the dressing at 1800 as ordered. b. Revise the plan of care and change the dressing now. c. Reassess the dressing and the wound in 2 hours. d. Discontinue the plan of care for wound care.
B (Because the dressing is saturated and leaking, the nurse needs to revise the plan of care and change the dressing now. Reflection-in-action involves a nurse's ability to recognize how a patient is responding and then adjusting interventions as a result. A nurse will either change the frequency of an intervention, change how the intervention is delivered, or select a new intervention. Waiting until 1800 or for another 2 hours is not appropriate because assessment data reflect that the dressing is saturated and needs to be changed now. Data are insufficient to support discontinuing the plan of care. Instead, data at this time indicate the need for revision of the plan of care.)
A nurse is providing education to a patient about self-administering subcutaneous injections. The patient demonstrates the self-injection. Which type of indicator did the nurse evaluate? a. Health status b. Health behavior c. Psychological self-control d. Health service utilization
B (Health behavior involves demonstrating a psychomotor skill such as self-injection. Health status is a clinical indicator such as exercise tolerance or blood pressure control. The skill is psychomotor, not psychological self-control. Health service utilization is readmission within 30 days or emergency department use.)
A nurse is modifying a patient's care plan after evaluation of patient care. In which order, starting with the first step, will the nurse perform the tasks? 1. Revise nursing diagnosis. 2. Reassess blood pressure reading. 3. Retake blood pressure after medication. 4. Administer new blood pressure medication. 5. Change goal to blood pressure less than 140/90. a. 1, 5, 2, 4, 3 b. 2, 1, 5, 4, 3 c. 4, 3, 1, 5, 2 d. 5, 4, 5, 1, 2
B (If a nursing diagnosis is unresolved or if you determine that a new problem has perhaps developed, reassessment is necessary. A complete reassessment of patient factors relating to an existing nursing diagnosis and etiology is necessary when modifying a plan. After reassessment, determine which nursing diagnoses are accurate for the situation; revise as needed. When revising a care plan, review the goals and expected outcomes for necessary changes after the diagnosis. Then evaluate and revise interventions as needed.)
The nurse is evaluating whether patient goals and outcomes have been met for a patient with physical mobility problems due to a fractured leg. Which finding indicates the patient has met an expected outcome? a. The nurse provides assistance while the patient is walking in the hallways. b. The patient is able to ambulate in the hallway with crutches. c. The patient will deny pain while walking in the hallway. d. The patient's level of mobility will improve.
B (The patient's being able to ambulate in the hallway with crutches is an expected outcome of nursing care. The outcomes of nursing practice are the measurable conditions of patient, family or community status, behavior, or perception. These outcomes are the criteria used to judge success in delivering nursing care. The option stating, "The patient's level of mobility will improve" is a broader goal statement. The nurse's assisting a patient to ambulate is an intervention. The patient's denying pain is an expected outcome for pain, not for physical mobility problems.)
A nurse is getting ready to discharge a patient who has a problem with physical mobility. What does the nurse need to do before discontinuing the patient's plan of care? a. Determine whether the patient has transportation to get home. b. Evaluate whether patient goals and outcomes have been met. c. Establish whether the patient has a follow-up appointment scheduled. d. Ensure that the patient's prescriptions have been filled to take home.
B (You evaluate whether the results of care match the expected outcomes and goals set for a patient before discontinuing a patient's plan of care. The patient needs transportation, but that does not address the patient's mobility status. Whether the patient has a follow-up appointment and ensuring that prescriptions are filled do not evaluate the problem of mobility.)
The nursing staff is developing a quality program for the floor. Which of the following are nursing-sensitive indicators from the National Database of Nursing Quality Indicators that the nurses can use to measure patient safety and quality for the unit? (Select all that apply.) A. Number of medication errors committed by registered nurses (RNs) B. Turnover rate of nurses on the unit C. Incidence of patient falls D. Number of certified RNs E. Number of emergency department admissions per year
B, C, D Nursing-sensitive outcomes are patient outcomes that are directly related to nursing care such as changes in patients symptom experiences, functional status, safety, psychological distress, and costs. They are also related to the environment in which nurses practice, which impact patient outcomes. For example, the nursing staff that implements strategies to decrease turnover on the nursing unit impacts overall hospital turnover rates. Nurses assume accountability and responsibility for the consequences of these outcomes
Which of the following are examples of the principle of patient-centered care that is focused on respect, values, preferences, and expressed needs? (Select all that apply.) A. Administer antihypertensive medications to patient daily. B. Pulling the curtain around the patient bed before changing the wound dressing on the patient's leg C. Allowing the patient to ask questions and express his or her concern about surgery D. Explaining a colonoscopy procedure to the patient E. Working with the family to bring in ethnic foods that the patient prefers
B, C, E Patient-centered care that is focused on respect, values, preferences, and expressed needs focuses on treating the patient with dignity and respect. A component is to keep the patient informed and involved in decision making. Consider patient preferences and perspectives when planning care. An environment where the patient is respected focuses on quality of life.
Which nursing actions reflect the use of philosophy as a knowledge base when delivering evidence- based care to patients? Select all that apply. A. A nurse interviews and examines a new patient diagnosed with prehypertension to formulate a care plan B. A nurse draws from personal experiences of being a patient to establish a therapeutic relationship with a patient C. A nurse searches the Internet to find the latest treatments for type 2 diabetes. D. A nurse uses spiritual training to draw strength when counseling a patient who is in hospice for an inoperable brain tumor E. A nurse follows the protocol for assessing postoperative patients in the ICU F. A nursing student studies anatomy and physiology of the body systems to understand the disease states of assigned patients
B, D Philosophy is the study of wisdom, fundamental knowledge, and the processes used to develop and construct one's perceptions of life. A philosophy is developed from personal experiences through formal and informal educational experiences, through religion and culture, and from the environment. Interviewing and examining patients to formulate a care plan and using protocol for assessing patients in the ICU involve knowledge of processes. Researching the Internet and studying anatomy and physiology use scientific knowledge to deliver evidence based care
Which nursing actions will the nurse perform in the evaluation phase of the nursing process? (Select all that apply.) a. Set priorities for patient care. b. Determine whether outcomes or standards are met. c. Ambulate patient 25 feet in the hallway. d. Document results of goal achievement. e. Use self-reflection and correct errors.
B, D, E (The expected outcomes established during planning are the standards against which you judge whether goals have been met and if care is successful. You evaluate whether the results of care match the expected outcomes and goals set for a patient. Documentation and reporting are important parts of evaluation because it is crucial to share information about a patient's progress and current status. Using self-reflection and correcting errors are indicators a nurse is performing evaluation. Setting priorities is part of planning, and ambulating with a patient in the hallway is an intervention, so it is included in the implementation step of the nursing process.)
Despite a national focus on health promotion, nurses working with patients in inner-city clinics continue to see disparities in health care for vulnerable populations. Which patients would be considered vulnerable populations? Select all that apply. A. A White male diagnosed with HIV B. An African American teenager who is 6 months pregnant C. A Hispanic male who has type II diabetes D. A low-income family living in rural America E. A middle-class teacher living in a large city F. A White baby who was born with cerebral palsy
B. An African American teenager who is 6 months pregnant C. A Hispanic male who has type II diabetes D. A low-income family living in rural America F. A White baby who was born with cerebral palsy
As goals, outcomes, and interventions are developed, the nurse must: A. Be in charge of all care and planning for the client. B. Be aware of and committed to accepted standards of practice from nursing and other disciplines. C. Not change the plan of care for the client. D. Be in control of all interventions for the client.
B. Be aware of and committed to accepted standards of practice from nursing and other disciplines.
When developing a nursing care plan for a client with a fractured right tibia, the nurse includes in the plan of care independent nursing interventions, including: A. Apply a cold pack to the tibia. B. Elevate the leg 5 inches above the heart. C. Perform range of motion to right leg every 4 hours. D. Administer aspirin 325 mg every 4 hours as needed.
B. Elevate the leg 5 inches above the heart
A client centered goal is a specific and measurable behavior or response that reflects a client's: A. Desire for specific health care interventions B. Highest possible level of wellness and independence in function. C. Physician's goal for the specific client. D. Response when compared to another client with a like problem.
B. Highest possible level of wellness and independence in function
When establishing realistic goals, the nurse: A. Bases the goals on the nurse's personal knowledge. B. Knows the resources of the health care facility, family, and the client. C. Must have a client who is physically and emotionally stable. D. Must have the client's cooperation.
B. Knows the resources of the health care facility, family, and the client.
Rockenstocks health belief model
Based on four core beliefs of people's perceptions by their own assessment: perceived susceptibility of the risk of getting the condition, perceived severity of the seriousness of the condition and potential consequences, perceived barriers of the influences that facilitates or discourages adoption of the promoted behavior, perceived benefits of the positive consequences of adopting the behavior
A nurse researcher is doing an experiment to determine the best method of teaching elderly patients how to take their medications accurately at home. The researcher wants to have an equal number of men and women. The list of possible participants is divided by gender and then the researcher randomly chooses participants from each list. This is an example of: a.Convenience sampling b. Cluster sampling c. Stratified random sampling d. Snowball sampling
C
A nurse researcher proposed the following question "What is the effect of breast feeding by teen mothers on the rate if infant infections during the first 6 months of life?" The dependent variable in this question is: a.Teen mothers b. Breast feeding c. The rate if infant infections d. The first 6 months of life
C
There is evidence to support that turning a patient every 2 to 4 hours prevents the development of a pressure injury. In what situation would it be most important for this recommendation to be implemented? a. For a patient in an acute setting who has no mobility impairment b. A patient who came in with shortness of breath and no insurance c. A confused elderly patient with a preexisting pressure injury who has a limited ability to swallow and move in bed d. A pregnant woman due to deliver in two days' time
C
Two researchers are conducting a study in which they compare people who have ling cancer to people that do not have lung cancer. They are reviewing past medical records for possible risk factors that related to the lung cancer This is an example of a: a.Cross-sectional descriptive study b. Prospective cohort study c. Retrospective case study d. Quasi-experimental study
C
What is the purpose of a literature review? a.To develop a PICOT question b. To gain knowledge about patient symptomology c. To identify the gaps in the evidence d. To utilize the clearinghouse server
C
What is the social process nurses use to communicate with residents in a teaching hospital? a.Case study b. Phenomenology c. Grounded theory d. Ethnographic method
C
Which method of data collection will the nurse use to establish a patient's database? a. Reviewing the current literature to determine evidence-based nursing actions b. Checking orders for diagnostic and laboratory tests c. Performing a physical examination d. Ordering medications
C
Which statement is accurate regarding the assent process for children considered old enough to assent for participation in pediatric research? a. A parental/guardian signature is not required for children who assent to participate in a study b. The study purpose is reviews with parents, not children c. The child should be able to express a preference for participation d. A child older than age 16 does not require a parent's signature for consent
C
You are caring for a patient. Visitors at the bedside include the patient's life partner, widowed father, brother, and niece. The nurse acknowledges that current trends in American families include A. Couples without children. B. More singles choosing to live alone. C. A very different look from 15 years ago. D. A mother, father, and more than one child.
C
You have completed a research study where the null hypothesis is "there is no difference in depression between patients that receive an educational intervention and those that receive routine care". You use a t-test and determine that there is a difference in the scores between the experimental and the control group. The p value is statistically significant at the 0.01 level, this means a.The results have a strong relationship to clinical significance b. There is one chance in ten that these results are due to chance c. There is one chance in a hundred that these results are due to chance d. The null hypothesis should be accepted
C
You read the following statement in a research article: F(6,42)=6.45, p=0.01. Which statement accurately reflects the interpretation of this information? a. The researchers used a Chi square test but the results are not statistically significant b. The researchers used a Chi square test and the results are statistically significant c. The researchers used Analysis of Variance and the results are statistically significant d. The researchers used Analysis of Variance and the results are not statistically significant
C
Which type of quantitative research is often conducted to examine the effects of nursing intervention on patient outcomes? A. Descriptive research B. Correlational research C. Quasi- experimental research D. Experimental research
C Quasi- experimental research is often conducted in clinical settings to examine the effects of nursing interventions on patient outcomes
It is important for the nurse to understand that evidence-based practice guidelines are: a.Based on a systematic review b. Includes recommendations for practice c. Includes a research question and methods section d. A and B above e. All of the above
D
capitation
the providers receive a fixed amount per pt or enrollee of a health care plan, influences the way health care providers deliver care in all types of settings
The nurse is caring for a patient who has an open wound and is evaluating the progress of wound healing. Which priority action will the nurse take? a. Ask the nursing assistive personnel if the wound looks better. b. Document the progress of wound healing as "better" in the chart. c. Measure the wound and observe for redness, swelling, or drainage. d. Leave the dressing off the wound for easier access and more frequent assessments.
C ( You examine the results of care by using evaluative measures, which are assessment skills and techniques (e.g., observations, physiological measurements, use of measurement scales, and patient interview). The nurse performs evaluative measures, such as completing a wound assessment, to evaluate wound healing. Nurses do not delegate assessment to nursing assistive personnel. Documenting "better" is subjective and does not objectively describe the wound. Leaving the dressing off for the nurse's benefit of easier access is not a part of the evaluation process.)
A new nurse asks the preceptor to describe the primary purpose of evaluation. Which statement made by the nursing preceptor is most accurate? a. "An evaluation helps you determine whether all nursing interventions were completed." b. "During evaluation, you determine when to downsize staffing on nursing units." c. "Nurses use evaluation to determine the effectiveness of nursing care." d. "Evaluation eliminates unnecessary paperwork and care planning."
C (Evaluation is a methodical approach for determining if nursing implementation was effective in influencing a patient's progress or condition in a favorable way. During evaluation, you do not simply determine whether nursing interventions were completed. The evaluation process is not used to determine when to downsize staffing or how to eliminate paperwork and care planning.)
A nurse is evaluating the goal of acceptance of body image in a young teenage girl. Which statement made by the patient is the best indicator of progress toward the goal? a. "I'm worried about what those other girls will think of me." b. "I can't wear that color. It makes my hips stick out." c. "I'll wear the blue dress. It matches my eyes." d. "I will go to the pool next summer."
C (The nurse is evaluating the improvement in body image. The only positive comment made is that the patient is wearing the blue dress to match her eyes. Worrying about others, making my hips stick out, and going to the pool next summer do not reflect positive changes in body image.)
After assessing the patient and identifying the need for headache relief, the nurse administers acetaminophen for the patient's headache. Which action by the nurse is priority for this patient? a. Eliminate headache from the nursing care plan. b. Direct the nursing assistive personnel to ask if the headache is relieved. c. Reassess the patient's pain level in 30 minutes. d. Revise the plan of care.
C (The nurse's priority action for this patient is to evaluate whether the nursing intervention of administering acetaminophen was effective. The nurse does not have enough evaluative data at this point to determine whether headache needs to be discontinued. Assessment is the nurse's responsibility and is not to be delegated to nursing assistive personnel. The nurse does not have enough evaluative data to determine whether the patient's plan of care needs to be revised.)
Planning is a category of nursing behaviors in which: A. The nurse determines the health care needed for the client. B. The Physician determines the plan of care for the client. C. Client-centered goals and expected outcomes are established. D. The client determines the care needed.
C. Client-centered goals and expected outcomes are established.
The patient tells the 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? A. This health plan is for people who cannot afford their own health insurance B. This health plan is operated by the government to provide health care to older adults C. This health plan provides you with a preferred list of physicians, hospitals, and providers from which you can choose D. This is a fee-for-service plan in which you can choose any physician or hospital
C. Preferred provider organization (PPO) plans limit the enrollee's choice to a list of preferred providers such as hospitals and physicians. A participant pays more to use a provider not on the preferred list. PPO plans focus on health maintenance.
The Collins family includes a mother, Jean; stepfather, Adam; two teenage biological daughters of the mother, Lisa and Laura; and a biological daughter of the father, 25-year-old Stacey. Stacey just moved home following the loss of her job in another city. The family is converting a study into Stacey's bedroom and is in the process of distributing household chores. When you talk to members of the family, they all think that their family can adjust to lifestyle changes. This is an example of family: diversity durability resiliency configuration
C. Resiliency is the ability of the family to cope with the unexpected. In this scenario the family used resources to provide some short-term solutions for the adult child's return home.
Mary has decided to set aside 30 minutes a day to walk after work next week. Mary is in what stage of risk factor modification? A.) Precontemplation B.) Contemplation C.) Preparation D.) Action E.) Maintenance
C.) preparation
According to Maslows hierarchy of needs, which of these needs would the patient seek to meet first? A.) Self-actaulization B.) psychological security C.) shelter D.) love and belonging
C.) shelter
Leininger's Theory
Care is a central unifying focus of nursing, a cure cannot occur without caring, culture is embedded in all aspects of ones being, and culturally congruent care promotes health and well-being
A researcher is interested in exploring the level of stress experienced by nursing students enrolled in a bacclaurete nursing program. The investigator plans to recruit the sample from a list of students that belong to the National Student Nurses Association. The type of bias that is most likely to be found in this study is: a. Investigator bias b. Implementation bias c. Analysis bias d. Sample selection bias
D
In an experimental research study which type of variable is manipulated by the investigator? a. Both the dependent and independent variable b. Neither the dependent or the independent variable c. The dependent variable only d. The independent variable only
D
In research studies using control groups, it is important for researchers to understand: a.placebos can be "sugar" pills b. placebos can be "sham" treatments c. patients given placebos sometimes experience actual improvement d. all of the above
D
The best level of evidence for a clinical intervention is provided by: a. Several cross sectional longitudinal studies on the topic b. A report from an expert on the topic c. A combination of non-experimental and qualitative studies d. A systematic review that synthesizes several randomized controlled trials
D
Which of the following is not a part of the recommendations from the Choosing Wisely Campaign: a.Don't automatically start fetal monitoring on low-risk pregnant women b. Limit the use of physical restraints on older hospitalized patients c. Insert urinary catheters in a patient only when it is necessary d. Change peripheral IV's every 48 hours
D
A nurse determines that the patient's condition has improved and has met expected outcomes. Which step of the nursing process is the nurse exhibiting? a. Assessment b. Planning c. Implementation d. Evaluation
D (Evaluation, the final step of the nursing process, is crucial to determine whether, after application of the first four steps of the nursing process, a patient's condition or well-being improves and if goals have been met. Assessment, the first step of the process, includes data collection. Planning, the third step of the process, involves setting priorities, identifying patient goals and outcomes, and selecting nursing interventions. During implementation, nurses carry out nursing care, which is necessary to help patients achieve their goals.)
A nurse completes a thorough database and carries out nursing interventions based on priority diagnoses. Which action will the nurse take next? a. Assessment b. Planning c. Implementation d. Evaluation
D (Evaluation, the final step of the nursing process, is crucial to determine whether, after application of the first four steps of the nursing process, a patient's condition or well-being improves. Assessment involves gathering information about the patient. During the planning phase, patient outcomes are determined. Implementation involves carrying out appropriate nursing interventions.)
A patient was recently diagnosed with pneumonia. The nurse and the patient have established a goal that the patient will not experience shortness of breath with activity in 3 days with an expected outcome of having no secretions present in the lungs in 48 hours. Which evaluative measure will the nurse use to demonstrate progress toward this goal? a. No sputum or cough present in 4 days b. Congestion throughout all lung fields in 2 days c. Shallow, fast respirations 30 breaths per minute in 1 day d. Lungs clear to auscultation following use of inhaler
D (In this case, the patient's goal is to not experience shortness of breath with activity in 3 days. If the lung sounds are clear following use of inhaler, the nurse can determine that the patient is making progress toward achieving the expected outcome. One way for the nurse to evaluate the expected outcome is to assess the patient's lung sounds. Goals are broad statements that describe changes in a patient's condition or behavior. Expected outcomes are measurable criteria used to evaluate goal achievement. When an outcome is met, you know that the patient is making progress toward goal achievement. The time frame of 4 days in the first option is not appropriate because this time frame exceeds the time frame stated in the goal. Congestion indicates fluid in the lungs, and a respiratory rate of 30 breaths per minute is elevated/abnormal. This indicates that the patient is still probably experiencing shortness of breath and secretions in the lungs.)
The nurse is evaluating whether a patient's turning schedule was effective in preventing the formation of pressure ulcers. Which finding indicates success of the turning schedule? a. Staff documentation of turning the patient every 2 hours b. Presence of redness only on the heels of the patient c. Patient's eating 100% of all meals d. Absence of skin breakdown
D (To determine whether a turning schedule is successful, the nurse needs to assess for the presence of skin breakdown. Redness on any part of the body, including only the patient's heels, indicates that the turning schedule was not successful. Documentation of interventions does not evaluate whether patient outcomes were met. Eating 100% of meals does not evaluate the effectiveness of a turning schedule.)
A nurse is presenting information to a management class of nursing students on the topic of groups of inpatient hospital services that have a fixed reimbursement amount, with adjustments made on the basis of case severity and regional costs. The nurse is presenting information to the class on which topic? A. Utilization review committee B. Resource utilization group C. Capitation payment system D. Diagnosis-related groups
D. Diagnosis-related groups (DRGs) are grouped inpatient hospital services for Medicare patients. Each group has a fixed reimbursement amount, with adjustments based on case severity, rural/urban/regional costs, and teaching costs. Hospitals receive a set amount for each patient based on the assigned DRG, regardless of patient's length of stay or use of services. DRGs are part of the prospective payment system.
A family's access to adequate health care, opportunity for education, sound nutrition, and decreased stress is affected by: development family function family structure economic stability
D. Economic Stability: the ability of families to meet health care, education, and basic needs is often affected by the economic resources of the family.
The following statements appear on a nursing care plan for a client after a mastectomy: Incision site approximated; absence of drainage or prolonged erythema at incision site; and client remains afebrile. These statements are examples of: A. Nursing interventions B. Short-term goals C. Long-term goals D. Expected outcomes.
D. Expected outcomes.
The planning step of the nursing process includes which of the following activities? A. Assessing and diagnosing B. Evaluating goal achievement. C. Performing nursing actions and documenting them. D. Setting goals and selecting interventions.
D. Setting goals and selecting interventions.
Which of the following statements about the nursing process is most accurate? A. The nursing process is a four-step procedure for identifying and resolving patient problems. B. Beginning in Florence Nightingale's days, nursing students learned and practiced the nursing process. C. Use of the nursing process is optional for nurses, since there are many ways to accomplish the work of nursing. D. The state board examinations for professional nursing practice now use the nursing process rather than medical specialties as an organizing concept.
D. The state board examinations for professional nursing practice now use the nursing process rather than medical specialties as an organizing concept.
Priorities are established to help the nurse anticipate and sequence nursing interventions when a client has multiple problems or alterations. Priorities are determined by the client's: A. Physician B. Non Emergent, non-life threatening needs C. Future well-being. D. Urgency of problems
D. Urgency of problems
Virginia Henderson's theory of of humane and holistic care for patients (1966)
Defines nursing as "assisting individuals to gain independence in relation to the performance of activities contributing to health or its recovery. Her 14 components are based on Maslow's Hierarchy of needs. She described the nurse's role as substitutive (doing for the person), supplementary (helping the person), or complimentary (working with the person), with patient independence as the ultimate goal
scope of practice
Defines the boundaries of the practice of nursing and clarifies how it may intersect with other professions or disciplines.
A patient has a bacterial infection and left lower leg. Which nursing diagnosis was the nurse add to the patient care plan?
Impaired skin integrity
When the nurse views the family as context, the primary focus is on the health and development of an individual member existing within a specific environment (i.e., the patient's family). Although the focus is on the individual's health status, the nurse should a. Assess how much the family provides the patient's basic needs. b. Assess family patterns versus individual characteristics. c. Maintain distinctions between "family as patient" and "family as context." d. Plan care to meet not only the patient's needs, but those of his family as well.
a. Assess how much the family provides the patient's basic needs. When the nurse views the family as context, the primary focus is on the health and development of an individual member existing within a specific environment (i.e., the patient's family). Although the focus is on the individual's health status, the nurse assesses how much the family provides the individual's basic needs. Family patterns are in the realm of "family as patient." It is important to understand that although the nurse is able to make theoretical and practical distinctions between "family as context" and "family as patient," they are not necessarily mutually exclusive. Often, the nurse will use the two simultaneously, as with the perspective of "family as system." "Family as patient" involves planning to meet the needs of the patient and those of his family as well.
The nurse is interviewing a patient who is being admitted to the hospital. The patient's family went home before the nurse's interview. The nurse asks the patient, "Who decides where to go on vacation?" In asking this, what is the nurse trying to do? a. Assess the family structure. b. Assess the family form. c. Assess the family function. d. Make a categorical generalization.
a. Assess the family structure. To assess the family structure, the nurse asks questions that determine the power structure and patterning of roles and tasks (e.g., "Who decides where to go on vacation?"). When focusing on family form, the nurse should begin the family assessment by determining the patient's definition of family. Family function is the ability of the family to provide emotional support and to cope with health problems or situations. The question asked above will not assess that. It is imperative to remember that categorical generalizations are misleading and should be avoided.
Social scientists have identified four threats facing the family in today's American society. Of the choices below, what are the four threats? *(Select all that apply.)* a. Changing economic status b. Homelessness c. Family violence d. Rise of homosexual families e. Presence of illness
a. Changing economic status b. Homelessness c. Family violence e. Presence of illness ANS: A, B, C, E Social scientists have identified four trends as threats facing the family. These include (1) changing economic status, (2) homelessness, (3) family violence, and (4) the presence of acute or chronic illness. Many homosexual couples define their relationship in family terms, but homosexual families are not listed as a threat facing the family.
The nurse is caring for an elderly patient who has no apparent family. When questioned about his family and his definition of family, the patient states, "I have no family. They're all gone." When asked, "Who prepares your meals?" he states, "I do, or I go out." Given the three different approaches to family nursing practice, which would be most appropriate for this patient? a. Family as context b. Family as patient c. Family as system d. Combination of "family as context" and "family as patient"
a. Family as context If only one family member receives nursing care, it is realistic and practical to view the "family as context." Although family nursing is based on the assumption that all people regardless of age are a member of some type of family form, the patient insists that he has no family. The nurse should investigate further. However, at this time, family as patient, as system, or in a combination is not appropriate.
Although the family as a whole differs from individual members, the measure of family health is more than a summary of the health of all members. Of the following, what areas are unique to family assessment? *(Select all that apply.)* a. Family form b. Family structure c. Family function d. Family health e. Individual health
a. Family form b. Family structure c. Family function d. Family health Although the family as a whole differs from individual members, the measure of family health is more than a summary of the health of all members. The form, structure, function, and health of the family are areas unique to family assessment. Although individual health is important, it varies from the family focus.
The nurse is providing discharge teaching for an older adult woman who will need dressing changes at home. Her husband, who is also elderly, is her only source of care. The husband states that he will not be able to perform the dressing changes. What does the nurse need to arrange for? a. Home care service referrals b. Extra dressing supplies c. Cancellation of the discharge d. An order for antibiotics
a. Home care service referrals Discharge planning with a family involves an accurate assessment of what will be needed for care at the time of discharge, along with any shortcomings in the home setting. If no one can do the dressings properly, the nurse will need to arrange for a home care service referral. Extra dressing supplies will not help the situation if the husband is afraid to use them. Only under extreme situations or in an unsafe situation will the discharge be canceled. An order for antibiotics is not a replacement for good dressing change technique.
Which of the following was a result (or outcome) of this study? In other words, what did the researchers find out? Select one: a. Family members of patients who had preoperative hand massage had lower anxiety levels. b. A statistically significant decrease in the postintervention anxiety measure. c. Postoperative patients who received hand massage had decreased length of stay in the hospital. d. Nurses who gave hand massages had increased anxiety levels.
b. A statistically significant decrease in the postintervention anxiety measure.
A nurse has identified a research question as, "Is there a relationship between self-esteem and body weight among postmenopausal women?" For this study, results of a self-esteem assessment tool will be correlated with body mass index. What type of study is this? Select one: a. Quasi-experimental design b. Non-experimental design c. Phenomenological design d. Randomized controlled trial Feedback
b. Non-experimental design
A researcher is planning an experimental research study that will use human subjects. The researcher has an obligation to ensure that no harm comes to the research participants. This is an example of which ethical principle: Select one: a. Autonomy b. Nonmaleficence c. Beneficence d. Justice
b. Nonmaleficence
What type of study would be most appropriate if the researcher was seeking to answer a question about the effectiveness of a particular treatment? Select one: a. Descriptive b. Quasi-experimental Qualitative
b. Quasi-experimental
A nurse designs a randomized controlled trial to determine which IV catheter brand nurses prefer. Which of the following may be a potential conflict of interest? Select one: a. None of the above are potential conflicts of interest b. Receiving funding from the study from BD, a brand of IV catheters that is being tested c. Working for the hospital in which the IV catheters are being tested d. Receiving funding from the National Institute of Nursing Research (NINR)
b. Receiving funding from the study from BD, a brand of IV catheters that is being tested
When reading a report of a qualitative study, the nurse finds direct quotes from the participants threaded through the narrative. In this instance: Select one: a. The technique ensures that the proper level of data saturation was achieved. b. The researcher is supporting the study's findings. c. The researcher is attempting to make the report more personal. d. The technique violates the privacy rules for participants in the study.
b. The researcher is supporting the study's findings.
Which of the following elements would the nurse expect to find in an article describing a qualitative study? SELECT ALL THAT APPLY. Select one or more: a. Independent variable b. Themes c. Participant quotes d. Statistical procedures e. A hypothesis
b. Themes c. Participant quotes
Why would a researcher assign subjects randomly in a study? Select one: a. To increase the chance that the study group and control group will be different from each other at baseline. b. To help ensure that all groups within a study are representative of the larger population. c. To help ensure that current events do not influence the outcomes of the study. d. To eliminate the need to establish eligibility criteria for participants.
b. To help ensure that all groups within a study are representative of the larger population.
Which of the following are characteristic of the data in qualitative research? The data is: Select one: a. In text form b. Used to show relationships between variables c. Free of patterns
b. Used to show relationships between variables
An independent variable is: Select one: a. The result of the research study b. What stays the same once the study starts, like the intervention or a pre-existing condition c. What the researchers assume will change after their intervention d. Not manipulated by the researchers
b. What stays the same once the study starts, like the intervention or a pre-existing condition
rue or False: Accepting the null hypothesis means you reject the research hypothesis. Select one: a. False b. True
b. true
minimum data set assessment sample info
background, psych, cognitive, mood, behavior, bowel and bladder continence, health conditions, disease, oral, nutritional, dental status, skin conditions, and medication use.
The nurse is caring for an elderly woman and notices that she is not using her cane properly. Which of the following statements by the nurse would most likely elicit a positive response from the patient? a. "You're doing that all wrong. Let me show you how to do it." b. "I don't know who showed how to use the cane like that, but you're not doing it right. Let me show you again." c. "You use the cane the way I did before I was shown a way to keep from tripping over it; do you mind if I show you?" d. "I used to use the cane the same way you are using it: the wrong way. I'll show you the right way to do it."
c. "You use the cane the way I did before I was shown a way to keep from tripping over it; do you mind if I show you?" When the nurse is confident and skillful instead of coming across as an authority on the subject, the patient's defenses will be down, making the patient more willing to listen without feeling embarrassed. Respectful communication is necessary.
When focusing on older adults, the nurse must be aware that a. Elder abuse happens in lower socioeconomic classes only. b. Elders have the same social networks as younger people. c. Caregivers may be spouses or middle-age children. d. Caregiver stress is minimal when caring for a parent.
c. Caregivers may be spouses or middle-age children. Caregivers are typically spouses, who may be older adults with declining physical stamina, or middle-age children, who often have other responsibilities. Abuse of older adults in families occurs across all social classes. Later-life families have a different social network than younger families because friends and same-generation family members often have died or have been ill themselves. The nurse should assess for caregiver stress such as tension in relationships between family and care recipient, changes in level of health, changes in mood, and anxiety and depression.
Which criteria are used to judge the trustworthiness of a qualitative study? SELECT ALL THAT APPLY. Select one or more: a. Coagulability b. Disposability c. Confirmability d. Credibility e. Authenticity
c. Confirmability d. Credibility e. Authenticity
How is the number of subjects for participation determined for a qualitative study? Select one: a. A power analysis of data collected in a pilot study is used to determine the number of subjects needed. b. The level of significance, or p value, is set and determined the number of subjects required. c. Data are collected from new subjects until data saturation is reached. d. The number of subjects is based on the number of subjects who are available in a given location
c. Data are collected from new subjects until data saturation is reached.
A researcher is interested in describing and summarizing the characteristics of the sample used in the study. To do this, the researcher will use: Select one: a. Mathematical statistics b. Inferential statistics c. Descriptive statistics d. Nonparametric statistics
c. Descriptive statistics
The family is a central institution in American society; however, the concept, structure, and functioning of the family unit continue to change over time. The uniqueness of each family is referred to as family a. Durability. b. Resiliency. c. Diversity. d. Forms.
c. Diversity. Family diversity is the uniqueness of each family unit. Family durability is the term for the intrafamilial system of support and structure that extends beyond the walls of the household. Family resiliency is the ability of the family to cope with expected and unexpected stressors. Family forms are patterns of people considered by family members to be included in the family.
A nurse reviews the results of a study on the effects of the relationship between childhood obesity and several variables. Based on the following results, what would be appropriate for the nurse to include in an education session on childhood obesity? Select all that apply. Having a biological parent with a BMI> 31, r=0.3, p=0.04 Stress level, r=0.1, p=0.6 Aerobic exercise 3 times or more a week, r=-0.7, p=0.01 Fed breast milk in the first 6 months of life, r=-0.3, p=0.08 Note: These are made up results. Select one or more: a. Stress is correlated with childhood obesity. b. Mothers should breastfeed infants for at least 6 months because it is protective against obesity. c. Exercising at least 3 times per week may be protective against obesity. d. Children with overweight parents will be overweight themselves.
c. Exercising at least 3 times per week may be protective against obesity.
The nurse is caring for a patient in hospice. As she observes the family dynamics, she notes that the patient is getting adequate care, but the wife is not sleeping well and needs rest. The nurse also assesses the need for better family nutrition and meals assistance. The nurse discusses these assessments with the patient and his family and formulates a plan of care with them to address these issues. The nurse is utilizing which approach to family nursing practice? a. Family as context b. Family as patient c. Family as system d. Autocratic determination
c. Family as system In "family as context," the primary focus is on the health of an individual member. In "family as patient," family processes and relationships are the primary focus. Often, the nurse will use the two simultaneously, as with the perspective of "family as system." Because the plan of care was developed with family input, autocratic determination was not used.
Different approaches may be taken to family nursing practice. When the nurse is caring for a patient who needs constant care in the home setting and for whom most of the care is provided by the patient's family, what is the best approach for the nurse to take? a. Family as context b. Family as patient c. Family as system d. Patient as individual
c. Family as system The newest model, called family as system includes both relational and transactional concepts. If only one family member receives nursing care, it is realistic and practical to view the family as context. When all family members are involved in the daily care of one another, the family as patient is the best approach. Although theoretical and practical distinctions have been noted between family as context and family as patient, they are not necessarily mutually exclusive. Often, the nurse will use the two simultaneously, such as with the perspective of the family as system. Family nursing is based on the assumption that all people are members of some type of family form.
It is essential for family members to realize that a family's beliefs, values, and practices strongly influence the health-promoting behaviors of its members, and to understand that a. American families are part of the same culture with the same values and beliefs. b. Economic status has little effect on a family's ability to access adequate health care. c. Family environment in early life has a strong influence on later health practices. d. All families place a high value on good health and health practices.
c. Family environment in early life has a strong influence on later health practices. Family environment is crucial because health behavior reinforced early in life has a strong influence on later health practices. Although American families exist within the same culture, they live in very different ways as a result of race, values, social class, and ethnicity. Economic stability increases a family's access to adequate health care. Some families do not place a high value on good health. In fact, some families accept harmful practices.
Balancing employment and family life creates a variety of challenges in terms of child care and household work for both parents. This has major implications in health care because a. Maternal employment has been demonstrated to be harmful for children. b. Maternal employment has shifted the majority of household tasks to the male. c. Fathers now participate more fully in day-to-day parenting responsibilities. d. The number of single-parent families has decreased since 1970.
c. Fathers now participate more fully in day-to-day parenting responsibilities. There is no proof that maternal employment is damaging for children. However, finding quality child care is a major issue. Managing household tasks is another challenge. Although equal division of labor receives verbal approval, most household tasks remain "women's work." Evidence suggests that the fathering role is changing. Fathers now participate more fully in day-to-day parenting responsibilities. The number of single-parent families, which doubled from the 1940s to the 1990s, seems to be stabilizing.
Identify which of the following is a research hypothesis: Select one: a. Do nursing students who practice deep breathing before an exam perform better than students who do not? b. Does deep breathing make students less stressed? c. Nursing students who practice deep breathing before an exam will have better exam scores than students who do not practice deep breathing. d. The purpose of this study was to determine if nursing students who practice deep breathing before an exam perform better than students who do not practice deep breathing.
c. Nursing students who practice deep breathing before an exam will have better exam scores than students who do not practice deep breathing.
What is the independent variable in the following research question: "How does oral nutrition supplementation during dialysis treatments affect the serum albumin levels of adult patients who have chronic kidney disease?" Select one: a. Patients receiving dialysis treatments b. Serum albumin levels c. Oral nutrition supplementation d. Adult patients with chronic kidney disease
c. Oral nutrition supplementation
social determinants of health
variables that affect health and wellness. They are a key component in guiding health promotion activities and preventative behaviors
The nurse researcher is conducting a qualitative research study using one participant who will be interviewed regarding her experience with postpartum depression. What is the rationale for using a qualitative instead of quantitative study design in this case? Select one: a. Qualitative research seeks to explain cause-and-effect relationships between variables. b. Quantitative research is usually conducted in natural settings using data that are words rather than numbers. c. Qualitative research seeks to understand meaning, allowing for in-depth understanding of an experience or phenomenon. d. Quantitative research typically uses a convenience sample, seeking to answer a clinical question about a human experience.
c. Qualitative research seeks to understand meaning, allowing for in-depth understanding of an experience or phenomenon.
The nurse is caring for a male patient newly diagnosed with type 1 diabetes mellitus. The patient is not adjusting well to the diagnosis and is refusing to learn how to self-inject insulin. The patient's wife is critical of the patient's refusal to learn; a small argument ensues, and the wife leaves, stating, "I'll be back later when I cool off." What should the nurse do? a. Ask the patient if he would like his wife excluded at visiting time. b. Tell the wife in the hall that her behavior is unacceptable and cannot be tolerated. c. Realize that the wife will be an important part of therapy. d. Tell the patient that he needs to listen to his wife more.
c. Realize that the wife will be an important part of therapy. Although relationships are strained when confronted with illness, research indicates that family members have the potential to be a primary force for coping. Excluding the wife would limit that potential. The "unacceptable behavior," in this situation, may be the way this individual expresses concern and frustration. The nurse may want to speak with the wife to allow her to vent those concerns and frustrations. Telling the patient that he needs to listen to his wife would set up an adversarial situation that should be avoided.
Which of the following statements is accurate regarding reliability and validity? Select one: a. Reliability is the ability of an instrument to measure something accurately, while validity is the ability of an instrument to measure something consistently. b. Types of validity include test-retest validity and internal consistency validity. Types of reliability include content reliability and construct reliability. c. Reliability is the ability of an instrument to measure something consistently, while validity is the ability of an instrument to measure something accurately. d. Reliability and validity have nothing to do with error.
c. Reliability is the ability of an instrument to measure something consistently, while validity is the ability of an instrument to measure something accurately.
The results section of a research article includes which of the following? Select one: a. Examines the theory supporting the study hypothesis b. Describes the study design c. Reports data regarding the dependent variable d. Describes instruments used in the study
c. Reports data regarding the dependent variable
External validity refers to which of these issues? Select one: a. The influence of a specific event on the independent variable. b. The degree to which extraneous or mediating variables interfere with the study outcomes. c. The degree to which findings are generalizable to populations beyond those studied. d. The relationship existing between the independent and the study outcomes.
c. The degree to which findings are generalizable to populations beyond those studied.
What is the key difference between independent and dependent variables? Select one: a. Although both the independent and dependent variables are manipulated, only the independent variable is considered an intervention. b. Although both the independent and dependent variables are manipulated, only the dependent variable is considered an intervention. c. The dependent variable should change in response to manipulation of the independent variable. d. The independent variable should change in response to manipulation of the dependent variable.
c. The dependent variable should change in response to manipulation of the independent variable
The nurse researcher's data includes a score reported to be in the 75th percentile. This indicates that: Select one: a. The score represents the average of all scores measured at this time b. The score has exceeded the mode c. The score is exceeded by only 25% of cases d. The score is at the median`
c. The score is exceeded by only 25% of cases
Which description is typical of a qualitative study? Select one: a. Deductive reasoning is used. b. Results are typically stated in numerical form. c. Truth is a subject's perception of reality. d. The sample size is determined prior to the start of the study.
c. Truth is a subject's perception of reality
The results of a particular study indicate that a t-test was performed to assess if the use of a standardized education program to prevent shaken baby syndrome (SBS) reduced the number of cases of children admitted after suffering from being shaken. Select the statement below that best interprets these results: Education group: n=64,205 Non-education group: n=74,504 Number of cases of SBS (t=2.38, p=0.03) Note: These are made up results. Select one: a. The study showed that the educational program was not effective. b. The study results are invalid due to the risk of type II error. c. The study group sowed a difference between groups, but the p value shows that the results are not significant. d. The education program was effective with a statistically significant difference between groups.
d. The education program was effective with a statistically significant difference between groups.
Why might a researcher choose to assign subjects randomly in a study? Select one: a. To eliminate the need to establish eligibility criteria for participants b. To help ensure that current events do not influence the outcomes of the study c. To increase the chance that the study group and control group will be different from each other at baseline. d. To help ensure that all groups within the study are representative of the larger population
d. To help ensure that all groups within the study are representative of the larger population
What is the overall purpose of a research design in a quantitative study? Select one: a. To assist the researcher in identifying gaps in the knowledge base b. To identify the problem statement c. To determine the sample size d. To provide the plan for answering the research question
d. To provide the plan for answering the research question
utilization review committees (UR)
review the admissions and the identify and eliminate overuse for diagnostic and treatment services ordered by physicians care for pts on medicare
Institute of Medicine (IOM) calls for health care delivery that is
safe, effective, pt centered, timely, efficient, and equitable