Chapter 1: Introduction to Nursing/ Course Point Quiz 1
Which advancement in the nursing profession occurred immediately after World War II?
Advanced nursing education was established.
Which definition of health is the best?
Health is a state of complete well-being.
The nurse in a free clinic caring for clients uses the Health Belief Model, which is based on three components. What is the main focus for this model?
What people believe to be true about their health
Which advanced nurse practitioner is best qualified to provide prenatal care for a pregnant client?
A nurse-midwife A nurse-midwife provides prenatal and postnatal care and also delivers babies for women with uncomplicated pregnancies. A nurse anesthetist carries out preoperative visits and assessments; administers and monitors anesthesia during surgery; and evaluates the postoperative status of clients. A clinical nurse specialist is considered to be an expert in a specialized area of nursing and carries out direct client care; consultation; teaching of client, families, and staff; and research. A nurse educator teaches in educational or clinical settings, teaches theoretical knowledge and clinical skills, and conducts research.
The registered nurse is performing a nutritional assessment to ensure that the client's diet is optimal for wound healing. The nurse's intervention can be traced back to which key contributor to nursing?
Florence Nightingale
The nurse going back to school for nurse midwifery can trace education for nurse midwifery to which nursing leader?
Mary Breckinridge
A prospective nursing student desires a career that will allow the opportunity to provide client care and to assist professional nurses with routine technical procedures. The prospective student needs to be employed in a full-time position quickly due to economic hardship. What type of nursing program would best suit this student?
licensed or vocational nursing program
The nurse is caring for a client who cannot meet health needs independently. Which action made by the nurse depicts concern and attachment?
asking the client, "How are you today? I am really worried about you." Concern and attachment are the result of a close relationship of one human being with another. Thus, asking the client how the client is feeling and expressing concern exemplifies caring. Stability and security, communication and teaching, and organization and evaluation are physical care themes that are part of nursing care.
Attracting minorities to the profession of nursing is an important consideration for the future of nursing. Which key historical nursing figure set a precedent in this area?
Mary Elizabeth Mahoney
The nurse is conducting a class for nursing assistants. One of the students asks the nurse why blood pressure, pulse, and temperature are called "vital signs." Which explanations would the nurse offer the student?
"Because significant deviation from normal is not compatible with life."
Which organization has established standards that help the nurse determine which clinical actions fall under the scope of nursing practice?
American Nurses Association
The nurse preparing a lecture on the history of nursing should include which international organization as the first for professional nurses?
Correct- International Council of Nurses The first international organization for professional nurses was the International Council of Nurses. American Nurses Association and National League for Nursing are U.S. nursing organizations. Sigma Theta Tau International is the international nursing honor society.
Which are approved as nursing diagnoses? Select all that apply.
Impaired Skin Integrity Caregiver Role Strain Compromised Family Coping
Which nursing activity reflects secondary prevention?
Making a referral for a mammogram
A nurse is thinking about pursuing a master's degree in nursing (MSN) and is reviewing information about various programs. What would the nurse expect to find about such programs?
Nurses pursuing such programs require solid scholastic abilities Nurses pursuing master's degree programs need solid scholastic abilities. Master's degree nursing education began in the 19th century, not the late 18th century. Though such degrees can be attained in a certain specific area of interest, generic master's degree courses are also offered. Students need to take the licensure examination after a baccalaureate degree, not after a master's degree.
The nurse conducts a home safety assessment for a client. Which statement best explains the standard of care being implemented?
The RN promotes a safe environment.
The American Nurses Association (ANA) Standards of Professional Nursing Practice provides standard of care for all nurses. Which statement on the assessment of the nursing process is accurate?
The nurse collects comprehensive data pertinent to the client's health or situation.
A nurse is considering relocating to another state to practice nursing. Which is the most appropriate action by the nurse to ensure ability to practice in the new state?
applying for a reciprocal license in the new state
A novice nurse is excited to finally be able to put all the training to use on the inpatient unit. Which factor should the nurse be sure to prioritize when beginning to interact with clients?
be an advocate for appropriate care
The registered nurse is teaching a community health class about illness prevention. Which statement reflects understanding of this concept?
"It is important to enroll in a smoking cessation class."
Which organization has established standards that help the nurse determine which clinical actions fall under the scope of nursing practice?
American Nurses Association The American Nurses Association (ANA) has established standards of clinical nursing practice that define the specific and unique activities of nurses. Standards serve as protection for the nurse, the client, and the institution where health care is given. The other organizations provide valuable services that differ from those of ANA. The National Council of State Boards of Nursing have the nurse practice acts which define state specific guidelines for nurses to practice. The National League for Nursing is a national organization for faculty nurses and leaders in nurse education. The International Council of Nurses is a federation of more than 130 national nurses associations.
What is the definition of wellness?
An active state of being healthy
The client's plan of care is created by the nurse using which guideline for nursing practice?
Nursing process Nursing process is used to identify the client's strengths, limitations, and health care needs, to formulate a plan of care to address the health care needs, to implement that plan of care, and to evaluate the effectiveness of the plan to achieve established outcomes.
Why do nurses need to care for their own health needs? Select all that apply.
To allow them to give effective nursing care to others To enable them to practice more efficiently To help them serve as role models for clients
A client asks an RN to prescribe a medication for pain. What is the best answer by the nurse?
"Only advanced practice registered nurses have prescriptive authority." The best answer by the nurse is that only advanced practice registered nurses have prescriptive authority. The registered nurse who is not an advanced practice nurse should not prescribe medications, even over-the-counter medications such as ibuprofen and acetaminophen.
The client's plan of care is created by the nurse using which guideline for nursing practice?
Nursing process Nursing process is used to identify the client's strengths, limitations, and health care needs, to formulate a plan of care to address the health care needs, to implement that plan of care, and to evaluate the effectiveness of the plan to achieve established outcomes. The ANA Standards of Nursing Practice defines the activities of nurses that are specific and unique to nursing. Nurse practice acts are laws established by each state to regulate the practice of nursing. Nursing's Social Policy Statement describes the values and social responsibility of nursing, provides a definition and scope of practice for nursing and nursing's knowledge base, as well as the methods by which nursing is regulated.
A physician tells the nurse that nursing is a discipline, but not a profession. Which criteria should the nurse utilize to demonstrate that nursing is increasingly recognized as a profession? Select all that apply.
Well-defined body of knowledge Code of ethics Ongoing research Sets standards
The nurse is caring for a client who ascribes to the theory of animism. When attempting to explain this theory to other staff members, the nurse should state:
"Everything in nature is alive with invisible forces." The theory of animism attempts to explain the cause of mysterious changes in bodily functions. This theory is based on the belief that everything in nature is alive with invisible forces and endowed with power. Good spirits bring health; evil spirits bring sickness and death. In cultures that ascribe to animism, the roles of the physician and the nurse are separate and distinct. The physician is the medicine man who treats disease by chanting, inspiring fear, or opening the skull to release evil spirits (Dolan, Fitzpatrick, & Herrmann, 1983). The nurse usually is the mother who cares for her family during sickness by providing physical care and herbal remedies. Pets are not involved in the theory of animism.
A nurse is planning to pursue further education in the hopes of becoming an expert in geriatric nursing who carries out direct care. For which expanded career role is the nurse preparing?
Clinical nurse specialist Clinical nurse specialists are nurses with an advanced degree who are considered experts in a specialized area of care. They also provide direct care, consultation, and education of clients, families, and staff. Nurse managers do not normally provide direct care. Nurse-midwives specialize in obstetrical care. Physician assistants are not nurses.
Which model is most useful in examining the cause of disease in an individual, based upon external factors?
Correct- The Agent-Host-Environment Model The Agent-Host-Environment Model is useful for examining the cause of disease in an individual. The agent, host, and environment interact in ways that create risk factors. The Health-Illness Continuum is a way to measure a person's level of health. The High-Level Wellness Model is characterized by functioning to one's maximum potential while maintaining balance and purposeful direction in the environment. The Health Belief Model is used to describe health behaviors.
A group of nurses is participating in a community health fair and is engaged in primary prevention activities. Which activities would these nurses be leading? Select all that apply.
Family planning services Accident prevention education Heart-healthy nutrition services Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Examples of primary-level activities are immunization clinics, family planning services, providing poison control information, and accident prevention education. Other nursing interventions include teaching about a healthy diet, the importance of regular exercise, safety in industry and farms, using seat belts, and safer sex practices. Screenings are a major activity in secondary health promotion. Rehabilitation is associated with tertiary health promotion.
The role of the nurse developed from the pre-civilization era through the eras representing the beginning of civilization, the beginning of the 16th century, the 18th and 19th centuries, World War II era, and up to the present day. Place the following roles of the nurse listed below in the correct chronologic order to follow this timeline.
Nurses were portrayed as a mother, caring for family and delivering physical care and health remedies. Nurses were viewed as slaves, carrying out menial tasks based on the orders of the priest. There was a shortage of nurses; criminals were recruited as nurses; nursing was viewed as disreputable. Florence Nightingale elevated nursing to a respected occupation and founded modern methods in nursing education. Efforts were made to upgrade nursing education, and women were more assertive and independent. Nursing was broadened in all areas and was practiced in a wide variety of settings; nursing was viewed as a profession
Which nursing actions demonstrate the aim of nursing to facilitate coping? Select all that apply.
Teaching a client and her family how to live with diabetes Assisting a client and his family to prepare for death Providing counseling for the family of a teenager with an eating disorder Coping is another important broad aim of nursing. Nurses facilitate client and family coping for those experiencing altered function, life crisis, and death. Examples of coping would be teaching a client and the client's family about how to live with diabetes. Another example would be assisting a client and the client's family to prepare for death. A third example would be providing counseling for the family of a teenager with an eating disorder. Changing bandages, starting an IV, or teaching a class on an expected health care issue or need would not be examples of the aim of facilitating coping with disability or death.
The nurse conducts a home safety assessment for a client. Which statement best explains the standard of care being implemented?
The RN promotes a safe environment. The standard of care being exemplified is standard 5b: health teaching and promotion: The RN employs strategies to promote health and a safe environment. Standard 3, which is outcomes identification, involves the registered nurse identifying expected outcomes for a plan individualized to the health care consumer or the situation. Standard 12 is education, in which the registered nurse seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. Standard 4 is planning, in which the registered nurse develops a plan that prescribes strategies and alternatives to attain expected, measurable outcomes.
A prospective nursing student desires a career that will allow the opportunity to provide client care and to assist professional nurses with routine technical procedures. The prospective student needs to be employed in a full-time position quickly due to economic hardship. What type of nursing program would best suit this student?
licensed or vocational nursing program A licensed practical or vocational nursing program will allow the student to earn a technical certificate in 1 year and sit for the state board of nursing examination to be licensed as an LPN or LVN. This would allow employment that will allow the graduate to provide client care and to assist professional nurses with routine technical procedures as desired. An associate program will take 2 years baccalaureate program will take 4 years; additionally these prepare new nurses to work in a more independent role than this person is seeking. There are very few diploma programs remaining in the U.S., and these programs typically take 3 years to complete.
The nurse is performing care for a client in the end stage of cancer. How can the nurse best facilitate the client and family's ability to cope? Select all that apply.
Assist the client with activities of daily living (ADLs). Assist the client and family with the preparation for end-of-life. Refer the client and family to hospice services. Nurses facilitate client and family coping with altered function, life crisis, and death. Altered function decreases an individual's ability to carry out ADLs and expected roles, and it is appropriate for the nurse to assist in a previously independent client role. Nurses facilitate an optimal level of function through maximizing the person's strengths and potentials, through teaching, and through referral to community support systems such as hospice services. Nurses provide care to both clients and families at the end of life, and they do so in hospitals, long-term care facilities, hospices, and homes. Nurses are active in hospice programs, which assist clients and their families in multiple settings in preparing for death and in living as comfortably as possible until death occurs. Informing the family that there is nothing that they can do for their loved one creates further grieving and a feeling of loss and hopelessness.
The American Nurses Association (ANA) Standards of Professional Nursing Practice provides standard of care for all nurses. Which statement on the assessment of the nursing process is accurate?
The nurse collects comprehensive data pertinent to the client's health or situation. The nursing process is used for all nurses as the standard of care. In the assessment phase, the RN collects comprehensive data pertinent to the client's health or situation. In the diagnosis phase, the RN analyzes the assessment data to determine the diagnoses or issues pertinent to the client. Next the RN identifies expected outcomes for a plan individualized to the client or the situation and develops a plan that prescribes strategies and alternatives to attain expected outcomes. The nurse does not dictate the plan. The RN implements the identified plan. This includes coordination of care, health teaching and health promotion, consultation, and prescriptive authority and treatment. evaluation phase, the RN evaluates progress toward attainment of outcomes. From the ethical standpoint, the nurse advocates for the client and makes sure that ethical standards are upheld, but this is not part of the nursing process.
A pregnant client at 10 weeks' gestation is receiving education by the nurse about the importance of abstaining from alcohol while pregnant. What statement made by the client demonstrates an understanding of the education provided?
"I should abstain from alcohol to prevent the development of a fetal alcohol spectrum disorder." Congenital disorders such as fetal alcohol spectrum disorders may be prevented by the client abstaining from alcohol while pregnant. Fetal alcohol spectrum disorders are congenital disorders caused by an undetermined amount of alcohol ingested by the mother which affects the fetus in the developmental stages of growth. Abstaining from alcohol will not prevent all types of congenital disorders, but clients should be educated about a variety of preventative measures in order to prevent interruption of the growth and development of the fetus. An idiopathic illness is one in which the cause is undetermined. A hereditary disorder is genetic and not altered by substance intake during pregnancy.
The nurse instructor has completed a session detailing major factors differentiating exacerbations from remissions. The instructor determines the session is successful when the students point out which factor(s) can contribute to exacerbations? Select all that apply.
Correct- immune system is functioning poorly sleep has been disrupted due to family issues client is facing a potential eviction Exacerbations of illnesses are often related to how poorly the immune system is functioning, the stressors the client is facing and overall health status (e.g., nutrition, sleep, hydration). Remission is the opposite and usually indicates how well the immune system is acting, how well the client is handling stressors, and his or her overall health status. Improving food choices and good hydration status are indications the individual is recovering and showing improvement in his or her health status.
An exacerbation refers to the reactivation of a disease. Which condition is associated with exacerbation?
Correct- Chronic illness Exacerbation is the increase in activity of a disease and aggravation of symptoms. This occurs periodically in clients with chronic diseases. It is often a result of physical, chemical, or emotional stress. Congenital illness (such as atrial septal defect), hereditary illness (such as cystic fibrosis), and acute illness (such as influenza) do not have exacerbation and remission stages.
A nurse is planning a health fair in the community to highlight promotion and prevention of the leading cause of death in the United States. Which disease process should the nurse address?
Correct- Coronary artery disease Heart disease is the leading cause of death in the United States. Lung cancer, emphysema, and cerebrovascular accidents are not the leading causes of death in the United States.
A client has been admitted to the hospital for the treatment of diabetic ketoacidosis, with a random blood glucose reading of 575 mg/dL (31.91 mmol/L), vomiting, and shortness of breath. This client has experienced which phenomenon?
Correct- Exacerbation This client has experienced a significant exacerbation of a chronic disease (diabetes mellitus), which has manifested as an acute threat to the client's health. Morbidity is an epidemiological statistic of the frequency of a disease. The client's problem does not have an infectious etiology. A risk factor is any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or injury.
A client comes to the health center for a routine visit. During the visit, the client tells the nurse, "I'm motivated to do things now to make sure I'm the healthiest I can be." When planning this client's care, the nurse should focus on which area?
Correct- Health promotion Health promotion is the behavior of a person who is motivated by a personal desire to increase well-being and health potential. In contrast, illness/disease prevention, also called health protection, is behavior motivated by a desire to avoid or detect disease or to maintain functioning within the constraints of an illness or disability. Self-concept incorporates both how people feel about themselves (self-esteem) and the way they perceive their physical self (body image). Diagnosis of disease involves a medical aspect such that a disease is traditionally diagnosed—and treatment is prescribed—by a physician or advanced practice nurse, whereas nurses focus on the person with an illness.
Which individual provided community-based care and founded public health nursing?
Correct- Lillian Wald Lillian Wald established a neighborhood nursing service for the sick and poor in New York City and is considered the founder of public health nursing. The other women were important to the development of nursing, but not to public health nursing. Nutting helped to found a modern nursing program at the school. Sojourner Truth was an African-American abolitionist and women's rights activist who was a nurse. Clarissa "Clara" Harlowe Barton was a pioneering nurse who founded the American Red Cross.
Which is an example of tertiary health promotion?
Correct- Rehabilitation Tertiary health promotion and disease prevention begin after an illness is diagnosed and treated to reduce disability and to help rehabilitate clients to a maximum level of functioning. Therefore, rehabilitation is an example of tertiary health promotion. Family counseling and Pap tests are examples of secondary health promotion. Water treatment is an example of primary health promotion.
The nurse is caring for a client with a diagnosis of heart failure. This admission is the client's third admission within 90 days. The nurse educates the client with the goal of preventing readmission. Which nursing activity for this client would represent tertiary level prevention?
Correct- Teaching about adhering to a low-sodium diet Tertiary health promotion and illness prevention begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate the client to a maximum level of functioning. Nursing activities on a tertiary level include teaching a client with heart failure the importance of adhering to a low-sodium diet. Primary prevention is directed toward promoting health and preventing the development of disease processes or injury. This client has a diagnosis. Secondary health promotion and illness prevention focus on screening for early detection of disease with prompt diagnosis and treatment of diseases found.
A nurse mentoring second-year nursing students from a community college plans clinical experiences for them. These students will most likely graduate in which time frame?
Correct- at the end of the year Nursing students from a community college are most likely students attempting to obtain an associate degree, which is a 2-year program. Therefore, the nurse should plan clinical experiences for students who will most likely graduate at the end of the year, as this is their second year.
The nurse is caring for a 46-year-old client recovering from a substance abuse disorder, who is admitted with suspected liver disease based on jaundiced skin and right upper quadrant tenderness. The laboratory results reveal the client is positive for hepatitis C. How would the client's current condition be classified?
Correct- secondary A secondary condition is a disorder that develops from a preexisting condition; in this case liver failure due to hepatitis C infection possibly related to the use of contaminated needles from the substance abuse disorder. A primary illness develops independently of any other disease. A hereditary disease is acquired from genetic codes of one or both parents, and an idiopathic illness is an illness of unknown cause.
Although all of the following are nursing responsibilities, which one would be expected of a nurse with a baccalaureate degree?
Correct- using research findings to improve practice Nurses with baccalaureate degrees are expected to use research findings to improve practice. Graduates from vocational, diploma, and associate degree programs do not have coursework in nursing research and are not expected to independently use it in clinical practice. Nurses from all levels of education provide direct care, administer medications, and collaborate with other health care providers.
The new nursing graduate is concerned about some of the critical changes that will be occurring in nursing. What changes does the nurse anticipate will impact nursing care?
Difficulty for nurses to remain current in a rapidly changing medical and technology environment The National Advisory Council on Nurse Education and Practice (NACNEP) identifies critical challenges to nursing practice in the 21st century: a growing population of hospitalized clients who are older and more acutely ill, increasing health care costs, and the need to stay current with rapid advances in medical knowledge and technology. Nursing is limitless and, with opportunities for furthering education, there are many various ways nurses can practice. Health costs are rising and there are more citizens needing health care. There is a projected nursing shortage that may be severe and there are no shortages of jobs for nurses.
The nurse is utilizing knowledge about a blood pressure medication's actions and side effects to determine whether or not to give a client, whose blood pressure is low, the prescribed blood pressure medication. What best describes the aspect of nursing demonstrated?
science of nursing The science of nursing is the knowledge base for the care provided by the nurse. In this example, the nurse is using this knowledge base to decide how best to care for the client by giving or not giving the blood pressure medication. The art of nursing is the application of the knowledge. In this example, it would be demonstrated by the nurse actually giving or holding the medication. Quality improvement activities and the conduction of research influence the science and the art of nursing by helping build the body of knowledge that is the science of nursing.
Which is the best example of a nurse demonstrating the role of caregiver?
starting an intravenous line in the client's arm In the role of caregiver, the nurse provides care to clients to meet their needs, such as when starting an intravenous line. The role of caregiver is the primary role of the nurse. Teaching a client about medication is the role of educator. Telling a doctor a lab value is the role of communicator. Securing a referral to the local clinic is the role of counselor. Assigning rooms is a management role.