Chapter 1 Review Questions

Mrs. Langman is in the hospital recovering from hip replacement surgery. Her surgery involved insertion of a new type of hip replacement prosthesis and newer postsurgical care. The advanced practice registered nurse is preparing her discharge medication and rehabilitation prescriptions. The staff nurse is preparing to transfer Mrs. Langman to a rehabilitation facility. The nurse educator is conducting bedside rounds to explain the new prosthesis and related postoperative care. 1. Identify similarities and differences in the roles of the staff nurse, advanced practice registered nurse, and nurse educator. 2. What is the educational preparation for each role? 3. Use information in this chapter to consider career objectives for yourself over the next 5 years. Obviously the first would be to complete your nursing program. But decide what you want to do as a professional nurse and then outline strategies to achieve these goals.

1. Similarities and differences in roles: All nurses follow the professional roles and responsibilities for a professional nurse. a. Staff nurse provides direct care for a group of patients in a health care setting. This practice is guided by the standards of professional practice and the agency practice philosophy. b. Advanced practice registered nurse (APRN) is the most independently functioning nurse. An APRN has a master's degree in nursing; advanced education in pathophysiology, pharmacology, and physical assessment; and certification and expertise in a specialized area of practice. c. Nurse educator works primarily in schools of nursing, staff development departments of health care agencies, and patient education departments. Nurse educators need experience in clinical practice to provide them with practical skills and theoretical knowledge. A faculty member in a school of nursing educates students to become professional nurses. Nursing faculty members are responsible for teaching current nursing practice, trends, theory, and necessary skills in laboratories and clinical settings. 2. Educational preparation a. Staff nurse—Basic nursing education and registered nurse licensure b. Advanced Practice Registered Nurse—Master's degree preparation and advance practice certification c. Nurse educator—Master's or doctoral degree in nursing 3. Discussion and self-reflection to determine future goals

Evidence-based practice is defined as: 1. Nursing care based on tradition 2. Scholarly inquiry of nursing and biomedical research literature 3. A problem-solving approach that integrates best current evidence with clinical practice 4. Quality nursing care provided in an efficient and economically sound manner

A problem-solving approach that integrates best current evidence with clinical practice

A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with the family. The nurse is acting as the patient's: 1. Educator 2. Advocate 3. Caregiver 4. Case manager

Advocate

Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) 1. Caregiver 2. Autonomy and accountability 3. Patient advocate 4. Health promotion 5. Lobbyist

Caregiver, Autonomy and accountability, patient advocate, health promotion (1,2,3,4)

You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A nonnursing colleague asks about this code. Which of the following statements best describes this code? 1. Improves self-health care 2. Protects the patient's confidentiality 3. Ensures identical care to all patients 4. Defines the principles of right and wrong to provide patient care

Defines the principles of right and wrong to provide patient care

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

Evaluation

Advanced practice registered nurses generally: 1. Function independently 2. Function as unit directors 3. Work in acute care settings 4. Work in the university setting.

Function independently

A nurse is working with a young childbearing family who has one child with a congenital heart disease. The parents are trying to determine the risks of a second child being born with congenital heart disease. Describe why genomics information is important in assisting the parents in this decision.

Genomics describes the study of all the genes in a person and the interactions of these genes with one another and with that person's environment. Genomic information allows health care providers to determine how genomic changes contribute to patient conditions and influence treatment decisions.

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

Implementation

Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? 1. Continuing education 2. Graduate education 3. In-service education 4. Professional Registered Nurse Education

In-service education

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

Informatics

Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform? 1. Moving from an acute illness to a health promotion, illness prevention model 2. Moving from illness prevention to a health promotion model 3. Moving from an acute illness to a disease management model 4. Moving from a chronic care to an illness prevention model

Moving from an acute illness to a health promotion, illness prevention model

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

Nurse Researcher

Which of the following nursing roles may have prescriptive authority in their practice? (Select all that apply.) 1. Critical care nurse 2. Nurse practitioner 3. Certified clinical nurse 4. Charge nurse

Nurse practitioner, Certified clinical nurse

The examination for registered nurse licensure is exactly the same in every state in the United States. This examination: 1. Guarantees safe nursing care for all patients 2. Ensures standard nursing care for all patients 3. Ensures that honest and ethical care is provided 4. Provides a minimal standard of knowledge for a registered nurse in practice

Provides a minimal standard of knowledge for a registered nurse in practice

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

Safety