Chapter 14 The Interdisciplinary Health Care Team The Role of the Practical Nurse

nursing staff

APRN, RN, LPN, student nurses, nurse assistant, cross trained staff

postanesthesia care unit

PACU RN, transport aide, staff nurse (RN)

diversity in educational preparation of nurses

RN, LPN, student nurses, nurse assistant, assistive personnel, unit secretary, unit manager

Which statement is true regarding licensed practical nurses (LPNs)? a) LPNs do not function independently. b) Upon graduation, an LPN receives a certificate. c) LPNs are the third largest group of health care workers. d) The educational progress varies from 24 to 36 months.

a) LPNs do not function independently. (The difference between RNs and LPNs is that RNs function independently whereas LPNs/LVNs have a dependent role. LPNs are the second-largest group of licensed health care workers.)

Which health care members are considered part of the interdisciplinary team? (Select all that apply.) a) Nurse practitioners b) LPNs/LVNs c) Student nurses d) NAs e) Clinical instructors f) RNs

a) Nurse practitioners b) LPNs/LVNs c) Student nurses d) NAs e) Clinical instructors f) RNs (Nurses in advanced practice roles (e.g., NPs), LPNs/RNs, student nurses, nursing assistants (NAs), clinical instructors, and RNs are all nursing members of an interdisciplinary team.)

Which educational specialty a research-focused degree? a) PhD b) Doctorate of nursing practice (DNP) c) Nurse practitioner (NP) d) Clinical nurse specialist (CNS)

a) PhD (Nurses who have a research-focused doctorate have a PhD. The DNP is a clinically focused degree. A NP is practice focused, can prescribe, and differs from medical practitioners because of the focus of the NP on psychosocial aspects of patient treatment. A CNS provides role modeling and mentoring and is a clinical resource in a variety of roles.)

Which outcome is emphasized in The Affordable Care Act? a) Quality care alternatives b) Decreased compensation for physicians c) Less care for individuals with acute care needs d) Fewer roles for nurses

a) Quality care alternatives

Which health care team member assists with budgeting, assignment, and evaluation of personnel and maintaining compliance with Medicare requirements? a) Unit manager b) Nursing assistants c) Nursing students d) Unlicensed assistive personnel

a) Unit manager

A disadvantage of primary nursing is the: a) cost of staffing. b) RN accountability for all patient care. c) fragmentation of patient care. d) holistic focus of care.

a) cost of staffing.

After passing the NCLEX-RN® exam, an associate-degree RN graduate can: a) enroll in a BSN completion program. b) be eligible for specialty board certification. c) work as a clinical nurse specialist. d) enroll in a doctoral nursing program.

a) enroll in a BSN completion program.

The following describes likely job settings and the job role of an LPN/LVN working as a vital member of the interprofessional team (Select all that apply.) a. Community: Team member for a chronically ill pediatric client in their home b. Long-term care: Charge nurse on the evening shift of a skilled care facility c. Acute care: Charge nurse on a surgical unit d. Community: Team member in a geriatric clinic e. Long-term care: Director of Nursing supervising skilled care and personal care units

a. Community: Team member for a chronically ill pediatric client in their home b. Long-term care: Charge nurse on the evening shift of a skilled care facility d. Community: Team member in a geriatric clinic

Which of the following are methods of delivering nursing care in acute care agencies? (Select all that apply.) a. Primary care b. Case method c. Team method d. Functional method e. Delegation method

a. Primary care b. Case method c. Team method d. Functional method

Which of the following statements best describes team nursing as a method of delivering nursing care? a. The method is based on the level of staff skill and client need. b. Task-oriented efficiency is divided among staff across all shifts. c. The RN plans and is accountable for total client care 24 hours a day. d. This method uses scarce nursing resources in a cost-effective way.

a. The method is based on the level of staff skill and client need.

Which statement is true about student nurses? a) Students are not members of the health care team. b) Students are under the supervision of clinical instructors. c) Students in the clinical area are there to give service. d) Legally, student nurses are expected to provide a different level of care from that of professional nurses.

b) Students are under the supervision of clinical instructors.

One key difference between an RN and an LPN is that an RN: a) functions interdependently. b) can initiate all phases of the nursing process. c) directs the care of respiratory therapists. d) must pass a licensing exam in order to practice.

b) can initiate all phases of the nursing process.

The major advantage of the case management system for the delivery of nursing care is the: a) division of nursing tasks among numerous staff members. b) provision of cost-effective, quality care to patients with complex needs. c) elimination of holistic patient care. d) 24-hour accountability of a single assigned RN.

b) provision of cost-effective, quality care to patients with complex needs.

A health care worker who assists in setting up equipment and supplies in the operating room is a: a) unit manager. b) surgical technician. c) nursing assistant. d) patient care associate.

b) surgical technician.

Which of the following statements differentiates the role of the LPN/LVN from the professional nurse? (Select all that apply.) a. The LPN/LVN is responsible for formulating all nursing diagnoses. b. The LPN/LVN has a collaborative role in health teaching for clients. c. The LPN/LVN is not employed in any charge/management positions. d. The LPN/LVN is responsible for triaging clients in an urgent care setting. e. The LPN/LVN is responsible for all members of the health care team.

b. The LPN/LVN has a collaborative role in health teaching for clients.

Select the statement that indicates an understanding of a major difference between the RN and LPN/LVN. a. The LPN/LVN initiates all health teaching for clients. b. The RN formulates nursing diagnoses. c. By law, the LPN/LVN functions in an independent role. d. The LPN/LVN interprets the results of research studies.

b. The RN formulates nursing diagnoses.

Which method of nursing care delivery is task oriented? a) Case method b) Team nursing c) Functional nursing d) Primary nursing

c) Functional nursing

Which action cannot be implemented by the licensed practical nurse? a) Teach patients about cleanliness and nutrition. b) Serve as a charge nurse. c) Order and interpret laboratory tests. d) Identify new nursing problems.

c) Order and interpret laboratory tests.

An advanced-practice nurse could work in which of the following roles? a) Occupational therapist b) Anesthesiologist c) Pediatric nurse practitioner d) Surgical technician

c) Pediatric nurse practitioner

A patient is preparing for discharge. The patient needs teaching about new medications and help with care needs at home. Which members of the health care team will be involved in assisting this patient with the patient's teaching and discharge needs? a) RN, social worker b) LPN, social worker c) RN, LPN d) Unit manager, pharmacist

c) RN, LPN (The RN initiates all health teaching, which includes education about medications and their side effects. The social worker assists the patient to organize care post discharge. The LPN/LVN can reinforce health teaching that has been initially provided by the RN.)

A clinical pathway is used to: a) locate key departments within large medical centers. b) provide appropriate nurse-to-patient staffing ratios. c) coordinate patient care within a case management framework. d) determine patient acuity levels in intensive care units.

c) coordinate patient care within a case management framework.

A patient care technologist (PCT): a) performs basic life support skills during patient transport to the ER. b) works only in the doctor's office. c) is an unlicensed assistive personnel member. d) works independently of nursing management.

c) is an unlicensed assistive personnel member.

An LPN/LVN hears the following discussion just prior to change of shift. Which statement requires follow-up discussion to ensure the RNs understand the role (aligned with the NPA) of the LPN? a. "The LPN/LVNs assignment will focus on the patients with chronic but stable conditions." b. "The LPN can assist with the new admissions orienting them to the unit and providing data to the RN facilitating the initiation of a care plan." c. "The LPN/LVN can focus on the care for the high-acuity client who needs hourly monitoring due to his exacerbation of COPD." d. "The LPN/LVN is a critical member of the health care team supervised by a RN or health care provider."

c. "The LPN/LVN can focus on the care for the high-acuity client who needs hourly monitoring due to his exacerbation of COPD."

home care

coordinated (PT,OT)

Practical/vocational nurses: a) work independently of other nursing personnel. b) initiate all patient teaching related to health matters. c) are not expected to think critically and solve problems. d) Comprise the second largest group of health care workers in the U.S.

d) Comprise the second largest group of health care workers in the U.S.

An LPN/LVN provides care that acknowledges the patient's preferences, needs, and values and communicates these to other members of the health care team. Which type of care is the LPN/LVN providing? a) Holistic care b) Total patient care c) Patient-centered care d) Relationship-centered care

d) Relationship-centered care (Relationship-centered care includes a therapeutic relationship with the patient and family. It also, unlike total, holistic, and patient-centered care, includes a professional relationship with members of the health care team for the purpose of respecting and responding to the patient's needs, preferences, and values.)

Patient-centered care is a(n): a) centralized approach to patient care delivery. b) inefficient method for providing patient care. c) obstacle to quality improvement and patient satisfaction. d) care delivery model to better meet the needs of patients.

d) care delivery model to better meet the needs of patients.

institute of medicine (IOM)

defines client centered care as "providing care thats respectful of and responsive to individual pt preference, needs and values, ensure pt values guide decisions"

surgical team

nurse anesthetist, surgical tech, anesthesiologist

rehab

nurse assistant, OT, OTA

direct care workers

nurse assistant, transport aides, pt care techs, LPN, RN

surgical unit/discharge

nurse manager, team lead, PT, PTA, social worker/case manager, PCT

interdisciplinary healthcare team

professionals from different disciplines who work together to manage the physical, psychological and spiritual needs pts; provide the best care for pts

nursing shortage

stock market drop in 2008 caused older RN to delay retiring, some retained jobs bc a spouse was laid off, part time switched to full time, affordable care act supported high quality, low cost care alternatives (transition in care)

intensive care

surgeon, pharmacist, respiratory therapist dept

acute care setting

total pt care, functional nursing, team nursing, primary nursing, nurse care management, skill mix

role of LPN

total pt care, task oriented, give meds, do treatments, lead team, collaborate with RN, dependent and interdependent role, Assists with all phases of nursing process, Works with established nursing diagnoses, Identifies possible new problems and reports to RN, First-line manager in long-term care setting, Initiates health teaching for basic health habits (e.g., nutrition and cleanliness), Reinforces and assists with health teaching as directed by the RN in other areas, Assists in implementing evidence-based practice, Collects data, as instructed, for research studies