Cherry 21, 22, 24, 26, 27

A new graduate secures the first interview and wants to work where cultural diversity is appreciated. The applicant feels that accepting this interview was the right choice when the recruiter states, "We do not discriminate based on sex, race, or age and practice inclusiveness of diversity." Which question would reflect this statement? a. "Nurses must work a master schedule where one month is Monday through Friday and the next month is the weekend shift. What is your religious belief about working on Sunday?" b. "We offer many benefits for employees such as educational benefits and health insurance." c. "Our mission is to provide patient-centered care that reflects the belief of the patient and family with an aim to win them over to Western medicine and less superstition, don't you agree?" d. "Do you have any issues with working with patients who are from a disadvantaged background because we have many people who refuse to work then want free care?"

b. "We offer many benefits for employees such as educational benefits and health insurance."

Nurses working on an orthopedic unit use personal digital assistants (PDAs) to review medications prior to administration to reduce potential drug interactions. Software is also installed that provides video clips of common procedures performed by nurses. Nurses on this unit are best demonstrating which QSEN competencies? a. Patient-centered care b. Informatics c. Teamwork d. Quality improvement

b. Informatics

A nonprofit organization that distributes to governmental agencies, the public, business, and health care professionals knowledge related to health care for the purpose of improving health is the: a. Institute for Safe Medication Practices. b. Institute of Medicine. c. National Committee for Quality Assurance. d. The Joint Commission.

b. Institute of Medicine.

A new graduate arrives for the first interview feeling prepared and excited about beginning a nursing career but quickly becomes concerned when the recruiter asks which illegal question? a. "Have you been convicted of a crime other than a minor traffic violation?" b. "We are very interested in hiring you but you do understand the position is contingent on the results of the preemployment physical and background check?" c. "What do you consider to be your major weaknesses for this particular position?" d. "Because you are applying for a position in the operating room, you must be able to be on call. How many children do you have responsibility for at home?"

d. "Because you are applying for a position in the operating room, you must be able to be on call. How many children do you have responsibility for at home?"

A novice nurse is stressed due to always being behind with her assignments. She is overheard saying, "No one here worries about checking nasogastric tube placement before they give medications and hang feedings. Skipping that step would save me an extra 30 minutes to be used for charting. If they can do it, so can I." This nurse is experiencing which stage of reality shock? a. loner. b. "rutter." c. change agent. d. "native."

d. "native."

An orthopedic unit is considering different types of care delivery models and staff have an opportunity to ask questions about how the models differ. The nurse manager provides an overview and uses the above visual to demonstrate which model of care delivery? a. Team b. Partnership c. Primary d. Functional

d. Functional

During the night, a patient fell in the bathroom and sustained a hip injury. The patient was very upset because of being unable to attend a granddaughter's wedding in 2 days. The team looked at the process and determined that the patient had been medicated with a narcotic, had urinary urgency so had not taken the time to put on shoes, failed to turn on the light because the door to the hall let in some light, and stumbled over a towel that had been placed to collect water leaks caused by construction that was in progress to replace damaged sinks. Which factor was a special cause variation? a. Failure to take time to put on shoes due to urgency b. Unsteady gait due to narcotic administration c. Poor lighting that led to decreased vision d. Improper construction that caused the leak and towel placement

d. Improper construction that caused the leak and towel placement

Which of the following statements concerning the Institute of Medicine (IOM) competencies is correct? a. Each competency is mutually exclusive. b. The competencies focus on individual efforts to reduce errors. c. Physicians lead the team to achieve each competency. d. The competencies address both individual and system approaches to transform care.

d. The competencies address both individual and system approaches to transform care.

In distinguishing between evaluation methods used in school versus those used in the work environment, it is noted that the work environment evaluation includes: a. determining whether steps are logical. b. formulating increments in correct order. c. efficiently organizing stages of the procedure. d. appraising outcomes according to policy.

d. appraising outcomes according to policy.

The role of the Clinical Nurse Leader (CNL) would include: a. diagnosing a patient with pneumonia and prescribing antibiotics. b. teaching members of a faith community how to avoid skin cancer and referring those with suspicious lesions. c. participating in the team who is investigating possible abuse of elderly persons by members of a gang known to sell illegal drugs. d. coordinating care of a patient admitted 4 days ago with stage IV heart failure and chronic bronchitis by revising care plan to include ambulation 50 feet with assistance.

d. coordinating care of a patient admitted 4 days ago with stage IV heart failure and chronic bronchitis by revising care plan to include ambulation 50 feet with assistance.

An organization's emergency preparedness task force meets to discuss how it should react in case of a terrorist attack and develops a disaster evacuation plan that details how each department will assist individuals in reaching safety. This type of diagram is referred to as a: a. Pareto chart. b. control chart. c. top-down flowchart. d. deployment chart.

d. deployment chart.

When preparing the education section of a resume: a. list high school, followed by the first college attended. b. include all colleges attended, even if a degree was not awarded. c. omit the address of the university unless requested by the potential employer. d. list in reverse chronologic order the names, dates, and addresses of universities that awarded degrees.

d. list in reverse chronologic order the names, dates, and addresses of universities that awarded degrees.

Accrediting agencies such as The Joint Commission address staffing by: a. imposing maximum staffing levels. b. requiring a specific staff mix. c. stipulating nurse-patient ratios. d. looking for evidence that patients receive satisfactory care.

d. looking for evidence that patients receive satisfactory care.

What characteristics are associated with the clinical nurse leader? (select all that apply) a. Is a generalist prepared at the master's level. b. Provides care at the bedside for complex patients. c. Identifies the best resources at the lowest price to achieve best health outcomes for a client. d. Serves as care coordinator whose practice is limited to acute care settings. e. Is an advanced practice nurse with an earned doctorate in nursing.

A, B

A novice nurse notices a patient is pacing the floor and twisting his hands. When the nurse enters the room, the patient stares at her and mumbles, "Can't anyone understand what I want?" while smiling and reaching out to shake the nurse's hand. The nurse recognizes a risk for violence based on which clinical findings? (select all that apply) a. Glaring at the nurse b. Nervousness, twisting of hands c. Murmuring when talking d. Diagnosis of a terminal illness e. Isolation, desire to be alone

A, B, C

An interdisciplinary team is evaluating the hospital's care of patients admitted with a myocardial infarction (heart attack) compared to national standards. The team analyzes the hospital's clinical indicator, which would be: (select all that apply) a. aspirin order within 24 hours of discharge. b. patient teaching related to stopping smoking completed prior to discharge. c. beta blocker administered upon arrival. d. support of employer to modify stress in workplace. e. patient's willingness to adhere to a strict cardiac diet after discharge.

A, B, C

A nurse responsible for staffing a medical-surgical unit must consider: (select all that apply) a. the patient census. b. physical layout of the unit. c. complexity of care required. d. educational level of all staff. e. task preferences of the nurses.

A, B, C, D

When preparing a portfolio, the nurse should include: (select all that apply) a. copies of diplomas awarded by colleges/universities. b. copies of college transcripts. c. a personal photograph, if not included with the application. d. letters of recognition for scoring high on national achievement tests while in nursing school. e. a copy of the voter's registration card.

A, B, D

Which factors would be considered in the first steps in developing an effective patient classification system? (select all that apply) a. Planned procedures b. Ethnic diversity of patients c. Clinical competency of staff d. Educational level of nurses e. Age of patients

A, B, E

A nurse wants to become an advanced practice nurse and investigates the requirements for a: (select all that apply) a. nurse practitioner. b. nurse executive. c. certified nurse-midwife. d. certified registered nurse anesthetist.

A, C, D

A patient with complicated diabetes is scheduled for a below the knee amputation at 7 AM. The surgical team adheres to the 2012 National Patient Safety Goals by implementing which protocols? (select all that apply) a. The surgical team asks the patient to verify his or her name, type of surgery, and limb to be removed. b. Ask each member of the surgical team to provide a copy of licensure and, if applicable, certification to patient and family. c. The surgical team uses the chart number and name/hospital number to ensure they have the correct patient. d. Mark the procedure site with "X" and again ask the patient to verify correct site. e. After arrival in the operating room, perform a "time-out" for final identification of patient and operative site along with agreement of what procedure is scheduled.

A, C, D, E

While participating in a task force to proactively plan for nursing care delivery over the next 20 years, a nurse learns that dramatic changes will occur as a result of: (select all that apply.) a. the increase in the number of minimally invasive procedures being performed for disease treatment. b. care provided for patients over an extended period in acute care settings. c. the reduction in the number of nurses and other health care professionals who are available to provide care. d. the widespread illiteracy and decreased self-efficacy of the aging patient population. e. the need to focus on social and environmental influences, educational level, and individual characteristics and values of the patient. f. the devaluing of nursing as a means of improving patient outcomes.

A, C, E

A new nurse decides to use the Internet to apply for possible positions. How does applying online compare to applying by more traditional methods? (select all that apply) a. Regardless of how one applies, it is important to check the resume for correctness. b. Follow-up with Internet applications is no sooner than 90 days compared to a 1- week follow-up for traditional applications. c. Researching the mission and philosophy of the agency is not necessary with Internet searches and applications. d. The resume and cover letter should be reviewed by someone with excellent skills in grammar and writing to ensure the first impression is one of professionalism and attention to detail. e. Internet applications should include specific questions to be answered prior to accepting an interview such as pay, shifts available, nurse-patient ratio, and autonomy of practice.

A, D

A nurse preparing a resume for the first position is anxious to demonstrate all achievements, which included completing a rigorous accelerated program and maintaining a high GPA while also serving in many community projects and leadership positions. The applicant finds it impossible to include all the accolades on one page and researches tips for professional cover letters and resumes and learns: a. margins should be at least 0.5 inch on all four sides, making conciseness important. b. paper should be bright colored to catch the attention of the recruiter. c. legal size paper may be used when applicants have many accolades or extensive work history. d. standardized cover letters present a professional image as opposed to those that stress the applicant's perspective too heavily. e. include in the cover letter that after researching other position, this is the applicant's preference.

A,E

A new graduate is excited about finding the first job but doesn't want to make the costly mistake of taking the first job offered or taking a job that doesn't meet her career goals. She learns the best way to know the culture of the potential employer is networking with: a. the executives at the competing agency. b. alumni that graduated from the same school and work in the area. c. nurses currently working in the agency. d. friends or people who have been patients at the agency. e. nurses who are former employees.

B, C, D, E

Faculty comes to class to present information about joining the Student Nurses Association (SNA). A student is heard saying, "Why join this organization? It is just a bunch of students like us. I'll wait and join the real nursing organization after graduation." This student is not aware of which benefits of SNA? (select all that apply) a. Members are eligible to sit for the licensure examination at a reduced rate. b. Leadership skills can be refined by working with other schools of nursing. c. The National SNA provides discounted rates for study abroad opportunities. d. A global view of nursing can be obtained through networking internationally. e. Lobbying efforts are a major benefit of belonging to SNA.

B, D

Advanced practice nurses are prepared minimally at the master's degree level with prescriptive privileges; these professionals include: (select all that apply) a. clinical nurse leader. b. nurse practitioner. c. nursing administrator. d. certified nurse-midwife. e. clinical nurse specialist.

B, D, E

In orientation, a new graduate is surprised to learn of workplace violence in health care agencies and asks, "What kind of violence is common in hospitals?" The educator describes workplace violence as: (select all that apply) a. care of patients admitted who are victims of domestic violence. b. experienced nurses withholding pertinent information from coworkers to portray them as incompetent. c. coworkers participating in an employee assistance program (EAP) to learn more about anger management for adult children living at home. d. care of persons being held for treatment prior to be incarcerated for committing homicide. e. statements such as "The new nurse has book sense but can't perform an admission physical without the help of everyone on the unit."

B, E

A nurse educator is explaining to licensed staff that health care is no longer safe and describes The Quality and Safety for Nursing (QSEN) recommended competencies for educating nursing professionals. These include: (select all that apply) a. advanced health assessment techniques. b. patient-centered care. c. prescriptive pharmacology content. d. quality improvement. e. safety.

B. D. E

A new graduate nurse is preparing for an interview for her first position and knows that: (select all that apply) a. the primary goal for the first job is to complete orientation and should be considered as an extension of nursing school. b. appointments for interviews should be scheduled immediately after graduation to avoid rushing into a position. c. self-confidence can be improved with self-talk, which reminds the graduate that peers from her school are effective practitioners. d. work history of even nonmedical positions can demonstrate commitment and reliability so letters from these employers should be in portfolio. e. it is best to arrive 10 to 15 minutes before the scheduled interview dressed for success.

C, D, E

A nurse interested in an entry level position as a registered nurse prepares the cover letter. A correctly written cover letter might include: a. "I am interested in a position where community outreach is valued as noted in your organization's mission statement." b. "I am highly educated and have several degrees including an Associate Degree in accounting, a certification in word processing, a Bachelor's degree in journalism, and a Bachelor's degree in nursing." c. "I am looking for a position that will allow me to develop my skills and still have a balanced home and work life." d. "I am married, a Christian, a single parent, and due to the downturn in the economy will be willing to work any shift or nursing unit."

a. "I am interested in a position where community outreach is valued as noted in your organization's mission statement."

Which message would be appropriate to leave on answering systems? a. "You have reached 910-999-1212. Please leave your name and number and I look forward to returning your call as soon as possible." b. Music that has messages that might be offensive to some callers downloaded as the response when applicant is unavailable. c. "Hi, I'm not here. Sorry you missed me. Call again." d. "I am interviewing for positions, hope to be home soon. If you are calling about an interview, please leave your name, number, and possible positions available."

a. "You have reached 910-999-1212. Please leave your name and number and I look forward to returning your call as soon as possible."

An RN has critical care experience and is proficient in advanced cardiac life support and often helps to lead "codes" and is an expert clinician with superior health assessment skills. Enjoying a challenge of a fast-paced environment with autonomy, this nurse would best be suited for which nursing role? a. Flight nurse b. Home health nurse c. Hospice nurse d. Occupational health nurse

a. Flight nurse

During orientation, a novice nurse sits and "virtually spends" the first few paychecks, envisioning the money going into a personal bank account. In the dream state, the nurse smiles and knows that the pain of nursing school was worth it. Which phase of reality shock is the nurse experiencing? a. Honeymoon b. Shock or rejection c. Recovery d. Resolution

a. Honeymoon

People are living longer and with older age comes a higher risk of terminal illness. Many individuals have chosen to maximize their quality of life but stop aggressive life-sustaining treatments. Nurses who work with terminally ill patients and their families to provide end-of-life care, pain management, and family support are practicing in which role? a. Hospice b. Infection control c. Coordinator d. Case manager

a. Hospice

When the novice nurse asks, "What will happen if this task is not completed," which skill is being demonstrated? a. Priority setting b. Delegation c. Organization d. Clinical skills

a. Priority setting

A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency? a. Safety b. Timely c. Equitable d. Patient-centered care

a. Safety

The staff on a nursing unit notes that patient satisfaction varies from month to month. They plot the degree of patient satisfaction each month for 1 year to determine when the periods of greatest dissatisfaction are occurring. The staff uses which type of graph? a. Time plot b. Pareto chart c. Flowchart d. Cause-and-effect diagram

a. Time plot

Nurses on a unit provide personal hygiene, administer medications, educate the patient and family about treatments, and provide emotional support. These nurses provide patient care based on which nursing delivery system? a. Total patient care b. Partnership nursing c. Team nursing d. Functional nursing

a. Total patient care

A novice nurse is in the "rejection phase" of stress and wonders if she made the right decision when deciding nursing was her chosen career. Which strategy would help the novice nurse cope with transition into practice and reduce stress? a. When asked by the charge nurse to accept the new admission even though she had no discharges, the novice nurse stops and considers if this request is acceptable and safe, then accepts the assignment based on two patients having a low acuity level. b. Refusing to eat anywhere but the hospital cafeteria to ensure a balanced diet and time to socialize with other staff and visitors. c. Avoid wasting time by listening to coworkers' problems or ideas on how to staff the unit during the upcoming holiday since the novice nurse's time is valuable and better spent getting her own work completed. d. Make an effort to "win over" hostile or angry coworkers who find fault with the novice nurse's work performance.

a. When asked by the charge nurse to accept the new admission even though she had no discharges, the novice nurse stops and considers if this request is acceptable and safe, then accepts the assignment based on two patients having a low acuity level.

A nurse groups patients with criteria such as "high risk for falls," "infection protocols," and "special communication needs" to determine the mix and number of staff needed on a telemetry unit. The nurse is using: a. a patient classification system to determine safe staffing levels. b. diagnostic-related groups for Medicare billing. c. case management to coordinate care. d. clinical pathways to determine care.

a. a patient classification system to determine safe staffing levels.

A nurse entering the job market wants to be certain that the first position is rewarding and allows for growth as a registered nurse. According to the Hallmarks of the Professional Nursing Environment, the nurse should ask: a. about the philosophy related to clinical care to determine the role of RNs in deciding outcomes related quality outcomes. b. if professional development opportunities are supported through paid leave and tuition reimbursement. c. how compensation packages compare to others in the same area and nationally. d. what the projected need for RNs is in the next 5 years and current turnover rate.

a. about the philosophy related to clinical care to determine the role of RNs in deciding outcomes related quality outcomes.

Several novice nurses share lunch breaks and have comments such as, "I have insomnia from worrying about what I forgot to do for my patient," and "I have no energy," and "I can't believe I can't do my job correctly." These novice nurses are each experiencing different symptoms of: a. burnout. b. low self-esteem. c. lack of confidence. d. resilience.

a. burnout.

A nurse notices that care is often withheld until an interpreter arrives, if the nurse is not multilingual. The nurse discusses this with the management team and suggests a three-part series be presented to the nursing staff to teach some commonly used medical terms in Spanish. This nurse is involved in the role of: a. change agent. b. educator. c. manager. d. coordinator.

a. change agent.

According to the Quality Chasm report: a. health care providers should be proactive rather than reactive to patient needs. b. common needs rather than individual preferences should be the priority. c. medical information should be confined to the primary care provider. d. specialized providers or case managers should control health care decisions.

a. health care providers should be proactive rather than reactive to patient needs.

The nurse manager is planning staffing levels and realizes that the first step is to: a. know the intensity of care needed by patients according to physical and psychosocial factors. b. examine the educational level of the staff. c. assess the skill level of caregivers. d. review the budget to determine the financial consequences of past staffing patterns.

a. know the intensity of care needed by patients according to physical and psychosocial factors.

A certified oncology nurse notices that a novice nurse is unsure of decision making and lacks technical skills. The novice nurse gains confidence by sharing and learning with the experienced nurse. This relationship continues and builds, allowing the novice nurse to become more confident. This relationship is known as: a. mentoring. b. role modeling. c. a preceptorship. d. socialization.

a. mentoring.

The novice nurse calls a supervisor and requests that a "float nurse" be assigned to help with all "assessments of new admissions and postoperative patients." The supervisor asks, "How many admissions and surgery patients have you received?" The novice nurse becomes flustered because she has not checked the census but simply bases the need on feeling overwhelmed. This situation best indicates a lack of _____ skills. a. organizational b. communication c. interpersonal d. clinical

a. organizational

The forensic nurse would most likely be involved in: a. performing an assessment of rape victim and collecting specimens needed for court. b. assigning a patient with chest pain to be seen first, followed by a patient with an insect bite of unknown origin with red streaks but no respiratory distress. c. assessing a patient at home by asking the patient to place a receiver over the pacemaker to evaluate capture of pacing stimuli and transmitting the results to another state where nurse located. d. performing pediatric life support at the scene of an accident to stabilize then transport via helicopter to the nearest trauma center.

a. performing an assessment of rape victim and collecting specimens needed for court.

Cover letters: a. should signify an interest in the employer and let the employer know that you took time to research the organization. b. must be handwritten so the employer can determine whether charting will be legible. c. should be limited to one paragraph because time is of the essence. d. let the employer know your desired salary, shift, and area of practice.

a. should signify an interest in the employer and let the employer know that you took time to research the organization.

The surgical team arrives in the operating room and one member states, "Everyone stop. Let's identify the patient and operative site. Now does anyone have any questions or concerns?" This process is known as: a. time-out. b. a critical pathway. c. special cause variation. d. lean methodology.

a. time-out.

The primary focus of the care provider role for the nurse involves: a. using the nursing process to provide guidance to the patient in recovery. b. encouraging consumer self-responsibility and emphasizing health promotion/maintenance. c. focusing on increasing satisfaction among professional nurses. d. advancing nursing practice through research.

a. using the nursing process to provide guidance to the patient in recovery.

Regardless of the term used to describe high-quality health care, the focus of quality is: a. what the consumer needs and wants. b. economical care. c. having the greatest technologic advancement. d. services equally distributed among populations.

a. what the consumer needs and wants.

A hospital is concerned that the number of medication errors has increased significantly in the past year. A project revealed four causes of medication errors. The above chart was used to help staff and administration know where to focus efforts to reduce errors. Which process improvement tool is used in this situation? a. Run chart b. Pareto chart c. Flowcharts d. Cause-and-effect diagrams

b. Pareto chart

A patient is admitted for a hysterectomy, and the RN develops and implements the plan of care but also delegates to the LPN/LVN the responsibility of administering oral medications. While off duty, this RN receives a call requesting a change in the plan of care because the patient has developed deep vein thrombosis. The nurse who originally planned the care is practicing which type of nursing care delivery? a. Modular b. Primary c. Team d. Functional

b. Primary

A nurse explaining the above graph indicates the frequency of falls in 2011 to detect and possibly explain causes of variation. The peaks in June were attributed to regular staff vacations during which agency nurses were used. The nurse is employed in which role? a. Case Manager b. Quality Manager c. Forensic Nurse d. Occupational Health Nurse

b. Quality Manager

A hospital standard states, "All intravenous (IV) sites must be rotated every 72 hours." The nurse who assesses and records variations from this standard is fulfilling which role of nursing? a. Infection control b. Quality management c. Coordinator position d. Counselor

b. Quality management

A task force is considering factors that contribute to high-quality safe staffing. Which statement reflects an understanding of the American Nurses Association's (ANA) recommendations? a. Because patient needs remain constant on a daily shift, staffing needs at the beginning of the shift should be sufficient to provide safe, high-quality care. b. Staffing should allow time for the RN to apply the nursing process so decisions result in high-quality, safe patient outcomes. c. Patient acuity levels affect staffing by increasing the need for unlicensed personnel to provide routine basic care rather than increasing RNs in staff mix. d. RN staffing is not cost-effective; thus is it important for staffing models to limit the number of RNs assigned per shift.

b. Staffing should allow time for the RN to apply the nursing process so decisions result in high-quality, safe patient outcomes.

A valuable tool for determining whether a potential employer is suitable for your career goals is to: a. call The Joint Commission (TJC) to ask whether the organization meets required standards. b. assess the work climate by walking through the facility. c. review financial statements of the institution. d. ask what they can do for you rather than what you can do for them.

b. assess the work climate by walking through the facility.

The nurse who is responsible for following the patient from admission through discharge or resolution of illness while working with a broad range of health care providers is called a: a. nurse manager. b. case manager. c. coordinator of patient-centered care delivery. d. team leader in team nursing care delivery.

b. case manager.

A patient is admitted with pneumonia. The case manager refers to a plan of care that specifically identifies dates when supplemental oxygen should be discontinued, positive-pressure ventilation with bronchodilators should be changed to self-administered inhalers, and antibiotics should be changed from intravenous to oral treatment, on the basis of assessment findings. This plan of care is referred to as a: a. patient classification system. b. clinical pathway. c. patient-centered plan of care. d. diagnosis-related group (DRG).

b. clinical pathway.

A nurse plans care knowing when specific recovery milestones are expected. The nurse is providing care via: a. patient classification systems. b. clinical pathways. c. functional nursing. d. case management.

b. clinical pathways.

An experienced nurse working in oncology is shocked to realize that he feels little empathy when a patient explains, "I developed cancer from having to work in the dry cleaning industry since I was only 8 years old to help support my younger siblings during the depression. Now they have all moved away and refuse to help me financially, and it takes everything I have to pay for my chemotherapy medicine." The nurse is experiencing: a. burnout. b. compassion fatigue. c. reality shock. d. horizontal hostility.

b. compassion fatigue.

Each month data on admission assessments that are based on the following standard are entered: "All patients will be assessed by an RN within 2 hours of admission." The target goal for this standard is 97% compliance. Data are displayed on a graph that shows number and time of admission assessments and compliance variation limits. This pictorial representation is: a. Pareto chart. b. control chart. c. deployment chart. d. top-down flowchart.

b. control chart.

Patients with heart failure have extended lengths of stay and are often readmitted shortly after they have been discharged. To improve quality of care, a type of "road map" that included all elements of care for this disease and that standardized treatment by guiding daily care was implemented. This road map is referred to as a(n): a. benchmark. b. critical pathway. c. algorithm. d. case management.

b. critical pathway.

A nurse in an acute care facility helps patients understand how to prevent diabetic neuropathies. This nurse is functioning in the role of: a. change agent. b. educator. c. manager. d. coordinator.

b. educator.

An RN testifies at a trial where domestic violence is being investigated. She had previously assisted with specimen collection and had assessed the victim. The nurse is involved in _____ nursing. a. triage b. forensic c. flight d. entrepreneurial

b. forensic

A hospital converts to a system of care delivery in which RNs, LPNs, and unlicensed assistive personnel (UAP) are responsible for implementing a specific task, such as medication administration or personal hygiene, for the entire nursing unit. This type of delivery system is: a. total patient care. b. functional nursing. c. team nursing. d. primary nursing.

b. functional nursing.

A nurse is responsible for determining the incidence rates of hospital-acquired diarrhea on a pediatric ward after receiving reports that five children admitted with uncontrolled asthma had developed diarrhea while hospitalized. The nurse is working in the role of: a. quality management. b. infection control. c. occupational health. d. forensics.

b. infection control.

In differentiating between interprofessional and multidisciplinary: a. multidisciplinary refers to the care of many diverse patients by one discipline. b. interprofessional involves members of many disciplines working together to provide patient care to a distinct population. c. interprofessional refers to members of the same discipline working together to provide patient care to a distinct population. d. interprofessional is the use of multiple interventions by nurses with varying levels of education.

b. interprofessional involves members of many disciplines working together to provide patient care to a distinct population.

Which nurse is more prone to burnout? The nurse who: a. graduated last in the class. b. is industrious and conscientious. c. refuses to work an extra shift even though he or she needs the money. d. volunteers to serve on only one committee and keeps in touch with schoolmates.

b. is industrious and conscientious.

A student nurse wants to meet other nursing students from different countries and to learn of employment possibilities. The student nurse should: a. participate in the clinical facility's employee satisfaction task force. b. join the Student Nurses Association. c. take part in self-mentoring. d. postpone taking the licensure examination so he or she can take a tour of foreign countries.

b. join the Student Nurses Association.

A nursing unit is comparing team nursing to the partnership model and finds that: a. with the partnership model, an RN does not have to be part of the mix. b. leadership abilities of the RN is a major determinant of effectiveness of care for both models. c. the RN teaches the LPN/LVN or unlicensed assistive personnel (UAP) how to apply the nursing process in team nursing. d. with team nursing the RN cares for the patient while the team members work with the family or significant others.

b. leadership abilities of the RN is a major determinant of effectiveness of care for both models.

Many nursing professionals have portfolios that include: a. family pictures. b. letters of commendation. c. articles that describe lack of quality in health care. d. high school achievements.

b. letters of commendation.

While performing a job search, a nurse reviews the list of Magnet hospitals of the American Nurses Credentialing Center because: a. these hospitals are able to hold on to revenue gained from patient care. b. nursing longevity, autonomy, and self-governance are important features of these institutions. c. all RNs have a minimum of a master's degree and are credentialed in the area in which they provide care. d. these hospitals have the most up-to-date diagnostic equipment such as magnetic resonance imagery.

b. nursing longevity, autonomy, and self-governance are important features of these institutions.

The nurse who organizes screenings for employees, assesses the work environment for hazards, and teaches health-promoting activities is employed in the field of: a. infection control. b. occupational health. c. informatics. d. transportation specialization.

b. occupational health.

A nurse who is participating in a health fair asks, "Other than nursing, what are some opportunities for careers in the health care professions, and what education is required?" The nurse informs participants that a baccalaureate degree is required as the minimum standard for the role of: a. speech therapist. b. occupational therapist. c. nurse-midwife. d. nurse anesthetist.

b. occupational therapist.

A patient has decided to stop hemodialysis because his renal failure progresses and he wishes to spend more time with family. Palliative care will continue, and the approach will be discussed with the patient and family as needed and at change of shift. The care delivery model in this situation is termed: a. partnership. b. patient-centered. c. case management. d. total patient care.

b. patient-centered.

A nurse manager is mentoring a novice nurse manager in determining staffing needs. The mentor explains, "We must determine the acuity level of the patient by: a. assessing patient satisfaction with nursing care." b. quantifying the amount and intensity of care required." c. examining the skill mix and educational preparation of the staff." d. determining the number of hospital days required by the patients."

b. quantifying the amount and intensity of care required."

A nurse is assisting with the delivery of twins. The first infant is placed on the scale to be weighed. The physician requests an instrument stat. The nurse turns to hand the instrument to the physician, and the infant falls off the scale. When evaluating the incident, the nurse and her manager list contributory factors such as the need for two nurses when multiple births are known, and the location of the scale so far from the delivery field. These nurses are performing a(n): a. standardization of care. b. root cause analysis. c. process variation. d. analysis of a deployment flowchart.

b. root cause analysis.

A nurse is removing a saturated dressing from an abdominal incision and must cut the tape to remove the dressing. The nurse accidentally cuts the sutures holding the incision, and evisceration occurs. In quality improvement, this incident is best identified as a: a. root cause. b. sentinel event. c. variation in performance. d. causal factor.

b. sentinel event.

A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed: a. honeymoon. b. shock or rejection. c. recovery. d. resolution.

b. shock or rejection.

The novice nurse arrives on the nursing unit, is introduced to the staff, is assigned a preceptor, and is asked to participate in the next staff meeting. This introduction into nursing is appropriately termed: a. biculturalism. b. socialization. c. transition. d. "going native."

b. socialization.

The nurse manager determines that four RNs, five LPN/LVNs, and two unlicensed assistive personnel (UAP) are required per shift to meet the needs of the patient population on the unit, according to acuity and census. The nurse manager is concerned with: a. assignments. b. staffing. c. output. d. productivity.

b. staffing.

A nurse is preparing to administer a medication by using the vastus lateralis site and is unfamiliar with the process. A step-by-step reference that shows how to complete the process is called a: a. deployment flowchart. b. top-down flowchart. c. Pareto chart. d. control plot.

b. top-down flowchart.

A patient is admitted with coronary artery disease and is scheduled for coronary artery bypass grafting (CABG). According to the clinical pathway the patient should be extubated and discharged from critical care the day after surgery. During surgery the patient's oxygen saturation decreased drastically as a result of chronic tobacco abuse. Subsequently, the patient remained on the ventilator an additional 2 days postoperatively. According to the clinical practice guideline for CABG, this situation represents a: a. patient outcome. b. variance. c. goal. d. standard.

b. variance.

When the job applicant is asked to identify weaknesses, one appropriate reply for the novice nurse might be: a. "I have no weaknesses." b. "Are you trying to set me up?" c. "Delegating to peers." d. "Caring requires weakness."

c. "Delegating to peers."

According to Kramer, nurses in the shock phase should ask themselves: a. "How can I fit in with other staff?" b. "Why can't I perform as everyone expects?" c. "What changes can I make to make me feel good about the choice to become a nurse?" d. "How can I get the rest of the staff to change?"

c. "What changes can I make to make me feel good about the choice to become a nurse?"

A novice nurse is placed in charge just after orientation ends. Which statement by the novice nurse would ensure a smooth delegation experience when delegating to an experienced staff member? a. "You have the patients in rooms 1 to 7. These patients require little skill so you will be fine." b. "Your assignments are posted in writing by the nurses' station. Be certain all your tasks are completed so the next shift is not behind." c. "You have patients in rooms 5 through 10 and I will administer all IV medications. I will let you know if I have to adjust. If you see you need help let me know." d. "Everyone is capable of providing the best care, so please sign up for the patients you would like to be assigned to."

c. "You have patients in rooms 5 through 10 and I will administer all IV medications. I will let you know if I have to adjust. If you see you need help let me know."

When should a follow-up letter be written to a recruiter? a. Before the interview to thank him or her for granting you the interview b. Approximately 2 weeks after you did not get the job to inquire c. A few days after the interview d. When you are sure you got the position

c. A few days after the interview

Which of the following occurrences would be classified as a sentinel event? a. A postpartum patient who elects to breastfeed only twice daily develops mastitis. b. A newly diagnosed diabetic patient self-injects insulin in the abdominal area rather than the upper thigh as instructed by the patient educator. c. A nurse assisting with the delivery of twins places the "Twin 1" name tag on the second-born twin, causing the first-born twin to undergo surgery that was scheduled for the other twin. d. A nurse administers 3 units of regular insulin rather than 3 units of NPH insulin subcutaneously, resulting in a drop in the patient's serum glucose from 160 to 100 mg.

c. A nurse assisting with the delivery of twins places the "Twin 1" name tag on the second-born twin, causing the first-born twin to undergo surgery that was scheduled for the other twin.

A new graduate desires a position in labor and delivery; however, no position is available. What is the best advice for this nurse? a. Continue to study to keep skills current and wait for desired position. b. Return to college until a position in labor or delivery opens. c. Accept another nursing position and transfer into labor and delivery when a position is available. d. Practice obstetrical skills in a simulation lab then present evidence of competency to potential employer.

c. Accept another nursing position and transfer into labor and delivery when a position is available.

A novice nurse is unsure how to correctly administer an injection using the Z-track method. What is the best approach for learning this procedure? a. Read the procedure manual and follow the steps exactly. b. Make an appointment at the skills laboratory of the former nursing school to practice. c. Ask to observe the skill as it is being performed; then perform it under direct supervision. d. Try to remember how the task was previously performed during a simulation.

c. Ask to observe the skill as it is being performed; then perform it under direct supervision.

A nurse tallies the patient satisfaction surveys and approves the use of an agency nurse because of the high census. This nurse is involved in which nursing role? a. Change agent b. Educator c. Manager d. Coordinator

c. Manager

The number of IV site infections has more than doubled on a nursing unit. The staff determine common causes include the site is cleaned using inconsistent methods, dressing frequently becomes wet when patient showers, IV tubing is not changed every 48 hours per protocol, and inadequate hand washing of RN prior to insertion. A bar graph demonstrates the frequency in descending order, with 80% of infections being attributed to inadequate hand washing. The quality tool used is a: a. cause-and-effect diagram. b. run chart. c. Pareto chart. d. flowchart.

c. Pareto chart.

Nurses, physicians, and social workers finalize the plan of care and coordinate discharge for a homeless person who will need wound care and follow up over the next 4 weeks. Each member contributes based on his or her area of expertise but also recognize other members' strengths. Which of the QSEN competencies are being demonstrated? a. Quality improvement b. Evidence-based practice c. Teamwork and collaboration d. Patient-centered care

c. Teamwork and collaboration

When comparing mentoring and role modeling, the role of mentoring is represented by which of the following situations? a. The experienced nurse is unaware that the novice nurse is observing him or her gathering supplies needed to start intravenous antibiotics. b. The novice nurse mimics conversations with his or her own patients that were unobtrusively overheard between the experienced nurse and his or her patients. c. The novice nurse receives feedback from the experienced nurse related to the use of a new occlusive dressing product and is told, "I couldn't have done it better myself." d. An experienced nurse is nominated for outstanding employee of the month by the novice nurse.

c. The novice nurse receives feedback from the experienced nurse related to the use of a new occlusive dressing product and is told, "I couldn't have done it better myself."

A graduate nurse should begin the job search knowing that: a. few jobs are available for RNs because of a failing health care economy. b. it would be more promising to apply to a rural hospital than to an urban hospital. c. although efforts have been made to reduce expenditures for health care, the need for RNs remains stable. d. the demand for nurses to work in acute care hospitals has decreased because most services are being shifted to outpatient and ambulatory settings.

c. although efforts have been made to reduce expenditures for health care, the need for RNs remains stable.

The appropriate procedure for addressing a cover letter when the applicant is unsure of the name and title of the person to whom the letter should be addressed is to: a. address the letter to "To Whom It May Concern." b. address the letter to "Nurse Recruiter." c. call the facility to inquire about the name and title of the person. d. leave the salutation blank if the name and the title are unknown.

c. call the facility to inquire about the name and title of the person.

A patient is admitted for a hip replacement complicated by uncontrolled diabetes and early dementia. The nurse coordinates referrals to an endocrinologist to establish an insulin protocol and organizes out-patient physical therapy in an Alzheimer's assisted living facility upon discharge. The role of this nurse is the: a. informatics specialist. b. educator. c. case manager. d. quality manager.

c. case manager.

The RN who identifies the best resources at the lowest cost to achieve optimal health outcomes for the client is fulfilling the role of: a. informatics specialist. b. educator. c. case manager. d. quality manager.

c. case manager.

A novice nurse notices the medication nurse hurriedly gathering medications to be administered for the entire day, removing them from the packages, and placing them in a paper cup with the patient's name and room number on the cup. When one of the patients points at a pill and asks, "What is this?" and "What does this do?" the medication nurse is uncertain, because it has long since been removed from the packaging. The novice nurse speaks to the nurse manager about her observations and describes her concerns. The novice nurse has assumed the role of: a. loner. b. "rutter." c. change agent. d. "native."

c. change agent.

A hospital is concerned with nurse retention and realizes that job satisfaction is a major influence. To enhance employee satisfaction related to staffing, the management team: a. negotiates for additional agency nurses. b. hires more part-time employees. c. includes participatory management into staffing decisions. d. uses "float" nurses to cover vacancies.

c. includes participatory management into staffing decisions.

A nurse working in a factory performs routine hearing tests for employees. The factory uses 90 dB as the safe limit for an 8-hour day's exposure to machine noise rather than 85 dB as recommended by the Occupational Safety and Health Administration. The nurse is functioning in the role of: a. quality management. b. informatics nurse specialist. c. occupational health nurse. d. case manager.

c. occupational health nurse.

A patient is ordered a low-protein, low-calorie diet but the patient's family brings fish, lentils, and unleavened bread for a meal to observe a cultural practice. The nurse works with the dietitian to adjust the next few meals to accommodate for this variance. This situation would represent: a. a sentinel event. b. an adverse event. c. patient-centered care. d. the communication technique of "call-out."

c. patient-centered care.

Customer satisfaction is primarily based on: a. access to modern, up-to-date facilities. b. availability of an extensive menu selection. c. personal interactions with employees. d. having to undergo fewer invasive procedures.

c. personal interactions with employees.

To determine basic competency, the interview for a nursing position may include a test in: a. pathophysiology. b. correctly writing nursing diagnoses. c. pharmacology. d. computer skills.

c. pharmacology.

When deciding which staffing option to use on a nursing unit that will open soon, the manager realizes that: a. continuity of care is enhanced and errors are reduced when nurses provide care over longer shifts and consecutive workdays, such as 12-hour shifts on 3 consecutive days per week. b. the use of part-time nurses provides the variability needed to meet diverse patient needs. c. satisfaction of the staff equates to satisfaction of patients. d. nurses provide the same level of care, regardless of the work environment.

c. satisfaction of the staff equates to satisfaction of patients.

A person from an underrepresented background in nursing is interested in entering nursing school and researches the ethnicity, age, and gender make-up of the nursing profession and finds: a. nursing is a career field that is primarily made up of women younger than 30 years. b. the number of male RNs has steadily increased and is equal to the number of female RNs. c. the majority of RNs are white or non-Hispanic. d. more than half of all RNs are ages 55 through 65.

c. the majority of RNs are white or non-Hispanic.

A potential applicant reviews the application process and learns that preemployment physicals often include: a. cholesterol screening. b. pregnancy testing. c. urine drug screening. d. vision and hearing tests.

c. urine drug screening.

According to the Hallmarks of the Professional Nursing Environment, a nurse should ask a potential employer: a. how salaries compare with those of larger facilities. b. what benefits are provided to RNs that are not available to other health care providers. c. what role nurses have in determining the quality of care. d. how the employer plans to provide long-term economic security to RNs.

c. what role nurses have in determining the quality of care.

Institute for Healthcare Improvement (IHI) proposed a process for quality improvement with steps known as "PDCA." When explaining the steps to a group of nurses interested in improving the process of medication reconciliation for heart failure patients with high rates of recidivism, the instructor states: a. P stands for process. Following a top-down flowchart provides the steps for reviewing patient medications taken at home compared to those prescribed during hospitalization. b. D stand for deviation, which is an alteration in the expected drugs ordered. c.C is for check if the process for change worked. Was there an improvement in accurate reconciliation? And what was learned? A stands for algorithm, which includes all steps of the process. d. A stands for algorithm, which includes all steps of the process

c.C is for check if the process for change worked. Was there an improvement in accurate reconciliation? And what was learned? A stands for algorithm, which includes all steps of the process.

A group of nurses is presenting the importance of high-quality care during a system- wide meeting of medical-surgical nurses. They point out a finding of the Quality Chasm that: a. being insured has little effect on a person's longevity and the quality of care received. b. lobbyists for the drug companies are able to gain permission for the use of new drugs within 1 year of their discovery. c. although a greater number of lawsuits stem from medication errors, more people actually die from human immunodeficiency virus (HIV) and acquired immunodeficiency disease syndrome (AIDS). d. medication-related errors place a tremendous financial burden on the U.S. health care system.

d. medication-related errors place a tremendous financial burden on the U.S. health care system.

A nurse makes patient care assignments as follows: RN1 has rooms 200-210; RN2 has rooms 211-221; RN3 has rooms 222-232. The two unlicensed assistive personnel have half the rooms, with one assigned to 200-215 and the second to 216-232. The care delivery model used in this situation is: a. team. b. primary. c. partnership. d. modular.

d. modular.

A nurse researcher is attempting to describe the demographics of today's RNs and reports that: a. less than half of all RNs work in hospital settings. b. the average age for an RN is 50 years. c. approximately 25% of RNs are male. d. most RN are practicing with a bachelor's degree.

d. most RN are practicing with a bachelor's degree.

A nurse is interested in practicing in a faith-based community; when researching the role of the parish nurse, the nurse finds that: a. certification is available at a basic level after a qualifying examination is completed and a set number of practice hours have been worked, as defined by the state's nurse practice act. b. this advanced practice role focuses on health promotion and disease prevention. c. this role has no set standards or scope of practice but instead follows the doctrine of the denomination being served. d. this role is recognized by the American Nurses Association (ANA) as a specialty with a defined set of practice guidelines.

d. this role is recognized by the American Nurses Association (ANA) as a specialty with a defined set of practice guidelines.

A nurse who is applying for a position contacts an expert on writing résumé and cover letters and is told: a. to use correction fluid sparingly. b. that when an error is made, a single line should be used to cross through the mistake, and initials should be inserted above the error. c. to limit margins to one half inch so that the page appears full of information. d. to be concise, limit the resume to a single page.

d. to be concise, limit the resume to a single page.

A recruiter is explaining benefits to a group of nursing externs who are highly sought for employment. The recruiter states, "We are the only hospital in town that offers a residency program." The recruiter further explains that a residency program: a. provides housing for the graduate nurse to decrease expenses until income is established. b. partners a medical resident with a nurse resident to learn interprofessional care. c. allows new graduates to work on a higher degree in nursing while being paid full- time. d.offers extended time for both theory and clinical activities that promote problem solving and clinical decision making.

d.offers extended time for both theory and clinical activities that promote problem solving and clinical decision making.