exam 6

A staff nurse is talking with a clinical nurse leader and asks, "What exactly do you do?" Which statement by the clinical nurse leader would be appropriate?

"I collaborate with health care teams to promote client care."

A group of nursing students is discussing reasons why they would like to become home health nurses after licensure. The nursing instructor facilitating this discussion would offer additional information when which statement is made? Select all that apply.

"I don't think fast enough to work in a hospital." "I would like to spend more time talking with clients than doing skills."

A nurse is assessing a terminally ill female client. Which client statement indicates that the client is in the bargaining stage of dying?

"I just want to see my daughter graduate from college. That's all." Bargaining is manifested by pleading for more time to reach an important goal. This is reflected in the client's statement about wanting to see her daughter's college graduation.

A nurse has just finished a presentation on hospice and palliative care. Which statement by a participant would indicate a need for further education?

"In hospice care, the nurses make most of the care decisions for the clients." (x)

A patient's family member asks the nurse what the purpose of hospice is. What is the best response by the nurse?

"It will enable the patient to remain home if that is what is desired."

While at a clinic visit, a client asks the nurse, "I'm going to be eligible for Medicare soon. Can you help explain what this involves?" Which information would the nurse likely include in the explanation? Select all that apply.

"Part A pays for inpatient hospital costs; Part B covers most outpatient costs." "It's good to have an extra policy to supplement what might not be covered."

The nurse is caring for a client who recently found out he has a terminal illness. The nurse notes that the client is hostile and yelling. Which statement by the nurse shows that she has understanding of the Kübler-Ross emotional responses to impending death?

"Sometimes a person returns to a previous stage."

Which statement regarding health care reform trends is most accurate?

"Systems are in place to pay for performance and penalize hospitals for excessive readmissions."

The new hospice nurse is reviewing the concepts of loss and grief with the preceptor. Which statement leads the preceptor to believe that the nurse has an understanding of grief and loss?

"The client who is isolating himself from social contact after the death of his spouse is demonstrating a social expression of grief."

A student nurse observes a nurse case manager coordinating discharge for a patient diagnosed with congestive heart failure (CHF). Which statement made by the patient indicates to the student that the patient understands the role of the case manager?

"The nurse case manager contacted my insurance company and has arranged for the home health nurse and physical therapist to visit me as soon as I get home."

Which statement by the nurse shows an understanding of the focus of the quality assurance programs developed in the 1980s?

"The quality assurance programs focus on processes used to provide care and improving those processes."

A nurse is working with the family of a terminally ill client, providing them with suggestions about how to manage the client's anorexia. Which statement by the family indicates that they have understood the instructions?

"We'll try adding powdered milk to milk and other foods to make them more nutritious."

The nurse is assessing the client's readiness to be discharged home after being admitted for 4 days due to falling at home. Which question should the nurse ask the client?

"What medications will you be taking at home?"

A patient with end-stage chronic obstructive pulmonary disease is admitted to a hospice facility and asks the admitting nurse, "How long will I be allowed to stay here?" What is the best response by the nurse?

"When your stay reaches 6 months, you will be recertified for a continued stay."

In what time period did nursing care as we now know it begin?

18th to 19th century From the middle of the 18th century to the 19th century, social reforms changed the roles of nurses and of women in general. It was during this time that nursing as we now know it began, based on the beliefs of Florence Nightingale.

A nurse demonstrates understanding of Healthy People 2030 by supporting which statement?

A client's health is affected by social, economic, and political factors. People believe "quality of life" to be synonymous with a healthy community. There is growing recognition that to achieve the goals of Healthy People 2030 a model inclusive of multiple health determinants is needed.

A client diagnosed with a terminal illness appoints her oldest son as the authorized individual to make medical decisions on her behalf when she is no longer able to speak for herself. Which proxy directive is the patient using?

A durable power of attorney for health care is also known as a health care power of attorney or a proxy directive. It allows another individual to make medical decisions on the client's behalf.

Which of the following best reflects the rationale for evidence-based practice?

A means to ensure quality care

Which is an example of an unintentional tort?

A nurse gives the client a medication, and the client has an adverse reaction to it.

Which scenario is an example of certification?

A nurse who demonstrates advanced expertise in a content area of nursing through special testing

Which nursing student would most likely be held liable for negligence?

A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home. The nursing student who administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home is performing a task outside the scope of the job responsibilities of a UAP. The other options demonstrate legally defensible actions by the nursing student.

Which of the following best describes the health-illness continuum?

A person may be considered neither completely healthy or completely ill.

Conscientious objection

A personal appeal that to carry out a particular action that has been ordered by legitimate authority would be against one's own conscience. 양심적 병역 거부

When conducting an education program for a group preparing for retirement, the nurse would include information about applying for Social Security benefits and Medicare insurance. The nurse would include in the education that Medicare is a federally funded insurance program which bases the fee for payment on what?

A prospective payment plan based on a predetermined fixed cost

Deception

A trick; an attempt to make someone believe something that is not true

After hearing a presentation about the American Nurses Association (ANA), a nurse decides to join the organization based on the understanding that:

ANA aims at fostering high standards of nursing in the United States.

Which process evaluates and recognizes educational programs as having met certain standards?

Accreditation Accreditation is the process by which an educational program is evaluated and recognized as having met certain standards.

Which is an emerging trend in health care delivery?

Active involvement of consumers

Which nursing interventions would be anticipated with hospice care? Select all that apply.

Administer prescribed morphine for pain control. Ease respiratory function by providing oxygen via nasal cannula. Administer prescribed antiemetics to control nausea. Insert a Foley catheter to prevent incontinence.

Which priority intervention should the nurse plan to implement to reduce a client's discomfort during terminal weaning?

Administer sedation and analgesia. Terminal weaning is the gradual withdrawal of mechanical ventilation from a client with a terminal illness. Providing sedation and analgesia is the best way to reduce the client's discomfort during the process.

Assisted suicide is expressly prohibited under statutory or common law in the overwhelming majority of states. Yet public support for physician-assisted suicide has resulted in a number of state ballot initiatives. The issue of assisted suicide is opposed by nursing and medical organizations as a violation of the ethical traditions of nursing and medicine. Which scenario would be an example of assisted suicide?

Administering a lethal dose of medication

The health care provider prescribes cold therapy every 4 hours for a client after foot surgery. The nurse places the ice pack directly on the client's skin and returns 60 minutes later. After removal of the ice pack, the skin is pale and cold to the touch. The client develops frostbite and begins a lawsuit for malpractice. When reviewing the case, the nurse attorney recognizes which most important statement about the malpractice suit?

All elements are in place to hold the nurse liable. All four elements are met: The nurse had a duty. The duty was breached. It is easy to find causation (an ice pack directly on skin for 60 minutes), and harm (development of frostbite) was done. The client is not responsible since the lack of sensation may have occurred early and it was the nurse's responsibility to ensure safety.

Which best exemplifies malpractice?

All elements of liability are in place for the scenario involving a nurse administering amoxicillin to a client with documented allergies to penicillin: the nurse had a duty and breached it by giving the medication (amoxicillin), which caused the client harm (seizures and respiratory arrest).

The nurse is caring for a client who has just expired. Which action will the nurse perform?

Allow the client's family to see the client's body before it is discharged. After the client has been pronounced dead, the nurse is responsible for preparing the body. Family members may need to see the client's body to accept the death fully; allow them to see the client's body before discharging to the mortician.

Which nursing group provides a definition and scope of practice for nursing?

American Nurses Association (ANA)

A client states, "My children still need me. Why did I get cancer? I am only 30." This client is exhibiting which stage according to Kübler-Ross?

Anger Anger is the second stage and is exhibited by statement similar to "Why me?" Denial occurs when the person refuses to believe certain information.

"I collaborate with health care teams to promote client care."

Anywhere from 44,000 to 98,000 people are estimated to die in U.S. hospitals each year as a result of preventable medical errors.

Although nurse practice acts may vary state by state, all recognize several basic principles supporting the legal parameters for all registered nurses. Select the activity that falls under the scope of nursing practice.

Appraising and enhancing an individual's health-seeking perspective

Which element would be included as a goal of case management?

Appropriateness of services The goals of care management are to ensure the quality, appropriateness, and timeliness of services as well as to reduce costs. Case managers do not have prescriptive authority. Fixed-price reimbursement is a feature of managed care. Case managers do not use the nursing process.

Conflict has emerged on a nursing unit because new graduates have found that some of the more experienced nurses are manipulating the client assignment to ensure a lighter workload during night shifts. How should the manager of the unit best address this conflict?

Arrange a meeting where the issue can be discussed and addressed by as many of the nurses as possible.

A patient who adheres to the dietary laws of Judaism is in traction and confined to bed. The patient needs assistance with the evening meal of chicken, rice, beans, a roll, and a carton of milk. Which nursing approach is most representative of promoting wellness?

Ask whether the patient would like to make any substitutions in the foods and fluids received. Wellness involves being proactive and being involved in self-care activities aimed toward a state of physical, psychological, and spiritual well-being

The nurse is performing an assessment on a client who reports having a rash on the back that is red and raised. What would be the most appropriate nursing action?

Assess the client's back visually.

A nurse is caring for a postoperative client 1 day after a total abdominal hysterectomy. Which action best demonstrates the nursing skill of caring in this situation?

Assisting the client to sit up in a chair

A client aged 83 years who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. The nurse communicates the client's wish to the family and health care team. This is an example of what ethical principle?

Autonomy Autonomy is the ethical principle of respecting the right of clients to make their own decisions about their health care. Nonmaleficence refers to preventing or not causing harm to clients. Veracity refers to telling the truth. Justice refers to fairness and treating clients with equal dignity.

The nurse inserts a prescribed urinary catheter into the client's urethra after the client has refused the procedure. The client suffers an injury. The client may sue the nurse for which type of tort?

Battery Battery is touching a person's body without consent. A nurse may be sued for battery if the nurse fails to obtain consent for a procedure. Assault is a threat or attempt to touch a person without that person's consent. Invasion of privacy is sharing a client's personal information with others without consent. There is no evidence of dereliction of duty by the nurse in this case, which would be negligence or deviation from standard nursing care.

A nurse working in a coronary care unit resuscitates a client who had expressed wishes not to be resuscitated. Which tort has the nurse committed?

Battery The nurse has committed battery by unlawfully carrying out a procedure that the client had refused. Battery is an assault and includes negligent touching of another person's body or clothes or anything attached to or held by that other person.

The nurse inserts a prescribed urinary catheter into the client's urethra after the client has refused the procedure. The client suffers an injury. The client may sue the nurse for which type of tort?

Battery is touching a person's body without consent. A nurse may be sued for battery if the nurse fails to obtain consent for a procedure

With new care systems continuing to emerge, nurse managers must retain the position and power necessary to be involved in these changes. This is the only appropriate rationale for this level of commitment.

Being on call 24 hours per day is not required for employment. The staff should not need constant supervision by the nurse manager. Although the nurse manager needs some knowledge of all aspects of care, this does not require being on call 24 hours per day.

When respecting autonomy, the nurse supports the client's right to make decisions with informed consent. When promoting the client's well-being, the nurse acts in the best interests of the client. Advocacy is linked to the belief that making choices about health is a fundamental human right that promotes the individual's dignity and well-being.

Beneficence is reflected by doing good and promoting what will benefit the client. Justice involves treating each client fairly. Fidelity involves being faithful and keeping promises.

Grief refers to the personal feelings that accompany an anticipated or actual loss.

Bereavement refers to the period of time during which mourning takes place. Spirituality is a personal belief system that focuses on a search for meaning and purpose of life.

Grief refers to the personal feelings that accompany an anticipated or actual loss.

Bereavement refers to the period of time during which mourning takes place. Spirituality is a personal belief system that focuses on a search for meaning and purpose of life.

A nurse fails to communicate a change in the client's condition to the physician. Which element related to proving malpractice has been met?

Breach of duty

Credentialing refers to ways in which professional competence is ensured and maintained. Licensure is the process by which a state determines that a candidate meets certain minimum requirements to practice in the profession—and grants that person the license to do so.

Certification is the process by which a person who has met certain criteria established by a nongovernmental association is granted recognition in a specified practice area.

A nurse fails to administer a medication that prevents seizures, and the client has a seizure. The nurse is in violation of the Nurse Practice Act. What type of law has the nurse violated?

Civil

The Quality and Safety Education for Nurses (QSEN) initiative has identified which key competencies for nurses? Select all that apply.

Client-centered care Teamwork and collaboration Evidence-based practice Quality improvement

A nurse working for a home health agency is scheduled to evaluate a client with worsening heart failure to determine whether the client is a candidate for the new "Hospital at Home" program. Which statement accurately reflects an outcome for this program?

Clients in the "Hospital at Home" program have been found to require shorter lengths of stay than when admitted to the acute care setting.

Normal expressions of grief may be physical, emotional, social (feeling detached from others and isolating oneself from social contact), and spiritual. Grief is an internal emotional reaction to loss and occurs with loss caused by separation (e.g., divorce) or by death.

Clients lamenting their loss of youth are demonstrating a type of perceived loss, which is intangible to others. Situational losses are experienced as a result of unpredictable events; a child going to college would be a maturational loss for the parent.

A nurse is caring for a client who has a PPO health care plan. What is the greatest advantage of this type of plan?

Cost effectiveness Cost effectiveness is the greatest advantage of the PPO health care plan. PPOs are not known for the ease of referrals, care coordination, or improved health outcomes.

This patient is experiencing respiratory alkalosis related to heatstroke. The pH level is elevated in hyperventilation; the patient's hyperventilation will "blow off" more CO2, leading to lower pCO2 levels.

Decreased pCO2 is caused by hyperventilation. Decreased CO2 levels are seen in renal failure. Renal failure is a sign of heatstroke. With rapid breathing SO2 can be increased with deep or rapid breathing. Acute airway management is indicated to improve tissue oxygenation.

Other helpful measures include positioning the client on the side with the head supported with pillows to allow secretions to drain freely from the mouth, gently suctioning the oral cavity, and administering prescribed anticholinergic agents sublingually or transdermally.

Deeper suctioning may cause significant discomfort to the dying client and rarely is of benefit because secretions tend to reaccumulate quickly.

A nurse is named as a defendant in a malpractice lawsuit. Which action would be recommended for this nurse?

Do not volunteer any information on the witness stand.

Which is an important element of implementation?

Documentation

Illness prevention involves identifying risk factors such as a family history of hypertension or diabetes and reducing the effects of risk factors on one's health.

Early detection uses screening diagnostic tests and procedures to identify a disease process earlier, so that treatment may be initiated earlier and be more effective. Health maintenance refers to protecting one's current level of health by preventing illness or deterioration, such as by complying with medication regimens, being screened for diseases such as breast and colon cancers, or practicing safe sex.

A registered nurse is providing community-based health care for a client diagnosed with early onset dementia. Which strategy is best for the nurse to employ to facilitate the family participating in the client's care?

Encourage active participation of the client and family in health care decisions.

A nurse manager is developing a program for the unit staff to foster critical thinking. Which activity would the nurse manager implement to promote theoretical knowledge?

Encouraging staff to read current journal articles

The nurse that has been in practice for 15 years is able to use intuition when providing care to clients and also utilizes resources and demands to attain specific goals. According to Author Patricia Benner, in From Novice to Expert (1984), what stage of practice is the nurse displaying?

Expert

A nurse is conducting a spiritual assessment of a terminally ill client using the four step FICA process and asks the question, "What gives your life meaning?" The nurse is assessing which of the following?

Faith and belief

virtues

Firm attitudes, stable dispositions, habitual perfections of intellect and will that govern our actions, order our passions, and guide our conduct according to reason and faith

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

Who is considered to be the first nursing theorist who conceptualized nursing in terms of manipulating the environment?

Florence Nightingale

laissez-faire approach

Free trade theories - absolute advantage and comparative advantage

Offering small amounts of nourishment frequently will not help potentiate the effects of pain medication.

Gentle massaging of the arms and legs helps to regulate body temperature. Encouraging the client to fall asleep will not help potentiate the effects of pain medication.

A nurse is assessing a dying client for realism of expectations and perception of condition. Which interview questions address this concern? Select all that apply.

Have you had any previous experience with this condition before? How do you see the next few weeks playing out? What do you think may be happening in the midst of all of this?

The nurse is providing a program at the local YMCA about stress-reduction techniques combined with a 1-mile walk around the indoor track once a week. What does this type of program address for the community?

Health promotion refers to engaging in strategies to enhance health such as eating a diet high in grains and complex carbohydrates, exercising regularly, balancing work with leisure activities, and practicing stress-reduction techniques.

The nurse is planning discharge of the client who had surgery for a left hip replacement. The client is being discharged from the hospital to the home and requires home medical services. Which item would be provided by home medical services?

High-rise toilet seat

A client believes that restoring optimal health takes more than treating the body; the client believes that the mind and spirit must be addressed as well. What is this perspective of health?

Holism

Which are community-based settings? Select all that apply.

Homes Schools Workplaces

The wife of a client who has been diagnosed with a terminal illness asks the nurse about the differences between palliative care and hospice care. Which information would the nurse most likely include in the response?

Hospice care is provided for clients who have 6 months or less to live; palliative care is provided at any time during illness.

The philosophy of hospice is that clients and families are empowered to achieve as much control over their lives as possible.

Hospice focuses on relieving symptoms and supporting clients with a life expectancy of 6 months or less, rather than years, and their families. However, palliative care may be given at any time during a client's illness, from diagnosis to end of life.

In closed awareness, the client is unaware of his or her terminal state, whereas others are aware.

In suspected awareness, the client suspects what others know and attempts to find it out. In open awareness, all are aware that the client is dying and are able to acknowledge that reality openly. Reference:

Health care trends already include paying for performance (HEDIS, HCAHPS) and penalizing hospitals for excess readmissions.

In the United States, private insurers dominate over public, unlike in most countries. The United States is first in health care spending worldwide, and it is estimated that 20% of the gross domestic product will be spent on medical services by 2021.

What is the process of considering a group of specific ideas and then drawing conclusions that relate to a general idea?

Inductive reasoning

A nurse is reading a journal article about how health care delivery in the United States compares with that in other nations in the world. The article goes on to describe areas for which the United States ranks near the bottom in comparison with other nations. The nurse demonstrates understanding of this article by identifying which area as being deficient in the United States when compared with other nations? Select all that apply.

Infant mortality Drug-related deaths Heart disease Obesity

Which communication technique is helpful in health teaching about relevant aspects of a client's well-being and self-care?

Informing

The registered nurse (RN) and unlicensed assistive personnel (UAP) are working together to admit a pediatric client to a nursing unit. Which task would be inappropriate for the RN to delegate to the UAP?

Initiating intravenous therapy

The nurse educator is planning a teaching session for nursing students related to the treatment and management of gestational diabetes. The nurse educator arranges for a dietitian, pharmacist, and physician assistant to participate in the lesson plan. Which professional nurse competency is the nurse educator demonstrating?

Interdisciplinary teamwork By integrating interdisciplinary core competencies into the curriculum, the nurse educator is demonstrating interdisciplinary teamwork.

Performance appraisal is typically conducted annually. Each organization determines a reward structure to define and to acknowledge success.

Interpreting quality indicators pertains to evaluation of general client care, not of an individual nurse. An employee's job satisfaction survey is a tool that allows the employee to give feedback on the employee's satisfaction with work, not a review of the employee's contribution conducted by the nurse manager.

Which statement best conveys the role of intuition in nurses' problem solving?

Intuition can be a clinically useful adjunct to logical problem solving.

A client is admitted to the hospital with an abscess on the leg that will not heal after multiple treatment options as an outpatient. The nurse knows from past experiences that the appearance of this type of wound in clients heavily suggests a resistant bacterial infection and the need for contact isolation and intravenous antibiotics. The nurse begins to prepare for this admission. What type of problem solving does this exhibit?

Intuitive

Which attributes should be characteristic of a nurse mentor? Select all that apply.

Is supportive Is resourceful Demonstrates leadership abilities Is an experienced, licensed professional

Which of the following is a true statement about critical thinking in nursing?

It involves purposeful, outcome-directed thinking. In nursing, critical thinking involves purposeful, outcome-directed thinking. Critical thinking makes judgments based on evidence rather than conjecture. Providing a foundation for evaluation and quality improvement and showing trends and patterns in client status are functions served by documentation.

Which of the following is a true statement about critical thinking according to Alfaro-LeFevre (2010)?

It is guided by professional standards and codes of ethics.

Living wills provide instructions about the kinds of health care that should be used or rejected under specific circumstances. The management of an individual's estate is specified in a will, not a living will.

It is not legal for a living will to make provisions for active euthanasia. A living will may or may not include reference to organ donation, but normally this is addressed in a separate, specific consent card or document.

Which of the following actions most clearly demonstrates a nurse's commitment to social justice?

Lobbying for an expansion of Medicare eligibility and benefits Social justice is a professional value that encompasses efforts to promote universal access to healthcare, such as the expansion of publicly funded programs like Medicare. Culturally competent care is a reflection of human dignity while answering patients' questions and documenting accurately are expressions of the value of integrity.

Which diseases would warrant a client receiving hospice care? Select all that apply.

Many clients receiving hospice services have cancer, AIDS, multiple sclerosis, congestive heart failure, or end-stage renal disease.

Home health care nurses are required to complete the Outcome and Assessment Information Set (OASIS) by which entity?

Medicare

Which is the largest single source of reimbursement for home health care services?

Medicare

Home health care nurses are required to complete the Outcome and Assessment Information Set (OASIS) by which entity?

Medicare OASIS provides standardized guidelines for admission and care, as well as a national database for evaluation, reimbursement, and quality improvement. The OASIS system of data collection is required by Medicare, not by Medicaid, insurance companies, or any other third-party payer.

The implementation of diagnosis-related groups (DRGs) by Medicare in 1983 affected hospitals in which way?

Medicare pays only the amount of money preassigned to a treatment for a diagnosis.

Which of the following is a term that refers to individual, family, group, and cultural expressions of grief and associated behaviors?

Mourning Mourning refers to individual, family, group, and cultural expressions of grief and associated behaviors.

Which of the following is a term that refers to individual, family, group, and cultural expressions of grief and associated behaviors?

Mourning refers to individual, family, group, and cultural expressions of grief and associated behaviors.

Which "awareness context" is characterized by the client, family, and health care professionals understanding that the client is dying, but all pretend otherwise?

Mutual pretense awareness , the client, the family, and the health care professionals are aware that the client is dying, but all pretend otherwise.

Which national nursing organization serves as a primary source of research data about nursing education, and is the professional organization for nurse educators?

National League for Nursing (NLN)

A nurse manager is on call 24 hours a day. What is the proper rationale for this level of commitment to nursing?

New care systems are emerging.

A nurse would like to study the effect that a new hand washing technique has on client infection rates. What is the independent variable?

New hand washing technique

Inhibited grief occurs when a person suppresses feelings of grief and may instead manifest somatic (body) symptoms, such as abdominal pain or heart palpitations. .

Normal expressions of grief may be physical (crying, headaches, difficulty sleeping, fatigue), emotional (feelings of sadness and yearning), social (feeling detached from others and isolating oneself from social contact), and spiritual (questioning the reason for the loss, the purpose of pain and suffering, the purpose of life, and the meaning of death)

A client admitted to the hospital is diagnosed with cancer. The client is assigned a nurse who will be the central point of contact for all of the client's care. Which role is the nurse filling?

Nurse navigator Although the nurse may be acting as a case manager or care coordinator, the nurse is filling the role of a nurse navigator, a clinically trained nurse responsible for the identification and removal of barriers to timely and appropriate cancer treatment.

Which statement about laws governing the distribution of controlled substances is true?

Nurses are responsible for adhering to specific documentation about controlled substances.

Which statements are true about informatics in nursing practice? Select all that apply.

Nurses should value technologies that support error prevention and care coordination. The use of informatics can help manage knowledge and mitigate error. Utilization of information services helps to support decision making.

What is the best explanation for the way evidence-based practice (EBP) has changed the way nursing care is delivered?

Nursing care now uses EBP as a means of ensuring quality care.

The client's plan of care is created by the nurse using which guideline for nursing practice?

Nursing process

If a nurse describes a study of people and the nursing profession including studies of education, policy development, ethics, and nursing history, then what is the nurse defining?

Nursing research

A nurse, working in a health clinic, treats a variety of conditions on a daily basis. One disorder that is rapidly increasing and is the leading cause of secondary morbidity is:

Obesity

The client is being discharged to the home setting following a stroke. The client requires assistance in relearning how to cook safely. To which home health care team member should the nurse refer the client?

Occupational therapist

A group of nursing students is reviewing information about palliative care. The students demonstrate a need for additional review when they identify which of the following?

Palliative care is the same as hospice care. (x)

When assessing a person who is grieving using the grief cycle model, which concept would be most important for the nurse to keep in mind? Select all that apply.

People vary widely in their responses to loss. Some people actually skip some stages of grief altogether. Stages occur at varying rates among people.

The focus of nursing is always on which of the four common concepts in nursing theory?

Person All of these concepts are important in nursing theory; however, the focus of nursing is on the person (client).

A client is experiencing anorexia related to the adverse effects of cancer treatment. Using Maslow's hierarchy, the nurse identifies this as a reflection of which need?

Physiologic needs Difficulties involving a loss of appetite would most likely indicate a nutritional problem, reflecting Maslow's physiologic needs.

A nurse is examining alternatives and judging the worth of evidence as part of preparing the plan of care for a client. The nurse would most likely be involved in which phase of the nursing process?

Planning

The RN develops an outcome standard of "client will ambulate with an assistive device 60 feet with assistance twice a day" for a client who had a hip replacement. What part of the nursing process is involved with this outcome statement?

Planning

A client complaining of bloody urine has scheduled an appointment with a family practitioner. What type of care is the client receiving?

Primary

What nursing function would be most commonly found in an ambulatory care facility?

Providing direct client care

A case-study approach planning care around individual patient preferences is an example of patient-centered care. Conducting a review of the evidence-based literature related to gestational diabetes reflects evidence-based practice.

Providing education related to measures/indicators or tools used to assess the level of care provided within a system of care to populations of patients with gestational diabetes exemplifies a quality improvement measure.

During the Christian era (AD 1-500), nursing care excluded which area?

Psychiatric services During the Christian era (AD 1-500) nursing focused on many of the same areas that nursing focuses on today, but excluded psychiatric services. Areas of focus included nutrition, mobility, medication administration, personal counseling, hygiene, and comfort measures.

Which term refers to a purposeful activity that leads to action, improvement of practice, and better client outcomes?

Reflection Reflection is defined as a purposeful activity that leads to action, improvement of practice, and better client outcomes. Memorization is strict learning of material for recall.

The nurse recognizes that a new mother is having difficulty breastfeeding. The nurse demonstrates various positions in which to hold the baby while feeding. The nurse also educates the mother on ways to ensure proper latching. The new mother attempts to breastfeed the baby again using the new techniques and is successful. Which statement in this scenario illustrates Lewin's stage of refreezing?

Refreezing involves making a change operational, or a part of one's everyday life. The mother feeding the baby using new techniques is an example of refreezing.

Which action by the nurse demonstrates an effective method to assess the client and the client's family's ability to cope with end-of-life interventions?

Remaining silent, allowing the client and family to respond after asking a question related to end-of-life care

Telling the truth (veracity) is one of the basic principles of North American culture. Three ethical dilemmas in clinical practice can directly conflict with this principle. Choose the three from the list below.

Revealing a diagnosis to people other than the client with the diagnosis Using placebos Not revealing a diagnosis to a client

A client has asked that a nurse witness the signing of the client's will. What should the nurse do prior to witnessing this signature? Select all that apply.

Review the client's medical record. Talk to the client about why the client is signing the will now. Check to see whether state laws allow the nurse to witness this signature. Assess the client's state of mind.

Which of the following delineates actions that are legally permitted for a particular profession based on specific educational qualifications

Scope of practice The Code of Ethics represents ethical standards. The code is an ideal framework for nurses to use in ethical decision-making. Under the Occupational Safety and Health Act of 1970, employers are responsible for providing a safe and healthy workplace for their employees.

A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS due to exposure to sex workers at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist. With what legal action could the nurse be charged?

Slander The nurse can be charged with slander, which is a verbal attack on a person's character. Libel pertains to damaging written statements read by others. Both libel and slander are considered defamation of character-an intentional tort in which one party makes derogatory remarks about another that diminish the other party's reputation.

An acute care nurse practitioner planning care for a client with rheumatoid arthritis reviews treatment guidelines developed by the American Nurses' Association (ANA). Which ANA document is the nurse accessing?

Standards of Professional Performance

The type of intervention that the nurse performs when he or she observes the spouse of a postoperative client performing the client's dressing change is described as

Supervisory

The nurse participates in the process by educating the client and family about the burdens and benefits of continued ventilation and what to expect when terminal weaning is initiated.

Supporting the family and having the family remain at the bedside are important roles of the nurse during terminal weaning, but do not directly affect discomfort as much as sedation and analgesia.

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 Providing counseling for the family of a teenager with an eating disorder Assisting a client and his family to prepare for death

Today, increasing emphasis is placed on health, health promotion, wellness, and self-care. Which of the following activities in the care of a female patient with a recent diagnosis of diabetes mellitus is most congruent with the philosophy of health promotion?

Teaching the patient about measures that she can take to minimize the long-term health effects of her disease

Secondary care includes referrals to facilities for additional testing.

Tertiary care is provided in hospitals where specialists and advanced technologies are available. Convalescent care helps clients recover health gradually after an illness.

A nurse has been providing in-home hospice care to an older adult client with lung cancer for more than six months. The family asks the nurse how long the Medicare hospice services will continue. What is the nurse's best response?

The Medicare hospice services can continue as long as the physician and hospice director agree about the client's terminal condition.

sovereignty

The ability of a state to govern its territory free from the control of its internal affairs by other states. 통치권, 자주권

The registered nurse (RN) has received orders to perform an unsafe practice on a client. The RN voices concern with the physician who gave the order, but the physician refuses to change the order. Whom should the nurse consult next regarding the order?

The charge nurse

A client in a long-term care facility has signed a form stating that he does not want to be resuscitated. He develops an upper respiratory infection that progresses to pneumonia. His health rapidly deteriorates, and he is no longer competent. The client's family states that they want everything possible done for the client. What should happen in this case?

The client should be treated with antibiotics for pneumonia.

A client has a nursing diagnosis of "Feeding self-care deficit related to right-sided weakness. Which of the following would be the most appropriate expected outcome for this client?

The client will demonstrate an ability to feed himself with a spoon at the morning meal. Outcomes are expressed in terms of client behavior and have a time period in which they are to be achieved. The outcome is associated with the nursing diagnosis. In this case, the diagnosis reflects a self-feeding problem caused by weakness. Therefore, being able to feed oneself would be a client behavior the nurse would expect to see achieved.

A client diagnosed with liver failure in hospice care died 10 hours ago. The client's spouse is having difficulty leaving the room and is crying uncontrollably. What situation does the nurse identify is happening with this client's spouse?

The client's spouse is demonstrating behaviors related to a grief reaction. The anticipatory grief occurs prior to the death. The client's spouse has not had enough of a length of time to determine if the grief is pathologic. The spouse is experiencing the denial stage of grief and not the bargaining stage.

Which statement is true regarding population demographics?

The culturally diverse population is increasing.

One of the fastest growing venues of practice for the nurse is home health care. What is the basis for the growth in this health care setting?

The discharge home of clients who are more critically ill

Which is the best definition of ethics?

The formal, systematic study of moral beliefs

Which of these statements best defines the term culture?

The learned patterns of behavior, beliefs, and values that can be attributed to a particular group of people

Telling the client that the surgery cannot be done until the form has been signed could be interpreted as coercion. The nurse's signature on the form indicates witness that the client or surrogate signed the paper.

The nurse can answer questions about the surgery (within scope of practice) prior to the client signing the form. The client who is aware that there are no guarantees is informed.

The nurse recognizing that a new mother is having difficulty breastfeeding is an example of unfreezing, in which the need for a change is recognized.

The nurse educating the mother on ways to ensure proper latching and demonstrating various positions in which to hold the baby while feeding are examples of moving, in which change is initiated after a careful process of planning.

Which are areas of potential liability for the nurse? Select all that apply.

The nurse fails to document refusal by the client to ambulate following surgery. The nurse documents that the client's blood pressure has increased from 118/72 to 188/98 mm Hg and decides to retake the blood pressure in an hour

A nurse uses the utilitarian action guiding theory when deciding how to handle the following ethical conflict: A 13-year-old client with anorexia refuses to eat food despite slowly starving to death. The parents insist that the nurse use a feeding tube to feed the client. Which statement is an example of this theory in practice?

The nurse forces food via an eating tube because the end result is good in that it will save the client's life.

The clinical nurse manager is evaluating a new nurse who has been employed for 3 months. What type of knowledge does the manager evaluate that is required for competent clinical reasoning? Select all that apply.

The nurse is committed to the organization's mission and values. The nurse is able to organize and manage time efficiently. The nurse understands nursing and medical terminology

The body is placed in normal anatomic position (flat) to avoid pooling of blood. In most cases it is unnecessary to wash the body, and some religions strictly forbid it.

The nurse is legally responsible for placing identification tags on either the shroud or garment that the body is clothed in, and on the ankle to ensure that the body can be identified even if separated from its shroud.

Which statement is true when comparing home care with acute care?

The nurse is the guest in the client's home. An essential difference in home care versus acute care is that the home care nurse is a "guest" in the client's home. In the home, clients and families retain the power and control that they give to providers in other settings. Nurses in the home usually work as members of a therapeutic team that includes the client and other members of the health care team working collaboratively. The client does not direct the education of the caregivers.

A nurse manager of a physician's office uses the laissez-faire style of leadership with the staff. Which nursing actions reflect this management style? Select all that apply.

The nurse manager allows self-scheduling. The nurse manager allows dominant staff members to direct the group activities. Manager and staff work independently, making task accomplishment difficult.

A nurse working in the emergency department (ED) reviews arterial blood gas (ABG) values for a patient diagnosed with heatstroke. Blood gas values are pH 7.48, pCO2 34, pO2 95, CO2 23, HCO2 22, and SO2 98%. Which of the following nursing interventions demonstrate the nurse's understanding of the patient's ABG's and knowledge of Maslow's hierarchy of needs when providing care for this patient?

The nurse prepares for endotracheal intubation and mechanical ventilation for the patient

Which situation violates an element of informed consent?

The nurse says, "You have to sign this before we can do the surgery." The elements of informed consent are disclosure, comprehension, competence, and voluntariness.

Advocacy is the protection and support of another's rights. If the nurse values client advocacy, the nurse would give priority to the good of the individual client rather than to the good of society in general.

The nurse would not be demonstrating advocacy if the nurse values the loyalty to an employing institution or to a colleague over the commitment to the client. The nurse demonstrating client advocacy would not choose the claims of the client's well-being over the claims of the client's autonomy. The nurse would not make decisions for clients who are uninformed concerning the client's rights and opportunities.

Two new nurses are requesting the same preceptor for unit orientation. Both new nurses have been very vocal about being unhappy if they do not receive their choice of preceptor. Which illustrates the nurses using a compromise approach to conflict resolution?

The nurses agree to have the preceptor precept one nurse at the beginning of the orientation and the other at the end.

Compromise involves both parties willingly relinquishing something of equal value. The nurses' decision to share the preceptor, with one having the preceptor at the beginning of the orientation and the other at the end, demonstrates compromise.

The nurses ignoring each other's request illustrates avoidance. Allowing the preceptor to decide which nurse to precept encourages competition. Competition involves a win-lose approach to conflict. The nurses agreeing that one nurse will obtain the preceptor for orientation in exchange for that nurse working each weekend illustrates accommodation. Accommodation involves one party deciding to let the other party win in exchange for something else of value.

The goal of hospice is to enable the patient to remain at home, surrounded by the people and objects that have been important to him or her throughout life.

The patient and family make up the unit of care. Hospice care does not seek to hasten death or encourage the prolongation of life through artificial means.

The patient has just received a central venous catheter placed by the physician. Which of the following should the nurse anticipate next?

The patient will have an X-ray to confirm placement of the device.

The nurse navigator guides the client through the cancer care continuum from diagnosis through survivorship and acts as a central point of contact for a client, coordinating all components involved in cancer care. A client navigator may be a nurse, a social worker, or a lay person

The primary distinction is that the client navigator (1) does not necessarily have a clinical background and (2) focuses on the support aspects of care. A care coordinator is the care provider (nurse case manager, social worker, community health worker, or lay person) who is responsible for identifying a client's health goals and coordinating services and providers to meet those goals.

Which is a characteristic of the care-based approach to bioethics?

The promotion of the dignity and respect of clients as people

When a multidisciplinary team is involved in meeting the home care needs of a client, who is the person responsible for the coordination of the care provided?

The registered nurse

utilitarian action guiding theory

The rightness and wrongness of an action depends on the consequences of the action

With this in mind, health care providers must aim to promote positive changes that are directed toward health and well-being.

The sense of wellness has a subjective aspect that addresses the importance of recognizing and responding to patient individuality and diversity in health care and nursing. Although all of the actions listed would promote the patient's comfort, addressing the patient's religious dietary needs is most representative of promoting wellness.

A nurse is developing a teaching plan for a terminally ill client and his family about the stages of dying and emotional reactions experienced. The nurse integrates knowledge of which of the following in the teaching plan?

The stages are applicable to any loss.

Research cannot begin before considerable review, investigation, and forethought have been given to the issue that appears to be the problem to be investigated. The problem statement in a research study identifies the direction that a research project will take.

The statement should be clear and unambiguous, express a relationship between two or more variables, identify the population to be studied, and encourage empiric testing.

Which statement best explains the importance of theoretic frameworks?

Theoretic frameworks advance nursing knowledge and practice.

Nursing students are reviewing information about attitudes related to death and dying. The students demonstrate understanding of the information when they identify which of the following as most accurate?

There remains a conspiracy of silence about dying despite progress in the area.

A registered nurse wishes to work as a nurse researcher. Which is true regarding nurse researchers?

They are responsible for the continued development and advancement of nursing.

Nurses who value client advocacy follow what guideline?

They give priority to the good of the individual client rather than to the good of society in general.

A clinical nurse leader is a master's-prepared nurse who has earned the certified CNL credential and works collaboratively with the health care team to facilitate, coordinate, and oversee care provided to clients.

This role is not considered an administrative or management role, but rather one of leadership in all health care settings. Clinical nurse specialists are advanced practice nurses with specialist education in a defined area of practice.

Clinical care has typically focused on diagnosing and treating symptoms. Understanding health in relation to personal behaviors, social factors, and other determinants provides a holistic context and not a quick resolution of needs. As an example, it is important to know whether an individual has access to a grocery store with fresh fruits and vegetables to comprehend that client's nutritional needs.

To affect social, economic, political, and educational health determinants, health initiatives are more effective if they are based in the community and incorporate community collaboration. While physical therapy can be helpful for a client in the home, it does not have a basis for the community emphasis in Health People 2030.

The nurse is caring for a pediatric client who is dying. The best way to provide care and comfort to dying clients and their families is to first do which of the following?

To care for others in the dying process, the nurse must explore his or her own feelings about mortality and death and dying. Understanding self provides a perspective to cope with and then support clients and families experiencing pain and grief. The other options are helpful in determining appropriate nursing care but not the first step.

Dilemma is a situation in which a difficult choice has to be made between two or more alternatives, especially equally undesirable ones. The client is not experiencing a dilemma.

Uncertainty means a feeling of not knowing what will happen. The adult child is certain that he or she cannot care for the parent. Dissatisfaction implies a sense of dislike for, or unhappiness in, one's surroundings. Although the adult child is unhappy, this is not the primary ethical problem.

The husband of a client who has died cannot express his feelings of loss and at times denies them. His bereavement has extended over a lengthy period. What type of grief is the husband experiencing?

Unresolved grief In unresolved grief, a person may have trouble expressing feelings of loss, may deny them, and the bereavement may extend over a lengthy period. Anticipatory loss or grief occurs when a person displays loss and grief behaviors for a loss that has yet to take place

In spite of administering the prescribed pain medication, a dying client is still experiencing dyspnea due to fear and anxiety. Which nursing intervention should the nurse use to potentiate the effects of pain medication and help reduce the dyspnea?

Use imagery, humor, and progressive relaxation Imagery, humor, and progressive relaxation are the various techniques to potentiate the effects of pain medication.

When assessing a terminally ill client, the nurse notices that the client has copious secretions at the back of the throat and in the mouth. The nurse is preparing a teaching plan for the family about caring for these secretions. Which of the following would be least appropriate to include?

Using a soft toothbrush to vigorously clean the mouth Secretions are often more distressing to the family than their presence is to the client. Gentle mouth care with a moistened swab or very soft toothbrush helps maintain the integrity of the client's mucous membranes.

A nurse is giving a presentation about community-oriented nursing practice to a group of new graduates. Which of the following would the nurse include as a central focus of this practice? Select all that apply.

Wellness promotion Reduced illness transmission Levels of prevention

During the Reformation, which factor influenced the decline of nursing?

Women's subordination to men

Humility

absence of vanity; humbleness

Current trends in nursing practice include the development of nursing centers, wellness promotion programs, care of older

adults, birthing centers, and home and community health care. Inpatient psychiatric settings have been downsizing for some time as efforts are being made to transition those who are homeless or mentally ill to live in stable, long-term housing. The number of ambulatory surgery centers has also been slowing, likely in response to poor profitability.

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."

After a nurse manager implements a solution to the problem of delays in obtaining supplies, the first task for the manager is to:

assess whether the desired results have occurred.

What current trends in nursing practice are increasingly being recognized?

birthing centers

The nurse is caring for a postoperative client. The health care provider has written a prescription for a pain medication, and the prescription gives a dosage range for the amount the nurse may give depending on the severity of the client's pain. This type of functioning within the health care team is called:

collaborative functioning.

Continuity of care is an important concept for quality nursing practice. The responsible nurse understands the best description of the process of continuity of care is to:

coordinate uninterrupted care and facilitate transfer between units and levels of care. The most comprehensive description of continuity of care is appropriate, uninterrupted care that facilitates transfer of the client between settings and levels of care.

One of the primary advantages of the managed care model is:

economic, quality care.

fidelity

faithfulness 충직함

Continuity of care for a particular client is most important to prevent:

fragmentation of services.

One of the primary reasons for conducting nursing research is to:

generate knowledge to guide practice. One of the major reasons for conducting nursing research is to generate knowledge to guide practice. The other answers pertain to other aspects of nursing practice but not to nursing research.

A nurse is a member of which entity within the larger healthcare environment?

healthcare team

Integrity

honesty

liaisons

individuals who have friends from several cliques but belong to none (두 집단·조직 간의) 연락 담당자

Despite spending far more per person on health care than any other nation, the United States has more people dying at younger ages than people in almost all other high-income countries. Among 16 peer nations, all affluent democracies, the United States is at or near the bottom in nine key areas of health:

infant mortality and low birth weight, injuries and homicides, teenage pregnancies and sexually transmitted infections (STIs), prevalence of HIV and AIDS, drug-related deaths, obesity and diabetes, heart disease, chronic lung disease, and disability. Cancer is not among the key areas of health in which the U.S. ranks lowest.

A client is brought to the emergency department by an adult child, who states, "I am unable to care for my parent anymore. Although I would like to, financially and physically I cannot do it anymore." What ethical problem is the adult child experiencing?

moral distress Moral distress is when someone wants to do the right thing but is not able. The adult child brings the parent to the emergency department to maintain the parent's safety, although the child needs to take care of the parent.

A nurse manager reviews an employee's contribution to the nursing division annually. This process is:

performance appraisal.

Public health nursing is the branch of nursing that:

provides health care for the community. Public health nursing focuses on the whole population and the health of the community at large, not just on assessing or providing care to individuals. Community-based nursing, not public health nursing, involves administering care for a defined geographic community.

Which stage of grieving is exhibited by the husband of a victim of sudden death who refuses to accept that she is dead?

shock

The children of a male client with late-stage Alzheimer disease have informed the nurse on the unit that their father possesses a living will. The nurse should recognize that this document is most likely to:

specify the treatment measures that the client wants and does not want.

What is the primary purpose of standards of nursing practice?

to ensure knowledgeable, safe, comprehensive nursing care

omitted

to leave out; fail to include or mention

The nurse is caring for a client who has recently lost a sibling due to suicide. Which type of grief does the nurse anticipate the client is experiencing?

traumatic grief

Veracity

truthfulness, honesty

Select the best description of how the nurse applies the nursing process in caring for clients. The nurse:

uses critical thinking to direct care for the individual client.

The nurse is caring for a group of inpatient clients. Which action by the nurse best demonstrates the use of universal precautions?

using universal precautions to protect the nurse from infection.

The differences between the pro-life and abortion rights movement are an example of:

values inquiry. Values inquiry is a method of examining social issues and the values that motivate human choices. Social activism indicates proactively advocating for a specific group or cause. Ethical inconsistency requires a conflict contributing to or creating a dilemma that must be resolved. Values clarification requires additional information or consideration to allow refinement and improve clarity.

Moral distress occurs when you know the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action.

Conscientious objection is the refusal to participate in certain types of treatment and care based on the fact that these activities violate the nurse's personal and professional ethical beliefs and standards. There is not an ethical dilemma present between the nurse and the workplace.

Which statement best conveys the concept of ethical agency?

Ethical practice requires a skill set that must be conscientiously learned and nurtured. Ethical agency must be cultivated in the same way that nurses cultivate the ability to do the scientifically right thing in response to a physiologic alteration. It is inaccurate to assume that it will passively develop from the presence of other ethical practitioners, or from years of experience. It is not an innate characteristic of personality.

What nursing activity forms the bridge between theory and practice?

Evidence-based research Evidence-based research is translational research that forms the bridge between theory and practice. Theoretical writing focuses on theory. Client-focused care and case management are focused on practice.

A female client is brought to the emergency room with matted hair, bruising, and malnutrition. The nurse suspects physical abuse and neglect. The nurse states, "This happens to many women." Which type of ethical approach is the nurse exhibiting?

Feminist A feminist approach is one in which the focus is on specific problems and concerns faced by women. The statement that "this happens to many women" is an example of a feminist approach.

A personal moral is a standard of right and wrong that helps a person determine the correct or permissible action in a given situation.

Professional values in nursing are a set of beliefs about the worth of things, about what matters, that provide the foundation for nursing practice and guide the nurse's interactions with clients, colleagues, and the public. Ethical principles are a set of specific concepts that guide a person's actions. A legal obligation is something that is required by law.

Human dignity is defined by the right of a person to be valued and respected for one's own sake, and to be treated ethically. The nurse is exemplifying this by protecting privacy, maintaining confidentiality, and providing culturally competent care.

Promoting universal health care would better exemplify the value of social justice and, in any case, would not be appropriate an appropriate action when providing care to clients. Demonstrating accountability is not a human dignity issue but is a core concept in the overall nursing care of a client.

The nurse strives to uphold human dignity when providing care to clients. Which behaviors by the nurse would best exemplify this value? Select all that apply.

Protects the privacy of the client Maintains confidentiality Provides culturally competent care

The care-based approach to bioethics focuses on the specific situations of individual clients, and characteristics of this approach include promoting the dignity and respect of clients as people.

The need to emphasize the relevance of clinical experience and the need for an orientation toward service are part of the criticisms of bioethics. The deontologic theory of ethics says that an action is right or wrong independent of its consequences.

Which nursing action(s) best demonstrate the ethical principle of autonomy? Select all that apply.

The nurse checks to ensure an informed consent document is signed prior to transferring the client for a surgical procedure. The nurse documents that a client refused a new medication.

Which traits are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply.

Trustworthiness Humility Compassion as well as cultivated dispositions of character and conduct, that motivate and enable us to be good human beings. Deception and conflict are negative traits that do not exemplify professional virtues.

Paternalism is action limiting a person's or group's liberty or autonomy that is intended to promote their own good (e.g., if the nurse stated that "I must make all decisions about this client's care for her, as she's not in any shape to do so herself").

Values clarification is a self-assessment process that enables a person to discover the content and strength of the person's own system of values. An example of this would be if the nurse stated, "I feel bad for the client, as no one deserves this." Moralizing is to comment on issues of right and wrong, typically with an unfounded air of superiority. An example of this would be if the nurse stated, "If she was a good girl, this would have never happened to her."

accountability

Willingness to take credit and blame for actions. 책임

A group of nurses is planning to investigate the effectiveness of turning immobilized stroke clients more frequently in order to prevent skin breakdown. The team has begun by formulating a PICO question. Which element will the "O" in the team's PICO question refer to?

Within the PICO question framework, the "O" denotes the outcome of interest. In this case, the desired outcome is the prevention of skin breakdown. Stroke clients are the "P," or population of interest, whereas turning clients more frequently is the "I," or intervention. The current turning schedule is the "C," referring to the comparison of interest.

During the Reformation, which factor influenced the decline of nursing?

Women's subordination to men Women were viewed as subordinate to men and were expected to remain at home caring for children; this decreased the number of qualified women practicing nursing.

The need for university-based nursing education programs was brought to light during which important historical time?

World War II

An example of primary health care is:

a hearing screening in the school setting. Primary prevention or primary health care involves health promotion, basic care, and health prevention, including screening clients to detect disease early and prevent it from developing further. Care of a client in the intensive care unit or on rehabilitation is secondary care. Diagnostic testing for HIV/AIDS is tertiary care.

To practice ethically, the nurse should avoid:

allowing the nurse's own personal judgment to guide practice.

The nurse is caring for a client with a new diagnosis of cancer, and allows the client to verbalize fears relating to how to tell the children. The nurse's intervention reflects which aspect of nursing?

art of nursing

The nurse is caring for a postoperative client. The health care provider has written a prescription for a pain medication, and the prescription gives a dosage range for the amount the nurse may give depending on the severity of the client's pain. This type of functioning within the health care team is called:

collaborative functioning. Nurses manage collaborative problems using both nurse- and health care provider-prescribed interventions to reduce the risk of complications.

Which nursing activities will be most effective to help achieve the Healthy People 2030 guideline to eliminate health disparities among clients?

conducting blood pressure screenings in an underserved area Conducting blood pressure screenings in an underserved area will enable the clients residing there access to a basic screening. This is important because clients in underserved areas often do not have access to health care, leading to health disparities. Although smoking cessation programs, colorectal screenings, and routine administration of immunizations are important, they will not help to eliminate health disparities.

A nurse admitting a client to the home health service is gathering information for the client's database. Within the database, the nurse gathers information on the client's health history, past surgeries, diet, exercise, psychosocial status, family and support persons, and spirituality. This information will assist in the development of the client's plan of care. This is considered a:

holistic database.

Which action by the nurse is the best indication that the nurse is incorporating the quality and safety education for nursing (QSEN) competency of teamwork and collaboration in the plan of care for a client?

including the client in the morning rounds of the health care team

A nurse has graduated with a baccalaureate degree in nursing. Which research activities would be appropriate for this nurse? Select all that apply.

interpreting research for applicability to nursing practice applying research findings to nursing practice sharing research findings with colleagues

Ethical distress is:

knowing the correct action but being unable to perform it due to constraints.

A nurse is of the Catholic faith and votes pro-life. This nurse is considered to have:

personal values.

The nurse is engaged in dialogue with a client in an effort to identify the client's values. Value systems are often formally embedded and integrated into:

religion Values are often codified and embedded into religion. This phenomenon is not noted in relation to nature, treatment, and activity.

What is one of the most significant trends in health care today?

shift from hospitals to community-based care

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.

What would be an example of the nurse practicing fidelity? The nurse:

stays with a client during death as promised. Fidelity requires the nurse to keep promises made and to be faithful to one's commitments. Regulating visitors is a demonstration of the value of privacy. Withholding client's information as requested is an example of maintaining confidentiality. Providing continuity of care is an example of integrity and professionalism.

Altruism

unselfish regard for the welfare of others 이타주의

A charge nurse has implemented staff education on nursing values. The nurse would determine that further education is required when which statement(s) are overheard? Select all that apply.

"I can't believe the client is giving that precious baby up for adoption." "The gonorrhea test was positive. That's what the client gets for sleeping around." "If that was my mother, I sure wouldn't agree to a no-code."

The director of nurses (DON) in a long-term care facility has noticed an increased number of urinary tract infections (UTIs) on the east wing of the facility, and would like the infection control nurse to investigate this problem. What is the best problem statement for this study?

"Is there a relationship between the personnel caring for specific clients and whether or not these clients developed UTIs?"

A nurse is conducting a class about health care trends for a group of newly graduated registered nurses at the community hospital. Which of the following six trends stated by the nurse reflects the Institute of Medicine's (IOM) focus?

"The system should be safe, effective, efficient, patient centered, timely, and equitable."

paternalism

(n.) the policy or practice of treating or governing people in the manner of a father dealing with his children 가부장적인

Moral resilience

- a shift in thinking - instead of dwelling on negativity, adopt an inquiring mindset - despite distress, able to ask questions that may help reveal unknown or overlooked possibilities

The American Nurses Association's Commission on Nursing Education developed guidelines for the investigative function of nurses at different educational levels. Which guideline is for a nurse with an associate degree?

Assists in collection of data within an established, structured format

A community health nurse has been visiting a diabetic client whose morning fasting glucose levels are constantly elevated. Upon further assessment, the nurse determines that the client's spouse does not understand how to prepare meals following the prescribed diabetic diet. Using Dorothea Orem's Self-Care Theory, how can the nurse help meet the needs of this client?

According to Dorothea Orem's theory, the role of the nurse is to facilitate self-care to sustain life and health, to recover from disease or injury, or to cope with its effects. Arranging an evaluation appointment with a dietitian facilitates self-care because the nurse is providing a service that assists the client and spouse to progressively maximize their self-care potential. People learn behaviors that they perform on their own behalf to maintain life, health, and well-being. The other options are providing care for the client, not facilitating self-care.

Which scenario is an example of the laissez-faire approach to value transmission?

Allowing a child to decide not to have an intravenous line inserted

Which organization has established standards that help the nurse determine which clinical actions fall under the scope of nursing practice?

American Nurses Association

Which example best describes feminist ethics?

An approach critiquing existing patterns of oppression and domination in society

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 growth in home health care is largely attributed to which factor?

Early discharge of clients from the hospital setting

A nurse has an older adult home care client who lives alone with no family nearby. On a recent visit, the nurse notices that his clothes are very loose, and he has difficulty letting the nurse leave when the visit is ending. After talking with him, the nurse learns that he has not been cooking for himself and he can't get to the grocery store easily. What service could the nurse suggest as an immediate response until a long-term plan can be formed?

Enroll the client in Meals on Wheels. The best option that can be arranged quickly is to enroll the client in Meals on Wheels, a voluntary agency. The other responses may be helpful in later planning for a long-term situation.

The QSEN competencies include client-centered care, teamwork and collaboration, quality improvement, safety, evidence-based practice, and informatics. The competency of teamwork and collaboration is best indicated by including the client in the morning rounds of the health care team, which fosters open communication, mutual respect, and shared decision making among team members.

Keeping the side rails up on the bed of a client who is confused is an example of the competency of safety. Using a new technique for patient care based on the latest research is an example of the competency of evidence-based practice. Gaining input from a client regarding personal goals for rehabilitation is an example of the competency of client-centered care.

A nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle?

Making a decision for a client who is confused to prevent an injury is an example of paternalism. Deception occurs when the true nature or reason is concealed and the client is deprived of basic human rights. Confidentiality requires a health care provider to keep a client's personal health information private unless consent to release the information is provided by the client. Conflict is a disagreement or argument and does not represent the example in this question.

ANA aims at fostering high standards of nursing in the United States. Membership is not open to all nurses in the United States; only registered nurses can become members.

Members of the National League for Nursing, not the ANA, include nurses, other health care providers, and lay people. Sigma Theta Tau, not ANA, invites students showing excellence in scholarship to become members.

A nurse working in a critical care unit has experienced personal tragedy, extreme shortage of staff in the work environment, and health issues. The nurse has overcome much of these hardships and is now mentoring other nurses in similar situations. What behavior is this nurse demonstrating?

Moral resilience Moral resilience is the developed capacity to respond well to morally distressing experiences and to emerge strong. This nurse has demonstrated that although life issues have been overwhelming, there is an emergence of strength and resilience.

Nursing research requires extensive education and is a uniquely specialized field. Nurse researchers are responsible for the continued development and refinement of nursing. They usually have advanced education post baccalaureate degree in nursing and most often work in large teaching hospitals or research centers.

Nurse administrators, not nurse researchers, serve as liaisons between staff members and directors of nursing, Nurse researchers may be found with a school of nursing at academic institutions, but not at community health centers and long-term care units.

A nurse educator is discussing the criteria that define nursing as a profession. Which nursing actions are based on these criteria? Select all that apply.

Nursing actions that would define nursing as a profession would include using diagnosis, interventions, and evaluation to plan nursing care, following an established code of ethics when caring for clients, and using research when planning nursing care for clients. Another nursing action that would define nursing as a profession would be independently choosing nursing intervention for a client. Examples would not include performing action based on standards established by the medical community or applying for membership in the American Nurses Association.

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.

Which theory describes, explains, predicts, and controls outcomes in nursing practice?

Nursing theory Nursing theory describes, explains, predicts, and controls outcomes in nursing practice. Systems theory describes how parts interact together. Adaptation theory describes adjustment of living things to other living things and the environment. Developmental theory describes maturation of humans through stages.

A nurse believes that abortion is an acceptable option if a pregnancy results from a situation of rape. What is the best description of this belief?

Personal moral

A nurse is providing care to a client recently admitted to the health care facility for treatment of an infection. The client experienced a traumatic brain injury several months ago that resulted in paralysis of both lower extremities and difficulty swallowing and speaking. The client's spouse is the primary caregiver. The client's spouse says to the nurse, "It's been really tough this last month caring for my spouse. Even though I have an aide who comes in to help for a couple of hours a week, I'm just spent, physically and emotionally." A referral for which service would be appropriate?

Respite care Respite care is a type of care provided for caregivers of homebound ill, disabled, or older clients. The main purpose is to give the primary caregiver some time away from the responsibilities of day-to-day care. Although parish nursing and palliative care may be helpful in providing the spouse with support, it would not necessarily provide the respite needed. Parish nursing emphasizes holistic health care, health promotion, and disease-prevention activities and combines professional nursing practice with health ministry, emphasizing health and healing within a faith community.

A nurse is a member of an interdisciplinary team providing home health care to a client who was discharged home after experiencing a stroke. The client has been receiving services to assist with swallowing. The nurse would collaborate with which member of the team to discuss the client's progress?

Speech therapist

Which are helpful tips for a nurse who has been active in health care policy and reform give to a nurse who is interested in becoming active in this area? Select all that apply.

Stay up to date regarding new pending legislature that will determine nursing practice. Join and participate in nursing associations. Advocate for the rights of all people in health care.

Ethical distress is: knowing the correct action but being unable to perform it due to constraints. Being aware of knowing what is right and wrong is the first step of having an ethical conscience.

Supporting a client during a hospitalization is an ethical principle of doing what is right (beneficence) and the focus of client-centered care. An ethical dilemma is a situation in which a person has difficulty deciding which of two or more conflicting ethical principles to follow.

A laissez-faire approach to value transmission is one that allows others, especially children, to make decisions without guidance, resulting in a decision that may not be a sound one.

Teaching a child about right and wrong behavior is a more active learning strategy, and reflects the moralizing approach to value transmission. Modeling or role modeling is leading (and transmitting values) by example—in this case, not smoking electronic cigarettes to show the teenagers good behavior. Telling the child about the injection feeling like a pinch is not an approach to value transmission.

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