NCLEX-RN
The nurse is conducting a community education program on chronic illness. The nurse evaluates that additional education is needed when the participants make which statement? "Chronic illness is a leading cause of death." "Chronic illness is increasing in developing countries." "Most people with chronic illness have health insurance." "Out-of-pocket expenses for chronic illness are low."
The nurse determines that additional education is needed when the participants state that out-of-pocket expenses for chronic illness are low. Although the majority of clients with chronic illness have health insurance, out-of-pocket expenses are high and are increasing. Chronic illness is a leading cause of death and is on the rise in developing countries.
What statement describes a required characteristic of all generic drugs? Generic drugs are required to be protected by a current American patent. Generic drugs are designated and patented exclusively by the manufacturer. Generic drugs are categorized according to overall usefulness and potential for abuse. Generic drugs must be therapeutically equivalent to brand name drugs.
Generic drugs must be therapeutically equivalent to the brand name drug and are usually less expensive. Generic drugs are categorized in the same fashion as are brand name drugs. The remaining statements are descriptive of brand name drugs.
Cost containment in the health care field has become a sought-after necessity because of rising costs and the influence of managed care. Nurses are instrumental in assisting with cost containment of health care by prioritizing which strategy? Alternative birth systems Health promotion Client teaching Quality improvement
Specific cost-containment strategies that nurses have been instrumental in implementing include health promotion, case management, and critical care paths. Health promotion is accomplished by methods such as using alternative birth systems, providing client teaching, and quality improvement.
Which is an emerging trend in health care delivery? Active involvement of consumers Resolution of the nursing shortage Simplification of client care Reduction in the use of technology at the bedside
Trends in health care delivery include the active involvement of consumers, continuing nursing shortage, increased complexity of client care, and a technology explosion. Other trends include changing demographics, increasing diversity, globalization of economy and society, increasing costs of health care, and the effects of health policy and regulation.
Which tools do case managers commonly rely on to plan and coordinate client care? clinical pathways, practice guidelines, and standards of care clinical pathways and drug formularies standards of care, HIPAA regulations, and electronic medical records practice guidelines, outcome data, and staff rosters
Case managers make use of tools such as clinical pathways, practice guidelines, and standards of care to help them plan and coordinate care. Hospitals and insurance companies may develop their own or rely on published protocols for guidance. Drug formularies are not tools used by case managers in planning and coordinating care. HIPAA regulations and EMRs are not tools used by case managers in planning and coordinating care. Outcome data and staff rosters are not tools used by case managers in planning and coordinating care.
A group of nursing students are preparing for a class presentation that describes community-based nursing. Which of the following would they most likely include? Caring for the needs of individual clients as the primary focus Practice on all the three levels of preventive care Delivery of nursing care with direct on-site supervision Care delivered by nurses functioning in limited roles
Community-based care involves nurses providing care at all three levels of prevention, that is, primary, secondary, and tertiary levels. There is a focus on community needs as well as on the needs of individual clients. Nurses often deliver care without direct on-site supervision or support of other health care personnel. Community health nurses assume many different roles such as epidemiologist, case manage, service coordinator, direct care provider, and educator.
Continuity of care for a particular client is most important to prevent: multiple providers. infection. fragmentation of services. rising health care costs.
Continuity of care is the provision of health care services without disruption, regardless of movement between settings. It is most important in preventing fragmentation of health care services. It does not prevent a client from needing the services of multiple providers, although it can ensure better communication and coordination among these providers, resulting in improved outcomes for the client. Continuity of care would not directly prevent infection, but in preventing fragmentation of care, it could indirectly help prevent infection. Ensuring continuity of care for a single client would not help prevent rising health care costs, in general, although it could help lower some costs for the individual client by reducing redundancy.
The nurse manager is concerned about staff being upset about the frequency of taking clients' vital signs and holds a meeting. The staff are allowed to make suggestions to amend the new policy and vote on which policy will be implemented. The nurse manager then makes the decision to implement the policy that is best. What types of leadership style(s) are being used by the nurse manager? Select all that apply Directive Quantum Participative Transactional Transformational
During the meeting the nurse manager used participative or democratic leadership by allowing the staff to have input in the decision-making process. After the meeting, the nurse manager decided to use directive or autocratic leadership by being the final and sole decision maker regarding the new policy. Quantum leadership views an organization and its members as interconnected and collaborative—a helpful approach when unpredictable events and changing environments present themselves. Transactional leadership style is based on a task-and-reward orientation. Team members agree to a satisfactory salary and working conditions in exchange for commitment and compliance to their leader. Transformational leadership can create revolutionary change. Often described as charismatic, transformational leaders are unique in their ability to inspire and motivate others.
The nurse is providing care to several clients on a medical-surgical unit. For which client's plan of care should the nurse include information regarding extended care? A middle-aged client who had a knee replacement A client who developed sepsis after a ruptured polyp A client who had a cholecystectomy An older adult client who fell at home and required a hip replacement
Extended care meets the health needs of clients who no longer require acute hospital care but require rehabilitation and skilled nursing care, such as an older adult following a hip replacement surgery, who may need additional assistance with mobility and more time for physical therapy before being ready to be discharged home. The other clients do not require, or would not benefit from, extended care.
A nurse is reading a journal article about the U.S. health care delivery system. When reading this article, which topics would the nurse expect to find? Select all that apply. An increased emphasis on disease treatment and cure View of a person's state of health as ever-changing Diverse cultural backgrounds affecting responses to health care Decreased prevalence of disabilities and chronic illnesses Increased ethical issues related to technological advancements
In the United States, there is a shift from a disease-oriented focus to increased emphasis on health and health promotion. Health and illness are viewed on a continuum, allowing a person to simultaneously possess degrees of both health and illness. Thus, a person's state of health is ever-changing, and rarely is a person completely healthy or completely ill. The cultural composition of the population is changing, with people from diverse sociocultural groups bringing various health care beliefs, values, and practices to the health care setting, in addition to risk factors for some disease conditions and unique reactions to treatment. This change affects the care delivered and potential outcomes. The prevalence of chronic illnesses and disability is increasing because of the lengthening of the lifespan, advances in care, and expanding treatment options. However, these advances have also resulted in many ethical issues for health care providers, clients, family, and society.
After many years of advanced practice nursing, a nurse has recently enrolled in a nurse practitioner (NP) program. This nurse has been attracted to the program by the potential after graduation to provide primary care for clients, an opportunity that is most likely to exist in which setting? A rural health center. A long-term care facility. A university hospital. A community hospital.
Many rural health centers employ few healthcare providers, and primary care is often provided by an NP. An NP may provide care in a long-term care facility or hospital, but in these settings, the NP is less likely to be the provider of primary care to clients.
Home health care nurses are required to complete the Outcome and Assessment Information Set (OASIS) by which entity? Medicare Medicaid Any third-party payer Any insurance company
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.
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. Palliative care developed after hospice care developed. Palliative care is conceptually broader than hospice care. Palliative care is often provided along with disease-lessening treatments.
Palliative care is not synonymous with hospice care. All hospice care is palliative but not all palliative care is hospice care. Palliative care is conceptually broader than hospice care and is an approach to care as well as a structured system for delivering care. Palliative care followed the development of hospice care. It does not begin when cure-focused treatment ends but is most helpful when provided along with disease-remitting treatment.
Which mental health treatment setting is not a residential treatment setting? Partial hospitalization programs Group homes Adult foster care Respite
Partial hospitalization programs are designed to help the client make a gradual transition from being inpatients to having independence and to prevent repeat admissions. The remaining options are all settings that are associated with long-term living arrangements.
A client asks an RN to prescribe a medication for pain. What is the best answer by the nurse? "No nurse can prescribe a medication." "Only advanced practice registered nurses have prescriptive authority." "Take two ibuprofen every 4 to 6 hours." "Take one acetaminophen every 4 hours."
The best answer by the nurse is that only advanced practice registered nurses have prescriptive authority. The registered nurse who is not an advanced practice nurse should not prescribe medications, even over-the-counter medications such as ibuprofen and acetaminophen.
A nurse manager of a hospital unit is working within a decentralized management structure. Which nursing action best exemplifies this type of system? Senior managers make all the decisions. Nurses are not intimately involved in decisions involving client care. Decisions are made by those who are most knowledgeable about the issue. Nurse managers are not accountable for clients, staffing, supplies, or budgets.
The best example of a nurse manager of a hospital unit working within a decentralized management structure would be that decisions are made by those who are most knowledgeable about the issue. Nurses would be greatly involved in decisions involving client care. Senior managers would not make all the decisions within a decentralized management structure. Nurse managers could be accountable for clients, staffing, supplies, and/or budgets.
A hospice nurse has developed a care plan for a client with liver cancer. The care plan focuses on providing palliative care for this client. The goal of palliative care is best described as providing clients with life-threatening illnesses a dignified quality of life through which means? aggressive management of symptoms treatment of the disease process eliminating all forms of medical and nursing care providing counseling related to the stages of death and dying
The goal of palliative care is to provide clients with life-threatening illnesses the best quality of life they can have by the aggressive management of symptoms. There is no treatment goal for the life-threatening illness for palliative care. Aggressive management of symptoms includes medical and nursing care for the client. Providing counseling related to the stages of death and dying is pursued after aggressive management of symptoms.
A nurse is assigned to assist with the admission of a laboring client. Which of the following actions are appropriate? Select all that apply. asking about the estimated date of childbirth estimating fetal size taking maternal and fetal vital signs asking about the woman's last menses administering an analgesic asking about the amount of time between contractions
The nurse should ask about the estimated date of childbirth and then compare the response to the information in the prenatal record. If the fetus is preterm, special precautions and equipment are necessary. Maternal and fetal vital signs should be obtained to evaluate the well-being of the client and fetus. Determining how far apart the contractions are provides the healthcare team with valuable baseline information. The physician estimates the size of the fetus. It would not be appropriate for the nurse to ask about the client's last menses. This information is collected at the first prenatal visit. It would be premature to administer an analgesic, which could slow or stop labor contractions.
