Nursing 110 Test #1
Contemporary nursing requires that the nurse possess knowledge and skills to carry out a variety of professional roles and responsibilities. Examples include which of the following? (Select all that apply.) A) Autonomy and accountability B) Advocacy C) Provision of bedside care D) Health promotion and illness prevention
A,B,C,D. Each of the options is an example of a professional role or responsibility of the professional nurse.
A nurse is planning a client's discharge from a subacute care unit to home. Education should be provided on which of the following topics? (Select all that apply.) A) Medication administration B) Stress reduction techniques with blood pressure assessment C) Circumstances in which the client should call the health care provider D) Hand-washing hygiene when assisting with transfer to the bathroom
A,C. Clients being discharged home need education regarding how to take their medication and when to call their health care provider. There is not enough information here to determine if options 2 and 4 are appropriate, although hand hygiene after toileting is always important.
Nurses who are new to practice can best contribute to nursing research by: A) Assisting with data collection B) Identifying clinical problems in nursing C) Obtaining financial backing and public interest D) Implementing research-based change in nursing practice
A. A nurse who is new to practice has not developed the experience required for research but can begin at the less complicated level of data collection. An experienced researcher is more qualified to identify problems for formal research, although input from all levels of nursing is valuable. Nurses with doctoral-level training are typically prepared for obtaining financial backing. An American Nurses Association position paper cites a master's degree as qualification for implementing research-based change in nursing practice.
Recent research provided evidence that a professional nursing staff affects health care financing. These results indicated that the positive benefit of a professional nursing staff is: A) Decreased length of stay B) Decreased rate of readmission C) Increased rate of nosocomial infections D) Decreased need to hire ancillary personnel
A. A positive benefit of a professional nursing staff is a decreased length of stay. The diagnosis-related group has greater influence on the rate of readmission. The ancillary personnel need to remain so that registered nurses can spend the necessary time to assess and manage clients. Nosocomial infections decrease with a professional nursing staff.
A nurse researcher is designing an exercise study that involves 100 clients who attend a wellness clinic. As the clients come to the clinic, each has a choice as to whether they want to be in the new exercise program or remain in the traditional program. The nurse plans to measure the clients' self-report of exercise before and 6 months after the program begins. What factor might influence the results of this study in an unfavorable way? A) Bias B) Anonymity C) Sample size D) Sampling method
A. Because the clients at the clinic are allowed their choice of the traditional versus the new exercise program, the sampling in this study is not random sampling and can bias study results.
An APN is the most independently functioning of all professional nurses. All of the following are examples of a clinically focused APN except: A) Care provider B) Case manager C) Nurse specialist D) Nurse practitioner
A. Care provider is a staff position, a nurse who provides direct care. The nurse specialist has clinical expertise in a specific area. The nurse practitioner has advanced training in assessment and pharmacology and is able to provide health care in specific settings. The case manager has additional experience and is able to coordinate activities of other members of the health care team.
Which of the following is an example of respite care? A) Day care B) Home care C) Nursing home D) Nurse extender
A. Day care is an example of respite care because it allows the family to maintain normalcy while the client is under their care. A nursing home client receives 24-hour care in the facility. Home care is an intermittent service in which only certain tasks are performed. Nurse extenders may be hired to perform a specific task, such as bathing.
Theories that are broad and complex are: A) Grand theories B) Descriptive theories C) Middle-range theories D) Prescriptive theories
A. Grand theories are described as broad and complex. Middle-range theories are limited in scope, less abstract, address specific phenomena or concepts, and reflect practice. Descriptive theories describe phenomena, speculate as to why the phenomena occur, and describe the consequences of phenomena. Prescriptive theories address nursing interventions and predict the consequence of a specific intervention.
A client is receiving health care from a health care provider who is a salaried employee. Which model is being followed by the managed care organization (MCO) to which the client belongs? (Select all that apply.) A) Staff model B) Group model C) Network model D) Independent practice association
A. In the staff model of an MCO, the physicians are salaried employees. In the group model, the MCO contracts with a single group practice. An independent practice association is a group of physicians who are under contact to the organization but are not members of it and whose practices include fee-for-service and capitated clients. The MCO contracts with multiple group practices and/or integrated organizations in the network model.
Which of the following professional organizations was created to address concerns of members in the nursing profession? A) NLN B) MSN C) PHA D) NIH
A. National League for Nursing (NLN) is the correct answer. The master of science in nursing (MSN) degree is earned through advanced educational preparation in nursing. Public Health Administration (PHA) is concerned with areas of public health. The National Institutes of Health (NIH) addresses health on a national level.
Nursing theories focus on the phenomena of nursing and nursing care. Which of the following is true of phenomena? A) They are aspects of reality that can be consciously sensed or experienced. B) They convey the general meaning of concepts in a manner that fits the theory. C) They are statements that describe concepts or connect two concepts that are factual. D) They are mental formulations of an object or event that come from individual perceptual experience.
A. Phenomena are defined as aspects of reality that can be consciously sensed or experienced.
Which of the following assures clients that they will receive quality care from a competent nurse? A) Standards of care B) Nurse Practice Act C) Accreditation certification D) National council licensure
A. Standards of care describe the competency level of nursing care as described by the ANA. The Nurse Practice Act regulates the licensing and practice of nursing; it describes the scope of practice. Accreditation allows the facility, school, or hospital to operate and be recognized in good standing according to standards set by peers. National council licensure is the standardized national examination that assess for a minimum knowledge base relevant to the client population that the nurse serves.
The nurses on a medical unit have seen an increase in the number of pressure ulcers developing in their clients. The nurses decide to initiate a quality improvement project using the PDSA (plan, do, study, act) model. Which of the following is an example of the "Do" step of that model? A) Implement a new skin care protocol on all medical units. B) Review the data collected on clients cared for using the new protocol. C) Review the quality improvement reports on the six clients who developed ulcers over the previous 3 months. D) Based on findings from clients who developed ulcers, implement an evidence-based skin care protocol.
A. The "Do" step consists of selecting an intervention based on a data review and implementing the change, plus studying the results of the change. The "Plan" step includes reviewing the available data to understand existing practice conditions or problems to identify the need for change. The results of the change are evaluated in the "Study" step. The "Act" step is the incorporation of the findings into current practice.
Nursing practice in the twenty-first century is an art and science that is centered on: A) The client B) The nursing process C) Cultural diversity D) The health care facility
A. The client is the correct choice. The health care facility is where the client goes to receive treatment. The nursing process is how nurses proceed to plan care for the client. Cultural diversity is not the correct choice.
Leininger's theory of cultural care diversity and universality specifically addresses: A) Caring for clients from unique cultures B) Understanding the humanistic aspects of life C) Identifying variables affecting a client's response to a stressor D) Caring for clients who cannot adapt to internal and external environmental demands
A. The goal of Leininger's theory is to provide the client with culturally specific nursing care, in which the nurse integrates the client's cultural traditions, values, and beliefs into the plan of care.
Generally the most independently functioning nurse. Requires a master's degree in nursing, advanced education in pharmacology, and physical assessment, an certificatin and expertise in a specialized area of practice.
Advanced Practical Nurse (APN)
Established in 1896, with help from Isabel Hampton Robb. Is also active in improving standards of health and the availability of health care, to foster high standards for nursing, and to promote professional development and general and econimc welfare of nurses.
American Nurses Association
What does ADOPIE stand for?
Assessment, Diagnosis, Outcomes Identification, Planning, Implentation, and Evaluation.
Which of the following statements is true about evidence-based practice? (Select all that apply.) Evidence-based practice: A) Is based only on the results of research B) Assists nurses in meeting standards of practice C) Helps nurses solve dilemmas in the clinical setting D) Requires nurses to review and critique research and practice findings
B,C,D. Evidence-based practice helps nurses to solve dilemmas in the clinical setting because it combines scientific research with clinical expertise and local values. Evidence-based practice does require nurses to review and critique research and practice findings. Nurses are expected to always meet the standards of practice.
A nurse is working in an acute care hospital that uses a case management model. About which of the following activities should the nurse communicate with the case manager? (Select all that apply.) A) Management of a client transfer to the radiology department B) Coordination of a client transfer to the step-down rehabilitation unit C) Follow-up after a client's discharge to evaluate whether needs have been met D) Permission for a family to bring in special food for a client
B,C. The case manager coordinates the efforts of all disciplines to achieve the most efficient and appropriate plan of care for the client, with a focus on discharge planning. Therefore, coordination of transfer to a step-down rehabilitation unit and follow-up after discharge to evaluate that needs have been met are the correct answers.
Which of the following clients should be cared for in an extended care facility with skilled nursing? (Select all that apply.) A) Client who had a stroke, can talk, and has lost bowel and bladder control B) Severely brain injured client on a ventilator who is receiving intravenous medications C) Client with Alzheimer's disease who is abusive, combative, and a threat to self and others D) Young child who recently had a spinal cord injury and is living with quadriplegia and needs to learn a new way of life
B,D. Extended care encompasses intermediate medical, nursing, or custodial care for clients recovering from acute illness or clients with chronic illnesses or disabilities. Extended care facilities include intermediate care facilities and skilled nursing facilities.
A nurse researcher interviews senior oncology nurses, asking them to describe how they deal with the loss of a client. The analysis of the interviews yields common themes describing the nurses' grief. This is an example of which type of study? A) Historical study B) Qualitative study C) Correlational study D) Experimental
B. A qualitative study involves inductive reasoning to develop generalizations or theories from specific observations or interviews. Historical research establishes facts and relationships concerning past events. Correlational research explores the interrelationships among variables of interest without any intervention by the researcher. An experimental study used tightly controlled subject groups, variables, and procedures to eliminate bias and ensure that findings can be generalized to similar groups of subjects.
A theory is a set of concepts, definitions, relationships, and assumptions that: A) Formulates legislation B) Explains a phenomenon C) Measures nursing functions D) Reflects the domain of nursing practice
B. A theory is a set of concepts, definitions, relationships, and assumptions that explains a phenomenon. Theories do not formulate legislation, measure nursing functions, or reflect any domain of nursing practice.
Advanced practice nurses (APNs) generally: A) Work in acute care settings B) Function independently C) Function as unit directors D) Work in the university setting
B. APNs are generally the most independently functioning nurses. An APN can work in a primary, acute, or restorative care setting. The setting may be a private, public, or university facility. The APN may function as a clinician, educator, case manager, consultant, or researcher.
The nurse involved in scientific research effectively analyzes the information collected and determines a course of nursing action by: A) Depending on tradition B) Using critical thinking C) Seeking the advice of experienced practitioners D) Relying on personal perspective or opinion
B. Critical thinking involves analyzing the data, learning, and problem solving to come up with a course of action. Tradition limits the ability to learn new ways and overlooks what research has to offer. The advice of experienced practitioners may limit research because experience may mean doing things the same way they have been done for years. Using personal opinion overlooks the objective data that are available.
Which theories describe an orderly process beginning with conception and continuing through death? A) Systems theories B) Developmental theories C) Interdisciplinary theories D) Stress and adaptation theories
B. Developmental theories discuss human growth from conception to death. The other options are incorrect.
A nurse manager is researching the effects of staff shortages on job satisfaction among new graduates. It would be most effective for the nurse to gather data by: A) Directly observing the nursing behaviors on the unit B) Interviewing staff nurses on the unit regarding their perceptions C) Setting up an experimental group and a control group for the study D) Calling on other nurses in the facility to suggest ways of handling the problem
B. Effective qualitative research can be carried out, because through narrative interviews the participants' perceptions can be compared and common characteristics can be discovered. It is difficult to collect data about perceptions or feelings without talking to those involved. Quantitative research involves precise measurements and would not be of use in this study of perceptions. Although obtaining suggestions for possible solutions could be useful, it does not help to identify the problems on this specific unit. The data must be collected first.
The nursing paradigm identifies four linkages of interest to the nursing profession. These four linkages are: A) Concepts, definitions, relationships, and assumptions B) The person, health, environment/situation, and nursing C) The individual, groups, situations, and interests specific to nursing D) Description, explanation, prediction, and prescription of an interrelationship of nursing
B. Identified linkages of a nursing paradigm are the person, health, environment/situation, and nursing itself. Concepts, definitions, relationship, and assumptions are components of a theory. The individuals, groups, situations, and interests specific to nursing are potential subjects for middle-range theories. Description, explanation, prediction, and prescription of an interrelationship of nursing are purposes of nursing theory.
The professional nurse responsible for increasing respect for the individual and awareness of cultural diversity was: A) Harriet Tubman B) Mary Mahoney C) Isabel Hampton D) Mary Adelaide Nutting
B. Mary Mahoney, the first African American professional nurse, worked to bring respect to individuals regardless of race, color, background, or religion. Tubman assisted slaves to freedom during the Civil War. Hampton founded the Nurses Associated Alumnae of the United States and Canada, which later became the American Nurses Association (ANA). Nutting was instrumental in the affiliation of nursing education with universities.
The nurse researcher who gains new knowledge regarding a procedure can most effectively share the information with the nursing profession by: A) Duplicating the study using different clients in different settings B) Communicating the research findings in a professional journal C) Recruiting clients who are willing to demonstrate the new technique D) Asking individual nurses to report their experiences related to the new procedure
B. Publication of research results provides other nurses with the scientific background of the study before they apply its findings in practice. Study subjects and setting should be similar to duplicate a study. Nurses should not change from accepted to unproven ways of providing care without careful research and collaboration with colleagues. Experimenting with new nursing measures is inappropriate and may place a client at risk.
A priority goal for nursing research is: A) Controlling cost for hospitals B) Improving client care C) Keeping up with technological advances D) Maintaining the professional climate in nursing
B. Quality client care is always the primary focus of nursing practice. Cost control would be a benefit but is not the primary focus. Research is not about technology. Many "old" procedures can be improved through research. Although research is a professional function of nursing, it is not done to serve the profession.
An operating room nurse is talking with colleagues during a meeting and asks, "I wonder if we would see fewer wound infections if we used chlorhexidine instead of povidone-iodine to clean the skin of our surgical clients? In this example of a PICO question, the P is: A) Povidone-iodine use B) Surgical clients C) Chlorhexidine use D) Operating room nurses
B. Surgical clients are the client population of interest (P) in the PICO (population, intervention, comparison, outcome) question. Chlorhexidine use is the comparison of interest, and povidone-iodine use is the intervention of interest. The operating room nurse is not an element of the PICO question.
The licensure and practice of nursing is regulated by: A) The NCLEX-RN B) The Nurse Practice Act C) The certification examination D) The ANA Congress for Nursing
B. The Nurse Practice Act regulates the license and practice of nursing; it describes the scope of practice and is the correct answer. The NCLEX-RN national licensure examination is administered in each state to test that candidates have the minimum knowledge level required for practice. Passage of an examination and requirements for certification signify additional knowledge and competence in a specific area. The ANA Congress for Nursing is an organization that addresses legal aspects of nursing practice.
The nursing theory that emphasizes the delivery of nursing care for the whole person to meet the physical, emotional, intellectual, social, and spiritual needs of the client and family is: A) Rogers' theory B) Abdellah's theory C) Henderson's theory D) Nightingale's theory
B. The question describes the nursing theory developed by Fay Abdellah and others. Rogers' theory considered the individual as an energy field existing within the universe. Henderson's theory defines nursing as "assisting the individual, sick, or well, in the performance of those activities that will contribute to health, recovery, or a peaceful death." Nightingale viewed nursing as providing fresh air, light, warmth, cleanliness, quiet, and adequate nutrition.
Evidence-based nursing practice is the end result of: A) Prescriptive theory B) Use of practical knowledge C) Application of theoretical knowledge D) Theory-generating and theory-testing research
B. The result of theory-generating or theory-testing research is to increase the knowledge base of nursing. As these research activities continue, clients become the recipients of evidence-based nursing care.
A nurse who uses critical thinking in the decision-making process to provide effective quality care to individuals is known as: A) An advanced care nurse B) A clinical decision maker C) A member of a multidisciplinary practice D) An evidence-based practitioner
B. This process may be carried out with other members of the health care team, and client and family members may be included. All nurses use critical thinking. An advanced care nurse has advanced educational preparation. An evidence-based practitioner draws on research findings as well as clinical expertise and client values. A multidisciplinary practice includes health care members from various fields of activity, such as physical therapy and dietary therapy, along with nursing.
The nurse completes the standard orders on a client's first day postoperatively. The instrument that is used to coordinate the client's care is: A) A Medicare plan B) A discharge plan C) A critical pathway D) Standard nursing care
C. A critical pathway is a multidisciplinary treatment plan with interventions prescribed within a structured framework. A discharge plan includes an assessment and anticipation of the client's needs. Medicare is a federal health insurance plan for those 65 years of age and older. Standard nursing care is the minimum care to be given to a client.
The nurse is caring for a client with end-stage lung disease. The client wants to go home on oxygen therapy and be comfortable. The family wants the client to undergo a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the client's wishes with the family. The nurse is acting as the client's: A) Manager B) Educator C) Advocate D) Caregiver
C. An advocate helps speak for the client, communicating the client's concerns and wishes to family and other caregivers. A caregiver assists in meeting all health care needs of the client, including taking measures to restore emotional, spiritual, and social well-being. A manager coordinates all the activities of the members of the nursing staff in delivering nursing care and has personnel, policy, and budgetary responsibilities for a specific nursing unit or agency. An educator explains concepts and facts about health, demonstrates procedures such as self-care activities, reinforces learning or client behavior, and evaluates the client's progress in learning.
The nursing process is an example of an open system. An open system: A) Is universal and dynamic B) Represents a relationship between two concepts C) Interacts with the environment by exchanging information D) Is a process through which information is returned to the system
C. An open system is defined as a system that interacts with the environment, exchanging information between the system and the environment.
The multidisciplinary care model used to move clients efficiently from admission to discharge is known as: A) Team nursing B) Nursing process C) Case management D) Interdisciplinary care
C. Case management is a model of organizing care in which the case manager monitors, directs, and advises the nursing care personnel on specific care issues and the progress of a client. In team nursing, care might be provided by groups composed of registered nurses, licensed practical nurses, and possibly assistive personnel. Nursing process is used to plan the nursing care for a client. Interdisciplinary care is care provided by a team whose members come from a variety of disciplines.
A nurse manager wants to determine how well a new policy is working in the clinical area. It would be appropriate to use: A) Survey methods B) Grounded theory C) Evaluation research D) Experimental research
C. Evaluation research is aimed at finding out how well a program, practice, policy, or procedure is working. A survey studies a large group to identify general information, opinions, attitudes, or perceptions. A grounded theory is a theory developed through the collection and analysis of qualitative data. Experimental research collects information about human subjects who are divided into a control group and a comparison group.
Evidence-based practice is defined as: A) Nursing care based on tradition B) Scholarly inquiry embodied in the nursing and biomedical research literature C) A problem-solving approach to clinical practice based on best practices D) Quality nursing care provided in an efficient and economically sound manner
C. Evidence-based practice is a problem-solving approach to clinical practice that uses the best available evidence, along with the nurse's expertise and the client's preference and values, in making decisions about care. The other answers are incorrect.
The nurse is giving discharge instructions to a client with newly diagnosed diabetes. The nurse discusses with the client what the dietary intake should be. This is an example of which health care service? A) Tertiary care B) Restorative care C) Health promotion D) Illness prevention
C. Health promotion includes dietary counseling. Blood glucose monitoring at the pharmacy is an example of illness prevention. Restorative care is care of a client who, for instance, is recovering from complications of diabetes. Any diagnostic procedure or tests completed in the hospital would be examples of such care.
The document that developed goals and objectives to meet the health of the public is known as: A) Notes on Nursing B) Last Acts Campaign C) Healthy People 2010 D) Nursing Principles and Practice 2010
C. Healthy People 2010, a federal document, outlines goals for the public. Notes on Nursing set forth Nightingale's first nursing philosophy. The Last Acts Campaign has developed standards and policies for end-of-life care. Nursing Principles and Practice 2010—current readings in journals are necessary for all nurses in practice.
To practice in today's health care environment, nurses need a strong scientific knowledge base in nursing and other disciplines, such as the physical, social, and behavioral sciences. This relates to which of the following? A) Systems theories B) Developmental theories C) Interdisciplinary theories D) Health and wellness model
C. Interdisciplinary theories provide a systematic view of a phenomenon. Developmental theories, health and wellness theories, and systems theories are examples of other types of theories.
Which task is it not appropriate for a professional nurse to delegate to assistive personnel? A) Ambulate a client B) Complete a bed bath C) Obtain a sterile urine specimen D) Complete the intake and output (I&O) record
C. Obtaining a sterile specimen requires insertion of a catheter, a procedure that must be performed by a licensed nurse. Therefore, this would not be an appropriate task to delegate to an assistive person. Assistive personnel would be able to ambulate a client, give a bed bath, and add to the I&O record.
Which of the following statements about prescriptive theories is accurate? A) They describe phenomena. B) They have the ability to explain nursing phenomena. C) They reflect practice and address specific phenomena. D) They provide a structural framework for broad abstract ideas.
C. Prescriptive theories address nursing interventions for a phenomenon and predict the consequence of a specific nursing intervention. Descriptive theories describe the phenomena, speculate on the reason the phenomena occur, and predict nursing phenomena. Grand theories are broad and complex and provide a structural framework for broad, abstract ideas about nursing.
The type of theory that tests the validity and predictability of nursing interventions is: A) A grand theory B) A descriptive theory C) A prescriptive theory D) A middle-range theory
C. Prescriptive theory addresses nursing interventions and predicts the consequence of a specific nursing intervention. Middle-range theories are limited in scope, less abstract than grand theories, address specific phenomena or concepts, and reflect practice. Descriptive theories describe phenomena, speculate as to why the phenomena occur, and describe the consequences of phenomena. Grand theories are broad and complex.
A clinical nurse develops a better way to secure an intravenous access device in a client and wants to see if it would benefit other clients. The first step in initiating a study should be to: A) Recruit clients to participate in the study. B) Use the new technique and gather client feedback. C) Review current literature related to the clinical problem. D) Survey clients regarding their preferences and feelings regarding the procedure.
C. Review of the literature is the first step in the orderly research process to determine what is already known about the problem. Recruiting clients occurs later in the process, after identifying the problem, researching the literature, and designing the study. Experimenting with new nursing procedures that have not been tested or approved is a risk to clients. Surveys are designed to obtain information from large study populations and would not be a first step in the research process.
The nurse researcher obtains informed consent from participants in a study primarily to: A) Release the researcher from legal liability. B) Control variables that might affect the study. C) Ensure that the study subjects understand their roles in the study. D) Maintain the confidentiality of the researcher and the participants.
C. The conduct of research must meet ethical standards in which the rights of human subjects are protected. The research participants must be told about the study's purpose and procedure, and their roles in the study. The researcher is always legally responsible for his or her actions. Control of variables is related to the study design, not to informed consent. Confidentiality is part of the ethical nature of research but is not the focus of informed consent.
Each science has a domain, which is the perspective of the discipline. This domain: A) Represents the recipients of the benefits of the science or discipline B) Is a model that explains the linkage of science, philosophy, and theory that is accepted and applied by the discipline C) Describes the subject, central concepts, values and beliefs, phenomena of interest, and central problems of the discipline D) Is a dynamic state of being in which the developmental and behavioral potential of the individual is realized to the fullest
C. The domain contains the subject, central concepts, values and beliefs, phenomena of interest, and the central problems of the discipline. A paradigm is a model that explains the linkage of science, philosophy and theory that is accepted and applied by the discipline.
Which of the following is the biggest consumer of health care? A) Hospitals B) Businesses C) Federal government D) Private insurance companies
C. The federal government, which pays for the Medicare and Medicaid programs, is the biggest consumer of health care. The other options are incorrect.
Maslow's hierarchy of needs is useful to nurses, who must continually prioritize a client's nursing care needs. The most basic or first-level needs include: A) Self-actualization B) Love and belonging C) Air, water, and food D) Esteem and self-esteem
C. The first level of Maslow's hierarchy of needs includes the need for air, food, and water—basic elements of survival. Love and belonging are on the second level, esteem and self-esteem are on the fourth level, and self-actualization is the final level.
An 18-year-old woman is in the emergency department with fever and cough. The physician asks the nurse to measure vital signs, auscultate lung sounds, listen to heart sounds, determine the level of comfort, and collect blood and sputum samples for analysis. The nurse is performing what aspect of practice? A) Diagnosis B) Evaluation C) Assessment D) Implementation
C. The nurse is assessing the client. Diagnosis occurs after all assessments are completed. Then a plan is developed and implemented. The process is completed with evaluation.
A nurse who has filled a position on the same unit for 2 years understands the unit's organization and the care of the clients on that nursing unit. Benner defines this nurse as able to anticipate nursing care and to formulate long-range goals; this nurse is given the title: A) Expert nurse B) Proficient nurse C) Competent nurse D) Advanced beginner
C. The nurse who has held the same position for 2 to 3 years and understands the specific area and client population is termed a competent nurse. The expert is a nurse with diverse experience who can focus on a specific problem and offer multidimensional solutions. The proficient nurse has more than 2 to 3 years' experience and applies knowledge and experience to a situation. The advanced beginner nurse has at least some level of experience.
Which of the following was most significant in influencing competition in health care costs? A) Medicare and Medicaid B) Diagnosis-related groups C) Prospective payment system D) Managed care organizations
C. The prospective payment system is one of the most significant factors influencing payment for health care. The prospective payment system groups payments into diagnosis-related groups for Medicare and Medicaid clients. Managed care organizations are systems in which there is administrative control over primary health care services for a defined client population.
There is a contemporary move toward addressing nursing as a science or as evidenced-based practice. This suggests that: A) One theory will guide nursing practice. B) Scientists will make nursing decisions. C) Theories will be tested to describe or predict client outcomes. D) Nursing will base client care on the practice of other sciences.
C. Theories will be tested to describe or predict client outcomes as nursing is addressed as a science and an art. Scientists will not make nursing decisions, and nursing will base client care on the practice of nursing science, which will be guided by multiple theories.
The client's health insurance changed, and instead of having a limited number of physicians from whom to choose, the client is voluntarily enrolled in a plan in which medical care is provided by a special group of caregivers. This arrangement is known as: A) Medicare B) Private insurance C) Managed care organization (MCO) D) Preferred provider organization (PPO)
C. This is the description of an MCO. In a PPO, choice of care providers is limited to those listed in the group. Medicare is a federally funded national health insurance program. Private insurance is a traditional fee-for-service plan.
In this role, you help the client regain health and a maximal level of independent function through the healing process.
Caregiver
An RN who is involved in providing indepedent care for women during normal pregnancy, labor, and delivery, as well as care for the newborn.
Certified Nurse-Midwife
An RN who provide surgical anesthesia under the guidance and supervision of an anesthesiologist.
Certified Registered Nurse Anesthetist
Founded the American Red Cross during The Civil War (1860-1865). Tended to soldiers on the battlefiels, cleansing wounds, meeting basic needs, an comforting them in death.
Clara Barton
In this role, you protect your client's human and legal rights and provide assistance in asserting those rights if the need arises.
Client Advocate
And Advanced Practice Nurse who is an expert clinician in a specialized area of nursing practice.
Clinical Nurse Specialist
The philosophical ideals of right and wrong that define the principles you will use to provide care to your clients.
Code of Ethics
This involves formal, organized educational programs offered by universities, hospitals, states nurses associations, professional nursing organizations, etc.
Continuing Education (CE)
A new nurse on an orthopedic unit is assigned to care for a client undergoing skeletal traction. The nurse asks a colleague, "What is the best practice for cleaning pin sites in skeletal traction?" This question is an example of which of the following? A) Hypothesis B) PICO question C) Problem-focused trigger D) Knowledge-focused trigger
D. A knowledge-focused trigger is a question regarding new information available on a topic. A problem-focused trigger is one faced while caring for a client or noting a trend. The PICO (population, intervention, comparison, outcome) format is a way to phrase a question to help clarify the question and the parts. A hypothesis is a prediction about the relationship between study variables.
An APN is pursuing a job change. Which of the following positions would the APN be unable to fill without meeting additional criteria? A) Case manager B) Nurse manager C) Nurse educator D) Certified registered nurse anesthetist
D. Additional training in anesthesia medicine would be required to be a certified registered nurse anesthetist.
As an art, nursing relies on knowledge gained from practice and reflection on past experiences. As a science, nursing relies on: A) Experimental research B) Nonexperimental research C) Physician-generated research D) Scientifically tested knowledge
D. As a science, nursing draws on scientifically tested knowledge applied in the practice setting.
A theory is a set of concepts, definitions, relationships, and assumptions or propositions to explain a phenomenon. The purposes of the components of a theory are to: A) Describe concepts or connect two concepts that are factual B) Formulate a perceptual experience to describe or label a phenomenon C) Express the global view about the individual, situations, or factors of interest to a specific discipline D) Describe, explain, predict, and/or prescribe interrelationships among the concepts that define the phenomenon
D. Describing, explaining, predicting, and/or prescribing interrelationships among concepts are stated purposes of research.
The nurse found that using tympanic thermometers was quick, easy, and yielded temperatures as reliable as those obtained using oral thermometers. This finding represents: A) Primary care B) Critical thinking C) Competency testing D) Evidence-based practice
D. Evidence-based practice draws on both research and clinical experience. Competencies are evidence that skills have been demonstrated. Critical thinking is the questioning thought process that nurses need to use in practice. Primary care is health care provided in the community by one caregiver who takes responsibility for managing a client's care.
Who acted to decrease mortality by improving sanitation in the battlefields, which resulted in a decline in illness and infection? A) Dorothea Dix B) Lillian Wald C) Clara Barton D) Florence Nightingale
D. Florence Nightingale is the correct choice. Barton founded the Red Cross. Dix organized hospitals, nurses, and supply lines to support the troops of the Union Army. Wald opened the first community health service for the poor.
A client is wheezing and short of breath. The physician orders a medicated nebulizer treatment now and in 4 hours. The nurse is providing what aspect of care? A) Planning B) Evaluation C) Assessment D) Implementation
D. Implementation is the actual delivery of care. Assessment is data gathering. Then the information is developed into a diagnosis and the planning occurs with the diagnosis. Evaluation is the final step of the nursing process.
A researcher gives a subject full and complete information about the purpose of a study. This is an example of: A) Bias B) Anonymity C) Confidentiality D) Informed consent
D. Informed consent means that the research subjects are given full and complete information about the purpose of the study, procedures, data collection, potential harm and benefits, and alternate methods of treatment. Confidentiality rules guarantee that any information the subject provides will not be reported to people outside the research team. Bias is any personal opinion or judgment that may be interjected into the results.
Mishel's theory of uncertainty in illness focuses on the experience of clients with cancer who live with continual uncertainty. The theory provides a basis for nurses to assist clients in appraising and adapting to the uncertainty and illness response and can be described as: A) A grand theory B) A descriptive theory C) A prescriptive theory D) A middle-range theory
D. Middle-range theories are limited in scope, less abstract than grand theories, address specific phenomena or concepts, and reflect practice. Grand theories are described as broad and complex. Prescriptive theories address nursing interventions and predict the consequence of a specific nursing intervention. Descriptive theories describe phenomena, speculate as to why the phenomena occur, and describe the consequences of phenomena.
Nursing's paradigm includes: A) Health, person, environment, and theory B) Concepts, theory, health, and environment C) Nurses, physicians, models, and client needs D) The person, health, environment/situation, and nursing
D. Nursing's paradigm includes four linkages: the person, health, environment/situation, and nursing.
A client discharged after suffering a stroke is transferred from a tertiary care facility to another facility for additional care to help the client recover and continue to regain function. This type of care facility is known as: A) Home care B) Assisted care C) Extended care D) Restorative care
D. Restorative care assists an individual in regaining the maximum possible level of functioning. Home care includes professional and paraprofessional services that are rendered in the home setting. Extended care is intermediate medical or nursing care for individuals with an acute or chronic illness or disability. Assisted care is a setting in which the client is able to function at a higher level of autonomy within a homelike environment but in which care can be given when needed.
Which of the following could be a barrier to nursing research? A) Presence of teams in nursing B) Pressure from the administration C) Staff wishes to change a policy D) Shortage of professional nursing stafforganization is also an incentive to research.
D. Shortage of staff could mean less time and personnel to conduct and participate in research. Nursing teams that have teamwork skills can aid research. The desire to change is an incentive for research. Pressure from higher levels in the organization is also an incentive to research.
A nurse volunteers to take blood pressure measurements after church services. This is an example of which level of health care service? A) Secondary care B) Restorative care C) Health promotion D) Illness prevention
D. Taking blood pressure measurements is illness prevention. Health promotion includes activities like exercise classes. Secondary care is often known as traditional care. It would include rehabilitation after a stroke in an individual with a history of elevated blood pressure.
The examination for the registered nurse (RN) licensure is exactly the same in every state in the United States. This examination: A) Guarantees safe nursing care for all clients B) Ensures standard nursing care for all clients C) Ensures that honest and ethical care is provided D) Provides a minimal standard of knowledge for practice
D. The RN licensure examination provides a minimum standard of knowledge for nurses. The examination cannot guarantee or ensure care for clients.
The nurse practices nursing in conformity with the code of ethics for professional registered nurses. This code: A) Improves self-health care B) Protects the client from harm C) Ensures identical care to all clients D) Defines the principles by which nurses' provide care to their clients
D. The code of ethics is the philosophical ideals of right and wrong that define the principles the nurse will use to provide care to clients. A code of ethics does not ensure identical care to all clients (which would not be acceptable). The nursing code of ethics does not protect clients from harm or improve self-health care.
The foundation of research is which of the following? A) Evidence B) Experience C) Critical thinking D) Scientific method
D. The scientific method is the foundation of research and the most reliable and objective of all methods of gaining knowledge. Experience, critical thinking, and evidence are not the foundation of research.
The purpose of a utilization review committee is to: A) Review quality, quantity, and cost of care B) Review the utilization of the payment mechanism C) Review reimbursement fees and appropriation of funds D) Review admissions, diagnostic tests, and treatments ordered by physicians
D. The utilization review committee reviews admissions, diagnostic procedures, and treatments ordered by physicians. Review of the quality, quantity, and cost of care is more similar to the functions of a professional standards review organization. Review of reimbursement fees and appropriation of funds involves review of diagnosis-related groups. Reviewing the utilization of the payment mechanism is similar to capitation.
Organized hospitals, appointed nurses, and oversaw and regulated supplies to the troops as superintendent of the Union Army during the Civil War.
Dorothea Lynde Dix
1860, Established the first nursing philosophy based on health maintenance and restoration. Connected poor sanitation with cholera and dysentery.
Florence Nightingale
Active in the Underground Railroad movement, assisting in leading over 300 slaves to freedom.
Harriet Tubman
Instructions or training provided by a health care agency or institution.
In-Service Education
Promotes national associations of nurses, improving standards of nursing practice, seeking a higher status for nurses, and providing an international power base for nurses.
International Council of Nurses (ICN)
Helped found the American Nurses Association, originally called the Nurses' Associated Alumnae of the US and Canada in 1896.
Isabel Hampton Robb
Opened the Henry Street Settlement in 1893, which focused on the health needs of poor people who lived in tenements in NYC.
Lillian Wald and Mary Brewster
Organized ambulance servies, supervised nurses, and walked abandoned battlefields at night, looking for wounded soldiers during the Civil War.
Mary Ann Ball (Mother Bickerdyke)
First professionally trained African American nurse, and brough forth an awareness of cultural diversity and respect for the individual, regardless of background, race, color, or religion.
Mary Maloney
Advances excellence in nursing education to prepare nurses to meet the needs of a diverse population in a changing healthcare environment.
National League for Nursing (NLN)
Beginning nursing student, or any nurse entering a situation in which there is no previous level of experience.
Novice
Manages client care and delivery of specific nursing services within a health care agency.
Nurse Administrator
Works primarily in schools of nursing, staff development departments of health care agencies, and client education departments.
Nurse Educator
Provides health care to a group of clients, usually in an out-patient, ambulatory care, or community-based setting.
Nurse Practioner
Investigates problems to improve nursing care and to further define and expand the scope of nursing practice.
Nurse Researcher
As defined by the ANA: the protection, promotion, an optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.
Nursing
Deals with issues of concern to those practicing in the profession.
Professional Organization
