Nursing Sciences
How many levels of critical thinking exist for nursing judgment? Record your answer using a whole number. ______
3 There are three levels of critical thinking in nursing judgment. The first level is basic critical thinking, in which the nurse has faith that the expert has the right answer to each problem. The second level is complex critical thinking. The nurse examines and analyzes information provided by the expert. A nurse engaging in this critical thinking may discover that another option is available with which to solve an issue. The third level of critical thinking is commitment. A nurse at this level can make choices without help from others. The nurse at this level of critical thinking takes full responsibility for every action in which he or she engages.
Which statement accurately describes correlational research? 1 Correlational research tests how well a program, practice, or policy is working. 2 Correlational research explores the relationships among variables of interest without any active intervention by the researcher. 3 In correlational research, the investigator controls the study variable and randomly assigns subjects to different conditions to test the variable. 4 Correlational research measures the characteristics of people, situations, or groups and the frequency with which certain events or characteristics occur.
ans: 2 Correlational research explores the relationships among variables of interest without any active intervention by the researcher. Evaluation research tests how well a program, practice, or policy is working. Experimental research is a study in which the investigator controls the study variable and randomly assigns subjects to different conditions to test the variable. Descriptive research measures the characteristics of people, situations, or groups and the frequency with which certain events or characteristics occur.
A registered nurse is teaching a nursing student about Piaget's theory of cognitive development that includes four periods, which are related to age. Which age group corresponds with concrete operations? 1 2 to 7 years 2 7 to 11 years 3 Birth to 2 years 4 11 years to adulthood
ans: 2 I put 1 According to Piaget's theory of cognitive development, the concrete operations period applies to the age group of 7 to 11 years of age. The preoperational period is during the age group of 2 to 7 years. The sensorimotor period applies to the age group of birth to 2 years. The formal operations period applies to the age group of 11 years to adulthood.
What is the purpose of block and parish nursing? 1 To provide services to older clients 2 To promote health throughout a school curriculum 3 To provide nursing services with a focus on health promotion and education 4 To provide primary care to a client population living in a community
ans: 2 In block and parish nursing, nurses living within a neighborhood provide services to older clients or those unable to leave their homes. Health promotion throughout a school curriculum is provided by school health. Nurse-managed clinics provide nursing services with a focus on health promotion and education, chronic disease assessment management, and support for self-care and caregivers. Community health centers are outpatient clinics that provide primary care to a client population living in a community.
Which nursing theory focuses on the client's self-care needs? 1 Roy's theory 2 Orem's theory 3 Watson's theory 4 Leininger's theory
ans: 2 Orem's self-care deficit theory focuses on the client's self-care needs. According to Roy's theory, the goal of nursing is to help a person adapt to changes in physiological needs, self-concept, role function, and interdependent relations during health and illness. Watson's theory of transpersonal caring defines the outcome of nursing activity with regards to the humanistic aspects of life. The major concept of Leininger's theory is cultural diversity, with the goal of nursing care being to provide the client with culturally specific nursing care.
A client is ambivalent about making a change in health behavior. Which stage of health behavior does the nurse suspect? 1 Preparation 2 Maintenance 3 Contemplation 4 Precontemplation
ans: 3 I put 4 The nurse suspects that the client is in the stage of contemplation. This stage of health behavior is characterized by the client's attitude toward a change and the client is most likely to accept that change over the next 6 months. In the preparation stage, the client believes that a change in behavior will be advantageous. The client may need assistance to bring about the change in behavior. During the maintenance stage, changes need to be implemented in the client's lifestyle. In the precontemplation stage, the client is not willing to receive any information about changes in behavior and may become defensive and confrontational.
A nursing student is listing the points that are applicable to grand theories of nursing. Which point mentioned by the nursing student needs correction? 1 Grand theories require further specification through research. 2 Grand theories are systematic and broad in scope and complex. 3 Grand theories include Mishel's theory of uncertainty in illness. 4 Grand theories do not provide guidance for specific nursing interventions.
ans: 3 Mishel's theory of uncertainty in illness is not an example of a grand theory; it is a middle-range theory. Neuman's systems model is a grand theory. Grand theories require further specification through research. Grand theories are systematic and broad in scope and complexity. Grand theories do not provide guidance for specific nursing interventions; instead they provide the structural framework for broad and abstract ideas about nursing.
A nurse finds that there is an inaccurate match between clinical cues and the nursing diagnosis. What is the category of the diagnostic error? 1 Labeling 2 Collecting 3 Clustering 4 Interpreting
ans: 4 An inaccurate match between clinical cues and the nursing diagnosis is an interpreting error. Interpreting errors include failing to consider conflicting cues, using an insufficient number of cues, and using unreliable or invalid cues errors. A labeling error is a failure to validate data. Collecting errors include inaccurate data, missing data, or disorganization. Errors at the clustering level include an insufficient cluster of cues, premature or early closure, or incorrect clustering.
Which healthcare system focuses solely on palliative care? 1 Hospice 2 Rehabilitation 3 Assisted Living 4 Extended care facilities
correct ans: 1 A hospice is a system of family-centered care that allows clients to live and remain at home with comfort, independence, and dignity while easing the pain of terminal illness. The focus of hospice care is palliative care, not curative treatment. Rehabilitation restores a person to his or her fullest physical, mental, social, vocational, and economic potential possible. Assisted living offers an attractive long-term care setting with an environment reminiscent of home and with some resident autonomy. An extended care facility provides intermediate medical, nursing, or custodial care to clients recovering from acute illnesses or clients with chronic illnesses or disabilities.
Which healthcare system is required after a physical or mental illness, injury, or chemical addiction? 1 Rehabilitation 2 Intensive care 3 Psychiatric facilities 4 Extended care facilities
correct ans: 1 Clients require rehabilitation after a physical illness, mental illness, injury, or chemical addiction. An intensive care unit is required when a client needs close monitoring in addition to medical care. Clients who suffer emotional and behavioral problems such as depression, violent behavior, and eating disorders often require special counseling and treatment in psychiatric facilities. An extended care facility provides intermediate medical, nursing, or custodial care for clients recovering from acute illness or clients with chronic illnesses or disabilities.
A client with colon cancer is receiving hospice care at home. What is the focus of hospice care? 1 To ease the pain from illness 2 To provide curative treatment 3 To assist with activities of daily living 4 To adapt to the limitations due to illness
correct ans: 1 The focus of hospice care is palliative care to ease the pain caused by the illness. It is a system of family-centered care that allows clients to live at home with dignity. Hospice care does not provide curative treatment. The health care team follows an individualized plan of care for the client. Assisted living facilities offer long-term care for the older client in settings with a home-like environment. These facilities assist the client with activities of daily living. Rehabilitation facilities provide restorative care that helps the client to adapt the limitations caused by the illness.
The school nurse conducts a class in nutrition planning for parents. What is the goal of school health nursing programs? 1 Health promotion 2 Disease management 3 Chronic care management 4 Environmental surveillance
correct ans: 1 The goal of school health nursing programs is health promotion through a school curriculum. A class on nutritional planning for parents contributes to health promotion. Disease management is one of the many programs of community health centers. These centers provide primary care to a specific client population within a community. Nurse-managed clinics provide nursing care with a focus on acute and chronic care management. The occupational health nurse may conduct an environmental surveillance for health promotion and accident prevention in the work setting.
A registered nurse is teaching a nursing student about Nightingale's theory of nursing. Which statements have been correctly stated by the nursing student as a result of the teaching? Select all that apply. 1 Nightingale's theory states that the focus of nursing is caring through the environment. 2 Nightingale's theory limits nursing to the administration of medications and treatment. 3 Nightingale's theory suggests that every nurse should know all about the disease process. 4 Nightingale's theory is oriented towards providing fresh air, light, warmth, cleanliness, quiet, and adequate nutrition. 5 Nightingale's theory focuses on helping the client deal with the symptoms and changes in function related to an illness.
correct ans: 1, 4, 5 Florence Nightingale's theory of nursing focuses on nursing by caring through the environment. Nightingale's theory is oriented toward providing fresh air, light, warmth, cleanliness, quiet, and adequate nutrition. Nightingale's theory focuses on helping the client deal with the symptoms and changes in function related to an illness. Nightingale's theory does not limit nursing to the administration of medications and treatment. Nightingale's theory suggests that nurses do not need to know all about the disease process, which differentiates nursing from medicine.
Which example indicates that the nurse is following evidence-based practice? 1 The nurse documents client care in an electronic health record. 2 The nurse reads current nursing journals and uses the latest scientific methods. 3 The nurse uses flowcharts and diagrams to record the client's progress. 4 The nurse encourages the hospitalized client's family to bring home-cooked food.
correct ans: 2 Evidence-based practice requires the nurse to read current nursing journals and use the latest scientific methods. It also requires the integration of best current evidence with clinical expertise and client preferences while providing health care. The nurse uses informatics to document client care in an electronic health record. The nurse uses flowcharts and diagrams to record the client's progress and monitor the outcomes of client care. This helps the nurse to improve the quality of care. The nurse provides client-centered care by encouraging the hospitalized client's family to bring home-cooked food.
In which role does the nurse oversee the budget of a specific nursing unit or agency? 1 Nurse educator 2 Nurse manager 3 Nurse researcher 4 Nurse practitioner
correct ans: 2 The nurse manager is responsible for the budget of a specific nursing unit or agency. The nurse educator works primarily in schools of nursing, staff development departments of health care agencies, and client education programs. The nurse researcher investigates problems to improve nursing care. The nurse practitioner provides health care to a group of clients usually in an outpatient, ambulatory care, or community-based setting.
Which statement defines "information" gathered by the nurse? 1 It is an individual piece of reality. 2 It is a combination of pieces of reality. 3 It is the organization and interpretation of data. 4 It is the identification of relationship of various data.
correct ans: 3 Information is defined as the organization and interpretation of data or pieces of reality. Datum is an individual piece of reality. When data are combined and relationships among data are identified, the nurse obtains knowledge.
A doctor asks a nurse to collect the medical history of a client. What nursing process should the nurse undertake? 1 Diagnosis 2 Evaluation 3 Assessment 4 Implementation
correct ans: 3 The documentation of the client's information is part of an assessment. The nurse will collect all the relevant medical data of the client to help the doctor understand the client's history a make an accurate diagnosis. During diagnosis, the collected data is analyzed to find out the client's problems or issues. Evaluation is the process to see if the expected outcomes of the treatment are achieved or not. Before an evaluation, a plan is made to solve all the client's problems and then the plan is implemented.
Which opposing conflict would a middle-aged adult face according to Erikson's theory of psychosocial development? 1 Integrity versus Despair 2 Intimacy versus Isolation 3 Identity versus Role Confusion 4 Generativity versus Self-Absorption and Stagnation
correct ans: 4 According to Erikson's theory of psychosocial development, a middle-aged adult is likely to face the opposing conflicts Generativity versus Self-Absorption and Stagnation. An older adult is likely to face the opposing conflicts Integrity versus Despair. A young adult may face the opposing conflicts Intimacy versus Isolation. An adolescent may face the opposing conflicts Identity versus Role Confusion.
Which statement about Henderson's theory of nursing care is correct? 1 Henderson's self-care deficit theory focuses on the client's self-care needs. 2 Henderson's theory is based on stress and the client's reaction to the stressor. 3 Henderson's concept of the environment includes the suggestion that nurses do not need to know all about the disease process differentiated nursing from medicine. 4 Henderson organized the theory into 14 basic needs of the whole person and includes phenomena from the following domains of the client: physiological, psychological, sociocultural, spiritual, and developmental.
correct ans: 4 Henderson's theory comprises 14 basic needs of the whole person and includes phenomena from the following domains of the client: physiological, psychological, sociocultural, spiritual, and developmental. Orem's self-care deficit theory focuses on the client's self-care needs. The Neuman systems model is based on stress and the client's reaction to the stressor. Nightingale's concept of the environment includes the suggestion that nurses do not need to know all about the disease process differentiated nursing from medicine.
Which of these is true about SOAP progress note method? 1 The A in SOAP stands for action. 2 The P in SOAP stands for problem. 3 SOAP progress note has a nursing origin. 4 SOAP progress note includes assessment inform
correct ans: 4 SOAP progress notes include assessment information or diagnoses based on data. The A in SOAP stands for assessment and not action. The P stands for plan, not problem. SOAP progress note originate from medical records.
What is the primary focus of nursing care in the "family as context" approach? 1 The relationship among family members 2 The health and development of an individual 3 The ability of the family to meet their basic needs 4 The family's process of caregiving for a sick member
i put 2 ans: 3 In the "family as context" approach, the primary focus is the health and development of an individual in a specific environment. The relationship and family processes are the primary focus when the family is viewed as client. When the family is viewed as context, the focus is the ability of the family to meet the basic needs of the individual, not their own needs. The process followed by the family when caring for the sick family member is assessed when family is viewed as client.
A nurse questions the staff about a change in a client's plan of care. What does this demonstrate? 1 Authority 2 Autonomy 3 Responsibility 4 Accountability
i put 3 ans: 1 The nurse asking questions about a change in a client's plan of care shows that the nurse has the power to make decisions. This is an example of the nurse's authority over other staff members. Independence in making choices about client care and work is autonomy. Responsibility refers to the duties and activities that an individual is employed to perform. Accountability means that individuals are answerable for their actions. The nurse demonstrates accountability by checking on the client and family after discharge.
A nurse helps a client to clarify health problems and choose appropriate courses of action. What competency in community-based practice is the nurse exercising? 1 Educator 2 Caregiver 3 Counselor 4 Epidemiologist
i put 3 ans: 1 When a nurse is helping a client to identify and clarify health problems and choose appropriate courses of action to solve those problems, the nurse is acting as a counselor. The nurse acts as an educator by establishing relationships with community service organizations. The nurse acts as an epidemiologist when he or she is involved in case finding, health teaching, and tracking incident rates of an illness. The nurse acts as a caregiver when he or she provides appropriate, individualized nursing care for specific clients and their families.
The Magnet Recognition Program for health care organizations is based on fourteen forces of magnetism related to five magnet model components. Which force of magnetism is assessed to review the structural empowerment of the organization? 1 Quality of care 2 Quality improvement 3 Interdisciplinary relationships 4 Personnel policies and programs
i put 4 ans: 1 Health care organizations that apply for Magnet status must demonstrate innovations in professional practice. One of the forces of magnetism that impacts the structural empowerment of the organization is its personnel policies and programs. Personnel policies of an organization should provide an innovative environment in which the staff are developed and empowered. Empirical quality outcomes are reviewed by assessing the quality of care. New knowledge, innovations, and improvements are reviewed by assessing the quality improvement of the health care organization. Interdisciplinary relationships are assessed to review exemplary professional practice.
Which nursing diagnosis is an example of a client response to a health condition? 1 Risk for acute confusion 2 Impaired social interaction 3 Readiness for enhanced nutrition 4 Readiness for increased family coping
i put 4 ans: 2 Impaired social interaction is an example of a client response to a health condition. Any nursing diagnoses beginning with "risk for" describes human responses to conditions that have not yet occurred, such as Risk for acute confusion. A health promotion nursing diagnosis reflects the clinical judgment that the individual or family client is willing to act to improve their health to prevent the onset of a health condition which has not yet occurred. Readiness for enhanced nutrition and readiness for enhanced family coping are examples of health promotion nursing diagnoses.
What are the steps of evidence-based practice (EBP) in order? 1. Evaluating the practice decision 2. Asking the relevant clinical question 3. Collecting the most relevant and best evidence 4. Critically appraising the evidence collected 5. Sharing the outcomes of EBP changes with others 6. Integrating all evidence with one's clinical expertise and client preferences
2. Asking the relevant clinical question 3. Collecting the most relevant and best evidence 4. Critically appraising the evidence collected 1. Evaluating the practice decision 5. Sharing the outcomes of EBP changes with others 6. Integrating all evidence with one's clinical expertise and client preferences
A registered nurse is teaching a nursing student about systems theories with a specific reference to Neuman's systems theory. Which statements made by the nursing student post teaching are accurate? Select all that apply. 1 "Factors that change the environment also affect an open system." 2 "The components are interrelated and share a common purpose to form a whole." 3 "A system is composed of separate components and the components can be open or closed." 4 "Neuman's systems theory defines a total-person model of holism and a closed-systems approach." 5 "An open system interacts with the environment, with an exchange of information between the system and the environment."
Ans: 1, 2, 5 Factors that change the environment also affect an open system. The components are interrelated and share a common purpose to form a whole. An open system such as a human organism or a process such as the nursing process interacts with the environment, exchanging information between the system and the environment. A system is composed of separate components, and there are two types of system, open or closed. Neuman's systems theory defines a total-person model of holism and an open-systems approach.
A nursing student notes the characteristics of middle-range theories. Which points noted by the nursing student are accurate? Select all that apply. 1 Middle-range theories are systematic and broad in scope and complexity. 2 Middle-range theories provide a basis to help nurses understand how clients cope with uncertainty and the illness response. 3 Middle-range theories do not address a specific phenomenon and do not reflect practices such as administration, clinical, or teaching. 4 Middle-range theories include Mishel's theory of uncertainty in illness, which focuses on a client's experiences with cancer while living with continual uncertainty. 5 Middle-range theories tend to focus on a specific field of nursing (such as uncertainty, incontinence, social support, quality of life, and caring) rather than reflect on a wide variety of nursing care situations.
Ans: 2, 4, 5 Middle-range theories provide a basis to help nurses understand how clients cope with uncertainty and the illness response. Mishel's theory of uncertainty in illness is an example of a middle-range theory; it focuses on a client's experiences with cancer while living with continual uncertainty. Middle-range theories tend to focus on a specific field of nursing (such as uncertainty, incontinence, social support, quality of life, and caring) rather than reflect on a wide variety of nursing care situations. Middle-range theories are more limited in scope and less abstract than grand theories. Middle-range theories address a specific phenomenon and reflect practices such as administration, clinical, or teaching.
Which system is used by a health care facility to determine certain aspects of client satisfaction? 1 Six Sigma 2 Value Stream Analysis 3 Health Care Effectiveness Data and Information Set (HEDIS) 4 The Hospital Consumer of Assessment of Healthcare Providers and Systems (HCAHPS)
Correct ans: 2 HCAHPS is a standardized survey developed to measure client perceptions of their hospital experience. The survey asks 27 questions about the client's hospital experience. The survey is taken by clients who were discharged from the hospital between 48 hours and six weeks ago. Six Sigma is a data-driven approach to process improvement that reduces variation in the process. Value Stream Analysis focuses on the improvement of processes. It studies each step of a process to determine if that step adds value to that process. It also determines if the process reduces the organization's time, cost, and resources. The National Committee for Quality Assurance (NCQA) created HEDIS to collect various data to measure the quality of care and services provided by different health plans. It is the database of choice for the Centers for Medicare and Medicaid Services.
Which type of theory is the Neuman systems model? 1 Grand theory 2 Descriptive theory 3 Prescriptive theory 4 Middle-range theory
I put 4 ans: 1 Neuman systems model is an example of a grand theory that provides a comprehensive foundation for scientific nursing practice, education, and research. Theories related to growth and development are descriptive theories. Prescriptive theories address nursing interventions for a phenomenon, describe the condition under which the prescription occurs, and predict the consequences. Mishel's theory of uncertainty is a prescriptive theory. Middle-range theories tend to focus on a specific field of nursing. Mishel's theory of uncertainty in illness is a middle-range theory.