Questions 372 Exam final review
7. A person receiving healthcare insurance from his employer knows that he should check the approved list of contracted healthcare providers before seeking services in order to receive them at a lower cost. What type of insurance is most likely involved? A) Medicaid B) preferred provider organization C) health maintenance organization D) long-term care insurance
PPO
An unintentional tort
is an unintended wrongful act against another person that produces injury or harm. An example of an unintentional tort would be leaving the side rails down, and the client falls and is injured.
1.A nurse is arrested for possession of illegal drugs. What kind of law is involved with this type of activity? A) civil B) private C) public D) criminal
D
. Which source of law best addresses a situation where nurse accidentally administers an incorrect dosage of morphine sulfate to the client? 1. Civil law 2. Criminal law 3. Common law 4. Administrative law
1
13. The nurse on the unit is determining which activities may be delegated to assistive personnel. Assuming that the nurse assistant is competent, which one of the following activities may be safely delegated by the registered nurse? 1. Vital signs on a stable client 2. An admission history on a new client 3. Initial transfer of a postoperative client 4. Administration of medications prepared by the nurse
1
18. Which of the following clients would most benefit from the case manager model of nursing care? 1. A client diagnosed with end-stage renal failure 2. A client who has a chronic wound on the left foot 3. A client newly diagnosed with type 2 diabetes mellitus 4. A postoperative client who had a cholecystectomy (gallbladder removal)
1
24. A nurse who performs a skin assessment while bathing an immobile client would be displaying: 1. Efficiency 2. Leadership 3. Organization 4. Effectiveness
1
30. An employee is able to receive health insurance from a former employer after changing jobs because of the: a. Health Insurance Portability and Accountability Act (HIPAA) b. Omnibus Budget Reconciliation Act c. Balanced Budget Act of 1997 d. Social Security Act
A HIPAA is a federal intervention to protect health insurance coverage for workers and families following a job change or loss.
1. Factors that influence health care costs include (select all that apply): a. Technology and intensity b. Demographics—the aging population c. Chronic illness d. Use of the health care system ANS: A, B, C
ABC
2. To achieve Magnet status, the nursing staff of a hospital must exhibit: (Select all that apply.) 1. A "client first" mentality 2. Autonomy of personal practice 3. Strong involvement in life-long learning 4. Ability to use "state of the art" technology 5. Strong nurse-health care provider collaboration 6. Clinical competence through earned certifications
ANS: 1, 2, 3, 5, 6
Which of the following statements regarding utilization of personnel made by a new graduate nurse requires immediate follow-up by the nurse's mentor? 1."My LPN is really good with dressings, so I usually delegate them to her." 2."I always take the time to ambulate a post op client the first time out of bed." 3."I always try to help my nursing assistant with the clients who require a total bed bath." 4."I have my nursing assistant take and document all vital signs and intake and outputs."
ANS: 4 The nurse is responsible for determining whether to perform an intervention or to delegate it to another member of the nursing team. Assessment of a client directs the decision about delegation and not the intervention alone. Vital signs are important indicators of a client's health status and the task should be delegated to ancillary personnel only when the client is in a stable condition; otherwise, the nurse should be responsible. The other options reflect responsible assignment of personnel.
1. The five rights of delegation include (Select all that apply.) a. Right task. b. Right circumstances. c. Right monetary compensation. d. Right person. e. Right direction. f. Right opinion. g. Right supervision.
ANS: A, B, D, E, G
1. Supply and demand is illustrated when: a. The demand for nurses in public health is low, but the supply is high b. Few goods or services are available, the price tends to rise c. Supplies are low, nurses must find alternate resources d. Lesser-developed countries receive supplies from other countries
B
1. The allocation of scarce resources within the health care sector and the focus on resource allocation issues related to producing and distributing health care is called: a. Economics b. Health economics c. Economic evaluation of health care d. Microeconomic theory
B
11. An elderly woman has total care of her husband with Alzheimer's disease. What type of care might the nurse suggest to give her some much-needed time of her own? A) primary care B) respite care C) bereavement care D) palliative care
B
14.A nurse believes in listening to patients and coworkers more than talking to them, allowing more personal control for all involved. This is a quality of which of the following managerial mind-sets? A) reflective B) analytical C) worldly D) collaborative
D
12. What population do hospice nurses provide with care? A) those requiring care to improve health B) children with chronic illnesses C) dying persons and their loved ones D) older adults requiring long-term care
C
15. Medicare uses a prospective payment plan based on diagnosis-related groups (DRGs). What are DRGs? A) locally supported healthcare financing, usually by donations B) a public assistance program for low-income individuals C) predetermined payment for services based on medical diagnoses D) a private insurance plan for subscribers who pay a copayment
C
2. On admission to the hospital, a terminal cancer patient says he has a living will. This document functions to state the client's desire to: a. Receive all means of technical assistance and equipment used to prolong his life b. Have his wife make decisions regarding his care c. Be allowed to die without life-prolonging techniques d. Have a lethal injection administered to relieve his suffering
C
15. In which of the following conflict resolution strategies is the conflict rarely resolved? A) collaborating B) compromising C) competing D) smoothing
D
27.Which of the following tasks could be delegated to unlicensed assistive personnel? A) an initial assessment of a patient B) determination of a nursing diagnosis C) evaluation of patient progress with the nursing care plan D) assisting patients with hygiene
D
29. A physician receives a set amount of money to provide care to a given group of clients for a set period of time. This is an example of: a. Retrospective reimbursement b. Prospective reimbursement c. Fee-for-service d. Capitation
D Capitation describes the practice of paying physicians and other practitioners a set amount to provide care to a given client or group of clients for a set period of time and amount of money. This is similar to prospective reimbursement for health care organizations.
13.A nurse does not assist with ambulation for a postoperative patient on the first day after surgery. The patient falls and fractures a hip. What charge might be brought against the nurse? A) assault B) battery C) fraud D) negligence
D CIVIL LAW
15. Swanson's theory of caring is best demonstrated when the nurse: 1. Demonstrates efficiency when performing ordered treatments 2. Offers to stay with the client during a painful bedside procedure 3. Administers the client's pain medication promptly when requested 4. Frequently updates a family regarding a client's status during surgery
2 Swanson's includes the 5 components of caring
20. Which of the following actions best reflects accountability for the client's care outcomes? 1. Reassessing a client's BP when the reported value is higher than usual 2. Assisting a team member in providing a client with a complete bed bath 3. Reevaluating a client's pain 30 minutes after administering pain medication 4. Asking a client's daughter to bring her father's non-skid slippers to the hospital
1 Accountability refers to individuals being responsible for their actions. It means that a nurse accepts the commitment to provide excellent client care and the responsibility for the outcomes of the actions in providing that care. Reassessing an abnormally high BP is the best example of nursing accountability because it shows the nurse being responsible for the accuracy of the assessment. The remaining options better reflect nursing responsibility.
1. When the oncology unit's interdisciplinary team meets every Monday morning at 0830 to discuss the unit's individual clients, the group is best displaying: 1. Staff education 2. Collaborative practice 3. Team communication 4. Nursing shared governance
2
15. The primary benefit of achieving Magnet status is the nursing staff is empowered to make innovative changes that: 1. Promote nursing autonomy 2. Positively affect client care outcomes 3. Enhance the perception of the nursing profession 4. Strengthen the collaborative RN/MD relationship
2
19. A nurse stealing narcotics from an acute care nursing unit is guilty of a: 1. Civil offense 2. Criminal offense 3. Common law offense 4. Administrative law offense
2
11. Accountability is a critical aspect of nursing care. An example of a specific decision-making process of accountability is demonstrated by: 1. Selecting the medication schedule for the client 2. Implementing discharge teaching plans that meet individual needs 3. Evaluating the client's outcomes following implementation of care 4. Promoting participation of all staff members in regular unit meetings
3
8. Indicators in a quality improvement program that evaluates the manner in which care is delivered are: 1. Structure indicators 2. Team indicators 3. Process indicators 4. Client indicators
3
28. Which of the following statements made by a nurse related to the organization of client care requires follow-up by the mentor? 1. "I had my LPN bring the Foley catheterization supplies into the room so they'd be there when I got there." 2. "I delegated all the stable vital signs to my nursing assistant and the treatments to the LPN." 3. "I was taking vitals on one client, dangling a second client while I had the third expelling an enema." 4. "Organization was never a strength of mine, but I believe I'm getting better at completing all my client's care."
3 Good time management involves completing one task before starting another.
3. A unit manager on a busy multi-service medical nursing unit decides to take responsibility for the direct client care of one of the many new admissions. Later the manager decides she is too busy to give adequate client care. Which of the following situational leadership styles does the nurse manager need to apply? 1. Coaching 2. Supporting 3. Delegating 4. Directing
3 Delegation is transferring responsibility for the performance of an activity or task while retaining accountability for the outcome. To be more efficient in providing adequate client care, the manager needs to use delegation.
1. It is necessary for the nurse manager to delegate tasks to the staff. Which of the following is a requirement of the delegation process? 1. Working alongside the staff to evaluate their care 2. Functioning from a laissez-faire style of leadership 3. Obtaining the employee's voluntary acceptance of the task 4. Communicating the work assignment in understandable terms
4
16. The newly enacted Health Insurance Portability and Accountability Act (HIPAA) of 2003 requires: 1. Insurance coverage for all clients 2. Policies on how to report communicable diseases 3. Limits on information and damages awarded in court cases 4. Safeguards to protect written and verbal information about clients
4
20. The case of a nurse accused of unethical nursing conduct will be heard by the state board of nursing. This is an example of: 1. Civil law 2. Criminal law 3. Common law 4. Administrative law
4
4. Which of the following statements best reflects the autocratic style of leadership? 1. "Let's discuss this case study thoroughly and decide on a plan of action as a group." 2. "I'll try to pair you in comparable work teams, and let's evaluate the success of this approach in 2 weeks." 3. "Everyone knows their work assignment, so let's not meet together unless we have an unexpected crisis." 4. "I'll consider each of your requests, and then I'll give you the guidelines for establishing new acuity ratings for our clients."
4
5. Although there are similarities in the different nursing theories, there are key elements that distinguish one from another. The emphasis of Jean Watson's conceptual model is that: 1. Self-care maintains wholeness 2. Stimuli disrupt an adaptive system 3. Subsystems exist in dynamic stability 4. Caring is central to the essence of nursing
4
9. A threshold of 90% is identified for an outcome indicator in the quality improvement program. Which of the following situations indicates a need for further review of the quality improvement plan? 1. The waiting time for clinic appointments has decreased 96%. 2. Clients with renal dialysis expressed a 95% satisfaction with their care. 3. In 93% of clients, subjective expressions of postoperative pain have decreased. 4. Wound infections are evident in 92% of clients after care of their IV access ports.
4
9. The Joint Commission (TJC) sets standards of care, in which an institution is required to have: 1. Limits of professional liability 2. Educational standards for nurses 3. A delineated scope of practice for health professionals 4. Written nursing policies and procedures for client care
4
The nurse understands the implications of the Patient Self-Determination Act. This legislation requires that: 1. Clients designate a power of attorney 2. DNR orders for clients meet standard criteria 3. Organ donation is required upon death, if possible 4. Information be provided to the client regarding rights for refusal of care
4
19. Which of the following actions is the best example of a nurse exercising nursing authority? 1. Assigning team responsibilities to individual team members 2. Evaluating a team member's ability to perform a bladder scan 3. Readjusting a client's turning schedule to provide hourly repositioning 4. Determining that a client will not be ambulated based on assessment findings
4 Authority refers to legitimate power to give commands and make final decisions specific to a given position. Canceling a client's ambulation is the best example because it shows critical thinking in determining the appropriateness of an intervention. The remaining options are better examples of nursing responsibility.
16.A nurse using the principle-based approach to patient care seeks to avoid causing harm to patients in all situations. This principle is known as: A) nonmaleficence B) justice C) fidelity D) autonomy
A
23. Which of the following organizations has established standards for clinical nursing practice? A) American Nurses Association B) National League for Nursing C) International Council of Nurses D) State Board of Nursing
A
4. Implementation of a teen pregnancy prevention program in a high school is shown to decrease the rate of teen pregnancy. This is an example of: a. Effectiveness b. Efficiency c. Microeconomics d. Production
A
4.A student nurse is working in the library on her plan of care for a clinical assignment. The patient's name is written at the top of her plan. What ethical responsibility is the student violating? A) confidentiality B) accountability C) trust D) informed consent
A
7. What type of leader shares decisions and activities with group participants? A) democratic B) autocratic C) laissez-faire D) situational
A
Stephanie considers shifting to transformational leadership. Which of the following statements best describes this type of leadership? A Uses visioning as the essence of leadership. B Serves the followers rather than being served. C Maintains full trust and confidence in the subordinates D Possesses innate charisma that makes others feel good in his presence.
A
11. When dealing with the concept of "touch," the nurse realizes what with regard to contact touch? a. Involves only skin-to-skin contact b. Involves eye contact c. Occurs only when tasks are being performed d. Is used only to protect the patient
A Contact touch involves obvious skin-to-skin contact, whereas noncontact touch refers to eye contact
8. Providing "presence" involves "being there" and "being with." What does this involve? a. Closeness and a sense of caring b. Focusing on the task that needs to be done c. Jumping in to provide patient comfort d. Being there without an identified goal
A Providing presence is a person-to-person encounter conveying closeness and a sense of caring. "Being there" seems to depend on the fact that a nurse is attentive to the patient more than the task. "Being with" means being available and at the patient's disposal. If the patient accepts the nurse, the nurse will be invited to see, share, and touch the patient's vulnerability and suffering. Jumping in may not be welcomed. Being there is something the nurse offers to the patient with the purpose of achieving some goal, such as support, comfort, or encouragement.
18. A nurse is assigned to care for the following patients who all need vital signs taken right now. Which of these patients is most appropriate for the nurse to delegate vital sign measurement to nursing assistive personnel (NAP)? a. Patient scheduled for a procedure in the nuclear medicine department b. Patient transferring from the intensive care unit (ICU) c. Patient returning from cardiac catheterization d. Patient returning from hip replacement surgery
A The nurse does not assign vital sign measurement or other tasks to NAP when patients are experiencing a change in level of care. The patient awaiting the procedure in nuclear medicine is the only patient who has not experienced a change in level of care. According to the rights of delegation, tasks that are repetitive, require little supervision, are relatively noninvasive, have results that are predictable, and have minimal risk can be delegated to assistive personnel. The patient in this question with the most predictable condition is the patient awaiting the nuclear medicine procedure. Once the nurse determines that the other patients are stable, the nurse could delegate their future vital sign measurement to the NAP. However, it is important for the nurse to assess patients coming from the ICU, the cardiac cath lab, and surgery when they first arrive on the unit.
9. The patient is to have thoracentesis at the bedside but tells the nurse that he is afraid and would like to cancel. The nurse sits with the patient and asks him to describe his fears. She then explains the procedure and assures the patient that she will be with him during the procedure. The patient agrees to have the procedure, and during the procedure, the nurse stays with the patient, explaining each step and providing encouragement. How has the nurse helped this patient? a. Providing a presence b. Listening c. Providing touch d. Providing family care
A The nurse's presence helps to calm anxiety and fear related to stressful situations. Giving reassurance and thorough explanations about a procedure, remaining at the patient's side, and coaching the patient through the experience all convey a presence that is invaluable to the patient's well-being. Listening and touch can be part of the "presence" but are not its entirety. No family was involved in this scenario.
15. A patient with an indwelling urinary catheter has been given a bed bath by a new nursing assistant. The nurse evaluating the cleanliness of the patient notices crusting at the urinary meatus. The best next action of this nurse is to a. Ask the nursing assistant to observe while the nurse performs catheter care. b. Leave the room and ask the nursing assistant to go back and perform proper catheter care. c. Discontinue the catheter. d. Document the incident in the patient's chart.
A Because the nursing assistant is new, it is best for the nurse to perform catheter care while the assistant observes. This action will ensure that the assistant has been shown the proper way to perform the task and fosters collaboration rather than leaving the room just to tell the assistant to come back. While the nurse is in the room, the nursing assistant should perform the task.
20. Which statement about the Medicare program is accurate? a. Part A provides coverage for hospitalization. b. Part A requires payment of a monthly premium for coverage. c. Part B provides payment for home health services and extended care facilities. d. Part B is available without cost to all elderly people who have paid social security taxes.
A Medicare Part A covers hospital care, home care, and skilled nursing care. Medicare Part B is a supplemental program available to all Medicare-eligible persons for a monthly premium.
32. A public health nurse is counseling a client who is trying to determine if a health maintenance organization (HMO) or preferred provider organization (PPO) will provide the better health care coverage. One main difference between these two types of managed care arrangements is: a. HMOs provide comprehensive care to its members for a fixed fee. b. PPOs designate providers that members can choose. c. PPOs employ physicians as PPO employees. d. HMOs provide financial incentives to encourage members to select HMO providers.
A The HMO is a provider arrangement whereby comprehensive care is provided to members for a fixed "per member per month" fee. A PPO uses predetermined rates for services to be delivered to members. HMOs have multiple models of delivery including the staff model, where physicians are HMO employees. PPOs provide financial incentives to encourage members to select PPO providers.
17. A nursing assistant reports seeing a reddened area on the patient's hip while bathing the patient. The nurse should a. Go to the patient's room to assess the patient's skin. b. Document the finding per the nursing assistant's report. c. Request a wound nurse consult. d. Ask the nursing assistant to apply a dressing over the reddened area.
A The nurse needs to assess the patient's skin. Assessment should not be delegated; it is the responsibility of the licensed professional nurse. The nurse needs to document the assessment findings objectively, not subjectively per the nursing assistant. Before requesting a consult or determining treatment, the nurse needs to assess the skin.
2. The concept of "knowing" the patient comprises both the nurse's understanding of a specific patient and the nurse's subsequent selection of interventions. To know a patient means that the nurse (Select all that apply.) a. Avoids assumptions. b. Focuses on the patient. c. Engages in a caring relationship. d. Forms the relationship quickly.
A B C
1. The client has an order for intramuscular (IM) morphine sulfate as needed for pain. A nurse accidentally administers an incorrect dosage of the morphine sulfate to the client. Which source of law best addresses this situation? a. Civil law b. Criminal law c. Common law d. Administrative law
A a. Civil laws protect the rights of individual persons within our society and encourage fair and equitable treatment among people. Generally, violations of civil laws cause harm to an individual or property, and damages involve payment of money. Administering an incorrect dosage of morphine sulfate would fall under civil law because it could cause harm to an individual. b. Criminal laws prevent harm to society and provide punishment for crimes (often imprisonment). c. Common law is created by judicial decisions made in courts when individual legal cases are decided (e.g., informed consent). d. Administrative law is created by administrative bodies, such as State Boards of Nursing when they pass rules and regulations (e.g., the duty to report unethical nursing conduct).
17.Planned change is a purposeful, systematic effort to alter or bring about change. What occurs next after alternative solutions to a problem are determined and analyzed? A) All of the alternative solutions are implemented. B) A course of action is chosen from among the alternatives. C) The effects of the change are evaluated. D) The change is stabilized and established.
B
24. What is the primary purpose of standards of nursing practice? A) to provide a method by which nurses perform skills safely B) to ensure knowledgeable, safe, comprehensive nursing care C) to establish nursing as a profession and a discipline D) to enable nurses to have a voice in healthcare policy
B
26.A patient tells the nurse that he does not want to have a painful procedure. By respecting and supporting the patient's right to make decisions, what is the nurse demonstrating? A) confidentiality B) advocacy C) altruism D) justice
B
3. A junior nursing student prepares to give her client an injection. What standard of care applies to the student nurse's conduct when providing care normally performed by a registered nurse (RN)? The student is held to: a. A standard of care of an unlicensed person b. The same standard of care as an RN c. A standard similar to but not the same as the staff nurse with whom she is assigned to work d. No special standard of care because her faculty member is responsible for her conduct
B
1. It is necessary for the new nurse manager to delegate tasks to the staff. What is a requirement for the nurse manager in this delegation process? a. Obtaining the employee's voluntary acceptance of the task b. Communicating the work assignment in understandable terms c. Functioning from a laissez-faire style of leadership d. Working alongside the staff to evaluate their care
B b. When delegating, the nurse should always provide unambiguous and clear directions by describing a task, the desired outcome, and the period within which the task should be competed. a. Tasks should be delegated to those who are capable, not necessarily to those who are willing. c. A laissez-faire style of leadership is not a requirement for delegation. d. The nurse manager does not necessarily have to work alongside staff to evaluate their care. The nurse manager can often evaluate staff performance in client outcomes.
22. A Medicare recipient has elected to pay a monthly premium for Medicare that will cover expenses, such as laboratory services and equipment. This part of Medicare is called Medicare Part: a. A b. B c. C d. D
B Medicare Part B is a supplemental (voluntary) program; it provides coverage for services that are not covered by Part A, such as laboratory services, ambulance transportation, prostheses, equipment, and some supplies.
21. Medicare and Medicaid are: a. Available to any citizen who wishes to enroll b. Two federal programs that provide insurance to special groups c. Private insurance providers d. Funded by the state government
B Medicare provides insurance for persons over 65, and Medicaid is for low-income and needy children, aged, blind, and/or disabled. Medicare is financed by the federal government. Medicaid is jointly financed by states and the federal government. They are not private insurance providers by definition.
1. Caring is a universal phenomenon that influences the ways in which people (Select all that apply.) a. Learn. b. Think. c. Believe. d. Feel. e. Behave.
B D E
20. A patient nearing the end of life requests that he be given no food or fluids. The physician orders the insertion of a nasogastric tube to feed the patient. What situation does this create for the nurse providing care? A) nurse must follow the physician's orders B) an inability to provide care for the patient C) an ethical dilemma about inconsistent courses of action D) a barrier to establishing an effective nurse-patient relationship
C
21.A nurse manager has encountered resistance to a planned change. What is one way the nurse can overcome the resistance? A) Tell the staff that if they don't like it, they can quit. B) Implement change rapidly and all at once. C) Encourage open communication and feedback. D) Let the staff know that the change is mandated.
C
22. What is one way in which nurses can help shape healthcare reform? A) do their job and do it well B) refuse to participate in organizations C) support legislation to improve care D) become a member of a support group
C
25.A nurse is considering the delegation of administering medications to an unskilled assistant. What is the first question the nurse must ask herself before doing so? A) Has the assistant been trained to perform the task? B) Have I evaluated the patient's response to this task? C) Is the delegated task permitted by law? D) Is appropriate supervision available?
C
27.A patient, unsure of the need for surgery, asks the nurse, "What should I do?" What answer by the nurse is based on advocacy? A) "If I were you, I sure would not have this surgical procedure." B) "Gosh, I don't know what I would do if I were you." C) "Tell me more about what makes you think you don't want surgery." D) "Let me talk to your doctor and I will get back to you as soon as I can."
C
6. What is the legal source of rules of conduct for nurses? A) agency policies and protocols B) constitution of the United States C) American Nurses Association D) Nurse Practice Acts
C
7. Nurses can promote efficiency by: a. Evaluating how well a program of service achieves what was intended b. Trying new products provided by sales representatives c. Using time wisely by delegating non-nursing tasks to unlicensed care providers d. Setting up a clinic to look aesthetically pleasing to clients
C
10. The nurse has cared for a patient for several days. The patient is terminal and is very near death. The nurse notices the heart rate on the monitor decreasing and then the absence of a pattern. The family is standing at the patient's bed, and when the nurse checks the patient and finds no pulse or blood pressure, the family begins sobbing and hugging each other. Some hold the patient's hand. The nurse is overwhelmed by the presence of grief and leaves the room to cry in the nurses' lounge. What is the nurse demonstrating? a. Task-oriented touch b. Caring touch c. Protective touch d. None of the above
C When a nurse withdraws or distances herself or himself from a patient when the nurse is unable to tolerate suffering or needs to escape from a situation that is causing tension, the nurse is practicing a form of protective touch that is used to protect the nurse emotionally. Task-oriented touch is done when performing a task or procedure. Caring touch is a form of nonverbal communication that influences a patient's comfort and security, enhances self-esteem, and improves reality orientation.
6. Conducting a class at a public health clinic on breast self-examination to a group of 50 women is an example of: a. Supply and demand b. Market c. Efficiency d. Effectiveness
C Efficiency refers to producing maximum output, such as a good or service, or using a given set of resources or inputs, such as labor, time, and available money. Teaching one topic to many people is an example of this.
25. Which service would be covered under Medicare Part A? a. Blood draw to assess PT/INR b. Physical therapy visit c. Stay in skilled nursing facility d. Transportation by an ambulance
C Medicare Part A covers hospital care, home care, and skilled nursing care.
4. The patient has had a colostomy placed but has not yet been able to look at it. The nurse is given the task of teaching the patient how to care for it. The nurse sits with the patient, and together they form a plan on how to approach dealing with colostomy care. Which caring process is the nurse performing? a. Knowing b. Doing for c. Enabling d. Maintaining belief
C Enabling is facilitating another's passage through a life transition and unfamiliar events. Working with the patient to find alternate ways to help him face his fears and perform the task is doing just that. Knowing is striving to understand an event because it has meaning in the life of another. This must be done before enabling can occur. Doing for is doing for the other as he or she would do for self if it were at all possible. The nurse here is not doing for the patient but is helping him find a way that he can do it. Maintaining belief is sustaining faith in the other's capacity to get through an event or transition and face a future with meaning. This may be an underlying theme to the process but is not what the nurse is actually doing.
19. Which of these staff members does the staff nurse assign to provide morning care for an older adult patient who requires assistance with activities of daily living? a. Licensed vocational nurse b. Cardiac monitor technician c. Nursing assistive personnel (NAP) d. None of the above; the nurse needs to provide morning care to this patient.
C The NAP is capable of caring for this patient and is the most cost-effective choice. The cardiac monitor technician's role is to watch the cardiac monitors for patients on the floor. The nurse and the licensed vocational nurse are not the most cost-effective options in this case, even though each could assist with activities of daily living. These nurses would be better used to administer medications, perform assessments, etc.
15.A nurse is providing nursing care in a neighborhood clinic to single pregnant teens. Which of the following actions is the best example of using the collaborator role as a nurse? A) Discussing the legal aspects of adoption for teens wishing to place their infants with a family B) Searching the Internet for information on child care for the teens who wish to return to school C) Conducting a patient interview and documenting the information on the patient's chart D) Referring a teen who admits having suicidal thoughts to a mental healthcare specialist
D
29. Which of the following is a current trend affecting nursing education and practice? A) over abundance of graduating nurses B) office-based care delivery systems C) increase in length of hospital stay D) increase in chronic health conditions
D
3. Which of the following phrases is characteristic of case management as a method of healthcare delivery? A) brings healthcare to where people live and work B) essentially the same method as primary care C) planned and monitored by patients themselves D) maximize positive outcomes and contain costs
D
31. An example of managed care is: a. Medicare b. Medicaid c. Medical savings accounts d. Health maintenance organizations
D
6.A nurse manager makes all of the decisions for staff activities. What type of leadership is demonstrated by this action? A) democratic B) self-governance C) laissez-faire D) autocratic
D
7. A staff nurse delegates a task to a nursing assistant, knowing that the assistant has never performed the task before. As a result, the patient is injured, and the nurse defensively states that the nursing assistant should have known how to perform such a simple task. This nurse is demonstrating lack of a. Responsibility. b. Autonomy. c. Authority. d. Accountability.
D
8. A nurse leader is described as charismatic, motivational, and passionate. Communications are open and honest, and the nurse is willing to take risks. What type of leadership is the nurse practicing? A) democratic B) autocratic C) quantum D) transformational
D
In Lewin's classic theory of change, what happens during unfreezing? A) Planning is conducted. B) Change is initiated. C) Change becomes operational. D) The need for change is recognized.
D
17. The nurse is investigating legislation that may have an effect on nursing practice. The nurse finds that the newly enacted Health Insurance Portability and Accountability Act (HIPAA) of 2003 requires: a. Insurance coverage for all clients b. Policies on how to report communicable diseases c. Limits on information and damages awarded in court cases d. Safeguards to protect written and verbal information about clients
D The Health Insurance Portability and Accountability Act (HIPAA) requires all hospitals and health agencies to have specific policies and procedures in place to ensure that reasonable safeguards protect written and verbal communications about clients.
12. Which of these approaches would be most appropriate for a nurse to take when faced with the challenge of performing many tasks in one shift? a. Evaluate the effectiveness of all tasks when all tasks are completed. b. Delegate tasks the nurse does not like doing. c. Do as much as possible by oneself before seeking assistance from others. d. Complete one task before starting another task.
D The appropriate clinical care coordination skill in these options is to complete one task before starting another task.
2. In which nursing care delivery model are clinicians held accountable for some standard of cost-effectiveness and quality of care? a. Total patient care b. Primary nursing c. Team nursing d. Case management
D What is unique about case management is that clinicians, as individuals or as part of a collaborative group, oversee the management of patient groups with specific case types and usually are held accountable for some standard of cost management and quality. Case management is a care approach that coordinates and links health care services to patients and families while streamlining costs
4. A nurse manager is evaluating patient outcomes on the hospital unit. The nurse manager discovers that the re-admission rate of hospitalized patients is very high on this unit. The nurse manager desires improved coordination of care and accountability for cost-effective quality care. The nursing care delivery model best suited to these needs is a. Total patient care. b. Primary nursing. c. Team nursing. d. Case management.
D What is unique about case management is that clinicians, as individuals or as part of a collaborative group, oversee the management of patient groups with specific case types and usually are held accountable for some standard of cost management and quality. Case management is a care approach that coordinates and links health care services to patients and families while streamlining costs
16. The nurse understands the implications of the Patient Self-Determination Act. This legislation requires that: a. Clients designate a power of attorney b. DNR orders for clients meet a standard criterion c. Organ donation is required on death, if possible d. Information be provided to the client regarding rights for refusal of care
D The Patient Self-Determination Act requires health care institutions to provide written information to clients concerning the clients' rights under state law to make decisions, including the right to refuse treatment and formulate advance directives.
15. Which individual would most likely experience a barrier when accessing health care? a. A 40-year-old female who speaks English b. A 25-year-old female with health insurance c. A 50-year-old male with hypertension d. A 30-year-old male who is unemployed
D Barriers to accessing care include the inability to afford health care, lack of transportation, physical barriers, communication problems, child care needs, lack of time or information, or refusal of services by providers. The unemployed male is most likely to experience a barrier because of not having a job, which may reduce his access to health insurance and limit his income.