Transitions Exam 2
The nurse wants to know how similar the 7-minute screen (7MS) is to the Mini-Mental State Examination (MMSE) in accurately screening for dementia. Can you distinguish the correct clinical question category for this type of question? a. Prognosis b. Diagnostic c. Harm/etiology d. Prevention
B
The nurse who respects the patient's right to refuse treatment is following which bioethical principle? a. Justice b. Beneficence c. Autonomy d. Fidelity
C
The nurse is caring for a patient following painful radiation treatment for newly diagnosed cancer. Which question, if asked by the nurse in the orientation phase of the nurse-patient relationship, is most likely to elicit a meaningful response? a. "Don't you love this weather?" b. "How have things been going for you?" c. "Tell me why you didn't stop smoking." d. "Are you having any pain?"
D
The nurse who fails to remove a patient from an unsafe situation has violated which bioethical principle? a. Justice b. Fidelity c. Veracity d. Beneficence
D
What is the function of Continuous Quality Improvement? a. To improve staff compliance with training b. To assist staff in building on nursing skills c. To assess patient care, from admission to discharge d. To improve collaboration of staff
C
The physician orders a dose of morphine that the nurse considers excessive. The nurse should a. administer the medication. b. ask another nurse to administer the medication. c. call the supervisor. d. contact the physician.
D
A nurse has a plan for teaching the patient about a newly diagnosed disease. On entering the room the nurse realizes that the patient is blind. What considerations for communication should the nurse be aware of? a. Tone, pitch, inflection, and intensity affect how messages are communicated. b. Messages are clearer when verbal communication and nonverbal cues are opposite. c. Verbal communication must be understood within the context of a patient's culture, gender, and age. d. Facial expressions and eye contact are characteristics of verbal communication.
A
A nurse manager attempts to explain why the greatest number of medication errors occurs during the evening shift. The nurse manager chooses a quasi-experimental design to study this relationship. Why did the nurse manager choose this type of research design? a. It does not allow for complete control over the variance. b. It allows for randomization. c. It allows for control over the independent variable. d. It requires manipulation of the variable.
A
A nurse manager is designing orientation processes for new graduate nurses by using the work of Hansten and Washburn as a model. All of the new graduates are instructed in the model during orientation. The manager knows that a graduate nurse needs more instruction if which comment is made during the evaluation interview? a. "I think I need more mentoring to continue to build my thinking skill." b. "Improving my critical thinking will assist in decreasing the risk of sentinel events for my patients." c. "Using my improving thinking skills will help improve patient care." d. "If my thinking skills are what they should be, fewer errors will happen in patient care."
A
An RN has been working with a patient on the nursing unit for a 12-hour shift. The nurse recognizes that each time the patient is turned to the left, the blood pressure drops 15 mm Hg. The same RN has seen this phenomenon in several other patients and makes the connection that patients with right-sided heart failure (the medical diagnosis) will experience a blood pressure drop if they are turned to their left side. This type of reasoning is called a. inductive. b. deductive. c. reductive. d. reflective.
A
An RN has collected extensive data on a patient with attention deficit disorder. When weighing potential actions to help the patient and considering alternative solutions, which of the attributes of the critical thinker is the RN demonstrating? a. Creativity b. Rational thought c. Reflection d. Curiosity
A
Assessment of patient learning is a required element of patient education. Shorter hospital stays make this step challenging, and we tend to evaluate learning immediately after teaching. What conclusion can be drawn from this? a. It takes time to truly incorporate what is learned, so immediate evaluation is not as accurate. b. The nurse will not have time to evaluate immediately after teaching. c. The patient will be too tired to participate in the evaluation. d. That would be too much information at one time.
A
Can you explain how the nurse's use of PICO helps to formulate an effective clinical question? a. PICO organizes the elements that guide the clinical question. b. PICO formulates an answer to the clinical question. c. PICO explains the hierarchy of evidence. d. PICO identifies the strength of the evidence.
A
Characteristics of a quantitative study include all of the following except: a. clarifies underlying assumptions. b. asks who, what, why, where, when, or how. c. describes the relationship between variables. d. is highly structured and controlled.
A
Florence Nightingale contributed to nursing in many different ways. The student nurse has an understanding of the history of nursing when she does which of the following? a. Educates another student about the efforts of Florence Nightingale to promote research. b. States that Nightingale is responsible for minor contributions to the early education of nurses. c. Believes that Nightingale was not involved in the theory of nursing. d. States that Nightingale did not assist in the development of the nursing process.
A
If you had access to the following databases for your research, which would you choose to review clinical trials on effective smoking cessation therapies? a. The Cochrane Library b. HealthStar c. Medline d. InfoPOEMS
A
The American Nurses Credentialing Center (ANCC) developed the Magnet Recognition Program for hospitals to address quality patient care. What is the significance of achieving magnet status? a. Excellence in quality patient care and recruitment and retention of nurses b. Excellence in research, patient care, and retention of physicians c. Excellence in recruiting nurses, early discharge, and effective billing d. Excellence in recruitment and retention of ancillary caregivers
A
The chief purpose of evidence-based practice is to a. offer a problem-solving approach to systematically research clinical evidence directed toward a specific patient problem. b. prepare the nurse to conduct specific research in patient care practices. c. prepare the nurse for employment in an evidence-based research center. d. research clinical evidence that covers the entire aspect of a specific problem.
A
The nurse is assessing a patient who needs teaching about how to care for her wound at home. The nurse knows to be sensitive about asking questions that cause embarrassment. Which question is stated in the best manner? a. "Would you like for me to write down how to change this dressing or is it better for you to see a demonstration?" b. "What is the highest grade you completed when you were in school?" c. "Do you read and write?" d. "I am going to give you a handout on how to perform your dressing change. Now don't worry if you do not read, I'll read it to you."
A
The nurse is listening to a lecture on critical thinking. Which statement indicates that teaching has been effective? a. "Critical thinking involves making inferences, solving problems, arriving at decisions." b. "Critical thinking involves persuading others, inducing debate, using intuition." c. "Critical thinking involves making inferences, reducing fractions, making decisions." d. "Critical thinking involves solving problems, elevating issues, reflecting actions."
A
The nurse is listening to a lecture on critical thought. Which statement indicates that the teaching has been effective? a. "Critical thought is a disciplined, rational, and self-directed activity that uses standards and criteria." b. "Critical thought is an intuitive process that relies only on the nurse's experience." c. "Critical thought is a persuasive process leading to sound decisions." d. "Critical thought is a reactive process after an intervention is completed."
A
The process of understanding and applying researched clinical evidence to nursing practice requires the nurse to become information literate. Which action by the nurse best describes the use of information literacy? a. Identifies a specific clinical problem, accesses appropriate resources, and assesses the relevancy of use of information for that particular patient's problem b. Identifies a particular patient problem and immediately notifies the physician and family for treatment c. Identifies the lack of research skills and consults a librarian for a workshop on conducting research studies d. Identifies the lack of research skills and consults a scientific researcher to teach basic computer information
A
What is the major social factor that has developed the role of nursing to what it is today? a. Society's attitude toward the role of women b. Society's lack of qualified health providers c. Society's lack of resources to pay for health care d. Society's lack of education about health care
A
What is the relationship between the design and layout when creating a critical appraisal tool? a. Design and layout differ but measure the same areas. b. Design and layout differ, and reliability measures differ. c. Design, layout, and reliability are similar but relevancy differs. d. Design, layout, and reliability differ but trustworthiness is the same.
A
When preparing for patient teaching what should the nurse do first? a. Assess the learner's needs. b. List key points to be presented. c. Collect the teaching materials. d. Think about how the skill can be done at home.
A
Which fact would you select to describe the mandate by The Joint Commission regarding educating patients? The training and education must be a. specific to the assessed needs, interdisciplinary, and evaluated for effectiveness. b. specific to the assessed needs, cost-effective, and focused. c. based on the patient's ability to learn, cost-effective, and timely. d. specific to assessed needs, timely, and delivered by only one person for continuity.
A
Which patient characteristic must a nurse consider when planning teaching? a. Literacy level b. Discharge instructions c. Good lighting d. Pain medication
A
Which statement best assists the nurse in planning care for the patient who is not adhering to the treatment regimen? a. Patients' health attitudes directly affect behavior and therefore influence adherence. b. Patients usually go to the hospital without preconceived ideas about what is wrong with them. c. Most patients adhere to the advice of health care providers even if they do not believe that the treatment will work. d. Noncompliance with prescribed treatment is irrational behavior.
A
Which statement reflects an important principle to be applied by the nurse who is developing a relevant clinical question regarding a specific patient concern, using PICO? a. The type of question will determine which resources to access. b. A systematic approach determines which questions will be asked. c. The clinical question is formulated at the conclusion of the literature search. d. Background questions are identified at the conclusion of the literature search.
A
Research studies must be scrutinized to be deemed credible and trustworthy. Choose all the strategies that may be used to critically appraise a research study. (Select all that apply.) a. Examine the validity of the research. b. Look at the reference list of the study. c. Look for criteria of inclusion. d. Look for use of PICO format. e. Examine the credentials of the authors. f. Look for a proper sample size.
A, B, C
What characteristics support evidence-based practice (EBP)? (Select all that apply.) a. The nurse's clinical experience is fundamental to the evidence-based practice process. b. Evidence-based practice provides a theoretical framework for accuracy and safety in patient care. c. Evidence-based practice involves the use of a holistic approach to patient care in health care. d. Evidence-based practice is designed to create a generic plan of patient care in clinical settings. e. Evidence-based practice allows the nurse autonomy in patient care because research proves success.
A, B, C
Before signing the verbal orders given earlier, the physician notifies the nurse of incorrectly wording the order. The physician requests the nurse to go back and insert the missing information. Which actions illustrate a lack of knowledge by the nurse? (Select all that apply.) a. Use a black pen and insert the missing information. b. Insist that the physician write a new order. c. Write an addendum clarifying the order. d. Toss the old order and write a new one.
A, B, D
The nurse who can think critically will make more effective clinical decisions, meet more of the patient's needs, and affect positive patient outcomes. How this is accomplished? (Select all that apply.) a. Committing to test one's own thought process for clarity, accuracy, and logic b. Accepting an individual's responsibility to develop critical thinking skills c. Joining nursing organizations to keep current on nursing policies affecting patient care d. Constantly seeking out others for answers to difficult clinical questions and problems e. Requesting that health care organizations adopt and foster a culture of critical thinking f. Maintaining the required amount of continued education units for license renewal
A, B, E
What are the problems with variables? (Select all that apply.) a. Vary from subject to subject b. Determined through statistics c. Difficult to account for them d. Challenging to explain in relation to the study topic e. Testing whether a correlation exists between results
A, C, D
The "graying of America" is estimated to include 65 million older Americans by 2030. What current evidence supports the need for increased nursing knowledge of geriatrics and home health care? (Select all that apply.) a. The elderly utilize more health care dollars per person than younger members of society. b. The elderly rely minimally on Social Security. c. The elderly have chronic illnesses. d. The elderly typically have fewer years of schooling. e. Some elderly are widowed and need assistance with care.
A, C, D, E
Which of the following are most responsible for the emerging use of evidence-based practice (EBP) in health care? (Select all that apply.) a. Accountability by consumers of governmental and health care agencies b. Introduction of national health care guidelines c. Shorter implementation time of new research d. Variability of care among health care practitioners and facilities e. Similarity with other science disciplines and their amounts of research f. Eligibility to receive government grants for research excellence
A, D
A 78-year-old patient has shortness of breath on very slight exertion. The physician has written an order for her to be taught about a 2-gram sodium diet. Based on these data, which factor would be likely to interfere with diet teaching? a. The patient's age b. The patient's shortness of breath c. The patient's reluctance to change d. The chronic nature of the patient's illness
B
A home health nurse is teaching a patient about a new medication he will be starting in the morning. The patient lives with his son's family, including two spirited children less than 6 years old. The patient replies, "I just can't learn new information like I used to." The nurse will plan to a. schedule the patient for daily visits for medication administration. b. provide privacy and minimize distractions and noise and try again. c. teach the patient's family members to give the medications. d. tell the patient it is not safe to take the medication independently.
B
A nurse discusses home arrangements and safety factors related to emptying and changing the patient's new colostomy bag. The patient has strong concerns about visibility of any stored colostomy supplies. Which teaching-learning principle does this example demonstrate? a. Using multiple teaching strategies to accommodate a variety of learning styles. b. Increased effectiveness of teaching by involving the patient in the setting of objectives. c. Paying attention to the timing during the hospitalization and planned discharge date when providing needed information. d. Developing a strong nurse-patient relationship from the beginning of the contract with the patient.
B
A nurse evaluates the results of two different studies examining the relationship between time of day and sundowning in the geriatric setting. After 1 month, the nurse realizes that there is a difference of 1 hour in the instruments used for measurement. What conclusion can be drawn about the type of threat this causes the study? a. Validity b. Reliability c. Causality d. Truthfulness
B
A patient has a problem that prevents him from shaving himself, tying his shoes, or fixing his meals. He is not physically able to compensate for the problem, so he is in need of assistance. Data support the nursing diagnosis "impaired physical mobility" by what mode of reasoning? a. Induction b. Deduction c. Reduction d. Reflection
B
A patient has just been informed by the physician that he will not be discharged today. The nurse brings in the patient's lunch tray and puts it on the overbed tray. The patient pushes it off onto the floor and shouts, "Get out of my room and leave me alone." The nurse's most therapeutic response would be a. "Is there something wrong with your lunch tray?" b. "You seem angry. Can you tell me about it?" c. "Why are you angry? You seemed so much happier earlier today." d. "I'll order you another lunch, and I'll be back when you're in a better mood."
B
Each element of the nursing process involves critical thinking. Which definition of assessment reflects critical thinking? a. Correctly and completely documenting the assessment data on a form b. A process of discovery and decision-making about the nature of the patient's needs c. Using a systematic approach to ensure comprehensive collection of assessment data d. Selecting the most accurate NANDA-I nursing diagnosis for the patient
B
Laura, a nurse manager, is meeting with the staff, which consists of nurses from the Veteran, Baby Boomer, Generation X, and Millennial generations. Which of the following is the best approach to encouraging collaboration and feedback from everyone? a. Ask for volunteers to form a committee to explore the issue. b. Form a committee made up of at least one representative from each generation. c. Form a committee primarily composed of experienced, older nurses. d. Meet with each nurse individually to solicit feedback.
B
Select the hospital patient who has the best chance of avoiding a hospital-acquired infection. a. A 42-year-old patient who had abdominal surgery b. A 35-year-old patient with a closed leg fracture c. A 5-month-old non-breastfed infant d. A 75-year-old patient receiving chemotherapy
B
The RN is documenting the patient's complaint of pain rated 6 on a scale of 0 to 10. Which chart entry would be the most appropriate, if made by the nurse? a. Pt. complaining of pain. MD notified. b. Pt complaining of pain rated at 6 on a scale of 0-10, states "My left leg is really hurting." Pt. grimacing, voice elevated. MD notified. c. Pt. complaining of pain rated at 6 on a scale of 0-10. Appears to be in pain. MD notified. d. Pt. complaining of pain rated 6. Wants more pain medication; appears to be drug-seeking. MD notified.
B
The nurse has just taught an adult patient with a new diagnosis of diabetes mellitus how to check blood glucose. The nurse should document a. "Demonstrated understanding of checking blood glucose." b. that the patient demonstrated the procedure properly and the time it took to complete the educational session. c. the steps of the procedure the patient was taught. d. that the nurse taught the patient how to check blood glucose.
B
The nurse is interested in whether antibiotic therapy or observation only is most effective in the treatment of sinusitis in young adults. Which of the following best describes the type of question being considered? a. Background questions b. Foreground questions c. General knowledge questions d. Both A and B.
B
The nurse is listening to a lecture on Florence Nightingale. Which statement indicates that the teaching has been effective? a. "Nursing is defined as doing as much as possible for each patient." b. "Nursing involves helping the patient restore health and prevent disease or injury." c. "Nursing is management of the patient and control of the environment." d. "Nursing is focused solely on care of the sick patient."
B
The nurse is listening to a lecture on Mildred Montag. Which statement indicates that teaching has been effective? a. "Montag fought for women's rights." b. "Montag promoted the associates degree as a way to enter the field of nursing." c. "Montag was America's first trained nurse." d. "Montag care for tenement families by establishing a visiting nurse service."
B
The nurse is preparing to assess a newly admitted Chinese patient. Which of the following would be most appropriate to assess first? a. Pain b. Language barrier c. Family support d. Religious preference
B
The nurse questions whether treatment with antibiotic therapy is as effective as observation in a 3-year-old boy with otitis media. What combination of information supports the proper order of information needed to compose a PICO statement? a. Effective treatment for otitis media; antibiotic therapy; observation; 3-year-old with otitis media b. Three-year-old with otitis media; antibiotic therapy; observation; effective treatment for otitis media c. Antibiotic therapy; 3-year-old with otitis media; effective treatment for otitis media; observation d. Observation; 3-year-old with otitis media; effective treatment for otitis media; antibiotic therapy
B
The nursing is listening to a lecture on reasoned thought. Which statement indicates that teaching has been effective? a. "Reasoned thought is reflection." b. "Reasoned thought is emotion." c. "Reasoned thought is parity." d. "Reasoned thought is contrast."
B
The nursing student addresses an 86-year-old patient by his first name at their initial meeting. To the patient, this behavior a. is a sign of the nursing student's empathy for the patient. b. could be interpreted as a lack of respect on the part of the student. c. clearly indicates that the student feels comfortable working with the patient. d. indicates that the student is establishing firm boundaries for the relationship.
B
When considering the creation of an environment for emotional support in a therapeutic relationship, the primary focus of the nurse should be a. removing stressors that cause anxiety and fear. b. developing a trusting relationship. c. encouraging the patient to become independent. d. allowing the patient to be in control of medical decision-making.
B
Which is the dominant focus of patient care in the current health care environment? a. To increase cost to increase profit b. To contain rising costs c. To ignore rising costs d. To manage care according to cost
B
Which item would most likely be a barrier to learning for a patient who must begin to care for a large open wound at home? a. Curiosity about the new experience and equipment b. Tendency for uneasiness about making mistakes c. Ability to prioritize tasks d. Understanding that he can promote his own healing
B
Which item would most likely be a barrier to learning for a patient who must begin to wear an insulin pump? a. Curiosity about new experiences and equipment. b. Tendency toward embarrassment about making mistakes and being seen with the pump. c. Ability to prioritize diabetes management. d. Understanding that the patient can promote his or her own well-being.
B
Which step does a researcher first use when starting a new study? a. Data collection b. Refining an abstract idea c. Literature review d. Statistical analysis
B
The nurse recognizes that, to be an effective teacher, communication must be clear. In an educational session for a patient newly diagnosed with congestive heart failure, which statements by the nurse would demonstrate barriers to teaching? (Select all that apply.) a. "Furosemide will increase urination, so you take it every morning." b. "To help reduce the risk of pulmonary edema, your sodium intake must be monitored." c. "Just remember, no sodium!" d. "Pulmonary edema can form if you have too much sodium." e. "You will need to make sure you eat less salt to help prevent fluid from collecting in your lungs."
B, C, D
Based on what you know, what events would you select to show the contributions that Isabel Hampton Robb made to nursing? (Select all that apply.) a. Established a visiting nurse service b. Reduced student working hours c. Wrote a book on the history of nursing d. Promoted licensure exams e. Fought for women's rights and the right to vote
B, D
Which goals best justify the need for evidence-based practice (EBP) in nursing? (Select all that apply.) a. Redesign the health care system and recruit more nurses. b. Improve patient outcomes with evaluations that track outcomes. c. Introduce national health care guidelines and standards. d. Restructure health care delivery and improve quality of health care. e. Apply clinical experience to improve patient care.
B, D
A novice RN is caring for a patient who is saying that something is wrong. Vital signs are normal and there are no new specific findings. The novice RN calls another, more experienced RN who briefly talks with the patient, calls the health care provider, and initiates a transfer to the ICU. Which statement is most likely true of the more experienced RN? a. The experienced RN is an advanced beginner with better assessment skills than the novice nurse. b. The experienced RN is proficient in assessment and the use of hospital protocol. c. The experienced RN is an expert nurse with intuitive judgment that the experienced nurse cannot quite explain. d. The experienced RN is arrogant, foolish, and likely to get in trouble for her assertive behavior.
C
A student understands the contributions of Clara Barton when she states, "Clara Barton a. is known as the Lady with the Lamp." b. fought for women's rights." c. is known as the Angel of the Battlefield." d. was America's first trained nurse."
C
Adult patients are adult learners. Knowing this, the nurse understands the assumptions about adult learners that will help the nurse plan and provide the appropriate education. Which statement provides proof that more instruction about adult learners is needed? a. "Adults will learn as the need develops and the learning will fulfill that need." b. "Adults use their lives as the point of reference for all learning." c. "Adults are visual learners and learn best by taking notes." d. "Adults prefer to have a say in their learning."
C
An 85-year-old patient with chronic health problems is being considered for placement in a long-term care facility after discharge from the hospital. What purpose does the cost-effective nursing strategy of patient teaching help to achieve? a. Providing reasonable expectations from health care b. Giving the patient a sense of control over illness c. Preventing complications of chronic illness d. Increasing patient satisfaction with care
C
Assess the given levels of evidence and choose the one most important when evaluating the strength of a research study. a. Level 3 evidence indicates that specific-quality criteria were met. b. Level 1 evidence implies an association with specific criteria. c. Level 1 evidence indicates that specific-quality criteria were met. d. Level 2 evidence implies a reliable association with specific criteria.
C
It has been said that Florence Nightingale revolutionized nursing. Which example supports this statement? a. She encouraged men to become nurses. b. She encouraged nurses to serve physicians in order to learn from them. c. She instituted changes that affected patient survival rates. d. She organized nursing in America.
C
The RN has assigned the nursing assistant (NA) a task. The NA becomes angry and begins yelling at the RN. What is the best approach for the RN to take? a. Tell the NA that you will let her leave early if she will do this for you. b. Ignore her and reassign the task. c. Meet with the NA to explore his or her feelings and the reason for resistance. d. Call the nursing supervisor and report the NA for insubordination.
C
The RN is educating the new RN on the primary focus of care when developing a therapeutic relationship with the patient. Which statement by the new RN indicates that teaching has been effective? a. "Meeting the needs of the nurse is the primary focus." b. "Medication administration is the primary focus." c. "The patient's needs and problems is the primary focus." d. "Self-care potential is the primary focus."
C
The nurse and patient are discussing the patient's perceptions and feelings related to the patient's illness. The patient is emotional and tearful and expresses feelings of hopelessness. During which phase of the nurse-patient relationship does the nurse interpret this patient to be in? a. Pre-orientation b. Orientation c. Working d. Termination
C
The nurse has received a change-of-shift report about these four patients. Which one should the nurse plan to assess first? a. A 23-year-old patient with cystic fibrosis who has pulmonary function testing scheduled in 30 minutes. b. A 35-year-old patient who was admitted the previous day with bacterial pneumonia and has a temperature of 100.2°F. c. A 46-year-old patient who is complaining of dyspnea after having a thoracentesis 1 hour previously. d. A 77-year-old patient with TB who has four antitubercular medications due in 15 minutes.
C
The nurse has received a shift report. Which patient should the nurse assess first? a. The patient diagnosed with type 2 diabetes mellitus who is complaining of dizziness with a glucose level of 120. b. The patient diagnosed with sleep apnea who is complaining of a morning headache. c. The patient diagnosed with diverticulitis who has a hard, rigid, abdomen and a temperature of 101.3°F. d. The patient diagnosed with a stomach virus who vomited three times during the previous shift.
C
The nurse is working in the outpatient clinic when a patient who has been waiting to be seen for an hour yells, "What are you people doing? I'm sick and tired of waiting!" Which response is the most therapeutic, if made by the nurse? a. "The doctor can only do so much." b. "Would you like a magazine?" c. "I can see that you are frustrated." d. "You need to be quiet!"
C
The nurse manager wants to determine the cause of an increase in medication errors over the past 6 months. This is an example of which type of research? a. Experimental b. Trial and error c. Quality assurance d. Scientific
C
The nurse recognizes that new parents may be ready to learn about their newborn after the birth. What understanding leads the nurse to this conclusion? a. The baby will not be discharged until the parents have the training. b. The nurses on the mother-baby division do a better job of teaching baby care. c. The parents now have the motivation to learn because the baby has been born. d. The parents have no choice at this point.
C
The student nurse is listening to a lecture on communication. Which statement indicates that the teaching has been effective? a. "A communication blocker is silence." b. "A communication blocker is eye contact." c. "A communication blocker is advising." d. "A communication blocker is clarifying."
C
The student nurse is listening to a lecture on therapeutic communication. Which statement indicates that teaching has been effective? a. "The purpose of therapeutic communication is psychotherapy." b. "The purpose of therapeutic communication is social communication." c. "The purpose of therapeutic communication is to develop a trusting relationship." d. "The purpose of therapeutic communication is emotional commitment to another."
C
The student understands the American Nurses Association (ANA) Code of Ethics for Nurses when she identifies which statement as incorrect? The Code of Ethics for Nurses a. provides a framework for ethical decision-making. b. is non-negotiable. c. is applicable to most practice settings. d. helps with professional self-regulation.
C
The student understands the bioethical decision-making theory of utilitarianism when she makes which statement? a. "Utilitarianism is concerned only with duty." b. "Utilitarianism is also called Kantian ethics." c. "Utilitarianism judges actions based on possible consequences." d. "Utilitarianism judges actions based on intent."
C
Using clinical judgment, the nurse makes decisions on whether to proceed with or revise a course of action. When providing this education to a nursing student, which statement indicates that the teaching has been effective? a. "The inquiry (investigational or exploratory) subprocess necessary for sound clinical judgment is reflective thinking." b. "The inquiry (investigational or exploratory) subprocess necessary for sound clinical judgment is persuasive thinking." c. "The inquiry (investigational or exploratory) subprocess necessary for sound clinical judgment is critical thinking." d. "The inquiry (investigational or exploratory) subprocess necessary for sound clinical judgment is intuitive thinking."
C
Which action by the nurse shows the use of the nursing process? a. The nurse works with the health care team to set outcomes and plan interventions for the patient. b. The same nurse admits the patient and then discharges him the next day. c. The nurse works with the patient to set outcomes and plan interventions. d. The nurse sends the provider in for an immediate assessment of the patient.
C
Which of the following is an example of direct research utilization? a. Advocating for a change in policy b. Basing practice on current research available c. Implementing new techniques for practice d. Critiquing a research study
C
Which question should the nurse ask in order to judge the validity of a research study? a. What reliability information has been provided? b. Are the instrument measures applied consistently? c. Does the instrument measure what it is supposed to measure? d. How much random error exists?
C
Which statement made by the nursing student indicates an accurate understanding of culturally competent care? a. "It means having knowledge of the health-related beliefs and practices of all cultures." b. "It is the ability to care only for individuals from one's own culture." c. "It means working within the cultural context of individuals, families, and communities." d. "It means avoiding discussing the patient's practices or beliefs because they may not agree with your own."
C
A 63-year-old patient is uncertain whether she can self-inject her medication. Which would be most likely to be an effective strategy at this time? a. Start with the details about her condition, why she has it, and the importance of her medication. b. In the first session, teach the patient how and why to rotate her abdominal injection sites. c. Start with information about avoiding rubbing or putting pressure on the site after an injection. d. In the first session let the patient handle a syringe while the nurse prepares and administers the next injection with another syringe.
D
A patient has been newly diagnosed with type 2 diabetes. The teaching begins in the hospital with an interdisciplinary approach and continues with outpatient classes. However, the patient continues to state, "I know I do not need to spend my time doing all this because I will be fine once I get out from under all this stress." The barrier to learning that the nurse recognizes and must deal with is the a. patient already knows all she needs to know, so more education is not necessary. b. patient doesn't know what she doesn't know, so the circle will continue. c. patient's blood sugar is keeping her from thinking clearly, so it is too soon to try to teach her. d. patient is in denial and that will need to be dealt with before she will accept the diagnosis and thus the education related to it.
D
A patient scheduled for surgery has a severe level of anxiety. Which action, if taken by the nurse, would be most appropriate at this time? a. Providing teaching about the upcoming surgery and what to expect b. Telling the patient that there is nothing to worry about c. Calling the patient's family and demanding that they help out d. Asking the patient about her concerns, feelings, and perceptions about the surgery
D
A student is studying the history of nursing. Which statement made by the student would be correct if she had an adequate understanding of America's first trained nurse? a. "America's first trained nurse reduced student nurses' working hours." b. "As America's first trained nurse, Isabel Hampton Robb promoted licensure exams." c. "America's first trained nurse worked to create associate degree programs." d. "America's first trained nurse was Linda Richards."
D
An 18-year-old patient is scheduled for heart surgery tomorrow. To assess this patient's level of knowledge, the nurse would say a. "Tell me the name of the surgery you are going to have." b. "Do you understand what the doctor is going to do to you?" c. "Would you be willing to take a test for me?" d. "Tell me what you know about what is going to happen tomorrow."
D
As elements of reasoning and critical thought, why are implications or consequences of outcomes important to consider? a. They can help the nurse make confident clinical decisions. b. They help the nurse understand complex ideas and events. c. They help the nurse understand how the patient is responding to the demands of the treatment. d. They can be expected or unexpected and affect the completion of a nursing intervention.
D
Persons seeking health care have increased autonomy and insist on taking an active role in their medical treatment decisions. What aspect of a nurse's role does this fact affect? a. Use of professional communication when doing patient teaching and admitting patients to the unit. b. Coordination of human and material resources that are directly used in the delivery of care at the bedside. c. Evaluation of performance and skills of nursing staff members involved in direct patient care. d. Patient collaboration with health care team members involved with the development of focused, quality care.
D
Several sections are included in a research article. For example, the methods section describes the research study and what assessment quality and criteria were used. What information does the abstract or introduction section include? a. An evidence summary from the results of several other studies b. An outline of the number of studies retrieved and excluded and respective reasons for their inclusions or exclusions c. A discussion about whether the results are heterogeneous with possible reasons d. A clearly stated review question
D
The nurse is caring for a 19-year-old trauma patient paralyzed from the neck down. He is alert and oriented, requires assistance with ADLs, and keeps his spirits up with frequent visitors. A priority for the nurse is a. rounding hourly to assess the patient's support system and acceptance of his condition. b. feeding the patient to maintain his nutritional status. c. ensuring the patient has constant stimuli through his friends because teenagers are peer-focused. d. watching and preventing skin breakdown as a result of immobility.
D
The nurse is caring for a 64-year-old woman 4 hours after knee replacement. Although she rates her pain at 6 out of 10, she refuses pain medication and tells the nurse, "I can deal with it." Which of the following is the nurse's best response? a. "OK, that's your decision." b. "You're just being stubborn." c. "OK, I'll come back later." d. "What is your concern?"
D
The nurse is caring for a patient 2 hours after a left above-the-knee amputation. The patient states, "My left leg is really hurting, and that medicine you gave me earlier didn't help." Which response is the most therapeutic, if made by the nurse? a. "That's impossible!" b. "You'll have to talk to your doctor." c. "Keep your chin up." d. "I will call your physician."
D
Which example demonstrates the principle that all adults learn best from and in relation to their experiences? a. Teaching the attitude of personal responsibility for health care b. Showing a patient newly diagnosed with diabetes the similarities between an insulin syringe and a 3-cc syringe c. Refraining from teaching two skills at one time d. Showing the patient how the current hand washing procedure he is now learning is like the hand washing he has always done
D
Which of the following is the best example of an open-ended question regarding a patient's pain? a. "For how many weeks have you been having this pain?" b. "Does it feel like a burning pain?" c. "Where on your body does the pain begin and end?" d. "Can you describe your pain for me?"
D
Which patient would the nurse see first at the start of the shift? a. A patient admitted yesterday with osteomyelitis of the right arm with a T of 101.0°F. b. A patient with hepatic encephalopathy who is being rude to the nursing assistant. c. A patient with lupus who has been on long-term corticosteroids and whose blood sugar is 180. d. A patient with circumferential burns of the right leg who is complaining of numbness in the right foot.
D
Which statement, if made by the nurse, is an example of a communication technique that can facilitate communication? a. "Yes, I agree with you." b. "You need to talk to your doctor." c. "I know just how you feel." d. "What are you thinking about?"
D
