Homework Lance
1. Contemporary nursing practice is based on knowledge generated through nursing theories. Florence Nightingale’s theory introduced the concept that nursing care focuses on:
1.
Psychological needs
2.
A maximal level of wellness
3.
Health maintenance and restoration
4.
Interpersonal interactions with the client
ANS: 3
Florence Nightingale believed the role of the nurse was to put the client’s body in the best state in order to remain free of disease or to recover from disease.
Although Florence Nightingale may have addressed meeting the psychological needs of her clients, it is not the focus of her theory. The goal of Nightingale’s theory is to facilitate “the body’s reparative processes” by manipulating the client’s environment.
Florence Nightingale thought the human body had reparative properties of its own if it was cared for in a way to recover from disease. Her theory did not focus on achieving a maximal level of wellness.
Florence Nightingale believed the nurse was in charge of the client’s health. Although she interacted with her clients by reading to them, her theory of nursing care did not focus upon interpersonal interactions.
DIF: A REF: 2 OBJ: Knowledge
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
2. Nursing education programs in the United States may seek voluntary accreditation by the appropriate accrediting commission council of the:
1.
National League for Nursing
2.
American Nurses Association
3.
Congress for Nursing Practice
4.
International Council of Nurses
ANS: 1
The National League for Nursing (NLN) is the professional nursing organization concerned with nursing education. The NLN provides accreditation to nursing programs that seek and meet the NLN accreditation requirements.
The American Nurses Association (ANA) is concerned with the nursing profession and issues affecting health care, including standards of care.
The Congress for Nursing Practice is the part of the ANA concerned with determining the legal aspects of nursing practice, the public recognition of the importance of nursing, and the impact of trends in health care on nursing practice.
The International Council of Nurses (ICN) is concerned about issues of health care and the nursing profession, including the provision of an international power base for nurses.
DIF: A REF: 8 OBJ: Knowledge
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
3. The minimum educational requirement for a nurse practitioner is:
1.
Diploma in nursing
2.
Master’s in nursing
3.
Doctorate in nursing
4.
Baccalaureate in nursing
ANS: 2
A master’s degree is nursing is required to become a nurse practitioner.
Diploma programs in nursing require 3 years of education after which the graduate may become a registered nurse, but not a nurse practitioner.
Doctoral programs focus on the application of research findings to clinical practice. The doctoral degree is beyond the master’s degree.
The baccalaureate degree program generally requires 4 years of study in a college or university, after which the graduate may become a registered nurse, not a nurse practitioner.
DIF: A REF: 8 OBJ: Knowledge
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
4. A group that lobbies at the state and federal level for advancement of nursing’s role, economic interest, and health care is the:
1.
State Board of Nursing
2.
American Nurses Association
3.
American Hospital Association
4.
National Student Nurses Association
ANS: 2
The American Nurses Association (ANA) hires lobbyists at the state and federal level to promote the advancement of health care and the economic and general welfare of nurses.
State Boards of Nursing primarily focus on licensure of nurses within their own state.
The American Hospital Association does not focus on nurses’ economic issues and the advancement of the role of nurses.
The National Student Nurses Association focuses on issues of importance for nursing students.
DIF: A REF: 8 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
5. A nurse moves from Seattle to Boston and begins working in a hospital. The most important factor for the nurse to consider when moving to another state is the:
1.
Massachusetts Nurse Practice Act
2.
Standard for nursing practice in Boston
3.
Clinical ladder of mobility in the new hospital
4.
Requirement for continuing education units (CEU) in Massachusetts
ANS: 1
Although most states have similar practice acts, each individual state has its own Nurse Practice Act that regulates the licensure and practice of nursing within that state. Knowledge of the Nurse Practice Act is necessary to provide safe and legal nursing care.
Standards of nursing practice are not specific to a city, but rather to the profession itself.
Although the clinical ladder of mobility may be of interest in regard to professional advancement, it is not the most important factor when practicing nursing in another state. Knowledge of the Nurse Practice Act in order to provide safe and legal nursing care is of higher importance.
Regardless of where a nurse practices, the nurse should strive to remain current.
DIF: C REF: 8 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
6. A nurse is caring for a client who has chronic renal failure. The nurse states, “We will do everything possible to return you to the optimum level of self-care possible.” In coordinating an approach to best meet the needs of this client, the nurse is fulfilling the role of:
1.
Manager
2.
Educator
3.
Counselor
4.
Communicator
ANS: 1
The nurse, in caring for this client, will coordinate the activities of other members of the health care team. This client may require the assistance of a nursing assistant to provide personal care until the client is less fatigued. A nutritionist may be necessary for diet evaluation, planning, and teaching. A nurse may provide education on the dialysis therapy and perform the skill necessary until the client is able to do so independently.
The nurse may include patient teaching in the client’s care, but more is required to meet the needs of this client.
The nurse is not performing in the role of counselor.
Clear communication will be necessary for the client to understand self-care measures regarding dialysis. The role of communicator does not, however, entirely meet the client’s physical needs at this time.
DIF: A REF: 10 OBJ: Comprehension
TOP: Nursing Process: Planning
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
7. Nurses have the opportunity to work in a wide variety of health care agencies around the world. The practice setting where the majority of nurses continue to work is:
1.
Acute care
2.
Home care
3.
Long-term care
4.
Ambulatory care
ANS: 1
Most nurses provide direct client care in the hospital setting.
Although opportunities for providing patient care in the client’s home are increasing, the majority of nurses are not employed in this setting.
The majority of nurses do not work in nursing homes or extended care settings.
Significantly fewer nurses work in an ambulatory care setting.
DIF: A REF: 10 OBJ: Knowledge
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
8. A client is receiving Dilantin to prevent seizure activity. To which allied health care professional should the nurse refer this client in order to minimize the challenges this condition creates?
1.
Physical therapist
2.
Physician’s assistant
3.
Respiratory therapist
4.
Occupational therapist
ANS: 4
An occupational therapist is a person who provides assessment and intervention to ameliorate physical and psychological deficits that interfere with the performance of activities and tasks of living, including one’s employment.
A physical therapist is responsible for the patient’s musculoskeletal system. A physical therapist may use exercises as an intervention to improve a client’s mobility.
A respiratory therapist provides treatment to preserve or improve pulmonary function.
A physician’s assistant performs tasks usually done by physicians and works under the direction of a supervising physician.
DIF: C OBJ: Analysis TOP: Nursing Process: Planning
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
9. The Goldmark Report concluded that:
1.
Nursing roles and responsibilities required clarification
2.
A theory-based curriculum was necessary for accreditation
3.
Nursing education programs must be affiliated with universities
4.
Increased financial support should be provided for nursing education
ANS: 4
In 1923 the Goldmark Report identified the need for increased financial support to university-based schools of nursing.
The National Commission on Nursing and Nursing Education Report of 1965 recommended that nursing roles and responsibilities be clarified in relation to other health care professionals.
In 1975 the National League for Nursing required theory-based curriculum for accreditation.
The Brown Report of 1948 concluded that all nursing education programs should be affiliated with universities and should have their own budgets.
DIF: A REF: 3 OBJ: Knowledge
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
10. In 1893 Lillian Wald and Mary Brewster made significant contributions to the nursing profession through their work involving the:
1.
Henry Street Settlement in New York
2.
First training school in Toronto, Canada
3.
Training school at Johns Hopkins in Baltimore
4.
Development of the American Journal of Nursing
ANS: 1
In 1893 Lillian Wald and Mary Brewster opened the Henry Street Settlement, which was the first community health service for the poor.
The first nurses’ training school in Canada was founded in St. Catherine’s, Ontario, in 1874.
In 1894 Isabel Hampton Robb was the first superintendent of the Johns Hopkins Training School in Baltimore, Maryland.
Isabel Hampton Robb was one of the original founders of the American Journal of Nursing.
DIF: A REF: 3 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
11. To obtain a certification in a specialty area, the nurse will have to complete:
1.
A request for state approval
2.
A graduate degree in nursing
3.
An examination and the minimum practice requirements
4.
A general examination given to all nurses seeking certification
ANS: 3
Set minimum practice requirements are based on the certification the nurse is seeking. After passing the initial examination, the nurse maintains certification by ongoing continuing education and clinical or administrative practice.
Individual states do not grant certification by request. Certification in a specialty area requires passing the examination for certification in that area and meeting minimum practice requirements.
A master’s degree in nursing is not required for certification in a specialty area.
A specialized examination is given according to the specific area of nursing practice in which certification is being sought.
DIF: A REF: 9 OBJ: Knowledge
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
12. In the ANA Standards of Professional Performance, which one of the following is a specific measurement criterion for “The nurse’s decisions and actions on behalf of clients are determined in an ethical manner”?
1.
Acts as client advocate
2.
Participates in the collection of client data
3.
Seeks experiences to maintain clinical skills
4.
Consults with appropriate health care providers
ANS: 1
As a client advocate, the nurse protects the client’s human and legal rights and provides assistance in asserting those rights if the need arises. Performing in the role of patient advocate fulfills a measurement criterion for the professional performance standard of ethics.
Participating in data collection is a measurement criterion for the professional performance standard of quality of practice.
The nurse who seeks experiences to maintain clinical skills is fulfilling a measurement criterion for the professional performance standard of education.
Consulting with health care providers is a measurement criterion for the professional performance standard of collaboration.
DIF: A REF: 7 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
13. In looking at the nineteenth century, the growth of professional nursing was stimulated by:
1.
The Civil War
2.
Federal legislation
3.
Florence Nightingale
4.
The women’s suffrage movement
ANS: 1
The Civil War stimulated the growth of nursing in the United States. Nurses were in demand to tend to the soldiers of the battlefield.
Throughout history, nurses and their professional organizations have lobbied for health care legislation to meet the needs of clients. However, legislation was not responsible for the growth of nursing in the nineteenth century.
Although Florence Nightingale had great impact on the practice of nursing, she was not the cause for the growth of nursing in the United States during the nineteenth century.
The women’s movement has encouraged nurses to seek greater autonomy and responsibility in providing care, and has caused female clients to seek more control of their health and lives. The women’s movement was not responsible for the growth of nursing in the nineteenth century.
DIF: A REF: 3 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
14. Which of the following educational activities is an example of in-service education?
1.
A workshop given at a nursing convention on malpractice
2.
A program on new cardiac medications provided at a local hospital
3.
Credit courses in communication offered at the community college
4.
Noncredit courses on nursing issues available through the internet
ANS: 2
An in-service education program is instruction or training provided by a health care agency or institution for its employees.
A workshop at a nursing convention is an example of a continuing education program.
Credit courses at a college are examples of continuing education that could possibly by applied toward furthering one’s degree.
Noncredit courses offered via the internet are an example of a continuing education program.
DIF: A REF: 8 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
15. Nurses need to be aware of current trends in the health care delivery system in order to respond in educational preparation and practice. A major trend that is influencing nursing practice today is:
1.
Decreased client acuity
2.
Increased hospital stays
3.
Decreased emphasis on health promotion
4.
Increased incidence of chronic disease processes
ANS: 4
In recent decades, there is a higher incidence of chronic, long-term illness.
With shortened hospital stays, client acuity has increased, not decreased.
Hospital stays have decreased, not increased. Lengths of stay have shortened with a trend toward home care, and health promotion and illness prevention.
With increased public awareness and rising health care costs, greater emphasis has been placed on health promotion and illness prevention.
DIF: A REF: 4 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
16. The nurse assists the client in a health promotion activity that also reduces the cost of health care delivery when:
1.
Administering medication
2.
Treating a diabetic foot ulcer
3.
Obtaining an operative consent
4.
Discussing exercise and nutrition
ANS: 4
The nurse may educate the client in such areas as exercise, nutrition, and healthy lifestyles to assist the client in health promotion and illness prevention.
By administering medication, the nurse is assisting to restore a person to health or maintain one’s health.
A nurse who treats a foot ulcer is assisting a client to restore their health, rather than promoting healthy behaviors.
Obtaining an operative consent pertains to legal aspects of care and is not considered a health promotion activity.
DIF: A REF: 5 OBJ: Comprehension
TOP: Nursing Process: Planning
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Programs
17. The nurse is best able to provide quality care that benefits both client and family by:
1.
Incorporating caring into the practice
2.
Making the client the center of the practice
3.
Integrating the science and art of nursing into the practice
4.
Being knowledgeable of the institution’s standards of practice
ANS: 3
Nursing is an art and a science. As a professional nurse you will learn to deliver care artfully with compassion, caring, and a respect for each client’s dignity and personhood. As a science, nursing is based on a body of knowledge that is continually changing with new discoveries and innovations. When you integrate the science and art of nursing into your practice, the quality of care you provide to your clients is at a level of excellence that benefits clients and their families.
Caring is one part of the art of nursing.
While the client is the focus of nursing practice, this focus is not the main contributor to quality care.
Standards of care provide guidelines for the delivery of client care. Awareness of the standards does not guarantee quality care.
DIF: C REF: 2 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
18. Which of the following statements best reflects Nightingales’ nursing philosophy on health maintenance and restoration?
1.
“Did all the clients eat a good breakfast?”
2.
“What is the client rating his pain level after his medication?”
3.
“Have any clients developed a nosocomial infection last month?”
4.
“Is anyone interested in volunteering to mentor our new graduates?”
ANS: 3
Florence Nightingale studied and implemented methods to improve battlefield sanitation, which ultimately reduced illness, infection, and mortality (Cohen, 1984). Today nurses are active in determining the best practices for skin care management, pain control, nutritional management, and care of older adults. Infection control and its impact on disease prevention was a major outcome of her contributions to nursing. Awareness of the connection between hospital-acquired infections (nosocomial) and nursing practice is the best example of her nursing philosophy.
Nutritional management and its impact on client health, while important does not reflect the best option offered.
Pain management while a vital client concern does not represent the best option offered
While volunteering is certainly reflected in Nightingale’s practice it is not the best option offered.
DIF: C REF: 2-3 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Disease Prevention
19. The twentieth century is recognized for which of the following nursing concepts?
1.
Code of Nursing Ethics
2.
Hospital-based nursing care
3.
Specialized nursing textbooks were adopted.
4.
Formalized university-based nursing education
ANS: 4
In the early twentieth century a movement toward a scientific, research-based defined body of nursing knowledge and practice was evolving. Nurses began to assume expanded and advanced practice roles. Mary Adelaide Nutting was instrumental in the affiliation of nursing education with universities.
In 1990 the American Nurses Association established the Center for Ethics and Human Rights.
Nursing in hospitals expanded in the late nineteenth century.
Isabel Hampton Robb helped found the Nurses’ Associated Alumnae of the United States and Canada in 1896. This organization became the American Nurses Association (ANA) in 1911. She authored many nursing textbooks, including Nursing: Its Principles and Practice for Hospital and Private Use (1894), Nursing Ethics (1900), and Educational Standards for Nurses (1907), and was one of the original founders of theAmerican Journal of Nursing (AJN).
DIF: A REF: 4 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment
20. The best example of the impact of the women’s movement on health care is:
1.
Improvement in breast cancer survival rates
2.
Insurance coverage for well-woman check-ups
3.
Women subjects to be included in all appropriate health research projects
4.
A single, teenage mother receiving Women, Infants, and Children (WIC) benefits
ANS: 3
The women’s movement brought about many changes in society as women increasingly demanded economic, political, occupational, and educational equality. As a result, there is greater sensitivity to the health care needs of women and the role of women in health care research. There are emerging health care specialties dealing with the needs of women. These new specialties expand from the traditional obstetrical specialty and address issues ranging from well- women’s examinations, to oncological subspecialties, to the management of menopause. Because of the prior lack of female subjects in biomedical research, the federal government now requires studies to routinely include women in research, unless specific exception criteria are met. For example, research focusing on management of prostatic cancer is an exception.
Improved survival rates for female-oriented cancers is evident because of emphasis being placed on research.
While important, increased insurance coverage is not the best option available because this action would be directly driven by research findings.
While important, increased federal funding for female-oriented benefits does not represent the best option available because this action would be directly driven by research findings.
DIF: C REF: 4 OBJ: Analysis
TOP: Nursing Process: Comprehension
MSC: NCLEX® test plan designation: Health Promotion and Maintenance
21. The human rights movement most directly impacts nursing practice because:
1.
Nurses act as advocates for all clients
2.
Clients require someone to focus on their needs
3.
Caring for clients is the focus of nursing practice
4.
Everyone deserves to be treated fairly and with respect
ANS: 1
Client advocacy is a nursing responsibility. The human rights movement changed the way society views the rights of all of its members, including minorities, clients with terminal illness, pregnant women, and older adults. Many groups have special health care needs, and nursing responds by respecting the human rights of all clients and their right to quality care. Nurses advocate the rights of all clients.
Clients do require someone to focus on their needs; advocacy is a responsibility of the nurse but the concept of the nurse as an advocate was established well before the human rights movement.
Caring for clients is the focus of nursing practice, but caring physically and emotionally for a client as a nursing responsibility was established well before the human rights movement.
Everyone deserves to be treated fairly and with respect. The realization of that truth was impacted by the human rights movement; however, this option does not directly relate to nursing.
DIF: C REF: 4-5 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
22. Nurses are caring for clients from a variety of cultures primarily as a result of:
1.
Increased ease of travel and mobility
2.
Political unrest in many foreign countries
3.
Increased incidence of contagious diseases
4.
Poor health care in underdeveloped countries
ANS: 1
Because the world’s population is more mobile, both immigration and travel have shown an increase over the last decades. Nursing practice will require the management and delivery of care for clients from many different cultures.
Although immigration to this country has been impacted by political strife in other countries, it is not the primary factor in an increasingly culturally diverse client population.
Increased incidence of contagious diseases has little impact on the cultural diversity of the client population.
Although poor health care services may contribute to some influx of foreign clients, it is not the primary factor in an increasingly culturally diverse client population.
DIF: C REF: 5 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Psychosocial Integrity/Cultural Diversity
23. Risk for injury during client transfer is minimized most effectively by:
1.
Implementation of lift teams
2.
Yearly personnel training sessions
3.
Using mechanical lifts when possible
4.
Use of evidence-based techniques
ANS: 4
Injuries to both caregiver and client occur during client transfer. The caregiver is at risk for musculoskeletal injuries. The client is at risk for falls as well as musculoskeletal injuries. There is a shift from ineffective, injury-prone client transfer techniques to evidence-based practices for safe client handling.
The implementation of a lift team is directly supported by evidence-based research (EBR).
Yearly training sessions are important but the specific training is determined first by EBR.
The use of mechanical lifts is directly supported by evidence-based research (EBR).
DIF: C REF: 6 OBJ: Analysis
TOP: Nursing Process: Planning
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Accident Prevention
MULTIPLE RESPONSE
1. Which of the following activities reflect the nurse’s role in health promotion and wellness? (Select all that apply.)
1.
Screening the local homeless population for head lice
2.
Monitoring blood pressures at a community health fair
3.
Organizing a foot race to benefit national cancer research
4.
Consulting a teenage mother on breast-feeding techniques
5.
Providing literature on smoking cessation to client families
6.
Presenting a nursing workshop on the care of diabetic ulcers
ANS: 1, 2, 4, 5
Nursing responds to this greater concern for health promotion by providing programs in the community such as health fairs and wellness programs; educational programs for specific diseases; and client and family teaching activities in hospitals, clinics, primary care facilities, and other health care settings.
While admirable, organizing a benefit for cancer research is not an activity directed towards health promotion and wellness but rather towards research that will benefit the population as a whole rather than specific individuals.
Presenting a workshop on a specific nursing intervention is not an activity directed toward health promotion and wellness but rather towards professional development of the nurses.
DIF: A REF: 5 OBJ: Comprehension
TOP: Nursing Process: Planning
MSC: NCLEX® test plan designation: Health Promotion and Maintenance/Programs
2. Changes in recent population demographics that have impacted the delivery of nursing care include the following: (Select all that apply.)
1.
Increased birth rates
2.
Increased life expectancy
3.
Decreasing rural population
4.
Expanding urban settlement
5.
Advances in medical modalities
6.
Availability of free public education
ANS: 2, 3, 4
Demographic changes affect the population. Changes influencing health care in recent decades include the population shift from rural areas to urban centers; the increased life span; the higher incidence of chronic, long-term illness; and the increased incidence of diseases such as alcoholism and lung cancer. Nursing responds to such changes by exploring new methods to provide care, by changing educational emphases, and by establishing practice standards.
Recent birth rates have declined.
Advances in medical modalities and availability of free public education do not reflect changes in population demographics but rather health care advances and social services.
DIF: A REF: 4 OBJ: Comprehension
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Coordinated Care
3. The number of medically uninsured clients requiring nursing care has been impacted by: (Select all that apply.)
1.
Rising unemployment rates
2.
Decreasing rural population
3.
Migration to the urban centers
4.
Growth in mental illness diagnoses
5.
Escalating cost of medical insurance
6.
Increasing numbers in the homeless population
ANS: 1, 4, 5, 6
The rising rates of unemployment, mental illness, homelessness, and health care costs all contribute to an increase in the medically underserved population. Some of the medically underserved population is poor and on Medicaid. Others are part of the working poor in that they cannot afford their own insurance, but they make too much money to qualify for Medicaid. In addition, there is an increase in the mentally ill population who has little or no access to health care. Today, nurses work in many health care settings providing health promotion and disease to the homeless, mentally ill, and others who have limited access to health care or who lack health care insurance (Cunningham, 2006).
Although stressing resources in locations where the population relocates, a change in rural population does not necessarily result in an increase of the medically uninsured.
Although stressing resources in locations where the population relocates, a change in urban population does not necessarily result in an increase of the medically uninsured.
DIF: C REF: 5 OBJ: Analysis
TOP: Nursing Process: Assessment
MSC: NCLEX® test plan designation: Health Promotion and Maintenance
Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.
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