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NR 581 FINAL EXAM PREP
Foundational Concepts for
Advanced Nursing Practice
ANSWERED
2023/2024
,1. What are the four domains of advanced nursing practice according to the National Organization of
Nurse Practitioner Faculties (NONPF)? Explain each domain briefly and provide an example of how it
applies to your practice.
- The four domains are: Scientific Foundation, Leadership, Quality, and Practice Inquiry. Scientific
Foundation refers to the use of scientific knowledge, theories, and models to guide advanced nursing
practice. An example is applying evidence-based guidelines to diagnose and treat patients.
Leadership refers to the ability to influence health policy, systems, and outcomes at various levels. An
example is advocating for health equity and social justice in your community. Quality refers to the use
of best practices, standards, and measures to ensure safe, effective, and efficient care. An example is
participating in quality improvement initiatives and audits in your workplace. Practice Inquiry refers to
the use of systematic methods to generate, evaluate, and disseminate knowledge that informs and
improves practice. An example is conducting a research project or a quality improvement project on a
clinical issue.
2. What are the three levels of prevention in public health nursing? Give an example of an intervention
for each level that you could implement as an advanced nurse practitioner.
- The three levels of prevention are: primary, secondary, and tertiary. Primary prevention aims to prevent
disease or injury before it occurs by reducing exposure to risk factors or enhancing resistance to them.
An example is providing immunizations or health education to a population. Secondary prevention
aims to detect and treat disease or injury early before it causes significant morbidity or mortality by
screening, diagnosis, and treatment. An example is performing mammograms or pap smears to detect
cancer or prescribing antibiotics to treat infections. Tertiary prevention aims to reduce the impact of
disease or injury after it has occurred by minimizing complications, disability, or death by rehabilitation,
palliation, or support. An example is providing physical therapy or hospice care to patients with chronic
or terminal conditions.
3. What are the five rights of clinical reasoning according to Levett-Jones et al. (2010)? How can you
apply them to your practice as an advanced nurse practitioner?
- The five rights of clinical reasoning are: collecting the right cues, taking the right action, for the right
patient, at the right time, and for the right reason. Collecting the right cues means gathering relevant
data from multiple sources, such as history, physical examination, laboratory tests, and diagnostic
imaging. Taking the right action means choosing the appropriate intervention based on the best
available evidence, clinical judgment, patient preferences, and ethical principles. For the right patient
means ensuring that the intervention is tailored to the individual needs, values, and goals of the
patient. At the right time means delivering the intervention in a timely manner based on the urgency
and priority of the situation. For the right reason means explaining the rationale and expected
outcomes of the intervention to the patient and other stakeholders.
4. What are some of the ethical principles that guide advanced nursing practice? How do you resolve
ethical dilemmas that may arise in your practice?
- Some of the ethical principles that guide advanced nursing practice are: autonomy, beneficence,
nonmaleficence, justice, fidelity, veracity, and respect for persons. Autonomy means respecting the
patient's right to self-determination and informed consent. Beneficence means doing good or
promoting well-being for the patient. Nonmaleficence means avoiding harm or minimizing risk for the
patient. Justice means treating patients fairly and equitably according to their needs and resources.
,Fidelity means being faithful or loyal to the patient and honoring commitments and promises. Veracity
means being truthful or honest with the patient and others involved in care. Respect for persons
means acknowledging the dignity and worth of each person regardless of their background, beliefs, or
preferences.
- To resolve ethical dilemmas that may arise in practice, you can use a systematic approach such as:
identifying the problem and its ethical dimensions; analyzing the relevant facts, values, stakeholders,
and alternatives; applying ethical principles and theories; making a decision based on sound
reasoning; implementing
1. Minority groups living within a dominant culture may lose the cultural characteristics that made them
different. What is this process called?
a. Cultural diversity
b. Cultural imposition
c. Cultural assimilation
d. Ethnocentrism
When minority groups live within a dominant group, many members lose the cultural
characteristics that once made them different.
2. Which of the following terms is defined as the sense of identification with a collective cultural group?
a. Ethnicity
b. Race
c. Cultural acquisition
d. Culture shock
Ethnicity is the sense of identification with a collective cultural group, largely based on the
group’s common heritage.
3. A nurse states, ―That woman is 78 years old—too old to learn how to change a dressing.‖ What is the
nurse demonstrating?
a. Cultural imposition
b. Clustering
c. Cultural competency
d. Stereotyping
Stereotyping is assuming that all members of a group are alike.
4. A young Hispanic mother comes to the local clinic because her baby is sick. She speaks only Spanish
and the nurse speaks only English. What should the nurse do?
a. Use short words and talk more loudly
b. Ask an interpreter for help
c. Explain why care can’t be provided
d. Provide instructions in writing
Many agencies have a qualified interpreter who understands the healthcare system and can
reliably provide assistance.
5. A nurse is interviewing a newly admitted patient. Which question would be considered culturally
sensitive?
a. ―Do you think you will be able to eat the food we have here?‖
b. ―Do you understand that we can’t prepare special meals?‖
c. ―What types of food do you eat for meals?‖
d. ―Why can’t you just eat our food while you are here?‖
Asking patients what types of foods they eat for meals is culturally sensitive.
, 6. What group is the largest subculture of the healthcare system?
a. Nurses
b. Physicians
c. Social workers
d. Physical therapists
Nurses are the largest subculture of the healthcare system.
7. A nurse states, ―I know I am cleaner than most of my patients.‖ What does this statement indicate?
a. Cultural assimilation
b. Racism
c. Ethnocentrism
d. Stereotyping
Ethnocentrism occurs when one believes that one’s own ideas and practices are superior to those
of others.
8. A nurse wants to acquire knowledge of a specific culture. What could be done first?
a. Talk to coworkers
b. Review literature
c. Talk to family members of the patient
d. Ask others with more experience for help
Reviewing the literature about a specific culture can provide the nurse with a starting point for
information about cultural values, dietary practices, family lines of authority, and health and
illness beliefs and practices.
9. Although all of the following are important to culturally competent nursing care, which one is most
basic?
a. Learning another language
b. Having significant information
c. Treating each person as an individual
d. Recognizing the importance of family
In all aspects of nursing, it is important to treat each patient as an individual. This is also true in
providing culturally competent care.
Situation: The primary objectives of the nurse as caregiver are to promote health, to prevent
illness, to restore health, and to facilitate coping with illness, disability, or death.
10. Of the following statements, which is most true of health and illness?
a. Health and illness are the same for all people.
b. Health and illness are individually defined by each person.
c. People with acute illnesses are actually healthy.
d. People with chronic illnesses have poor health beliefs.
Each person defines health and illness individually, based on a number of factors.
11. A nurse has volunteered to give influenza injections at a local clinic. What level of care is he
demonstrating?
a. Tertiary
b. Secondary
c. Primary
d. Promotive
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