Chapter_01.bnk
MULTIPLE CHOICE
1. Which nurse most likely kept records on sanitation techniques and the
effects on health?
a. Florence Nightingale
b. Mary Nutting
c. Clara Barton
d. Lillian Wald
ANS: a
Nightingale was the first practicing nurse epidemiologist. Her statistical
analyses connected poor sanitation with cholera and dysentery. Mary
Nutting, Clara Barton, and Lillian Wald came after Nightingale, each
contributing to the nursing profession in her own way. Mary Nutting
was instrumental in moving nursing education into universities. Clara
Barton founded the American Red Cross. Lillian Wald helped open the
Henry Street Settlement.
PTS: 1
DIF: Understand (comprehension)
OBJ: Discuss the influence of social, historical, political, and economic
changes on nursing practices.
TOP: Evaluation
MSC: Health Promotion and Maintenance
2.The nurse prescribes strategies and alternatives to attain expected
outcome. Which standard of nursing practice is the nurse following?
a. Assessment
b. Diagnosis
c. Planning
d. Implementation
ANS: c
In planning, the registered nurse develops a plan that prescribes
strategies and alternatives to attain expected outcomes. During
assessment, the registered nurse collects comprehensive data pertinent to
,the patient's health and/or the situation. In diagnosis, the registered nurse
analyzes the assessment data to determine the diagnoses or issues.
During implementation, the registered nurse implements (carries out) the
identified plan.
PTS: 1
DIF: Understand (comprehension)
OBJ: Discuss the development of professional nursing roles.
TOP: Planning
MSC: Management of Care
3.An experienced medical-surgical nurse chooses to work in obstetrics.
Which level of proficiency is the nurse upon initial transition to the
obstetrical floor?
a. Novice
b. Proficient
c. Competent
d. Advanced beginner
ANS: a
A beginning nursing student or any nurse entering a situation in which
there is no previous level of experience (e.g., an experienced operating
room nurse chooses to now practice in home health) is an example of a
novice nurse. A proficient nurse perceives a patient's clinical situation as
a whole, is able to assess an entire situation, and can readily transfer
knowledge gained from multiple previous experiences to a situation. A
competent nurse understands the organization and specific care required
by the type of patients (e.g., surgical, oncology, or orthopedic patients).
This nurse is a competent practitioner who is able to anticipate nursing
care and establish long-range goals. A nurse who has had some level of
experience with the situation is an advanced beginner. This experience
may only be observational in nature, but the nurse is able to identify
meaningful aspects or principles of nursing care.
PTS: 1
DIF: Apply (application)
OBJ: Discuss the development of professional nursing roles.
TOP: Evaluation
MSC: Management of Care
,4. A nurse assesses a patient's fluid status and decides that the patient
needs to drink more fluids. The nurse then encourages the patient to
drink more fluids. Which concept is the nurse demonstrating?
a. Licensure
b. Autonomy
c. Certification
d. Accountability
ANS: b
Autonomy is an essential element of professional nursing that involves
the initiation of independent nursing interventions without medical
orders. To obtain licensure in the United States, the RN candidate must
pass the NCLEX-RN®. Beyond the NCLEX-RN®, the nurse may
choose to work toward certification in a specific area of nursing practice.
Accountability means that you are responsible, professionally and
legally, for the type and quality of nursing care provided.
PTS: 1
DIF: Apply (application)
OBJ: Discuss the roles and career opportunities for nurses.
TOP: Implementation
MSC: Management of Care
A nurse prepares the budget and policies for an intensive care unit.
5.
Which role is the nurse implementing?
a. Educator
b. Manager
c. Advocate
d. Caregiver
ANS: b
A manager coordinates the activities of members of the nursing staff in
delivering nursing care and has personnel, policy, and budgetary
responsibility for a specific nursing unit or facility. As an educator, you
explain concepts and facts about health, describe the reason for routine
care activities, demonstrate procedures such as self-care activities,
,reinforce learning or patient behavior, and evaluate the patient's progress
in learning. As a patient advocate, you protect your patient's human and
legal rights and provide assistance in asserting these rights if the need
arises. As a caregiver, you help patients maintain and regain health,
manage disease and symptoms, and attain a maximal level function and
independence through the healing process.
PTS: 1
DIF: Apply (application)
OBJ: Discuss the roles and career opportunities for nurses.
TOP: Implementation
MSC: Management of Care
6.The nurse has been working in the clinical setting for several years as
an advanced practice nurse. However, the nurse has a strong desire to
pursue research and theory development. To fulfill this desire, which
program should the nurse attend?
a. Doctor of Nursing Science degree (DNSc)
b. Doctor of Philosophy degree (PhD)
c. Doctor of Nursing Practice degree (DNP)
d. Doctor in the Science of Nursing degree (DSN)
ANS: b
Some doctoral programs prepare nurses for more rigorous research and
theory development and award the research-oriented Doctor of
Philosophy (PhD) in nursing. Professional doctoral programs in nursing
(DSN or DNSc) prepare graduates to apply research findings to clinical
nursing. The DNP is a practice doctorate that prepares advanced practice
nurses such as nurse practitioners.
PTS: 1
DIF: Understand (comprehension)
OBJ: Compare and contrast the educational programs available for
professional registered nurse (RN) education.
TOP: Teaching/Learning
MSC: Management of Care
A nurse attends a workshop on current nursing issues provided by the
7.
American Nurses Association. Which type of education did the nurse
,receive?
a. Graduate education
b. Inservice education
c. Continuing education
d. Registered nurse education
ANS: c
Continuing education involves formal, organized educational programs
offered by universities, hospitals, state nurses associations, professional
nursing organizations, and educational and health care institutions. After
obtaining a baccalaureate degree in nursing, you can pursue graduate
education leading to a master's or doctoral degree in any number of
graduate fields, including nursing. Inservice education programs are
instruction or training provided by a health care facility or institution.
Registered nurse education is the education preparation for an individual
intending to be an RN.
PTS: 1
DIF: Apply (application)
OBJ: Compare and contrast the educational programs available for
professional registered nurse (RN) education.
TOP: Teaching/Learning
MSC: Management of Care
8.A nurse identifies gaps between local and best practices. Which
Quality and Safety Education for Nurses (QSEN) competency is the
nurse demonstrating?
a. Safety
b. Patient-centered care
c. Quality improvement
d. Teamwork and collaboration
ANS: c
Quality improvement identifies gaps between local and best practices.
Safety minimizes risk of harm to patients and providers through both
system effectiveness and individual performance. Patient-centered care
recognizes the patient or designee as the source of control and full
,partner in providing compassionate and coordinated care based on
respect for patient's preferences, values, and needs. Teamwork and
collaboration allows effective functioning within nursing and
interprofessional teams, fostering open communication, mutual respect,
and shared decision making.
PTS: 1
DIF: Understand (comprehension)
OBJ: Discuss the roles and career opportunities for nurses.
TOP: Evaluation
MSC: Management of Care
9. A nurse has compassion fatigue. What is the nurse experiencing?
a. Lateral violence and intrapersonal conflict
b. Burnout and secondary traumatic stress
c. Short-term grief and single stressor
d. Physical and mental exhaustion
ANS: b
Compassion fatigue is a term used to describe a state of burnout and
secondary traumatic stress. Compassion fatigue may contribute to what
is described as lateral violence (nurse-nurse interactions, not
intrapersonal). Frequent, intense, or prolonged exposure to grief and loss
places nurses at risk for developing compassion fatigue. Stressors, not a
single stressor, contribute to compassion fatigue. Physical and mental
exhaustion describes burnout only.
PTS: 1
DIF: Understand (comprehension)
OBJ: Discuss the influence of social, historical, political, and economic
changes on nursing practices.
TOP: Assessment
MSC: Health Promotion and Maintenance
10. A patient is scheduled for surgery. When getting ready to obtain the
informed consent, the patient tells the nurse, "I have no idea what is
going to happen. I couldn't ask any questions." The nurse does not allow
the patient to sign the permit and notifies the health care provider of the
situation. Which role is the nurse displaying?
,a. Manager
b. Patient educator
c. Patient advocate
d. Clinical nurse specialist
ANS: c
As a patient advocate, the nurse protects the patient's human and legal
rights, including the right of the patient to understand procedures before
signing permits. Although nurses can be educators, it is the
responsibility of the surgeon to provide education for the patient in
preparation for surgery, and it is the nurse's responsibility to notify the
health care provider if the patient is not properly educated. Managers
coordinate the activities of members of the nursing staff in delivering
nursing care, and clinical nurse specialists are experts in a specialized
area of nursing practice in a variety of settings.
PTS: 1
DIF: Apply (application)
OBJ: Discuss the roles and career opportunities for nurses.
TOP: Evaluation
MSC: Management of Care
11. The patient requires routine gynecological services after giving birth
to her son, and while seeing the nurse-midwife, the patient asks for a
referral to a pediatrician for the newborn. Which action should the
nurse-midwife take initially?
a. Provide the referral as requested.
b. Offer to provide the newborn care.
c. Refer the patient to the supervising provider.
d. Tell the patient that is not allowed to make referrals.
ANS: b
The practice of nurse-midwifery involves providing independent care for
women during normal pregnancy, labor, and delivery, as well as care for
the newborn. After being apprised of the midwifery role, if the patient
insists on seeing a pediatrician, the nurse-midwife should provide the
,referral. The supervising provider is an obstetric provider, not a
pediatrician. A nurse-midwife can make referrals.
PTS: 1
DIF: Analyze (analysis)
OBJ: Discuss the roles and career opportunities for nurses.
TOP: Implementation
MSC: Management of Care
12.The nurse has a goal of becoming a certified registered nurse
anesthetist (CRNA). Which activity is appropriate for a CRNA?
a. Manages gynecological services such as PAP smears.
b. Works under the guidance of an anesthesiologist.
c. Obtains a PhD degree in anesthesiology.
d. Coordinates acute medical conditions.
ANS: b
Nurse anesthetists provide surgical anesthesia under the guidance and
supervision of an anesthesiologist, who is a physician (health care
provider) with advanced knowledge of surgical anesthesia. Nurse
practitioners, not CRNAs, manage self-limiting acute and chronic stable
medical conditions; certified nurse-midwives provide gynecological
services such as routine Papanicolaou (Pap) smears. The CRNA is an
RN with an advanced education in a nurse anesthesia accredited
program. A PhD is not a requirement.
PTS: 1
DIF: Understand (comprehension)
OBJ: Discuss the roles and career opportunities for nurses.
TOP: Implementation
MSC: Management of Care
13. A nurse teaches a group of nursing students about nurse practice
acts. Which information is most important to include in the teaching
session about nurse practice acts?
a. Protects the nurse.
b. Protects the public.
c. Protects the provider.
,d. Protects the hospital.
ANS: b
The nurse practice acts regulate the scope of nursing practice and protect
public health, safety, and welfare. They do not protect the nurse,
provider, or hospital.
PTS: 1
DIF: Understand (comprehension)
OBJ: Discuss the influence of social, historical, political, and economic
changes on nursing practices.
TOP: Teaching/Learning
MSC: Management of Care
14. A bill has been submitted to the State House of Representatives that
is designed to reduce the cost of health care by increasing the
patient-to-nurse ratio from a maximum of 2:1 in intensive care units to
3:1. What should the nurse realize?
a. Legislation is politics beyond the nurse's control.
b. National programs have no bearing on state politics.
c. The individual nurse can influence legislative decisions.
d. Focusing on nursing care provides the best patient benefit.
ANS: c
Nurses can influence policy decisions at all governmental levels. One
way is to get involved by participating in local and national efforts. This
effort is critical in exerting nurses' influence early in the political
process. Legislation is not beyond the nurse's control. National program
can have bearing on state politics. The question is focusing on
legislation and health care costs, not nursing care.
PTS: 1
DIF: Analyze (analysis)
OBJ: Discuss the influence of social, historical, political, and economic
changes on nursing practices.
TOP: Evaluation
MSC: Management of Care
15. A nurse is using a guide that provides principles of right and wrong
to provide care to patients. Which guide is the nurse using?
, a. Code of ethics
b. Standards of practice
c. Standards of professional performance
d. Quality and safety education for nurses
ANS: a
The code of ethics is the philosophical ideals of right and wrong that
define the principles you will use to provide care to your patients. The
standards of practice describe a competent level of nursing care. The
ANA Standards of Professional Performance describe a competent level
of behavior in the professional role. Quality and safety education for
nurses addresses the challenge to prepare nurses with the competencies
needed to continuously improve the quality of care in their work
environments.
PTS: 1
DIF: Understand (comprehension)
OBJ: Discuss the influence of social, historical, political, and economic
changes on nursing practices.
TOP: Implementation
MSC: Management of Care
16. A graduate of a baccalaureate degree program plans to start working
as a registered nurse (RN) in the emergency department. Which action
must the nurse take first?
a. Obtain certification for an emergency nurse.
b. Pass the National Council Licensure Examination.
c. Take a course on genomics to provide competent emergency care.
d. Complete the Hospital Consumer Assessment of Healthcare Providers
Systems.
ANS: b
Currently, in the United States, the most common way to become a
registered nurse (RN) is through completion of an associate degree or
baccalaureate degree program. Graduates of both programs are eligible
to take the National Council Licensure Examination for Registered
Nurses (NCLEX-RN) to become registered nurses in the state in which
