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Which concept best reflects the position of the Pew Health Professions Commission (1995) and the role of the associate degree nurse?
Differentiated practice-The Pew Commission report specifically recommends that the role of the ADN be different from that of the BSN.
A nurse coordinates care services, including acute care and home care, for a patient with a chronic illness. This situation is an example of which pattern of nursing care delivery?
Case management. - In case management, the case manager is responsible for providing care for a patient throughout the continuum of care.
Which best describes an autonomous profession? The profession has
Legal authority to set its own standards. - Only through legal authority over one's practice does the profession become autonomous.
Which time management strategy would be the most effective for a nursing unit manager? The unit manager
Schedules time to complete paperwork every day. - Scheduling time for paperwork every day helps keep it from becoming backlogged and becoming a seemingly insurmountable task.
- What has been a major influence in moving nursing to a professional status?
- Theory-based practice -Basing nursing practice on theory allows for a testable, specialized knowledge base, which is a characteristic of a profession.
- Why does the American Nurses Association (ANA) approve the use of collective bargaining as a method for influencing nursing practice? Collective bargaining is
- A means to advance the economic and general welfare of nurses. -Collective bargaining is the negotiation of an agreement between an employer and a group of employees with respect to wages and other conditions of employment.
Which leadership style is characterized by facilitation of staff autonomy in some decision making?
Democratic -In democratic leadership, the leader asks for input into decision making and allows the staff some autonomy in decision making.
Which best describes the differentiated practice model of delivery of nursing care? Nurses receive patient assignments
According to their education and level of expertise. -Differentiated practice assigns roles based on education and expertise.
What was the primary purpose for the development of the Nursing Interventions Classification (NIC) taxonomy?
To develop a standardized language for nursing treatments to be used in practice, education, and research -The primary purpose of NIC was to establish a standardized language for nursing interventions (treatments).
A health care agency decides that all nurses must become certified in CPR. How can nurses implement this change?
Participate in establishing appropriate guidelines for training and practice in CPR. - Participation is one way to help implement the change. The nurses will feel ownership of the change.
Which is an advantage of primary nursing?
The autonomy of the nurse is increased. - The primary nurse is responsible for the patient, making the nurse accountable 24/7.
In which situation would case management be the most appropriate type of nursing care delivery?
Several health care professionals are providing services to the patient. - Case management is a method where the nurse acts as the manager of the health care team and focuses on outcomes.
- What is the responsibility of the nurse who is assigned to an inadequately staffed unit?
- Report the situation to the nurse's supervisor. - Reporting the situation the nursing supervisor is the nurse's responsibility. The supervisor is in a position to act to resolve the issue.
- Which patient care activity can the RN delegate to a nursing assistant?
- Monitor the volume of urinary output. -Monitoring the volume of urinary output is within the nursing assistant's scope of practice and would be appropriate to delegate.
- Which nursing practice environment will best promote a positive self-concept in the beginning professional nurse? A nursing practice environment that
- Allows freedom to assume increasing responsibility- New nurses need to gain confidence in their ability. A non-punitive environment acknowledges this and provides positive feedback.
- Which best defines critical pathways?
- Multidisciplinary treatment plans with a timeline to achieve goals -Critical pathways outline the outcomes and care activities for each day of a patient's hospitalization.
- How is team nursing best described?
- A group of health care providers,
- Directed by a professional nurse, providing individualized nursing care to patients -The nurse directs the care of the patients to health care providers based on patient need and health care provider abilities.
- A nurse manager who is in charge of a medical-surgical unit allows the registered nurses to determine the staffing schedule for the unit with the stipulation that adequate coverage must be provided on all shifts. Which management style is the nurse manager using?
- Democratic -In democratic leadership, the nurse manager allows the staff to make the scheduling decisions, but does state that there must be adequate coverage.
- Which nursing action would be most characteristic of a client advocate?
- Assessing a client's need for information to make a decision -The role of the advocate is to assist the patient in making a decision. It is critical that the patient have the correct information.
Which is an example of functional nursing? The nurse
Is assigned to administer medication to 25 patients in a long-term care facility. - In functional nursing the health care provider is assigned a care task based on their ability and scope of practice.
One characteristic of a profession is that it represents a specialized body of knowledge. Which nursing activity best reflects this characteristic?
Formulating nursing diagnoses for each client -Nursing diagnosis requires a specialized knowledge base in nursing care.
What would be the most appropriate action if a nurse is unsure whether the unlicensed assistive personnel (UAPs) know how to obtain a blood glucose level?
Examine the list of skills for which each UAP has demonstrated competency. -The best action is to examine the list of skills of the UAPs. Before any delegation, the nurse must know the strengths and weaknesses of the persons to whom he/she is delegating.
Which describes functional nursing?
It requires ancillary staff to perform simple tasks with high proficiency. - A team leader is responsible for managing licensed and unlicensed staff to care for a group of patients.
Which action best demonstrates how a nurse should follow the appropriate channels of communication when reporting unsafe health care practices? The nurse reports
A physician's questionable diagnosis to the nurse manager. -The nurse's channel of communication generally flows upward to the nurse manager. This is an appropriate action.
Over the last two decades the public has grown increasing distrustful toward individuals, like nurses, who provide essential services. What shows that the profession of nursing has been responsive to the public?
Consumer presence on professional boards of nursing -Adding consumers to professional boards of nursing shows that nursing is responsive to the public. It demonstrates the nursing responsibilities of advocacy and service. A consumer presence represents an advocacy on behalf of health care consumers and a service orientation that is customer focused.
Which is an example of appropriate delegation by the nurse manager? The nurse manager
Assigns a staff nurse to check the emergency cart. - Checking the code cart can be done by anyone who has the skill to do it. The nurse manager is not the only one who has that skill.
Which function best illustrates the role of the nurse as manager of care? The nurse
Delegates appropriate aspects of care to other health team members. -Appropriate delegation is the cornerstone of the role of nurse as manager of care.
- On a special care unit, nurses usually work independently, and are each responsible for two or three patients whose care requires a high degree of professional knowledge and competence. Which leadership style would be most conducive to the effective management of this unit?
- Democratic - Democratic style respects the nurses' professionalism and knowledge. It encourages accountability and promotes autonomy.
A nurse who is licensed in one state moves to another state. Which is the nurse's best source of information to determine what tasks can be delegated to unlicensed assistive personnel (UAPs) in the new state?
State board of nursing -The state board of nursing is the appropriate source to understand what tasks can be delegated to unlicensed assistive personnel (UAPs), since these tasks vary from state to state.
In differentiated nursing practice, which activity can be carried out by BSN nurses but not by ADN nurses? BSN nurses
Develop educational programs for patients in the community. -In differentiated practice, BSN nurses have additional education in population-focused nursing.
- Using surveys to document clients' and their families' experiences with handling complaints and concerns about health care services received is part of what process?
- Quality assurance -This is an example of the quality assurance process. Quality assurance focuses on the clinical aspects of the provider's care and is frequently used in response to an identified problem.
Which is an appropriate action by an institution's ethics committee? The ethics committee
Provides a forum in which diverse views can be expressed. -One of the functions of the ethics committee is to provide a forum in which diverse views on ethical issues can be discussed and resolved.
- What is the primary purpose of a state's nurse practice act?
- To define the scope of nursing practice-The primary purpose of a state's nurse practice act is to legally define the range of nursing practice in that state.
What is a primary function of a state's nurse practice act?
It defines the parameters of professional nursing. -The primary function of a state nurse practice act is to define the parameters of professional nursing, including education and scope of practice.
- Which of the following describes the process of values clarification?
- People identify values, examine them, and develop their own individual values. - Values clarification is the ongoing process of people becoming more conscious of and naming what they value or consider worthy. It requires the ability to be reflective and have self-directed behavior.
- Which action by the nurse is psychological abuse? The nurse
- Threatens to insert a nasogastric feeding tube when the patient refuses to eat. -This intervention is inappropriate and constitutes psychological abuse. The patient has a right to refuse to eat.
What is the legal implication of the doctrine of respondeat superior?
It holds the employer responsible for employees' performance. -The doctrine of respondeat superior indicates that an employer may be held liable for the negligent acts of an employee when those acts are conducted in the course and scope of employment.
A patient is admitted to the emergency department with a laceration over the eyebrow. The medical intern is preparing to suture the injury without informing the patient about the treatment. What should the nurse do?
Ask to speak to the intern in private and discuss the patient's right to know.-The nurse should discuss the patient's right to know with the intern. The nurse has an ethical duty and a professional responsibility to respect the patient's autonomy. The patient must be given information about the condition and treatment options so that the patient can make an informed decision.
How can the nurse encourage members of historically underrepresented groups to donate organs?
Provide education and informational materials on the benefits of organ donations. -Historically underrepresented groups have been found to lack knowledge about organ donation. Providing education and informational materials is an effective action by the nurse.
Which has had the greatest impact on nursing home administration?
Omnibus Budget Reconciliation Act (OBRA)-The Omnibus Budget Reconciliation Act (OBRA) mandates national standards of care in skilled nursing facilities.
- The nurse who is allergic to latex requests that latex-free products be provided. Which act requires that the employer comply with this request?
- Occupational Safety and Health Administration (OSHA) Act- The Occupational Safety and Health Administration is responsible for ensuring safe working conditions for all occupations. Since the OSHA Act was enacted in 1970, many updates have been added, including those related to providing personal protective equipment (PPE), including latex-free supplies if the individual has an allergy.
- Which ethical principle of Good Samaritan laws protects the health care provider who is rendering care in an emergency situation?
- Beneficence -Beneficence is the principle that refers to a person's obligation to promote the welfare of other people by doing good, not harm. This principle is the foundation for Good Samaritan laws.
Which was the first state to allow only its own associate degree graduates to take nursing licensure examinations?
North Dakota -North Dakota was the first state to do this.
Nurses in a hospital are using a scale developed by nurse researchers to identify patients who are at risk for developing pressure ulcers. Which patient outcome demonstrates how use of nursing research can lead to effective patient care?
Fewer patients will develop pressure ulcers.-If the research scale measures patients at risk for developing pressure ulcers, not patients who already have pressure ulcers, then the best outcome is that fewer patients will develop pressure ulcers.
- The nurse gives a patient the wrong oral medication. Which actions should the nurse take first?
- Notify the patient's physician and complete an incident report. -The first step is to inform the physician and complete an incident report. When a medication error occurs, the health care professionals involved are responsible for instituting immediate corrective action. The corrective action is ordered by the physician.
- Which nursing action may be considered criminal behavior? The nurse
- Changes a patient's written medication order.- This nursing action is a violation of federal controlled substance legislation and may constitute criminal behavior.
- A patient is burned as a result of a heat lamp treatment. The nurse who administered the treatment is found by a court of law to be liable for the harm caused to the patient. Which is the most likely consequence for the nurse?
- The nurse may have to pay a sum of money to the patient. -This is the appropriate outcome when a nurse is found legally liable for causing harm to a patient.
- What is the purpose of the American Nurses Association (ANA) Code of Ethics for Nurses (2001)?
- To provide a method of professional self-regulation - The code functions as a tool for professional self-regulation. A code of is a statement of ethical obligations and duties for practice.
What is an obligation of a nurse who serves as an expert witness? The nurse is obligated to
Offer an opinion regarding standards of care. - The function of the expert witness is to offer an opinion regarding the standards of care and how they apply to the case.
Nationwide implementation of which of the following would limit nurses' autonomy over their clinical practice?
Institutional licensure - Institutional licensure would limit nurses' autonomy over their clinical practice, because licensure would vary from institution to institution.
- An attorney tells the nurse that the court has issued an order to reveal the prognosis of a patient under the nurse's care. How should the nurse respond?
- Refer the attorney to the hospital administration. -Hospital administrators are in the best position to respond to court orders.
What is the responsibility of the nurse who discovers an incorrect count of a controlled substance in the medication cabinet?
Report the discrepancy to the nursing supervisor. -The nurse must report the discrepancy to the nursing supervisor, who is required to take further action.
- What is the nursing profession's greatest responsibility to the public?
- To attain and maintain the highest possible standards of practice -The nursing profession's greatest responsibility is to assure safe standards of practice for the protection of the public.
Which ethical theory is based on the premise "The end justifies the means"?
Utilitarianism - Utilitarianism is based on the premise "The end justifies the means." It focuses on consequences of an action rather than on the nature of the action.
- A physician writes a medication order but the nurse cannot determine whether the order states "bid" or "tid". What is the first action the nurse should take?
- Contact the physician to seek clarification. - The appropriate first action is to ask the physician to clarify the order. The nurse should write the clarification below the original order and indicate that it is a verbal order.
- For which responsibility does the American Nurses Association (ANA) Standards of Clinical Nursing Practice hold nurses accountable?
- Assessment -The American Nurses Association Standards of Clinical Practice describe the scope of nursing practice for which nurses are held accountable. Assessment is one of these standards.
What breach of conduct is committed by a nurse who fails to report the abuse of controlled substances by another nurse?
Misdemeanor - Failure to report observed substance abuse is a misdemeanor, which is an infraction of criminal law.
- The nurse mistakenly administers the wrong medication to a patient who suffers no ill effects from the medication error. If the patient files a lawsuit for negligence, which is the most likely legal action?
- The nurse will not be held liable. -Negligence requires four elements: duty, breach of duty, proximate cause, and harm. In this case there is no harm, so the nurse will not be held liable.
Which activity best reflects a nurse's adherence to the American Nurses Association (ANA) Standards of Clinical Nursing Practice? The nurse
Refers a discharged patient to the appropriate support group. - The ANA Standards of Clinical Nursing Practice are authoritative statements describing the responsibilities for which nurses are accountable. The standards provide direction for professional nursing practice and a framework for the evaluation of practice. Referring a patient reflects the standard of planning.
Which is an example of Neuman's Systems Model of a tertiary prevention method?
Teaching the patient how to use an asthma inhaler -This is an example of tertiary prevention. In Neuman's model, tertiary prevention offers support to the patient and attempts to add energy to the system or reduce energy to facilitate reconstitution.
How does theory development benefit nursing? Theory development
Makes it possible to base practice on science. -Theory development enables practice to be based on science. A theory is a scientifically acceptable general principle that governs practice or is proposed to explain observed facts.
In which situation is the nurse adhering to legal guidelines for documentation? The nurse
Charts the patient's response after the patient receives a pain medication.-The nurse is legally responsible for accurately documenting observations, decisions made, nursing actions, and patient's response to care.
What should be the first action taken by a nurse who feels sexually harassed by a coworker?
Report the behavior to the nursing supervisor.-Reporting the behavior to the supervisor is the correct first step. The supervisor is now in a position to take action.
- Which is an element of a valid employment contract?
- It may be oral. -A valid employment contract may be written or oral.
How does the nurse implement the principle of nonmaleficence? The nurse
delivers care without harming the patient. -Delivering care without harming the patient demonstrates the principle of nonmaleficence, which is the duty to do no harm.
- Which best describes a nurse who holds a generic master's degree? The nurse
- Should discuss performance expectations with the employer. -A generic master's program is for students who have a baccalaureate degree in an area other than nursing. A nurse with a generic master's degree is a novice in nursing. The nurse should discuss performance expectations with an employer who may expect that the master's degree represents an expert level of nursing.
What best describes continuing nursing education as a condition of license renewal?
Continuing nursing education requirements are mandated by law. -Mandatory continuing education affects licensure. A nurse renewing a license in a state mandating continuing education will have to satisfy that requirement.
- What was Lillian Wald's primary contribution to nursing?
- She founded the Visiting Nurse Service. -Lillian Wald founded the Visiting Nurse Service around 1893 in impoverished areas of New York City.
Which of the following most accurately reflects the purpose of the Brown Report (1948)?
To analyze the changing needs of nursing as a profession-The purpose of the Brown report (Nursing for the Future) was to analyze the changing needs of nursing as a profession.
Which example best illustrates nursing practice associated with the leading health indicators of Healthy People 2010? The nurse
Teaches adolescents about responsible sexual behavior. -Healthy People 2010 includes five sets of indicators that focus on health and disease outcomes, preventive health behaviors, mental health indicators, health system access, and ecological indicators. Teaching adolescents about responsible sexual behaviors to avoid unwanted pregnancies and sexually transmitted diseases is the best example of nursing practice associated with these indicators.
Which of the following agencies consists of both nursing and non-nursing individuals and agencies whose objective is to foster the development and improvement of all services and education for nurses?
National League for Nursing (NLN) -The National League for Nursing is comprised of non-nurses who have an interest in nursing services. Its members also include nurses from all levels of practice.
- What was Mildred Montag's reason for suggesting the development of associate degree nursing programs?
- To relieve the shortage of registered nurses (RNs) after World War II -Montag made the suggestion as a solution to the acute shortage of nurses that came about because of World War II.
What was Clara Barton's most notable contribution to nursing?
Establishment of the American Red Cross -Clara Barton organized the American Red Cross which linked with the International Red Cross.
Which organization did not pass any resolutions related to the American Nurses Association's (ANA) A Position Paper on Educational Preparation for Nurse Practitioners and Assistants to Nurses?
National League for Nursing (NLN) -The National League for Nursing (NLN) did not pass a resolution in support of the ANA position paper. The NLN includes educational councils representing practical, diploma, associate degree, baccalaureate, and higher degree nursing programs and supports all of these programs. The NLN has "postponed indefinitely" any resolutions addressing the issues raised in the ANA position paper.
Which nurse theorist is associated with the concept of human caring?
Jean Watson -Jean Watson developed a nursing model related to the concept of human caring.
- Which services were provided by the Deaconesses?
- Visiting the homebound sick -Deaconesses' duties usually included assisting with church services such as baptism of women and visiting members of the church who were sick in their homes.
Which nursing leader established the Henry Street Settlement in order to provide nursing services for the poor and children?
Lillian Wald - Lillian Wald established the Henry Street settlement and Visiting Nurse Service to provide nursing and social services to those who were poor.
Who is considered to be the first nurse theorist?
Florence Nightingale - Florence Nightingale lived from 1820 to 1910 and is considered to be the first nursing theorist. Her many contributions included the use of statistical analysis to promote reform in the British military health care system during the Crimean War.
- How is the National Organization for the Advancement of Associate Degree Nursing (NOAADN) unique among nursing organizations?
- It focuses exclusively on one level of nursing education. - The NOAADN is unique in that it focuses exclusively on one level of nursing education, the associate degree.
Why are the Pew Health Professions Commission recommendations on the adequacy and supply of nurses considered irrelevant today?
There is a shortage of nurses in specialized technical areas and geographic regions.-The focus of the Pew Health Professions Commission recommendations emphasized the need for nurses in specialty roles. Today there is too great a shortage of these nurses especially in rural areas to meet the need.
Which is an example of an official, public-sector agency?
County health department -A county health department is an official, public-sector agency responsible for creating, monitoring, and administering a safe environment of health care delivery for the residents of the county.
In which situation is a nurse being held professionally accountable?
A nurse is reprimanded for failure to ensure that lab work is completed prior to a patient's discharge. -This is an example of professional accountability, which refers to the process of answering for or being responsible for what occurs and carries legal implications for task performance.
What is the primary function of the American Nurses Association Political Action Committee (ANA-PAC)?
To serve as a lobbyist at the federal level -The American Nurses Association Political Action Committee (ANA-PAC) focuses on political initiatives, including lobbying and supporting candidates for political office.
How can nurse’s best meet consumer health care needs?
Involve patients in health promotion and prevention services. -By involving patients in health promotion and illness prevention activities, the nurse helps to increase wellbeing and actualize human health potential of consumers in general.
In addition to overseeing worker safety, which function does the nurse in an industrial clinic perform?
Provides health education - The occupational health nurse, also called an industrial nurse, provides nursing care at the workplace to employees, customers, and others with injuries and illnesses. Functions of the industrial nurse include providing health education, giving emergency care, and assessing the work environment to identify potential or actual health problems.
Which was an underlying factor that influenced the development of health maintenance organizations (HMOs)?
Reducing the cost of health care by providing preventive treatment -The underlying factor is that acute care for health crises and disease management is more costly than preventive care.
In developing objectives and identifying functions for the nursing division in a health care organization, the nurse manager must ensure that the objectives and functions are consistent with which of the following?
The mission and goals of the health care organization-The nursing division's objectives and functions must be consistent with the mission and goals of the health care organization.
What is hospice care?
A community-based agency that provides care at the end of life - Hospice provides care for individuals who are dying and for their families.
What increased consumer awareness of the health care system?
Community members' participation on health organization planning committees - Consumer awareness of the health care system is most increased with community member participation in established committees.
Which organization evaluates the policies, procedures, and outcomes of care provided by hospitals?
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) - JCAHO approves health care institutions and agencies, such as hospitals, that meet specific quality criteria.
Which statement best illustrates patient advocacy at the national level for universal health care access?
Joining a professional nursing organization that lobbies for health care for all -Joining a professional nursing organization is an example of patient advocacy. As a member of the organization, the nurse can participate in activities that include political initiatives at the national level.
Which statement is accurate with regard to the pathway of a bill from conceptualization to law?
A bill requires a sponsor to bring it to the House or to the Senate. -A sponsor is necessary to bring the bill to the House or Senate. A sponsor can be one or multiple legislators.
- Which is the best way for nurses to influence key legislators on committees dealing with nursing issues?
- Write letters to their elected legislators who serve on the committees. - Letter writing is an effective way for nurses to participate in grass roots efforts to help legislators understand and frame health issues.
What is the primary goal of managed care?
To establish cost-effective quality care for groups of patients -This is the primary goal of managed care, which is a cost-containment system for health care delivery.
Health care distribution continues to be a problem in the United States. Where is the greatest problem with the supply of health care services?
Rural areas -Health care distribution and access is a very great problem in rural areas.
- What is a primary outcome related to diagnosis-related groups (DRGs)?
- Patients are prematurely discharged. -Patients may be prematurely discharged, because the DRG system encourages shorter hospital stays.
What is a primary problem of the fee-for-service reimbursement method?
It provides no rewards for careful use of resources and sets no controls on volume. -With the traditional fee-for-service method, a fee is generated and billed for each service provided. The more services given, the more fees generated. There is no control of services used.
Which agency regulates health and working conditions in the workplace?
Occupational Safety and Health Administration (OSHA) - The mission of the Occupational Safety and Health Administration (OSHA) is to save lives, prevent injuries, and protect the health of individuals in the workplace.
- Why do consumers and health professionals often believe that proprietary hospitals are less responsive to patients' health needs than are other types of hospitals? Proprietary hospitals
- May be motivated to reduce overhead by stockholders' desires for profit.-Proprietary hospitals are for-profit organizations and, as such, are motivated to be cost efficient to improve profit.
What is the primary impact of technological advances on nursing practice?
Nurses balance task-oriented care with a humanistic approach to patients. -Technological advances result in more task-oriented care, which nurses must balance with a humanistic approach.