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Test Banks For Medical Surgical Nursing
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Test Bank for Lewis Medical Surgical Nursing 12th Edition by Mariann M. Harding, Jeffrey Kwong,
1. The nurse completes an admission database and explains that the plan of care and discharge goals will be developed with the patient‘s input. The patie... [Show More] nt asks, “How is this different from what the physician does?” Which response would the nurse provide? a. “The role of the nurse is to administer medications and other treatments prescribed by your physician.” b. “In addition to caring for you while you are sick, the nurses will help you plan to maintain your health.” c. “The nurse‘s job is to collect information and communicate any problems that occur to the physician.” d. “Nurses perform many of the same procedures as the physician, but nurses are with the patients for a longer time than the physician.” ANS: B The American Nurses Association (ANA) definition of nursing describes the role of nurses in promoting health. The other responses describe dependent and collaborative functions of the nursing role but do not accurately describe the nurse‘s unique role in the health care system. DIF: Cognitive Level: Analyze (Analysis) TOP: Nursing Process: Implementation MSC: NCLEX: Safe and Effective Care Environment 2. Which statement by the nurse accurately describes the use of evidence-based practice (EBP)? a. “Patient care is based on clinical judgment, experience, and traditions.” b. “Data are analyzed later to show that the patient outcomes are consistently met.” c. “Research from all published articles are used as a guide for planning patient care.” d. “Recommendations are based on research, clinical expertise, and patient preferences.” ANS: D Evidence-based practice (EBP) is the use of the best research-based evidence combined with clinician expertise and consideration of patient preferences. Clinical judgment based on the nurse‘s clinical experience is part of EBP, but clinical decision making should also incorporate current research and research-based guidelines. Evaluation of patient outcomes is important, but data analysis is not required to use EBP. All published articles do not provide research evidence; interventions should be based on credible research, preferably randomized controlled studies with a large number of subjects. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment 3. Which statement by the nurse provides a clear explanation of the nursing process? a. “The nursing process is a research method of diagnosing the patient‘s health care problems.” b. “The nursing process is used primarily to explain nursing interventions to other health care professionals.” c. “The nursing process is a problem-solving tool used to identify and manage the patients‘ health care needs.” d. “The nursing process is based on nursing theory that incorporates the biopsychosocial nature of humans.” ANS: C The nursing process is a problem-solving approach to the identification and treatment of patients‘ problems. Nursing process does not require research methods for diagnosis. The primary use of the nursing process is in patient care, not to establish nursing theory or explain nursing interventions to other health care professionals. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care Environment 4. A patient admitted to the hospital for surgery tells the nurse, “I do not feel comfortable leaving my children with my parents.” Which action would the nurse take next? a. Reassure the patient that these feelings are common for parents. b. Have the patient call the children to ensure that they are doing well. c. Gather information on the patient‘s concerns about the child care arrangements. d. Call the patient‘s parents to determine whether adequate child care is being provided. ANS: C Because a complete assessment is necessary in order to identify a problem and choose an appropriate intervention, the nurse‘s first action should be to obtain more information. The other actions may be appropriate, but more assessment is needed before the best intervention can be chosen. DIF: Cognitive Level: Analyze (Analysis) TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity 5. A patient with a bacterial infection is hypovolemic due to a fever and excessive diaphoresis. Which expected outcome would the nurse select for this patient? a. Patient has a balanced intake and output. b. Patient‘s bedding is kept clean and free of moisture. c. Patient understands the need for increased fluid intake. d. Patient‘s skin remains cool and dry throughout hospitalization. ANS: A Balanced intake and output gives measurable data showing resolution of the problem of deficient fluid volume. The other statements would not indicate that the problem of hypovolemia was resolved. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity 6. Which statement describes the purpose of the evaluation phase of the nursing process? a. To document the nursing care plan in the progress notes of the health record b. To determine if interventions have been effective in meeting patient outcomes c. To decide whether the patient‘s health problems have been completely resolved d. To establish if the patient agrees that the nursing care provided was satisfactory ANS: B Evaluation consists of determining whether the desired patient outcomes have been met and whether the nursing interventions were appropriate. The other responses do not describe the evaluation phase. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Evaluation MSC: NCLEX: Safe and Effective Care Environment 7. Which statement describes the purpose of the assessment phase of the nursing process? a. To teach interventions that relieve health problems b. To use patient data to evaluate patient care outcomes c. To obtain data to diagnose patient strengths and problems d. To help the patient identify realistic outcomes for health problems ANS: C During the assessment phase, the nurse gathers information about the patient to diagnose patient strengths and problems. The other responses are examples of the planning, intervention, and evaluation phases of the nursing process. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Assessment MSC: NCLEX: Safe and Effective Care Environment 8. When developing the plan of care, which components would the nurse include in the clinical problem statement? a. The problem and the suggested patient goals or outcomes b. The problem, its causes, and the signs and symptoms of the problem c. The problem with the possible etiology and the planned interventions d. The problem, its pathophysiology, and the expected outcome ANS: B When writing clinical problems or nursing diagnoses, the subjective as well as objective data to support the problem‘s existence should be included. Goals, outcomes, and interventions are not included in the problem statement. DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Diagnosis MSC: NCLEX: Safe and Effective Care Environment 9. Which patient care task would the nurse delegate to experienced assistive personnel (AP)? a. Instruct the patient about the need to alternate activity and rest. b. Monitor level of shortness of breath or fatigue after ambulation. c. Obtain the patient‘s blood pressure and pulse rate after ambulation. d. Determine whether the patient is ready to increase the activity level. ANS: C AP education includes accurate vital sign measurement. Assessment and patient teaching require registered nurse education and scope of practice and cannot be delegated. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment 10. A nurse is caring for a group of patients on the medical-surgical unit with the help of one float registered nurse (RN), one assistive personnel (AP), and one licensed practical/vocational nurse (LPN/VN). Which assignment, if delegated by the nurse, would be outside that individual‘s scope of practice? a. Check for the presence of bowel sounds by AP b. Administration of oral medications by LPN/VN c. Insulin administration by float RN from the pediatric unit d. Measurement of a patient‘s urinary catheter output by AP ANS: A Assessment requires RN education and scope of practice so it cannot be delegated to an LPN/VN or AP. The other assignments made by the RN are appropriate for the role of the team member. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment 11. Which task is appropriate for the nurse to delegate to a licensed practical/vocational nurse (LPN/VN)? a. Complete the initial admission assessment and plan of care. b. Measure bedside blood glucose before administering insulin. c. Document teaching completed before a diagnostic procedure. d. Instruct a patient about low-fat, reduced sodium dietary restrictions. ANS: B The education and scope of practice of the LPN/LVN include activities such as obtaining glucose testing using a finger stick and administering insulin. Patient teaching and the initial assessment and development of the plan of care are nursing actions that require registered nurse education and scope of practice. DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Planning MSC: NCLEX: Safe and Effective Care Environment 12. A nurse is assigned as a case manager for a hospitalized patient who has a spinal cord injury. Which activity can the patient expect the nurse in this role to perform? a. Care for the patient during hospitalization for the injuries. b. Assist the patient with home care activities during recovery. c. Coordinate the services the patient receives in the hospital and at home. d. Determine what medical care the patient needs for optimal rehabilitation. ANS: C [Show Less]
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Test Bank for Medical Surgical Nursing Brunner & Suddarth Textbook
1. The public health nurse is presenting a health promotion class to a group of new mothers. How should the nurse best define health? A) Health is being... [Show More] disease free. B) Health is having fulfillment in all domains of life. C) Health is having psychological and physiological harmony. D) Health is being connected in body, mind, and spirit. Ans: D Feedback: The World Health Organization (WHO) defines health in the preamble to its constitution as a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity. The other answers are incorrect because they are not congruent with the WHO definition of health. 2. A nurse is speaking to a group of prospective nursing students about what it is like to be a nurse. What is one characteristic the nurse would cite as necessary to possess to be an effective nurse? A) Sensitivity to cultural differences B) Team-focused approach to problem-solving C) Strict adherence to routine D) Ability to face criticism Ans: A Feedback: To promote an effective nurse-patient relationship and positive outcomes of care, nursing care must be culturally competent, appropriate, and sensitive to cultural differences. Team-focused nursing and strict adherence to routine are not characteristics needed to be an effective nurse. The ability to handle criticism is important, but to a lesser degree than cultural competence. 3. With increases in longevity, people have had to become more knowledgeable about their health and the professional health care that they receive. One outcome of this phenomenon is the development of organized self-care education programs. Which of the following do these programs prioritize? A) Adequate prenatal care B) Government advocacy and lobbying C) Judicious use of online communities D) Management of illness Ans: D Feedback: Organized self-care education programs emphasize health promotion, disease prevention, management of illness, self-care, and judicious use of the professional health care system. Prenatal care, lobbying, and Internet activities are secondary. 4. The home health nurse is assisting a patient and his family in planning the patients return to work after surgery and the development of postsurgical complications. The nurse is preparing a plan of care that addresses the patients multifaceted needs. To which level of Maslows hierarchy of basic needs does the patients need for self-fulfillment relate? A) Physiologic B) Transcendence C) Love and belonging D) Self-actualization Ans: D Feedback: Maslows highest level of human needs is self-actualization, which includes self-fulfillment, desire to know and understand, and aesthetic needs. The other answers are incorrect because self-fulfillment does not relate directly to them. 5. The view that health and illness are not static states but that they exist on a continuum is central to professional health care systems. When planning care, this view aids the nurse in appreciating which of the following? A) Care should focus primarily on the treatment of disease. B) A persons state of health is ever-changing. C) A person can transition from health to illness rapidly. D) Care should focus on the patients compliance with interventions. Ans: B Feedback: By viewing health and illness on a continuum, it is possible to consider a person as being neither completely healthy nor completely ill. Instead, a persons state of health is ever-changing and has the potential to range from high-level wellness to extremely poor health and imminent death. The other answers are incorrect because patient care should not focus just on the treatment of disease. Rapid declines in health and compliance with treatment are not key to this view of health. 6. A group of nursing students are participating in a community health clinic. When providing care in this context, what should the students teach participants about disease prevention? A) It is best achieved through attending self-help groups. B) It is best achieved by reducing psychological stress. C) It is best achieved by being an active participant in the community. D) It is best achieved by exhibiting behaviors that promote health. Ans: D Feedback: Today, increasing emphasis is placed on health, health promotion, wellness, and self-care. Health is seen as resulting from a lifestyle oriented toward wellness. Nurses in community health clinics do not teach that disease prevention is best achieved through attending self-help groups, by reducing stress, or by being an active participant in the community, though each of these activities is consistent with a healthy lifestyle. 7. A nurse on a medical-surgical unit has asked to represent the unit on the hospitals quality committee. When describing quality improvement programs to nursing colleagues and members of other health disciplines, what characteristic should the nurse cite? A) These programs establish consequences for health care professionals actions. B) These programs focus on the processes used to provide care. C) These programs identify specific incidents related to quality. D) These programs seek to justify health care costs and systems. Ans: B Feedback: Numerous models seek to improve the quality of health care delivery. A commonality among them is a focus on the processes that are used to provide care. Consequences, a focus on incidents, and justification for health care costs are not universal characteristics of quality improvement efforts. 8. Nurses in acute care settings must work with other health care team members to maintain quality care while facing pressures to care for patients who are hospitalized for shorter periods of time than in the past. To ensure positive health outcomes when patients return to their homes, what action should the nurse prioritize? A) Promotion of health literacy during hospitalization B) Close communication with insurers C) Thorough and evidence-based discharge planning D) Participation in continuing education initiatives Ans: C Feedback: Following discharges that occur after increasingly short hospital stays, nurses in the community care for patients who need high-technology acute care services as well as long-term care in the home. This is dependent on effective discharge planning to a greater degree than continuing education, communication with insurers, or promotion of health literacy. 9. You are admitting a patient to your medical unit after the patient has been transferred from the emergency department. What is your priority nursing action at this time? A) Identifying the immediate needs of the patient B) Checking the admitting physicians orders C) Obtaining a baseline set of vital signs D) Allowing the family to be with the patient Ans: A Feedback: Among the nurses important functions in health care delivery, identifying the patients immediate needs and working in concert with the patient to address them is most important. The other nursing functions are important, but they are not the most important functions. 10. A nurse on a postsurgical unit is providing care based on a clinical pathway. When performing assessments and interventions with the aid of a pathway, the nurse should prioritize what goal? A) Helping the patient to achieve specific outcomes B) Balancing risks and benefits of interventions C) Documenting the patients response to therapy D) Staying accountable to the interdisciplinary team [Show Less]
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Test Bank for Medical Surgical Nursing Concepts For Interprofessional Collaborative Care 9th Editi
1. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse best demonstrates this concept? a. Assesses for cultural... [Show More] influences affecting health care b. Ensures that all the clients basic needs are met c. Tells the client and family about all upcoming tests d. Thoroughly orients the client and family to the room ANS: A Competency in client-focused care is demonstrated when the nurse focuses on communication, culture, respect compassion, client education, and empowerment. By assessing the effect of the clients culture on health care, this nurse is practicing client-focused care. Providing for basic needs does not demonstrate this competence. Simply telling the client about all upcoming tests is not providing empowering education. Orienting the client and family to the room is an important safety measure, but not directly related to demonstrating client-centered care. DIF: Understanding/Comprehension REF: 3 KEY: Patient-centered care| culture MSC: Integrated Process: Caring NOT: Client Needs Category: Psychosocial Integrity 2. A nurse is caring for a postoperative client on the surgical unit. The clients blood pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is best? a. Call the Rapid Response Team. b. Document and continue to monitor. c. Notify the primary care provider. d. Repeat blood pressure measurement in 15 minutes. ANS: A The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating before they suffer either respiratory or cardiac arrest. Since the client has manifested a significant change, the nurse should call the RRT. Changes in blood pressure, mental status, heart rate, and pain are particularly significant. Documentation is vital, but the nurse must do more than document. The primary care provider should be notified, but this is not the priority over calling the RRT. The clients blood pressure should be reassessed frequently, but the priority is getting the rapid care to the client. DIF: Applying/Application REF: 3 KEY: Rapid Response Team (RRT)| medical emergencies MSC: Integrated Process: Communication and Documentation NOT: Client Needs Category: Physiological Integrity: Physiological Adaptation 3. A nurse is orienting a new client and family to the inpatient unit. What information does the nurse provide to help the client promote his or her own safety? a. Encourage the client and family to be active partners. b. Have the client monitor hand hygiene in caregivers. c. Offer the family the opportunity to stay with the client. d. Tell the client to always wear his or her armband. ANS: A Each action could be important for the client or family to perform. However, encouraging the client to be active in his or her health care as a partner is the most critical. The other actions are very limited in scope and do not provide the broad protection that being active and involved does. DIF: Understanding/Comprehension REF: 3 KEY: Patient safety MSC: Integrated Process: Teaching/Learning NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control 4. A new nurse is working with a preceptor on an inpatient medical-surgical unit. The preceptor advises the student that which is the priority when working as a professional nurse? a. Attending to holistic client needs b. Ensuring client safety c. Not making medication errors d. Providing client-focused care ANS: B All actions are appropriate for the professional nurse. However, ensuring client safety is the priority. Up to 98,000 deaths result each year from errors in hospital care, according to the 2000 Institute of Medicine report. Many more clients have suffered injuries and less serious outcomes. Every nurse has the responsibility to guard the clients safety. DIF: Understanding/Comprehension REF: 2 KEY: Patient safety MSC: Integrated Process: Nursing Process: Intervention NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control 5. A client is going to be admitted for a scheduled surgical procedure. Which action does the nurse explain is the most important thing the client can do to protect against errors? a. Bring a list of all medications and what they are for. b. Keep the doctors phone number by the telephone. c. Make sure all providers wash hands before entering the room. d. Write down the name of each caregiver who comes in the room. ANS: A Medication errors are the most common type of health care mistake. The Joint Commissions Speak Up campaign encourages clients to help ensure their safety. One recommendation is for clients to know all their medications and why they take them. This will help prevent medication errors. DIF: Applying/Application REF: 4 KEY: Speak Up campaign| patient safety MSC: Integrated Process: Teaching/Learning NOT: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control 6. Which action by the nurse working with a client best demonstrates respect for autonomy? a. Asks if the client has questions before signing a consent b. Gives the client accurate information when questioned c. Keeps the promises made to the client and family d. Treats the client fairly compared to other clients ANS: A Autonomy is self-determination. The client should make decisions regarding care. When the nurse obtains a signature on the consent form, assessing if the client still has questions is vital, because without full information the client cannot practice autonomy. Giving accurate information is practicing with veracity. Keeping promises is upholding fidelity. Treating the client fairly is providing social justice. DIF: Applying/Application REF: 4 KEY: Autonomy| ethical principles MSC: Integrated Process: Caring NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care 7. A student nurse asks the faculty to explain best practices when communicating with a person from the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community. What answer by the faculty is most accurate? a. Avoid embarrassing the client by asking questions. b. Dont make assumptions about their health needs. c. Most LGBTQ people do not want to share information. d. No differences exist in communicating with this population. ANS: B Many members of the LGBTQ community have faced discrimination from health care providers and may be reluctant to seek health care. The nurse should never make assumptions about the needs of members of this population. Rather, respectful questions are appropriate. If approached with sensitivity, the client with any health care need is more likely to answer honestly. DIF: Understanding/Comprehension REF: 4 KEY: LGBTQ| diversity MSC: Integrated Process: Teaching/Learning NOT: Client Needs Category: Psychosocial Integrity 8. A nurse is calling the on-call physician about a client who had a hysterectomy 2 days ago and has pain that is unrelieved by the prescribed narcotic pain medication. Which statement is part of the SBAR format for communication? a. A: I would like you to order a different pain medication. b. B: This client has allergies to morphine and codeine. c. R: Dr. Smith doesnt like nonsteroidal anti-inflammatory meds. d. S: This client had a vaginal hysterectomy 2 days ago. ANS: B SBAR is a recommended form of communication, and the acronym stands for Situation, Background, Assessment, and Recommendation. Appropriate background information includes allergies to medications the on-call physician might order. Situation describes what is happening right now that must be communicated; the clients surgery 2 days ago would be considered background. Assessment would include an analysis of the clients problem; asking for a different pain medication is a recommendation. Recommendation is a statement of what is needed or what outcome is desired; this information about the surgeons preference might be better placed in background. DIF: Applying/Application REF: 5 KEY: SBAR| communication MSC: Integrated Process: Communication and Documentation NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care 9. A nurse working on a cardiac unit delegated taking vital signs to an experienced unlicensed assistive personnel (UAP). Four hours later, the nurse notes the clients blood pressure is much higher than previous readings, and the clients mental status has changed. What action by the nurse would most likely have prevented this negative outcome? a. Determining if the UAP knew how to take blood pressure b. Double-checking the UAP by taking another blood pressure c. Providing more appropriate supervision of the UAP d. Taking the blood pressure instead of delegating the task ANS: C Supervision is one of the five rights of delegation and includes directing, evaluating, and following up on delegated tasks. The nurse should either have asked the UAP about the vital signs or instructed the UAP to report them right away. An experienced UAP should know how to take vital signs and the nurse should not have to assess this at this point. Double-checking the work defeats the purpose of delegation. Vital signs are within the scope of practice for a UAP and are permissible to delegate. The only appropriate answer is that the nurse did not provide adequate instruction to the UAP. DIF: Applying/Application REF: 6 KEY: Supervision| delegation| unlicensed assistive personnel MSC: Integrated Process: Communication and Documentation NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care [Show Less]
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Test Bank For Understanding Pathophysiology 7th edition by Huether, McCance
1. A student is observing a cell under the microscope. It is observed to have supercoiled DNA with histones. Which of the following would also be observed ... [Show More] by the student? a. A single circular chromosome b. A nucleus c. Free-floating nuclear material d. No organelles ANS: B The cell described is a eukaryotic cell, so it has histones and a supercoiled DNA within its nucleus; thus, the nucleus should be observed. A single circular chromosome is characteristic of prokaryotic cells, which do not have histones. Free-floating nuclear material describes a prokaryotic cell, which would not have a distinct nucleus. Eukaryotic cells have membrane bounded cellular components called organelles. No organelles describes a prokaryotic cell. 2. A nurse is instructing the staff about cellular functions. Which cellular function is the nurse describing when an isolated cell absorbs oxygen and uses it to transform nutrients to energy? a. Metabolic absorption b. Communication c. Secretion d. Respiration ANS: D The ability of the cell to absorb oxygen refers to the cells function of respiration. The ability of the cell to function within a society of cells refers to its function of communication. The ability of the cell to take in nutrients refers to the cells function of metabolic absorption. The ability of the cell to synthesize new substances and secrete these elsewhere refers to the cells function of secretion. 3. A eukaryotic cell is undergoing DNA replication. In which region of the cell would most of the genetic information be contained? a. Mitochondria b. Ribosome c. Nucleolus d. Nucleus ANS: C The region of the cell that contains genetic material, including a large amount of ribonucleic acid, most of the DNA, and DNA-binding proteins, is the nucleolus. The mitochondria is the site of cellular respiration. The ribosomes are involved in manufacturing of proteins within the cell. The nucleus contains the nucleolus, and it is the nucleolus that contains genetic material. 4. The fluid mosaic model for biologic membranes describes membrane behavior. According to this model, which of the following float singly or as aggregates in the fluid lipid bilayer? a. Peripheral membrane proteins b. Integral membrane proteins c. Glycoproteins d. Cell adhesion molecules ANS: B Integral membrane proteins float freely in the fluid lipid bilayer. Peripheral membrane proteins are not embedded in the layer, but reside at the surface. Glycoproteins act as cell surface markers. Cell adhesion molecules are on the outside of the membrane and allow cells to hook together. 5. Which of the following can bind to plasma membrane receptors? a. Oxygen b. Ribosomes c. Amphipathic lipids d. Ligands ANS: D Ligands are specific molecules that can bind with receptors on the cell membrane. Oxygen moves by diffusion; it does not bind to receptors. Ribosomes make proteins and are not involved in binding. Amphipathic lipids are a portion of the cell membrane. 6. A nurse is reviewing a report from a patient with metastatic cancer. What finding would support the diagnosis of metastatic cancer? Alterations in extracellular matrix that include: a. Decreased fibronectin b. Increased collagen c. Decreased elastin d. Increased glycoproteins ANS: A Reduced amounts of fibronectin are found in some types of cancerous cells, allowing cancer cells to travel, or metastasize. Collagen provides strength, and its breakdown is associated with osteoarthritis, not cancer. Elastin is found in the lungs and allows tissues to stretch; it is not associated with cancerous cells. Decreased, not increased, glycoproteins are associated with cancerous cells. 7. Which form of cell communication is used to relate to other cells in direct physical contact? a. Cell junction b. Gap junction c. Desmosomes d. Tight junctions ANS: A Cell junctions hold cells together and permit molecules to pass from cell to cell. Gap junctions allow communication from the inside of one cell to the inside of another. Desmosomes are not involved in communication, but allow cells to hold together. Tight junctions are barriers that prevent movement of some substances and leakages of others. 8. Pancreatic beta cells secrete insulin, which inhibits secretion of glucagon from neighboring alpha cells. This action is an example of which of the following signaling types? a. Paracrine b. Autocrine c. Neurohormonal d. Hormonal ANS: A Paracrine signaling involves the release of local chemical mediators that are quickly taken up, destroyed, or immobilized, as in the case of insulin and the inhibition of the secretion of glucagon. When cells produce signals that they themselves respond to, autocrine signaling is used. Neurohormonal signaling involves secretion of hormones into the bloodstream by neurosecretory hormones. Hormonal signaling involves specialized endocrine cells that secrete hormone chemicals released by one set of cells that travel through the tissue through the bloodstream to produce a response in other sets of cells. 9. In cellular metabolism, each enzyme has a high affinity for a: a. Solute b. Substrate c. Receptor d. Ribosome ANS: B Each enzyme has a high affinity for a substrate, a specific substance converted to a product of the reaction. Solutes are small particles that pass through the cell membrane. A receptor is a site on the cell wall that allows transport into the cell. Ribosomes are located inside the cell and are not related to the work of enzymes. 10. An athlete runs a marathon, after which his muscles feel fatigued and unable to contract. The athlete asks the nurse why this happened. How should the nurse respond? A deficiency in [Show Less]
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Test Bank Brunner and Suddarth-s Textbook of Medical-Surgical Nursing 15th Edition
When the nurse encourages a patient with heart failure to alternate rest and activity periods to reduce cardiac workload, which phase of the nursing proces... [Show More] s is being used? Planning Diagnosis Evaluation Implementation D. Implementation Carrying out a specific, individualized plan constitutes the implementation phase of the nursing process. The nurse's action of encouragement and instruction to the patient is part of carrying out a plan of action. When planning care for a patient, the nurse may use a visual diagram of patient problems and interventions to illustrate the relationships among pertinent clinical data. This format is called a concept map. critical pathway. clinical pathway. nursing care plan. A. concept map A concept map is another method of recording a nursing care plan. In a concept map, the nursing process is recorded in a visual diagram of patient problems and interventions. A clinical (critical) pathway is a prewritten plan that directs the entire interprofessional care team in the daily care goals for select health care problems. A nurse is providing care for a patient who had a transurethral resection of his prostate this morning. The patient is receiving continuous bladder irrigation, and the urinary catheter is now occluded. The nurse is planning to contact the patientts health care provider and communicate using the SBAR (Situation-Background-Assessment- Recommendation) format. Which statement is a component of communication using SBAR? "What do you think could be causing this occlusion?" "I think that we should manually irrigate his catheter." "What do you know about this patient and his history?" "Could you please provide some direction for his care?" B."I think that we should manually irrigate his catheter." Proposing a recommendation is a component of the "R" component of SBAR communication. Asking the health care provider for possible contributing factors to the problem or for general direction may be appropriate in some circumstances, but these are not explicit components of SBAR. The nurse should briefly identify the patient and his circumstances, not ask an open-ended question regarding the health care provider's familiarity. What factor has been most clearly identified as an influence on the future of nursing practice? Aging of the American population and increases in chronic illnesses Correct Increasing birth rates coupled with decreased average life expectancy Increased awareness of determinants of health and improved self-care Apathy around health behaviors and the relationship of lifestyle to health A. Aging of the American population and increases in chronic illnesses The American population is aging at the same time that the incidence of chronic health conditions is increasing. There is no noted increase in the overall awareness of the determinants of health, but at the same time, observers have not identified apathy as a predominant attitude. Life expectancy is increasing, not decreasing. A registered nurse (RN) has delegated the administration of IV medications to a licensed practical/vocational nurse (LPN/LVN). Which statement accurately describes delegation? The RN must teach the LPN how to administer the IV medications. Ultimate responsibility for administering the medication lies with the LPN.. The RN is responsible for observing the LPN administer the IV medication The RN is the one accountable for the quality of care that the patient receives. D. The RN is the one accountable for the quality of care that the patient receives. Delegation entails a redistribution of nursing work, but the RN remains ultimately responsible and accountable for the execution of the task. It would be inappropriate to delegate if the LPN was unfamiliar with the task. The RN is not obliged to observe the LPN's execution of the task. In which patient care delivery model does the nurse plan and coordinate the aspects of patient care with other disciplines focusing on continuity of care and interprofessional collaboration even if the nurse is absent? Team nursing model Primary nursing model Total patient care model Case management nursing model B. Primary nursing model The primary nursing model includes planning the patient's care and coordinating and communicating all aspects of care with other disciplines and those providing care in the nurse's absence. The focus is on continuity of care and interprofessional collaboration. Team nursing uses the RN as the team leader to organize and manage the care for a group of patients with other ancillary workers. The RN has authority and accountability for the quality of care delivered by the team only during the work period. In a total patient care model, the nurse is accountable for the complete care of the patient during the assigned shift. Case management is not a model of care delivery but a collaborative process that involves assessing, planning, facilitating, and advocating for health services with a variety of resources to promote cost- effective outcomes. A nurse with an associate or baccalaureate degree who meets licensing requirements is qualified to practice as a nurse practitioner. a certified specialist. an entry-level generalist. an advanced practice nurse. C. an entry-level generalist Entry-level nurses with an associate or baccalaureate degree are prepared to function as generalists. With experience and continued study, nurses may specialize in an area of practice and may obtain certification in nursing specialties. Certification usually requires clinical experience and successful completion of an examination. A nurse practitioner is an example of an advanced practice nurse. An advanced practice nurse has a minimum of a master's degree with advanced education in pharmacology and physical assessment as well as expertise in a specialized area of practice. When nurses disagree about the effectiveness of a commonly practiced nursing intervention, the best evidence for determining which intervention to use is A. a systematic review of randomized controlled trials. B. a qualitative research study with a large sample size C. a methodological Internet search using key medical terms. D. anecdotal evidence retrieved from two or more case studies. A. a systematic review of randomized controlled trials. Systematic reviews of randomized controlled trials (RCTs) are considered the strongest level of evidence to answer questions about interventions (i.e., cause and effect). The nurse establishes priorities and determines outcomes for an individual patient during which phase of the nursing process? Analysis Planning Evaluation Assessment B. Planning During the planning phase of the nursing process, patient outcomes or goals are developed and nursing interventions are identified to accomplish the outcomes. The assessment phase of the nursing process includes the collection of subjective and objective patient information on which to base the plan of care. The evaluation phase of the nursing process determines if the patient outcomes have been met as a result of nursing interventions. Nursing diagnosis is the act of analyzing the assessment data and making a judgment about the nature of the data. A nurse is monitoring all of the patients in an outpatient procedure area for complications of administering IV fluids. What type of nursing function is being demonstrated by the nurse? Dependent Independent Autonomous Collaborative D. Collaborative A collaborative nursing function is demonstrated when the nurse monitors patients for complications of acute illness, administers IV fluids and medications per health care provider's orders, and implements nursing interventions such as providing emotional support or teaching about specific procedures. Nursing functions may be dependent, collaborative, or independent. The nurse functions dependently when carrying out medical orders. Physician-initiated nursing functions may include administering medications, performing or assisting with certain medical treatments, and assisting with diagnostic tests and procedures. Independent nursing functions include interventions such as promotion and optimization of health, prevention of illness, and patient advocacy. A patient is being prepared for discharge home after a laparoscopic cholecystectomy. Which team member can be assigned to complete a discharge assessment and provide patient teaching for post-discharge care? Registered nurse (RN) Nursing technician (NT) Unlicensed assistive personnel (UAP) Licensed practical/vocational nurse (LPN/LVN) A. Registered nurse (RN) Nursing interventions that requ [Show Less]
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Test Bank For Psychiatric Mental Health Nursing by Mary Townsend 9th Edition 2022-2023
1. A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 1... [Show More] 10 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data? A. The client is experiencing severe distress and is at risk for physical and psychological illness. B. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness. C. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports. D. The client may view these losses as challenges and perceive them as opportunities. ANS: C The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500 or more, indicates high stress in a clients life. However, positive coping mechanisms and strong social support can limit susceptibility to stress-related illnesses. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity 2. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a nurse: Perhaps this was the best thing to happen. Maybe Ill look into pursuing an art degree. How should the nurse characterize the clients appraisal of the job loss stressor? A. Irrelevant B. Harm/loss C. Threatening D. Challenging ANS: D The client perceives the situation of job loss as a challenge and an opportunity for growth. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity 3. Which client statement should alert a nurse that a client may be responding maladaptively to stress? A. Ive found that avoiding contact with others helps me cope. B. I really enjoy journaling; its my private time. C. I signed up for a yoga class this week. D. I made an appointment to meet with a therapist. ANS: A Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can prevent learning appropriate coping skills and can prevent access to needed support systems. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity 4. A nursing student finds that she comes down with a sinus infection toward the end of every semester. When this occurs, which stage of stress is the student most likely experiencing? A. Alarm reaction stage B. Stage of resistance C. Stage of exhaustion D. Fight-or-flight stage ANS: C At the stage of exhaustion, the students exposure to stress has been prolonged and adaptive energy has been depleted. Diseases of adaptation occur more frequently in this stage. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity 5. A school nurse is assessing a female high school student who is overly concerned about her appearance. The clients mother states, Thats not something to be stressed about! Which is the most appropriate nursing response? A. Teenagers! They dont know a thing about real stress. B. Stress occurs only when there is a loss. C. When you are in poor physical condition, you cant experience psychological well-being. D. Stress can be psychological. A threat to self-esteem may result in high stress levels. ANS: D Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a physiological change. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity 6. A bright student confides in the school nurse about conflicts related to attending college or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time? A. Meditation B. Problem-solving training C. Relaxation D. Journaling ANS: B The student must assess his or her situation and determine the best course of action. Problem-solving training, by providing structure and objectivity, can assist in decision making. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity 7. An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention? A. Encourage the student to use the alternative coping mechanism of relaxation exercises. B. Complete the problem-solving process for the client. C. Work through the problem-solving process with the client. D. Encourage the client to keep a journal. ANS: C During times of high anxiety and stress, clients will need more assistance in problem-solving and decision making. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity 8. A school nurse is assessing a distraught female high school student who is overly concerned because her parents cant afford horseback riding lessons. How should the nurse interpret the students reaction to her perceived problem? A. The problem is endangering her well-being. B. The problem is personally relevant to her. C. The problem is based on immaturity. D. The problem is exceeding her capacity to cope. ANS: B Psychological stressors to self-esteem and self-image are related to how the individual perceives the situation or event. Self-image is of particular importance to adolescents, who feel entitled to have all the advantages that other adolescents experience. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity 9. Meditation has been shown to be an effective stress management technique. When meditation is effective, what should a nurse expect to assess? A. An achieved state of relaxation B. An achieved insight into ones feelings C. A demonstration of appropriate role behaviors D. An enhanced ability to problem-solve ANS: A Meditation produces relaxation by creating a special state of consciousness through focused concentration. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity 10. A distraught, single, first-time mother cries and asks a nurse, How can I go to work if I cant afford childcare? What is the nurses initial action in assisting the client with the problem-solving process? A. Determine the risks and benefits for each alternative. B. Formulate goals for resolution of the problem. C. Evaluate the outcome of the implemented alternative. D. Assess the facts of the situation. ANS: D [Show Less]
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Test Bank For Burns Pediatric Primary Care 7th Edition 2022-2023
1. Which region globally has the highest infant mortality rate? A. Indonesia B. Southern Asia C. SubSaharan Africa Correct D. Syria 2. The primary c... [Show More] are pediatric nurse practitioner understands that, to achieve the greatest worldwide reduction in child mortality from pneumonia and diarrhea, which intervention is most effective? A. Antibiotics B. Optimal nutrition C. Vaccinations Correct D. Water purification 3. Which is true about the health status of children in the United States? . 13348413856 A. Globalism has relatively little impact on child health measures in the U.S. B. Obesity rates among 2to5yearolds have shown a recent significant decrease. Correct . C. The rate of household poverty is lower than in other economically developed nations. D. Young children who attend preschool or day care have higher food insecurity. 4. The primary care pediatric nurse practitioner understands that a major child health outcome associated with worldwide climate change is A. cost of living. B. education. C. nutrition. Correct D. pollution. 5. When providing well child care for an infant in the first year of life, the primary care pediatric nurse practitioner is adhering to the most recent American Academy of PediatricsRecommendations for Preventive Pediatric Health Care guidelines by A. focusing less on development and more on illness prevention and nutrition. B. following guidelines established by theBright Futures publication. C. scheduling wellbaby visits to coincide with key developmental milestones. Correct D. seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due. Chapter 2. Unique Issues in Pediatrics 1. A nurse is explaining the therapeutic milieu to a new nurse. The best explanation of this term would be: 1. The place where the child is receiving care. 2. Group therapy. 3. Personal interactions between patients and staff. 4. All of the above are correct. ANS: 4 2. A 16-year-old male has received a pink-slip from the police for inpatient psychiatric treatment. The teen has been expressing thoughts of hanging himself because Life sucks. The nursing staff should consider placing the child: 1. With peers. 2. In an area where he can be watched one-on-one. 3. With a roommate that is expressing the same concerns. 4. In an area close to an external door. ANS: 2 3. Learning disabilities in children have scientifically been linked to: 1. Poor nutrition. 2. The environment in which the child lives. 3. Genetics. 4. Watching more than four hours of television a day. ANS: 3 4. A mental health nurse has assessed a child and determined that the child exhibits behavioral challenges. When the school nurse explains this to a teacher, the best description would be: . 1. The child may exhibit physical outbursts. 2. The child may exhibit violence toward others. 3. The child may be defiant or have tantrums. 4. The child will need special interventions for learning. ANS: 3 5. A child that has not exhibited enuresis in four years has exhibited this behavior pattern for the last week. The reason a child may revert back to this behavior pattern is because of: 1. Hallucinations. 2. Behavioral challenges. 3. Delusions. 4. Stress. [Show Less]
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Test Bank For Pharmacology A Patient Centered Nursing Process Approach 2023
1. All of the following would be considered subjective data, EXCEPT: a. Patient-reported health history b. Patient-reported signs and symptoms of their i... [Show More] llness c. Financial barriers reported by the patient's caregiver d. Vital signs obtained from the medical record ANS: D Subjective data is based on what patients or family members communicate to the nurse. Patient- reported health history, signs and symptoms, and caregiver reported financial barriers would be considered subjective data. Vital signs obtained from the medical record would be considered objective data. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Planning MSC: NCLEX: Management of Client Care 2. The nurse is using data collected to define a set of interventions to achieve the most desirable outcomes. Which of the following steps is the nurse applying? a. Recognizing cues (assessment) b. Analyze cues & prioritize hypothesis (analysis) c. Generate solutions (planning) d. Take action (nursing interventions) ANS: C When generating solutions (planning), the nurse identifies expected outcomes and uses the patient's problem(s) to define a set of interventions to achieve the most desirable outcomes. Recognizing cues (assessment) involves the gathering of cues (information) from the patient about their health and lifestyle practices, which are important facts that aid the nurse in making clinical care decisions. Prioritizing hypothesis is used to organize and rank the patient problem(s) identified. Finally, taking action involves implementation of nursing interventions to accomplish the expected outcomes. DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Nursing Intervention MSC: NCLEX: Management of Client Care 3. A 5-year-old child with type 1 diabetes mellitus has had repeated hospitalizations for episodes of hyperglycemia. The parents tell the nurse that they can't keep track of everything that has to be done to care for their child. The nurse reviews medications, diet, and symptom management with the parents and draws up a daily checklist for the family to use. These activities are completed in which step of the nursing process? a. Recognizing cues (assessment) b. Analyze cues & prioritize hypothesis (analysis) c. Generate solutions (planning) d. Take action (nursing interventions) ANS: D Taking action through nursing interventions is where the nurse provides patient health teaching, drug administration, patient care, and other interventions necessary to assist the patient in accomplishing expected outcomes. [Show Less]
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Textbook of Basic Nursing 12th Edition Rosdahl Test Bank
1. Which of Florence Nightingale's nursing principles is still practiced today? A) The nurse's role is defined by the physician's orders. B) The nurse's ... [Show More] primary role is to spend time caring for others. C) The nurse is viewed as an independent healthcare provider D) The nurse is tasked with the responsibility of keeping the environment clean. 2. What contribution did Roman Matron Phoebe make to the origins of nursing? A) Established first gerontological facility B) Was the first deaconess and visiting nurse C) Established inns and hospitals for pilgrims D) Was the namesake of the first free hospital in Rome in 390 AD 3. What contribution did Roman Matron Saint Marcella make to the origins of nursing? A) First to teach nursing skills B) Was the first deaconess and visiting nurse C) Established inns and hospitals for pilgrims D) Was the namesake of the first free hospital in Rome in 390 AD 4. In what time period were monastic orders established to care for the sick? A) 500 BC B) 460 BC C) First century D) Second century 5. Which nursing programs were established on the basis of the Nightingale plan? Select all that apply. A) Kaiserswerth School for Nursing B) Bellevue Hospital School of Nursing C) Connecticut Training School in New Haven D) Boston Training School at Massachusetts E) St. Thomas Hospital in London 6. A beginning nursing student asks about the principles taught by the Nightingale Nursing School. What should the nurse's answer include? Select all that apply. A) Cleanliness is vital to recovery. B) Cure is better than prevention. C) The nurse must work as a member of a team. D) The nurse should be healthy in both mind and in body E) The nurse must use discretion, but must follow the physician's orders. 7. A student nurse is interested in knowing some of the Nightingale School's innovation in the field of nursing. What should the nurse's response include? A) Establishment of a nurses' residence B) Records of school employment before graduation C) Exit examinations and academic and personal requirements, including a character reference before working D) Records of each student's progress that was later known as the “Henderson plan,” a model for current nursing programs 8. A nursing student asks about the significance of the Nightingale lamp. What is the symbolism attached to this image? A) Warmth of caring B) Nursing education C) Energy of the nurse to heal others D) Commitment of the nurse to heal others 9. Which interventions did Nightingale insist upon, that immediately served to reduce the mortality rate during the Crimean War? Select all that apply. A) Securing more funds and support B) Establishing sanitary conditions C) Providing quality nursing care D) Increasing the available nurses E) Procuring more medication 10. What contribution did Isabel Hampton Robb make to the development of nursing in the United States? A) Founded the school of nursing at Johns Hopkins University B) Moved nursing from menial work to an honored profession C) Organized the school of nursing at Massachusetts General Hospital [Show Less]
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Test Bank for Pathophysiology The Biologic Basis For Disease in Adults and Children 8th Edition
1. Which statement best describes the cellular function of metabolic absorption? a. Cells can produce proteins. b. Cells can secrete digestive enzymes. ... [Show More] c. Cells can take in and use nutrients. d. Cells can synthesize fats. ANS: C In metabolic absorption, all cells take in and use nutrients and other substances from their surroundings. The remaining options are not inclusive in their descriptions of cellular metabolic absorption. PTS: 1 DIF: Cognitive Level: Remembering 2. Where is most of a cell’s genetic information, including RNA and DNA, contained? a. Mitochondria b. Ribosome c. Nucleolus d. Lysosome ANS: C The nucleus contains the nucleolus, a small dense structure composed largely of RNA, most of the cellular DNA, and the DNA-binding proteins, such as the histones, which regulate its activity. The mitochondria are responsible for cellular respiration and energy production. Ribosomes’ chief function is to provide sites for cellular protein synthesis. Lysosomes function as the intracellular digestive system. PTS: 1 DIF: Cognitive Level: Remembering 3. Which component of the cell produces hydrogen peroxide (H2O2) by using oxygen to remove hydrogen atoms from specific substrates in an oxidative reaction? a. Lysosomes b. Peroxisomes c. Ribosomes d. Endosome ANS: B Peroxisomes are so named because they usually contain enzymes that use oxygen to remove hydrogen atoms from specific substrates in an oxidative reaction that produces H2O2, which is a powerful oxidant and potentially destructive if it accumulates or escapes from peroxisomes. Ribosomes are RNA-protein complexes (nucleoproteins) that are synthesized in the nucleolus and secreted into the cytoplasm through pores in the nuclear envelope called nuclear pore complexes. Lysosomes are saclike structures that originate from the Golgi complex and contain more than 40 digestive enzymes called hydrolases, which catalyze bonds in proteins, lipids, nucleic acids, and carbohydrates. An endosome is a vesical that has been pinched off from the cellular membrane. PTS: 1 DIF: Cognitive Level: Remembering 4. Which cell component is capable of cellular autodigestion when it is released during cell injury? a. Ribosome b. Golgi complex c. Smooth endoplasmic reticulum d. Lysosomes ANS: D The lysosomal membrane acts as a protective shield between the powerful digestive enzymes within the lysosome and the cytoplasm, preventing their leakage into the cytoplasmic matrix. Disruption of the membrane by various treatments or cellular injury leads to a release of the lysosomal enzymes, which can then react with their specific substrates, causing cellular self- digestion. The chief function of a ribosome is to provide sites for cellular protein synthesis. The Golgi complex is a network of flattened, smooth vesicles and membranes often located near the cell nucleus. The smooth endoplasmic reticulum is involved in steroid hormone production and removing toxic substances from the cell. PTS: 1 DIF: Cognitive Level: Remembering 5. Which cAMP-mediated response is related to antidiuretic hormone? a. Increased heart rate and force of contraction b. Secretion of cortisol c. Increased retention of water d. Breakdown of fat ANS: C Antidiuretic hormone leads to increased retention of water in the body. Epinephrine causes increases in heart rate and force of contraction. Increased cortisol secretion is due to ACTH. Breakdown of fat is due to glucagon. PTS: 1 DIF: Cognitive Level: Remembering 6. During which phase of the cell cycle is DNA synthesized? a. G1 b. S c. G2 d. M ANS: B The four designated phases of the cell cycle are: (1) the G1 phase (G = gap), which is the period between the M phase (M = mitosis) and the start of DNA synthesis; (2) the S phase (S = synthesis), during which DNA is synthesized in the cell nucleus; (3) the G2 phase, during which RNA and protein synthesis occurs, the period between the completion of DNA synthesis and the next phase (M); and (4) the M phase, which includes nuclear and cytoplasmic division. PTS: 1 DIF: Cognitive Level: Remembering 7. What organic compound facilitates transportation across cell membranes by acting as receptors, transport channels for electrolytes, and enzymes to drive active pumps? a. Lipids b. Proteases c. Proteins d. Carbohydrates ANS: C Proteins have several functions, including acting as receptors, transport channels for electrolytes, and enzymes to drive active pumps Lipids help act as the “glue” holding cell membranes together. Proteases cause the breakdown of protein. Carbohydrates are involved in cellular protection and lubrication and help produce energy via oxidative phosphorylation. PTS: 1 DIF: Cognitive Level: Remembering 8. Understanding the various steps of proteolytic cascades may be useful in designing drug therapy for which human diseases? a. Cardiac and vascular disorders b. Autoimmune and malignant disorders c. Gastrointestinal and renal disorders d. Endocrine and gastrointestinal disorders ANS: B Understanding the various steps involved in this process is crucial for designing drug interventions. Dysregulation of proteases features prominently in many human diseases, including cancer, autoimmunity, and neurodegenerative disorders. Cardiac, vascular, gastrointestinal, renal, and endocrine disorders do not involve this process. PTS: 1 DIF: Cognitive Level: Remembering 9. Which structure prevents water-soluble molecules from entering cells across the plasma membrane? a. Carbohydrate chains b. Glycoprotein channels c. Membrane channel proteins d. Lipid bilayer ANS: D The bilayer’s structure accounts for one of the essential functions of the plasma membrane. It is impermeable to most water-soluble molecules (molecules that dissolve in water) because the water-soluble molecules are insoluble in the oily core region. The bilayer serves as a barrier to the diffusion of water and hydrophilic substances while allowing lipid-soluble molecules, such as oxygen (O2) and carbon dioxide (CO2), to diffuse through it readily. Carbohydrate chains, glycoprotein channels, and membrane channel proteins do not prevent water-soluble molecules from entering cells across the cell membrane. PTS: 1 DIF: Cognitive Level: Remembering 10. A student asks for an explanation of the absolute refractory period of the action potential. What response by the professor is best? a. A stronger than normal impulse will evoke another response. b. No stimulus is able to evoke another response at this time. c. Multiple stimuli can produce more rapid action potentials. d. The hyperpolarized state means a weaker stimulus produces a response [Show Less]
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TEST BANK Porth-s Essentials of Pathophysiology 5th Edition
1. At an international nursing conference, many discussions and breakout sessions focused on the World Health Organization (WHO) views on health. Of the fo... [Show More] llowing comments made by nurses during a discussion session, which statements would be considered a good representation of the WHO definition? Select all that apply. A) Interests in keeping the elderly population engaged in such activities as book reviews and word games during social time B) Increase in the number of chair aerobics classes provided in the skilled care facilities C) Interventions geared toward keeping the elderly population diagnosed with diabetes mellitus under tight blood glucose control by providing in-home cooking classes D) Providing transportation for renal dialysis patients to and from their hemodialysis sessions E) Providing handwashing teaching sessions to a group of young children Ans: A, B, C, E Feedback: The WHO definition of health is defined as “a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity.” Engaging in book reviews facilitates mental and social well-being; chair aerobics helps facilitate physical well-being; and assisting with tight control of diabetes helps with facilitating physical well-being even though the person has a chronic disease. Handwashing is vital in the prevention of disease and spread of germs. 2. A community health nurse is teaching a group of recent graduates about the large variety of factors that influence an individual's health or lack thereof. The nurse is referring to the Healthy People 2020 report from the U.S. Department of Health and Human Services as a teaching example. Of the following aspects discussed, which would be considered a determinant of health that is outside the focus of this report? A) The client has a diverse background by being of Asian and Native American descent and practices various alternative therapies to minimize effects of stress. B) The client has a family history of cardiovascular disease related to hypercholesterolemia and remains noncompliant with the treatment regime. C) The client has a good career with exceptional preventative health care benefits. D) The client lives in an affluent, clean, suburban community with access to many health care facilities. Ans: B Feedback: In Healthy People 2020, the focus is to promote good health to all (such as using alternative therapies to minimize effects of stress); achieving health equity and promoting health for all (which includes having good health care benefits); and promoting good health (which includes living in a clean community with good access to health care). A client's noncompliance with treatments to control high cholesterol levels within the presence of a family history of CV disease does not meet the “attaining lives free of preventable disease and premature death” determinant. 3. A physician is providing care for a number of patients on a medical unit of a large, university hospital. The physician is discussing with a colleague the differentiation between diseases that are caused by abnormal molecules and diseases that cause disease. Which of the following patients most clearly demonstrates the consequences of molecules that cause disease? A) A 31-year-old woman with sickle cell anemia who is receiving a transfusion of packed red blood cells B) A 91-year-old woman who has experienced an ischemic stroke resulting from familial hypercholesterolemia C) A 19-year-old man with exacerbation of his cystic fibrosis requiring oxygen therapy and chest physiotherapy D) A 30-year-old homeless man who has Pneumocystis carinii pneumonia (PCP) and is HIV positive. Ans: D Feedback: PCP is an example of the effect of a molecule that directly contributes to disease. Sickle cell anemia, familial hypercholesterolemia, and cystic fibrosis are all examples of the effects of abnormal molecules. 4. A member of the health care team is researching the etiology and pathogenesis of a number of clients who are under his care in a hospital context. Which of the following aspects of clients' situations bNesUt chSaraNctGerTizBes paOthMogenesis rather than etiology? A) A client who has been exposed to the Mycobacterium tuberculosis bacterium B) A client who has increasing serum ammonia levels due to liver cirrhosis C) A client who was admitted with the effects of methyl alcohol poisoning D) A client with multiple skeletal injuries secondary to a motor vehicle accident Ans: B Feedback: Pathogenesis refers to the progressive and evolutionary course of disease, such as the increasing ammonia levels that accompany liver disease. Bacteria, poisons, and traumatic injuries are examples of etiologic factors. 5. A new myocardial infarction patient requiring angioplasty and stent placement has arrived to his first cardiac rehabilitation appointment. In this first session, a review of the pathogenesis of coronary artery disease is addressed. Which statement by the patient verifies to the nurse that he has understood the nurse's teachings about coronary artery disease? A) “All I have to do is stop smoking, and then I won't have any more heart attacks.” B) “My artery was clogged by fat, so I will need to stop eating fatty foods like French fries every day.” C) “Sounds like this began because of inflammation inside my artery that made it easy to form fatty streaks, which lead to my clogged artery.” D) “If I do not exercise regularly to get my heart rate up, blood pools in the veins causing a clot that stops blood flow to the muscle, and I will have a heart attack.” Ans: C Feedback: The true etiology/cause of coronary artery disease (CAD) is unknown; however, the pathogenesis of the disorder relates to the progression of the inflammatory process from a fatty streak to the occlusive vessel lesion seen in people with coronary artery disease. Risk factors for CAD revolve around cigarette smoking, diet high in fat, and lack of exercise. 6. A 77-year-old man is a hospital inpatient admitted for exacerbation of his chronic obstructive pulmonary disease (COPD), and a respiratory therapist (RT) is assessing the client for the first time. WhicNh ofRtheIfolGloTwBin.gCaOspMects of the patient's current state of health would be best characterized as a symptom rather than a sign? A) The patient's oxygen saturation is 83% by pulse oxymetry. B) The patient notes that he has increased work of breathing when lying supine. C) The RT hears diminished breath sounds to the patient's lower lung fields bilaterally. D) The patient's respiratory rate is 31 breaths/minute. Ans: B Feedback: Symptoms are subjective complaints by the person experiencing the health problem, such as complaints of breathing difficulty. Oxygen levels, listening to breath sounds, and respiratory rate are all objective, observable signs of disease. 7. Which of the following situations would be classified as a complication of a disease or outcome from the treatment regimen? Select all that apply. A) Massive pulmonary emboli following diagnosis of new-onset atrial fibrillation B) Burning, intense incision pain following surgery to remove a portion of colon due to intestinal aganglionosis C) Development of pulmonary fibrosis following treatment with bleomycin, an antibiotic chemotherapy agent used in treatment of lymphoma D) Gradual deterioration in ability to walk unassisted for a patient diagnosed with Parkinson disease E) Loss of short-term memory in a patient diagnosed with Alzheimer disease Ans: A, C Feedback: Development of pulmonary emboli and pulmonary fibrosis following chemotherapy are both examples of a complication (adverse extensions of a disease or outcome from treatment). It is normal to expect incisional pain following surgery. As Parkinson disease progresses, the inability to walk independently is expected. This is a normal progression for people diagnosed with Parkinson's. Loss of short-term memory in a patient diagnosed with Alzheimer disease is an expected finding. 8. Laboratory testing is ordered for a male patient during a clinic visit for a routine follow-up assessment of hypertension. When interpreting lab values, the nurse knows that A) a normal value represenNtsUtRheStIesNt reTsuBlts thOat fall within the bell curve. B) if the lab result is above the 50% distribution, the result is considered elevated. C) all lab values are adjusted for gender and weight. D) if the result of a very sensitive test is negative, that does not mean the person is disease free. Ans: A Feedback: What is termed a normal value for a laboratory test is established statistically from results obtained from a selected sample of people. A normal value represents the test results that fall within the bell curve or the 95% distribution. Some lab values (like hemoglobin) are adjusted for gender, other comorbidities, or age. If the result of a very sensitive test is negative, it tells us the person does not have the disease, and the disease has been ruled out or excluded. 9. The laboratory technologists are discussing a new blood test that helps establish a differential diagnosis between shortness of breath with a cardiac etiology and shortness of breath with a respiratory/pulmonary etiology. A positive result is purported to indicate a cardiac etiology. The marketers of the test report that 99.8% of patients who have confirmed cardiac etiologies test positive in the test. However, 1.3% of patients who do not have cardiac etiologies for their shortness of breath also test positive. Which of the following statements best characterizes this blood test? A) Low validity; high reliability B) High sensitivity; low specificity C) High specificity; low reliability D) High sensitivity; low reliability [Show Less]
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Test Bank Community Public Health Nursing 7th Edition 2022-2023
1. Which best describes the primary reason that Americans are concerned about health care? a. Politicians are discussing how to improve health care. b. T... [Show More] he media has provided mixed messages about the health care system. c. Our national health care costs keep increasing. d. The new health care system offers free services to Americans. ANS: C The primary reason for the focus on health care is the constantly increasing costs, which cannot be sustained. The costs of caring for the sick accounted for the majority of escalating health care dollars, which increased from 5.7% of the gross domestic product in 1965 to 17.8% in 2015. Politicians and the media both influence Americans’ perceptions about health care; however, they are not the primary reason why Americans are concerned. The new health care system will change the health care access and availability, but will not necessarily be offering any free services to Americans. DIF: Cognitive Level: Understand (Comprehension) 2. A nurse has begun to lobby with politicians for changes to the health care system. Why is this involvement important? a. Nurses, as central characters in several popular TV series, are currently very visible in American mediNa. R I G B.C M b. Nurses are primarily responUsibSle foNr mTanagingOthe various units in our health care system. c. Nurses are the largest segment of health care providers. d. Nurses are the only group that is employed both inside and outside of hospitals. ANS: C As the largest segment of health care providers, nurses are informed about the current health care system and all the problems that result from people not seeking care until they are desperately ill. Nurses, as the American Nurses Association (ANA) emphasize, usually believe that health care is a right, not a privilege. Therefore, nurses, whose work is central to our current health care delivery system, can also be instrumental in working politically to create a health care delivery system that will meet health needs. While nurses are in several current TV series and are employed both inside and outside of hospitals, physicians and other health care providers are as well. Nurses are often managers, but managers often have other backgrounds, such as business administration. DIF: Cognitive Level: Understand (Comprehension) 3. What conclusion can be drawn from examining where nurses are employed? a. There is a trend toward consolidation of health care into large central medical centers. b. There is an increased emphasis on community-based health care. c. There is an obvious need to decrease health care costs by cutting positions. d. Managed care organizations (MCOs) are employing nurses to improve customer relations. ANS: B MCOs are employing nurses in many capacities. Although hospitals are closing and acute care is increasingly found in central medical centers, the same trend may be seen in an increase in neighborhood-based practice centers. While positions are cut in most industries, health care is recognized as an area where growth in employment is expected. However, nurses are increasingly employed in community settings as opposed to hospitals. This change reflects the move toward community-based care rather than hospital-based tertiary care. To help decrease the continued rise in health care costs, the increased emphasis is on disease prevention rather than high-cost treatment. DIF: Cognitive Level: Understand (Comprehension) 4. Which ethical belief would be most helpful in the current health care crisis? a. Emphasis should be on individual and corporation freedom in the marketplace. b. Emphasis should be on individual autonomy and freedom of choice. c. Emphasis should be on social justice and collective responsibility. d. Emphasis should be on the effectiveness of technology in resolving problems. ANS: C Public health recognizes the necessity of collective action in keeping the environment safe and in egalitarian tradition and vision. An overinvestment in technology and seeking of cures within the market justice system has stifled the evolution of a health system to protect and preserve the health of the population. Although individual autonomy and freedom of choice are important, so is the recognition of collective responsibility in ensuring social justice, which entitles all people to basic necessities. N R I G B.C M DIF: Cognitive Level: Apply (Application) 5. What is the primary problem seen in Healthy People 2020’s emphasis on choosing healthy lifestyle behaviors, such as daily exercise or healthy food choices? a. Emphasis on other lifestyle choices, such as not smoking and minimal use of alcohol or drugs, is also needed. b. All of us must work together to make unhealthy behaviors socially unacceptable. c. It costs more to make healthy choices, such as buying and eating fresh fruits and vegetables as opposed to quick and cheap fast-food choices. d. Public policy emphasizes personal responsibility but ignores social and environmental changes needed for well-being. ANS: D Although all responses are accurate, the primary problem is the emphasis on personal choices in the Healthy People 2020 objectives. Emphasis on personal choices ignores the need for community responsibility and action that addresses environmental or cultural restraints to health. DIF: Cognitive Level: Apply (Application) 6. What responsibility does the American Nurses Association (ANA) Code of Ethics require of the nurse beyond giving excellent care to patients? a. Accept longer work schedules to ensure that professional care is always available to clients. b. Recognize the need for experienced nurses to mentor new graduates to help increase and expand the number of professionals available. c. Support health legislation to improve accessibility and cost of health care. d. Volunteer to work overtime as needed to ensure maximum quality of care. ANS: C The ANA Code of Ethics promotes social reform by focusing on health policy and legislation to positively affect accessibility, quality, and cost of health care. The code does not directly address workplace issues, such as work schedules or need for overtime. DIF: Cognitive Level: Analyze (Analysis) 7. What is the community health nursing definition of health? a. Health is a person’s goal-directed purposeful process toward well-being or wholeness. b. Health is an individual’s physical, mental, and social well-being, not merely the absence of disease or infirmity. c. Health is the mutual adaptation between a person and his or her environment in meeting daily existence. d. Health is families and aggregates choosing actions to ensure safety and well-being. ANS: D The text stresses that health is not just the result of an individual’s choices, but choices and actions of individuals, families, groups, and communities that lead to better health. DIF: Cognitive Level: Apply (Application) N R I G B.C M 8. How does community health nursing define community? a. A group of persons living within specific geographic boundaries b. A group of persons who share a common identity and environment c. A group of persons who work together to meet common goals d. A group of persons who resolve a community concern ANS: B Community health nurses work with both geopolitical groups (within specific geographic boundaries) and phenomenological groups (who have a common identity based on culture, history, or goals). A particular phenomenological group may or may not have been a planned group—that is, a group that came together to resolve a recognized common problem or to meet a common goal. However, of all the choices, a group of persons who share a common identity (phenomenological group) and environment (which implies a specific geographic setting) is the broadest and most complete definition. DIF: Cognitive Level: Apply (Application) 9. Which variable has a major influence on a community’s health? a. Behavior choices made by persons in the community b. Number of health care providers and hospitals in the community c. Quality of the public safety officers (police officers, firefighters, etc.) d. The number and credentials of public health officials in the community ANS: A Individual behavior choices are responsible for about 50% of health outcomes. Individual choices are affected through interaction with other individuals, and their mutual social and physical environments. The number of health care providers has not played a major role in the health outcomes in the community in comparison to individual health behaviors. The quality of public safety officers and number of public health officials have not been identified as major contributors to the determinants of health. DIF: Cognitive Level: Apply (Application) 10. What change could most effectively lead to a longer life span in Americans? a. Parenting and sexual behavior classes in all public school systems b. Legislation restricting alcohol and drug use c. Notably reducing speed limits on all state and federal highways, and changing the age limit for driving to 21 years of age d. The belief that smoking is shameful and disgusting, as well as expensive, becoming the social norm [Show Less]
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Test Bank Medical Surgical Nursing 10th Edition Ignatavicius Workman
1. A new nurse is working with a preceptor on a medical-surgical unit. The preceptor advises the new nurse that which is the priority when working as a pro... [Show More] fessional nurse? a. Attending to holistic client needs b. Ensuring client safety c. Not making medication errors d. Providing client-focused care ANS: B All actions are appropriate for the professional nurse. However, ensuring client safety is the priority. Health care errors have been widely reported for 25 years, many of which result in client injury, death, and increased health care costs. There are several national and international organizations that have either recommended or mandated safety initiatives. Every nurse has the responsibility to guard the client’s safety. The other actions are important for quality nursing, but they are not as vital as providing safety. Not making medication errors does provide safety, but is too narrow in scope to be the best answer. DIF: Understanding TOP: Integrated Process: Nursing Process: Intervention KEY: Client safety MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control 2. A nurse is orienting a new client and family to the medical-surgical unit. What information does the nurse provide to best help the client promote his or her own safety? a. Encourage the client and family to be active partners. b. Have the client monitor hand hygiene in caregivers. c. Offer the family the opportunity to stay with the client. d. Tell the client to always wear his or her armband. ANS: A Each action could be important for the client or family to perform. However, encouraging the client to be active in his or her health care as a safety partner is the most critical. The other actions are very limited in scope and do not provide the broad protection that being active and involved does. DIF: Understanding TOP: Integrated Process: Teaching/Learning KEY: Client safety MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control 3. A nurse is caring for a postoperative client on the surgical unit. The client’s blood pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action would the nurse take first? a. Call the Rapid Response Team. b. Document and continue to monitor. c. Notify the primary health care provider. d. Repeat the blood pressure in 15 minutes. ANS: A The purpose of the Rapid Response Team (RRT) is to intervene when clients are deteriorating before they suffer either respiratory or cardiac arrest. Since the client has manifested a significant change, the nurse would call the RRT. Changes in blood pressure, mental status, heart rate, temperature, oxygen saturation, and last 2 hours’ urine output are particularly significant and are part of the Modified Early Warning System guide. Documentation is vital, but the nurse must do more than document. The primary health care provider would be notified, but this is not more important than calling the RRT. The client’s blood pressure would be reassessed frequently, but the priority is getting the rapid care to the client. DIF: Applying TOP: Integrated Process: Communication and Documentation KEY: Rapid Response Team (RRT), Clinical judgment MSC: Client Needs Category: Physiological Integrity: Physiological Adaptation 4. A nurse wishes to provide client-centered care in all interactions. Which action by the nurse best demonstrates this concept? a. Assesses for cultural influences affecting health care. b. Ensures that all the client’s basic needs are met. c. Tells the client and family about all upcoming tests. d. Thoroughly orients the client and family to the room. ANS: A Showing respect for the client and family’s preferences and needs is essential to ensure a holistic or “whole-person” approach to care. By assessing the effect of the client’s culture on health care, this nurse is practicing client-focused care. Providing for basic needs does not demonstrate this competence. Simply telling the client about all upcoming tests is not providing empowering education. Orienting the client and family to the room is an important safety measure, but not directly related to demonstrating client-centered care. DIF: Understanding TOP: Integrated Process: Culture and Spirituality KEY: Client-centered care, Culture MSC: Client Needs Category: Psychosocial Integrity 5. A client is going to be admitted for a scheduled surgical procedure. Which action does the nurse explain is the most important thing the client can do to protect against errors? a. Bring a list of all medications and what they are for. b. Keep the provider’s phone number by the telephone. c. Make sure that all providers wash hands before entering the room. d. Write down the name of each caregiver who comes in the room. ANS: A Medication reconciliation is a formal process in which the client’s actual current medications are compared to the prescribed medications at the time of admission, transfer, or discharge. This National client Safety Goal is important to reduce medication errors. The client would not have to be responsible for providers washing their hands, and even if the client does so, this is too narrow to be the most important action to prevent errors. Keeping the provider’s phone number nearby and documenting everyone who enters the room also do not guarantee safety. DIF: Applying TOP: Integrated Process: Teaching/Learning KEY: Client safety, Informatics MSC: Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control 6. Which action by the nurse working with a client best demonstrates respect for autonomy? a. Asks if the client has questions before signing a consent. b. Gives the client accurate information when questioned. c. Keeps the promises made to the client and family. d. Treats the client fairly compared to other clients. ANS: A Autonomy is self-determination. The client would make decisions regarding care. When the nurse obtains a signature on the consent form, assessing if the client still has questions is vital, because without full information the client cannot practice autonomy. Giving accurate information is practicing with veracity. Keeping promises is upholding fidelity. Treating the client fairly is providing social justice. DIF: Applying TOP: Integrated Process: Caring KEY: Ethics, Autonomy MSC: Client Needs Category: Safe and Effective Care Environment: Management of Care 7. A nurse asks a more seasoned colleague to explain best practices when communicating with a person from the lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) community. What answer by the faculty is most accurate? a. Avoid embarrassing the client by asking questions. b. Don’t make assumptions about his or her health needs. c. Most LGBTQ people do not want to share information. d. No differences exist in communicating with this population. ANS: B Many members of the LGBTQ community have faced discrimination from health care providers and may be reluctant to seek health care. The nurse would never make assumptions about the needs of members of this population. Rather, respectful questions are appropriate. If approached with sensitivity, the client with any health care need is more likely to answer honestly. DIF: Understanding TOP: Integrated Process: Teaching/Learning KEY: Health care disparities, LGBTQ MSC: Client Needs Category: Psychosocial Integrity 8. A nurse is calling the on-call health care provider about a client who had a hysterectomy 2 days ago and has pain that is unrelieved by the prescribed opioid pain medication. Which statement comprises the background portion of the SBAR format for communication? a. “I would like you to order a different pain medication.” b. “This client has allergies to morphine and codeine.” c. “Dr. Smith doesn’t like nonsteroidal anti-inflammatory meds.” d. “This client had a vaginal hysterectomy 2 days ago.” ANS: B SBAR is a recommended form of communication, and the acronym stands for Situation, Background, Assessment, and Recommendation. Appropriate background information includes allergies to medications the on-call health care provider might order. Situation describes what is happening right now that must be communicated; the client’s surgery 2 days ago would be considered background. Assessment would include an analysis of the client’s problem; none of the options has assessment information. Asking for a different pain medication is a recommendation. Recommendation is a statement of what is needed or what outcome is desired. DIF: Applying TOP: Integrated Process: Communication and Documentation KEY: Teamwork and collaboration, SBAR MSC: Client Needs Category: Safe and Effective Care Environment: Management of Care 9. A nurse working on a cardiac unit delegated taking vital signs to an experienced assistive personnel (AP). Four hours later, the nurse notes that the client’s blood pressure taken by the AP was much higher than previous readings, and the client’s mental status has changed. What action by the nurse would most likely have prevented this negative outcome? a. Determining if the AP knew how to take blood pressure b. Double-checking the AP by taking another blood pressure c. Providing more appropriate supervision of the AP d. Taking the blood pressure instead of delegating the task ANS: C Supervision is one of the five rights of delegation and includes directing, evaluating, and following up on delegated tasks. The nurse would either have asked the AP about the vital signs or instructed the AP to report them right away. An experienced AP would know how to take vital signs and the nurse would not have to assess this at this point. Double-checking the work defeats the purpose of delegation. Vital signs are within the scope of practice for a AP and are permissible to delegate. The only appropriate answer is that the nurse did not provide adequate instruction to the AP. DIF: Analyzing TOP: Integrated Process: Communication and Documentation KEY: Teamwork and collaboration, Delegation MSC: Client Needs Category: Safe and Effective Care Environment: Management of Care 10. A newly graduated nurse in the hospital states that because of being so new, participation in quality improvement (QI) projects is not wise. What response by the precepting nurse is best? a. “All staff nurses are required to participate in quality improvement here.” b. “Even being new, you can implement activities designed to improve care.” c. “It’s easy to identify what indicators would be used to measure quality.” d. “You should ask to be assigned to the research and quality committee.” [Show Less]
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TESTBANK FOR LNP TO RN TRANSITION 5TH EDITION BY CLAYWELL LATEST 2023 GRADED A+ WITH EXPLANATION
1. A nursing advisor is meeting with a student who is interested in earning her RN degree. She knows that licensed practical nurse/license vocational nurse... [Show More] (LPN/LVNs) who enter nursing school to become RNs come into the learning environment with prior knowledge and understanding. Which statement by the nursing advisor best describes her understanding of the effect experience may have on learning? a. ―Experience may be a source of insight and motivation, or a barrier.‖ b. ―Experience is usually a stumbling block for LPN/LVNs.‖ c. ―Experience never makes learning more difficult.‖ d. ―Once something is learned, it can never be truly modified.‖ SELECTED ANSWER: A Experience accentuates differences among learners and serves as a source of insight and motivation, but it can also be a barrier. Experience can serve as a foundation for defining the self. DIF: Cognitive Level: Application OBJ: Identify how experiences influence learning in adults. TOPIC: Adult Learning 2. There is a test on the cardiovascular system on Friday morning, and it is now Wednesday night. The student has already taken a vacation day from work Thursday night so that she can stay home and study. She is considering skipping her exercise class on Thursday morning to go to the library to prepare for the test. Which response best identifies the student‘s outcome priority? a. Exercise class b. Going to the library c. Avoiding work by taking a vacation d. Doing well on the test on Friday SELECTED ANSWER: D The outcome priority is the essential issue or need to be addressed at any given time within a set of conditions or circumstances. DIF: Cognitive Level: Application OBJ: Identify motivations and personal outcome priorities for returning to school. TOPIC: Motivation to Learn 3. A nurse who has been an LPN/LVN for 10 years is meeting with an advisor to discuss the possibility of taking classes to become an RN. The advisor interprets which statement by the nurse as the driving force for returning to school? a. ―I‘ll need to schedule time to attend classes.‖ b. ―I‘ll have to budget for paying tuition.‖ c. ―I‘ll have to rearranging my schedule.‖ d. ―There is a possibility of advancement into administration.‖ SELECTED ANSWER: D Driving forces are those that push toward making the change, as opposed to restraining forces, which are those that usually present a challenge that needs to be overcome for the change to take place or present a negative effect the change may initiate. DIF: Cognitive Level: Application OBJ: Identify motivations and personal outcome priorities for returning to school. TOPIC: Motivations for Change 4. An RN is caring for a diabetic patient. The patient appears interested in changing her lifestyle and has been asking questions about eating better. The nurse can interpret this behavior as which stage of Lewin‘s Change Theory? a. Moving b. Unfreezing c. Action d. Refreezing SELECTED ANSWER: B The patient is in the first phase of Lewin‘s Change Theory, known as unfreezing. This phase involves determining that a change needs to occur and deciding to take action. Moving is the second phase and involves actively planning changes and taking action on them. Refreezing is the last stage, and it occurs when the change has become a part of the person‘s life. DIF: Cognitive Level: Analysis OBJ: Understand Change Theory and how it applies to becoming an RN. TOPIC: Change Theory 5. An LPN is talking with her clinical instructor about her decision to return to school to become an RN. The clinical instructor iNnterprets the LPNs outcome priority based on which statement? a. ―My family wanted me to go back to school.‖ b. ―I want to better my financial situation.‖ c. ―I really enjoy school.‖ d. ―I would like to advance to a teaching role someday.‖ SELECTED ANSWER: B The outcome priority is the essential need that must be addressed, determined by internal and external factors, such as needing to better a financial situation. The other statements indicate reasons for returning to school, but they are not essential needs or issues to be addressed. DIF: Cognitive Level: Analysis OBJ: Identify how experiences influence learning in adults. TOPIC: Adult Learning 6. A nurse notices a posting for a management position for which she is qualified. If the nurse is in the moving phase of Lewin‘s Change Theory, which statement reflects the action she is most likely to take? a. Does nothing to obtain the position b. Applies for the position c. Identifies that change is needed d. Settles into the routine of her job SELECTED ANSWER: B Unfreezing begins when reasons for change are identified. The moving phase involves active planning and action. Moving also meSELECTED ANSWER you are dealing with both positive and negative forces as they ebb and flow, and you are making modifications to your plan as needed. Refreezing occurs after the change has become routine. DIF: Cognitive Level: Application OBJ: Understand Change Theory and how it applies to becoming an RN. TOPIC: Change Theory 7. An Orthopedic Nurse is contemplating changes in her professional life and identifying goals. Which action should the nurse take if she is interested in pursuing a long-term goal? a. Studies for a telemetry exam scheduled for next week b. Enrolls in a Nurse Practitioner program c. Attends a seminar to become a charge nurse d. Continues to work on the orthopedic floor full-time SELECTED ANSWER: B A short-term goal is one that can be attained in a period of 6 months or less. Short-term goals include becoming a charge nurse and passing the telemetry exam. A long-term goal is attained in greater than 6 months and includes studying to become a Nurse Practitioner. Continuing to work on the orthopedic floor does not represent either a short-term or a long-term goal. DIF: Cognitive Level: Application OBJ: Identify both short- and long-term personal and professional goals. TOPIC: Setting Goals 8. The RN is talking with the unit manager about ways to improve patient care. The manager introduces the concept of a cohNort. Which statement by the RN indicates that the teaching has been effective? a. ―A cohort is a web of connections‖. b. ―A cohort is a group of people who share common experiences with each other‖. c. ―A cohort is a group linked together for common purposes‖. d. ―A cohort consists of groups of individuals that make up a whole‖. SELECTED ANSWER: B A cohort is a group of people who share common experiences with each other. A scheme is a web of connections, a team is a group linked together for common purposes, and a unit consists of groups or individuals that make up a whole. DIF: Cognitive Level: Evaluation OBJ: Identify how experiences influence learning in adults. TOPIC: Adult Learning 9. The nurse educator is presenting a lecture to a group of new RNs. Which statement by one of the RNs indicates that teaching has been effective? a. ―Experience is a stepping stone to new learning‖. b. ―Experience can be a barrier to new learning‖. c. ―Experience can be an avenue to new learning‖. d. ―Experience can be a detour to new learning‖. SELECTED ANSWER: B Experience accentuates differences among learners, serves as a source of insight and motivation, can be a barrier to new learning, and serves as a foundation for defining the self. DIF: Cognitive Level: Evaluation OBJ: Identify motivations and personal outcome priorities for returning to school. TOPIC: Adult Learning 10. The nurse educator is presenting a lecture on experience and learning to a group of RNs. Which statement by one of the RNs indicates that teaching has been effective? a. ―Experiences always help educational endeavors‖. b. ―The process of unlearning is easier than the initial learning‖. c. ―Learning can often be more difficult if previous knowledge is contradicted‖. d. ―Experiences rarely serve the student in the learning process‖. [Show Less]
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Test Bank For Maternal & Child Health Nursing 9th Edition By JoAnne Silbert-Flagg Complete Question
. A patient is admitted to the labor and delivery unit, and a plan of care based on that patient’s needs is developed by which member of the health-care... [Show More] team? 1) Licensed practical nurse (LPN)/Licensed vocational nurse (LVN) 2) Registered nurse (RN) 3) Nurse practitioner 4) Certified nurse midwife 2. How does a nurse practitioner’s role differ from that of a certified nurse midwife with regard to maternity care? 1) The nurse practitioner does not usually deliver babies but cares for women before and after delivery. 2) The certified nurse midwife cannot prescribe medications, but a nurse practitioner does have prescribing privileges. 3) The certified nurse midwife is hired by the hospital, whereas a nurse practitioner practices independently and does not have hospital privileges. 4) The certified nurse midwife and the nurse practitioner have very similar roles with little difference between the two. 3. The provider explains the need for an amniocentesis, but the patient declines the procedure. The nurse supports the patient’s right to make this decision, demonstrating an understanding of which ethical principle? 1) Autonomy 2) Beneficence 3) Nonmaleficence 4) Justice 4. The nurse joins a community outreach program to promote vaccination of children, demonstrating which ethical principle? 1) Autonomy 2) Beneficence 3) Nonmaleficence 4) Justice 5. The nurse working in an acute care facility makes it a point to never look at the declaration page showing the patient’s insurance or lack of insurance because of a belief that all patients should be treated equally. This demonstrates which ethical principle? 1) Autonomy 2) Beneficence 3) Nonmaleficence 4) Justice 6. A patient asks the student nurse whether a medication is safe to take during pregnancy. The student thinks it is an approved medication during pregnancy. Which is the student’s best response? 1) “I’m pretty sure it is a safe medication.” 2) “I’m not qualified to answer that question.” 3) “I will ask your obstetric provider.” 4) “I really don’t know.” 7. Which term describes assisting a family to feel supported, listened to, and competent? 1) Enable 2) Empathy 3) Egocentric 4) Empowerment 8. Which action should the nurse implement in order to apply the principles of family- centered care in the hospital environment? 1) Implementing strict visitation policy for siblings 2) Allowing a child to “cry it out” when parents leave the bedside 3) Encouraging parents to continue bedtime routines, such as reading a story 4) Discouraging cultural foods because they cannot be provided by the dietary department 9. Which anatomical difference between adults and children places a pediatric patient at risk for insensible losses? 1) Large body surface area 2) Obligatory nose breathing 3) Disproportionate head size 4) Poorly developed intercostal chest muscles 10. Which pediatric anatomical factor increases the risk for respiratory failure when care is provided to a child? 1) Smaller airway 2) Obligatory nose breathing 3) Large posterior head bone occiput 4) Poorly developed intercostal chest muscles 11. Which pediatric anatomical factor increases the risk for airway occlusion when care is provided to a child? 1) A large posterior head bone occiput 2) An increase in total body surface area 3) A decrease in circulatory blood volume 4) Intercostal chest muscles that are poorly developed 12. The nurse is preparing an 8-year-old child for a procedure. Which statement is true of assent? 1) Feedback from the child is part of the agreement or assent. 2) All children 7 or older can participate in assent. 3) Assent only applies to emancipated children. 4) The health-care team does not need to include the parent or guardian in assent. [Show Less]
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