\CNL EXAM 3|113 Questions with Verified Answers
How does Stanhope define the advanced practice nurse? - CORRECT ANSWER The advanced practice nurse is a
... [Show More] licensed professional nurse prepared at the master's level or doctoral level to take leadership roles in applying the nursing process and public health sciences to achieve specific health outcomes for the community.
What organization offers the certification examinations for the advanced practice nurse? - CORRECT ANSWER American Nurses Credentialing Center (ANCC).
What are the roles of the advanced practice nurse? - CORRECT ANSWER Clinician, educator, administrator, consultant, and researcher
What is a clinical nurse leader and how is their role different from the BSN prepared - CORRECT ANSWER The clinical nurse leader is defined as a nurse who is a master's prepared generalist who function at the micro-system level and assumes accountability for health care outcomes for a specific group of clients within a unit or area. Their role is different from the BSN prepared nurse in the manor of the clinical nurse leader will take on the role of outcomes-based practice, and quality improvement strategies. The clinical nurse leader will collect and evaluate patient outcomes, assess cohort risk, and has the decision-making authority to change care plans when necessary.
What is the nurse role and responsibility in creating a new future for healthier communities? - CORRECT ANSWER These nurses have the responsibility to provide leadership in creating a new future for healthier communities. Nurse leaders act as change agents because they foster agency adaptation. Roles include: nurse leaders, managers, and consultants.
What are some of the theories community health nurse can use to explain group and individual behavior? - CORRECT ANSWER Systems theories and systems thinking emphasize the interdependence of multiple parties- dynamics of rapid interconnected change and the emergence of patterns of activity. Complex adaptive systems theory- accounts for the unpredictability of behavior of people and organizations.
What are some of the competencies nurse leaders need and why do they need these? - CORRECT ANSWER Nurse leaders need the following competencies: empowerment, delegation, critical thinking, decision making, and communication skills.
Empowerment is insuring nurses have the necessary knowledge, skills, and resources to effectively make the decision for which they are held accountable. This is needed as it allows for the clinical nurse leader to make their own decision about patient care, but also ensures they are held responsible for what occurs with the care given.
Delegation is used to for time management. This can help the clinical nurse leader to effectively do the work that is within their scope of practice. If they are able to give a task to a position below them, it can allow for work to be done more efficiently.
Critical thinking is used for the analysis and synthesis of data, using knowledge and values in making judgements, and using creative approaches in decision making and problem solving. The clinical nurse leader is responsible for evaluating client outcomes and changes plans when necessary. Critical thinking is needed to perform this task.
Decision making is used when the clinical nurse leader must decide on plan of care for a client. The clinical nurse leader will have the knowledge and skill to evaluate what will work best with the patient to have best overall care. Decision making is used to help in the performance of this task, as it gives effective decisions.
Communication skills are very effective in a leadership position. The clinical nurse leader needs communication skills as it allows for proper conflict resolution. The clinical nurse leader will talk with many people throughout the day either in person or through media. Communication skills will give the clinical nurse leader the ability to talk with clients effectively and resolve conflicts.
What is the difference between a home health and hospice nurse? - CORRECT ANSWER A home health nurse is a specialized nurse who delivers care in the residence of the client. A hospice nurse is a specialized nurse who provides "evidence-based physical, emotional, psychological, and spiritual or existential care to individuals and families experiencing life-limiting, progressive illness". p.890
How important is the involvement of family in home health care and hospice? - CORRECT ANSWER The involvement of family in home health care and hospice is very important. Family caregivers provide many aspects of care in the home that previously provided in hospitals or in home by professional caregivers.
What is transitional care and why has it become a new area for care delivery? - CORRECT ANSWER Transitional care is defined as a set of actions designed to ensure the coordination and continuity of health care as clients transfer between different locations and different levels of care in the same location. Transitional care consistently shows cost saving and improvements in clinical and quality outcomes for clients receiving the intervention compared with the usual care. The most common outcome across all populations is a consistent reduction in readmission to a hospital.
What is the Omaha System model of problem-solving and what is included in the system? - CORRECT ANSWER The Omaha System model of problem-solving was developed to operationalize the nursing process and provide a practical, easily understood, computer-compatible guide for daily use in the community. The system includes the Problem Classification Scheme, the Intervention Scheme, and the Problem Rating Scale for Outcomes.
When does Stanhope state that school nursing began? - CORRECT ANSWER Stanhope states that school nursing began in the late 1800s in England, where the Metropolitan Association of Nursing provided medical exams for children in the schools of London.
What are key legislative acts that promoted school nursing in the U.S.? - CORRECT ANSWER What are key legislative acts that promoted school nursing in the U.S.? Key legislative acts that promoted school nursing in the U.S. include: PL 93-112 Section 504 of the Rehabilitation Act, PL 94-142 Education for All Handicapped Children Act, Americans with Disabilities Act, PL 105-17 Individuals with Disabilities Education Act (IDEA), No Child Left Behind Act, and the Child Nutrition and WIC Reauthorization Act of 2004.
What is the professional body that developed standards of practice for the school nurse and what are the 11 criteria the professional standards rely on? - CORRECT ANSWER The National Association of School Nurses (NASN) is the professional body that developed standards for the school nurse. The professional standards rely on nurses to give care based on the following 11 criteria: 1. Develop school health policies and procedures
2. Evaluate their own nursing practice
3. Keep up with nursing knowledge
4. Interact with the interprofessional health care team 5. Ensure confidentiality in providing health care
6. Consult with others to provide complete care
7. Use research findings in practice
8. Ensure the safety of children, including when delegating care to other school personnel
9. Have good communication skills
10. Manage a school health program effectively
11. Teach others about wellness
What are school nurse roles? - CORRECT ANSWER Direct caregiver, health educator, case manager, consultant, counselor, community outreach, and researcher
Risk in epidemiology means what? - CORRECT ANSWER Risk means that some people have a higher probability of getting an illness than others. For example, people who smoke are at risk to lung cancer due to the cellular changes from smoking.
What is a vulnerable population group? - CORRECT ANSWER A vulnerable population group is a subgroup within a population that is more likely to develop health problems as a result of exposure to risk or to have worse outcomes from these health problems than the rest of the population.
Provide some examples of vulnerable population groups. - CORRECT ANSWER A few examples of vulnerable population groups are: the poor and homeless, pregnant adolescents, migrant workers and immigrants, the mental health population, those who abuse addictive substances, abuse victims or victims of violence, persons with communicable disease at those at risk of contracting said communicable disease, HIV positive persons, and those who have Hepatitis B or STDs.
What are disadvantaged populations? - CORRECT ANSWER Disadvantaged populations are those who experience health disparities due to having fewer resources for promoting health and treating illness than the average person in the United States.
Define outreach. - CORRECT ANSWER Outreach is an approach to making healthcare more easily available to certain populations by implementing health education, counseling, or support services in places where people normally congregate, such as places of worship, schools, workplaces, and community centers.
What is case finding related to vulnerable populations? - CORRECT ANSWER Case finding is when nurses design methods to find these vulnerable populations and individuals especially in need of service.
What is a safety net provider, and please give an example. - CORRECT ANSWER A Safety net provider is a term applied usually to community health centers or nurse-managed clinics that increase access to health and social services for vulnerable populations and those with limited financial ability to pay for care.
What is food insecurity? - CORRECT ANSWER Food insecurity is an issue that those living in extreme poverty such as the homeless or those living in marginal housing face. It can be described as a state where one does not know when or where their next meal will come from. These individuals do not have a steady supply or surplus of food to rely on throughout each day.
To be an effective nurse one must recognize and acknowledge what? - CORRECT ANSWER To be an effective nurse, one must recognize and acknowledge the beliefs, values, and knowledge that influence one's practice and worldview.
What were the Elizabethan poor laws and how did they impact society? - CORRECT ANSWER These laws were established in the 17th century, and said that persons who were born within the boundaries of the community should be given assistance by that community.
Define poverty. - CORRECT ANSWER Poverty is defined as having insufficient financial resources to meet basic living expenses. In the western cultures, poverty is most often viewed negatively; alternatively, poverty is respected in other cultures.
How is poverty determined in the U.S.? - CORRECT ANSWER The official poverty level in the United States in 2011 was $22, 350.
near poor mean? - CORRECT ANSWER Near poor refers to persons whose income is above the federal guidelines, yet is inadequate to meet basic needs.
What is neighborhood poverty? - CORRECT ANSWER This type of poverty is based on geographically defined areas of high poverty, characterized by dilapidated housing and high levels of unemployment. These areas also have higher mortality and morbidity rates, compared to higher income neighborhoods.
How is poverty related to health? - CORRECT ANSWER Poverty is associated with higher rates of chronic illness; higher infant morbidity and mortality rates; shorter life expectancy; more complex health problems; more significant complications and physical limitation from chronic diseases such as asthma, diabetes, and hypertension; and higher hospitalization rates.
homelessness? - CORRECT ANSWER Homelessness is defined as "lacking a fixed, regular, and adequate night-time residence and...has a primary nighttime residency that is:
(a) a supervised publicly or privately operated shelter designed to provide temporary living conditions
(b) an institution that provides a temporary residence for individuals intended to be institutionalized
(c) a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings" (p.743).
causes of homelessness? - CORRECT ANSWER A trend in a growing shortage of affordable housing, along with an increase in poverty, are the two main causes of homelessness. Deinstitutionalization of chronically mentally ill individuals from the public psychiatric hospitals is also a major cause of homelessness.
What effects does homelessness have on health? - CORRECT ANSWER Homeless people suffer greater incidences of acute and chronic illnesses, AIDS, and trauma. This population has limited access to adequate health care resources. Furthermore, this population often give lower priority to health promotion and health maintenance than to obtaining food and shelter.
What is the role of the nurse with homeless and poor populations? - CORRECT ANSWER The nurse creates a trusting environment; shows respect compassion, and concern; does not make assumptions; coordinate a number of services and providers; advocate for accessible health care services; focus on prevention; know when to walk beside the client and when to encourage the client to walk ahead; and develops a network of support for oneself.
What is the definition of the migrant farm worker? - CORRECT ANSWER An individual whose principal employment within the past 24 months is in agriculture on a seasonal basis and who establishes for the purpose of such employment a temporary abode.
What is the definition of the seasonal farm worker? - CORRECT ANSWER A seasonal farmworkers work cyclically in agriculture but do not migrate.
Migrant Health Act? - CORRECT ANSWER The Migrant Health Act was signed in 1962 and provides funds for primary and supplemental health services to migrant workers and their families. These funds are disbursed to 154 migrant health centers in 42 states that serve as models for delivery of services to a difficult-to-reach migrant population.
What are some of the occupational health risks for migrant farm workers? - CORRECT ANSWER Working conditions, such as standing on ladders, being exposed to chemicals, and using machinery, produce occupational health risks for the migrant farmworkers who may be inadequately protected or educated. Lack of a comprehensive surveillance system makes it difficult to know the extent of all injuries within the migrant population. Injuries such as sprains and strains, fractures, and lacerations are the most common.
Other injuries include amputations; crush injuries from tractors, trucks, or other machinery; acute pesticide poisoning; electrical injuries; drowning in ditches; chronic back pain; and dermatitis or conjunctivitis caused from irritation from the chemicals.
Pesticide exposure is common because the migrant farmworker;s dwell near fields or orchards and they may not have access to protective clothing or unable to afford it.
● Acute health effects of pesticide exposure include mild psychological and behavioral deficits such as memory loss, difficulty with concentration, mood changes, abdominal pain, nausea, vomiting, diarrhea, headache, malaise, skin rashes, and eye irritation.
● Chronic exposure might lead to cancer, blindness, Parkinson disease, infertility or sterility, liver damage, and polyneuropathy and neurobehavorial problems.
What impact does migrant farm work have on children in these families? - CORRECT ANSWER ● Malnutrition (vitamin A and iron deficiencies)
● Infectious diseases (upper respiratory tract infection, gastroenteritis) ●
Dental caries (from prolonged bottle-feeding, bottle-propping, and limited access to fluoride and dental care)
●Inadequate immunization status
● Pesticide exposure, injuries, overcrowding and poor housing conditions
● Disruption of their social and school life, lead to anxiety-related problems.
How does Mexican cultural beliefs' concerning health differ from the U.S. culture? - CORRECT ANSWER Mexican clients may not seek care with health professionals first. Instead they may consult with knowledgeable individuals in their family or community or with folk healers. They would consult issues with the wise older woman living in the community such as their grandmother or local parish priest.
Often time love for their children, rather than concern for their own health may encourage migrant parents to adopt healthier lifestyles. For example, when the parents of a child with asthma choose to stop smoking.
Mexican clients may be more willing to following the advice of another Mexican individual with a similar health problem rather than advice of the health professional.
The Mexican individual may not follow up with a clinic appointment because their perception of health is that a healthy person is one who can continue to work and maintain daily activities independent of symptoms or diagnosed diseases.
Mexican individuals may believe that illnesses are a punishment from God and may cite this belief as a rationale for why therapies have not cured them. This often leads to more chronic conditions.
What are the main causes of teen mortality in the U.S.? - CORRECT ANSWER Motor vehicle accident (usually including alcohol), homicide, suicide, and accidental injuries (such as falls, fires, or drowning)
What are the reasons that teens may not seek help for their problems? - CORRECT ANSWER 1. Access to health care may be hindered due to a limited number of professionals with expertise in dealing with teenagers
2. Cost of care or availability of insurance may limit services
3. Adolescents need to believe that their visits are confidential before they will honestly reveal information
4. Health care professionals must be able to discuss sensitive topics in a non-judgemental and supportive manner and demonstrate a desire to work with youths.
What are two reasons teens seek out healthcare assistance? - CORRECT ANSWER Concerns about a possible pregnancy or to find a birth control method
Describe the teens that have children and explain the difference in this population. - CORRECT ANSWER Teen parents often lack self-confidence and knowledge about proper infant care. They may have unrealistic expectations for the child, and lack knowledge about infant growth and development. Due to limited knowledge about normal child development, abusive parenting is more likely to occur.
The nurse can play an important role in educating the teen mother about proper infant care, expectations, and normal growth and development. The reason for the difference in this population may be related to the developmental stage of the teen mother and lack of preparedness--minimal prenatal care, lack of knowledge about infant care, etc.
Name some issue for teenage mothers and what is the nurse's role with these issues. - CORRECT ANSWER Violence
Nurse must observe for physical signs of abuse, as well as for controlling or intrusive partner behavior Initiation of
Prenatal Care
Cooperation between nurse and clinical staff can maximize client compliance with special health or nutritional needs. Nurse who makes home visits can provide additional assemssnet of the ten's condition and can solve problems about self-care, hygiene, meals, and schooling.
Nutrition
Nurse can reinforce the need for teen to take prenatal vitamins during pregnancy and after baby's birth. The nurse should also educate about iron-rich foods and foods that promote iron absorption, such as those containing vitamin C.
Infant care
Nurse observe mother response to infant cues. Specific techniques can be instructed to use in early child care. Begin early education as early as possible.
Repeat pregnancies
Nurses should review contraceptive options and help identify methods teen most likely use. After birth, follow up on woman's plan and identify obstacles and help problem solve with new mother.
How does Healthy People 2020 define mental health? - CORRECT ANSWER Mental health is defined by Healthy People 2020 as encompassing the ability to engage in productive activities and fulfilling relationships with other people, to adapt to change, and to cope with adversity
What is the National Alliance for the Mentally Ill - CORRECT ANSWER The National Alliance for the Mentally Ill is a consumer advocacy group that worked to establish education and self-help services for individuals and families with mental illness.
How does managed care impact mental illness? - CORRECT ANSWER Managed care impacted mental illness by providing a method to control costs and access to mental health care in the private insurance sector, managed care became a significant factor to public mental health, and more than half of the Medicaid recipients were enrolled in a managed mental health care plan.
How has the treatment of the mentally ill changed in the last 50 years? - CORRECT ANSWER First psychiatric hospital was built in Virginia, and approximately 50 years passed before widespread construction of facilities in other states. Even after the development of hospitals and site of treatment, persons with mental disorders were neglected and mistreated. There has been continued development of research and education programs, early intensive treatment for acute mental illness, and shifting the care of severely mentally ill persons away from the large hospitals to psychiatric wards in general hospitals and to community mental health clinics. Along with prevention and intervention, community services were to include aftercare services following hospitalization for individuals with major mental illness.
What did deinstitutionalization do to the mentally ill and how has this impacted healthcare and nursing? - CORRECT ANSWER Deinstitutionalization involved transitioning large numbers of people from state psychiatric hospitals to communities. The goal was to improve the quality of life for people with mental disorders by providing services in the communities where they lived rather than in large institutions. To change the locus of care, large hospital wards were closed and persons with severe mental disorders were returned to the community to live.
What is ATOD and why the change? - CORRECT ANSWER ATOD refers to 'alcohol, tobacco, and other drug'. The change in term was to remind the public that alcohol and tobacco are the major drugs of abuse when discussing chemical dependency.
How have attitudes shifted about the use of alcohol, tobacco, and drug use in the U.S. over the last 100 years? - CORRECT ANSWER Prior attitudes were formed around the way society categorized drugs. Drugs used to categorized to be either good or bad, in which good drugs were OTC drugs and those prescribed by a doctor, but these can be just as dangerous and addictive as the 'bad drugs'.
Bad drugs were those that low-life irresponsible people used including alcohol, tobacco, and other drugs. However, in 1954 the AMA listed alcohol addiction as an illness and tobacco addiction followed years after. Now these problems are viewed as medical diagnoses that require treatment.
Also, previous methods to control the war on drugs aimed at criminalizing those caught using drugs that were banned in the United States. However this has led to increase money spent on law enforcement than actual treatment and eradication of the drugs. Therefore, new methods are aimed and treating addicts and helping them get over their addiction to lead to eradication of drug use.
What is the role of the nurse in primary, secondary, and tertiary prevention in the use of alcohol, tobacco, and drugs? - CORRECT ANSWER Primary prevention role: Primary prevention focuses on the promotion of healthy lifestyles and resiliency factors, along with education about drugs and guidelines for their use. Nurses utilize many health promotion strategies including education on alternatives and drugs altogether to prevent the use of harmful drugs.
Secondary prevention role: The nurse uses screening tools to detect ATOD problems, followed by educating the individuals to understand the connection between their drug use and the negative consequences they have. Also, early intervention can be used to treat the problems to avoid needing further more intensive treatment.
Tertiary prevention role: The nurse focuses on supporting the patient along with their family through the treatment process while connecting them to all the possible resources to ensure proper treatment and care. Many addicts can get lost in the process of detox or smoking cessation programs, leading to giving up altogether. It is the nurse's role to follow the patient throughout the process to support them and keep them on track to complete treatment.
What is violence? - CORRECT ANSWER Violence is non-accidental acts that occur interpersonally and intrapersonally that result in physical or psychological injury. Violence is predictable therefore preventable with community action.
How has religion played a role in violence in families? - CORRECT ANSWER Although religion can help those experiencing anguish get through times, it can also lead to continuation of violence. Due to religions that do not accept divorce, men and women being abused by their partner will stay in the violent relationship to uphold their religious beliefs. Also, religious affiliation and religious conservatism have been identified as risk factors for family violence, especially child abuse.
What is homicide, assault, and rape and what might be a nurse's role in dealing with victims, families, and communities of these acts? - CORRECT ANSWER Homicide:
Intentional killing of one person by another. Nurse have a role in preventing homicide in families where abuse is present and detected. Nurses who understand how upbringing, living conditions, and increased stress contribute to IPV are more equipped to manage abusive families. [Show Less]