The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two
... [Show More] types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career?
A. Clinical nurse specialist
B. Nurse administrator
C. Nurse educator
D. Nurse researcher
D
Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform?
A. Moving from an acute illness to a health promotion, illness prevention model
B. Moving from illness prevention to a health promotion model
C. Moving from an acute illness to a disease management model
D. Moving from a chronic care to an illness prevention model
A
An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, listens to her lung and heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed?
A. Diagnosis
B. Evaluation
C. Assessment
D. Implementation
C
A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with them. The nurse is acting as the patient's:
A. Educator
B. Advocate
C. Caregiver
D. Case manager
B
A nurse meets with the registered dietician and physical therapist to develop a plan of care that focuses on improving nutrition and mobility for a patient. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency?
A. Patient-centered care
B. Safety
C. Teamwork and collaboration
D. Informatics
C
You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which of the following statements best describes this code?
A. Improves self-health care
B. Protects the patient's confidentiality
C. Ensures identical care to all patients
D. Defines the principles of right and wrong to provide patient care
D
Nurses in an acute care hospital are attending a unit based education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education?
A. Continuing education
B. Graduate education
C. In-service education
D. Professional Registered Nurse Education
C
A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed?
A. Planning
B. Evaluation
C. Assessment
D. Implementation
D
Which of the following Internet resources available can assist consumers when comparing quality care measures?
A. WebMD
B. Hospital Compare
C. Magnet Recognition Program
D. Hospital Consumer Assessment of Healthcare
E. The American Hospital Association's web page
B, D
According to Benner, an expert nurse goes through five levels of proficiency. Identify them.
1. Novice
2. Advanced Beginner
3. Competent
4. Proficient
5. Expert
What are the ANA Standards of Practice?
ADO PIE
1. Assessment
2. Diagnosis
3. Outcome identification
4. Planning
5. Implementation
6. Evaulation
Define nursing according to ANA
the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations
Identify the ANA Standards of Professional Performance
1. Ethics
2. Education
3. EBP and research
4. Quality of care
5. Communication
6. Leadership
7. Collaboration
8. Professional practice evaluation
9. Resources
10. Environmental health
How did Florence Nightingale see the role of the nurse in the early 1800s?
Having "charge of someone's health" based on knowledge of how to put body in such a state to be free of disease or to recover from disease
Lilian Wald and Mary Brewster
Opened the Henry Street Settlement, focusing on the health needs of the poor
Mary Adelaide Nutting
Instrumental in moving nursing education into universities.
Mary Mahoney
First professionally trained African American nurse
The factor that best advanced the practice of nursing in the twenty-first century was:
A. Growth of cities
B. Teachings of Christianity
C. Better education of nurses
D. Improved conditions for women
C
A group that lobbies at the state and federal levels for advancement of nurses' role, economic interests, and health care is the:
A. State boards of nursing
B. American Nurses Association
C. American Hospital Association
D. National student nurses association
B
A nurse is presenting information to a management class of nursing students on the topic of financial reimbursement for achievement of established, measurable patient outcomes. The nurse is presenting information to the class on which topic?
A. Prospective payment system
B. Pay for performance
C. Capitation payment system
D. Managed care systems
B
Nurses on a nursing unit are discussing the processes that led up to a near-miss error on the clinical unit. They are outlining strategies that will prevent this in the future. This is an example of nurses working on what issue in the health care system?
A. Patient safety
B. Evidence-based practice
C. Patient satisfaction
D. Maintenance of competency
A
The nurses on a medical unit have seen an increase in the number of pressure ulcers that develop in their patients. They decide to initiate a quality improvement project using the Plan-Do-Study-Act (PDSA) model. Which of the following is an example of "Do" from that model?
A. Implementing the new skin care protocol on all medicine units.
B. Reviewing the data collected on patients cared for using the protocol.
C. Reviewing the quality improvement reports on the six patients who developed ulcers over the last 3 months.
D. Based on findings from patients who developed ulcers, implementing an evidence-based skin care protocol.
D
Which of the following nursing activities is provided in a secondary health care environment?
all that apply
A. Conducting blood pressure screenings for older adults at the Senior Center.
B. Teaching a clinic patient with chronic obstructive pulmonary disease purse-lipped breathing techniques.
C. Changing the postoperative dressing for a patient on a medical-surgical unit.
D. Doing endotracheal suctioning for a patient on a ventilator in the medical intensive care unit.
C, D
Which of the following are examples of the nurse participating in primary care activities?
all that apply
A. Providing prenatal teaching on nutrition to a pregnant woman during the first trimester
B. Assessing the nutritional status of older adults who come to the community center for lunch.
C. Working with patients in a cardiac rehabilitation program
D. Providing home wound care to a patient
E. Teaching a class to parents at the local grade school about the importance of immunizations.
A, B, E
A nurse is using data collected from the unit to monitor the incidence of falls after the unit implemented a new fall protocol. The nurse is working in which area?
A. Quality improvement
B. Health care patient system
C. Nursing informatics
D. Computerized nursing network
A
A group of staff nurses notice an increased incidence of medication errors on their unit. After further investigation it is determined that the nurses are not consistently identifying the patient correctly. A change is needed quickly. What type of quality improvement method would be most appropriate?
A. PDSA
B. Six Sigma
C. Rapid-improvement event
D. A randomized controlled trial
C
A patient tells a nurse that she is enrolled in a preferred provider organization (PPO) but does not understand what this is. What is the nurse's best explanation of a PPO?
A. This health plan is for people who cannot afford their own health insurance
B. This health plan is operated by the government to provide health care to older adults
C. This health plan gives you with a list of physicians and hospitals from which you can choose
D. This is a fee-for-service plan in which you can choose any physician or hospital
C
A nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is an appropriate goal for restorative care?
A. Patient will be able to walk 200 feet without shortness of breath
B. Wound will heal without signs of infection
C. Patient will express concerns related to return to home
D. Patient will identify strategies to improve sleep habits
A
The nursing staff is developing a quality program. Which of the following are nursing-sensitive indicators from the National Database of Nursing Quality Indicators (NDNQI) that the nurses can use to measure patient safety and quality for the unit?
Select all that apply.
A. Use of physical restraints
B. Pain assessment, intervention, and reassessment
C. Patient satisfaction with food preparation
D. Registered nurse (RN) education and certification
E. Number of outpatient surgical cases per year
A, B, D
Which of the following statements is true regarding Magnet status recognition for a hospital?
A. Nursing is run by a Magnet manager who makes decisions for the nursing units
B. Nurses in Magnet hospitals make all of the decisions on the clinical units
C. Magnet is a term that is used to describe hospitals that are able to hire the nurses they need
D. Magnet is a special designation for hospitals that achieve excellence in nursing practice
D
A community center is presenting a nurse-led program on the Patient Protection and Affordable Care Act. Which statement made by a participant indicates a need for further teaching?
A. "My small company will now have to offer the 75 employees health insurance or pay a penalty."
B. "As long as my son is a full-time student in College, I will be able to keep him on my health insurance until he is 26 years old."
C. "I signed up for the state health insurance exchange before the designated deadline to make sure I had health insurance."
D. "Since I have now been diagnosed with diabetes, my health insurance plan cannot charge me higher premiums."
B
A nurse is using the Plan-Do-Study-Act (PDSA) strategy to do a quality improvement project to decrease patient falls on a nursing unit. What is the correct sequence for PDSA?
1. Bedside change of shift report is piloted on two medical-surgical units
2. Patient satisfaction levels after implementation of the bedside report are compared to patient satisfaction levels before the change
3. The nursing council develops a strategy for bedside change of shift report
4. After modifications are made in the shift report elements, bedside shift report is implemented on all nursing units
A. 1, 3, 2, 4
B. 2, 1, 3, 4
C. 1, 2, 3, 4
D. 3, 1, 2, 4
D
Which activity performed by a nurse is related to maintaining competency in nursing practice?
A. Asking another nurse about how to change the settings on a medication pump
B. Regularly attending unit staff meetings
C.Participating as a member of the professional nursing council
D. Attending a review course in preparation for a certification examination
D
Which of the following are characteristics of managed care systems?
Select all that apply.
A. Provider receives a predetermined payment for each patient in the program.
B. Payment is based on a set fee for each service provided.
C. System includes a voluntary prescription drug program for an additional cost.
D. System tries to reduce costs while keeping patients healthy.
E. Focus of care is on prevention and early intervention.
A, D, E
Theory is essential to nursing practice because it:
Select all that apply.
A. Contributes to nursing knowledge.
B. Predicts patient behaviors in situations.
C. Provides a means of assessing patient vital signs.
D. Guides nursing practice.
E. Formulates health care legislation.
F. Explains relationships between concepts.
A, B, C, F
The components of the nursing metaparadigm include:
A. Person, health, environment, and theory
B. Health, theory, concepts, and environment
C. Nurses, physicians, health, and patient needs
D. Person, health, environment, and nursing
D
The nurse is caring for a patient admitted to the neurological unit with the diagnosis of a stroke and right-sided weakness. The nurse assumes responsibility for bathing and feeding the patient until the patient is able to begin performing these activities. The nurse in this situation is applying the theory developed by:
A. Neuman
B. Orem
C. Roy
D. Peplau
B
While working in a rehabilitation facility, it is important to obtain nursing histories and develop a therapeutic nurse-patient relationship. Which of the following lists in correct order the phases of Peplau's theory as applied in this setting. The nurse:
1. Ensures that the patient has access to appropriate community resources for long-term care.
2. Collaborates with the patient to identify specific patient needs
3. Collects essential information from the patient's health record.
4. Works with the patient to develop a plan for resolving patient issues.
A. 3, 4, 2, 1
B. 1, 3, 2, 4
C. 3, 2, 4, 1
D. 2, 3, 4, 1
C
Which of the following types of theory influence the "evidence" in current "evidence-based practice (EBP)"?
A. Grand theory
B. Middle-range theory
C. Practice theory
D. Shared theory
B
Using Maslow's hierarchy of needs, identify the priority for a patient who is experiencing chest pain and difficulty breathing.
A. Self-actualization
B. Air, water, and nutrition
C. Safety
D. Esteem and self-esteem needs
B
Which of the following statements related to theory-based nursing practice are correct?
Select all that apply.
A. Nursing theory differentiates nursing from other disciplines.
B. Nursing theories are standardized and do not change over time.
C. Integrating theory into practice promotes coordinated care delivery.
D. Nursing knowledge is generated by theory.
E. The theory of nursing process is used in planning patient care.
F. Evidence-based practice results from theory-testing research.
A, C, D, F [Show Less]