Timby's Introductory Medical-Surgical Nursing 13th Edition Moreno Test Bank
Chapter 1 Concepts and Trends in Healthcare
◦ A new nurse is working with
... [Show More] a preceptor on an inpatient medical-surgical unit. The preceptor advises the student that which is the priority when working as a professional nurse?
◦ Attending to holistic client needs ◦
Ensuring client safety
◦ Not making medication errors ◦
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 clientshave 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
◦ 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 ownsafety?
◦ ◦ ◦ ◦
Encourage the client and family to be active partners. Have the client monitor hand hygiene in caregivers. Offer the family the opportunity to stay with the client.
Tell the client to always wear his orher 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 isthe most critical. The other actions are ◦ ◦
very limited in scope and do not provide the broad protection
thatbeing active and involved does. ◦
DIF: Understanding/Comprehension REF: 3
KEY: Patient safety MSC: Integrated Process: Teaching/ Learning ◦
NOT: Client Needs Category: Safe and Effective CareEnvironment: Safety and Infection Control
◦ A nurse is caring for a postoperative client on the surgical unit. The clients
bloodpressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm
Hg. What action by the nurse is best?
Call the Rapid Response Team.
◦
◦
Document and continue to monitor.
◦ Notify the primary care provider.
◦
Repeat blood pressure
measurementin 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 theclient 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
◦
◦ A nurse wishes to provide client-centered care in all interactions.
Whichaction by the nurse best demonstrates this concept?
◦ Assesses for cultural influences affecting health care
◦
Ensures that all the clients basic needs are met
◦
◦
Tells the client and family about all upcoming tests
Thoroughly orients the client
andfamily to the roomANS: A
◦
Competency in client-focused care is demonstrated when the
nursefocuses 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
tellingthe 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
◦ 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 doto protect against errors?
◦
◦
◦
◦
Bring a list of all medications and what they are for.
Keep the doctors phone number by the telephone.
Make sure all providers wash hands before entering the room.
Write down the name of each caregiver
whocomes 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
theytake 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
◦ Which action by the nurse working with a client best demonstrates respect
forautonomy?
◦ Asks if the client has questions before signing a consent
◦
Gives the client accurate information when questioned
◦
◦
◦
Keeps the promises made to the client and family
Treats the client fairly
compared to other
clientsANS: 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
cannotpractice autonomy. Giving accurate information is practicing with veracity.
Keeping promises is upholding fidelity. Treating the
◦
◦
◦
◦
◦
◦
of Care
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◦
◦ A student nurse asks the faculty to explain best practices when
communicatingwith a person from the lesbian, gay, bisexual, transgender,
and queer/ questioning (LGBTQ) community. What answer by the faculty is
most accurate?
◦ Avoid embarrassing the client by asking questions.
◦
Dont make assumptions about their health needs.
◦
◦
Most LGBTQ people do not want to share information.
No differences exist in communicating
withthis 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 anyhealth care need is more likely to answer honestly.
◦
DIF: Understanding/Comprehension REF:
4KEY: LGBTQ| diversity MSC: Integrated Process:
Teaching/Learning
◦
NOT: Client Needs Category: Psychosocial Integrity
◦
◦ A nurse is calling the on-call physician about a client who had a
hysterectomy 2days ago and has pain that is unrelieved by the prescribed
narcotic pain medication. Which statement is part 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.
R: Dr. Smith doesnt like nonsteroidal anti-inflammatory meds.
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
mightorder. 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
preferencemight be better placed in background.
◦
DIF: Applying/
Application REF: 5 KEY:
SBAR| communication◦
of Care◦
◦
◦ A nurse working on a cardiac unit delegated taking vital signs to an
experienced unlicensed assistive personnel (UAP). Four hours later, the
nursenotes 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?
Determining if the UAP knew how to take blood pressure
◦
◦
◦
◦
Double-checking the UAP by taking another blood pressure
Providing more appropriate supervision of the UAP
Taking the blood pressure instead
ofdelegating 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 ofdelegation. 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:
IntegratedProcess: Communication and
Documentation
◦
MSC: Integrated Process: Communication and Documentation
NOT: Client Needs Category: Safe and Effective Care Environment: Management
NOT: Client Needs Category: Safe and Effective Care Environment: Management
of Care
◦
◦ A newly graduated nurse in the hospital states that, since she is so new, she
cannot participate in quality improvement (QI) projects. What response by
theprecepting nurse is best?
◦ All staff nurses are required to participate in quality improvement here.
◦
Even being new, you can implement activities designed to improve care.
◦
◦
Its easy to identify what indicators should be used to measure quality.
You should ask to be assigned to the research
andquality committee. ANS: B
◦
◦
The preceptor should try to reassure the nurse that implementing
QI measures is not out of line for a newly licensed nurse. Simply stating that all
nurses are required to participate does not help the nurse understand how that is
possible andis dismissive. Identifying indicators of quality is not an easy, quick process and
would not be the best place to suggest a new nurse to start.
◦
Asking to be assigned to the QI committee does not give the
nurseinformation about how to implement QI in daily practice.
◦
DIF: Applying/
Application REF: 6 KEY:
Quality improvement
◦
MSC: Integrated Process: Communication and Documentation
◦
of Care
◦
◦ A nurse is talking with a client who is moving to a new state and needs to
finda new doctor and hospital there. What advice by the nurse is best?
◦ Ask the hospitals there about standard nurse-client ratios.
◦
Choose the hospital that has the newest technology.
◦
◦
Find a hospital that is accredited by The Joint Commission.
Use a facility affiliated with a medical
ornursing school. ANS: C
◦
Accreditation by The Joint Commission (TJC) or other accrediting
body gives assurance that the facility has a focus on safety. Nurse-client ratios
differby unit type and change over time. New technology doesnt necessarily mean
the hospital is safe. Affiliation with a health professions school has several
advantages, but safety is most important.
◦
DIF: Understanding/
Comprehension REF: 2 KEY: The Joint
Commission (TJC)| accreditation
◦
MSC: Integrated Process: Communication and Documentation
◦
NOT: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
◦
MULTIPLE RESPONSE
◦
◦ A nurse manager wishes to ensure that the nurses on the unit are
practicing at their highest levels of competency. Which areas should
themanager assess to determine if the nursing staff demonstrate
competency according to the Institute of Medicine (IOM) report
Health Professions Education: A Bridge to Quality? (Select all that
apply.)
◦
◦
◦
Collaborating with an interdisciplinary team
◦
Implementing evidence-based care
Providing family-focused care
NOT: Client Needs Category: Safe and Effective Care Environment: Management◦
Routinely using informatics in practice
◦ Using quality improvement
in client care ANS: A, B, D,E
◦
The IOM report lists five broad core competencies that all health
care providers should practice. These include collaborating with the
interdisciplinary team,implementing evidence-based practice, providing client-
focused care, using informatics in client care, and using quality improvement in
client care.
◦
◦
DIF: Remembering/Knowledge REF: 3
KEY: Competencies| Institute
of Medicine (IOM) MSC: Integrated Process:
Nursing Process: Assessment
◦
NOT: Client Needs Category: Safe and Effective Care
Environment: Safety and Infection Control
◦ A nurse is interested in making interdisciplinary work a high
priority. Which actions by the nurse best demonstrate this skill?
(Select all thatapply.)
◦
◦
◦
◦
◦
Consults with other disciplines on client care
Coordinates discharge planning for home safety
Participates in comprehensive client rounding
Routinely asks other disciplines about client progress
Shows the nursing care plans to
other disciplines ANS: A, B, C, D
◦
Collaborating with the interdisciplinary team involves planning,
implementing, and evaluating client care as a team with all other disciplines
included.Simply showing other caregivers the nursing care plan is not actively
involving them or collaborating with them.
◦
◦
◦
◦
of Care
◦
◦
The nurse utilizing evidence-based practice (EBP) considers
whichfactors when planning care? (Select all that apply.)
◦
Cost-saving measures
◦ Nurses expertise
◦
◦
Client preferences
DIF: Applying/Application REF: 4
KEY: Collaboration| interdisciplinary team
MSC: Integrated Process: Communication and Documentation
NOT: Client Needs Category: Safe and Effective Care Environment: Management◦
◦
Research findings
Values
of the
client
ANS:
B, C,
D, E
◦
EBP consists of utilizing current evidence, the clients values and
preferences, and the nurses expertise when planning care. It does not include
cost-saving measures.
◦
DIF:
Remembering/Knowledge REF:
6 KEY: Evidence-based
practice (EBP)
◦
MSC: Integrated Process: Nursing Process: Planning
◦
of Care
◦
◦ A nurse manager wants to improve hand-off communication among
thestaff. What actions by the manager would best help achieve this
goal? (Select all that apply.)
◦ Attend hand-off rounds to coach and mentor.
◦
Conduct audits of staff using a new template.
◦
◦
◦
Create a template of topics to include in report.
Encourage staff to ask questions during hand-off.
Give raises based on
compliancewith reporting. ANS:
A, B, C, D
◦
NOT: Client Needs Category: Safe and Effective Care Environment: Management
A good tool for standardizing hand-off reports and other critical
communication is the SHARE model. SHARE stands for standardize critical
information, hardwire within your system, allow opportunities to ask questions,
reinforce quality and measurement, and educate and coach.
◦
Attending hand-off report gives the manager opportunities to
educateand coach. Conducting audits is part of reinforcing quality. Creating a
template is hardwiring within the system.
◦
Encouraging staff to ask questions and think critically about the
information is allowing opportunities to ask questions. The manager may need to
tie raises into compliance if the staff is resistive and other measures have failed,
but thisis not part of the SHARE model.
◦
◦
Chapter 2
CareMULTIPLE CHOICE
Settings and Models for Nursing•
The nurse ensures that a clients bedspace is neat and clean
with the call light within easy reach. The nurse is focusing on
which nursing theorist who realized the importance of the
environmentfor care?
•
•
•
•
ANS: 1
Florence Nightingales theory focused on the environment for care.
SisterCallista Roys model is based in systems theory and an
individuals abilityto adapt. Dorothea Orems model is the self- care
deficit theory. Martha Rogers model is the science of unitary human
beings.
PTS:1DIF:Apply
REF:Emergence of Contemporary Nursing in the United States
•
Florence Nightingale
Sister Callista Roy
Dorothea Orem
Martha Rogers
The nurse is instructing a client on self-administration of
insulin so that the client will not need a health care provider to
do this activity. The nurse is implementing which of the
following aspectsof Virginia Hendersons theory of nursing?
• A caring relationship
•
Helping the client achieve independence from the nurses assistance as quickly
aspossible
•
Integration of objective and subjective data
• Application of critical thinking
ANS: 2Virginia Hendersons theory of nursing is to help people achieve health
ora peaceful death so that they can be independent from the nurses
assistance as quickly as possible. A caring relationship, integration of
objective and subjective data, and application of critical thinking are
included in the American Nurses Associations essential features of
professional nursing.
PTS:1DIF:Analyze
REF:Emergence of Contemporary Nursing in the United States
3.A client tells the nurse that he has an HMO for his health insurance.
Thenurse understands that the purpose of this type of health plan is to:
•
ensure payment is made to Medicare for services rendered.
• maximize the utilization of health care resources.
•
efficiently manage costs while providing quality care.
•
ANS: 3
Health maintenance organizations (HMOs) were created to efficiently
manage health care costs while providing quality care. An HMO is a
typeof managed care plan with the goal of providing wellness care and
not focusing on the illness during the provision of care. HMOs do not
ensurepayment is made to Medicare for services rendered. HMOs also
do not maximize the utilization of health care resources but rather
uses financialincentives to decrease care costs.
PTS: 1 DIF: Understand REF: Cost of Care
•
client tells the nurse that he does not have a primary
care physician but rather makes an appointment with
a doctor who specializes in the area in which he is
experiencing a problem. The nurse realizes this client
isat risk for which of the following?
•
Fragmented care
focus on the illness when providing care.•
•
•
ANS: 1
In the 1980s, the close and trusting relationship between an individual
andthe individuals physician waned and was replaced by acquaintances
with specialists based upon particular health care problems. These
episodes of care cause fragmentation of care. The client who utilizes
specialists is not at risk for overpayment of services, the inability to
sustain health, or finding an appropriate general practitioner.
PTS:1DIF:AnalyzeREFroviders of Care
•
The nurse is attending a masters degree
program in efforts to be educationally
prepared to serve as a hospital leader. The
nurse realizes that this educational
preparationwill:
•
•
hinder the nurses ability to work with physicians.
be viewed as not supporting the profession of nursing by
othernurses.
•
ensure the nurse is biased towards clinicians interests.
prepare the nurse to serve as strong clinical support with the ability to integrate
business and
•
ANS: 4
The nurse is attending an educational program to serve as a hospital
leader. This education will prepare the nurse to serve as strong clinical
support with the ability to integrate business and caring. This
education will not hinder the nurses ability to work with physicians.
This educationwill not be viewed as unsupportive to the profession of
nursing. The
caring.
Overpayment of services
Inability to sustain health
Finding an appropriate general practitionereducation will ensure that the nurse is not biased towards
cliniciansinterests.
PTS: 1 DIF: Analyze REF: Clinical Systems Leadership
•
client tells the nurse that all hospitals care about is
doing the minimum for a client regardless of the
outcome. Whichof the following should the nurse
respond to this client?
•
•
•
It does feel like that sometimes.
Health insurance companies have caused this problem.
The doctors will get paid regardless of the clients outcomes.
There are quality programs in place to make sure clients receive the best
quality ofcare regardless
•
of the cost.
ANS: 4
In response to concerns about safety and quality of care voiced by
clientsand providers, total quality management and continuous quality
improvement programs were initiated. These programs ensure society
that cost management is not compromising safety or quality. This is
whatthe nurse should respond to the client. The other choices do not
address the clients concerns nor do they explain quality management
programs.
PTS: 1 DIF: Apply REF: Quality Measure Shift
•
The nurse is providing care at a time that is the most
beneficial to the client. The nurse is implementing which of
the following Joint Commission Dimensions of Quality
Performance?
•
•
•
Safety
Timeliness
Efficiency• Availability
ANS: 2
The dimension of timeliness means the degree in which interventions
are provided at the most beneficial time to the client. Safety means the
degreein which the risk of an intervention and risk to the environment
are reduced for both client and health care provider. Efficiency means
the degree in which care has the desired effect with a minimum of
effort, waste, or expense.
Availability means the degree in which appropriate interventions
areavailable to meet the clients needs.
PTS:1DIF:Analyze
REF:Box 1-1 Joint Commission Dimensions of Quality Performance
•
The nurse is providing care while adhering to safety as a
Joint Commission Dimension of Quality Performance.
Which of the following did the nurse provide to the
client?
• Using a needleless device when providing intravenous medications
•
Keeping the siderails of the bed in the down position after providing a
painmedication to a client
•
•
ANS: 1
The dimension of safety means the degree in which the risk of an
intervention and risk to the environment are reduced for both client
andhealth care provider. The nurse who uses a needleless device when
providing intravenous medications is adhering to this dimension.
Keeping the siderails in the down position is not a safe practice.
Havinga client sit in a wheelchair with the wheels unlocked is not a
safe practice. Placing cloth towels over a spill in the room of an
ambulatory client is not a safe practice.
PTS:1DIF:Analyze
REF:Box 1-1 Joint Commission Dimensions of Quality Performance
•
The nurse is planning and providing care while adhering to the
Having the client sit in a wheelchair with the wheels in the unlocked position
Placing cloth towels over a spill in the room of an ambulatory clientAmerican NursesAssociation definition of professional
nursing.Which of the following does the nurse include when
implementing client care?
•
•
•
Follows the NANDA nursing diagnoses process
Integrates objective and subjective data
Respects cultural diversity of peers
• Acknowledges the experience and training of physicians
ANS: 2
The American Nurses Association acknowledges six essential features
of professional nursing. These include: 1) a caring relationship, 2)
attention to the full range of human health and illness experiences, 3)
integrates objective and subjective data, 4) applies scientific knowledge
and criticalthinking, 5) advances nursing knowledge through scholarly
inquiry, and
6) promotes social justice. The nurse integrating objective and
subjectivedata is implementing one of the six essential features of
professional nursing. The other choices are not essential features of
professional nursing.
PTS:1DIF:Analyze
•
The nurse has shifted her practice from an illness focus
to ahealth focus. Which ofthe following has this nurse
implemented?
•
•
•
•
Standardized care plans
Critical pathways
Instructing a client on relaxation techniques to aid with sleep
Holding around-the-clock medication when a client is asleepANS: 3
The use of client education as a strategy to attain and maintain the
potential for health is an example of the shift of care from an illness
focus to a health focus. The nurse instructing a client on relaxation
techniques to aid with sleep is implementing a health focus of care.
Theother choices do not support the shift from an illness focus to a
health focus.
PTS: 1 DIF: Analyze REF: Leadership
•
client is admitted with a highly communicable disease.
The nurses do not want to participate in the care of
this client. Which of the following should be done to
ensure the client receives the highest quality of care?
• Adhere to strict standard precautions.
•
Plan to have the client transferred to another health care organization.
• Ask the physician if the client can be cared for in the home.
•
Suspend the nurses without pay who refuse to care for the client.
ANS: 1
When providing care in a highly global environment, the risks of
communicable diseases increases. In the event that a client is admitted
with a highly communicable disease and the nurses are fearing for
their own health and safety, the only safe approach is to ensure all
staff adhereto strict standard precautions. The other choices do not
ensure that the client will receive the highest quality of care. The
nurses must learn emotional intelligence and resolve issues under fire.
•
The nurse has been an employee of an organization for
2years and is considering a job change. Which of the
following does this nurses plan suggest to any future
employers?
•
The nurse moves to other jobs too frequently.•
•
The nurse is inflexible.
The nurse is searching for a more challenging environment with
careeropportunities.
•
ANS: 3
At one point in time, job changes every 2 or 3 years was considered a
red flag for employers. This does not hold true today. The nurse who
changes jobs every 2 or 3 years is interested in career advancement
andsuccess. Creativity is valued and opportunities are desired.
Moving to another job in 2 to 3 years does not mean the nurse is
inflexible. The new generation of nurses does not want to sacrifice
home and personal life for a job.
PTS: 1 DIF: Analyze REF: Care Delivery Models
•
The nurse is experiencing pain and fatigue in both arms
when using the computer to document client care. Which
ofthe following can the nurse do to reduce these
symptoms?
•
•
Refuse to use the computer and document using a pen and paper.
Stand up when using the computer.
• Adjust the keyboard and chair to reduce the pressure on the wrists and arms.
• Ask another nurse to input the information for client care activities.
ANS: 3
Ergonomic hazards are increasing with health care providers and
nurses in particular. Many of these hazards are because of the
implementation ofcomputers for documentation. The nurse should
adjust the keyboard and chair to reduce the pressure on the wrists and
arms when documenting with the computer. The nurse cannot refuse
to use the computer. Standingup may not reduce the nurses symptoms.
The nurse cannot legally ask another nurse to document client care.
The nurse is willing to sacrifice home and personal life for a job.MULTIPLE RESPONSE
•
The nurse is planning care for a client and reviewing
appropriateeducational materials to use for discharge
instructions. Which domains of nursing is this nurse
implementing? (Select all that apply.)
• Nursing process
•
Clinical practice
•
•
Education
Literature
• Administration
•
Research
ANS: 2, 3
The four domains of nursing are: 1) clinical practice, 2) education, 3)
administration, and 4) research. When the nurse plans care for a
client, the domain being implemented is clinical practice. When
reviewing appropriate educational materials to use for discharge
instructions, the domain being implemented is education. The nurse is
not utilizing the domains of research or administration. Nursing
process and literature arenot domains of nursing.
PTS:1DIF:Apply
REF:Emergence of Contemporary Nursing in the United States
•
The nurse suspects that another health care colleague may
bechemically dependentwhen which of the following is
assessed? (Select all that apply.)
•
Prolonged work breaks
•
Clinical care omissions• Mood stability
•
•
•
Extraordinary accomplishments
Heavy use of fragrances
Inability to recall recent
eventsANS: 1, 2, 4, 5, 6
Clues of possible chemical dependency include tardiness, late sick calls,
frequent or prolonged work breaks, inability to recall recent events,
heavy use of fragrances, clinical care omissions or errors, patient
complaints or requests for a change in care provider, mood instability,
and extraordinary accomplishments. Mood stability is not a
characteristicof a colleague who is experiencing chemical dependency.
PTS:1DIF:Apply
REF:Box 1-6 Clues to the Possibility of Chemical Dependence
•
The nurse is a member of a health care team that includes a
physician and other health care providers. These providers
worktogether to ensure the client is relieved of suffering, has
diseases cured, and experiences enhanced health and
performance. Which of the following are the levels of care
represented by this team of health care providers? (Select all
that apply.)
•
•
•
Sustain life
Maintain health
Regain health
• Minimize injury• Maximize cost
• Attain enhanced health
ANS: 1, 2, 3, 6
The medical teams mission is to relieve suffering and cure disease.
Thisinvolved the three levels of care: 1) sustain life, 2) regain health,
and 3) maintain health. Once the shift toward health care occurred,
the fourth level of attaining enhanced health was added. Minimize
injury and maximize cost is not a level of care.
PTS:1DIF:AnalyzeREFroviders of Care
•
client tells the nurse that she is disappointed that her
employer is offering a health maintenance
organization for a health care benefit. Which of the
following can thenurse use as responses to the client
as advantages of thistype of health plan? (Select all
that apply.)
•
•
Since there is a nursing shortage, clients need to stay out of the hospital.
This type of plan provides wellness care at a minimal cost to keep
peoplehealthy.
•
•
This type of plan helps clients avoid illnesses with high costs.
An HMO standardizes diagnostic and treatment decisions across
thenation.
•
This type of plan ensures coordinated services from wellness to death.
This type of plan costs as much as the traditional plans, but the insurance
companiesget the extra
• money from premiums.
ANS: 2, 3, 4, 5There are several missions and visions of managed care. The first is to
provide wellness care at a minimal cost to keep people healthy and
avoidproviding illness care at a higher cost. Another mission is to
standardize diagnostic and treatment decisions across the nation.
Managed care emphasizes the delivery of coordinated services across
the care spectrum from wellness to death and uses financial incentives
to decrease length ofstay and achieve cost efficiency. Managed care
was not implemented to address the nursing shortage. This type of
plan does not cost as much as a traditional health plan nor do the
insurance companies receive the extramoney from premiums.
PTS: 1 DIF: Apply REF: Cost of Care
•
The nurse has incorporated several criteria that are
essential for being a member ofa profession. Which
ofthe following has this nurse done? (Select all that
apply.)
•
Has passed the licensure examination
• Works regularly scheduled shifts
•
Completed a bachelors degree in nursing
•
•
•
Limits absences from work
Joined the American Nurses Association
Reads evidenced-based information to incorporate into planning client
careANS: 1, 3, 5, 6
There are seven essential criteria for a profession. The nurse has
incorporated four of these criteria by passing the licensure
examination, the nurse has implemented a code of ethics; by
completing a bachelors degree in nursing, the nurse has been educated
in an institution of higher education; by joining the American Nurses
Association and reading evidenced-based information, the nurse is
affiliated with a professional association that promotes and ensures
quality practice. Working regularlyscheduled shifts and limiting absences from work are not essentialcriteria for a profession.
◦ ◦
•
Chapter 4-Chapter 6 Chapter 5
Interviewing and Physical Assessment Legal and Ethical Issues Chapter 6 andManagement Functions
When a nurse becomes involved in a legal action, the first step to occur is that a document is filed in an appropriate court. Whatis this document called?
Leadership Roles
a. b.
c. d.
ANS: C
A document called a complaint is filed in an appropriate court as the first step in litigation. A deposition is when witnesses are required to undergo questioning by the attorneys. An appeal is arequest for a review of a decision by a higher court. A summons is a court order that notifies the defendant of the legal action.
PTS: 1 DIF: Cognitive Level: Knowledge REF: Page 23 OBJ: 1 TOP: Legal KEY: NursingProcess Step: N/A MSC:NCLEX: N/A •
Deposition Appeal
Complaint Summons
The nurse caring for a patient in the acute care setting assumes responsibility for a patients care. What is this legally binding situation?
a. b. c. d.
ANS: A
When the nurse assumes responsibility for a patients care, the nurse-patient relationship is formed. This is a legally binding contract for which the nurse musttake responsibility. Accountability is being responsible for ones own actions. An advocate is one who defends or pleads a cause or issue on behalf of another. Standards of care define [Show Less]