(Test Bank) Fundamentals Of Nursing Care Concepts, Connections & Skills

Burton, 3

Nursing

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3rd Edition

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Fundamentals of Nursing Care: Concepts, Connections & Skills Edition 3Test Bank Chapter 1 The Vista of Nursing 1. The first practicing nurse epidemiologist was a. Florence Nightingale. b. Mildred Montag. c. Clara Barton. d. Mary Agnes Snively. ANS: A Nightingale wa s the first practicing nurse epidemiologist. Her statistical analyses connected poor sanitation with cholera and dysentery. Mildred Montag, Clara Barton, and Mary Agnes Snively came after Nightingale, each contributing to the nursing profession in her own way. Clara Barton founded the American Red Cross. Dr. Mildred Montag established the first associate degree nursing program in 1952. Mary Agnes Snively began forming the Canadian National Association of Trained Nurses in 1883. 2. The American Red Cross was founded by a. Florence Nightingale. b. Harriet Tubman. c. Clara Barton. d. Mary Mahoney. ANS: C In 1882, the United States ratified the American Red Cross, founded by Clara Barton. Florence Nightingale established the Training School for Nurses in London, England, i n 1860. Harriet Tubman was active in the Underground Railroad movement during the American Civil War. Mary Mahoney was the first professionally trained African American nurse. Stuvia.com - The Marketplace to Buy and Sell your Study Material 3. Nurses working in the Henry Street Settlement in 1893 were among the first n urses to demonstrate autonomy in practice. This was because those nurses a. Had no ability to work in the hospital setting. b. Were required to use critical thinking skills. c. Focused solely on healing the very ill. d. Planned their care around research findings. ANS: B In 1893, nurses working in the Henry Street Settlement were some of the first to demonstrate autonomy in practice because they encountered situations that required quick and innovative problem solving and critical thinking, and provided therapies ai med at maintaining wellness, as well as curing the ill. Nursing hospitals expanded in the late nineteenth century and were major providers of nursing care. Not until the early twentieth century was there a movement toward a scientific, research -based body of nursing knowledge. 4. In 1923, the Goldmark Report was an important study that a. Formed formal nurse midwifery programs. b. Established the Center for Ethics and Human Rights. c. Revised the ANA code of ethics. d. Led to the development of the Yale School of Nursin g. ANS: D In 1923, the Goldmark Report identified the need for increased financial support for university - based schools of nursing. As a result, the Yale School of Nursing was developed. Graduate nurse midwifery programs did not come into existence unti l the 1940s, and the Center for Ethics and Human Rights was founded in 1990. The ANA code of ethics was published in 1985 and was last updated in 2001. 5. The major difference between a baccalaureate degree nursing program and an associates degree nursing pr ogram is that the baccalaureate program includes studies in Stuvia.com - The Marketplace to Buy and Sell your Study Material a. Basic sciences and theoretical courses. b. Social sciences and humanities. c. Theoretical and clinical courses. d. Basic sciences and clinical courses. ANS: B Both associates degree programs and bacc alaureate programs focus on basic sciences and on theoretical and clinical courses. Baccalaureate programs, however, also focus on courses in the social sciences, arts, and humanities to support nursing theory. 6. The nurse has been working in the clinical s etting for several years as an advanced practice nurse and has earned her masters degree as a family nurse practitioner. However, she seems unfulfilled and has a strong desire to do research. To fulfill her desire, the nurse most likely would apply to atte nd a program that would lead to a a. Doctor of Nursing Science degree (DNSc). b. Doctor of Philosophy degree (PhD). c. Doctor of Nursing Practice degree (DNP). d. Doctor in the Science of Nursing degree (DSN). ANS: B PhD programs emphasize basic research and theory and are research oriented. Professional doctoral programs in nursing (DSN or DNSc) prepare graduates to apply research findings to clinical nursing. The DNP is a practice doctorate that prepares advanced practice nurses such as nurse practitioners. 7. The n urse is caring for her patients and is focused on managing their care as opposed to managing and performing skills. This nurse demonstrates which level of proficiency according to Benner? a. Novice b. Competent Stuvia.com - The Marketplace to Buy and Sell your Study Material c. Proficient d. Expert ANS: C The proficient nurs e focuses on managing care as opposed to managing and performing skills. The novice nurse deals with a specific set of rules or procedures, which are usually stepwise and linear. The competent nurse understands the organization and the specific care requir ed by specific types of patients and has experience with psychomotor skills. The expert nurse identifies patient -centered problems, as well as problems related to the health care system. 8. Which of the following resources guides faculty on structure and eva luation of the nursing curriculum? a. ANAs Standards of Nursing Practice b. Essentials of Baccalaureate Education c. NLNAC Interpretive Guidelines d. Standards of Professional Performance ANS: B The American Association of Colleges of Nursing (AACN) published Essen tials of Baccalaureate Education for Professional Nursing: A Final Report (1998), which guides faculty on structure and evaluation of the curriculum and the performance of the graduate. The ANAs Standards of Nursing Practice demonstrates the critical think ing model known as the nursing process. Standards of Professional Performance describes a competent level of behavior in the professional role. NLNAC Interpretive Guidelines identifies core competencies for the professional nurse. 9. The nurse is caring for the patient who has had major abdominal surgery and also has a large sacral pressure sore. The nurse implements coughing and deep breathing exercises and consults the wound care specialist to evaluate and prescribe care for the pressure sore, even though n o physician order has provided instructions to do so. In doing this, the nurse is implementing the element of Stuvia.com - The Marketplace to Buy and Sell your Study Material a. Autonomy. b. Accountability. c. Advanced practice. d. Nurse practitioner. ANS: A Autonomy is an essential element of professional nursing. Some indep endent nursing interventions such as implementing coughing and deep breathing exercises and collaboration with other health professionals can be initiated without medical orders. Accountability means that the nurse is responsible, professionally and legall y, for the type and quality of nursing care provided. Advanced practice nurse is an umbrella term for advanced clinical nurses such as nurse practitioners who provide care to a group of patients. 10. The physician is planning to take the patient to surgery in the morning and leaves an order for the nurse to get the patient to sign the surgical permit. The physicians note indicates that the patient has been educated on the procedure. However, the patient tells the nurse, I have no idea what hes going to do. He rushed in and rushed out so fast, I couldnt ask any questions. The nurse does not allow the patient to sign the permit and calls the physician to inform him of the patients statement. This is an example of the nurse acting as a. Patient advocate. b. Patient educator. c. Manager. d. Clinical nurse specialist. ANS: A As a patient advocate, the nurse protects the patients human and legal rights, including the right of the patient to understand procedures before signing permits. Although nurses can be educators, it is t he responsibility of the surgeon to provide education for the patient in preparation for surgery, and it is the nurses responsibility to notify the physician if the patient is not properly educated. Managers coordinate the activities of members of the nursing staff in Stuvia.com - The Marketplace to Buy and Sell your Study Material delivering nursing care, and clinical nurse specialists are experts in a specialized area of nursing practice in a variety of settings. 11. The patient requires routine gynecological services after giving birth to her son, and while seeing th e nurse midwife, she asks for a referral to a pediatrician for the newborn. The nurse midwife should a. Provide the referral as requested. b. Offer to provide the newborn care. c. Refer the patient to the supervising physician. d. Tell the patient that she cannot make referrals. ANS: B The practice of nurse midwifery involves providing independent care for women during normal pregnancy, labor, and delivery, as well as care for the newborn. As an independent practitioner, supervising physicians are not required by th e certified nurse midwife (CNM). However, a CNM practices with a health care agency that provides medical consultation, collaborative management, and referral. After being apprised of the CNM role, if the patient insists on seeing a pediatrician, the nurse midwife should provide the referral. 12. The student nurse has a goal of becoming a certified registered nurse anesthetist (CRNA). It is important for the student to understand that the CRNA a. Works under the guidance of an anesthesiologist. b. Manages acute medical conditions. c. Manages gynecological services such as PAP smears. d. Must have a PhD degree in anesthesiology. ANS: A Nurse anesthetists provide surgical anesthesia under the guidance and supervision of an anesthesiologist, who is a physician with advance d knowledge of surgical anesthesia. Nurse practitioners, not CRNAs, manage self-limiting acute and chronic stable medical conditions; Stuvia.com - The Marketplace to Buy and Sell your Study Material certified nurse midwives provide gynecological services such as routine Papanicolaou (Pap) smears. The CRNA is an RN w ith an advanced education in a nurse anesthesia accredited program. A PhD is not a requirement. 13. The nurse is speaking in front of a group of ninth grade students about nursing as a profession. One student states that she does not want to be a nurse becaus e all nurses do is take care of sick people and play politics. The most appropriate response that the nurse could give and expand on is that a. Nursing is ideal for the person who hates politics. b. Nursing focuses on curing the persons disease. c. Nursing is not political because it has its own knowledge base. d. An area of nursing exists for every interest. ANS: D It is important to remember that opportunities are limitless for caring, compassionate, and competent nursing care; an area of nursing exists for every interest. Current philosophies and definitions of nursing demonstrate the holistic trend in nursingto address the whole person in all dimensions, in health and illness, and in interaction with family and community. Political activism and commitment are a p art of professionalism and are an important aspect of the delivery of health care. Nursing continues to draw on the social sciences and other fields as the focus of nursing care expands. 14. A bill has been submitted to the State House of Representatives that is designed to reduce the cost of health care by increasing the patient -to-nurse ratio from a maximum of 2:1 in intensive care units to 3:1. The nurse realizes that a. Legislation is politics beyond the nurses control. b. National programs have no bearing on state politics. c. The individual nurse can influence legislative decisions. d. Focusing on nursing care provides the best patient benefit. ANS: C Stuvia.com - The Marketplace to Buy and Sell your Study Material Nurses can influence policy decisions at all governmental levels. One way is to get involved in ANAs national e fforts, such as Nursings Agenda for the Future: A Call to the Nation . This effort is critical in exerting nurses influence early in the political process. Nurses need to become serious students of social needs, activists in influencing policy to meet those needs, and generous contributors of time and money to nursing organizations and candidates to help legislate conditions that are likely to produce the best care possible. 15. During the American Civil War, which of the following women was active in the Under ground Railroad movement and assisted in leading more than 300 slaves to freedom? a. Harriet Tubman b. Clara Barton c. Dorothea Dix d. Mary Ann Ball (Mother Bickerdyke) ANS: A Harriet Tubman was active in the Underground Railroad movement and assisted in leading mo re than 300 slaves to freedom. Clara Barton, founder of the American Red Cross, tended soldiers on the battlefields, cleansing their wounds, meeting their basic needs, and comforting them in death. As superintendent of the female nurses of the Union Army, Dorothea Lynde Dix organized hospitals, appointed nurses, and oversaw and regulated supplies to the troops. Mother Bickerdyke organized ambulance services and walked abandoned battlefields at night, looking for wounded soldiers. 16. Graduates of baccalaureate degree or associates degree nursing programs are eligible to take which of the following to become registered nurses in the state in which they will practice? a. Continuing education credits b. In-service education programs c. National Council Licensure Examinati on d. Graduate education ANS: C Stuvia.com - The Marketplace to Buy and Sell your Study Material Currently, in the United States, the most common way to become a registered nurse (RN) is through completion of an associates degree or baccalaureate degree program. Graduates of both programs are eligible to take the Natio nal Council Licensure Examination for Registered Nurses (NCLEX -RN) to become registered nurses in the state in which they will practice. Continuing education involves formal, organized educational programs offered by universities, hospitals, state nurse as sociations, professional nursing organizations, and educational and health care institutions. In -service education programs consist of instruction or training provided by a health care agency or institution. An in -service program is held in the institution and is designed to increase the knowledge, skills, and competencies of nurses and other health care professionals. A nurse who is completing a graduate program can receive a masters degree in nursing. 17. Which concept means that the nurse is responsible, pr ofessionally and legally, for the type and quality of nursing care provided? a. Autonomy b. Accountability c. Patient advocacy d. Patient education ANS: B Accountability means that the nurse is responsible, professionally and legally, for the type and quality of nu rsing care provided. Autonomy is an essential element of professional nursing that involves the initiation of independent nursing interventions without medical orders. As a patient advocate, the nurse protects the patients human and legal rights and provid es assistance in asserting these rights if the need arises. As an educator, the nurse explains concepts and facts about health, describes the reasons for routine care activities, demonstrates procedures such as self-care activities, reinforces learning or patient behavior, and evaluates the patients progress in learning. MULTIPLE RESPONSE Stuvia.com - The Marketplace to Buy and Sell your Study Material 1. The nurse in the twenty -first century is facing an extremely complex profession with multiple external forces affecting the nursing profession. Factors influencing th e nursing profession include which of the following? (Select all that apply.) a. Demography b. Womens health care c. Human rights d. The threat of bioterrorism e. The medically underserved ANS: A, B, C, D, E Multiple external forces affect nursing. These include demog raphic changes in the population, human rights, increasing numbers of medically underserved, and the threat of bioterrorism. The womens movement brought greater sensitivity to the health care needs of women and the role of women in health care research. 2. After licensure, the practicing nurse is required to update his or her knowledge about the latest research and practice developments. The most common way nurses do this is through programs. (Select all that apply.) a. Continuing education b. Masters degree c. In-service education d. DNP ANS: A, C Continuing education updates the nurses knowledge about the latest research and practice developments. In -service education programs are provided by a health care agency to increase the knowledge, skills, and competencies of nurses employed by the institution. Both can provide the nurse with continuing education credit. Masters degree programs are valuable for those in the role of nurse educator, nurse administrator, or advanced practice nurse. The DNP is a practice doctorate that prepares advanced practice nurses. Stuvia.com - The Marketplace to Buy and Sell your Study Material 3. Which of the following is (are) an example of an advanced practice nurse? (Select all that apply.) a. Nurse practitioner b. Clinical nurse specialist c. Patient advocate d. Certified registered nurse anesthetist e. Nurse midw ife ANS: A, B, D, E Although all nurses should function as patient advocates, advanced practice nurse is an umbrella term for an advanced clinical nurse such as a nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, or nurse midwife. 4. The nurse manager from the oncology unit has had two callouts; the orthopedic unit has had multiple discharges and probably will have to cancel one or two of its nurses. The orthopedic unit has agreed to float two of its nurses to the oncolo gy unit if oncology can float a nursing assistant to the orthopedic unit to help with obtaining vital signs. This is an example of (Select all that apply.) a. Autonomy. b. Accountability. c. Political activism. d. Politics. ANS: A, B, D Staffing is an independent n ursing intervention and is an example of autonomy. Along with increased autonomy comes accountability or responsibility for outcomes of an action. Nurses are involved in politics when seeking additional resources. However, political activism usually involv es more than day -to-day activities such as unit staffing. Stuvia.com - The Marketplace to Buy and Sell your Study Material Chapter 2 Health -Care Delivery, Settings and Economics 1. Public health nursing differs from community health nursing in that public health nursing a. Focuses on individuals and families. b. Understa nds the needs of a population. c. Ignores political processes. d. Considers the individual as one member of a group. ANS: B Public health nursing requires understanding the needs of a population. A public health nurse understands factors that influence the pol itical processes used to affect public policy. The primary focus of community health nursing is the care of individuals, families, and groups in the community. By focusing on subpopulations, the community health nurse cares for the community as a whole and considers the individual or family as only one member of a group at risk. 2. A specialist in public health nursing requires a. The same level of education as the community health nurse. b. Preparation at the basic entry level. c. An advanced degree regardless of public health experience. d. A graduate level education with a focus in public health science. ANS: D A specialist in public health has a graduate level education with a focus in public health science. Public health nursing requires preparation at the basic e ntry level and sometimes requires a baccalaureate degree in nursing. Not all hiring agencies require an advanced degree in community health nursing. However, nurses with a graduate degree in nursing who practice in community settings are considered communi ty health nurse specialists, regardless of their public health experience. 3. The community health nurse differs from the community -based nurse in that the community health nurse a. Understands the needs of the population. Stuvia.com - The Marketplace to Buy and Sell your Study Material b. Focuses on the needs of the indiv idual. c. Is the first level of contact in the health care system. d. Involves the family in decision making. ANS: A The community health nurse understands the needs of a population or community through experience with individual families in working through th eir social and health care issues. The community -based nurse focuses on the needs of the individual or family. Community -based nursing centers function as the first level of contact between members of a community and the health care system. The community -based nurse learns to partner with patients and families so that ultimately the patient and the family become involved in planning, decision making, implementation, and evaluation of health care approaches. 4. The type of nursing that focuses on acute and chr onic care of individuals and families while enhancing patient autonomy is known as nursing. a. Public health b. Community health c. Community -based d. Community -focused ANS: C Community -based nursing involves acute and chronic care of individuals and families and enhances their capacity for self -care while promoting autonomy in decision making. Public health nursing focuses on the needs of a population. Community health nursing cares for the community as a whole and considers the individual or the family as only one member of a group at risk. Community -focused nursing understands the needs of a population or community. 5. The community health nurse is administering flu shots to children at a local playground. In doing so, the nurses focus is on a. Preventing individual illness. b. Preventing community outbreak of illness. c. Preventing outbreak of illness in the family. d. The needs of the individual or family. ANS: B Stuvia.com - The Marketplace to Buy and Sell your Study Material By focusing on subpopulations, the community health nurse cares for the community as a whole and considers th e individual or the family as only one member of a group at risk. Community - based nursing, as opposed to community health nursing, focuses on the needs of the individual or family. 6. The community health nurse is providing counseling to a group of teenage girls related to birth control and disease prevention. The nurse does this because a. Focusing on subpopulations leads to community health. b. Community health nursing focuses on individuals only. c. Community health nursing excludes direct care to subpopulations. d. The focus is on preventing illness and unwanted pregnancy. ANS: A By focusing on subpopulations, the community health nurse cares for the community as a whole and considers the individual or the family as only one member of a group at risk. Community health nursing is a nursing practice in the community, with the primary focus on the health care of individuals, families, and groups in a community. Subpopulations are often a clinical focus. The goal is to protect, promote, or maintain health, not to preve nt illness. 7. Community -based nursing care takes place in community settings such as the home or a clinic. Ideally, this is done to a. Exert greater control over individual or family decisions. b. Provide services close to where patients live. c. Isolate patients a nd prevent the spread of disease. d. Reduce the need for self-care. ANS: B The ideal is to provide health care services close to where patients live. This lessens the cost of care as well as the stress associated with the financial burdens of care. The focu s is on the needs of the individual or family. The nurse learns to partner with patients and families so they assume responsibility for their health care decisions. 8. The community -based nurse is caring for a patient who is home bound by arthritis and chron ic lung problems. The patient, however, receives many visitors from the neighborhood and from former coworkers, as well as frequent phone calls from extended family. When concerned about how the large number of visitors may be fatiguing the patient, the nu rse should Stuvia.com - The Marketplace to Buy and Sell your Study Material a. Restrict the number of visitors for the patients welfare. b. Voice concerns to the patient and proceed according to the patients wishes. c. Allow visitors to come and go freely as they have been. d. Create visiting hours when the patient may see nonfamily members. ANS: B With the individual and the family as patients, the context of community -based nursing is family -centered care within the community. This focus requires a strong knowledge base in family theory, principles of communication, group dy namics, and cultural diversity. The nurse learns to partner with patients and families, so ultimately the patient and the family assume responsibility for their health care decisions. 9. The student nurse is trying to determine what type of nurse she wants t o be after graduation. In class, she states that community health nursing is probably not for her because community nursing focuses only on community issues such as preventing epidemics. The instructors most appropriate response would be that community hea lth nursing a. Focuses on the health care of individuals, families, and groups in a community. b. Focuses only on the health of a specific subgroup in a community. c. Requires an advanced nursing degree, so the student need not worry. d. Focuses only on maintaining the health of the community. ANS: A Community health nursing is a nursing practice with the primary focus on the health care of individuals, families, and groups in a community. The goal is to preserve, protect, promote, or maintain health. Not all hiring agencies require an advanced degree. 10. Vulnerable populations include those patients who are more likely to develop health problems as a result of a. Pregnancy. b. Nontraditional healing practices. c. Excessive risk. d. Unlimited access to health care. ANS: C