(Test Bank) Fundamental Concepts And Skills For Nursing

Dewit, 6

Nursing

Test Bank

6th Edition

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Author(s): Dewit

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Copyright © 2022, Elsevier Inc. All Rights Reserved. 1Chapter 01: Nursing and the Health Care SystemWilliams: Fundamental Concepts and Skills for Nursing, 6th EditionMULTIPLE CHOICE 1. Florence Nightingale’s contributions to nursing practice and education:a.are historically important but have no validity for nursing today.b.were neither recognized nor appreciated in her own time.c.were a major factor in reducing the death rate in the Crimean War.d.were limited only to the care of severe traumatic wounds.ANS: CBy improving sanitation, nutrition ventilation, and handwashing techniques, Florence Nightingale’s nurses dramatically reduced the death rate from injuries in the Crimean War.DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #1TOP: Nursing History KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 2. Early nursing education and care in the United States:a.were directed at community health.b.provided independence for women through education and employment.c.were an educational model based in institutions of higher learning.d.have continued to be entirely focused on hospital nursing.ANS: BBecause of the influence of early nursing leaders, nursing education became more formalized through apprenticeships in Nightingale schools that offered independence to women through education and employment.DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #4TOP: Nursing History KEY: Nursing Process Step: N/AMSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 2 3. In order to fulfill the common goals defined by nursing theorists (promote wellness, prevent illness, facilitate coping, and restore health), the LPN must take on the roles of:a.caregiver, educator, and collaborator.b.nursing assistant, delegator, and environmental specialist.c.medication dispenser, collaborator, and transporter.d.dietitian, manager, and housekeeper.ANS: AIn order for the LPN to apply the common goals of nursing, he or she must assume the roles of caregiver, educator, collaborator, manager, and advocate.DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: Theory #2TOP: Art and Science of Nursing KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 4. Although nursing theories differ in their attempts to define nursing, all of them base their beliefs on common concepts concerning:a.self-actualization, fundamental needs, and belonging.b.stress reduction, self-care, and a systems model.c.curative care, restorative care, and terminal care.d.human relationships, the environment, and health.ANS: DAlthough nursing theories differ, they all base their beliefs on human relationships, the environment, and health.DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: Theory #2TOP: Nursing Theories KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 5. Standards of care for the nursing practice of the LPN are established by the:a.Boards of Nursing Examiners in each state.b.National Council of States Boards of Nursing (NCSBN).c.American Nurses Association (ANA).d.National Association of Licensed Practical Nurses.ANS: DThe practical nurse follows standards written by the National Association of Licensed Practical Nurses to deliver safe, knowledgeable nursing care (Box 1.1, Appendix D)DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: Theory #2TOP: Standards of Care KEY: Nursing Process Step: N/AMSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 3 6. The LPN demonstrates an evidence-based practice by:a.using a drug manual to check compatibility of drugs.b.using scientific information to guide decision making.c.using medical history of a patient to direct nursing interventions.d.basing nursing care on advice from an experienced nurse.ANS: BThe use of scientific information from high-quality research to guide nursing decisions is reflective of the application of evidence-based practice.DIF: Cognitive Level: Knowledge REF: p. 4 OBJ: Theory #3TOP: Evidence-Based Practice KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 7. Lillian Wald and Mary Brewster established the Henry Street Settlement Service in New York in 1893 in order to:a.offer a shelter to injured war veterans.b.found a nursing apprenticeship.c.provide health care to poor persons living in tenements.d.offer better housing to low-income families.ANS: CHenry Street Settlement Service brought the provision of community health care to the poor people living in tenements.DIF: Cognitive Level: Comprehension REF: p. 2 OBJ: Theory #4TOP: Growth of Nursing KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 8. An educational pathway for an LPN/LVN refers to an LPN/LVN:a.learning on the job and being promoted to a higher level of responsibility.b.moving from a maternity unit to a more complicated surgical unit.c.obtaining additional education to move from one level of nursing to another.d.learning that advancement requires consistent work and commitment.ANS: CBy broadening the educational base, an LPN/LVN may advance and build a nursing career.DIF: Cognitive Level: Knowledge REF: p. 7 OBJ: Theory #7TOP: Nursing Education Pathways KEY: Nursing Process Step: N/AMSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 4 9. When diagnosis-related groups (DRGs) were established by Medicare in 1983, the purpose was to:a.put patients with the same diagnosis on the same unit.b.attempt to contain the costs of health care.c.increase the availability of medical care to older adults.d.identify a patient’s condition more quickly.ANS: BThe purpose of instituting DRGs was to contain skyrocketing costs of health care.DIF: Cognitive Level: Knowledge REF: p. 10 OBJ: Theory #10TOP: Health Care Delivery KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 10. The advent of diagnosis-related groups (DRGs) required that nurses working in health care agencies:a.record supportive documentation to confirm a patient’s need for care in order to qualify for reimbursement.b.use the DRG rather than their own observations for patient assessment.c.be aware of the specific drugs related to the diagnosis.d.acquire cross-training to make staffing more flexible.ANS: ADRGs required that nurses provide more supportive documentation of their assessments and identified patient’s needs to qualify the facility for Medicare reimbursement. Observant assessment might also indicate another DRG classification and consequently more reimbursement for the facility.DIF: Cognitive Level: Comprehension REF: p. 10 OBJ: Theory #10TOP: Managed Care KEY: Nursing Process Step: N/AMSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 5 11. If a member of a health maintenance organization (HMO) is having respiratory problems such as fever, cough, and fatigue for several days and wants to see a specialist, the person is required to go:a.directly to an emergency room for treatment.b.to any general practitioner of choice.c.directly to a respiratory specialist.d.to a primary care provider for a referral.ANS: DParticipants in an HMO must see their primary provider to receive a referral for a specialist in order for the HMO to pay for the care.DIF: Cognitive Level: Comprehension REF: p. 10 OBJ: Theory #11TOP: Managed Care KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 12. An advantage of preferred provider organizations (PPOs) is that:a.they make insurance coverage of employees less expensive to employers.b.there are fewer physicians to choose from than in an HMO.c.long-term relationships with physicians are more likely.d.patients may go directly to a specialist for care.ANS: AThe use of PPOs allows insurance companies to keep their premiums low and in turn makes insurance coverage less expensive for the employers. There are usually more physicians from which to choose than from an HMO, but long-term relationships between physician and patient cannot be established easily. Patients still must see their primary physician before being referred to other specialties.DIF: Cognitive Level: Knowledge REF: p. 11 OBJ: Theory #11TOP: Preferred Provider Organizations KEY: Nursing Process Step: N/AMSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 6 13. After passing the National Council Licensure Examination for Practical Nurses (NCLEX PN), the nurse is qualified to take an additional certification in the field of:a.pharmacology.b.care of infants and children.c.operating room technology.d.community health.ANS: AAfter becoming an LPN, the nurse may apply for additional certification in pharmacology, long-term care, and/or IV therapy.DIF: Cognitive Level: Knowledge REF: p. 7 OBJ: Theory #6TOP: Educational Opportunities KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 14. Nursing interventions are best defined as activities that:a.are taken to improve the patient’s health.b.involve researching methods to maintain asepsis.c.include the family in nursing care.d.review guidelines for handling infectious wastes.ANS: AInterventions are actions taken to improve, maintain, or restore health.DIF: Cognitive Level: Comprehension REF: p. 3 OBJ: Theory #2TOP: Art and Science of Nursing KEY: Nursing Process Step: PlanningMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 15. Nurse Practice Acts define the legal scope of an LPN’s practice, which are written and enforced by:a.American Nurses Association.b.National Council Licensure Examiners.c.each state.d.each health care agency.ANS: CEach state writes and enforces the Nurse Practice Act, which defines the legal scope of nursing practice.DIF: Cognitive Level: Comprehension REF: p. 6 OBJ: Theory #3TOP: Nurse Practice Act KEY: Nursing Process Step: N/AMSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 7 16. Women volunteers were organized to give nursing care to the wounded soldiers during the Civil War by:a.Florence Nightingale.b.Dorothea Dix.c.Clara Barton.d.Lillian Wald.ANS: BThe Union government appointed Dorothea Dix, a social worker, to organize women volunteers to provide nursing care for the soldiers during the Civil War.DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #4TOP: Nursing History KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 17. The nursing theory presented by Sister Calista Roy is based on:a.reduction of stress.b.achievement of maximum level of wellness.c.relief of self-care deficit.d.adaptation modes.ANS: DAdaptation modes (physiological, psychological, sociological, and independence) are the basis of the nursing theory of Sister Calista Roy.DIF: Cognitive Level: Knowledge REF: p. 5|Table 1-1 OBJ: Theory #2 TOP: Nursing Theories KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 18. The founding of the Red Cross is attributed to:a.Lillian Wald.b.Dorothea Dix.c.Florence Nightingale.d.Clara Barton.ANS: DClara Barton founded the Red Cross.DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #4TOP: Nursing History KEY: Nursing Process Step: N/AMSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 8 19. The nursing theorist whose practice framework is based on 14 fundamental needs is:a.Dorothy Johnson.b.Jean Watson.c.Virginia Henderson.d.Martha Rogers.ANS: CVirginia Henderson’s nursing theory framework is based on 14 fundamental needs.DIF: Cognitive Level: Knowledge REF: p. 5|Table 1-1 OBJ: Theory #2 TOP: Nursing Theories KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 20. The nursing theory that uses seven behavioral subsystems in an adaptation model is:a.Betty Neumann.b.Sister Calista Roy.c.Dorothy Johnson.d.Patricia Benner.ANS: CDorothy Johnson’s practice framework is based on seven behavioral subsystems in an adaptation model.DIF: Cognitive Level: Knowledge REF: p. 5|Table 1-1 OBJ: Theory #2 TOP: Nursing Theories KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 21. The Standards of Nursing Practice are designed to direct LPNs to:a.advance their nursing career.b.seek a scientific basis for their interventions.c.deliver safe, knowledgeable care.d.a leadership role.ANS: CThe Standards of Nursing Practice are designed to guide the LPN to deliver safe, knowledgeable care.DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory #2TOP: Nursing Standards KEY: Nursing Process Step: N/AMSC: NCLEX: Safe, Effective Care Environment Copyright © 2022, Elsevier Inc. All Rights Reserved. 9 22. A state’s Nurse Practice Act is designed to protect the:a.physician.b.nurse.c.public.d.hospital.ANS: CNurse Practice Acts are designed to protect the public.DIF: Cognitive Level: Knowledge REF: p. 6 OBJ: Theory #5TOP: Nurse Practice Act KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 23. It is appropriate for practical nurses to provide direct patient care to persons in a hospital under the supervision of a:a.medical assistant.b.registered nurse on the unit.c.supervising nurse who is responsible for care on several units.d.more experienced LPN on the unit.ANS: BPractical nurses provide direct patient care under the direct supervision of a registered nurse, physician, or dentist.DIF: Cognitive Level: Knowledge REF: p. 7 OBJ: Theory #9TOP: Scope of Practice KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 24. An example of tertiary health care is:a.hospice care.b.restorative care.c.emergency care.d.home health care.ANS: ATertiary health care includes extended care, chronic disease management, medical homes, in-home personal care, and hospice care.DIF: Cognitive Level: Comprehension REF: p. 11|Box 1-2 OBJ: Theory #8 TOP: Health Care Services KEY: Nursing Process Step: N/A MSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 10 25. Which nursing care delivery systems have some nursing schools adopted as the foundation of their education programs?a.Relationship-based careb.Team nursingc.Patient-centered cared.Total patient careANS: ARelationship-based care appeared in the early 2000s. It emphasizes three critical relationships: (1) the relationship between caregivers and the patients and families they serve; (2) the caregiver’s relationship with him- or herself; and (3) the relationship among health team members (Koloroutis & Abelson, 2017). The motivation behind relationship-based care was to promote a cultural transformation by improving relationships to foster care for the patient. Some schools of nursing have adopted relationship-based care as the foundation of their nursing education curriculum.DIF: Cognitive Level: Knowledge REF: p. 9 OBJ: Theory #8TOP: Delivery of Nursing Care KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 26. Which nursing care delivery system has been fully embraced by the nursing community and is identified as one of the seven QSEN competencies?a.Relationship-based careb.Team nursingc.Patient-centered cared.Total patient careANS: CPatient-centered care has been described since the 1950s, but it came to the forefront in 2001 when the Institute of Medicine (IOM) targeted six areas for improvement in the US health care system, including safety, effectiveness, patient-centeredness, timeliness, efficiency, and equitableness (National Academies of Sciences, Engineering, and Medicine, 2018). Patient-centered care has been fully embraced by the nursing community, and it is identified as one of the seven QSEN competencies (QSEN.org, 2018).DIF: Cognitive Level: Knowledge REF: p. 18 OBJ: Theory #8TOP: Delivery of Nursing Care KEY: Nursing Process Step: N/AMSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 11 27. Which of the following is considered a positive aspect of the Affordable Care Act?a.A 38-year-old mother is penalized on her taxes for not purchasing health insurance.b.A 42-year-old laborer who has chronic kidney disease is denied insurance coverage.c.Jamie, age 24, cannot continue insurance coverage on his parent’s insurance since he has graduated from college.d.Maria, age 60, is able to obtain health insurance at a rate that is manageable on her income.ANS: DThe Patient Protection and Affordable Care Act (the “Affordable Care Act,”) was signed into law in 2010 as was meant to be phased in over several years. It created health insurance exchanges, expanded eligibility for Medicaid, allowed young adults to remain on their parents’ insurance through age 26, and stopped insurance providers from denying coverage for pre-existing conditions. Uninsured people were required to purchase health insurance and were penalized on their income taxes if they did not. Since the Republican administration came to power in 2017, however, many aspects of the Affordable Care Act have either been defunded or repealed. For example, the penalty for not purchasing insurance has been removed, the enrollment period has been cut in half, and “navigators” (people employed to help those looking into buying insurance) have had their funding cut. Fortunately, enrollment hasn’t declined significantly so far, although the current administration has a goal to repeal and replace the Affordable Care Act. As coverage under the Affordable Care Act expanded, the national uninsured rate initially fell from 16% to 11% of people under age 65 (people over age 65 generally have universal coverage by Medicare), although with the weakening of the Affordable Care Act the uninsured rate has gone back up to nearly 16% (Collins 2018).DIF: Cognitive Level: Analysis REF: p. 12 OBJ: Theory #10TOP: The Patient Protection and Affordable Care Act KEY: Nursing Process Step: N/A MSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 12MULTIPLE RESPONSE 1. Characteristics of primary nursing include: (Select all that apply.)a.elimination of fragmentation of care between shifts.b.evolved in the mid-1950s.c.planning and direction performed by one nurse.d.ancillary workers used to increase productivity.e.the care plan covering the entire day.f.associate nurses taking over care and planning when the primary nurse is off duty.ANS: A, C, D, E, FPrimary care reduces fragmentation of care between shifts. Care is planned by one nurse to cover a 24-hour period using ancillary workers to increase the productivity. An associate nurse may take on direction of care in the absence of the primary nurse.DIF: Cognitive Level: Knowledge REF: p. 9 OBJ: Theory #8TOP: Nursing Care Delivery KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 2. In 1991, the American Nurses Association (ANA) published the Standards of Nursing Practice. These standards are designed to: (Select all that apply.)a.set standards for safe nursing care delivery.b.define the legal scope of practice.c.state legal requirements for clinical practice.d.protect the nurse, patient, and health care agency.e.regulate the nursing profession.f.define activities in which nurses may engage.ANS: A, D, FThe Standards of Nursing Practice generally define activities in which nurses may engage, set standards for nursing care and delivery, and thereby protect the nurse, patient, and health care agency.DIF: Cognitive Level: Knowledge REF: p. 6|Box 1-1 OBJ: Theory #2TOP: Nursing Practice KEY: Nursing Process Step: N/AMSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 13 3. During the Civil War, nursing schools offered education to women both in England and in the United States. The schools in the United States differed from those in Europe because in US schools: (Select all that apply.)a.students worked without pay.b.the core curriculum was the same.c.instruction was presented by physicians at the bedside.d.the educational focus was on nursing care.e.classes were held separately from the clinical experience.ANS: A, CIn the United States, the students staffed the hospital and worked without pay. There were no formal classes; education was achieved through work. There was no set curriculum, and content varied depending on the type of cases present in the hospital. Instruction was done at the bedside by the physician and therefore came from a medical viewpoint.DIF: Cognitive Level: Comprehension REF: p. 2 OBJ: Theory #4TOP: Early Nursing Education KEY: Nursing Process Step: N/AMSC: NCLEX: N/A COMPLETION 1. Preferred provider organizations (PPOs) use ____________ to finance their services and pay the physical cost of the service.ANS: capitated costThe capitated cost is the set fee that is paid to the network for each patient enrolled to finance its services.DIF: Cognitive Level: Knowledge REF: p. 11 OBJ: Theory #8TOP: Capitated Cost KEY: Nursing Process Step: N/AMSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 14 2. In the United States, the Young Women’s Christian Association (YMCA) in New York opened The ____________ School, the first practical nursing school.ANS: BallardIn 1892, the YMCA opened The Ballard School, a 3-month course in practical nursing that was the first school of practical nursing.DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: Theory #4TOP: Ballard School KEY: Nursing Process Step: N/AMSC: NCLEX: N/A 3. Such health services as surgical procedures, restorative care, and home health care would be classified as ________ care.ANS: secondarySurgical procedures, restorative care, and home health are part of the many services classified as secondary care.DIF: Cognitive Level: Comprehension REF: p. 11|Box 1-2 OBJ: Theory #10 TOP: Health Care Services KEY: Nursing Process Step: N/A MSC: NCLEX: N/A Copyright © 2022, Elsevier Inc. All Rights Reserved. 1Chapter 02: Concepts of Health, Illness, Stress, and Health PromotionWilliams: Fundamental Concepts and Skills for Nursing, 6th EditionMULTIPLE CHOICE 1. The nurse is aware that any description of health would include the concept that:a.health is the absence of illness, and illness is the presence of chronic disease.b.culture, education, and socioeconomic status influence one’s definition of health or illness.c.illness is a biological malfunction, and health is biological soundness.d.lifestyle factors are the major determinants of health or illness.ANS: BThe concept of health is influenced by culture, education, and socioeconomic factors.DIF: Cognitive Level: Comprehension REF: p. 15 OBJ: Theory #1TOP: Views of Health and Illness KEY: Nursing Process Step: PlanningMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease 2. The nurse takes into consideration that the patient with an admitting diagnosis of Type 2 diabetes mellitus and influenza is described as having:a.two chronic illnesses.b.two acute illnesses.c.one chronic and one acute illness.d.one acute and one infectious illness.ANS: CChronic illnesses can be controlled but not cured and are long-lasting. Acute illnesses develop suddenly and resolve in a short time. Type 2 diabetes mellitus would be considered chronic, whereas influenza would be considered acute.DIF: Cognitive Level: Application REF: p. 15 OBJ: Theory #1TOP: Classification of Illnesses KEY: Nursing Process Step: PlanningMSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease