(Test Bank) Est Bank-2020-Nursing Exam Questions(Complete Rationalized Correct Responses

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Chapter 1. Nursing Past & Present Chapter 1. Nursing Past & Present Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. What is the most influential factor that has shaped the nursing profession? 1) Physicians need for handmaidens 2) Societal need for healthcare outside the home 3) Military demand for nurses in the field 4) Germ theory influence on sanitation ANS: 3 Throughout the centuries, stability of the government has been related to the success of the military to protect or extend its domain. As the survival and well- being of soldiers is critical, nurses provided healthcare to the sick and injured at the battle site. The physicians handmaiden was/is a nursing stereotype rather than an influence on nursing. Although there has been need for healthcare outside the home throughout history, this has more influence on the development of hospitals than on nursing; this need provided one more setting for nursing work. Germ theory and sanitation helped to improve healthcare but did not shape nursing.PTS: 1 DIF: Moderate REF: pp. 910 KEY: Nursing process: N/A Client need: N/A | Cognitive level: Recall ____ 2. Which of the following is an example of an illness prevention activity? Select all that apply. 1) Encouraging the use of a food diary 2) Joining a cancer support group 3) Administering immunization for HPV 4) T eaching a diabetic patient about his diet ANS: 3 Administering immunization for HPV is an example of illness prevention. Although cancer is a disease, it is assumed that a person joining a support group would already have the disease; therefore, this is not disease prevention but treatment. Illness-prevention activities focus on avoiding a specific disease. A food diary is a health-promotion activity. T eaching a diabetic patient about diet is a treatment for diabetes; the patient already has diabetes, so it cannot prevent diabetes. PTS: 1 DIF: Moderate REF: p. 18; high-level question, not directly stated in text KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Application ____ 3. Which of the following contributions of Florence Nightingale had an immediate impact on improving patients health? 1) Providing a clean environment2) Improving nursing education 3) Changing the delivery of care in hospitals 4) Establishing nursing as a distinct profession ANS: 1 Improved sanitation (a clean environment) greatly and immediately reduced the rate of infection and mortality in hospitals. The other responses are all activities of Florence Nightingale that improved healthcare or nursing, but the impact is long range, not immediate. PTS: 1 DIF: Easy REF: V1, p. 3; student must infer from content | V1, p. 10; student must infer from content KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application ____ 4. All of the following are aspects of the full-spectrum nursing role. Which one is essential for the nurse to do in order to successfully carry out all the others? 1) Thinking and reasoning about the clients care 2) Providing hands-on client care 3) Carrying out physician orders 4) Delegating to assistive personnelANS: 1 A substantial portion of the nursing role involves using clinical judgment, critical thinking, and problem solving, which directly affect the care the client will actually receive. Providing hands-on care is important; however, clinical judgment, critical thinking, and problem solving are essential to do it successfully. Carrying out physician orders is a small part of a nurses role; it, too, requires nursing assessment, planning, intervention, and evaluation. Many simple nursing tasks are being delegated to nursing assistive personnel; delegation requires careful analysis of patient status and the appropriateness of support personnel to deliver care. Another way to analyze this question is that none of the options of providing hands-on care, carrying out physician orders, and delegating to assistive personnel is required for the nurse to think and reason about a clients care; so the answer must be 1. PTS:1DIFifficultREF: p. 11 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Analysis ____ 5. Which statement pertaining to Benners practice model for clinical competence is true? 1) Progression through the stages is constant, with most nurses reaching the proficient stage. 2) Progression through the stages involves continual development of thinking and technical skills. 3) The nurse must have experience in many areas before being considered an expert. 4)The nurses progress through the stages is determined by years of experience and skills. ANS: 2 Movement through the stages is not constant. Benners model is based on integration of knowledge, technical skill, and intuition in the development of clinical wisdom. The model does not mention experience in many areas. The model does not mention years of experience. PTS:1DIF:ModerateREF:p. 15 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall ____ 6. Which of the following best explains why it is difficult for the profession to develop a definition of nursing? 1) There are too many different and conflicting images of nurses. 2) There are constant changes in healthcare and the activities of nurses. 3) There is disagreement among the different nursing organizations. 4) There are different education pathways and levels of practice. ANS: 2 The conflicting images of nursing make it more important to develop a definition; they may also make it more difficult, but not to the extent that constant change does. Healthcare is constantly changing and with it come changes in where, how, and what nursing care is delivered. Constant changes make it difficult to develop a definition. Although different nursing organizations have different definitions, they are similar in most ways. The different education pathways affect entry into practice, not the definition of nursing. PTS: 1 DIF: Moderate REF: p. 11; How Is Nursing Defined? KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Analysis ____ 7. Nurses have the potential to be very influential in shaping healthcare policy. Which of the following factors contributes most to nurses influence? 1) Nurses are the largest health professional group. 2) Nurses have a long history of serving the public. 3) Nurses have achieved some independence from physicians in recent years. 4) Political involvement has helped refute negative images portrayed in the media. ANS: 1 Nurses are trusted professionals and the largest health professional group. As such, they have political power to effect changes. If nursing were a small group, there would be little potential for power in shaping policies, even if all the other answers were true. Serving the public, while positive, does not necessarily help nurses to be influential in establishing health policy. Independence from physicians, although positive, does not necessarily make nurses influential in establishing healthcare policy. Refuting negative media, although positive, does not necessarily make nurses influential in establishing healthcare policy. PTS: 1 DIF: Moderate REF: p. 21 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Analysis____ 8. Nursing was described as a distinct occupation in the sacred books of which faith? 1) Buddhism 2) Christianity 3) Hinduism 4) Judaism ANS: 3 The Vedas, the sacred books of the Hindu faith, described Indian healthcare practices and were the earliest writings of a distinct nursing occupation. PTS:1DIF:EasyREF:p. 7 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall ____ 9. The American Red Cross was established by 1) Louisa May Alcott 2) Clara Barton 3) Dorothea Dix 4)Harriet Tubman ANS: 2 Clara Barton was an American teacher, nurse, and humanitarian who organized the American Red Cross after the Civil War. Louisa May Alcott was an American novelist who wrote Little Women in 1868. Dorothea Dix was an American activist who acted on behalf of the indigent population with mental illness. She was credited for establishing the first psychiatric institution. Harriet Tubman was an African American abolitionist and Union spy during the Civil War. After escaping captivity, she set up a network of antislavery activists, known as the Underground Railroad. PTS:1DIF:EasyREF:p. 10 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall ____ 10. Which of the following is the most important reason to develop a definition of nursing? 1) Recruit more informed people into the nursing profession 2) Evaluate the degree of role satisfaction 3) Dispel the stereotypical images of nurses and nursing 4) Differentiate nursing activities from those of other health professionals ANS: 4 Nursing organization leaders think it is important to develop a definition of nursing to bring value and understanding to the profession, differentiate nursing activities from those of other health professionals, and help student nurses understand what is expected of them. A definition of nursing would not be likely to increase the number of informed people recruited into nursing. A definition of nursing would do little to improve the nurses role satisfaction. Although a definition of nursing might contribute to fighting stereotypes of nursing, other, more powerful influences (e.g., media portrayals) exist to counteract it. PTS:1DIF:EasyREF:V1, pp. 1113; students must infer from content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall ____ 11. Which of the following provides evidence-based support for the contribution that advanced practice nurses (APNs) make within healthcare? 1) Reduced usage of diagnostics using advanced technology 2) Decreased number of unnecessary visits to the emergency department 3) Improved patient compliance with prescribed treatments 4) Increased usage of complementary alternative therapies ANS: 3 Studies demonstrate that APNs have improved patient outcomes over those of physicians, including increased patient understanding and cooperation with treatments and decreased need for hospitalizations. No well-known, scientific studies support APNs effect on the use of advanced technology. No well-known, scientific studies support APNs effect on the frequency of emergency department visits. No well-known, scientific studies support APNs effect on the use of alternative therapies. PTS:1DIF:ModerateREF:p. 20KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall ____ 12. Which of the following is an example of what traditional medicine and complementary and alternative medicine therapies have in common? 1) Both can produce adverse effects in some patients. 2) Both use prescription medications. 3) Both are usually reimbursed by insurance programs. 4) Both are regulated by the FDA. ANS: 1 Both traditional and complementary therapies can produce adverse effects in some patients. Many medications are derived from herbs, but the alternative treatments usually use the herbs, not prescription medication. Insurance programs do not necessarily reimburse alternative treatments, because many are not supported by sound scientific research methodology. Alternative medications are not regulated by the FDA. PTS:1DIF:ModerateREF:p. 20 KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall ____ 13. Of the following, the biggest disadvantage of having nursing assistive personnel (NAP) help nurses is that the nurse 1) Must know what aspects of care can legally and safely be delegated to the NAP 2)May rely too heavily on information gathered by the NAP when making patient care decisions 3) Is removed from many components of direct patient care that have been delegated to the NAP 4) Still maintains responsibility for the patient care given by the NAP ANS: 2 All of the options may be disadvantages to using NAPs, but making decisions based on anothers information is the greatest drawback because of the potential for negatively affecting patient care. Treatment decisions based on incorrect information may cause harm to the patient. PTS:1DIFifficultREF:p. 2021; students must conclude from content KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Analysis ____ 14. An older adult has type 1 diabetes. He can perform self-care activities but needs help with shopping and meal preparation as well as with blood glucose monitoring and insulin administration. Which type of healthcare facility would be most appropriate for him? 1) Acute care facility 2) Ambulatory care facility 3) Extended care facility 4)Assisted living facility ANS: 4 Assisted living facilities are intended for those who are able to perform self-care activities but who require assistance with meals, housekeeping, or medications. Acute care facilities focus on preventing illnesses and treating acute problems. These facilities include physicians offices, clinics, and diagnostic centers. Ambulatory care facilities provide outpatient care. Clients live at home or in nonhospital settings and come to the site for care. Ambulatory care facilities include private health and medical offices, clinics, surgery centers, and outpatient therapy centers. Extended care facilities typically provide long-term care, rehabilitation, wound care, and ongoing monitoring of patient conditions. PTS:1DIF:EasyREF:p. 18; ESG, Chapter 1, Healthcare Delivery SystemsExpanded Discussion, Where is Healthcare Provided? KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application ____ 15. The nurse in the intensive care unit is providing care for only one patient, who was admitted in septic shock. Based on this information, which care delivery model can you infer that this nurse is following? 1) Functional 2) Primary 3) Case method 4) T eam ANS: 3The nurse is following the case method model of nursing care. In this model, one nurse cares for one patient during a single shift. When the functional nursing model is employed, care is compartmentalized, and each task is assigned to a staff member with the appropriate knowledge and skills. In primary nursing, one nurse plans the care for a group of patients round-the-clock. The primary nurse assesses the patient and develops the plan of care. When he or she is working, he or she provides care for those patients that he or she is responsible for. In his or her absence, the associate nurses deliver care. Although the nurse in this case could possibly be a primary nurse, there are not enough data to confidently infer that. If the team nursing approach is utilized, a licensed nurse (RN or LVN) is paired with a nursing assistant. The pair is then assigned to a group of patients. PTS:1DIF:ModerateREF:ESG, Chapter 1, Healthcare Delivery SystemsExpanded Discussion, What Models of Care Are Used to Provide Nursing Care? KEY: Nursing process: Implementation | Client need: SECE | Cognitive level: Analysis ____ 16. Which healthcare worker should the nurse consult to counsel a patient about financial and family stressors affecting healthcare? 1) Social worker 2) Occupational therapist 3) Physicians assistant 4) T echnologist ANS: 1The social worker coordinates services and counsels patients about financial, housing, marital, and family issues affecting healthcare. The occupational therapist helps patients regain function and independence for activities of daily living. Physicians assistants work under the physicians direction to diagnose certain diseases and injuries. T echnologists provide a variety of specific functions in hospitals, diagnostic centers, and emergency care. For example, laboratory technologists aid in the diagnosis and treatment of patients by examining blood, urine, tissue, and body fluids. Radiology technologists perform x-rays and other diagnostic testing. PTS:1DIF:ModerateREF:ESG, Chapter 1, Healthcare Delivery SystemsExpanded Discussion, What Healthcare Providers Will You Work With? KEY: Nursing process: Planning | Client need: SECE | Cognitive level: Comprehension ____ 17. Which type of managed care allows patients the greatest choice of providers, medications, and medical devices? 1) Health maintenance organization 2) Integrated delivery network 3) Preferred provider organization 4) Employment-based private insurance ANS: 3 Preferred provider organizations are a form of managed care that allows the patient a greater choice of providers, medications, and medical devices within the designated list. Health maintenance organizations allow the patient to choose a primary care provider within the organization to coordinate his care. This type of program will only reimburse medical care when the patient has first obtained a referral from the primary provider. Integrated delivery networks combine providers, healthcare facilities, pharmaceuticals, and services into one system, and the patient must remain within the system to receive care. Employment-based private insurance is not a managed care organization. PTS:1DIF:EasyREF:ESG, Chapter 1, Healthcare Delivery Systems, Expanded Discussion, How Do Healthcare Policy and Reform Efforts Affect Care? KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Analysis ____ 18. A patient who underwent a total abdominal hysterectomy is assisted out of bed as soon as her vital signs are stable. This intervention is most likely being directed by a 1) Critical pathway 2) Nursing care plan 3) Case manager 4) Traditional care model ANS: 1 This patients care is most likely being directed by a critical pathway. A critical pathway is a multidisciplinary approach to care that sequences interventions over a length of stay for a given case type, such as total abdominal hysterectomy. Using this model, the patient can be assisted out of bed as soon as her vital signs are stable. Using the traditional model, the nurse would have to obtain a physicians order to assist the patient out of bed after surgery. The