(Test Bank) Foundations Midterm 2021

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Test Bank for Foundations Midterm 2021, The downloadable file consists of 188 pages, and the total size of the file is 1.45 MB. Purchase now only for highly discounted price.

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Fundamentals of Nursing 9th edition - test bank Chapter 02: The Health Care Delivery System 1. The nurse is caring for a patient whose insurance coverage is Medicare. The nurse should consider which information when planning care for this patient? a. Capitation provides the hospital with a means of recovering variable charges. b. The hospital will be paid for the full cost of the patient’s hospitalization. c. Diagnosis -related groups (DRGs) provide a fixed reimbursement of cost. d. Medicare will pay the national average for the patient’s condition. ANS: C 2. A nurse is teaching the staff about managed care. Which information should the nurse include in the teaching session? a. Managed care insures full coverage of health care costs. b. Managed care only assumes the financial risk involved. c. Managed care allows providers to focus on illness care. d. Managed care causes providers to focus on prevention. ANS: D 3. A nurse is teaching a family about health care plans. Which information from the nurse indicates a correct understanding of the Affordable Care Act? a. A family can choose whether to have health insurance with no consequences. b. Primary care physician payments from Medicaid services can equal Medicare. c. Adult children up to age 26 are allowed coverage on t he parent’s plan. d. Private insurance companies can deny coverage for any reason. ANS: C 4. A nurse is caring for a patient in the hospital. When should the nurse begin discharge planning? a. When the patient is ready b. Close to the time of discharge c. Upon admission to the hospital d. After an order is written/prescribed ANS: C 5. The nurse is applying for a position with a home care organization that specializes in spinal cord injury. In which type of health care facility does the nurse want to work? a. Secondary acute b. Continuing c. Restorative d. Tertiary ANS: C 6. A nurse provides immunization to children and adults through the public health department. Which type of health care is the nurse providing? a. Primary care b. Preventive care c. Restorative care d. Continuing care ANS: B 7. A nurse is following the PDSA cycle for quality improvement. Which action will the nurse take for the letter “A”? a. Act b. Alter c. Assess d. Approach ANS: A 8. The nurse is trying to determine how well a certain health plan compares with other health plans. To gather this type of data, which information will the nurse utilize? a. Pew Health Professions Commission b. Healthcare Effectiveness Data and Information Set (HEDIS) c. American Nurses Credentialing Center (ANCC) Magnet Recognition Program d. Hospital Consumer of Assessment of Healthcare Providers and Systems (HCAHPS) ANS: B 9. An older adult patient has extensive wound care needs after discharge from the hospital. Which facility should the nurse discuss with the patient? a. Hospice b. Respite care c. Assisted living d. Skilled nursing ANS: D 10. A nurse working in a community hospital’s emergency department provides care to a patient having chest pain. Which level of care is the nurse providing? a. Continuing care b. Restorative care c. Preventive care d. Tertiary care ANS: D 11. A nurse is teaching about the effects of globalization. Which information should the nurse include in the teaching session? a. Increased spread of communicable diseases b. Increased homogeneous mix of nursing staff c. Decreased poverty and increased “health tourism” d. Decreased urbanization as populations shift to the suburbs ANS: A 12. A nurse is using research findings to improve clinical practice. Which technique is the nurse using? a. Performance improvement b. Integrated delivery networks c. Nursing -sensitive outcomes d. Utilization review committees ANS: A 13. Which finding indicates the best quality improvement process? a. Staff identifies the wait time in the emergency department is too long. b. Administration identifies the design of the facility’s lobby increases patient stress. c. Director of the hospital identifies th e payment schedule does not pay enough for overtime. d. Health care providers identify the inconsistencies of some of the facility’s policy and procedures. ANS: A 14. A nurse is providing home care to a home -bound patient treated with intravenous (IV) therapy and enteral nutrition. What is the home health nurse’s primary objective? a. Screening b. Education c. Dependence d. Counseling ANS: B 15. A nurse hears a co -worker state that anybody could be a nurse since it is so automated with infusion devices and electronic monitoring; technology is doing the work. What is the nurse’s best response? a. “Technology use has to be combined with nursing judgment.” b. “The focus of effective nursing care is technology.” c. “If it’s s o easy, why don’t you do it?” d. “That is true in the 20th century.” ANS: A 16. A nurse is completing a minimum data set. Which area is the nurse working? a. Nursing center b. Psychiatric facility c. Rehabilitation center d. Adult day care center ANS: A MULTIPLE RESPONSE 1. Which government -instituted programs should the nurse include in a teaching session about controlling health care costs? ( Select all that apply. ) a. Professional standards review organizations b. Prospective payment systems c. Diagnosis -related groups d. Third -party payers e. “Never events” ANS: A, B, C 2. A nurse is teaching the staff about the Institute of Medicine competencies. Which examples indicate the staff has a correct understanding of the teaching? ( Select all that apply. ) a. Use informatics. b. Use transparency. c. Apply globalization. d. Apply quality improvement. e. Use evidence -based practice. ANS: A, D, E 3. A nurse is evaluating care based upon the nursing quality indicators. Which areas should the nurse evaluate? ( Select all that apply. ) a. Patient satisfaction level b. Hospital readmission rates c. Nursing hours per patient day d. Patient falls/falls with injuries e. Value stream analysis for quality ANS: B, C, D 4. A nurse is working in a health care organization that has achieved Magnet status. Which components are indicators of this status? ( Select all that apply. ) a. Empirical quality results b. Structural empowerment c. Transformational leadership d. Exemplary professional practice e. Willingness to recommend the agency ANS: A, B, C, D MATCHING A nurse is teaching about the different types of health care plans. Match the correct information to the type of health care plans the nurse should include in the teaching session. a. Insurance for low -income families b. Federal insurance for people aged 65 and older c. Health maintenance focus to specific group of voluntarily enrolled people d. Services at a discount for companies under contract 1. Preferred provider organization 2. Managed care organization 3. Medicaid 4. Medicare 1.ANSDIF:Understand (comprehension)REF:15 -16 OBJ: Compare the various methods for financing health care. TOP: Teaching/Learning MSC:Management of Care 2.ANS:CDIF:Understand (comprehension)REF:15 -16 OBJ: Compare the various methods for financing health care. TOP: Teaching/Learning MSC:Management of Care 3.ANS:ADIF:Understand (comprehension)REF:15 -16 OBJ: Compare the various methods for financing health ca re. TOP: Teaching/Learning MSC:Management of Care 4.ANS:BDIF:Understand (comprehension)REF:15 -16 OBJ: Compare the various methods for financing health care. TOP: Teaching/Learning MSC:Management of Care Free Chapter 03: Community -Based Nursing Practice 1. A nurse is working as a public health nurse. What will be the nurse’s primary focus? a. The individual as one member of a group b. Individuals and families c. Needs of a population d. Health promotion ANS: C 2. A nurse wants to become a specialist in public health nursing. Which educational requirement will the nurse have to obtain? a. A baccalaureate degree in nursing b. Preparation at the basic entry level c. The same level of education as the community health nurse d. A graduate level education with a focus in public health science ANS: D 3. A nurse is working as a community health nurse. Which action is a priority for this nurse? a. Provide direct care to subpopulations. b. Focus on the needs of the ill individual. c. Provide first level of contact to health care systems. d. Focus on providing care in various community settings. ANS: A 4. A nurse is focusing on acute and chronic care of individuals and families within a community while enhancing patient autonomy. Which type of nursing care is the nurse providing? a. Public health b. Community health c. Community -based d. Community assessment ANS: C 5. The community health nurse is administering flu shots to children at a local playground. What is the rationale for this nurse’s action? a. To prevent individual illness b. To prevent community outbreak of illness c. To prevent outbreak of illness in the family d. To prevent needs of the local population groups ANS: B 6. A nurse attended a seminar on community -based health care. Which information indicates the nurse has a good understanding of community -based health care? a. It occurs in hospitals. b. Its focus is on ill individuals. c. Its priority is health promotion. d. It provides services primarily to the poor. ANS: C 7. A nurse is using the Healthy People 2020 to establish goals for the community. Which goal ispriority ? a. Reduce health care costs. b. Increase life expectancy. c. Provide services close to where patients live. d. Isolate patients to prevent the spread of disease. ANS: B 8. A nurse is working in community -based nursing. Which competency is priority for this nurse? a. Caregiver b. Collaborator c. Change agent d. Case manager ANS: A 9. A nurse observes an outbreak of lice in a certain school district. The nurse collects data and identifies a common practice of sharing lockers, caps, and hair brushes. The nurse shares the information with the school. Which community -based nursin g competency did the nurse use? a. Educator b. Caregiver c. Case manager d. Epidemiologist ANS: D 10. A nurse is providing screening at a health fair. Which finding indicates the person may be a vulnerable patient who is most likely to develop health problems? a. One who is pregnant b. One who has excessive risks c. One who has unlimited access to health care d. One who uses nontraditional healing practices ANS: B 11. The instructor is teaching student nurses about identifying members of vulnerable populations when the nursing student asks, “Why is it that not all poor people are considered members of vulnerable populations?” How should the nurse respond? a. “All poor people are members of a vulnerable population.” b. “Poor people are mem bers of a vulnerable population only if they take drugs.” c. “Poor people are members of a vulnerable population only if they are homeless.” d. “Members of vulnerable groups frequently have a combination of risk factors.” ANS: D 12. The nurse is making a home visit to a Korean mother after the birth of girl. The spouse is pressing different parts of the patient’s hand and lower arm to relieve a headache. What is the nurse’s next action? a. Tell the spouse to stop and give the mother acetaminophen. b. Let the spouse finish and then give the mother medication. c. Ask the mother and/or spouse to explain the procedure. d. Explain to the spouse that it will not work. ANS: C 13. A nurse is assessing the social system of a community. Which area should the nurse assess? a. Housing b. Economic status c. Volunteer programs d. Predominant ethnic groups ANS: C 14. The nurse is working with a 16 -year-old pregnant female who tells the nurse that she needs an abortion. The nurse, acting as a counselor, provides the patient with information on alternatives to abortion, but after several sessions, the patient still insists on having the abortion. What should the nurse, in the counselor role, do next? a. Encourage the patient to speak with a “Rig ht-to-Life” advocate. b. Refuse to provide a referral to an abortion service. c. Provide referral to an abortion service. d. Delay referral to an abortion service. ANS: C 15. Before a patient with beginning stage of Alzheimer’s disease is discharged, the community - based nurse is making a visit to the patient’s home. The patient’s daughter and family live in the home with the patient. What is the major focus of this visit? a. Teach the family how to monitor blood pressure. b. Demonstrate techniques for providing care. c. Stress to the family how difficult it will be to provide care at home. d. Encourage the family to send the patient to an extended care facility. ANS: B 17. The nurse uses statistics on increased incidence of communicable disease to influence legislatures to pass a bill for mandatory vaccinations to enroll in school. Which type of nursing will the nurse use in this process? a. Public health nursing b. Community -based nursing c. Community health n ursing d. Vulnerable population nursing ANS: A MULTIPLE RESPONSE 1. A community -based nursing is working with a family. For which key areas will the nurse need a strong knowledge base? ( Select all that apply. ) a. Family theory b. Communication c. Group dynamics d. Cultural diversity e. Individual -centered care ANS: A, B, C, D 2. Which community -based nursing activities indicate the nurse is working in the role of educator? (Select all that apply. ) a. Offers prenatal classes b. Offers a child safety program c. Offers to defend patients’ decisions d. Offers creative solutions to local problems e. Offers coordinate resources after discharge ANS: A, B 3. A nurse is caring for vulnerable populations in a local community. Which patients will the nurse care for in this community? ( Select all that apply. ) a. A 47 -year-old immigrant who speaks only Spanish b. A 35 -year-old living in own home c. A 22 -year-old pregnant woman d. A 40 -year-old schizophrenic e. A 15 -year-old rape victim ANS: A, D, E MATCHING A nurse is assessing a community. Match each community element the nurse will assess with the correct example. a. Education level b. Housing c. Government 1. Structure 2. Population 3. Social system 1.ANS:BDIF:Understand (comprehension)REF:38 OBJ: Describe elements of a community assessment. TOP: Assessment MSC:Health Promotion and Maintenance 2.ANS:ADIF:Understand (comprehension)REF:38 OBJ: Describe elements of a community assessment. TOP: Assessment MSC:Health Promotion and Maintenance 3.ANS:CDIF:Understand (comprehension)REF:38 OBJ: Describe elements of a community assessment. TOP: Assessment MSC:Health Promotion and Maintenance Chapter 04: Theoretical Foundation s of Nursing Practice 1. The nursing instructor is teaching a class on nursing theory. One of the students asks, “Why do we need to know this stuff? It doesn’t really affect patients.” What is the instructor’s bestresponse? a. “You are correct, but we have to learn it anyway.” b. “This keeps the focus of nursing narrow.” c. “Theories help explain why nurses do what they do.” d. “Exposure to theories will help you later in graduate school.” ANS: C 2. The nurse is caring for a patient who does not follow the prescribed regimen for diabetes management. As a prescriber to Orem’s theory, the nurse interviews the patient in an attempt to identify the cause of the patient’s “noncompliance.” What is the rationale for the nurse’s behavior? a. Orem’s theory is useful in designing interventions to promote self -care. b. Orem’s theory focuses on cultural issues that may affect compliance. c. Orem’s theory allows for reduction of anxiety with communication. d. Orem’s theory helps nurses manipulate the patient ’s environment. ANS: A 3. A nurse is testing meditation for migraine headaches and the expected outcome of care when performing this intervention. Which type of theory is the nurse using? a. Grand b. Prescriptive c. Descriptive d. Middle -range ANS: B 4. The nurse researcher is evaluating whether holding pressure at an injection site after injecting the anticoagulant enoxaparin will reduce bruising at the injection site. This study involves a prescriptive theory. What is the nurse ’s rationale for involving a prescriptive theory? a. It explains why bruising occurs. b. It is broad in scope and complex. c. It tests a specific nursing intervention. d. It reflects a wide variety of nursing care situations. ANS: C 5. A nurse is using nursing theory and the nursing process simultaneously to plan nursing care. How will the nurse use nursing theory and the nursing process in practice? a. Nursing theory can direct how a nurse uses the nursing process. b. Nursing theory requires the nursing process to develop knowledge. c. Nursing theory with the nursing process has a minor role in professional nursing. d. Nursing theory combined with the nursing process is specific to certain ill patients. ANS: A 6. The nurse views the patient as an open system that needs help in coping with stressors. Which theorist is the nurse using? a. King b. Levine c. Neuman d. Johnson ANS: C 7. The nurse is caring for a patient diagnosed with essential hypertension. The health care provider prescribes blood pressure medication that the nurse administers. The nurse then monitors the patient’s blood pressure for several days to help determine effectiveness. Which system component is the nurse evaluating? a. Input b. Output c. Content d. Feedback ANS: B 8. A patient is admitted with possible methicillin -resistant Staphylococcus aureus (MRSA) and is placed in isolation until cultures can be obtained and declared noninfectious. During the isolation process, the nurse encourages family visits. Which level of Maslow’s hierarchy of needs is the nurse promoting when the family is encouraged to visit? a. First level b. Second level c. Third level d. Fourth level ANS: C 9. A nurse is caring for pediatric patients and using the developmental theory to plan nursing care. What is the focus of this nurse’s care? a. Humans have an orderly, predictive process of growth and development. b. Humans respond to threats by adapting with growth and development. c. Humans respond with cognitive principles for growth and development. d. Humans have psychosocial domains to growth and development. ANS: A 10. Upon assessment, the nurse notices that the patient’s respirations have increased, and the tip of the nose and earlobes are becoming cyanotic. The nurse finds that the patient’s pulse rate is over 100 beats per minute. According to Maslow’s hierarchy of needs, which patient need should the nurse address first? a. Self-esteem b. Physiological c. Self-actualization d. Love and belonging ANS: B 11. Which behavior from a nurse indicates the nurse is using Nightingale’s theory to plan nursing care? a. Knows all about the disease processes affecting patients b. Focuses on medication administration and treatments c. Thinks about the patients and patients’ environments d. Considers nursing knowledge and medicine the same ANS: C 12. The home health nurse listens to the patient’s concerns about having “open -heart” surgery. The nurse explains the different surgical procedures and other options, like cardiac rehabilitation. After several visits, the patient wants cardiac rehabilitation. The nurse notifies the health care provider and sets up a referral. Which theory is the nurse u sing? a. Peplau’s theory b. Henderson’s theory c. Nightingale’s theory d. Orem’s self -care deficit theory ANS: A 13. The nurse is caring for a patient who is actively bleeding. The health care provider prescribes blood transfusions. The patient is a Jehovah’s Witness and does not want blood products. The nurse contacts the health care provider to request alternative treatment. Which theory is the nurse using? a. Roy’s theory b. Leininger’s theory c. Watson’s theory d. Orem’s theory ANS: B 14. The patient is terminally ill and is receiving hospice care. The nurse cares for the patient by bathing, shaving, and repositioning him. The patient would like a Catholic priest called to provide the Sacrament of the Sick. The nurse places a call and arran ges for the priest’s visit. Which theory does this nurse’s care represent? a. Roy’s theory b. Watson’s theory c. Henderson’s theory d. Orem’s self -care deficit theory ANS: C 15. The patient is newly diagnosed with diabetes and will be discharged in the next day or so. The nurse is teaching the patient how to draw up and self -administer insulin. Which nursing theory is the nurse utilizing? a. Watson’s theory b. Orem’s theory c. Roger’s theory d. Henderson’s theory ANS: B 16. A nurse is conducting research about the needs of depressed patients. The nurse writes the following: Depression is a patient reporting a score above 7 on the Hamilton Depression Rating Scale. What did the nurse write? a. Operational definition b. Conceptua l definition c. Paradigm d. Concept ANS: A 17. Which action indicates the nurse is using the nursing process in patient care? a. Generates nursing knowledge for use in nursing practice. b. Conceptualizes an aspect of nursing to predict nursing care. c. Develops nursing care as a specific, distinct phenomenon. d. Delivers nursing care using a systematic approach. ANS: D 18. A nurse is using theoretical knowledge in nursing practice to provide patient care. Which nursing behavior is an example of theoretical knowledge? a. Reads about different concepts b. Reflects on clinical experiences c. Combines the art and science of nursing d. Creates a narrow understanding of nursing practice ANS: A 19. A nurse is using Maslow’s hierarchy of needs to prioritize care. Place the levels in order of basic priority to highest priority that the nurse will follow. 1. Physiological 2. Self -esteem 3. Self -actualization 4. Safety and security 5. Love and belonging a. 4, 1, 2, 3, 5 b. 1, 4, 5, 3, 2 c. 4, 5, 3, 2, 1 d. 1, 4, 5, 2, 3 ANS: D MULTIPLE RESPONSE 1. A nurse is using a nursing metaparadigm to define nursing. Which concepts will the nurse include? ( Select all that apply. ) a. Person b. Disease c. Health d. Nursing e. Environment ANS: A, C, D, E 2. A nurse wants to incorporate psychosocial theories into nursing practice. Which elements will the nurse include? ( Select all that apply. ) a. Physiological needs of the patient b. Psychological needs of the patient c. Sociocultural needs of the patient d. Cognitive needs of the patient e. Spiritual needs of the patient ANS: A, B, C, E Chapter 05: Evidence -Based Practice 1. A nurse uses evidence -based practice (EBP) to provide nursing care. What is the bestrationale for the nurse’s behavior? a. EBP is a guide for nurses in making clinical decisions. b. EBP is based on the latest textbook information. c. EBP is easily attained at the bedside. d. EBP is always right for all situations. ANS: A 2. In caring for patients, what must the nurse remember about evidence -based practice (EBP)? a. EBP is the only valid source of knowledge that should be used. b. EBP is secondary to traditional or convenient care knowledge. c. EBP is dependent on patient values and expectations. d. EBP is not shown to provide better patient outcomes. ANS: C 3. A nurse wants to change a patient procedure. Which action will the nurse take to easily find research evidence to support this change? a. Read all the articles found on the Internet. b. Make a general search of the Internet. c. Use a PICOT format for the search. d. Start with a broad question. ANS: C 4. A nurse has collected several research findings for evidence -based practice. Which article will be the best for the nurse to use? a. An article that uses randomized controlled trials (RCT) b. An article that is an opinion of expert committees c. An article that uses qualitative research d. An article that is peer -reviewed ANS: A 5. The nurse is reviewing a research article on a patient care topic. Which area should entice the nurse to read the article? a. Literature review b. Introduction c. Methods d. Results ANS: B 6. The nurse is caring for a patient with chronic low back pain. The nurse wants to determine the best evidence -based practice regarding clinical guidelines for low back pain. What is thebest database for the nurse to access? a. MEDLINE b. EMBASE c. PsycINFO d. AHRQ ANS: D 7. A nurse writes the following PICOT question: How do patients with breast cancer rate their quality of life? How should the nurse evaluate this question? a. A true PICOT question regardless of the number of elements b. A true PICOT question because the intervention comes before the control c. Not a true PICOT question because the comparison comes after the intervention d. Not a true PICOT question because the time is not designated ANS: A 8. A nurse is reviewing literature for an evidence -based practice study. Which study should the nurse use for the most reliable level of evidence that uses statistics to show effectiveness? a. Meta -analysis b. Systematic review c. Single random controlled trial d. Control trial without randomization ANS: A The main difference is that in a meta -analysis the researcher uses statistics to show the effect of an intervention on an outcome. In a systematic review no statistics are used to draw conclusions about the evidence. A single random controlled trial (RCT) is not as conclusive as a review of several RCTs on the same question. Control trials without randomization may involve bias in how the study is conducted. 9. A nurse is reviewing research studies for evidence -based practice. Which article should the nurse use for qualitative nursing research? a. An article about the number of falls after use of no side rails b. An article about infection rates after use of a new wound dressing c. An article about the percentage of new admiss ions on a new floor d. An article about emotional needs of dying patients and their families ANS: D 10. A nurse develops the following PICOT question: Do patients who listen to music achieve better control of their anxiety and pain after surgery when compared with patients who receive standard nursing care following surgery? Which information will the nurse use as the “C”? a. After surgery b. Who listen to music c. Who receive standard nursing care d. Achieve better control of their anxiety and pain ANS: C 11. The nurse uses a PICOT question to develop an evidence -based change in protocol for a certain nursing procedure. However, to make these changes throughout the entire institution would require more evidence than is available at this time. What is the nurse’s best option? a. Conduct a pilot study to investigate findings. b. Drop the idea of making the change at this time. c. Insist that management hire the needed staff to facilitate the change. d. Seek employment in another institut ion that may have the staff needed. ANS: A 12. The nurse is trying to identify common general themes relative to the effectiveness of cardiac rehabilitation from patients who have had heart attacks and have gone through cardiac rehabilitation programs. The nurse conducts interviews and focus groups. Which type of research is the nurse conducting? a. Nonexperimental research b. Experimental research c. Qualitative research d. Evaluation research ANS: C 13. In conducting a research study, the nurse researcher guarantees the subject no information will be reported in any manner that will identify the subject and only the research team will have access to the information. Which concept is the nurse researcher fulf illing? a. Bias b. Confidentiality c. Informed consent d. The research process ANS: B 14. The nurse researcher is preparing to publish the findings and is preparing to add the limitations to the manuscript. Which area of the manuscript will the nurse researcher add this information? a. Abstract b. Conclusion c. Study design d. Clinical implications ANS: B 15. A nurse is trying to decrease the rate of falls on the unit. After reviewing the literature, a strategy is implemented on the unit. After 3 months, the nurse finds that the falls have decreased. Which process did the nurse institute? a. Performance improvement b. Peer-reviewed project c. Generalizability study d. Qualitative research ANS: A 16. A nurse identifies a clinical problem with pressure ulcers. Which step should the nurse take next in the research process? a. Analyze results. b. Conduct the study. c. Determine method. d. Develop a hypothesis. ANS: D 17. After reviewing the literature, the evidence -based practice committee institutes a practice change that bedrails should be left in the down position and hourly nursing rounds should be conducted. The results indicate over a 40% reduction in falls. What is the committee’s next step? a. Evalua te the changes in 1 month. b. Implement the changes as a pilot study. c. Wait a month before implementing the changes. d. Communicate to staff the results of this project. ANS: D 18. A nurse is developing a care delivery outcomes research project. Which population will the nurse study? a. Nurses b. Patients c. Administrators d. Health care providers ANS: B 19. A nurse is implementing an evidence -based practice project regarding infection rates. After reviewing research literature, which other evidence should the nurse review? a. Quality improvement data b. Inductive reasoning data c. Informed consent data d. Biased data ANS: A When implementing an evidence -based practice project, it is important to first review evidence from appropriate research and quality improvement data. Inductive reasoning is used to develop generalizations or theories from specific observations; this study needs specifics. Informed consent