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Test Bank for Clinical Nursing Skills and Techniques 9th Edition by Perry

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By: Perry

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Chapter 01: Using Evidence in Practice

Perry et al.: Clinical Nursing Skills & Techniques, 9th Edition

 

MULTIPLE CHOICE

 

  1. Evidence-based practice is a problem-solving approach to making decisions about patient care that is grounded in:
a.the latest information found in textbooks.
b.systematically conducted research studies.
c.tradition in clinical practice.
d.quality improvement and risk-management data.

 

 

ANS:   B

The best evidence comes from well-designed, systematically conducted research studies described in scientific journals. Portions of a textbook often become outdated by the time it is published. Many health care settings do not have a process to help staff adopt new evidence in practice, and nurses in practice settings lack easy access to risk-management data, relying instead on tradition or convenience. Some sources of evidence do not originate from research. These include quality improvement and risk-management data; infection control data; retrospective or concurrent chart reviews; and clinicians’ expertise. Although non–research-based evidence is often very valuable, it is important that you learn to rely more on research-based evidence.

 

DIF:    Cognitive Level: Comprehension       REF:    Text reference: p. 2

OBJ:    Discuss the benefits of evidence-based practice.

TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Safe and Effective Care Environment (management of care)

 

  1. When evidence-based practice is used, patient care will be:
a.standardized for all.
b.unhampered by patient culture.
c.variable according to the situation.
d.safe from the hazards of critical thinking.

 

 

ANS:   C

Using your clinical expertise and considering patients’ cultures, values, and preferences ensures that you will apply available evidence in practice ethically and appropriately. Even when you use the best evidence available, application and outcomes will differ; as a nurse, you will develop critical thinking skills to determine whether evidence is relevant and appropriate.

 

DIF:    Cognitive Level: Application             REF:    Text reference: p. 2

OBJ:    Discuss the benefits of evidence-based practice.

TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Assessment

MSC:   NCLEX: Safe and Effective Care Environment (management of care)

 

  1. When a PICOT question is developed, the letter that corresponds with the usual standard of care is:
a.P.
b.I.
c.C.
d.O.

 

 

ANS:   C

C = Comparison of interest. What standard of care or current intervention do you usually use now in practice?

P = Patient population of interest. Identify your patient by age, gender, ethnicity, disease, or health problem.

I = Intervention of interest. What intervention (e.g., treatment, diagnostic test, and prognostic factor) do you think is worthwhile to use in practice?

O = Outcome. What result (e.g., change in patient’s behavior, physical finding, and change in patient’s perception) do you wish to achieve or observe as the result of an intervention?

 

DIF:    Cognitive Level: Knowledge             REF:    Text reference: p. 3

OBJ:    Develop a PICO question.                 TOP:    PICO

KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe and Effective Care Environment (management of care)

 

  1. A well-developed PICOT question helps the nurse:
a.search for evidence.
b.include all five elements of the sequence.
c.find as many articles as possible in a literature search.
d.accept standard clinical routines.

 

 

ANS:   A

The more focused a question that you ask is, the easier it is to search for evidence in the scientific literature. A well-designed PICOT question does not have to include all five elements, nor does it have to follow the PICOT sequence. Do not be satisfied with clinical routines. Always question and use critical thinking to consider better ways to provide patient care.

 

DIF:    Cognitive Level: Analysis                  REF:    Text reference: p. 3

OBJ:    Describe the six steps of evidence-based practice.

TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe and Effective Care Environment (management of care)

 

  1. The nurse is not sure that the procedure the patient requires is the best possible for the situation. Utilizing which of the following resources would be the quickest way to review research on the topic?
a.CINAHL
b.PubMed
c.MEDLINE
d.The Cochrane Database

 

 

ANS:   D

The Cochrane Community Database of Systematic Reviews is a valuable source of synthesized evidence (i.e., pre-appraised evidence). The Cochrane Database includes the full text of regularly updated systematic reviews and protocols for reviews currently happening. MEDLINE, CINAHL, and PubMed are among the most comprehensive databases and represent the scientific knowledge base of health care.

 

DIF:    Cognitive Level: Synthesis                REF:    Text reference: p. 4

OBJ:    Describe the six steps of evidence-based practice.

TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe and Effective Care Environment (management of care)

 

  1. The nurse is getting ready to develop a plan of care for a patient who has a specific need. The best source for developing this plan of care would probably be:
a.The Cochrane Database.
b.MEDLINE.
c.NGC.
d.CINAHL.

 

 

ANS:   C

The National Guidelines Clearinghouse (NGC) is a database supported by the Agency for Healthcare Research and Quality (AHRQ). It contains clinical guidelines—systematically developed statements about a plan of care for a specific set of clinical circumstances involving a specific patient population. The NGC is a valuable source when you want to develop a plan of care for a patient. The Cochrane Community Database of Systematic Reviews, MEDLINE, and CINAHL are all valuable sources of synthesized evidence (i.e., pre-appraised evidence).

 

DIF:    Cognitive Level: Synthesis                REF:    Text reference: p. 4

OBJ:    Describe the six steps of evidence-based practice.

TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe and Effective Care Environment (management of care)

 

  1. The nurse has done a literature search and found 25 possible articles on the topic that she is studying. To determine which of those 25 best fit her inquiry, the nurse first should look at:
a.the abstracts.
b.the literature reviews.
c.the “Methods” sections.
d.the narrative sections.

 

 

ANS:   A

An abstract is a brief summary of an article that quickly tells you whether the article is research based or clinically based. An abstract summarizes the purpose of the study or clinical query, the major themes or findings, and the implications for nursing practice. The literature review usually gives you a good idea of how past research led to the researcher’s question. The “Methods” or “Design” section explains how a research study is organized and conducted to answer the research question or to test the hypothesis. The narrative of a manuscript differs according to the type of evidence-based article—clinical or research.

 

DIF:    Cognitive Level: Application             REF:    Text reference: p. 7

OBJ:    Discuss elements to review when critiquing the scientific literature.

TOP:    Randomized Controlled Trials           KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe and Effective Care Environment (management of care)

 

  1. The nurse wants to determine the effects of cardiac rehabilitation program attendance on the level of postmyocardial depression for individuals who have had a myocardial infarction. The type of study that would best capture this information would be a:
a.randomized controlled trial.
b.qualitative study.
c.case control study.
d.descriptive study.

 

 

ANS:   B

Qualitative studies examine individuals’ experiences with health problems and the contexts in which these experiences occur. A qualitative study is best in this case of an individual nurse who wants to examine the effectiveness of a local program. Randomized controlled trials involve close monitoring of control groups and treatment groups to test an intervention against the usual standard of care. Case control studies typically compare one group of subjects with a certain condition against another group without the condition, to look for associations between the condition and predictor variables. Descriptive studies focus mainly on describing the concepts under study.

 

DIF:    Cognitive Level: Synthesis                REF:    Text reference: p. 6

OBJ:    Discuss ways to apply evidence in nursing practice.

TOP:    Randomized Controlled Trials           KEY:   Nursing Process Step: Implementation

MSC:   NCLEX: Safe and Effective Care Environment (management of care)

 

  1. Six months after an early mobility protocol was implemented, the incidence of deep vein thrombosis in patients was decreased. This is an example of what stage in the EBP process?
a.Asking a clinical question
b.Applying the evidence
c.Evaluating the practice decision
d.Communicating your results

 

 

ANS:   C

After implementing a practice change, your next step is to evaluate the effect. You do this by analyzing the outcomes data that you collected during the pilot project. Outcomes evaluation tells you whether your practice change improved conditions, created no change, or worsened conditions.

 

DIF:    Cognitive Level: Application             REF:    Text reference: p. 9

OBJ:    Discuss ways to apply evidence in nursing practice.

TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Evaluation

MSC:   NCLEX: Safe and Effective Care Environment (safety and infection control)

 

MULTIPLE RESPONSE

 

  1. To use evidence-based practice appropriately, you need to collect the most relevant and best evidence and to critically appraise the evidence you gather. This process also includes: (Select all that apply.)
a.asking a clinical question.
b.applying the evidence.
c.evaluating the practice decision.
d.communicating your results.

 

 

ANS:   A, B, C, D

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DescriptionBy: Perry Edition: 9th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadEdition: 8th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Urden Edition: 8th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadEdition: 1st Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Wilkinson Edition: 3rd Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Bauldoff Edition: 7th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant Download
ContentChapter 01: Using Evidence in Practice Perry et al.: Clinical Nursing Skills & Techniques, 9th Edition   MULTIPLE CHOICE  
  1. Evidence-based practice is a problem-solving approach to making decisions about patient care that is grounded in:
a.the latest information found in textbooks.
b.systematically conducted research studies.
c.tradition in clinical practice.
d.quality improvement and risk-management data.
    ANS:   B The best evidence comes from well-designed, systematically conducted research studies described in scientific journals. Portions of a textbook often become outdated by the time it is published. Many health care settings do not have a process to help staff adopt new evidence in practice, and nurses in practice settings lack easy access to risk-management data, relying instead on tradition or convenience. Some sources of evidence do not originate from research. These include quality improvement and risk-management data; infection control data; retrospective or concurrent chart reviews; and clinicians’ expertise. Although non–research-based evidence is often very valuable, it is important that you learn to rely more on research-based evidence.   DIF:    Cognitive Level: Comprehension       REF:    Text reference: p. 2 OBJ:    Discuss the benefits of evidence-based practice. TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Assessment MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. When evidence-based practice is used, patient care will be:
a.standardized for all.
b.unhampered by patient culture.
c.variable according to the situation.
d.safe from the hazards of critical thinking.
    ANS:   C Using your clinical expertise and considering patients’ cultures, values, and preferences ensures that you will apply available evidence in practice ethically and appropriately. Even when you use the best evidence available, application and outcomes will differ; as a nurse, you will develop critical thinking skills to determine whether evidence is relevant and appropriate.   DIF:    Cognitive Level: Application             REF:    Text reference: p. 2 OBJ:    Discuss the benefits of evidence-based practice. TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Assessment MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. When a PICOT question is developed, the letter that corresponds with the usual standard of care is:
a.P.
b.I.
c.C.
d.O.
    ANS:   C C = Comparison of interest. What standard of care or current intervention do you usually use now in practice? P = Patient population of interest. Identify your patient by age, gender, ethnicity, disease, or health problem. I = Intervention of interest. What intervention (e.g., treatment, diagnostic test, and prognostic factor) do you think is worthwhile to use in practice? O = Outcome. What result (e.g., change in patient’s behavior, physical finding, and change in patient’s perception) do you wish to achieve or observe as the result of an intervention?   DIF:    Cognitive Level: Knowledge             REF:    Text reference: p. 3 OBJ:    Develop a PICO question.                 TOP:    PICO KEY:   Nursing Process Step: Implementation MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. A well-developed PICOT question helps the nurse:
a.search for evidence.
b.include all five elements of the sequence.
c.find as many articles as possible in a literature search.
d.accept standard clinical routines.
    ANS:   A The more focused a question that you ask is, the easier it is to search for evidence in the scientific literature. A well-designed PICOT question does not have to include all five elements, nor does it have to follow the PICOT sequence. Do not be satisfied with clinical routines. Always question and use critical thinking to consider better ways to provide patient care.   DIF:    Cognitive Level: Analysis                  REF:    Text reference: p. 3 OBJ:    Describe the six steps of evidence-based practice. TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Implementation MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. The nurse is not sure that the procedure the patient requires is the best possible for the situation. Utilizing which of the following resources would be the quickest way to review research on the topic?
a.CINAHL
b.PubMed
c.MEDLINE
d.The Cochrane Database
    ANS:   D The Cochrane Community Database of Systematic Reviews is a valuable source of synthesized evidence (i.e., pre-appraised evidence). The Cochrane Database includes the full text of regularly updated systematic reviews and protocols for reviews currently happening. MEDLINE, CINAHL, and PubMed are among the most comprehensive databases and represent the scientific knowledge base of health care.   DIF:    Cognitive Level: Synthesis                REF:    Text reference: p. 4 OBJ:    Describe the six steps of evidence-based practice. TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Implementation MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. The nurse is getting ready to develop a plan of care for a patient who has a specific need. The best source for developing this plan of care would probably be:
a.The Cochrane Database.
b.MEDLINE.
c.NGC.
d.CINAHL.
    ANS:   C The National Guidelines Clearinghouse (NGC) is a database supported by the Agency for Healthcare Research and Quality (AHRQ). It contains clinical guidelines—systematically developed statements about a plan of care for a specific set of clinical circumstances involving a specific patient population. The NGC is a valuable source when you want to develop a plan of care for a patient. The Cochrane Community Database of Systematic Reviews, MEDLINE, and CINAHL are all valuable sources of synthesized evidence (i.e., pre-appraised evidence).   DIF:    Cognitive Level: Synthesis                REF:    Text reference: p. 4 OBJ:    Describe the six steps of evidence-based practice. TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Implementation MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. The nurse has done a literature search and found 25 possible articles on the topic that she is studying. To determine which of those 25 best fit her inquiry, the nurse first should look at:
a.the abstracts.
b.the literature reviews.
c.the “Methods” sections.
d.the narrative sections.
    ANS:   A An abstract is a brief summary of an article that quickly tells you whether the article is research based or clinically based. An abstract summarizes the purpose of the study or clinical query, the major themes or findings, and the implications for nursing practice. The literature review usually gives you a good idea of how past research led to the researcher’s question. The “Methods” or “Design” section explains how a research study is organized and conducted to answer the research question or to test the hypothesis. The narrative of a manuscript differs according to the type of evidence-based article—clinical or research.   DIF:    Cognitive Level: Application             REF:    Text reference: p. 7 OBJ:    Discuss elements to review when critiquing the scientific literature. TOP:    Randomized Controlled Trials           KEY:   Nursing Process Step: Implementation MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. The nurse wants to determine the effects of cardiac rehabilitation program attendance on the level of postmyocardial depression for individuals who have had a myocardial infarction. The type of study that would best capture this information would be a:
a.randomized controlled trial.
b.qualitative study.
c.case control study.
d.descriptive study.
    ANS:   B Qualitative studies examine individuals’ experiences with health problems and the contexts in which these experiences occur. A qualitative study is best in this case of an individual nurse who wants to examine the effectiveness of a local program. Randomized controlled trials involve close monitoring of control groups and treatment groups to test an intervention against the usual standard of care. Case control studies typically compare one group of subjects with a certain condition against another group without the condition, to look for associations between the condition and predictor variables. Descriptive studies focus mainly on describing the concepts under study.   DIF:    Cognitive Level: Synthesis                REF:    Text reference: p. 6 OBJ:    Discuss ways to apply evidence in nursing practice. TOP:    Randomized Controlled Trials           KEY:   Nursing Process Step: Implementation MSC:   NCLEX: Safe and Effective Care Environment (management of care)  
  1. Six months after an early mobility protocol was implemented, the incidence of deep vein thrombosis in patients was decreased. This is an example of what stage in the EBP process?
a.Asking a clinical question
b.Applying the evidence
c.Evaluating the practice decision
d.Communicating your results
    ANS:   C After implementing a practice change, your next step is to evaluate the effect. You do this by analyzing the outcomes data that you collected during the pilot project. Outcomes evaluation tells you whether your practice change improved conditions, created no change, or worsened conditions.   DIF:    Cognitive Level: Application             REF:    Text reference: p. 9 OBJ:    Discuss ways to apply evidence in nursing practice. TOP:    Evidence-Based Practice                   KEY:   Nursing Process Step: Evaluation MSC:   NCLEX: Safe and Effective Care Environment (safety and infection control)   MULTIPLE RESPONSE  
  1. To use evidence-based practice appropriately, you need to collect the most relevant and best evidence and to critically appraise the evidence you gather. This process also includes: (Select all that apply.)
a.asking a clinical question.
b.applying the evidence.
c.evaluating the practice decision.
d.communicating your results.
    ANS:   A, B, C, D

Test Bank Focus on Nursing Pharmacology 8th Edition

Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch) Table of Contents Chapter 01 - Introduction to Drugs Chapter 02 - Drugs and the Body Chapter 03 - Toxic Effects of Drugs Chapter 04 - The Nursing Process in Drug Therapy and Patient Safety Chapter 05 - Dosage Calculations Chapter 06 - Challenges to Effective Drug Therapy Chapter 07 - Introduction to Cell Physiology Chapter 08 - Antiinfective Agents Chapter 09 - Antibiotics Chapter 10 - Antiviral Agents Chapter 11 - Antifungal Agents Chapter 12 - Antiprotozoal Agents Chapter 13 - Anthelmintic Agents Chapter 14 - Antineoplastic Agents Chapter 15 - Introduction to the Immune Response and Inflammation Chapter 16 - Antiinflammatory, Antiarthritis, and Related Agents Chapter 17 - Immune Modulators Chapter 18 - Vaccines and Sera Chapter 19 - Introduction to Nerves and the Nervous System Chapter 20 - Anxiolytic and Hypnotic Agents Chapter 21 - Antidepressant Agents Chapter 22 - Psychotherapeutic Agents Chapter 23 - Antiseizure Agents Chapter 24 - Antiparkinsonism Agents Chapter 25 - Muscle Relaxants Chapter 26 - Narcotics, Narcotic Antagonists, and Antimigraine Agents Chapter 27 - General and Local Anesthetic Agents Chapter 28 - Neuromuscular Junction Blocking Agents Chapter 29 - Introduction to the Autonomic Nervous System Chapter 30 - Adrenergic Agonists Chapter 31 - Adrenergic Antagonists Chapter 32 - Cholinergic Agonists Chapter 33 - Anticholinergic Agents Chapter 34 - Introduction to the Endocrine System Chapter 35 - Hypothalamic and Pituitary Agents Chapter 36 - Adrenocortical Agents Chapter 37 - Thyroid and Parathyroid Agents Chapter 38 - Agents to Control Blood Glucose Levels Chapter 39 - Introduction to the Reproductive System Chapter 40 - Drugs Affecting the Female Reproductive System Chapter 41 - Drugs Affecting the Male Reproductive System Chapter 42 - Introduction to the Cardiovascular System Chapter 43 - Drugs Affecting Blood Pressure Chapter 44 - Agents for Treating Heart Failure Chapter 45 - Antiarrhythmic Agents Chapter 46 - Antianginal Agents Chapter 47 - Lipid-Lowering Agents Chapter 48 - Drugs Affecting Blood Coagulation Chapter 49 - Drugs Used to Treat Anemias Chapter 50 - Introduction to the Renal System Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch) 2 Chapter 51 - Diuretic Agents Chapter 52 - Drugs Affecting the Urinary Tract and the Bladder Chapter 53 - Introduction to the Respiratory System Chapter 54 - Drugs Acting on the Upper Respiratory Tract Chapter 55 - Drugs Acting on the Lower Respiratory Tract Chapter 56 - Introduction to the Gastrointestinal System Chapter 57 - Drugs Affecting Gastrointestinal Secretions Chapter 58 - Drugs Affecting Gastrointestinal Motility Chapter 59 - Antiemetic Agents

Test Bank For Critical Care Nursing 8th Edition By Urden

Sample Questions 

Chapter 04: Genetic Issues Urden: Critical Care Nursing, 8th Edition MULTIPLE CHOICE
  1. What is a genetic variant that exists in greater than 1% of the population termed?
a.Genetic mutation
b.Genetic polymorphism
c.Genetic deletion
d.Tandem repeat
ANS:  B When a genetic variant occurs frequently and is present in 1% or more of the population, it is described as a genetic polymorphism. The term genetic mutation refers to a change in the DNA genetic sequence that can be inherited that occurs in less than 1% of the population. Genetic material in the chromosome can also be deleted and new information from another chromosome can be inserted or can be a tandem repeat (multiple repeats of the same sequence). PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 43 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. Which type of genetic disorder occurs when there is an interaction between genetic and environmental factors such as that which occurs with type 2 diabetes?
a.Chromosome
b.Mitochondrial
c.Multifactorial disorders
d.Allele dysfunction
ANS:  C In multifactorial disorders there is an interaction between vulnerable genes and the environment. Cardiovascular atherosclerotic diseases and type 2 diabetes are examples of multifactorial disorders that result from an interaction of genetic and environmental factors. PTS:   1                    DIF:    Cognitive Level: Understanding     REF:   p. 46 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. Prader-Willi syndrome (PWS) is a rare genetic disorder in which genes on chromosome 15 (q11.2-13) are deleted. What type of disorder is PWS?
a.Chromosome disorder
b.Mitochondrial disorder
c.Complex gene disorder
d.Multifactorial disorder
ANS:  A Prader-Willi syndrome (PWS) is a chromosome disorder as a result of several missing genes on chromosome 15. In chromosome disorders, the entire chromosome or very large segments of the chromosome are damaged, missing, duplicated, or otherwise altered. PTS:   1                    DIF:    Cognitive Level: Applying              REF:   p. 45 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. A family pedigree is used to determine whether a disease has a genetic component. What does a proband indicate in a family pedigree?
a.The disease being mother related or father related
b.The first person in the family who was diagnosed with the disorder
c.Who in the family is the xy band
d.The disease genotype including locus
ANS:  B For nurses, it is important to ask questions that elucidate which family members are affected versus those who are unaffected and then to identify the individuals who may carry the gene in question but who do not have symptoms (carriers). The proband is the name given to the first person diagnosed in the family pedigree. Homozygous versus heterozygous determines if the disorder is carried by a gene from one or both parents. The xy band determines if the disorder is carried through the sex genes. A disease locus is the genetic address of the disorder. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 46 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. Philadelphia translocation is a specific chromosomal abnormality that occurs from a reciprocal translocation between chromosomes 9 and 22, where parts of these two chromosomes switch places. This abnormality is associated with which disease?
a.Hemophilia A
b.Chronic myelogenous leukemia
c.Obesity
d.Marfan syndrome
ANS:  B Philadelphia chromosome or Philadelphia translocation is a specific chromosomal abnormality associated with chronic myelogenous leukemia. It occurs from a reciprocal translocation between chromosomes 9 and 22, where parts of these two chromosomes switch places. Hemophilia A is a sex-linked inheritance. Obesity is being studied with the FTO gene on chromosome 16. Marfan syndrome is classified as a single-gene disorder. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 42 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. What was the goal of the Human Genome Project?
a.Identifying haplotype tags
b.Exposing untaggable SNPs and recombination hot spots
c.Producing a catalog of human genome variation
d.Mapping all the human genes
ANS:  D The Human Genome Project was a huge international collaborative project that began in 1990 with the goal of making a map of all the human genes (the genome). The final genome sequence was published in 2003. The HapMap project was to identify haplotype tags. The Genome-Wide Association Studies was used to expose untaggable SNPs and recombination hot spots. The 1000 Genomes project was used to map all the human genes. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 49 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. The patient is placed under general anesthesia for a carotid endarterectomy. During the surgery, the patient develops muscle contracture with skeletal muscle rigidity, acidosis, and elevated temperature. What is a possible cause for malignant hyperthermia?
a.Polymorphism in RYR1 at chromosome 19q13.1
b.Variant in the VKOR1 gene
c.Variant in the cytochrome P450 enzyme CYP2C9 gene
d.Halothane overdose
ANS:  A Individuals with polymorphisms in the ryanodine receptor gene (RYR1) at chromosome 19q13.1 are at risk of a rare pharmacogenetic condition known as malignant hyperthermia. In affected individuals, exposure to inhalation anesthetics and depolarizing muscle relaxants during general anesthesia induces life-threatening muscle contracture with skeletal muscle rigidity, acidosis, and elevated temperature. Warfarin is being researched as a variant in the VKOR1 gene and in the cytochrome P450 enzyme CYP2C9 gene. PTS:   1                    DIF:    Cognitive Level: Evaluating            REF:   p. 53|Box 4-3 OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. What is the study of heredity particularly as it relates to the transfer heritable physical characteristics called?
a.Chromatids
b.Karyotype
c.Genetics
d.Histones
ANS:  C Genetics refers to the study of heredity, particularly as it relates to the ability of individual genes to transfer heritable physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 54 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. Each chromosome consists of an unbroken strand of DNA inside the nucleus of the cell. What is the arrangement of human chromosomes termed?
a.Chromatids
b.Karyotype
c.Genomics
d.Histones
ANS:  B A karyotype is the arrangement of human chromosomes from largest to smallest. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 39 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. What is the study of all the genetic material within the cell and its impact on biologic and physical characteristics called?
a.Chromatids
b.Karyotype
c.Genomics
d.Histones
ANS:  C Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest. A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 39 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. A specialized class of proteins that organizes the double-stranded DNA into what looks like a tightly coiled telephone cord is known which of the following?
a.Chromatids
b.Karyotype
c.Genomics
d.Histones
ANS:  D A specialized class of proteins called histones organizes the double-stranded DNA into what looks like a tightly coiled telephone cord. Genomics refers to the study of all of the genetic material within cells and encompasses the environmental interaction and impact on biologic and physical characteristics. Each somatic chromosome, also called an autosome, is made of two strands, called chromatids, which are joined near the center. A karyotype is the arrangement of human chromosomes from largest to smallest. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 39 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. To achieve a consistent distance across the width of the DNA strand, the nucleotide base guanine (G) can only be paired with what other genetic material?
a.Adenine (A)
b.Thymine (T)
c.Cytosine (C)
d.Sex chromosome X
ANS:  C Four nucleotide bases—adenine (A), thymine (T), guanine (G), and cytosine (C)—comprise the “letters” in the genetic DNA “alphabet.” The bases in the double helix are paired T with A and G with C. The nucleotide bases are designed so that only G can pair with C and only T can pair with A to achieve a consistent distance across the width of the DNA strand. The TA and GC combinations are known as base pairs. PTS:   1                    DIF:    Cognitive Level: Evaluating            REF:   p. 40 OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. Why are monozygotic twins separated at birth used to study the effects of genetics versus environment?
a.They share an identical genome.
b.They have different sex chromosomes.
c.They have mirror chromosomes.
d.They have identical health issues.
ANS:  A Studies of identical twins offer a unique opportunity to investigate the association of genetics, environment, and health. Identical twins are monozygotic and share an identical genome. Monozygotic twins are the same sex. Studies occur much less frequently today because tremendous efforts are made to keep siblings together when they are adopted. Genetics can be stable in a study group, but the environment and health issues are dynamic even in a controlled study group. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 48 OBJ:   Nursing Process Step: General        TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. The process that is used to make polypeptide chains that constitute proteins can be written as:
a.RNA ® DNA ® protein.
b.DNA ® RNA ® protein.
c.Protein ® RNA ® DNA.
d.Protein ® DNA ® RNA.
ANS:  B The nucleotides A, T, C, and G can be thought of as “letters” of a genetic alphabet that are combined into three-letter “words” that are transcribed (written) by the intermediary of ribonucleic acid (RNA). The RNA translates the three-letter words into the amino acids used to make the polypeptide chains that constitute proteins. This process may be written as DNA ® RNA ® protein. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 41 OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. What are the studies called that are done on large, extended families who have several family members affected with a rare disease?
a.Genetic association
b.Genetic epidemiology
c.Kinships
d.Phenotypes
ANS:  C In genetic epidemiologic research of a rare disease, it can be a challenge to find enough people to study. One method is to work with large, extended families, known as kinships, which have several family members affected with the disease. Genetic association studies are usually conducted in large, unrelated groups based on demonstration of a phenotype (disease trait or symptoms) and associated genotype. Genetic epidemiology represents the fusion of epidemiologic studies and genetic and genomic research methods. Phenotypes are different at different stages of a disease and are influenced by medications, environmental factors, and gene–gene interaction. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 48 OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. What is an example of direct-to-consumer genomic testing?
a.Genetic testing through amniocentesis
b.Paternity testing from buccal swabs of the child and father
c.Biopsy of a lump for cancer
d.Drug testing using hair follicles
ANS:  B An example of direct-to-consumer testing is paternity testing from buccal swabs of the child and father. Genetic testing can be done through biopsies and amniocentesis, but they are performed in a facility by a medical professional. Drug testing and genomic testing are two different tests and are unrelated. PTS:   1                    DIF:    Cognitive Level: Evaluating            REF:   p. 53 OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance
  1. What was the Genetic Information Nondiscrimination Act (GINA) of 2008 designed to prevent from happening?
a.Abuse of genetic information in employment and health insurance decisions
b.Genetic counselors from reporting results to the health insurance companies
c.Mandatory genetics testing of all individuals with certain diseases
d.Information sharing between biobanks that are studying the same genetic disorders
ANS:  A The Genetic Information Nondiscrimination Act (GINA) of 2008 is an essential piece of legislation designed to prevent abuse of genetic information in employment and health insurance decisions in the United States. One of the paramount concerns in the genomic era is to protect the privacy of individuals’ unique genetic information. Many countries have established biobanks as repositories of genetic material, and many tissue samples are stored in medical center tissue banks. Some people who may be at risk for a disorder disease will not be tested because they fear that a positive result may affect their employability. GINA also mandates that genetic information about an individual and his or her family has the same protections as health information. PTS:   1                    DIF:    Cognitive Level: Remembering      REF:   p. 53 OBJ:   Nursing Process Step: Diagnosis     TOP:   Genetics in Critical Care MSC:  NCLEX: Health Promotion and Maintenance MULTIPLE RESPONSE
  1. Which patients would be candidates for genetic testing for long QT syndrome (LQTS)? (Select all that apply.)
a.Patients with prolonged QT interval during a cardiac and genetic work-up
b.Family history of positive genotype and negative phenotype
c.Patients diagnosed with torsades de pointes
d.Family history of sudden cardiac death
e.Family history of bleeding disorders
f.Family history of obesity
ANS:  A, B, C, D

Medical-Surgical Nursing: Making Connections to Practice 1st edition Hoffman, Sullivan Test Bank

 

Chapter 1: Foundations for Medical-Surgical Nursing

Multiple Choice Identify the choice that best completes the statement or answers the question.

____ 1. The medical-surgical nurse identifies a clinical practice issue and wants to determine if there is sufficient evidence to support a change in practice. Which type of study provides the strongest evidence to support a practice change? 1) Randomized control study 2) Quasi-experimental study 3) Case-control study 4) Cohort study

____ 2. The medical-surgical unit recently implemented a patient-centered care model. Which action implemented by the nurse supports this model? 1) Evaluating care 2) Assessing needs 3) Diagnosing problems 4) Providing compassion

____ 3. Which action should the nurse implement when providing patient care in order to support The Joint Commission’s (TJC) National Patient Safety Goals (NPSG)? 1) Silencing a cardiorespiratory monitor 2) Identifying each patient using one source 3) Determining patient safety issues upon admission 4) Decreasing the amount of pain medication administered

____ 4. Which interprofessional role does the nurse often assume when providing patient care in an acute care setting? 1) Social worker 2) Client advocate 3) Care coordinator 4) Massage therapist

____ 5. The medical-surgical nurse wants to determine if a policy change is needed for an identified clinical problem. Which is the first action the nurse should implement? 1) Developing a question 2) Disseminating the findings 3) Conducting a review of the literature 4) Evaluating outcomes of practice change

____ 6. The nurse is evaluating the level of evidence found during a recent review of the literature. Which evidence carries the lowest level of support for a practice change? 1) Level IV 2) Level V 3) Level VI 4) Level VII

____ 7. The nurse is reviewing evidence from a quasi-experimental research study. Which level of evidence should the nurse identify for this research study? 1) Level ITestBankWorld.org 2) Level II 3) Level III 4) Level IV

____ 8. Which level of evidence should the nurse identify when reviewing evidence from a single descriptive research study? 1) Level IV 2) Level V 3) Level VI 4) Level VII

____ 9. Which statement should the nurse make when communicating the “S” in the SBAR approach for effective communication? 1) “The patient presented to the emergency department at 0200 with lower left abdominal pain.” 2) “The patient rated the pain upon admission as a 9 on a 10-point numeric scale.” 3) “The patient has no significant issues in the medical history.” 4) “The patient was given a prescribed opioid analgesic at 0300.” ____ 10. The staff nurse is communicating with the change nurse about the change of status of the patient. The nurse would begin her communication with which statement if correctly using the SBAR format? 1) “The patient’s heartrate is 110.” 2) “I think this patient needs to be transferred to the critical care unit.” 3) “The patient is a 68-year-old male patient admitted last night.” 4) “The patient is complaining of chest pain.” ____ 11. Which nursing action exemplifies the Quality and Safety Education for Nursing (QSEN) competency of safety? 1) Advocating for a patient who is experiencing pain 2) Considering the patient’s culture when planning care 3) Evaluating patient learning style prior to implementing discharge instructions 4) Assessing the right drug prior to administering a prescribed patient medication ____ 12. Which type of nursing is the root of all other nursing practice areas? 1) Pediatric nursing 2) Geriatric nursing 3) Medical-surgical nursing 4) Mental health-psychiatric nursing ____ 13. Which did the Nursing Executive Center of The Advisory Board identify as an academic-practice gap for new graduate nurses? 1) Patient advocacy 2) Patient education 3) Disease pathophysiology 4) Therapeutic communication ____ 14. Which statement regarding the use of the nursing process in clinical practice is accurate? 1) “The nursing process is closely related to clinical decision-making.” 2) “The nursing process is used by all members of the interprofessional team to plan care.” 3) “The nursing process has 4 basic steps: assessment, planning, implementation, evaluation.” 4) “The nursing process is being replaced by the implementation of evidence-based practice.”TestBankWorld.org ____ 15. Which is the basis of nursing care practices and protocols? 1) Assessment 2) Evaluation 3) Diagnosis 4) Research ____ 16. Which is a common theme regarding patient dissatisfaction related to care provided in the hospital setting? 1) Space in hospital rooms 2) Medications received to treat pain 3) Time spent with the health-care team 4) Poor quality food received from dietary ____ 17. The nurse manager is preparing a medical-surgical unit for The Joint Commission (TJC) visit With the nurse manager presenting staff education focusing on TJC benchmarks, which of the following topics would be most appropriate? 1) Implementation of evidence-based practice 2) Implementation of patient-centered care 3) Implementation of medical asepsis practices 4) Implementation of interprofessional care ____ 18. Which aspect of patient-centered care should the nurse manager evaluate prior to The Joint Commission site visit for accreditation? 1) Visitation rights 2) Education level of staff 3) Fall prevention protocol 4) Infection control practices ____ 19. The medical-surgical nurse is providing patient care. Which circumstance would necessitate the nurse verifying the patient’s identification using at least two sources? 1) Prior to delivering a meal tray 2) Prior to passive range of motion 3) Prior to medication administration 4) Prior to documenting in the medical record ____ 20. The nurse is providing care to several patients on a medical-surgical unit. Which situation would necessitate the nurse to use SBAR during the hand-off process? 1) Wound care 2) Discharge to home 3) Transfer to radiology 4) Medication education Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 21. The staff nurse is teaching a group of student nurses the situations that necessitate hand-off communication. Which student responses indicate the need for further education related to this procedure? Select all that apply. 1) “A hand-off is required prior to administering a medication.” 2) “A hand-off is required during change of shift.” 3) “A hand-off is required for a patient is transferred to the surgical suite.”TestBankWorld.org 4) “A hand-off is required whenever the nurse receives a new patient assignment.” 5) “A hand-off is required prior to family visitation.” ____ 22. Which actions by the nurse enhance patient safety during medication administration? Select all that apply. 1) Answering the call bell while transporting medications for a different patient 2) Identifying the patient using two sources prior to administering the medication 3) Holding a medication if the patient’s diagnosis does not support its use 4) Administering the medication two hours after the scheduled time 5) Having another nurse verify the prescribed dose of insulin the patient is to receive ____ 23. The medical-surgical nurse assumes care for a patient who is receiving continuous cardiopulmonary monitoring. Which actions by the nurse enhance safety for this patient? Select all that apply. 1) Silencing the alarm during family visitation 2) Assessing the alarm parameters at the start of the shift 3) Responding to the alarm in a timely fashion 4) Decreasing the alarm volume to enhance restful sleep 5) Adjusting alarm parameters based on specified practitioner prescription ____ 24. The nurse is planning an interprofessional care conference for a patient who is approaching discharge from the hospital. Which members of the interprofessional team should the nurse invite to attend? Select all that apply. 1) Physician 2) Pharmacist 3) Unit secretary 4) Social worker 5) Home care aide ____ 25. The nurse manager wants to designate a member of the nursing team as the care coordinator for a patient who will require significant care during the hospitalization. Which skills should this nurse possess in order to assume this role? Select all that apply. 1) Effective clinical reasoning 2) Effective communication skills 3) Effective infection control procedures 4) Effective documentation 5) Effective intravenous skillsTestBankWorld.org Chapter 1: Foundations for Medical-Surgical Nursing Answer Section MULTIPLE CHOICE 1. ANS: 1 Chapter number and title: 1, Foundations for Medical Surgical Practice Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical nursing Chapter page reference: 003-004 Heading: Evidence-Based Nursing Care Integrated Processes: Nursing Process: Planning Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Evidence-Based Practice Difficulty: Easy Feedback 1 Systematic reviews of randomized control studies (Level I) are the highest level of evidence because they include data from selected studies that randomly assigned participants to control and experimental groups. The lower the numerical rating of the level of evidence indicates the highest level of evidence; therefore, this type of study provides the strongest evidence to support a practice change. 2 Quasi-experimental studies are considered Level III; therefore, this study does not provide the strongest evidence to support a practice change. 3 Case-control studies are considered Level IV; therefore, this study does not provide the strongest evidence to support a practice change. 4 Cohort studies are considered Level IV; therefore, this study does not provide the strongest evidence to support a practice change. PTS: 1 CON: Evidence-Based Practice 2. ANS: 4 Chapter number and title: 1, Foundations of Medical-Surgical Practice Chapter learning objective: Explaining the importance of patient-centered care in the management of medical-surgical patients Chapter page reference: 004-005 Heading: Patient-Centered Care in the Medical-Surgical Setting Integrated Processes: Caring Client Need: Psychosocial Integrity Cognitive level: Application [Applying] Concept: Nursing Roles Difficulty: Moderate Feedback 1 Evaluation is a step in the nursing process; however, this is not an action that supports the patient-centered care model. 2 Assessment is a step in the nursing process; however, this is not an action that supports the patient-centered care model.TestBankWorld.org 3 Diagnosis is a step in the nursing process; however, this is not an action that supports the patient-centered care model. 4 Compassion is a competency closely associated with patient-centered care; therefore, this action supports the patient-centered model of care. PTS: 1 CON: Nursing Roles 3. ANS: 3 Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice Chapter learning objective: Discussing implications to medical-surgical nurses of Quality and Safety Education for Nurses (QSEN) competencies Chapter page reference: 005-006 Heading: Patient Safety Outcomes Integrated Processes: Nursing Process: Implementation Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Application [Applying] Concept: Safety Difficulty: Moderate Feedback 1 Safely using alarms is a NPSG identified by TJC. Silencing a cardiorespiratory monitor is not nursing action that supports this NPSG. 2 Patient identification using two separate resources is a NPSG identified by TJC. Identifying a patient using only one source does not support this NPSG. 3 Identification of patient safety risks is a NPSG identified by the TJC. Determining patient safety issues upon admission supports this NPSG. 4 Safe use of medication is a NPSG identified by the TJC. Decreasing the amount of pain medication administered does not support this NPSG. PTS: 1 CON: Safety 4. ANS: 3 Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice Chapter learning objective: Describing the role and competencies of medical-surgical nursing Chapter page reference: 006-007 Heading: Interprofessional Collaboration and Communication Integrated Processes: Nursing Process: Implementation Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Nursing Roles Difficulty: Easy Feedback 1 The nurse does not often assume the interprofessional role of social worker when providing patient care in an acute care setting. 2 The nurse does not often assume the interprofessional role of client advocate role when providing patient care in an acute care setting. 3 The nurse often assumes the interprofessional role of care coordinator when providing patient care in an acute care setting. 4 The nurse does not often assume the interprofessional role of massage therapist when providing patient care in an acute care setting.TestBankWorld.org PTS: 1 CON: Nursing Roles 5. ANS: 1 Chapter number and title: 1, Foundations of Medical-Surgical Practice Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical nursing Chapter page reference: 003 Heading: Box 1.3 Steps of Evidence-Based Practice Integrated Processes: Nursing Process: Implementation Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Analysis [Analyzing] Concept: Evidence-Based Practice Difficulty: Difficult Feedback 1 The first step of evidence-based practice is to develop a question based on the clinical issue. 2 The last step of evidence-based practice is to disseminate findings. 3 The second step of evidence-based practice is to conduct a review of the literature, or current evidence, available. 4 The fifth step of evidence-based practice is to evaluate the outcomes associated with the practice change. PTS: 1 CON: Evidence-Based Practice 6. ANS: 4 Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical nursing Chapter page reference: 004 Heading: Box 1.4 Evaluating Levels of Evidence Integrated Processes: Nursing Process: Planning Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Evidence-Based Practice Difficulty: Easy Feedback 1 The lower the numeric value of the evidence the greater the support for a change in practice. Level IV evidence does not carry the lowest level of support for a practice change. 2 The lower the numeric value of the evidence the greater the support for a change in practice. Level V evidence does not carry the lowest level of support for a practice change. 3 The lower the numeric value of the evidence the greater the support for a change in practice. Level VI evidence does not carry the lowest level of support for a practice change. 4 The lower the numeric value of the evidence the greater the support for a change in practice. Level VII evidence carries the lowest level of support for a practice change.

Test Bank for Fundamentals of Nursing 3rd Edition by Wilkinson

Chapter 1. Evolution of Nursing Thought & Action MULTIPLE CHOICE
  1. Which of the following is an example of an illness prevention activity?
a.Encouraging the use of a food diary
b.Joining a cancer support group
c.Administering immunization for HPV
d.Teaching a diabetic patient about his diet
ANS:  C 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, it would be treatment and not disease prevention. Illness prevention activities focus on avoiding a specific disease. A food diary is a health promotion activity. Teaching a diabetic patient about diet is a treatment for diabetes; the patient already has diabetes, so the teaching cannot prevent diabetes. Difficulty: Moderate Client Need: Health Promotion and Maintenance Cognitive Level: Application Page 15 PTS:   1
  1. Which organization can require nurses to take continuing education courses as a condition of licensure renewal?
a.American Nurses Association
b.National League for Nursing
c.Sigma Theta Tau
d.State Board of Nursing
ANS:  D Continuing education is a professional strategy designed to ensure that nurses remain current in their clinical knowledge. Many states require nurses to engage in a certain number of continuing-education requirements to renew their license. The knowledge gained in the nursing curriculum is sufficient for nursing school graduates to obtain their initial license. Requirements for renewal of a nurse’s license can be found in the state’s nurse practice act (state board of nursing). Difficulty: Difficult Cognitive Level: Analysis Client Need: Health Promotion and Maintenance Cognitive Level: Application Page 11 PTS:   1
  1. An experienced seasoned nurse uses her knowledge of patient medical conditions and intuition to identify patient problems. She is often the resource for other nurses on the unit. What stage of proficiency has this nurse achieved?
a.Novice
b.Advanced beginner
c.Competent
d.Expert
ANS:  D The nurse who has reached the expert stage of proficiency has a deep understanding of the clinical situation based on knowledge and experience. The nurse often senses a potential problem in the absence of classic signs and symptoms. The novice nurse is inexperienced and relies on rules and processes. The advanced beginner focuses on aspects of a situation and is unable to see the comprehensive perspective. A nurse functioning at the competent level is able to prioritize to meet the patient needs but does not fully grasp the total situation. Difficulty: Moderate Cognitive Level: Comprehension Pages 11-12 PTS:   1
  1. Which of the following best explains the importance of standards of practice?
a.Nurses and other healthcare providers have the same standards of practice.
b.Standard of practice only apply to nurses who work in hospital settings.
c.Standards of practice identify the knowledge, skills, and attitudes nurses need to provide safe care.
d.Standards of practice differ among registered nurses because the roles are different based on the population they serve.
ANS:  C Standards of practice are authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently. Standards are derived from several sources, including professional organizations and healthcare facilities’ policies and procedures. Difficulty: Moderate Cognitive Level: Application Pages 12-13 PTS:   1
  1. What is the primary goal of the National League for Nursing?
a.Advocate for the needs of registered nurses to promote patient safety
b.Establish and maintain standards for nursing education
c.Support global health policies and improve health worldwide
d.Foster nursing scholarship, leadership, and service to improve health worldwide
ANS:  B The National League for Nursing (NLN) was founded to establish and maintain a universal standard of nursing education. The NLN focuses on faculty development in nursing education programs and is the voice for nursing education. Difficulty: Moderate Cognitive Level: Application Page 14   PTS:   1
  1. A patient who requires long-term rehabilitation needs which type of care?
a.Primary care
b.Secondary care
c.Tertiary care
d.Preventive care
ANS:  C Tertiary care is required for individuals who need long-term care or for those who are dying. Difficulty: Easy Cognitive Level: Knowledge Page 18 PTS:   1
  1. An elderly patient is covered under Medicare. She is scheduled for discharge and tells the nursing student that several therapists will come to her home to help her regain functional abilities. The patient then asks, “Why can’t I just stay in the hospital and receive this type of care?” What is the nursing student’s best response?
a.“You should be able to stay in the hospital. I will ask the nurse to call your doctor.”
b.“Once you have reached your reimbursable length of stay and your condition is stable, it is more cost effective to provide you with home healthcare.”
c.“Medicare is a type of managed care, which mean that you are only allowed to stay in the hospital for a certain number of days before being discharged, regardless of your condition.”
d.“You should be glad to be in your own home. You will recover in no time.”
ANS:  B Home healthcare services are provided to patients who still require skilled care but are discharged from the hospital because the reimbursable length-of-stay has expired. The patient is stable and can receive provider services at home. It would be incorrect and misleading to tell the patient she “should be able to stay in the hospital.” It would be incorrect to tell the patient she is allowed only “a certain number of days before being discharged,” because the patient’s condition is a factor in determining whether the patient can be discharged from the hospital. Telling the patient that she should be glad to be going home is a form of closed communication and does not address her question. Difficulty: Moderate

LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)

Chapter 1   Medical-Surgical Nursing in the 21st Century

  1) A patient is instructed on the role of diet, exercise, and medication to control type 2 diabetes mellitus. Which core competency for healthcare professionals is the nurse implementing?
  1. Quality improvement
  2. Evidence-based practice
  3. Patient-centered care
  4. Teamwork and collaboration
Answer:  3 Explanation:  1. Identifying safety hazards and measuring quality is an example of the core competency quality improvement.
  1. Using best research when providing patient care is an example of the core competency evidence-based practice.
  2. Patient teaching is an example of the competency patient-centered care.
  3. The core competency teamwork and collaboration involves collaboration between disciplines to provide continuous and reliable care.
Page Ref: 5 Cognitive Level:  Applying Client Need & Sub:  Safe and Effective Care Environment: Management of Care Standards:  QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively; listen openly and cooperatively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning Learning Outcome:  1.1 Describe the core competencies for healthcare professionals: Patient-centered care, interprofessional teams, evidence-based practice, quality improvement, safety, and health information technology. MNL Learning Outcome:  1. Demonstrate use of the core competencies for healthcare professionals in nursing practice.    

2) The nurse is planning to utilize the core competency use informatics when providing patient care. Which action should the nurse perform when using this core competency?

  1. Change the sharps container in a patient's room.
  2. Document the effectiveness of pain medication for a patient.
  3. Discuss the effectiveness of bedside physical therapy with the therapist.
  4. Search through a database of articles to find current research on wound care.
Answer:  4 Explanation:  1. Changing the sharps container is an example of quality improvement.
  1. Documenting the effectiveness of pain medication for a patient is an example of patient-centered care.
  2. Discussing the effectiveness of bedside physical therapy with the therapist is an example of teamwork and collaboration.
  3. Searching through a database of articles to find current research on wound care is an example of use informatics.
Page Ref: 5 Cognitive Level:  Applying Client Need & Sub:  Safe and Effective Care Environment: Management of Care Standards:  QSEN Competencies: VI.B.2. Apply technology and information management tools to support safe processes of care | AACN Essentials Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice | NLN Competencies: Knowledge and Science: Practice-Know-How: Retrieve research findings and other sources of information | Nursing/Integrated Concepts:
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