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Test Bank for deWits Fundamental Concepts and Skills for Nursing 5th Edition by Williams

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Chapter 06: Implementation and Evaluation

Williams: deWit’s Fundamental Concepts and Skills for Nursing, 5th Edition

MULTIPLE CHOICE

1. The nurse is aware that one of the time flexible tasks to be accomplished would be:

a. administering daily insulin 30 minutes before breakfast.
b. taking the patient’s vital signs once a day.
c. weighing the patient before breakfast.
d. monitoring a critical patient’s vital signs every 15 minutes.

ANS: B

Daily vital signs can be taken at any time during the day, whereas the other tasks mentioned have a time constraint.

DIF: Cognitive Level: Application REF: p. 73 OBJ: Theory #2

TOP: Care Delivery KEY: Nursing Process Step: Planning

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

2. Prior to the nurse implementing a nursing procedure for a patient, the nurse should initially:

a. question the rationale for the procedure.
b. perform a physical assessment of the patient.
c. check the agency manual for the procedure.
d. mentally review the procedure.

ANS: D

Reviewing the procedure, checking the manual if uncertain, confirming the order for the procedure, assessing that there is no interference with the completion of the procedure, and identifying the patient are standard steps in deliberative nursing action.

DIF:Cognitive Level: ApplicationREF:p. 76|Box 6-2

OBJ: Theory #1TOP: Care Delivery

KEY: Nursing Process Step: Planning

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

3. At the 7:00 AM handoff report, the nurse receives the report that patient A had a sleepless night related to pain and just fell asleep after an increased pain medication administration 1/2 hour ago. Patient B, who is scheduled for surgery at 8:30 AM, is also sleeping. How would an organized nurse plan the early morning activities?

a. Wake patient A for breakfast.
b. Perform time flexible tasks that can be done while both patients sleep.
c. Prepare patient B now; allow patient A to sleep.
d. Assign a nursing assistant to wake and help feed patient A.

ANS: C

Setting priorities and identifying time fixed tasks would indicate that patient B needs to be prepared for surgery. Patient A needs to sleep.

DIF: Cognitive Level: Analysis REF: p. 73 OBJ: Theory #1

TOP: Care Delivery KEY: Nursing Process Step: Implementation

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

4. Preparing a patient for a diagnostic test, and telling the patient what to expect during and after the test, is considered:

a. an independent nursing action.
b. the doctor’s responsibility.
c. a dependent nursing action that requires the doctor’s authorization.
d. an interdependent nursing action.

ANS: A

Patient education is an independent nursing action.

DIF: Cognitive Level: Comprehension REF: p. 74 OBJ: Theory #2

TOP: Patient Education KEY: Nursing Process Step: Implementation

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

5.The nurse explains that a multidisciplinary step-by-step approach to patient care is:

a. documented in the nursing care plan in the patient’s medical record.
b. not used often since managed care became part of health care.
c. referred to as a clinical pathway and is used instead of a nursing care plan.
d. more expensive than the traditional separation of health care services.

ANS: C

An outgrowth of managed care has been collaborative models of care called clinical pathways.

DIF: Cognitive Level: Knowledge REF: p. 74 OBJ: Theory #1

TOP: Clinical Pathways KEY: Nursing Process Step: Implementation

MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care

6.The nurse documents interventions periodically during the shift in nurses’ notes primarily to:

a. validate the number of nonlicensed personnel who interact with the patient.
b. indicate that the nursing care plan has been implemented.
c. briefly summarize activities during the shift.
d. confirm that the nursing diagnoses in the care plan are appropriate.

ANS: B

The nursing care must be documented in the nurses’ notes to prove that interventions were implemented. In some facilities documentation is required at least every 2 hours.

DIF: Cognitive Level: Comprehension REF: p. 76 OBJ: Theory #3

TOP: Documentation KEY: Nursing Process Step: Implementation

MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care

7.The nurse compares actual nursing outcomes to the expected nursing outcomes in order to:

a. prepare the patient to be discharged from the facility.
b. determine if the patient’s health problems have been treated.
c. calculate charges for nursing services during the patient’s hospital stay.
d. determine if progress is made or to determine if revisions are needed.

ANS: D

Evaluation of patient responses to treatment and progress toward goals is performed continuously so that the nursing care plan may be modified if needed.

DIF: Cognitive Level: Comprehension REF: p. 77 OBJ: Theory #5

TOP:OutcomesKEY:Nursing Process Step: Evaluation

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

8.The general rule is that the initial care plan for a patient is:

a. developed by an RN in an acute care setting.
b. used as the basis of care throughout a hospital stay without alteration.
c. completed on the day of admission.
d. developed by the primary care provider and incorporated into the nursing care.

ANS: A

An RN is responsible for developing the plan of care for patients in acute care settings. An LPN may begin the care plan in a skilled nursing facility and will collaborate with the RN for revision. The nursing care plan will be revised frequently as the patient’s condition changes.

DIF: Cognitive Level: Comprehension REF: p. 79 OBJ: Theory #2

TOP: Care Planning KEY: Nursing Process Step: Planning

MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care

9.The nurse is aware that the nursing audit is a valuable process used to:

a. determine whether a particular patient received the care indicated in the nursing care plan.
b. evaluate whether nursing care for a group of patients meets the standards of care in that facility.
c. determine the cost of nursing care in the hospital in order to set rates for daily care.
d. identify careless or negligent nursing care to protect the facility from lawsuits.

ANS: B

Nursing audits are performed to improve nursing practice by checking a group of patient records for how well particular standards were met and standards of care were being used.

DIF: Cognitive Level: Knowledge REF: p. 79 OBJ: Theory #6

TOP: Nursing Audits KEY: Nursing Process Step: Planning

MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care

10.The nurse evaluates that the patient has met the outcome of feeding himself independently. The nurse should:

a. inactivate the nursing diagnosis from the care plan.
b. notify the primary care provider that the patient can now feed himself.
c. document the ability to self-feed and mark the nursing diagnosis as resolved.
d. inform the RN to document the self-feeding and to cancel the nursing diagnosis.

ANS: C

The LPN should document the meeting of the outcome and mark the nursing diagnosis as “resolved.”

DIF: Cognitive Level: Application REF: p. 77 OBJ: Theory #6

TOP: Nursing Care Plan Revision KEY: Nursing Process Step: Intervention

MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care

11.An example of an appropriately worded nursing goal or outcome for the nursing diagnosis of “Risk for falls related to weakness” would be:

a. nurse will assist the patient to the bathroom every 2 hours.
b. patient will be free of injury from falls.
c. patient will call for assistance when ambulating for the next week.
d. nurse will keep room well lit 24 hours a day.

ANS: C

An appropriately worded outcome is a patient centered, measurable, and time defined goal based on a nursing diagnosis.

DIF:Cognitive Level: ApplicationREF:p. 79|Box 6-3

OBJ:Theory #5TOP:Expected Outcomes

KEY:Nursing Process Step: Evaluation

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

12.Nurses design interventions that are appropriate for a patient that are:

a. based on the primary care provider’s orders and the medical diagnosis.
b. expected to help the patient meets the goals most quickly.
c. used to evaluate whether the nursing care plan should be revised.
d. based on cost effectiveness and staff availability.

ANS: B

Nursing interventions are based on nursing diagnoses and are those most likely to assist the patient in meeting outcomes related to those diagnoses.

DIF:Cognitive Level: ComprehensionREF:p. 79|Box 6-3

OBJ:Theory #2TOP:Care Delivery

KEY:Nursing Process Step: Planning

MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care

13.Before performing a catheterization, the inexperienced nurse should:

a. close the door or curtains to provide the patient with privacy.
b. provide necessary education and explanation of the procedure to the patient.
c. observe rules of Standard Precautions to protect herself from exposure to blood or body fluids.
d. review the agency’s procedure manual for the accepted way of performing the procedure.

ANS: D

Reviewing the procedure manual should occur before the inexperienced nurse explains to the patient, provides privacy, or observes Standard Precautions.

DIF: Cognitive Level: Application REF: p. 75 OBJ: Clinical Practice #2

TOP:Standards for All Nursing Procedures

KEY:Nursing Process Step: Implementation

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

14.During morning care in a skilled nursing facility, the student nurse notices that the patient who is at risk for impaired skin integrity has developed a small open area on his sacrum. To best address this situation, the student would first:

a. position the patient to lie on his side, document it, and inform the head nurse.
b. position the patient on his side and encourage him to massage around the area.
c. report to the primary care provider so that the nursing care plan can be revised.
d. tell the nursing assistant to change the patient’s position every 2 hours.

ANS: A

This change in the patient’s position with documentation is the initial intervention. The discovery of an open lesion requires a change in the nursing plan.

DIF: Cognitive Level: Analysis REF: p. 77 OBJ: Theory #2

TOP: Care Delivery KEY: Nursing Process Step: Implementation

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

15.A review of a patient’s nursing care plan before beginning care allows the nurse to:

a. make revisions in the plan as indicated by the shift report.
b. use critical thinking skills to organize care for the patient.
c. begin nursing interventions without needing an initial assessment.
d. skip the shift report and begin with the initial assessment.

ANS: B

Reviewing the patient’s care plan gives the nurse a starting point for organizing care.

DIF: Cognitive Level: Comprehension REF: p. 75 OBJ: Theory #2

TOP:PlanningKEY:Nursing Process Step: Planning

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

16.The nurse giving a patient a back massage is performing an intervention considered to be:

a. a dependent nursing action.
b. an independent nursing action.
c. an interdependent nursing action.
d. a semi-dependent nursing action.

ANS: B

An independent nursing action does not require a primary care provider’s order, but it does require critical thinking and nursing judgment. Giving a back massage would be an independent nursing action.

DIF: Cognitive Level: Comprehension REF: p. 74 OBJ: Theory #2

TOP: Care Delivery KEY: Nursing Process Step: Implementation

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

17.The nurse administering a medication to a patient is performing an intervention that is:

a. an independent nursing action.
b. an interdependent nursing action.
c. a semi-dependent nursing action.
d. a dependent nursing action.

ANS: D

The administration of a medication is a dependent nursing action because giving medication requires a primary care provider’s order.

DIF: Cognitive Level: Comprehension REF: p. 74 OBJ: Theory #2

TOP: Care Delivery KEY: Nursing Process Step: Implementation

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

18.The nurse caring for a group of patients would show cultural sensitivity to assign an older male nursing assistant to the care of:

a. a 45-year-old white male patient with uncontrolled diabetes.
b. a 50-year-old Hispanic man with a broken leg.
c. a 55-year-old Japanese man with irritable bowel syndrome.
d. a 60-year-old Muslim woman with pneumonia.

ANS: C

Older Japanese men may resist care given by a younger person or a female.

DIF: Cognitive Level: Analysis REF: p. 75 OBJ: Theory #1

TOP: Cultural Considerations KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

19.In assigning tasks to the nursing assistant, the nurse could appropriately select:

a. range of motion exercises to lower limbs.
b. sterile dressing change on a leg wound.
c. postoperative education to a post-hysterectomy patient.
d. witnessing of the signature on an operative permit.

ANS: A

Range of motion exercises may be provided by nursing assistants, physical therapy aides, or restorative aides. The nurse performs any invasive procedure, legal document witnessing, and any sterile procedure.

DIF: Cognitive Level: Application REF: p. 75 OBJ: Theory #3

TOP:DelegationKEY:Nursing Process Step: Planning

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

20.The nurse is assessing a patient who just returned from a bowel resection 1 hour ago. The nurse notes a dressing over the suture line that is wet with sero sanguineous drainage. The nurse should initially:

a. perform a sterile dressing change.
b. document and report the wet dressing to the charge nurse.
c. reinforce the wet dressing and document.
d. place a towel on the bed and turn the patient to the operated side.

ANS: C

The general rule is that the initial dressing change is performed by the surgeon who will give further orders pertinent to future dressing changes. The dressing should be reinforced with sterile materials; findings should be documented and reported to the charge nurse.

DIF: Cognitive Level: Analysis REF: p. 74 OBJ: Theory #3

TOP: Initial Dressing Change KEY: Nursing Process Step: Implementation

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

MULTIPLE RESPONSE

1.The nurse coming on duty has received a report that an IV of 1000 mL of 5% glucose in 0.9% normal saline is running at a rate of 50 mL an hour to be followed by another 1000 mL to be run at the same rate. The reporting nurse states that the second IV should be hung at 9:00 AM. The prudent nurse should: (Select all that apply.)

a. hang the next 1000 mL when the first is finished.
b. check to label on the present IV.
c. confirm the flow rate.
d. check the order for the IVs.
e. speed up the flow so that the IV will be completed by 9:00 AM.

ANS: B, C, D

The nurse should check the order and the flow rate, and the amount and type of fluid to follow for accuracy, and not depend on the handoff report.

DIF: Cognitive Level: Analysis REF: p. 73 OBJ: Theory #2

TOP: Care Delivery KEY: Nursing Process Step: Implementation

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

2.The purpose of the evaluation step of the nursing process is to: (Select all that apply.)

a. determine if outcomes have been reached and the goals are met.
b. compare actual outcomes with expected outcomes.
c. identify inefficient care given by assigned staff.
d. confirm that nursing interventions are effective.
e. ensure that the facility has not put itself at risk for litigation.

ANS: A, B, D

Evaluation attempts to determine if the outcomes have been reached and that the interventions being used are effective. Evaluation also demonstrates if the actual outcomes agree with the expected outcomes in the nursing care plan.

DIF: Cognitive Level: Comprehension REF: p. 77 OBJ: Theory #5

TOP: Nursing Process KEY: Nursing Process Step: Evaluation

MSC:NCLEX: Physiological Integrity: Basic Care and Comfort

3.Standards of care are set by: (Select all that apply.)

a. the state’s nurse practice act.
b. professional medical association standards.
c. the facility’s policies and procedures.
d. the primary care provider in charge of the patient’s treatment.
e. the director of nurses and the agency administrator.

ANS: A, B, C

Standards of care are set by the state’s nursing practice act, professional association standards, and the facility’s policies and procedures.

DIF: Cognitive Level: Comprehension REF: p. 75 OBJ: Theory #3

TOP: Standards of Care KEY: Nursing Process Step: Planning

MSC:NCLEX: N/A

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DescriptionBy: Williams Edition: 5th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Burton Edition: 2nd Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadEdition: 9th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Townsend 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 DownloadEdition: 8th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant Download
ContentChapter 06: Implementation and Evaluation

Williams: deWit’s Fundamental Concepts and Skills for Nursing, 5th Edition

MULTIPLE CHOICE 1. The nurse is aware that one of the time flexible tasks to be accomplished would be:
a. administering daily insulin 30 minutes before breakfast.
b. taking the patient’s vital signs once a day.
c. weighing the patient before breakfast.
d. monitoring a critical patient’s vital signs every 15 minutes.
ANS: B Daily vital signs can be taken at any time during the day, whereas the other tasks mentioned have a time constraint. DIF: Cognitive Level: Application REF: p. 73 OBJ: Theory #2 TOP: Care Delivery KEY: Nursing Process Step: Planning MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 2. Prior to the nurse implementing a nursing procedure for a patient, the nurse should initially:
a. question the rationale for the procedure.
b. perform a physical assessment of the patient.
c. check the agency manual for the procedure.
d. mentally review the procedure.
ANS: D Reviewing the procedure, checking the manual if uncertain, confirming the order for the procedure, assessing that there is no interference with the completion of the procedure, and identifying the patient are standard steps in deliberative nursing action. DIF:Cognitive Level: ApplicationREF:p. 76|Box 6-2 OBJ: Theory #1TOP: Care Delivery KEY: Nursing Process Step: Planning MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 3. At the 7:00 AM handoff report, the nurse receives the report that patient A had a sleepless night related to pain and just fell asleep after an increased pain medication administration 1/2 hour ago. Patient B, who is scheduled for surgery at 8:30 AM, is also sleeping. How would an organized nurse plan the early morning activities?
a. Wake patient A for breakfast.
b. Perform time flexible tasks that can be done while both patients sleep.
c. Prepare patient B now; allow patient A to sleep.
d. Assign a nursing assistant to wake and help feed patient A.
ANS: C Setting priorities and identifying time fixed tasks would indicate that patient B needs to be prepared for surgery. Patient A needs to sleep. DIF: Cognitive Level: Analysis REF: p. 73 OBJ: Theory #1 TOP: Care Delivery KEY: Nursing Process Step: Implementation MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 4. Preparing a patient for a diagnostic test, and telling the patient what to expect during and after the test, is considered:
a. an independent nursing action.
b. the doctor’s responsibility.
c. a dependent nursing action that requires the doctor’s authorization.
d. an interdependent nursing action.
ANS: A Patient education is an independent nursing action. DIF: Cognitive Level: Comprehension REF: p. 74 OBJ: Theory #2 TOP: Patient Education KEY: Nursing Process Step: Implementation MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 5.The nurse explains that a multidisciplinary step-by-step approach to patient care is:
a. documented in the nursing care plan in the patient’s medical record.
b. not used often since managed care became part of health care.
c. referred to as a clinical pathway and is used instead of a nursing care plan.
d. more expensive than the traditional separation of health care services.
ANS: C An outgrowth of managed care has been collaborative models of care called clinical pathways. DIF: Cognitive Level: Knowledge REF: p. 74 OBJ: Theory #1 TOP: Clinical Pathways KEY: Nursing Process Step: Implementation MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care 6.The nurse documents interventions periodically during the shift in nurses’ notes primarily to:
a. validate the number of nonlicensed personnel who interact with the patient.
b. indicate that the nursing care plan has been implemented.
c. briefly summarize activities during the shift.
d. confirm that the nursing diagnoses in the care plan are appropriate.
ANS: B The nursing care must be documented in the nurses’ notes to prove that interventions were implemented. In some facilities documentation is required at least every 2 hours. DIF: Cognitive Level: Comprehension REF: p. 76 OBJ: Theory #3 TOP: Documentation KEY: Nursing Process Step: Implementation MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care 7.The nurse compares actual nursing outcomes to the expected nursing outcomes in order to:
a. prepare the patient to be discharged from the facility.
b. determine if the patient’s health problems have been treated.
c. calculate charges for nursing services during the patient’s hospital stay.
d. determine if progress is made or to determine if revisions are needed.
ANS: D Evaluation of patient responses to treatment and progress toward goals is performed continuously so that the nursing care plan may be modified if needed. DIF: Cognitive Level: Comprehension REF: p. 77 OBJ: Theory #5 TOP:OutcomesKEY:Nursing Process Step: Evaluation MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 8.The general rule is that the initial care plan for a patient is:
a. developed by an RN in an acute care setting.
b. used as the basis of care throughout a hospital stay without alteration.
c. completed on the day of admission.
d. developed by the primary care provider and incorporated into the nursing care.
ANS: A An RN is responsible for developing the plan of care for patients in acute care settings. An LPN may begin the care plan in a skilled nursing facility and will collaborate with the RN for revision. The nursing care plan will be revised frequently as the patient’s condition changes. DIF: Cognitive Level: Comprehension REF: p. 79 OBJ: Theory #2 TOP: Care Planning KEY: Nursing Process Step: Planning MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care 9.The nurse is aware that the nursing audit is a valuable process used to:
a. determine whether a particular patient received the care indicated in the nursing care plan.
b. evaluate whether nursing care for a group of patients meets the standards of care in that facility.
c. determine the cost of nursing care in the hospital in order to set rates for daily care.
d. identify careless or negligent nursing care to protect the facility from lawsuits.
ANS: B Nursing audits are performed to improve nursing practice by checking a group of patient records for how well particular standards were met and standards of care were being used. DIF: Cognitive Level: Knowledge REF: p. 79 OBJ: Theory #6 TOP: Nursing Audits KEY: Nursing Process Step: Planning MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care 10.The nurse evaluates that the patient has met the outcome of feeding himself independently. The nurse should:
a. inactivate the nursing diagnosis from the care plan.
b. notify the primary care provider that the patient can now feed himself.
c. document the ability to self-feed and mark the nursing diagnosis as resolved.
d. inform the RN to document the self-feeding and to cancel the nursing diagnosis.
ANS: C The LPN should document the meeting of the outcome and mark the nursing diagnosis as “resolved.” DIF: Cognitive Level: Application REF: p. 77 OBJ: Theory #6 TOP: Nursing Care Plan Revision KEY: Nursing Process Step: Intervention MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care 11.An example of an appropriately worded nursing goal or outcome for the nursing diagnosis of “Risk for falls related to weakness” would be:
a. nurse will assist the patient to the bathroom every 2 hours.
b. patient will be free of injury from falls.
c. patient will call for assistance when ambulating for the next week.
d. nurse will keep room well lit 24 hours a day.
ANS: C An appropriately worded outcome is a patient centered, measurable, and time defined goal based on a nursing diagnosis. DIF:Cognitive Level: ApplicationREF:p. 79|Box 6-3 OBJ:Theory #5TOP:Expected Outcomes KEY:Nursing Process Step: Evaluation MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 12.Nurses design interventions that are appropriate for a patient that are:
a. based on the primary care provider’s orders and the medical diagnosis.
b. expected to help the patient meets the goals most quickly.
c. used to evaluate whether the nursing care plan should be revised.
d. based on cost effectiveness and staff availability.
ANS: B Nursing interventions are based on nursing diagnoses and are those most likely to assist the patient in meeting outcomes related to those diagnoses. DIF:Cognitive Level: ComprehensionREF:p. 79|Box 6-3 OBJ:Theory #2TOP:Care Delivery KEY:Nursing Process Step: Planning MSC:NCLEX: Safe, Effective Care Environment: Coordinated Care 13.Before performing a catheterization, the inexperienced nurse should:
a. close the door or curtains to provide the patient with privacy.
b. provide necessary education and explanation of the procedure to the patient.
c. observe rules of Standard Precautions to protect herself from exposure to blood or body fluids.
d. review the agency’s procedure manual for the accepted way of performing the procedure.
ANS: D Reviewing the procedure manual should occur before the inexperienced nurse explains to the patient, provides privacy, or observes Standard Precautions. DIF: Cognitive Level: Application REF: p. 75 OBJ: Clinical Practice #2 TOP:Standards for All Nursing Procedures KEY:Nursing Process Step: Implementation MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 14.During morning care in a skilled nursing facility, the student nurse notices that the patient who is at risk for impaired skin integrity has developed a small open area on his sacrum. To best address this situation, the student would first:
a. position the patient to lie on his side, document it, and inform the head nurse.
b. position the patient on his side and encourage him to massage around the area.
c. report to the primary care provider so that the nursing care plan can be revised.
d. tell the nursing assistant to change the patient’s position every 2 hours.
ANS: A This change in the patient’s position with documentation is the initial intervention. The discovery of an open lesion requires a change in the nursing plan. DIF: Cognitive Level: Analysis REF: p. 77 OBJ: Theory #2 TOP: Care Delivery KEY: Nursing Process Step: Implementation MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 15.A review of a patient’s nursing care plan before beginning care allows the nurse to:
a. make revisions in the plan as indicated by the shift report.
b. use critical thinking skills to organize care for the patient.
c. begin nursing interventions without needing an initial assessment.
d. skip the shift report and begin with the initial assessment.
ANS: B Reviewing the patient’s care plan gives the nurse a starting point for organizing care. DIF: Cognitive Level: Comprehension REF: p. 75 OBJ: Theory #2 TOP:PlanningKEY:Nursing Process Step: Planning MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 16.The nurse giving a patient a back massage is performing an intervention considered to be:
a. a dependent nursing action.
b. an independent nursing action.
c. an interdependent nursing action.
d. a semi-dependent nursing action.
ANS: B An independent nursing action does not require a primary care provider’s order, but it does require critical thinking and nursing judgment. Giving a back massage would be an independent nursing action. DIF: Cognitive Level: Comprehension REF: p. 74 OBJ: Theory #2 TOP: Care Delivery KEY: Nursing Process Step: Implementation MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 17.The nurse administering a medication to a patient is performing an intervention that is:
a. an independent nursing action.
b. an interdependent nursing action.
c. a semi-dependent nursing action.
d. a dependent nursing action.
ANS: D The administration of a medication is a dependent nursing action because giving medication requires a primary care provider’s order. DIF: Cognitive Level: Comprehension REF: p. 74 OBJ: Theory #2 TOP: Care Delivery KEY: Nursing Process Step: Implementation MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 18.The nurse caring for a group of patients would show cultural sensitivity to assign an older male nursing assistant to the care of:
a. a 45-year-old white male patient with uncontrolled diabetes.
b. a 50-year-old Hispanic man with a broken leg.
c. a 55-year-old Japanese man with irritable bowel syndrome.
d. a 60-year-old Muslim woman with pneumonia.
ANS: C Older Japanese men may resist care given by a younger person or a female. DIF: Cognitive Level: Analysis REF: p. 75 OBJ: Theory #1 TOP: Cultural Considerations KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 19.In assigning tasks to the nursing assistant, the nurse could appropriately select:
a. range of motion exercises to lower limbs.
b. sterile dressing change on a leg wound.
c. postoperative education to a post-hysterectomy patient.
d. witnessing of the signature on an operative permit.
ANS: A Range of motion exercises may be provided by nursing assistants, physical therapy aides, or restorative aides. The nurse performs any invasive procedure, legal document witnessing, and any sterile procedure. DIF: Cognitive Level: Application REF: p. 75 OBJ: Theory #3 TOP:DelegationKEY:Nursing Process Step: Planning MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 20.The nurse is assessing a patient who just returned from a bowel resection 1 hour ago. The nurse notes a dressing over the suture line that is wet with sero sanguineous drainage. The nurse should initially:
a. perform a sterile dressing change.
b. document and report the wet dressing to the charge nurse.
c. reinforce the wet dressing and document.
d. place a towel on the bed and turn the patient to the operated side.
ANS: C The general rule is that the initial dressing change is performed by the surgeon who will give further orders pertinent to future dressing changes. The dressing should be reinforced with sterile materials; findings should be documented and reported to the charge nurse. DIF: Cognitive Level: Analysis REF: p. 74 OBJ: Theory #3 TOP: Initial Dressing Change KEY: Nursing Process Step: Implementation MSC:NCLEX: Physiological Integrity: Basic Care and Comfort MULTIPLE RESPONSE 1.The nurse coming on duty has received a report that an IV of 1000 mL of 5% glucose in 0.9% normal saline is running at a rate of 50 mL an hour to be followed by another 1000 mL to be run at the same rate. The reporting nurse states that the second IV should be hung at 9:00 AM. The prudent nurse should: (Select all that apply.)
a. hang the next 1000 mL when the first is finished.
b. check to label on the present IV.
c. confirm the flow rate.
d. check the order for the IVs.
e. speed up the flow so that the IV will be completed by 9:00 AM.
ANS: B, C, D The nurse should check the order and the flow rate, and the amount and type of fluid to follow for accuracy, and not depend on the handoff report. DIF: Cognitive Level: Analysis REF: p. 73 OBJ: Theory #2 TOP: Care Delivery KEY: Nursing Process Step: Implementation MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 2.The purpose of the evaluation step of the nursing process is to: (Select all that apply.)
a. determine if outcomes have been reached and the goals are met.
b. compare actual outcomes with expected outcomes.
c. identify inefficient care given by assigned staff.
d. confirm that nursing interventions are effective.
e. ensure that the facility has not put itself at risk for litigation.
ANS: A, B, D Evaluation attempts to determine if the outcomes have been reached and that the interventions being used are effective. Evaluation also demonstrates if the actual outcomes agree with the expected outcomes in the nursing care plan. DIF: Cognitive Level: Comprehension REF: p. 77 OBJ: Theory #5 TOP: Nursing Process KEY: Nursing Process Step: Evaluation MSC:NCLEX: Physiological Integrity: Basic Care and Comfort 3.Standards of care are set by: (Select all that apply.)
a. the state’s nurse practice act.
b. professional medical association standards.
c. the facility’s policies and procedures.
d. the primary care provider in charge of the patient’s treatment.
e. the director of nurses and the agency administrator.
ANS: A, B, C Standards of care are set by the state’s nursing practice act, professional association standards, and the facility’s policies and procedures. DIF: Cognitive Level: Comprehension REF: p. 75 OBJ: Theory #3 TOP: Standards of Care KEY: Nursing Process Step: Planning MSC:NCLEX: N/A

Test Bank for Fundamentals of Nursing Care 2nd Edition by Burton

Chapter 1 Multiple Choice Identify the choice that best completes the statement or answers the question. ____    1.   A nurse is educating a nursing student about nursing history. The nurse explains that throughout ancient history, nursing care was provided by family members and
1. Nurses.
2. Physicians.
3. Male priests.
4. Female priests.
____    2.   A nurse is teaching a student about the history of nursing. The nurse informs the student that in 1836, the first school of nursing was established in Kaiserworth, Germany, by
1. Jean Watson.
2. Clara Barton.
3. Theodor Fliedner.
4. Florence Nightingale.
____    3.   A nurse teaches a student nurse that in 1897, the Nurses Associated Alumnae of the United States was formed in an effort to
1. Set standards and rules in nursing education.
2. Keep nurses aware of the newest medical information.
3. Oversee training to protect patients from incompetent nurses.
4. Keep nurses updated on the newest information about nursing education.
____    4.   The purpose of the National League for Nursing is to
1. Set standards and rules in nursing education.
2. Keep nurses aware of the newest medical information.
3. Oversee training to protect patients from incompetent nurses.
4. Keep nurses updated on the newest information about nursing education.
____    5.   All states required practical nurses to be licensed in the year
1. 1940.
2. 1945.
3. 1950.
4. 1955.
____    6.   The title licensed practical nurse (LPN) is used in all states except California and
1. Texas.
2. Maine.
3. Alaska.
4. Arizona.
____    7.   The National Council Licensure Examination for Practical Nursing (NCLEX-PN) is
1. Taken in order to practice as a nurse.
2. Given as an entrance examination for nursing school.
3. Individualized based on where an examinee resides.
4. Taken in order to practice as a certified nursing assistant (CNA).
____    8.   A nurse recruiter is seeking a graduate nurse who has been educated more extensively on management and leadership. The graduate nurse who most likely fits this description is the
1. Diploma nurse.
2. Associate degree nurse (ADN).
3. Licensed practical/vocational nurse (LPN/LVN).
4. Baccalaureate degree nurse (BSN).
____    9.   Which statement about the Nurse Practice Act is accurate?
1. The Nurse Practice Act clarifies who can supervise a physician.
2. The Nurse Practice Act is the law that governs the actions of nurses.
3. The Nurse Practice Act is determined by the National League of Nursing.
4. The Nurse Practice Act specifies the tasks of the unlicensed assistive personnel.
____   10.   A nurse educates a nursing student about the Nurse Practice Act. The nursing student demonstrates understanding when he or she states:
1. “The Nurse Practice Act is the same in every state.”
2. “The Nurse Practice Act does not specify who can supervise a nurse.”
3. “The Nurse Practice Act is determined by the American Nurses Association.”
4. “The Nurse Practice Act establishes the scope of practice for each level of nurse.”
____   11.   While caring for a patient, a nurse performs a nursing action that is not within his or her scope of practice. The nurse has violated the
1. Ethics Committee.
2. Nurse Practice Act.
3. State Department of Health.
4. National League for Nursing Education.
____   12.   The Nurse Practice Act is enforced by the
1. State Board of Nursing.
2. County Health Department.
3. State Department of Health.
4. National League for Nursing.
____   13.   A nurse is caring for a resident in a long-term setting. The nurse best demonstrates a caring approach when
1. Performing all activities of daily living for the resident.
2. Asking the resident’s spouse to bring a family picture for the resident’s room.
3. Answering the resident’s questions quickly without allowing time for clarification.
4. Encouraging the resident’s spouse to decide which activities the resident should do.
____   14.   A nurse is caring for multiple patients on a medical unit. The nurse can best practice the art of nursing with an emphasis on caring by
1. Providing identical care to each patient.
2. Individualizing care provided to each patient.
3. Viewing the patients in terms of a cellular disorder.
4. Viewing the patients as seriously ill and needing a cure.
____   15.   A nurse is educating a student nurse about the responsibilities of a student nurse. The nurse recognizes that additional teaching is needed when the student nurse states:
1. “I will check laboratory results for my patients often.”
2. “I am responsible for noting abnormal assessment findings.”
3. “I will frequently check the patient’s chart for diagnostic test results.”
4. “It is not within my scope of practice to notify someone of abnormal findings.”
____   16.   A nursing instructor teaches a student nurse about the importance of joining a professional organization. The nursing instructor recognizes that further instruction is necessary when the student nurse states,
1. “Professional organizations allow me to have a collective voice.”
2. “Professional organizations limit my ability to influence laws and policies.”
3. “Professional behavior is demonstrated by joining a professional organization.”
4. “By joining a professional organization, I will have opportunities for leadership.”
 

Test Bank for Pharmacology and the Nursing Process 9th Edition

Contents Chapter 01: The Nursing Process and Drug Therapy................................................................................. 4 Chapter 02: Pharmacologic Principles...................................................................................................... 8 Chapter 03: Lifespan Considerations...................................................................................................... 14 Chapter 04: Cultural, Legal, and Ethical Considerations.......................................................................... 20 Chapter 05: Medication Errors: Preventing and Responding .................................................................. 26 Chapter 06: Patient Education and Drug Therapy................................................................................... 29 Chapter 07: Over-the-Counter Drugs and Herbal and Dietary Supplements ........................................... 34 Chapter 08: Gene Therapy and Pharmacogenomics............................................................................... 38 Chapter 09: Photo Atlas of Drug Administration .................................................................................... 41 Chapter 10: Analgesic Drugs.................................................................................................................. 50 Chapter 11: General and Local Anesthetics............................................................................................ 57 Chapter 12: Central Nervous System Depressants and Muscle Relaxants............................................... 61 Chapter 13: Central Nervous System Stimulants and Related Drugs....................................................... 66 Chapter 14: Antiepileptic Drugs............................................................................................................. 70 Chapter 15: Antiparkinson Drugs.............................................................................................................76 Chapter 16: Psychotherapeutic Drugs.................................................................................................... 81 Chapter 17: Substance Use Disorder...................................................................................................... 88 Chapter 18: Adrenergic Drugs................................................................................................................ 93 Chapter 19: Adrenergic-Blocking Drugs.................................................................................................. 98 Chapter 20: Cholinergic Drugs ............................................................................................................. 103 Chapter 21: Cholinergic-Blocking Drugs............................................................................................... 108 Chapter 22: Antihypertensive Drugs.................................................................................................... 113 Chapter 23: Antianginal Drugs............................................................................................................. 119 Chapter 24: Heart Failure Drugs........................................................................................................... 125 Chapter 25: Antidysrhythmic Drugs..................................................................................................... 131 Chapter 26: Coagulation Modifier Drugs.............................................................................................. 137 Chapter 27: Antilipemic Drugs............................................................................................................. 143 Chapter 28: Diuretic Drugs................................................................................................................... 148 Chapter 29: Fluids and Electrolytes...................................................................................................... 154 Chapter 30: Pituitary Drugs.................................................................................................................. 160 Chapter 31: Thyroid and Antithyroid Drugs.......................................................................................... 163 Chapter 32: Antidiabetic Drugs............................................................................................................ 168 Chapter 33: Adrenal Drugs................................................................................................................... 177 Chapter 34: Women’s Health Drugs..................................................................................................... 181 Chapter 35: Men’s Health Drugs.......................................................................................................... 188 Chapter 36: Antihistamines, Decongestants, Antitussives, and Expectorants ....................................... 193 Chapter 37: Respiratory Drugs............................................................................................................. 198 Chapter 38: Antibiotics Part 1.............................................................................................................. 204 Chapter 39: Antibiotics Part 2.............................................................................................................. 211 Chapter 40: Antiviral Drugs.................................................................................................................. 216 Chapter 41: Antitubercular Drugs ........................................................................................................ 221 Chapter 42: Antifungal Drugs............................................................................................................... 226 Chapter 43: Antimalarial, Antiprotozoal, and Anthelmintic Drugs ........................................................ 231 Chapter 44: Anti-inflammatory and Antigout Drugs............................................................................. 236 Chapter 45: Antineoplastic Drugs Part 1: Cancer Overview and Cell Cycle–Specific Drugs..................... 242 Chapter 46: Antineoplastic Drugs Part 2: Cell Cycle–Nonspecific Drugs and Miscellaneous Drugs......... 248 Chapter 47: Biologic Response–Modifying and Antirheumatic Drugs ................................................... 253 Chapter 48: Immunosuppressant Drugs............................................................................................... 258 Chapter 49: Immunizing Drugs............................................................................................................. 263 Chapter 50: Acid-Controlling Drugs...................................................................................................... 268 Chapter 51: Bowel Disorder Drugs....................................................................................................... 274 Chapter 52: Antiemetic and Antinausea Drugs..................................................................................... 281 Chapter 53: Vitamins and Minerals...................................................................................................... 286 Chapter 54: Anemia Drugs................................................................................................................... 292 Chapter 55: Nutritional Supplements................................................................................................... 299 Chapter 56: Dermatologic Drugs.......................................................................................................... 304 Chapter 57: Ophthalmic Drugs............................................................................................................. 310 Chapter 58: Otic Drugs ............................
Chapter 1. The Concept of Stress Adaptation

Test Bank for Psychiatric Mental Health Nursing 8th Edition by Townsend

Multiple Choice
  1. A client has experienced the death of a close family member and at the same time becomes unemployed. This situation has resulted in a 6-month score of 110 on the Recent Life Changes Questionnaire. How should the nurse evaluate this client data?
  2. The client is experiencing severe distress and is at risk for physical and psychological illness.
  3. A score of 110 on the Miller and Rahe Recent Life Changes Questionnaire indicates no significant threat of stress-related illness.
  4. Susceptibility to stress-related physical or psychological illness cannot be estimated without knowledge of coping resources and available supports.
  5. The client may view these losses as challenges and perceive them as opportunities.
ANS: C The Recent Life Changes Questionnaire is an expanded version of the Schedule of Recent Experiences and the Rahe-Holmes Social Readjustment Rating Scale. A 6-month score of 300 or more, or a year-score total of 500 or more, indicates high stress in a client’s life. However, positive coping mechanisms and strong social support can limit susceptibility to stress-related illnesses. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity
  1. A physically and emotionally healthy client has just been fired. During a routine office visit he states to a nurse: “Perhaps this was the best thing to happen. Maybe I’ll look into pursuing an art degree.” How should the nurse characterize the client’s appraisal of the job loss stressor?
  2. Irrelevant
  3. Harm/loss
  4. Threatening
  5. Challenging
ANS: D The client perceives the situation of job loss as a challenge and an opportunity for growth. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity
  1. Which client statement should alert a nurse that a client may be responding maladaptively to stress?
  2. “I’ve found that avoiding contact with others helps me cope.”
  3. “I really enjoy journaling; it’s my private time.”
  4. “I signed up for a yoga class this week.”
  5. “I made an appointment to meet with a therapist.”
ANS: A Reliance on social isolation as a coping mechanism is a maladaptive method to relieve stress. It can prevent learning appropriate coping skills and can prevent access to needed support systems.  KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity
  1. A nursing student finds that she comes down with a sinus infection toward the end of every semester. When this occurs, which stage of stress is the student most likely experiencing?
  2. Alarm reaction stage
  3. Stage of resistance
  4. Stage of exhaustion
  5. Fight-or-flight stage
ANS: C At the stage of exhaustion, the student’s exposure to stress has been prolonged and adaptive energy has been depleted. Diseases of adaptation occur more frequently in this stage. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity
  1. A school nurse is assessing a female high school student who is overly concerned about her appearance. The client’s mother states, “That’s not something to be stressed about!” Which is the most appropriate nursing response?
  2. “Teenagers! They don’t know a thing about real stress.”
  3. “Stress occurs only when there is a loss.”
  4. “When you are in poor physical condition, you can’t experience psychological well-being.”
  5. “Stress can be psychological. A threat to self-esteem may result in high stress levels.”
ANS: D Stress can be physical or psychological in nature. A perceived threat to self-esteem can be as stressful as a physiological change. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity
  1. A bright student confides in the school nurse about conflicts related to attending college or working to add needed financial support to the family. Which coping strategy is most appropriate for the nurse to recommend to the student at this time?
  2. Meditation
  3. Problem-solving training
  4. Relaxation
  5. Journaling
ANS: B The student must assess his or her situation and determine the best course of action. Problem-solving training, by providing structure and objectivity, can assist in decision making. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity
  1. An unemployed college graduate is experiencing severe anxiety over not finding a teaching position and has difficulty with independent problem-solving. During a routine physical examination, the graduate confides in the clinic nurse. Which is the most appropriate nursing intervention?
  2. Encourage the student to use the alternative coping mechanism of relaxation exercises.
  3. Complete the problem-solving process for the client.
  4. Work through the problem-solving process with the client.
  5. Encourage the client to keep a journal.
ANS: C During times of high anxiety and stress, clients will need more assistance in problem-solving and decision making. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity
  1. A school nurse is assessing a distraught female high school student who is overly concerned because her parents can’t afford horseback riding lessons. How should the nurse interpret the student’s reaction to her perceived problem?
  2. The problem is endangering her well-being.
  3. The problem is personally relevant to her.
  4. The problem is based on immaturity.
  5. The problem is exceeding her capacity to cope.
ANS: B Psychological stressors to self-esteem and self-image are related to how the individual perceives the situation or event. Self-image is of particular importance to adolescents, who feel entitled to have all the advantages that other adolescents experience. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity
  1. Meditation has been shown to be an effective stress management technique. When meditation is effective, what should a nurse expect to assess?
  2. An achieved state of relaxation
  3. An achieved insight into one’s feelings
  4. A demonstration of appropriate role behaviors
  5. An enhanced ability to problem-solve
ANS: A Meditation produces relaxation by creating a special state of consciousness through focused concentration. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity
  1. A distraught, single, first-time mother cries and asks a nurse, “How can I go to work if I can’t afford childcare?” What is the nurse’s initial action in assisting the client with the problem-solving process?
  2. Determine the risks and benefits for each alternative.
  3. Formulate goals for resolution of the problem.
  4. Evaluate the outcome of the implemented alternative.
  5. Assess the facts of the situation.
ANS: D Before any other steps can be taken, accurate information about the situation must be gathered and assessed. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity

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 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
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