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Test Bank for Fundamentals Of Nursing 9th Edition by Potter

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Test Bank for Fundamentals Of Nursing 9th Edition by Potter

Chapter 01: Nursing Today
Fundamentals of Nursing, 9th Edition

MULTIPLE CHOICE

1. Which nurse most likely kept records on sanitation techniques and the effects on health?
a. Florence Nightingale
b. Mary Nutting
c. Clara Barton
d. Lillian Wald
ANS: A
Nightingale was the first practicing nurse epidemiologist. Her statistical analyses connected poor
sanitation with cholera and dysentery. Mary Nutting, Clara Barton, and Lillian Wald came after
Nightingale, each contributing to the nursing profession in her own way. Mary Nutting was
instrumental in moving nursing education into universities. Clara Barton founded the American
Red Cross. Lillian Wald helped open the Henry Street Settlement.
2. The nurse prescribes strategies and alternatives to attain expected outcome. Which standard of
nursing practice is the nurse following?
a. Assessment
b. Diagnosis
c. Planning
d. Implementation
ANS: C
In planning, the registered nurse develops a plan that prescribes strategies and alternatives to
attain expected outcomes. During assessment, the registered nurse collects comprehensive data
pertinent to the patient’s health and/or the situation. In diagnosis, the registered nurse analyzes
the assessment data to determine the diagnoses or issues. During implementation, the registered
nurse implements (carries out) the identified plan.
NURSINGTB.COM
FUNDAMENTALS OF NURSING 9TH EDITION POTTER TEST BANKNURSINGTB.COM
Prime yourself for your Tests – Study Questions
3. An experienced medical-surgical nurse chooses to work in obstetrics. Which level of
proficiency is the nurse upon initial transition to the obstetrical floor?
a. Novice
b. Proficient
c. Competent
d. Advanced beginner
ANS: A
A beginning nursing student or any nurse entering a situation in which there is no previous level
of experience (e.g., an experienced operating room nurse chooses to now practice in home
health) is an example of a novice nurse. A proficient nurse perceives a patient’s clinical situation
as a whole, is able to assess an entire situation, and can readily transfer knowledge gained from
multiple previous experiences to a situation. A competent nurse understands the organization and
specific care required by the type of patients (e.g., surgical, oncology, or orthopedic patients).
This nurse is a competent practitioner who is able to anticipate nursing care and establish longrange goals. A nurse who has had some level of experience with the situation is an advanced
beginner. This experience may only be observational in nature, but the nurse is able to identify
meaningful aspects or principles of nursing care.
4. A nurse assesses a patient’s fluid status and decides that the patient needs to drink more fluids.
The nurse then encourages the patient to drink more fluids. Which concept is the nurse
demonstrating?
a. Licensure
b. Autonomy
c. Certification
d. Accountability
ANS: B
Autonomy is an essential element of professional nursing that involves the initiation of
independent nursing interventions without medical orders. To obtain licensure in the United
States, the RN candidate must pass the NCLEX-RN®. Beyond the NCLEX-RN®, the nurse may
choose to work toward certification in a specific area of nursing practice. Accountability means
that you are responsible, professionally and legally, for the type and quality of nursing care
provided.

FUNDAMENTALS OF NURSING 9TH EDITION POTTER TEST BANKNURSINGTB.COM
Prime yourself for your Tests – Study Questions

5. A nurse prepares the budget and policies for an intensive care unit. Which role is the nurse
implementing?
a. Educator
b. Manager
c. Advocate
d. Caregiver
ANS: B
A manager coordinates the activities of members of the nursing staff in delivering nursing care
and has personnel, policy, and budgetary responsibility for a specific nursing unit or facility. As
an educator, you explain concepts and facts about health, describe the reason for routine care
activities, demonstrate procedures such as self-care activities, reinforce learning or patient
behavior, and evaluate the patient’s progress in learning. As a patient advocate, you protect your
patient’s human and legal rights and provide assistance in asserting these rights if the need arises.
As a caregiver, you help patients maintain and regain health, manage disease and symptoms, and
attain a maximal level function and independence through the healing process.
6. The nurse has been working in the clinical setting for several years as an advanced practice
nurse. However, the nurse has a strong desire to pursue research and theory development. To
fulfill this desire, which program should the nurse attend?
a. Doctor of Nursing Science degree (DNSc)
b. Doctor of Philosophy degree (PhD)
c. Doctor of Nursing Practice degree (DNP)
d. Doctor in the Science of Nursing degree (DSN)
ANS: B
Some doctoral programs prepare nurses for more rigorous research and theory development and
award the research-oriented Doctor of Philosophy (PhD) in nursing. Professional doctoral
programs in nursing (DSN or DNSc) prepare graduates to apply research findings to clinical
nursing. The DNP is a practice doctorate that prepares advanced practice nurses such as nurse
practitioners.
NURSINGTB.COM
FUNDAMENTALS OF NURSING 9TH EDITION POTTER TEST BANKNURSINGTB.COM
Prime yourself for your Tests – Study Questions
7. A nurse attends a workshop on current nursing issues provided by the American Nurses
Association. Which type of education did the nurse receive?
a. Graduate education
b. Inservice education
c. Continuing education
d. Registered nurse education
ANS: C
Continuing education involves formal, organized educational programs offered by universities,
hospitals, state nurses associations, professional nursing organizations, and educational and
health care institutions. After obtaining a baccalaureate degree in nursing, you can pursue
graduate education leading to a master’s or doctoral degree in any number of graduate fields,
including nursing. Inservice education programs are instruction or training provided by a health
care facility or institution. Registered nurse education is the education preparation for an
individual intending to be an RN.
8. A nurse identifies gaps between local and best practices. Which Quality and Safety Education
for Nurses (QSEN) competency is the nurse demonstrating?
a. Safety
b. Patient-centered care
c. Quality improvement
d. Teamwork and collaboration
ANS: C
Quality improvement identifies gaps between local and best practices. Safety minimizes risk of
harm to patients and providers through both system effectiveness and individual performance.
Patient-centered care recognizes the patient or designee as the source of control and full partner
in providing compassionate and coordinated care based on respect for patient’s preferences,
values, and needs. Teamwork and collaboration allows effective functioning within nursing and
interprofessional teams, fostering open communication, mutual respect, and shared decision
making.
NURSINGTB.COM
FUNDAMENTALS OF NURSING 9TH EDITION POTTER TEST BANKNURSINGTB.COM
Prime yourself for your Tests – Study Questions
9. A nurse has compassion fatigue. What is the nurse experiencing?
a. Lateral violence and intrapersonal conflict
b. Burnout and secondary traumatic stress
c. Short-term grief and single stressor
d. Physical and mental exhaustion
ANS: B
Compassion fatigue is a term used to describe a state of burnout and secondary traumatic stress.
Compassion fatigue may contribute to what is described as lateral violence (nurse-nurse
interactions, not intrapersonal). Frequent, intense, or prolonged exposure to grief and loss places
nurses at risk for developing compassion fatigue. Stressors, not a single stressor, contribute to
compassion fatigue. Physical and mental exhaustion describes burnout only.
10. A patient is scheduled for surgery. When getting ready to obtain the informed consent, the
patient tells the nurse, “I have no idea what is going to happen. I couldn’t ask any questions.”
The nurse does not allow the patient to sign the permit and notifies the health care provider of the
situation. Which role is the nurse displaying?
a. Manager
b. Patient educator
c. Patient advocate
d. Clinical nurse specialist
ANS: C
As a patient advocate, the nurse protects the patient’s human and legal rights, including the right
of the patient to understand procedures before signing permits. Although nurses can be
educators, it is the responsibility of the surgeon to provide education for the patient in
preparation for surgery, and it is the nurse’s responsibility to notify the health care provider if the
patient is not properly educated. Managers coordinate the activities of members of the nursing
staff in delivering nursing care, and clinical nurse specialists are experts in a specialized area of
nursing practice in a variety of settings.

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DescriptionEdition: 9th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Sole Edition: 7th 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: Davidson Edition: 6th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Woo Edition: 4th Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant DownloadBy: Stanhope Edition: 3rd Edition Format: Downloadable ZIP Fille Resource Type: Test bank Duration: Unlimited downloads Delivery: Instant Download
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Test Bank for Fundamentals Of Nursing 9th Edition by Potter

Chapter 01: Nursing Today Fundamentals of Nursing, 9th Edition MULTIPLE CHOICE 1. Which nurse most likely kept records on sanitation techniques and the effects on health? a. Florence Nightingale b. Mary Nutting c. Clara Barton d. Lillian Wald ANS: A Nightingale was the first practicing nurse epidemiologist. Her statistical analyses connected poor sanitation with cholera and dysentery. Mary Nutting, Clara Barton, and Lillian Wald came after Nightingale, each contributing to the nursing profession in her own way. Mary Nutting was instrumental in moving nursing education into universities. Clara Barton founded the American Red Cross. Lillian Wald helped open the Henry Street Settlement. 2. The nurse prescribes strategies and alternatives to attain expected outcome. Which standard of nursing practice is the nurse following? a. Assessment b. Diagnosis c. Planning d. Implementation ANS: C In planning, the registered nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes. During assessment, the registered nurse collects comprehensive data pertinent to the patient’s health and/or the situation. In diagnosis, the registered nurse analyzes the assessment data to determine the diagnoses or issues. During implementation, the registered nurse implements (carries out) the identified plan. NURSINGTB.COM FUNDAMENTALS OF NURSING 9TH EDITION POTTER TEST BANKNURSINGTB.COM Prime yourself for your Tests – Study Questions 3. An experienced medical-surgical nurse chooses to work in obstetrics. Which level of proficiency is the nurse upon initial transition to the obstetrical floor? a. Novice b. Proficient c. Competent d. Advanced beginner ANS: A A beginning nursing student or any nurse entering a situation in which there is no previous level of experience (e.g., an experienced operating room nurse chooses to now practice in home health) is an example of a novice nurse. A proficient nurse perceives a patient’s clinical situation as a whole, is able to assess an entire situation, and can readily transfer knowledge gained from multiple previous experiences to a situation. A competent nurse understands the organization and specific care required by the type of patients (e.g., surgical, oncology, or orthopedic patients). This nurse is a competent practitioner who is able to anticipate nursing care and establish longrange goals. A nurse who has had some level of experience with the situation is an advanced beginner. This experience may only be observational in nature, but the nurse is able to identify meaningful aspects or principles of nursing care. 4. A nurse assesses a patient’s fluid status and decides that the patient needs to drink more fluids. The nurse then encourages the patient to drink more fluids. Which concept is the nurse demonstrating? a. Licensure b. Autonomy c. Certification d. Accountability ANS: B Autonomy is an essential element of professional nursing that involves the initiation of independent nursing interventions without medical orders. To obtain licensure in the United States, the RN candidate must pass the NCLEX-RN®. Beyond the NCLEX-RN®, the nurse may choose to work toward certification in a specific area of nursing practice. Accountability means that you are responsible, professionally and legally, for the type and quality of nursing care provided. FUNDAMENTALS OF NURSING 9TH EDITION POTTER TEST BANKNURSINGTB.COM Prime yourself for your Tests – Study Questions 5. A nurse prepares the budget and policies for an intensive care unit. Which role is the nurse implementing? a. Educator b. Manager c. Advocate d. Caregiver ANS: B A manager coordinates the activities of members of the nursing staff in delivering nursing care and has personnel, policy, and budgetary responsibility for a specific nursing unit or facility. As an educator, you explain concepts and facts about health, describe the reason for routine care activities, demonstrate procedures such as self-care activities, reinforce learning or patient behavior, and evaluate the patient’s progress in learning. As a patient advocate, you protect your patient’s human and legal rights and provide assistance in asserting these rights if the need arises. As a caregiver, you help patients maintain and regain health, manage disease and symptoms, and attain a maximal level function and independence through the healing process. 6. The nurse has been working in the clinical setting for several years as an advanced practice nurse. However, the nurse has a strong desire to pursue research and theory development. To fulfill this desire, which program should the nurse attend? a. Doctor of Nursing Science degree (DNSc) b. Doctor of Philosophy degree (PhD) c. Doctor of Nursing Practice degree (DNP) d. Doctor in the Science of Nursing degree (DSN) ANS: B Some doctoral programs prepare nurses for more rigorous research and theory development and award the research-oriented Doctor of Philosophy (PhD) in nursing. Professional doctoral programs in nursing (DSN or DNSc) prepare graduates to apply research findings to clinical nursing. The DNP is a practice doctorate that prepares advanced practice nurses such as nurse practitioners. NURSINGTB.COM FUNDAMENTALS OF NURSING 9TH EDITION POTTER TEST BANKNURSINGTB.COM Prime yourself for your Tests – Study Questions 7. A nurse attends a workshop on current nursing issues provided by the American Nurses Association. Which type of education did the nurse receive? a. Graduate education b. Inservice education c. Continuing education d. Registered nurse education ANS: C Continuing education involves formal, organized educational programs offered by universities, hospitals, state nurses associations, professional nursing organizations, and educational and health care institutions. After obtaining a baccalaureate degree in nursing, you can pursue graduate education leading to a master’s or doctoral degree in any number of graduate fields, including nursing. Inservice education programs are instruction or training provided by a health care facility or institution. Registered nurse education is the education preparation for an individual intending to be an RN. 8. A nurse identifies gaps between local and best practices. Which Quality and Safety Education for Nurses (QSEN) competency is the nurse demonstrating? a. Safety b. Patient-centered care c. Quality improvement d. Teamwork and collaboration ANS: C Quality improvement identifies gaps between local and best practices. Safety minimizes risk of harm to patients and providers through both system effectiveness and individual performance. Patient-centered care recognizes the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs. Teamwork and collaboration allows effective functioning within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making. NURSINGTB.COM FUNDAMENTALS OF NURSING 9TH EDITION POTTER TEST BANKNURSINGTB.COM Prime yourself for your Tests – Study Questions 9. A nurse has compassion fatigue. What is the nurse experiencing? a. Lateral violence and intrapersonal conflict b. Burnout and secondary traumatic stress c. Short-term grief and single stressor d. Physical and mental exhaustion ANS: B Compassion fatigue is a term used to describe a state of burnout and secondary traumatic stress. Compassion fatigue may contribute to what is described as lateral violence (nurse-nurse interactions, not intrapersonal). Frequent, intense, or prolonged exposure to grief and loss places nurses at risk for developing compassion fatigue. Stressors, not a single stressor, contribute to compassion fatigue. Physical and mental exhaustion describes burnout only. 10. A patient is scheduled for surgery. When getting ready to obtain the informed consent, the patient tells the nurse, “I have no idea what is going to happen. I couldn’t ask any questions.” The nurse does not allow the patient to sign the permit and notifies the health care provider of the situation. Which role is the nurse displaying? a. Manager b. Patient educator c. Patient advocate d. Clinical nurse specialist ANS: C As a patient advocate, the nurse protects the patient’s human and legal rights, including the right of the patient to understand procedures before signing permits. Although nurses can be educators, it is the responsibility of the surgeon to provide education for the patient in preparation for surgery, and it is the nurse’s responsibility to notify the health care provider if the patient is not properly educated. Managers coordinate the activities of members of the nursing staff in delivering nursing care, and clinical nurse specialists are experts in a specialized area of nursing practice in a variety of settings.

Test Bank for Introduction to Critical Care Nursing 7th Edition by Sole

Chapter 05: Comfort and Sedation

Sole: Introduction to Critical Care Nursing, 7th Edition

MULTIPLE CHOICE 1.Nociceptors differ from other nerve receptors in the body in that they:
a.adapt very little to continual pain response.
b.inhibit the infiltration of neutrophils and eosinophils.
c.play no role in the inflammatory response.
d.transmit only the thermal stimuli.
ANS: A Nociceptors are stimulated by mechanical, chemical, or thermal stimuli. Nociceptors differ from other nerve receptors in the body in that they adapt very little to the pain response. The body continues to experience pain until the stimulus is discontinued or therapy is initiated. This is a protective mechanism so that the body tissues being damaged will be removed from harm. Nociceptors usually initiate inflammatory responses near injured capillaries. As such, the response promotes infiltration of injured tissues with neutrophils and eosinophils. DIF: Cognitive Level: Remember/Knowledge REF: p. 54 OBJ:Discuss the physiology of pain and anxiety. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 2.A postsurgical patient is on a ventilator in the critical care unit. The patient has been tolerating the ventilator well and has not required any sedation. On assessment, the nurse notes the patient is tachycardic and hypertensive with an increased respiratory rate of 28 breaths/min. The patient has been suctioned recently via the endotracheal tube, and the airway is clear. The patient responds appropriately to the nurse’s commands. The nurse should:
a.assess the patient’s level of pain.
b.decrease the ventilator rate.
c.provide sedation as ordered.
d.suction the patient again.
ANS: A Pulse, respirations, and blood pressure frequently result from activation of the sympathetic nervous system by the pain stimulus. Because the patient is postoperative, the patient should be assessed for the presence of pain and need for pain medication. Decreasing the ventilator rate will not help in this situation. Providing sedation may calm the patient but will not solve the problem if the physiological changes are from pain. The patient has just been suctioned and the airway is clear. There is no need to suction again. DIF: Cognitive Level: Analyze/Analysis REF: p. 55 OBJ: Describe the positive and negative effects of pain and anxiety in critically ill patients. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 3.The assessment of pain and anxiety is a continuous process. When critically ill patients exhibit signs of anxiety, the nurse’s first priority is to
a.administer antianxiety medications as ordered.
b.administer pain medication as ordered.
c.identify and treat the underlying cause.
d.reassess the patient hourly to determine whether symptoms resolve on their own.
ANS: C When patients exhibit signs of anxiety or agitation, the first priority is to identify and treat the underlying cause, which could be hypoxemia, hypoglycemia, hypotension, pain, or withdrawal from alcohol and drugs. Treatment is not initiated until assessment is completed. Medication may not be needed if the underlying cause can be resolved. DIF: Cognitive Level: Apply/Application REF: p. 70 | Table 5-11 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 4.Both the electroencephalogram (EEG) monitor and the Bispectral Index Score (BIS) or Patient State Index (PSI) analyzer monitors are used to assess patient sedation levels in critically ill patients. The BIS and PSI monitors are simpler to use because they
a.can be used only on heavily sedated patients.
b.can be used only on pediatric patients.
c.provide raw EEG data and a numeric value.
d.require only five leads.
ANS: C The BIS and PSI have very simple steps for application, and results are displayed as raw EEG data and the numeric value. A single electrode is placed across the patient’s forehead and is attached to a monitor. These monitors can be used in both children and adults and in patients with varying levels of sedation. DIF: Cognitive Level: Understand/Comprehension REF: p. 60 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 5.The nurse is caring for a patient who requires administration of a neuromuscular blocking agent to facilitate ventilation with nontraditional modes. The nurse understands that neuromuscular blocking agents provide:
a.antianxiety effects.
b.complete analgesia.
c.high levels of sedation.
d.no sedation or analgesia.
ANS: D Neuromuscular blocking (NMB) agents do not possess any sedative or analgesic properties. Patients who receive NMBs must also receive sedatives and pain medication. DIF: Cognitive Level: Remember/Knowledge REF: p. 72 OBJ: Discuss assessment and management challenges in subsets of critically ill patients. TOP:Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity 6.The patient is receiving neuromuscular blockade. Which nursing assessment indicates a target level of paralysis?
a.Glasgow Coma Scale score of 3
b.Train-of-four yields two twitches
c.Bispectral index of 60
d.CAM-ICU positive
ANS: B A train-of-four response of two twitches (out of four) using a peripheral nerve stimulator indicates adequate paralysis. The Glasgow Coma Scale does not assess paralysis; it is an indicator of consciousness. The bispectral index provides an assessment of sedation. The CAM-ICU is a tool to assess delirium. DIF: Cognitive Level: Remember/Knowledge REF: p. 73 OBJ: Discuss assessment and management challenges in subsets of critically ill patients. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 7.The nurse is concerned that the patient will pull out the endotracheal tube. As part of the nursing management, the nurse obtains an order for
a.arm binders or splints.
b.a higher dosage of lorazepam.
c.propofol.
d.soft wrist restraints.
ANS: D The priority in caring for agitated patients is safety. The least restrictive methods of keeping the patient safe are appropriate. If possible, the tube or device causing irritation should be removed, but if that is not possible, the nurse must prevent the patient from pulling it out. Restraints are associated with an increased incidence of agitation and delirium. Therefore, restraints should not be used unless as a last resort for combative patients. The least amount of sedation is also recommended; therefore, neither increasing the dosage of lorazepam nor adding propofol is indicated and would be likely to prolong mechanical ventilation. DIF: Cognitive Level: Apply/Application REF: p. 61 OBJ:Identify nonpharmacological and pharmacological strategies to promote comfort and reduce anxiety.TOP:Nursing Process Step: Planning MSC: NCLEX Client Needs Category: Safe and Effective Care Environment 8.The primary mode of action for neuromuscular blocking agents used in the management of some ventilated patients is
a.analgesia.
b.anticonvulsant therapy.
c.paralysis.
d.sedation.
ANS: C These agents cause respiratory muscle paralysis. They do not provide analgesia or sedation. They do not have anticonvulsant properties. DIF: Cognitive Level: Remember/Knowledge REF: p. 72 OBJ: Discuss assessment and management challenges in subsets of critically ill patients. TOP:Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity 9.The most important nursing intervention for patients who receive neuromuscular blocking agents is to
a.administer sedatives in conjunction with the neuromuscular blocking agents.
b.assess neurological status every 30 minutes.
c.avoid interaction with the patient, because he or she won’t be able to hear.
d.restrain the patient to avoid self-extubation.
ANS: A Neuromuscular blocking agents cause paralysis only; they do not cause sedation. Therefore, concomitant administration of sedatives is essential. Neurological status is monitored according to unit protocol. Nurses should communicate with all critically ill patients, regardless of their status. If the patient is paralyzed, restraining devices may not be needed. DIF: Cognitive Level: Apply/Application REF: p. 72 OBJ: Discuss assessment and management challenges in subsets of critically ill patients. TOP:Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity 10.The best way to monitor agitation and effectiveness of treating it in the critically ill patient is to use a/the:
a.Confusion Assessment Method (CAM-ICU).
b.FACES assessment tool.
c.Glasgow Coma Scale.
d.Richmond Agitation Sedation Scale.
ANS: D Various sedation scales are available to assist the nurse in monitoring the level of sedation and assessing response to treatment. The Richmond Agitation Sedation Scale is a commonly used tool that has been validated. The CAM-ICU assesses for delirium. The FACES scale assesses pain. The Glasgow Coma Scale assesses neurological status. DIF: Cognitive Level: Remember/Knowledge REF: p. 59 | Table 5-5 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 11.The nurse is caring for a patient receiving intravenous ibuprofen for pain management. The nurse recognizes which laboratory assessment to be a possible side effect of the ibuprofen?
a.Creatinine: 3.1 mg/dL
b.Platelet count 350,000 billion/L
c.White blood count 13, 550 mm3
d.ALT 25 U/L
ANS: A Ibuprofen can result in renal insufficiency, which may be noted in an elevated serum creatinine level. Thrombocytopenia (low platelet count) is another possible side effect. This platelet count is elevated. An elevated white blood count indicates infection. Although ibuprofen is cleared primarily by the kidneys, it is also important to assess liver function, which would show elevated liver enzymes, not low values such as shown here. DIF: Cognitive Level: Analyze/Analysis REF: p. 71 OBJ:Identify nonpharmacological and pharmacological strategies to promote comfort and reduce anxiety.TOP:Nursing Process Step: Evaluation MSC: NCLEX Client Needs Category: Physiological Integrity 12.The nurse is assessing pain levels in a critically ill patient using the Behavioral Pain Scale. The nurse recognizes __________ as indicating the greatest level of pain.
a.brow lowering
b.eyelid closing
c.grimacing
d.relaxed facial expression
ANS: C The Behavioral Pain Scale issues the most points, indicating the greatest amount of pain, to assessment of facial grimacing. DIF: Cognitive Level: Understand/Comprehension REF: p. 58 | Table 5-3 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 13.The nurse wishes to assess the quality of a patient’s pain. Which of the following questions is appropriate to obtain this assessment if the patient is able to give a verbal response?
a.“Is the pain constant or intermittent?”
b.“Is the pain sharp, dull, or crushing?”
c.“What makes the pain better? Worse?”
d.“When did the pain start?”
ANS: B If the patient can describe the pain, the nurse can assess quality, such as sharp, dull, or crushing. The other responses relate to continuous or intermittent presence, what provides relief, and duration. DIF: Cognitive Level: Understand/Comprehension REF: p. 56 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 14.The nurse is assessing the patient’s pain using the Critical Care Pain Observation Tool. Which of the following assessments would indicate the greatest likelihood of pain and need for nursing intervention?
a.Absence of vocal sounds
b.Fighting the ventilator
c.Moving legs in bed
d.Relaxed muscles in upper extremities
ANS: B Fighting the ventilator is rated with the greatest number of points for compliance with the ventilator, and could indicate pain or anxiety. Absence of vocal sounds (e.g., no crying) and relaxed muscles do not indicate pain and are not given a point value. The patient may be moving the legs as a method of range of motion, not necessarily in response to pain. The patient needs to be assessed for restlessness if the movement is excessive. DIF: Cognitive Level: Apply/Application REF: p. 59 | Table 5-4 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 15.The nurse is caring for four patients on the progressive care unit. Which patient is at greatest risk for developing delirium?
a.36-year-old recovering from a motor vehicle crash; being treated with an evidence-based alcohol withdrawal protocol.
b.54-year-old postoperative aortic aneurysm resection with a 40 pack-year history of smoking
c.86-year-old from nursing home with dementia, postoperative from colon resection, still being mechanically ventilated
d.95-year-old with community-acquired pneumonia; family has brought in eyeglasses and hearing aid
ANS: C From this list, the 86-year-old postoperative nursing home resident is at greatest risk due to advanced age, cognitive impairment, and some degree of respiratory failure. The 96-year-old has been provided eyeglasses and a hearing aid, which will decrease the risk of delirium. Smoking is a possible risk for delirium. The 36-year-old is receiving medications as part of an alcohol withdrawal protocol, which should decrease the risk for delirium. DIF: Cognitive Level: Analyze/Analysis REF: p. 61 | Table 5-8 OBJ: Describe methods and tools for assessing pain and anxiety in the critically ill patient. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 16.The nurse is caring for a patient with hyperactive delirium. The nurse focuses interventions toward keeping the patient:
a.comfortable.
b.nourished.
c.safe.
d.sedated.
ANS: C The greatest priority in managing delirium is to keep the patient safe. Sedation may contribute to the development of delirium. Comfort and nutrition are important, but they are not priorities. DIF: Cognitive Level: Understand/Comprehension REF: p. 61 OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Safe and Effective Care Environment 17.The nurse is caring for a critically ill trauma patient who is expected to be hospitalized for an extended period. Which of the following nursing interventions would improve the patient’s well-being and reduce anxiety the most?
a.Arrange for the patient’s dog to be brought into the unit (per protocol).
b.Provide aromatherapy with scents such as lavender that are known to help anxiety.
c.Secure the harpist to come and play soothing music for an hour every afternoon.
d.Wheel the patient out near the unit aquarium to observe the tropical fish.
ANS: A Nonpharmacological approaches are helpful in reducing stress and anxiety, and each of these activities has the potential for improving the patient’s well-being. The patient is likely to benefit most from the presence of his or her own dog rather than the other activities, however; if unit protocol does not allow the patient’s own dog, the nurse should investigate the use of therapy animals or the other options. DIF: Cognitive Level: Apply/Application REF: p. 64 OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Intervention MSC: NCLEX Client Needs Category: Psychological Integrity 18.The nurse recognizes that which patient is likely to benefit most from patient-controlled analgesia (PCA)?
a.Patient with a C4 fracture and quadriplegia
b.Patient with a femur fracture and closed head injury
c.Postoperative patient who had elective bariatric surgery
d.Postoperative cardiac surgery patient with mild dementia
ANS: C The patient undergoing bariatric surgery (an elective procedure) is the best candidate for PCA as this patient should be awake, cognitively intact, and will have the acute pain related to the surgical procedure. The quadriplegic would be unable to operate the PCA pump. The cardiac surgery patient with mild dementia may not understand how to operate the pump. Likewise, the patient with the closed head injury may not be cognitively intact. DIF: Cognitive Level: Analyze/Analysis REF: p. 71 | Box 5-6 OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Intervention MSC: NCLEX Client Needs Category: Physiological Integrity 19.The nurse is caring for a patient receiving a benzodiazepine intermittently. The nurse understands that the best way to administer such drugs is to:
a.administer around the clock, rather than as needed, to ensure constant sedation.
b.administer the medications through the feeding tube to prevent complications.
c.give the highest allowable dose for the greatest effect.
d.titrate to a predefined endpoint using a standard sedation scale.
ANS: D The best approach for administering benzodiazepines (and all sedatives) is to administer and titrate to a desired endpoint using a standard sedation scale. Administering around the clock as well as giving the highest allowable dose without basing it on an assessment target may result in excessive sedation. For greatest effect, most benzodiazepines are given intravenously. DIF: Cognitive Level: Apply/Application REF: p. 72 OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Intervention MSC: NCLEX Client Needs Category: Physiological Integrity 20.The nurse is concerned about the risk of alcohol withdrawal syndrome in a postoperative patient. Which statement by the nurse indicates understanding of management of this patient?
a.“Alcohol withdrawal is common; we see it all of the time in the trauma unit.”
b.“There is no way to assess for alcohol withdrawal.”
c.“This patient will require less pain medication.”
d.“We have initiated the alcohol withdrawal protocol.”
ANS: D The most important treatment of alcohol withdrawal syndrome is prevention. Many units have protocols that are initiated early to prevent the syndrome. Alcohol withdrawal syndrome is common; however, this statement does not indicate knowledge of management. The patient experiencing alcohol withdrawal may exhibit a variety of symptoms, such as disorientation, agitation, and tachycardia. Patients with substance abuse require increased dosages of pain medications. DIF: Cognitive Level: Understand/Comprehension REF: p. 74 OBJ: Identify nonpharmacological and pharmacological strategies to promote comfort, reduce anxiety, and prevent delirium. TOP: Nursing Process Step: Intervention MSC: NCLEX Client Needs Category: Physiological Integrity MULTIPLE RESPONSE 1.Nonpharmacological approaches to pain and/or anxiety that may best meet the needs of critically ill patients include: (Select all that apply.)
a.anaerobic exercise.
b.art therapy.
c.guided imagery.
d.music therapy.
e.animal therapy.
ANS: C, D, E Guided imagery is a powerful technique for controlling pain and anxiety, especially that associated with painful procedures. Similar to guided imagery, a music therapy program offers patients a diversionary technique for pain and anxiety relief. Likewise animal therapy has many benefits for the critically ill patient. Anaerobic exercise is not a nonpharmacological approach for managing pain and anxiety. Most critically ill patients are not able to participate in art therapy. DIF: Cognitive Level: Remember/Knowledge REF: pp. 62-64 OBJ:Identify nonpharmacological and pharmacological strategies to promote comfort and reduce anxiety.TOP:Nursing Process Step: Implementation MSC: NCLEX Client Needs Category: Physiological Integrity 2.Which of the following statements regarding pain and anxiety are true? (Select all that apply.)
a.Anxiety is a state marked by apprehension, agitation, autonomic arousal, and/or fearful withdrawal.
b.Critically ill patients often experience anxiety, but they rarely experience pain.
c.Pain and anxiety are often interrelated and may be difficult to differentiate because their physiological and behavioral manifestations are similar.
d.Pain is defined by each patient; it is whatever the person experiencing the pain says it is.
e.While anxiety is unpleasant, it does not contribute to mortality or morbidity of the critically ill patient.
ANS: A, C, D Pain is defined by each patient, anxiety is associated with marked apprehension, and pain and anxiety are often interrelated. Critically ill patients commonly have both pain and anxiety. Anxiety does increase both morbidity and mortality in critically ill patients, especially those with cardiovascular disease. DIF: Cognitive Level: Understand/Comprehension REF: p. 53 OBJ: Define pain and anxiety. TOP: Nursing Process Step: Planning MSC: NCLEX Client Needs Category: Physiological Integrity 3.Which of the following factors predispose the critically ill patient to pain and anxiety? (Select all that apply.)
a.Inability to communicate
b.Invasive procedures
c.Monitoring devices
d.Nursing care
e.Preexisting conditions
ANS: A, B, C, D, E All of these factors predispose the patient to pain or anxiety. DIF: Cognitive Level: Remember/Knowledge REF: pp. 53-54 OBJ: Identify factors that place the critically ill patient at risk for developing pain and anxiety. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 4.Choose the items that are common to both pain and anxiety. (Select all that apply.)
a.Cyclical exacerbation of one another
b.Require good nursing assessment for proper treatment
c.Response only to real phenomena
d.Subjective in nature
e.Perception may be influenced by prior experience
ANS: A, B, D, E Both pain and anxiety are subjective in nature. One can exacerbate the other in a vicious cycle that often requires good nursing assessment to manage the precipitating problem and break the cycle. Anxiety is a response to a real or perceived fear. Pain is a response to real or “phantom” phenomenon but always involves transmission of nerve impulses. Both relate to the patient’s perceptions of pain and fear. Previous experiences of both pain and/or anxiety can influence the patient’s perception of both. Anxiety is a response to real or perceived fear, and pain is a response to a real or “phantom” phenomenon. DIF: Cognitive Level: Understand/Comprehension REF: pp. 53-54 OBJ: Identify factors that place the critically ill patient at risk for developing pain and anxiety. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 5.Anxiety differs from pain in that: (Select all that apply.)
a.it is confined to neurological processes in the brain.
b.it is linked to reward and punishment centers in the limbic system.
c.it is subjective.
d.there is no actual tissue injury.
e.it can be increased by noise and light.
ANS: A, B, D, E Unlike pain, anxiety is linked to the reward and punishment centers in the limbic system of the brain. It is totally neurological and does not involve tissue injury. Like pain, it is a subjective phenomenon. Noise, light, and other stimuli can increase the intensity of anxiety. Both anxiety and pain are subjective in nature. DIF: Cognitive Level: Understand/Comprehension REF: pp. 53-55 OBJ:Discuss the physiology of pain and anxiety. TOP: Nursing Process Step: Assessment 6.Factors in the critical care unit that may predispose the client to increased pain and anxiety include: (Select all that apply.)
a.an endotracheal tube.
b.frequent vital signs.
c.monitor alarms.
d.room temperature.
e.hostile environment.
ANS: A, B, C, D, E Anxiety is likely to result from loss of control, the inability to communicate, continuous noise and lighting, excessive stimulation (including repeated vital sign measurements), lack of mobility, and uncomfortable room temperatures. Increased anxiety levels often lead to increased pain perception. Environments that are perceived as hostile also contribute. DIF: Cognitive Level: Understand/Comprehension REF: pp. 53-54 OBJ: Identify factors that place the critically ill patient at risk for developing pain and anxiety. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 7.In the healthy individual, pain and anxiety: (Select all that apply.)
a.activate the sympathetic nervous system (SNS).
b.decrease stress levels.
c.help remove one from harm.
d.increase performance levels.
e.limit sympathetic nervous system activity.
ANS: A, C, D In the healthy person, pain and anxiety are adaptive mechanisms used to increase performance levels or to remove one from potential harm. The “fight or flight” response occurs in response to pain and/or anxiety and involves the activation of the sympathetic nervous system. Pain and anxiety, however, can induce significant stress. The SNS is activated, not limited, by pain and/or anxiety. DIF: Cognitive Level: Remember/Knowledge REF: p. 55 OBJ: Describe the positive and negative effects of pain and anxiety in critically ill patients. TOP:Nursing Process Step: Assessment MSC: NCLEX Client Needs Category: Physiological Integrity 8.The nurse is caring for a patient who is intubated and on a ventilator following extensive abdominal surgery. Although the patient is responsive, the nurse is not able to read the patient’s lips as the patient attempts to mouth the words. Which of the following assessment tools would be the most appropriate for the nurse to use when assessing the patient’s pain level? (Select all that apply.)
a.The FACES scale
b.Pain Intensity Scale
c.The PQRST method
d.The Visual Analogue Scale
e.The CAM tool
ANS: A, D

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

Old’s Maternal-Newborn Nursing and Women’s Health, 11e (Davidson/London/Ladewig)

 

Chapter 1 Contemporary Maternal-Newborn Nursing

 
  • The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect?
 
  1. Shortens newborn length of stay
  2. Decreases use of home health agencies
  3. Decreases healthcare costs
  4. Decreases the number of emergency department visits
  Answer:C   Explanation:
  1. Length of stay is often determined by third-party payer (insurance company) policies as well as the physiologic stability of the mother and newborn. Home healthcare agencies often are involved in client care to decrease hospital stay time.
  2. Home healthcare agencies often are involved in client care to decrease hospital stay time.
  3. Research indicates that self-care significantly decreases healthcare costs.
  4. Acute emergencies are addressed by emergency departments, and are not delayed by those practicing self-care.
  Page Ref: 3   Cognitive Level:Understanding Client Need/Sub:Health Promotion and Maintenance: Self-Care Standards: QSEN Competencies: Ⅰ.A.2. Describe strategies to empower patients or families in all aspects of the healthcare process. | 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: Context and Environment: Health care economic policy; reimbursement structures; accreditation standards; staffing models and productivity; supply chain models | Nursing/Integrated Concepts: Nursing Process: Planning. Learning Outcome:1 Discuss the impact of the self-care movement on contemporary childbirth. MNL LO:Recognize contemporary issues related to care of the childbearing family.    
  • Care delivered by nurse-midwives can be safe and effective and can represent a positive response to the healthcare provider shortage. Nurse-midwives tend to use less technology, which often results in which of the following?
 
  1. There is less trauma to the mother.
  2. More childbirth education classes are available.
  3. They are instrumental in providing change in the birth environment at work.
  4. They advocate for more home healthcare agencies.
  Answer:A   Explanation:
  1. Nurse-midwife models of care can be one way to ensure that mothers receive excellent prenatal and intrapartum care.
  2. It is appropriate for nurse-midwives, in conjunction with doctors and hospitals, to provide childbirth classes for expectant families.
  3. By working with other staff members and doctors, the nurse-midwife is able to implement changes as needed within the birthing unit.
  4. Clients are increasingly going home sooner, so there needs to be more follow-up in the home.
  Page Ref: 3   Cognitive Level:Understanding Client Need/Sub:Health Promotion and Maintenance: Health Promotion/Disease Prevention Standards: QSEN Competencies: Ⅲ.A.6. Describe how the strength and relevance of available evidence influences the choice of interventions in provision of patient-centered care. | AACN Essentials Competencies: Ⅸ. 5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing Process: Planning. Learning Outcome:2 Compare the nursing roles available to the maternal-newborn nurse. MNL LO:Recognize contemporary issues related to care of the childbearing family.    
  • The nurse is telling a new client how advanced technology has permitted the physician to do which of the following?
 
  1. Treat the fetus and monitor fetal development.
  2. Deliver at home with a nurse-midwife and doula.
  3. Have the father act as the coach and cut the umbilical cord.
  4. Breastfeed a new baby on the delivery table.
  Answer:A   Explanation:
  1. The fetus is increasingly viewed as a patient separate from the mother, although treatment of the fetus necessarily involves the mother.
  2. A nurse-midwife and a doula are not examples of technological care.
  3. Fathers being present during labor and coaching their partners represents nontechnological care during childbirth.
  4. Breastfeeding is not an example of technology impacting care.
  Page Ref: 2—3   Cognitive Level:Understanding Client Need/Sub:Safe and Effective Care Environment: Management of Care Standards:QSEN Competencies: Ⅰ.B.10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: Ⅸ.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences. | NLN Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Implementation. Learning Outcome:6 Evaluate the potential impact of some of the special situations in contemporary maternity care. MNL LO:Recognize contemporary issues related to care of the childbearing family.
  • A nurse is examining different nursing roles. Which example best illustrates an advanced practice nursing role?
 
  1. A registered nurse who is the manager of a large obstetrical unit
  2. A registered nurse who is the circulating nurse during surgical deliveries (cesarean sections)
  3. A clinical nurse specialist working as a staff nurse on a mother-baby unit
  4. A clinical nurse specialist with whom other nurses consult for her expertise in caring for high-risk infants
Answer:D Explanation:
  1. A registered nurse who is the manager of a large obstetrical unit is a professional nurse who has graduated from an accredited program in nursing and completed the licensure examination.
  2. A registered nurse who is a circulating nurse at surgical deliveries (cesarean sections) is a professional nurse who has graduated from an accredited program in nursing and completed the licensure examination.
  3. A clinical nurse specialist working as a staff nurse on a mother-baby unit might have the qualifications for an advanced practice nursing staff member but is not working in that capacity.
  4. A clinical nurse specialist with whom other nurses consult for expertise in caring for high-risk infants is working in an advanced practice nursing role. This nurse has specialized knowledge and competence in a specific clinical area, and is master’s prepared.
Page Ref: 5 Cognitive Level:Understanding Client Need/Sub:Safe and Effective Care Environment: Management of Care Standards:QSEN Competencies: Ⅱ.A.2. Describe scopes of practice and roles of healthcare team members. | AACN Essentials Competencies: Ⅵ. 6. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education, and licensure requirements). | NLN Competencies: Teamwork: Scope of practice, roles, and responsibilities of health care team members, including overlaps. | Nursing/Integrated Concepts: Nursing Process: Assessment. Learning Outcome:2 Compare the nursing roles available to the maternal-newborn nurse. MNL LO:Recognize contemporary issues related to care of the childbearing family.  

Test Bank for Pharmacotherapeutics for Advanced Practice Nurse Prescribers 4th Edition by Woo

Chapter 1. The Role of the Nurse Practitioner   Multiple Choice Identify the choice that best completes the statement or answers the question.   ____    1.   Nurse practitioner prescriptive authority is regulated by:
1.The National Council of State Boards of Nursing
2.The U.S. Drug Enforcement Administration
3.The State Board of Nursing for each state
4.The State Board of Pharmacy
    ____    2.   The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:
1.Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program.
2.Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care.
3.APRNs are less likely to prescribe narcotics and other controlled substances.
4.APRNs are able to prescribe independently in all states, whereas a physician’s assistant needs to have a physician supervising their practice.
    ____    3.   Clinical judgment in prescribing includes:
1.Factoring in the cost to the patient of the medication prescribed
2.Always prescribing the newest medication available for the disease process
3.Handing out drug samples to poor patients
4.Prescribing all generic medications to cut costs
    ____    4.   Criteria for choosing an effective drug for a disorder include:
1.Asking the patient what drug they think would work best for them
2.Consulting nationally recognized guidelines for disease management
3.Prescribing medications that are available as samples before writing a prescription
4.Following U.S. Drug Enforcement Administration guidelines for prescribing
    ____    5.   Nurse practitioner practice may thrive under health-care reform because of:
1.The demonstrated ability of nurse practitioners to control costs and improve patient outcomes
2.The fact that nurse practitioners will be able to practice independently
3.The fact that nurse practitioners will have full reimbursement under health-care reform
4.The ability to shift accountability for Medicaid to the state level
  Chapter 1. The Role of the Nurse Practitioner Answer Section   MULTIPLE CHOICE  
  1. ANS:  3                     PTS:   1
 
  1. ANS:  2                     PTS:   1
 
  1. ANS:  1                     PTS:   1
 
  1. ANS:  2                     PTS:   1
 
  1. ANS:  1                     PTS:   1

Test Bank Community Health Nursing in Canada, 3rd Edition by Marcia Stanhope

Chapter 01: Community Health Nursing

Stanhope: Community Health Nursing in Canada, 3rd Canadian Edition

MULTIPLE CHOICE

1.   Which of the following best describes community health nursing?
a.Giving care with a focus on the aggregate’s needs
b.Giving care with a focus on the group’s needs
c.Focusing on the health care of individual clients in the community
d.Working with an approach of unique client care
ANS:  C By definition, community health nursing is the health care of individual clients in the community. DIF:    Cognitive Level: Knowledge/Remember                         REF:   p. 3 OBJ:   1.6 TOP:   Client Need: Safe and Effective Care Environment - Management of Care 2.   Which of the following best describes primary health care?
a.A comprehensive way to address issues of social justice
b.Giving the care to manage acute or chronic conditions
c.Giving direct care to ill individuals within their family setting
d.Having the goal of health promotion and disease prevention
ANS:  A By definition, primary health care is comprehensive and addresses issues of social justice and equity. Social justice in the context of health refers to ensuring fairness and equality in health services so that vulnerable individuals in society have easy access to health care. DIF:    Cognitive Level: Knowledge/Remember                         REF:   p. 10 OBJ:   1.4                 TOP:   Client Need: Health Promotion and Maintenance 3.   The health of which of the following is the primary focus of public health nurses (PHNs)?
a.Families
b.Groups
c.Individuals
d.Populations
ANS:  D PHNs use knowledge of nursing, social sciences, and public health sciences for the promotion and protection of health and for the prevention of disease among populations. DIF:    Cognitive Level: Knowledge/Remember                         REF:   p. 13, Table 1-4 | p. 20 OBJ:   1.5                 TOP:   Client Need: Health Promotion and Maintenance 4.   Which change is the primary explanation for life expectancy increasing so notably since the early 1900s?
a.An increase in findings from medical laboratory research
b.Incredible advances in surgical techniques and procedures
c.Improved sanitation and other public health activities
d.Increased use of antibiotics to fight infections
ANS:  C Improvement in control of infectious diseases through immunizations, sanitation, and other public health activities led to the increase in life expectancy since the early 1900s. DIF:    Cognitive Level: Knowledge/Remember                         REF:   pp. 12-13 OBJ:   1.5                 TOP:   Client Need: Health Promotion and Maintenance 5.   Which community health nursing practice area receives funding from the private sector?
a.Telenurses
b.Corrections nurses
c.Nurse entrepreneurs
d.Street or outreach nurses
ANS:  C The nurse entrepreneur receives private funding, whereas all of the other community health nurse (CHN) roles are with provincially or federally funded positions. DIF:    Cognitive Level: Knowledge/Remember                         REF:   p. 22, Table 1-4 Examples OBJ:   1.6 TOP:   Client Need: Safe and Effective Care Environment - Management of Care 6.   A PHN strives to prevent disease and disability, often in partnership with other community groups. Which statement is an appropriate summary of the PHN’s role?
a.The PHN asks the political leaders what interventions should be chosen.
b.The PHN assesses the community and decides on appropriate interventions.
c.The PHN uses data from the main health care institutions in the community to determine needed health services.
d.The PHN works with community members to carry out public health functions.
ANS:  D It is crucial that the PHN work with members of the community to carry out core public health functions. DIF:    Cognitive Level: Application/Apply                                          REF:    p. 13, How To box OBJ:   1.5                 TOP:   Client Need: Health Promotion and Maintenance 7.   Which of the following is used as a measurement of population health?
a.Health status indicators
b.The levels of prevention
c.The number of memberships at the local fitness centre
d.Reported provincial alcohol and tobacco sales in any given month
ANS:  A Population health refers to the health outcomes of a population as measured by determinants of health and health outcomes. DIF:    Cognitive Level: Knowledge/Remember                         REF:   p. 16 OBJ:   1.2                 TOP:   Client Need: Health Promotion and Maintenance 8.   A registered nurse (RN), has just been employed as a CHN. Which question would be most relevant to her practice as she begins her position?
a.“Which community groups are at greatest risk for problems?”
b.“Which patients should I see first as I begin my day?”
c.“With which physicians will I be collaborating most closely?”
d.“Who is the nursing assistant to whom I can refer patients?”
ANS:  A CHNs apply the nursing process to the entire community; asking which groups are at greatest risk reflects a community-oriented perspective. The other possible responses focus on particular individuals. DIF:    Cognitive Level: Application/Apply                                          REF:    p. 15 OBJ:   1.6                 TOP:   Client Need: Health Promotion and Maintenance 9.   The CHN working with women at the senior citizens’ centre reminds them that the only way the centre will be able to afford a driver and a van service for those who cannot drive themselves is to continue to write letters to their local city council representatives, requesting funding for such a service. What is the CHN doing?
a.Ensuring that the women do not expect the CHN herself to do anything about their problem
b.Demonstrating that she understands the women’s concerns and needs
c.Expressing empathy, support, and concern
d.Helping the women engage in political action locally
ANS:  D CHNs have an imperative to work with the members of the community to carry out public health functions such as political action. DIF:    Cognitive Level: Application/Apply                                          REF:    p. 13, How To box OBJ:   1.5 | 1.6 TOP:   Client Need: Safe and Effective Care Environment - Management of Care 10.   Which activity is an example of the “advocate” role of the CHN?
a.Organizing home care support for a newly discharged older adult client
b.Acting as a member of a community action group for provision of accessible transit choices
c.Doing prenatal assessments
d.Facilitating a self-help group for smoking cessation
ANS:  B An advocate provides a voice to client concerns when acting as a member of a community action group for provision of accessible transit choices. DIF:    Cognitive Level: Application/Apply                                          REF:    p. 19, Table 1-3 OBJ:   1.6 TOP:   Client Need: Safe and Effective Care Environment - Management of Care 11.   In which scenario is the PHN most comprehensively fulfilling collaborative practice responsibilities?
a.The PHN meets with several groups about community recreation issues.
b.The PHN spends the day attending meetings at various health agencies.
c.The PHN talks to several people about their particular health concerns.
d.The PHN watches television, including a telecast of a city council meeting on the local cable station.
ANS:  B Any of these might represent a PHN communicating, cooperating, or collaborating with community residents or groups about health concerns. However, the PHN who spends the day attending meetings at various health agencies is most comprehensively fulfilling requirements effectively, since health is broader than recreation, individual concerns are not as important as aggregate priorities, and watching television is only one-way communication. DIF:    Cognitive Level: Synthesis/Synthesize                            REF:   pp. 15-16 OBJ:   1.5 TOP:   Client Need: Safe and Effective Care Environment - Management of Care 12.   A CHN often has to make resource allocation decisions. In such cases, which approach will most help the CHN to arrive at the decision?
a.Choosing a moral or ethical principle
b.Choosing the cheapest, most economical approach
c.Choosing the most rational outcome
d.Choosing the needs of the aggregate, rather than the needs of a few individuals
ANS:  D Although all of the answers represent components of the CHN’s decision-making process, the predominant needs of the population outweigh the expressed needs of one person or a few people. DIF:    Cognitive Level: Application/Apply                                          REF:    pp. 7-8 OBJ:   1.3 TOP:   Client Need: Safe and Effective Care Environment - Management of Care 13.   Which situation most closely represents the focus of public health nursing?
a.Assessing the services and effectiveness of the school health clinic
b.Caring for patients after their outpatient surgeries
c.Giving care to schoolchildren at the school clinic and to the children’s families
d.Treating paediatric patients at an outpatient clinic
ANS:  A A public health or population-focused approach would consider the entire group of children receiving care, to see if services are effective in achieving the goal of improving the health of the school population. DIF:    Cognitive Level: Application/Apply                                          REF:    p. 13, How To box OBJ:   1.5                 TOP:   Client Need: Health Promotion and Maintenance 14.   Which public health service best represents primary prevention?
a.Developing a health education program about the dangers of smoking
b.Providing a diabetes clinic for adults in low-income neighbourhoods
c.Providing an influenza vaccination program in a community retirement village
d.Teaching school-aged children about the positive effects of exercise
ANS:  C Although all the services listed are appropriate and valuable, providing influenza vaccines to healthy adults represents the primary level of health prevention. DIF:    Cognitive Level: Application/Apply                                          REF:    p. 14 OBJ:   1.5                 TOP:   Client Need: Health Promotion and Maintenance 15.   What term is used interchangeably with the term subpopulations?
a.Groups
b.Aggregates
c.Clients
d.Communities
ANS:  B Generally, subpopulations are referred to as aggregates within the larger community population. DIF:    Cognitive Level: Knowledge/Remember                         REF:   p. 16 OBJ:   1.2                 TOP:   Client Need: Health Promotion and Maintenance
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