1.You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which of the following statements best describes this code?
1. Improves self–health care
2. Protects the patient’s confidentiality
3. Ensures identical care to all patients
4. Defines the principles of right and wrong to provide patient care
2. An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, listens to her lung and heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed?
1. Diagnosis
2. Evaluation
3. Assessment
4. Implementation
3. A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed?
1. Planning
2. Evaluation
3. Assessment
4. Implementation
4. A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient’s wishes with them. The nurse is acting as the patient’s:
1. Educator.
2. Advocate.
3. Caregiver.
4. Case manager.
5. The nurse spends time with the patient and family reviewing the dressing change procedure for the patient’s wound. The patient’s spouse demonstrates how to change the dressing. The nurse is acting in which professional role?
1. Educator
2. Advocate
3. Caregiver
4. Case manager
6. The examination for registered nurse (RN) licensure is exactly the same in every state in the United States. This examination:
1. Guarantees safe nursing care for all patients.
2. Ensures standard nursing care for all patients.
3. Ensures that honest and ethical care is provided.
4. Provides a minimal standard of knowledge for an RN in practice.
7. Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.)
1. Caregiver
2. Autonomy and accountability
3. Patient advocate
4. Health promotion
5. Lobbyist
8. Match the advanced practice nurse specialty with the statement about the role.
1. Clinical nurse specialist-b. Expert clinician in a specialized area of practice such as adult diabetes care
2. Nurse anesthetist-d. Provides care and services under the supervision of an anesthesiologist
3. Nurse practitioner-c. Provides comprehensive care, usually in a primary care setting, directly managing the medical care of patients who are healthy or have chronic conditions
4. Nurse-midwife-a. Provides independent care, including pregnancy and gynecological services
9. Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform?
1. Moving from an acute illness to a health promotion, illness prevention model
2. Moving from an illness prevention to a health promotion model
3. Moving from an acute illness to a disease management model
4. Moving from a chronic care to an illness prevention model
10. A nurse meets with the registered dietitian and physical therapist to develop a plan of care that focuses on improving nutrition and mobility for a patient. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency?
1. Patient-centered care
2. Safety
3. Teamwork and collaboration
4. Informatics
11. A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency?
1. Patient-centered care
2. Safety
3. Teamwork and collaboration
4. Informatics
13. The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career?
1. Clinical nurse specialist
2. Nurse administrator
3. Nurse educator
4. Nurse researcher
14. Nurses in an acute care hospital are attending a unit-based education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education?
1. Continuing education
2. Graduate education
3. In-service education
4. Professional Registered Nurse Education
15. Which of the following Internet resources can help consumers compare quality care measures? (Select all that apply.)
1. WebMD
2. Hospital Compare
3. Magnet Recognition Program
4. Hospital Consumer Assessment of Healthcare
5. The American Hospital Association’s webpage.
1. The components of the nursing metaparadigm include:
1. Person, health, environment, and theory
2. Health, theory, concepts, and environment
3. Nurses, physicians, health, and patient needs
4. Person, health, environment, and nursing
2. Theory is essential to nursing practice because it: (Select all that apply.)
1. Contributes to nursing knowledge.
2. Predicts patient behaviors in situations.
3. Provides a means of assessing patient vital signs.
4. Guides nursing practice.
5. Formulates health care legislation.
6. Explains relationships between concepts.
3. A nurse ensures that each patient’s room is clean; well ventilated; and free from clutter, excessive noise, and extremes in temperature. Which theorist’s work is the nurse practicing in this example?
1. Henderson
2. Orem
3. King
4. Nightingale
4. The nurse is caring for a patient admitted to the neurological unit with the diagnosis of a stroke and right-sided weakness. The nurse assumes responsibility for bathing and feeding the patient until the patient is able to begin performing these activities. The nurse in this situation is applying the theory developed by:
1. Neuman.
2. Orem.
3. Roy.
4. Peplau.
5. Match the following types of theory with the appropriate description.
1. Middle-range theory-d. Addresses a specific phenomenon and reflects practice
2. Shared theory-c. Applies theory from other disciplines to nursing practice
3. Grand theory-a. Very abstract; attempts to describe nursing in a global context
4. Practice theory-b. Specific to a particular situation; brings theory to the bedside
6. Match the following descriptions to the appropriate grand theorist.
1. King-d. Based on the belief that nurses should work with patients to develop goals for care
2. Henderson-c. Based on 14 activities, the belief that the nurse should assist patients with meeting needs until they are able to do so independently
3. Orem-b. Based on the belief that people who participate in self-care activities are more likely to improve their health outcomes
4. Neuman-a. Based on the theory that focuses on wellness and prevention of disease
7. Match the following description to the appropriate middle-range theory.
1. Benner’s Skill Acquisition-b. The nurse progresses through five stages of expertise.
2. AACN’s Synergy Model-d. Matching nurse competencies to patient needs can improve patient outcomes
3. Mishel’s Uncertainty in Illness-c. The nurse helps the patient to process and find meaning related to his or her illness.
4. Kolcaba’s Theory of Comfort- a. The nurse strives to relieve patients’ distress.
8. Which of the following statements related to theory-based nursing practice are correct? (Select all that apply.)
1. Nursing theory differentiates nursing from other disciplines.
2. Nursing theories are standardized and do not change over time.
3. Integrating theory into practice promotes coordinated care delivery.
4. Nursing knowledge is generated by theory.
5. The theory of nursing process is used in planning patient care.
6. Evidence-based practice results from theory-testing research.
9. A nurse is caring for a patient who recently lost a leg in a motor vehicle accident. The nurse best assists the patient to cope with this situation by applying which of the following theories?
1. Roy
2. Levine
3. Watson
4. Johnson
10. Using Maslow’s hierarchy of needs, identify the priority for a patient who is experiencing chest pain and difficulty breathing.
1. Self-actualization
2. Air, water, and nutrition
3. Safety
4. Esteem and self-esteem needs
11. Which of the following categories of shared theories would be most appropriate for a patient who is grieving the loss of a spouse?
1. Biomedical
2. Leadership
3. Psychosocial
4. Developmental
12. While working in a rehabilitation facility, it is important to obtain nursing histories and develop a therapeutic nurse-patient relationship. List in correct order the phases of Peplau’s theory as applied in this setting. The nurse:
3) Ensures that the patient has access to appropriate community resources for long-term care.
2)Collaborates with the patient to identify specific patient needs.
4)Collects essential information from the patient’s health record.
1)Works with the patient to develop a plan for resolving patient issues.
13. Nurses have developed theories in response to: (Select all that apply.)
1. Changes in health care.
2. Prior nursing theories.
3. Changes in nursing practice.
4. Research findings.
5. Government regulations.
6. Theories from other disciplines.
7. Physician opinions.
14. Which of the following types of theory influence the “evidence” in current “evidence-based practice (EBP)”?
1. Grand theory
2. Middle-range theory
3. Practice theory
4. Shared theory
15. A nurse is preparing to begin intravenous fluid therapy for a patient. Which category of theory would be most helpful to the nurse at this time?
1. Grand theory
2. Middle-range theory
3. Practice theory
4. Shared theory
1. A nurse is presenting a program to workers in a factory covering safety topics, including the wearing of hearing protectors when workers are in the factory. Which level of prevention is the nurse practicing?
1. Primary prevention
2. Secondary prevention
3. Tertiary prevention
4. Quaternary prevention
2. A patient had surgery for a total knee replacement a week ago and is currently participating in daily physical rehabilitation sessions at the surgeon’s office. In what level of prevention is the patient participating?
1. Primary prevention
2. Secondary prevention
3. Tertiary prevention
4. Quaternary prevention
3. Based on the transtheoretical model of change, what is the most appropriate response to a patient who states: “Me, stop smoking? I’ve been smoking since I was 16!”
1. “That’s fine. Some people who smoke live a long life.”
2. “OK. I want you to decrease the number of cigarettes you smoke by one each day, and I’ll see you in 1 month.”
3. “I understand. Can you think of the greatest reason why stopping smoking would be challenging for you?”
4. “I’d like you to attend a smoking cessation class this week and use nicotine replacement patches as directed.”
4. A patient comes to the local health clinic and states: “I’ve noticed how many people are out walking in my neighborhood. Is walking good for you?” What is the best response to help the patient through the stages of change for exercise?
1. “Walking is OK. I really think running is better.”
2. “Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?”
3. “Yes, I want you to begin walking. Walk for 30 minutes every day and start to eat more fruits and vegetables.”
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4. “They probably aren’t walking fast enough or far enough. You need to spend at least 45 minutes if you are going to do any good.”
5. A male patient has been laid off from his construction job and has many unpaid bills. He is going through a divorce from his marriage of 15 years and has been seeing his pastor to help him through this difficult time. He does not have a primary health care provider because he has never really been sick and his parents never took him to a physician when he was a child. Which external variables influence the patient’s health practices? (Select all that apply.)
1. Difficulty paying his bills
2. Seeing his pastor as a means of support
3. Age of patient (46 years)
4. Stress from the divorce and the loss of a job
5. Family practice of not routinely seeing a health care provider
6. A nurse is conducting a home visit with an older-adult couple. While in the home the nurse weighs each individual and reviews the 3-day food diary with them. She also checks their blood pressure and encourages them to increase their fluids and activity levels to help with their voiced concern about constipation. The nurse is addressing which level of need according to Maslow?
1. Physiological
2. Safety and security
3. Love and belonging
4. Self-actualization
7. When taking care of patients, a nurse routinely asks if they take any vitamins or herbal medications, encourages family members to bring in music that the patient likes to help the patient relax, and frequently prays with her patients if that is important to them. The nurse is practicing which model?
1. Holistic
2. Health belief
3. Transtheoretical
4. Health promotion
8. Using the Transtheoretical Model of Change, order the steps that a patient goes through to make a lifestyle change related to physical activity.
1. 2:The individual recognizes that he is out of shape when his daughter asks him to walk with her after school.
2. 5:Eight months after beginning walking, the individual participates with his wife in a local 5K race.
3. 1:The individual becomes angry when the physician tells him that he needs to increase his activity to lose 30 lbs.
4. 4:The individual walks 2 to 3 miles, 5 nights a week, with his wife.
5. 3: The individual visits the local running store to purchase walking shoes and obtain advice on a walking plan.
9. Which statement made by a nurse shows that the nurse is engaging in an activity to help cope with secondary traumatic stress and burnout?
1. “I don’t need time for lunch since I am not very hungry.”
2. “I am enjoying my quilting group that meets each week at my church.”
3. “I am going to drop my gym membership because I don’t have time to go.”
4. “I don’t know any of the other nurses who met today to discuss hospital-wide problems with nurse satisfaction.”
10. Which of the following are symptoms of secondary traumatic stress and burnout that commonly affect nurses? (Select all that apply.)
1. Regular participation in a book club
2. Lack of interest in exercise
3. Difficulty falling asleep
4. Lack of desire to go to work
5. Anxiety while working
11. After a class on Pender’s health promotion model, students make the following statements. Which statement does the faculty member need to clarify?
1. “The desired outcome of the model is health-promoting behavior.”
2. “Perceived self-efficacy is not related to the model.”
3. “The individual has unique characteristics and experiences that affect his or her actions.”
4. “Patients need to commit to a plan of action before they adopt a health-promoting behavior.”
12. A patient registered at the local fitness center and purchased a pair of exercise shoes. The patient is in what stage of behavioral change?
1. Precontemplation
2. Contemplation
3. Preparation
4. Action
13. As part of a faith community nursing program in her church, a nurse is developing a health promotion program on breast self-examination for the women’s group. Which statement made by one of the participants is related to the individual’s perception of susceptibility to an illness?
1. “I have a door hanging tag in my bathroom to remind me to do my breast self-examination monthly.”
2. “Since my mother had breast cancer, I know that I am at increased risk for developing breast cancer.”
3. “Since I am only 25 years of age, the risk of breast cancer for me is very low.”
4. “I participate every year in our local walk/run to raise money for breast cancer research.”
14. The nurse assesses the following risk factors for coronary artery disease (CAD) in a female patient. Which factors are classified as genetic and physiological? (Select all that apply.)
1. Sedentary lifestyle
2. Mother died from CAD at age 48
3. History of hypertension
4. Eats diet high in sodium
5. Elevated cholesterol level
15. Which activity shows a nurse engaged in primary prevention?
1. A home health care nurse visits a patient’s home to change a wound dressing.
2. A nurse is assessing risk factors of a patient in the emergency department admitted with chest pain.
3. A school health nurse provides a program to the first-year students on healthy eating.
4. A nurse schedules a patient who had a myocardial infarction for cardiac rehabilitation sessions weekly.
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