Test Bank Fundamentals of NursingTest Bank Fundamentals of Nursing (9th Edition by Craven).

Test Bank Fundamentals of Nursing (9th Edition by Craven). Chapter 01- The Profession of Nursing 1. What is the major difference between nursing students today and nursing students 50 years ago? A) B) C) D) Todays students are less caring. Todays students are more intelligent. Todays students reflect a more diverse population. Todays students are less likely to be competent nurses. Ans: C Feedback: Nursing students 50 years ago were mostly women and entered nursing school immediately after graduating from high school. Many of todays nursing students have pursued other career paths prior to nursing, are of various ethnic backgrounds, and have jobs and families to consider while attending nursing school. In addition, many more men have entered the field of nursing over the last 50 years. 2. The nurse is caring for a diabetic patient who expresses the desire to learn more about a diabetic diet in an attempt to gain better control of his blood sugar. The nurses actions will be based on which non-nursing theory? A) B) C) D) Change theory Maslows hierarchy of human needs Neumans systems model Watsons theory of caring Ans: A 1Feedback: The patient has identified a need for change, which will guide the nurses actions. Maslows hierarchy of human needs helps nurses prioritize actions. Neuman and Watson are nursing theorists. 3. The Quality and Safety Education for Nurses Initiative (QSEN) has identified which key competencies for nurses? Select all that apply. A) B) C) D) E) Ans: Patient-centered care Teamwork and collaboration Evidence-based practice Quality improvement Correct documentation A, B, C, D Feedback: The QSEN has identified patient-centered care, teamwork and collaboration, evidence- based practice, and quality improvement as a means for nurses to improve the quality and safety of patient care wherever they work. Additional key competencies identified are safety and informatics. 4. The nurse is caring for a patient who is on a ventilator. The nurse is bathing the patient and talking to them as she is carrying out care, as well as telling the patient what is going to happen next. The nurse speaks to the patient in a soothing manner. The nurse is acting in which role? (Select all that apply) A) B) Caregiver Decision-maker 2C) D) E) Ans: Communicator Educator Patient advocate A, C, D Feedback: The nurse is fulfilling the role of caregiver by providing the care and speaking to the patient in a soothing manner. The nurse is also acting as a communicator talking to the patient even if the patient cant respond. The nurse is also acting as an educator by informing the patient of the care that will be performed. The nurse is not assisting in making any decisions or speaking on behalf of the patient. 5. The nurse offers a patient two possible times to ambulate as the physician has ordered. The nurse is acting in which nursing role? A) B) C) D) Communicator Patient advocate Manager and coordinator Caregiver Ans: C Feedback: While the nurse is acting in many roles, the nurse is managing and coordinating the care for the patient by giving choices on when care will be implemented. 6. The nurse is performing an extensive dressing change on a burn patient. The nurse 3explains each step as it is being performed. The nurse is acting in which role by providing explanation of each step? A) B) C) D) Caregiver Patient advocate Decision-maker Educator Ans: D Feedback: The nurse is acting in the role of educator by explaining each step. The act of changing the dressing and providing support is the caregiver role. 7. What type of nursing program would allow a student with a 4-year degree in psychology to enter and complete a baccalaureate degree in nursing, take the NCLEX examination, and transition into a masters in nursing program? A) B) C) D) Ans: Baccalaureate program Graduate entry program Advanced degree program Continuing education program B Feedback: Graduate entry program students possess a baccalaureate degree in a field other than nursing. These students can track directly into a masters or doctorate in nursing program 4after successfully passing the NCLEX-RN. 8. A prospective nursing student desires a career that will allow him to provide patient care and to assist professional nurses with routine technical procedures. The prospective student needs to be employed in a full-time position quickly due to economic hardship. What type of nursing program would best suit this student? A) B) C) D) Associate of science registered nursing program Baccalaureate of science registered nursing program Licensed or vocational nursing program Diploma nursing program Ans: C Feedback: A licensed practical or vocational nursing program will allow the student to earn a technical certificate in 1 year and sit for the state board of nursing examination to be licensed as an LPN or LVN. An associate program will take 2 years and a baccalaureate program will take 4 years. There are very few diploma programs remaining in the US, and these programs typically take 3 years to complete. 9. Nurses that enlist their services to the military are able to do so thanks to the work of which organizer of healthcare? A) B) C) D) Linda Richards Florence Nightingale Theodor Fliedner Dorthea Dix Ans: D 5Feedback: Dorthea Dix, while not a nurse, established the Nurse Corps of the United States Army during the Civil War. Linda Richards was the first trained nurse to graduate from a nursing program. Theodor Fliedner opened the first hospital-based school of nursing, and Florence Nightingale was nursings first professional leader. 10. Due to the rising cost of healthcare services, many procedures and treatments are being delivered in what type of setting? A) B) C) D) hospital medical centers outpatient facility community healthcare center Ans: C Feedback: Many procedures and treatments are being delivered in outpatient settings since hospital and medical center stays significantly increase healthcare costs to the patient and insurance company. Community healthcare centers typically refer to facilities such as day care centers or ambulatory clinics. 11. The nurse in a rehabilitative facility makes certain the patient he is caring for is participating in group activities that are of interest to the patient. The nurse is ensuring which patient need is met? A) Love and belonging 6B) C) D) Self-actualization Safety and security Self-esteem Ans: A Feedback: The nurse is responsible for making sure the needs of the patient are met based on Maslows hierarchy of needs. Attending a group activity helps meet the needs of love and belonging (need to feel that one belongs and is loved to avoid loneliness and isolation). Self-actualization is the highest need and refers to realizing fully all of ones abilities and qualities. Safety and security refers to physical and psychological protection issues. Self- esteem indicates a feeling of self-worth. 12. The nurse is caring for a postoperative patient. The nurse administers a pain medication prescribed on a prn basis by the physician. What best describes the type of intervention the nurse is demonstrating? A) B) C) D) Ans: Physician-prescribed intervention Collaborative intervention Patient advocacy intervention Nurse-prescribed intervention B Feedback: Nurse initiated interventions, such as turning and repositioning a patient, are described as nurse-prescribed interventions. Physician-directed actions are described as physician-prescribed interventions. The administration of a prn medication requires a physician-prescribed intervention (the medication order) as well as a nurse-prescribed intervention (determining when the order should be carried out and proper 7administration of the medication); therefore, this action would be considered a collaborative intervention. Patient advocacy refers to communicating the needs and protecting the safety of the patient. 13. A nurse in the community has been asked to join an organization based on the leadership abilities she has demonstrated both in her facility of employment and community-based activities. What organization best describes this process? A) B) C) D) Ans: nurse researcher clinical nurse specialist nurse educator nurse administrator B Feedback: The clinical nurse specialist has advanced experience and expertise in a specialized area of practice such as gerontology, and would be best suited to provide education on palliative care. The nurse researcher is responsible for the continued development and refinement of nursing knowledge and practice through the investigation of nursing problems. The nurse educator generally has specific clinical specialties and advanced clinical experience in a particular area. The nurse administrator is responsible for managing patient care. 14. During the Christian era, nursing care excluded which area? A) Nutrition B) C) D) Personal counseling Comfort measures Psychiatric services 8Ans: D Feedback: During the Christian era nursing focused on many of the same areas that nursing focuses on today. Included areas of focus were nutrition, mobility, medication administration, personal counseling, hygiene, and comfort measures. 15. The nurse is caring for a postoperative patient. The physician has written orders for a pain medication. The order gives a dosage range for the amount the nurse may give depending on the severity of the patients pain. This type of functioning within the healthcare team is called: A) B) C) D) E) Ans: Authoritative functioning Independent functioning Assistive functioning Dependent functioning Collaborative functioning E Feedback: Nurses manage collaborative problems using both nurse- and physician-prescribed interventions to reduce risk of complications (Carpenito-Moyet, 2009). 16. Which of the following is an appropriately stated nursing intervention? A) Ambulate in the hall B) Stand at bedside with assistance 9C) D) Ambulate 30 ft. twice a day with assistance of walker Ambulate with assistance of walker Ans: C Feedback: Correctly stated patient outcomes are specific, measurable, and realistic. The other choices are poorly defined and do not specify when or how or by whom. 17. All members of the healthcare team are encouraged to read and contribute to the individual plans of care for their patients. Which of the following healthcare providers develops the plan of care? A) B) C) D) E) The RN The LPN or RN The physician The patient Any licensed member of the healthcare team Ans: A Feedback: To serve as evaluation criteria and meet the standards of the Joint Commission (2010), the plan must be developed by a registered nurse, it must be documented in the patients health record, and it must reflect the standards of care established by the institution 10and the profession. 18. Current trends in nursing practice include the development of A) B) C) D) Ans: Acute care centers Birthing centers Homeless shelters Ambulatory surgery centers B Feedback: Current trends in nursing practice include the development of nursing centers, wellness promotion programs, care of older adults, birthing centers, and home and community healthcare. 19. The Standards of Practice provide nurses with A) Legislation for healthcare reform B) C) D) Evaluation of care provided by nurses Measurement criteria for payment Guidelines for providing care Ans: D Feedback: 11Standards of practice are essential because they serve as guidelines for providing and evaluating nursing care. 20. A nurse receives an x-ray report on a newly admitted patient suspected of having a fractured tibia. The nurse contacts the physician to report the findings. What role is the nurse engaged in? A) B) C) D) Communicator Advocate Caregiver Researcher Ans: A Feedback: Nurses are communicators when they report findings to the healthcare team. Advocacy involves actions such as protecting the patients safety or rights. Administering care measures directly to the patient and demonstrates the caregiver role. Research involves collecting and analyzing data. 21. A nurse is caring for a young victim of a terrorist attack. During the rehabilitative process, the nurse assists the patient in bathing and dressing. The role the nurse is engaged in is A) B) C) D) Ans: Advocate Caregiver Counselor Educator B 12Feedback: As providers of care, nurses assume responsibility for helping patients promote, restore, and maintain health and wellness. Communicating the patients needs and concerns, and protecting the patient and the patients rights are components of the advocacy role of nursing. The nurse is simply assisting in hygiene measures; no education or counseling is being provided. 22. A student is choosing her educational path and desires a nursing degree that has a track that contains community nursing and leadership, as well as liberal arts. The student would best be suited in which type of program? A) B) C) D) Licensed practical nursing program Certification in a nursing specialty Diploma nursing program Baccalaureate program Ans: D Feedback: The baccalaureate degree in nursing offers students a full college or university education with a background in the liberal arts. 23. The director of nursing (DON) of a major hospital is searching to hire a nurse with a strong technical background to care for patients on a busy surgical unit. The DON is most likely going to hire a nurse prepared at which level of nursing? A) B) C) Doctoral level Masters level Baccalaureate level 13D) Associate level Ans: D Feedback: The ANAs 1965 resolution prompted the 1985 ANA statement adopting the titles of associate nurse (a nurse prepared in an associate degree program with an emphasis on technical practice) and professional nurse (a nurse possessing the baccalaureate degree in nursing) for these two levels. Masters and doctoral prepared nurses possess higher degrees and expertise. 24. A nursing student begins to speak using medical terminology. This is considered to be part of which process? A) B) C) D) Ans: Learning Socialization Role development Evolutionary B Feedback: Socialization is a process that involves learning theory and skills and internalizing an identity appropriate to a specific role. 25. Which of the following factors has most influenced how nurses practice their profession? A) B) Financial support of nursing education Professional organizations such as ANA 14C) D) National Commission on Nursing Increased incidence of chronic illness Ans: D Feedback: Professional organizations speak to nurses on various topics and may have some influence on ideas regarding nursing care, but longer lifespans, increased incidence of chronic illness, and new family structures have dramatically affected where and how nurses practice. 26. The first nursing journal owned, operated, and published by nurses was A) American Journal of Nursing B) C) D) Nurse Educator Nursing Research Standards of Clinical Nursing Practice Ans: A Feedback: The American Journal of Nursing was first published in 1900 and was owned, operated, and published by nurses. 27. Advocating for financial support for university-based schools of nursing was noted in which government document? A) The Goldmark Report 15B) C) D) Hill Burton Amendment Health Care Initiative Reform Act Lysaught Report Ans: A Feedback: The Goldmark Report in 1923 advocated for financial support for university-based schools of nursing. 28. The need for university-based nursing education programs was brought to light during which important historical time? A) B) C) D) Spanish American War World War I World War II Korean War Ans: C Feedback: Esther Lucille Brown, in her report on nursing education published at that time, wrote that nursing education belonged in colleges and universities, not in hospitals. 29. The Henry Street Settlement was founded by A) Dorothea Dix 16B) C) D) Ans: Lillian Wald Florence Nightingale Isabel Hampton Robb B Feedback: Lillian Wald and Mary Brewster established the Henry Street Settlement, which was the first public health service for the sick and poor. 30. The Nurse Corps of the United States Army was established by A) Dorothea Dix B) C) D) Lillian Wald Florence Nightingale Isabel Hampton Robb Ans: A Feedback: Dorothea Dix established the Nurse Corps of the United States Army. 31. Florence Nightingale classified sick nursing as A) Care of the dying patient 17B) C) D) Ans: Use of patients reparative processes Addressing the community problems Implementation of restorative processes B Feedback: Nightingale viewed sick nursing as helping patients use their own reparative processes to get well. 32. The purpose of nursing was shaped by which of the following eras? A) Egyptian era B) C) D) Ans: Christian era Revolutionary War era Victorian era B Feedback: Christianitys influence improved the status of nursing by attracting intelligent individuals from respected families. Chapter 02- The Nurse's Role in Healthcare Quality and Patient Safety 181. A nurse is preparing to administer a medication by using the vastus lateralis site and is unfamiliar with the process. A step-by-step reference that shows how to complete the process is called a: A) B) C) D) Ans: Deployment Flowchart Top-down Flowchart Pareto chart Control plot B Feedback: Correct: A top-down flowchart shows the sequence of steps in a job or process such as medication administration. Incorrect: a. A deployment flowchart shows the detailed steps involved in a process and the people or departments that are involved at each step in the process; this is not involved in this scenario. c. The Pareto chartis used in quality improvement to indicate that 80% of problems usually stem from 20% of causes; it displays data so that a few problems are easily depicted and facilitates improvement that focuses on those few. d. A control plotis a run chart that has a center-line and added statistical control limits; it helps reveal specific types of change within a process, rather than providing a sequencing of steps. 2. A nonprofit organization that distributes to governmental agencies, the public, business, and health care professionals knowledge related to health care for the purpose of improving health is the: A) B) C) Institute for Safe Medication Practices. Institute of Medicine. National Committee for Quality Assurance. 19D) Ans: The Joint Commission. B Feedback: Correct: The Institute of Medicine is a nonprofit organization whose mission is to advance and disseminate to the government, the corporate sector, the professions, and the public scientific information that will improve human health. Incorrect: a. The Institute for Safe Medication Practices is a nonprofit organization that is an educational resource only for the prevention of medication errors. c. The National Committee for Quality Assurance is the accrediting body for health maintenance organizations. d. The Joint Commission is a national agency that conducts surveys and certifies compliance with established standards for inpatient and ambulatory facilities. 3. A nurse is assisting with the delivery of twins. The first infant is placed on the scale to be weighed. The physician requests an instrument stat. The nurse turns to hand the instrument to the physician, and the infant falls off the scale. When evaluating the incident, the nurse and her manager list contributory factors such as the need for two nurses when multiple births are known, and the location of the scale so far from the delivery field. These nurses are performing a(n): A) B) C) D) Ans: standardization of care. root cause analysis. process variation. analysis of a deployment flowchart. B Feedback: Correct: A root cause analysis is a process by which factors that underlie variation in performance, including the occurrence or possible occurrence of a sentinel event, are identified. The purpose of root cause analysis is to identify improvements that can be 20implemented to prevent future occurrences. Incorrect: a. Standardization of care is the process of developing and adhering to best known methods and repeating key tasks in the same way, thereby creating exceptional service with maximum efficiency. c. Process variation looks at the steps in a process to determine how variation affects each step but does not identify causal events. d. A deployment flowchart analysis looks at the steps of a process and determines which department is responsible for each step, but it does not identify causal events. 4. Each month data on admission assessments that are based on the following standard are entered: “All patients will be assessed by an RN within 2 hours of admission.” The target goal for this standard is 97% compliance. Data are displayed on a graph that shows number and time of admission assessments and compliance variation limits. This pictorial representation is a: A) B) C) D) Ans: Pareto chart. control chart. deployment chart. top-down flowchart. B Feedback: Correct: The control chart is a run chart that has a center-line and added statistical control limits that help to detect specific types of change needed to improve a process. Incorrect: a. The Pareto chart is used in quality improvement to identify that 80% of problems usually stem from 20% of causes; it displays data so that a few problems are easily depicted and facilitates improvement that focuses on those few. c. A deployment flowchart shows the detailed steps involved in a process and the people or departments that are involved at each step. d. A top-down flowchart shows the sequence of steps in a job or process such as medication administration at a particular site, but it does not show variation limits. 5. Regardless of the term used to describe high-quality health care, the focus of quality is: 21A) B) C) D) what the consumer needs and wants. economical care. having the greatest technologic advancement. services equally distributed among populations. Ans: A Feedback: Correct: The customer determines quality on the basis of his or her unique perception of high-quality care. Incorrect: b. High-quality health care can be inexpensive, but if it does not meet the criteria established by the consumer, then it is not high-quality health care. c. Although technologic advancements may indeed facilitate superior diagnostics, unless the patient perceives that the technology was an indicator of quality or that it improved quality, then it is not the focus. d. The perception of quality is unique among individuals. 6. A) B) C) D) In differentiating between early efforts of quality assurance and present-day quality improvement efforts, which statement is correct? Quality assurance: had a broad focus. promoted problem-solving by all members of the health care team. was preventive in nature. tended to occur as a reaction to a specific problem. Ans: D Feedback: 22Correct: Early efforts focused on identified problems and were reactive rather than proactive. Incorrect: a. Quality assurance focused on specific incidents rather than on broad system improvements. b. With quality assurance, only a few people such as auditors focused on problems, and administration only later recognized the importance of proactive initiatives involving all members of the health care team. c. Early efforts of quality assurance focused on identified problems rather than on avoiding future problems. 7. An organization’s emergency preparedness task force meets to discuss how it should react in case of a terrorist attack and develops a disaster evacuation plan that details how each department will assist individuals in reaching safety. This type of diagram is referred to as a: A) B) C) D) Pareto chart. control chart. top-down flowchart. deployment chart. Ans: D Feedback: Correct: A deployment flowchart would show the detailed steps involved in the process and the people or departments that are to be involved at each step to assist individuals in reaching safety. Incorrect: a. The Pareto chart displays data so that a few problems that cause the greatest variance are easily depicted and facilitates improvement that focuses on those few. b. A control chart distinguishes between common and special cause variations and is basically a run chart with added statistical control limits. c. The top-down flowchart simply lists the main steps and substeps of a process in a linear fashion and does not detail the departments or people needed. 8. Patients with heart failure have extended lengths of stay and are often readmitted shortly after they have been discharged. To improve quality of care, a type of “road map” that included all elements of care for this disease and that standardized treatment by guiding daily care was implemented. This road map is referred to as a(n): 23A) B) C) D) Ans: benchmark. critical pathway. algorithm. case management. B Feedback: Correct: A critical pathway determines the best order and timing of interventions provided by health care team members for a particular diagnosis. Incorrect: a. A benchmark is a process used in quality improvement to evaluate different aspects of a process in relation to best practices, with the goal of improving performance. c. An algorithm represents a decision path that a practitioner might take for a particular condition. d. Case management is a type of health care delivery that matches the most appropriate services to the patient’s care needs in the most efficient, effective manner, often with the use of a critical pathway or a clinical guideline. 9. The staff on a nursing unit notes that patient satisfaction varies from month to month. They plot the degree of patient satisfaction each month for 1 year to determine when the periods of greatest dissatisfaction are occurring. The staff uses which type of graph? A) B) C) D) Time plot. Pareto chart. Flowchart. Cause-and-effect diagram. Ans: A 24Feedback: Correct: A run plot, or time plot, graphs data in time order to identify any changes that occur over time. Incorrect: b. A Pareto chart is used in quality improvement to display data so that a few problems that cause the greatest variance are easily depicted and facilitates improvement that focuses on those few. c. A flowchart provides pictures of the sequence of steps in a process. d. A cause-and-effect diagram lists potential causes, arranged by categories, to show their potential impact on a problem. It is not arranged by time. 10. The number of IV site infections has more than doubled on a nursing unit. The staff determine common causes include the site is cleaned using inconsistent methods, dressing frequently becomes wet when patient showers, IV tubing is not changed every 48 hours per protocol, and inadequate hand washing of RN prior to insertion. A bar graph demonstrates the frequency in descending order, with 80% of infections being attributed to inadequate hand washing. The quality tool used is a: A) B) C) D) cause-and-effect diagram. run chart. Pareto chart. flowchart. Ans: C Feedback: Correct: Pareto charts are bar graphs that show causes contributing to a problem in descending order so the leading cause is easily recognized. Incorrect: a. With the cause-and-effect diagram, all causes are listed but not in frequency of occurrence. b. Run charts show data over time. d. Flowcharts show steps in a process. Chapter 03- Values, Ethics, and Legal Issues 251. A) B) C) D) The nurse is preparing to administer a medication ordered by the surgeon in a dose much higher than is recommended. What action should the nurse take? Call the surgeon to clarify the order. Administer the medication as ordered and chart the high dose. Administer the medication and stay with the patient to observe for adverse reactions. Administer the medication in the usual dosage. Ans: A Feedback: Under current nurse practice laws, nurses are responsible for their own actions regardless of the providers written order. If an order is ambiguous or inappropriate, the nurse must clarify the medication order with the prescribing healthcare provider. If the nurse is dissatisfied with the providers response and still believes that the order is incorrect or unsafe, he or she must notify a supervisor. 2. When the nurse inserts an ordered urinary catheter into the patients urethra after the patient has refused the procedure and the patient suffers an injury, the patient may sue the nurse for which type of tort? A) B) C) D) Battery Assault Invasion of privacy Dereliction of duty Ans: A Feedback: 26Battery is the actual carrying out of such threat (unlawful touching of a persons body). A nurse may be sued for battery if he or she fails to obtain consent for a procedure. 3. A baccalaureate-prepared nurse is applying for a nurse practitioner position. The nurse is A) B) C) D) Well educated and can perform these duties Able to practice as a nurse practitioner Educated to practice only with pediatric patients Practicing beyond his scope according to licensure Ans: D Feedback: A nurse without an advanced practice license is not able to practice beyond his or her scope in accordance with the Nurse Practice Act. 4. A nurse fails to administer a medication that prevents seizures, and the patient has a seizure. The nurse is in violation of the Nurse Practice Act. What type of law is the nurse in violation of? A) B) C) D) Criminal Federal Civil Supreme Ans: C 27Feedback: Malpractice cases are generally the kind of civil cases that involve nurses. 5. A post-anesthesia nurse is reporting about the patient to the intensive care unit nurse in the elevator. There are staff members and visitors in the elevator. The nurse is A) B) C) D) Implementing therapeutic communication Interacting to maintain coordination of care Breaching the patients confidentiality Maintaining the continuity of care Ans: C Feedback: The principle of confidentiality requires that information about a patient be kept private. Discussing patients outside the clinical setting, telling friends or family about patients, or even discussing patients in the elevator with other workers violates patient confidentiality and must be avoided. 6. When the nurse informs a patients employer of his autoimmune deficiency disease, the nurse is committing the tort of A) B) C) D) Breach of contract Assault Invasion of privacy Battery 28Ans: C Feedback: Nurses have access to information recorded in the medical record, information shared or observed through care or interactions with friends and family, and through access to the patients body. A loss of privacy occurs if others inappropriately use their access to a person. 7. A nurse states to the patient that she will keep her free of pain. However, her family wishes to try a treatment to prolong her life that may necessitate withholding pain medication. This factor will cause an ethical dilemma for the nurse in relation to which ethical principle? A) B) C) D) Fidelity Veracity Justice Autonomy Ans: A Feedback: Fidelity means being faithful to ones commitments and promises. 8. An oncology patient in an outpatient chemotherapy clinic asks several questions regarding his care and treatment. The nurse explains the clinics routine, typical side effects of the chemotherapy, and ways to decrease the number of side effects experienced. What characteristic is the nurse demonstrating? A) B) Veracity Fidelity 29C) D) Justice Autonomy Ans: A Feedback: Veracity means telling the truth, which is essential to the integrity of the patientprovider relationship. 9. The foundation for decisions about resource allocation throughout a society or group is based on the ethical principle of A) B) C) D) Veracity Autonomy Justice Confidentiality Ans: C Feedback: Justice is the foundation for decisions about resource allocation throughout a society or group. 10. The patient being admitted to the oncology unit conveys his wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the patient that it would be in his best interest to obtain which document? A) A will 30B) C) D) Ans: A living will Proof of healthcare power of attorney A proxy directive B Feedback: A living will is an advance directive that specifies the type of medical treatment patients do or do not want to receive should they be unable to speak for themselves in a terminal or permanently unconscious condition. 11. A legal document that states a patients health-related wishessuch as a preference for pain management if the patient becomes terminally illand also allows the patients daughter to direct his or her care, is a(an) A) B) C) D) Will Standard of care License Advance directive Ans: D Feedback: Patients communicate their wishes to healthcare providers by verbally participating in healthcare decision making and by employing written documents called advance directives. 12. A patient is in a persistent vegetative state. The patient has no immediate family and is a ward of the state. Under these circumstances, who will speak on her behalf? 31A) B) C) D) Surrogate decision maker Church-appointed guardian A significant other Her best friend Ans: A Feedback: Infants, young children, people who are severely mentally handicapped or incapacitated, and people in a persistent vegetative state or coma do not have the capacity to participate in decision making about their healthcare. For such people, a surrogate decision maker must be identified to act on their behalf. 13. An 83-year-old woman who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. This is an example of what ethical principle? A) B) C) D) Nonmaleficence Veracity Autonomy Justice Ans: C Feedback: Autonomy essentially means independence and the ability to be self-directed. 3214. An emergency department nurse and healthcare team, caring for a 2-year-old, semiconscious child with numerous fractures and evidence of cigarette burns, suspect child abuse. The nurse reports the family to the child abuse hotline. The nurse is following which ethical principle? A) B) C) D) Ans: Beneficence Nonmaleficence Justice Fidelity B Feedback: The principle of nonmaleficence means to avoid doing harm, to remove harm, and to prevent harm. 15. A home care nurse visits a patient who is confined to bed and is cared for by her daughter. The daughter is known to suffer from chemical dependence. The home is cluttered and unclean. During the assessment the nurse notes that the patient is wet with urine and has dried feces on her buttocks, and demonstrates signs of dehydration. After caring for the patient, the nurse contacts the physician and reports the incident to Adult Protective Services. This is an example of which ethical framework? A) B) C) D) Justice Beneficence Nonmaleficence Fidelity Ans: C 33Feedback: The principle of nonmaleficence means to avoid doing harm, to remove harm, and to prevent harm. Beneficence means doing or promoting good. Nurses work to accomplish good for patients by promoting their best interests and striving to achieve optimal outcomes. The patients circumstances indicate harm. 16. A nurse is caring for a 28-year-old woman who has delivered a baby by cesarean section. She describes her pain as a 9. The nurse medicates her for pain. This is an example of which of the following ethical frameworks? A) B) C) D) Justice Fidelity Beneficence Nonmaleficence Ans: C Feedback: Beneficence means doing or promoting good. The treatment of the patients pain is the nurses act of doing good. 17. The American Nurses Associations Code of Ethics for Nurses A) B) C) D) Serves to establish personal ethics for nurses Delineates nurses conduct and responsibilities Serves as a guideline for all healthcare Plays an important role in legal proceedings 34Ans: B Feedback: The ANA recently revised the Code of Ethics for Nurses that delineates the conduct and responsibilities expected of all nurses in their nursing practices. 18. A nurse is caring for a patient who is a practicing Jehovahs Witness. The physician orders 2 units of packed cells based on his low hemoglobin and hematocrit levels. The nurse states to the surgeon that it is unethical to go against the patients beliefs even though his blood counts are very low. What is the best description of the nurses intentions? A) B) C) D) Acting in the patients best interest Siding with the patient over the surgeon Observing institutional policies Being legally responsible Ans: A Feedback: Nurses ethical obligations include acting in the best interest of their patients not only as individual practitioners but also as members of the nursing profession, the healthcare team, and the community at large. 19. To practice ethically, the nurse should A) Allow a committee to guide her practice B) C) Review past cases before guiding practice Avoid allowing her judgment to guide practice 35D) Ask the family their views on caring Ans: C Feedback: Personal convictions apply only to situations and decisions pertaining to the individual. In ethical practice, nurses avoid allowing personal judgments to bias their treatment of patients. 20. A hospital owned by a Catholic order of nuns will not allow tubal ligations to be performed. This is considered to be A) B) C) D) Personal morality Personal values Institutional policy Legal obligation Ans: C Feedback: Institutional policies are guidelines developed by healthcare institutions to direct professional practice. 21. A nurse is of the Catholic faith and votes pro-life. He is considered to have A) Personal morality B) C) Personal values Ethics 36D) Ans: Legal obligations B Feedback: Personal values are ideas or beliefs a person considers important and feels strongly about. 22. A nurse believes that abortion is an acceptable option if a pregnancy results from a situation of rape. What is the best description of this belief? A) B) C) D) Personal morality Professional values Ethics Legal obligations Ans: A Feedback: Personal morality is the set of beliefs about the standards of right and wrong that helps a person determine the correct or permissible action in a given situation. 23. Ethics is best defined as A) B) Basis for moral reasoning Standards of conduct 37C) D) Ans: Dealing with conflict Decision making B Feedback: Ethics is the branch of philosophy dealing with standards of conduct and moral judgment. 24. A child on a pediatric unit hits one of the other children and subsequently has video game privileges revoked for the rest of the day. The next day the same child plays with the other children without any problems in order to avoid losing video game privileges again. According to Kohlberg, the child is demonstrating what stage of development? A) B) C) D) Trust versus mistrust Moralizing First-level preconventional stage Self-actualization Ans: C Feedback: As children progress to toddlerhood, morals and values development begins as they identify behaviors that elicit reward or punishment. Kohlberg refers to this process as the first-level preconventional stage when children learn to distinguish right from wrong and understand the choice between obedience and punishment. 25. During adolescence, values are primarily formed from A) Schools 38B) C) D) Work Parents Peers Ans: D Feedback: In adolescence, peer groups are the primary source of value formation. The attitudes, beliefs, and behaviors that grow out of peer group relationships are powerful. 26. How are values converted from knowledge into messages which can then be processed as information? A) B) C) D) Religion Nature Time Activity Ans: A Feedback: Values are codified in social institutions such as family, school, and religion. Values can then be adopted, adapted, or dismissed based on the persons life experiences and social system. 27. The purpose of a values inquiry discussion with a group of nursing students is to A) Examine past decisions 39B) C) D) Ans: Examine social issues Alter the groups views Improve the groups image B Feedback: Values inquiry is a method of examining social issues and the values that motivate human choices. 28. The differences between the pro-life and abortion rights movement is an example of A) Values inquiry B) C) D) Social activism Ethical inconsistency Values clarification Ans: A Feedback: Values inquiry is a method of examining social issues and the values that motivate human choices. 29. A dying patient tells the nurse that he doesnt want to see his family because he doesnt want to cause them more sadness. Which action by the nurse is most appropriate? 40A) B) C) D) Ans: Arrange a meeting between the family and the patient Help the patient clarify his values Educate the patient on death and dying concepts Allow the patient time for quiet reflection B Feedback: Values clarification is a method of self-discovery by which people identify their personal values and value rankings. The patients value of family may be obscured because of his overwhelming need to protect his family. 30. A hospice nurse is caring for a patient with terminal cancer. The family would like the patient to continue aggressive therapy to treat the cancer, but the patient has voiced to the nurse that, after much thought, he does not want to pursue any further treatment. The nurse speaks to the family about the patients wishes, condition, and terminal state. This action is most likely derived from which nursing obligation? A) B) C) D) Legal responsibilities Nursing education principles Advanced practice licensure guidelines Moral values Ans: D Feedback: Moral values involve correct behavior, such as having some sense of right and wrong. Moral values help direct nurses to deal with human interactions that involve the integrity of life or health. 4131. A nursing students attitude is defined as: A) Belief in ones self B) Desire to do good C) D) Disposition toward situations Choosing between alternatives Ans: C Feedback: An attitude is ones disposition toward an object or a situation; it can be a mental or emotional mindset, and it can be positive or negative. 32. Socialization into the nursing profession may have the most significant effect on A) Roles B) C) D) Ans: Values Documentation Planning B 42Feedback: Values that the nurse will need to balance include truth, harmony, duty, and responsibility. 33. What are standards for decision making that endure for a significant time in ones life? A) Beliefs B) C) D) Ethics Roles Values Ans: D Feedback: Values are standards for decision making that endure for a significant time in ones life. Chapter 04- Nursing Research and Evidence-Based Care 1. In the development of a literature review, the most effective source of information for nursing research is which of the following? New England Journal of Medicine A) Cumulative Index of Nursing and Allied Health Literature B) Journal of Nursing Research C) American Journal of Nursing D) 43Ans: B Feedback: Indexes such as the Cumulative Index to Nursing and Allied Health Literature, International Nursing Index, Index Medicus, Nursing Studies Index, MedLine, and Nursing Research Index are valuable in locating nursing-based literature and research studies. 2. When did evidenced-based practice become an important component of the delivery of nursing care? A) B) C) D) The early 1800s The early 1900s The late 1900s The early 2000s Ans: D Feedback: In the early years of the 21st century, a heightened focus on evidence-based practice has developed, which relies on research findings to support nursing practice. 3. Why is it important for the findings of a research study to be disseminated? Select all that apply. A) B) C) So that clinical application can occur To allow the nurse researcher to receive notoriety for the findings In order for research replication by other nurses to take place 44D) E) Ans: Because graduate-level nurses must conduct a specific number of research studies to maintain nursing licensure To strengthen and validate conclusions by similar findings in more than one research study A, C, E Feedback: The study and its findings must be dispersed in order to validate the findings through clinical practice and through replication of the study; hopefully, with similar findings. There is not a specified number of studies required for graduate-level nurses to conduct, and the nurse researcher should never conduct a study for the purpose of being recognized. 4. The nurse researcher is aware that the type of variable that can be manipulated in a study is which type of variable? A) B) C) D) Ans: Dependent Independent Quantitative Qualitative B Feedback: The independent variable is presumed to have an effect on the dependent variable. It may be manipulated if the researcher is doing an experimental study; in a non- experimental study, it is assumed to have occurred naturally before or during the study. 5. The director of nurses (DON) in a long-term care facility has noticed an increased number of urinary tract infections (UTIs) on the east wing of the facility, and would like the infection control nurse to investigate this problem. What is the best problem 45statement for this study? A) B) C) D) Is there a relationship between the personnel caring for specific patients and whether or not these patients developed UTIs? Is there an increase in the number of UTIs on the east wing of the facility? Does the east wing have a greater number of UTIs than the west wing of the facility? What is the patient census on the east wing as opposed to the other wings of the facility? Ans: A Feedback: The problem statement in a research study identifies the direction that a research project will take. The statement should be clear and unambiguous, express a relationship between two or more variables, identify the population to be studied, and encourage empiric testing. 6. A nursing researcher presents the findings of his current study at a School of Nursings research conference. While there, he speaks with another nurse researcher interested in similar topics and the two decide to discuss forming a partnership for further research projects. What is this type of interaction an example of? A) B) C) D) Hypothesizing Identifying variables Investigating foreground questions Networking Ans: D Feedback: 46Networking is a way to meet other nurses with similar interests and is a good way to disseminate and to expand ones knowledge, as well as to meet with other professional nurses. 7. What type of research study would a hospital conduct to determine additional services the community would like to see offered by the facility? A) B) C) D) Ans: Quantitative Qualitative Ordinal Interval B Feedback: Quantitative researchers tend to use deductive reasoning, logic, and measurable attributes of human experience, whereas qualitative researchers tend to use dynamic, individual aspects of the human experience in a holistic approach. Ordinal and interval refers to types of variables. 8. What are the four properties identified by Diers that comprise the holistic perspective of nursing research? A) B) C) The focus of nursing research must be on a variance that makes a difference in improving patient care. Nursing research has the potential for contributing to the development of theory and the body of scientific nursing knowledge. A research problem is a nursing research problem when nurses have access to and control over the phenomena being studied. 47D) E) Ans: A nurse interested in research must have an inquisitive, curious, and questioning mind. A nurse interested in research must be a graduate-level nurse to be able to adequately perform nursing research. A, B, C, D Feedback: Nursing is concerned with the whole person, which describes holistic nursing. When nurses conduct research, they tend to focus on the physiologic, psychological, sociologic, cultural, and economic factors that affect a person. They view the situation from a nursing perspective and ask questions about what they see. 9. When the nurse researcher informs the participant that his or her identity will not be linked with the information that is collected, the researcher is ensuring the participants A) B) C) D) Anonymity Protection from harm Ability to withdraw Confidentiality Ans: D Feedback: Confidentiality ensures that the subjects identities will not be linked with the information they provide and will not be publicly divulged. 10. The role of the institutional review boards for research studies is to A) Determine the worthiness of a research study 48