Fundamentals Unit 1 Test Bank

Fundamentals Unit 1 Test Bank Which organization is preparing future nurses to have the knowledge, skills, and attitudes (KSAs) of evidence-based practices necessary to continuously improve the quality and safety of the health care systems within which they work? a. The Joint Commission b. Quality and Safety Education for Nurses (QSEN) c. The National Database of Nursing Quality Improvement (NDNQI) d. The Agency for Health care Research and Quality (AHRQ) - ANS Quality and Safety Education for Nurses (QSEN) A registered nurse questioned the nurses on the neonatal intensive care unit about the practice of kangaroo care for neonates. The nurse had read literature supporting the practice, but the nurses that work on the neonatal unit stated that they had never done anything like that at their institution. The nurse continued to ask questions and began a literature review. Which behavior was the nurse demonstrating? a. Variables b. Peer review c. Evidence-based practice d. Process measurement - ANS Evidence-based practice A registered nurse wants to review the latest information regarding prevention of a health care acquired infection. Where is the best place for the nurse to obtain this information? a. Online information b. Peer-reviewed nursing journal c. Latest edition of a nursing textbook d. Most recent edition of a popular magazine - ANS Latest edition of a nursing textbook A 15-year-old patient was admitted to the hospital with a bowel obstruction. The patient underwent surgery and was experiencing postoperative pain. The nurse caring for the patient had recently read a research article in which a study had been done with neonatal (infant) patients and the use of therapeutic touch to assist with pain control. Which factor is most important for the nurse to consider in this case when applying research to clinical practice? a. The patients gender b. The patients preference c. The patients allergies d. The patients roommate - ANS The patients preference A nurse is using evidence-based practice (EBP) to provide care. Which action should the nurse take first? a. Collect the most relevant and best evidence. b. Integrate evidence with ones clinical expertise. c. Critically appraise the evidence gathered. d. Ask a clinical question. - ANS Ask a clinical question. The nurse manager of a 30-bed medical surgical unit has noticed that the fall rate of postoperative patients has increased in the past 2 months. The nurse manager wants to address this situation using evidence-based practice. Which type of trigger did the nurse manager use? a. Literature-focused trigger b. Problem-focused trigger c. Knowledge-focused trigger d. Expectations-focused trigger - ANS Problem-focused trigger A registered nurse who works for a surgical intensive care unit (ICU) has recently read several articles in professional nursing journals about the use of quiet time in the ICU to enhance patient outcomes. The nurse would like to apply the research findings to the unit. How did the nurse formulate the clinical question? a. Measurement-focused trigger b. Problem-focused trigger c. Knowledge-focused trigger d. Expectations-focused trigger - ANS Knowledge-focused trigger A nurses manager has suggested that a nurse formulate a PICO question to clarify the topic before doing a literature review. When the nurse asks what the acronym PICO stands for, how should the nurse manager respond? a. Policy, information, comparison, outcome b. Patient, information, collection, outcome c. Patient, intervention, comparison, outcome d. Policy, intervention, communication, outcome - ANS Patient, intervention, comparison, outcome A nurse working on a PICO question has found a large amount of literature available on the topic with multiple studies that have been published. Which type of study should have the best evidence? a. Meta-analysis of randomized control trials b. Opinion of an expert committee c. One well-designed randomized control trial d. Systematic review of descriptive and qualitative studies - ANS Meta-analysis of randomized control trials .A registered nurse is concerned about the patients perceptions and feelings about the quality of life that they experience after a diagnosis of liver cancer. Which is the most appropriate type of research study the nurse should use to gather information about this situation? a. Quantitative study b. Randomized trial c. Qualitative study d. Case controlled study - ANS Qualitative study A nurse works for a facility in which the facility sends information to The National Data Base for Nursing Quality Improvement (NDNQI) regarding patient falls, pressure ulcer incidence, and nursing satisfaction. The nurse works at which facility? a. The Joint Commission b. A magnet-designated hospital c. The Centers for Disease Control and Prevention d. The American Association of Critical Care Nurses - ANS A magnet-designated hospital A student nurse is looking for research articles that can be used to complete a research paper. Where can the nursing student look to quickly find out if an article is research or clinically based? a. p value b. Abstract c. Analysis d. Literature review - ANS Abstract A nurse working in an acute care setting wanted to determine the most accurate way to take patients temperatures. The nurse noticed that the tympanic thermometers used by the unit were often not accurate. The nurse found that the literature showed tympanic thermometers were not the most accurate method of obtaining a temperature. The nurse wants to change the nursing practice of the unit. What is the nurses most logical next step? a. Discuss the findings with a patient to gain support. b. Tell the aides to stop taking temperatures. c. Share the findings with the nursing policy and procedure committee. d. Write an editorial in the public newspaper to bring the community into the process. - ANS Share the findings with the nursing policy and procedure committee. .After a practice change has taken place in an organization because of a nurse following evidence-based practice in a task force, which final step should the nurse take? a. Evaluate b. Encourage c. Engage d. Execute - ANS Evaluate .The nursing unit staff has used evidence-based practice to implement a practice change. What is the next step in the process the nursing staff should implement? a. Review literature. b. Engage companies. c. Measure outcomes. d. Ask a clinical question. - ANS Measure outcomes. At a health care organization, patients are turned every 2 hours to help prevent pressure ulcers. Because of this nursing intervention, patients exhibit far fewer pressure ulcers than the national average. Which term should the nurse use to describe this finding? a. Sentinel event b. Qualitative research c. Manuscript narrative d. Nursing-sensitive outcome - ANS Nursing-sensitive outcome The quality improvement or performance improvement (QI/PI) process should begin at which level of nursing? a. Staff nurse b. Nurse manager c. Nurse administrator d. Advanced practice registered nurse - ANS Staff nurse The nurse is investigating an area of practice in which no research evidence is available. What types of non-research information should the nurse consider? (Select all that apply.) a. Performance improvement and risk management data b. International, national and local standards of care c. Study with pre- and post-test design d. Benchmarking e. Retrospective or concurrent chart reviews - ANS Performance improvement and risk management data International, national and local standards of care Benchmarking Retrospective or concurrent chart reviews A nurse is describing types of performance improvement models. Which information should the nurse include? (Select all that apply.) a. Six Sigma b. Balanced scorecard c. Plan-Do-Study-Act d. Root cause analysis e. Human subjects committee - ANS Six Sigma Balanced scorecard Plan-Do-Study-Act Root cause analysis A registered nurse is caring for a patient in the trauma unit who had been involved in a motor vehicle accident. Although the patient denied pain, during the nurses assessment, the nurse observed that the patient groaned when moving and was protective of the right arm. The nurse believed the patient had pain and reported it to the primary health care provider, who ordered a radiograph (x-ray) of the right arm. The radiograph revealed a fractured arm. Which technique did the nurse use? a. Intuition b. Critical thinking c. Perseverance d. Reflection - ANS Critical thinking A registered nurse is caring for a postoperative patient whose systolic blood pressure has dropped 10 points during the shift. The nurse remembers that this was similar to a situation that happened in the past when a patient developed an internal bleed. Based upon the nurses thoughts, which skill did the nurse use? a. Intuition b. Critical thinking c. Nursing process d. Reflection - ANS Reflection A nurse is admitting a 73-year-old woman with a fractured ulna and radius to the trauma unit of the hospital. The patients daughter and son-in-law are present. The nurse notices that the patient does not make eye contact when answering questions and the nurse senses that something is not right about the situation. Which technique did the nurse use? a. Intuition b. Critical thinking c. Nursing process d. Reflection - ANS Intuition A student nurse is administering an enema with an instructor in the room. The patient states that he or she can no longer hold the enema solution. The student nurse acknowledges the patients request and begins to tell the patient to go to the bathroom but asks the instructor if this is OK. The instructor suggests that the patient wait a few minutes to give the enema solution time to be absorbed into the bowel. In this situation the student nurse demonstrates what level of critical thinking according to Kataoka-Yahiro and Saylors model? a. Level 1: Basic b. Level 2: Complex c. Level 3: Commitment d. Level 4: Expert - ANS Level 1: Basic .A nurse is describing risk taking, creativity, and integrity in nursing care. What is the nurse explaining? a. Attitudes of critical thinking b. Competencies of critical thinking c. Standards for critical thinking d. Nursing process for critical thinking - ANS Attitudes of critical thinking A nurse is using the scientific method to solve a patient situation. Which action should the nurse take first? a. Collect data. b. Identify a problem. c. Formulate a question. d. Evaluate the results. - ANS Identify a problem. A registered nurse is explaining a procedure to a patient who speaks another language. Which action by the nurse reflects critical thinking? a. Teach with unfamiliar explanations. b. Explain using medical jargon. c. Use vague descriptions. d. Obtain an interpreter. - ANS Obtain an interpreter. A patient receiving blood after an abdominal surgery notified the nurse that the IV pump was alarming. The nurse checked the pump and determined that the tubing was kinked. The tubing was straightened out and the nurse left the room. Five minutes later the IV pump again alarmed. The nurse returned to find the tubing was again kinked. On further investigation, the nurse discovered that the IV tubing had become twisted. This is an example of which behavior on the part of the nurse? a. Effective problem solving b. Diagnostic reasoning c. Scientific method d. Commitment level of critical thinking - ANS Effective problem solving .A patient on a pediatric unit who underwent an appendectomy for a ruptured appendix 3 days ago complains of acute pain and has a high fever. The nurse is concerned that the patient may have an infection and notifies the primary health care provider of the change in the patients condition. This concern is based on the nurses experience as a pediatric nurse. The nurses ability to make a tentative conclusion regarding this patients situation based on observed data is known as what? a. Scientific method b. Clinical inference c. Effective problem solving d. Data collection - ANS Clinical inference A patient with cancer is undergoing outpatient chemotherapy. The clinic nurse notes that the patients white blood cell count is very low and has little energy. The plan of care is based upon the nursing diagnosis Risk for Infection. The nurse provides patient teaching in order to reduce the risk for infection. The nurse is using which skill in this situation? a. Medical diagnosis b. Scientific method c. Diagnostic reasoning d. Data collection - ANS Diagnostic reasoning .A nurse is caring for an elderly lady who recently experienced a stroke and who coughs/chokes after eating or drinking. The nurse knew that the patient was at risk for aspiration because of the stroke and was concerned that the patient may have impaired swallowing. The nurse develops a care plan based on the nursing diagnosis Impaired Swallowing. Which skill is the nurse using to make this nursing diagnosis? a. Medical diagnosis b. Scientific method c. Diagnostic reasoning d. Data collection - ANS Diagnostic reasoning Which situation represents a nurse using clinical decision-making skills? a. Collecting information about a patient and coming to a conclusion about his or her health problems b. Developing a new idea based on experience and knowledge over time c. Selecting appropriate treatment after forming diagnostic conclusions d. Clarifying the problem and analyzing possible causes - ANS Selecting appropriate treatment after forming diagnostic conclusions A new registered nurse working for a busy unit of an acute care teaching hospital begins the shift with four patients. Which patient should the nurse attend to first? a. Patient who needs assistance in ambulating the hall b. Patient whose blood pressure suddenly drops and who passes out (faints) c. Recovering stable surgical patient whose family has just arrived d. Recovering patient who is resting quietly watching television - ANS Patient whose blood pressure suddenly drops and who passes out (faints) .A nurse is teaching a group of nursing students about the nursing process. In which order should the nurse list the steps? a. Assessment, diagnosis, planning, implementation, and evaluation b. Diagnosis, assessment, planning, implementation, and evaluation c. Planning, evaluation, diagnosis, implementation, and assessment d. Evaluation, diagnosis, planning, implementation, and assessment - ANS Assessment, diagnosis, planning, implementation, and evaluation .Upon checking a medication order, the nurse notices that the dosage is more than three times the normal range for this medication. The nurse calls the primary health care provider to question the order. Which critical thinking attitude did the nurse use? a. Confidence b. Risk taking c. Fairness d. Curiosity - ANS Risk taking A nurse is caring for a patient who underwent an above-the-knee amputation that requires a dressing change, a skill the nurse has never done. The nurse asks another nurse to help with the dressing change for the amputated leg. The nurse is demonstrating which critical thinking attitude? a. Humility b. Confidence c. Risk-taking d. Fairness - ANS Humility A student nurse in the last semester of nursing school found that keeping a journal of clinical experiences helped the student nurse understand why certain actions were taken and to evaluate whether there was a better way of approaching the task. The student nurse has found that this has helped strengthen critical thinking skills. Which skill for developing critical thinking did the student nurse use? a. Professional standards b. Nursing process c. Concept mapping d. Purposeful reflection - ANS Purposeful reflection A new nurse who has just begun working for an oncology unit is frustrated with trying to figure out the relationships between a patients problems and appropriate nursing interventions. What is the best tool that the nurse can use to synthesize data into meaningful information? a. Concept map b. Reflective journal c. Plan of care d. Intellectual standards - ANS Concept map A nurse walks into a room and finds a patient to be severely confused. The nurse examines and observes the patient closely and thinks about other situations with severely confused patients before making a nursing diagnosis. Which skill is the nurse using? a. Clinical inferences b. Reflective journaling c. Accountability d. Intuition - ANS Clinical inferences A nurse is using scientific knowledge and experience to choose strategies to use in the care of a patient. Which critical thinking skill is the nurse using? a. Analysis b. Evaluation c. Explanation d. Self-regulation - ANS Explanation A nurse is alert to potentially problematic situations in a patient and is using evidence-based knowledge. Which concept for a critical thinker is the nurse using? a. Maturity b. Analyticity c. Systematicity d. Inquisitiveness - ANS Analyticity 22.A surgical unit uses Betadine to prep the skin before surgery. A nurse is using the scientific method to decide if soap and water is better than Betadine for preparing the skin for surgery. A nurse washes one group of patients with soap and water and washes another group of patients with Betadine. Which step did the nurse implement? a. Identifying the problem b. Forming the question or hypothesis c. Answering the question or hypothesis d. Evaluating the results of the test or study - ANS Answering the question or hypothesis Which patient situation indicates the nurse used fairness? a. The nurse used original thinking to find solutions outside the standard routine. b. The nurse asked why the interventions were used to help the patient. c. The nurse did not allow personal attitudes to influence delivery of care. d. The nurse followed the six rights when giving medication to a patient. - ANS The nurse did not allow personal attitudes to influence delivery of care. Which information indicates the nurse has a correct understanding of critical thinking? a. It is a continuous process characterized by open-mindedness. b. It is the same thing as the nursing process. c. It is a haphazard method of providing nursing care. d. It is moving from writing a plan of care to thinking. - ANS It is a continuous process characterized by open-mindedness. While a nurse is assessing a patients chest pain, the patient states, The pain hurts in the middle of my chest. The nurse asks, Can you tell me where the pain is exactly and describe what it feels like? Which attitude for critical thinking is the nurse using? a. Integrity b. Discipline c. Planning d. Nursing diagnosis - ANS Discipline A nurse is teaching the staff about the major elements in the critical thinking model. Which information should the nurse include in the teaching session? (Select all that apply.) a. Intricate b. Attitudes c. Standards d. Experience e. Competence - ANS b. Attitudes c. Standards d. Experience e. Competence A nurse works at a health care organization that is accredited by The Joint Commission. What is the best method for this health care organization to demonstrate that it is providing quality patient care? a. Cost of care per patient day b. Number of registered nurses c. Absence of sentinel events d. Documentation audits - ANS Documentation audits A registered nurse is caring for an older adult patient with lung cancer. The daughter, who is also a nurse, asks to see the chart. What is the nurses best response? a. Come with me and we will look at it together. b. Im sorry; this information is confidential. c. Let me ask my supervisor if it is okay. d. You should know better than to ask me that. - ANS Im sorry; this information is confidential. A nursing student is working on a clinical assignment. Which information is acceptable for the student to write on the clinical care plan that will be given to the instructor? a. Patient room number b. Patient date of birth c. Patient medical record number d. Patient nursing diagnosis - ANS Patient nursing diagnosis A nurse is working in an agency with standards that require a nurses documentation to be within the context of the nursing process. The nurse is working for which agency? a. Centers for Disease Control and Prevention accredited hospital b. World Health Organization hospital c. The Joint Commission accredited hospital d. Agency for Healthcare Research and Quality hospital - ANS The Joint Commission accredited hospital Which information indicates the nurse has a correct understanding of the purpose of a patients medical record? a. To invoice the nurse for reimbursement b. To protect the patient in case of a malpractice suit c. To ensure everyone is working toward a common goal of providing safe care d. To contribute to a worldwide databank for trends in health care - ANS To ensure everyone is working toward a common goal of providing safe care A nurse is frustrated about the lack of staffing for the shift. When one of the patients fell and broke a hip, the nurse documented the incident in the patients chart. Which entry is the best way that the nurse should document what happened? a. Patient stated that fell while going to the bathroom. Physician notified. b. Nobody available to answer call bell; patient got up on own and fell. c. Patient fell because of unsafe staffing levels on unit. d. Patient waited as long as possible but nobody there to help and fell. - ANS Patient stated that fell while going to the bathroom. Physician notified. A registered nurse is documenting patient assessments. Which documentation written by the nurse is most clear? a. Seems comfortable at this time. b. Is asleep, appears not to be experiencing pain. c. Apparently is not in pain because patient didnt rate it high on the scale. d. States pain is a 2 on a 0 to 10 scale. - ANS States pain is a 2 on a 0 to 10 scale. A patient states that he or she is experiencing pain in the lower back. What is the best way for the nurse to document this subjective information? a. Seems back is hurting. b. States My lower back hurts. c. Grimaces when moving; I believe patient has lower back pain. d. Appears to be uncomfortable with lower back pain. - ANS States My lower back hurts. .Which documentation by the nurse best describes patient data? a. Moderate amount of clear yellow urine voided. b. Voided 220 mL clear yellow urine. c. A small amount of urine voided into absorbent pad. d. Patient incontinent of urine. - ANS Voided 220 mL clear yellow urine. .Which entry by the nurse demonstrates the most accurate and safe documentation of patient care? a. Sm. amt. of emesis. b. 150 mL of cloudy dark yellow urine. c. Had a good day. d. Looks bad. - ANS 150 mL of cloudy dark yellow urine. Which documentation by the nurse is most appropriate? a. The patient states would except moving to a semi-private room. b. Developed aspiration pneumonia due to dysphasia. c. Bruise noted on right side over fractured abdimin. d. Right jugular vein distended. - ANS Right jugular vein distended. .A nurse is documenting the last entry for the day. It is 3:15 PM and the agency uses military time. Which time should the nurse enter? a. 315 b. 0315 c. 1315 d. 1515 - ANS 1515 Which information by a nurse indicates more teaching is needed about The Joint Commissions requirements for writing plans of care? a. A care plan must be developed for patients in a clinic. b. A care plan must be developed for patients in an acute care hospital. c. A care plan must be developed for patients in a rehabilitation agency. d. A care plan must be developed for patients in an extended care facility. - ANS A care plan must be developed for patients in a clinic. .A registered nurse recently went to work for a health care organization that uses the SOAP format for documentation. The nurse charts the following: Discuss alternatives for pain control. Which component of SOAP did the nurse chart? - ANS Discuss alternatives for pain control is a Plan .A nurse is told during orientation that the organization is very patient focused and that it uses a documentation system with the acronym PIE. What will the nurse be charting? a. Problem, intervention, evaluation b. Patient, interview, evaluation c. Population, intervention, encourage d. Plan, interview, enhance - ANS Problem, intervention, evaluation A new registered nurse is working on a pediatric unit in a large teaching hospital that uses focus charting with the acronym DAR. What will the nurse be charting? a. Data, assessment, reaction b. Data, assessment, recommendation c. Data, actions, response d. Data, actions, recovery - ANS Data, actions, response A registered nurse recently changed jobs and is now working in home health. What must the nurse chart to obtain reimbursement from Medicare, Medicaid, and private insurance companies? a. Patients response to care b. Whether patient had a good or bad day c. Whether family liked nurse or not d. Patients number of marriages - ANS Patients response to care The nurse manager of a large medical unit in a busy urban teaching hospital reviews the unit trends for staffing, which are determined by an acuity system. The nurse manager notices that the acuity level is high. What should the nurse manager do? a. More staff may be needed. b. Talk to the patients. c. Less staff may be needed. d. Talk to the families. - ANS More staff may be needed. A nurse began working at a local hospital and learned that the hospital had just instituted a hand-off protocol. What will the nurse be doing? a. Performing transfer reports b. Completing IV fluid flow sheets c. Using standardized care plans d. Reviewing laboratory reports - ANS Performing transfer reports A nurse is using SBAR and tells the primary health care provider that the abdomen is distended and firm with a pain rating of 8 on a 0-10 scale. Which component of SBAR did the nurse communicate? - ANS A - Assessment A nurse records the following at 1800: patient states that the abdominal pain is worse now than last nightBetty Smith, RN. The nurse is using which type of charting? a. PIE documentation b. SOAP documentation c. Narrative charting d. Charting by exception - ANS Narrative charting A nurse completes an incident/occurrence report on a patient who fell while walking in the hallway. The nurse completes this report for what purpose? a. To exchange information among health care members b. To provide information about patients on one unit to another c. To prevent a legal lawsuit from the patient d. To aid in the hospitals quality improvement program - ANS To aid in the hospitals quality improvement program After a nurse receives a medication telephone order for a patient, what is the proper action? a. Withholding the medication until the physician or health care provider signs the order b. Verifying the physicians or health care providers order with the pharmacy c. Reading it back to the person who gave the order d. Clarifying the new medication order with another registered nurse - ANS Reading it back to the person who gave the order A nurse is giving a change-of-shift report. Which action should the nurse take? a. Exchange judgments made about the patients attitudes. b. Include a description of how to perform procedures. c. Provide a concise and organized description of the patients normal findings. d. Make walking rounds with the nurse coming on duty to review the patients status and needs. - ANS Make walking rounds with the nurse coming on duty to review the patients status and needs. A nurse is using critical pathways to care for a patient. Which area will the nurse address according to the pathway? a. Activity b. Nursing diagnosis c. Times to chart d. Admission form - ANS Activity A nurse is preparing a discharge summary. Which item should the nurse include? a. Provision for follow-up care b. Patient status at admission c. Standardized nursing care plan d. Detailed description of nursing procedures - ANS Provision for follow-up care .A nurse is teaching the staff about informatics and describing the key concepts. Which information should the nurse include during the teaching session? a. Wisdom b. Charting c. Assessment d. Evaluation - ANS Wisdom A nurse is using a computer to locate and review laboratory test results, and chart and order sterile supplies. What type of system is the nurse using? a. Clinical information system b. Computerized provider order entry system c. Administrative information system d. Clinical decision support system - ANS Clinical information system Which action should the nurse take when handling and disposing of patient information? a. Keep patient information to take home for disposal. b. Use programmed speed-dial keys when faxing. c. Throw hand-written notes about the patient in the trash. d. Place fax machines in a public place. - ANS Use programmed speed-dial keys when faxing. Which information by the staff indicates teaching by the nurse was successful for the purposes of documentation? (Select all that apply.) a. To aid in clinical research b. To maintain a legal and financial record of care c. To include a step-by-step description of how to perform procedures d. To evaluate quality process and performance improvement e. To communicate patient needs and progress toward meeting outcomes - ANS To aid in clinical research To maintain a legal and financial record of care To evaluate quality process and performance improvement To communicate patient needs and progress toward meeting outcomes .Which benchmarks will indicate to the nurse that the agency has computerized information systems that demonstrate meaningful use? (Select all that apply.) a. Improves quality and safety b. Improves patient compliance c. Improves care coordination d. Improves public health e. Improves hospitals reputation - ANS Improves quality and safety Improves care coordination Improves public health Which guidelines must the nurse follow to appropriately manage electronic patient information? (Select all that apply.) a. Never share passwords with co-workers. b. Only the supervisor should have the nurses password and it should be stored in a protected place. c. Leave the computer terminal unattended when logged on. d. Avoid leaving patient information displayed on a computer where others can see it. e. Keep the same password for as long as the nurse works at the agency. - ANS Never share passwords with co-workers. Avoid leaving patient information displayed on a computer where others can see it. The nurse is attempting to teach a patient how to perform wound care for when he goes home. Using the teach back method the nurse should do which of the following? a. Repeat the instructions until the patient understands. b. Present the information and clarify with closed-ended questions. c. Ask the patient if he understands the instructions. d. Ask if the patient has any questions about the technique. - ANS Repeat the instructions until the patient understands. A student nurse is caring for a patient of Mexican descent. In an attempt to become culturally aware, the student should consciously think about which of the following? a. What people of Mexican descent believe b. The relationship between culture and ethnicity c. The fact that the patient belongs to an isolated social group d. Where the person is in the intersections of socially constructed categories - ANS Where the person is in the intersections of socially constructed categories When dealing with cultural awareness, the nurse realizes that the term oppression involves which of the following? a. Maintaining advantages based on social group membership b. Systems that maintain disadvantages aimed purely at individuals c. Intentional discrepancies alone d. Issues at institutional levels independent of individual or cultural factors - ANS Maintaining advantages based on social group membership The student nurse has been studying different cultures in relationship to nursing. She understands that transcultural nursing has been developed as a distinct discipline and can be defined as which of the following? a. Understanding that cultural patterns are generated from predetermined criteria b. Knowing that culturally congruent care is based on health care system values c. Understanding cultural similarities and differences among groups of people d. The realization that illness and disease are the same - ANS Understanding cultural similarities and differences among groups of people .Cultural competence is the ongoing process in which a health care professional continuously strives to achieve the ability to work effectively within the cultural context. To do this effectively, what must the nurse do? a. Understand the cultural norms of the patients community. b. See herself or himself as being culturally competent. c. Face the reality that cultural competence can take up to a year to achieve. d. View herself or himself as becoming culturally competent. - ANS View herself or himself as becoming culturally competent. A student nurse assigned to a female, observant Muslim patient noticed her discomfort with several of the male health care providers. She wonders if this discomfort is related to the patients religious beliefs. In her preparation for clinical, she learned that Muslims differ in their adherence to tradition, but that modesty is the overarching Islamic ethic pertaining to interaction between the sexes (Rabin, 2010). The student nurse states which of the following to the patient? a. Im going to request that you only have female physicians see you. Does having male nurses bother you as well? b. I know that its hard to get used to, but you just have to get used to it. Thats how it is in America. c. It must be difficult for people like you to adjust to our ways, but there are limitations for all of us. d. I know that for many of our Muslim patients modesty is very important. Is there some way I can make you more comfortabl - ANS I know that for many of our Muslim patients modesty is very important. Is there some way I can make you more comfortable? The nurse is caring for a patient of a culture different from her own. To provide culturally competent care for this patient, what does the nurse need to do? a. Not be curious about other ways of being in the world b. Understand the forces that influence her own world view c. Recognize that she must not hold any bias toward the patient d. Have no predispositions relative toward the patients culture - ANS Understand the forces that influence her own world view The current focus on promoting a culturally competent health care environment is on which of the following? a. The health care providers efforts to become self-aware b. The health care provider learning about other cultures c. Avoiding the systematic provision of care d. Ensuring that cultural competence is integrated into administrative processes - ANS Ensuring that cultural competence is integrated into administrative processes The nurse is performing a cultural assessment on a patient. What does the nurse know about cultural assessments? a. They are intrusive and time consuming. b. They are not dependent on a trusting relationship. c. They are rarely plagued by miscommunication. d. They are based in similarities of behavior. - ANS They are intrusive and time consuming. A nurse is in the process of admitting an ethnically diverse patient. To plan culturally competent care, what must the nurse do? (Select all that apply.) a. Assume that cultural processes are the same within a social group. b. Conduct a systematic cultural assessment. c. Communicate effectively. d. Negotiate world view differences. - ANS Conduct a systematic cultural assessment. Communicate effectively Negotiate world view differences. Health care regulatory agencies, national think tanks, and government agencies expect health care organizations to incorporate cultural competence into policies and practices to ensure effective communication, patient safety and quality, and patient-centered care. Some examples of such organizational policies and practices include which of the following? (Select all that apply.) a. Instituting a requirement for all staff to be trained in cultural competence b. Maintaining the traditional description of family in written policies c. Enforcing strict visitation policies and practices d. Ensuring that persons who are deaf or speak limited English have access to an interpreter e. Embedding health literacy principles in written and verbal communication - ANS Instituting a requirement for all staff to be trained in cultural competence Ensuring that persons who are deaf or speak limited English have access to an interpreter Embedding health literacy principles in written and verbal communication Health disparities are unequal burdens of disease morbidity and mortality rates experienced by racial and ethnic groups that are often exacerbated by which of the following? (Select all that apply.) a. Social status b. Economics c. Environment d. Improved access to health care - ANS Social status Economics Environment