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Fundamentals of Nursing 3rd Edition Yoost
on
Test Bank
fid
en
Chapter 01: Nursing, Theory, and Professional Practice
Yoost & Crawford: Fundamentals of Nursing: Active Learning for Collaborative
tia
Practice, 3rd Edition
l
MULTIPLE CHOICE
1. A group of nursing students are discussing the impact of nonnursing theories in clinical
practice. The students would be correct if they chose which theory to prioritize patient care?
a. Erikson‘s Psychosocial Theory
b. Paul‘s Critical-Thinking Theory
c. Maslow‘s Hierarchy of Needs
d. Rosenstock‘s Health Belief Model
ANS: C
Maslow‘s hierarchy of needs specifies the psychological and physiologic factors that affect
C
each person‘s physical and mental health. The nurse‘s understanding of these factors helps
with formulating Nursing diagnoses that address the patient‘s needs and values to prioritize
on
care. Erikson‘s Psychosocial Theory of Development and Socialization is based on
individuals‘ interacting and learning about their world. Nurses use concepts of developmental
fid
theory to critically think in providing care for their patients at various stages of their lives.
Rosenstock (1974) developed the psychological Health Belief Model. The model addresses
en
possible reasons for why a patient may not comply with recommended health promotion
behaviors. This model is especially useful to nurses as they educate patients.
tia
DIF: Remembering OBJ: 1.5 TOP: Planning
MSC: NCLEX Client Needs CN
a t e gR
o r y : IS a f G
e a nB
dE.C M
ffective Care Environment: Management of Care
l
NOT: Concepts: Care CoordinatiU on S N T O
2. A nursing student is preparing study notes from a recent lecture in nursing history. The
student would credit Florence Nightingale for which definition of nursing?
a. The imbalance between the patient and the environment decreases the capacity for
health.
b. The nurse needs to focus on interpersonal processes between nurse and patient.
c. The nurse assists the patient with essential functions toward independence.
d. Human beings are interacting in continuous motion as energy fields.
ANS: A
Florence Nightingale‘s (1860) concept of the environment emphasized prevention and clean
air, water, and housing. This theory states that the imbalance between the patient and the
environment decreases the capacity for health and does not allow for conservation of energy.
Hildegard Peplau (1952) focused on the roles played by the nurse and the interpersonal
process between a nurse and a patient. Virginia Henderson described the nurse‘s role as
substitutive (doing for the person), supplementary (helping the person), or complementary
(working with the person), with the goal of independence for the patient. Martha Rogers
(1970) developed the Science of Unitary Human Beings. She stated that human beings and
their environments are interacting in continuous motion as infinite energy fields.
, DIF: Understanding OBJ: 1.4 TOP: Planning
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
C
NOT: Concepts: Health Promotion
on
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en
tia
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C
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en
tia
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3. The nurse identifies which nurse established the American Red Cross during the Civil War?
on
a. Dorothea Dix
b. Linda Richards
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c. Lena Higbee
d. Clara Barton
en
ANS: D
Clara Barton practiced nursing in the Civil War and established the American Red Cross.
tia
Dorothea Dix was the head of the U.S. Sanitary Commission, which was a forerunner of the
Army Nurse Corps. Linda Richards was America‘s first trained nurse, graduating from
Boston‘s Women‘s Hospital in 1873, and Lena Higbee, superintendent of the U.S. Navy
l
Nurse Corps, was awarded the Navy Cross in 1918.
DIF: Remembering OBJ: 1.3 TOP: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: Concepts: Professionalism
4. The nursing instructor is researching the five proficiencies regarded as essential for students
and professionals. The nursing instructor identifies which organization would be found to
have added safety as a sixth competency?
a. Quality and Safety Education for Nurses (QSEN)
b. Institute of Medicine (IOM)
C
c. American Association of Colleges of Nursing (AACN)
on
d. National League for Nursing (NLN)
ANS: A
fid
The Institute of Medicine r epNo rt ,RH e I GP r oBf e.s sCi o nMs Education: A Bridge to Quality (2003),
outlines five core competencies. Sa l t hinclude
U These patient-centered care, interdisciplinary
en
teamwork, use of evidence-based medicine, quality improvement, and use of information
technology. QSEN added safety as a sixth competency. The Essentials of Baccalaureate
Education for Professional Nursing Practice are provided and updated by the American
tia
Association of Colleges of Nursing (AACN) (2008). The document offers a framework for the
education of professional nurses with outcomes for students to meet. The National League for
l
Nursing (NLN) outlines and updates competencies for practical, associate, baccalaureate, and
graduate nursing education programs.
DIF: Remembering OBJ: 1.1 TOP: Planning
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
5. The nurse manager is interviewing graduate nurses to fill existing staffing vacancies. When
hiring graduate nurses, the nurse manager realizes that they will probably not be considered
―competent‖ until they complete which task?
a. They graduate and pass NCLEX.
b. They have worked 2 to 3 years.
c. Their last year of nursing school.
d. They are actually hired.
ANS: B
, Benner‘s model identifies five levels of proficiency: novice, advanced beginner, competent,
C
proficient, and expert. The student nurse progresses from novice to advanced beginner during
on
nursing school and attains the competent level after approximately 2 to 3 years of work
experience after graduation. To obtain the RN credential, a person must graduate from an
fid
approved school of nursing and pass a state licensing examination called the National Council
Licensure Examination for Registered Nurses (NCLEX-RN) usually taken soon after
en
completion of an approved nursing program.
DIF: Remembering OBJ: 1.7 TOP: Planning
tia
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
l
6. The prospective student is considering options for beginning a career in nursing. Which
degree would best match the student‘s desire to conduct research at the university level?
a. Associate Degree in Nursing (ADN)
b. Bachelor of Science in Nursing (BSN)
c. Doctor of Nursing Practice (DNP)
d. Doctor of Philosophy in Nursing (PhD)
ANS: D
Doctoral nursing education can result in a Doctor of Philosophy (PhD) degree. This degree
prepares nurses for leadership roles in research, teaching, and administration that are essential
to advancing nursing as a profession. Associate Degree in Nursing (ADN) programs usually
C
are conducted in a community college setting. The nursing curriculum focuses on adult acute
on
and chronic disease; maternal/child health; pediatrics; and psychiatric/mental health nursing.
ADN RNs may return to school to earn a bachelor‘s degree or higher in an RN-to-BSN or
RN-to-MSN program. Bachelor‘s degree programs include community health and
fid
management courses be yon d Nt hUo R
s eSpI
r oNviG
dTe dBi.
nCanOas s o c iate degree program. A newer
practice-focused doctoral degree is the Doctor of Nursing practice (DNP), which concentrates
en
on the clinical aspects of nursing. DNP specialties include the four advanced practice roles of
NP, CNS, CNM, and CRNA.
tia
DIF: Remembering OBJ: 1.9 TOP: Assessment
l
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
7. During a staff meeting, the nurse manager announces that the hospital will be seeking Magnet
status. To explain the requirements for this award, the nurse manager will contact which
organization?
a. American Nurses Association (ANA)
b. American Nurses Credentialing Center (ANCC)
c. National League for Nursing (NLN)
d. Joint Commission
ANS: B
The American Nurses Credentialing Center (ANCC) awards Magnet Recognition to hospitals
that have shown excellence and innovation in nursing. The ANA is a professional
organization that provides standards of nursing practice. The National League for Nursing
(NLN) outlines and updates competencies for practical, associate, baccalaureate, and graduate
nursing education programs. The Joint Commission is the accrediting organization for health
care facilities in the United States.
,C
DIF: Remembering OBJ: 1.1 TOP: Assessment
on
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
fid
8. The nurse is caring for a patient who refuses two units of packed red blood cells. When the
nurse notifies the health care provider of the patient‘s decision, the nurse is acting in which
en
role?
a. Manager
tia
b. Change agent
c. Advocate
l
d. Educator
ANS: C
As the patient‘s advocate, the nurse interprets information and provides the necessary
education. The nurse then accepts and respects the patient‘s decisions even if they are
different from the nurse‘s own beliefs. The nurse supports the patient‘s wishes and
communicates them to other health care providers. A nurse manages all of the activities and
treatments for patients. In the role of change agent, the nurse works with patients to address
their health concerns and with staff members to address change in an organization or within a
community. The nurse ensures that the patient receives sufficient information on which to
base consent for care and related treatment. Education becomes a major focus of discharge
planning so that patients will be prepared to handle their own needs at home.
C
on
DIF: Applying OBJ: 1.2 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
fid
NURSINGTB.COM
9. The nursing student develops a plan of care based on a recently published article describing
en
the effects of bed rest on a patient‘s calcium blood levels. When creating the plan of care, the
nursing student has the obligation to consider which action?
a. Critically appraise the evidence and determine validity.
tia
b. Ensure that the plan of care does not alter current practice.
c. Change the process even when there is no problem identified.
l
d. Maintain the plan of care regardless of initial outcome.
ANS: A
Evidence-based practice (EBP) is an integration of the best-available research evidence with
clinical judgment about a specific patient situation. The nurse assesses current and past
research, clinical guidelines, and other resources to identify relevant literature. The application
of EBP includes critically appraising the evidence to assess its validity, designing a change for
practice, assessing the need for change and identifying a problem, and integrating and
maintaining change while monitoring process and outcomes by reevaluating the application of
evidence and assessing areas for improvement.
DIF: Applying OBJ: 1.2 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
,C
10. The nurse is delegating frequent blood pressure (BP) measurements for a patient admitted
with a gunshot wound to a licensed practical nurse (LPN). When delegating, the nurse
on
understands which fact?
a. He/she may assume that the LPN is able to perform this task appropriately.
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b. The LPN is ultimately responsible for the patient findings and assessment.
c. The LPN may perform the tasks assigned without further supervision.
en
d. He/she retains ultimate responsibility for patient care and supervision is needed.
ANS: D
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The RN retains ultimate responsibility for patient care, which requires supervision of those to
whom patient care is delegated. In the process of collaboration, the nurse delegates certain
l
activities to other health care personnel. The RN needs to know the scope of practice or
capabilities of each health care member for delegation to be effective and safe.
DIF: Understanding OBJ: 1.2 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
11. The nurse is preparing to discharge a patient admitted with fever of unknown origin. The
patient states, ―I never got past the fifth grade in school. Don‘t read much. Never saw much
sense in it. But I do OK. I can read most stuff. But my doctor explains things good and
doesn‘t think that my sickness is serious.‖ Considering this patient response, what action
should the nurse carry out?
C
a. Provide discharge medication information from a professional source to provide
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the most information.
b. Expect that the patient may return to the hospital if the discharge process is poorly
done. NURSINGTB.COM
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c. Assume that the physician and the patient have a good rapport and that the
physician will clarify everything.
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d. Defer offering the patient the opportunity to sign up for wellness classes due to the
low literacy rate.
tia
ANS: B
Low health literacy is associated with increased hospitalization, greater emergency care use,
l
lower use of mammography, and lower receipt of influenza vaccine. A goal of patient
education by the nurse is to inform patients and deliver information that is understandable by
examining their level of health literacy. The more understandable health information is for
patients, the closer the care is coordinated with need.
DIF: Applying OBJ: 1.2 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Health Promotion
12. A nurse is caring for a patient who lost a large amount of blood during childbirth. The nurse
provides the opportunity for the patient to maintain her activity level while providing adequate
periods of rest and encouragement. Which nursing theory would the nurse most likely choose
as a framework for addressing the fatigue associated with the low blood count?
a. Watson Human Caring Theory
b. Parse‘s Theory of Human Becoming
c. Roy‘s Adaptation Model
d. Rogers‘ Science of Unitary Human Beings
,C
ANS: C
Roy‘s Adaptation Model is based on the human being as an adaptive open system. The person
on
adapts by meeting physiologic-physical needs, developing a positive self-concept–group
identity, performing social role functions, and balancing dependence and independence.
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Stressors result in illness by disrupting the equilibrium. Nursing care is directed at altering
stimuli that are stressors to the patient. The nurse helps patients strengthen their abilities to
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adapt to their illnesses or helps them to develop adaptive behaviors. Watson‘s theory is based
on caring, with nurses dedicated to health and healing. The nurse functions to preserve the
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dignity and wholeness of humans in health or while peacefully dying. Parse‘s theory is called
the Human Becoming School of Thought. Parse formulated the Theory of Human Becoming
by combining concepts from Martha Rogers‘ Science of Unitary Human Beings with
l
existential-phenomenologic thought. This theory looks at the person as a constantly changing
being, and at nursing as a human science. Martha Rogers (1970) developed the Science of
Unitary Human Beings. She stated that human beings and their environments are interacting
in continuous motion as infinite energy fields.
DIF: Applying OBJ: 1.4 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
13. The nurse recognizes which nursing theorist who described the relationship between the nurse
and the patient as an interpersonal and therapeutic process?
C
a. Virginia Henderson
on
b. Betty Neuman
c. Imogene King
d. Hildegard Peplau
fid
NURSINGTB.COM
ANS: D
en
Hildegard Peplau focused on the roles played by the nurse and the interpersonal process
between a nurse and a patient. The interpersonal process occurs in overlapping phases: (1)
orientation, (2) working, consisting of two subphases: identification and exploitation, and (3)
tia
resolution. Betty Neuman‘s Systems Model includes a holistic concept and an open-system
approach. The model identifies energy resources that provide for basic survival, with lines of
l
resistance that are activated when a stressor invades the system. Virginia Henderson described
the nurse‘s role as substitutive (doing for the person), supplementary (helping the person), or
complementary (working with the person), with the ultimate goal of independence for the
patient. Imogene King developed a general systems framework that incorporates three levels
of systems: (1) individual or personal, (2) group or interpersonal, and (3) society or social.
The theory of goal attainment discusses the importance of interaction, perception,
communication, transaction, self, role, stress, growth and development, time, and personal
space. In this theory, both the nurse and the patient work together to achieve the goals in the
continuous adjustment to stressors.
DIF: Remembering OBJ: 1.4 TOP: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation
NOT: Concepts: Health Promotion
14. When a nursing class volunteers to serve hot meals at a local homeless shelter on a Saturday
afternoon, which term identifies this focus on serving the community?
a. Altruism
, C
b. Accountability
c. Autonomy
on
d. Advocate
ANS: A
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A profession provides services needed by society. Additionally, practitioners‘ motivation is
public service over personal gain (altruism). Service to the public requires intellectual
en
activities, which include responsibility. This accountability has legal, ethical, and professional
implications. Members of a profession have autonomy in decision making and practice and
tia
are self-regulating in that they develop their own policies in collaboration with one another.
As the patient‘s advocate, the nurse interprets information and provides the necessary
education. The nurse then accepts and respects the patient‘s decisions even if they are
l
different from the nurse‘s own beliefs.
DIF: Understanding OBJ: 1.6 TOP: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: Concepts: Health Promotion
15. A patient is being discharged from the hospital with wound care dressing changes. The nurse
recommends a referral for home health nursing care. The nurse is using which standard of
practice?
a. Assessment
b. Diagnosis
C
c. Planning
on
d. Implementation
ANS: C
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As a care provider, the nurseNfoUllR
owSsIthNeGnTuB
rsi.
ngCprM
ocess to assess patient data, prioritize
Nursing diagnoses, plan the care of the patient, implement the appropriate interventions, and
en
evaluate care in an ongoing cycle. In recommending a referral, the nurse is, in effect, planning
care.
tia
DIF: Applying OBJ: 1.2 TOP: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity: Basic Care and Comfort
l
NOT: Concepts: Care Coordination
16. The nurse administers a medication to the patient and then realizes that the medication had
been discontinued. The error is immediately reported to the physician. The nurse recognizes
which term that identifies complying with the standards of professional performance?
a. Ethics
b. Socialization
c. Altruism
d. Autonomy
ANS: A
Fundamentals of Nursing 3rd Edition Yoost
on
Test Bank
fid
en
Chapter 01: Nursing, Theory, and Professional Practice
Yoost & Crawford: Fundamentals of Nursing: Active Learning for Collaborative
tia
Practice, 3rd Edition
l
MULTIPLE CHOICE
1. A group of nursing students are discussing the impact of nonnursing theories in clinical
practice. The students would be correct if they chose which theory to prioritize patient care?
a. Erikson‘s Psychosocial Theory
b. Paul‘s Critical-Thinking Theory
c. Maslow‘s Hierarchy of Needs
d. Rosenstock‘s Health Belief Model
ANS: C
Maslow‘s hierarchy of needs specifies the psychological and physiologic factors that affect
C
each person‘s physical and mental health. The nurse‘s understanding of these factors helps
with formulating Nursing diagnoses that address the patient‘s needs and values to prioritize
on
care. Erikson‘s Psychosocial Theory of Development and Socialization is based on
individuals‘ interacting and learning about their world. Nurses use concepts of developmental
fid
theory to critically think in providing care for their patients at various stages of their lives.
Rosenstock (1974) developed the psychological Health Belief Model. The model addresses
en
possible reasons for why a patient may not comply with recommended health promotion
behaviors. This model is especially useful to nurses as they educate patients.
tia
DIF: Remembering OBJ: 1.5 TOP: Planning
MSC: NCLEX Client Needs CN
a t e gR
o r y : IS a f G
e a nB
dE.C M
ffective Care Environment: Management of Care
l
NOT: Concepts: Care CoordinatiU on S N T O
2. A nursing student is preparing study notes from a recent lecture in nursing history. The
student would credit Florence Nightingale for which definition of nursing?
a. The imbalance between the patient and the environment decreases the capacity for
health.
b. The nurse needs to focus on interpersonal processes between nurse and patient.
c. The nurse assists the patient with essential functions toward independence.
d. Human beings are interacting in continuous motion as energy fields.
ANS: A
Florence Nightingale‘s (1860) concept of the environment emphasized prevention and clean
air, water, and housing. This theory states that the imbalance between the patient and the
environment decreases the capacity for health and does not allow for conservation of energy.
Hildegard Peplau (1952) focused on the roles played by the nurse and the interpersonal
process between a nurse and a patient. Virginia Henderson described the nurse‘s role as
substitutive (doing for the person), supplementary (helping the person), or complementary
(working with the person), with the goal of independence for the patient. Martha Rogers
(1970) developed the Science of Unitary Human Beings. She stated that human beings and
their environments are interacting in continuous motion as infinite energy fields.
, DIF: Understanding OBJ: 1.4 TOP: Planning
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
C
NOT: Concepts: Health Promotion
on
fid
en
tia
l
C
on
fid
en
tia
l
,C
3. The nurse identifies which nurse established the American Red Cross during the Civil War?
on
a. Dorothea Dix
b. Linda Richards
fid
c. Lena Higbee
d. Clara Barton
en
ANS: D
Clara Barton practiced nursing in the Civil War and established the American Red Cross.
tia
Dorothea Dix was the head of the U.S. Sanitary Commission, which was a forerunner of the
Army Nurse Corps. Linda Richards was America‘s first trained nurse, graduating from
Boston‘s Women‘s Hospital in 1873, and Lena Higbee, superintendent of the U.S. Navy
l
Nurse Corps, was awarded the Navy Cross in 1918.
DIF: Remembering OBJ: 1.3 TOP: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: Concepts: Professionalism
4. The nursing instructor is researching the five proficiencies regarded as essential for students
and professionals. The nursing instructor identifies which organization would be found to
have added safety as a sixth competency?
a. Quality and Safety Education for Nurses (QSEN)
b. Institute of Medicine (IOM)
C
c. American Association of Colleges of Nursing (AACN)
on
d. National League for Nursing (NLN)
ANS: A
fid
The Institute of Medicine r epNo rt ,RH e I GP r oBf e.s sCi o nMs Education: A Bridge to Quality (2003),
outlines five core competencies. Sa l t hinclude
U These patient-centered care, interdisciplinary
en
teamwork, use of evidence-based medicine, quality improvement, and use of information
technology. QSEN added safety as a sixth competency. The Essentials of Baccalaureate
Education for Professional Nursing Practice are provided and updated by the American
tia
Association of Colleges of Nursing (AACN) (2008). The document offers a framework for the
education of professional nurses with outcomes for students to meet. The National League for
l
Nursing (NLN) outlines and updates competencies for practical, associate, baccalaureate, and
graduate nursing education programs.
DIF: Remembering OBJ: 1.1 TOP: Planning
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
5. The nurse manager is interviewing graduate nurses to fill existing staffing vacancies. When
hiring graduate nurses, the nurse manager realizes that they will probably not be considered
―competent‖ until they complete which task?
a. They graduate and pass NCLEX.
b. They have worked 2 to 3 years.
c. Their last year of nursing school.
d. They are actually hired.
ANS: B
, Benner‘s model identifies five levels of proficiency: novice, advanced beginner, competent,
C
proficient, and expert. The student nurse progresses from novice to advanced beginner during
on
nursing school and attains the competent level after approximately 2 to 3 years of work
experience after graduation. To obtain the RN credential, a person must graduate from an
fid
approved school of nursing and pass a state licensing examination called the National Council
Licensure Examination for Registered Nurses (NCLEX-RN) usually taken soon after
en
completion of an approved nursing program.
DIF: Remembering OBJ: 1.7 TOP: Planning
tia
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
l
6. The prospective student is considering options for beginning a career in nursing. Which
degree would best match the student‘s desire to conduct research at the university level?
a. Associate Degree in Nursing (ADN)
b. Bachelor of Science in Nursing (BSN)
c. Doctor of Nursing Practice (DNP)
d. Doctor of Philosophy in Nursing (PhD)
ANS: D
Doctoral nursing education can result in a Doctor of Philosophy (PhD) degree. This degree
prepares nurses for leadership roles in research, teaching, and administration that are essential
to advancing nursing as a profession. Associate Degree in Nursing (ADN) programs usually
C
are conducted in a community college setting. The nursing curriculum focuses on adult acute
on
and chronic disease; maternal/child health; pediatrics; and psychiatric/mental health nursing.
ADN RNs may return to school to earn a bachelor‘s degree or higher in an RN-to-BSN or
RN-to-MSN program. Bachelor‘s degree programs include community health and
fid
management courses be yon d Nt hUo R
s eSpI
r oNviG
dTe dBi.
nCanOas s o c iate degree program. A newer
practice-focused doctoral degree is the Doctor of Nursing practice (DNP), which concentrates
en
on the clinical aspects of nursing. DNP specialties include the four advanced practice roles of
NP, CNS, CNM, and CRNA.
tia
DIF: Remembering OBJ: 1.9 TOP: Assessment
l
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
7. During a staff meeting, the nurse manager announces that the hospital will be seeking Magnet
status. To explain the requirements for this award, the nurse manager will contact which
organization?
a. American Nurses Association (ANA)
b. American Nurses Credentialing Center (ANCC)
c. National League for Nursing (NLN)
d. Joint Commission
ANS: B
The American Nurses Credentialing Center (ANCC) awards Magnet Recognition to hospitals
that have shown excellence and innovation in nursing. The ANA is a professional
organization that provides standards of nursing practice. The National League for Nursing
(NLN) outlines and updates competencies for practical, associate, baccalaureate, and graduate
nursing education programs. The Joint Commission is the accrediting organization for health
care facilities in the United States.
,C
DIF: Remembering OBJ: 1.1 TOP: Assessment
on
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
fid
8. The nurse is caring for a patient who refuses two units of packed red blood cells. When the
nurse notifies the health care provider of the patient‘s decision, the nurse is acting in which
en
role?
a. Manager
tia
b. Change agent
c. Advocate
l
d. Educator
ANS: C
As the patient‘s advocate, the nurse interprets information and provides the necessary
education. The nurse then accepts and respects the patient‘s decisions even if they are
different from the nurse‘s own beliefs. The nurse supports the patient‘s wishes and
communicates them to other health care providers. A nurse manages all of the activities and
treatments for patients. In the role of change agent, the nurse works with patients to address
their health concerns and with staff members to address change in an organization or within a
community. The nurse ensures that the patient receives sufficient information on which to
base consent for care and related treatment. Education becomes a major focus of discharge
planning so that patients will be prepared to handle their own needs at home.
C
on
DIF: Applying OBJ: 1.2 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
fid
NURSINGTB.COM
9. The nursing student develops a plan of care based on a recently published article describing
en
the effects of bed rest on a patient‘s calcium blood levels. When creating the plan of care, the
nursing student has the obligation to consider which action?
a. Critically appraise the evidence and determine validity.
tia
b. Ensure that the plan of care does not alter current practice.
c. Change the process even when there is no problem identified.
l
d. Maintain the plan of care regardless of initial outcome.
ANS: A
Evidence-based practice (EBP) is an integration of the best-available research evidence with
clinical judgment about a specific patient situation. The nurse assesses current and past
research, clinical guidelines, and other resources to identify relevant literature. The application
of EBP includes critically appraising the evidence to assess its validity, designing a change for
practice, assessing the need for change and identifying a problem, and integrating and
maintaining change while monitoring process and outcomes by reevaluating the application of
evidence and assessing areas for improvement.
DIF: Applying OBJ: 1.2 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
,C
10. The nurse is delegating frequent blood pressure (BP) measurements for a patient admitted
with a gunshot wound to a licensed practical nurse (LPN). When delegating, the nurse
on
understands which fact?
a. He/she may assume that the LPN is able to perform this task appropriately.
fid
b. The LPN is ultimately responsible for the patient findings and assessment.
c. The LPN may perform the tasks assigned without further supervision.
en
d. He/she retains ultimate responsibility for patient care and supervision is needed.
ANS: D
tia
The RN retains ultimate responsibility for patient care, which requires supervision of those to
whom patient care is delegated. In the process of collaboration, the nurse delegates certain
l
activities to other health care personnel. The RN needs to know the scope of practice or
capabilities of each health care member for delegation to be effective and safe.
DIF: Understanding OBJ: 1.2 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
11. The nurse is preparing to discharge a patient admitted with fever of unknown origin. The
patient states, ―I never got past the fifth grade in school. Don‘t read much. Never saw much
sense in it. But I do OK. I can read most stuff. But my doctor explains things good and
doesn‘t think that my sickness is serious.‖ Considering this patient response, what action
should the nurse carry out?
C
a. Provide discharge medication information from a professional source to provide
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the most information.
b. Expect that the patient may return to the hospital if the discharge process is poorly
done. NURSINGTB.COM
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c. Assume that the physician and the patient have a good rapport and that the
physician will clarify everything.
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d. Defer offering the patient the opportunity to sign up for wellness classes due to the
low literacy rate.
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ANS: B
Low health literacy is associated with increased hospitalization, greater emergency care use,
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lower use of mammography, and lower receipt of influenza vaccine. A goal of patient
education by the nurse is to inform patients and deliver information that is understandable by
examining their level of health literacy. The more understandable health information is for
patients, the closer the care is coordinated with need.
DIF: Applying OBJ: 1.2 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Health Promotion
12. A nurse is caring for a patient who lost a large amount of blood during childbirth. The nurse
provides the opportunity for the patient to maintain her activity level while providing adequate
periods of rest and encouragement. Which nursing theory would the nurse most likely choose
as a framework for addressing the fatigue associated with the low blood count?
a. Watson Human Caring Theory
b. Parse‘s Theory of Human Becoming
c. Roy‘s Adaptation Model
d. Rogers‘ Science of Unitary Human Beings
,C
ANS: C
Roy‘s Adaptation Model is based on the human being as an adaptive open system. The person
on
adapts by meeting physiologic-physical needs, developing a positive self-concept–group
identity, performing social role functions, and balancing dependence and independence.
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Stressors result in illness by disrupting the equilibrium. Nursing care is directed at altering
stimuli that are stressors to the patient. The nurse helps patients strengthen their abilities to
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adapt to their illnesses or helps them to develop adaptive behaviors. Watson‘s theory is based
on caring, with nurses dedicated to health and healing. The nurse functions to preserve the
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dignity and wholeness of humans in health or while peacefully dying. Parse‘s theory is called
the Human Becoming School of Thought. Parse formulated the Theory of Human Becoming
by combining concepts from Martha Rogers‘ Science of Unitary Human Beings with
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existential-phenomenologic thought. This theory looks at the person as a constantly changing
being, and at nursing as a human science. Martha Rogers (1970) developed the Science of
Unitary Human Beings. She stated that human beings and their environments are interacting
in continuous motion as infinite energy fields.
DIF: Applying OBJ: 1.4 TOP: Implementation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care
NOT: Concepts: Care Coordination
13. The nurse recognizes which nursing theorist who described the relationship between the nurse
and the patient as an interpersonal and therapeutic process?
C
a. Virginia Henderson
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b. Betty Neuman
c. Imogene King
d. Hildegard Peplau
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NURSINGTB.COM
ANS: D
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Hildegard Peplau focused on the roles played by the nurse and the interpersonal process
between a nurse and a patient. The interpersonal process occurs in overlapping phases: (1)
orientation, (2) working, consisting of two subphases: identification and exploitation, and (3)
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resolution. Betty Neuman‘s Systems Model includes a holistic concept and an open-system
approach. The model identifies energy resources that provide for basic survival, with lines of
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resistance that are activated when a stressor invades the system. Virginia Henderson described
the nurse‘s role as substitutive (doing for the person), supplementary (helping the person), or
complementary (working with the person), with the ultimate goal of independence for the
patient. Imogene King developed a general systems framework that incorporates three levels
of systems: (1) individual or personal, (2) group or interpersonal, and (3) society or social.
The theory of goal attainment discusses the importance of interaction, perception,
communication, transaction, self, role, stress, growth and development, time, and personal
space. In this theory, both the nurse and the patient work together to achieve the goals in the
continuous adjustment to stressors.
DIF: Remembering OBJ: 1.4 TOP: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation
NOT: Concepts: Health Promotion
14. When a nursing class volunteers to serve hot meals at a local homeless shelter on a Saturday
afternoon, which term identifies this focus on serving the community?
a. Altruism
, C
b. Accountability
c. Autonomy
on
d. Advocate
ANS: A
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A profession provides services needed by society. Additionally, practitioners‘ motivation is
public service over personal gain (altruism). Service to the public requires intellectual
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activities, which include responsibility. This accountability has legal, ethical, and professional
implications. Members of a profession have autonomy in decision making and practice and
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are self-regulating in that they develop their own policies in collaboration with one another.
As the patient‘s advocate, the nurse interprets information and provides the necessary
education. The nurse then accepts and respects the patient‘s decisions even if they are
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different from the nurse‘s own beliefs.
DIF: Understanding OBJ: 1.6 TOP: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: Concepts: Health Promotion
15. A patient is being discharged from the hospital with wound care dressing changes. The nurse
recommends a referral for home health nursing care. The nurse is using which standard of
practice?
a. Assessment
b. Diagnosis
C
c. Planning
on
d. Implementation
ANS: C
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As a care provider, the nurseNfoUllR
owSsIthNeGnTuB
rsi.
ngCprM
ocess to assess patient data, prioritize
Nursing diagnoses, plan the care of the patient, implement the appropriate interventions, and
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evaluate care in an ongoing cycle. In recommending a referral, the nurse is, in effect, planning
care.
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DIF: Applying OBJ: 1.2 TOP: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity: Basic Care and Comfort
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NOT: Concepts: Care Coordination
16. The nurse administers a medication to the patient and then realizes that the medication had
been discontinued. The error is immediately reported to the physician. The nurse recognizes
which term that identifies complying with the standards of professional performance?
a. Ethics
b. Socialization
c. Altruism
d. Autonomy
ANS: A
