NCLEX-PN: PRACTICE QUESTIONS AND ANSWERS: Has 860 Q&A - $17.49   Add to cart

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NCLEX-PN: PRACTICE QUESTIONS AND ANSWERS: Has 860 Q&A

NCLEX-PN: PRACTICE QUESTIONS AND ANSWERS The family of a client who died of heart failure is making arrangements for a ritual bath to be given by a ritual burial society. Nurses are making arrangements for access and privacy. Which religions have this tradition? (Select all that apply.) A. Buddhism B. Baptist Christianity C. Lutheran Christianity D. Islam E. Judaism A. Buddhism B. Baptist Christianity C. Lutheran Christianity ***D. Islam ***E. Judaism Both the Muslim and Jewish religions have a tradition of a ritual bath after death. That is not true of the Buddhist religion or the Baptist or Lutheran traditions within Christianity. A nurse has transferred from a clinic setting to an inpatient unit. The nurse notices several questions about spiritual beliefs on the admission form that the nurse had never asked new clinic clients. What is the most likely reason for asking these questions? A. Invitation to attend the hospital's worship services B. The Joint Commission's accreditation requirements C. Identify which members of the clergy to call for spiritual emergencies D. Finding a better match for a semiprivate room A. Invitation to attend the hospital's worship services ***B. The Joint Commission's accreditation requirements C. Identify which members of the clergy to call for spiritual emergencies D. Finding a better match for a semiprivate room The most likely reason to ask questions about spiritual beliefs is The Joint Commission's requirements for clients admitted to an institution. The requirements are not mandated for clinic clients. It is not about attending worship services, matching roommates, or calling the right clergyperson. When the assisted living nurse asks the new client about her religious beliefs, the client answers, "I am not convinced that a Higher Power exists. But I am still open to thinking about it." Which category of religious beliefs does the client identify with? A. Agnostic B. Atheistic C. Nontheistic D. Monotheistic ***A. Agnostic B. Atheistic C. Nontheistic D. Monotheistic The client identifies with agnostics, who believe that the existence of a Higher Power has not been proved. The client is not an atheist, who does not believe in any god. The client is not a monotheist, who believes in one god. There is no category called nontheistic. A young client has just learned of a diagnosis of stage 4 lung cancer. The client was about to graduate from school and get married. "I can't believe in God anymore," the client tells the oncology nurse. "He should be all-loving." Which situation would the nurse identify the client as expressing? A. Spiritual distress B. Fear of unemployment C. Premarital anxiety D. A justice complaint ***A. Spiritual distress B. Fear of unemployment C. Premarital anxiety D. A justice complaint The client is expressing spiritual distress about the loss of hope in his belief system. It is not a complaint about justice, anxiety about a planned marriage, or fear of the job market. As a client comes into the admitting area, a nurse notices a jeweled cross on the client's necklace. The nurse comments, "Great look; I can see your religious beliefs are important to you," and starts with the spiritual assessment of the client. How would this approach be evaluated? A. Complimenting the client's appearance is helpful B. A focus on jewelry might appear materialistic C. It is efficient and effective to dive right into the interview D. No time was taken to establish rapport with the client A. Complimenting the client's appearance is helpful B. A focus on jewelry might appear materialistic C. It is efficient and effective to dive right into the interview ***D. No time was taken to establish rapport with the client Starting with the spiritual assessment of the client leaves no time to establish rapport with the client. It is not about jewelry, compliments, or starting quickly. A nurse is an active member of an evangelical church. The nurse prays with some clients. Which statements by the nurse would indicate appropriate considerations? (Select all that apply.) A. "I pray only with clients whose minds can still make choices." B. "I ask clients about wanting to pray together." C. "Before praying, I confirm that it's a convenient time for clients." D. "I tell clients who don't join me that they're on my prayer list." E. "Praying together is the best therapeutic relationship." ***A. "I pray only with clients whose minds can still make choices." ***B. "I ask clients about wanting to pray together." ***C. "Before praying, I confirm that it's a convenient time for clients." D. "I tell clients who don't join me that they're on my prayer list." E. "Praying together is the best therapeutic relationship." It is appropriate for the nurse to ask about clients' desires, to select only those who can make decisions, and to select those for whom it is a convenient time. Being too enthusiastic about the effects of prayer or trying to include those who are opting out is not appropriate. What is a term for appreciation of a dimension beyond the self? A. Becoming B. Transcendence C. Value D. Meaning A. Becoming ***B. Transcendence C. Value D. Meaning Transcendence is a term for appreciation of a dimension beyond the self. Meaning is the term for having purpose, making sense of life. Value is the term for having cherished beliefs and standards. Becoming is the term for allowing life to unfold, and knowing oneself. What are the best times to do a nursing assessment of spirituality? (Select all that apply.) A. Following the psychosocial assessment B. Following the health history C. Before the physical assessment D. At the end of the assessment process E. Right after mutual introductions ***A. Following the psychosocial assessment B. Following the health history C. Before the physical assessment ***D. At the end of the assessment process E. Right after mutual introductions The best times to do a nursing assessment of spirituality are at the end of the assessment process or following the psychosocial assessment. Having built up some rapport is important. That rapport will be stronger at those times than right after mutual introductions, following the health history, or before the physical assessment. Which organization mandates that each client admitted to an institution be assessed for spiritual beliefs and practices? A. National Council of Churches B. American Nurses Association C. Nursing Outcomes Classification Project D. The Joint Commission A. National Council of Churches B. American Nurses Association C. Nursing Outcomes Classification Project ***D. The Joint Commission The Joint Commission mandates that each client admitted to an institution be assessed for spiritual beliefs and practices. That is not the agenda of any of the other organizations. Which religions have a rule about not eating pork? (Select all that apply.) A. Methodism B. Islam C. Mormonism D. Roman Catholicism E. Orthodox Judaism A. Methodism ***B. Islam C. Mormonism D. Roman Catholicism ***E. Orthodox Judaism Both Orthodox Jews and Muslims are prohibited from eating pork. That is not true of Mormons, Roman Catholics, or Methodists. Which religion asks its members to fast during daylight hours for a month? A. Christianity B. Islam C. Buddhism D. Judaism A. Christianity ***B. Islam C. Buddhism D. Judaism Muslims are asked to fast during daylight hours In the month of Ramadan. This request is not made of people following the religions of Buddhism, Judaism, or Christianity. A nurse is admitting 55-year-old librarian Tamura Washington to the rehabilitation unit. The nurse asks Ms. Washington, "Is there a group of like-minded believers with whom you regularly meet?" What aspect of the client's life is the nurse assessing? A. Her ability to work as a member of a team B. Her work at the library affecting her personal life C. Her participation in healthy social activities D. Her membership in a faith community A. Her ability to work as a member of a team B. Her work at the library affecting her personal life C. Her participation in healthy social activities ***D. Her membership in a faith community The nurse is asking a general question to identify whether the client is a member of a faith community. The nurse is not interested in teamwork, a balanced life, or social activities. During the nursing assessment interview, 40-year-old Nirali Dayada states that she follows a strict diet consistent with her Hindu religious beliefs. What hospital menu choices would be most likely for Ms. Dayada's stay? A. Vegetarian entrees B. Gluten-free products C. Noncaffeinated beverages D. Kosher food ***A. Vegetarian entrees B. Gluten-free products C. Noncaffeinated beverages D. Kosher food Vegetarian entrees would be appropriate for a practicing Hindu. The other choices would not be relevant to her religious beliefs. A pediatric nurse Jason Mosely is making sure that the activity room of his unit is stocked with crayons, coloring books, and stuffed animals. What is the best reason for Mr. Mosely to take that approach? A. Providing materials for nonverbal expression B. Giving entertaining options to fight boredom C. Allowing hospitalized children to exercise their limbs D. Setting up items to develop fine motor skills ***A. Providing materials for nonverbal expression B. Giving entertaining options to fight boredom C. Allowing hospitalized children to exercise their limbs D. Setting up items to develop fine motor skills Crayons, coloring books, and musical toys provide materials for nonverbal expression by hospitalized children. This is more important during an inpatient stay than entertainment, skill development, or exercise. A nurse who is a certified diabetes specialist is aware of the negative effects of fasting on glucose control. The nurse knows that clients with diabetes and clients with other conditions are often exempt from fasting requirements. Which people have conditions that often exempt them from religious fasting? (Select all that apply.) A. Nursing mothers B. Growing teenagers C. People over 65 D. Marathon runners E. Menstruating women ***A. Nursing mothers B. Growing teenagers C. People over 65 D. Marathon runners ***E. Menstruating women People who are often exempted from fasting, besides diabetics, are nursing mothers and menstruating women. The same exemption is not extended to growing teenagers, marathon runners, or people over 65. A nurse is observing a newly admitted client for details to add to the spiritual assessment. Which clinical observations would be useful additions? (Select all that apply.) A. Behavior B. Mood C. Interactions with others D. Mealtime choices E. Speech ***A. Behavior ***B. Mood ***C. Interactions with others D. Mealtime choices ***E. Speech Clinical observations of behavior, speech, mood, and interactions with others would be useful. Observing mealtime choices is not an example of a clinical observation the nurse would make. This item would be asked during the initial admission assessment of the client. A client admitted for major cardiac surgery states a religious preference. Then the client lists all the church's rules that the client disagrees with. What does the admitting nurse understand about the client's religious status? A. The client is a former member of that group. B. The client has been excommunicated from that group. C. The client is a dissenting member of that group. D. The client is an outsider trying to be part of that group. A. The client is a former member of that group. B. The client has been excommunicated from that group. ***C. The client is a dissenting member of that group. D. The client is an outsider trying to be part of that group. The client is a dissenting member of that group. It is not a matter of past membership, of being rejected, or of being an outsider. A nurse working in the memory care unit listens as the newly admitted client talks about his work as a pilot as if he had just left the airport. The nurse knows he has been retired for decades. What does the nurse recognize as the benefits of hearing his work life story? (Select all that apply.) A. Entertaining the other clients and families B. Giving the nurse insight into the client's behavior C. Keeping his verbal abilities exercised D. Helping the client maintain a sense of identity E. Focusing on the positive aspects of a past work life A. Entertaining the other clients and families ***B. Giving the nurse insight into the client's behavior C. Keeping his verbal abilities exercised ***D. Helping the client maintain a sense of identity E. Focusing on the positive aspects of a past work life Hearing details of the client's past work life helps the client maintain a sense of identity, and gives the nurse insight into the client's behavior. It is not a matter of focusing on the positive aspects, exercising verbal ability, or providing entertainment. A dialysis nurse does not agree with a client's decision to stop treatment. "I promised my spouse I would try it for a while, but it's too much," the client reveals. In supporting the client's decision, which principle of morality is the nurse honoring? A. Veracity B. Fidelity C. Justice D. Autonomy A. Veracity B. Fidelity C. Justice ***D. Autonomy In supporting the client's decision, the nurse is honoring the principle of autonomy (the client's right to make decisions). It is not a matter of fidelity (keeping a promise), veracity (telling the truth), or justice (fairness). Two nurses are discussing the ways in which spiritual practices affect individuals. "I can't believe how many different ways they affect people," one concludes. The other nurse agrees. Which individual habits and events could be connected to spiritual practices? (Select all that apply.) A. Diet and nutrition B. Birth and death C. Dress D. Medications E. Healing ***A. Diet and nutrition ***B. Birth and death ***C. Dress D. Medications ***E. Healing All of the above answers are correct. Diet and nutrition, medications, healing, dress, and birth and death all could be connected with spiritual practices. The nurse manager is interviewing a candidate for a staff nurse position. During the interview, the nurse manager evaluates the candidate's professional commitment to nursing. Which statement by the staff nurse best reflects commitment to the nursing profession? A. "The values and goals of nursing are honorable, but they are unrealistic and difficult to achieve." B. "I believe the nurse's choices outside of the workplace are unrelated to the nurse's professional role." C. "Whenever possible, the nurse should try to abide by the professional code of ethics for nurses." D. "I'm a member of two national nursing organizations, and I belong to one specialty nursing group." A. "The values and goals of nursing are honorable, but they are unrealistic and difficult to achieve." B. "I believe the nurse's choices outside of the workplace are unrelated to the nurse's professional role." C. "Whenever possible, the nurse should try to abide by the professional code of ethics for nurses." ***D. "I'm a member of two national nursing organizations, and I belong to one specialty nursing group." Factors associated with professional commitment include desire to maintain membership in the profession; strong acceptance of and belief in a profession's role, code, values, goals, standards; willingness to exert considerable personal effort on behalf of the profession; and a pattern of behaviors that is consistent with the nurses' professional code of ethics. The rules of professionalism in nursing extend to behaviors outside the workplace. The nurse educator is teaching a class about professional development in nursing. When describing an area of nursing competence, which component is most appropriate for the nurse educator to include in the teaching? A. Knowing and demonstrating adherence to the ethics of primary care providers B. Recognizing the nurse's responsibility to remain strictly in a client-centered role C. Understanding that client populations tend to demonstrate the same personal needs D. Understanding the culture of the client population and the healthcare institution A. Knowing and demonstrating adherence to the ethics of primary care providers B. Recognizing the nurse's responsibility to remain strictly in a client-centered role C. Understanding that client populations tend to demonstrate the same personal needs ***D. Understanding the culture of the client population and the healthcare institution Areas of nursing competence include understanding the culture of the client and the institution; knowing and demonstrating adherence to the ethics of the nursing profession; acknowledging the client's need for individualized care; and assuming multiple nursing responsibilities, including legal, professional, ethical, and client-centered roles. The nurse preceptor is designing a nursing orientation program that addresses abuse of power in the workplace. Which information should the nurse preceptor include in the program? A. The Joint Commission has not taken an official stand on addressing workplace intimidation. B. Bullying behaviors and incivility are among the leading causes of sentinel client events. C. Nursing research finds limited evidence of bullying and lateral violence among nursing professionals. D. Improper use of authority in the workplace is a form of sexual harassment. A. The Joint Commission has not taken an official stand on addressing workplace intimidation. ***B. Bullying behaviors and incivility are among the leading causes of sentinel client events. C. Nursing research finds limited evidence of bullying and lateral violence among nursing professionals. D. Improper use of authority in the workplace is a form of sexual harassment. Intimidation, sexual harassment, bullying, and lateral violence are forms of abuse of power. In the healthcare setting, evidence of bullying, lateral violence, and incivility has been well documented in nursing research for more than three decades. The Joint Commission has identified bullying behaviors and incivility in health care as being among the leading causes of sentinel client events. The Joint Commission calls for zero tolerance of workplace bullying and intimidation and recommends that healthcare facilities implement policies to stop such behaviors. The nursing student is designing a poster that describes how to recognize burnout among nurses. Which recommendation for identifying manifestations of burnout should be included on the poster? A. Understand that emotional depletion is a natural response to the demands of employment B. Interpret that smoking and an increase in coffee consumption may be potential warning signs C. Recognize that outbursts of anger are normal signs of professional frustration D. Acknowledge feelings of helplessness as signs of inexperience or professional inadequacy A. Understand that emotional depletion is a natural response to the demands of employment ***B. Interpret that smoking and an increase in coffee consumption may be potential warning signs C. Recognize that outbursts of anger are normal signs of professional frustration D. Acknowledge feelings of helplessness as signs of inexperience or professional inadequacy Manifestations of burnout include physical and emotional depletion, negative attitude and self-concept, and feelings of helplessness and hopelessness. Danger signs that may precede the development of burnout include increased coffee consumption and smoking. The nurse educator is explaining the significance of punctuality and attendance in the nursing profession to a class of nursing students. Which statement is most appropriate for the nurse educator to include in the discussion? A. "The most severe consequence of excessive tardiness for the professional nurse is suspension." B. "Chronic tardiness and frequent absenteeism among nurses can compromise client care." C. "Nurses must be flexible about helping colleagues who routinely need to miss work." D. "During a nursing shortage, hospital attendance requirements usually are less strict." A. "The most severe consequence of excessive tardiness for the professional nurse is suspension." ***B. "Chronic tardiness and frequent absenteeism among nurses can compromise client care." C. "Nurses must be flexible about helping colleagues who routinely need to miss work." D. "During a nursing shortage, hospital attendance requirements usually are less strict." In nursing practice, chronic tardiness and frequent absenteeism place a greater burden on colleagues, compromise client care, and can cause conflict among staff. Just as excessive tardiness to clinicals can lead to severe repercussions, even during a nursing shortage, professional nurses who demonstrate excessive tardiness or absences may face disciplinary actions including suspension and termination. The novice nurse asks the nurse preceptor to explain the relationship between the business of health care and the provision of client care. Which response by the nurse preceptor is the most appropriate? A. "The Institute of Medicine compels nurses to preserve a caring model within health care's business model." B. "When nursing standards conflict with organizational standards, the nurse must maintain commitment to the organization's standards." C. "The business of health care is the same thing as the provision of client care." D. "Nurses are morally responsible for recognizing the business of health care as the main priority." ***A. "The Institute of Medicine compels nurses to preserve a caring model within health care's business model." B. "When nursing standards conflict with organizational standards, the nurse must maintain commitment to the organization's standards." C. "The business of health care is the same thing as the provision of client care." D. "Nurses are morally responsible for recognizing the business of health care as the main priority." Because the business of health care and the provision of client care are two distinct issues, corporate goals can collide with nursing ethics. Nurses have the moral responsibility to address client needs and to advocate for safe care within the business of health care. The Institute of Medicine (IOM) compels nurses to lead the healthcare transformation and to preserve a caring model within the business model of health care. The nurse must maintain commitment to the nursing profession even when doing so conflicts with organizational commitment. While talking with a nursing colleague, the staff nurse states, "I don't drink alcohol, but I smoke marijuana." Which response by the nursing colleague best reflects correct understanding of professional behaviors? A. "Even in your personal life, the same rules of professionalism still apply to your behavior." B. "If you're arrested for smoking marijuana, your professional credibility will be negatively affected." C. "If your client care is negatively affected, then you should stop smoking marijuana." D. "Even though you're a nurse, what you do in your personal life is your business." ***A. "Even in your personal life, the same rules of professionalism still apply to your behavior." B. "If you're arrested for smoking marijuana, your professional credibility will be negatively affected." C. "If your client care is negatively affected, then you should stop smoking marijuana." D. "Even though you're a nurse, what you do in your personal life is your business." Unprofessional behaviors include substance abuse. The rules of professionalism and the dangers of unprofessional behavior extend to social situations. The effects of unprofessional behavior may include adversely affecting client outcomes, but unprofessional behavior is inappropriate with or without consequences. Engaging in unprofessional behavior, regardless of whether it leads to an arrest, can negatively impact the nurse's credibility. In an annual evaluation, the nurse unit leader describes the staff nurse as "skilled at analyzing a complex situation and able to pick out the most important aspects of a clinical scenario." According to Patricia Benner's model of nursing development, which developmental stage best matches the nurse unit leader's evaluation of the staff nurse? A. Proficient B. Novice C. Competent D. Expert ***A. Proficient B. Novice C. Competent D. Expert According to Benner's model, the novice nurse has no experience and relies only on guidelines, policies, and theories. The advanced beginner is starting to gain experience, with a focus on tasks and guidelines as the nurse at this stage does not have the experience to consider complexities. The competent nurse has begun to master some tasks, but does not yet possess the speed and flexibility of the proficient nurse. The proficient nurse is able to view the complexities of a situation, looking at the whole and determining which are the most important aspects. The expert nurse possesses an intuitive understanding of most situations and is able to quickly determine a course of action without much problem solving. The nurse leader is presenting an in-service about competence in nursing. Which examples should the nurse leader include in the in-service as examples of nursing competence? (Select all that apply.) A. Elimination of factors that negatively influence client care B. Acknowledgement of the client's need for individualized care C. Completion of documentation in an accurate, timely manner D. Awareness of factors that positively affect client care E. Knowledge about the culture of the healthcare institution A. Elimination of factors that negatively influence client care ***B. Acknowledgement of the client's need for individualized care ***C. Completion of documentation in an accurate, timely manner ***D. Awareness of factors that positively affect client care ***E. Knowledge about the culture of the healthcare institution Competence includes the nurse's awareness of the positive and negative factors that affect client care; however, the inability to eliminate the negative factors does not necessarily reflect a lack of nursing competence. Additional areas of nursing competence include understanding the culture of the client and the institution; acknowledging the client's need for individualized care; and accurate, timely completion of client documentation. The nurse preceptor is discussing integrity with the novice nurse. Which examples should the nurse preceptor use to illustrate integrity in nursing? (Select all that apply.) A. Delivering error-free nursing care B. Maintaining accountability for personal actions C. Accepting positive feedback from peers D. Working within the scope of practice E. Accepting negative feedback from clients A. Delivering error-free nursing care ***B. Maintaining accountability for personal actions ***C. Accepting positive feedback from peers ***D. Working within the scope of practice ***E. Accepting negative feedback from clients Examples of ways in which nurses demonstrate integrity include accepting feedback (positive or negative) as a tool for improving the delivery of client care, maintaining accountability for their actions, following their state's nurse practice act, and working only within their scope of practice. Nursing integrity does not require nurses to be perfect; rather, it requires nurses to admit when they make mistakes. During hospital orientation, the human resources specialist is defining and explaining sexual harassment. Which statement should be included in the human resource specialist's discussion of sexual harassment? A. "Sexual harassment interferes with performance in the workplace." B. "Sexual harassment requires the victim and violator to be of different genders." C. "Discrimination is one type of sexual harassment." D. "Physical contact is required for a behavior to be considered sexual harassment." ***A. "Sexual harassment interferes with performance in the workplace." B. "Sexual harassment requires the victim and violator to be of different genders." C. "Discrimination is one type of sexual harassment." D. "Physical contact is required for a behavior to be considered sexual harassment." By definition, sexual harassment interferes with the victim's performance in the workplace. Sexual harassment is one form of discrimination. The victim and violator may or may not be of the same gender. Examples of sexual harassment include requests for sexual favors and unwelcome verbal or physical sexual advances. During a classroom discussion, the nurse educator asks the nursing students to describe intimidation. Which students' statements most accurately describe intimidation? (Select all that apply.) A. "Intimidation includes having negative thoughts about nursing peers or colleagues." B. "Intimidation can include threatening someone with consequences for disobedience." C. "Intimidation includes experienced nurses who bully new nurses." D. "Covert and overt behaviors may qualify as being intimidation." E. "Nurses always realize when their behaviors toward clients are forms of intimidation." A. "Intimidation includes having negative thoughts about nursing peers or colleagues." ***B. "Intimidation can include threatening someone with consequences for disobedience." ***C. "Intimidation includes experienced nurses who bully new nurses." ***D. "Covert and overt behaviors may qualify as being intimidation." E. "Nurses always realize when their behaviors toward clients are forms of intimidation." Intimidation includes threatening, bullying, or forcing someone who is emotionally or physically weaker to do something in order to avoid retribution or negative consequences. Subtle, or covert, forms of intimidation may include standing close to someone while maintaining a hostile facial expression. Unexpressed negative thoughts are not reflective of intimidation. Intimidation may be unintentional on the nurse's part, including making statements such as, "If you do not take your medicine (or go to physical therapy, or follow the treatment plan), you're going to get worse." While the nurse's statement may be true, this approach is intimidating and unprofessional. The novice nurse asks the nurse preceptor to describe normative commitment. Which items should the nurse preceptor include in the description? (Select all that apply.) A. It may be demonstrated by engaging in profession-specific organizations and service activities. B. It develops when professional involvement produces a satisfying experience. C. It creates ties that are similar to those that emerge as a result of continuance commitment. D. It may be reflected by choosing to enter nursing due to experiences with personal illness. E. It can manifest as a feeling of obligation to continue in one's profession. A. It may be demonstrated by engaging in profession-specific organizations and service activities. B. It develops when professional involvement produces a satisfying experience. C. It creates ties that are similar to those that emerge as a result of continuance commitment. ***D. It may be reflected by choosing to enter nursing due to experiences with personal illness. ***E. It can manifest as a feeling of obligation to continue in one's profession. Normative commitment manifests as a feeling of obligation to continue in one's profession. It develops in response to benefits or positive experiences gained by way of engagement in one's profession. For example, the nurse whose desire to enter nursing or whose choice to remain in the profession stems from personal or family experiences with illness is reflective of normative commitment. Affective commitment develops when professional involvement produces a satisfying experience. Manifestations of affective commitment include engaging in profession-specific organizations and service activities. The ties created by continuance commitment differ from the ties that stem from affective or normative commitment. The nurse educator asks the nursing students to describe the stage of commitment development during which the student discovers negative aspects of a chosen profession. Which student's response is accurate? A. "The testing stage." B. "The quiet-and-bored stage." C. "The passionate stage." D. "The integrated stage." ***A. "The testing stage." B. "The quiet-and-bored stage." C. "The passionate stage." D. "The integrated stage." Development begins with the exploratory stage, followed by the testing stage, the passionate stage, the quiet-and-bored stage, and the integrated stage. The testing stage, which is the second stage of professional commitment, involves the individuals' discovery of negative aspects of the profession. The nursing student is experiencing the integrated stage of commitment development. When developing professional commitment, which behavior would the nursing student be most likely to demonstrate during the integrated stage? A. Being eager to take the NCLEX-RN® examination B. Considering switching to a major other than nursing C. Becoming involved in a student nursing association D. Learning about positive aspects of the nursing profession ***A. Being eager to take the NCLEX-RN® examination B. Considering switching to a major other than nursing C. Becoming involved in a student nursing association D. Learning about positive aspects of the nursing profession Being eager to take the NCLEX-RN®examination is reflective of the integrated stage of professional commitment development. The exploratory stage begins when individuals learn about the positive aspects of their profession. During the testing stage, students discover negative aspects of the profession and begin to assess their willingness and ability to cope with those negative aspects. Nursing students who do not move beyond the testing stage may drop out of school or change majors. Becoming involved in a student nursing association best illustrates a behavior demonstrated during the passionate stage of professional commitment development. The psychiatric nurse practitioner is giving a webinar about prevention of burnout in nursing. Which items should the psychiatric nurse practitioner include when describing tips related to having compassion? (Select all that apply.) A. Joining nursing associations that promote constructive discussion of work issues B. Acknowledging that most individuals do the best they can do C. Learning to ask for help from colleagues or confidantes when needed D. Perceiving errors and failures as opportunities for constructive learning E. Recognizing the limitations associated with any given situation A. Joining nursing associations that promote constructive discussion of work issues ***B. Acknowledging that most individuals do the best they can do ***C. Learning to ask for help from colleagues or confidantes when needed ***D. Perceiving errors and failures as opportunities for constructive learning E. Recognizing the limitations associated with any given situation Compassion includes learning to accept errors and failures, and recognizing these situations as opportunities for constructive learning. Acknowledging that most individuals do the best they can and learning to ask for help are also reflective of compassion. Participating in professional organizations that promote recognition and constructive discussion of workplace issues is reflective of professional engagement. Recognition of limitations associated with situations is reflective of acceptance. Jasmine Riddle is a novice nurse in the telemetry unit of a large hospital. While assessing her client, 72-year-old Albert Griswald, Jasmine notes that his pulse feels irregular. When she calls the telemetry monitoring station, the monitoring technician, Miguel, tells Jasmine that Mr. Griswald just developed atrial fibrillation. The technician praises Jasmine for catching the change in Mr. Griswald's cardiac rhythm so quickly—even before the telemetry technician recognized it. In her response, which action would reflect Jasmine's nursing integrity? A. Advising the telemetry technician to focus on his job and monitor clients' heart rhythms more closely B. Thanking the telemetry technician for praising her and for being part of the client's care team C. Notifying the telemetry technician's supervisor of his failure to recognize the change in cardiac rhythm D. Telling the telemetry technician that noticing the client's change in cardiac rhythm was "pure luck" A. Advising the telemetry technician to focus on his job and monitor clients' heart rhythms more closely B. Thanking the telemetry technician for praising her and for being part of the client's care team C. Notifying the telemetry technician's supervisor of his failure to recognize the change in cardiac rhythm D. Telling the telemetry technician that noticing the client's change in cardiac rhythm was "pure luck" Examples of ways in which nurses demonstrate integrity include accepting feedback (positive or negative) as a tool for improving the delivery of client care. Attributing excellent assessment skills to "luck" is not wrong, but it does not reflect integrity. Admonishing the telemetry technician or contacting his supervisor are neither warranted nor appropriate actions. Scott Nitroskey, a home health nurse, is caring for 67-year-old Martha Miriste, a female client who is diagnosed with diabetes. Scott is completing Mrs. Mireste's client teaching. During the teaching session, which statement might Mrs. Mireste interpret as being Scott's attempt to intimidate her? A. "If you don't stop eating so much candy, your diabetes is going to get much worse." B. "Regular exercise can help with the management of your diabetes." C. "If you cut back on your sugar intake, you might see some improvement in your diabetes." D. "Increased sugar in your diet can cause your blood sugar to go up and impact your diabetes." ***A. "If you don't stop eating so much candy, your diabetes is going to get much worse." B. "Regular exercise can help with the management of your diabetes." C. "If you cut back on your sugar intake, you might see some improvement in your diabetes." D. "Increased sugar in your diet can cause your blood sugar to go up and impact your diabetes." Intimidation may be unintentional on the nurse's part, including making statements such as, "If you do not take your medicine (or go to physical therapy, or follow the treatment plan), you're going to get worse." Although eating excess amounts of candy may cause the client's diabetes to worsen, this approach is intimidating and unprofessional. Encouraging the client through telling her which interventions may improve her condition is not reflective of intimidation, nor is explaining the link between dietary sugar and blood sugar. Mitchell Asplund, a clinical nursing instructor, is assigned to serve as a student faculty advisor. Mitchell's responsibilities include determining which stage of commitment to nursing his students are experiencing. He is evaluating nursing student Don Rowlands, who is a junior in nursing school. During his evaluation, Don states, "I want to join the National Student Nurses Association. I'm also volunteering to participate in the student health fair. I know I'm really busy, but my schedule will be crazy when I'm working as a nurse, too. It's worth it to me." Mitchell recognizes that Don is in which stage of making a professional commitment to nursing? A. Testing B. Passionate C. Integrated D. Exploratory A. Testing ***B. Passionate C. Integrated D. Exploratory The passionate stage, which is the third stage of commitment, begins as the individual processes the positive and negative aspects of the profession. At this point, students are willing to commit to their profession and to contribute to its well-being. Examples of student behaviors that are reflective of this stage include serving as a class officer, becoming involved in student nursing associations, and volunteering for activities not associated with a grade. The exploratory stage, which is the first stage of professional commitment, begins when individuals explore the positive aspects of their profession. During the testing stage, which is the second stage of professional commitment, students discover negative aspects of the profession. The quiet-and-bored stage, which is the fourth stage of commitment, involves settling into the nursing program's routines. The integrated stage, which is the fifth and final stage of commitment, requires integration of positive and negative elements of the profession into a more flexible, complex, and enduring form of commitment. The nurse unit manager is giving an in-service about sexual harassment in the workplace. When discussing what constitutes sexual harassment, which statement is most appropriate for the nurse unit manager to include in the in-service? A. Sexual harassment must be considered both a form of discrimination and a violation of an individual's rights. B. Behaviors must include unwelcome advances of a sexual nature that are demonstrated through the perpetrator's physical conduct. C. The sexual behaviors must interfere with the victim's work performance and prevent fulfillment of work functions. D. Submitting to requests for sexual behaviors must be explicitly considered a condition of an individual's employment. ***A. Sexual harassment must be considered both a form of discrimination and a violation of an individual's rights. B. Behaviors must include unwelcome advances of a sexual nature that are demonstrated through the perpetrator's physical conduct. C. The sexual behaviors must interfere with the victim's work performance and prevent fulfillment of work functions. D. Submitting to requests for sexual behaviors must be explicitly considered a condition of an individual's employment. Sexual harassment is a form of discrimination, as well as a violation of an individual's rights. The Equal Employment Opportunity Commission (EEOC) defines sexual harassment as "unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature" occurring when submitting to such requests or behavior is considered, either explicitly or implicitly, a condition of an individual's employment; when submission to or rejection of such requests or behavior is used as the basis for employment decisions affecting the individual (e.g., promotion); or when such conduct interferes with an individual's work performance or creates an "intimidating, hostile, offensive working environment." The nurse leader is planning an in-service about integrity in nursing practice. Which statement regarding integrity in nursing is most appropriate for the nurse leader to include in the in-service? A. "Integrity means understanding that negative feedback from peers has little value." B. "Integrity means internalizing professional practices that the nurse prefers to follow." C. "Nurses with integrity adhere to a strict moral or ethical code." D. "Nurses with integrity provide excellent care and do not make errors." A. "Integrity means understanding that negative feedback from peers has little value." B. "Integrity means internalizing professional practices that the nurse prefers to follow." ***C. "Nurses with integrity adhere to a strict moral or ethical code." D. "Nurses with integrity provide excellent care and do not make errors." Integrity requires adherence to a strict ethical or moral code, such as the ANA Code of Ethics for Nurses. Integrity involves practicing consistent behaviors based on the internalization of the ethics, values, and best practices of the nursing profession. Integrity in nursing includes accepting positive or negative feedback as a tool for improving the delivery of client care. Nurses with integrity are not perfect; however, they admit to their mistakes. As part of hospital orientation for a group of nurses, the human resources representative is discussing intimidation. Which information is most appropriate for the human resources representative to include in the discussion? A. Intimidation may include repeatedly asking another individual for favors. B. Intimidation may include unintentional nursing behaviors and statements made to clients. C. Covert forms of intimidation may include making verbal threats. D. Overt forms of intimidation may include standing too close to someone. A. Intimidation may include repeatedly asking another individual for favors. ***B. Intimidation may include unintentional nursing behaviors and statements made to clients. C. Covert forms of intimidation may include making verbal threats. D. Overt forms of intimidation may include standing too close to someone. Intimidation includes threatening, bullying, or forcing someone who is emotionally or physically weaker to do something in order to avoid retribution or negative consequences. Asking an individual for favors without any associated retribution or negative consequences is not reflective of intimidation. Subtle, or covert, forms of intimidation include standing close to someone while maintaining a hostile facial expression. Intimidation may also be overt, such as threatening an individual with consequences for not obeying an order. On the nurse's part, intimidation may be unintentional; for example, making statements such as, "If you do not take your medicine (or go to physical therapy, or follow the treatment plan), you're going to get worse." The nurse leader is evaluating the charge nurse's type of commitment to the nursing profession. Which behavior by the charge nurse is most reflective of affective commitment to nursing? A. Choosing to stay in nursing due to personal experiences with illness B. Joining professional nursing organizations and engaging in nursing service activities C. Remaining in the nursing profession to avoid loss of income D. Expressing a sense of obligation to remain in the nursing profession A. Choosing to stay in nursing due to personal experiences with illness ***B. Joining professional nursing organizations and engaging in nursing service activities C. Remaining in the nursing profession to avoid loss of income D. Expressing a sense of obligation to remain in the nursing profession Affective commitment develops when professional involvement produces a satisfying experience. Manifestations of affective commitment include engaging in profession-specific organizations and service activities. Normative commitment manifests as a feeling of obligation to continue in one's profession and it develops in response to benefits or positive experiences gained by way of engagement in one's profession. For example, the nurse whose desire to enter nursing stems from personal or family experiences with illness is reflective of normative commitment. Continuance commitment develops when negative consequences of leaving, such as loss of income, are viewed as reasons to stay. The nurse leader is preparing a webinar about how to prevent burnout in nursing. To accurately describe strategies for preventing burnout, which activity should the nurse educator include in the webinar? A. Actively engage in efforts to produce constructive change if organizational policies create stress B. Develop acceptance and recognize that the limitations of any situation can be changed C. Study assertiveness and learn to take on added responsibilities even when feeling overwhelmed D. Learn to depend on oneself and to avoid expressions of emotions toward colleagues ***A. Actively engage in efforts to produce constructive change if organizational policies create stress B. Develop acceptance and recognize that the limitations of any situation can be changed C. Study assertiveness and learn to take on added responsibilities even when feeling overwhelmed D. Learn to depend on oneself and to avoid expressions of emotions toward colleagues Strategies for preventing burnout in nursing include involvement, studying assertiveness techniques, expressing compassion, and developing acceptance. Involvement includes being active in efforts to produce constructive change if organizational policies cause stress. Studying assertiveness techniques, which can help with overcoming feelings of powerlessness in relationships, includes learning to say no. Compassion includes learning to ask for help and expressing emotions toward colleagues. Acceptance includes recognizing the limitations associated with each situation and accepting what cannot be changed. A nurse is interviewing for a staff position on a medical-surgical unit. Which portion of the hiring process best represents the hospital's efforts to evaluate the nurse's commitment to the profession? A. Requiring the candidate to provide official copies of college transcripts B. Offering the candidate the option of completing a four-week unit orientation and preceptorship C. Inviting current staff nurses to serve as members of the candidate's interview committee D. Exploring the candidate's desire to maintain membership in the profession A. Requiring the candidate to provide official copies of college transcripts B. Offering the candidate the option of completing a four-week unit orientation and preceptorship C. Inviting current staff nurses to serve as members of the candidate's interview committee ***D. Exploring the candidate's desire to maintain membership in the profession The candidate's desire to maintain membership in the nursing profession is reflective of professional commitment. The requirement to provide official college transcripts is not directly related to the candidate's commitment to the nursing profession. Inviting current staff nurses to serve as interview committee members and offering a unit orientation and preceptorship are not direct methods of evaluating the candidate's professional commitment to nursing. The clinical nursing instructor is evaluating the student's developmental stage of professional commitment. The student has settled into the nursing program's routine and reports experiencing decreased performance anxiety. Which stage of professional commitment is most appropriate for the clinical nursing instructor to use when describing the student's current level of development? A. The exploratory stage B. The quiet-and-bored stage C. The integrated stage D. The testing stage A. The exploratory stage ***B. The quiet-and-bored stage C. The integrated stage D. The testing stage Development begins with the exploratory stage, which begins when individuals explore the positive aspects of their profession. Examples include the excitement nursing students experience when first wearing their new uniforms or when purchasing their first stethoscope. The second stage is the testing stage, during which students discover the positive and negative aspects of the nursing profession. During the third stage, which is the passionate stage, students are willing to commit to their profession and to contribute to its well-being. Examples of student behaviors that are reflective of this stage include serving as a class officer and becoming involved in student nursing associations. During the fourth stage, which is the quiet-and-bored stage, students settle into the nursing program's routines, grow more comfortable in their role, and experience decreased performance anxiety. The integrated stage, which is the fifth stage, manifests through the student's demonstration of commitment as a matter of habit. This stage usually begins in the final phases of the nursing program, with students beginning to see themselves as nurses, and growing eager to take the NCLEX-RN® and to begin working. The staff nurse is caring for a client who has recently undergone surgical repair of an inguinal hernia. Despite administration of pain medications as ordered, the client continues to complain of excruciating pain. When the staff nurse offers to reposition the client, the client states, "You don't have any idea what you're doing. I need more medication. I need a nurse who can help me!" Which behavior best illustrates demonstration of compassion by the staff nurse? A. Notifying the primary care provider about the client's complaints of pain despite receiving medication B. Collaborating with the charge nurse and requesting that another nurse assume the client's care C. Explaining that inguinal hernia repairs usually require significantly less medication for adequate pain relief D. Seeking out a nursing colleague to privately vent about the client's rudeness and inconsideration ***A. Notifying the primary care provider about the client's complaints of pain despite receiving medication B. Collaborating with the charge nurse and requesting that another nurse assume the client's care C. Explaining that inguinal hernia repairs usually require significantly less medication for adequate pain relief D. Seeking out a nursing colleague to privately vent about the client's rudeness and inconsideration Professionalism in nursing requires demonstrating a positive attitude while working with clients, their family members, and other healthcare professionals. Venting to a nursing colleague is not reflective of a positive attitude. Professionalism in nursing also requires compassion, which is an awareness of and concern about other individuals' suffering. Requesting that the client's care be reassigned to another staff nurse is not reflective of compassion. Demonstrations of compassion in nursing include recognizing and meeting clients' needs and treating each client as a unique and special individual and not as a diagnosis (for example, "an inguinal hernia repair") or number. Notifying the primary care provider about the client's complaints of pain despite receiving pain medication best reflects recognizing and meeting the client's needs. The ten-year-old client is very interested in learning about her cancer care and in participating in the decisions about her care. What is the most appropriate action by the pediatric nurse? A. Distracting the child with a video game B. Informing the healthcare team that the child is going to be a problem C. Telling the client's mother that she needs to explain things to her child D. Providing adequate, age-appropriate information about the disease and treatment options A. Distracting the child with a video game B. Informing the healthcare team that the child is going to be a problem C. Telling the client's mother that she needs to explain things to her child ***D. Providing adequate, age-appropriate information about the disease and treatment options The pediatric nurse would provide adequate, age-appropriate information about the disease and treatment options. The client's mother would be included in the teaching process before being called upon to explain things to her child. A child who wants to be involved in her care is not a problem. Distraction would be inappropriate and counter to the concepts of advocacy. The nurse provides education to the client who is facing a difficult healthcare choice. What is the intended goal of this action? A. Enabling B. Co-dependency C. Informed consent D. Empowerment A. Enabling B. Co-dependency C. Informed consent ***D. Empowerment Nurses advocate for clients in order to protect their rights and empower them to participate in making informed healthcare decisions. While enabling is a type of advocacy, it is not the intended goal for this client. Principles of informed consent are not involved here. Co-dependency is the opposite of what advocacy seeks to achieve. The nurse is developing the plan of care for an English-speaking Micronesian man with an 8th grade education who has hypertension. The client is noncompliant with taking medications and is not following up with the healthcare provider as needed. Which criteria indicates the need for an advocate to help the client access the resources he requires? A. Very ill or in pain B. Lower literacy level C. Low income level D. Non-English speaking A. Very ill or in pain ***B. Lower literacy level C. Low income level D. Non-English speaking Clients with low overall literacy and low health literacy levels have difficulty understanding their medical situation and become easily confused with navigating the healthcare system. Advocacy is needed in that situation. The client speaks English. The client feels well and is not in pain. There is not enough information to determine his income level. The bilingual nurse is caring for a client who speaks only Spanish. What is the best way for the nurse to advocate for this client? A. Arranging for bill payment for the client B. Representing the client's needs and wishes to other healthcare professionals C. Signing consent forms on the client's behalf D. Discussing the client's care with the client's visitors A. Arranging for bill payment for the client ***B. Representing the client's needs and wishes to other healthcare professionals C. Signing consent forms on the client's behalf D. Discussing the client's care with the client's visitors The nurse would use bilingual skills to interpret medical information for the client and then relay the client's needs and wishes to other healthcare professionals. The nurse would never sign documents on the client's behalf. The nurse would not discuss the client's care with anyone but other healthcare professionals who are involved in the client's care. The nurse would never be involved in the client's financial transactions. The nurse makes a telephone call to a client who was recently discharged. The nurse wants to assess whether the client has read the discharge material and made appointments with the healthcare provider. Which dimension of advocacy is involved with this intervention? A. Following-up regarding care B. Advising about legal rights C. Enabling self-care D. Going above and beyond ***A. Following-up regarding care B. Advising about legal rights C. Enabling self-care D. Going above and beyond The nurse advocate is following-up, which is one of the four dimensions of advocacy. The other three are being a client advocate, providing resources, and going above and beyond. Routine calls are not going above and beyond. Enabling self-care and advising the client of legal rights are not included in the four dimensions of advocacy. The nurse is caring for a client with Down syndrome. The client was recently denied employment because of the syndrome, and the client and his mother are very upset and are requesting assistance. Which piece of federal legislation is most appropriate for the nurse to refer to when advocating for this client? A. The Social Security Act Amendments of 1965 (SSA) B. The Americans with Disabilities Act of 1990 (ADA) C. The Patient Self-Determination Act of 1991 (PSDA) D. The Patient Protection and Affordable Care Act of 2010 (PPACA) A. The Social Security Act Amendments of 1965 (SSA) ***B. The Americans with Disabilities Act of 1990 (ADA) C. The Patient Self-Determination Act of 1991 (PSDA) D. The Patient Protection and Affordable Care Act of 2010 (PPACA) The client is afforded protection in the area of employment, public services, and benefits by the Americans with Disabilities Act of 1990. The PPACA is a health insurance and assurance act. The PSDA regards rights to decision-making in medical care. The SSA Amendments introduced the Medicare program. Which client groups are more likely to need an advocate when accessing healthcare resources? (Select all that apply.) A. A family who is living in poverty B. A family whose primary language is Spanish C. A client who has a lower literacy level D. A client in chronic pain E. A client diagnosed with cancer who has family support ***A. A family who is living in poverty ***B. A family whose primary language is Spanish ***C. A client who has a lower literacy level ***D. A client in chronic pain E. A client diagnosed with cancer who has family support Clients who do not speak English, have lower literacy levels, are very ill or in pain, or are of low income levels have more difficulty navigating the healthcare system and would benefit from the assistance of a nurse advocate. Clients who have family support may also have better resources for obtaining information needed for decision making. Which statement describes the overall goal of client advocacy? A. The overall goal of client advocacy is to safeguard the client from harm. B. The overall goal of client advocacy is to educate clients. C. The overall goal of client advocacy is to speak for clients. D. The overall goal of client advocacy can only be achieved by specially trained nurses. ***A. The overall goal of client advocacy is to safeguard the client from harm. B. The overall goal of client advocacy is to educate clients. C. The overall goal of client advocacy is to speak for clients. D. The overall goal of client advocacy can only be achieved by specially trained nurses. The overall goal of client advocacy is to safeguard clients from harm and to represent their needs to other healthcare professionals. Speaking for clients and educating clients are actions that support the protection of the client's rights. All nurses are client advocates, with or without special training. Which type of client advocacy concerns itself with growth and development, ensuring good nutrition and exercise, stress management, and preventing disease? A. Safety B. Patient Self-Determination Act (PSDA) C. Bill of Rights D. Health promotion A. Safety B. Patient Self-Determination Act (PSDA) C. Bill of Rights ***D. Health promotion Health promotion concerns itself with growth and development, ensuring good nutrition and exercise, stress management, and preventing disease. Safety concerns itself with injury prevention, neglect, and abuse. The Bill of Rights helps clients to understand their rights. The PSDA protects the rights of clients to accept or reject aspects of their medical care. In deciding to report a co-worker who has engaged in illegal, immoral, or unethical conduct, the nurse can turn to which organizations for guidance? (Select all that apply.) A. The police B. The American Nurses Association C. The state board of nursing D. The National Alliance on Mental Illness E. Nursing school A. The police ***B. The American Nurses Association ***C. The state board of nursing D. The National Alliance on Mental Illness E. Nursing school The nurse would turn to the state board of nursing or the American Nurses Association for guidance regarding the behavior of a co-worker. Nursing school would not be an official resource. The National Alliance on Mental Illness is an advocacy program. The nurse would not initiate consultation with the police - this would be done by the employer. When initially evaluating the needs of children and families, it is most important for the nurse to have knowledge of which item? A. The Affordable Care Act (ACA) B. Ability to manage symptoms C. The Americans with Disabilities Act (ADA) D. Healthcare options A. The Affordable Care Act (ACA) B. Ability to manage symptoms C. The Americans with Disabilities Act (ADA) ***D. Healthcare options When assessing a child and family for advocacy needs, it is most important for the nurse to look at the healthcare options available to the child and family. The nurse would take the client's ability to manage symptoms into account when working with a client with a mental health disorder. The nurse would not be involved in health insurance planning through the ACA. The ADA would not be part of the initial assessment of needs. Which actions by professional staff are considered abusive or unprofessional behavior toward clients with mental health disorders? (Select all that apply.) A. Supplying clients with drugs or alcohol in return for favors B.

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