,
,
,
, 11. Which of the following provides evidence-based support for the
contribution that advanced practice nurses (APNs) make within healthcare?
1)
Reduced usage of diagnostics using advanced technology
2)
Decreased number of unnecessary visits to the emergency department 3)
Improved patient compliance with prescribed treatments
4)
Increased usage of complementary alternative therapies
ANS: 3
Studies demonstrate that APNs have improved patient outcomes over those of physicians,
including increased patient understanding and cooperation with treatments and decreased
need for hospitalizations. No well-known, scientific studies support APNs effect on the use
of advanced technology. No well-known, scientific studies support APNs effect on the
frequency of emergency department visits. No well-known, scientific studies support
APNs effect on the use of alternative therapies.
PTS:1DIF:ModerateREF:p. 20
KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall
12. Which of the following is an example of what traditional medicine
and complementary and alternative medicine therapies have in common?
1)
Both can produce adverse effects in some patients.
2)
Both use prescription medications.
3)
Both are usually reimbursed by insurance programs.
4)
Both are regulated by the FDA.
ANS: 1
Both traditional and complementary therapies can produce adverse effects in some
patients. Many medications are derived from herbs, but the alternative treatments usually
use the herbs, not prescription medication. Insurance programs do not necessarily
reimburse alternative treatments, because many are not supported by sound scientific
research methodology. Alternative medications are not regulated by the FDA.
PTS:1DIF:ModerateREF:p. 20
KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall
13. Of the following, the biggest disadvantage of having nursing assistive
personnel (NAP) help nurses is that the nurse
1)
Must know what aspects of care can legally and safely be delegated to the NAP
2)
May rely too heavily on information gathered by the NAP when making patient care
decisions
3)
Is removed from many components of direct patient care that have been delegated to the
NAP
4)
Still maintains responsibility for the patient care given by the NAP
ANS: 2
,All of the options may be disadvantages to using NAPs, but making decisions based on
anothers information is the greatest drawback because of the potential for negatively
affecting patient care. Treatment decisions based on incorrect information may cause
harm to the patient.
PTS:1DIFifficultREF:p. 2021; students must conclude from content KEY:
Nursing process: N/A | Client need: N/A | Cognitive level: Analysis
14. An older adult has type 1 diabetes. He can perform self-care activities but
needs help with shopping and meal preparation as well as with blood glucose monitoring
and insulin administration. Which type of healthcare facility would be most appropriate
for him?
1)
Acute care facility 2)
Ambulatory care facility 3)
Extended care facility
4)
Assisted living facility
ANS: 4
Assisted living facilities are intended for those who are able to perform self-care
activities but who require assistance with meals, housekeeping, or medications. Acute
care facilities focus on preventing illnesses and treating acute problems. These facilities
include physicians offices, clinics, and diagnostic centers. Ambulatory care facilities
provide outpatient care. Clients live at home or in nonhospital settings and come to the
site for care. Ambulatory care facilities include private health and medical offices, clinics,
surgery centers, and outpatient therapy centers. Extended care facilities typically provide
long-term care, rehabilitation, wound care, and ongoing monitoring of patient conditions.
PTS:1DIF:EasyREF:p. 18; ESG,
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
15. The nurse in the intensive care unit is providing care for only one patient, who
was admitted in septic shock. Based on this information, which care delivery model can
you infer that this nurse is following?
1)
Functional
2)
Primary
3)
Case method
4)
Team ANS:
3
The nurse is following the case method model of nursing care. In this model, one nurse
cares for one patient during a single shift. When the functional nursing model is
employed, care is compartmentalized, and each task is assigned to a staff member with
the appropriate knowledge and skills. In primary nursing, one nurse plans the care for a
group of patients round-the-clock. The primary nurse assesses the patient and develops
the plan of care. When he or she is working, he or she provides care for those patients
that he or she is responsible for. In his or her absence, the associate nurses deliver care.
Although the nurse in this case could possibly be a primary nurse, there are not enough
data to confidently infer that. If the team nursing approach is utilized, a licensed nurse
(RN or LVN) is paired with a nursing assistant. The pair is then assigned to a group of
patients.
,PTS:1DIF:ModerateREF:ESG,
KEY: Nursing process: Implementation | Client need: SECE | Cognitive level: Analysis
16. Which healthcare worker should the nurse consult to counsel a patient
about financial and family stressors affecting healthcare?
1)
Social worker
2)
Occupational therapist
3)
Physicians assistant
4)
Technologist
ANS: 1
The social worker coordinates services and counsels patients about financial, housing,
marital, and family issues affecting healthcare. The occupational therapist helps patients
regain function and independence for activities of daily living. Physicians assistants work
under the physicians direction to diagnose certain diseases and injuries. Technologists
provide a variety of specific functions in hospitals, diagnostic centers, and emergency care.
For example, laboratory technologists aid in the diagnosis and treatment of patients by
examining blood, urine, tissue, and body fluids. Radiology technologists perform x- rays
and other diagnostic testing.
PTS:1DIF:ModerateREF:ESG,
KEY: Nursing process: Planning | Client need: SECE | Cognitive level: Comprehension
17. Which type of managed care allows patients the greatest choice of
providers, medications, and medical devices?
1)
Health maintenance organization
2)
Integrated delivery network 3)
Preferred provider organization
4)
Employment-based private insurance
ANS: 3
Preferred provider organizations are a form of managed care that allows the patient a
greater choice of providers, medications, and medical devices within the designated list.
Health maintenance organizations allow the patient to choose a primary care provider
within the organization to coordinate his care. This type of program will only reimburse
medical care when the patient has first obtained a referral from the primary provider.
Integrated delivery networks combine providers, healthcare facilities, pharmaceuticals,
and services into one system, and the patient must remain within the system to receive
care. Employment-based private insurance is not a managed care organization.
PTS:1DIF:EasyREF:ESG,
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Analysis
18. A patient who underwent a total abdominal hysterectomy is assisted out of bed
as soon as her vital signs are stable. This intervention is most likely being directed by a
1)
Critical pathway 2)
Nursing care plan
3)
Case manager
,4)
Traditional care model
ANS: 1
This patients care is most likely being directed by a critical pathway. A critical pathway
is a multidisciplinary approach to care that sequences interventions over a length of stay
for a given case type, such as total abdominal hysterectomy. Using this model, the patient
can be assisted out of bed as soon as her vital signs are stable. Using the traditional model,
the nurse would have to obtain a physicians order to assist the patient out of bed after
surgery. The nursing care plan guides nursing care but cannot specify when the patient can
get out of bed postoperatively without a physicians order. When case management is used,
care is coordinated by the case manager across the healthcare setting, but the case manager
does not direct each care intervention.
PTS:1DIF:ModerateREF:ESG
KEY: Nursing process: Planning | Client need: SECE | Cognitive level: Application
19. Which member of the healthcare team typically serves as the case
manager? 1)
Occupational therapist
2)
Physician
3)
Physicians assistant
4)
Registered nurse
ANS: 4
Typically, registered nurses serve as case managers for patients with specific diagnoses.
Their role is coordinator of care across the healthcare system. The occupational therapist,
physician, and physicians assistant all serve on the healthcare team and take direction
from the case manager.
PTS: 1 DIF: Easy REF: ESG,
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Recall
20. Which of the following is considered a primary care
service? 1)
Providing wound care
2)
Administering childhood immunizations
3)
Providing drug rehabilitation
4)
Outpatient hernia repair
ANS: 2
Primary care services focus on health promotion and disease prevention; administering
childhood immunizations is one such service. Providing wound care and drug
rehabilitation are examples of tertiary care services. Outpatient hernia repair surgery is an
example of a secondary care service.
PTS:1DIF:ModerateREF:ESG,
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
21. Which of the following nursing activities represent direct care? Choose all
that apply.
1)
,Bathing a patient
2)
Administering a medication
3)
Documenting an assessment
4)
Making work assignments for the shift
ANS: 1
B
Direct care involves personal interaction between the nurse and clients (e.g., giving
medications, dressing a wound, or teaching a client about medicines or care). Nurses
deliver indirect care when they work on behalf of an individual, group, family, or
community to improve their health status (e.g., restocking the code blue cart [an
emergency cart], ordering unit supplies, or arranging unit staffing).
PTS:1DIF:EasyREF:p. 17
KEY: Nursing process: Implementation | Client need: SECE | Cognitive level:
Comprehension
22. An 80-year-old patient fell and fractured her hip and is in the hospital. Before
the fall, she lived at home with her husband and managed their activities of daily living
very well. The goal is for the patient to recover from the injury and return to her home.
The hospital is ready to discharge her because she has exceeded the recommended length
of stay in a hospital. However, she cannot walk or care for herself yet, and she will require
lengthy physical therapy and further monitoring of her medications and her physical and
mental status. To which type of facility should she be transferred?
1)
Nursing home
2)
Rehabilitation center 3)
Outpatient therapy center
4)
None of these; she should receive home healthcare
ANS: 2
A skilled nursing facility primarily provides skilled nursing care for patients who can be
expected to improve with treatment. For example, a patient who no longer needs
hospitalization may transfer to a skilled nursing facility to get skilled care until she is able
to return home. A nursing home provides custodial care for people, like this patient, who
cannot live on their own but who are not sick enough to require hospitalization. It provides
a room, custodial care, and opportunity for recreation. This patient cannot ambulate or
perform activities of daily living, so outpatient therapy and home care would not be
appropriate.
PTS:1DIF:ModerateREF:p. 18
KEY: Nursing process: Implementation | Client need: SECE | Cognitive level:
Application
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. Which of the following are examples of a health-promotion activity? Select
all that apply.
1)
Helping a client develop a plan for a low-fat, low-cholesterol diet
, 2)
Disinfecting an abraded knee after a child falls off a bicycle
3)
Administering a tetanus vaccination after an injury from a car accident
4)
Distributing educational brochures about the benefits of exercise
ANS: 1, 4
Health promotion includes strategies that promote positive lifestyle changes. Disinfecting
an abraded knee is a treatment/intervention for an injury. Administering a vaccination is a
disease-prevention and treatment activity.
PTS: 1 DIF: Moderate REF: p. 18; high-level question, not directly stated in text
KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Application
Matching
Match the nursing role listed on the left with the appropriate activity listed on the right.
Each activity has only one correct answer.
1)
Planning the units staffing schedule
2)
Participating on a committee to develop a program to teach schoolchildren proper
handwashing
3)
Teaching the client about a scheduled test
4)
Discussing new medication at a staff meeting
5)
Discussing with the physician the clients reasons for not wanting the recommended
surgery.
1. Direct care provider
2. Client advocate
3. Manager
4. Change agent
1.ANS:3PTS:1DIF:Moderate
REF:p. 13; must recognize examples not provided in content
KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application
2.ANS:5PTS:1DIF:Moderate
REF:p. 13; must recognize examples not provided in content
KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application
3.ANS:1PTS:1DIF:Moderate
REF:p. 13; must recognize examples not provided in content
KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application
4.ANS:2PTS:1DIF:Moderate
REF:p. 13; must recognize examples not provided in content
KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application Match
the event with the appropriate year. Each item has only one correct answer. 1)
Nursing programs become affiliated with religious groups
2)
Start of public health nursing with the founding of the Henry Street Settlement
3)
First formal nursing education in United States
,
,
, 11. Which of the following provides evidence-based support for the
contribution that advanced practice nurses (APNs) make within healthcare?
1)
Reduced usage of diagnostics using advanced technology
2)
Decreased number of unnecessary visits to the emergency department 3)
Improved patient compliance with prescribed treatments
4)
Increased usage of complementary alternative therapies
ANS: 3
Studies demonstrate that APNs have improved patient outcomes over those of physicians,
including increased patient understanding and cooperation with treatments and decreased
need for hospitalizations. No well-known, scientific studies support APNs effect on the use
of advanced technology. No well-known, scientific studies support APNs effect on the
frequency of emergency department visits. No well-known, scientific studies support
APNs effect on the use of alternative therapies.
PTS:1DIF:ModerateREF:p. 20
KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall
12. Which of the following is an example of what traditional medicine
and complementary and alternative medicine therapies have in common?
1)
Both can produce adverse effects in some patients.
2)
Both use prescription medications.
3)
Both are usually reimbursed by insurance programs.
4)
Both are regulated by the FDA.
ANS: 1
Both traditional and complementary therapies can produce adverse effects in some
patients. Many medications are derived from herbs, but the alternative treatments usually
use the herbs, not prescription medication. Insurance programs do not necessarily
reimburse alternative treatments, because many are not supported by sound scientific
research methodology. Alternative medications are not regulated by the FDA.
PTS:1DIF:ModerateREF:p. 20
KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall
13. Of the following, the biggest disadvantage of having nursing assistive
personnel (NAP) help nurses is that the nurse
1)
Must know what aspects of care can legally and safely be delegated to the NAP
2)
May rely too heavily on information gathered by the NAP when making patient care
decisions
3)
Is removed from many components of direct patient care that have been delegated to the
NAP
4)
Still maintains responsibility for the patient care given by the NAP
ANS: 2
,All of the options may be disadvantages to using NAPs, but making decisions based on
anothers information is the greatest drawback because of the potential for negatively
affecting patient care. Treatment decisions based on incorrect information may cause
harm to the patient.
PTS:1DIFifficultREF:p. 2021; students must conclude from content KEY:
Nursing process: N/A | Client need: N/A | Cognitive level: Analysis
14. An older adult has type 1 diabetes. He can perform self-care activities but
needs help with shopping and meal preparation as well as with blood glucose monitoring
and insulin administration. Which type of healthcare facility would be most appropriate
for him?
1)
Acute care facility 2)
Ambulatory care facility 3)
Extended care facility
4)
Assisted living facility
ANS: 4
Assisted living facilities are intended for those who are able to perform self-care
activities but who require assistance with meals, housekeeping, or medications. Acute
care facilities focus on preventing illnesses and treating acute problems. These facilities
include physicians offices, clinics, and diagnostic centers. Ambulatory care facilities
provide outpatient care. Clients live at home or in nonhospital settings and come to the
site for care. Ambulatory care facilities include private health and medical offices, clinics,
surgery centers, and outpatient therapy centers. Extended care facilities typically provide
long-term care, rehabilitation, wound care, and ongoing monitoring of patient conditions.
PTS:1DIF:EasyREF:p. 18; ESG,
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
15. The nurse in the intensive care unit is providing care for only one patient, who
was admitted in septic shock. Based on this information, which care delivery model can
you infer that this nurse is following?
1)
Functional
2)
Primary
3)
Case method
4)
Team ANS:
3
The nurse is following the case method model of nursing care. In this model, one nurse
cares for one patient during a single shift. When the functional nursing model is
employed, care is compartmentalized, and each task is assigned to a staff member with
the appropriate knowledge and skills. In primary nursing, one nurse plans the care for a
group of patients round-the-clock. The primary nurse assesses the patient and develops
the plan of care. When he or she is working, he or she provides care for those patients
that he or she is responsible for. In his or her absence, the associate nurses deliver care.
Although the nurse in this case could possibly be a primary nurse, there are not enough
data to confidently infer that. If the team nursing approach is utilized, a licensed nurse
(RN or LVN) is paired with a nursing assistant. The pair is then assigned to a group of
patients.
,PTS:1DIF:ModerateREF:ESG,
KEY: Nursing process: Implementation | Client need: SECE | Cognitive level: Analysis
16. Which healthcare worker should the nurse consult to counsel a patient
about financial and family stressors affecting healthcare?
1)
Social worker
2)
Occupational therapist
3)
Physicians assistant
4)
Technologist
ANS: 1
The social worker coordinates services and counsels patients about financial, housing,
marital, and family issues affecting healthcare. The occupational therapist helps patients
regain function and independence for activities of daily living. Physicians assistants work
under the physicians direction to diagnose certain diseases and injuries. Technologists
provide a variety of specific functions in hospitals, diagnostic centers, and emergency care.
For example, laboratory technologists aid in the diagnosis and treatment of patients by
examining blood, urine, tissue, and body fluids. Radiology technologists perform x- rays
and other diagnostic testing.
PTS:1DIF:ModerateREF:ESG,
KEY: Nursing process: Planning | Client need: SECE | Cognitive level: Comprehension
17. Which type of managed care allows patients the greatest choice of
providers, medications, and medical devices?
1)
Health maintenance organization
2)
Integrated delivery network 3)
Preferred provider organization
4)
Employment-based private insurance
ANS: 3
Preferred provider organizations are a form of managed care that allows the patient a
greater choice of providers, medications, and medical devices within the designated list.
Health maintenance organizations allow the patient to choose a primary care provider
within the organization to coordinate his care. This type of program will only reimburse
medical care when the patient has first obtained a referral from the primary provider.
Integrated delivery networks combine providers, healthcare facilities, pharmaceuticals,
and services into one system, and the patient must remain within the system to receive
care. Employment-based private insurance is not a managed care organization.
PTS:1DIF:EasyREF:ESG,
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Analysis
18. A patient who underwent a total abdominal hysterectomy is assisted out of bed
as soon as her vital signs are stable. This intervention is most likely being directed by a
1)
Critical pathway 2)
Nursing care plan
3)
Case manager
,4)
Traditional care model
ANS: 1
This patients care is most likely being directed by a critical pathway. A critical pathway
is a multidisciplinary approach to care that sequences interventions over a length of stay
for a given case type, such as total abdominal hysterectomy. Using this model, the patient
can be assisted out of bed as soon as her vital signs are stable. Using the traditional model,
the nurse would have to obtain a physicians order to assist the patient out of bed after
surgery. The nursing care plan guides nursing care but cannot specify when the patient can
get out of bed postoperatively without a physicians order. When case management is used,
care is coordinated by the case manager across the healthcare setting, but the case manager
does not direct each care intervention.
PTS:1DIF:ModerateREF:ESG
KEY: Nursing process: Planning | Client need: SECE | Cognitive level: Application
19. Which member of the healthcare team typically serves as the case
manager? 1)
Occupational therapist
2)
Physician
3)
Physicians assistant
4)
Registered nurse
ANS: 4
Typically, registered nurses serve as case managers for patients with specific diagnoses.
Their role is coordinator of care across the healthcare system. The occupational therapist,
physician, and physicians assistant all serve on the healthcare team and take direction
from the case manager.
PTS: 1 DIF: Easy REF: ESG,
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Recall
20. Which of the following is considered a primary care
service? 1)
Providing wound care
2)
Administering childhood immunizations
3)
Providing drug rehabilitation
4)
Outpatient hernia repair
ANS: 2
Primary care services focus on health promotion and disease prevention; administering
childhood immunizations is one such service. Providing wound care and drug
rehabilitation are examples of tertiary care services. Outpatient hernia repair surgery is an
example of a secondary care service.
PTS:1DIF:ModerateREF:ESG,
KEY: Nursing process: N/A | Client need: SECE | Cognitive level: Application
21. Which of the following nursing activities represent direct care? Choose all
that apply.
1)
,Bathing a patient
2)
Administering a medication
3)
Documenting an assessment
4)
Making work assignments for the shift
ANS: 1
B
Direct care involves personal interaction between the nurse and clients (e.g., giving
medications, dressing a wound, or teaching a client about medicines or care). Nurses
deliver indirect care when they work on behalf of an individual, group, family, or
community to improve their health status (e.g., restocking the code blue cart [an
emergency cart], ordering unit supplies, or arranging unit staffing).
PTS:1DIF:EasyREF:p. 17
KEY: Nursing process: Implementation | Client need: SECE | Cognitive level:
Comprehension
22. An 80-year-old patient fell and fractured her hip and is in the hospital. Before
the fall, she lived at home with her husband and managed their activities of daily living
very well. The goal is for the patient to recover from the injury and return to her home.
The hospital is ready to discharge her because she has exceeded the recommended length
of stay in a hospital. However, she cannot walk or care for herself yet, and she will require
lengthy physical therapy and further monitoring of her medications and her physical and
mental status. To which type of facility should she be transferred?
1)
Nursing home
2)
Rehabilitation center 3)
Outpatient therapy center
4)
None of these; she should receive home healthcare
ANS: 2
A skilled nursing facility primarily provides skilled nursing care for patients who can be
expected to improve with treatment. For example, a patient who no longer needs
hospitalization may transfer to a skilled nursing facility to get skilled care until she is able
to return home. A nursing home provides custodial care for people, like this patient, who
cannot live on their own but who are not sick enough to require hospitalization. It provides
a room, custodial care, and opportunity for recreation. This patient cannot ambulate or
perform activities of daily living, so outpatient therapy and home care would not be
appropriate.
PTS:1DIF:ModerateREF:p. 18
KEY: Nursing process: Implementation | Client need: SECE | Cognitive level:
Application
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. Which of the following are examples of a health-promotion activity? Select
all that apply.
1)
Helping a client develop a plan for a low-fat, low-cholesterol diet
, 2)
Disinfecting an abraded knee after a child falls off a bicycle
3)
Administering a tetanus vaccination after an injury from a car accident
4)
Distributing educational brochures about the benefits of exercise
ANS: 1, 4
Health promotion includes strategies that promote positive lifestyle changes. Disinfecting
an abraded knee is a treatment/intervention for an injury. Administering a vaccination is a
disease-prevention and treatment activity.
PTS: 1 DIF: Moderate REF: p. 18; high-level question, not directly stated in text
KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Application
Matching
Match the nursing role listed on the left with the appropriate activity listed on the right.
Each activity has only one correct answer.
1)
Planning the units staffing schedule
2)
Participating on a committee to develop a program to teach schoolchildren proper
handwashing
3)
Teaching the client about a scheduled test
4)
Discussing new medication at a staff meeting
5)
Discussing with the physician the clients reasons for not wanting the recommended
surgery.
1. Direct care provider
2. Client advocate
3. Manager
4. Change agent
1.ANS:3PTS:1DIF:Moderate
REF:p. 13; must recognize examples not provided in content
KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application
2.ANS:5PTS:1DIF:Moderate
REF:p. 13; must recognize examples not provided in content
KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application
3.ANS:1PTS:1DIF:Moderate
REF:p. 13; must recognize examples not provided in content
KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application
4.ANS:2PTS:1DIF:Moderate
REF:p. 13; must recognize examples not provided in content
KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Application Match
the event with the appropriate year. Each item has only one correct answer. 1)
Nursing programs become affiliated with religious groups
2)
Start of public health nursing with the founding of the Henry Street Settlement
3)
First formal nursing education in United States
