CHERRY & JACOB CONTEMPORARY NURSING ISSUES, TRENDS, AND MANAGEMENT, 8TH EDITION

CHERRY & JACOB CONTEMPORARY NURSING ISSUES, TRENDS, AND MANAGEMENT, 8TH EDITION Chapter 01: The Evolution of Professional Nursing MULTIPLE CHOICE 1. Clara Barton is known for: a. becoming the first black public health nurse. b. establishing the Henry Street Settlement. c. founding the American Red Cross. d. publicizing the inadequacies of hospital-based nursing schools. ANS: C The American Red Cross, founded by Clara Barton in 1882, assisted in efforts to continue public health nursing. DIF: Knowledge REF: p. 11 2. Students are assigned to write to their state leaders about an issue affecting their community. One student writes about the need among rural community for greater access to acute care services. Which of the following pieces of legislation should the student use as a reference? a. Social Security Act b. Hill-Burton Act c. Sheppard-Towner Act d. U.S. Civil Service Act ANS: B The purpose of the Hill-Burton Act was to provide funding to construct hospitals and to help states in plan for other health care facilities in accordance with the needs of communities. DIF: Knowledge REF: p. 13 3. The practice of public health nursing and the Henry Street Settlement are credited to: a. Mary Breckenridge. b. Mary Seacole. c. Clara Barton. d. Lillian Wald. ANS: D Lillian Wald, a pioneer in public health nursing, is best known for the development and establishment of the Henry Street Settlement. DIF: Knowledge REF: p. 6 4. Occupational health nursing features beliefs similar to those of which early nursing pioneer? a. Lillian Wald b. Florence Nightingale c. Clara Barton d. Mary Seacole ANS: A Lillian Wald developed the first nursing service for occupational health. DIF: Comprehension REF: p. 10 5. What historical event first led to the recognition of the contribution of blacks to nursing? a. Florence Nightingale’s acceptance of black nurses into the first nursing school b. The contributions of black nurses at the Pennsylvania Hospital, the first hospital in America c. Mary Seacole’s efforts to care for soldiers during the Crimean War d. The work done by wives of wealthy black nobles who carried food and medicine from house to house during the Middle Ages ANS: C Although Nightingale’s school refused Seacole, she was able to make a difference in the Crimean War and later was recognized for her efforts. DIF: Comprehension REF: pp. 8-9 6. World War I contributed to the advancement of health care by: a. increasing the number of private care hospitals and decreasing the role of public health services. b. employing a large number of civilians to provide care to returning soldiers through the Red Cross. c. introducing specialists in nursing such as nurse anesthetists. d. increasing the number of community health nurses. ANS: C World War I offered nurses a chance to enter into new fields of specialization, as is seen in the example of nurse anesthetists, who became part of surgical teams at the front lines. DIF: Comprehension REF: p. 11 7. The primary purpose of the Social Security Act of 1935 was to: a. increase research that focused on minority groups. b. provide medical care for chemically impaired persons. c. ensure health care for older adults through a national insurance system. d. decrease the public’s financial burden by limiting services offered by local health departments. ANS: C By providing health insurance for older adults, the Social Security Act of 1935 set the precedent for the passage of the Medicare and Medicaid Acts that followed in 1965, but the act also provided maternal and child welfare services, rehabilitation for the mentally and physically challenged, medical care for blind individuals and crippled children, and unemployment benefits. DIF: Comprehension REF: p. 12 8. A client asks the nurse, “Can you explain Medicare, an amendment to the Social Security Act?” The nurse responds that Medicare: a. led to many hospital closings, along with a decrease in acute care hospital–based nursing care. b. provided medical insurance to those younger adults or children who were not eligible for private insurance because of catastrophic illnesses such as cancer. c. provided preventive care for women, infants, and children. d. ensured that individuals ages 65 and older and those with end-stage renal disease or permanent disabilities had health care insurance. ANS: D The Medicare program provides hospital insurance, Part A, and medical insurance, Part B, to all people ages 65 and older who are eligible to receive Social Security benefits; people with total, permanent disabilities; and people with end-stage renal disease. DIF: Comprehension REF: p. 14 9. A comparison of nursing in the 1980s to nursing in the 1990s reveals that: a. in the 1990s nursing experienced a significant reduction occurred in preventable diseases caused by unsafe/unhealthy lifestyles. b. tuberculosis was the primary concern for nursing in the 1980s, whereas the AIDS epidemic emerged and was its focus during the 1990s. c. a decrease in ambulatory services in the 1980s prompted an increase in public health nurses in the 1990s. d. the demand for advanced practice nurses increased in the 1980s and the 1990s as a result of the economy and concern about the health of the nation. ANS: D The numbers of advanced nurse practitioners increased as evidence of their cost-effectiveness as providers of primary and preventive health care became established. DIF: Comprehension REF: pp. 16-17 10. Which statement accurately describes the historical perspective of nursing practice? a. Nursing has existed to meet the needs of populations, individuals, and aggregates by providing care that is determined by the needs and beliefs of society in different historical contexts. b. As men began to become interested in nursing, it changed into a respected profession based on scientific fact rather than superstition. c. Nursing has historically accepted individuals from all social and ethnic backgrounds. d. The United States has led the way throughout history to advance nursing and health care by providing the first hospital and medical school. ANS: A Nursing has existed since biblical times to address needs ranging from contagious diseases in early times to health prevention in the present time, with care based on health needs and beliefs of the time. DIF: Comprehension REF: p. 3 |pp. 18-19 11. The use of herbs has become a popular alternative to prescription drugs in today’s health care milieu. During which other historical periods did health practices focus on the use of herbs? a. Prehistoric times and the Middle Ages b. Civil War period and World War I c. Renaissance and Reformation periods and the Colonial American period d. Crimean War and Civil War periods ANS: A During prehistoric times, tribes used herbs to rid themselves of disease; in the Middle Ages, women used herbs. DIF: Comprehension REF: p. 6 12. A care provider sacrifices an animal and waves an herb-filled sack over a client who is complaining of painful joints and chest pain with exertion. This ritual represents health care during: a. the prehistoric period. b. early civilization in Egypt. c. the Renaissance. d. the Middle Ages. ANS: A During prehistoric times, illness was thought to be caused by evil spirits that providers attempted to scare away through rituals and dances. DIF: Comprehension REF: p. 3 13. A prospective nursing student who researches universities that offer a baccalaureate degree in nursing would want to ensure that the program is accredited by the: a. American Nurses Association. b. Commission on Collegiate Nursing Education. c. National Institutes of Health. d. National Nursing Council. ANS: B The Commission on Collegiate Nursing Education (CCNE) is the agency that exclusively accredits baccalaureate and graduate-degree nursing programs. DIF: Comprehension REF: p. 4, Box 1-1 14. Nursing in the 1990s was characterized by: a. men leaving nursing to enter the armed services. b. traditional 8-hour shifts to nurse burnout and compassion fatigue. c. a focus on preventable diseases. d. a decrease in nursing research. ANS: C Health promotion and disease prevention were recognized as the means to reduce the high number of mortalities associated with preventable diseases—Healthy People 2000 was published as a nationwide effort to reduce preventable deaths. DIF: Comprehension REF: pp. 16-17 15. A nurse is part of the policy committee for a hospital. The committee is provided with statistics indicating that patients participating in a satisfaction survey felt they lacked sufficient information about new drugs started while hospitalized and continued after discharge. In addition, charts noted high recidivism rates. The committee recommended that a formalized patient education plan be instituted to reconcile all medications and provide patient information about new medications. The committee is using which component of the Institute of Medicine (IOM) 2011 message? a. Nurses should achieve higher levels of education to be effective members of an interdisciplinary team. b. Nurses should have a minimum of a master’s degree to sit on policy committees that affect an entire facility. c. Pay for nurses should be consistent with that of physicians since the committee is interdisciplinary. d. Policy is based on data, which provides the groundwork for decision making. ANS: D The IOM report initiatives include effective workforce planning and policymaking based on better data collection and improved infrastructure. DIF: Application REF: p. 16| p. 18 16. The Affordable Care Act of 2011: a. requires that by 2020 all newly licensed nurses have a bachelor’s degree at minimum. b. would provide health care benefits to millions who were previously uninsurable or unable to afford insurance. c. caps the amount that hospitals and physicians can charge for procedures. d. subsidizes private insurance companies, thereby reducing health care costs for individuals who have chronic or catastrophic illness such as cancer. ANS: B It is anticipated that the ACA (2011) will make insurance coverage possible for millions who have previously not had insurance or had been denied insurance. DIF: Comprehension REF: pp. 18-19 17. It has been said that “history repeats itself because no one was listening the first time.” Which statement is true when comparing the nursing care provided in the Civil War (1861 to 1865) to that provided during the Crimean War? a. Epidemics such as smallpox and typhoid were the primary emphasis of nursing care in both wars. b. Soldiers were housed in substandard conditions, but due to Nightingale’s push for sanitary conditions, in the Civil War soldiers were housed in aseptic conditions. c. Black nurses were widely accepted by society and the profession, receiving equal compensation during the Civil War due in large part to the efforts of Mary Seacole during the Crimean War. d. Both Nightingale (Crimean War) and Dix (Civil War) completed nursing training before accepting positions as nurses in the wars. ANS: A Numerous epidemics plagued the country, including syphilis, gonorrhea, malaria, smallpox, and typhoid. DIF: Application REF: p. 9 MULTIPLE RESPONSE 1. What uniquely twenty-first century issue challenges today’s professional nurse. (select all that apply) a. Caring for an aging population b. Increased patient acuity c. Access to health care services d. Expanding technology e. Increasing intercultural patient population ANS: A, B, D, E Professional nurses in the twenty-first century are faced with many challenges including an aging patient population. Professional nurses in the twenty-first century are faced with many challenges including an increase in high acuity patients. Professional nurses in the twenty-first century are faced with many challenges including an ever expanding array of technologies that affect patient care. Professional nurses in the twenty-first century are faced with many challenges including the existence of an intercultural patient population. DIF: Comprehension REF: p. 18 2. A newly licensed nurse compares the challenges facing nursing today with those faced by nurses when her mentor graduated in 1990. The mentor states, “Prevention was the focus of nursing when I graduated. We stressed preventive health measures such as smoking cessation education to reduce preventable diseases and prevention to reduce the spread of infectious disease such as AIDS.” The mentor asks, “What do you think the challenges will be for nurses graduating now? The correct response would be: (select all that apply) a. coordinating care for a more diverse aging population who have complex health values. b. managing care provided by nurses who are technologically advanced and skilled at interprofessional collaboration. c. providing care to well-informed consumers who are younger with narrow health values. d. redesigning nursing care delivery models to streamline care based on fewer generational differences. e. focusing on care from a systems perspective. ANS: A, B, E Our society, thus our patients/consumers, is aging and better informed about health care options, with health values as diverse as the various populations of patients served. Nurses educated in the twenty-first century are introduced to advanced technologies throughout the curriculum, but a gap still exists between the potential benefits of technology and the use made of it to reduce errors and improve patient care; interprofessional collaboration is a challenge with incivility and workplace violence increasing. Today’s nurses must view health care from a systems perspective rather than a nursing unit perspective to decrease errors/costs that arise from system errors. DIF: Analysis REF: pp. 18-19 3. A nurse who has practiced for 1 year on a medical-surgical unit is very interested in a position in the operating room. She traces the nursing history of surgery to learn how nursing has evolved in this practice. To determine if, historically, surgery methods advanced the practice of nursing, select the correct statements. (select all that apply) a. The Ancient Egyptians were the first to use anesthesia in the operating room. b. The “Barbers” of the Middle Ages used sterile techniques to reduce wound infections. c. The Indian culture from 274 to 236 BC had hospitals staffed with female nurses who practiced much like today’s nurses. d. During the Renaissance, advances in nursing education, including surgery, were nonexistent. e. Following World War II, nurses practiced in mobile army surgical hospitals, where medical and surgical techniques were further refined. ANS: D, E During the Renaissance, major advancements were made in pharmacology, chemistry, and medical knowledge, including anatomy, physiology, and surgery with new emphasis given to medical education, but nursing education was practically nonexistent. Following World War II, nurses volunteered for the Korean War, where care was provided in MASH units and surgical techniques were defined. DIF: Application REF: p. 7 |pp. 13-15 COMPLETION 1. Which group in early civilization is credited with developing a pharmacopoeia to classify more than 700 drugs used in caring for the sick? ANS: Egyptians A pharmacopoeia that classified more than 700 drugs was written by the Egyptians to assist in the care and management of disease. DIF: Knowledge REF: p. 3 Chapter 02: The Contemporary Image of Professional Nursing Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 8th Edition MULTIPLE CHOICE 1. Which item below correctly describes the U.S. Bureau of Labor Statistics predictions by 2020? a. Positions that historically required registered nurses will be filled by unlicensed personnel. b. The job growth rate for RNs will surpass job growth in all other occupations. c. The need for hospital nurses will dramatically decrease. d. Hospitals will finally achieve the required RN workforce. ANS: B With an employment rate expected to increase by more than 19%, job production for nurses is projected to grow faster than the average of all occupations (11%) until 2020. DIF: Knowledge REF: pp. 23-24 2. What effect did the movie One Flew Over the Cuckoo’s Nest have on health care? a. Funding for mental health care increased, allowing the point of care to change from the community to standardized institutional care. b. The public and the nursing profession were made aware of the rights of vulnerable populations. c. Nurses were seen as advocates for individuals who cannot advocate for themselves. d. Funding for nursing traineeships was eliminated. ANS: B One Flew Over the Cuckoo’s Nest reminded us that all individuals have rights and that it is the responsibility of the public and health care professionals to ensure that these rights are protected. DIF: Comprehension REF: p. 26 3. Which nurse died after deliberately acquiring two bites from yellow fever carrier mosquitoes to enable her to provide care to soldiers with yellow fever during the Spanish-American War? a. Florence Nightingale b. Margaret Hoolihan c. Clara Maas d. Sairy Gamp ANS: C Clara Maas is noted as the nurse who deliberately acquired two bites from yellow fever carrier mosquitoes to enable her to provide care to soldiers with yellow fever. DIF: Knowledge REF: p. 26 4. A bronze statue of a nurse in battle fatigues who is obviously exhausted but demonstrates caring by holding a soldier’s head is an artistic representation of nurses who served in which war? a. World War I b. World War II c. Spanish-American War d. Vietnam War ANS: D This statue represents the caring provided by nurses during the Vietnam War. DIF: Knowledge REF: p. 27 5. What was the purpose of the Nurse Reinvestment Act of 2002? a. Provided disability insurance to RNs who contract a life-threatening illness while on duty b. Funded public service announcements that promote unlicensed caregivers as an alternative to professional nurses c. Focused on nurse retention and safety enhancement grants to address the current nursing shortage d. Provided pediatric nursing training grants ANS: C This act provided nursing scholarships, public service announcements promoting nursing as a career, faculty loan cancellation programs, geriatric training grants, and nurse retention and safety enhancement grants. DIF: Knowledge REF: pp. 23-24 6. What is the best way for the individual nurse to maintain the most effective professional image? a. Change out of their work attire before running errands. b. Renew membership in a nursing organization. c. Earning an advanced nursing degree. d. Developing effective nurse-physician relationships. ANS: B Professional nurses recognize that their greatest benefit—and one of the most efficient and powerful uses for their money—is less than 1% of their salary they spend for membership in the ANA, the National League for Nursing, Sigma Theta Tau International, and their specialty organization. They look forward to annual meetings because such meetings provide an excellent opportunity to meet colleagues and discuss issues and practice innovations. DIF: Application REF: pp. 33-34 7. Charles Dickens’ character Sairy Gamp: a. portrayed nurses as trained professional individuals who put others before themselves. b. chose nursing because she had no other avenue for employment. c. was a prostitute who took advantage of sick old men. d. characterized nurses as being at the forefront of technology and autonomy. ANS: B Sairy Gamp endured nursing because of the lack of other opportunities. DIF: Knowledge REF: p. 25 8. What does the Spirit of Nursing statue honor? a. Florence Nightingale’s accomplishments in public health b. Edith Cavell’s attempt to help the victims of the Tuskegee experiment seek treatment c. Clara Maas, who found the cure for yellow fever during WWII d. All military nurses for their bravery and compassion ANS: D The statue the Spirit of Nursing was created to honor all military nurses. DIF: Knowledge REF: p. 25 9. Although the media portrayed nursing in a negative light in M*A*S*H through the character of a promiscuous, uncaring nurse, it also provided Americans with a promising glimpse of: a. nurses who can be promiscuous and still help doctors. b. the fact that caring is not as important as the desire to serve one’s country. c. the ability of nurses to cope with the dreadfulness of war by using humor. d. the contributions of male military nurses. ANS: C The sitcom M*A*S*H did show humor as a coping mechanism for nurses in a war setting. DIF: Knowledge REF: p. 26 10. With the crisis in health care and the nursing shortage, why is the image of nursing still important? a. Nursing care is often delivered during a time of uncertainty, and the image of nurses during this time can reinforce trust in the nurse-patient relationship. b. Physicians have a distinctive body of knowledge that identifies them as professionals, whereas nursing has yet to develop a unique body of knowledge on which to base practice. c. Nurses must present a unified image if they hope to ever establish nursing as a profession. d. The dynamic state of today’s health care requires nurses to move from a caring image to one of technologic competence. ANS: A A person who seeks health care is entering a world of uncertainty. The nurse provides continuity and compassion and stabilizes the environment of the patient. DIF: Comprehension REF: p. 23 11. Nurses can combat the nursing shortage by: a. joining unions, which influence employers to provide incentives such as pay raises and free child care, thus encouraging the large percentage of nonworking nurses to return to the workforce. b. demanding that the requirements of the qualifying examination for foreign nurses should be reduced, so they are eligible to sit for the licensure examination. c. working more hours with a higher nurse/patient ratio. d. advocating for funds to pay for nursing education and a safer work environment. ANS: D Advocating for funds to pay for nursing education and a safer work environment is a positive strategy, as can be seen by results attained after the Reinvestment Act P.L. 107-205 provided $20 million for nursing scholarships, public service announcements, faculty loan cancellation programs, geriatric training grants, and nurse retention and safety enhancement grants. This is the best defense against the nursing shortage. Nursing graduates in many states have increased in number, and enrollment in nursing schools is also on the rise. DIF: Application REF: pp. 23-24 12. The demographics of the twenty-first century nursing population indicate that: a. individuals entering nursing are second-degree students who average 45 years of age. b. more white nurses enter and obtain graduate degrees than any other ethnic group. c. the highest level of nursing education for most RNs is an associate degree. d. the majority of nurses practice in hospitals. ANS: D Fifty-six percent of nurses practice in hospitals. DIF: Comprehension REF: p. 29 13. A nursing student asks, “I wonder if the reason that the nursing shortage is so severe is that registered nurses are unhappy with their jobs.” To research the answer, the National Survey of Registered Nurses was reviewed and found: a. registered nurses change employers every year to prevent burnout and to keep the nursing shortage from increasing. b. nursing faculty are aging or leaving academia due to increased work demands and generational difference from students. c. practicing registered nurses are satisfied with their job and most remain with same employer they worked for the previous year. d. registered nurses were the least satisfied with their job of all health care providers. ANS: C According to the latest National Sample Survey of Registered Nurses (NSSR), 79.8% of practicing RNs were satisfied with their job and 88.4% were with the same employer as they had been in the preceding year (U.S. Department of Health and Human Services, 2010). Among all RNs, nursing faculty are the most satisfied (86.6%). DIF: Comprehension REF: p. 29 14. A registered nurse is on break and checking e-mails. One e-mail contains a picture of a celebrity who is a patient in the hospital, and on the same floor, where the nurse works. Included with the photo is a message, “check out my Facebook,” which contains additional photographs of the patient. The nurse immediately deletes the picture to prevent having to report the “friend” to supervisors. Based on the action of the nurse who received the message, which statement is correct? a. The nurse is not at risk for having his or her license suspended since removing the photos made them temporary and invisible to all others. b. Because the nurse did not send the message and immediately deleted the photo, there is no risk for discipline. c. Failing to report receiving the message demonstrates poor ethical and legal role-modeling as well as placing the nurse at risk for discipline. d. Because the patient is on the same floor as the one on which the nurse works, the information can be ethically and legally shared. ANS: C Failing to report the image can result in discipline. DIF: Comprehension REF: pp. 27-28 15. A nurse executive is concerned that the mortality rate in his or her hospital exceeds the national average and searches the literature finding Aiken’s 2011 Survey on the effects of nurse staffing and education on mortality, including work environment. If Aiken’s recommendations are followed, which change would be most effective? a. Increasing staffing ratios to include more nurses of all levels of educational preparation on all shifts b. Employing bachelor’s prepared nurses who participate in interprofessional rounds with attending physicians where their voices are heard c. Ensuring nurse managers and administrators have at minimum a master’s degree d. Encouraging all unlicensed assistive personnel to attend educational programs to be certified ANS: B Aiken (2011) found that simply increasing the number of RNs was not the only answer to reduce mortality. Increasing the number of BSN-prepared nurses along with developing a positive work environment had the most impact on reducing mortality. The impact on reducing mortality by increasing the educational level of nurse managers/administrators and certified unlicensed assistive personnel was not documented. DIF: Application REF: pp. 30-31 16. In order to best improve patient outcomes on an acute care hospital unit, which intervention should the nursing staff advocate for? a. Staffing only 8 hour shifts on the unit b. Decreasing the number of patients cared for on any specific unit c. Increasing salaries for experienced nurses d. Increasing staffing on the evening shift ANS: D The data clearly indicate that decreased nurse-patient ratios have been associated with higher rates of mortality, shock, urinary tract infections, sepsis, hospital acquired pneumonia, and failure to rescue, especially among surgical patients. DIF: Application REF: pp. 30-31 17. A physician complains to administration that the nurse working last evening is unethical, based on observing the nurse educate the patient about a new medication ordered. The physician demanded the nurse be reprimanded and reminded that only physicians have the educational background to teach patients about new medications. Which comment and action by the administrator would be most effective in changing nurse-physician relationships in this instance? a. Inform the nurse, “You will be suspended for 3 days for going beyond your job description,” and enforce the 3-day suspension because the physician did not write the order to “teach the patient about the new medication” b. Advise the physician that only nurses can teach patients about medications; the physician’s role is to only prescribe. No action will be taken against the nurse. c. After investigating the situation, thank the physician while also providing information that patient education related to medication is within the scope of practice of registered nurses. Share the physician’s concern and administrator’s response with the nurse so both parties are aware of the resolution of the concerns. d. Contact the patient’s family and ask, “Do you prefer that all teaching related to medications be performed by the physician rather than the nurse” to determine what action to take. ANS: C Investigating the situation to provide evidence is the first step. Once the facts are known, action can be taken. In this instance, including the ethics committee would help ensure an unbiased decision. DIF: Application REF: pp. 31-32 18. Which nurse best portrays nursing as a “knowledge worker”? a. Nurse in matched scrubs with lab coat, hair back, small stud earrings b. Nurse in mismatched scrubs, no lab coat, large hoop earrings c. Nurse in white uniform with apron with no jewelry/hair back d. Nurse with nose ring and eyebrow piercing with starched white uniform and cap ANS: A Nursing scrubs have become a popular alternative to the traditional white uniform; clean wrinkle-free matching scrubs presented a professional image. Small stud earrings reduce risk of injury to nurse when caring for confused or combative patients. DIF: Comprehension REF: pp. 30-32 MULTIPLE RESPONSE 1. According to current data related to the nursing shortage: (select all that apply) a. salaries of nurses are competitive with those of other professionals such as teachers. b. only 19% of nurses are minorities. c. overall, nurses are satisfied with their jobs but leave the profession because of fear of contracting fatal diseases. d. the employment opportunities for nurses continue to be strong. e. staff nurses are returning to school to obtain certificates to teach nursing. ANS: B, D Only 19% of nurses are minorities. RNs have one of the highest growth rates of employment of all occupations. DIF: Knowledge REF: pp. 23-24 |p. 29 2. A group of new graduate nurses is asked to speak to a group of politicians to describe the current state of professional nursing and how best to alleviate the nursing shortage. Which statements accurately portray professional nursing today and tomorrow? (select all that apply) a. More RNs attain a bachelor’s degree than an associate degree or diploma. b. Because of pressure to shorten length of stay in hospitals, more RNs practice in outpatient settings and home health than in acute care settings. c. The most popular advanced practice specialty is nurse anesthesia. d. White nurses are more likely to enter graduate school than nurses from other ethnic groups. e. Nursing represents the largest health care professional group, followed by medical doctors. ANS: A, E Recipients of BSN degrees represent the largest graduating educational profile (47.2%). Nurses make up the largest group of health care professionals. DIF: Comprehension REF: p. 29 3. Which actions would result in a greater number of nurses entering and staying in practice, given today’s state of nursing? (select all that apply) a. Determine why few black women enter graduate school. b. Provide incentives for minorities and men to enter nursing. c. Obtain grant funding to increase the number of faculty members and scholarship availability for students entering baccalaureate nursing programs. d. Survey nurses to determine why their job satisfaction is lower than that of other health care professions. e. Develop ad campaigns that target younger students. ANS: B, C, E Core solutions to the nursing shortage include providing incentives for minorities and men to enter nursing. Core solutions to the nursing shortage include obtaining grant funding to increase the number of faculty members and scholarship availability for students entering baccalaureate nursing programs. Core solutions to the nursing shortage include developing ad campaigns that target younger students. DIF: Comprehension REF: pp. 28-29 4. The Nurses of America’s media campaign raised awareness of which aspects of nursing? (select all that apply) a. Nurses are expert clinicians. b. A higher nurse/patient ratio is needed. c. Nurses are invisible in the news media. d. Nurses are caring. e. Nurses are well paid. ANS: A, C The campaign was designed to convey to the public that nurses are expert clinicians. A strategically important part of the campaign raised consciousness among nurses of the invisibility of nursing in the news media. DIF: Comprehension REF: p. 28 Chapter 03: The Influence of Contemporary Trends and Issues on Nursing Education Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 8th Edition MULTIPLE CHOICE 1. A current trend is for students to be evaluated to determine whether they demonstrate competence in the actual client care environment or with a standardized patient. This process occurs in addition to or instead of traditional pencil-and-paper evaluations. This type of evaluation is referred to as: a. core practice competencies. b. continuing competence. c. distance learning. d. performance-based assessment. ANS: D Performance-based assessment is the evaluation of abilities based on an objective demonstration of specific required competencies. This may include performance in actual or simulated situations. DIF: Knowledge REF: p. 44 2. One of the major trends that currently influences nursing education and practice is: a. increased technology in the field of critical care. b. a narrowing scope of practice for nurses. c. incivility or disregard of others’ rights in social interactions. d. a decrease in ethnicity due to international programs allowing students to study from a distance. ANS: C Incivility has escalated and can be demonstrated by the common practice of text-messaging during class and an increase in academic dishonesty. DIF: Comprehension REF: pp. 46-47 3. Although the use of technology and the Internet provides nursing faculty and students with unlimited resources and current information, an outcome associated with this trend is that: a. users of electronic resources spend a disproportionate amount of time looking for pertinent content. b. additional time is available to study and revise curricula because special skills are not needed to access information via the Internet. c. immediate results and outcomes are expected from students and faculty, thus enhancing time management. d. skills that require problem solving and reflective abilities are developed. ANS: A Students can easily become distracted by pursuit of the intriguing web of links they encounter while they search websites to complete assignments or find pertinent content. DIF: Analysis REF: pp. 41-43 4. A new trend in nursing education that is consistent with real-world practice is focused on: a. outcomes. b. objectives. c. goals. d. subjective appraisals. ANS: A Outcomes and criteria establish real expectations for clinical practice and have a powerful influence on nursing education and practice at all levels. Outcomes are used in all areas of nursing in the nursing process. DIF: Knowledge REF: p. 43 5. The practice of nurses, nursing students, and faculty is affected by demographic changes due to: a. the growing percentage of adults ages 50 to 55 years. b. increasing numbers of obese children and adults. c. changes by which families are becoming more nuclear. d. social programs that are essentially eliminating poverty. ANS: B The United States is experiencing an epidemic of obesity with major consequences for health and the health care system. DIF: Knowledge REF: p. 46 6. The first university to offer nursing graduates a baccalaureate degree was: a. Columbia Teachers College. b. Yale University. c. Harvard University. d. the New York Regents Program. ANS: B In 1924, Yale University offered the first separate Department of Nursing, whose graduates earned a baccalaureate degree. DIF: Knowledge REF: p. 53 7. Which nursing model is referred to as the “class without walls”? a. Articulation b. Career ladder (2 + 2) c. External degree d. Second degree ANS: C An external degree does not require attendance and provides no course classes; it enrolls thousands and is accessible regardless of geographic location. DIF: Knowledge REF: p. 56 8. When focusing on addressing issues identified by the 2000 Institute of Medicine report, the nursing faculty will access information associated with which initiative? a. Quality and Safety in Nursing Education b. Competency Outcomes and Performance Model (COPA) c. The National Organization of Nurse Practitioner Faculties (NONPF) d. Academic Center for Evidence-Based Practice (ACE) ANS: A In response to the Institute of Medicine report (IOM, 2000), The Robert Wood Johnson Foundation funded a national initiative, Quality and Safety in Nursing Education (QSEN), to help nursing programs reorganize curricula to focus on patient safety and quality care. DIF: Application REF: p. 43 9. The number of reported medical errors demonstrates a need for what priority intervention? a. Simulation experiences b. Performance competency exercises c. Comprehensive instructor-constructed examinations d. Detailed care planning exercises ANS: B The increase in reported medical-related errors vividly emphasizes the need for more effective validation of performance competence in schools and the workplace. DIF: Application REF: p. 45 10. Which trend is an effect of the nursing shortage on nursing education? a. Only devoted qualified nurses are continuing to provide bedside nursing because of the complexity of care required, resulting in excellent preceptorships for students. b. The number of applicants to nursing programs has risen, but enrollment is limited because of a decrease in the number of available scholarships and grants. c. With an increase in the number of nurses who are entering graduate school to escape bedside nursing, students will soon enjoy a lower faculty/student ratio. d. Students may be assigned to preceptors who have not yet developed expertise in the field of interest. ANS: D Qualified preceptors are few. DIF: Analysis REF: p. 49 11. The NCLEX® examination is created and administered by the: a. American Association of Colleges of Nursing (AACN). b. American Nurses Association (ANA). c. National Council of State Boards of Nursing (NCSBN). d. National League for Nursing (NLN). ANS: C The NCSBN coordinates licensure activities on a national level and creates and administers the licensure examination (NCLEX®). DIF: Knowledge REF: p. 57, Box 3-1 12. A student is planning to enroll in prerequisite courses after graduating from high school and is researching options for nursing programs. During a career fair the student compares different types of nursing education programs and discovers that: a. diploma programs focus on family and community, with an emphasis on health promotion. b. most practicing RNs graduated from diploma programs because this was the first type of RN program. c. baccalaureate programs focus on technical and hands-on nursing skills in diverse community settings. d. master’s programs such as that for the clinical nurse leader provide entry into practice with a focus on interdisciplinary and bedside nursing care for complex client populations. ANS: D A clinical nurse leader oversees the care coordination of groups of clients and actively provides direct client care in complex situations, evaluates client outcomes, and has the decision-making authority to change care plans when necessary. DIF: Comprehension REF: p. 55 13. When preparing to complete a competency examination involving a neurologic assessment in a simulation laboratory, the nurse reviews the critical elements, which consist of: a. those steps that result in life or death of a client. b. required criteria that must be incorporated into the assessment for the desired outcome. c. fundamental strategies unique to complex dynamic care environments. d. objective data that can be used to determine the likelihood that the client will recover. ANS: B Critical elements include the application of mandatory principles that must be used according to established practice standards. DIF: Comprehension REF: p. 40 14. An RN with a diploma preparation wants to participate in decisions about health care and decides the first step is to obtain a BSN. The nurse enrolls in a nursing program offering self-scheduling and a self-paced curriculum. This nurse is taking advantage of: a. educational mobility. b. a traditional nursing program. c. training for advanced practice nursing. d. credit by examination. ANS: A Education mobility is the progressive movement from one level or type of education to another—in this instance, diploma to BSN. Programs are aimed to make the transition possible through creative flexible scheduling. DIF: Application REF: p. 56 15. A nursing student scores 95% on the written examination for the adult health course. To be successful in this course, this same student must then perform an indwelling catheter insertion and wound care in a simulated environment meeting core competencies. The student asks, “What are core competencies?” The nursing instructor replies, “Core competencies are: a. a trend used in nursing education to reduce attrition in prelicensure students.” b. those skills necessary for safe, competent nursing practice.” c. educational opportunities that provide remediation when student is unable to perform psychomotor skills correctly.” d. critical thinking exercises aimed to improve reading and math skills.” ANS: B Core competencies are those skills and elements that are fundamental and essential for safe, competent practice. DIF: Comprehension REF: pp. 39-40 16. A nurse realizes that a health care concern related to globalization was: a. the emergence of epidemic hepatitis A. b. the pandemic of H1N1 “swine flu.” c. reemergence of polio. d. an increase in chronic illnesses. ANS: B In 2009, there was a pandemic of H1N1 on every continent and a reemergence of Staphylococcus aureus (MRSA). DIF: Knowledge REF: pp. 47-48 17. A student nurse is preparing a presentation that requires identification of outcomes for the care of heart failure patients. Which is a correctly written outcome? a. Develop a teaching program to address physical activities that result in improved cardiac function. b. Discuss the clinical manifestations associated with Level 4 heart failure. c. List the most common pharmaceutical approaches to reduce preload in heart failure patients. d. Recognize the economic impact that recidivism has on the patient and health care facility. ANS: A Outcomes use action words, actions that nurses actually do, such as develop, plan, implement, integrate, plan, or conduct. DIF: Application REF: p. 43 18. A member of a nursing students study group comments, “I wish our instructor would just tell us the important information that we will be tested on in our course and on NCLEX®. Instead, we spend some time early in the class discussing key facts then the most of the time working through case studies, then practicing on the simulator rather than caring for ‘real’ patients.” This teaching-learning style represents: a. memorization of basic facts presented early in the lecture. b. Objective Structured Clinical Examinations (OSCE). c. peer-to-peer learning. d. practice-based competency. ANS: D Practice-based competency includes active engagement and application in real practice situations and interactive strategies such as case studies and simulation. DIF: Application REF: pp. 43-44 19. Which experience is best designed to support a nursing student’s preparation for interprofessional team participation? a. Attending a seminar on interprofessional team cooperation b. Completing a preceptorship with an advanced practice nurse c. Carrying for three patients with varying medical diagnoses d. Presenting patient information at the daily care planning meeting on a mental health unit ANS: D While interprofessional educational experiences are encouraged for all health care disciplines, Delunas and Rouse (2014) cite the importance of preparation of students for interprofessional educational experiences, and the need for regular meetings when students are engaged in learning as a member of a health care team. DIF: Application REF: pp. 47-48 20. A person interested in employment in the health care sector has less than 1 year to pursue his or her education and wants to focus on functional aspects of patient care. He/she desires to work in a long-term facility. Which type of nursing program should this person request information about? a. Bachelor’s degree in nursing (BSN) b. Licensed practical nurse (LPN) c. Associate degree in nursing d. Master’s degree in nursing ANS: B LPN programs provide basic technical bedside care and employment opportunities at hospitals, nursing homes, home care, and doctor offices. DIF: Comprehension REF: p. 52, Table 3-2 MULTIPLE RESPONSE 1. A nurse is concerned that the policy of using povidone-iodine (Betadine) to clean foot ulcers may lead to unwarranted allergic reactions and drying of surrounding tissue. A literature review is performed to determine the “best practice” related to care of foot ulcers. This nurse: (select all that apply) a. is applying evidence-based practice to the clinical setting. b. is using critical thinking to change procedures performed in the care of foot ulcers. c. is minimally educated at the master’s level and participating in research to provide cost-effective care (soap is less expensive than povidone-iodine). d. lacks clinical competence in health assessment and in application of theory to the clinical setting. e. is using information to problem-solve and ensure safe, competent care. ANS: A, B, E Critical thinking is an essential part of applying evidence-based practice—that is using research findings to guide actual practice. DIF: Analysis REF: p. 44 COMPLETION 1. The oldest, most traditional type of program that prepares a candidate for RN licensure is the hospital-based _ program. ANS: diploma The earliest training programs for nurses were hospital based and designed to meet the needs of the particular institution; these were referred to as diploma programs. DIF: Knowledge REF: p. 52 2. According to Lenburg, the use of practice-based assessments in nursing education is aimed toward the target of . ANS: competence The target that students need to meet to practice safely in today’s complex health environment is achieving critical competencies and demonstrating of practice-based skills. DIF: Comprehension REF: p. 45 Chapter 04: Nursing Licensure and Certification Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 8th Edition MULTIPLE CHOICE 1. The advanced practice nurse who is seeking information about requirements for practice in a specialized area should contact the: a. American Nurses Association (ANA). b. National League for Nursing (NLN). c. American Nurses Credentialing Center (ANCC). d. National Council of State Boards of Nursing (NCSBN). ANS: C The nurse should contact the ANCC to determine the education, experience, and examination requirements that must be met if one is to become certified. DIF: Comprehension REF: p. 63 |p. 71 2. The primary purpose of licensure for RNs is to: a. prevent others from using the title nurse. b. demonstrate a specialized body of knowledge. c. protect the public. d. enhance recognition for the profession. ANS: C Protecting the public is one of the essential purposes of the state board of nursing, which regulates licensure. DIF: Knowledge REF: p. 65 3. Nurse practice acts: a. are written and passed by legislators. b. cannot be influenced by special interest groups. c. reflect only the concerns of RNs. d. are affected by the practice of dentists. ANS: A Just as other sections of state codes are written and passed by legislators, so is the nurse practice act of each state. DIF: Knowledge REF: p. 69 4. To ensure that nursing legislation is current and is reviewed by specific dates, if a nurse practice act fails to be reviewed, it is automatically rescinded under which law? a. Nurse review act b. Sunset legislation c. Mandatory revocation d. Grandfathering ANS: B Sunset legislation may be included in a state’s nurse practice act, and this means that the act must be reviewed by a specific date; if not, it is automatically rescinded. DIF: Comprehension REF: p. 70 5. Current trends in telecommunications and increased mobility of nurses have led to the approval of a mutual recognition model of nursing regulation, in which nurses are allowed to practice in states that are compact states without obtaining a license in each state. On which website would a nurse find a list of current compact states? a. National League for Nursing (NLN) b. National Council of State Boards of Nursing (NCSBN) c. American Association of Colleges of Nursing (AACN) d. Commission on Collegiate Nursing Education (CCNE) ANS: B The NCSBN website contains this information. DIF: Knowledge REF: pp. 70-71 6. The first field of nursing to certify advanced practitioners was the field of: a. adult nurse practitioners. b. nurse-midwifery. c. clinical nurse specialist. d. nurse anesthesia. ANS: D In 1946, nurse anesthesia became the first field of nursing practice to certify advanced practitioners. DIF: Knowledge REF: pp. 71-72 7. A graduate of a nursing school in the United States plans to practice nursing in Paris, France. To request licensure to practice in Paris, the nurse: a. must contact the Graduates of Foreign Nursing Schools to complete a special examination. b. realizes that education in the United States is so generalized that he or she is eligible to practice in other countries without additional licensure. c. is required to take a language proficiency examination for the primary language of that particular country, as well as a cultural assessment test, prior to licensure. d. should contact the International Council of Nurses or the nursing regulatory board of that country. ANS: D A nurse who is interested in practicing internationally may contact the International Council of Nurses or the nursing regulatory board of the country in which he or she wishes to practice. DIF: Comprehension REF: p. 69 8. A nurse who is licensed in Georgia and moves to Oregon: a. must check Oregon’s nurse practice act related to licensure for endorsement. b. will automatically be grandfathered in as a licensed registered nurse. c. may request certification in Oregon rather than licensure, so as not to have to retake the NCLEX-RN®. d. should contact the American Nurses Credentialing Center to determine whether he or she is eligible to practice in an another state. ANS: A Endorsement refers to the original program whereby a nurse who is licensed in one state can apply and seek licensure in another without undergoing repeat examination, in accordance with the nurse practice act of that state. DIF: Application REF: p. 68 9. When practicing in a compact state: a. the nurse must abide solely by the practice act of the largest state. b. patients’ rights in relation to the nurse practice act are protected by the mutual recognition model. c. the nurse must pay for a license in all states that participate in the mutual recognition model. d. the nurse must refer to the nurse practice act for the list of skills that can be performed. ANS: B Nurses who practice in a compact state are responsible for following the laws and regulations of each state in which they practice. DIF: Comprehension REF: pp. 70-71 10. When participating in a nurse licensure compact, the nurse: a. is held responsible for complying with the nursing practice laws in the state where practicing at the time care is rendered. b. must purchase a license in each state but does not retake the licensure examination. c. determines residency based on the state where educated as registered nurse. d. may practice using one license in any state or territory in the United States that recognizes the NCLEX as the source of licensure. ANS: A The nurse is accountable for practicing according to the state practice laws where patient care was provided, although disciplinary action is the responsibility of the state of the nurse’s residency. DIF: Knowledge REF: pp. 70-71 11. A new graduate from a master’s entry program in nursing announces, “I just passed my clinical nurse leader certification examination.” Certification as a clinical nurse leader: a. is granted by the state board of nursing. b. denotes minimum level of knowledge and skills to practice safely. c. allows independent nursing practice, often in primary care. d. recognizes achievement of advanced skills and knowledge. ANS: D Certification provides validation of achievement of advanced education and competence. DIF: Comprehension REF: p. 71 12. A nurse holds a license in one state but wishes to practice in a second state that is not participating in a nurse licensure compact agreement. The nurse is granted licensure on payment of a fee but does not retake the licensure examination. The nurse obtains licensure in the second state: a. by licensure and by endorsement. b. through mandatory continuing education. c. by the statutory process known as being grandfathered. d. through sunset legislation. ANS: A Licensure by endorsement allows a nurse licensed in one state to obtain licensure to practice in a second state without examination. DIF: Comprehension REF: p. 68 13. A nurse practicing in the early 1900s was awarded a permissive license. These licenses: a. were voluntary; however, a nurse who failed the examination could not use the title RN. b. required a maximum of 1 year of formalized nurse training. c. allowed nurses who did not pass the licensure examination to still practice. d. allowed nurses the choice of taking a written or oral licensure examination. ANS: A These permissive licenses permitted but did not require nurses to become registered. DIF: Comprehension REF: p. 65 14. A group of registered nurses with ADN degrees are concerned that the minimum educational standard for licensure as a registered nurse is being raised to the bachelor’s (BSN) level. After contacting the American Nurses Association, they learn they will be “grandfathered” in. Under the “grandfather clause,” nurses with associate degrees will: a. be required to complete a bridge program to earn a BSN and then be tested only on material that was not part of the ASN curriculum. b. continue to use the title “registered nurse.” c. have 10 years to obtain a BSN or the license will be revoked. d. use whatever title is established for associate degree nurses. ANS: B All ASNs licensed before the change would be “grandfathered” in, allowing them to use the title of RN. DIF: Comprehension REF: p. 63 15. Who establishes the “rules” for nursing practice? a. Individual state boards of nursing b. Employer, based on area of practice c. United States Department of Health and Human Services d. Local health officials ANS: A The State Practice Act of each state establishes the rules for practice within that state. DIF: Knowledge REF: pp. 68-69 16. A nurse is completing the degree requirements for an advanced practice role as a nurse practitioner and is concerned about certification requirements. Which statement concerning certification for advanced practice is true? a. All states require certification for all specialty roles that are identified as advanced practice. b. Nurse anesthetists and nurse-midwives are the only advanced practice role that require certification in the state nurse practice acts. c. Scope of practice remains unclear in state nurse practice acts due to the increasing number of new advanced practice roles. d. Certification is automatic when the nurse applies for an advanced practice license. ANS: A All states require evidence of certification in the specialty area, and many require periods of practice in the specialty prior to awarding certification status. DIF: Comprehension REF: p. 68 17. Nurses in Tennessee, Mississippi, and Arkansas gather for a conference related to improving quality and safety in practice and nursing education. They are awarded continuing education (CE) credit for participation and evaluation of the conference. One nurse from California states, “I need these CEs to renew my license.” The nurse from Mississippi replies, “You do not need CEs for license renewal or advance practice certification renewal.” Which statement about CEs would help these nurses? a. All states require proof of continuing education for renewal of license with the number of hours varying. b. The purpose of continuing education is to ensure competence of the workforce after graduation, but each state determines if CEs are required. c. Continuing education is required if nurses work across state lines. d. Initial licensure provides evidence of a minimum safety and competence, so it is illegal for states to require continuing education for renewal of license. ANS: B CE is important to ensure continued competency, and each state determines if CEs are mandatory for renewal and how many units are needed. DIF: Comprehension REF: p. 68 MULTIPLE RESPONSE 1. A nurse who wishes to practice in another state: (select all that apply) a. must retake the NCLEX-RN for that state. b. should determine whether the state is a compact state. c. may obtain licensure by endorsement. d. must revoke licensure in the current state because nurses cannot be licensed in more than one state concurrently. ANS: B, C If the state is a member of a compact state, that state has established an agreement with other states under which nurses are permitted to practice within the state without additional licensure. Licensure by endorsement refers to the original program whereby nurses who are licensed in one state seek licensure in another state without repeat examination. DIF: Comprehension REF: p. 68 2. Which statements concerning licensure as a registered nurse are correct? (select all that apply) a. Nurses who graduate from different types of nursing education programs are granted different types of licenses, those with a baccalaureate degree having the most expanded role. b. A nursing license cannot be revoked, only suspended. c. Each nurse practice act describes requirements for initial licensure. d. It is illegal for states to ask about the mental or physical status of an applicant. e. Students who graduate in the top 10% of their class are exempt from taking the NCLEX-RN for licensure. f. Candidates for licensure must present proof of graduation as required by the state. ANS: C, F A section of each nurse practice act describes requirements and procedures that are necessary for initial licensure. Candidates for licensure must submit evidence of graduation as defined by each state. DIF: Comprehension REF: pp. 67-68 3. A group of graduates were just notified that they had successfully passed the licensure examination. During the orientation process at the hospital, one asks, “I am looking at my license, but I don’t really know the duties performed by the board of nursing.” The staff development nurse explains that the board of nursing: (select all that apply) a. grants nursing licensure. b. constructs the licensure examination. c. assigns disciplinary action when the nurse acts in a manner that results in harm to a patient. d. members are appointed. e. conducts certification examinations for advanced practice nurses. ANS: A, C, D The board of nursing ensures that nursing licenses are granted and renewed. The board of nursing assigns disciplinary action when provisions of the nurse practice act are violated. Members are appointed. DIF: Comprehension REF: pp. 68-69 4. A nursing student is in the final term of an Associate Science of Nursing (ASN) program and is preparing for licensure. Prior to licensure the candidate must provide evidence of: (select all that apply) a. graduation from a nursing program. b. graduation from high school or high school equivalency. c. evidence of current malpractice insurance. d. evidence of plan to continue study to obtain a minimum of a BSN within 2 years. e. validation of skills competence provided by a certifying agency. ANS: A, B Candidates for licensure must provide evidence of graduation through transcripts of course work or letter from the Dean/Director of the nursing program. All candidates must show evidence of graduating from high school or earning a GED. DIF: Comprehension REF: pp. 67-68 COMPLETION 1. The primary purpose of licensure is protection of the . ANS: public DIF: Knowledge REF: p. 65 Chapter 05: Theories of Nursing Practice Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 8th Edition MULTIPLE CHOICE 1. Which nursing theory might a nurse use as a conceptual framework to determine how to meet the needs of immigrants while ensuring provision of high-quality and culturally sensitive care? a. Martha Rogers’ nursing theory b. Dorothea Orem’s nursing theory c. Hildegard Peplau’s nursing theory d. Madeleine Leininger’s nursing theory ANS: D Madeleine Leininger proposed the theory of cultural care diversity and universality. This theory of transcultural nursing comprises concepts involving caring and the components of a cultural care theory: diversity, universality, worldview, and ethnohistory. DIF: Comprehension REF: p. 85 2. When reading Peplau’s theory, a nurse was unable to determine the relationships among concepts. The nurse listed each concept and drew lines denoting relationships to be able to understand the effect of each element. The nurse created a: a. hypothesis. b. model. c. construct. d. variable. ANS: B A model is a group of concepts that are associated because of their relevance to a common theme. DIF: Application REF: p. 78 3. The statement, “Nursing is a caring profession that focuses on helping people be as healthy as possible,” is an example of a: a. concept. b. construct. c. philosophy. d. model. ANS: C A philosophy is the values and beliefs of the discipline. DIF: Comprehension REF: p. 79, Table 5-1 4. Einstein’s theory of relativity laid the groundwork for theories of mathematics, and Freud and Jung provided the basis for a philosophy of man. Which nursing theory served as the foundation for nursing science? a. Rogers’ science of unitary human beings b. Nightingale’s theory of practice c. Watson’s theory of human caring d. King’s theory of goal attainment ANS: B Florence Nightingale investigated the effect of the environment on healing, and this serves as the foundation for nursing science. DIF: Comprehension REF: pp. 81-82 5. A community health nurse has been visiting a postpartum client who suffered domestic violence throughout the pregnancy, and now the infant may be at risk. The nurse assisted the client in finding shelter and legal protection. The nurse’s role and the conceptual framework involved are: a. change agent, according to Roy’s adaptation model. b. translator, according to Leininger’s theory of cultural care diversity and universality. c. case manager, according to Peplau’s interpersonal relations model. d. caregiver, according to Rogers’ science of unitary human beings. ANS: A In Roy’s adaptation model, when the client incurs an insult that renders him or her in need of environmental modification, the nurse will be the change agent in assisting the individual with this adaptation. DIF: Application REF: p. 79, Table 5-1 |p. 85 6. What are general explanations that scholars use to explain, predict, control, and understand commonly occurring events? a. Theories b. Constructs c. Systems d. Propositions ANS: A Theories are a group of related concepts that explain existing phenomena and predict events. Theories provide us with a frame of reference, the ability to choose concepts to study, or ideas that are within one’s practice. DIF: Comprehension REF: p. 79, Table 5-1 7. Which type of theory most often guides present nursing practice? a. Grand theory b. Middle range theory c. Developmental theory d. Values theory ANS: B Middle range theory is a nursing theory that refers to a specific population or to a specific situation, thereby making the theory easy to understand. An example is the theory of unpleasant symptoms (Lenz and Pugh), which examines symptoms that are influenced by physiologic, psychological, and situational factors as they relate to performance. DIF: Knowledge REF: p. 79 8. A client is hypertensive, and the doctor prescribes weight reduction. The client is excited about beginning the diet, but on arriving home the spouse states, “You ha