Foundations Exam 1 Questions and Answers

Foundations Exam 1 Questions and Answers Standards of care for the nursing practice of the LPN are established by the National Federation of Licensed Practical Nurses. The LPN demonstrates an evidence-based practice by using scientific information to guide decision making. Lillian Wald and Mary Brewster established the Henry Street Settlement Service in New York in 1893 in order to: provide health care to poor persons living in tenements. An educational pathway for an LPN refers to an LPN obtaining additional education to move from one level of nursing to another When diagnosis-related groups (DRGs) were established by Medicare in 1983, the purpose was to: attempt to contain the costs of health care. The advent of diagnosis-related groups (DRGs) required that nurses working in health care agencies: record supportive documentation to confirm a patient's need for care in order to qualify for reimbursement If a member of a health maintenance organization (HMO) is having respiratory problems such as fever, cough, and fatigue for several days and wants to see a specialist, the person is required to go: to a primary care physician for a referral. An advantage of preferred provider organizations (PPOs) is that: they make insurance coverage of employees less expensive to employers. After passing the National Council Licensure Examination for Practical Nurses (NCLEX-PN), the nurse is qualified to take an additional certification in the field of: pharmacology. Nursing interventions are best defined as activities that: are taken to improve the patient's health. Nurse Practice Acts define the legal scope of an LPN's practice, which are written and enforced by: each state. Women volunteers were organized to give nursing care to the wounded soldiers during the Civil War by Dorothea Dix. The nursing theory presented by Sister Calista Roy is based on: adaptation modes The founding of the Red Cross is attributed to: Clara Barton. The nursing theorist whose practice framework is based on 14 fundamental needs is: Virginia Henderson. The nursing theory that uses seven behavioral subsystems in an adaptation model is: Dorothy Johnson. The Standards of Clinical Nursing Practice are designed to direct LPNs to: deliver safe, knowledgeable care. A state's Nurse Practice Act is designed to protect the public. It is appropriate for practical nurses to provide direct patient care to persons in a hospital under the supervision of a: registered nurse on the unit. An example of tertiary health care is _____ care. hospice Preferred provider organizations (PPOs) use __________ to finance their services and pay the physical cost of the service capitated cost In the United States, the Young Women's Christian Association (YMCA) in New York opened The __________ School, the first practical nursing school. Ballard Such health services as surgical procedures, restorative care, and home health care would be classified as __________ care. secondary Characteristics of primary nursing include which of the following? (Select all that apply.) 1. Elimination of fragmentation of care between shifts 2. Evolved in the mid-1950s 3. Planning and direction performed by one nurse 4. Ancillary workers used to increase productivity 5. The care plan covering the entire day 6. Associate nurses taking over care and planning when the primary nurse is off duty 1, 3, 4, 5, 6 In 1991, the American Nurses Association (ANA) published the Standards of Clinical Nursing Practice. These standards are designed to: (Select all that apply.) 1. set standards for safe nursing care delivery. e the legal scope of practice. 3. establish state legal requirements for clinical practice. ct the nurse, patient, and health care agency. ate the nursing profession 6. define activities in which nurses may engage 1, 4, 6 An example of the role of an LPN as a delegator is: (Select all that apply.) 1. changing a patient's wound dressing 2. assisting a patient to complete his or her bath 3. assigning patient care tasks to certified nursing assistants. 4. requesting the housecleaning staff to mop the floor of a patient's room 5. instructing the unit secretary to page a physician to the floor. 3, 4, 5 During the Civil War, nursing schools offered education to women both in England and in the United States. The schools in the United States differed from those in Europe because in U.S. schools: (Select all that apply.) 1. students worked without pay. 2. the core curriculum was the same. 3. instruction was presented by physicians at the bedside 4. the educational focus was on nursing care 5. classes were held separately from the clinical experience. 1, 3 The nurse is aware that any description of health would include the concept that: culture, education, and socioeconomic status influence one's definition of health or illness. The nurse takes into consideration that the patient with an admitting diagnosis of type 2 diabetes mellitus and influenza is described as having: one chronic and one acute illness. The nurse explains that an idiopathic disease is one that: has an unknown cause The nurse assesses a terminal illness in a: 43 year old with Lou Gehrig's disease who is refusing food and fluid The nurse clarifies to a patient who now has an abscess following a ruptured appendix that the abscess is considered to be: a secondary illness. The nurse uses a diagram to demonstrate how Dunn's theory of health and illness can be compared with a: continuum, with peak wellness and death at opposite ends; the person moves back and forth in a dynamic state of change. A patient has been advised by the physician to take medication for high cholesterol and to change eating habits after discharge home. The home health nurse discovered that the patient refused to follow the medical and nutritional directions. The nurse's best initial response to this situation is to: determine whether any cultural, socioeconomic, or religious values conflict, thus interfering with the patient's compliance. A nurse practicing a holistic approach to nursing care must: recognize that a change in one aspect of the person's life can alter the whole of that person's life. According to Maslow's hierarchy, physiological needs are those that: are essential to human life. The factors involved in assessing the importance the patient attaches to the relief of a particular deficit include: needs that the nurse must assess to prioritize care, because they may be different from person to person. The nurse believes that teaching a patient how to give insulin and monitor blood glucose levels will improve the level of the patient's: self esteem, by promoting independence and learning. Homeostasis can be described as a tendency of biological systems toward stability of the internal environment by continuously adjusting to survive A patient admitted for diagnostic tests is frightened of hospital procedures and is nervous about the possible outcome of the tests. She states that her mouth is dry and her heart is pounding. Her blood pressure is 168/78 mm Hg (her usual blood pressure is 140/80 mm Hg), pulse is 112 beats/min, and respirations are 22 breaths/min. The nurse will recognize that these signs and symptoms are: the effects of the sympathetic nervous system that can negatively affect the patient's health. According to Hans Selye's general adaptation syndrome (GAS), a person who has experienced excessive and prolonged stress is likely to: develop an illness or disease such as allergy, arthritis, or asthma The nurse is aware that a stressor as experienced by an individual is usually perceived: in different ways based on previous experience and personality traits. In 1946, the World Health Organization redefined health as the: state of complete physical, mental, and social well being. The nurse assesses that a person is in the acceptance stage of illness when the patient: assumes the "sick" role The nurse instructs a patient that according to Selye's GAS theory, when stress is strong enough and occurs over a long enough period, the patient will enter the stage of: exhaustion. The nurse explains defense mechanisms as a patient's attempt to: reduce anxiety In giving nursing care to persons of Asian origin, the nurse should: ask permission before touching the patient Sickle cell anemia is an example of a biological trait found primarily in _____ populations African When a young family man hospitalized after a breaking his leg confides to the nurse that he is concerned about the well being of his family and financial stress, the nurse can best support his sense of security by: actively listening to his concerns. The nurse assesses successful adaptation in a post stroke patient when the patient learns to walk and maintain balance with the aid of a walker The nurse takes into consideration that in the stage of resistance in Selye's GAS, the patient continues to battle for equilibrium A patient states, "I am not obese. My entire family is large." The nurse assesses that the patient is using the defense mechanism of: denial A child who has just been scolded by her mother proceeds to hit her doll with a hairbrush. The nurse recognizes the child's actions are characteristic of: displacement The nurse encourages a patient to participate in health maintenance by maintaining an ideal body weight as a method of _____ prevention primary A nurse clarifies that methods of tertiary prevention are designed for: rehabilitation When a new admission to an extended care facility wanders about listlessly, eats only a small amount of each meal, and keeps himself isolated, the nurse can intervene by: supporting him to interact with an exercise group. Exercise can reduce stress and anxiety by the release of __________. endorphins Adequate __________ is necessary in the communication between nurse and patient in order to meet the higher basic needs of security, love, belonging, and self esteem. feedback When the brain perceives a situation as threatening, the sympathetic nervous system reacts by stimulating which of the following physiological functions? (Select all that apply.) 1. Constriction of the pupils 2. Dilation of the bronchial tubes 3. Decreased heart rate 4. Dilation of the pupils 2, 4 The nurse describes behaviors of the transition stage of illness, which are: (Select all that apply.) 1. awareness of vague symptoms 2. denial of feeling ill 3. resorts to self medication 4. withdrawal from roles and responsibilities 5. recovery from illness begins 1, 2, 3 Which defines the holistic approach to caring for the sick and promoting wellness? (Select all that apply.) 1. The nurse's focus is specific to the disease or injury 2. The nurse realizes that each person has a responsibility for his or her own health 3. Health care providers are required to intervene on behalf of all persons to ensure that health goals are met. 4. Providers combine traditional methods of health care with relaxation techniques for pain management. 5. A change in one aspect of a person's life may or may not alter the person as a whole. 2, 3, 4, 5 The responses during the alarm stage of the general adaptation syndrome as defined by Hans Selye include: (Select all that apply.) 1. slight increase in body temperature 2. substantial increase in energy 3. decreased appetite 4. hormones released for mobilization for defense 5. the body's adaptation abilities temporarily overreacting 1, 3, 4 The nurse can best ensure that communication is understood by: obtaining feedback from the patient that indicates accurate comprehension. The nurse recognizes a verbal response when the patient: writes the answer to a question asked by the nurse. The nurse recognizes the patient who demonstrates communication congruency when the patient: is tearful and slow in speech when talking about her husband's death. A Hispanic patient approaches the Asian nurse and, standing very close, touches the nurse's shoulder during their conversation. The nurse begins to step back to 18 to 24 inches, while smiling and nodding to the patient. This situation is most likely an example of: a difference in culturally learned personal space of the nurse and the patient A nurse says to a patient, "I am going to take your TPR, and then I'll check to see whether you can have a PRN analgesic." In considering factors that affect communication, the nurse has: used medical jargon, which might not be understood by the patient. A nurse using active listening techniques would use nonverbal cues such as leaning forward, focusing on the speaker's face, and slightly nodding to indicate that the message has been heard. When the patient says, "I don't want to go home," the nurse's best therapeutic verbal response would be: "You don't want to go home?" To begin talking with a newly admitted patient about pain management, the nurse would most appropriately state: "Tell me about the pain you've been having." When a patient begins crying during a conversation with the nurse about the patient's upcoming surgery for possible malignancy, the nurse's most therapeutic response would be: "Here is a tissue. I'd like to sit here for a while if you want to talk." To enhance the establishment of rapport with a patient, the nurse should: act in a trustworthy and reliable manner; respect the individuality of the patient. The nurse explains that the therapeutic nurse-patient relationship differs from the social relationship because the nurse-patient relationship ends when the patient is discharged The nurse has selected an outcome for the patient to eat all of the food on the breakfast tray each day. Assessing that the patient has eaten all of the breakfast, the nurse would give positive feedback by saying "Hurray! You finished your whole meal! What would you like for tomorrow?" A 67-year-old woman had major abdominal surgery yesterday. She has IV lines, a urinary catheter, and an abdominal wound dressing, and she is receiving PRN pain medication. The end-of-shift report that best conveys the patient status is: "Abdominal dressing dry, IVs—800 mL left in #6; NS running at 125 mL/hr; urine output 800 mL this shift; had morphine 15 mg for pain at 8:00 AM and at 1:30 PM. She's comfortable now. Vital signs are stable, no fever." An aspect of computer use in patient care in which the LPN may need to be proficient includes input of data such as requests for radiographs or laboratory services A patient with a nursing diagnosis of Sensory perception, disturbed auditory, would most appropriately require the nurse to: speak slowly and distinctly, but not shout When an office nurse asks the patient to repeat information that he has just given to the patient over the telephone, the nurse is: verifying that the patient understands the information A 36-year-old woman who is in traction for a fractured femur that she received in an auto accident is found crying quietly. The nurse can best address this situation by saying: "You are upset. Can you tell me what's wrong?" When the nurse is giving direction to a nursing assistant who is being delegated part of the patient care, the nurse's most effective direction would be: "Give the patient in 204A a shower after breakfast, and call me to check her feet before you get her dressed." When the patient says, "I get so anxious just lying here in this hospital bed. I have a million things I should be doing at home," the most empathetic response would be: "It sounds like you're having a tough time dealing with this situation." A patient asks the nurse, "What would you do if you had cancer and had to choose between surgery and chemotherapy?" The reply that can best help the patient is: "What solutions have you considered?" The nurse chooses to use touch in the nurse-patient relationship because touch: can convey caring and support when words are difficult When the nurse makes the statement, "We can come back to that later—right now I need to know about when your symptoms started," the nurse is: refocusing the patient to the issue at hand when the conversation has wandered A patient who has had a stroke is unable to speak clearly and has right-sided hemiplegia. The nurse will design the approach to the assessment interview by: speaking slowly and giving the patient time to respond. When a nurse is conducting an assessment interview, the most efficient technique would be asking closed questions to obtain essential information. While interviewing a Native American man for the admission history, the nurse should expect to: wait patiently through long pauses in the conversation. The nurse is aware that the purpose of therapeutic communication is to: focus on the patient and the patient needs to facilitate interaction. The practical nursing student who is engaged in a therapeutic communication with a patient will have the most difficulty with the technique of silence To convey the intervention of active listening, the nurse would: make a conscious effort to block out other sounds in the immediate environment. When the nurse enters the room, the patient is laughing out loud at something on TV. The patient stops and apologizes for the laughter, saying, "I guess I ought not be laughing at all since I am stuck here with two broken legs." The nurse can use evidence-based information when she responds: "Laughter truly is the best medicine as it has a positive effect on the immune system." When interacting with an elderly patient, the nurse would enhance communication by: speaking slowly in order to allow the patient to process the message. When the nurse observes a resident in a long-term facility pounding his fists on his legs and grinding his teeth, the nurse will validate her perception of the patient's non-verbal expression of anger by: sitting down near the patient and saying, "You seem upset...can I help?" When a patient states, "I don't feel like walking today," the nurse's most therapeutic verbal response would be: 1. "You have to walk today." 2. "You don't want to walk today?" 3. "I don't feel like walking today either." 4. "Why don't you want to walk today?" 2- This is considered reflection. When a patient states, "My son hasn't been to see me in months," the nurse's best verbal response is: 1. "Don't worry; I'm sure your son will visit." 2. "Your son hasn't been around much lately?" 3. "My son doesn't come to visit me either." 4. "How terrible that he doesn't visit you." 2- This is restating in different words.