Test Bank Fundamentals of Nursing (9th Edition by Craven)

Test Bank Fundamentals of Nursing (9th Edition by Craven) Table of Contents Chapter 01- The Profession of Nursing .................................................................................................2 Chapter 02- The Nurse's Role in Healthcare Quality and Patient Safety ................................................. 18 Chapter 03- Values, Ethics, and Legal Issues ....................................................................................... 25 Chapter 04- Nursing Research and Evidence-Based Care ..................................................................... 42 Chapter 05- Nursing Process: Foundation for Clinical Judgment ............................................................ 56 Chapter 06- Nursing Assessment ....................................................................................................... 73 Chapter 07- Nursing Diagnosis .......................................................................................................... 89 Chapter 08- Outcome Identification and Planning .................................................................................. 98 Chapter 09- Implementation and Evaluation ........................................................................................ 108 Chapter 10- Healthcare Team Communication: Documenting and Reporting ............................................. 117 Chapter 11- Health, Wellness, and Integrative Healthcare .................................................................... 132 Chapter 12- Healthcare in the Community and Home .......................................................................... 148 Chapter 13- Culture and Diversity ..................................................................................................... 166 Chapter 14- Communication in the Nurse-Patient Relationship ............................................................ 182 Chapter 15- Patient Education and Health Promotion .......................................................................... 198 Chapter 16- Caring for the Older Adult .............................................................................................. 210 Chapter 17- Safety ......................................................................................................................... 223 Chapter 18- Health Assessment ....................................................................................................... 238 Chapter 19- Vital Signs ................................................................................................................... 251 Chapter 20- Asepsis and Infection Control ......................................................................................... 260 Chapter 21- Medication Administration .............................................................................................. 271 Chapter 22- Intravenous Therapy ..................................................................................................... 285 Chapter 23- Perioperative Nursing .................................................................................................... 295 Chapter 24- Hygiene and Self-Care .................................................................................................. 310 Chapter 25- Mobility ....................................................................................................................... 326 Chapter 26- Skin Integrity and Wound Healing ................................................................................... 341 Chapter 27- Infection Prevention and Management ............................................................................. 352 Chapter 28- Pain Management ......................................................................................................... 362 Chapter 29- Sensory Perception ...................................................................................................... 372 Chapter 30- Respiratory Function ..................................................................................................... 388 Chapter 31- Cardiac Function .......................................................................................................... 403 Chapter 32- Fluid, Electrolytes, and Acid-Base ................................................................................... 417 Chapter 33- Nutrition ...................................................................................................................... 433 Chapter 34- Urinary Elimination ........................................................................................................ 448 Chapter 35- Bowel Elimination ......................................................................................................... 462 Chapter 36- Sleep and Rest ............................................................................................................ 477 Chapter 37- Self-Concept ................................................................................................................ 492 Chapter 38- Families and Their Relationships ..................................................................................... 508 Chapter 39- Cognitive Processes ..................................................................................................... 523 Chapter 40- Sexuality ..................................................................................................................... 538 1 | P a g eChapter 41- Stress, Coping, and Adaptation ....................................................................................... 553 Chapter 42- Loss and Grieving ........................................................................................................ 567 Chapter 43- Spiritual Health ............................................................................................................. 583 Chapter 01- The Profession of Nursing 1. What is the major difference between nursing students today and nursing students 50 years ago? A) B) C) D) Todays students are less caring. Todays students are more intelligent. Todays students reflect a more diverse population. Todays students are less likely to be competent nurses. Ans: C Feedback: Nursing students 50 years ago were mostly women and entered nursing school immediately after graduating from high school. Many of todays nursing students have pursued other career paths prior to nursing, are of various ethnic backgrounds, and have jobs and families to consider while attending nursing school. In addition, many more men have entered the field of nursing over the last 50 years. 2. The nurse is caring for a diabetic patient who expresses the desire to learn more about a diabetic diet in an attempt to gain better control of his blood sugar. The nurses actions will be based on which non-nursing theory? A) B) C) D) 2 | P a g e Change theory Maslows hierarchy of human needs Neumans systems model Watsons theory of caringAns: A Feedback: The patient has identified a need for change, which will guide the nurses actions. Maslows hierarchy of human needs helps nurses prioritize actions. Neuman and Watson are nursing theorists. 3. A) B) C) D) E) Ans: The Quality and Safety Education for Nurses Initiative (QSEN) has identified which key competencies for nurses? Select all that apply. Patient-centered care Teamwork and collaboration Evidence-based practice Quality improvement Correct documentation A, B, C, D Feedback: The QSEN has identified patient-centered care, teamwork and collaboration, evidence- based practice, and quality improvement as a means for nurses to improve the quality and safety of patient care wherever they work. Additional key competencies identified are safety and informatics. 4. The nurse is caring for a patient who is on a ventilator. The nurse is bathing the patient and talking to them as she is carrying out care, as well as telling the patient what is going to happen next. The nurse speaks to the patient in a soothing manner. The nurse is acting in which role? (Select all that apply) A) B) 3 | P a g e Caregiver Decision-makerC) D) E) Ans: Communicator Educator Patient advocate A, C, D Feedback: The nurse is fulfilling the role of caregiver by providing the care and speaking to the patient in a soothing manner. The nurse is also acting as a communicator talking to the patient even if the patient cant respond. The nurse is also acting as an educator by informing the patient of the care that will be performed. The nurse is not assisting in making any decisions or speaking on behalf of the patient. 5. A) B) C) D) The nurse offers a patient two possible times to ambulate as the physician has ordered. The nurse is acting in which nursing role? Communicator Patient advocate Manager and coordinator Caregiver Ans: C Feedback: While the nurse is acting in many roles, the nurse is managing and coordinating the care for the patient by giving choices on when care will be implemented. 6. The nurse is performing an extensive dressing change on a burn patient. The nurse explains each step as it is being performed. The nurse is acting in which role by providing explanation of each step? 4 | P a g eA) B) C) D) Caregiver Patient advocate Decision-maker Educator Ans: D Feedback: The nurse is acting in the role of educator by explaining each step. The act of changing the dressing and providing support is the caregiver role. 7. What type of nursing program would allow a student with a 4-year degree in psychology to enter and complete a baccalaureate degree in nursing, take the NCLEX examination, and transition into a masters in nursing program? A) B) C) D) Baccalaureate program Graduate entry program Advanced degree program Continuing education program Ans: B Feedback: Graduate entry program students possess a baccalaureate degree in a field other than nursing. These students can track directly into a masters or doctorate in nursing program after successfully passing the NCLEX-RN. 8. A prospective nursing student desires a career that will allow him to provide patient care and to assist professional nurses with routine technical procedures. The prospective student needs to be employed in a full-time position quickly due to economic hardship. What type of nursing program would best suit this student? 5 | P a g eA) B) C) D) Associate of science registered nursing program Baccalaureate of science registered nursing program Licensed or vocational nursing program Diploma nursing program Ans: C Feedback: A licensed practical or vocational nursing program will allow the student to earn a technical certificate in 1 year and sit for the state board of nursing examination to be licensed as an LPN or LVN. An associate program will take 2 years and a baccalaureate program will take 4 years. There are very few diploma programs remaining in the US, and these programs typically take 3 years to complete. 9. Nurses that enlist their services to the military are able to do so thanks to the work of which organizer of healthcare? A) B) C) D) Linda Richards Florence Nightingale Theodor Fliedner Dorthea Dix Ans: D Feedback: Dorthea Dix, while not a nurse, established the Nurse Corps of the United States Army 6 | P a g eduring the Civil War. Linda Richards was the first trained nurse to graduate from a nursing program. Theodor Fliedner opened the first hospital-based school of nursing, and Florence Nightingale was nursings first professional leader. 10. Due to the rising cost of healthcare services, many procedures and treatments are being delivered in what type of setting? A) B) C) D) hospital medical centers outpatient facility community healthcare center Ans: C Feedback: Many procedures and treatments are being delivered in outpatient settings since hospital and medical center stays significantly increase healthcare costs to the patient and insurance company. Community healthcare centers typically refer to facilities such as day care centers or ambulatory clinics. 11. The nurse in a rehabilitative facility makes certain the patient he is caring for is participating in group activities that are of interest to the patient. The nurse is ensuring which patient need is met? A) B) C) D) Love and belonging Self-actualization Safety and security Self-esteem Ans: A Feedback: 7 | P a g eThe nurse is responsible for making sure the needs of the patient are met based on Maslows hierarchy of needs. Attending a group activity helps meet the needs of love and belonging (need to feel that one belongs and is loved to avoid loneliness and isolation). Self-actualization is the highest need and refers to realizing fully all of ones abilities and qualities. Safety and security refers to physical and psychological protection issues. Self- esteem indicates a feeling of self-worth. 12. The nurse is caring for a postoperative patient. The nurse administers a pain medication prescribed on a prn basis by the physician. What best describes the type of intervention the nurse is demonstrating? A) B) C) D) Physician-prescribed intervention Collaborative intervention Patient advocacy intervention Nurse-prescribed intervention Ans: B Feedback: Nurse initiated interventions, such as turning and repositioning a patient, are described as nurse-prescribed interventions. Physician-directed actions are described as physician-prescribed interventions. The administration of a prn medication requires a physician-prescribed intervention (the medication order) as well as a nurse-prescribed intervention (determining when the order should be carried out and proper administration of the medication); therefore, this action would be considered a collaborative intervention. Patient advocacy refers to communicating the needs and protecting the safety of the patient. 13. A nurse in the community has been asked to join an organization based on the leadership abilities she has demonstrated both in her facility of employment and community-based activities. What organization best describes this process? A) B) C) 8 | P a g e nurse researcher clinical nurse specialist nurse educatorD) nurse administrator Ans: B Feedback: The clinical nurse specialist has advanced experience and expertise in a specialized area of practice such as gerontology, and would be best suited to provide education on palliative care. The nurse researcher is responsible for the continued development and refinement of nursing knowledge and practice through the investigation of nursing problems. The nurse educator generally has specific clinical specialties and advanced clinical experience in a particular area. The nurse administrator is responsible for managing patient care. 14. During the Christian era, nursing care excluded which area? A) Nutrition B) C) D) Personal counseling Comfort measures Psychiatric services Ans: D Feedback: During the Christian era nursing focused on many of the same areas that nursing focuses on today. Included areas of focus were nutrition, mobility, medication administration, personal counseling, hygiene, and comfort measures. 15. The nurse is caring for a postoperative patient. The physician has written orders for a pain medication. The order gives a dosage range for the amount the nurse may give depending on the severity of the patients pain. This type of functioning within the healthcare team is called: A) 9 | P a g e Authoritative functioningB) C) D) E) Independent functioning Assistive functioning Dependent functioning Collaborative functioning Ans: E Feedback: Nurses manage collaborative problems using both nurse- and physician-prescribed interventions to reduce risk of complications (Carpenito-Moyet, 2009). 16. Which of the following is an appropriately stated nursing intervention? A) Ambulate in the hall B) C) D) Stand at bedside with assistance Ambulate 30 ft. twice a day with assistance of walker Ambulate with assistance of walker Ans: C Feedback: Correctly stated patient outcomes are specific, measurable, and realistic. The other choices are poorly defined and do not specify when or how or by whom. 17. All members of the healthcare team are encouraged to read and contribute to the individual plans of care for their patients. Which of the following healthcare providers 10 | P a g edevelops the plan of care? A) B) C) D) E) The RN The LPN or RN The physician The patient Any licensed member of the healthcare team Ans: A Feedback: To serve as evaluation criteria and meet the standards of the Joint Commission (2010), the plan must be developed by a registered nurse, it must be documented in the patients health record, and it must reflect the standards of care established by the institution and the profession. 18. Current trends in nursing practice include the development of A) B) C) D) Acute care centers Birthing centers Homeless shelters Ambulatory surgery centers Ans: B Feedback: Current trends in nursing practice include the development of nursing centers, wellness promotion programs, care of older adults, birthing centers, and home and community 11 | P a g ehealthcare. 19. The Standards of Practice provide nurses with A) Legislation for healthcare reform B) C) D) Evaluation of care provided by nurses Measurement criteria for payment Guidelines for providing care Ans: D Feedback: Standards of practice are essential because they serve as guidelines for providing and evaluating nursing care. 20. A nurse receives an x-ray report on a newly admitted patient suspected of having a fractured tibia. The nurse contacts the physician to report the findings. What role is the nurse engaged in? A) B) C) D) Communicator Advocate Caregiver Researcher Ans: A Feedback: Nurses are communicators when they report findings to the healthcare team. Advocacy involves actions such as protecting the patients safety or rights. Administering care measures directly to the patient and demonstrates the caregiver role. 12 | P a g eResearch involves collecting and analyzing data. 21. A nurse is caring for a young victim of a terrorist attack. During the rehabilitative process, the nurse assists the patient in bathing and dressing. The role the nurse is engaged in is A) B) C) D) Advocate Caregiver Counselor Educator Ans: B Feedback: As providers of care, nurses assume responsibility for helping patients promote, restore, and maintain health and wellness. Communicating the patients needs and concerns, and protecting the patient and the patients rights are components of the advocacy role of nursing. The nurse is simply assisting in hygiene measures; no education or counseling is being provided. 22. A student is choosing her educational path and desires a nursing degree that has a track that contains community nursing and leadership, as well as liberal arts. The student would best be suited in which type of program? A) B) C) D) Licensed practical nursing program Certification in a nursing specialty Diploma nursing program Baccalaureate program Ans: D Feedback: 13 | P a g eThe baccalaureate degree in nursing offers students a full college or university education with a background in the liberal arts. 23. The director of nursing (DON) of a major hospital is searching to hire a nurse with a strong technical background to care for patients on a busy surgical unit. The DON is most likely going to hire a nurse prepared at which level of nursing? A) B) C) D) Doctoral level Masters level Baccalaureate level Associate level Ans: D Feedback: The ANAs 1965 resolution prompted the 1985 ANA statement adopting the titles of associate nurse (a nurse prepared in an associate degree program with an emphasis on technical practice) and professional nurse (a nurse possessing the baccalaureate degree in nursing) for these two levels. Masters and doctoral prepared nurses possess higher degrees and expertise. 24. A nursing student begins to speak using medical terminology. This is considered to be part of which process? A) B) C) D) Learning Socialization Role development Evolutionary Ans: B Feedback: 14 | P a g eSocialization is a process that involves learning theory and skills and internalizing an identity appropriate to a specific role. 25. Which of the following factors has most influenced how nurses practice their profession? A) B) C) D) Financial support of nursing education Professional organizations such as ANA National Commission on Nursing Increased incidence of chronic illness Ans: D Feedback: Professional organizations speak to nurses on various topics and may have some influence on ideas regarding nursing care, but longer lifespans, increased incidence of chronic illness, and new family structures have dramatically affected where and how nurses practice. 26. The first nursing journal owned, operated, and published by nurses was A) American Journal of Nursing B) C) D) Ans: Nurse Educator Nursing Research Standards of Clinical Nursing Practice A Feedback: 15 | P a g eThe American Journal of Nursing was first published in 1900 and was owned, operated, and published by nurses. 27. Advocating for financial support for university-based schools of nursing was noted in which government document? A) B) C) D) Ans: The Goldmark Report Hill Burton Amendment Health Care Initiative Reform Act Lysaught Report A Feedback: The Goldmark Report in 1923 advocated for financial support for university-based schools of nursing. 28. The need for university-based nursing education programs was brought to light during which important historical time? A) B) C) D) Spanish American War World War I World War II Korean War Ans: C Feedback: Esther Lucille Brown, in her report on nursing education published at that time, wrote 16 | P a g ethat nursing education belonged in colleges and universities, not in hospitals. 29. The Henry Street Settlement was founded by A) Dorothea Dix B) C) D) Lillian Wald Florence Nightingale Isabel Hampton Robb Ans: B Feedback: Lillian Wald and Mary Brewster established the Henry Street Settlement, which was the first public health service for the sick and poor. 30. The Nurse Corps of the United States Army was established by A) Dorothea Dix B) C) D) Ans: Lillian Wald Florence Nightingale Isabel Hampton Robb A Feedback: Dorothea Dix established the Nurse Corps of the United States Army. 31. Florence Nightingale classified sick nursing as 17 | P a g eA) B) C) D) Ans: Care of the dying patient Use of patients reparative processes Addressing the community problems Implementation of restorative processes B Feedback: Nightingale viewed sick nursing as helping patients use their own reparative processes to get well. 32. The purpose of nursing was shaped by which of the following eras? A) Egyptian era B) C) D) Christian era Revolutionary War era Victorian era Ans: B Feedback: Christianitys influence improved the status of nursing by attracting intelligent individuals from respected families. Chapter 02- The Nurse's Role in Healthcare Quality and Patient Safety 18 | P a g e1. A nurse is preparing to administer a medication by using the vastus lateralis site and is unfamiliar with the process. A step-by-step reference that shows how to complete the process is called a: A) B) C) D) Deployment Flowchart Top-down Flowchart Pareto chart Control plot Ans: B Feedback: Correct: A top-down flowchart shows the sequence of steps in a job or process such as medication administration. Incorrect: a. A deployment flowchart shows the detailed steps involved in a process and the people or departments that are involved at each step in the process; this is not involved in this scenario. c. The Pareto chartis used in quality improvement to indicate that 80% of problems usually stem from 20% of causes; it displays data so that a few problems are easily depicted and facilitates improvement that focuses on those few. d. A control plotis a run chart that has a center-line and added statistical control limits; it helps reveal specific types of change within a process, rather than providing a sequencing of steps. 2. A nonprofit organization that distributes to governmental agencies, the public, business, and health care professionals knowledge related to health care for the purpose of improving health is the: A) B) C) D) 19 | P a g e Institute for Safe Medication Practices. Institute of Medicine. National Committee for Quality Assurance. The Joint Commission.Ans: B Feedback: Correct: The Institute of Medicine is a nonprofit organization whose mission is to advance and disseminate to the government, the corporate sector, the professions, and the public scientific information that will improve human health. Incorrect: a. The Institute for Safe Medication Practices is a nonprofit organization that is an educational resource only for the prevention of medication errors. c. The National Committee for Quality Assurance is the accrediting body for health maintenance organizations. d. The Joint Commission is a national agency that conducts surveys and certifies compliance with established standards for inpatient and ambulatory facilities. 3. A nurse is assisting with the delivery of twins. The first infant is placed on the scale to be weighed. The physician requests an instrument stat. The nurse turns to hand the instrument to the physician, and the infant falls off the scale. When evaluating the incident, the nurse and her manager list contributory factors such as the need for two nurses when multiple births are known, and the location of the scale so far from the delivery field. These nurses are performing a(n): A) B) C) D) standardization of care. root cause analysis. process variation. analysis of a deployment flowchart. Ans: B Feedback: Correct: A root cause analysis is a process by which factors that underlie variation in performance, including the occurrence or possible occurrence of a sentinel event, are identified. The purpose of root cause analysis is to identify improvements that can be implemented to prevent future occurrences. Incorrect: a. Standardization of care is the process of developing and adhering to best known methods and repeating key tasks in the same way, thereby creating exceptional service with maximum efficiency. 20 | P a g ec. Process variation looks at the steps in a process to determine how variation affects each step but does not identify causal events. d. A deployment flowchart analysis looks at the steps of a process and determines which department is responsible for each step, but it does not identify causal events. 4. Each month data on admission assessments that are based on the following standard are entered: “All patients will be assessed by an RN within 2 hours of admission.” The target goal for this standard is 97% compliance. Data are displayed on a graph that shows number and time of admission assessments and compliance variation limits. This pictorial representation is a: A) B) C) D) Pareto chart. control chart. deployment chart. top-down flowchart. Ans: B Feedback: Correct: The control chart is a run chart that has a center-line and added statistical control limits that help to detect specific types of change needed to improve a process. Incorrect: a. The Pareto chart is used in quality improvement to identify that 80% of problems usually stem from 20% of causes; it displays data so that a few problems are easily depicted and facilitates improvement that focuses on those few. c. A deployment flowchart shows the detailed steps involved in a process and the people or departments that are involved at each step. d. A top-down flowchart shows the sequence of steps in a job or process such as medication administration at a particular site, but it does not show variation limits. 5. Regardless of the term used to describe high-quality health care, the focus of quality is: A) B) C) 21 | P a g e what the consumer needs and wants. economical care. having the greatest technologic advancement.D) services equally distributed among populations. Ans: A Feedback: Correct: The customer determines quality on the basis of his or her unique perception of high-quality care. Incorrect: b. High-quality health care can be inexpensive, but if it does not meet the criteria established by the consumer, then it is not high-quality health care. c. Although technologic advancements may indeed facilitate superior diagnostics, unless the patient perceives that the technology was an indicator of quality or that it improved quality, then it is not the focus. d. The perception of quality is unique among individuals. 6. A) B) C) D) In differentiating between early efforts of quality assurance and present-day quality improvement efforts, which statement is correct? Quality assurance: had a broad focus. promoted problem-solving by all members of the health care team. was preventive in nature. tended to occur as a reaction to a specific problem. Ans: D Feedback: Correct: Early efforts focused on identified problems and were reactive rather than proactive. Incorrect: a. Quality assurance focused on specific incidents rather than on broad system improvements. b. With quality assurance, only a few people such as auditors focused on problems, and administration only later recognized the importance of proactive initiatives involving all members of the health care team. c. Early efforts of quality assurance focused on identified problems rather than on avoiding future problems. 22 | P a g e7. An organization’s emergency preparedness task force meets to discuss how it should react in case of a terrorist attack and develops a disaster evacuation plan that details how each department will assist individuals in reaching safety. This type of diagram is referred to as a: A) B) C) D) Pareto chart. control chart. top-down flowchart. deployment chart. Ans: D Feedback: Correct: A deployment flowchart would show the detailed steps involved in the process and the people or departments that are to be involved at each step to assist individuals in reaching safety. Incorrect: a. The Pareto chart displays data so that a few problems that cause the greatest variance are easily depicted and facilitates improvement that focuses on those few. b. A control chart distinguishes between common and special cause variations and is basically a run chart with added statistical control limits. c. The top-down flowchart simply lists the main steps and substeps of a process in a linear fashion and does not detail the departments or people needed. 8. Patients with heart failure have extended lengths of stay and are often readmitted shortly after they have been discharged. To improve quality of care, a type of “road map” that included all elements of care for this disease and that standardized treatment by guiding daily care was implemented. This road map is referred to as a(n): A) B) C) D) 23 | P a g e benchmark. critical pathway. algorithm. case management.Ans: B Feedback: Correct: A critical pathway determines the best order and timing of interventions provided by health care team members for a particular diagnosis. Incorrect: a. A benchmark is a process used in quality improvement to evaluate different aspects of a process in relation to best practices, with the goal of improving performance. c. An algorithm represents a decision path that a practitioner might take for a particular condition. d. Case management is a type of health care delivery that matches the most appropriate services to the patient’s care needs in the most efficient, effective manner, often with the use of a critical pathway or a clinical guideline. 9. The staff on a nursing unit notes that patient satisfaction varies from month to month. They plot the degree of patient satisfaction each month for 1 year to determine when the periods of greatest dissatisfaction are occurring. The staff uses which type of graph? A) B) C) D) Time plot. Pareto chart. Flowchart. Cause-and-effect diagram. Ans: A Feedback: Correct: A run plot, or time plot, graphs data in time order to identify any changes that occur over time. Incorrect: b. A Pareto chart is used in quality improvement to display data so that a few problems that cause the greatest variance are easily depicted and facilitates improvement that focuses on those few. c. A flowchart provides pictures of the sequence of steps in a process. d. A cause-and-effect diagram lists potential causes, arranged by categories, to show their potential impact on a problem. It is not arranged by time. 10. The number of IV site infections has more than doubled on a nursing unit. The staff determine common causes include the site is cleaned using inconsistent methods, dressing frequently becomes wet when patient showers, IV tubing is not changed every 24 | P a g e48 hours per protocol, and inadequate hand washing of RN prior to insertion. A bar graph demonstrates the frequency in descending order, with 80% of infections being attributed to inadequate hand washing. The quality tool used is a: A) B) C) D) cause-and-effect diagram. run chart. Pareto chart. flowchart. Ans: C Feedback: Correct: Pareto charts are bar graphs that show causes contributing to a problem in descending order so the leading cause is easily recognized. Incorrect: a. With the cause-and-effect diagram, all causes are listed but not in frequency of occurrence. b. Run charts show data over time. d. Flowcharts show steps in a process. Chapter 03- Values, Ethics, and Legal Issues