Medical-Surgical Nursing
Comprehensive Final Exam Review
Questions with Correct Answers
Professional Nursing *(Chapter 1: Harding Textbook)* - ANSWERSAs a nurse, you (1)
offer skilled care to those recovering from illness or injury, (2) advocate for patients'
rights, (3) teach patients to manage their health, (4) support patients and their
caregivers at critical times, and (5) help them navigate the complex health care system.
Definition of Nursing - ANSWERSNursing is described as both an art and a science; a
heart and a mind.
- Nursing is putting the patient in the best condition for nature to act (Florence
Nightingale).
- The nurse's unique function is to aid patients, sick or well, in performing those
activities contributing to health or its recovery (or to peaceful death) that they would
perform unaided if they had the necessary strength, will, or knowledge--and to do this in
such a way as to help them gain independence (Henderson).
- *Nursing is the protection, promotion, and optimization of health and abilities,
prevention of illness and injury, alleviation of suffering through the diagnosis and
treatment of human response, and advocacy in the care of individuals, families,
communities, and populations (American Nursing Association).*
Nursing's View of Humanity (7 Dimensions of Wellness) - ANSWERS7 Dimensions of
Wellness that contribute to health and quality of life:
1. Physical
2. Psychological
3. Social
4. Spiritual
5. Intellectual
6. Career (Occupational)
7. Environmental
Scope of Nursing Practice - ANSWERSThe essential core of nursing is to deliver
holistic patient-centered care. *Describes the services that a qualified health
professional is deemed competent to perform and permitted to undertake.*
- More education and experience can prepare nurses for advanced practice. An
*advanced practice registered nurse (APRN)* is a nurse educated at the master's or
doctoral level.
Standards of Professional Nursing Practice - ANSWERSThe American Nurses
Association (ANA) defines Standards of Professional Nursing Practice to guide nurses
in how to perform professionally.
, - 2 Parts:
- Standards of Practice: describes a competent level of nursing care based on the
nursing process (ADPIE).
- Standards of Professional Performance: describes behavioral competencies expected
of a nurse.
Quality and Safety Education for Nurses (QSEN) - ANSWERSAddresses the challenge
to prepare nurses with the competencies needed to continuously improve the quality of
care in their work environments.
- Defines specific competencies nurses need to possess to practice safely and
effectively
Nurse Practice Act (NPA) - ANSWERSDefines the scope and limitations of professional
nursing practice; vary from state to state
- Defines the nursing scope of practice in addition to delegating patient care.
Clinical Judgement - ANSWERSThe ability to make decisions and solve problems by
making sense of information in a situation (the observed outcome of critical thinking and
decision-making).
Nursing Process - ANSWERSAssessment
Diagnosis
Planning
Implementation
Evaluation
Core Nursing Competencies (QSEN) - ANSWERS*Patient-Centered Care*: Provide
holistic, compassionate, and coordinated care based on respect for patient's
preferences.
*Interprofessional Partnerships*: Function effectively within nursing and
interprofessional teams
*Safety*: Minimize risk of harm to patients and providers.
*Quality Improvement*: Use data to monitor the outcomes of care and to improve the
quality and safety of health care systems.
*Informatics and Health Care Technology*: Use information and technology to
communicate, manage knowledge, reduce errors, and support decision making.
*Evidence-Based Practice*: Integrate best current evidence with clinical expertise and
the patient/caregiver preferences and values for delivery of optimal health care.
Nursing Care Plans - ANSWERSThe comprehensive nursing care plan is the central
source of information needed to guide holistic, goal-oriented care, and address each
client's unique needs
- Guides for routine care
,Coordinating Care - ANSWERSEffective communication is key to fostering teamwork
and coordinating care. To provide safe, effective care, team members must exchange
information clearly and accurately among team members.
- *Situation-Background-Assessment-Recommendation (SBAR)*: Offers a structured
way to discuss a patient's condition between team members. It allows you to attention
and action.
- *Patient Handoff Report*: The process of passing patient information to another team
member during a transition.
Clinical Pathways - ANSWERSInterprofessional care plans outline the care and desired
outcomes for a specific time for patients with a specific diagnosis. If a patient's progress
differs from the planned path, a *variance* has occurred (These can be positive or
negative)
Delegation and Assignment - ANSWERS*Delegation* allows a care provider to perform
a specific nursing activity, skill, or procedure beyond their usual role. (Initial
assessment, patient teaching, and evaluation CANNOT be delegated) (bathing, vital
signs, ambulating, and feeding CAN be delegated)
*Assignment* is referred to when a RN directs an LPN/VN/ or AP to do an activity or
procedure that is part of their everyday job.
5 Rights of Delegation - ANSWERS1. Right task
2. Right circumstance
3. Right person
4. Right direction/communication
5. Right supervision/evaluation
Evidence-Based Practice - ANSWERSA problem solving approach to making clinical
decisions using the best evidence available.
- Steps of EBP Process:
1. Asking a clinical question
2. Searching for the best evidence
3. Critically appraise the evidence
4. Implement the evidence into practice
5. Evaluate the outcome
6. Share the results
National Patient Safety Goals (NPSGs) - ANSWERSGoals issued by the Joint
Commission to improve patient safety in healthcare organizations nationwide
-Improve accuracy of client identification.
-Improve effectiveness of communication
among caregivers.
-Improve safety of using medications.
-Reduce risk of health-care-associated infections.
-Identify client safety risks inherent in its
patient population.
, PICOT format - ANSWERS*P* - Identify the population or problem (age, gender,
ethnicity, disease/disorder)
*I* - Intervention, or range of interventions of interest (exposure to disease, risk
behavior, education)
*C* - What will you compare the intervention against? (no disease, absence of risk
factors, placebo or no intervention)
*O* - Outcome of interest (risk of disease, rates of occurrence of adverse outcomes,
accuracy of diagnosis)
*T* - Time it takes for intervention to achieve the outcome (selected to observe the
population or problem/condition)
Care and Performance Initiatives that influence payment for health care services -
ANSWERS- Clinical outcomes
- Patient satisfaction
- Use of EBP
- Occurrence of serious reportable events
Accountable Care Organization (ACO) - ANSWERSAn organization of healthcare
providers accountable for the quality, cost, and overall care of Medicare beneficiaries
who are assigned and enrolled in the traditional fee-for-service program
National Quality Forum (NQF) - ANSWERSReduces the occurrence of serious
reportable events by providing a list of effective Safe Practices to e used in health care
settings.
Preferred Provider Organization (PPO) and Health Maintenance Organizations -
ANSWERSProvide health care services with charges established with predetermined
reimbursement rates or capitation fees in advance of the medical, hospital, and other
care services delivered.
Social Determinants of Health *(Chapter 2: Harding Textbook)* - ANSWERSSocial and
cultural factors influence equity in health care. *Health disparities* are differences in the
incidence, prevalence, mortality rate, and burden of diseases that exist among specific
population groups.
Social Determinants of Health: - ANSWERSAre nonmedical factors that (1) influence
the health of persons and groups and (2) explain why some people have poorer health
than others.
Health status - ANSWERSA holistic concept that is more than the presence or absence
of disease. It encompasses life expectancy and self-assessment of health.
Examples of Social Health Determinants - ANSWERS- Neighborhood
- Economic Stability
- Health Care
Comprehensive Final Exam Review
Questions with Correct Answers
Professional Nursing *(Chapter 1: Harding Textbook)* - ANSWERSAs a nurse, you (1)
offer skilled care to those recovering from illness or injury, (2) advocate for patients'
rights, (3) teach patients to manage their health, (4) support patients and their
caregivers at critical times, and (5) help them navigate the complex health care system.
Definition of Nursing - ANSWERSNursing is described as both an art and a science; a
heart and a mind.
- Nursing is putting the patient in the best condition for nature to act (Florence
Nightingale).
- The nurse's unique function is to aid patients, sick or well, in performing those
activities contributing to health or its recovery (or to peaceful death) that they would
perform unaided if they had the necessary strength, will, or knowledge--and to do this in
such a way as to help them gain independence (Henderson).
- *Nursing is the protection, promotion, and optimization of health and abilities,
prevention of illness and injury, alleviation of suffering through the diagnosis and
treatment of human response, and advocacy in the care of individuals, families,
communities, and populations (American Nursing Association).*
Nursing's View of Humanity (7 Dimensions of Wellness) - ANSWERS7 Dimensions of
Wellness that contribute to health and quality of life:
1. Physical
2. Psychological
3. Social
4. Spiritual
5. Intellectual
6. Career (Occupational)
7. Environmental
Scope of Nursing Practice - ANSWERSThe essential core of nursing is to deliver
holistic patient-centered care. *Describes the services that a qualified health
professional is deemed competent to perform and permitted to undertake.*
- More education and experience can prepare nurses for advanced practice. An
*advanced practice registered nurse (APRN)* is a nurse educated at the master's or
doctoral level.
Standards of Professional Nursing Practice - ANSWERSThe American Nurses
Association (ANA) defines Standards of Professional Nursing Practice to guide nurses
in how to perform professionally.
, - 2 Parts:
- Standards of Practice: describes a competent level of nursing care based on the
nursing process (ADPIE).
- Standards of Professional Performance: describes behavioral competencies expected
of a nurse.
Quality and Safety Education for Nurses (QSEN) - ANSWERSAddresses the challenge
to prepare nurses with the competencies needed to continuously improve the quality of
care in their work environments.
- Defines specific competencies nurses need to possess to practice safely and
effectively
Nurse Practice Act (NPA) - ANSWERSDefines the scope and limitations of professional
nursing practice; vary from state to state
- Defines the nursing scope of practice in addition to delegating patient care.
Clinical Judgement - ANSWERSThe ability to make decisions and solve problems by
making sense of information in a situation (the observed outcome of critical thinking and
decision-making).
Nursing Process - ANSWERSAssessment
Diagnosis
Planning
Implementation
Evaluation
Core Nursing Competencies (QSEN) - ANSWERS*Patient-Centered Care*: Provide
holistic, compassionate, and coordinated care based on respect for patient's
preferences.
*Interprofessional Partnerships*: Function effectively within nursing and
interprofessional teams
*Safety*: Minimize risk of harm to patients and providers.
*Quality Improvement*: Use data to monitor the outcomes of care and to improve the
quality and safety of health care systems.
*Informatics and Health Care Technology*: Use information and technology to
communicate, manage knowledge, reduce errors, and support decision making.
*Evidence-Based Practice*: Integrate best current evidence with clinical expertise and
the patient/caregiver preferences and values for delivery of optimal health care.
Nursing Care Plans - ANSWERSThe comprehensive nursing care plan is the central
source of information needed to guide holistic, goal-oriented care, and address each
client's unique needs
- Guides for routine care
,Coordinating Care - ANSWERSEffective communication is key to fostering teamwork
and coordinating care. To provide safe, effective care, team members must exchange
information clearly and accurately among team members.
- *Situation-Background-Assessment-Recommendation (SBAR)*: Offers a structured
way to discuss a patient's condition between team members. It allows you to attention
and action.
- *Patient Handoff Report*: The process of passing patient information to another team
member during a transition.
Clinical Pathways - ANSWERSInterprofessional care plans outline the care and desired
outcomes for a specific time for patients with a specific diagnosis. If a patient's progress
differs from the planned path, a *variance* has occurred (These can be positive or
negative)
Delegation and Assignment - ANSWERS*Delegation* allows a care provider to perform
a specific nursing activity, skill, or procedure beyond their usual role. (Initial
assessment, patient teaching, and evaluation CANNOT be delegated) (bathing, vital
signs, ambulating, and feeding CAN be delegated)
*Assignment* is referred to when a RN directs an LPN/VN/ or AP to do an activity or
procedure that is part of their everyday job.
5 Rights of Delegation - ANSWERS1. Right task
2. Right circumstance
3. Right person
4. Right direction/communication
5. Right supervision/evaluation
Evidence-Based Practice - ANSWERSA problem solving approach to making clinical
decisions using the best evidence available.
- Steps of EBP Process:
1. Asking a clinical question
2. Searching for the best evidence
3. Critically appraise the evidence
4. Implement the evidence into practice
5. Evaluate the outcome
6. Share the results
National Patient Safety Goals (NPSGs) - ANSWERSGoals issued by the Joint
Commission to improve patient safety in healthcare organizations nationwide
-Improve accuracy of client identification.
-Improve effectiveness of communication
among caregivers.
-Improve safety of using medications.
-Reduce risk of health-care-associated infections.
-Identify client safety risks inherent in its
patient population.
, PICOT format - ANSWERS*P* - Identify the population or problem (age, gender,
ethnicity, disease/disorder)
*I* - Intervention, or range of interventions of interest (exposure to disease, risk
behavior, education)
*C* - What will you compare the intervention against? (no disease, absence of risk
factors, placebo or no intervention)
*O* - Outcome of interest (risk of disease, rates of occurrence of adverse outcomes,
accuracy of diagnosis)
*T* - Time it takes for intervention to achieve the outcome (selected to observe the
population or problem/condition)
Care and Performance Initiatives that influence payment for health care services -
ANSWERS- Clinical outcomes
- Patient satisfaction
- Use of EBP
- Occurrence of serious reportable events
Accountable Care Organization (ACO) - ANSWERSAn organization of healthcare
providers accountable for the quality, cost, and overall care of Medicare beneficiaries
who are assigned and enrolled in the traditional fee-for-service program
National Quality Forum (NQF) - ANSWERSReduces the occurrence of serious
reportable events by providing a list of effective Safe Practices to e used in health care
settings.
Preferred Provider Organization (PPO) and Health Maintenance Organizations -
ANSWERSProvide health care services with charges established with predetermined
reimbursement rates or capitation fees in advance of the medical, hospital, and other
care services delivered.
Social Determinants of Health *(Chapter 2: Harding Textbook)* - ANSWERSSocial and
cultural factors influence equity in health care. *Health disparities* are differences in the
incidence, prevalence, mortality rate, and burden of diseases that exist among specific
population groups.
Social Determinants of Health: - ANSWERSAre nonmedical factors that (1) influence
the health of persons and groups and (2) explain why some people have poorer health
than others.
Health status - ANSWERSA holistic concept that is more than the presence or absence
of disease. It encompasses life expectancy and self-assessment of health.
Examples of Social Health Determinants - ANSWERS- Neighborhood
- Economic Stability
- Health Care
