Complete|HESI EXIT Family Nurse Practitioner/APRN 2024 Final Exam|100% Verified With Rationale|Graded A+

Complete|HESI EXIT Family Nurse Practitioner/APRN 2024 Final Exam|100% Verified With Rationale|Graded A+ Which of the following nursing actions demonstrates that the nurse understands the nursing process? a) Prioritizing patient goals, documenting all health records precisely, conducting the health history, and documenting the nursing diagnosis b) Reviewing health record, documenting patient goals, identifying etiology of the nursing problem, and evaluating treatment outcome. c) Assessing for allergies, administering analgesic, obtaining baseline vital signs, and documenting nursing diagnosis as acute pain d) Obtaining vital signs, documenting nursing diagnosis as acute pain, administering analgesic, and evaluating comfort level d) Obtaining vital signs, documenting nursing diagnosis as acute pain, administering analgesic, and evaluating comfort level Rationale: Steps of the nursing process in order are: Assessment, Diagnosis, Planning, Implementation, and Evaluation. Assessment is the systematic collection of data to determine the patient's health status and any actual or potential health problems. Nursing diagnoses are actual or potential health problems that can be managed by independent nursing interventions. Planning is the development of goals and outcomes. Implementation is the actualization of the plan of care through nursing interventions. Evaluation is the determination of the patient’s responses to the nursing interventions and the extent to which the outcomes have been achieved. 1. The nurse educator is planning a teaching session for nursing students related to treatment and management of gestational diabetes. The nurse educator arranges for a dietitian, pharmacist, and physician assistant to participate in the lesson plan. Which professional nurse competency is the nurse educator demonstrating? a) Evidence-based practice b) Patient-centered care c) Interdisciplinary teamwork d) Quality improvement measures c) Interdisciplinary teamwork Rationale: By integrating interdisciplinary core competencies into their respective curricula the nurse educator is demonstrating interdisciplinary teamwork. A case-study approach planning care around individual patient preferences is an example of patient-centered care. Conducting an evidence- based literature review related to gestational diabetes reflects evidence-based practice. Providing education related to measures/indicators or tools used to assess the level of care provided within a system of care to populations of patients with gestational diabetes exemplifies a quality improvement measure. 2. A nursing student observes the home care nurse provide education to a patient with congestive heart failure (CHF). The nurse teaches the patient how to read food labels and calculate sodium content. The nursing student recognizes that the home care nurse is aware of which of the following basic principles of patient education? a) The home care nurse is providing hospital discharge instructions b) The home care nurse has a physician order to teach a 2-g sodium diet c) Patients are required to learn about their therapeutic nutritional regimen d) Patient instruction related to self-care activities promotes patient independence d) Patient instruction related to self-care activities promotes patient independence Rationale: Teaching is a function of nursing to assist patients to alter lifestyle patterns that increase health risk. By teaching the client how to calculate sodium content of foods the nurse is facilitating independence in nutrition disease management. Patients have the right to decide whether or not to learn. Teaching is an independent function of nursing and does not require a physician’s order. Teaching related to food labels in the patient home is an appropriate environment for this client. The nurse can use actual foods from the patient’s kitchen. 3. A nurse working in the intensive care unit (ICU) refers to the Institute for Healthcare Improvement (IHI) Ventilator Bundle prior to planning patient care. The nurse realizes nursing interventions outlined in the bundle will improve patients’ outcomes. Which of the following statement best describes how IHI- established nursing interventions should be included in each bundle? a) Nursing interventions found within the IHI bundles were selected based on the ability to provide optimal time management for the nurse b) Best practice derived from valid and reliable research studies guided nursing interventions being added to the IHI bundles c) Nurse case managers serving as patient advocates recommended nursing interventions to be included in the IHI bundles based on patient preference d) Hospitals, physicians, and nurses worked collaboratively to design patient care activities included in IHI bundles b) Best practice derived from valid and reliable research studies guided nursing interventions being added to the IHI bundles Rationale: Bundles include evidence-based practices. Hospitals, physicians, and nurses work collaboratively to provide care directed by bundles. Nurses advocate on behalf of the patient. Effective time management is a key element in the provision of care, however; IHI-based bundles on evidence-based practice. 4. A 54-year-old woman on a fixed income has had an electrocardiogram (ECG) as part of her annual physical examination. Her physician notes an abnormal Q wave on an otherwise unremarkable ECG. What legislation supports this focus on disease prevention, health promotion, and management of chronic conditions? a) Building a Safer Health System Act b) The Patient Protection and Affordable Care Act c) Healthcare Research and Quality Improvement Bill d) A New Health System for the 21st Century Bill b) The Patient Protection and Affordable Care Act Rationale: The Patient Protection and Affordable Care Act, also known as the ACA, supports access to quality, affordable health care, improved access to innovative and preventive health care programs and therapies, and expanded insurance coverage. “To Err Is Human: Building a Safer Health System” and “Crossing the Quality Chasm: A New Health System for the 21st Century” are IOM reports. Centers for Medicare and Medicaid Services (CMS) partnered with the Agency for Healthcare Research and Quality (AHRQ) to launch the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. 5. According to Hood and Leddy (2007), which of the following are components of wellness? a) Inability to obtain personal goals b) Expression of disharmony c) Feelings of well-being d) Inability to adapt to changing situations c) Appropriateness of services Rationale: The goals of care management are quality, appropriateness, and timeliness of services as well as cost reduction. Case managers do not have prescriptive authority. Fixed-price reimbursement is a feature of managed care. Case managers do not use the nursing process. 6. The school nurse informs the mother of a second-grade student that she found lice in her child’s hair. The mother explains to the nurse that she has another child to pick up and cannot stay to receive education related to the treatment of lice at this time. The mother reassures the nurse that she will “look up treatment options on the Internet and take care of the child.” What would be the best action of the school nurse in this situation? a) Instruct the mother to treat the other child for lice in the same manner as the second grade child b) Provide the mother with a list of credible Web sites related to the treatment of lice c) Notify the social worker of suspected child neglect and make a referral to child protective services d) Perform hand hygiene and notify the second-grade teacher to wash down the classroom b) Provide the mother with a list of credible Web sites related to the treatment of lice Rationale: Providing the mother with a list of previewed Web sites related to treating lice assist the mother to receive trustworthy, credible, and timely information related to treatment options. Although assessing and treating the other children in the home is indicated, it is more important to direct the mother to accurate information related to the treatment of lice. The nurse should perform routine hand hygiene, washing the classroom is not indicated. The presence of lice does not warrant a referral to the social worker or child protective services. 7. In which of the following situations is the nurse demonstrating the ethical principle of beneficence? a) Providing truthful and accurate information to a patient about a procedure b) Volunteering to provide vaccinations at the local health center c) Ensuring adequate staffing to provide care to all patients d) Refusing to give an ordered medication based on assessment findings b) Volunteering to provide vaccinations at the local health center Rationale: Beneficence is the duty to do good and the active promotion of benevolent acts. Fidelity refers to the duty to be faithful to one's commitments. Veracity is the obligation to tell the truth. Nonmaleficence is the duty not to inflict, as well as to prevent and remove, harm; it is more binding than beneficence. 8. What percentage of people older than 65 years of age has one or more a) 50 b) 80 c) 70 d) 60 b) 80 Rationale: Eighty percent of people older than 65 years of age have one or more chronic illness and many are limited in their activity 9. Which of the following examples of therapeutic communication techniques may occur during the planning stage and increases the patient’s perception of available options? a) “Home health services are also available in our community if you feel an assisted living situation is uncomfortable.” b) “You appear confused about assisted living facilities.” c) “Let’s discuss specific concerns you have regarding assisted living facilities.” d) “I hear you say that you are uncomfortable with the idea of going to an assisted living facility.” a) “Home health services are also available in our community if you feel an assisted living situation is uncomfortable.” Rationale: Suggesting is the presentation of alternative ideas such as home health services the patient's consideration and increases the perception of other possible solutions relative to the problem. Clarification is asking the patient to explain what he or she means or attempting to help verbalize the patient's vague ideas or unclear thoughts to enhance the nurse's understanding. Focusing includes questions or statements to help the patient develop or expand an idea. Reflection directs back to the patient his feelings but does not increase the patient’s perception of available options. 10. The nurse caring for a HIV patient diagnosed with acute pneumonia demonstrates understanding of the nurse’s role in the current focus on management of chronic illness and disability in which of the following situations? a) Reviewing the patient’s CD4 count b) Making a referral to an HIV support group c) Administering prescribed antibiotics d) Teaching the patient to avoid crowds d) Teaching the patient to avoid crowds Rationale: Current focus on chronic disease conditions is focused on disease prevention. Teaching the patient to avoid crowds encourages the patient to take control of their health and reduce the risk of pneumonia exacerbations. Administering prescribed antibiotics is indicated in this situation; however, it does not promote independence in the patient. Making a referral to a HIV support group is indicated in this situation; however, the focus is on actions of the nurse not the patient. Reviewing the patient’s CD4 count is important but does not indicate the patient’s ability to control his or her health. 11. In which of the following actions is the nurse illustrating the step of the nursing process that determines if the patient understands the health teaching that is provided? a) Setting short-term educational goals for the patient newly diagnosed with diabetes b) Teaching injection sites to a patient newly diagnosed with diabetes c) Watching a return demonstration of insulin administration from a newly diagnosed diabetic d) Asking a new diabetic, “What are your questions about giving yourself an insulin injection?” c) Watching a return demonstration of insulin administration from a newly diagnosed diabetic Rationale: Evaluation includes observing the patient, asking questions, and then comparing the patient’s behavioral responses with the expected outcomes. Observation of a return demonstration is a form of evaluation. Assessment includes determining the patient’s readiness regarding learning. Planning includes identification of teaching strategies, writing the teaching plan, and setting goals of the teaching strategies. Implementation is the step during which the teaching plan is put into action.