Test Bank
Brunner and Suddarths Canadian Textbook of Medical-
Surgical Nursing 4th Edition by Mohamed El Hussein;
Joseph Osuji | 9781975108038 | Chapter 1-74
TEST BANK
, Table of Contents
Table of Contents 1
Chapter 01: Health Care Delivery and Evidence-Based Nursing Practice 3
Chapter 02: Community-Based Nursing Practice 22
Chapter 03: Critical Thinking, Ethical Decision Making and the Nursing Process 41
Chapter 04: Health Education and Promotion 64
Chapter 05: Adult Health and Nutritional Assessment 83
Chapter 06: Individual and Family Homeostasis, Stress, and Adaptation 104
Chapter 07: Overview of Transcultural Nursing 124
Chapter 08: Overview of Genetics and Genomics in Nursing 144
Chapter 09: Chronic Illness and Disability 164
Chapter 10: Principles and Practices of Rehabilitation 183
Chapter 11: Health Care of the Older Adult 220
Chapter 12: Pain Management 240
Chapter 13: Fluid and Electrolytes: Balance and Disturbance 260
Chapter 14: Shock and Multiple Organ Dysfunction Syndrome 280
Chapter 15: Management of Patients with Oncologic Disorders 300
Chapter 16: End-of-Life Care 319
Chapter 17: Preoperative Nursing Management 338
Chapter 18: Intraoperative Nursing Management 357
Chapter 19: Postoperative Nursing Management 376
Chapter 20: Assessment of Respiratory Function 396
Chapter 21: Respiratory Care Modalities 415
Chapter 22: Management of Patients With Upper Respiratory Tract Disorders 434
Chapter 23: Management of Patients with Chest and Lower Respiratory Tract Disorders
453
Chapter 24: Management of Patients With Chronic Pulmonary Disease 472
Chapter 25: Assessment of Cardiovascular Function 490
Chapter 26: Management of Patients With Dysrhythmias and Conduction Problems 508
Chapter 27: Management of Patients With Coronary Vascular Disorders 526
Chapter 28: Management of Patients With Structural, Infectious, and Inflammatory Cardiac
Disorders 545
Chapter 29: Management of Patients With Complications from Heart Disease 564
Chapter 30: Assessment and Management of Patients With Vascular Disorders and
Problems of Peripheral Circulation 582
Chapter 31: Assessment and Management of Patients With Hypertension 601
Chapter 32: Assessment of Hematologic Function and Treatment Modalities 620
Chapter 33: Management of Patients With Nonmalignant Hematologic Disorders 638
Chapter 34: Management of Patients With Hematologic Neoplasms 656
Chapter 35: Assessment of Immune Function 674
Chapter 36: Management of Patients With Immune Deficiency Disorders 692
Chapter 37: Assessment and Management of Patients With Allergic Disorders 710
Chapter 38: Assessment and Management of Patients With Rheumatic Disorders 728
Chapter 39: Assessment of Musculoskeletal Function 746
Chapter 40: Musculoskeletal Care Modalities 764
Chapter 41: Management of Patients With Musculoskeletal Disorders 782
Chapter 42: Management of Patients With Musculoskeletal Trauma 800
Chapter 43: Assessment of Digestive and Gastrointestinal Function 819
Chapter 44: Digestive and Gastrointestinal Treatment Modalities 837
Chapter 45: Management of Patients with Oral and Esophageal Disorders 855
Chapter 46: Management of Patients with Gastric and Duodenal Disorders 874
Chapter 47: Management of Patients With Intestinal and Rectal Disorders 893
,Chapter 48: Assessment and Management of Patients with Obesity 911
Chapter 49: Assessment and Management of Patients with Hepatic Disorders 921
Chapter 50: Assessment and Management of Patients with Biliary Disorders 940
Chapter 51: Assessment and Management of Patients with Diabetes 959
Chapter 52: Assessment and Management of Patients with Endocrine Disorders 978
Chapter 53: Assessment of Kidney and Urinary Function 996
Chapter 54: Management of Patients with Kidney Disorders 1015
Chapter 55: Management of Patients with Urinary Disorders 1034
Chapter 56: Assessment and Management of Patients With Female Physiologic Processes
1054
Chapter 57: Management of Patients with Female Reproductive Disorders 1072
Chapter 58: Assessment and Management of Patients with Breast Disorders 1091
Chapter 59: Assessment and Management of Patients With Male Reproductive Disorders
1110
Chapter 60: Assessment of Integumentary Function 1129
Chapter 61: Managements of Patients with Dermatologic Problems 1147
Chapter 62: Managements of Patients with Burn Injury 1165
Chapter 63: Assessment and Management of Patients with Eye and Vision Disorders
1184
Chapter 64: Assessment and Management of Patients with Hearing and Balance Disorders
1203
Chapter 65: Assessment of Neurologic Function 1221
Chapter 66: Management of Patients with Neurologic Dysfunction 1239
Chapter 67: Management of Patients with Cerebrovascular Disorders 1257
Chapter 68: Management of Patients with Neurologic Trauma 1276
Chapter 69: Management of Patients with Neurologic Infections, Autoimmune Disorders,
and Neuropathies 1294
Chapter 70: Management of Patients With Oncologic or Degenerative Neurologic Disorders
1312
Chapter 71: Management of Patients With Infectious Diseases 1331
Chapter 72: Emergency Nursing 1349
Chapter 73: Terrorism, Mass Casualty, and Disaster Nursing 1367
,Chapter 01: Health Care Delivery and Evidence-Based Nursing Practice
1. The public health nurse is presenting a health promotion class to a group of new mothers. How
shouldthe nurse best define health?
Health is being disease free.
Health is having fulfillment in all domains of life.
Health is having psychological and physiological harmony.
Health is being connected in body, mind, and spirit.
Ans: D
Feedback:
The World Health Organization (WHO) defines health in the preamble to its constitution as a state of
complete physical, mental, and social well-being and not merely the absence of disease and infirmity. The
other answers are incorrect because they are not congruent with the WHO definition of health.
2. A nurse is speaking to a group of prospective nursing students about what it is like to be a nurse. What isone
characteristic the nurse would cite as necessary to possess to be an effective nurse?
Sensitivity to cultural differences
Team-focused approach to problem-solving
Strict adherence to routine
Ability to face criticism
Ans: A
Feedback:
To promote an effective nurse-patient relationship and positive outcomes of care, nursing care must be
culturally competent, appropriate, and sensitive to cultural differences. Team-focused nursing and strict
adherence to routine are not characteristics needed to be an effective nurse. The ability to handle
criticism is important, but to a lesser degree than cultural competence.
3. With increases in longevity, people have had to become more knowledgeable about their health and the
professional health care that they receive. One outcome of this phenomenon is the development of
organized self-care education programs. Which of the following do these programs prioritize?
,Adequate prenatal care
Government advocacy and lobbying
Judicious use of online communities
Management of illness
Ans: D
Feedback:
Organized self-care education programs emphasize health promotion, disease prevention, management
of illness, self-care, and judicious use of the professional health care system. Prenatal care, lobbying, and
Internet activities are secondary.
4. The home health nurse is assisting a patient and his family in planning the patients return to work after
surgery and the development of postsurgical complications. The nurse is preparing a plan of care that
addresses the patients multifaceted needs. To which level of Maslows hierarchy of basic needs does the
patients need for self-fulfillment relate?
Physiologic
Transcendence
Love and belonging
Self-actualization
Ans: D
Feedback:
Maslows highest level of human needs is self-actualization, which includes self-fulfillment, desire to
know and understand, and aesthetic needs. The other answers are incorrect because self-fulfillment does
not relate directly to them.
5. The view that health and illness are not static states but that they exist on a continuum is central to
professional health care systems. When planning care, this view aids the nurse in appreciating which ofthe
following?
Care should focus primarily on the treatment of disease.
A persons state of health is ever-changing.
,A person can transition from health to illness rapidly.
Care should focus on the patients compliance with interventions.
Ans: B
Feedback:
By viewing health and illness on a continuum, it is possible to consider a person as being neither
completely healthy nor completely ill. Instead, a persons state of health is ever-changing and has the
potential to range from high-level wellness to extremely poor health and imminent death. The other
answers are incorrect because patient care should not focus just on the treatment of disease. Rapid
declines in health and compliance with treatment are not key to this view of health.
6. A group of nursing students are participating in a community health clinic. When providing care in this
context, what should the students teach participants about disease prevention?
It is best achieved through attending self-help groups.
It is best achieved by reducing psychological stress.
It is best achieved by being an active participant in the community.
It is best achieved by exhibiting behaviors that promote health.
Ans: D
Feedback:
Today, increasing emphasis is placed on health, health promotion, wellness, and self-care. Health is seen
as resulting from a lifestyle oriented toward wellness. Nurses in community health clinics do not teach
that disease prevention is best achieved through attending self-help groups, by reducing stress, or by
being an active participant in the community, though each of these activities is consistent with a healthy
lifestyle.
7. A nurse on a medical-surgical unit has asked to represent the unit on the hospitals quality committee.
When describing quality improvement programs to nursing colleagues and members of other health
disciplines, what characteristic should the nurse cite?
These programs establish consequences for health care professionals actions.
These programs focus on the processes used to provide care.
These programs identify specific incidents related to quality.
These programs seek to justify health care costs and systems.
,Ans: B
Feedback:
Numerous models seek to improve the quality of health care delivery. A commonality among them is a
focus on the processes that are used to provide care. Consequences, a focus on incidents, and
justification for health care costs are not universal characteristics of quality improvement efforts.
8. Nurses in acute care settings must work with other health care team members to maintain quality
carewhile facing pressures to care for patients who are hospitalized for shorter periods of time than in
the past. To ensure positive health outcomes when patients return to their homes, what action should
the nurse prioritize?
Promotion of health literacy during hospitalization
Close communication with insurers
Thorough and evidence-based discharge planning
Participation in continuing education initiativesAns: C
Feedback:
Following discharges that occur after increasingly short hospital stays, nurses in the community care for
patients who need high-technology acute care services as well as long-term care in the home. This is
dependent on effective discharge planning to a greater degree than continuing education, communication
with insurers, or promotion of health literacy.
9. You are admitting a patient to your medical unit after the patient has been transferred from the
emergency department. What is your priority nursing action at this time?
Identifying the immediate needs of the patient
Checking the admitting physicians orders
Obtaining a baseline set of vital signs
Allowing the family to be with the patientAns: A
Feedback:
, Among the nurses important functions in health care delivery, identifying the patients immediate needs and
working in concert with the patient to address them is most important. The other nursing functionsare
important, but they are not the most important functions.
10. A nurse on a postsurgical unit is providing care based on a clinical pathway. When performing
assessments and interventions with the aid of a pathway, the nurse should prioritize what goal?
Helping the patient to achieve specific outcomes
Balancing risks and benefits of interventions
Documenting the patients response to therapy
Staying accountable to the interdisciplinary teamAns: A
Feedback:
Pathways are an EBP tool that is used primarily to move patients toward predetermined outcomes.
Documentation, accountability, and balancing risks and benefits are appropriate, but helping the patient
achieve outcomes is paramount.
11. Staff nurses in an ICU setting have noticed that their patients required lower and fewer doses of
analgesiawhen noise levels on the unit were consciously reduced. They informed an advanced
practiceRN of this and asked the APRN to quantify the effects of noise on the pain levels of
hospitalized patients. How does this demonstrate a role of the APRN?
Involving patients in their care while hospitalized
Contributing to the scientific basis of nursing practice
Critiquing the quality of patient care
Explaining medical studies to patients and RNsAns: B
Feedback:
Research is within the purview of the APRN. The activity described does not exemplify explaining
studies to RNs, critiquing care, or involving patients in their care.
12. Nurses now have the option to practice in a variety of settings and one of the fastest growing venues of
practice for the nurse in todays health care environment is home health care. What is the main basis for
, the growth in this health care setting?
Chronic nursing shortage
Western focus on treatment of disease
Nurses preferences for day shifts instead of evening or night shifts
Discharge of patients who are more critically illAns: D
Feedback:
With shorter hospital stays and increased use of outpatient health care services, more nursing care is
provided in the home and community setting. The other answers are incorrect because they are not the
basis for the growth in nursing care delivered in the home setting.
13. Nurses have different educational backgrounds and function under many titles in their practice setting. Ifa
nurse practicing in an oncology clinic had the goal of improving patient outcomes and nursing care by
influencing the patient, the nurse, and the health care system, what would most accurately describe this
nurses title?
Nursing care expert
Clinical nurse specialist
Nurse manager
Staff nurse
Ans: B
Feedback:
Clinical nurse specialists are prepared as specialists who practice within a circumscribed area of care
(e.g., cardiovascular, oncology). They define their roles as having five major components: clinical
practice, education, management, consultation, and research. The other answers are incorrect because
they are not the most accurate titles for this nurse.
14. Nursing continues to recognize and participate in collaboration with other health care disciplines to
meetthe complex needs of the patient. Which of the following is the best example of a collaborative
practice model?
The nurse and the physician jointly making clinical decisions.
, The nurse accompanying the physician on rounds.
The nurse making a referral on behalf of the patient.
The nurse attending an appointment with the patient.
Ans: A
Feedback:
The collaborative model, or a variation of it, promotes shared participation, responsibility, and
accountability in a health care environment that is striving to meet the complex health care needs of the
public. The other answers are incorrect because they are not examples of a collaborative practice model.
15. A hospice nurse is caring for a patient who is dying of lymphoma. According to Maslows hierarchy of
needs, what dimension of care should the nurse consider primary in importance when caring for a dying
patient?
Spiritual
Social
Physiologic
Emotional
Ans: C
Feedback:
Maslow ranked human needs as follows: physiologic needs; safety and security; sense of belonging and
affection; esteem and self-respect; and self-actualization, which includes self-fulfillment, desire to know
and understand, and aesthetic needs. Such a hierarchy of needs is a useful framework that can be applied
to the various nursing models for assessment of a patients strengths, limitations, and need for nursing
interventions. The other answers are incorrect because they are not of primary importance when caring
for a dying patient, though each should certainly be addressed.
16. A nurse is planning a medical patients care with consideration of Maslows hierarchy of needs. Withinthis
framework of understanding, what would be the nurses first priority?
Allowing the family to see a newly admitted patient
Ambulating the patient in the hallway
Administering pain medication
Brunner and Suddarths Canadian Textbook of Medical-
Surgical Nursing 4th Edition by Mohamed El Hussein;
Joseph Osuji | 9781975108038 | Chapter 1-74
TEST BANK
, Table of Contents
Table of Contents 1
Chapter 01: Health Care Delivery and Evidence-Based Nursing Practice 3
Chapter 02: Community-Based Nursing Practice 22
Chapter 03: Critical Thinking, Ethical Decision Making and the Nursing Process 41
Chapter 04: Health Education and Promotion 64
Chapter 05: Adult Health and Nutritional Assessment 83
Chapter 06: Individual and Family Homeostasis, Stress, and Adaptation 104
Chapter 07: Overview of Transcultural Nursing 124
Chapter 08: Overview of Genetics and Genomics in Nursing 144
Chapter 09: Chronic Illness and Disability 164
Chapter 10: Principles and Practices of Rehabilitation 183
Chapter 11: Health Care of the Older Adult 220
Chapter 12: Pain Management 240
Chapter 13: Fluid and Electrolytes: Balance and Disturbance 260
Chapter 14: Shock and Multiple Organ Dysfunction Syndrome 280
Chapter 15: Management of Patients with Oncologic Disorders 300
Chapter 16: End-of-Life Care 319
Chapter 17: Preoperative Nursing Management 338
Chapter 18: Intraoperative Nursing Management 357
Chapter 19: Postoperative Nursing Management 376
Chapter 20: Assessment of Respiratory Function 396
Chapter 21: Respiratory Care Modalities 415
Chapter 22: Management of Patients With Upper Respiratory Tract Disorders 434
Chapter 23: Management of Patients with Chest and Lower Respiratory Tract Disorders
453
Chapter 24: Management of Patients With Chronic Pulmonary Disease 472
Chapter 25: Assessment of Cardiovascular Function 490
Chapter 26: Management of Patients With Dysrhythmias and Conduction Problems 508
Chapter 27: Management of Patients With Coronary Vascular Disorders 526
Chapter 28: Management of Patients With Structural, Infectious, and Inflammatory Cardiac
Disorders 545
Chapter 29: Management of Patients With Complications from Heart Disease 564
Chapter 30: Assessment and Management of Patients With Vascular Disorders and
Problems of Peripheral Circulation 582
Chapter 31: Assessment and Management of Patients With Hypertension 601
Chapter 32: Assessment of Hematologic Function and Treatment Modalities 620
Chapter 33: Management of Patients With Nonmalignant Hematologic Disorders 638
Chapter 34: Management of Patients With Hematologic Neoplasms 656
Chapter 35: Assessment of Immune Function 674
Chapter 36: Management of Patients With Immune Deficiency Disorders 692
Chapter 37: Assessment and Management of Patients With Allergic Disorders 710
Chapter 38: Assessment and Management of Patients With Rheumatic Disorders 728
Chapter 39: Assessment of Musculoskeletal Function 746
Chapter 40: Musculoskeletal Care Modalities 764
Chapter 41: Management of Patients With Musculoskeletal Disorders 782
Chapter 42: Management of Patients With Musculoskeletal Trauma 800
Chapter 43: Assessment of Digestive and Gastrointestinal Function 819
Chapter 44: Digestive and Gastrointestinal Treatment Modalities 837
Chapter 45: Management of Patients with Oral and Esophageal Disorders 855
Chapter 46: Management of Patients with Gastric and Duodenal Disorders 874
Chapter 47: Management of Patients With Intestinal and Rectal Disorders 893
,Chapter 48: Assessment and Management of Patients with Obesity 911
Chapter 49: Assessment and Management of Patients with Hepatic Disorders 921
Chapter 50: Assessment and Management of Patients with Biliary Disorders 940
Chapter 51: Assessment and Management of Patients with Diabetes 959
Chapter 52: Assessment and Management of Patients with Endocrine Disorders 978
Chapter 53: Assessment of Kidney and Urinary Function 996
Chapter 54: Management of Patients with Kidney Disorders 1015
Chapter 55: Management of Patients with Urinary Disorders 1034
Chapter 56: Assessment and Management of Patients With Female Physiologic Processes
1054
Chapter 57: Management of Patients with Female Reproductive Disorders 1072
Chapter 58: Assessment and Management of Patients with Breast Disorders 1091
Chapter 59: Assessment and Management of Patients With Male Reproductive Disorders
1110
Chapter 60: Assessment of Integumentary Function 1129
Chapter 61: Managements of Patients with Dermatologic Problems 1147
Chapter 62: Managements of Patients with Burn Injury 1165
Chapter 63: Assessment and Management of Patients with Eye and Vision Disorders
1184
Chapter 64: Assessment and Management of Patients with Hearing and Balance Disorders
1203
Chapter 65: Assessment of Neurologic Function 1221
Chapter 66: Management of Patients with Neurologic Dysfunction 1239
Chapter 67: Management of Patients with Cerebrovascular Disorders 1257
Chapter 68: Management of Patients with Neurologic Trauma 1276
Chapter 69: Management of Patients with Neurologic Infections, Autoimmune Disorders,
and Neuropathies 1294
Chapter 70: Management of Patients With Oncologic or Degenerative Neurologic Disorders
1312
Chapter 71: Management of Patients With Infectious Diseases 1331
Chapter 72: Emergency Nursing 1349
Chapter 73: Terrorism, Mass Casualty, and Disaster Nursing 1367
,Chapter 01: Health Care Delivery and Evidence-Based Nursing Practice
1. The public health nurse is presenting a health promotion class to a group of new mothers. How
shouldthe nurse best define health?
Health is being disease free.
Health is having fulfillment in all domains of life.
Health is having psychological and physiological harmony.
Health is being connected in body, mind, and spirit.
Ans: D
Feedback:
The World Health Organization (WHO) defines health in the preamble to its constitution as a state of
complete physical, mental, and social well-being and not merely the absence of disease and infirmity. The
other answers are incorrect because they are not congruent with the WHO definition of health.
2. A nurse is speaking to a group of prospective nursing students about what it is like to be a nurse. What isone
characteristic the nurse would cite as necessary to possess to be an effective nurse?
Sensitivity to cultural differences
Team-focused approach to problem-solving
Strict adherence to routine
Ability to face criticism
Ans: A
Feedback:
To promote an effective nurse-patient relationship and positive outcomes of care, nursing care must be
culturally competent, appropriate, and sensitive to cultural differences. Team-focused nursing and strict
adherence to routine are not characteristics needed to be an effective nurse. The ability to handle
criticism is important, but to a lesser degree than cultural competence.
3. With increases in longevity, people have had to become more knowledgeable about their health and the
professional health care that they receive. One outcome of this phenomenon is the development of
organized self-care education programs. Which of the following do these programs prioritize?
,Adequate prenatal care
Government advocacy and lobbying
Judicious use of online communities
Management of illness
Ans: D
Feedback:
Organized self-care education programs emphasize health promotion, disease prevention, management
of illness, self-care, and judicious use of the professional health care system. Prenatal care, lobbying, and
Internet activities are secondary.
4. The home health nurse is assisting a patient and his family in planning the patients return to work after
surgery and the development of postsurgical complications. The nurse is preparing a plan of care that
addresses the patients multifaceted needs. To which level of Maslows hierarchy of basic needs does the
patients need for self-fulfillment relate?
Physiologic
Transcendence
Love and belonging
Self-actualization
Ans: D
Feedback:
Maslows highest level of human needs is self-actualization, which includes self-fulfillment, desire to
know and understand, and aesthetic needs. The other answers are incorrect because self-fulfillment does
not relate directly to them.
5. The view that health and illness are not static states but that they exist on a continuum is central to
professional health care systems. When planning care, this view aids the nurse in appreciating which ofthe
following?
Care should focus primarily on the treatment of disease.
A persons state of health is ever-changing.
,A person can transition from health to illness rapidly.
Care should focus on the patients compliance with interventions.
Ans: B
Feedback:
By viewing health and illness on a continuum, it is possible to consider a person as being neither
completely healthy nor completely ill. Instead, a persons state of health is ever-changing and has the
potential to range from high-level wellness to extremely poor health and imminent death. The other
answers are incorrect because patient care should not focus just on the treatment of disease. Rapid
declines in health and compliance with treatment are not key to this view of health.
6. A group of nursing students are participating in a community health clinic. When providing care in this
context, what should the students teach participants about disease prevention?
It is best achieved through attending self-help groups.
It is best achieved by reducing psychological stress.
It is best achieved by being an active participant in the community.
It is best achieved by exhibiting behaviors that promote health.
Ans: D
Feedback:
Today, increasing emphasis is placed on health, health promotion, wellness, and self-care. Health is seen
as resulting from a lifestyle oriented toward wellness. Nurses in community health clinics do not teach
that disease prevention is best achieved through attending self-help groups, by reducing stress, or by
being an active participant in the community, though each of these activities is consistent with a healthy
lifestyle.
7. A nurse on a medical-surgical unit has asked to represent the unit on the hospitals quality committee.
When describing quality improvement programs to nursing colleagues and members of other health
disciplines, what characteristic should the nurse cite?
These programs establish consequences for health care professionals actions.
These programs focus on the processes used to provide care.
These programs identify specific incidents related to quality.
These programs seek to justify health care costs and systems.
,Ans: B
Feedback:
Numerous models seek to improve the quality of health care delivery. A commonality among them is a
focus on the processes that are used to provide care. Consequences, a focus on incidents, and
justification for health care costs are not universal characteristics of quality improvement efforts.
8. Nurses in acute care settings must work with other health care team members to maintain quality
carewhile facing pressures to care for patients who are hospitalized for shorter periods of time than in
the past. To ensure positive health outcomes when patients return to their homes, what action should
the nurse prioritize?
Promotion of health literacy during hospitalization
Close communication with insurers
Thorough and evidence-based discharge planning
Participation in continuing education initiativesAns: C
Feedback:
Following discharges that occur after increasingly short hospital stays, nurses in the community care for
patients who need high-technology acute care services as well as long-term care in the home. This is
dependent on effective discharge planning to a greater degree than continuing education, communication
with insurers, or promotion of health literacy.
9. You are admitting a patient to your medical unit after the patient has been transferred from the
emergency department. What is your priority nursing action at this time?
Identifying the immediate needs of the patient
Checking the admitting physicians orders
Obtaining a baseline set of vital signs
Allowing the family to be with the patientAns: A
Feedback:
, Among the nurses important functions in health care delivery, identifying the patients immediate needs and
working in concert with the patient to address them is most important. The other nursing functionsare
important, but they are not the most important functions.
10. A nurse on a postsurgical unit is providing care based on a clinical pathway. When performing
assessments and interventions with the aid of a pathway, the nurse should prioritize what goal?
Helping the patient to achieve specific outcomes
Balancing risks and benefits of interventions
Documenting the patients response to therapy
Staying accountable to the interdisciplinary teamAns: A
Feedback:
Pathways are an EBP tool that is used primarily to move patients toward predetermined outcomes.
Documentation, accountability, and balancing risks and benefits are appropriate, but helping the patient
achieve outcomes is paramount.
11. Staff nurses in an ICU setting have noticed that their patients required lower and fewer doses of
analgesiawhen noise levels on the unit were consciously reduced. They informed an advanced
practiceRN of this and asked the APRN to quantify the effects of noise on the pain levels of
hospitalized patients. How does this demonstrate a role of the APRN?
Involving patients in their care while hospitalized
Contributing to the scientific basis of nursing practice
Critiquing the quality of patient care
Explaining medical studies to patients and RNsAns: B
Feedback:
Research is within the purview of the APRN. The activity described does not exemplify explaining
studies to RNs, critiquing care, or involving patients in their care.
12. Nurses now have the option to practice in a variety of settings and one of the fastest growing venues of
practice for the nurse in todays health care environment is home health care. What is the main basis for
, the growth in this health care setting?
Chronic nursing shortage
Western focus on treatment of disease
Nurses preferences for day shifts instead of evening or night shifts
Discharge of patients who are more critically illAns: D
Feedback:
With shorter hospital stays and increased use of outpatient health care services, more nursing care is
provided in the home and community setting. The other answers are incorrect because they are not the
basis for the growth in nursing care delivered in the home setting.
13. Nurses have different educational backgrounds and function under many titles in their practice setting. Ifa
nurse practicing in an oncology clinic had the goal of improving patient outcomes and nursing care by
influencing the patient, the nurse, and the health care system, what would most accurately describe this
nurses title?
Nursing care expert
Clinical nurse specialist
Nurse manager
Staff nurse
Ans: B
Feedback:
Clinical nurse specialists are prepared as specialists who practice within a circumscribed area of care
(e.g., cardiovascular, oncology). They define their roles as having five major components: clinical
practice, education, management, consultation, and research. The other answers are incorrect because
they are not the most accurate titles for this nurse.
14. Nursing continues to recognize and participate in collaboration with other health care disciplines to
meetthe complex needs of the patient. Which of the following is the best example of a collaborative
practice model?
The nurse and the physician jointly making clinical decisions.
, The nurse accompanying the physician on rounds.
The nurse making a referral on behalf of the patient.
The nurse attending an appointment with the patient.
Ans: A
Feedback:
The collaborative model, or a variation of it, promotes shared participation, responsibility, and
accountability in a health care environment that is striving to meet the complex health care needs of the
public. The other answers are incorrect because they are not examples of a collaborative practice model.
15. A hospice nurse is caring for a patient who is dying of lymphoma. According to Maslows hierarchy of
needs, what dimension of care should the nurse consider primary in importance when caring for a dying
patient?
Spiritual
Social
Physiologic
Emotional
Ans: C
Feedback:
Maslow ranked human needs as follows: physiologic needs; safety and security; sense of belonging and
affection; esteem and self-respect; and self-actualization, which includes self-fulfillment, desire to know
and understand, and aesthetic needs. Such a hierarchy of needs is a useful framework that can be applied
to the various nursing models for assessment of a patients strengths, limitations, and need for nursing
interventions. The other answers are incorrect because they are not of primary importance when caring
for a dying patient, though each should certainly be addressed.
16. A nurse is planning a medical patients care with consideration of Maslows hierarchy of needs. Withinthis
framework of understanding, what would be the nurses first priority?
Allowing the family to see a newly admitted patient
Ambulating the patient in the hallway
Administering pain medication
