You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A nonnursing colleague asks about this code. Which of the following statements best describes this code?
A. Improves self-health care
B. Protects the patient’s confidentiality
C. Ensures identical care to all patients
D. Defines the principles of right and wrong to provide patient care
D. Defines the principles of right and wrong to provide patient care
When giving care, it is essential to provide a specified service according to standards of practice and to follow a code of ethics. The code of ethics is the philosophical ideals of right and wrong that define the principles you will use to provide care for your patients. The code serves as a guide for carrying out nursing responsibilities to provide quality nursing care and the ethical obligations of the profession.
An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, auscultates her lung sounds, listens to her heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed?
A. Diagnosis
B. Evaluation
C. Assessment
D. Implementation
C. Assessment
Assessment is the collection of comprehensive data pertinent to the patient’s health and/or the situation.
A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed?
A. Planning
B. Evaluation
C. Assessment
D. Implementation
D. Implementation
Implementation is completing coordinating care and the prescribed plan of care.
A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient’s wishes with the family. The nurse is acting as the patient’s:
A. Educator
B. Advocate
C. Caregiver
D. Case manager
B. Advocate
An advocate protects the patient’s human and legal right to make choices about his or her care. An advocate may also provide additional information to help a patient decide whether or not to accept a treatment or find an interpreter to help family members communicate their concerns.
Evidence-based practice is defined as:
A. Nursing care based on tradition
B. Scholarly inquiry of nursing and biomedical research literature
C. A problem-solving approach that integrates best current evidence with clinical practice
D. Quality nursing care provided in an efficient and economically sound manner
C. A problem-solving approach that integrates best current evidence with clinical practice
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
The examination for registered nurse licensure is exactly the same in every state in the United States. This examination:
A. Guarantees safe nursing care for all patients
B. Ensures standard nursing care for all patients
C. Ensures that honest and ethical care is provided
D. Provides a minimal standard of knowledge for a registered nurse in practice
D. Provides a minimal standard of knowledge for a registered nurse in practice
Registered nurse (RN) candidates must pass the NCLEX-RN® that the individual State Boards of Nursing administer. Regardless of educational preparation, the examination for RN licensure is exactly the same in every state in the United States. This provides a standardized minimum knowledge base for nurses.
Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.)
A. Caregiver
B. Autonomy and accountability
C. Patient advocate
D. Health promotion
E. Lobbyist
A. Caregiver
B. Autonomy and accountability
C. Patient advocate
D. Health promotion
E. Lobbyist
Each of these roles includes activities for the professional nurse. Each of these is used in direct care or is part of professionalism that guides nursing practice. Some nurses are lobbyists, but being a lobbyist is not expected of all professional nurses
Advanced practice registered nurses generally:
A. Function independently
B. Function as unit directors
C. Work in acute care settings
D. Work in the university setting
A. Function independently
Advanced practice registered nurse functions independently as a clinician, educator, case manager, consultant, and researcher within his or her area of practice to plan or improve the quality of nursing care for the patient and family.
Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform?
A. Moving from an acute illness to a health promotion, illness prevention model
B. Moving from illness prevention to a health promotion model
C. Moving from an acute illness to a disease management model
D. Moving from a chronic care to an illness prevention model
A. Moving from an acute illness to a health promotion, illness prevention model
Health care reform also affects how health care is delivered. There is greater emphasis on health promotion, disease prevention, and management of illness.
Which of the following nursing roles may have prescriptive authority in their practice? (Select all that apply.)
A. Critical care nurse
B. Nurse practitioner
C. Certified clinical nurse specialist
D. Charge nurse
B. Nurse practitioner
Nurse practitioners and certified clinical nurse specialists encompass the role and preparation of the advanced practice registered nurse. According to the American Nurses Association standards of practice, prescriptive authority may be granted to these nurses.
A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency?
A. Patient-centered care
B. Safety
C. Teamwork and collaboration
D. Informatics
D. Informatics
Using decision support systems is one example of using and gaining competency in informatics.
A nurse is caring for an older-adult couple in a community-based assisted living facility. During the family assessment he notes that the couple has many expired medications and multiple medications for their respective chronic illnesses. They note that they go to two different health care providers. The nurse begins to work with the couple to determine what they know about their medications and helps them decide on one care provider rather than two. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency?
A. Patient-centered care
B. Safety
C. Teamwork and collaboration
D. Informatics
B. Safety
Helping the patients understand the consequences and complications of multiple medications helps to build the competency in safety.
ID: 514968103
The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career?
A. Clinical nurse specialist
B. Nurse administrator
C. Nurse educator
D. Nurse researcher
D. Nurse researcher
The nurse researcher investigates problems to improve nursing care and to further define and expand the scope of nursing practice. He or she often works in an academic setting, hospital, or independent professional or community service agency.
Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education?
A. Continuing education
B. Graduate education
C. In-service education
D. Professional Registered Nurse Education
C. In-service education
In-service education programs are instruction or training provided by a health care agency or institution. An in-service program is held in the institution and is designed to increase the knowledge, skills, and competencies of nurses and other health care professionals employed by the institution.
Which of the following are components of the paradigm of nursing?
A. The person, health, environment, and theory
B. Health, theory, concepts, and environment
C. Nurses, physicians, health, and patient needs
D. The person, health, environment/situation, and nursing
D. The person, health, environment/situation, and nursing
The nursing paradigm focuses on person, health, environment/situation, and nursing. All the elements interact with one another, with the patient being central.
A theory is a set of concepts, definitions, relationships, and assumptions that:
A. Formulate legislation.
B. Explain a phenomenon.
C. Measure nursing functions.
D. Reflect the domain of nursing practice.
B. Explain a phenomenon.
Theories are designed to explain a phenomenon such as self-care or caring. A theory is a way of seeing through a “set of relatively concrete and specific concepts” and the propositions that describe or link the concepts.
A patient with diabetes is controlling the disease with insulin and diet. The nursing health care provider is focusing efforts to teach the patient self-management. Which of the following nursing theories is useful in promoting self management?
A. Neuman
B. Orem
C. Roy
D. Peplau
B. Orem
Orem’s theory of self-care provides a solid theoretical background for self-management for a variety of diseases. This theory shows the nurse how to direct the patient toward self-management to promote health and/or sustain wellness.
While working in a community health clinic, it is important to obtain nursing histories and get to know the patients. Part of history taking is to develop the nurse-patient relationship. Which of the following apply to Peplau’s theory when establishing the nurse-patient relationship? (Select all that apply.)
A. An interaction between the nurse and patient must develop.
B. The patient’s needs must be clarified and described.
C. The nurse-patient relationship is influenced by patient and nurse preconceptions.
D. The nurse-patient relationship is influenced only by the nurse’s preconceptions.
A. An interaction between the nurse and patient must develop.
B. The patient’s needs must be clarified and described.
C. The nurse-patient relationship is influenced by patient and nurse preconceptions.
The nurse-patient relationship is influenced only by the nurse preconceptions; is incorrect because the focus is only on the nurse.
Theory-based nursing practice uses a theoretical approach for nursing care. This approach moves nursing forward as a science. This suggests that:
A. One theory will guide nursing practice.
B. Scientists will decide nursing decisions.
C. Nursing will only base patient care on the practice of other sciences.
D. Theories will be tested to describe or predict patient outcomes
D. Theories will be tested to describe or predict patient outcomes
There are multiple theories for the practice of nursing; these theories are tested to develop the evidence to describe or predict patient outcomes.
To practice in today’s health care environment, nurses need a strong scientific knowledge base from nursing and other disciplines such as the physical, social, and behavioral sciences. This statement identifies the need for which of the following?
A. Systems theories
B. Developmental theories
C. Interdisciplinary theories
D. Health and wellness models
C. Interdisciplinary theories
As the health system evolves and the health care needs of the patient focus on health promotion, illness prevention, and treatment, more disciplines are involved in patient care. To be effective in practice nurses need to be aware of theoretical approaches of care arising from other disciplines and from nursing.
Which of the following theories describe the life processes of an older adult facing chronic illness?
A. Systems theories
B. Developmental theories
C. Interdisciplinary theories
D. Health and wellness models
B. Developmental theories
Developmental theories describe and predict behavior and development at various phases of the life continuum, as in the phase of older adulthood.
Match the following components of systems theory with the definition of that component.
A. Feedback
B. Input
C. Content
D. Output
- Data entering the system
- End product
- Data related to system functioning
- Product and information obtained from the system
A. Feedback—-3. Data related to system functioning
B. Input—– 1. Data entering the system
C. Content—–4. Product and information obtained from the system
D. Output—- 2. End product
A patient is admitted to an acute care area. The patient is an active business man who is worried about getting back to work. He has had severe diarrhea and vomiting for the last week. He is weak, and his breathing is labored. Using Maslow’s hierarchy of needs, identify this patient’s immediate priority.
A. Self-actualization
B. Air, water, and nutrition
C. Safety
D. Esteem and self-esteem needs
B. Air, water, and nutrition
The immediate priority is air, water, and nutrition. The patient needs to have sufficient air exchange, which might require oxygen administration. In addition the patient needs to have appropriate fluid balance and some nutritional supplement.
Match the following theories with their definitions.
A. Grand theory
B. Middle-range theory
C. Descriptive theory
D. Prescriptive theory
- Addresses specific phenomena and reflect practice
- First level in theory development and describes a phenomenon
- Provides a structural framework for broad concepts about nursing
- Linked to outcomes (consequences of specific nursing interventions)
A. Grand theory—- 3. Provides a structural framework for broad concepts about nursing
B. Middle-range theory—-1. Addresses specific phenomena and reflect practice
C. Descriptive theory—- 2. First level in theory development and describes a phenomenon
D. Prescriptive theory—-4. Linked to outcomes (consequences of specific nursing interventions)
Which of the following is closely aligned with Leininger’s theory?
A. Caring for patients from unique cultures
B. Understanding the humanistic aspects of life
C. Variables affecting a patient’s response to a stressor
D. Caring for patients who cannot adapt to internal and external environmental demands
A. Caring for patients from unique cultures
Leininger’s theory of transcultural nursing focuses on the patient’s culture and the impact of culture heritage on health care needs and interventions.
A nurse is applying Henderson’s theory as a basis for theory based-nursing practice. Which other elements are important for theory-based nursing practice? (Select all that apply.)
A. Knowledge of nursing science
B. Knowledge of related sciences
C. Knowledge about current health care issues
D. Knowledge of standards of practice
A. Knowledge of nursing science
B. Knowledge of related sciences
D. Knowledge of standards of practice
Regardless of which particular nursing theory is selected, the nurse must use knowledge from nursing and related sciences, experience, and standards of practice when providing care.
Which of the following statements apply to theory generation? (Select all that apply.)
A. Builds scientific knowledge base of nursing
B. Discovers relationships of phenomena to practice
C. Tests specific phenomena
D. Identifies observations about a phenomenon
A. Builds scientific knowledge base of nursing
B. Discovers relationships of phenomena to practice
D. Identifies observations about a phenomenon
Theory-generating research identifies observations or describes phenomena. It contributes to the scientific knowledge base of nursing. Relationships of the phenomena to practice and testing specific phenomena are part of the theory-testing research activities
Which of the following statements about theory-based nursing practice is incorrect?
A. Contributes to evidence-based practice
B. Provides a systematic process for designing nursing interventions
C. Is not linked to nursing outcomes
D. Guides the nurse’s assessment
C. Is not linked to nursing outcomes
Theory-based nursing practice does reflect nursing outcomes. For example, prescriptive theories address specific nursing interventions and predict the patient response.
As an art nursing relies on knowledge gained from practice and reflection on past experiences. As a science nursing relies on (select all that apply):
A. Experimental research.
B. Nonexperimental research.
C. Research from other disciplines.
D. Professional opinions.
A. Experimental research.
B. Nonexperimental research.
C. Research from other disciplines.
As a science, nursing relies on knowledge gained through research from nursing and other disciplines and scientifically tested knowledge applied in the practice setting.
The nurse is participating at a health fair at the local mall giving influenza vaccines to senior citizens. What level of prevention is the nurse practicing?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Quaternary prevention
A. Primary prevention
Primary prevention is aimed at health promotion and includes health-education programs, immunizations, and physical and nutritional fitness activities. It can be provided to an individual and includes activities that focus on maintaining or improving the general health of individuals, families, and communities. It also includes specific protection such as immunization for influenza.
A patient experienced a myocardial infarction 4 weeks ago and is currently participating in the daily cardiac rehabilitation sessions at the local fitness center. In what level of prevention is the patient participating?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Quaternary prevention
C. Tertiary prevention
Tertiary prevention involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration following the myocardial infarction. Tertiary-prevention activities are directed at rehabilitation rather than diagnosis and treatment. Care at this level aims to help patients achieve as high a level of functioning as possible, despite the limitations caused by illness or impairment. This level of care is called preventive care because it involves preventing further disability or reduced functioning.
Based on the transtheoretical model of change, what is the most appropriate response to a patient who states: “Me, exercise? I haven’t done that since junior high gym class, and I hated it then!”
A. “That’s fine. Exercise is bad for you anyway.”
B. “OK. I want you to walk 3 miles 4 times a week, and I’ll see you in 1 month.”
C. “I understand. Can you think of one reason why being more active would be helpful for you?”
D. “I’d like you to ride your bike 3 times this week and eat at least four fruits and vegetables every day.”
C. “I understand. Can you think of one reason why being more active would be helpful for you?”
The patient’s response indicates that the patient is in the precontemplation stage and does not intend to change his behavior in the next 6 months. In this stage the patient is not interested in information about the behavior and may be defensive when confronted with it. Asking an open-ended question may stimulate the patient to identify a reason to begin a behavior change. Nurses are challenged to motivate and facilitate change in health behavior when working with individuals.
A patient comes to the local health clinic and states: “I’ve noticed how many people are out walking in my neighborhood. Is walking good for you?” What is the best response to help the patient through the stages of change for exercise?
A. “Walking is OK. I really think running is better.”
B. “Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?”
C. “Yes, I want you to begin walking. Walk for 30 minutes every day and start to eat more fruits and vegetables.”
D. “They probably aren’t walking fast enough or far enough. You need to spend at least 45 minutes if you are going to do any good.”
B. “Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?”
The patient’s response indicates that the patient is in the contemplative state, possibly intending to make a behavior change within the next 6 months. The nurse’s statement reinforces the behavior and provides a specific goal for the patient to begin a walking plan.
A male patient has been laid off from his construction job and has many unpaid bills. He is going through a divorce from his marriage of 15 years and has been seeing his pastor to help him through this difficult time. He does not have a primary health care provider because he has never really been sick and his parents never took him to the physician when he was a child. Which external variables influence the patient’s health practices? (Select all that apply.)
A. Difficulty paying his bills
B. Seeing his pastor as a means of support
C. Family practice of not routinely seeing a health care provider
D. Stress from the divorce and the loss of a job
A. Difficulty paying his bills
C. Family practice of not routinely seeing a health care provider
D. Stress from the divorce and the loss of a job
External factors impacting health practices include family beliefs and economic impact. How patients; families use health care services generally affects their health practices. Their perceptions of the serious nature of diseases and their history of preventive care behaviors (or lack of them) influence how patients will think about health. Economic variables may affect a patient;s level of health by increasing the risk for disease and influencing how or at what point the patient enters the health care system
The nurse is conducting a home visit with an older adult couple. She assesses that the lighting in the home is poor and there are throw rugs throughout the home and a low footstool in the living room. She discusses removing the rugs and footstool and improving the lighting with the couple. The nurse is addressing which level of need according to Maslow?
A. Physiological
B. Safety and security
C. Love and belonging
D. Self-actualization
B. Safety and security
The teaching addresses the need for safety and security. The throw rugs, low lighting, and low stool are hazards that can cause falls in the elderly. Preventing falls is a priority safety issue for older adults.
When taking care of patients, the nurse routinely asks them if they take any vitamins or herbal medications, encourages family members to bring in music that the patient likes to help the patient relax, and frequently prays with her patients if that is important to them. The nurse is practicing which model?
A. Holistic
B. Health belief
C. Transtheoretical
D. Health promotion
A. Holistic
The nurse is using a holistic model of care that considers emotional and spiritual well-being and other dimensions of an individual to be important aspects of physical wellness. The holistic health model of nursing attempts to create conditions that promote optimal health. Nurses using the holistic nursing model recognize the natural healing abilities of the body and incorporate complementary and alternative interventions such as music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery because they are effective, economical, noninvasive, nonpharmacological complements to traditional medical care.
When illness occurs, different attitudes about it cause people to react in different ways. What do medical sociologists call this reaction to illness?
A. Health belief
B. Illness behavior
C. Health promotion
D. Illness prevention
B. Illness behavior
Illness behavior involves how people monitor their bodies, define and interpret their symptoms, take remedial actions, and use the resources in the health care system. Personal history, social situations, social norms, and past experiences can affect illness behavior.
A patient at the community clinic asks the nurse about health promotion activities that she can do because she is concerned about getting diabetes mellitus since her grandfather and father both have the disease. This statement reflects that the patient is in what stage of the health belief model?
A. Perceived threat of the disease
B. Likelihood of taking preventive health action
C. Analysis of perceived benefits of preventive action
D. Perceived susceptibility to the disease.
D. Perceived susceptibility to the disease.
The health belief model addresses the relationship between a person’s beliefs and behaviors. It provides a way of understanding and predicting how patients will behave in relation to their health and how they will comply with health care therapies. In the perceived susceptibility to the disease phase, the patient recognizes the familial link to the disease.
A nurse works in a special care unit for children with severe immunology problems and is caring for a 3-year-old boy from Greece. The boy’s father is with him while his mother and sister are back in Greece. The nurse is having difficulty communicating with the father. What action does the nurse take?
A. Care for the boy as she would any other patient
B. Ask the manager to talk with the father and keep him out of the unit
C. Have another nurse care for the boy because maybe that nurse will do better with the father
D. Search for help with interpretation and understanding of the cultural differences by contacting someone from the local Greek community
D. Search for help with interpretation and understanding of the cultural differences by contacting someone from the local Greek community
The nurse needs to understand how the Greek culture impacts the father’s health beliefs and communication with health care providers. Cultural variables must be incorporated into the child’s plan of care. Cultural background influences beliefs, values, and customs. It influences the approach to the health care system, personal health practices, and the nurse-patient relationship. Cultural background may also influence an individual’s beliefs about causes of illness and remedies or practices to restore health. If nurses are not aware of their own and other cultural patterns of behavior and language, they may not be able to recognize and understand a patient’s behavior and beliefs and may have difficulty interacting with the patient.
A patient with a 20-year history of diabetes mellitus had a lower leg amputation. Which statement made by the patient indicates that he is experiencing a problem with body image?
A. “I just don’t have any energy to get out of bed in the morning.”
B. “I’ve been attending church regularly with my wife since I got out of the hospital.”
C. ” My wife has taken over paying the bills since I’ve been in the hospital.”
D. “I don’t go out very much because everyone stares at me.”
D. “I don’t go out very much because everyone stares at me.”
The amputation resulted in a change in physical appearance that caused a change in body image. Reactions of patients and families to changes in body image depend on the type of changes (e.g., loss of a limb or an organ), their adaptive capacity, the rate at which changes take place, and the support services available. When a change in body image such as results from a leg amputation occurs, the patient generally adjusts in the following phases: shock, withdrawal, acknowledgment, acceptance, and rehabilitation. The patient’s statement indicates he is in the stage of withdrawal.
The patient states she joined a fitness club and attends the aerobics class three nights a week. The patient is in what stage of behavioral change?
A. Precontemplation
B. Contemplation
C. Preparation
D. Action
D. Action
The patient is in the action stage of behavioral change. In this stage the patient is actively engaged in strategies to change behavior. This stage may last up to 6 months.
The nurse is developing a health promotion program on healthy eating and exercise for high school students using the health belief model as a framework. Which statement made by a nursing student is related to the individual’s perception of susceptibility to an illness?
A. “I don’t have time to exercise because I have to work after school every night.”
B. “I’m worried about becoming overweight and getting diabetes because my father has diabetes.”
C. “The statistics of how many teenagers are overweight is scary.”
D. “I’ve decided to start a walking club at school for interested students.”
B. “I’m worried about becoming overweight and getting diabetes because my father has diabetes.”
The statement indicates that the patient is concerned about developing diabetes and believes that there is a risk or susceptibility based on recognition of a familial link for the disease. Once this link is recognized, the patient may perceive the personal risk for diabetes.
The nurse assesses the following risk factors for coronary artery disease (CAD) in a male patient. Which factors are classified as genetic and physiological? (Select all that apply.)
A. Sedentary lifestyle
B. Father died from CAD at age 50
C. History of hypertension
D. Eats diet high in sodium
E. Elevated cholesterol level
F. Age is 44 years
B. Father died from CAD at age 50
C. History of hypertension
E. Elevated cholesterol level
F. Age is 44 years
Genetic and physiological risk factors include those related to heredity, genetic predisposition to an illness, or those that involve the physical functioning of the body. Certain physical conditions such as being pregnant or overweight place increased stress on physiological systems (e.g., the circulatory system), increasing susceptibility to illness in these areas. A person with a family history of coronary artery disease is at risk for developing the disease later in life because of a hereditary and genetic predisposition to the disease.
Which activity represents secondary prevention?
A. A home health care nurse visits a patient’s home to change a wound dressing.
B. A 50-year-old woman with no history of disease attends the local health fair and has her blood pressure checked.
C. The school health nurse provides a program to the first-year students on healthy eating.
D. The patient attends cardiac rehabilitation sessions weekly.
A. A home health care nurse visits a patient’s home to change a wound dressing.
Secondary prevention focuses on individuals who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions. The home health nurse changing the wound dressing is an activity that is focused on preventing complications. Much of the nursing care related to secondary prevention is delivered in homes, hospitals, or skilled nursing facilities.
A patient needs to learn to use a walker. Which domain is required for learning this skill?
A. Affective domain
B. Cognitive domain
C. Attentional domain
D. Psychomotor domain
D. Psychomotor domain
Using a walker requires the integration of mental and muscular activity.
The nurse is planning to teach a patient about the importance of exercise. When is the best time for teaching to occur? (Select all that apply.)
A. When there are visitors in the room
B. When the patient’s pain medications are working
C. Just before lunch, when the patient is most awake and alert
D. When the patient is talking about current stressors in his or her life
B. When the patient’s pain medications are working
C. Just before lunch, when the patient is most awake and alert
Plan teaching when the patient is most attentive, receptive, alert, and comfortable
A patient newly diagnosed with cervical cancer is going home. The patient is avoiding discussion of her illness and postoperative orders. What is the nurse’s best plan in teaching this patient?
A. Teach the patient’s spouse
B. Focus on knowledge the patient will need in a few weeks
C. Provide only the information that the patient needs to go home
D. Convince the patient that learning about her health is necessary
C. Provide only the information that the patient needs to go home
This patient is in denial; thus it is appropriate to only give her information that is needed immediately.
The school nurse is about to teach a freshman-level high school health class about nutrition. What is the best instructional approach to ensure that the students meet the learning outcomes?
A. Provide information using a lecture
B. Use simple words to promote understanding
C. Develop topics for discussion that require problem solving
D. Complete an extensive literature search focusing on eating disorders
C. Develop topics for discussion that require problem solving
Adolescents learn best when they are able to use problem solving to help them make choices.
A nurse is going to teach a patient how to perform breast self-examination. Which behavioral objective does the nurse set to best measure the patient’s ability to perform the examination?
A. The patient will verbalize the steps involved in breast self-examination within 1 week.
B. The nurse will explain the importance of performing breast self-examination once a month.
C. The patient will perform breast self-examination correctly on herself before the end of the teaching session.
D. The nurse will demonstrate breast self-examination on a breast model provided by the American Cancer Society.
C. The patient will perform breast self-examination correctly on herself before the end of the teaching session.
Return demonstration provides an excellent source of feedback and reinforcement to evaluate learning.
A patient with chest pain is having an emergency cardiac catheterization. Which teaching approach does the nurse use in this situation?
A. Telling approach
B. Selling approach
C. Entrusting approach
D. Participating approach
A. Telling approach
The telling approach is most appropriate when preparing a patient for an emergency procedure.
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The nurse is teaching a parenting class to a group of pregnant adolescents. The nurse pretends to be the baby’s father, and the adolescent mother is asked to show how she would respond to the father if he gave her a can of beer. Which teaching approach did the nurse use?
A. Role play
B. Discovery
C. An analogy
D. A demonstration
A. Role play
In role play people are asked to play themselves or someone else in a situation to enhance their confidence in handling that situation in the future.
An older adult is being started on a new antihypertensive medication. In teaching the patient about the medication, the nurse:
A. Speaks loudly.
B. Presents the information once.
C. Expects the patient to understand the information quickly.
D. Allows the patient time to express himself or herself and ask questions.
D. Allows the patient time to express himself or herself and ask questions.
When teaching older adults, it is important to establish rapport, involve them in their care, and allow them to progress at their own pace.
A patient needs to learn how to administer a subcutaneous injection. Which of the following reflects that the patient is ready to learn?
A. Describing difficulties a family member has had in taking insulin
B. Expressing the importance of learning the skill correctly
C. Being able to see and understand the markings on the syringe
D. Having the dexterity needed to prepare and inject the medication
B. Expressing the importance of learning the skill correctly
Patients are ready to learn when they understand the importance of learning and are motivated to learn.
A patient who is hospitalized has just been diagnosed with diabetes. He is going to need to learn how to give himself injections. Which teaching method does the nurse use?
A. Simulation
B. Demonstration
C. Group instruction
D. One-on-one discussion
B. Demonstration
Demonstration is used to help patients learn psychomotor skills.
When a nurse is teaching a patient about how to administer an epinephrine injection in case of a severe allergic reaction, he or she tells the patient to hold the injection like a dart. Which of the following instructional methods did the nurse use?
A. Telling
B. Analogy
C. Demonstration
D. Simulation
B. Analogy
Analogies use familiar images when teaching to help explain complex information.
A nurse needs to teach a young woman newly diagnosed with asthma how to manage her disease. Which of the following topics does the nurse teach first?
A. How to use an inhaler during an asthma attack
B. The need to avoid people who smoke to prevent asthma attacks
C. Where to purchase a medical alert bracelet that says she has asthma
D. The importance of maintaining a healthy diet and exercising regularly
A. How to use an inhaler during an asthma attack
It is important to start with essential life-saving information when teaching people because they usually remember what you tell them first.
A nurse is teaching a group of young college-age women the importance of using sunscreen when going out in the sun. What type of content is the nurse providing?
A. Simulation
B. Restoring health
C. Coping with impaired function
D. Health promotion and illness prevention
D. Health promotion and illness prevention
Health promotion and illness prevention are the focus when nurses provide information to help patients improve their health and avoid illness.
A nurse is planning a teaching session about healthy nutrition with a group of children who are in first grade. The nurse determines that after the teaching session the children will be able to name three examples of foods that are fruits. This is an example of:
A. A teaching plan.
B. A learning objective.
C. Reinforcement of content.
D. Enhancing the children’s self-efficacy.
B. A learning objective.
A learning objective describes what the learner will do after the teaching session.
A nurse is teaching a 27-year-old gentleman how to adjust his insulin dosages based on his blood sugar results. What type of learning is this?
A. Cognitive
B. Affective
C. Adaptation
D. Psychomotor
A. Cognitive
Cognitive learning requires thinking; learning how to adjust insulin requires analysis, synthesis, and evaluation, which are all types of cognitive learning.
The client who would be least likely to participate in health teaching activities would choose which model?
A. Clinical model
B. Adaptive model
C. Role performance model
D. Eudaimonistic model
A. Clinical model
The clinical model of health has the absence of signs and symptoms of disease as indicative of health. People who use this model of health to guide their use of health care services may not seek preventative health services, or they may wait until they are very ill to seek care. Personal responsibility for health may not be a motivating factor for this individual because the provider is responsible for dealing with the health problem and returning the person to a state of health. Attempts at health-promoting activities may not be effective with this person. The role performance model has the ability to perform social roles as indicative of health. This model is the basis for work and school physical examinations and physician-excused absences. The adaptive model of health has the ability to adapt positively to social, mental, and physiological changes indicative of health. The eudaimonistic model of health uses exuberant well-being as indicative of health. This model is also more congruent with integrative modes of therapy.
The nurse is teaching about primary prevention and includes which educational statement in the instructions?
A. Everyone should participate in colorectal cancer screening.
B. Health teaching about the risk factors of heart disease should be performed.
C. Limiting disability is a vital role of nursing since preventive measures are therapeutic.
D. The nurse is involved in minimizing the effects of disease and disability by surveillance and maintenance.
B. Health teaching about the risk factors of heart disease should be performed.
Primary prevention precedes disease or dysfunction. Primary prevention intervention includes health promotion, such as health teaching about risk factors for heart disease, and specific protection, such as immunization against hepatitis B. Its purpose is to decrease the vulnerability of the individual or population to disease or dysfunction. People are taught to use appropriate primary preventive measures. Screening is secondary prevention because the principle goal is to identify individuals in an early, detectable stage of the disease process. Delayed recognition of disease results in the need to limit future disability in late secondary prevention. Tertiary prevention occurs when a defect or disability is permanent and irreversible. The process is minimizing the effects the disease and disability by surveillance and maintenance activities aimed at preventing complications and deterioration.
Public health nurses are involved in supporting active health promotion strategies such as:
A. supporting clean water.
B. advocating for vitamin D in all milk.
C. supporting sanitary sewage systems.
D. participating in an individual daily exercise program.
D. participating in an individual daily exercise program.
Health-promotion strategies are either active or passive. Passive strategies involve the individual as an inactive participant or recipient. Examples of passive strategies include public health efforts to maintain clean water and sanitary sewage systems, and efforts to introduce vitamin D in all milk to ensure that children will not be at risk for rickets when there is little sunlight. Active strategies depend on the individual becoming personally involved in adopting a proposed program of health promotion. Examples of lifestyle changes are daily exercise as part of a physical fitness plan and a stress-management program as part of daily living.
Nurses in the school setting can participate in health promotion activities through creating nut-free schools. This would protect hypersensitive children from life-threatening allergic reactions to peanuts and other nut products. This type of program is an example of which of the following interventions?
A. Primary
B. Secondary
C. Tertiary
D. Emergent
A. Primary
Primary prevention interventions are considered health protection when they emphasize shielding or defending the body (or the public) from specific causes of injury or disease. An example is creating nut-free schools to protect hypersensitive children from life-threatening allergic reactions to peanut and other nut products. Such initiatives have largely been the result of grassroots parent organizations working with formal community organizations to adopt policies that protect the health of these children. Nurses may be involved in the parent organizations or the school or public health boards that review the proposed policies. Secondary prevention ranges from providing screening activities and treating early stages of disease to limiting disability by averting or delaying the consequences of advanced disease. Tertiary prevention occurs when a defect or disability is permanent and irreversible. Emergent care is not associated with health promotion activities.
In addition to changes in ethnic and racial distribution within the population, it is expected that changes in _ distribution will affect health promotion practice.
A. geographic
B. environmental
C. age
D. social
C. age
In addition to changes in the ethnic and racial distribution within the population, the projected changes in age distribution will affect health promotion practice. Considerable growth is expected in the proportion of the population that is 25 years of age and older. Analysis of population trends and projections helps health professionals determine changing needs. Additionally, analysis of the social and economic environment is necessary for developing social policy concerning health. Geographic, environmental, and social aspects are not expected means of impacting health promotional practices although social and environmental concerns determine health outcomes.
Four distinct models have been used to describe concepts of health. Which of the following statements accurately describes some of the models used? (select all that apply)
A. In the clinical health model, health and illness are defined by signs and symptoms of disease.
B. The role performance model of health defines health in terms of individuals’ ability to perform social roles.
C. The clinical model is the basis for occupational health evaluations.
D. In the adaptive model of health, people’s ability to adjust positively to social, mental, and physiological change is the measure of their health.
E. In the eudaimonistic model, exuberant well-being indicates optimal health.
B. The role performance model of health defines health in terms of individuals’ ability to perform social roles.
D. In the adaptive model of health, people’s ability to adjust positively to social, mental, and physiological change is the measure of their health.
E. In the eudaimonistic model, exuberant well-being indicates optimal health.
The role performance model of health defines health in terms of individuals’ ability to perform social roles. Role performance includes work, family, and social roles, with performance based on societal expectations. Illness would be the failure to perform roles at the level of others in society. In the adaptive model of health, people’s ability to adjust positively to social, mental, and physiological change is the measure of their health. Illness occurs when the person fails to adapt or becomes maladaptive to these changes. In the eudaimonistic model, exuberant well-being indicates optimal health. This model emphasizes the interactions between physical, social, psychological, and spiritual aspects of life and the environment that contribute to goal attainment and create meaning. In the clinical model, health is defined by the absence, and illness by the conspicuous presence, of signs and symptoms of disease. The role performance model of health defines health in terms of individuals’ ability to perform social roles. This model is the basis for occupational health evaluations.
Health is considered to be a metaparadigm for nursing and includes which of the following components? (select all that apply)
A. Person
B. Health
C. Environment
D. Nursing
E. Psychosocial wellness
A. Person
B. Health
C. Environment
D. Nursing
Health is defined as a state of physical, mental, spiritual, and social functioning that realizes a person’s potential and is experienced within a developmental context. Health is considered to be part of the metaparadigm for nursing, which includes the four components of person, health, environment, and nursing. Health encompasses spiritual, developmental, and environmental aspects over time. Psychosocial wellness is not considered to be one of the four components of the metaparadigm for nursing.
Which of the following agencies or initiatives have been driving forces in health care reform and the prevention of disease in society? (select all that apply)
A. Healthy People
B. Health Insurance Portability and Accountability Act
C. U.S. Department of Health, Education, and Welfare
D. Patient Protection and Affordable Care Act
E. U.S. Department of Health and Human Services
A. Healthy People
C. U.S. Department of Health, Education, and Welfare
E. U.S. Department of Health and Human Services
Public health has always had the prevention of disease in society as its focus. Over the past 30 years, the promotion of health and individual responsibility moved to the forefront within public health. A key milestone in promoting health was the advent of Healthy People, related to the U.S. Department of Health, Education and Welfare. The U.S. Department of Health and Human Services is now responsible for the Healthy People objectives. The Health Insurance Portability and Accountability Act and the Patient Protection and Affordable Care Acts are not associated with the prevention of disease in society.
What are the two overarching goals of Healthy People 2010? (select two that apply)
A. Increase quality and years of life
B. Eliminate health disparities
C. Create access to preventive services for all.
D. Increase the span of healthy life
A. Increase quality and years of life
B. Eliminate health disparities
Healthy People 2010 set out two overarching goals. They are to: increase quality and years of healthy life, and eliminate health disparities. Healthy People 2000 set out three broad goals. They were to: increase the span of healthy life, reduce health disparities, and create access to preventive services for all.
The nurse assesses a community for evidence of health-promotion strategies. Which of the following are health-promotion strategies? (select all that apply)
A. Seeking primary care in the acute care hospital
B. Self-care for minor illness
C. Entry into acute care facilities to manage chronic illness
D. Environmental changes to enhance clean air
E. Supporting Habitat for Humanity house construction
B. Self-care for minor illness
D. Environmental changes to enhance clean air
E. Supporting Habitat for Humanity house construction
Health-promotion strategies go beyond providing information. It is proactive decision making at all levels of society. Strategies identified within this decision-making process are screening, self-care for minor illness, readiness for emergencies, successful management of chronic illness, environmental changes to enhance positive behaviors, and health-enhancing policies within an organizational setting. Health-promotion efforts focus on maintaining or improving the general health of individuals, families, and communities through support of housing at the public and community level; and at the personal level by voting and volunteering for improved low-income housing.
The nurse is performing an initial antepartal assessment on a woman who has missed two periods. Assessment of this woman for alcohol consumption is best determined by the:
A. CAGE test.
B. T-ACE test.
C. non-stress test.
D. protein dipstick test.
B. T-ACE test.
The T-ACE test provides a much more sensitive measure of alcohol intake patterns than that derived from the CAGE test. The T-ACE test considers the following assessment criteria:
- How many drinks does it Take to make you feel high?
- Have you ever been Annoyed by people criticizing your drinking?
- Have you ever felt you ought to Cut down your drinking?
- Have you ever had a drink first thing in the morning (Eye Opener) to steady your nerves or get rid of a hangover?
The CAGE test considers data collected from the client on Cutting down on drinking, being Annoyed by criticism of drinking, feeling Guilty about drinking, and using alcohol as an Eye opener.
The non-stress test evaluates the fetal heart rate response to fetal movement, which is assessed after the fetus is 20 weeks or more. The protein dipstick is performed at each prenatal visit and measures the amount of protein in the client’s urine. Proteinuria is a symptom seen with pre-eclampsia.
The nurse, teaching a class on primary prevention at a women’s health club, emphasizes participation in:
A. physician visits during illness.
B. recommended immunization schedules.
C. taking antibiotics at the first sign of symptoms.
D. water aerobics to develop muscle building.
B. recommended immunization schedules.
Primary prevention is a concept central to nursing and includes generalized health promotion and specific protection from disease. Health promotion connotes an active process involving specific protections, including immunizations, occupational safety, and environmental control, along with a set of behaviors that enhances health. Physician visits that promote health promotion focus on screening and wellness visits that include teaching on preventative health practices. Antibiotics should only be taken when there is evidence of an infection. Water aerobics focuses on flexibility, not muscle building.
The individual’s perceived health and well-being and how health is managed describes the:
A. cognitive-perceptual pattern.
B. coping-stress tolerance pattern.
C. health perception-health management pattern.
D. self-perception-self-concept pattern.
C. health perception-health management pattern.
The health perception-health management pattern provides an overview of the individual’s health status and the health practices that are used to reach the current level of health or wellness. The focus is on perceived health status and the meaning of health, along with the individual’s level of commitment to maintaining health. The cognitive-perceptual pattern focuses on sensory perceptual and cognitive patterns. The coping-stress tolerance pattern identifies the general coping pattern and effectiveness on stress tolerance. The self-perception-self-concept pattern describes the individual’s perception of self to include body comfort, body image, and feeling state as well as self-conception and self-esteem.
In assessing the nutritional-metabolic pattern, the nurse performs an examination of:
A. attention span.
B. blood pressure.
C. mucous membranes.
D. urine color.
C. mucous membranes.
Assessment of the mucous membranes determines hydration status, which is part of the nutrition-metabolic pattern. Other specific assessment findings for the nutritional-metabolic pattern may point to an individual who is overweight, underweight, overly hydrated, dehydrated, or experiencing difficulties in skin integrity, such as skin breakdown or delayed healing. The attention span is part of the self-perception-self-concept pattern. Measurement of blood pressure is part of the activity-exercise pattern. Urine color is part of the elimination pattern.
When teaching about proper nutrition to a person with congestive heart failure, which affective component should be included in the educational plan?
A. Eating with someone
B. Food preparation techniques
C. Knowledge of dietary restrictions
D. Values of adhering to the diet
D. Values of adhering to the diet
The affective component of education addresses the attitudes and values the person believes regarding the education and how it will apply to his or her life beliefs. If the person values the education, it will be more likely to be followed as opposed to if the person finds that the education is not congruent with his or her values. Even when the person possesses the knowledge base, assessment of whether the individual also values the importance of adhering to the modifications in lifestyle is vital.
The nurse is preparing education on prevention of urinary tract infections. A principle emphasized in the teaching plan would be:
A. Decreasing oral intake facilitates urinary dilution.
B. Empty the bladder at the first sensation of fullness.
C. Frequency is a common symptom that can be ignored.
D. Increasing time between urinations decreases the risk of infection.
B. Empty the bladder at the first sensation of fullness.
The nurse uses evidence-based practice to guide his or her practice. Emptying the bladder as soon as bladder sensation of fullness occurs is a practice that decreases the time the urine remains in the bladder, thus decreasing the chance for bacterial growth to occur. Decreasing oral intake will cause the urine to become concentrated. Urinary frequency is a symptom seen with urinary tract infections. Research indicates that delayed time between urinations is associated with increased incidence of urinary tract infection.
A person reports his exercise pattern is one golf game per week. The nurse evaluates this pattern and teaches the individual that:
A. exercise should include jogging.
B. exercises should be repetitive.
C. golfing one time per week is adequate.
D. weekly workouts at the gym should be included.
B. exercises should be repetitive.
Exercise is a type of physical activity that is planned, structured, and repetitive, and performed to improve or maintain physical fitness. Active social activities such as backyard softball or golf would be considered physical activity. Activities such as jogging, walking, or gym workouts would be considered exercise. Sedentary social activities such as bingo, reading, knitting, stamp collection, cards, or participation in discussion groups would not be considered physical activity.
When assessing the older adult for sleep quality, the nurse expects to find that the person will state:
A. “I continue to be a night owl.”
B. “I experience difficulty returning to sleep.”
C. “I experience a night of deep sleep.”
D. “I rarely wake up during the night.”
B. “I experience difficulty returning to sleep.”
Most difficulties associated with sleep are amenable to nursing therapies. Frequent awakenings do not necessarily imply sleep interruption. Many individuals may awaken numerous times during the night but return to sleep within seconds. This may be especially true of older adults who generally spend most of the night in stages of light sleep. Their normal developmental pattern does not include deep sleep; therefore, awakenings may not affect the sleep cycles and resultant feelings after awakening in the morning. More commonly, older adult individuals experience difficulty returning to sleep because they experience discomfort, fears, or other variables.
The nurse is preparing a class on wellness and health promotion for a group of middle school students. Developmental tasks of early adolescence include a learning focus emphasis on:
A. coping with life events and problems.
B. economic responsibility.
C. risk taking and its consequences.
D. social responsibility for self and others.
C. risk taking and its consequences.
Early adolescence developmental focus is on industry verses inferiority as identified by Erikson. The wellness tasks identified include:
- learning that health is an important value.
- learning self-regulation of physiological needs—sleep, rest, food, drink, and exercise.
- learning risk taking and its consequences (injury prevention).
The other three options define adolescent (identity verses role confusion) wellness developmental tasks, which include learning to cope with life events and problems, learning economic responsibility, and learning social responsibility for self and others.
Major goals in assessing each person’s functional pattern are to determine: (select all that apply)
A. ability to manage health-promoting activities.
B. herbal medications that promote health.
C. knowledge of health promotion.
D. the need for physician referral for illness care.
E. the value that the person ascribes to health promotion.
A. ability to manage health-promoting activities.
C. knowledge of health promotion.
E. the value that the person ascribes to health promotion.
A major goal in assessing each pattern is to determine the individual’s knowledge of health promotion, the ability to manage health-promoting activities, and the value that the individual ascribes to health promotion. The assessment of herbal medications is important to determine potential for interactions with other prescribed medications, and adverse effects produced by the herbal medications. Referral to the physician for illness care would not be part of the assessment of functional health patterns.