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Evidence-Based Practice in Nursing: Roles, Patient-Centered Care, and Outcomes, Exams of Nursing

The concept of evidence-based practice in nursing, including the definition, roles of advanced practice registered nurses, patient-centered care, and the impact of healthcare reform. It also covers various nursing sensitive outcomes and research processes.

Typology: Exams

2023/2024

Available from 03/21/2024

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Download Evidence-Based Practice in Nursing: Roles, Patient-Centered Care, and Outcomes and more Exams Nursing in PDF only on Docsity! Fundamentals Mid-Term Exam with 100% SOLUTIONs 2024 FINAL EXAM REVISION MATERIAL ASSURED A+ 1. 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 non-nursing 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 - SOLUTION d. Defines the principles of right and wrong to provide patient care 2. 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 - SOLUTION c. Assessment 3. 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 - SOLUTION d. Implementation 4. 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 - SOLUTION b. Advocate 5. 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 - SOLUTION c. A problem-solving approach that integrates best current evidence with clinical practice 6. 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 - SOLUTION d. Provides a minimal standard of knowledge for a registered nurse in practice 7. 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 - SOLUTION a. Caregiver b. Autonomy and accountability c. Patient advocate d. Health promotion 8. Advanced practice registered nurses generally: a. Function independently b. Function as unit directors d. Attending a review course in preparation for the certification examination - SOLUTION d. Attending a review course in preparation for the certification examination 3. The patient tells the nurse that she is enrolled in a preferred provider organization (PPO) but does not understand what this is. What is the nurse's best explanation of a PPO? a. This health plan is for people who cannot afford their own health insurance b. This health plan is operated by the government to provide health care to older adults c. This health plan provides you with a preferred list of physicians, hospitals, and providers from which you can choose d. This is a fee-for-service plan in which you can choose any physician or hospital - SOLUTION c. This health plan provides you with a preferred list of physicians, hospitals, and providers from which you can choose 4. Which of the following is an example of the nurse participating in primary care activities? a. Providing prenatal teaching on nutrition to a pregnant woman during the first trimester Correct b. Working with patients in a cardiac rehabilitation program c. Assessing a patient at an emergent care facility d. Providing home wound care to a patient - SOLUTION a. Providing prenatal teaching on nutrition to a pregnant woman 5. Nurses on a nursing unit are discussing the processes that led up to a near-miss error on the clinical unit. They are outlining strategies that will prevent this in the future. This is an example of nurses working on what issue in the health care system? a. Patient safety b. Evidence-based practice c. Patient satisfaction d. Maintenance of competency - SOLUTION a. Patient safety 6. Which of the following statements is true regarding Magnet status recognition for a hospital? a. Nursing is run by a Magnet manager who makes decisions for the nursing units b. Nurses in Magnet hospitals make all of the decisions on the clinical units c. Magnet is a term that is used to describe hospitals that are able to hire the nurses they need d. Magnet is a special designation for hospitals that achieve excellence in nursing practice - SOLUTION d. Magnet is a special designation for hospitals that achieve excellence in nursing practice 7. Which statement made by the nurse is an example of applying the principle of patient-centered care while focusing on alleviation of a patient's fear and anxiety? a. "Let's talk about the concerns that you have about going home." b. "I'll get the medication prescriptions for you before discharge" c. "I'll be back in 30 minutes to help you get cleaned up" d. "I'll make a referral to the home health nurse for you" - SOLUTION a. "Let's talk about the concerns that you have about going home." 8. Which of the following is/are characteristics of managed care systems? (Select all that apply.) a. Provider receives a predetermined payment for each patient in the program. b. Payment is based on a set fee for each service provided. c. System includes a voluntary prescription drug program for an additional cost. d. System tries to reduce costs while keeping patients healthy. e. Focus of care is on prevention and early intervention. - SOLUTION a. Provider receives a predetermined payment for each patient in the program. d. System tries to reduce costs while keeping patients healthy. e. Focus of care is on prevention and early intervention. 9. Which of the following nursing activities is found in a tertiary health care environment? a. Administering influenza immunizations at the senior independent living facility b. Providing well-baby care in the clinic run by the local community health department c. Admitting a patient following open heart surgery to the cardiovascular intensive care unit d. Working the triage desk in the emergency department - SOLUTION c. Admitting a patient following open heart surgery to the cardiovascular intensive care unit 10. Which of the following activities performed by the nurse is/are focused on the patient-centered care principle of physical comfort? (Select all that apply.) a. Asking the patient what a tolerable level of pain is for him or her following surgery b. Providing a back rub at bedtime c. Offering the patient a warm washcloth for his or her hands before eating d. Teaching the patient about the new antihypertensive medication ordered e. Scheduling the patient's follow-up appointments on discharge f. Changing the bed linens for a patient who is experiencing diaphoresis - SOLUTION a. Asking the patient what a tolerable level of pain is for him or her following surgery b. Providing a back rub at bedtime c. Offering the patient a warm washcloth for his or her hands before eating f. Changing the bed linens for a patient who is experiencing diaphoresis 11. The nursing staff is developing a quality program for the floor. Which of the following are nursing-sensitive indicators from the National Database of Nursing Quality Indicators that the nurses can use to measure patient safety and quality for the unit? (Select all that apply.) a. Number of medication errors committed by registered nurses (RNs) b. Turnover rate of nurses on the unit c. Incidence of patient falls d. Number of certified RNs e. Number of emergency department admissions per year - SOLUTION b. Turnover rate of nurses on the unit c. Incidence of patient falls d. Number of certified RNs 12. The nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is an appropriate goal for restorative care? a. Patient will be able to walk 200 feet without shortness of breath b. Wound will heal without signs of infection c. Patient will express concerns related to return to home d. Patient will identify strategies to improve sleep habits - SOLUTION a. Patient will be able to walk 200 feet without shortness of breath d. Theories will be tested to describe or predict patient outcomes. - SOLUTION d. Theories will be tested to describe or predict patient outcomes. 6. 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 - SOLUTION c. Interdisciplinary theories 7. 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 - SOLUTION b. Developmental theories 8. Match the following components of systems theory with the definition of that component. a. Feedback: b. Input: c. Content: d. Output: - SOLUTION a. Feedback: "Data related to system functioning" b. Input: "Data entering the system" c. Content: "Product and information obtained from the system" d. Output: "End product" 9. 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 - SOLUTION b. Air, water, and nutrition 10. Match the following theories with their definitions. a. Grand theory: b. Middle-range theory: c. Descriptive theory: d. Prescriptive theory: - SOLUTION a. Grand theory: "Provides a structural framework for broad concepts about nursing" b. Middle-range theory: "Addresses specific phenomena and reflect practice" c. Descriptive theory: "First level in theory development and describes a phenomenon" d. Prescriptive theory: Linked to outcomes (consequences of specific nursing interventions) 11. 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 - SOLUTION a. Caring for patients from unique cultures 12. 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 - SOLUTION a. Knowledge of nursing science b. Knowledge of related sciences d. Knowledge of standards of practice 13. 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 - SOLUTION a. Builds scientific knowledge base of nursing b. Discovers relationships of phenomena to practice d. Identifies observations about a phenomenon 14. 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 - SOLUTION c. Is not linked to nursing outcomes 15. 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. - SOLUTION a. Experimental research. b. Nonexperimental research. c. Research from other disciplines. 1. A nurse researcher interviews parents of children who have diabetes and asks them to describe how they deal with their child's illness. The analysis of the interviews yields common themes and stories describing the parents' coping strategies. This is an example of which type of study? a. Historical b. Qualitative c. Correlational d. Experimental - SOLUTION b. Qualitative 2. A nurse who works in a newborn nursery asks, "I wonder if the moms who breastfeed their babies would be able to breastfeed more successfully if we played peaceful music while they were breastfeeding." In this example of a PICOT question, the I is: a. Breastfeeding moms. b. Infants. c. Peaceful music. d. The nursery. - SOLUTION c. Peaceful music. 3. A nurse researcher conducts a study that randomly assigns 100 patients who smoke and attend a wellness clinic into two groups. One group 11. A nurse is providing care to a patient who is experiencing major abdominal trauma following a car accident. The patient is losing blood quickly and needs a blood transfusion. The nurse finds out that the patient is a Jehovah's Witness and cannot have blood transfusions because of religious beliefs. He or she notifies the patient's health care provider and receives an order to give the patient an alternative to blood products. This is an example of: a. A quality improvement study. b. An evidence-based practice change. c. A time when calling the hospital's ethics committee is essential. d. Considering the patient's preferences and values while providing care. - SOLUTION d. Considering the patient's preferences and values while providing care. 12. A group of staff educators are reading a research study together at a journal club meeting. While reviewing the study, one of the nurses states that it evaluates if newly graduated nurses progress through orientation more effectively when they participate in patient simulation exercises. Which part of the research process is reflected in this nurse's statement? a. Introduction b. Purpose statement c. Methods d. Results - SOLUTION b. Purpose statement 13. A research study is investigating the following research question: What is the effect of the diagnosis of breast cancer on the roles of the family? In this study "the diagnosis of breast cancer" and "family roles" are examples of: a. Surveys b. The sample c. Variables d. Data collection points - SOLUTION c. Variables 14. A nurse researcher is developing a research proposal and is in the process of selecting an instrument to measure anxiety. In which part of the research process is this nurse? a. Analyzing the data b. Designing the study c. Conducting the study d. Identifying the problem - SOLUTION b. Designing the study 1. 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 - SOLUTION a. Primary prevention 2. 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 - SOLUTION c. Tertiary prevention 3. 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." - SOLUTION c. "I understand. Can you think of one reason why being more active would be helpful for you?" 4. 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." - SOLUTION b. "Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" 5. 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 - SOLUTION 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 6. 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 - SOLUTION b. Safety and security 7. 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 - SOLUTION a. Holistic 8. When illness occurs, different attitudes about it cause people to react in different ways. What do medical sociologists call this reaction to illness? c. The school health nurse provides a program to the first-year students on healthy eating. d. The patient attends cardiac rehabilitation sessions weekly. - SOLUTION a. A home health care nurse visits a patient's home to change a wound dressing. 1. A nurse hears a colleague tell a nursing student that she never touches a patient unless she is performing a procedure or doing an assessment. The nurse tells the student that from a caring perspective: a. She does not touch the patients either. b. Touch is a type of verbal communication. c. There is never a problem with using touch. d. Touch forms a connection between nurse and patient. - SOLUTION d. Touch forms a connection between nurse and patient. 2. Of the five caring processes described by Swanson, which describes "knowing the patient"? a. Anticipating the patient's cultural preferences b. Determining the patient's physician preference c. Establishing an understanding of a specific patient d. Gathering task-oriented information during assessment - SOLUTION c. Establishing an understanding of a specific patient 3. A Muslim woman enters the clinic to have a woman's health examination for the first time. Which nursing behavior applies Swanson's caring process of "knowing the patient?" a. Sharing feelings about the importance of having regular woman's health examinations b. Gaining an understanding of what a woman's health examination means to the patient c. Recognizing that the patient is modest; obtaining gendercongruent caregiver d. Explaining the risk factors for cervical cancer - SOLUTION b. Gaining an understanding of what a woman's health examination means to the patient 4. Helping a new mother through the birthing experience demonstrates which of Swanson's five caring processes? a. Knowing b. Enabling c. Doing for d. Being with - SOLUTION b. Enabling 5. A patient is fearful of upcoming surgery and a possible cancer diagnosis. He discusses his love for the Bible with his nurse, who recommends a favorite Bible verse. Another nurse tells the patient's nurse that there is no place in nursing for spiritual caring. The patient's nurse replies: a. "Spiritual care should be left to a professional." b. "You are correct, religion is a personal decision." c. "Nurses should not force their religious beliefs on patients." d. "Spiritual, mind, and body connections can affect health." - SOLUTION d. "Spiritual, mind, and body connections can affect health." 6. Which of the following is a strategy for creating work environments that enable nurses to demonstrate more caring behaviors? a. Increasing the working hours of the staff b. Increasing salary benefits of the staff c. Creating a setting that allows flexibility and autonomy for staff d. Encouraging increased input concerning nursing functions from physicians - SOLUTION c. Creating a setting that allows flexibility and autonomy for staff 7. When a nurse helps a patient find the meaning of cancer by supporting beliefs about life, this is an example of: a. Instilling hope and faith. b. Forming a human-altruistic value system. c. Cultural caring. d. Being with. - SOLUTION a. Instilling hope and faith. 8. An example of a nurse caring behavior that families of acutely ill patients perceive as important to patients' well-being is: a. Making health care decisions for patients. b. Having family members provide a patient's total personal hygiene. c. Injecting the nurse's perceptions about the level of care provided. d. Asking permission before performing a procedure on a patient. - SOLUTION d. Asking permission before performing a procedure on a patient. 9. A nurse demonstrates caring by helping family members: a. Become active participants in care. b. Provide activities of daily living (ADLs). c. Remove themselves from personal care. d. Make health care decisions for the patient. - SOLUTION a. Become active participants in care. 10. Listening is not only "taking in" what a patient says; it also includes: a. Incorporating the views of the physician. b. Correcting any errors in the patient's understanding. c. Injecting the nurse's personal views and statements. d. Interpreting and understanding what the patient means. - SOLUTION d. Interpreting and understanding what the patient means. 11. A nurse is caring for an older adult who needs to enter an assisted- living facility following discharge from the hospital. Which of the following is an example of listening that displays caring? a. The nurse encourages the patient to talk about his concerns while reviewing the computer screen in the room. b. The nurse sits at the patient's bedside, listens as he relays his fear of never seeing his home again, and then asks if he wants anything to eat. c. The nurse listens to the patient's story while sitting on the side of the bed and then summarizes the story. d. The nurse listens to the patient talk about his fears of not returning home and then tells him to think positively. - SOLUTION c. The nurse listens to the patient's story while sitting on the side of the bed and then summarizes the story. 12. Presence involves a person-to-person encounter that: a. Enables patients to care for self. b. Provides personal care to a patient. c. Conveys a closeness and a sense of caring. d. Describes being in close contact with a patient. - SOLUTION c. Conveys a closeness and a sense of caring. 13. A nurse enters a patient's room, arranges the supplies for a Foley catheter insertion, and explains the procedure to the patient. She tells the patient what to expect; just before inserting the catheter, she tells the patient to relax and that, once the catheter is in place, she will not feel the bladder pressure. The nurse then proceeds to skillfully insert the Foley catheter. This is an example of what type of touch? a. Caring touch b. Protective touch disparities in health outcomes between the rich and poor. This is an example of a(n): a. Illness attributed to natural and biological forces. b. Creation of the student's interpretation and descriptions of the data. c. Influence of socioeconomic factors in morbidity and mortality. d. Combination of naturalistic, religious, and supernatural modalities. - SOLUTION c. Influence of socioeconomic factors in morbidity and mortality. 8. Culture strongly influences pain expression and need for pain medication. However, cultural pain is: a. Not expressed verbally or physically. b. Expressed only to others from a similar culture. c. Usually more intense than physical pain. d. Suffered by a patient whose valued way of life is disregarded by practitioners. - SOLUTION d. Suffered by a patient whose valued way of life is disregarded by practitioners. 9. Which of the following best represents the dominant values in American society on individual autonomy and self-determination? a. Physician orders b. Advance directive c. Durable power of attorney d. Court-appointed guardian - SOLUTION b. Advance directive 10. The nurse at an outpatient clinic asks a patient who is Chinese American with newly diagnosed hypertension if he is limiting his sodium intake as directed. The patient does not make eye contact with the nurse but nods his head. What should the nurse do next? a. Ask the patient how much salt he is consuming each day b. Discuss the health implications of sodium and hypertension c. Remind the patient that many foods such as soy sauce contain "hidden" sodium d. Suggest some low-sodium dietary alternatives - SOLUTION a. Ask the patient how much salt he is consuming each day 11. A female Jamaican immigrant has been late to her last two clinic visits, which in turn had to be rescheduled. The best action that the nurse could take to prevent the patient from being late to her next appointment is: a. Give her a copy of the city bus schedule. b. Call her the day before her appointment as a reminder to be on time. c. Explore what has prevented her from being at the clinic in time for her appointment. d. Refer her to a clinic that is closer to her home. - SOLUTION c. Explore what has prevented her from being at the clinic in time for her appointment. 12. A nursing student is taking postoperative vital signs in the postanesthesia care unit. She knows that some ethnic groups are more prone to genetic disorders. Which of the following patients is most at risk for developing malignant hypertension? a. Ashkenazi Jew b. Chinese American c. African American d. Filipino - SOLUTION c. African American 13. A community health nurse is making a healthy baby visit to a new mother who recently emigrated to the United States from Ghana. When discussing contraceptives with the new mom, the mother states that she won't have to worry about getting pregnant for the time being. The nurse understands that the mom most likely made this statement because: a. She won't resume sexual relations until her baby is weaned. b. She is taking the medroxyprogesterone (Depo-Provera) shot. c. Her husband was recently deployed to Afghanistan. d. She has access to free condoms from the clinic. - SOLUTION a. She won't resume sexual relations until her baby is weaned. 14. During their clinical post-conference meeting, several nursing students were discussing their patients with their instructor. One student from a middle-class family shared that her patient was homeless. This is an example of caring for a patient from a different: a. Ethnicity. b. Culture. c. Heritage. d. Religion. - SOLUTION b. Culture. 15. When interviewing a Native American patient on admission to the hospital emergency department, which questions are appropriate for the nurse to ask? (Select all that apply.) a. Do you use any folk remedies? b. Do you have a family physician? c. Do you use a Shaman? d. Does your family have a history of alcohol abuse? - SOLUTION a. Do you use any folk remedies? b. Do you have a family physician? c. Do you use a Shaman? 1. While assessing a patient, the nurse observes that the patient's intravenous (IV) line is not infusing at the ordered rate. The nurse assesses the patient for pain at the IV site, checks the flow regulator on the tubing, looks to see if the patient is lying on the tubing, checks the point of connection between the tubing and the IV catheter, and then checks the condition of the site where the intravenous catheter enters the patient's skin. After the nurse readjusts the flow rate, the infusion begins at the correct rate. This is an example of: a. Inference. b. Diagnostic reasoning. c. Competency. d. Problem solving. - SOLUTION d. Problem solving. 2. The nurse sits down to talk with a patient who lost her sister 2 weeks ago. The patient reports she is unable to sleep, feels very fatigued during the day, and is having trouble at work. The nurse asks her to clarify the type of trouble. The patient explains she can't concentrate or even solve simple problems. The nurse records the results of the assessment, describing the patient as having ineffective coping. This is an example of: a. Diagnostic reasoning. b. Competency. c. Inference. d. Problem solving. - SOLUTION a. Diagnostic reasoning. 3. A patient on a surgical unit develops sudden shortness of breath and a drop in blood pressure. The staff respond, but the patient dies 30 minutes later. The manager on the nursing unit calls the staff involved in the emergency response together. The staff discusses what occurred over the 30-minute time frame, the actions taken, and whether other steps should have been implemented. The nurses in this situation are: a. Problem solving. b. Showing humility. c. Conducting reflective practice. d. Exercising responsibility. - SOLUTION c. Conducting reflective practice. d. A description of what the nurse said to the mother, the mother's response, and how the nurse might approach the situation differently in the future 9. A nurse has been working on a surgical unit for 3 weeks. A patient requires a Foley catheter to be inserted, so the nurse reads the procedure manual for the institution to review how to insert it. The level of critical thinking the nurse is using is: a. Commitment. b. Scientific method. c. Basic critical thinking. d. Complex critical thinking. - SOLUTION c. Basic critical thinking. 10. A patient had hip surgery 16 hours ago. During the previous shift the patient had 40 mL of drainage in the surgical drainage collection device for an 8-hour period. The nurse refers to the written plan of care, noting that the health care provider is to be notified when drainage in the device exceeds 100 mL for the day. On entering the room, the nurse looks at the device and carefully notes the amount of drainage currently in it. This is an example of: a. Planning. b. Evaluation. c. Intervention. d. Diagnosis. - SOLUTION b. Evaluation. 11. The nurse asks a patient how she feels about her impending surgery for breast cancer. Before the discussion the nurse reviewed the description of loss and grief and therapeutic communication principles in his textbook. The critical thinking component involved in the nurse's review of the literature is: a. Experience. b. Problem solving. c. Knowledge application. d. Clinical decision making. - SOLUTION c. Knowledge application. 12. A nurse is working with a nursing assistive personnel (NAP) on a busy oncology unit. The nurse has instructed the NAP on the tasks that need to be performed, including getting patient A out of bed, collecting a urine specimen from patient B, and checking vital signs on patient C, who is scheduled to go home. Which of the following represent(s) successful delegation? (Select all that apply.) a. A nurse explains to the NAP the approach to use in getting the patient up and why the patient has activity limitations. b. A nurse is asked by a patient to help her to the bathroom; the nurse leaves the room and directs the NAP to assist the patient instead. c. The nurse sees the NAP preparing to help a patient out of bed, goes to assist, and thanks the NAP for her efforts to get the patient up early. d. The nurse is in patient B's room to check an intravenous (IV) line and collects the urine specimen while in the room. e. - SOLUTION a. A nurse explains to the NAP the approach to use in getting the patient up and why the patient has activity limitations. c. The nurse sees the NAP preparing to help a patient out of bed, goes to assist, and thanks the NAP for her efforts to get the patient up early. d. The nurse is in patient B's room to check an intravenous (IV) line and collects the urine specimen while in the room. 13. Which of the following is unique to the commitment level of critical thinking? a. Weighs benefits and risks when making a decision. b. Analyzes and examine choices more independently. c. Concrete thinking. d. Anticipates when to make choices without others' assistance. - SOLUTION d. Anticipates when to make choices without others' assistance. 14. In which of the following examples is the nurse not applying critical thinking skills in practice? a. The nurse considers personnel experience in performing intravenous (IV) line insertion and ways to improve performance. b. The nurse uses a fall risk inventory scale to determine a patient's fall risk. c. The nurse observes a change in a patient's behavior and considers which problem is likely developing. d. The nurse explains the procedure for giving a tube feeding to a second nurse who has floated to the unit to assist with care. - SOLUTION d. The nurse explains the procedure for giving a tube feeding to a second nurse who has floated to the unit to assist with care. 1. A nurse assesses a patient who comes to the pulmonary clinic. "I see that it's been over 6 months since you've been in, but your appointment was for every 2 months. Tell me about that. Also I see from your last visit that the doctor recommended routine exercise. Can you tell me how successful you have been following his plan?" The nurse's assessment covers which of Gordon's functional health patterns? a. Value-belief pattern b. Cognitive-perceptual pattern c. Coping-stress-tolerance pattern d. Health perception-health management pattern - SOLUTION d. Health perception-health management pattern 2. The nurse asks a patient, "Describe for me your typical diet over a 24- hour day. What foods do you prefer? Have you noticed a change in your weight recently?" This series of questions would likely occur during which phase of a patient-centered interview? a. Setting the stage b. Gathering information about the patient's chief concerns c. Collecting the assessment d. Termination - SOLUTION c. Collecting the assessment 3. What type of interview techniques does the nurse use when asking these questions, "Do you have pain or cramping?" "Does the pain get worse when you walk?" (Select all that apply.) a. Active listening b. Open-ended questioning c. Closed-ended questioning d. Problem-oriented questioning - SOLUTION c. Closed-ended questioning d. Problem-oriented questioning 4. What technique(s) best encourage(s) a patient to tell his or her full story? (Select all that apply.) a. Active listening b. Back channeling c. Validating d. Use of open-ended questions e. Use of closed-ended questions - SOLUTION a. Active listening b. Back channeling d. Use of open-ended questions 11. A patient tells the nurse during a visit to the clinic that he has been sick to his stomach for 3 days and he vomited twice yesterday. Which of the following responses by the nurse is an example of probing? a. So you've had an upset stomach and began vomiting—correct? b. Have you taken anything for your stomach? c. Is anything else bothering you? d. Have you taken any medication for your vomiting? - SOLUTION c. Is anything else bothering you? 12. The nurse is assessing the character of a patient's migraine headache and asks, "Do you feel nauseated when you have a headache?" The patient's response is "yes." In this case the finding of nausea is which of the following? a. An objective finding b. A clinical inference c. A validation d. A concomitant symptom - SOLUTION d. A concomitant symptom 13. During the review of systems in a nursing history, a nurse learns that the patient has been coughing mucus. Which of the following nursing assessments would be best for the nurse to use to confirm a lung problem? (Select all that apply.) a. Family report b. Chest x-ray film c. Physical examination with auscultation of the lungs d. Medical record summary of x-ray film findings - SOLUTION c. Physical examination with auscultation of the lungs d. Medical record summary of x-ray film findings 14. A nurse working on a medicine nursing unit is assigned to a 78-year-old patient who just entered the hospital with symptoms of H1N1 flu. The nurse finds the patient to be short of breath with an increased respiratory rate of 30 breaths/min. He lost his wife just a month ago. The nurse's knowledge about this patient results in which of the following assessment approaches at this time? (Select all that apply.) a. A problem-focused approach b. A structured comprehensive approach c. Using multiple visits to gather a complete database d. Focusing on the functional health pattern of role-relationship - SOLUTION a. A problem-focused approach c. Using multiple visits to gather a complete database 15. A 58-year-old patient with nerve deafness has come to his doctor's office for a routine examination. The patient wears two hearing aids. The advanced practice nurse who is conducting the assessment uses which of the following approaches while conducting the interview with this patient? (Select all that apply.) a. Maintain a neutral facial expression b. Lean forward when interacting with the patient c. Acknowledge the patient's answers through head nodding d. Limit direct eye contact - SOLUTION b. Lean forward when interacting with the patient c. Acknowledge the patient's answers through head nodding 1. Review the following nursing diagnoses and identify the diagnoses that are stated correctly. (Select all that apply.) a. Anxiety related to fear of dying b. Fatigue related to chronic emphysema c. Need for mouth care related to inflamed mucosa d. Risk for infection - SOLUTION a. Anxiety related to fear of dying d. Risk for infection 2. A nurse reviews data gathered regarding a patient's pain symptoms. The nurse compares the defining characteristics for acute pain with those for chronic pain and in the end selects acute pain as the correct diagnosis. This is an example of the nurse avoiding an error in: a. Data collection. b. Data clustering. c. Data interpretation. d. Making a diagnostic statement. - SOLUTION c. Data interpretation. 3. The nursing diagnosis readiness for enhanced communication is an example of a(n): a. Risk nursing diagnosis. b. Actual nursing diagnosis. c. Health promotion nursing diagnosis d. Wellness nursing diagnosis. - SOLUTION c. Health promotion nursing diagnosis 4. In the following examples, which nurses are making nursing diagnostic errors? (Select all that apply.) a. The nurse who listens to lung sounds after a patient reports "difficulty breathing" b. The nurse who considers conflicting cues in deciding which diagnostic label to choose c. The nurse assessing the edema in a patient's lower leg who is unsure how to assess the severity of edema d. The nurse who identifies a diagnosis on the basis of a single defining characteristic - SOLUTION c. The nurse assessing the edema in a patient's lower leg who is unsure how to assess the severity of edema d. The nurse who identifies a diagnosis on the basis of a single defining characteristic 5. A nurse is reviewing a patient's list of nursing diagnoses in the medical record. The most recent nursing diagnosis is diarrhea related to intestinal colitis. This is an incorrectly stated diagnostic statement, best described as: a. Identifying the clinical sign instead of an etiology. b. Identifying a diagnosis based on prejudicial judgment. c. Identifying the diagnostic study rather than a problem caused by the diagnostic study. d. Identifying the medical diagnosis instead of the patient's response to the diagnosis. - SOLUTION d. Identifying the medical diagnosis instead of the patient's response to the diagnosis. 6. Review the following list of nursing diagnoses and identify those stated incorrectly. (Select all that apply.) a. Acute pain related to lumbar disk repair b. Sleep deprivation related to difficulty falling asleep c. Constipation related to inadequate intake of liquids d. Potential nausea related to nasogastric tube insertion - SOLUTION a. Acute pain related to lumbar disk repair b. Sleep deprivation related to difficulty falling asleep d. Potential nausea related to nasogastric tube insertion 7. The nurse completed the following assessment: 63-year-old female patient has had abdominal pain for 6 days. She reports not having a bowel movement for 4 days, whereas she normally has a bowel movement every 2 to 3 days. She has not been hospitalized in the past. Her abdomen is distended. She reports being anxious about upcoming tests. Her d. Obtain the next IV fluid bag from the medication room - SOLUTION a. Reconnect the drainage tubing 3. A nurse assesses a 78-year-old patient who weighs 240 pounds (108.9 kg) and is partially immobilized because of a stroke. The nurse turns the patient and finds that the skin over the sacrum is very red and the patient does not feel sensation in the area. The patient has had fecal incontinence on and off for the last 2 days. The nurse identifies the nursing diagnosis of risk for impaired skin integrity. Which of the following goals are appropriate for the patient? (Select all that apply.) a. Patient will be turned every 2 hours within 24 hours. b. Patient will have normal bowel function within 72 hours. c. Patient's skin will remain intact through discharge. d. Patient's skin condition will improve by discharge. - SOLUTION b. Patient will have normal bowel function within 72 hours. c. Patient's skin will remain intact through discharge. 4. Setting a time frame for outcomes of care serves which of the following purposes? a. Indicates which outcome has priority b. Indicates the time it takes to complete an intervention c. Indicates how long a nurse is scheduled to care for a patient d. Indicates when the patient is expected to respond in the desired manner - SOLUTION d. Indicates when the patient is expected to respond in the desired manner 5. A patient has been in the hospital for 2 days because of newly diagnosed diabetes. His medical condition is unstable, and the medical staff is having difficulty controlling his blood sugar. The physician expects that the patient will remain hospitalized at least 3 more days. The nurse identifies one nursing diagnosis as deficient knowledge regarding insulin administration related to inexperience with disease management. Which of the following patient care goals are long term? a. Patient will explain relationship of insulin to blood glucose control. b. Patient will self-administer insulin. c. Patient will achieve glucose control. d. Patient will describe steps for preparing insulin in a syringe. - SOLUTION c. Patient will achieve glucose control. 6. A patient has been in the hospital for 2 days because of newly diagnosed diabetes. His medical condition is unstable, and the medical staff is having difficulty controlling his blood sugar. The physician expects that the patient will remain hospitalized at least 3 more days. The nurse identifies one nursing diagnosis as deficient knowledge regarding insulin administration related to inexperience with disease management. What does the nurse need to determine before setting the goal of "patient will self-administer insulin?" (Select all that apply.) a. Goal within reach of the patient b. The nurse's own competency in teaching about insulin c. The patient's cognitive function d. Availability of family members to assist - SOLUTION a. Goal within reach of the patient c. The patient's cognitive function d. Availability of family members to assist 7. The nurse writes an expected-outcome statement in measurable terms. An example is: a. Patient will be pain free. b. Patient will have less pain. c. Patient will take pain medication every 4 hours. d. Patient will report pain acuity less than 4 on a scale of 0 to 10. - SOLUTION d. Patient will report pain acuity less than 4 on a scale of 0 to 10. 8. A patient has the nursing diagnosis of nausea. The nurse develops a care plan with the following interventions. Which are examples of collaborative interventions? a. Provide frequent mouth care. b. Maintain intravenous (IV) infusion at 100 mL/hr. c. Administer prochlorperazine (Compazine) via rectal suppository. d. Consult with dietitian on initial foods to offer patient. e. Control aversive odors or unpleasant visual stimulation that triggers nausea. - SOLUTION d. Consult with dietitian on initial foods to offer patient. 9. A nurse is preparing for change-of-shift rounds with the nurse who is assuming care for his patients. Which of the following statements or actions by the nurse are characteristics of ineffective handoff communication? a. This patient is anxious about his pain after surgery; you need to review the information I gave him about how to use a patient-controlled analgesia (PCA) pump this evening. b. The nurse refers to the electronic care plan in the electronic health record (EHR) to review interventions for the patient's care. c. During walking rounds the nurse talks about the problem the patient care technicians created by not ambulating the patient. d. The nurse gives her patient a pain medication before report so there is likely to be no interruption during rounding. - SOLUTION c. During walking rounds the nurse talks about the problem the patient care technicians created by not ambulating the patient. 10. Which of the following outcome statements for the goal, "Patient will achieve a gain of 10 lbs (4.5 kg) in body weight in a month" are worded incorrectly? (Select all that apply.) a. Patient will eat at least three fourths of each meal by 1 week. b. Patient will verbalize relief of nausea and have no episodes of vomiting in 1 week. c. Patient will eat foods with high-calorie content by 1 week. d. Give patient liquid supplements 3 times a day. - SOLUTION b. Patient will verbalize relief of nausea and have no episodes of vomiting in 1 week. d. Give patient liquid supplements 3 times a day. 11. A nurse from home health is talking with a nurse who works on an acute medical division within a hospital. The home health nurse is making a consultation. Which of the following statements describes the unique difference between a nursing care plan from a hospital versus one for home care? a. The goals of care will always be more long term. b. The patient and family need to be able to independently provide most of the health care. c. The patient's goals need to be mutually set with family members who will care for him or her. d. The expected outcomes need to address what can be influenced by interventions. - SOLUTION b. The patient and family need to be able to independently provide most of the health care. 12. Which outcome allows you to measure a patient's response to care more precisely? a. The patient's wound will appear normal within 3 days. 6. The nurse enters a patient's room, and the patient asks if he can get out of bed and transfer to a chair. The nurse takes precautions to use safe patient handling techniques and transfers the patient. This is an example of which physical care technique? a. Meeting the patient's expressed wishes b. Indirect care measure c. Protecting a patient from injury d. Staying organized when implementing a procedure - SOLUTION c. Protecting a patient from injury 7. In which of the following examples is a nurse applying critical thinking attitudes when preparing to insert an intravenous (IV) catheter? (Select all that apply.) a. Following the procedural guideline for IV insertion b. Seeking necessary knowledge about the steps of the procedure from a more experienced nurse c. Showing confidence in performing the correct IV insertion technique d. Being sure that the IV dressing covers the IV site completely - SOLUTION b. Seeking necessary knowledge about the steps of the procedure from a more experienced nurse c. Showing confidence in performing the correct IV insertion technique 8. Which steps does the nurse follow when he or she is asked to perform an unfamiliar procedure? (Select all that apply.) a. Seeks necessary knowledge b. Reassesses the patient's condition c. Collects all necessary equipment d. Delegates the procedure to a more experienced staff member e. Considers all possible consequences of the procedure - SOLUTION a. Seeks necessary knowledge c. Collects all necessary equipment e. Considers all possible consequences of the procedure 9. A nurse is talking with a patient who is visiting a neighborhood health clinic. The patient came to the clinic for repeated symptoms of a sinus infection. During their discussion the nurse checks the patient's medical record and realizes that he is due for a tetanus shot. Administering the shot is an example of what type of preventive intervention? a. Tertiary b. Direct care c. Primary d. Secondary - SOLUTION c. Primary 10. A nurse is orienting a new graduate nurse to the unit. The graduate nurse asks, "Why do we have standing orders for cases when patients develop life-threatening arrhythmias? Is not each patient's situation unique?" What is the nurse's best answer? a. Standing orders are used to meet our physician's preferences. b. Standing orders ensure that we are familiar with evidence-based guidelines for care of arrhythmias. c. Standing orders allow us to respond quickly and safely to a rapidly changing clinical situation. d. Standing orders minimize the documentation we have to provide. - SOLUTION c. Standing orders allow us to respond quickly and safely to a rapidly changing clinical situation. 11. A nurse on a cancer unit is reviewing and revising the written plan of care for a patient who has the nursing diagnosis of nausea. Place the following steps in their proper order: a. The nurse revises approaches in the plan for controlling environmental factors that worsen nausea. b. The nurse enters data in the assessment column showing new information about the patient's nausea. c. The nurse adds the current date to show that the diagnosis of nausea is still relevant. d. The nurse decides to use the patient's self-report of appetite and fluid intake as evaluation measures. - SOLUTION a. The nurse revises approaches in the plan for controlling environmental factors that worsen nausea. b. The nurse enters data in the assessment column showing new information about the patient's nausea. c. The nurse adds the current date to show that the diagnosis of nausea is still relevant. d. The nurse decides to use the patient's self-report of appetite and fluid intake as evaluation measures. 12. When a nurse properly positions a patient and administers an enema solution at the correct rate for the patient's tolerance, this is an example of what type of implementation skill? a. Interpersonal b. Cognitive c. Collaborative d. Psychomotor - SOLUTION d. Psychomotor 13. The nurse reviews a patient's medical record and sees that tube feedings are to begin after a feeding tube is inserted. In recent past experiences the nurse has seen patients on the unit develop diarrhea from tube feedings. The nurse consults with the dietitian and physician to determine the initial rate that will be ordered for the feeding to lessen the chance of diarrhea. This is an example of what type of direct care measure? a. Preventive b. Controlling for an adverse reaction c. Consulting d. Counseling - SOLUTION b. Controlling for an adverse reaction 14. A nurse is starting on the evening shift and is assigned to care for a patient with a diagnosis of impaired skin integrity related to pressure and moisture on the skin. The patient is 72 years old and had a stroke. The patient weighs 250 pounds and is difficult to turn. As the nurse makes decisions about how to implement skin care for the patient, which of the following actions does the nurse implement? (Select all that apply.) a. Review the set of all possible nursing interventions for the patient's problem b. Review all possible consequences associated with each possible nursing action c. Consider own level of competency d. Determine the probability of all possible consequences - SOLUTION a. Review the set of all possible nursing interventions for the patient's problem b. Review all possible consequences associated with each possible nursing action d. Determine the probability of all possible consequences 1. A nurse caring for a patient with pneumonia sits the patient up in bed and suctions his airway. After suctioning, the patient describes some discomfort in his abdomen. The nurse auscultates the patient's lung sounds and gives him a glass of water. Which of the following is an evaluative measure used by the nurse? a. Suctioning the airway dressing and notes the date on the dressing label. In what ways did the nurse evaluate the IV intervention? (Select all that apply.) a. Checked the IV infusion location in left arm b. Checked the type of IV solution c. Confirmed from nurses' notes the time of dressing change and checked label d. Inspected the condition of the IV dressing - SOLUTION c. Confirmed from nurses' notes the time of dressing change and checked label d. Inspected the condition of the IV dressing 9. Which of the following statements correctly describe the evaluation process? (Select all that apply.) a. Evaluation is an ongoing process. b. Evaluation usually reveals obvious changes in patients. c. Evaluation involves making clinical decisions. d. Evaluation requires the use of assessment skills. - SOLUTION a. Evaluation is an ongoing process. c. Evaluation involves making clinical decisions. d. Evaluation requires the use of assessment skills. 10. A clinic nurse assesses a patient who reports a loss of appetite and a 15-pound weight loss since 2 months ago. The patient is 5 feet 10 inches tall and weighs 135 pounds (61.2 kg). She shows signs of depression and does not have a good understanding of foods to eat for proper nutrition. The nurse makes the nursing diagnosis of imbalanced nutrition: less than body requirements related to reduced intake of food. For the goal of, "Patient will return to baseline weight in 3 months," which of the following outcomes would be appropriate? (Select all that apply.) a. Patient will discuss source of depression by next clinic visit. b. Patient will achieve a calorie intake of 2400 daily in 2 weeks. c. Patient will report improvement in appetite in 1 week. d. Patient will identify food protein sources. - SOLUTION b. Patient will achieve a calorie intake of 2400 daily in 2 weeks. c. Patient will report improvement in appetite in 1 week. 11. A patient is being discharged after abdominal surgery. The abdominal incision is healing well with no signs of redness or irritation. Following instruction, the patient has demonstrated effective care of the incision, including cleansing the wound and applying dressings correctly to the nurse. These behaviors are an example of: a. Evaluative measure. b. Expected outcome. c. Reassessment. d. Standard of care. - SOLUTION b. Expected outcome. 12. A patient has limited mobility as a result of a recent knee replacement. The nurse identifies that he has altered balance and assists him in ambulation. The patient uses a walker presently as part of his therapy. The nurse notes how far the patient is able to walk and then assists him back to his room. Which of the following is an evaluative measure? a. Uses walker during ambulation b. Presence of altered balance c. Limited mobility in lower extremities d. Observation of distance patient is able to walk - SOLUTION d. Observation of distance patient is able to walk 13. A patient is being discharged today. In preparation the nurse removes the intravenous (IV) line from the right arm and documents that the site was "clean and dry with no signs of redness or tenderness." On discharge the nurse reviews the care plan for goals met. Which of the following goals can be evaluated with what you know about this patient? a. Patient expresses acceptance of health status by day of discharge. b. Patient's surgical wound will remain free of infection. c. Patient's IV site will remain free of phlebitis. d. Patient understands when to call physician to report possible complications. - SOLUTION c. Patient's IV site will remain free of phlebitis. 14. A nursing student is talking with one of the staff nurses who works on a surgical unit. The student's care plan is to include nursing-sensitive outcomes for the nursing diagnosis of acute pain. A nursing-sensitive outcome suitable for this diagnosis would be: a. Patient will achieve pain relief by discharge. b. Patient will be free of a surgical wound infection by discharge. c. Patient will report reduced pain severity in 2 days. d. Patient will describe purpose of pain medicine by discharge. - SOLUTION c. Patient will report reduced pain severity in 2 days. 1. After the 0700 shift report the registered nurse (RN) delegates three tasks to the nursing assistant. At 1300 the RN tells the nursing assistant that he would like to talk to her about the first task that was delegated, which was walking the patient, Mrs. Taylor, earlier that morning. The RN says, "You did a good job walking Mrs. Taylor by 0930. I saw that you recorded her pulse before and after the walk. I saw that Mrs. Taylor walked in the hallway barefoot. For safety, the next time you walk a patient, you need to make sure that the patient wears slippers or shoes. Please walk Mrs. Taylor again by 1500." Which characteristics of good feedback did the RN use when talking to the nursing assistant? (Select all that apply.) a. Feedback is given immediately. b. Feedback focuses on one issue. c. Feedback offers concrete details. d. Feedback identifies ways to improve. e. Feedback focuses on changeable things. f. Feed - SOLUTION b. Feedback focuses on one issue. c. Feedback offers concrete details. d. Feedback identifies ways to improve. e. Feedback focuses on changeable things. 2. As the nurse, you need to complete all of the following. Which task do you complete first? a. Administer the oral pain medication to the patient who had surgery 3 days ago b. Make a referral to the home care nurse for a patient who is being discharged in 2 days c. Complete wound care for a patient with a wound drain that has an increased amount of drainage since last shift d. Notify the health care provider of the decreased level of consciousness in the patient who had surgery 2 days ago - SOLUTION d. Notify the health care provider of the decreased level of consciousness in the patient who had surgery 2 days ago 3. You are the charge nurse on a surgical unit. You are doing staff assignments for the 3-to-11 shift. Which patient do you assign to the licensed practical nurse (LPN)? a. The patient who transferred out of intensive care an hour ago b. The patient who requires teaching on new medications before discharge c. The patient who had a vaginal hysterectomy 2 days ago and is being discharged tomorrow d. The patient who is experiencing some bleeding problems following surgery earlier today - SOLUTION c. The patient who had a vaginal hysterectomy 2 days ago and is being discharged tomorrow 13. Which example demonstrates the nurse performing the skill of evaluation? a. The nurse explains the side effects of the new blood pressure medication ordered for the patient. b. The nurse asks the patient to rate pain on a scale of 0 to 10 before administering the pain medication. c. After completing the teaching, the nurse observes the patient draw up and administer an insulin injection. d. The nurse changes the patient's leg ulcer dressing using aseptic technique. - SOLUTION c. After completing the teaching, the nurse observes the patient draw up and administer an insulin injection. 14. The nurse is explaining the case management model to a group of nursing students. Which characteristics best describe the model? (Select all that apply.) a. Case managers provide all patient care. b. Multidisciplinary care plans are used. c. Case managers coordinate discharge planning. d. Staffing is expensive and may not decrease care costs. e. Communication with health care team members is important. f. Model helps to improve patient safety and quality. - SOLUTION b. Multidisciplinary care plans are used. c. Case managers coordinate discharge planning. e. Communication with health care team members is important. f. Model helps to improve patient safety and quality. 15. The nurse collects the supplies for the dressing change for the patient in bed 1 and signs out the capillary blood glucose monitoring equipment to test the glucose of the patient in bed 2 before walking down the hall to the room. The nurse is displaying: a. Organizational skills. b. Use of resources. c. Priority setting. d. Clinical decision making. - SOLUTION a. Organizational skills. 9. The nurse is caring for the patient who has had major abdominal surgery and also has a large sacral pressure sore. The nurse implements coughing and deep breathing exercises and consults the wound care specialist to evaluate and prescribe care for the pressure sore, even though no physician order has provided instructions to do so. In doing this, the nurse is implementing the element of - SOLUTION 10. The physician is planning to take the patient to surgery in the morning and leaves an order for the nurse to get the patient to sign the surgical permit. The physician's note indicates that the patient has been educated on the procedure. However, the patient tells the nurse, "I have no idea what he's going to do. He rushed in and rushed out so fast, I couldn't ask any questions." The nurse does not allow the patient to sign the permit and calls the physician to inform him of the patient's statement. This is an example of the nurse acting as - SOLUTION 10. When the nurse first meets the patient, it is important to establish a dialogue if possible; patient-centered care stresses that it is important for the nurse to recognize that - SOLUTION 11. As the initial model for nursing, Nightingale's "descriptive theory" encouraged nurses to - SOLUTION 13. The nurse is caring for a patient who is actively bleeding. The physician orders blood transfusions. The nurse notes in the chart that the patient is a Jehovah's Witness and informs the patient of the physician's order. The patient states that she is a Jehovah's Witness and does not want blood products. The nurse contacts the physician to tell him that blood cannot be given to this patient and requests alternative treatment. In doing so, the nurse is operating within which of the following theories? - SOLUTION 14. The patient is terminally ill and is under hospice care. The nurse cares for the patient by bathing, shaving, and repositioning him. The family believes that the end is very near and would like a Catholic priest called to provide the patient with the Sacrament of the Sick. The nurse places a call to the Catholic Church the patient attended and arranges for the priest's visit. Under which of the following theories does the nurse's care fall? - SOLUTION