Understanding Nursing Conceptual Models & Evidence-Based Practice in Patient Care, Exams of Nursing

Download Understanding Nursing Conceptual Models & Evidence-Based Practice in Patient Care and more Exams Nursing in PDF only on Docsity! LPN to RN Transitions 5th Edition Harrington Test Bank ISBN:978- 1496382733|Complete Guide A+|100% Correct Answers>. 1 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers LPN to RN Transitions 5th Edition Harrington Test Bank ISBN:978- 1496382733| Complete Guide A+|100% Correct Answers. Chapter 01: Honoring Your Past, Planning Your Future MULTIPLE CHOICE 1.A nursing advisor is meeting with a student who is interested in earning her RN degree. She knows that licensedpractical nurse/license vocational nurse (LPN/LVNs) who enter nursing school to become RNs come into the learning environment with prior knowledge and understanding. Which statement by the nursing advisor best describes her understanding of the effect experience may have on learning? a. “Experience may be a source of insight and motivation, or a barrier.” b. “Experience is usually a stumbling block for LPN/LVNs.” c. “Experience never makes learning more difficult.” d. “Once something is learned, it can never be truly modified.” ANS: A Experience accentuates differences among learners and serves as a source of insight and motivation, but it can also bea barrier. Experience can serve as a foundation for defining the self. DIF: Cognitive Level: Application OBJ: Identify how experiences influence learning in adults. TOP: Adult Learning 2.There is a test on the cardiovascular system on Friday morning, and it is now Wednesday night. The student has already taken a vacation day from work Thursday night so that she can stay home and study. She is consideringskipping her exercise class on Thursday morning to N go to the library to prepare for the test. Which response best identifies the student’s outcome priority? a. Exercise class b. Going to the library c. Avoiding work by taking a vacation d. Doing well on the test on Friday ANS: D The outcome priority is the essential issue or need to be addressed at any given time within aset of conditions or circumstances. DIF: Cognitive Level: Application OBJ: Identify motivations and personal outcome priorities for returning to school. TOP:Motivation to Learn 3. A nurse who has been an LPN/LVN for 10 years is meeting with an advisor to discuss the possibility of taking classes to become an RN. The advisor interprets which statement by the nurse as the driving force for returning toschool? a. “I’ll need to schedule time to attend classes.” 4 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers OBJ: Understand Change Theory and how it applies to becoming an RN. TOP: ChangeTheory 7. An Orthopedic Nurse is contemplating changes in her professional life and identifying goals. Which action should the nurse take if she is interested in pursuing a long-term goal? a. Studies for atelemetry exam scheduled for next week b. Enrolls in a Nurse Practitioner program c. Attends a seminar to become a charge nurse d. Continues to work on the orthopedic floor full-time ANS: B A short-term goal is one that can be attained in a period of 6 months or less. Short-term goals include becoming a charge nurse and passing the telemetry exam. A long-term goal is attained in greater than 6 months and includes studying to become a Nurse Practitioner. Continuing to work on the orthopedic floor does not represent either a short-term or a long- term goal. DIF: Cognitive Level: Application OBJ: Identify both short- and long-term personal and professional goals. TOP: SettingGoals 8. The RN is talking with the unit manager about ways to improve patient care. The manager introduces the concept ofa cohort. Which statement by the RN indicates that the teaching has N been effective? a. “A cohort is a web of connections”. b. “A cohort is a group of people who share common experiences with each other”. c. “A cohort is a group linked together for common purposes”. d. “A cohort consists of groups of individuals that make up a whole”. ANS: B A cohort is a group of people who share common experiences with each other. A scheme is a web of connections, ateam is a group linked together for common purposes, and a unit consists of groups or individuals that make up a whole. DIF: Cognitive Level: Evaluation OBJ: Identify how experiences influence learning in adults. TOP: Adult Learning 9. The nurse educator is presenting a lecture to a group of new RNs. Which statement by one of the RNs indicates thatteaching has been effective? a. “Experience is a stepping stone to new learning”. b. “Experience can be a barrier to new learning”. c. “Experience can be an avenue to new learning”. d. “Experience can be a detour to new learning”. ANS: B Experience accentuates differences among learners, serves as a source of insight and motivation, can be a barrier tonew learning, and serves as a foundation for defining the self. DIF: Cognitive Level: Evaluation OBJ: Identify motivations and personal outcome priorities for returning to school. TOP: AdultLearning 10. The nurse educator is presenting a lecture on experience and learning to a group of RNs. 5 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers Which statement by one of the RNs indicates that teaching has been effective? a. “Experiencesalways help educational endeavors”. b. “The process of unlearning is easier than the initial learning”. c. “Learning can often be more difficult if previous knowledge is contradicted”. d. “Experiences rarely serve the student in the learning process”. ANS: C Experiences may either help or hinder both present and future educational endeavors (Knowles et al., 2015). Experience may serve as a chain to which new learning may be linked, making concepts understandable within your personal context. Conversely, some experiences make learning more difficult in that newinformation may contradict previously accepted information and make it necessary to unlearn it. The process of unlearning is more difficult than initial learning. DIF: Cognitive Level: Evaluation OBJ: Delineate both positive and negative effect experiences. TOP: Adult Learning MULTIPLE RESPONSE 1.A student nurse and the staff RN are discussing recent changes on the nursing unit. Which of the following areexamples of change processes? (N Select all that apply.) a. Coercive b. Collaborative c. Technocratic d. Planned e. Organized ANS: A, C, D Coercive is a type of change that is forced or pushed on another. A decision for change made by the most knowledgeable person is known as technocratic. Planned change involves careful thought and decision-making.Collaborative and organized are not considered to be types of change. DIF: Cognitive Level: Application OBJ: Understand Change Theory and how it applies to becoming an RN.TOP: Change Theory 6 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers Chapter 02: Assessing Yourself and Designing Success MULTIPLE CHOICE 1. After a particularly challenging examination, a student is overheard in the hallway exclaiming, “That instructor just grades too hard! She only gave me a B on the test!” This student is exhibiting traits of a(n) a. external locus ofcontrol. b. internal locus of control. c. perfectionist. d. realist. ANS: A Persons with an external locus of control often do not take responsibility for what happens to them. Persons with an internal locus of control take responsibility for what happens to them. A perfectionist strives for perfection in all thathe or she does, which is a self- defeating behavior. A realist accepts the world as it is and handles it accordingly. DIF: Cognitive Level: Application OBJ: Interpret the role of locus of control on personal empowerment. TOP:Locus of Control 2. A student must come back to the learning laboratory to repeat the skills and check for insertion of a nasogastrictube. The instructor overhears the student saying, “I know I can do this, I know I can do this!” The instructor interprets this behavior as a. a self- defeating behavior. N b. positive self-talk. c. perfectionism. d. blaming. ANS: B The student is expressing positive self-talk by telling herself, “I know I can do this.” Stating “I can’t do this” is an example of a self-defeating behavior. A student expecting to perform tasks perfectly is striving for perfectionism. Blaming is not occurring here because the student is taking responsibility for his/her own actions. DIF: Cognitive Level: Analysis OBJ: Explain the impact of positive self-talk. TOP: Self-Talk 3. A clinical instructor notices that one of her students worries a lot, expects negative outcomes for most situations,strives for perfection, and seems to look for the tiniest faults in her work. The clinical instructor interprets these behaviors as a. commitment to learning. b. assuming an external locus of control. c. self-directedness. d. self-defeating behaviors. ANS: D The student may be committed to learning, but she is showing signs of self-defeating behaviors. Self- defeating behaviors include pessimism, nit-picking, worrying, perfectionism, and blaming. Assuming an external locus of 9 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers c. total dedication until resolve begins to wane. d. discipline to change the plan as needed. ANS: B Commitment requires discipline to maintain resolve even when other responsibilities or attractive opportunities beginto mount. DIF: Cognitive Level: Analysis OBJ: Explain four key work habits that contribute to success. TOP: Managing the Work of Success 8. A nursing student is learning about effective time management in her first semester of nursing school. Which actionby the student indicates that she understands the first critical step? a. Setting goals based on the desired outcome b. Prioritizing goals in order of simple to complex c. Prioritizing tasks in chronological order d. Assessing the reality of the complete situation ANS: D N Assessing the complete situation is the first step in time management. One must be clear about the reality of thecurrent set of tasks and schedule in order to begin to manage the time associated with the tasks. DIF: Cognitive Level: Application OBJ: Explain four key work habits that contribute to success. TOP: Managingthe Work of Success 9. Stress reduction while in nursing school is an important part of maintaining one’s health. Holistic cognitive theory forstress reduction has four steps. The student shows that he or she understands the first step to achieving awareness by doing which of the following? a. Becomes aware of the early physical signs of stress b. Concentrates on placing himself or herself as the center of everything c. Mentally filters perceptions d. Disqualifies the positive in the experience ANS: A The awareness step is a time of understanding how the student feels under stress, coming to know the symptoms, andtaking steps to neutralize the symptoms. DIF: Cognitive Level: Application OBJ: Identify steps that aid in stress reduction. TOP: Stress Reduction 10. A student exclaims, “I have to make a 100% on this test because anything less is just like failing in my book. I eitherknow it or I don’t and if I don’t know it now, I never will.” This student is obviously stressed, and the statements represent a. awareness reduction. b. cognitive distortions. c. positive coping mechanisms. d. acceptance of reality. ANS: B Cognitive distortions are illogical, irrational thoughts; those in this question are“all-or-nothing thinking” and “emotional reasoning.” DIF: Cognitive Level: Application OBJ: Identify steps that aid in stress reduction. TOP: Stress Reduction 10 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers 11. A lab instructor is observing placement of a Foley catheter by a senior nursing student. If the student is in the active experimentation phase of Kolb’s Theory of Experiential Learning, what action can the lab instructor expect from thestudent? a. The student will need to observe placement before proceeding. b. The student assists the instructor in placing the catheter. c. The student places the Foley catheter without assistance. d. The student verbalizes beginning to understand catheter placement. ANS: C According to Kolb’s Theory of Experiential Learning, the student is in the active experimentation phase. When the student nurse places the Foley catheter, he or she is actively involved in the experience. Concrete experience occurs when the student is actively involved in a new experience. Reflective observation begins when the student observes the experience. N Abstract conceptualization occurs when the student begins to understand the process of placing theFoley catheter. DIF: Cognitive Level: Analysis OBJ: Describe how learning style affects the learning process.TOP: Learning Style 12. A lab instructor is preparing to teach a group of students. After reading questionnaires filled out by the students in hergroup, she notes that the students would best learn by reflective observation. What activity should the instructor plan so that the students have the best chance of success? a. Set up stations so that the students can try to “figure it out for themselves.” b. Allow the students to observe a presentation. c. Present the information in a lecture while students take notes. d. Present information and allow the students to be directly involved in a hands-on setting. ANS: B Learning by observing is what Kolb terms reflective observation. Concrete experience involves hands-on learning. Inactive experimentation, students learn by trying to figure it out for themselves. Abstract conceptualization is the process of learning through data collection, such as lecture. DIF: Cognitive Level: Application OBJ: Describe how learning style affects the learning process. TOP: Learning Style 13. A nurse is trying to manage success in the workplace. Which action demonstrates that she understands key habits thatmust be developed and maintained? a. Carefully list and organize the day’s tasks. b. Complete a task over again because it wasn’t done perfectly the first time. c. Avoid difficult tasks because they won’t be done correctly. d. Blame others for lack of organization. ANS: A Carefully listing and organizing the day’s tasks demonstrates that the nurse understands key habits needed for success, such as time management. Completing tasks over again, avoiding tasks, and blaming others are all self-defeating behaviors that do not help manage success. DIF: Cognitive Level: Application OBJ: Explain four key work habits that contribute to success.TOP: Habits for Success 14. A nurse is listening to a lecture on self-awareness. Which statement by the nurse indicates that the teaching has beeneffective? a. “Self-confidence involves knowing oneself”. b. “Competence involves knowing oneself”. 11 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers c. “Understanding involves knowing oneself”. d. “Self-awareness involves knowing oneself”. ANS: D Self-awareness involves understanding and being conscious of oneself. This involves being aware of one’s strengthsand weaknesses. Self-confidence, competence, and understanding do not encompass this. N DIF: Cognitive Level: Evaluation OBJ: Identify personal gifts and barriers. TOP: Self-Awareness 15. The student is listening to a lecture on self-defeating behaviors. Which statement by the student indicates thatteaching has been effective? a. “Nit-picking is viewing situations from a negative aspect.” b. “Pessimism is looking for all imperfections.” c. “Worrying is being concerned over issues that may or may not be in your control.” d. “Perfectionism is rejecting responsibility for actions or inactions.” ANS: C Worrying means to be concerned over issues that may or may not be in your control. Pessimism occurs when situations are viewed from a negative aspect. Nit-picking means to look for all imperfections. Perfectionism means tocontinuously strive to be perfect or do things perfectly. DIF: Cognitive Level: Evaluation OBJ: Describe self-defeating behaviors. TOP: Self- DefeatingBehaviors MULTIPLE RESPONSE 1. Which actions or statements can the nurse take to eliminate self-defeating behaviors? (Select all that apply.) a. Say, “I know that I can do this.” b. Accept responsibility for his or her actions. c. Worry about things that are out of his or her control. d. Strive for perfection. e. Believe that his or her actions are out of his or her control. ANS: A, B Stating “I know I can do this” and accepting responsibility for his or her actions are actions and statements that the nurse can take to eliminate self-defeating behaviors. Worrying, striving for perfection, and believing that his or her actions are out of his or her control are examples of self- defeating behaviors. DIF: Cognitive Level: Application OBJ: Describe self-defeating behaviors. TOP: Self- DefeatingBehaviors 2. A group of nursing students is discussing how their lives have changed since beginning nursing school. The studentwho understands the second step of holistic cognitive theory for stress reduction recognizes which comments as descriptive of automatic thoughts? (Select all that apply.) a. “My lab instructor doesn’t like me. I had to repeat my cardiac assessment when no one else did.” b. “After studying for hours, I finally remembered all the steps to insert a Foley catheter. I will use this methodagain.” c. “My child is having behavioral issues in preschool. I know it is because I am in school right now.” N d. “Right after I turned in my test I knew there were at least two answers that I should have changed. I know I failedthe test.” 14 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers Chapter 03: Study Habits and Test-Taking Skills MULTIPLE CHOICE 1. A first semester student is struggling in class and did not do well on her last exam. She has determined the problem tobe her lack of skill in note taking. What can the student do in order to take more effective notes during lecture? a. Focus on writing key words and phrases. b. Photocopy someone else’s notes. c. Write verbatim all that is said. d. Practice memorization in class instead of taking notes. ANS: A The student should focus on writing key words and phrases in order to be more effective at note taking. Photocopyingsomeone else’s notes, writing verbatim, and memorizing lecture will not help the student with effective note taking. DIF: Cognitive Level: Application OBJ: Describe the components of effective listening. TOP: Note-Taking 2. A student nurse feels that his reading skills are not adequate. Which action would he take in order to have effectivereading skills? a. Focus on improving reading speed. b. Read slowly and thoroughly. c. Ask his friends and family read to him. d. Passively engage in reading.N ANS: A Evidence relates reading speed to comprehension; the faster you read, the more you understand what you are reading.DIF: Cognitive Level: Application OBJ: Describe how to improve reading skills. TOP: Effective Reading 3. A struggling student admits that she is reading the same paragraph over and over when she tries to read the text. Theinstructor recognizes this as inhibitory to her comprehension of the material. Which suggestion could the instructor make to the student to help correct the situation? a. “Just keep trying. Maybe you need to read it over a few times to get it.” b. “Maybe you are waiting too late at night to study. Try studying earlier in the day.” c. “Try putting your finger under the words one at a time.” d. “If the words are a stumbling block, study them alone first, and then as you read, you will be less likely tostumble over them and regress.” ANS: D Regression, or rereading what was just read, may be caused by stumbling over unfamiliar terms that cause reading toslow and decrease. DIF: Cognitive Level: Application OBJ: Describe how to improve reading skills. TOP: Effective Reading 4. The student is listening to a lecture on the SQRRR method. Which statement indicates that teaching has beeneffective? a. “The appropriate way to use the method is to scan, skim, survey, read, recite, review”. b. “The appropriate way to use the method is to scan, skim, read, recite, review, reread”. 15 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers c. “The appropriate way to use the method is to survey, question, read, recite, review”. 16 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers d. “The appropriate way to use the method is to survey, question, read, review, reread”. ANS: C SQRRR is a tried and true method: survey, question, read, recite, and review. DIF: Cognitive Level: Evaluation OBJ: Prepare to study effectively using the SQRRR method. TOP: Improving Your Study Skills 5. A nursing student is preparing for her first day of lecture. She knows that in order to succeed, she should a. skip the first day of class and read the material at home. b. sit in the front of the room, away from distractions. c. take notes from the book during lecture time. d. sit in the back of the class, next to her best friend. ANS: B Students should sit in the front of the classroom for optimal learning, away from distractions. N DIF: Cognitive Level: Application OBJ: Describe positive face-to-face and online class strategies.TOP: General Face-to-Face Classroom Behaviors 6. A patient comes to the emergency department with complaints of crushing chest pain that radiates down his left arm. While reviewing his health history with the RN, the patient states that he has been getting over a cold. He also has seasonal allergies and is allergic to peanuts. The nurse interprets the major detail for the patient’s ER visit as thepatient a. has a peanut allergy. b. is experiencing crushing chest pain. c. is getting over a cold. d. has seasonal allergies. ANS: B The major detail in this scenario is the patient’s crushing chest pain, which brought him into the ER. All other areminor details. DIF: Cognitive Level: Analysis OBJ: Distinguish between major and minor details. TOP: Major/Minor Details 7. The RN is performing an assessment on a patient being admitted for back pain. The nurse interprets which of thepatient’s statements as a minor detail? a. The patient has not been able to void in 12 hours. b. The patient ate 90% of his meal. c. The patient reports being unable to walk. d. The patient was involved in a car accident 2 days ago. ANS: B Minor details support the major details and peripherally support the main idea. In this scenario, the patient eating 90%of his meal is a minor detail. The other choices are major details. DIF: Cognitive Level: Analysis OBJ: Describe how to improve reading skills. TOP: Relating Details to aMain Idea 8. A student has been out of school for a number of years. She is concerned that she may not be able to studyeffectively. What action can the student take that will increase her ability to focus on her studies? a. Study for 1 hour a night. b. Study in a loud coffee shop. 19 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers MULTIPLE RESPONSE 1.A nursing student knows that effective listening requires attention and preparation. What actions can she take toensure that she is proficient? (Select all that apply.) a. Read over the assigned material before class begins. b. Read over the material as soon as class is over. c. No special attention or preparation is required. d. Read the material during class.N e.Study independently during discussion time. ANS: A, B To listen effectively, prepare for what you will hear before class. In class maintain concentration and actively engagein the discussion, and then after class review notes and add clarifying comments. DIF: Cognitive Level: Application OBJ: Describe the components of effective listening. TOP: Effective Listening 2. You are a first semester nursing student and have just received your first reading assignment for class tomorrow. You know that in order to succeed you will need to practice effective listening. Which actions would prepare you for classtomorrow? (Select all that apply.) a. Read over the assigned material tonight. b. Scan over the material before class, looking at the main points and subpoints. c. Read the text during class instead of listening to lecture. d. Review your notes immediately after class. e. Do not review anything before class. ANS: A, B, D In order to be prepared for class you should: Read over assigned material the night before; scan over the material before class, looking at both main points and subpoints; and review notes immediately after class. Practicing effectivelistening includes giving the instructor your undivided attention. Often instructors emphasize points that they do not want students to miss. These points often end up on exams. DIF: Cognitive Level: Application OBJ: Describe the components of effective listening. TOP: Effective Listening 3. A student is studying for an upcoming test. She has read the assigned text once and is now ready to highlight. Whichactions by the student indicate that she understands how to highlight? (Select all that apply.) a. Uses circles to highlight key words or phrases b. Draws an asterisk next to an important paragraph or sentence c. Underlines sentences of importance d. Draws squares around words for emphasis e. Marks a section with a star for future reference ANS: A, B, C, E Circles, asterisks, underlines, and stars are all acceptable ways of highlighting that would indicate differences in thematerial. DIF: Cognitive Level: Application OBJ: Describe how to improve reading skills. TOP: Highlighting 4. A student has just listened to a lecture on better strategies for studying. Which of the student’s actions indicateunderstanding? (Select all that apply.) a. Wait until the evening to study.N b. Begin with the most difficult subjects. c. Create a conducive study environment. d. Record the lectures and listen to them in your car. 20 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers e. Begin to study the day before an exam.ANS: B, C, D 21 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers Beginning study sessions with the most difficult subjects, creating a conducive study environment, and listening tolectures in your car are all ways to create better strategies for studying. DIF: Cognitive Level: Application OBJ: Prepare to study effectively using the SQRRR method. TOP: Improving Your Study Skills 24 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers 7. The charge nurse is creating assignments for the oncoming shift. She notices that today staffing consists of threeRNs and one LPN. Which assignment would be most appropriate for the LPN? a. Acute MI: needs preparation for the catheter lab b. Flu-like symptoms: needs reassessment of vital signs every hour c. Possible stroke: needs anticoagulation therapy d. Dehydration: needs IVF boluses and IV antiemetic ANS: B The most appropriate assignment for the LPN would be the patient with flu-like symptoms. The LPN can perform basic assessment and data collection and can meet the basic needs of the patient. The RNs should be assigned the patients with acute MI, possible stroke, and dehydration, all of whom require critical thinking and a higher level ofcare. DIF: Cognitive Level: Application OBJ: Compare and contrast the scope of practice for the LPN/LVN and the RN.TOP: Professional Roles MSC: NCLEX: Safe and Effective Care Environment: Management of Care 8. The RN understands that the National League for Nursing (NLN) delineates three professional roles of theassociate degree nurse when she lists all of the following except a. manager of care. b. team player. N c. provider of care. d. member of profession. ANS: B The NLN delineates the following as professional roles of the associate degree nurse: manager of care, provider of care, and member of the profession. For all three of these roles, the nurse follows the nursing process. The NLN doesnot delineate being a team player as a professional role. DIF: Cognitive Level: Application OBJ: Compare and contrast the scope of practice for the LPN/LVN and the RN.TOP: Registered Nursing MSC: NCLEX: Safe and Effective Care Environment: Management of Care 9. An LPN/LVN in RN school is experiencing frustration because the expectations of her as a nurse at work are verydifferent from her role as a student in nursing school, and fulfilling both is confusing at times. She has an appropriate understanding of her situation when she states that it is known as a. role conflict. b. dissociative behavior. c. coping mechanism. d. license confusion. ANS: A Role conflict may occur when expectations or requirements of competing roles are incompatible. DIF: Cognitive Level: Application OBJ: Discuss the concept of role transition from practical nurse to registered nurse.TOP: Role Transition MSC: NCLEX: Psychosocial Integrity 10. A nurse manager is teaching a class about the different role elements of RNs. If she has an adequate understanding,she can state that a care provider is a. “a nurse who medically manages patients.” b. “an RN who carries out interventions that assist patients to meet positive outcomes.” 25 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers c. “a nurse who seeks out new endeavors.” 26 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers d. “a nurse who seeks out positive changes in the best interest of his or her patients.” ANS: B Care provider is the role element of the RN when interventions are provided. DIF: Cognitive Level: Application OBJ: Describe various role elements that are inherent in the scope of registered nursing practice.TOP: Role TransitionMSC: NCLEX: Caring 11. A student is preparing for an exam on the different role elements of an RN. She is prepared for the exam when shecan state that all of the following are elements of the RN role except a. collaborator. b. manager. c. counselor. d. therapist. N ANS: D Although there are many therapists involved in the collaborative care of the patient, RNs are not therapists.Collaborator, manager, and counselor are identified elements of the RN role. DIF: Cognitive Level: Application OBJ: Describe various role elements that are inherent in the scope of registered nursing practice.TOP: Role TransitionMSC: NCLEX: Caring 12. An RN has called the physician to explain that the patient is having second thoughts about a procedure and wouldlike to learn more about the alternatives before proceeding. In this instance the RN is enacting the element of the RN role known as a. counselor. b. researcher. c. advocate. d. mentor. ANS: C The registered nurse’s role as advocate requires the nurse to be a protector willing to shield the client and family from harm. In assuming this duty, the nurse chooses to provide complete, honest information to those in his or her care and to speak up against any harmful or unnecessary forces that could impede progress toward a healthy state. A client advocate agrees to “take the side” of the health care recipient and “stand up for” the patient’s rights to autonomy andself-determination. DIF: Cognitive Level: Application OBJ: Describe various role elements that are inherent in the scope of registered nursing practice.TOP: Role Transition MSC: NCLEX: Safe and Effective Care Environment: Management of Care 13. An RN student is discussing formal role socialization with her nursing professor. The professor believes the RNstudent has a good understanding when she states that formal role socialization a. “can occur in any informal setting.” b. “occurs during patient teaching.” c. “does not occur in the classroom setting.” d. “only occurs spontaneously.” ANS: B Formal professional role socialization is planned rather than happening spontaneously or vicariously. It involvesplanned educational experiences, such as performing physical assessment, developing nursing diagnoses for a patient’s care plan, or doing patient teaching. 29 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers 17. The nurse would assume the care provider role of educator during which action? 30 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers a. Leading a hand washing initiative to reduce infection rates b. Answering a new mother’s questions about breastfeedingN c. Working with colleagues to transfer a patient into a rehab center d. Requesting more pain medications for a patient who is recovering from a total hip replacement ANS: B The nurse assumes the care provider role of educator when she answers a new mother’s questions about breastfeeding. Leading a hand washing initiative refers to a change agent. Working with colleagues to transfer a patient refers to the collaborator role. The nurse functions as an advocate when he or she requests more medicationfor a patient recovering from surgery. DIF: Cognitive Level: Application OBJ: Describe various role elements that are inherent in the scope of registered nursing practice.TOP: Role Elements MSC: NCLEX: Safe and Effective Care Environment: Management of Care 18. A nurse on a postsurgical unit is alarmed by the number of postoperative infections that have been reported for herunit over the last year. The nurse acquires data from other hospitals and begins observing the health care team to determine the hand washing rates. This nurse is functioning in which care provider role? a. Manager b. Change agent c. Researcher d. Counse l orANS: C The nurse who researches the infection rate and begins data gathering by observing is functioning in the researcherrole. Managers oversee change, change agents initiate change, and counselors assist patients and families with psychosocial needs. DIF: Cognitive Level: Application OBJ: Describe various role elements that are inherent in the scope of registered nursing practice.TOP: Role Elements MSC: NCLEX: Nursing Process 19. The RN utilizes problem-solving skills to do all of the following except a. establish mutual goals with the patient and family. b. formulate a care plan. c. assist patients to achieve expected outcomes in the plan of care. d. oversee implementation and evaluation of the plan. ANS: C The LPN/LVN typically assists patients to achieve expected outcomes in the plan of care. The RN utilizes problem-solving skills to formulate a plan of care, establish mutual goals, and oversee the implementation and evaluation of the plan. DIF: Cognitive Level: Application OBJ: Compare and contrast the scope of practice for the LPN/LVN and the RN.TOP: Care Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care MULTIPLE RESPONSE N 1.The registered nurse takes on different care provider roles in the health care setting. Which roles could the nurse assume when caring for a patient who has just been diagnosed with cancer? (Select all that apply.) a. Counselor b. Educator 31 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers c. Advocate d. Collaborator e. Medical power of attorney ANS: A, B, C, D The nurse functions in the care provider roles of counselor, educator, advocate, and collaborator when caring for thispatient. The nurse would not take on the role of medical power of attorney for the patient. DIF: Cognitive Level: Application OBJ: Describe various role elements that are inherent in the scope of registered nursing practice.TOP: Role Elements MSC: NCLEX: Safe and Effective Care Environment: Management of Care 34 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers DIF: Cognitive Level: Synthesis 35 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter.TOP: Nursing Theory MSC: NCLEX: Safe and Effective Care Environment: Management of Care 7. Betty Neuman’s Systems Model for nursing emphasizes the holistic aspects of nursing from a systems-basedperspective. Which of the following is not an example of the clinical application of this theory? a. Caring for the patient at the primary, secondary, and tertiary levels of care b. Evaluating patient stability c. Focusing on the nurse–patient relationship d. Evaluating the effect of stressors on the patient ANS: C Focusing on the nurse–patient relationship is the focus of Hildegard Peplau’s Theory of Interpersonal Relations. Caring for the patient at the primary, secondary, and tertiary levels of care; evaluating patient stability; and evaluatingthe effect of stressors on the patient are examples of the clinical application of Neuman’s theory. The Neuman’s Systems Model focuses on responses of patient systems to actual or potential stressors and uses primary, secondary, and tertiary nursing interventions for optimal wellness. DIF: Cognitive Level: Application N OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed inthis chapter. TOP: Nursing Theory MSC: NCLEX: Safe and Effective Care Environment: Management of Care 8. Which statement by a nurse reflects an accurate understanding of systems theory? a. “My patient has anemia reflected by low RBC, Hgb, and Hct values, so I have to monitor for fatigue, dyspnea,and tachycardia.” b. “It is my responsibility to provide my patients with basic human needs including food, water, and sleep.” c. “Would you like me to call the chaplain for you to discuss your feelings about your upcoming surgery?” d. “My patient’s daughter makes all decisions and living arrangements for my patient such as reserving a homehealth aide and Meals on Wheels during the week.” ANS: A “A change in one part of the whole will have an effect on another” is an accurate understanding of systems theory. “Humans have certain basic needs” explains Maslow’s Theory of the Hierarchy of Needs. “One must consider how humans cope or do not cope with stress” is an example of Betty Neuman’s Healthcare Systems Model. “Roles changeover a lifetime” illustrates role theory. DIF: Cognitive Level: Evaluation OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed inthis chapter. TOP: Nursing Theory MSC: NCLEX: Safe and Effective Care Environment: Management of Care 9. The nurse is listening to a lecture on nursing conceptual models. Which statement indicates that the teaching hasbeen effective? a. “Nursing conceptual models provide a broad explanation of the world”. b. “Nursing conceptual models are composed of a defined and interrelated set of concepts”. c. “Nursing conceptual models are abstract concepts that propose outcomes”. d. “Nursing conceptual models are related constructs that broadly explain a phenomenon of interest”. ANS: D 36 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers “Nursing conceptual models are related constructs that broadly explain a phenomenon of interest” is true of nursingconceptual models. “Nursing conceptual models provide a broad explanation of the world” is true of nursing 39 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers Jean Watson’s Theory of Care (1979) emerged from her own values and beliefs guided by her commitment to the caring-healing role or nursing and its mission to help sustain humanity and wholeness as the foundation of health andnursing’s purpose for existing. The belief that nursing practice should be autonomous, changes in health care deliveryand patient satisfaction survey responses, and the three theories promoting the capacity of self- care have nothing in common with Jean Watson’s Theory of Care. N DIF: Cognitive Level: Application OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed inthis chapter. TOP: Nursing Theory MSC: NCLEX: Safe and Effective Care Environment: Management of Care 13. Which of the following is an example of the application of Madeleine Leininger’s Cultural Care Theory of Diversityand Universality? a. Preparing a patient for a medical procedure by using medical terminology b. Learning about diverse ethnic patient populations c. Planning nursing care in a standardized manner ensuring that everyone is treated the same way d. Asking a non-English-speaking patient to provide an English-speaking person to translate details of care ANS: B Demonstrating cultural competency includes learning about the cultural community as individuals, families, and communities and their expressive abilities of caring, values, beliefs, actions, and practices that are based on their cultural lifestyles. This will ensure that nurses deliver the appropriate level of care respectfully based on these aspectswith a noted increase in nursing satisfaction performance, healing, and well-being. Speaking in medical jargon is discouraged and does not help to explain or alleviate anxiety. Planning individualized nursing care is the goal, rather than treating everyone in the same manner. Asking a non- English- speaking patient to provide a translator does not demonstrate respect for a diverse population. DIF: Cognitive Level: Application OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed inthis chapter. TOP: Nursing Theory MSC: NCLEX: Safe and Effective Care Environment: Management of Care 14. Which is an example of Dorothea Orem’s Theory of Self-Care Deficit? a. A nurse asks a patient how much she can do for herself following a stroke. b. A nurse performs total care on a stroke patient to conserve the patient’s energy. c. A nurse leaves a stroke patient to walk to the bathroom and shower by herself. d. A nurse enables a stroke patient to wash up in bed by providing bath wipes. ANS: D Dorothea Orem’s Theory of Self-Care Deficit is explained in the fifth edition of her book, Nursing: Concepts of Practice. In this model of practice, the outcomes of all nursing actions should be to promote the capacity for self-carein all individuals; activities of self-care are defined as purposeful, ordered, and learned; and the degree to which a person is able to participate in this is called self-care agency. N DIF: Cognitive Level: Application OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed inthis chapter. TOP: Nursing Theory MSC: NCLEX: Safe and Effective Care Environment: Management of Care 15. The goal of Ida Jean Orlando’s theory of effective 40 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers nursing practice is to a. focus on relationships among the environment, nurse, and patient. b. reduce the duration of hospital stays. 41 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers c. meet the immediate needs of the patient and relieve distress or discomfort. d. integrate holism into nursing. ANS: C Orlando believed that the goal of the nurse is to meet the immediate needs of the patient and relieve distress and discomfort. A major assumption by Orlando was that nursing practice should be autonomous. She believed that usingthe nursing process in the provision of nursing care provides an overall framework for nursing and is effective in achieving a good outcome. Florence Nightingale’s theory focused on three major relationships: environment to patient, nurse to environment, and nurse to patient. Virginia Henderson is well known for defining nursing. She wasalso credited with integrating the view of holism into nursing. She believed that humans have needs that are not onlybiological but also psychological. Reduction of hospital stays is not discussed. DIF: Cognitive Level: Application OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter.TOP: Nursing Theory MSC: NCLEX: Safe and Effective Care Environment: Management of Care 16. Which theory focuses on patterns, life processes, and wholeness and describes seeing the life process as a progressionbelieving that health and the evolving pattern of consciousness are the same? a. Theory of Goal Attainment b. Theory of Health as Expanding Consciousness: Margaret Newman c. Theory of Interpersonal Relations d. Roy Adaptation Model ANS: B Margaret Newman’s Theory of Health as Expanding Consciousness focuses on patterns, life processes, and wholeness. She saw the life process as a progression toward higher levels of consciousness health and believed that health and the evolving pattern of consciousness are the same. Imogene King developed the Theory of Goal Attainment. Her theory is based on her belief that humans are composed of three interacting systems (personal, interpersonal, and social), and that they can lead to goal attainment, representing outcomes. Hildegard Peplau developed the Theory of Interpersonal Relations. This theory describes the connection of nurse, patient, health, and environment and should be viewed within the context of environment. Sister Callista Roy developed the Roy’s Adaptation Model. Roy believed that the goal of nursing is to promote adaptive responses through a six-step nursingprocess. DIF: Cognitive Level: Application OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed inthis chapter. TOP: Nursing Theory MSC: NCLEX: Safe and Effective Care Environment: Management of CareN 17. What example illustrates the conclusion that can be drawn from deductive reasoning? a. All men are mortal and the Dalai Lama is a man; therefore, the Dalai Lama is mortal. b. The planet Earth orbits the Sun; therefore, all planets orbit the Sun. c. Five marbles taken from the bag are blue; therefore, all marbles from the bag are blue. d. The first five people you met at a work interview were nice; therefore, everyone at this office is nice. ANS: A “All men are mortal and the Dalai Lama is a man; therefore, the Dalai Lama is mortal” is correct. Deductive reasoning goes from the general to the specific. Here the reasoning progresses such that you would use a true broad premise or principle to progress logically to a more detailed conclusion. The other answer choices are all examples ofinductive reasoning. Reasoning proceeds from the specific to the general. 44 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers on another. All theories should be clear, simple, 45 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers generalizable, important, and accessible, not just middle-range nursing theories. Nursing theories, in general, are builton adapted scientific theories, not just middle-range nursing theories. DIF: Cognitive Level: Evaluation OBJ: Compare and contrast the nursing philosophies, theories, models, and frameworks discussed in this chapter.TOP: Middle-Range Nursing Theory MSC: NCLEX: Safe and Effective Care Environment: Management of Care N 46 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers Chapter 06: Providing Patient-Centered Care Through the Nursing Process MULTIPLE CHOICE 1. Which statement by the nurse illustrates how a RN’s patient assessment differs from the LPNs patient assessment? a. “The RN gathers basic date for interpretation by the LPN.” b. “The RN function is to provide assistance with dressing and bathing.” c. “The RN assesses the patient as a whole and interprets the findings.” d. “The RN reports abnormal findings to the physician.” ANS: C The RN role differs from the LPN role in that the RN: gathers comprehensive date regarding the patient has a whole and interprets this information, and makes a plan of care for the patient. The LPN gathers basic data about the patientfor the RN to interpret. Both the RN and LPN can report abnormal findings to the physician. DIF: Cognitive Level: Evaluation OBJ: Compare and contrast the responsibilities of the RN with the role of the LPN/LVN in assessment and developing the plan of care.TOP: Nursing Process MSC: NCLEX: Safe and Effective CareEnvironment: Management of Care 2. The nurse is using Gordon’s 11 categories for data collection in performing a health assessment. Which of thefollowing represents assessment of cognition? a. How educated is the patient? b. How does the patient describe his or her health?N c. Is the patient well nourished? d. Has the patient had treatment for emotional problems? ANS: A Asking the patient’s educational level is an assessment of cognition. How the patient describes his or her health is anassessment of health perception and health management. Asking whether the patient is well nourished will assess metabolic pattern, and asking the patient about treatment for emotional problems will assess the patient’s pattern of coping and stress tolerance. DIF: Cognitive Level: Application OBJ: Discuss the five realms that may affect a patient’s health status that should be addressed in order to complete a thorough nursing assessment. TOP: Nursing Process MSC: NCLEX: Psychosocial Integrity 3. The nurse is charting on the patient who is status post-surgery for an abdominal abscess and notes: “Pt’stemperature has not exceeded 37°C this shift.” This is an example of a(n) a. intervention. b. outcome. c. plan. d. diagnosis or analysis. ANS: B An outcome measures the effectiveness of the plan of care. An intervention, a plan, and a diagnosis or analysis areincorrect. DIF: Cognitive Level: Analysis OBJ: Compare and contrast the steps of the nursing process. TOP: 49 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers the practice setting. TOP: Nursing Process MSC: NCLEX: Safe and Effective Care Environment: Management of Care 50 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers 7. An RN team leader has one LPN and one medical assistant assigned to the unit. Which patient would be mostappropriate to assign to the LPN? a. Right lower lobectomy, 1 day postoperatively, whose temperature went from 37.1°C to 38.3°C during the lastshift. b. 72-year-old right hip replacement, 2 days postoperatively, complaining of leg and chest pain. c. 48-year-old female patient who had a laparoscopic appendectomy 8 hours ago: urine output 165 mL, Hgb 7 g/dL,and Hct 21%. d. Post cerebral vascular accident 1 week ago who had a Dobhoff feeding tube inserted and is now on continuousfeedings at 45 mL/hour. ANS: D Licensed practical nurses can implement actions specific to the patient care needs. Monitoring the stroke patient and maintaining the continuous feeding is an appropriate delegation. LPNs can also collect data, perform basic teaching, record data as well as interventions, and report N to the RNs the progress the patient is making. The patient one- day post-op from the right lower lobectomy, the patient with the hip replacement, and the patient with the appendectomy are inappropriate to delegate to a LPN because each requires a focused assessment, advanced interventions, evaluation, and updating of the patients’ plans of care and outcome priorities. DIF: Cognitive Level: Application OBJ: Explain the steps of the nursing process.TOP: Nursing Process MSC: NCLEX: Safe and Effective Care Environment: Management of Care 8. Which of these strategies should be a priority when the nurse is planning care for a patient with hypertension? a. Obtain less expensive antihypertensive medications. b. Assist with dietary changes as the first action. c. Follow evidence-based guidelines for appropriate interventions. d. Teach about the impact of exercise on hypertension. ANS: C Planning goals and desired outcomes occurs in the planning phase. The plan of care includes the process of identifying the interventions needed for the patient to regain a level of independence at or higher than the patient hadbefore admission into the hospital. DIF: Cognitive Level: Application OBJ: Formulate and apply reasonable and measurable outcomes to patient care in the practice setting. TOP: Nursing Process MSC: NCLEX: Safe and Effective Care Environment: Management of Care 9. The nurse reviews assessment findings for assigned patients. Based on this information, which patient demands thenurse’s immediate attention? The patient with a. renal failure on dialysis whose WBC is 10,000 mm3 (normal). b. abdominal aneurysm whose blood pressure is 170/90. c. atrial fibrillation whose lab results show and INR of 2.5 (normal). d. endocarditis who has a loud heart murmur. ANS: B Assessment contains both objective and subjective data. Among other things, the nurse interprets laboratory data to determine whom to see first. The hypertensive patient with an abdominal aneurysm presents the greatest emergency.The patient on dialysis, the patient with A-Fib, and the patient with endocarditis all have normal lab values and clinical findings and present no urgent need for attention. DIF: Cognitive Level: Application OBJ: Explain the steps of the 51 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers nursing process.TOP: Nursing Process MSC: NCLEX: Safe and Effective Care Environment: Management of Care 54 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers d. Bathe daily in a tub. N ANS: A A reasonable outcome is that the patient’s mobility will increase as pain decreases. “Care for the catheter independently” is incorrect because the patient would not be expected to have a catheter. “Walking without assistance” and “bathe daily in a tub” are not reasonable for the patient 12 hours status post hip replacement. DIF: Cognitive Level: Analysis OBJ: Formulate and apply reasonable and measurable outcomes to patient care in the practice setting. TOP: Nursing Process MSC: NCLEX: Safe and Effective Care Environment: Management of Care 14. An RN is making assignments on a medical-surgical unit. Which patient could the RN assign to a float RN from thematernity unit? a. A 68-year-old female patient with COPD and viral pneumonia b. A 60-year-old female patient with atrial fibrillation and a heart rate of 150 c. A 50–year-old male patient post open heart surgery whose blood pressure is 90/50 d. A 36-year-old male patient who is severely neutropenic awaiting chemotherapy ANS: A When prioritizing nursing care, the most critical problems receive the highest priority. In this scenario, the float nursefrom another department serves as another health care team member unfamiliar with the medical-surgical patient population. The medical-surgical RN serves as an all-around organizer of care and interventions that other health careteam members provide. The patient with COPD and viral pneumonia is the most stable of the group. The patient withA-Fib, the post open heart surgery patient with dangerously low blood pressure, and the neutropenic patient awaiting chemotherapy all require close attention and advanced interventions by the RN familiar with these types of patients. DIF: Cognitive Level: Application OBJ: Compare and contrast the steps of the nursing process. TOP: Nursing ProcessMSC: NCLEX: Safe and Effective Care Environment: Management of Care 15. A patient with pneumonia has been using the incentive spirometer four times daily while awake during his 3-dayhospitalization. How would the nurse explore the effectiveness of this intervention? a. The nurse would ask whether the patient was breathing better. b. The nurse would add turn, cough, and deep breathing exercises. c. The nurse would watch the patient use the incentive spirometer. d. The nurse would auscultate the lungs for adventitious breath sounds. ANS: D The nurse would evaluate the effectiveness of the incentive spirometer treatment by listening for adventitious lungsounds. Asking whether the patient is breathing better; adding turn, cough, and deep breathing exercises; and watching the patient using the incentive spirometer do not examine the effectiveness of the plan of care. DIF: Cognitive Level: Synthesis N OBJ: Compare and contrast the steps of the nursing process. TOP: Nursing Process MSC:NCLEX: Safe and Effective Care Environment: Management of Care 16. Which nursing diagnosis would be a priority for a patient in acute respiratory distress? a. Pain b. Reduced gas exchange 55 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers c. Reduced stamina d. Need for health teaching 56 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers ANS: B Remember your ABCs. Airway is always a priority. Pain, reduced stamina, and the need for health teaching are notpriorities. DIF: Cognitive Level: Analysis OBJ: Formulate and prioritize nursing diagnoses in the practice setting. TOP: Nursing Process MSC: NCLEX: Safe and Effective Care Environment: Management of Care 17. Determine which example is true of measurability within the context of the nursing diagnosis. a. The patient will list signs of infection such as redness, pain, swelling, and warmth by the end of the shift. b. The patient will be pain-free and then walk to the bathroom. c. The patient reported abdominal pain for 2 days but denies nausea, vomiting, anddiarrhea. d. The patient received Dilaudid 1 mg IV and 2 hours later received Lortab 500/5. ANS: A Measurability provides the means to evaluate outcomes consistently. The outcome criterion of listing the specific signs of infection is consistently measurable by anyone choosing to attain that outcome criterion. Being pain-free andthen walking to the bathroom is not measurable because one outcome criterion cannot depend on completion of another criterion. Each outcome criterion is considered an individual goal. The statements addressing abdominal painand nausea, vomiting, diarrhea are collected data and taking account of the pain medications administered to the patient have nothing in common with measurability. DIF: Cognitive Level: Evaluation OBJ: Apply the nursing process to the practice setting.TOP: Nursing Process MSC: NCLEX: Safe and Effective Care Environment: Management of Care 18. The nurse is admitting a 64-year-old Hispanic male patient to the rehabilitation facility following surgicalintervention for a broken hip. The nurse should first assess which of the following? a. Self-care ability b. Self-esteem c. Communication d. Pain ANS: D Pain is the first priority for the patient admitted for rehabilitation following surgical intervention. Self-care ability andself-esteem are not the first to be assessed. The ability to communicate pain can be facilitated using graphic representations if the patient does not speak N English. DIF: Cognitive Level: Analysis OBJ: Formulate and prioritize nursing diagnoses in the practice setting. TOP: Nursing Process MSC: NCLEX: Safe and Effective Care Environment: Management of Care 19. The nurse is attempting to take the history of a newly admitted 92-year-old patient but is unable to obtain the information because of the patient’s cognitive status. The nurse should a. refuse to complete the admission withoutmore information. b. contact the family for information on the patient’s history. c. call the doctor in the emergency room for a history. 59 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers Every nursing diagnosis must be substantiated by identifying criteria, also known as defining characteristics. For a nursing diagnosis to be accepted, often numerous signs and symptoms together make up the actual diagnosis. Theseidentifying criteria must be present in the patient to assign that diagnosis. Placing data in incorrect categories, not validating data with the patient, and relying on team members are not discussed. DIF: Cognitive Level: Evaluation OBJ: Compare and contrast the steps of the nursing process. TOP: Nursing ProcessMSC: NCLEX: Safe and Effective Care Environment: Management of Care 23. An example of an intervention independently initiated by the nurse is a. starting a teaching plan for the patient who will go home tomorrow. b. instituting diet restrictions with subsequent progression of diet as tolerated. c. sending an abnormal appearing urine sample to the lab for routine urinalysis. d. writing an order for aspirin for a headache. ANS: A Starting a teaching plan is an independent nursing function. Accountability for both independent and interdependentfunctions remains a part of the role of the RN. Instituting diet restrictions, sending a sample for urinalysis, and writing an order are not functions of a nurse and require physician’s orders to carry out. DIF: Cognitive Level: Application OBJ: Apply the nursing process to the practice setting.TOP: Nursing Process MSC: NCLEX: Safe and Effective Care Environment: Management of Care 24. A nursing intervention directs the patient to be turned every 2 hours to prevent skin breakdown from immobility. Assessment findings on new reddened areas on the lateral N aspects of the right knee and ankle are obtained. What isthe most appropriate way for these findings to be used when the care plan is evaluated? a. The information will be added to the relevant area of the electronic medical record. b. The nursing diagnosis will be changed from an actual problem to a potential problem. c. The new intervention of calling the physician will be added to the care plan. d. The intervention will change to have the patient turned every hour. ANS: D Evaluation is the process of examining the effectiveness of the plan of care and adjusting it to ultimately meet the needs of the patient. Because redness is observed over bony prominences with turning the patient every 2 hours, theintervention must be adjusted, so the patient must be turned more frequently to prevent further skin breakdown. Documenting of information in the electronic medical record does not address the immediate skin integrity problem. Changing the actual problem to a potential problem is incorrect. Calling the physician is not an independent nursingintervention and does not address the issue of skin integrity. DIF: Cognitive Level: Application OBJ: Apply the nursing process to the practice setting.TOP: Nursing Process MSC: NCLEX: Safe and Effective Care Environment: Management of Care MULTIPLE RESPONSE 1. In the assessment phase of the nursing process, there are several ways to collect data. Which statements reflect the needfor more training? (Select all that apply.) a. “The patient is talking in full sentences with visitors and appears to be breathing without distress.” b. “Bowel sounds are hypoactive in all four quadrants; no pain with palpation.” 60 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers c. “Mrs. Collins, are you experiencing any pain right now?” d. “According to the chart, the patient slept well last night as a result of the pain medicine administered at 2100.” 61 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers e. “The abdominal wound is slightly red at the approximated edges, no edema noted.” ANS: C, D Methods of data collection include observation, physical assessment, and interviewing. Asking yes-no questions maylimit the information received. Reading the chart for any previous notes is important to know for continuity of care, but it is not a method of data collection in the assessment phase of the nursing process. Noticing the patient speakingin full sentences tells the nurse the patient is in no distress. Auscultating and palpating the abdomen are part of the physical assessment done at the beginning of every shift and as needed. Noting wound healing including redness andedema is a direct observation. DIF:Cognitive Level: Application OBJ: Apply the nursing process to the practice setting.TOP: Nursing Process MSC: NCLEX: Safe and Effective Care Environment: Management of Care N 64 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers Nursing Process 7. Each element of the nursing process involves critical thinking. Which definition of assessment reflects criticalthinking? a. Correctly and completely documenting the assessment data on a form 65 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers b. A process of discovery and decision-making about the nature of the patient’s needs c. Using a systematic approach to ensure comprehensive collection of assessment data d. Selecting the most accurate NANDA-I nursing diagnosis for the patient ANS: B Assessment is a process of discovering and making decisions about the nature of the patient’s nursing problems orneeds. It involves purposeful and systematic data gathering about the patient’s present illness or situation and pasthealth history (subjective data), data gathering by physical examination (objective data), and review of functional health patterns for both subjective and objective data. DIF: Cognitive Level: Analysis N OBJ: Explain the importance of critical thinking in nursing. TOP: Critical Thinking MSC:NCLEX: Nursing Process 8. A novice RN is caring for a patient who is saying that something is wrong. Vital signs are normal and there are no new specific findings. The novice RN calls another, more experienced RN who briefly talks with the patient, calls thehealth care provider, and initiates a transfer to the ICU. Which statement is most likely true of the more experienced RN? a. The experienced RN is an advanced beginner with better assessment skills than the novice nurse. b. The experienced RN is proficient in assessment and the use of hospital protocol. c. The experienced RN is an expert nurse with intuitive judgment that the experienced nurse cannot quiteexplain. d. The experienced RN is arrogant, foolish, and likely to get in trouble for her assertive behavior. ANS: C The expert RN is able to connect the understanding of a situation with an appropriate action. The expert RN has an intuitive grasp of each situation and zeroes in on the accurate region of the problem without wasteful consideration ofalternative actions. The strength of inference by the expert RN is based on the extent of the RN’s knowledge and experience. The RN with limited experience and with developing knowledge may rely on the proven and look to others for validation of decisions. Practice at this stage demonstrates the highest level of critical thinking in that the expert RN knows holistically what to do without consciously thinking through the process of critical thinking. DIF: Cognitive Level: Application OBJ: Identify the types of reasoning based on critical thinking. TOP: Reasoning MSC: NCLEX:Nursing Process 9. An RN has collected extensive data on a patient with attention deficit disorder. When weighing potential actions tohelp the patient and considering alternative solutions, which of the attributes of the critical thinker is the RN demonstrating? a. Creativity b. Rational thought c. Reflection d. Curiosity ANS: A Creativity is the ability to be innovative, resourceful, and inventive in finding solutions. Rational thought is fueled by knowledge gained through study and experience. Reflection allows the critical thinker to look back and review ideas, thoughts, and actions. Curiosity is the desire to understand what something is or how something works. DIF: Cognitive Level: Application N OBJ: Identify attributes of critical thinkers.TOP: Attributes of Critical Thinkers MSC: NCLEX: Nursing Process 66 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers 10. A nurse manager is designing orientation processes for new graduate nurses by using the work of Hansten and Washburn as a model. All of the new graduates are instructed in the model during orientation. The manager knowsthat a graduate nurse needs more instruction if which comment is made during the evaluation interview? a. “I think I need more mentoring to continue to build my thinking skill.” b. “Improving my critical thinking will assist in decreasing the risk of sentinel events for my patients.” c. “Using my improving thinking skills will help improve patient care.” d. “If my thinking skills are what they should be, fewer errors will happen in patient care.” ANS: A Hansten and Washburn (1999) indicated that the nurse must be able to think critically as a way to decrease errors andsentinel events and assist in cultivating an improved patient care system. Mentoring new employees is not discussed. DIF: Cognitive Level: Evaluation OBJ: Identify the types of reasoning based on critical thinking. TOP: Reasoning MSC: NCLEX:Nursing Process 11. The nurse has received a shift report. Which patient should the nurse assess first? a. The patient diagnosed with type 2 diabetes mellitus who is complaining of dizziness with a glucose level of120. b. The patient diagnosed with sleep apnea who is complaining of a morning headache. c. The patient diagnosed with diverticulitis who has a hard, rigid, abdomen and a temperature of 101.3 F. d. The patient diagnosed with a stomach virus who vomited three times during the previous shift. ANS: C Clinical judgment is perceptive understanding of a situation based on knowledge, empirical data (data that can be observed or experienced), theory, and scientific inquiry. Clinical judgment requires a series of decisions based on changing observations and collected data. A hard, rigid abdomen and elevated temperature are abnormal in any circumstance, and the nurse should assess this patient first. These are clinical manifestations of peritonitis, a potentially life-threatening condition. A glucose level of 120 is normal for a patient with type 2 diabetes. The patient complaining of a headache is the least urgent compared with the other patients. The patient who vomited three times is an urgent patient requiring monitoring of hydration, but less urgent than a patient with a potentially life- threateningcondition. DIF: Cognitive Level: Application OBJ: Explain the importance of critical thinking in nursing. TOP: Critical Thinking MSC:NCLEX: Nursing Process 12. The nurse has received a change-of-shift report about these four patients. Which one should the nurse plan to assessfirst? a. A 23-year-old patient with cystic fibrosis who has pulmonary function testing N scheduled in 30 minutes. b. A 35-year-old patient who was admitted the previous day with bacterial pneumonia and has a temperature of 100.2 F. c. A 46-year-old patient who is complaining of dyspnea after having a thoracentesis 1 hour previously. d. A 77-year-old patient with TB who has four antitubercular medications due in 15 minutes. ANS: C Clinical judgment is perceptive understanding of a situation based on knowledge, empirical data (data that can be observed or experienced), theory, and scientific inquiry. Clinical 69 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers will work. d. Noncompliance with prescribed treatment is irrational behavior. ANS: A Understanding the patient’s health attitudes helps the nurse to understand the patient’s point of view about the treatment regimen. All thinking stems from a point of view. An enlightened thinker is able to interpret data and clarify meaning from several points of view, that is, to explain or illustrate how the data can be understood from 70 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers multiple positions. The RN can recognize that a routine treatment may seem strange and frightening from the patient’s point of view. In gathering data to support this assumption, the nurse will ask questions to better understandhow the patient is responding to the demands of the treatment. An unenlightened nurse may make erroneous assumptions that label the patient as problematic and noncompliant. All the other answer choices have nothing to do with understanding the patient’s point of view. DIF: Cognitive Level: Application OBJ: Explain the importance of critical thinking in nursing. TOP: Critical Thinking MSC:NCLEX: Nursing Process 16. Select the hospital patient who has the best chance of avoiding a hospital-acquired infection. a. A 42-year-old patient who had abdominal surgery b. A 35-year-old patient with a closed leg fracture c. A 5-month-old non-breastfed infant d. A 75-year-old patient receiving chemotherapy ANS: B Clinical judgment is perceptive understanding of a situation based on knowledge, empirical data (data that can be observed or experienced), theory, and scientific inquiry. Clinical N judgment requires a series of decisions based onchanging observations and collected data. The patient with the closed leg fracture is the patient with the best chance of avoiding a hospital-acquired infection. The patient with abdominal surgery is at risk for contracting a hospital- acquired infection because of healing surgical wounds. The non-breastfed infant and the patient receiving chemotherapy are patients with compromised immune systems that put them at risk for a hospital-acquired infection. DIF: Cognitive Level: Application OBJ: Explain the importance of critical thinking in nursing. TOP: Critical Thinking MSC:NCLEX: Nursing Process 17. The nurse is caring for a 19-year-old trauma patient paralyzed from the neck down. He is alert and oriented, requiresassistance with ADLs, and keeps his spirits up with frequent visitors. A priority for the nurse is a. rounding hourly to assess the patient’s support system and acceptance of his condition. b. feeding the patient to maintain his nutritional status. c. ensuring the patient has constant stimuli through his friends because teenagers are peer- focused. d. watching and preventing skin breakdown as a result of immobility. ANS: D Clinical judgment is perceptive understanding of a situation based on knowledge, empirical data (data that can be observed or experienced), theory, and scientific inquiry. Clinical judgment requires a series of decisions based onchanging observations and collected data. Patient safety is a nurse’s priority. Watching and preventing skin breakdown are the priorities for an immobile patient. Hourly rounding, nutritional status, and ensuring that the patient is kept busy are important but of lowerpriority. DIF: Cognitive Level: Application OBJ: Explain the importance of critical thinking in nursing. TOP: Critical Thinking MSC:NCLEX: Nursing Process 18. Which of the following is the best example of an open-ended question regarding a patient’s pain? a. “For how many weeks have you been having this pain?” 71 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers b. “Does it feel like a burning pain?” c. “Where on your body does the pain begin and end?” d. “Can you describe your pain for me?” 74 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers Developing the clinical question is the most important step in the evidence-based process. The RN must develop a clinical question that encompasses the key components to ensure that the question addresses an answerable concern that can be converted into relevant application. Use of the PICO format allows the nurse to develop the question utilizing all needed components. A systematic approach that determines which questions will be asked is incorrect. All evidence-based research is a systematic approach. Formulation of the he clinical question at the conclusion of theliterature search and identification of the background questions at the conclusion of the literature search are stated in the wrong order of the research process. DIF: Cognitive Level: Evaluation OBJ: Develop a sound clinical question utilizing the PICO format. TOP: Developinga Clinical Question MSC: NCLEX: Safe and Effective Care Environment: Management of Care 4. The nurse is interested in whether antibiotic therapy or observation only is most effective in the treatment of sinusitisin young adults. Which of the following best describes the type of question being considered? a. Background questions b. Foreground questions c. General knowledge questions d. Both A and B. ANS: B Foreground questions have four key components: (1) patient- or problem-centered focus on N knowledge about managing patients with a disease, (2) intervention, (3) comparative intervention (an optional step, used only if relevant), and (4) clinical outcome. Ask for specific information about managing patients with a disease. Backgroundquestions seek general knowledge about a disease or disease process. DIF: Cognitive Level: Analysis OBJ: Develop a sound clinical question utilizing the PICO format. TOP: Clinical Questions in Evidence- Based PracticeMSC: NCLEX: Safe and Effective Care Environment 5. Can you explain how the nurse’s use of PICO helps to formulate an effective clinical question? a. PICO organizes the elements that guide the clinical question. b. PICO formulates an answer to the clinical question. c. PICO explains the hierarchy of evidence. d. PICO identifies the strength of the evidence. ANS: A Using the PICO approach allows for a systematic method of identifying important concepts when formulating the clinical question. Although every component of the PICO model may not be used in every case, PICO is an acronym used to describe a format of the four elements required to formulate a good clinical question (P, patient or problem; I,intervention; C, comparison; O, outcomes). PICO questions do not formulate answers, nor do PICO questions have anything to do with evidence. DIF: Cognitive Level: Analysis OBJ: Develop a sound clinical question utilizing the PICO format. TOP: PICO Format MSC: NCLEX: Safe and Effective Care Environment 6. The nurse questions whether treatment with antibiotic therapy is as effective as observation in a 3-year- old boy withotitis media. What combination of information supports the proper order of information needed to compose a PICO statement? a. Effective treatment for otitis media; antibiotic therapy; observation; 3-year-old with otitis 75 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers media b. Three-year-old with otitis media; antibiotic therapy; observation; effective treatment for otitis media 76 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers c. Antibiotic therapy; 3-year-old with otitis media; effective treatment for otitis media; observation d. Observation; 3-year-old with otitis media; effective treatment for otitis media; antibiotic therapy ANS: B PICO is an acronym used to describe a format of the four elements required to formulate a good clinical question (P,patient or problem; I, intervention; C, comparison intervention; O, outcomes). “Three-year-old with otitis media; antibiotic therapy; observation; effective treatment for otitis media” organizes the elements in the correct order.“Effective treatment for otitis media; antibiotic therapy; observation; 3-year- old with otitis media,” “Antibiotic therapy; 3-year-old with otitis media; effective treatment for otitis media; observation,” and “Observation; 3-year-oldwith otitis media; effective treatment for otitis media; antibiotic therapy” have the elements in the incorrect order. DIF: Cognitive Level: Synthesis N OBJ: Develop a sound clinical question utilizing the PICO format. TOP: PICO Format MSC: NCLEX: Safe and Effective Care Environment 7. The nurse wants to know how similar the 7-minute screen (7MS) is to the Mini-Mental State Examination (MMSE) in accurately screening for dementia. Can you distinguish the correct clinical question category for thistype of question? a. Prognosis b. Diagnostic c. Harm/etiology d. Prevention ANS: B Diagnostic questions emphasize how to select a diagnostic test or interpret the results of a particular test. Harm/etiology questions focus on what the harmful effects of a particular treatment are or how harmful effects can beavoided. Prognosis questions focus on the disease process, screening, and risk reduction. Prevention questions are interested in how to modify patient’s risk factors to reduce the risk of disease. DIF: Cognitive Level: Analysis OBJ: Develop a sound clinical question utilizing the PICO format. TOP: Screening for Dementia MSC: NCLEX: Safe and Effective Care Environment 8. If you had access to the following databases for your research, which would you choose to review clinical trialson effective smoking cessation therapies? a. The Cochrane Library b. HealthStar c. Medline d. InfoPOEMS ANS: A The Cochrane Database of Systematic Reviews is one of the most popular databases in the Cochrane Library. It evaluates individual clinical trials and condenses systematic reviews from more than 100 medical journals. The database provides an efficient method of interpreting the results of many studies. HealthStar includes published literature from journals, book chapters, and government documents on clinical and nonclinical aspects of health care delivery. Medline is the largest biomedical research literature database (more than 10 million references) for general information. Medline compiles information from Index Medicus, Index to Dental Literature, and International Nursing Index. InfoPOEMs (Patient- Oriented Evidence that Matters) is a clinical awareness system that allows healthcare practitioners to access the most current, concrete medical information available. 79 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers a. Identifies a specific clinical problem, accesses appropriate resources, and assesses the relevancy of use ofinformatN ion for that particular patient’s problem b. Identifies a particular patient problem and immediately notifies the physician and family for treatment c. Identifies the lack of research skills and consults a librarian for a workshop on conducting research studies d. Identifies the lack of research skills and consults a scientific researcher to teach basic computerinformation ANS: A Information literacy is a fundamental skill that the nurse must develop. Information literacy is defined as the ability torecognize when information is needed and have the ability to locate, evaluate, and effectively use the information. Identifying a particular patient problem and immediately notifying the physician and family for treatment address direct patient care rather than nursing research. Identifying the lack of research skills and consulting a librarian for aworkshop on conducting research studies and identifying a lack of research skills and consulting a scientific researcher to teach basic computer information incorrectly focus on the lack of research skills. DIF: Cognitive Level: Analysis OBJ: Discuss the hierarchy (levels) of evidence. TOP: Information Literacy MSC: NCLEX: Safe and Effective Care Environment 10. Assess the given levels of evidence and choose the one most important when evaluating the strength of a researchstudy. a. Level 3 evidence indicates that specific-quality criteria were met. b. Level 1 evidence implies an association with specific criteria. c. Level 1 evidence indicates that specific-quality criteria were met. d. Level 2 evidence implies a reliable association with specific criteria. ANS: C Level 1 evidence represents the most valid reports addressing patient-oriented outcomes. A level 1 ranking also indicates that specific-quality criteria were met based on the study type. Level 3 evidence represents reports that arenot based on scientific analysis of patient- oriented outcomes. Level 2 evidence implies an association with specific criteria rather than reliable evidence. DIF: Cognitive Level: Evaluation OBJ: Discuss the hierarchy (levels) of evidence. TOP: Hierarchy of Evidence MSC: NCLEX: Safe and Effective Care Environment 11. What is the relationship between the design and layout when creating a critical appraisal tool? a. Design and layout differ but measure the same areas. b. Design and layout differ, and reliability measures differ. c. Design, layout, and reliability are similar but relevancy differs. d. Design, layout, and reliability differ but trustworthiness is the same. ANS: A The nurse remembers the three basic questions that are universal for any type of research study. Critique appraisal tools differ slightly in design and layout, but each tool asks these same questions of the research study: (1) Is it worth looking at the results of this study, and can I trust the results (reliability)? (2) What are the results? (3) Are the results relevant for the patient? “Design and layout differ, and reliability measures differ” and “Design, layout, and reliabilityare similar but relevancy differs” are incorrect because each critical appraisal tool asks the same questions of the research study. “Design, layout, and reliability differ but trust N worthiness is the same” is incorrect because trustworthiness has nothing to do with appraising research studies. 80 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers DIF: Cognitive Level: Analysis OBJ: Discuss the hierarchy (levels) of evidence. TOP: Critical Appraisal Tool MSC: NCLEX: Safe and Effective Care Environment 81 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers 12. Several sections are included in a research article. For example, the methods section describes the research study andwhat assessment quality and criteria were used. What information does the abstract or introduction section include? a. An evidence summary from the results of several other studies b. An outline of the number of studies retrieved and excluded and respective reasons for their inclusions orexclusions c. A discussion about whether the results are heterogeneous with possible reasons d. A clearly stated review question ANS: D The review question should be clearly stated in the title, the abstract, or final paragraph of the introduction. The summary section provides an evidence summary from the results of several studies. The results section outlines thenumber of studies retrieved, excluded, and why. The data/analysis section states whether the results are heterogeneous and discusses possible reasons. DIF: Cognitive Level: Synthesis OBJ: Articulate the role of the RN in research and research utilization. TOP: Critical Appraisal MSC: NCLEX: Safe and Effective Care Environment 13. A nurse manager attempts to explain why the greatest number of medication errors occurs during the evening shift.The nurse manager chooses a quasi-experimental design to study this relationship. Why did the nurse manager choose this type of research design? a. It does not allow for complete control over the variance. b. It allows for randomization. c. It allows for control over the independent variable. d. It requires manipulation of the variable. ANS: A In quasi-experimental designs, strict control is not possible. Allowing for randomization and for control over theindependent variable and requiring the manipulation of the variable are true of experimental studies. DIF: Cognitive Level: Evaluation OBJ: Articulate the role of the RN in research and research utilization. TOP: Nursing Research MSC: NCLEX: Safe and Effective Care Environment:Management of Care 14. The nurse manager wants to determine the cause of an increase in medication errors over the past 6 months. This isan example of which type of research? a. Experimental b. Trial and error c. Quality assurance d. Scientific N ANS: C Quality assurance research uses data not only to determine whether procedures are being done per protocol, but alsoto determine whether patient outcomes are being met, and if charting is complete. Experimental research is a type ofstudy design. Trial and error is not proper research methodology. Scientific research is what all evidence- based research demonstrates. DIF: Cognitive Level: Application OBJ: Describe the research process.TOP: Nursing Research MSC: NCLEX: Safe and Effective Care Environment: Management of Care 84 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers Direct research utilization describes applying research findings directly to change practice. Advocating a change in policy based on research findings such as when working on a policy and procedure committee is persuasive researchutilization. Basing practice on current research available and critiquing a research study are examples of indirect research utilization. DIF: Cognitive Level: Application OBJ: Articulate the role of the RN in research and research utilization.TOP: Nursing Research MSC: NCLEX: Safe and Effective Care Environment: Management of Care 19. Characteristics of a quantitative study include all of the following except: a. clarifies underlying assumptions. b. asks who, what, why, where, when, or how. c. describes the relationship between variables. d. is highly structured and controlled. ANS: A A quantitative study asks the question who, what, why, where, when, or how and attempts to describe the relationshipbetween one variable and another. A quantitative study plan is also highly structured and controlled. A qualitative study tries to clarify underlying assumptions that are vague or unclear by asking what the perceptions, beliefs, or tenets are within a particular setting. DIF: Cognitive Level: Application OBJ: Describe the research process.TOP: Nursing Research MSC: NCLEX: Safe and Effective Care Environment: Management of Care MULTIPLE RESPONSE 1. Which of the following are most responsible for the emerging use of evidence-based practice(EBP) in health care? (Select all that apply.) a. Accountability by consumers of governmental and health care agencies b. Introduction of national health care guidelines c. Shorter implementation time of new research d. Variability of care among health care practitioners and facilities e. Similarity with other science disciplines and their amounts of researchN f. Eligibility to receive government grants for research excellence ANS: A, D Economic factors, the variability of care, and the rising cost of health care have been the driving force in the call for EBP. Consumers and governmental agencies are insisting on transparency, accountability for effectiveness, and efficiency in health care. EBP began before the introduction of national health care guidelines. Shorter implementation time of new research is irrelevant in the use of EBP. Similarity with other sciences and their amountsof research and eligibility to receive government funding for research excellence are incorrect. DIF: Cognitive Level: Analysis OBJ: Define evidence-based practice. TOP: Accountability and Variability in Health Care MSC: NCLEX: Safe and Effective Care Environment: Management of Care 2. What characteristics support evidence-based practice (EBP)? (Select all that apply.) a. The nurse’s clinical experience is fundamental to the evidence-based practice process. b. Evidence-based practice provides a theoretical framework for accuracy and safety in patient care. c. Evidence-based practice involves the use of a holistic approach to patient care in health care. 85 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers d. Evidence-based practice is designed to create a generic plan of patient care in clinical settings. e. Evidence-based practice allows the nurse autonomy in patient care becauseresearch proves success. ANS: A, B, C EBP is problem-solving in its approach, which takes into account the clinical experience of the nurse. Clinical experience refers to the nurse’s ability to use clinical skills and past experience to identify the patient’s health state,diagnosis, and the risks and benefits of the prospective interventions. EBP combines researched evidence with knowledge and theory. The use of patient-centered researched evidence allows for accuracy and precision of diagnostic tests and prognosis markers, in addition to the effectiveness and safety of therapeutic treatment. EBP allows for patients’ values to be expressed and incorporated into treatment regimens. Patients bring their individual preferences, concerns, and expectations to the clinical setting. The statement that EBP is designed to create a genericplan of patient care in clinical settings is incorrect because a patient’s plan of care should always be individualized and never generic. EBP does not authorize autonomy for any nursing professional. DIF: Cognitive Level: Analysis OBJ: Define evidence-based practice.TOP: Evidence-Based Practice MSC: NCLEX: Safe and Effective Care Environment: Management of Care 3. Research studies must be scrutinized to be deemed credible and trustworthy. Choose all the strategies that may beused to critically appraise a research study. (Select all that apply.) a. Examine the validity of the research. b. Look at the reference list of the study. c. Look for criteria of inclusion. d. Look for use of PICO format. e. Examine the credentials of the authors. f. Look for a proper sample size.N ANS: A, B, C Examining the validity of the research, looking at the reference list of the study, and looking for criteria on inclusionare all strategies that can be used to appraise research studies critically. PICO is an acronym used to describe one format that includes four elements needed to construct a good clinical question. Looking for the PICO format and looking for a proper sample size are not strategies for critically appraising research studies. DIF: Cognitive Level: Analysis OBJ: Discuss the hierarchy (levels) of evidence. TOP: Hierarchy of Evidence MSC: NCLEX: Safe and Effective Care Environment 4. Which goals best justify the need for evidence-based practice (EBP) in nursing? (Select all that apply.) a. Redesign the health care system and recruit more nurses. b. Improve patient outcomes with evaluations that track outcomes. c. Introduce national health care guidelines and standards. d. Restructure health care delivery and improve quality of health care. e. Apply clinical experience to improve patient care. ANS: B, D The initial intent of EBP was to improve patient outcomes by evaluating and tracking outcomes, including qualitative reports by patients, and to redesign health care delivery and improve the quality of health care. EBP has nothing to do with nurse recruitment or national health care guidelines and standards. Applying clinical experience to patient care isnot a goal 86 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers of EPB. Clinical expertise is a factor used in research. DIF: Cognitive Level: Analysis OBJ: Define evidence-based practice. TOP: Evidence-Based Practice MSC: NCLEX: Safe and Effective Care Environment 89 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers Chapter 09: Communicating With Patients and Co-Workers MULTIPLE CHOICE 1. The student nurse is listening to a lecture on therapeutic communication. Which statement indicates that teachinghas been effective? a. “The purpose of therapeutic communication is psychotherapy.” b. “The purpose of therapeutic communication is social communication.” c. “The purpose of therapeutic communication is to develop a trusting relationship.” d. “The purpose of therapeutic communication is emotional commitment to another.” ANS: C The purpose of therapeutic communication is to establish a trusting relationship. The RN should try to understand with sensitivity. Therapeutic communication and the establishment of the therapeutic relationship require empathy, genuineness, positive regard, and self- awareness. Psychotherapy, social communication, and emotional commitmentto another are not definitions of therapeutic communication. DIF: Cognitive Level: Evaluation OBJ: State the purpose of the therapeutic relationship and apply therapeutic communication to theclinical setting. TOP: The RN as Communicator MSC: NCLEX: Psychosocial Integrity 2. The student nurse is listening to a lecture on communication. Which statement indicates that the teaching hasbeen effective? a. “A communication blocker is silence.”N b. “A communication blocker is eye contact.” c. “A communication blocker is advising.” d. “A communication blocker is clarifying.” ANS: C Communication blockers tend to stop conversation and build mistrust. Giving advice fosters dependency and conveysto the patient that the nurse knows best. Silence, eye contact, and clarifying are techniques that enhance (facilitate) communication. DIF: Cognitive Level: Evaluation OBJ: Compare and contrast facilitators and blockers of communication. TOP: The RN as Communicator MSC: NCLEX: Psychosocial Integrity 3. The nurse is caring for a patient 2 hours after a left above-the-knee amputation. The patient states, “My left leg isreally hurting, and that medicine you gave me earlier didn’t help.” Which response is the most therapeutic, if made by the nurse? a. “That’s impossible!” b. “You’ll have to talk to your doctor.” c. “Keep your chin up.” d. “I will call your physician.”ANS: D 90 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers “I will call your physician” is validating the patient’s perception of pain. “That’s impossible!” minimizes the patient’sfeelings. “You’ll have to talk to your doctor” may cause the patient to feel rejected by the nurse. Making a stereotypical comment such as “Keep your chin up” is never therapeutic. DIF: Cognitive Level: Application OBJ: Demonstrate effective communication skills to resolve conflict in the health care setting.TOP: The RN as Communicator MSC: NCLEX: Psychosocial Integrity 4. The RN is documenting the patient’s complaint of pain rated 6 on a scale of 0 to 10. Which chart entry would bethe most appropriate, if made by the nurse? a. Pt. complaining of pain. MD notified. b. Pt complaining of pain rated at 6 on a scale of 0–10, states “My left leg is really hurting.” Pt. grimacing, voiceelevated. MD notified. c. Pt. complaining of pain rated at 6 on a scale of 0–10. Appears to be in pain. MD notified. d. Pt. complaining of pain rated 6. Wants more pain medication; appears to be drug- seeking. MD notified. ANS: B With “Pt complaining of pain rated at 6 on a scale of 0–10, states ‘My left leg is really hurting.’ Pt. grimacing, voiceelevated. MD notified,” the entry contains the problem, the assessment, subjective comments, observations, and the plan. The entry “Pt. complaining of pain. MD notified,” does not define the patient’s pain. The entries “Pt. complaining of pain rated at 6 on a scale of 0–10. Appears to be in pain. MD notified” and “Pt. complaining of painrated 6. Wants more pain medication; appears to be drug- seeking. MD notified” reflect opinions of the nurse. N DIF: Cognitive Level: Application OBJ: Utilize SBAR to assertively communicate with co-workers within the health care team to minimize risks associated with handoffs. TOP: The RN as Communicator MSC: NCLEX:Safe and Effective Care Environment: Management of Care 5. The RN has assigned the nursing assistant (NA) a task. The NA becomes angry and begins yelling at the RN. What isthe best approach for the RN to take? a. Tell the NA that you will let her leave early if she will do this for you. b. Ignore her and reassign the task. c. Meet with the NA to explore his or her feelings and the reason for resistance. d. Call the nursing supervisor and report the NA for insubordination. ANS: C Meeting with the NA to explore the reason for resisting the request is the best approach in order to address the underlying issue. Telling the NA that you will let her leave early if she will do this for you and ignoring her and reassigning the task are negative reinforcements and will likely perpetuate the behavior. Calling the nursing supervisor and reporting the NA for insubordination should occur if the RN has been unsuccessful in resolving theproblem. DIF: Cognitive Level: Application OBJ: Demonstrate effective communication skills to resolve conflict in the health care setting.TOP: The RN as Communicator MSC: NCLEX: Safe and Effective Care Environment: Management of Care 6. The nurse is caring for a 64-year-old woman 4 hours after knee replacement. Although she rates her pain at 6 out of10, she refuses pain medication and tells the nurse, “I can deal with it.” Which of the following is the nurse’s best response? a. “OK, that’s your decision.” 91 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers b. “You’re just being stubborn.” c. “OK, I’ll come back later.” d. “What is your concern?” 94 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers d. contact the physician. ANS: D The physician must be notified for clarification of the dose. If the nurse still considers the dose excessive, he or shemay refuse to administer it. Administering the medication is not a safe option, nor is asking another nurse to administer it. If the issue cannot be resolved between the nurse and physician, the supervisor should be notified. DIF: Cognitive Level: Application OBJ: Appreciate the value of collaborative communication in the health care environment.TOP: The RN as Communicator MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection ControlN 10. The nurse is caring for a patient following painful radiation treatment for newly diagnosed cancer. Which question, ifasked by the nurse in the orientation phase of the nurse–patient relationship, is most likely to elicit a meaningful response? a. “Don’t you love this weather?” b. “How have things been going for you?” c. “Tell me why you didn’t stop smoking.” d. “Are you having any pain?” ANS: D Pain must first be addressed before the interview can proceed. “Don’t you love this weather?” is a general andnondescript comment. “How have things been going for you?” is best offered once pain has been assessed and treated. Exploration of needs, feelings, emotions, and concerns would be addressed in the working phase. “Tell mewhy you didn’t stop smoking” is likely to elicit a defensive response and will hinder therapeutic communication. DIF: Cognitive Level: Application OBJ: Conduct a patient interview in the clinical setting utilizing effective communication skills andactive listening. TOP: The RN as Communicator MSC: NCLEX: Psychosocial Integrity 11. The RN is educating the new RN on the primary focus of care when developing a therapeutic relationship with thepatient. Which statement by the new RN indicates that teaching has been effective? a. “Meeting the needs of the nurse is the primary focus.” b. “Medication administration is the primary focus.” c. “The patient’s needs and problems is the primary focus.” d. “Self-care potential is the primary focus.” ANS: C The primary focus of care is on the patient’s needs and problems. The focus of the nurse–patient therapeutic relationship is never to meet the needs of the nurse. Medication administration and self-care potential can beaddressed once needs and problems have been identified. DIF: Cognitive Level: Evaluation OBJ: Conduct a patient interview in the clinical setting utilizing effective communication skills and active listening.TOP: The RN as Communicator MSC: NCLEX: Safe and Effective Care Environment: Management of Care 12. A patient scheduled for surgery has a severe level of anxiety. Which action, if taken by the nurse, would be mostappropriate at this time? a. Providing teaching about the upcoming surgery and what to expect b. Telling the patient that there is nothing to worry about c. Calling the patient’s family and demanding that they help out 95 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers d. Asking the patient about her concerns, feelings, and perceptions about the surgery 96 of 123TEST BANK FOR LPN TO RN TRANSITIONS 5TH EDITION BY CLAYWELL Alberts academics: questions with correct answers ANS: D The most appropriate action for the nurse to take at this time is to ask the patient about her concerns, feelings, and perceptions about the surgery. Providing teaching during periods of high anxiety is ineffective and does not addressthe patient’s anxiety. Telling the patient that there is nothing to worry about is giving false reassurance. Calling the patient’s family and N demanding that they help out is projecting the nurse’s frustration onto the family and avoidingresponsibility. DIF: Cognitive Level: Application OBJ: Conduct a patient interview in the clinical setting utilizing effective communication skills andactive listening. TOP: The RN as Communicator MSC: NCLEX: Psychosocial Integrity 13. The nurse is preparing to assess a newly admitted Chinese patient. Which of the following would be most appropriateto assess first? a. Pain b. Language barrier c. Family support d. Religious preference ANS: B The nurse must first assess the ability to communicate with the patient before pain, family support, or religiouspreference can be assessed. DIF: Cognitive Level: Application OBJ: Respect the cultural diversity among individuals.TOP: The RN as Communicator MSC: NCLEX: Safe and Effective Care Environment: Management of Care 14. The nurse and patient are discussing the patient’s perceptions and feelings related to the patient’s illness. The patient is emotional and tearful and expresses feelings of hopelessness. During which phase of the nurse–patient relationshipdoes the nurse interpret this patient to be in? a. Pre-orientation b. Orientation c. Working d. Termination ANS: C Discussing perceptions and feelings typically occurs in the working phase, at which time intense emotions may arise. Pre-orientation is not a phase of the nurse–patient relationship. The orientation phase includes introductions and goal setting. The termination phase is the completion of the nurse–patient relationship as a result of discharge, transfer, orthe nurse’s time off. DIF: Cognitive Level: Analysis OBJ: State the purpose of the therapeutic relationship and apply therapeutic communication to theclinical setting. TOP: The RN as Communicator MSC: NCLEX: Psychosocial Integrity 15. A nurse has a plan for teaching the patient about a newly diagnosed disease. On entering the room the nurse realizesthat the patient is blind. What considerations for communication should the nurse be aware of? a. Tone, pitch, inflection, and intensity affect how messages are communicated. b. Messages are clearer when verbal communication and nonverbal cues are opposite. c. Verbal communication must be understood within the context of a patient’s culture, gender, and age. N d. Facial expressions and eye contact are characteristics of verbal communication.ANS: A