Potter/Perry Fundamentals Ch 1-6 review questions and answers, Exams of Nursing

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You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation you have your classmates read The Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which of the following statements best describes this code? - correct answer Defines the principles of right and wrong to provide patient care An 18 year-old woman is in the ER with fever and cough. The RN obtains her VS, listens to her lung and heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? - correct answer Assessment A patient in the ER has developed wheezing and SOB. The RN gives the ordered medicated nebulizer now and in 4 hours. Which standard of practice is performed? - correct answer implementation A RN is caring for a patient with end-stage lung disease. the patient wants to go home on O2 and be comfortable. The family wants to have a new surgical procedure. the RN explains the risks and benefits of the surgery to the family and discusses the patient's wishes with them. The nurse is acting as the patient's - correct answer advocate The RN spends time with the pt and family reviewing the dressing change procedure for the patient's wound. The pt's spouse

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demonstrates how to change the dressing. The nurse is acting in which professional role? - correct answer educator The exam for RN licensure is exactly the same in every state in the US. This exam: - correct answer provides a minimal standard of knowledge for an RN in practice Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) A. Caregiver B. Autonomy and accountability C. Patient advocate D. Health promotion E. Lobbyist - correct answer Caregiver, autonomy/accountability, patient advocate, health promotion health care reform will bring changes in the emphasis of care. Which of the following models is expressed from health care reform? - correct answer moving from an acute illness to a health promotion, illness prevention model

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A nurse meets with the registered dietician and physical therapist to develop a plan of care that focuses on improving nutrition and mobility for a patient. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? - correct answer teamwork and collaboration A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? - correct answer informatics The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? - correct answer Nurse researcher Nurses in an acute care hospital are attending a unit based education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? - correct answer In-service education Which of the following Internet resources can help consumers compare quality care measures? (select all the apply)

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1. WebMd
2. Hospital Compare
3. Magnet Recognition Program
4. Hospital consumer Assessment of Healthcare
5. The American Hospital Association's Webpage - correct answer Hospital Compare, Hospital Consumer assessment of Healthcare A community center is presenting a nurse-led program on the Patient Protection and Affordable Care Act. Which statement made by a participant indicates a need for further teaching?
6. "My small company will now have to offer the 75 employees health insurance or pay a penalty."
7. "As long as my son is a full-time student in college, I will be able to keep him on my health insurance until he is 26 years old."
8. "I signed up for the state health insurance exchange before the designated deadline to make sure I had health insurance."
9. "Since I have now been diagnosed with diabetes, my health insurance plan cannot charge me higher premiums." - correct answer 2. "As long as my son is a full-time student in college, I will be able to keep him on my health insurance until he is 26 years old."

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2. Which activity performed by a nurse is related to maintaining competency in nursing practice?
3. Asking another nurse about how to change the settings on a medication pump
4. Regularly attending unit staff meetings
5. Participating as a member of the professional nursing council
6. Attending a review course in preparation for a certification examination - correct answer 4. Attending a review course in preparation for a certification examination
7. A patient tells a nurse that she is enrolled in a preferred provider organization (PPO) but does not understand what this is. What is the nurse's best explanation of a PPO?
8. This health plan is for people who cannot afford their own health insurance.

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2. This health plan is operated by the government to provide health care to older adults.
3. This health plan gives you a list of physicians and hospitals from which you can choose.
4. This is a fee-for-service plan in which you can choose any physician or hospital. - correct answer 3. This health plan gives you a list of physicians and hospitals from which you can choose.
5. Which of the following are examples of a nurse participating in primary care activities? (Select all that apply.)
6. Providing prenatal teaching on nutrition to a pregnant woman during the first trimester
7. Assessing the nutritional status of older adults who come to the community center for lunch
8. Working with patients in a cardiac rehabilitation program
9. Providing home wound care to a patient

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5. Teaching a class to parents at the local grade school about the importance of immunizations - correct answer 1. Providing prenatal teaching on nutrition to a pregnant woman during the first trimester
6. Assessing the nutritional status of older adults who come to the community center for lunch
7. Teaching a class to parents at the local grade school about the importance of immunizations
8. Nurses on a nursing unit are discussing the processes that led up to a near-miss error on the clinical unit. They are outlining strategies that will prevent this in the future. This is an example of nurses working on what issue in the health care system?
9. Patient safety
10. Evidence-based practice
11. Patient satisfaction
12. Maintenance of competency - correct answer 1. Patient safety

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6. Which of the following statements is true regarding Magnet status recognition for a hospital?
7. Nursing is run by a Magnet manager who makes decisions for the nursing units.
8. Nurses in Magnet hospitals make all of the decisions on the clinical units.
9. Magnet is a term that is used to describe hospitals that are able to hire the nurses they need.
10. Magnet is a special designation for hospitals that achieve excellence in nursing practice. - correct answer 4. Magnet is a special designation for hospitals that achieve excellence in nursing practice.
11. A group of staff nurses notice an increased incidence of medication errors on their unit. After further investigation it is determined that the nurses are not consistently identifying the patient correctly. A change is needed quickly. What type of quality improvement method would be most appropriate?
12. PDSA

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2. Six Sigma
3. Rapid-improvement event (RIE)
4. A randomized controlled trial - correct answer 3. Rapid-improvement event (RIE)
5. Which of the following are characteristics of managed care systems? (Select all that apply.)
6. Provider receives a predetermined payment for each patient in the program.
7. Payment is based on a set fee for each service provided.
8. System includes a voluntary prescription drug program for an additional cost.
9. System tries to reduce costs while keeping patients healthy.
10. Focus of care is on prevention and early intervention. - correct answer 1. Provider receives a predetermined payment for each patient in the program.

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4. System tries to reduce costs while keeping patients healthy.
5. Focus of care is on prevention and early intervention
6. Which of the following nursing activities is provided in a secondary health care environment?
7. Conducting blood pressure screenings for older adults at the Senior Center
8. Teaching a clinic patient with chronic obstructive pulmonary disease purse-lipped breathing techniques
9. Changing the postoperative dressing for a patient on a medical- surgical unit
10. Doing endotracheal suctioning for a patient on a ventilator in the medical intensive care unit - correct answer 3. Changing the postoperative dressing for a patient on a medical-surgical unit
11. Doing endotracheal suctioning for a patient on a ventilator in the medical intensive care unit

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A nurse is using the Plan-Do-Study-Act (PDSA) strategy to do a quality improvement project to decrease patient falls on a nursing unit. Place the steps in the correct sequence for PDSA.

1. Bedside change of shift report is piloted on two medical-surgical units.
2. Patient satisfaction levels after implementation of the bedside report are compared to patient satisfaction levels before the change.
3. The nursing council develops a strategy for bedside change of shift report.
4. After modifications are made in the shift report elements, bedside shift report is implemented on all nursing units. - correct answer 3. The nursing council develops a strategy for bedside change of shift report.
5. Bedside change of shift report is piloted on two medical-surgical units.
6. Patient satisfaction levels after implementation of the bedside report are compared to patient satisfaction levels before the change.

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4. After modifications are made in the shift report elements, bedside shift report is implemented on all nursing units.
5. The nursing staff is developing a quality program. Which of the following are nursing-sensitive indicators from the National Database of Nursing Quality Indicators (NDNQI) that the nurses can use to measure patient safety and quality for the unit? (Select all that apply.)
6. Use of physical restraints
7. Pain assessment, intervention, and reassessment
8. Patient satisfaction with food preparation
9. Registered nurse (RN) education and certification
10. Number of outpatient surgical cases per year - correct answer 1. Use of physical restraints
11. Pain assessment, intervention, and reassessment

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4. Registered nurse (RN) education and certification
5. A nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is an appropriate goal for restorative care?
6. Patient will be able to walk 200 feet without shortness of breath.
7. Wound will heal without signs of infection.
8. Patient will express concerns related to return to home.
9. Patient will identify strategies to improve sleep habits. - correct answer 1. Patient will be able to walk 200 feet without shortness of breath
10. A nurse is presenting information to a management class of nursing students on the topic of financial reimbursement for achievement of established, measurable patient outcomes. The nurse is presenting information to the class on which topic?
11. Prospective payment system

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2. Pay for performance
3. Capitation payment system
4. Managed care systems - correct answer 2. Pay for performance
5. A nurse is using data collected from the unit to monitor the incidence of falls after the unit implemented a new fall protocol. The nurse is working in which area?
6. Quality improvement (QI)
7. Health care patient system
8. Nursing informatics
9. Computerized nursing network - correct answer 1. Quality improvement (QI) The nurses on a medical unit have seen an increase in the number of pressure ulcers that develop in their patients. They decide to initiate a quality improvement project using the Plan-Do-Study-Act (PDSA) model. Which of the following is an example of "Do" from that model?

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1. Implementing the new skin care protocol on all medicine units
2. Reviewing the data collected on patients cared for using the protocol
3. Reviewing the quality improvement reports on the six patients who developed ulcers over the last 3 months
4. Based on findings from patients who developed ulcers, implementing an evidence-based skin care protocol - correct answer 4. Based on findings from patients who developed ulcers, implementing an evidence-based skin care protocol
5. A community nurse in a diverse community is working with health care professionals to provide prenatal care for underemployed and underinsured South African women. Which overall goal of Healthy People 2020 does this represent?
6. Assess the health care needs of individuals, families, or communities.
7. Develop and implement public health policies and improve access to care.

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3. Gather information on incident rates of certain diseases and social problems.
4. Increase life expectancy and quality of life and to eliminate health disparities. - correct answer 4. Increase life expectancy and quality of life and to eliminate health disparities.
5. Using Healthy People 2020 as a guide, which of the following would improve delivery of care to a community? (Select all that apply.)
6. Community assessment
7. Implementation of public health policies
8. Home safety assessment
9. Increased access to care
10. Determining rates of specific illnesses - correct answer 1. Community assessment
11. Implementation of public health policies

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4. Increased access to care
5. Determining rates of specific illnesses
6. A nursing student in the last semester of a baccalaureate nursing program is beginning the community health practicum and will be working in a clinic with a focus on asthma and allergies. What is the primary focus of the community health nurse in this clinic setting? (Select all that apply.)
7. Decrease the incidence of asthma attacks in the community
8. Increase patients' ability to self-manage their asthma
9. Treat acute asthma attack in the hospital
10. Provide asthma education programs for the teachers in the local schools
11. Provide scheduled immunizations to people who come to the clinic - correct answer 1. Decrease the incidence of asthma attacks in the community

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2. Increase patients' ability to self-manage their asthma
3. Provide asthma education programs for the teachers in the local schools
4. The nurse caring for a Bosnian community identifies that the children are undervaccinated and the community is unaware of resources. The nurse assesses the community and determines that there is a health clinic within a 5-mile radius. The nurse meets with the community leaders and explains the need for immunizations, the location of the clinic, and the process of accessing health care resources. Which of the following practices is the nurse providing? (Select all that apply.)
5. Providing community resources for the children
6. Teaching the community about health promotion and illness prevention
7. Promoting autonomy in decision-making about health practices
8. Improving the health care of the community's children

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5. Participating in professional development activities to maintain nursing competency - correct answer 1. Providing community resources for the children
6. Teaching the community about health promotion and illness prevention
7. Improving the health care of the community's children
8. Vulnerable populations of patients are those who are more likely to develop health problems as a result of:
9. Chronic diseases, homelessness, and poverty
10. Poverty and limits in access to health care services
11. Lack of transportation, dependence on others for care, and homelessness
12. Excess risks, limits in access to health care services, and dependency on others for care - correct answer 4. Excess risks, limits in access to health care services, and dependency on others for care

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6. Which of the following are major public health problems commonly affecting older adults? (Select all that apply.)
7. Substance abuse
8. Confusional states
9. Financial limitations
10. Communicable diseases
11. Acute and chronic physical illnesses - correct answer 1. Substance abuse
12. Confusional states
13. Financial limitations
14. Acute and chronic physical illnesses

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7. Some nurses are collecting data to determine how many adolescents attempt suicide in a community. This is an example of what type of community assessment data? - correct answer incident rates
8. Many older homes in a neighborhood are undergoing a lot of restoration. Lead paint was used. The community clinic in the neighborhood is initiating a lead screening program. This activity is based on which social determinant of health? - correct answer physical environment
9. Following a community assessment that focused on adolescent health behaviors, a nurse determines that a large number of adolescents smoke and designs a smoking cessation program at the youth community center. This is an example of which nursing role:
10. Educator
11. Counselor
12. Collaborator
13. Case manager - correct answer 2. Counselor

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A nurse in a community health clinic noticed an increase in the number of positive tuberculosis (TB) skin tests from students in a local high school during the most recent academic year. After comparing these numbers to the previous years, 10% increase in positive tests was found. The nurse contacts the school nurse and the director of the health department. Together they begin to expand their assessment to all students and employees of the school district. The community nurse was acting in which nursing role(s)? (Select all that apply.)

1. Epidemiologist
2. Counselor
3. Collaborator
4. Case manager
5. Caregiver - correct answer 1. Epidemiologist
6. Collaborator
7. A nursing student is giving a presentation to a group of other nursing students about the needs of patients with mental illnesses in

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the community. The nursing professor needs to clarify the student's presentation when the student states:

1. "Many patients with mental illness do not have a permanent home."
2. "Unemployment is a common problem experienced by people with a mental illness."
3. "The majority of patients with mental illnesses live in long-term care settings."
4. "Patients with mental illnesses are often at a higher risk for abuse and assault." - correct answer 3. "The majority of patients with mental illnesses live in long-term care settings."
5. The nurse in a new community-based clinic is requested to complete a community assessment. Order the steps for completing this assessment.
6. Structure or locale
7. Social systems

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3. Population - correct answer 1. Structure or locale
4. Population
5. Social systems
6. On the basis of an assessment, the nurse identifies an increase in the immigrant population group in the community. How would the nurse determine the health needs of this population? (Select all that apply.)
7. Identify what the immigrant population views as the two most important health needs.
8. Apply information from Healthy People 2020.
9. Determine how the population uses available health care resources.
10. Determine which health care agencies will accept immigrant populations.

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5. Identify perceived barriers for health care. - correct answer 1. Identify what the immigrant population views as the two most important health needs.
6. Apply information from Healthy People 2020.
7. Determine how the population uses available health care resources.
8. Identify perceived barriers for health care. A patient is worried about her 76-year-old grandmother who is in very good health and wants to live at home. The patient's concerns are related to her grandmother's safety. The neighborhood does not have a lot of crime. Using this scenario, which of the following are the most relevant to assess for safety?
9. Crime rate, locks, lighting, neighborhood traffic
10. Lighting, locks, clutter, medications
11. Crime rate, medications, support system, clutter