Nursing Education and Professional Development: Historical and Contemporary Issues, Exams of Nursing

Download Nursing Education and Professional Development: Historical and Contemporary Issues and more Exams Nursing in PDF only on Docsity! NURSING 2058 DIMENSIONS EXAM 1,2 AND FINAL EXAM /RASMUSSEN COLLEGE NURSING 2058 EXAM 1,2& FINAL EXAM LATEST 2022-2023| QUESTIONS AND ANSWERS WITH RATIONALES |AGRADE Dimensions Exam 1: Study Guide Chapter 1 1. Identify the most important element in nursing’s attempt to gain full autonomy of practice. A) Economic exploitation of nurses B) Maintaining the education system for nurses as it is now C) Gaining and maintaining control of nursing practice by nurses D) Restricting the latitude of decisions made by nurses 2. In its attempt to gain freedom and independence, what corresponding factors must the nursing profession embrace? A) Health and happiness B) Chaos and disorder C) Loss of control and negative feedback D) Responsibility and accountability 3. Select the most effective method that nurses can use to gain power over their practice. A) Use strikes and union tactics to increase pay. B) Join professional organizations in large numbers. C) Leave nursing as soon as better jobs come along. D) Confront hospital administrators about poor staffing. 4. What allows a nurse to exert referent power over a client when providing nursing care? A) The ability to withhold pain medication if the client does not comply with routines B) The ability to provide the client with additional food when he or she does comply with the nurse’s requests the client does not comply with routines B) The ability to provide the client with additional food when he or she does comply with the nurse’s requests C) The power given to the nurse by reason of state licensure D) The establishment of a professional and personal relationship with the client 13. Select the trait of a profession that requires the most improvement in the promotion and recognition of nursing as a full and equal profession. A) Activities involve a high level of individual responsibility. B) Activities are based on a specialized body of knowledge. C) Activities serve the public and are generally altruistic in nature. D) Activities are learned in institutions of higher education. 14. Which statement is the best description of a profession from the power approach method of defining a profession? A) The members of the profession attain all the traits required for that profession. B) The members of the profession have high income levels. C) The profession is near the end of its developmental process. D) The education for the members of the profession must be attained in graduate schools. COMPLETION 1. List in correct order the progression of the levels of health-care providers from the most educated to the least educated. (Enter the letter of each in the proper sequence; do not use commas or spaces.) A) APRN B) LPN-VN C) ADN-RN D) UAP E) BSN-RN EBCAD 2. Fill in the blank with the appropriate word to complete the statement: The overall goal of nurses who work as case managers is to the use of health-care services in the most efficient and cost-effective manner possible. coordinate Chapter 2 1. The early Christian era brought which of these important changes in health care? A) The development of aqueducts and sewage systems B) A belief in the sanctity of life C) A deep understanding of the anatomy of the human body D) The shift of care from the home to large hospitals 2. Which development during the European Middle Ages led to a major improvement in health care? A) A rapid growth in medical knowledge B) Establishment of large central hospitals C) Growth of religious orders to care for the sick D) A shift to care of ill persons by women 3. Who is called the “father of modern medicine”? A) William Harvey B) Hippocrates C) Cyrus the Great D) Emperor Darius 4. What are the dates of Florence Nightingale’s birth and death? A) March 3, 1578; June 10, 1657 B) January 9, 1715; September 30, 1785 C) May 12, 1820; August 13, 1910 D) April 15, 1932; December 10, 1957 5. Identify a key element in the success of Nightingale’s school of nursing. A) It was not under control of the hospital. B) Large amounts of private funds were paid to well-qualified teachers. C) The Watson Model for nursing was used. D) The primary goal was service to the hospital rather than education. 6. What was a major goal of Lavinia Dock? A) Establish a new nursing organization. B) Publish a nursing journal. C) Obtain the right to vote for women. D) Improve the education for nurses. 7. Which belief about what nurses needed to do shaped Lillian D. Wald’s nursing practice? al 8. Which problem had the most severe effect on nursing education during the 1920s and 1930s? A) Too many college-based schools of nursing B) A lack of qualified nursing instructors C) Too many nursing students from the lower and middle classes D) Not enough demand for educated nurses 9. Identify a negative effect that World War II had on health care in the United States. A) A rapid increase in medical knowledge B) Expanded health-care services C) Increased use of LPNs and aides to substitute for a lower number of RNs D) Increases in pay for nurses 10. Select the statement that most accurately states the effects of increasing populations on health care. d A) Spend more time in clinical preparation and less time in the classroom. B) Fight political corruption to procure the types of legislation needed to improve soci conditions. C) Conduct more research into the conditions of hospital patients. D) Stand up to medical doctors who were arrogant and obnoxious. A) Economically depressed populations have fewer health-care needs. B) Larger populations often lead to large numbers of well-educated and well- nourishe people. Chapter 4 1. What is a type of nursing education program conducted in junior and community colleges that is nominally 2 years in length? A) Diploma program B) Baccalaureate program C) Associate degree program D) Professional nursing program 2. Identify an important similarity between the various types of educational programs for nurses. A) There is homogeneity of entering students. B) No state or national approval is required. C) The same courses are taught in all programs. D) Clinical experience is required to gain certain knowledge and skills. 3. Select an important element found in baccalaureate nursing programs that is usually not found in other types of nursing education programs. A) Use of both classroom and clinical experiences for learning B) Limiting enrollment to students with the highest ability C) Comprehensive curriculum D) Development of the total intellectual skills of the individual 4. Which contribution of Florence Nightingale had the greatest impact on nursing education? A) Recognizing that formal, systematic education in both theory and practice was essential for the preparation of high- quality nurses B) Advocating that all nurses be educated in universities so that nursing care would meet the standards established by the government C) Forcing physicians and hospitals to recognize that clinical practice was not as important as the theory-based learning obtained in the classroom D) Enforcing the requirement that all nursing instructors have a master’s degree in nursing to provide the highest quality education possible for students 5. Which statement best describes nursing education in the United States during the 1800s and early 1900s? A) It was high quality with a balance between classroom education and clinical practice. B) Strict criteria were established for nursing education by the NLN and the ANA to guarantee high-quality education. C) There were no formal nursing education programs during this time period; nurses were trained in apprenticeships only. D) There was little or no classroom education, and students learned through hands-on experience during their 12- to 14-hour shifts on the hospital units. 6. Identify a major benefit of the diploma-type training programs for nurses. A) Nurses from these programs were assertive and could stand up to physicians who made unrealistic demands. B) Nurses from diploma programs were proficient in basic nursing skills and could assume a hospital position with minimal orientation. C) Nurses trained in diploma programs were often limited to employment in the institutions where they were trained. D) All diploma schools were regulated by the NLN criteria and met strict standards for educating students. 7. Which practice of diploma nursing programs most concerned the state boards of nursing? A) Excessive use of classroom time during the program B) Mandatory housing of the students in a closed dormitory near the hospital C) Use of the students as unpaid hospital personnel during their education programs D) High failure rates of diploma graduates on the NCLEX examinations 8. How can the concept of a career ladder in education best be described? A) Specialized programs for associate degree or diploma RNs to attain a baccalaureate degree B) The ability of staff nurses to be promoted based on their clinical skills C) The relationship between one level of nursing education and the next level of education D) After nurses pass the NCLEX examination, they are all considered professionals. 9. What are common characteristics usually found in LPN educational programs? A) Located on college campus, 2 years in length, require no clinical experiences B) Theory-oriented curriculum, wide scope of practice, highly selective admission C) Technically oriented, located in vocational technical schools or community colleges, 9 to 12 months in length D) Clinical experience in advanced care areas, located in community colleges, prepare nurses for professional practice 10. Which category of advanced practice nurses is the most widely accepted by the public? A) Expanded practice nurses B) Clinical nurse specialists nursing programs. MULTIPLE RESPONSE 1. Select all of the elements that are found in the Pew Health Professions Commission Report on the reform for nursing education. A) Increasing the use of computer technology and interactive software B) Preparing all nursing faculty at the doctoral level C) Promoting interdisciplinary education D) Developing cultural sensitivity E) Limiting nursing class size to no more than 40 students F) Expanding the scientific basis of the programs 2. Select all of the elements that were found as assumptions in the ANA Position Paper on Nursing Education. A) Nursing education should meet the increasing need for nurses as quickly as possible. B) The professional practitioner is responsible for the nature and quality of all nursing care clients receive. C) Education for those in the health-care professions must increase in depth and breadth as scientific knowledge expands. D) Community colleges are able to prepare nurses just as well as 4-year colleges. E) The demand for the services of nurses will continue to increase. 3. Select all of the elements that are QSEN competencies. A) Quality Improvement B) Outcome Based Education C) Teamwork and Collaboration D) Informatics COMPLETION 1. Fill in the blanks with the correct word(s) to complete the following statement: Nursing care that is client-focused and revolves around the client’s trust in, value of, and understanding of the nurse’s skills is called . relationship; centered 2. Fill in the blank with the correct word(s) to complete the following statement: In 1996, the American Association of Colleges of Nursing presented a position paper emphasizing the belief that the degree should be the minimal requirement for entry into the nursing profession. baccalaureate Chapter 5 1. What measure can nurses use to establish a nurse support network? A) Insist that all nurses follow the same path to success. B) Avoid criticizing each other in public. C) Set very high standards for care. D) Advocate for a multi-entry level education system. 2. What is the primary goal for establishing licensure of nurses? A) Guarantee high-quality nurses. B) Increase tax revenues for the state. C) Set a minimum level of competency to protect the public. D) Maintain high numbers of nurses in the profession. 3. Identify the basic requirement found in a mandatory nurse practice act. A) Nurses must be employed under the general supervision of a licensed physician. B) Nurses must be currently licensed in the state where they wish to practice nursing. C) Nurses must graduate from a school accredited by a national nursing organization. D) Nurses must be enrolled at least yearly in courses approved by the state to meet requirements for continuing education. 4. What is the primary form of RN licensure currently used in the United States? A) Optional B) Compulsory C) Customary D) Traditional 5. In relationship to a profession, what is the primary purpose of professional organizations? A) Collect dues and fund research. B) Monitor professional practice and discipline incompetent practitioners. C) Fund political actions groups. D) Establish standards for maintaining high- quality practice in the profession. 6. Which term is used to identify the listing of names of individuals on an official roster when they have met certain pre-established criteria? A) Certification B) Licensure C) Registration D) Practitioner 7. Identify the primary function of permissive licensure. A) Protects only the title “Registered Nurse” B) Allows anyone to use the title “Registered Nurse” C) Used by states to maintain quality and control over nurses D) Allows institutions to use foreign nurses as RNs 8. Select the most serious problem encountered when institutional licensure is used. A) The standards are too difficult for most nurses to meet. B) It makes moving from one institution to another more difficult. C) Many qualified individuals are excluded A) Members are very passionate about only one or two issues. B) The organization is usually well funded from local sources. C) Membership is drawn from a diverse, more representative population. D) The organization deals with issues that have national significance. 17. Why is it important to determine if the goals and purposes of a specialty organization are at odds with the goals and purposes of the American Nurses Association? A) Divergent goals produce better dialog between groups of nurses to improve both the quality and the options for care. B) Nurses will have a choice between several distinct options and can make more informed decisions about which organization to belong to. C) Legislators can become easily confused if they receive conflicting information from several different groups of nurses. D) The health-care system has become so complex that only a wide range of options for the provision of health care can successfully be used. COMPLETION 1. Fill in the blanks with the correct word(s) to complete the following statement: One of the most important factors in recent changes that have occurred in the health-care system is demands by for higher quality care. health-care; consumers 2. Fill in the blanks with the correct word(s) to complete the following statement: The primary driving force in the history of the development of licensure for nurses was of nursing care and protection of the public. inconsistent; quality MULTIPLE RESPONSE 1. Select all of the items characteristics of the New York State Licensure Bill of 1904. A) Required hospitals to accept nursing students for training B) Required nursing schools to be registered with the state board of regents C) Formulated rules for the examination of nurses D) Established the minimum length of basic nursing programs at 1 year E) Established a State Board of Nursing Chapter 17 1. What is the underlying principle upon which all definitions of civility are built? A) Good manners B) The Civil Rights Act of 1974 C) Recognizing the importance of all human beings D) The fight against injustice and oppression 2. The caring-civility link is best exemplified by which of the following? A) Helping in disasters in foreign countries B) Conducting scholarly research into overcoming health-care disparities C) Accepting criticisms from physicians even though unjustified D) Making nursing assignments based on clients’ needs and nurses’ skills 3. Which element increases the likelihood of incivility? A) Using a problem-solving approach B) Using assertive communication C) Internalizing workplace issues D) Increased levels of stress 4. Why are interpersonal bonds important in establishing an environment of civility? A) It provides individuals with a feeling that they have a duty to each other B) Individuals are less likely to demonstrate incivility to others they know well C) A close family atmosphere always enhances civility D) People are more likely to overlook individuals imperfections 5. What has been identified as a key element to effective education of nursing students A) A feeling of personal safety in the classroom setting B) Low stress levels produced by decreased work assignments C) Permitting students to use cell phones during classes D) High-quality interpersonal relationships between students and teachers 6. What is an example of horizontal violence? A) A student talking back to an instructor in the classroom B) Posting false and derogatory information on FaceBook about a fellow student C) Faculty assigning additional homework when students fall asleep during class D) Keying the car of faculty who are unreasonable and unfair 7. Identify the characteristic that would commonly be found in an individual recognized as a “violator/tormentor”? A) Self-absorption and negative attitudes B) High self-esteem and rigid behavior C) Positive attitudes and codependence D) High energy levels and manipulative behavior 8. What action would contribute most in preventing experienced nurses from “eating their young”? C) It has not been connected by research to the production of physical symptoms. D) The concept of inappropriate use of coercive power becomes a key element in lateral violence. 16. Extreme bottom-up vertical violence can sometimes manifest itself as: A) using passive-aggressive ways to decrease productivity. B) an environment that remains in a constant state of fear. C) an employee “going postal” and causing physical injury. D) decreased communication. 17. All of the following are methods faculty can use to overcome academic incivility, except: A) become a catalyst and a change agent in one’s own nursing program. B) make civility and cooperation a key element in the vision, mission statement, and outcomes of the program. C) revise the curriculum so that shared values, collegiality, and collaboration are threads that guide students and faculty in the learning process. D) develop and post a list of uncivil behaviors that nursing faculty display. MULTIPLE RESPONSE 1. Select all of the elements that may make a person a target for bullying. A) Being highly self-confident B) Having a different sexual orientation C) Possessing physical defects D) Defending himself or herself against bullies E) Unintentionally displaying an attitude of timidity F) Being ostracized from the group 2. Select all of the elements that are commonly a result of workplace lateral violence. A) A toxic work environment B) Increased self-esteem C) Workplace physical violence D) Psychological pain E) Positive emotions F) Anxiety 3. Select all of the actions that the Nursing Organizations Alliance recommends help build a positive workplace environment and overcome incivility. A) Developing an action plan to immediately stop lateral violence and bullying B) Training leaders competent in cooperation and communication C) Sharing decision-making with all those it will affect D) Developing professional standards including the development and acquisition of an appropriate set of values and an ethical framework in the work environment E) Continuously developing employee skills and clinical knowledge F) Recognizing and rewarding employees’ contributions COMPLETION 1. Fill in the blanks with the correct word(s) to complete the following statement: When the becomes part of the culture of a unit or institution, it may not even be recognized as bullying. bullying; vicious; circle Chapter 14 1. What is acute care of sick persons that is provided in hospitals called? A) Primary intervention B) Secondary intervention C) Tertiary intervention D) Assistive intervention 2. Identify a negative effect of the centralization of health care in hospitals rather than the home setting. A) Minimized individual responsibility B) Increased concerns about the cost of health care C) Professionalization of nursing D) Increased reliance on advanced technology 3. Which element is usually excluded in the current trend toward decentralized health care? A) Provision of care on an outpatient basis B) Emphasis on the cure of illness C) Promotion of responsible self- care practices D) Cost containment measures by health- care providers 4. Which demographic factor has the most significant effect on the health-care delivery system of the future? A) Large numbers of babies being born to minority women B) Increasing use of alcohol and tobacco among teenagers C) Rapidly increasing average age of the population D) Oversupply of nurses 5. Identify the most significant element in the continued rise in health-care costs in the United States. A) Expensive new technology B) Increasing need for long-term care C) Lack of motivation for consumers to comparison shop D) Expensive new medications without referral outside the system C) Several health-care agencies working together to cut costs by sharing resources D) The development of clinics outside the hospital to provide services traditionally found in the hospital 14. What is the primary focus of nurse-run clinics? A) Health promotion B) Disease cure C) Pregnancy counseling services D) Cost control 15. Identify the factor that is most important in the increased development of alternative ambulatory services. A) Increased length of hospital stays B) New technology that enables complicated and dangerous procedures to be performed on an outpatient basis C) Consumer demand for more technology in the cure of disease D) Establishment of satellite clinics in suburbs and rural communities 16. Identify a type of care delivery model that is task oriented in that each person performs a specific job to meet a particular need of the unit. A) Modular nursing B) Team nursing C) Primary care nursing D) Functional nursing 17. Identify a type of care delivery model that focuses on the whole person and gives the nurse responsibility for all of the client’s nursing needs. A) Modular nursing B) Team nursing C) Primary care nursing D) Functional nursing 18. What is a type of care delivery model based on a decentralized organizational system that emphasizes close interdisciplinary collaboration? A) Modular nursing B) Team nursing C) Primary care nursing D) Functional nursing 19. Which care delivery model takes a unified approach to client care involving different levels of care providers working together to achieve client health-care goals? A) Modular nursing B) Team nursing C) Primary care nursing D) Functional nursing 20. Cross-trained personnel are an integral part of which of the following care delivery models? A) Team nursing B) Modular nursing C) Primary care nursing D) Functional nursing 21. What is the primary advantage of the case method of care delivery? A) It is inexpensive and cost effective. B) It allows several health-care providers trained at different levels to provide care at the same time. C) It gives nurses a high degree of autonomy and responsibility. D) It allows nurses with minimal education to provide high-quality care for all clients. 22. Which two types of care delivery models are commonly used in managed care? A) Functional and team nursing B) Case management and functional nursing C) Modular nursing and primary care nursing D) Case management and primary care nursing 23. What is the primary goal of using the Six Sigma process in the health-care setting? A) Providing a reliable process of care in all cases by eliminating errors B) Helping nurses increase the number of clients for which they can safely care C) Increasing data collection used in evidenced-based practice D) Organizing client care based on a reliable statistical model COMPLETION 1. Fill in the blank with the correct word(s) to complete the following statement: The health-care system uses tax dollars to pay for health services through health insurance available from a nonprofit agency (e.g., government). Type II MULTIPLE RESPONSE 1. Select all of the components that are found in the Canadian Federal- Provincial Arrangements and Established Programs Financing Act. A) Per capita payments are made based on previous expenditures and adjusted regularly in relation to the gross national product (GNP). B) No out-of-pocket expenses are required for any health care. C) Tax points are transferred by the federal government, allowing provinces to reduce their tax contribution to the federal government and at the same time increase the portion of tax collected at the provincial level. D) Equalization of tax points is distributed among poorer provinces. E) Coverage is not extended to government employees because they have their own system of health-care payment. F) Additional per capita payments are indexed to help pay for nursing home, residential care, home care, and ambulatory care. A) A continuum B) A lack of illness C) A state or process of being and becoming an integrated, whole person D) A state of physical and mental well-being C 6. Identify the two concepts upon which the framework for assessment is based in the Roy Adaptation Model of nursing. A) Cognator and regulator B) Input and stimuli C) Output and behavioral responses D) Focal and contextual A 7. In the Roy Adaptation Model of nursing, the second-level assessment modes are most closely related to which part of the system? A) Input B) Output C) Ventral system D) Feedback loop B 8. Why is it important for nurses to understand and use a nursing theory or model in practice? A) Nurses with this knowledge automatically provide higher quality care. B) Understanding models of theories demonstrates a nurse’s knowledge level. C) Keeping within the practice limits provided by a model or theory protects nurses from legal action because of failure to follow the scope of nursing practice. D) Using models or theories of nursing aids practitioners in providing their care in an organized manner. D 9. Identify the four concepts that are common in most nursing theories. A) Client, health, environment, nursing B) Care, adaptation, system, cure C) Nurse, physician, client, other providers D) Hospital, nursing home, clinic, physician’s office A 10. What belief forms the basis for the Orem Self-Care Model? A) The nurse helps the client adapt to his or her illness. B) The primary goal of health care is cure of the client. C) Health care is the responsibility of each individual. D) Health-care goals must be established for each client. C 11. Identify the primary goal of nursing in the Orem Self-Care Model. A) Reestablish the absolute state of health the client had before his or her illness. B) Help the client conduct self-care activities to reach the highest level of functioning. C) Prevent further injury to the client’s biosystems. D) Help balance technological care with humanistic aspects of care. B 12. Select a major contribution that King’s model made to the practice of nursing. A) Formalization of the use of goals to guide client care B) Introduction of the concept of care as a key element in nursing care C) Use of the idea of adaptation as an important client goal D) Integration of systems theory into nursing care A 13. What aspect of Watson’s Model of Human Caring distinguishes it from most other nursing models? A) Understanding health as a dynamic state rather than a static goal B) Viewing nursing as a process to help clients achieve their greatest potential rather than as a curing profession C) Use of a philosophical approach rather than a systems theory approach D) Defining environment as both internal and external rather than just external C 14. Identify the most important aspect of caring according to Watson’s Model of Human Caring. A) Assisting the client to adapt to health changes B) Assessing the client’s health-care needs C) Identifying self-care problems and needs D) Establishing a helping and trusting relationship D 15. How is a “client” most accurately described in Johnson’s Behavioral System Model? A) An individual who is responsible for his or her own health care B) A behavioral system that is an integrated whole C) A dynamic entity with both input and output D) An individual who must adapt to illness B 16. Upon which principle is Neuman’s Health-Care Systems Model based? D) To reinforce all of the client’s actions that they undertake to protect themselves from harm, either internal or external and are shown in actions toward others and the environment in general C 23. Which of the following is an essential element in Parse’s the Man-Living-Health Model? A) Understanding the patterns of how clients made the successful transition to wellness B) Invoking the principle of nonsummativity C) Viewing the client as an open system that exchanges energy and information with the environment D) The client’s ability to make free choices D 24. Identify the primary role of the nurse in Parse’s the Man-Living-Health Model. A) To motivate clients to maintain and improve their health B) To guide clients in finding and understanding the meaning of their lives C) To guide the client through discussions of their experiences so that they believe that their problems are understood D) To reinforce all of the client’s actions that they undertake to protect themselves from harm, either internal or external and are shown in actions toward others and the environment in general B MULTIPLE RESPONSE 1. Select all of the factors that are key to Pender’s Health Promotion Model that are linked to a person’s motivation to improve his or her health status. A) How important it is to be healthy B) How much control he or she has over his or her health C) How the health-care system addresses his or her needs D) What it means to him or her to be healthy E) What types of diseases and illnesses he or she overcame in the past F) What the benefits and barriers are to health improvement A, B, D, F 2. Select all of the caring processes that are essential in Swanson’s Theory of Caring for the successful transition to health experienced by clients. A) Loving B) Maintaining hope C) Knowing D) Being with E) Doing for F) Enabling C, D, E, F 3. Select all of the characteristics of middle range nursing theories. A) They contain only a few basic ideas or concepts. B) They have a large number of variables. C) They tend to focus on one or two problems at a time. D) Their primary focus is human beings, environment, health care, or nursing. E) They are more abstract than the major nursing theories. F) They are more easily applied to practice hypotheses. A, C, D, F 4. Select all of the elements that are considered key to the King’s model of nursing. A) Action B) Transaction C) Rejection D) Feedback E) Teaching F) Interaction A, B, D, F COMPLETION 1. Fill in the blank with the correct word(s) to complete the following statement: The nursing profession uses the term when attempting to explain apparent relationships between observed behaviors and their effects on a client’s health. theory Chapter 6: 1. What is best described as the concepts, ideals, behaviors, and significant themes that give meaning to a person’s life? A) Morals B) Values C) Laws D) Ethics B 2. What are rules of conduct that protect the social fabric? A) Morals B) Values C) Laws D) Ethics C 3. What term is best defined as standards of right and wrong that often are based on religious beliefs? A) Morals B) Values C) Laws D) Ethics A 12. Identify the system of ethical decision-making that is based on the discovery and confirmation of a set of morals or rules that govern the ethical dilemma. A) Deontological B) Jurisdictional C) Teleological D) Theological A 13. What is the ethical principle that requires that the primary goal of health care and nursing is to do good for others? A) Autonomy B) Fidelity C) Beneficence D) Veracity C 14. What is the best definition of the ethical principle of nonmaleficence? A) Health-care workers avoiding harm to clients B) Telling the truth to clients in all matters C) Being faithful to commitments made to clients D) The right of self-determination of clients A 15. Identify the term used when an ethical situation arises in which there is a choice between two equally unfavorable alternatives. A) A tort B) Ethical antagonism C) Contraindication D) Ethical dilemma D 16. What is the first step in the ethical decision-making process? A) Consider the alternatives. B) Collect, analyze, and interpret the data. C) Consider the consequences of the actions. D) Make a decision. B 17. Identify the outcome that best demonstrates a critical care nurse’s successful application of the ethical principle of nonmaleficence to the care of a client who has experienced a cerebrovascular accident. A) The client is aware of his or her diagnosis despite attempts of the family to withhold that information. B) The client is beginning to be able to use simple words to express his or her needs. C) The family has been taught the necessary skills to care for the client at home with the supervision of a home health-care nurse. D) There is no evidence of skin breakdown on bony pressure points, and the client’s shoulder and hip on the affected side remain intact. D 18. Identify the best method for a nurse to acknowledge a client’s autonomy. A) Follow only the instructions of the client’s family. B) Know and understand the state’s laws that address living wills. C) Use the ethical principle of best interest when making decisions about the client’s care needs. D) Incorporate the ethical principle of paternalism into all client care activities. B COMPLETION 1. Arrange the steps of the ethical decision-making process in their correct order. (Enter the letter of each step in the proper sequence; do not use commas or spaces.) A) Consider the choices of action. B) Act on the decision. C) Collect, analyze, and interpret data. D) Analyze the advantages of each action. E) State the dilemma. CEADB 2. Fill in the blanks with the correct word(s) to complete the following statement: Over time, popular acceptance of rights can give them force of rights. ethical; legal Chapter 7: 1. What conclusion can be drawn about abortion based on the Roe v. Wade decision? A) Abortion is both moral and ethical. B) The right to an abortion is guaranteed by the Constitution of the United States. C) The right to self-determination includes the right to have an abortion. D) When there is a conflict between the rights of the mother and the rights of the fetus, abortion is one of the options. C 2. How does the deontological approach to ethics consider abortion? A) It is the greatest good for the greatest number of individuals and therefore is ethical. B) It involves the conflicts of the right of the mother to self-determination with the right of the fetus to life. C) It can be performed for any reason because the law makes it legal and ethical. D) It can be performed in situations in which the mother is unwed and already has several other children. B 3. How does the teleological approach to ethics consider abortion? A) It is ethical only when the mother is B) The organs cannot be taken without the family’s permission because the client is underage. C) Continue to attempt to locate the client’s family while preparing for the transplant. D) Only remove organs that will not kill the client. C 10. An unresponsive 94-year-old woman who has recently had a leg amputated for terminal cancer develops renal failure. She has no living relatives. Although hemodialysis will prolong her life for several weeks to several months, her health-care team is having difficulty deciding if it should be initiated. What is the key ethical issue involved in this dilemma? A) Distributive justice B) Veracity C) Fidelity D) Nonmaleficence A 11. A client in the intensive care unit has a do not resuscitate (DNR) order on his chart. What does the nurse caring for him need to recognize about DNR orders? A) DNR orders may be given orally by the physician. B) There is no specific time limit to DNR orders. C) DNR orders protect the client’s family from making difficult decisions. D) DNR orders must be written by the physician. D 12. A physician writes a DNR order for a competent client. Which individual may give permission for this order? A) The client’s spouse B) The client’s only child C) The client D) Any close blood-related relative C 13. Which treatment modality would most likely be considered extraordinary? A) IV fluids by subclavian catheter B) Oxygen by face mask at 60 percent C) Counter-pulsating intra-aortic balloon pump D) Chest tubes C 14. What is the practice of allowing a client to die without the use of any extraordinary measures sometimes called? A) Active euthanasia B) Passive euthanasia C) Mercy killing D) Assisted suicide B 15. Identify the two most important ethical issues that surround clients infected with HIV and those who have AIDS. A) Confidentiality and right to care B) Self-determination and distributive justice C) Veracity and informed consent D) Fidelity and option rights A 16. What is a potential serious problem when living wills are formulated long before they are to be used? A) Questions may arise about how informed the client is about current treatment modalities. B) Witnesses to the document may have died, thereby rendering it invalid. C) The attending physician may not be willing to recognize a living will that is more than 5 years old. D) The client’s family may forget that the living will was made and refuse to honor it. A 17. Upon what ethical principle do supporters of assisted suicide base their support for the practice? A) Beneficence includes acts that will help to permanently end a client’s suffering. B) The health-care provider is permitted to use paternalism when the client is unsure about the best course of treatment. C) Only by allowing the client to decide among all possible options will the principle of informed consent be fulfilled. D) The right to self-determination includes the decision to end one’s life. D 18. What ethical principles are sometimes overlooked in attempting to identify and report suspected child abuse? A) Best interest and nonmaleficence B) Privacy and self-determination C) Paternalism and beneficence D) Veracity and obligation B 19. Identify the outcome that best demonstrates a critical care nurse’s successful application of the ethical principle of veracity to the care of a client who was diagnosed with late stage pancreatic cancer. A) The client is aware of his or her diagnosis despite attempts of the family to withhold that information. B) The client is beginning to be able to use simple words to express his or her needs. C) The family has been taught the necessary skills to care for the client at home with the supervision of a home health-care nurse. 3. If the nurse is sued for negligence after the administration of an injection, which one of the following persons will most likely be asked to serve as an expert witness to describe standards of care? A) An experienced nursing supervisor or instructor B) A lawyer who has successfully defended another nurse sued for negligence C) A judge who is considered to be an expert in the field of professional negligence D) Another patient who had received an injection by the same nurse but without complications A 4. The nurse working in an emergency room is of the opinion that to carry out a certain order written by a physician could possibly constitute unethical or illegal behavior. Which one of the following courses of action would be best for the nurse to take in this situation? A) Carry out the order and then discuss it with the physician. B) Carry out the order and then discuss it with the supervisor. C) Do not carry out the order and report the situation to the physician. D) Do not carry out the order and report the situation to the supervisor. D 5. What is the best definition of assault as a tort? A) Application of force to another person without lawful justification B) Threats to do bodily harm to the person or another person C) A legal wrong committed by one person against the property of another D) A legal wrong committed against the public and punishable by law B 6. Identify the best description of battery from the standpoint of civil law. A) Doing something that a reasonable person with the same education or preparation would not do B) A legal wrong committed by one person against the property of another C) Application of force to the person or another person without lawful justification or permission D) Maligning the character of an individual while threatening to do bodily harm C 7. Under which category are nursing licensure laws included? A) Criminal laws B) Contract laws C) Federal laws D) Civil laws D 8. Clients’ charts are considered legal documents that are of vital importance in the care of clients. Which of these statements should the nurse avoid charting? A) The client does not keep follow-up appointments. B) The client discontinues treatment. C) The client refuses medication. D) The nurse thinks the client is hostile. D 9. In which situation would an emergency room nurse be justified in proceeding without obtaining consent, verbal or otherwise? A) An unconscious, profusely bleeding victim is brought in by ambulance. B) A 13-year-old child is brought to the emergency room after suffering a fractured arm while at school. C) A construction worker comes into the emergency room to have a boil lanced. D) A 15-year-old high school girl comes in for treatment of psoriasis. A 10. In which situation is the nurse allowed to breech a client’s right of confidentiality? A) A local politician is admitted after an automobile accident in which he was inebriated. B) An 18-year-old unwed teenager seeks an abortion at an abortion clinic. C) A 32-year-old housewife comes to the emergency room for care after being raped in a parking lot. D) An important member of the business community is treated for cuts and bruises after a fight with his neighbor. C 11. An 18-month-old infant is brought into the emergency room with several recent cigarette burns on his chest and legs. He cannot move his left arm, which is edematous. What is the nurse’s legal responsibility in this case? A) Do nothing immediately but plan to check the child carefully if it occurs again. B) Notify the attending physician or the emergency room supervisor. C) Tell the mother that he or she suspects abuse and chastise her about her actions. D) Since the nurse only has suspicions, remember that an individual is innocent until proven guilty. B 12. The newborn nursery is desperately short of staff. A nurse agrees to work an extra shift. During the 14th hour on duty, the nurse makes a medication error. Because the nurse was filling a “desperate” staffing need, and therefore was fatigued, what is the legal concerning Mr. Smith’s diagnosis of gonorrhea B 19. Identify the situation in which a nurse would likely be charged with negligence. A) Slapping a client across the face for using foul language B) Leaving the side rails down on a bed of a confused client C) Using restraints on a client without a doctor’s order D) Telling the local newspaper of a client’s diagnosis B 20. A nurse is accused of professional negligence. In determining if he or she is guilty, a jury would compare the nurse to what standard? A) What a physician would have done in the same situation B) What a well-educated layperson would have done in the same situation C) What a reasonable and prudent nurse would have done in the same situation D) What a lawyer would have done in the same situation C 21. What is another term that can be used for professional negligence? A) Crime B) Consent C) Misdemeanor D) Malpractice D 22. Ms. Jones, RN, is the night charge nurse on your unit. She has come to work obviously drunk. What would your legal obligations be as a professional nurse? A) Ignore her condition out of professional etiquette. B) Have a second person validate your observation. C) Give her several cups of strong coffee to sober her up. D) Have her “sleep it off” in an empty room and cover for her. B 23. Identify the primary role that the SBAR system (Situation, Background, Assessment, Recommendation) plays in the clinical setting. A) Establishes the physician as the primary and sole source of authority during codes B) Reduces confusion in the communication between nurse and physician in emergencies C) Aids nurses in independent practice when necessary D) Reduces the number of lawsuits associated with the care of critically ill clients B 1. Based on accepted standards of care for documentation, identify all the elements that nurses should include in clients’ medical records. A) Blank spaces between the lines for late entries B) Date and time on all entries C) Opinions about the client’s behaviors D) Statements about the physician’s attitude toward the nurses E) Direct observations F) Quotes of statements made by clients and families B, E, F 2. Select all the items that are considered appropriate when giving a deposition. A) Be familiar with the client’s medical record. B) Volunteer additional information so the statement is complete. C) Look the questioning lawyer in the eye as much as possible. D) Avoid using absolutes in the answers to questions. E) Speculate about what really happened. F) Clarify all questions before answering. A, C, D, F COMPLETION 1. Fill in the blanks with the correct word(s) to complete the following statement: When someone is accused of violating a , the government at the county, city, state, or federal level imposes appropriate punishments. criminal; law Correctional institutions 26. What would be a likely result of the development of a universally agreed upon nomenclature and taxonomy for nursing clinical information and management data? The establishment of appropriate reimbursement for nursing activities 27. A particularly vocal staff nurse on a busy obstetric unit has been complaining to the other nurses about the unit manager’s preferential treatment of the night-shift nurses. Select the action that the unit manager should take to resolve this problem, which best demonstrates the use of the assertive approach to conflict resolution. Sets up a time and place for a one-on-one meeting with the staff nurse 28. When do most health-care expenditures occur in a person’s life? As old age sets in due to the development of multiple chronic illnesses 29. Which assignment is most appropriate for a CNA/UAP (unlicensed assistive personnel) floated to the medical-surgical unit from the outpatient clinic? Obtaining a temperature on a29 yr. old woman with gastrointestinal bleeding during the last 30 minutes of a whole blood transfusion 30. What is the primary goal of the nurse navigator role? Elimination of the barriers of care to make moving through the treatment maze easier 31. True or False: It is estimated that 98,000 people die per year due to adverse events & medical errors in hospitals. True 32. Identify a communication style that involves interpersonal behaviors that permit people to defend and maintain their legitimate rights in a respectful manner that does not violate the rights of others. Assertive 33. Which nursing intervention is of limited effectiveness in addressing the needs of a client with a nursing diagnosis of Spiritual Distress? Explain the nurse’s religious beliefs and values immediately when requested to do so by the client 34. When does the encoding process of communication take place? The receiver thinks about the information, understands it, and forms an idea based on the message. 35. Who is called the “father of modern medicine”? Hippocrates 36. Identify the task that may be delegated to an LPN (LVN) if all of the clients are stable. Turning a client with a CVA every 2 hours 37. A patient is anxious about a procedure. Knowing the patient loves the beach, the nurse instructs them to close their eyes and picture the ocean, sand, and rays of the sun. Which of the following practices is the nurse implementing? Guided Imagery 38. Identify the primary change that increased the need for many more certified RN-coders and certified RN-auditors. The switch to the new ICD-10 coding system 39. Identify the four concepts that are common in most nursing theories. Client, health, environment, nursing 40. Which of the following demonstrates the planning phase of the nursing process? The nurse specifies short and long term outcomes for the client 41. What is the best way to increase the motivation to learn in the elderly population? Link positive reinforcement to changes in behavior. 42. Why is it important for nurses in general practice to have an awareness of forensic knowledge? Nurses are often in positions to report crimes or preserve evidence. 43. Why is term healing preferred to medicine when referring to alternative and complementary modalities? The treatments are based on holistic philosophies that go beyond treatment or cure of the physiological 44. An example of civility in the classroom consists of keeping cell phones on silent and using proper cell phone etiquette? True 45. What primary skills are required of the nurse to provide cultural competent care? All of the above: Sensitivity, Understanding, and Communication 46. Both nursing models and theories help explain and direct nursing actions. True 47. Which of the following statements is most accurate about the vast majority of the elderly? They are relatively healthy and most manage their chronic conditions at home 48. Although the assessment techniques used for different individuals may be identical, the nurse needs to know the basic biological and physical variations among ethnic groups. True 49. The client’s short term outcome was to sit up in a chair at bedside for 30 minutes. The nurse reviews the client outcome, determines that it was not met, and modifies the interventions. Which phase of the nursing process is this? Evaluation 50. This lengthy assessment tool provides a thorough overview of a client’s culture. Purnell’s Model 51. True or False: By law, supplements are regulated be the Food and Drug Administration (FDA) False 52. Which of the following describes Callista Roy’s definition of nursing as indicated in her nursing model? Multistep process that helps the client adapt and reach the highest level of functioning 53. An ethical code does which of the following? Provides a framework for decision- making 54. To which individual can the charge nurse delegate the task of completing the history and physical assessment for a newly admitted client? RN 55. A client sustained a complete C2 spinal cord injury after a motor vehicle crash. He is unable to move bilateral upper and lower extremities. He requires total nursing care including assistance eating, turning, and voiding. Which of the following describes the level of care the nurse provides according to Orem’s self-care model? Wholly compensated care 56. Function in nursing informatics focuses on which of the following? How the management and processing of information helps nurses enter, organize, or retrieve information 57. Identify the best method for a nurse to acknowledge a client’s autonomy Know and understand the state’s laws that address living wills 58. Select the most appropriate client for the RN to assign to the CNA/UAP (unlicensed assistive personnel). True 81. Why is heritage consistency important to cultural groups? All of the above: It allows them to advance within the larger culture, it allows them to retain many of their cultural elements, and it allows them to fit in with the larger culture 82. Identify the term used when a person lives with consciousness of a reality beyond what is knowable through the five senses and is aware of a transcendent reality. Spirituality 83. True or False: Total quality improvement is based upon the organization with the higher- quality service that will capture a greater share of the market than competitors with lower- quality services. True 84. Which of the following is not a reason the State Board of Nursing may revoke a nursing license? Ethical conduct in the practice of nursing 85. What would be a characteristic of the ideal electronic health care record? The system reflects the lifelong, continuous record of all care the client has received. 86. The type of reimbursement system that pays a fixed-rate based on diagnosis (or DRG) is called what: Prospective Payment System 87. Which of the following organizations provides nursing with a code of ethics? American Nurses Association 88. Which of the following reasons is not a reason for the increasing use of alternative and complementary healing practices? Traditions passed on from parents 89. Identify the primary driving force behind the development and use of telehealth or telemedicine. Consumer concerns about access to health care 90. The establishment of a professional organization is insignificant in defining characteristics of a profession. False 91. A registered nurse (RN) is assigned to a step-down coronary care unit with 20 clients in various stages of recovery. What is the primary consideration in assigning the unit staff that includes two RNs, two licensed practical nurses (LPNs), and one certified nursing assistant (CNA) or UAP (unlicensed assistive personnel)? Skill level of each staff member 92. What is acute care of sick persons that is provided in hospitals called? Secondary intervention 93. Identify the characteristics of a task that is to be delegated that would require it to be assigned to an RN. The task requires decision-making to complete it. 94. Evidence-based practice is the practice of nursing in which interventions are based on data from research that demonstrates that they are appropriate and successful. True 95. Identify the health-care area in which the use of computers has improved the efficiency of care. Documentation 96. What is a major benefit for the elderly who now have easy access to and use of technology such as the Internet and smartphones? They have opportunities to obtain screening and treatment that they might not otherwise seek. 97. This federally funded program is known for financing a large portion of maternal and child care for the poor. Medicaid 98. What is the primary purpose for the development of the Quality and Safety Education for Nurses (QSEN) project? Focus nursing education on competencies to reduce the number of medical errors 99. Which behavior indicates that a nurse, who is forced to confront a conflict situation, is using a submissive approach to communication? Refers the problem to a supervisor 100. What advantage does the electronic health record system have over traditional paper systems? Reduces redundancy Cultural belief Pg. 545 Vietnamese Americans believe that mental illness results from some action that offended one or more of the gods. What culture believes fraternal twins was witchcraft: Native American Native American groups attributed twin births to witchcraft and believed that one of the twin infants had to die so that the other might live. In traditional Middle Eastern families, the birth process is valued as an event strictly involving women, and the father is usually not present to either witness or assist in the delivery.