Nursing in Today's World: Trends, Issues, and Management Eleventh, North American Edition Test Bank

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Nursing-in-Todays-World-Ellis-11thTESTBANKChapter: Chapter 1: Exploring the Growth of Nursing as a ProfessionMultiple Choice1.Which of the following statements most accurately describes thepractice of medicine in Greece from 800 BC to 300 BC?A) Greek culture stressed natural causes for disease, a patient-centeredapproach, and the necessity of accurate observations and record keeping.B) Greek culture borrowed medical practices from the countries itconquered, and physicians were often slaves.C) Major and minor surgery, childrens diseases, and diseases of thenervous and urinary systems were described in Greek culture.D) Medicine men (known first as shamans and later as priests) wereresponsible for curing ills of body and mind.Ans: AClient Needs: BCognitive Level: ComprehensionDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 1Feedback:Hippocrates, born about 400 BC, was a Greek citizen whobecame known as the Father of Modern Medicine. He emphasized naturalcauses for disease, a patient-centered approach, and the necessity ofaccurate observations and record keeping. These priorities influenced thepractice of medicine both in Greece and beyond. Persia was known toutilize slaves as physicians, and Rome borrowed medical practices fromthe countries it conquered. Ancient India emphasized hygiene andprevention of sickness and described major and minor surgery, childrensdiseases, and diseases of the nervous and urinary systems. Medicine menwere characteristic of the Mayan and Aztec civilizations.2.Florence Nightingale fostered the development of nursing as aprofession. What was the basis of her nursing theory?A) The nurses role is to assist individuals (sick or well) to carry out thoseactivities that they would perform unaided if they had the necessarystrength, will, or knowledge.B) The goal of nursing is to put the patient in the best condition for natureto act upon him, primarily by altering the environment.

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C) The focus of nursing is the spiritual subjective aspects of both the nurseand the patient and the caring moment relating to the time when the nurseand the patient first come together.D) The focus of nursing is the care of human beings who are viewed asopen systems in constant interaction with their environments.Ans: BClient Needs: A-1Cognitive Level: AnalysisDifficulty: DifficultIntegrated Process: Nursing ProcessObjective: 2Feedback:Florence Nightingale, in herNotes on Nursing: What It Is andWhat It Is Not, described the nurses role as one that would put the patientin the best condition for nature to act upon him (Nightingale, 1954, p. 133),a definition that often is quoted today. This action was prioritized overphysically assisting the patient. Watson emphasized the spiritualsubjective aspects of the nurse and the patient, and the open systemsconcept is central to Kings theory of nursing.3.Which one of the following statements accurately describes an elementof the process of providing a definition of nursing?A) Researchers can pinpoint the period in history when nursing firstevolved.B) Nurses agree on a single definition of nursing, partly because of thehistory of nursing.C) There is an obvious distinction between nursing and medicine.D) Nursing theorists developed definitions of nursing consistent with theirconceptual frameworks.Ans: DClient Needs: A-1Cognitive Level: AnalysisDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 7, 8Feedback:As nursing has grown into a true profession, many nursingtheorists have developed definitions of nursing consistent with theirconceptual frameworks; these frameworks provide the foundation for anygiven definition of nursing. The historical emergence of nursing did nottake place at one particular time, and there are multiple definitions ofnursing. While nursing and medicine indeed differ, the distinctionsbetween the two professions are not always clear.

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4.A nurse wishes to document nursing actions using a standardizedlanguage. Which of the following systems might the nurse use?A) NANDA International (NANDA-I)B) Nursing Outcomes Classification (NOC)C) Minimum Data Set for Nursing Home Resident Assessment and CareScreening (MDS)D) Nursing Interventions Classification (NIC)Ans: DClient Needs: A-1Cognitive Level: ApplicationDifficulty: ModerateIntegrated Process: Communication and DocumentationObjective: 12Nursing Interventions ClassificationFeedback:Started in 1996 at the University of Iowa, the NursingInterventions Classification (NIC) is a comprehensive, standardizedlanguage that describes actions that nurses perform in all settings and inall specialties and includes both physiologic and psychosocialinterventions. NANDA and NOC provide standardized language for nursingdiagnoses and outcomes. The MDS is an assessment tool specific to long-term care settings.5.An RN who practices in a community clinic recognizes the need for astandardized classification and documentation system. Which of thefollowing systems of nursing care classification and documentation wouldbest fit the RNs needs?A) NANDA International (NANDA-I)B) Nursing Outcomes Classification (NOC)C) The Omaha SystemD) Patient Care Data Set (PCDS)Ans: CClient Needs: A-1Cognitive Level: ApplicationDifficulty: DifficultIntegrated Process: Communication and DocumentationObjective: 13,The Omaha SystemFeedback:The Omaha System is a research-based comprehensive practicedocumentation standardized taxonomy designed to document client carefrom admission to discharge. It was designed as a three-part,comprehensive yet brief approach to documentation and information

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management for multidisciplinary healthcare professionals who practicein community settings. NANDA and NOC provide frameworks only fornursing diagnoses and outcomes, while the PCDS is specific to hospitalsettings.6.The number and size of nursing schools in the United States grewsignificantly in the years of the early 20th century. Which of the followingcharacteristics was emphasized in these schools?A) A thorough knowledge of anatomy, physiology, and epidemiologyB) Critical thinking, assertiveness, and autonomyC) An understanding of the relationship among mind, body, and spiritD) Religious devotion and subservience to authorityAns: DClient Needs: A-1Cognitive Level: ComprehensionDifficulty: EasyIntegrated Process: Nursing ProcessObjective: 3Characteristics of the Early SchoolsFeedback:In early nursing schools, the nurse in training was expected toyield to her superiors and demonstrate the obedience characteristics of agood soldier with actions governed by the dedication to duty derived fromreligious devotion. These expectations superseded the importance ofcritical thinking, scientific knowledge, or the holistic nature of health.7.Florence Nightingale is acknowledged as one of the individuals whocontributed most significantly to the development of nursing as aprofession. What other phenomenon contributed most to thisdevelopment?A) Labor-saving technology that freed many women from working in thehomeB) The social recognition of the importance of public funding for thetreatment of diseaseC) Increased understanding of the pathophysiology of illness and theimportance of infection controlD) The high mortality rates that existed during times of warAns: DClient Needs: A-1Cognitive Level: ComprehensionDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 4

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The Nightingale InfluenceFeedback:The death and disease that accompanied conflicts such as theCrimean War and the Civil War provided the impetus for much of thedevelopment of the nursing profession. Nursing did not primarily grow outof the availability of a female workforce, public funding for health, orincreased scientific knowledge.8.Nurses have historically had difficulty identifying a single,comprehensive definition of nursing. What factor most accounts for thisdifficulty in agreeing on a definition for nursing?A) It can be challenging to reconcile the theoretical and practical aspects ofnursing.B) Nursing exists in the psychomotor (hands-on) domain rather than in thecognitive domain.C) Compared with medicine, nursing has a relatively short history.D) Nurses have traditionally been reluctant to acknowledge the outcomesof their practice.Ans: AClient Needs: A-1Cognitive Level: ComprehensionDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 5Developing a Definition for NursingFeedback:A major factor that has made it difficult to define nursing is thatit is taught as encompassing both theoretic and practical aspects, but it ispursued (and continues to be defined) primarily through practice, untilrecently a little-studied area. Nursing spans psychomotor and cognitivedomains, and it has a very long history. Nurses have often failed todocument and publish the results of their practice, but there is noindication that nurses tended not to acknowledge their influence on health.9.One of the challenges that nurses have faced in the past, and whichcontinues to the present, is the need to distinguish the practice of nursingfrom that of medicine. Which of the following statements best conveys adefining characteristic of nursing?A) Education within a formal, credential-granting settingB) An emphasis on objective, rather than subjective, health assessmentC) A holistic perspective on the health of individualsD) A recognition that health is not always attainable for all individualsAns: CClient Needs: A-1

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Cognitive Level: AnalysisDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 6Distinguishing Nursing from MedicineFeedback:Nursing is concerned with caring for the person from a holisticperspective in a variety of health-related situations. Both nursing andmedicine are taught in formal educational settings, though these settingsdiffer. Nursing does not denigrate subjective health assessment nor does itclaim that health is unattainable for some individuals.10.Society has sometimes questioned whether nursing can be consideredto be a true profession and whether nurses can be considered to beprofessionals. What characteristic of nursing is among the characteristicsthat social scientists use to define a profession?A) The median annual nursing wage is greater than $45,000.B) Nurses use the scientific method to enhance their body of knowledge.C) Nurses can be held legally accountable for their actions.D) Nursing has a demonstrated commitment to the well-being of thepublic.Ans: BClient Needs: A-1Cognitive Level: AnalysisDifficulty: DifficultIntegrated Process: Nursing ProcessObjective: 7Table 1.8Feedback:Social scientists have identified seven criteria for a profession,including the use of the scientific method to enhance knowledge. Earningsand commitment to the public are not among the defining characteristicsof a profession. Autonomy and accountability are criteria that are used todefine a profession, but legal accountability for actions is not restricted toprofessionals.11.Among the traditions that exist in nursing education is a passing of thelamp ceremony that is sometimes conducted during graduation. Thisceremony communicatesA) the light that nursing provides in communities and society.B) an acknowledgment of the contributions made by important nurses inhistory.C) the continuity of care from practicing nurses to newly graduated nurses.D) the need to continually build the nurses base of knowledge.

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Ans: CClient Needs: A-1Cognitive Level: KnowledgeDifficulty: EasyIntegrated Process: Nursing ProcessObjective: 9Ceremonies Associated with Nursing ProgramsFeedback:Some schools use the tradition of a passing of the lamp. Arepresentative of the graduating class hands a lamp to a representative ofthe next graduating class, thus reinforcing the concept of the continualcaring represented in nursing. This ceremony does not primarilyemphasize the light of the profession, the contribution of nurses in history(though the lamp symbolizes the lamp carried by Florence Nightingale), orthe need to add to existing knowledge.12.A nurse who provides care on a medical unit at a community hospitalis concerned about negative portrayals of nurses in the media. Why shouldthis nurse be concerned with the image of nurses and nursing?A) A negative image of nursing can dissuade potential nurses fromentering the profession.B) A negative image of nursing reduces patients adherence to treatmentregimens.C) A negative image of nursing interferes with professional accountabilityin hospital settings.D) A negative image of nursing reduces the development of nursingknowledge.Ans: AClient Needs: CCognitive Level: AnalysisDifficulty: ModerateIntegrated Process: Communication and DocumentationObjective: 10The Image of Nursing TodayFeedback:Negative attitudes about nursing may discourage many capableprospective nurses, who will choose another career that offers greaterappeal in stature, status, and salary. The image of nursing is not noted toinfluence patient adherence to treatment or accountability. A negativeimage may indirectly limit nursing knowledge through reduced funding forresearch, but this phenomenon is less pronounced than the effect onpotential nurses.

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13.Megan, a 21-year-old junior college student, has been frustrated by herunsuccessful attempts to gain entry to the nursing program at the localuniversity despite her strong academic record and work experience.Which of the following factors has most contributed to the limited numberof seats available in many nursing programs?A) Technological developments that have decreased the projected need fornursesB) The tendency of practicing nurses to delay retirement until after the ageof 65 yearsC) The high cost to educational institutions of providing nursing educationD) The negative image of nursing in the media and popular cultureAns: CClient Needs: A-1Cognitive Level: ComprehensionDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 10Page and Header: Nursings Image and the Nursing ShortageFeedback:A factor affecting the nursing supply is the limited number ofspaces in nursing programs. Because nursing education is costly, manyeducational institutions have not been able to increase the size of theirprograms in the past decade. This trend is not attributable to technologicalchange, increased length of service, or the negative image of nursing.14.Mrs. Jimenez is a 28-year-old pregnant woman who is in labor. Due tothe fact that her labor was progressing very slowly, she was started on aninfusion of oxytocin, a drug used to increase the progression of her labor.In the planning of Mrs. Jimenezs care, the nurse has documented a Risk ofFluid Volume Excess in light of this common adverse effect of oxytocin. Thenurse has demonstrated the use of what nursing classification system?A) The Minimum Data Set (MDS)B) Nursing Outcomes Classification (NOC)C) Nursing Interventions Classification (NIC)D) NANDA International (NANDA-I)Ans: DClient Needs: A-1Cognitive Level: AnalysisDifficulty: DifficultIntegrated Process: Communication and DocumentationObjective: 12NANDA International

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Feedback:Risk of Fluid Volume Excess is an example of a nursingdiagnosis, which is the focus of NANDA-I. This does not denote anintervention or desired outcome. The MDS is an assessment tool specific tolong-term care settings.15.During the years of the 20th century, there was exponential growth inthe number and quality of research studies that were conducted aboutnurses and nursing. What factor provided the original motivation for thesestudies?A) The entry of larger number of men into nursing schools and the nursingprofessionB) A desire to lessen the knowledge gap between nurses and physiciansC) The low quality of nursing schools and nursing graduatesD) Allocation of federal and state funding for nursing researchAns: CClient Needs: A-1Cognitive Level: AnalysisDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 11Studies for and About NursingFeedback:In the early 20th century, nurses, doctors, friends, and critics ofnursing became concerned that the preparation being offered wasinadequate. Before the problem could be corrected, it was necessary tolearn more about the programs and how nurses were being used in theemployment market. To accomplish this, studies about nursing and nurseswere initiated. These studies did not primarily result from increasedfunding opportunities, the entry of men into the profession, or theknowledge gap between doctors and nurses.

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Chapter: Chapter 2: Educational Preparation for NursingMultiple Choice1.Manuel has a baccalaureate degree in biology and wishes to make acareer change to eventually become an advanced practice RN. Which of thefollowing courses of study would be the most time-efficient choice to meethis educational goals?A) Masters degree in nursingB) Baccalaureate degree in nursingC) Doctoral degree in nursingD) Associate degree in nursingAns: DClient Needs: A-1Cognitive Level: AnalysisDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 2Characteristics of Associate Degree EducationFeedback:Students may be admitted to masters programs in nursing witha baccalaureate degree in another discipline and are granted a mastersdegree in nursing after completing an established 2-year program of studythat prepares them for RN licensure. However, people who already possessbaccalaureate or higher degrees in other fields sometimes seek admissionto an associate degree program, often because it can be completed in ashorter period of time than would be needed to earn anotherbaccalaureate degree (though accelerated baccalaureate programs arebecoming more common).2.Which nursing report recommended that nursing education move awayfrom the system of apprenticeship that predominated at the time andmove toward a planned program of education similar to that offered byother professions?A) The Surgeon Generals Consultant Group Report on NursingB) The Brown ReportC) The American Nurses Association Position PaperD) The Pew Health Profession Commission StudyAns: BClient Needs: A-1Cognitive Level: ComprehensionDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 4

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The Brown ReportFeedback:InNursing for the Future, Brown (1948) recommended thatnursing education move away from the system of apprenticeship thatpredominated at the time and move toward a planned program ofeducation similar to that offered by other professions. This predated theSurgeon Generals Consultant Group Report on Nursing, the AmericanNurses Association Position Paper, and the Pew Health ProfessionCommission Study.3.Which of the following accurately states a major position of the ANAPosition Paper on Educational Preparation?A) The education of those who are licensed to practice nursing should takeplace in hospitals.B) Minimum preparation for beginning professional nursing practice at thepresent time should be an associate degree in nursing.C) Minimum preparation for beginning technical nursing practice at thepresent time should be a baccalaureate degree in nursing.D) Education for assistants in health service occupations should be short,intensive preservice programs in vocational educational institutions.Ans: DClient Needs: A-1Cognitive Level: ComprehensionDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 5Display 2.2Feedback:One of the four major positions of the ANA Position Paper onEducational Preparation is that education for assistants in the healthservice occupations should be short, intensive preservice programs invocational education institutions, rather than on-the-job trainingprograms. It also states that the education of all those who are licensed topractice nursing should take place in institutions of higher education, notin hospitals. The paper specifies an associate degree as the minimum fortechnical nursing and a baccalaureate degree for professional nursing.4.Sister Calista Roy identified an adaptation model that characterizes theindividual as being in constant interaction with a changing environment,therefore requiring adaptation. Which of the following identifies anadaptive mode listed in her theory?A) Role functionB) NutritionC) Spirituality

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D) Genetic makeupAns: AClient Needs: A-1Cognitive Level: AnalysisDifficulty: DifficultIntegrated Process: Nursing ProcessObjective: 9Feedback:Roy identifies four adaptive modes, or ways in which a personadapts through: (1) physiologic needs, (2) self-concept, (3) role function,and (4) interdependence relations. Nutrition, spirituality, and geneticmakeup are not discrete concepts within this theory.5.Mr. Van is a 79-year-old widower who is being transferred to a long-term facility following hip replacement surgery. The nurse in charge of hiscare hopes to provide holistic nursing care for him based on his responseto the interaction between his internal and external environment. Thisapproach represents the model of care proposed by which of the followingtheorists?A) Dorothy JohnsonB) Madeleine LeiningerC) Dorothea OremD) Myra LevineAns: DClient Needs: A-1Cognitive Level: AnalysisDifficulty: DifficultIntegrated Process: Nursing ProcessObjective: 9Feedback:Levine supports a holistic approach to nursing based onrecognition of the total response of the person to the interaction betweenthe internal and the external environment. This approach is not specifiedby Johnson, Leininger, or Orem.Multiple Selection6.A college sophomore has become disillusioned with her current field ofstudies and has begun exploring careers in nursing. To her surprise, she isunable to identify any hospital-based programs of study in her home state.Which of the following factors have contributed to the demise of hospital-based diploma programs? (Select all that apply.)A) Increased patient acuity in hospitalsB) Increased popularity of college- and university-based nursing programsC) The growth of managed care and its influence on hospital management

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D) Increased costs to hospitals for maintaining nursing programsE) The emergence of the baccalaureate degree as the entry to technicalnursing practiceAns: B, DClient Needs: A-1Cognitive Level: AnalysisDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 1Hospital-Based Programs TodayFeedback:The elimination of hospital-based programs occurred becausehospitals could not sustain the costs of supporting the programs andbecause students became more attracted to programs located in collegesand universities. Patient acuity and managed care have not been identifiedas causative factors. The baccalaureate degree has been proposed as theentry to professional nursing practice, not technical nursing.Multiple Choice7.Kirsten is a 22-year-old woman who has just been granted admission toan associate degree program at a local college. During her course of study,Kirsten should expect to completeA) the National Council Licensure Examination (NCLEX).B) a preceptorship under the direction of a licensed practical (vocational)nurse.C) a major, original research project immediately prior to graduation.D) numerous nonnursing courses in a variety of disciplines.Ans: AClient Needs: A-1Cognitive Level: ApplicationDifficulty: EasyIntegrated Process: Nursing ProcessObjective: 1Characteristics of Associate Degree EducationFeedback:In a typical ADN program, approximately 40% of the creditsneeded for the associate degree must be fulfilled by general educationcourses such as English, anatomy, physiology, speech, psychology, andsociology; the rest are to be fulfilled by nursing courses. Original researchis not a component of undergraduate nursing education, andpreceptorships are normally completely under the direction of an RN. TheNCLEX is written after graduation.

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8.Ben is a 30-year-old man who has applied for an acceleratedbaccalaureate program at a university because the 15-month program ofstudy will allow him to accommodate his family and financialresponsibilities. In order to be granted admission, what will Ben mostlikely require?A) A varied work history that demonstrates initiative and responsibilityB) A baccalaureate degree in another fieldC) A mentor or sponsor within the nursing fieldD) Volunteer experience in a health-related settingAns: BClient Needs: A-1Cognitive Level: ComprehensionDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 3Accelerated ProgramsFeedback:Building on previous learning experiences, acceleratedprograms are designed to transition adults with baccalaureate andgraduate degrees in other fields into nursing. A strong work history,volunteer experience, and an available mentor in the field are all assets forsuccess, but these are less likely to be absolutely required for admission.9.Julia has just graduated with her Bachelor of Science in Nursing degreefrom her state university and has begun seeking employment. However,she is anxious about her level of clinical competence due to the fact thatshe completed far fewer clinical hours than many practicing nurses. Whichof the following has the potential to ease Julias transition to practice?A) Completing a residency or internship at the hospital where she will beemployedB) Auditing courses in a nonnursing, health-related disciplineC) Working for several months as a nursing assistant in order to gainconfidenceD) Taking online courses in advanced nursing practiceAns: AClient Needs: A-1Cognitive Level: ApplicationDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 2Residencies and Structured Orientation for the New Graduate

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Feedback:Internships and residencies for new graduates have beeninstituted by hospitals to ease the transition from the role of student tothat of staff by providing the opportunity to increase clinical skills andknowledge as well as self-confidence. Taking more academic coursesand/or working as a nursing assistant are unlikely to increase Juliasconfidence and competence in her clinical nursing role.10.According to the ANA Position Paper on Educational Preparation,which of the following four individuals is adequately prepared to providecare?A) A nursing assistant who has just completed an on-the-job trainingprogram in a local hospitalB) A nurse who graduated from a hospital-based diploma programC) A nurse in a high-acuity setting who possesses an associate degree innursing (ADN) degreeD) A nursing assistant who graduated from the training program at acommunity collegeAns: DClient Needs: A-1Cognitive Level: AnalysisDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 5Display 2.2Feedback:The ANA Position Paper specifies that education for assistantsin the health service occupations should be short, intensive preserviceprograms in vocational education institutions, rather than on-the-jobtraining programs. The Paper also specifies a minimum of an ADN degreefor all nursing practice and a baccalaureate degree for professional nursing(e.g., in high-acuity settings).11.Nurse. L. provides care in a state that has mandatory continuingeducation requirements for nurses. What are the consequences of thispolicy for Nurse L.?A) Nurse L. must demonstrate a commitment to making practiceimprovements.B) Nurse L. must have a baccalaureate degree in order to provideprofessional nursing care.C) Nurse L. is obliged to update her diploma to an associate degree.D) Nurse L. must demonstrate continuing education for license renewal.Ans: DClient Needs: A-1

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Cognitive Level: ApplicationDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 6Continuing EducationFeedback:Mandatory continuing education affects licensure, meaning thatany nurse renewing a license in a state requiring (mandating) continuingeducation will have to satisfy that requirement. However, this does notnecessarily mean that a nurse must update his or her degree or diploma orundertake practice improvements.12.The administrators of a large, university hospital have expressed acommitment to differentiated nursing practice. Which of the followingmost clearly exemplifies differentiated practice?A) Each nurse performs a role that is commensurate with his or hereducation and experience level.B) Each nurse in the hospital is expected to provide competent care in avariety of different settings.C) Nurses demonstrate evidence of continuing education in two or moredifferent specialties.D) Each nurse in the hospital possesses an ADN or baccalaureate degree innursing.Ans: AClient Needs: A-1Cognitive Level: ApplicationDifficulty: DifficultIntegrated Process: Nursing ProcessObjective: 7Differentiated PracticeFeedback:Differentiated nursing practice can be defined as the practice ofstructuring nursing roles on the basis of education, experience, andcompetence. It does not necessarily specify the provision of care in diversesettings, evidence of continuing education, or the possession of a nursingdegree.13.A nurse manager who oversees the provision of community-based careto a large number of clients has been mandated to implementdifferentiated care over the next year. In order to carry out this directive,the nurse manager must be able toA) teach each nurse to become a generalist rather than a specialist.B) identify the evidence that underlies the nursing care that is provided.C) clearly identify the specific roles and tasks that these nurses perform.

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D) hire more licensed practical (vocational) nurses.Ans: CClient Needs: A-1Cognitive Level: ApplicationDifficulty: DifficultIntegrated Process: Nursing ProcessObjective: 7Differentiated PracticeFeedback:Differentiated practice requires that the specific roles that areperformed in the provision of care be clearly identified and delineated.This is necessary in order to appropriately match individual care providersto particular tasks and functions. Nurses do not need to becomegeneralists nor are more practical nurses necessarily required. Evidenceunderlying nursing care should be identified, but this is not necessary fordifferentiated care.14.Pressure from students and the healthcare industry has prompted thenursing educators at a college to implement new technology into thenursing education that they provide. Which of the following statements istrue of technological change and nursing education?A) Technology is typically high in colleges and universities but low inhospitals and other care settings.B) Many of the purported educational benefits of technology have not beendemonstrated in the nursing literature.C) Computer literacy is high among students but most nursing educatorslack computer skills.D) The costs of integrating new technology into nursing education can beprohibitive.Ans: DClient Needs: A-1Cognitive Level: AnalysisDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 8Feedback:High-technology equipment is often expensive, a fact that oftenpresents a challenge to educational institutions. The benefits of technologyin learning have been demonstrated and computer literacy is nearlyuniversal. Hospitals are high-technology work environments.15.The faculty members of a college-based school of nursing have takenaction to increase the teaching and clinical time in the curriculum that is

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devoted to community-based nursing. Which of the following phenomenaprovides the most valid rationale for this change?A) Public mistrust of hospitals is increasing and many individuals prefer toremain at home.B) The number of patients who qualify for Medicare and Medicaid isincreasing.C) Patients are typically discharged from the hospital much earlier than inthe past.D) Evidence demonstrates that students learn more in the community thanin the hospital.Ans: CClient Needs: A-1Cognitive Level: AnalysisDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 8Increasing Community-Based Practice ExperiencesFeedback:Earlier hospital discharge to the home and an increasingemphasis on prevention has created new demands on nursing in thecommunity. This shift is not rooted in mistrust of hospitals, a lack oflearning in hospitals, or trends in Medicare and Medicaid.

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Chapter: Chapter 3: Credentials for Healthcare ProvidersMultiple Choice1.What is the major advantage of sunset laws?A) Nurses can modify their standards of practice on a daily basis.B) They guarantee that the legislature will review and evaluate agenciesand programs.C) The legislature can close facilities that do not meet governmentalrequirements.D) Facilities must renew their accreditation in a specified amount of time.Ans: BClient Needs: A-1Cognitive Level: ComprehensionDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 4Sunset Laws and Nurse Practice ActsFeedback:Because sunset laws are set to expire at a specified point intime, legislatures are obligated to review and evaluate them prior toexpiry. Sunset laws do not directly influence the nurses standards ofpractice, the quality of healthcare facilities, or the accreditation process.2.A nurse who is licensed to practice in Pennsylvania decides to seek anursing position in Florida. This nurse would obtain this license by whichof the following methods?A) Licensure by endorsementB) Licensure by examinationC) Licensure by renewalD) Reciprocal licensureAns: AClient Needs: A-1Cognitive Level: ComprehensionDifficulty: ModerateIntegrated Process: Communication and DocumentationObjective: 6Obtaining a Nursing LicenseFeedback:The method of obtaining a license when the nurse is alreadylicensed in another jurisdiction is called licensure by endorsement; this isan alternative to license by examination. This transfer is not termedreciprocal licensure or licensure by renewal.3.A nursing board asks the court to stop a nurse from practicing until itinvestigates allegations that the nurse was providing care while under the

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influence of alcohol. What is the name of the process that allows thisaction?A) RevocationB) SuspensionC) Injunctive reliefD) Court investigationAns: CClient Needs: A-2Cognitive Level: ApplicationDifficulty: DifficultIntegrated Process: Nursing ProcessObjective: 7Grounds for Disciplinary ActionFeedback:A board of nursing may be authorized to ask a court to halt aspecific practice that it believes is contrary to the law until a full hearingcan be held. This is called injunctive relief. This term refers to the courtorder called an injunction that requires an individual or organization tostop a particular activity, such as practicing nursing. The investigation isperformed by the board, not the court. Revocation involves the removal ofa license, and suspension does not typically involve the courts.4.Which of the following is a recommendation of the Institute of MedicinereportHealth Profession Education: A Bridge to Quality(2003)?A) Developing separate core competencies to regulate each healthprofessionB) Revising the processes of accreditation bodies to require outcomesrelated to core competenciesC) Allowing each profession to educate, practice, and dialogue within itsown boundariesD) Changing healthcare workforce regulations based on what is termed asafe focusAns: BClient Needs: A-1Cognitive Level: ComprehensionDifficulty: DifficultIntegrated Process: Nursing ProcessObjective: 10, Institute of Medicine RecommendationsFeedback:The IOM report recommended that both licensing bodies andspecialty certification bodies require health professionals to demonstratein some way their continued competence in the previously determined

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core competencies. The report does not advocate the development ofseparate core competencies, the isolation of each profession, or changes toworkforce regulations.5.A nurse administers insulin to a diabetic patient via an insulin pump.Based on the NCLEX examination, this action would fall under which of thecategories of client needs?A) Safe effective care environmentB) Health promotion and maintenanceC) Psychosocial integrityD) Physiological integrityAns: DClient Needs: A-1Cognitive Level: AnalysisDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 6Table 3.1Feedback:The client needs category of physiological integrityencompasses nursing actions that address a clients physical needs and thetreatment of illness. Administration of medication is not normallyconsidered a health promotion activity, an aspect of psychosocial integrity,or a demonstration of safety measures.6.A nurse who has provided care in acute settings for several years hasbegun the process of gaining additional credentials. Which of the followingstatements best describes credentials?A) Credentials indicate that an individual has demonstrated a continuingcommitment to competence.B) Credentials recognize an individuals professional superiority to his orher peers.C) Credentials indicate that an individual has met specific criteria andstandards.D) Credentials indicate that an individual has the authority to directpractice in a particular care setting.Ans: CClient Needs: A-1Cognitive Level: ComprehensionDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 1Introduction

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Feedback:Credentials indicate that an individual (or organization) hasmet specific standards that are important to fulfilling a professionalmandate. This is not necessarily synonymous with a continuedcommitment, though such a commitment may help facilitate theattainment of credentials. Individual credentials do not necessarilyindicate superiority or leadership potential.7.After completing an associate degree in nursing and passing the NCLEX-RN examination, a nurse has been granted a license to practice. A license topractice provides the nurse withA) formal recognition of the nurses graduation from an accredited schoolof nursing.B) legal permission to practice the nursing profession.C) the authority to practice nursing in any state.D) recognition of advanced learning and competence in a particular caresetting.Ans: BClient Needs: A-1Cognitive Level: AnalysisDifficulty: EasyIntegrated Process: Communication and DocumentationObjective: 2LicensureFeedback:A license is a legal credential awarded by an individual statethat grants permission to that individual to practice a given profession. Alicense is normally specific to a particular jurisdiction. It does not denoteadvanced learning in a specific setting. Graduation from a school of nursingis required for licensure, but a license does not explicitly document thiseducation.8.The students and faculty of a school of nursing are pleased that theschool has recently been granted a renewal of its current accreditation.Accreditation of a school of nursing is based primarily on which of thefollowing?A) The proportion of graduates who pass the NCLEX-RNB) The academic credentials of faculty membersC) The findings of an external review committeeD) The overall contribution of the school to the body of nursing knowledgeAns: CClient Needs: A-1Cognitive Level: ApplicationDifficulty: Moderate

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Integrated Process: Communication and DocumentationObjective: 3Accreditation of Educational InstitutionsFeedback:Accreditation of a school of nursing is primarily based on thefindings of nursing experts who visit the institution and appraise theeducation that is provided. Other factors may be considered, such as thesuccess of graduates, the credentials of instructors, or the research that isconducted, but the findings of external reviewers are paramount.9.A state board of nursing is legally empowered to carry out theprovisions of the Nurse Practice Act. Which of the following activities bestdemonstrates the mandate and jurisdiction of a state board of nursing?A) Advocating for nurses during labor negotiationsB) Organizing information campaigns to enhance the public perception ofthe nursing professionC) Specifying the way that nursing care is organized in public hospitalsD) Establishing the standards that nurses must meet in order to belicensedAns: DClient Needs: A-1Cognitive Level: AnalysisDifficulty: DifficultIntegrated Process: Communication and DocumentationObjective: 5The Role of the State Board of NursingFeedback:State boards of nursing perform multiple functions, includingexamination and licensure of nurses. Participation in labor negotiations,advertising to increase awareness of the profession, and specifying theway that care is provided are activities that are normally beyond thepurview of a state board of nursing.10.A registered nurse who completed her education in the Philippines andwho is in the process of immigrating in the United States is attempting toobtain a license to practice in New Jersey, her intended state of residence.In order to obtain a license, the nurse will primarily be in contact withA) the New Jersey Board of Nursing.B) the American Nurses Association (ANA).C) one of the accredited schools of nursing in New Jersey.D) the National Council of State Boards of Nursing, Inc. (NCSBN).Ans: AClient Needs: A-1Cognitive Level: Application

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Difficulty: EasyIntegrated Process: Communication and DocumentationObjective: 5The Role of the State Board of NursingFeedback:Licensure is one of the main responsibilities of state boards ofnursing, and a nurse seeking a license to practice in a particular state mustobtain a license from that states board of nursing. Schools of nursing, theANA, and the NCSBN do not directly grant licensure.Multiple Selection11.Amanda is a nurse who currently works in a community clinic in a citynear state lines. She is exploring employment possibilities in a neighboringstate and hopes to obtain a license through mutual recognition oflicensure. Which of the following conditions must be met in order forAmanda to obtain a nursing license in this manner? (Select all that apply.)A) Amandas home state must be party to the Nurse Licensure Compact.B) Amanda must obtain a nursing license in the intended state as well as inher home state.C) Amanda must meet the standards for licensure in the state where sheintends to practice.D) The state in which Amanda wishes to practice must belong to the NurseLicensure Compact.E) Amanda must possess an ADN or baccalaureate degree in nursing.Ans: A, C, DClient Needs: A-1Cognitive Level: AnalysisDifficulty: DifficultIntegrated Process: Communication and DocumentationObjective: 8Mutual Recognition of LicensureFeedback:Obtaining a license through mutual recognition of licensurerequires that an individuals home state and the intended state of practicebe party states. As well, an applicant must qualify for licensure in theintended state. A diploma in nursing does not preclude transfer oflicensure, and an individual may not possess licenses in both statessimultaneously.Multiple Choice12.Under the provisions of the Nurse Licensure Compact (NLC), a nursewho is licensed in Arizona has been practicing for the past year in NewMexico. The nurse is alleged to have become involved in an inappropriaterelationship with a patient in New Mexico and grounds for disciplinary

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action appear to exist. How will the discipline of this nurse most likelyproceed?A) The New Mexico Board of Nursing may withdraw the nurses license ifthis is deemed necessary.B) The nurses discipline is referred to the American Nurses Associationbecause two state boards of nursing have interest in the matter.C) The New Mexico Board of Nursing will undertake investigation, but theArizona State Board of Nursing will implement appropriate discipline.D) The New Mexico Board of Nursing will be unable to change the Arizonalicensure status of the nurse.Ans: DClient Needs: A-1Cognitive Level: ApplicationDifficulty: DifficultIntegrated Process: Communication and DocumentationObjective: 8Concerns Regarding Mutual Recognition of LicensesFeedback:A major concern with mutual recognition is the disciplinaryprocess. Although the board of nursing can investigate nursing practicesand enforce its own standards in the state, it cannot change the licensurestatus of the person whose licensure originates in a different state. TheANA does not participate in disciplinary matters, and a state would notnormally undertake discipline based on an investigation in another partystate.13.Nurse T. has been notified by her state board of nursing that acomplaint has been lodged regarding her practice. How should Nurse T.best respond to this news?A) Retain the services of an attorney.B) Organize a private meeting between her and the complainant.C) Have colleagues write statements attesting to her competence.D) Explore practice opportunities in other states.Ans: AClient Needs: A-1Cognitive Level: ApplicationDifficulty: ModerateIntegrated Process: Communication and DocumentationObjective: 8Revocation of Limitation of a LicenseFeedback:The individual being investigated for any violation of the NursePractice Act should have an attorney who is knowledgeable about

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professional disciplinary issues from the time of notification of thecomplaint. This is an important action, whether or not there are groundsfor the accusation. A meeting with the complainant would beinappropriate, and enlisting support from colleagues would be a secondaryconcern compared with hiring an attorney. It would be premature, andlikely inappropriate, to explore options out-of-state at this early stage.14.A nurse has been working in pediatrics for 6 years since graduatingfrom an accredited nursing school. The nurse is now interested in pursuingAmerican Nurses Credentialing Center certification as a pediatric ClinicalNurse Specialist. What factor will primarily determine whether the nurseobtains this ANCC certification?A) Enrollment in a PhD, DNS, or DNP degree programB) A review of the nurses marks from nursing school and interviews withmanagers and colleaguesC) Completion of an original research project related to pediatric nursingD) The demonstration of knowledge and skills in beyond those requiredfor licensure as an RNAns: DClient Needs: A-1Cognitive Level: ComprehensionDifficulty: ModerateIntegrated Process: Communication and DocumentationObjective: 9American Nurses Credentialing Center CertificationFeedback:ANCC certification is a method of recognizing nurses who havespecial expertise. Applicants must demonstrate current practice andknowledge beyond that required for licensure as an RN. Enrollment in adoctoral program is not necessary. Marks from nursing school, theopinions of supervisors, and the completion of research do not form thebasis for certification.15.The Institute of Medicine (IOM) reportHealth Profession Education: ABridge to Quality (2003)came to several conclusions around the issuesconfronting health professions education. Which of the following issueswas addressed in the report?A) The tendency of each health discipline to educate and practiceindependently of the other disciplinesB) The lack of recognition of credentials and the credentialing processoutside of the field of nursingC) The trend toward managed care and the inability of nursing educatorsto adapt to this change

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D) The historical animosity between nursing and medicine and the failureto bridge this gapAns: AClient Needs: A-1Cognitive Level: AnalysisDifficulty: DifficultIntegrated Process: Communication and DocumentationObjective: 10Institute of Medicine RecommendationsFeedback:The IOM noted that each health profession tends to educate,practice, and dialogue within a silo. These narrowly constructed wallsmake it difficult for interdisciplinary collaboration to occur. The reportdoes not focus on the relationship between medicine and nursing, thetrend toward managed care, or the lack of recognition of credentials.Chapter: Chapter 4: Making Professional Goals a RealityMultiple Choice1.Which organization developed the most definitive statements on thecompetencies needed by the newly licensed practical nurse (PN) and theRN?A) National Council of State Boards of Nursing (NCSBN)B) American Association of Nurses (ANA)C) National League for Nursing (NLN)D) American Association of Colleges of NursingAns: AClient Needs: A-1Cognitive Level: ComprehensionDifficulty: EasyIntegrated Process: Communication and DocumentationObjective: 2, National Council of State Boards of Nursing CompetenciesFeedback:The most definitive statements on the competencies needed bythe newly licensed practical nurse (PN) and the RN have been developedby the NCSBN based on its job analysis studies, which serve as the basis forthe NCLEX-RN and NCLEX-PN.2.In what type of healthcare setting are the most RNs currently employed?A) Ambulatory care centersB) Doctors officesC) Acute care hospitalsD) Long-term care facilities

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Ans: CClient Needs: A-1Cognitive Level: KnowledgeDifficulty: EasyIntegrated Process: Communication and DocumentationObjective: 1Employment Opportunities TodayFeedback:As of 2008, over 89% of nurses worked in hospital settings,4.8% worked in long-term care, and 4.3% worked in community-based orambulatory care settings. Only 1.7% of nurses indicated that they workedin other settings.3.Which of the following statements accurately reflects what employersgenerally should expect when hiring a newly graduated RN?A) The RN should be proficient with the documentation system used by theinstitution.B) The RN should be able to perform all nursing skills, enabling him or herto work independently.C) The RN should function with speed comparable to that of the othernurses.D) The RN should be able to develop plans of care and follow plansdeveloped by the agency.Ans: DClient Needs: D-1Cognitive Level: ApplicationDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 1Employers Expectations Regarding CompetenciesFeedback:New graduates should be able to develop plans of care andfollow plans, such as care pathways, that have been developed by theagency. Proficiency, speed, and complete independence are developed overtime and with increased experience and orientation.4.A nurse decides to apply for a position in a hospital in her hometown.Which of the following statements provides good advice for her job quest?A) She should call the human resources department and speak to theperson who is in charge of hiring nurses.B) She should include a cover letter with her rsum that is no more thantwo pages long and briefly reiterates the information found in the rsum.C) She should invest in a professionally prepared rsum to make a betterimpression on potential employers.

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D) She should focus her rsum on accomplishments and use active verbs todescribe her skills.Ans: DClient Needs: A-1Cognitive Level: ApplicationDifficulty: ModerateIntegrated Process: Communication and DocumentationObjective: 5Employment HistoryFeedback:In a rsum, it is best to focus on accomplishments and use activeverbs to describe skills. Professional preparation of a rsum is notnecessary, and telephone communication is generally discouraged. A coverletter should ideally not exceed one page in length.5.Which of the following is a recommended guideline when resigning aposition?A) Provide the employer with 2 weeks to seek a replacement.B) Clearly state the details if you wish to be compensated for any vacationor holiday time accrued.C) If resigning because of problems in the work setting, it is a good idea toput the reason in the resignation letter.D) Place comments regarding positive factors experienced in theworkplace in a separate correspondence from the resignation letter.Ans: BClient Needs: A-1Cognitive Level: ApplicationDifficulty: ModerateIntegrated Process: Communication and DocumentationObjective: 5ResignationFeedback:If you have accrued vacation or holiday time and want to takethe time off or be paid for it when resigning, clearly state that. A monthsnotice is ideal, and a resignation letter should not go into detail regardingthe contributing problems in the workplace. Positive factors experiencedin the workplace may be included in the resignation letter.6.A student nurse is scheduled to graduate in a few weeks and ispreparing to begin searching for employment. Which of the followingstatements best conveys an aspect of the current job market for nurses?A) Most nursing graduates are expected to perform in the role of a nursingassistant or practical (vocational) nurse after graduation.

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B) The majority of nursing opportunities for new graduates are ininternational settings.C) Job openings in acute care have decreased in many places but long-termcare openings continue to grow.D) The increasing severity of the nursing shortage means that jobopportunities for nursing graduates are greater than ever.Ans: CClient Needs: A-1Cognitive Level: ComprehensionDifficulty: ModerateIntegrated Process: Communication and DocumentationObjective: 1Employment Opportunities TodayFeedback:Positions for new graduate RNs have recently decreased. This isdue in part to the effects of the economic recession. Although hospitalvacancies have decreased in many places, those in long-term care continueto increase. Some, but not most, graduates may find work in other roles,and a minority of positions are in international settings.7.A recent nursing graduate is attempting demonstrate the competenciesthat she learned as a nursing students and to reconcile the expectations ofher new colleagues and employer with her own abilities. Which of thefollowing tasks is the most important and most frequently performed?A) Helping patients and families navigate the healthcare environmentB) Applying the principles of infection control and standard precautionsC) Initiating vascular access and maintaining peripheral and/or central IVaccessD) Liaising with members of other health disciplines to ensure safe andcontinuous careAns: BClient Needs: A-1Cognitive Level: ApplicationDifficulty: ModerateIntegrated Process: Nursing ProcessObjective: 2Feedback:Apply principles of infection control (e.g., hand hygiene, roomassignment, isolation, aseptic/sterile technique, universal/standardprecautions) is among the most common, and most important, nursingactions as identified by nursing organizations. Patient advocacy,interdisciplinary cooperation, and IV therapy are all important, but none isperformed as frequently as infection control measures.

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