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Flashcards in Chapter 28 Deck (24):
1

A nursing instructor quizzes the students on factors that have contributed to the nursing shortage. Which answer by a student would indicate that further teaching is needed?
a. increase of elderly and frail patients
b. aging nursing population
c. variable numbers of nursing students
d. restructuring efforts in the health care system

C: Further teaching is needed if a student responded variable numbers of nursing students. Some contributing factors to the nursing shortage are declining number of nursing students in the pipeline, an increase in chronically ill and frail elderly patients who need nursing care, an aging nursing population, and various restructuring efforts in our health care system.
INTRODUCTION

2

A vital factor, from a nursing education perspective, that contributes to the nursing shortage is which of the following?
a. lack of qualified nursing student applicants
b. lack of qualified nursing instructors
c. lack of nursing programs
d. lack of nursing students who pass the NCLEX-RN

B: NLN statistical data revealed that even though there has been an increase in student enrollment in nursing programs, the number of qualified instructors has continued to decline, hence causing potential students to be rejected or placed on waiting lists. INTRODUCTION

3

An ongoing issue in nursing has been the minimum appropriate entry-level requirements to practice as a registered nurse and what programs are qualified to educate professional nurses for the RN degree. As a result numerous motions and suggestions have been made regarding RN degree. Which of the following is not a part of these contributing factors?
a. 1965 American Nurses Association (ANA) House of Delegates (HOD) motion to work toward a baccalaureate as the foundation for professional nursing practice
b. 1985 ANA HOD agreed to urge state nursing associations to establish the BS degree as the minimum for RNs
c. Two-year associate degree and three-year diploma schools can grant a RN degree
d. Only four-year baccalaureate degree school can grant viable RN degrees

D: A number of factors have contributed to the ongoing discussion of what constitutes the minimum appropriate requirements for the degree of registered nurse. In 1965 American Nurses Association (ANA) House of Delegates (HOD) moved to work toward a baccalaureate as the foundation for professional nursing practice, and in 1985 ANA HOD agreed to urge state nursing associations to establish the BS degree as the minimum for RNs. However, today the BS degree is still not a mandatory requirement (only recommended) for the degree of registered nurse, and two-year associated degree schools and three-year diploma schools provide viable RN degrees. INTRODUCTION

4

The field of advanced practice nursing (APN) has grown since its inception in the 1800s. In this list of types of APN degrees, which is not necessarily correct?
a. CRNA c. NP
b. CSN d. CNM

B: Some types of advance practice nursing specialization that are available to nurses today are the CRNA (Certified Registered Nurse Anesthetist), CNS (Clinical Nurse Specialist – not a CSN), NP (Nurse Practitioner), and CNM (Certified Nurse Midwife). INTRODUCTION

5

In nursing, a formal recognition of the specialized knowledge, skills, and experience demonstrated by the achievement of standards identified by a nursing specialty to promote health outcomes is a definition of:
a. CRNA c. certification
b. NP d. advance practice

C: Certification in nursing is a marker of knowledge and experience of a professional RN. The American Board of Nursing Specialties (ABNS) defines certification as “a formal recognition of the specialized knowledge, skills, and experience demonstrated by the achievement of standards identified by a nursing specialty to promote health outcomes.” CERTIFICATION

6

There are a variety of specialization areas available to nurses. Which of the following is a certification recognized by the American Nurses Association for those with a BS degree?
a. family nursing c. advanced diabetes management
b. case management d. technology nursing

B: An individual with a BS can obtain specialization in case management. Advanced diabetes management nurses generally hold an advanced practice certification as either a Nurse Practitioner or Clinical Nurse Specialist. Family nurses general are Nurse Practitioners. There is no such certification as technology nurse. However, nurses can be certified in Informatics Nursing.
TABLE 28-1 CERTIFICATIONS AVAILABLE FROM AMERICAN NURSES CREDENTIALING CENTER

7

A number of organizations certify advance practice nurses. Some of these certifying organizations are listed below. Which is not necessarily one of these organizations?
a. AANCP c. NAPNAP
b. AANA d. ACCN

A: Some certifying organizations that grant advance practice nursing certifications are the AANA (American Association of Nurse Anesthetists), NAPNAP (National Association of Pediatric Nurse Associates and Practitioners), AACN (Association of Critical Care Nurses), ANA (American Nurses Association), and AWHONN (Association of Women’s Health, Obstetric and Neonatal Nurses. AANCP is not an acronym for a nursing organization.
CERTIFICATION

8

A nursing instructor explores with a group of students the range of different opportunities available for today’s nurses. The instructor would recognize that clarification is needed if a student suggested which of the following?
a. traveling nurse c. pharmaceutical sales
b. flight nurse d. reservations nurse

D: The instructor would recognize that further clarification is needed if a student suggested reservation nurse. As opportunities arise for nurses outside the traditional roles of staff nurse of nursing supervisor/administration, a variety of alternate career paths have opened up. Some of these are certifications (i.e., APN, etc.), traveling nurse, flight nurse, pharmaceutical and health care sales, case manager, and nurse entrepreneur. EMERGING OPPORTUNITIES

9

A nursing student shares with the class that traveling nurses seem to have a wonderful job. The student further explains some of the important issues concerning this type of position. Which comment made by the student would the nursing instructor need to clarify regarding traveling nurses?
a. generally work a three-month assignment on the same unit
b. do not need a license for each state they work in
c. often need only the basic hospital and unit orientation
d. should know exactly what their contract stipulates of them

B: The nursing instructor would need to clarify the students comment that traveling nurses do not need a license for each state they work in. This statement is not totally correct. A traveling nurse may need a license for each state they work in if the state is not a multi-state licensure compact state (not don’t need a license for each state). TRAVELING NURSE

10

Some characteristics of traveling nurses are listed below. Which is not necessarily correct?
a. flexibility c. ambiguous
b. adaptability d. independence

C: Traveling nurses need to have certain qualities about their personalities and skill sets in order to be able to rapidly adapt to different work situations and work relationships. Some of these characteristics are flexibility, adaptability, assertiveness (not ambiguity), independence, confidence, strong organizational and interpersonal skills, and the ability to learn new skills and techniques. TRAVELING NURSE

11

Flight nursing has been around for a number of years, but the original idea for the air ambulance was initiated in:
a. Denver in 1972
b. 1933 with the Emergency Flight Corps of the Armed Services
c. the Korean War
d. Philadelphia in 1965

A: Flight nursing began in 1933 with the Emergency Flight Corps of the Armed Services. The concept of the air ambulance was developed in 1972 in Denver. FLIGHT NURSING

12

A number of skills are critical for flight nurses. Which skill is not necessarily correct?
a. patient intubation c. chest tube placement
b. EKG interpretation d. advanced anesthesia techniques

D: Flight nursing requires many specialized nursing skills. Some of these vital skills are patient intubation, EKG interpretation, chest tube placement, intravenous (IV) insertion, medication administration, sedation (not advanced anesthesia techniques), and central line placement. FLIGHT NURSING

13

The majority of flight nurse opportunities nationally require the following. Which is not necessarily correct?
a. ACLS
b. PALS
c. NPR
d. a nationally recognized trauma certification

C: Just as flight nurses need to have a variety of specialized skills, they must also display their abilities to care for patients in critical situations with a number of certifications and experiences. Some of these are ACLS (Advanced Cardiac Life Support), PALS (Pediatric Advanced life Support), NRP (Neonatal resuscitation Program – not NPR), graduation from a nationally recognized trauma program such as PHTLS, BTLS, TNCC, or TNATC, and two to three years critical care experience. FLIGHT NURSING

14

Other opportunities for nurses include working for or representing national health care institutions or organizations. Some of these consist of companies involved in the following. Which is not necessary correct?
a. pharmaceutical sales c. home care
b. durable medical equipment d. advertising

D: Opportunities for nurses outside of traditional roles have included national health care organizations and institutions. Some of these roles are in pharmaceutical sales, durable medical equipment, home care, insurance coverage, and health maintenance organizations.
HEALTH CARE SALES/PHARMACEUTICAL REPRESENTATIVES

15

Within the case management model, case managers utilize a number of tools in order to achieve quality and cost effective outcomes. Which is not necessarily correct?
a. medical management c. variance analysis
b. critical pathways d. protocols

A: The case management model establishes certain criteria and methods for patient management utilizing specific tools. Some of these tools are practice guidelines (not medical management, because only a health practitioner such as a physician or advanced practice nurse may do this), critical pathways, variance analysis, protocols, and outcome measurement tools. CASE MANAGER

16

Some major characteristics of nurse entrepreneurs are listed below. Which is not necessarily correct?
a. visionary and self motivated
b. risk takers and have common sense
c. self-confident and aggressive
d. market driven with good financial foresight

C: Nurse entrepreneurs plan organize, finance, and manage their own businesses (Leong, 2005). Characteristics and attributes of effective nurse entrepreneurs include being a visionary, being self motivated, taking risks, having common sense, being self confident, assertive (not aggressive), autonomous, and creative, being responsive to a perceived need, and being market driven with good financial foresight. NURSE ENTREPRENEUR

17

Four integral contributions to the concept of advanced practice nursing are listed below. Which is not necessarily correct?
a. 1925 Frontier Nursing Service in rural Kentucky
b. Mid to late 19th century nurse anesthetist role
c. 1955 Rutgers University clinical nurse specialists
d. 1975 University of Colorado nurse practitioners

D: Four primary contributions to the concept and development to advance practice nursing are the mid to late 19th century creation of the role of the nurse anesthetist, 1925 Frontier Nursing Service in rural Kentucky nurse midwifery, 1955 Rutgers University clinical nurse specialists, and in 1965 (not 1975) University of Colorado nurse practitioners with Loretta Ford. ADVANCED PRACTICE NURSING

18

A person involved with the development of midwifery in Kentucky was:
a. Loretta Ford c. Sister Mary Bernard
b. Mary Breckenridge d. Alice Magaw

B: Mary Breckenridge was a British midwife who worked with the Frontier Nursing Services in rural Kentucky in the 1920s. Loretta Ford helped establish the role of the nurse practitioner in 1975 at the University of Colorado, and Sister Mary Bernard was the first recorded nurse administering anesthesia in 1877. Alice Magaw is considered the “mother of anesthesia” for her contributions to the field, some of which include publishing articles and researching the practice of anesthesia. CERTIFIED NURSE-MIDWIFE (CNM)

19

A nurse asks a colleague what are considered the essential competencies for a clinical nurse specialist. According to Wyers, Grove, and Pastorino (1985), the colleague would be least likely to list which of the following?
a. serving as a practitioner and teacher
b. serving as a role model
c. demonstrating clinical expertise in all areas of clinical practice
d. developing an in-depth knowledge base

C: Wyers, Grove, and Pastorino’s (1985) essential criteria for clinical nurse specialists are serving as a practitioner, teacher, consultant, and researcher, developing an in-depth knowledge base, serving as a role model, and demonstrating clinical expertise in a selected area of clinical practice (not all areas). CLINICAL NURSE SPECIALIST (CNS)

20

Who was the first recorded nurse administering anesthesia?
a. Loretta Ford c. Alice Magaw
b. Sister Mary Bernard d. Mary Breckenridge

B: The first recorded nurse administering anesthesia was Sister Mary Bernard, a Catholic nun, in 1877. Alice Magaw, is considered the mother of anesthesia for her outstanding contributions to the field. Mary Breckenridge was a British midwife who worked with the Frontier Nursing Services in rural Kentucky in the 1920s. Loretta Ford helped establish the role of the nurse practitioner in 1975 at the University of Colorado CERTIFIED NURSE ANESTHETIST

21

You have been considering advancing your nursing career. You decide to utilize your knowledge and clinical expertise to provide services, such as expert opinions or advice on health, illness, and injury-related issues. Based on this, you would most likely choose to become a:
a. Legal Nurse Consultant c. Clinical Nurse Specialist
b. Clinical Research Nurse d. Wound Care Nurse

A: The legal nurse consultant is an individual who utilizes knowledge and clinical expertise to provide services, such as expert opinions or advice on health, illness, and injury-related issues. LEGAL NURSE CONSULTANT

22

A group of nurses decide to leave their positions at their respective hospitals. They decide that it would be a new experience to open their own home health agency. The role that this group has taken is that of which of the following?
a. unionizers c. patient advocates
b. entrepreneurs d. trailblazers

B: Nurse entrepreneurs manage and assume the risks of a business or enterprise. By starting their own home health agency the nurses are assuming all of the responsibilities for the functioning of their business. NURSE ENTREPRENEUR

23

A relatively new emerging role that allows the nurse a unique opportunity to offer novel treatment approaches to patients who may have otherwise reached a dead end in their treatment course is known as which of the following?
a. Legal Nurse Consultant c. Clinical Nurse Specialist
b. Clinical Research Nurse d. Nurse Entrepreneur

B: The Clinical Research Nurse is a relatively new emerging role that allows the nurse a unique opportunity to offer novel treatment approaches to patients who may have otherwise reached a dead end in their treatment course. The CRN coordinates the day to day management of a research trial, though the primary research investigator still has ultimate responsibility for all study activities. The CRN is employed by the health care site, which may be a hospital, university setting, private health care practice, etc. CLINICAL RESEARCH NURSE (CRN)

24

2008 statistics indicated that the highest credential for the largest percentage of registered nurses was that of which of the following?
a. Associate Degree c. Bachelor Degree
b. Diploma d. Advance Degree

C: 2008 statistics showed that the Diploma was the highest educational credential for 13.9% of RNs, while a Bachelor Degree was the highest educational credential for 36.8% of RNs. The Associate Degree was the highest educational credential for 36.1% of RNs. Advanced degrees, e.g., master’s degree or doctorate degree) were held by 13.2% of Registered Nurses. INTRODUCTION