Section 1 Flashcards
(13 cards)
A nurse with an associate or baccalaureate degree who meets licensing requirements is qualified to practice as A. a nurse practioner B. a certified specialist C. an entry level generalist D. an advanced practice nurse
C. an entry level generalist
Entry-level nurses with an associate or baccalaureate degree are prepared to function as generalists. With experience and continued study, nurses may specialize in an area of practice and may obtain certification in nursing specialties. Certification usually requires clinical experience and successful completion of an examination. A nurse practitioner is an example of an advanced practice nurse. An advanced practice nurse has a minimum of a master’s degree with advanced education in pharmacology and physical assessment as well as expertise in a specialized area of practice.
When nurses disagree about the effectiveness of a commonly used nursing intervention, the best evidence for solving the question related to an intervention is
A. a systematic review of randomized controlled trials
B. a qualitative research study with a large sample size
C. a methodological Internet search using key medical terms
D. anecdotal evidence retrieved from two or more case studies
A. a systematic review of randomized controlled trials.
Systematic reviews of randomized controlled trials (RCTs) are considered the strongest level of evidence to answer questions about interventions (i.e., cause and effect
The nurse establishes priorities and determines outcomes for an individual patient during the
A. analysis phase of the nursing process.
B. planning phase of the nursing process.
C. evaluation phase of the nursing process.
D. assessment phase of the nursing process.
B. planning phase of the nursing process
During the planning phase of the nursing process, patient outcomes or goals are developed and nursing interventions are identified to accomplish the outcomes. The assessment phase of the nursing process includes the collection of subjective and objective patient information on which to base the plan of care. The evaluation phase of the nursing process determines if the patient outcomes have been met as a result of nursing interventions. Nursing diagnosis is the act of analyzing the assessment data and making a judgment about the nature of the data.
A nurse is monitoring all of the patients in an outpatient procedure area for complications of IV fluid administration. What type of function is the nurse demonstrating? A. Dependent nursing function B. Independent nursing function C. Autonomous nursing function D. Collaborative nursing function
D. Collaborative nursing function
A collaborative nursing function is demonstrated when the nurse monitors patients for complications of acute illness, administers IV fluids and medications per physician or nurse practitioner orders, and implements nursing interventions such as providing emotional support or teaching about specific procedures. Nursing functions may be dependent, collaborative, or independent. The nurse functions dependently when carrying out medical orders. Physician-initiated nursing functions may include administering medications, performing or assisting with certain medical treatments, and assisting with diagnostic tests and procedures. Independent nursing functions include interventions such as promotion and optimization of health, prevention of illness, and patient advocacy.
A 40-year-old female patient is being prepared for discharge home after a laparoscopic cholecystectomy. Which team member can be assigned to complete a discharge assessment and provide patient teaching for post-discharge care?
A. Registered nurse (RN)
B. Nursing technician (NT)
C. Unlicensed assistive personnel (UAP)
D. Licensed practical/vocational nurse (LPN/LVN)
A. Registered nurse
Nursing interventions that require independent nursing knowledge, skill, or judgment such as assessment, patient teaching, and evaluation of care cannot be delegated. These interventions are the responsibility of the RN. The scope of practice for LPN/LVNs is determined by each state board of nursing. The RN must know the legal scope of practical/vocational nursing practice and delegates and assigns nursing functions appropriately. In most states LPN/LVNs may administer medications, perform sterile procedures, and provide a wide variety of interventions planned by the RN. UAP are unlicensed individuals who serve in an assistive role to the RN and may include nursing assistants or technicians. The RN may delegate specific activities such as obtaining routine vital signs on stable patients, feeding/assisting patients at mealtimes, ambulating stable patients, and helping patients with bathing and hygiene.
When the nurse encourages a patient with heart failure to alternate rest and activity periods to reduce cardiac workload, what phase of the nursing process is being used? A. Planning B. Diagnosis C. Evaluation D. Implementation
D. Implementation
Carrying out a specific, individualized plan constitutes the implementation phase of the nursing process. The nurse’s action of encouragement and instruction to the patient is part of carrying out a plan of action
When planning care for a patient, the nurse may use a visual diagram of patient problems and interventions to illustrate the relationships among pertinent clinical data. What is this format called? A. Concept map B. Critical pathway C. Clinical pathway D. Nursing care plan
A. Concept map
A concept map is another method of recording a nursing care plan. In a concept map, the nursing process is recorded in a visual diagram of patient problems and interventions. A clinical (critical) pathway is a prewritten plan that directs the entire health care team in the daily care goals for select health care problems.
A nurse is providing care for a patient who had transurethral resection of his prostate this morning. The patient is receiving continuous bladder irrigation, but his urinary catheter is now occluded. The nurse is now planning to phone the patient’s health care provider and communicate using the SBAR (Situation-Background-Assessment-Recommendation) format. Which statement is a component of communication using SBAR?
A. “What do you think could be causing this occlusion?”
B. “I think that we should manually irrigate his catheter.”
C. “What do you know about this patient and his history?”
D. “Could you please provide some direction for his care?”
B. I think that we should manually irrigate his catheter.
Proposing a recommendation is a component of the “R” component of SBAR communication. Asking the health care provider for possible contributing factors to the problem or for general direction may be appropriate in some circumstances, but these are not explicit components of SBAR. The nurse should briefly identify the patient and his circumstances, not ask an open-ended question regarding the physician’s familiarity.
What factor has been most clearly identified as an influence on the future of nursing practice?
A. Aging of the American population and increases in chronic illnesses
B. Increasing birth rates coupled with decreased average life expectancy
C. Increased awareness of determinants of health and improved self-care
D. Apathy around health behaviors and the relationship of lifestyle to health
A. Aging of the American population and increases in chronic illnessess
The American population is aging at the same time that the incidence of chronic health conditions is increasing. There is no noted increase in the overall awareness of the determinants of health, but at the same time, observers have not identified apathy as a predominant attitude. Life expectancy is increasing, not decreasing.
A group of nurses have a plan to implement evidence-based practice (EBP) for care of patients with pressure ulcers. What will this change in practice encompass (select all that apply)?
A. Consulting with the wound care and ostomy nurse
B. The preferences of patients and their particular circumstances
C. Nurses’ expertise and their bodies of experience and knowledge
D. The traditions that surround pressure ulcer practices on the unit
E. Journal articles that address the care of patients with pressure ulcers
A. B. C. E.
EBP draws on research, data from local quality improvement, professional organization standards, patient preferences, and clinical expertise. The particular traditions on the nursing unit are not part of EBP.
A registered nurse (RN) has delegated the administration of IV medications to a licensed practical/vocational nurse (LPN/LVN). Which statement accurately describes delegation?
A. The RN should first teach the LPN how to administer IV medications.
B. Ultimate responsibility for the execution of the task now lies with the LPN.
C. The RN is still accountable for the quality of care and procedures that the patient receives.
D. The RN is responsible for observing and evaluating the administration of IV medications by the LPN.
C. The RN is still accountable for the quality of care and procedures that the patient receives.
Delegation entails a redistribution of nursing work, but the RN remains ultimately responsible and accountable for the execution of the task. It would be inappropriate to delegate if the LPN was unfamiliar with the task. The RN is not obliged to observe the LPN’s execution of the task.
Nurses deliver patient-centered care in collaboration with the interdisciplinary health care team within the framework of a care delivery model. In which care delivery model does the nurse plan and coordinate the aspects of patient care with other disciplines with a focus on continuity of care and interdisciplinary collaboration even when the nurse is absent? A. Team nursing model B. Primary nursing model C. Total patient care model D. Case management nursing model
B. Primary nusing model
Primary nursing model includes planning the patient’s care, coordinating and communicating all aspects of care with other disciplines and those providing care in the nurse’s absence. The focus is on continuity of care and interdisciplinary collaboration. Team nursing uses the RN as the team leader to organize and manage the care for a group of patients with other ancillary workers. The RN has authority and accountability for the quality of care delivered by the team only during the work period. In a total patient care model, the nurse is accountable for the complete care of the patient during the assigned shift. Case management is not a model of care delivery, but a collaborative process that involves assessing, planning, facilitating, and advocating for health services with a variety of resources to promote cost-effective outcomes.
Which interventions are independent nursing actions (select all that apply)?
A. IV reinsertion
B. Assessing lung sounds
C. Medication administration
D. First postoperative dressing change
E. Obtaining informed consent from the patient
A. B.
Independent nursing actions are those that a nurse is legally able to order or begin independently (e.g., turn every two hours, monitor for complications). Dependent interventions are physician-initiated. Medication administration is collaborative care as the health care provider must order the medication. Surgeons usually do the first postoperative dressing change. The health care provider legally must obtain informed consent from the patient, although the nurse may witness the consent.
