Trends Exam 1 Flashcards

The advanced practice nurse who is seeking information about requirements for practice in a specialized area should contact what nursing organization?

What is the primary purpose of licensure for professional registered nurses?

What statement presents accurate information concerning nurse practice acts?

Nursing legislation is to be current and reviewed annually by specific dates. If a nurse practice act fails to be reviewed, it is automatically rescinded under which law?

On which website would a nurse find a list of current compact states that allow for a single license recognized in multiple states?

What was the first field of nursing to certify advanced practitioners?

To request licensure to practice in France, a nurse licensed in the United States must engage in what initial step?

What should the nurse who is licensed in Georgia and moves to Oregon should do initially in preparation for seeking a nursing position as a pediatric nurse?

What statement accurately describes what it means to practice in a compact state?

What action is considered a nursing responsibility when participating in a nurse licensure compact?

A new graduate from a master‘s entry program in nursing announces, ―I just passed my clinical nurse leader certification examination.ǁ Certification as a clinical nurse leader provides acknowledgement of what nursing achievement?

A nurse holds a license in one state but wishes to practice in a second state that is not participating in a nurse licensure compact agreement. The nurse is granted licensure on payment of a fee but does not retake the licensure examination. The nurse has obtained licensure in the second state by what process?

A nurse practicing in the early 1900s was awarded a permissive license. What action was required by this type of license?

A group of registered nurses with associate nursing (and) degrees are concerned that the minimum educational standard for licensure as a registered nurse is being raised to the bachelor‘s (BSN) level. After contacting the American Nurses Association, they learn they will be ―grandfatheredǁ in. Under the ―grandfather clause,ǁ what action will be required of nurses with associate degrees?

What entity establishes the ―rulesǁ for nursing practice?

A nurse is completing the degree requirements for an advanced practice role as a nurse practitioner and is concerned about certification requirements. Which statement concerning certification for advanced practice is true?

Nurses in Tennessee, Mississippi, and Arkansas gather for a conference related to improving quality and safety in practice and nursing education. They are awarded continuing education (CE) credit for participation and evaluation of the conference. One nurse from California states, ―I need these CEs to renew my license.ǁ The nurse from Mississippi replies, ―You do not need CEs for license renewal or advance practice certification renewal.ǁ Which statement about CEs would help these nurses?

What actions should a nurse who wishes to practice in another state take initially? (Select all that apply.)

Which statements concerning licensure as a registered nurse are correct? (Select all that apply.)

What duties are assumed by a state‘s board of nursing? (Select all that apply.)

A nursing student is in the final term of an Associate Science of Nursing (ASN) program and is preparing for licensure. Prior to licensure the candidate must provide evidence that they have fulfilled what requirements? (Select all that apply.)

Which nursing theory might a nurse use as a conceptual framework to determine how to meet the needs of immigrants while ensuring provision of high-quality and culturally sensitive care?

What term is used to identify the process used to determine the relationships among related concepts and a common theme?

The statement, ―Nursing is a caring profession that focuses on helping people be as healthy as possible,ǁ is an example of what term?

Which nursing theory served as the foundation for nursing science?

A community health nurse has been visiting a postpartum client who experienced domestic violence throughout the pregnancy, and now she and the infant may be at risk. The nurse assisted the client in finding shelter and legal protection. Which conceptual framework is the basis for the nurse‘s safety interventions?

What term is used to identify the general explanations that scholars use to explain, predict, control, and understand commonly occurring events?

Which type of theory most often guides present nursing practice?

A client is hypertensive, and the doctor prescribes weight reduction. The client is excited about beginning the diet, but on arriving home the spouse states, ―You have always been fat, and I am not going to starve because you can‘t control yourself.ǁ The client becomes anxious and is unable to participate in the diet plan, resulting in a weight gain of 5 pounds in 2 weeks. Which theorist could best be referred to for guidance regarding interventions in this situation?

A nurse believes that humans use creativity and critical thinking to balance their connections with their surroundings. The nurse decides to conduct a study based on this belief. Which nursing theory would be best for this study?

A client involved in a motor vehicle accident is blinded. The nurse helps the client obtain a guide dog so the client may continue grocery shopping and visiting friends and family. This enables the client to cope with the handicap and perform activities of daily living. Which nursing theory can be applied to this scenario?

A young child is having abdominal pain, and the doctor informs the parents that a computed tomography (CT or CAT) scan of the abdomen will be ordered. The doctor tells the child, ―This CAT scan won‘t hurt you.ǁ The child is visibly upset because of a fear of cats. According to Mishel‘s uncertainty in illness theory, which stage of the framework is represented?

A nurse researcher determines whether findings are substantial by calculating the level of significance. Which aspect of the scientific inquiry is being conducted?

At delivery the physician informs the mother who has practiced nursing for 10 years, ―Your baby has Alport syndrome, but then I don‘t have to explain what that means with your medical background.ǁ The mother is unfamiliar with this disease and withdraws as a coping mechanism. Which nursing theory would provide a framework to guide nursing care for this mother?

When applying Nightingale‘s theory to current practice, the nurse‘s first step will be to evaluate the hospital room‘s air quality. What should be the nurse‘s second step?

A nurse develops a new nursing theory related to stress and viability. The nurse determines the theory accounts for historical events in which soldiers suffering from the stress of inadequate clothing to protect them from the cold and lack of correspondence from home had an increased mortality related to gunshot wounds. The theory will predict gunshot victims‘ need for proper clothing and letters from significant others as they serve in Iraq. Which criterion for theory acceptance is being validated?

A nurse practicing on a unit where domestic violence is common wants to learn how to apply nursing theory to practice on this unit. The nurse considers the interrelatedness of the constructs of Watson‘s Theory of Caring and creates a design related to what?

A nurse plans activity of daily living to prevent excessive fatigue while allowing the patient to exercise autonomy in selecting what they wear. This nurse is best applying which theory to practice?

A nurse is evaluating Levin‘s Theory of Conservation to determine if it can be applied to patients in the initial phases of chemotherapy treatment. During this phase of theory acceptance, the nurse wants to determine if all the concepts of energy, structural integrity, personal integrity, and social integrity are included in the care of cancer treatment. The nurse is applying which criteria of theory acceptance?

A nurse is heard making this comment, ―I believe human dignity is based on perceived self-worth while caring is based on perceived role in society that forms the basis of nursing practice.ǁ This nurse‘s statement is associated with what action?

A group of nurses are interested in the how to improve teaching effectiveness for patients who have a hearing impairment and lack family involvement while hospitalized. They believe ―hearing loss decreases the teaching effectiveness while hospitalized.ǁ The group plans to evaluate teaching effectiveness using a 10-point Likert scale pre-post teaching, perform a hearing test to determine degree of hearing loss on admission, and have social work evaluate the impact of hearing impairment on patient‘s ability to safely live alone prior to discharge. The group is working in which step of the scientific process?

Which of the following are concepts related to nursing theory? (Select all that apply.)

A client arrives in active labor and exhibits toxemia with irregular fetal heart tones. theclient is an immigrant and is uninsured. Which act would prevent theclient from being transferred to another facility?

A nurse is caring for a client with malignant hypertension whose blood pressure has increased by 40 mm Hg during thepast hour. thenurse goes to lunch and fails to report thechange to thephysician. thenurse is at risk for being charged with which legal claim?

A nurse is caring for a client who just suffered a stroke and is medicated for pain. the nurse completes the following interventions: places the client on the examining table, completes a thorough history and physical, covers the client with a sheet, places the call button within reach, and goes out in the hall to speak with the client‘s primary care provider. The client tries to get up to speak with his family and falls, sustaining a hematoma on the head and a broken hip. the nurse's actions reflect which legal claim?

A nursing student planning to apply for licensure knows that being charged with which offense would result in a misdemeanor criminal offense?

When differentiating between slander and libel, the nurse knows that libel is characterized by what action?

A client states, ―I am leaving. No one here knows what they are doing.ǁ The nurse completing the Against Medical Advice form must implement what intervention to best assure client safety.

When can a nurse detain a client by implementing restraints?

When the client is unable to make medical decisions, authorization that allows another person to make these decisions is referred to by what term?

All hospitals receiving Medicare and Medicaid funds must ask clients whether they have a living will or a durable power of attorney. What legislative act makes this action mandatory?

A nurse who functions in the role of team leader can be held negligent for matters involving what focus?

Although a hospital reversed all charges when a client was the victim of wrong-site surgery, the court awarded the client $1.5 million. The client could return to work in 6 weeks and had no permanent damages. This monetary compensation is referred to by what term?

A primary health provider prescribes a drug for a patient with a known allergy, it is administered and results in anaphylactic shock. What statement is accurate regarding disclosure of this event?

A nurse testifies at trail that a professional with the knowledge and skill of an RN should understand that, before administering digoxin, the client‘s potassium level and pulse level is always checked to prevent negative effects on cardiac output. the nurse's testimony as to what constitutes reasonable care is based on what criteria source?

A blood reaction occurrence is noted in a client who did not receive pretransfusion care as clearly documented in the facility‘s policies and procedures. the nurse providing care is liable for which legal tort?

A physician shares with the patient‘s family that, while a central line was being inserted, the patient‘s lungs were inadvertently punctured, which required oxygen administration. The physician also explains that a chest x-ray indicated the lung remained intact and no additional treatment was required. The physician‘s role in this instance is based on what legal principle?

A nurse is assigned to a unit other than the one she is normally assigned due to increased census on the alternate unit. She is assigned to care for seven patients and participates in walking rounds where the patient‘s condition and needs are discussed between oncoming and off-going shifts of the interdisciplinary team. the nurse carefully makes notes of all pending orders and prioritizes needs. The nurse enters the cafeteria later and the notes accidentally fall from her pocket, which contain the above information that contains patient sensitive data. the liabilities arising from this incident would be covered under what issue?

Which components must be included regarding informed consent? (Select all that apply.)

Which nursing situation demonstrates the greatest need for individual malpractice insurance to help manage professional legal risk? (Select all that apply.)

Which types of abuse are the nurse required to report or be subject to fines and imprisonment for not reporting? (Select all that apply.)

What examples should the nurse provide to best describe an advance directive? (Select all that apply.)

A nurse learns in orientation that an incident report does not ―blameǁ anyone but concisely documents the events leading up to an occurrence. Which events would warrant completion of an incident report? (Select all that apply.)

A priority action for the nurse who works with culturally diverse clients to complete initially is completion of additional form of support.

A nurse is caring for a recent Asian immigrant client and is overheard making the following comment, ―These rituals you believe in are false. You live in America now and must believe in realistic health practices, like Americans do.ǁ the nurse is exhibiting behavior associated with what belief?

A nurse is submitting a grant application to improve access to health care and mortality for minority groups. thegrant focuses on thesix causes of death that are identified as priorities for minorities, which include what medical diagnosis?

A nurse is given a referral to make a home visit to a Russian immigrant. the nurse knows very little about the health beliefs of this ethnic group. To research this group, what term should the nurse use in an Internet search?

Which statement is true regarding health care for minorities?

While completing a masters nursing degree in Virginia, a nurse who is interested in teaching in Laredo, Texas, enrolls in Spanish classes for 4 years, knowing that a high number of Mexican-Americans live there. This nurse is demonstrating what social value?

A nurse plans to move to an area that is rich in immigrants from several countries and is concerned about respecting others‘ cultural beliefs. What is the nurse‘s first step to ensure cultural competence and sensitivity?

An Asian teenager is admitted with an eating disorder which she contributes to not meeting the academic expectations of her parents. The nurse is overheard saying, ―That isn‘t the reason; all Asians are really smart.ǁ This nurse is demonstrating is which cultural biases?

Six cultural phenomena that vary among cultural groups are known to affect health care. The influence of the consequences of these phenomena can be seen in which of the following? (Select all that apply.)

A nurse involved in researching the leading causes of death for minorities considers the federally defined minority groups, which include what populations? (Select all that apply.)

The task of completing and signing the initial assessment on a newly admitted patient who is about to undergo minimally invasive procedures on an outpatient basis can be delegated to whom?

An RN recently relocated to another region of the country and immediately assumed the role of charge nurse. When determining the appropriate person to whom to delegate, the RN bases decisions on what fact?

Which task is most likely to be considered in a state‘s practice act as appropriate to delegate to a LPN/LVN if the patient‘s condition is stable and competence in the task has been established?

A patient is admitted with hypotension, shortness of breath, flushing, and hives. All levels of staff have been trained to assess vital signs. Given budget restrictions and proper delegation rules, to which care provider would the RN delegate the task of obtaining the initial blood pressure reading?

A nurse is delegating to the newly hired nursing unlicensed assistive personnel (UAP) the task of assisting with oral hygiene, knowing that this assignment ―does not require decisions based on the nursing process.ǁ The nurse is correctly using which of the five rights of delegation?

A student nurse is concerned about delegation practices and wonders why hospitals employ unlicensed assistive personnel (UAP) and LPN/LVNs. The student nurse refers to the National Council of State Boards of Nursing and learns that the role of these personnel is to focus on what?

An RN delegates to the unlicensed assistive personnel (UAP) the task of performing blood pressure checks for a group of patients on a nursing unit. The UAP accepts the task and is responsible for what associated task?

Which task is appropriate for the RN to delegate to the unlicensed assistive personnel (UAP) provided the delegate has had experience and training?

An LPN/LVN has transferred to a nursing unit and arrives for the first day. The RN checks with the LPN/LVN often throughout the shift to provide support and determine if assistance is needed. The RN is providing which level of supervision?

An RN is counseled by the nurse manager regarding inappropriate delegation when the RN engages in what activity?

An RN delegates to an experienced LPN/LVN the task of administering oral medications to a group of patients. The RN then observes the LPN/LVN recording a patient‘s medication administration just before entering the patient‘s room. What is the RN‘s initial intervention

Which statement related to delegation is correct?

During orientation, an RN learns that LPN/LVNs in the facility receive additional training to perform some tasks such as hanging continuously infusing intravenous fluids that have no additives. It is important for the RN to understand that what is the basis for this practice?

A nurse moves from California to Arkansas and due to having 20 years of experience as a registered nurse is immediately placed in charge of the telemetry unit. The staffing consists of LPNs and two unlicensed assistive personnel. The RN is unsure of the scope of practice of the LPNs and reviews the nurse practice act for Arkansas, which lacks clarity on some tasks. What should the RN do to best acquire the necessary information?

An RN makes the following assignments at the beginning of the shift. Which assignment would be considered high-risk delegation?

The RN instructs the LPN to ―Give an enema to the discharged patient in room 327 who is reporting being constipated. Then be sure to document on the medication administration record when given.ǁ Which of the five rights was missing in this situation? The right of

Which situation would be appropriate for the supervisory level of initial direction and/or periodic inspection?

When determining the scope of practice for licensed practical nurses (LPN) and unlicensed assistive personnel (UAP), which statement accurately describes the common policies which exist in most state practice acts?

A nurse is concerned about the risk of delegating tasks to licensed practical nurses and unlicensed assistive personnel. What is the best way for the nurse to determine competency of an inexperienced delegatee?

Care delivery using the team-based approach is used on a telemetry nursing unit. The team consists of one registered nurse (RN), two licensed practical nurses (LPNs), and one unlicensed assistive personnel (UAP). Staff have been charged to improve quality of care while ensuring cost containment. Which assignments would meet both criteria?

Which statement made by an RN regarding delegation indicates the need for additional teaching? (Select all that apply.)

When considering the feasibility of an all-RN staff, a nursing administrator determines what fact concerning the RN‘s role? (Select all that apply.)

Which functions can be delegated only to another RN with appropriate experience and training? (Select all that apply.)

What process is a nurse engaging in when making the decision that no action is required when assessing a 40-year-old client‘s blood pressure and noting that it is 116/78 mmHg?

Which statement made by a novice nurse best demonstrates the use of clinical experience when engaging in clinical judgment?

Which nursing action best demonstrates the expected outcome of an assessment?

The nurse is prioritizing hypotheses related to a patient‘s primary areas of concern. Which nursing statement reflects the outcome of this process?

The nurse has been assessing a client‘s vital signs every 4 hours as ordered. After noting that the client‘s blood pressure has fallen 6 systolic points over the last 2 assessments, the nurse begins to assess the vital signs every two hours. This is an example of what process associated with clinical judgment?

In addition to identifying a client‘s strengths and weaknesses, while analyzing the assessment data, what should the nurse be doing?

In what phase/stage is it appropriate for the nurse to refer to quality improvement activities regarding client care?

The nurse recognizes that an appropriately developed nursing diagnosis contains what component parts? (Select all that apply.)

Which of the following are phases of Tanner‘s Clinical Judgment model (TCJM)? (Select all that apply.)

A novice nurse caring for a post-operative client discovers that the client‘s abdominal wound has dehisced. After the client is returned to surgery for the needed repair, the nurse manager encourages the novice nurse to engage in the process of reflection. What questions would be included in this process? (Select all that apply.)

During orientation, a novice nurse sits and ―virtually spendsǁ the first few paychecks, envisioning the money going into a personal bank account. In the dream state, the nurse smiles and knows that the pain of nursing school was worth it. Which phase of reality shock is the nurse experiencing?

A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is identified with what term?

According to Kramer, nurses in the shock phase should ask themselves what?

The novice nurse arrives on the nursing unit, is introduced to the staff, is assigned a preceptor, and is asked to participate in the next staff meeting. This introduction into nursing is appropriately identified using what term?

Several novice nurses share lunch breaks and have comments such as, ―I have insomnia from worrying about what I forgot to do for my patient,ǁ and ―I have no energy,ǁ and ―I can‘t believe I can‘t do my job correctly.ǁ These novice nurses are each experiencing different symptoms of what process?

which nurse is more prone to burnout?

A nurse notices the novice medication nurse hurriedly gathering medications to be administered for the entire day, removing them from the packages, and placing them in a paper cup with the patient‘s name and room number on the cup. When one of the patients points at a pill and asks, ―What is this?ǁ and ―What does this do?ǁ the medication nurse is uncertain, because it has long since been removed from the packaging. What role is the nurse playing when taking his/her observations, concerns, and suggestions to the nurse manager?

The novice nurse calls a supervisor and requests that a ―float nurseǁ be assigned to help with all ―assessments of new admissions and postoperative patients.ǁ The supervisor asks, ―How many admissions and surgery patients have you received?ǁ The novice nurse becomes flustered because she has not checked the census but simply bases the need on feeling overwhelmed. This situation best indicates a lack of what type of skills?

When the novice nurse asks, ―What will happen if this task is not completed,ǁ which skill is being demonstrated?

in distinguishing between evaluation methods used in school versus those used in the work environment, it is noted that the work environment evaluation includes what?

When comparing mentoring and role modeling, the role of mentoring is represented by which of the following situations?

A certified oncology nurse notices that a novice nurse is unsure of decision making and lacks technical skills. The novice nurse gains confidence by sharing and learning with the experienced nurse. This relationship continues and builds, allowing the novice nurse to become more confident. This relationship is identified by what term?

A novice nurse is unsure how to correctly administer an injection using the Z-track method. What is the best approach for learning this procedure?

A student nurse wants to meet other nursing students from different countries and to learn of employment possibilities. The student nurse should consider doing what?

An experienced nurse working in oncology is shocked to realize that he/she feels little empathy when a patient explains, ―I developed cancer from having to work in the dry cleaning industry since I was only 8 years old to help support my younger siblings during the depression. Now they have all moved away and refuse to help me financially, and it takes everything I have to pay for my chemotherapy medicine.ǁ What term is used to describe this situation?

A recruiter is explaining benefits to a group of nursing externs who are highly sought for employment. The recruiter states, ―We are the only hospital in town that offers a residency program.ǁ What further information should the recruiter provide about a residency program?

A novice nurse is stressed due to always being behind with her assignments. She is overheard saying, ―No one here worries about checking nasogastric tube placement before they give medications and hang feedings. Skipping that step would save me an extra 30 minutes to be used for charting. If they can do it, so can I.ǁ This nurse is experiencing which stage of reality shock?

A novice nurse is placed in charge just after orientation ends. Which statement by the novice nurse would ensure a smooth delegation experience when delegating to an experienced staff member?

A novice nurse is in the ―rejection phaseǁ of stress and wonders if she/he made the right decision when deciding nursing was her/his chosen career. Which strategy would help the novice nurse cope with transition into practice and reduce stress?

In orientation, a new graduate is surprised to learn of workplace violence in health care agencies and asks, ―What kind of violence is common in hospitals?ǁ The educator describes workplace violence bases on what statement? (Select all that apply.)

Faculty comes to class to present information about joining the Student Nurses Association (SNA). A student is heard saying, ―Why join this organization? It is just a bunch of students like us. I‘ll wait and join the real nursing organization after graduation.ǁ This student is not aware of which benefits of SNA? (Select all that apply.)

Which statements demonstrate characteristics would be desirable in a mentor? (Select all that apply.)

When may the graduates from approved schools of nursing sign their charting as registered nurses (RNs)?

Which statement concerning the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination is correct?

What does the phrase computerize nursing focused adaptive testing imply?

1. On the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination, when the candidate is asked to set goals in collaboration with other members of the health care team, the nurse is being tested on what area of nursing practice?

What is the length of the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination based upon?

What is the primary purpose of the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination?

A student nurse who is preparing to graduate and take the licensure examination asks, ―What is compulsory licensure?ǁ What is the appropriate response of the nursing advisor?

The National Council of State Boards of Nursing determines acceptable National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination questions based on what criteria?

Although the NCLEX-RN examination has new formats for questions, what is the most common format?

When delegating care, the RN assigns one nurse to care for a patient with shingles and a different nurse to care for a patient with human immunodeficiency virus/acquired immunodeficiency disease syndrome (HIV/AIDS). This represents which category of nursing care?

A patient is brought to the unit with mediastinal chest tubes with no fluctuation in the water seal chamber; arterial blood gas results reveal pH, 7.55; CO2, 55; HCO, 28 mEq/L, and O2, 98%. Carotid artery pulsation is visible with the head of the bed elevated and the use of tangential lighting. What should be the nurse‘s first action? The above question represents which level of Bloom‘s taxonomy?

A candidate who is taking the NCLEX-RN examination received only 75 questions before the test was stopped. She called her professor and stated, ―I passed. I had to answer only 75 questions.ǁ The professor correctly provides what response?

Which statement accurately describes an expectation of the NCLEX-RN examination tester?

In the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination test plan, client needs form the organizing framework of the examination with questions in four categories: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiologic integrity. Certain processes are then integrated throughout the categories of client needs. Which process is integrated into all client need categories?

Which action would help a student successfully prepare for the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination?

The nurse prepares to apply sterile gloves needed for a procedure. After introducing self and verifying patient information, the nurse performs hand hygiene. The nurse should open the outer package and then perform the following steps in order: (items on left will be moved in correct order on the right)

A graduate is preparing for the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination. Based on the latest practice survey, the candidate would focus the most amount of time on which content?

Which strategy would promote a high rate of success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination?

A candidate is taking the NCLEX-RN examination when the computer turns off. The candidate was aware they had reached the 6-hour time limit. A count of completed questions had been recorded on the note pad, and 100 questions were answered. How will the examination be scored?

The order reads: Administer 500 mg of cefazolin sodium intramuscular. Using information located on the medication vial above, the nurse will administer how many mL?
The above question represents which type of alternate-format question written at which level of Bloom‘s taxonomy?

A patient with end-stage renal disease has a potassium level of 7.5 mEq/L. Based on this laboratory result, the nurse interprets which symptom as significant prompting which action?

A patient presents with chest pain that increases when lying flat and a low-grade fever. Assessment reveals muffled heart sounds, tachycardia, and 3+ edema in the lower extremities. The nurse asks the patient to learn forward, which eases respiratory efforts. The nurse then places the stethoscope at which area on the chest to facilitate auscultation?
The above question represents which type of alternate-format question written at which level of Bloom‘s taxonomy?

The nurse prepares to apply sterile gloves needed for a procedure. After introducing self and verifying patient information, the nurse performs hand hygiene. The nurse should open the outer package and then perform steps in which order.