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Trends Exam 1

front 1

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

back 1

American Nurses Credentialing Center (ANCC)

front 2

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

back 2

Protecting the public from physical and emotional harm

front 3

What statement presents accurate information concerning nurse practice acts?

back 3

They are written and passed by state legislators.

front 4

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 If a nurse practice act fails to be reviewed, it is automatically rescinded under which law?

back 4

Sunset legislation

front 5

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

back 5

National Council of State Boards of Nursing (NCSBN)

front 6

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

back 6

Nurse anesthesia

front 7

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

back 7

Contacting the International Council of Nurses (ICN) or the nursing regulatory board of that country

front 8

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?

back 8

Review Oregon‘s nurse practice act related to licensure for endorsement.

front 9

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

back 9

Patients‘ rights in relation to the nurse practice act are protected by the mutual recognition model.

front 10

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

back 10

Complying with the nursing practice laws in the state where practicing at the time care is rendered

front 11

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?

back 11

Demonstrating advanced nursing skills and knowledge

front 12

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?

back 12

Licensure by endorsement

front 13

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

back 13

While licensure was voluntary; if you failed the examination, you could not use the title RN.

front 14

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?

back 14

They will continue to use the title ―registered nurse earned by their original success with the licensure process.

front 15

What entity establishes the ―rulesǁ for nursing practice?

back 15

Individual state boards of nursing

front 16

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?

back 16

All states require certification for all specialty roles that are identified as advanced practice.

front 17

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?

back 17

The purpose of continuing education is to ensure competence of the workforce after graduation, but each state determines if CEs are required.

front 18

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

back 18

Determine whether the state is a compact state.

Inquire about obtaining licensure by endorsement.

front 19

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

back 19

Each nurse practice act describes requirements for initial licensure.

Candidates for licensure must present proof of graduation as required by the state.

front 20

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

back 20

Grants nursing licensure.

Assigns disciplinary action when the nurse acts in a manner that results in harm to a patient.

Assures qualified members are appointed to the board.

front 21

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.)

back 21

Graduation from a nursing program

Graduation from high school or high school equivalency

front 22

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?

back 22

Madeleine Leininger‘s nursing theory

front 23

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

back 23

Model

front 24

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

back 24

Philosophy

front 25

Which nursing theory served as the foundation for nursing science?

back 25

Nightingale‘s theory of practice

front 26

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?

back 26

Change agent, according to Roy‘s adaptation model

front 27

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

back 27

Theories

front 28

Which type of theory most often guides present nursing practice?

back 28

Middle range theory

front 29

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?

back 29

Hildegard E. Peplau

front 30

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?

back 30

Rogers‘ science of unitary human beings: humans as energy fields that interact constantly with the environment

front 31

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?

back 31

Orem‘s self-care deficit

front 32

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?

back 32

Stimuli frame

front 33

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

back 33

Evaluation

front 34

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?

back 34

Mishel‘s uncertainty of illness

front 35

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?

back 35

Arrange for the client‘s window blinds to remain open as appropriate.

front 36

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?

back 36

Accuracy

front 37

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?

back 37

Conceptual model of caring

front 38

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?

back 38

Levine‘s Theory of Conservation

front 39

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?

back 39

Inclusiveness

front 40

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?

back 40

Making a proposition concerning the constructs of nursing practice

front 41

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?

back 41

Method

front 42

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

back 42

Environment
Health

Nursing

Comfort

front 43

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?

back 43

The Emergency Medical Treatment and Active Labor Law

front 44

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?

back 44

Negligence

front 45

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?

back 45

Negligence

front 46

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

back 46

Failing to report elder abuse

front 47

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

back 47

Defamation caused by subjective comments written in thenurse‘s notes

front 48

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.

back 48

Inform the client that leaving could result in complications and impairment.

front 49

When can a nurse detain a client by implementing restraints?

back 49

There are current prescribed instructions for their use.

front 50

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

back 50

Durable power of attorney

front 51

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?

back 51

Uniform Health Care Decisions Act

front 52

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

back 52

Delegation

front 53

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?

back 53

Punitive damages

front 54

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?

back 54

Disclosure as an essential component of the national patient safety movement.

front 55

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?

back 55

The legal definition of standard of care

front 56

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?

back 56

Criminal negligence

front 57

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?

back 57

Disclosure

front 58

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?

back 58

Compliance with theHealth Insurance Portability and Accountability Act (HIPAA)

front 59

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

back 59

Identification of risks for non-treatment

Discussion of expected benefits

Identification of known risks

Acknowledgement of alternative therapy

front 60

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

back 60

Accepting the role of weekend unit manage

Delegating health care responsibilities to nursing staff

Being licensed in a state where sovereign immunity is in effect

Regularly working in the facility's float pool

front 61

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

back 61

Child

Infant

front 62

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

back 62

Providing instructions about personal preferences regarding life-sustaining medical procedures

Giving someone the legal right to act on one‘s behalf when one becomes

incapacitated

front 63

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.)

back 63

An intravenous antibiotic given preoperatively does not infuse because of a faulty pump.

The nurse is unable to carry out orders written by the specialist because of illegibility.

A client falls while in the shower after being instructed not to get up alone.

The registered nurse is not available to complete the preoperative checklist.

front 64

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

back 64

Cultural self-assessment

front 65

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?

back 65

Ethnocentrism

front 66

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?

back 66

Breast cancer

front 67

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?

back 67

Marginalized populations

front 68

Which statement is true regarding health care for minorities?

back 68

Higher costs of health care coupled with lower wages for minorities have prevented most minorities from seeking health care.

front 69

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?

back 69

Cultural competence

front 70

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?

back 70

Conducting a cultural self-assessment to identify biases or prejudices

front 71

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?

back 71

Stereotyping

front 72

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.)

back 72

Blacks and American Indians often resist direct eye contact.

Mexican Americans are more likely to stand close and touch health care providers.

front 73

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.)

back 73

Blacks

Hispanics

Asians or Pacific Islanders

front 74

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?

back 74

The registered nurse (RN)

front 75

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?

back 75

Review of the state‘s nurse practice act for LPN/LVNs is vital since it defines the role and scope of practice of the LPN/LVN.

front 76

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?

back 76

Administer an enema for an elective surgery patient.

front 77

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?

back 77

RN

front 78

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?

back 78

Circumstance

front 79

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?

back 79

Aiding the RN by performing appropriately delegated care tasks

front 80

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?

back 80

Keeping the RN informed of any abnormal blood pressure readings

front 81

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

back 81

Obtain a sterile urine sample from a patient with a Foley catheter that is connected to a closed drainage system.

front 82

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?

back 82

Continual supervision is being provided until the RN determines competency.

front 83

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

back 83

Assigning the float LPN/LVN the task of completing a plan of care for a stable patient who was admitted for routine replacement of a feeding tube.

front 84

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

back 84

Stopping the LPN/LVN immediately and nonjudgmentally discuss the possible consequences of this action.

front 85

Which statement related to delegation is correct?

back 85

The RN must be knowledgeable about the laws and regulations that govern nursing practice, as well as those that have no clearly defined parameters, such as for UAP.

front 86

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?

back 86

The nurse practice act and state regulations related to delegation override the organization‘s policies.

front 87

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?

back 87

Contact the state board of nursing to determine legal scope of practice for LPNs.

front 88

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

back 88

An unlicensed assistive person (UAP) is assigned the task of assisting a patient with late stages of Huntington‘s disease to ambulate.

front 89

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

back 89

direction and communication.

front 90

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

back 90

The RN assigns the LPN tasks within her scope of practice and checks back during the shift to ensure the tasks are completed correctly.

front 91

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?

back 91

To determine what tasks can be safely delegated, the RN must first assess the patient.

front 92

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?

back 92

Personally observe the delegatee perform the assigned task.

front 93

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?

back 93

The experienced UAP places telemetry electrodes and attaches to cardiac monitor.

front 94

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

back 94

Unlicensed assistive personnel (UAP) can assess vital signs during the first 5 minutes for a patient who is receiving a blood transfusion because a reaction now is unlikely.

An LPN/LVN can administer a PPD (tuberculin skin test) if there is no history of a positive PPD.

When dopamine is ordered continuously, the LPN/LVN can administer dopamine at a low dose for increasing renal perfusion.

front 95

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

back 95

They have a positive effect on patient outcomes when managing patient care.

They are effective overseers of patients‘ overall health condition.

Their training makes them effective care delegators.

front 96

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

back 96

Assessment of skin integrity on third day of hospitalization

Evaluation of patient teaching related to turn, cough, and deep breathing exercises

Nursing judgment related to withholding medication based on vital signs

Formulation of nursing diagnosis ―potential for fallǁ

front 97

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?

back 97

Clinical judgment

front 98

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

back 98

The primary care provider prescribed a sedative when a patient had a similar reaction.ǁ

front 99

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

back 99

Noticing the patient‘s fingernails have a bluish cast

front 100

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

back 100

At Risk for Injury related to Falling evidenced by unsteady gait.

front 101

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?

back 101

Responding

front 102

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

back 102

Recognizing potential health problems

front 103

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

back 103

Evaluating

front 104

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

back 104

Etiology

Diagnostic label

Relevant signs and symptoms

front 105

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

back 105

Noticing

Interpreting

Responding

front 106

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.)

back 106

What should I‘ve done differently?ǁ

Did any of my actions turnout poorly?ǁ

Which of my actions had a positive effect?

Where there any of my actions that were unnecessary?ǁ

front 107

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?

back 107

Honeymoon

front 108

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?

back 108

Shock or rejection

front 109

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

back 109

What changes can I make to make me feel good about the choice to become a nurse?ǁ

front 110

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?

back 110

Socialization

front 111

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?

back 111

Burnout

front 112

which nurse is more prone to burnout?

back 112

The one who accepts most offers of overtime

front 113

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?

back 113

Change agent

front 114

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?

back 114

Organizational

front 115

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

back 115

Priority setting

front 116

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?

back 116

Appraising outcomes according to policy expectation

front 117

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

back 117

The novice nurse receives feedback from the experienced nurse related to the use of a new occlusive dressing product and is told, ―I couldn‘t have done it better myself.ǁ

front 118

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?

back 118

Mentoring

front 119

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?

back 119

Ask to observe an experienced nurse as the skill as it is being performed; then perform it under direct supervision.

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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?

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Joining the Student Nurses Association

front 121

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?

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Compassion fatigue

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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?

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It offers extended time for both theory and clinical activities that promote problem solving and clinical decision-making.

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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?

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Native

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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?

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You have patients in rooms 5 through 10 and I will administer all IV medications.I will let you know if I must adjust. If you see you need help let me know.ǁ

front 125

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?

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When asked by the charge nurse to accept the new admission even though she/he had no discharges, the novice nurse stops and considers if this request is acceptable and safe, then accepts the assignment based on two patients having a low acuity level.

front 126

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.)

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It is experienced nurses withholding pertinent information from coworkers to portray them as incompetent

It is demonstrated in statements such as ―The new nurse has book sense but can‘t perform an admission physical without the help of everyone on the unit.ǁ

front 127

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.)

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Leadership skills can be refined by working with other schools of nursing.

A global view of nursing can be obtained through networking internationally.

front 128

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

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How were you taught to do this is school?ǁ

Can you think of a way to make this easier for the patient?ǁ

Let me know when it‘s a good time to show you how to do this new scale.ǁ

Today was rough but there are fewer admissions scheduled for tomorrow.ǁ

front 129

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

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After passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN®)

front 130

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

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Graduates from all three types of nursing programs (diploma, associate degree, and baccalaureate degree) take the same NCLEX-RN examination.

front 131

What does the phrase computerize nursing focused adaptive testing imply?

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Competency is determined based on the difficulty of questions, knowledge of the nursing process, and the number of questions answered correctly.

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  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?

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Planning

front 133

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

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The performance of the candidate

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

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Ensuring that practitioners have the minimum skills and knowledge needed to provide care that will produce the best patient care outcomes

front 135

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?

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To practice as an RN, the nurse must be licensed as a registered nurse (RN).

front 136

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?

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Research that indicates needed skills for positions in which most entry level nurses are employed

front 137

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

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Multiple-choice question item, which allows candidates to select the one correct answer.

front 138

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?

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Safe and effective care environment

front 139

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?

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Analysis

front 140

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?

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It is possible to receive only 75 questions and not be successful; however, we will keep a positive attitude.ǁ

front 141

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

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They should study and take practice examinations written at the application and analysis level to ensure that they can meet the higher standards of nursing care and health care delivery.

front 142

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?

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Teaching/learning

front 143

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

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Practicing taking NCLEX-RN examination-type questions and reviewing rationales for correct and incorrect answers

front 144

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)

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Drag-and-drop item, comprehension

front 145

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?

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Pharmacologic pain management

front 146

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

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Read the entire question and all possible answer options before selecting an answer.

front 147

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?

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The computer will analyze the last 60 questions and if above the passing standard, the candidate passes.

front 148

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?

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Chart/exhibit item, analysis level

front 149

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?

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Drowsiness, stimulate the patient every 30 minutes

front 150

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?

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Hot-spot item, analysis level

front 151

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.

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Open inner package, taking care not to touch inner surface.

Put glove on dominant hand by grasping folded cuff edge, touching only inside of cuff.

Put the glove on the nondominant hand using the sterile gloved hand.

Adjust each glove carefully by sliding finders under the cuff.