Test Bank for Nursing in Today's World 10th Edition by Ellis

Transcription

1 Test Bank for Nursing in Today's World 10th Edition by Ellis Link download full: wnload/test-bank-for-nursing-intodays-world-10th-edition-by-ellis Chapter 1: Exploring the Growth of Nursing as a Profession Multiple Choice 1. Which of the following statements most accurately describes the practice of medicine in Greece from 800 BC to 300 BC? A) Greek culture stressed natural causes for disease, a patient-centered approach, and the necessity of accurate observations and record keeping. B) Greek culture borrowed medical practices from the countries it conquered, and physicians were often slaves. C) Major and minor surgery, childrens diseases, and diseases of the nervous and urinary systems were described in Greek culture. D) Medicine men (known first as shamans and later as priests) were responsible for curing ills of body and mind. Ans: A Client Needs: B Cognitive Level: Comprehension Objective: 1 Page and Header: 4, Table 1.1 Feedback: Hippocrates, born about 400 BC, was a Greek citizen who became known as the Father of Modern Medicine. He emphasized natural causes for disease, a patient-centered approach, and the necessity of accurate observations and record keeping. These priorities influenced the practice of medicine both in Greece and beyond. Persia was known to utilize slaves as physicians, and Rome borrowed medical practices from the countries it conquered. Ancient India emphasized hygiene and prevention of sickness and described major and minor surgery, childrens diseases, and diseases of the nervous and urinary systems. Medicine men were characteristic of the Mayan and Aztec civilizations.

2 2. Florence Nightingale fostered the development of nursing as a profession. What was the basis of her nursing theory? A) The nurses role is to assist individuals (sick or well) to carry out those activities that they would perform unaided if they had the necessary strength, will, or knowledge. B) The goal of nursing is to put the patient in the best condition for nature to act upon him, primarily by altering the environment. C) The focus of nursing is the spiritual subjective aspects of both the nurse and the patient and the caring moment relating to the time when the nurse and the patient first come together. D) The focus of nursing is the care of human beings who are viewed as open systems in constant interaction with their environments. Ans: B Difficulty: Difficult Objective: 2 Page and Header: 21, Early Definitions of Nursing Feedback: Florence Nightingale, in her Notes on Nursing: What It Is and What It Is Not, described the nurses role as one that would put the patient in the best condition for nature to act upon him (Nightingale, 1954, p. 133), a definition that often is quoted today. This action was prioritized over physically assisting the patient. Watson emphasized the spiritual subjective aspects of the nurse and the patient, and the open systems concept is central to Kings theory of nursing. 3. Which one of the following statements accurately describes an element of the process of providing a definition of nursing? A) Researchers can pinpoint the period in history when nursing first evolved. B) Nurses agree on a single definition of nursing, partly because of the history of nursing. C) There is an obvious distinction between nursing and medicine. D) Nursing theorists developed definitions of nursing consistent with their conceptual frameworks. Objective: 7, 8 Page and Header: 23, Influences on the Definition of Nursing

3 Feedback: As nursing has grown into a true profession, many nursing theorists have developed definitions of nursing consistent with their conceptual frameworks; these frameworks provide the foundation for any given definition of nursing. The historical emergence of nursing did not take place at one particular time, and there are multiple definitions of nursing. While nursing and medicine indeed differ, the distinctions between the two professions are not always clear. 4. A nurse wishes to document nursing actions using a standardized language. Which of the following systems might the nurse use? A) NANDA International (NANDA-I) B) Nursing Outcomes Classification (NOC) C) Minimum Data Set for Nursing Home Resident Assessment and Care Screening (MDS) D) Nursing Interventions Classification (NIC) Objective: 12 Page and Header: 40, Nursing Interventions Classification Feedback: Started in 1996 at the University of Iowa, the Nursing Interventions Classification (NIC) is a comprehensive, standardized language that describes actions that nurses perform in all settings and in all specialties and includes both physiologic and psychosocial interventions. NANDA and NOC provide standardized language for nursing diagnoses and outcomes. The MDS is an assessment tool specific to long-term care settings. 5. An RN who practices in a community clinic recognizes the need for a standardized classification and documentation system. Which of the following systems of nursing care classification and documentation would best fit the RNs needs? A) NANDA International (NANDA-I) B) Nursing Outcomes Classification (NOC) C) The Omaha System D) Patient Care Data Set (PCDS) Ans: C Difficulty: Difficult Objective: 13 Page and Header: 41, The Omaha System

4 Feedback: The Omaha System is a research-based comprehensive practice documentation standardized taxonomy designed to document client care from admission to discharge. It was designed as a three-part, comprehensive yet brief approach to documentation and information management for multidisciplinary healthcare professionals who practice in community settings. NANDA and NOC provide frameworks only for nursing diagnoses and outcomes, while the PCDS is specific to hospital settings. 6. The number and size of nursing schools in the United States grew significantly in the years of the early 20th century. Which of the following characteristics was emphasized in these schools? A) A thorough knowledge of anatomy, physiology, and epidemiology B) Critical thinking, assertiveness, and autonomy C) An understanding of the relationship among mind, body, and spirit D) Religious devotion and subservience to authority Cognitive Level: Comprehension Difficulty: Easy Objective: 3 Page and Header: 12, Characteristics of the Early Schools Feedback: In early nursing schools, the nurse in training was expected to yield to her superiors and demonstrate the obedience characteristics of a good soldier with actions governed by the dedication to duty derived from religious devotion. These expectations superseded the importance of critical thinking, scientific knowledge, or the holistic nature of health. 7. Florence Nightingale is acknowledged as one of the individuals who contributed most significantly to the development of nursing as a profession. What other phenomenon contributed most to this development? A) Labor-saving technology that freed many women from working in the home B) The social recognition of the importance of public funding for the treatment of disease C) Increased understanding of the pathophysiology of illness and the importance of infection control D) The high mortality rates that existed during times of war Cognitive Level: Comprehension Objective: 4

5 Page and Header: 8, The Nightingale Influence Feedback: The death and disease that accompanied conflicts such as the Crimean War and the Civil War provided the impetus for much of the development of the nursing profession. Nursing did not primarily grow out of the availability of a female workforce, public funding for health, or increased scientific knowledge. 8. Nurses have historically had difficulty identifying a single, comprehensive definition of nursing. What factor most accounts for this difficulty in agreeing on a definition for nursing? A) It can be challenging to reconcile the theoretical and practical aspects of nursing. B) Nursing exists in the psychomotor (hands-on) domain rather than in the cognitive domain. C) Compared with medicine, nursing has a relatively short history. D) Nurses have traditionally been reluctant to acknowledge the outcomes of their practice. Ans: A Cognitive Level: Comprehension Objective: 5 Page and Header: 21, Developing a Definition for Nursing Feedback: A major factor that has made it difficult to define nursing is that it is taught as encompassing both theoretic and practical aspects, but it is pursued (and continues to be defined) primarily through practice, until recently a little-studied area. Nursing spans psychomotor and cognitive domains, and it has a very long history. Nurses have often failed to document and publish the results of their practice, but there is no indication that nurses tended not to acknowledge their influence on health. 9. One of the challenges that nurses have faced in the past, and which continues to the present, is the need to distinguish the practice of nursing from that of medicine. Which of the following statements best conveys a defining characteristic of nursing? A) Education within a formal, credential-granting setting B) An emphasis on objective, rather than subjective, health assessment C) A holistic perspective on the health of individuals D) A recognition that health is not always attainable for all individuals Ans: C Objective: 6 Page and Header: 22, Distinguishing Nursing from Medicine

6 Feedback: Nursing is concerned with caring for the person from a holistic perspective in a variety of health-related situations. Both nursing and medicine are taught in formal educational settings, though these settings differ. Nursing does not denigrate subjective health assessment nor does it claim that health is unattainable for some individuals. 10. Society has sometimes questioned whether nursing can be considered to be a true profession and whether nurses can be considered to be professionals. What characteristic of nursing is among the characteristics that social scientists use to define a profession? A) The median annual nursing wage is greater than $45,000. B) Nurses use the scientific method to enhance their body of knowledge. C) Nurses can be held legally accountable for their actions. D) Nursing has a demonstrated commitment to the well-being of the public. Ans: B Difficulty: Difficult Objective: 7 Page and Header: 27, Table 1.8 Feedback: Social scientists have identified seven criteria for a profession, including the use of the scientific method to enhance knowledge. Earnings and commitment to the public are not among the defining characteristics of a profession. Autonomy and accountability are criteria that are used to define a profession, but legal accountability for actions is not restricted to professionals. 11. Among the traditions that exist in nursing education is a passing of the lamp ceremony that is sometimes conducted during graduation. This ceremony communicates A) the light that nursing provides in communities and society. B) an acknowledgment of the contributions made by important nurses in history. C) the continuity of care from practicing nurses to newly graduated nurses. D) the need to continually build the nurses base of knowledge. Ans: C Cognitive Level: Knowledge Difficulty: Easy Objective: 9 Page and Header: 31, Ceremonies Associated with Nursing Programs Feedback: Some schools use the tradition of a passing of the lamp. A representative of the graduating class hands a lamp to a representative of the next graduating class, thus

7 reinforcing the concept of the continual caring represented in nursing. This ceremony does not primarily emphasize the light of the profession, the contribution of nurses in history (though the lamp symbolizes the lamp carried by Florence Nightingale), or the need to add to existing knowledge. 12. A nurse who provides care on a medical unit at a community hospital is concerned about negative portrayals of nurses in the media. Why should this nurse be concerned with the image of nurses and nursing? A) A negative image of nursing can dissuade potential nurses from entering the profession. B) A negative image of nursing reduces patients adherence to treatment regimens. C) A negative image of nursing interferes with professional accountability in hospital settings. D) A negative image of nursing reduces the development of nursing knowledge. Ans: A Client Needs: C Objective: 10 Page and Header: 32, The Image of Nursing Today Feedback: Negative attitudes about nursing may discourage many capable prospective nurses, who will choose another career that offers greater appeal in stature, status, and salary. The image of nursing is not noted to influence patient adherence to treatment or accountability. A negative image may indirectly limit nursing knowledge through reduced funding for research, but this phenomenon is less pronounced than the effect on potential nurses. 13. Megan, a 21-year-old junior college student, has been frustrated by her unsuccessful attempts to gain entry to the nursing program at the local university despite her strong academic record and work experience. Which of the following factors has most contributed to the limited number of seats available in many nursing programs? A) Technological developments that have decreased the projected need for nurses B) The tendency of practicing nurses to delay retirement until after the age of 65 years C) The high cost to educational institutions of providing nursing education D) The negative image of nursing in the media and popular culture Ans: C Cognitive Level: Comprehension Objective: 10

8 Page and Header: Nursings Image and the Nursing Shortage Feedback: A factor affecting the nursing supply is the limited number of spaces in nursing programs. Because nursing education is costly, many educational institutions have not been able to increase the size of their programs in the past decade. This trend is not attributable to technological change, increased length of service, or the negative image of nursing. 14. Mrs. Jimenez is a 28-year-old pregnant woman who is in labor. Due to the fact that her labor was progressing very slowly, she was started on an infusion of oxytocin, a drug used to increase the progression of her labor. In the planning of Mrs. Jimenezs care, the nurse has documented a Risk of Fluid Volume Excess in light of this common adverse effect of oxytocin. The nurse has demonstrated the use of what nursing classification system? A) The Minimum Data Set (MDS) B) Nursing Outcomes Classification (NOC) C) Nursing Interventions Classification (NIC) D) NANDA International (NANDA-I) Difficulty: Difficult Objective: 12 Page and Header: 40, NANDA International Feedback: Risk of Fluid Volume Excess is an example of a nursing diagnosis, which is the focus of NANDA-I. This does not denote an intervention or desired outcome. The MDS is an assessment tool specific to long-term care settings. 15. During the years of the 20th century, there was exponential growth in the number and quality of research studies that were conducted about nurses and nursing. What factor provided the original motivation for these studies? A) The entry of larger number of men into nursing schools and the nursing profession B) A desire to lessen the knowledge gap between nurses and physicians C) The low quality of nursing schools and nursing graduates D) Allocation of federal and state funding for nursing research Ans: C Objective: 11 Page and Header: 35, Studies for and About Nursing

9 Feedback: In the early 20th century, nurses, doctors, friends, and critics of nursing became concerned that the preparation being offered was inadequate. Before the problem could be corrected, it was necessary to learn more about the programs and how nurses were being used in the employment market. To accomplish this, studies about nursing and nurses were initiated. These studies did not primarily result from increased funding opportunities, the entry of men into the profession, or the knowledge gap between doctors and nurses. Chapter: Chapter 2: Educational Preparation for Nursing Multiple Choice 1. Manuel has a baccalaureate degree in biology and wishes to make a career change to eventually become an advanced practice RN. Which of the following courses of study would be the most time-efficient choice to meet his educational goals? A) Masters degree in nursing B) Baccalaureate degree in nursing C) Doctoral degree in nursing D) Associate degree in nursing Objective: 2 Page and Header: 53, Characteristics of Associate Degree Education Feedback: Students may be admitted to masters programs in nursing with a baccalaureate degree in another discipline and are granted a masters degree in nursing after completing an established 2-year program of study that prepares them for RN licensure. However, people who already possess baccalaureate or higher degrees in other fields sometimes seek admission to an associate degree program, often because it can be completed in a shorter period of time than would be needed to earn another baccalaureate degree (though accelerated baccalaureate programs are becoming more common). 2. Which nursing report recommended that nursing education move away from the system of apprenticeship that predominated at the time and move toward a planned program of education similar to that offered by other professions? A) The Surgeon Generals Consultant Group Report on Nursing B) The Brown Report C) The American Nurses Association Position Paper D) The Pew Health Profession Commission Study Ans: B Cognitive Level: Comprehension

10 Objective: 4 Page and Header: 72, The Brown Report Feedback: In Nursing for the Future, Brown (1948) recommended that nursing education move away from the system of apprenticeship that predominated at the time and move toward a planned program of education similar to that offered by other professions. This predated the Surgeon Generals Consultant Group Report on Nursing, the American Nurses Association Position Paper, and the Pew Health Profession Commission Study. 3. Which of the following accurately states a major position of the ANA Position Paper on Educational Preparation? A) The education of those who are licensed to practice nursing should take place in hospitals. B) Minimum preparation for beginning professional nursing practice at the present time should be an associate degree in nursing. C) Minimum preparation for beginning technical nursing practice at the present time should be a baccalaureate degree in nursing. D) Education for assistants in health service occupations should be short, intensive preservice programs in vocational educational institutions. Cognitive Level: Comprehension Objective: 5 Page and Header: 74, Display 2.2 Feedback: One of the four major positions of the ANA Position Paper on Educational Preparation is that education for assistants in the health service occupations should be short, intensive preservice programs in vocational education institutions, rather than on-the-job training programs. It also states that the education of all those who are licensed to practice nursing should take place in institutions of higher education, not in hospitals. The paper specifies an associate degree as the minimum for technical nursing and a baccalaureate degree for professional nursing. 4. Sister Calista Roy identified an adaptation model that characterizes the individual as being in constant interaction with a changing environment, therefore requiring adaptation. Which of the following identifies an adaptive mode listed in her theory? A) Role function B) Nutrition C) Spirituality D) Genetic makeup

11 Ans: A Difficulty: Difficult Objective: 9 Page and Header: 84, Table 2.2 Feedback: Roy identifies four adaptive modes, or ways in which a person adapts through: (1) physiologic needs, (2) self-concept, (3) role function, and (4) interdependence relations. Nutrition, spirituality, and genetic makeup are not discrete concepts within this theory. 5. Mr. Van is a 79-year-old widower who is being transferred to a long-term facility following hip replacement surgery. The nurse in charge of his care hopes to provide holistic nursing care for him based on his response to the interaction between his internal and external environment. This approach represents the model of care proposed by which of the following theorists? A) Dorothy Johnson B) Madeleine Leininger C) Dorothea Orem D) Myra Levine Difficulty: Difficult Objective: 9 Page and Header: 84, Table 2.2 Feedback: Levine supports a holistic approach to nursing based on recognition of the total response of the person to the interaction between the internal and the external environment. This approach is not specified by Johnson, Leininger, or Orem. Multiple Selection 6. A college sophomore has become disillusioned with her current field of studies and has begun exploring careers in nursing. To her surprise, she is unable to identify any hospital-based programs of study in her home state. Which of the following factors have contributed to the demise of hospital-based diploma programs? (Select all that apply.) A) Increased patient acuity in hospitals B) Increased popularity of college- and university-based nursing programs C) The growth of managed care and its influence on hospital management D) Increased costs to hospitals for maintaining nursing programs

12 E) The emergence of the baccalaureate degree as the entry to technical nursing practice Ans: B, D Objective: 1 Page and Header: 52, Hospital-Based Programs Today Feedback: The elimination of hospital-based programs occurred because hospitals could not sustain the costs of supporting the programs and because students became more attracted to programs located in colleges and universities. Patient acuity and managed care have not been identified as causative factors. The baccalaureate degree has been proposed as the entry to professional nursing practice, not technical nursing. Multiple Choice 7. Kirsten is a 22-year-old woman who has just been granted admission to an associate degree program at a local college. During her course of study, Kirsten should expect to complete A) the National Council Licensure Examination (NCLEX). B) a preceptorship under the direction of a licensed practical (vocational) nurse. C) a major, original research project immediately prior to graduation. D) numerous nonnursing courses in a variety of disciplines. Ans: A Difficulty: Easy Objective: 1 Page and Header: 53, Characteristics of Associate Degree Education Feedback: In a typical ADN program, approximately 40% of the credits needed for the associate degree must be fulfilled by general education courses such as English, anatomy, physiology, speech, psychology, and sociology; the rest are to be fulfilled by nursing courses. Original research is not a component of undergraduate nursing education, and preceptorships are normally completely under the direction of an RN. The NCLEX is written after graduation. 8. Ben is a 30-year-old man who has applied for an accelerated baccalaureate program at a university because the 15-month program of study will allow him to accommodate his family and financial responsibilities. In order to be granted admission, what will Ben most likely require? A) A varied work history that demonstrates initiative and responsibility B) A baccalaureate degree in another field

13 C) A mentor or sponsor within the nursing field D) Volunteer experience in a health-related setting Ans: B Cognitive Level: Comprehension Objective: 3 Page and Header: 59, Accelerated Programs Feedback: Building on previous learning experiences, accelerated programs are designed to transition adults with baccalaureate and graduate degrees in other fields into nursing. A strong work history, volunteer experience, and an available mentor in the field are all assets for success, but these are less likely to be absolutely required for admission. 9. Julia has just graduated with her Bachelor of Science in Nursing degree from her state university and has begun seeking employment. However, she is anxious about her level of clinical competence due to the fact that she completed far fewer clinical hours than many practicing nurses. Which of the following has the potential to ease Julias transition to practice? A) Completing a residency or internship at the hospital where she will be employed B) Auditing courses in a nonnursing, health-related discipline C) Working for several months as a nursing assistant in order to gain confidence D) Taking online courses in advanced nursing practice Ans: A Objective: 2 Page and Header: 68, Residencies and Structured Orientation for the New Graduate Feedback: Internships and residencies for new graduates have been instituted by hospitals to ease the transition from the role of student to that of staff by providing the opportunity to increase clinical skills and knowledge as well as self-confidence. Taking more academic courses and/or working as a nursing assistant are unlikely to increase Julias confidence and competence in her clinical nursing role. 10. According to the ANA Position Paper on Educational Preparation, which of the following four individuals is adequately prepared to provide care? A) A nursing assistant who has just completed an on-the-job training program in a local hospital B) A nurse who graduated from a hospital-based diploma program

14 C) A nurse in a high-acuity setting who possesses an associate degree in nursing (ADN) degree D) A nursing assistant who graduated from the training program at a community college Objective: 5 Page and Header: 74, Display 2.2 Feedback: The ANA Position Paper specifies that education for assistants in the health service occupations should be short, intensive preservice programs in vocational education institutions, rather than on-the-job training programs. The Paper also specifies a minimum of an ADN degree for all nursing practice and a baccalaureate degree for professional nursing (e.g., in high-acuity settings). 11. Nurse. L. provides care in a state that has mandatory continuing education requirements for nurses. What are the consequences of this policy for Nurse L.? A) Nurse L. must demonstrate a commitment to making practice improvements. B) Nurse L. must have a baccalaureate degree in order to provide professional nursing care. C) Nurse L. is obliged to update her diploma to an associate degree. D) Nurse L. must demonstrate continuing education for license renewal. Objective: 6 Page and Header: 69, Continuing Education Feedback: Mandatory continuing education affects licensure, meaning that any nurse renewing a license in a state requiring (mandating) continuing education will have to satisfy that requirement. However, this does not necessarily mean that a nurse must update his or her degree or diploma or undertake practice improvements. 12. The administrators of a large, university hospital have expressed a commitment to differentiated nursing practice. Which of the following most clearly exemplifies differentiated practice? A) Each nurse performs a role that is commensurate with his or her education and experience level. B) Each nurse in the hospital is expected to provide competent care in a variety of different settings.

15 C) Nurses demonstrate evidence of continuing education in two or more different specialties. D) Each nurse in the hospital possesses an ADN or baccalaureate degree in nursing. Ans: A Difficulty: Difficult Objective: 7 Page and Header: 77, Differentiated Practice Feedback: Differentiated nursing practice can be defined as the practice of structuring nursing roles on the basis of education, experience, and competence. It does not necessarily specify the provision of care in diverse settings, evidence of continuing education, or the possession of a nursing degree. 13. A nurse manager who oversees the provision of community-based care to a large number of clients has been mandated to implement differentiated care over the next year. In order to carry out this directive, the nurse manager must be able to A) teach each nurse to become a generalist rather than a specialist. B) identify the evidence that underlies the nursing care that is provided. C) clearly identify the specific roles and tasks that these nurses perform. D) hire more licensed practical (vocational) nurses. Ans: C Difficulty: Difficult Objective: 7 Page and Header: 77, Differentiated Practice Feedback: Differentiated practice requires that the specific roles that are performed in the provision of care be clearly identified and delineated. This is necessary in order to appropriately match individual care providers to particular tasks and functions. Nurses do not need to become generalists nor are more practical nurses necessarily required. Evidence underlying nursing care should be identified, but this is not necessary for differentiated care. 14. Pressure from students and the healthcare industry has prompted the nursing educators at a college to implement new technology into the nursing education that they provide. Which of the following statements is true of technological change and nursing education? A) Technology is typically high in colleges and universities but low in hospitals and other care settings.

16 B) Many of the purported educational benefits of technology have not been demonstrated in the nursing literature. C) Computer literacy is high among students but most nursing educators lack computer skills. D) The costs of integrating new technology into nursing education can be prohibitive. Objective: 8 Page and Header: 80, Computer Technology in the Classroom Feedback: High-technology equipment is often expensive, a fact that often presents a challenge to educational institutions. The benefits of technology in learning have been demonstrated and computer literacy is nearly universal. Hospitals are high-technology work environments. 15. The faculty members of a college-based school of nursing have taken action to increase the teaching and clinical time in the curriculum that is devoted to community-based nursing. Which of the following phenomena provides the most valid rationale for this change? A) Public mistrust of hospitals is increasing and many individuals prefer to remain at home. B) The number of patients who qualify for Medicare and Medicaid is increasing. C) Patients are typically discharged from the hospital much earlier than in the past. D) Evidence demonstrates that students learn more in the community than in the hospital. Ans: C Objective: 8 Page and Header: 82, Increasing Community-Based Practice Experiences Feedback: Earlier hospital discharge to the home and an increasing emphasis on prevention has created new demands on nursing in the community. This shift is not rooted in mistrust of hospitals, a lack of learning in hospitals, or trends in Medicare and Medicaid. Chapter: Chapter 3: Credentials for Healthcare Providers Multiple Choice 1. What is the major advantage of sunset laws? A) Nurses can modify their standards of practice on a daily basis.

17 B) They guarantee that the legislature will review and evaluate agencies and programs. C) The legislature can close facilities that do not meet governmental requirements. D) Facilities must renew their accreditation in a specified amount of time. Ans: B Cognitive Level: Comprehension Objective: 4 Page and Header: 102, Sunset Laws and Nurse Practice Acts Feedback: Because sunset laws are set to expire at a specified point in time, legislatures are obligated to review and evaluate them prior to expiry. Sunset laws do not directly influence the nurses standards of practice, the quality of healthcare facilities, or the accreditation process. 2. A nurse who is licensed to practice in Pennsylvania decides to seek a nursing position in Florida. This nurse would obtain this license by which of the following methods? A) Licensure by endorsement B) Licensure by examination C) Licensure by renewal D) Reciprocal licensure Ans: A Cognitive Level: Comprehension Objective: 6 Page and Header: 104, Obtaining a Nursing License Feedback: The method of obtaining a license when the nurse is already licensed in another jurisdiction is called licensure by endorsement; this is an alternative to license by examination. This transfer is not termed reciprocal licensure or licensure by renewal. 3. A nursing board asks the court to stop a nurse from practicing until it investigates allegations that the nurse was providing care while under the influence of alcohol. What is the name of the process that allows this action? A) Revocation B) Suspension C) Injunctive relief D) Court investigation Ans: C Client Needs: A-2

18 Difficulty: Difficult Objective: 7 Page and Header: 100, Grounds for Disciplinary Action Feedback: A board of nursing may be authorized to ask a court to halt a specific practice that it believes is contrary to the law until a full hearing can be held. This is called injunctive relief. This term refers to the court order called an injunction that requires an individual or organization to stop a particular activity, such as practicing nursing. The investigation is performed by the board, not the court. Revocation involves the removal of a license, and suspension does not typically involve the courts. 4. Which of the following is a recommendation of the Institute of Medicine report Health Profession Education: A Bridge to Quality (2003)? A) Developing separate core competencies to regulate each health profession B) Revising the processes of accreditation bodies to require outcomes related to core competencies C) Allowing each profession to educate, practice, and dialogue within its own boundaries D) Changing healthcare workforce regulations based on what is termed a safe focus Ans: B Cognitive Level: Comprehension Difficulty: Difficult Objective: 10 Page and Header: 117, Institute of Medicine Recommendations Feedback: The IOM report recommended that both licensing bodies and specialty certification bodies require health professionals to demonstrate in some way their continued competence in the previously determined core competencies. The report does not advocate the development of separate core competencies, the isolation of each profession, or changes to workforce regulations. 5. A nurse administers insulin to a diabetic patient via an insulin pump. Based on the NCLEX examination, this action would fall under which of the categories of client needs? A) Safe effective care environment B) Health promotion and maintenance C) Psychosocial integrity D) Physiological integrity

19 Objective: 6 Page and Header: 105, Table 3.1 Feedback: The client needs category of physiological integrity encompasses nursing actions that address a clients physical needs and the treatment of illness. Administration of medication is not normally considered a health promotion activity, an aspect of psychosocial integrity, or a demonstration of safety measures. 6. A nurse who has provided care in acute settings for several years has begun the process of gaining additional credentials. Which of the following statements best describes credentials? A) Credentials indicate that an individual has demonstrated a continuing commitment to competence. B) Credentials recognize an individuals professional superiority to his or her peers. C) Credentials indicate that an individual has met specific criteria and standards. D) Credentials indicate that an individual has the authority to direct practice in a particular care setting. Ans: C Cognitive Level: Comprehension Objective: 1 Page and Header: 89, Introduction Feedback: Credentials indicate that an individual (or organization) has met specific standards that are important to fulfilling a professional mandate. This is not necessarily synonymous with a continued commitment, though such a commitment may help facilitate the attainment of credentials. Individual credentials do not necessarily indicate superiority or leadership potential. 7. After completing an associate degree in nursing and passing the NCLEX- RN examination, a nurse has been granted a license to practice. A license to practice provides the nurse with A) formal recognition of the nurses graduation from an accredited school of nursing. B) legal permission to practice the nursing profession. C) the authority to practice nursing in any state. D) recognition of advanced learning and competence in a particular care setting. Ans: B Difficulty: Easy

20 Objective: 2 Page and Header: 92, Licensure Feedback: A license is a legal credential awarded by an individual state that grants permission to that individual to practice a given profession. A license is normally specific to a particular jurisdiction. It does not denote advanced learning in a specific setting. Graduation from a school of nursing is required for licensure, but a license does not explicitly document this education. 8. The students and faculty of a school of nursing are pleased that the school has recently been granted a renewal of its current accreditation. Accreditation of a school of nursing is based primarily on which of the following? A) The proportion of graduates who pass the NCLEX-RN B) The academic credentials of faculty members C) The findings of an external review committee D) The overall contribution of the school to the body of nursing knowledge Ans: C Objective: 3 Page and Header: 89, Accreditation of Educational Institutions Feedback: Accreditation of a school of nursing is primarily based on the findings of nursing experts who visit the institution and appraise the education that is provided. Other factors may be considered, such as the success of graduates, the credentials of instructors, or the research that is conducted, but the findings of external reviewers are paramount. 9. A state board of nursing is legally empowered to carry out the provisions of the Nurse Practice Act. Which of the following activities best demonstrates the mandate and jurisdiction of a state board of nursing? A) Advocating for nurses during labor negotiations B) Organizing information campaigns to enhance the public perception of the nursing profession C) Specifying the way that nursing care is organized in public hospitals D) Establishing the standards that nurses must meet in order to be licensed Difficulty: Difficult Objective: 5 Page and Header: 103, The Role of the State Board of Nursing

21 Feedback: State boards of nursing perform multiple functions, including examination and licensure of nurses. Participation in labor negotiations, advertising to increase awareness of the profession, and specifying the way that care is provided are activities that are normally beyond the purview of a state board of nursing. 10. A registered nurse who completed her education in the Philippines and who is in the process of immigrating in the United States is attempting to obtain a license to practice in New Jersey, her intended state of residence. In order to obtain a license, the nurse will primarily be in contact with A) the New Jersey Board of Nursing. B) the American Nurses Association (ANA). C) one of the accredited schools of nursing in New Jersey. D) the National Council of State Boards of Nursing, Inc. (NCSBN). Ans: A Difficulty: Easy Objective: 5 Page and Header: 103, The Role of the State Board of Nursing Feedback: Licensure is one of the main responsibilities of state boards of nursing, and a nurse seeking a license to practice in a particular state must obtain a license from that states board of nursing. Schools of nursing, the ANA, and the NCSBN do not directly grant licensure. Multiple Selection 11. Amanda is a nurse who currently works in a community clinic in a city near state lines. She is exploring employment possibilities in a neighboring state and hopes to obtain a license through mutual recognition of licensure. Which of the following conditions must be met in order for Amanda to obtain a nursing license in this manner? (Select all that apply.) A) Amandas home state must be party to the Nurse Licensure Compact. B) Amanda must obtain a nursing license in the intended state as well as in her home state. C) Amanda must meet the standards for licensure in the state where she intends to practice. D) The state in which Amanda wishes to practice must belong to the Nurse Licensure Compact. E) Amanda must possess an ADN or baccalaureate degree in nursing. Ans: A, C, D Difficulty: Difficult

22 Objective: 8 Page and Header: 109, Mutual Recognition of Licensure Feedback: Obtaining a license through mutual recognition of licensure requires that an individuals home state and the intended state of practice be party states. As well, an applicant must qualify for licensure in the intended state. A diploma in nursing does not preclude transfer of licensure, and an individual may not possess licenses in both states simultaneously. Multiple Choice 12. Under the provisions of the Nurse Licensure Compact (NLC), a nurse who is licensed in Arizona has been practicing for the past year in New Mexico. The nurse is alleged to have become involved in an inappropriate relationship with a patient in New Mexico and grounds for disciplinary action appear to exist. How will the discipline of this nurse most likely proceed? A) The New Mexico Board of Nursing may withdraw the nurses license if this is deemed necessary. B) The nurses discipline is referred to the American Nurses Association because two state boards of nursing have interest in the matter. C) The New Mexico Board of Nursing will undertake investigation, but the Arizona State Board of Nursing will implement appropriate discipline. D) The New Mexico Board of Nursing will be unable to change the Arizona licensure status of the nurse. Difficulty: Difficult Objective: 8 Page and Header: 110, Concerns Regarding Mutual Recognition of Licenses Feedback: A major concern with mutual recognition is the disciplinary process. Although the board of nursing can investigate nursing practices and enforce its own standards in the state, it cannot change the licensure status of the person whose licensure originates in a different state. The ANA does not participate in disciplinary matters, and a state would not normally undertake discipline based on an investigation in another party state. 13. Nurse T. has been notified by her state board of nursing that a complaint has been lodged regarding her practice. How should Nurse T. best respond to this news? A) Retain the services of an attorney. B) Organize a private meeting between her and the complainant. C) Have colleagues write statements attesting to her competence. D) Explore practice opportunities in other states.

23 Ans: A Objective: 8 Page and Header: 110, Revocation of Limitation of a License Feedback: The individual being investigated for any violation of the Nurse Practice Act should have an attorney who is knowledgeable about professional disciplinary issues from the time of notification of the complaint. This is an important action, whether or not there are grounds for the accusation. A meeting with the complainant would be inappropriate, and enlisting support from colleagues would be a secondary concern compared with hiring an attorney. It would be premature, and likely inappropriate, to explore options out-of-state at this early stage. 14. A nurse has been working in pediatrics for 6 years since graduating from an accredited nursing school. The nurse is now interested in pursuing American Nurses Credentialing Center certification as a pediatric Clinical Nurse Specialist. What factor will primarily determine whether the nurse obtains this ANCC certification? A) Enrollment in a PhD, DNS, or DNP degree program B) A review of the nurses marks from nursing school and interviews with managers and colleagues C) Completion of an original research project related to pediatric nursing D) The demonstration of knowledge and skills in beyond those required for licensure as an RN Cognitive Level: Comprehension Objective: 9 Page and Header: 114, American Nurses Credentialing Center Certification Feedback: ANCC certification is a method of recognizing nurses who have special expertise. Applicants must demonstrate current practice and knowledge beyond that required for licensure as an RN. Enrollment in a doctoral program is not necessary. Marks from nursing school, the opinions of supervisors, and the completion of research do not form the basis for certification. 15. The Institute of Medicine (IOM) report Health Profession Education: A Bridge to Quality (2003) came to several conclusions around the issues confronting health professions education. Which of the following issues was addressed in the report? A) The tendency of each health discipline to educate and practice independently of the other disciplines

24 B) The lack of recognition of credentials and the credentialing process outside of the field of nursing C) The trend toward managed care and the inability of nursing educators to adapt to this change D) The historical animosity between nursing and medicine and the failure to bridge this gap Ans: A Difficulty: Difficult Objective: 10 Page and Header: 117, Institute of Medicine Recommendations Feedback: The IOM noted that each health profession tends to educate, practice, and dialogue within a silo. These narrowly constructed walls make it difficult for interdisciplinary collaboration to occur. The report does not focus on the relationship between medicine and nursing, the trend toward managed care, or the lack of recognition of credentials. Chapter: Chapter 4: Making Professional Goals a Reality Multiple Choice 1. Which organization developed the most definitive statements on the competencies needed by the newly licensed practical nurse (PN) and the RN? A) National Council of State Boards of Nursing (NCSBN) B) American Association of Nurses (ANA) C) National League for Nursing (NLN) D) American Association of Colleges of Nursing Ans: A Cognitive Level: Comprehension Difficulty: Easy Objective: 2 Page and Header: 124, National Council of State Boards of Nursing Competencies Feedback: The most definitive statements on the competencies needed by the newly licensed practical nurse (PN) and the RN have been developed by the NCSBN based on its job analysis studies, which serve as the basis for the NCLEX-RN and NCLEX- PN. 2. In what type of healthcare setting are the most RNs currently employed? A) Ambulatory care centers B) Doctors offices C) Acute care hospitals

25 D) Long-term care facilities Ans: C Cognitive Level: Knowledge Difficulty: Easy Objective: 1 Page and Header: 122, Employment Opportunities Today Feedback: As of 2008, over 89% of nurses worked in hospital settings, 4.8% worked in long-term care, and 4.3% worked in community-based or ambulatory care settings. Only 1.7% of nurses indicated that they worked in other settings. 3. Which of the following statements accurately reflects what employers generally should expect when hiring a newly graduated RN? A) The RN should be proficient with the documentation system used by the institution. B) The RN should be able to perform all nursing skills, enabling him or her to work independently. C) The RN should function with speed comparable to that of the other nurses. D) The RN should be able to develop plans of care and follow plans developed by the agency. Client Needs: D-1 Objective: 1 Page and Header: 126, Employers Expectations Regarding Competencies Feedback: New graduates should be able to develop plans of care and follow plans, such as care pathways, that have been developed by the agency. Proficiency, speed, and complete independence are developed over time and with increased experience and orientation. 4. A nurse decides to apply for a position in a hospital in her hometown. Which of the following statements provides good advice for her job quest? A) She should call the human resources department and speak to the person who is in charge of hiring nurses. B) She should include a cover letter with her rsum that is no more than two pages long and briefly reiterates the information found in the rsum. C) She should invest in a professionally prepared rsum to make a better impression on potential employers. D) She should focus her rsum on accomplishments and use active verbs to describe her skills.

26 Objective: 5 Page and Header: 138, Employment History Feedback: In a rsum, it is best to focus on accomplishments and use active verbs to describe skills. Professional preparation of a rsum is not necessary, and telephone communication is generally discouraged. A cover letter should ideally not exceed one page in length. 5. Which of the following is a recommended guideline when resigning a position? A) Provide the employer with 2 weeks to seek a replacement. B) Clearly state the details if you wish to be compensated for any vacation or holiday time accrued. C) If resigning because of problems in the work setting, it is a good idea to put the reason in the resignation letter. D) Place comments regarding positive factors experienced in the workplace in a separate correspondence from the resignation letter. Ans: B Objective: 5 Page and Header: 151, Resignation Feedback: If you have accrued vacation or holiday time and want to take the time off or be paid for it when resigning, clearly state that. A months notice is ideal, and a resignation letter should not go into detail regarding the contributing problems in the workplace. Positive factors experienced in the workplace may be included in the resignation letter. 6. A student nurse is scheduled to graduate in a few weeks and is preparing to begin searching for employment. Which of the following statements best conveys an aspect of the current job market for nurses? A) Most nursing graduates are expected to perform in the role of a nursing assistant or practical (vocational) nurse after graduation. B) The majority of nursing opportunities for new graduates are in international settings. C) Job openings in acute care have decreased in many places but long-term care openings continue to grow. D) The increasing severity of the nursing shortage means that job opportunities for nursing graduates are greater than ever.