Test Bank For Brunner and Suddarth's Textbook Of Medical-Surgical Nursing, 13th Edition
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Chapter 1
1.
The public health nurse is presenting a health promotion class to a group of new mothers. How
should the nurse best define health?
A) Health is being disease free.
B) Health is having fulfillment in all domains of life.
C) Health is having psychological and physiological harmony.
D) Health is being connected in body, mind, and spirit.
Ans: D
Feedback:
The World Health Organization (WHO) defines health in the preamble to its constitution as a
“ state of complete physical, mental, and social well-being and not merely the absence of disease
and infirmity.” The other answers are incorrect because they are not congruent with the WHO
definition of health.
2.
A nurse is speaking to a group of prospective nursing students about what it is like to be a nurse.
What is one characteristic the nurse would cite as necessary to possess to be an effective nurse?
A) Sensitivity to cultural differences
B) Team-focused approach to problem-solving
C) Strict adherence to routine
D) Ability to face criticism
Ans: A
Feedback:
To promote an effective nurse-patient relationship and positive outcomes of care, nursing care must
be culturally competent, appropriate, and sensitive to cultural differences. Team-focused nursing
and strict adherence to routine are not characteristics needed to be an effective nurse. The ability to
handle criticism is important, but to a lesser degree than cultural competence.
3.
With increases in longevity, people have had to become more knowledgeable about their health
and the professional health care that they receive. One outcome of this phenomenon is the
development of organized self-care education programs. Which of the following do these programs
prioritize?
A) Adequate prenatal care
B) Government advocacy and lobbying
1.
The public health nurse is presenting a health promotion class to a group of new mothers. How
should the nurse best define health?
A) Health is being disease free.
B) Health is having fulfillment in all domains of life.
C) Health is having psychological and physiological harmony.
D) Health is being connected in body, mind, and spirit.
Ans: D
Feedback:
The World Health Organization (WHO) defines health in the preamble to its constitution as a
“ state of complete physical, mental, and social well-being and not merely the absence of disease
and infirmity.” The other answers are incorrect because they are not congruent with the WHO
definition of health.
2.
A nurse is speaking to a group of prospective nursing students about what it is like to be a nurse.
What is one characteristic the nurse would cite as necessary to possess to be an effective nurse?
A) Sensitivity to cultural differences
B) Team-focused approach to problem-solving
C) Strict adherence to routine
D) Ability to face criticism
Ans: A
Feedback:
To promote an effective nurse-patient relationship and positive outcomes of care, nursing care must
be culturally competent, appropriate, and sensitive to cultural differences. Team-focused nursing
and strict adherence to routine are not characteristics needed to be an effective nurse. The ability to
handle criticism is important, but to a lesser degree than cultural competence.
3.
With increases in longevity, people have had to become more knowledgeable about their health
and the professional health care that they receive. One outcome of this phenomenon is the
development of organized self-care education programs. Which of the following do these programs
prioritize?
A) Adequate prenatal care
B) Government advocacy and lobbying
Chapter 1
1.
The public health nurse is presenting a health promotion class to a group of new mothers. How
should the nurse best define health?
A) Health is being disease free.
B) Health is having fulfillment in all domains of life.
C) Health is having psychological and physiological harmony.
D) Health is being connected in body, mind, and spirit.
Ans: D
Feedback:
The World Health Organization (WHO) defines health in the preamble to its constitution as a
“ state of complete physical, mental, and social well-being and not merely the absence of disease
and infirmity.” The other answers are incorrect because they are not congruent with the WHO
definition of health.
2.
A nurse is speaking to a group of prospective nursing students about what it is like to be a nurse.
What is one characteristic the nurse would cite as necessary to possess to be an effective nurse?
A) Sensitivity to cultural differences
B) Team-focused approach to problem-solving
C) Strict adherence to routine
D) Ability to face criticism
Ans: A
Feedback:
To promote an effective nurse-patient relationship and positive outcomes of care, nursing care must
be culturally competent, appropriate, and sensitive to cultural differences. Team-focused nursing
and strict adherence to routine are not characteristics needed to be an effective nurse. The ability to
handle criticism is important, but to a lesser degree than cultural competence.
3.
With increases in longevity, people have had to become more knowledgeable about their health
and the professional health care that they receive. One outcome of this phenomenon is the
development of organized self-care education programs. Which of the following do these programs
prioritize?
A) Adequate prenatal care
B) Government advocacy and lobbying
1.
The public health nurse is presenting a health promotion class to a group of new mothers. How
should the nurse best define health?
A) Health is being disease free.
B) Health is having fulfillment in all domains of life.
C) Health is having psychological and physiological harmony.
D) Health is being connected in body, mind, and spirit.
Ans: D
Feedback:
The World Health Organization (WHO) defines health in the preamble to its constitution as a
“ state of complete physical, mental, and social well-being and not merely the absence of disease
and infirmity.” The other answers are incorrect because they are not congruent with the WHO
definition of health.
2.
A nurse is speaking to a group of prospective nursing students about what it is like to be a nurse.
What is one characteristic the nurse would cite as necessary to possess to be an effective nurse?
A) Sensitivity to cultural differences
B) Team-focused approach to problem-solving
C) Strict adherence to routine
D) Ability to face criticism
Ans: A
Feedback:
To promote an effective nurse-patient relationship and positive outcomes of care, nursing care must
be culturally competent, appropriate, and sensitive to cultural differences. Team-focused nursing
and strict adherence to routine are not characteristics needed to be an effective nurse. The ability to
handle criticism is important, but to a lesser degree than cultural competence.
3.
With increases in longevity, people have had to become more knowledgeable about their health
and the professional health care that they receive. One outcome of this phenomenon is the
development of organized self-care education programs. Which of the following do these programs
prioritize?
A) Adequate prenatal care
B) Government advocacy and lobbying
C) Judicious use of online communities
D) Management of illness
Ans: D
Feedback:
Organized self-care education programs emphasize health promotion, disease prevention,
management of illness, self-care, and judicious use of the professional health care system. Prenatal
care, lobbying, and Internet activities are secondary.
4.
The home health nurse is assisting a patient and his family in planning the patient’s return to work
after surgery and the development of postsurgical complications. The nurse is preparing a plan of
care that addresses the patient’s multifaceted needs. To which level of Maslow’s hierarchy of basic
needs does the patient’s need for self-fulfillment relate?
A) Physiologic
B) Transcendence
C) Love and belonging
D) Self-actualization
Ans: D
Feedback:
Maslow’s highest level of human needs is self-actualization, which includes self-fulfillment, desire
to know and understand, and aesthetic needs. The other answers are incorrect because self-
fulfillment does not relate directly to them.
5.
The view that health and illness are not static states but that they exist on a continuum is central to
professional health care systems. When planning care, this view aids the nurse in appreciating
which of the following?
A) Care should focus primarily on the treatment of disease.
B) A person’s state of health is ever-changing.
C) A person can transition from health to illness rapidly.
D) Care should focus on the patient’s compliance with interventions.
Ans: B
Feedback:
By viewing health and illness on a continuum, it is possible to consider a person as being neither
completely healthy nor completely ill. Instead, a person’s state of health is ever-changing and has
the potential to range from high-level wellness to extremely poor health and imminent death. The
other answers are incorrect because patient care should not focus just on the treatment of disease.
Rapid declines in health and “ compliance” with treatment are not key to this view of health.
D) Management of illness
Ans: D
Feedback:
Organized self-care education programs emphasize health promotion, disease prevention,
management of illness, self-care, and judicious use of the professional health care system. Prenatal
care, lobbying, and Internet activities are secondary.
4.
The home health nurse is assisting a patient and his family in planning the patient’s return to work
after surgery and the development of postsurgical complications. The nurse is preparing a plan of
care that addresses the patient’s multifaceted needs. To which level of Maslow’s hierarchy of basic
needs does the patient’s need for self-fulfillment relate?
A) Physiologic
B) Transcendence
C) Love and belonging
D) Self-actualization
Ans: D
Feedback:
Maslow’s highest level of human needs is self-actualization, which includes self-fulfillment, desire
to know and understand, and aesthetic needs. The other answers are incorrect because self-
fulfillment does not relate directly to them.
5.
The view that health and illness are not static states but that they exist on a continuum is central to
professional health care systems. When planning care, this view aids the nurse in appreciating
which of the following?
A) Care should focus primarily on the treatment of disease.
B) A person’s state of health is ever-changing.
C) A person can transition from health to illness rapidly.
D) Care should focus on the patient’s compliance with interventions.
Ans: B
Feedback:
By viewing health and illness on a continuum, it is possible to consider a person as being neither
completely healthy nor completely ill. Instead, a person’s state of health is ever-changing and has
the potential to range from high-level wellness to extremely poor health and imminent death. The
other answers are incorrect because patient care should not focus just on the treatment of disease.
Rapid declines in health and “ compliance” with treatment are not key to this view of health.
6.
A group of nursing students are participating in a community health clinic. When providing care in
this context, what should the students teach participants about disease prevention?
A) It is best achieved through attending self-help groups.
B) It is best achieved by reducing psychological stress.
C) It is best achieved by being an active participant in the community.
D) It is best achieved by exhibiting behaviors that promote health.
Ans: D
Feedback:
Today, increasing emphasis is placed on health, health promotion, wellness, and self-care. Health is
seen as resulting from a lifestyle oriented toward wellness. Nurses in community health clinics do
not teach that disease prevention is best achieved through attending self-help groups, by reducing
stress, or by being an active participant in the community, though each of these activities is
consistent with a healthy lifestyle.
7.
A nurse on a medical-surgical unit has asked to represent the unit on the hospital’s quality
committee. When describing quality improvement programs to nursing colleagues and members of
other health disciplines, what characteristic should the nurse cite?
A) These programs establish consequences for health care professionals’ actions.
B) These programs focus on the processes used to provide care.
C) These programs identify specific incidents related to quality.
D) These programs seek to justify health care costs and systems.
Ans: B
Feedback:
Numerous models seek to improve the quality of health care delivery. A commonality among them
is a focus on the processes that are used to provide care. Consequences, a focus on incidents, and
justification for health care costs are not universal characteristics of quality improvement efforts.
8.
Nurses in acute care settings must work with other health care team members to maintain quality
care while facing pressures to care for patients who are hospitalized for shorter periods of time than
in the past. To ensure positive health outcomes when patients return to their homes, what action
should the nurse prioritize?
A) Promotion of health literacy during hospitalization
B) Close communication with insurers
C) Thorough and evidence-based discharge planning
D) Participation in continuing education initiatives
A group of nursing students are participating in a community health clinic. When providing care in
this context, what should the students teach participants about disease prevention?
A) It is best achieved through attending self-help groups.
B) It is best achieved by reducing psychological stress.
C) It is best achieved by being an active participant in the community.
D) It is best achieved by exhibiting behaviors that promote health.
Ans: D
Feedback:
Today, increasing emphasis is placed on health, health promotion, wellness, and self-care. Health is
seen as resulting from a lifestyle oriented toward wellness. Nurses in community health clinics do
not teach that disease prevention is best achieved through attending self-help groups, by reducing
stress, or by being an active participant in the community, though each of these activities is
consistent with a healthy lifestyle.
7.
A nurse on a medical-surgical unit has asked to represent the unit on the hospital’s quality
committee. When describing quality improvement programs to nursing colleagues and members of
other health disciplines, what characteristic should the nurse cite?
A) These programs establish consequences for health care professionals’ actions.
B) These programs focus on the processes used to provide care.
C) These programs identify specific incidents related to quality.
D) These programs seek to justify health care costs and systems.
Ans: B
Feedback:
Numerous models seek to improve the quality of health care delivery. A commonality among them
is a focus on the processes that are used to provide care. Consequences, a focus on incidents, and
justification for health care costs are not universal characteristics of quality improvement efforts.
8.
Nurses in acute care settings must work with other health care team members to maintain quality
care while facing pressures to care for patients who are hospitalized for shorter periods of time than
in the past. To ensure positive health outcomes when patients return to their homes, what action
should the nurse prioritize?
A) Promotion of health literacy during hospitalization
B) Close communication with insurers
C) Thorough and evidence-based discharge planning
D) Participation in continuing education initiatives
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Ans: C
Feedback:
Following discharges that occur after increasingly short hospital stays, nurses in the community
care for patients who need high-technology acute care services as well as long-term care in the
home. This is dependent on effective discharge planning to a greater degree than continuing
education, communication with insurers, or promotion of health literacy.
9.
You are admitting a patient to your medical unit after the patient has been transferred from the
emergency department. What is your priority nursing action at this time?
A) Identifying the immediate needs of the patient
B) Checking the admitting physician’s orders
C) Obtaining a baseline set of vital signs
D) Allowing the family to be with the patient
Ans: A
Feedback:
Among the nurse’s important functions in health care delivery, identifying the patient’s immediate
needs and working in concert with the patient to address them is most important. The other nursing
functions are important, but they are not the most important functions.
10.
A nurse on a postsurgical unit is providing care based on a clinical pathway. When performing
assessments and interventions with the aid of a pathway, the nurse should prioritize what goal?
A) Helping the patient to achieve specific outcomes
B) Balancing risks and benefits of interventions
C) Documenting the patient’s response to therapy
D) Staying accountable to the interdisciplinary team
Ans: A
Feedback:
Pathways are an EBP tool that is used primarily to move patients toward predetermined
outcomes. Documentation, accountability, and balancing risks and benefits are appropriate, but
helping the patient achieve outcomes is paramount.
11.
Staff nurses in an ICU setting have noticed that their patients required lower and fewer doses of
analgesia when noise levels on the unit were consciously reduced. They informed an advanced
practice RN of this and asked the APRN to quantify the effects of noise on the pain levels of
hospitalized patients. How does this demonstrate a role of the APRN?
A) Involving patients in their care while hospitalized
Feedback:
Following discharges that occur after increasingly short hospital stays, nurses in the community
care for patients who need high-technology acute care services as well as long-term care in the
home. This is dependent on effective discharge planning to a greater degree than continuing
education, communication with insurers, or promotion of health literacy.
9.
You are admitting a patient to your medical unit after the patient has been transferred from the
emergency department. What is your priority nursing action at this time?
A) Identifying the immediate needs of the patient
B) Checking the admitting physician’s orders
C) Obtaining a baseline set of vital signs
D) Allowing the family to be with the patient
Ans: A
Feedback:
Among the nurse’s important functions in health care delivery, identifying the patient’s immediate
needs and working in concert with the patient to address them is most important. The other nursing
functions are important, but they are not the most important functions.
10.
A nurse on a postsurgical unit is providing care based on a clinical pathway. When performing
assessments and interventions with the aid of a pathway, the nurse should prioritize what goal?
A) Helping the patient to achieve specific outcomes
B) Balancing risks and benefits of interventions
C) Documenting the patient’s response to therapy
D) Staying accountable to the interdisciplinary team
Ans: A
Feedback:
Pathways are an EBP tool that is used primarily to move patients toward predetermined
outcomes. Documentation, accountability, and balancing risks and benefits are appropriate, but
helping the patient achieve outcomes is paramount.
11.
Staff nurses in an ICU setting have noticed that their patients required lower and fewer doses of
analgesia when noise levels on the unit were consciously reduced. They informed an advanced
practice RN of this and asked the APRN to quantify the effects of noise on the pain levels of
hospitalized patients. How does this demonstrate a role of the APRN?
A) Involving patients in their care while hospitalized
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B) Contributing to the scientific basis of nursing practice
C) Critiquing the quality of patient care
D) Explaining medical studies to patients and RNs
Ans: B
Feedback:
Research is within the purview of the APRN. The activity described does not exemplify
explaining studies to RNs, critiquing care, or involving patients in their care.
12.
Nurses now have the option to practice in a variety of settings and one of the fastest growing
venues of practice for the nurse in today’s health care environment is home health care. What is
the main basis for the growth in this health care setting?
A) Chronic nursing shortage
B) Western focus on treatment of disease
C) Nurses’ preferences for day shifts instead of evening or night shifts
D) Discharge of patients who are more critically ill
Ans: D
Feedback:
With shorter hospital stays and increased use of outpatient health care services, more nursing care
is provided in the home and community setting. The other answers are incorrect because they are
not the basis for the growth in nursing care delivered in the home setting.
13.
Nurses have different educational backgrounds and function under many titles in their practice
setting. If a nurse practicing in an oncology clinic had the goal of improving patient outcomes and
nursing care by influencing the patient, the nurse, and the health care system, what would most
accurately describe this nurse’s title?
A) Nursing care expert
B) Clinical nurse specialist
C) Nurse manager
D) Staff nurse
Ans: B
Feedback:
Clinical nurse specialists are prepared as specialists who practice within a circumscribed area of
care (e.g., cardiovascular, oncology). They define their roles as having five major components:
clinical practice, education, management, consultation, and research. The other answers are
incorrect because they are not the most accurate titles for this nurse.
C) Critiquing the quality of patient care
D) Explaining medical studies to patients and RNs
Ans: B
Feedback:
Research is within the purview of the APRN. The activity described does not exemplify
explaining studies to RNs, critiquing care, or involving patients in their care.
12.
Nurses now have the option to practice in a variety of settings and one of the fastest growing
venues of practice for the nurse in today’s health care environment is home health care. What is
the main basis for the growth in this health care setting?
A) Chronic nursing shortage
B) Western focus on treatment of disease
C) Nurses’ preferences for day shifts instead of evening or night shifts
D) Discharge of patients who are more critically ill
Ans: D
Feedback:
With shorter hospital stays and increased use of outpatient health care services, more nursing care
is provided in the home and community setting. The other answers are incorrect because they are
not the basis for the growth in nursing care delivered in the home setting.
13.
Nurses have different educational backgrounds and function under many titles in their practice
setting. If a nurse practicing in an oncology clinic had the goal of improving patient outcomes and
nursing care by influencing the patient, the nurse, and the health care system, what would most
accurately describe this nurse’s title?
A) Nursing care expert
B) Clinical nurse specialist
C) Nurse manager
D) Staff nurse
Ans: B
Feedback:
Clinical nurse specialists are prepared as specialists who practice within a circumscribed area of
care (e.g., cardiovascular, oncology). They define their roles as having five major components:
clinical practice, education, management, consultation, and research. The other answers are
incorrect because they are not the most accurate titles for this nurse.
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14.
Nursing continues to recognize and participate in collaboration with other health care disciplines
to meet the complex needs of the patient. Which of the following is the best example of a
collaborative practice model?
A) The nurse and the physician jointly making clinical decisions.
B) The nurse accompanying the physician on rounds.
C) The nurse making a referral on behalf of the patient.
D) The nurse attending an appointment with the patient.
Ans: A
Feedback:
The collaborative model, or a variation of it, promotes shared participation, responsibility, and
accountability in a health care environment that is striving to meet the complex health care needs
of the public. The other answers are incorrect because they are not examples of a collaborative
practice model.
15.
A hospice nurse is caring for a patient who is dying of lymphoma. According to Maslow’s
hierarchy of needs, what dimension of care should the nurse consider primary in importance
when caring for a dying patient?
A) Spiritual
B) Social
C) Physiologic
D) Emotional
Ans: C
Feedback:
Maslow ranked human needs as follows: physiologic needs; safety and security; sense of
belonging and affection; esteem and self-respect; and self-actualization, which includes self-
fulfillment, desire to know and understand, and aesthetic needs. Such a hierarchy of needs is a
useful framework that can be applied to the various nursing models for assessment of a patient’s
strengths, limitations, and need for nursing interventions. The other answers are incorrect because
they are not of primary importance when caring for a dying patient, though each should certainly
be addressed.
16.
A nurse is planning a medical patient’s care with consideration of Maslow’s hierarchy of needs.
Within this framework of understanding, what would be the nurse’s first priority?
A) Allowing the family to see a newly admitted patient
B) Ambulating the patient in the hallway
C) Administering pain medication
Nursing continues to recognize and participate in collaboration with other health care disciplines
to meet the complex needs of the patient. Which of the following is the best example of a
collaborative practice model?
A) The nurse and the physician jointly making clinical decisions.
B) The nurse accompanying the physician on rounds.
C) The nurse making a referral on behalf of the patient.
D) The nurse attending an appointment with the patient.
Ans: A
Feedback:
The collaborative model, or a variation of it, promotes shared participation, responsibility, and
accountability in a health care environment that is striving to meet the complex health care needs
of the public. The other answers are incorrect because they are not examples of a collaborative
practice model.
15.
A hospice nurse is caring for a patient who is dying of lymphoma. According to Maslow’s
hierarchy of needs, what dimension of care should the nurse consider primary in importance
when caring for a dying patient?
A) Spiritual
B) Social
C) Physiologic
D) Emotional
Ans: C
Feedback:
Maslow ranked human needs as follows: physiologic needs; safety and security; sense of
belonging and affection; esteem and self-respect; and self-actualization, which includes self-
fulfillment, desire to know and understand, and aesthetic needs. Such a hierarchy of needs is a
useful framework that can be applied to the various nursing models for assessment of a patient’s
strengths, limitations, and need for nursing interventions. The other answers are incorrect because
they are not of primary importance when caring for a dying patient, though each should certainly
be addressed.
16.
A nurse is planning a medical patient’s care with consideration of Maslow’s hierarchy of needs.
Within this framework of understanding, what would be the nurse’s first priority?
A) Allowing the family to see a newly admitted patient
B) Ambulating the patient in the hallway
C) Administering pain medication
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D) Teaching the patient to self-administer insulin safely
Ans: C
Feedback:
In Maslow’s hierarchy of needs, pain relief addresses the patient’s basic physiologic need.
Activity, such as ambulation, is a higher level need above the physiologic need. Allowing the
patient to see family addresses a higher level need related to love and belonging. Teaching the
patient is also a higher level need related to the desire to know and understand and is not
appropriate at this time, as the basic physiologic need of pain control must be addressed before
the patient can address these higher level needs.
17.
A medical-surgical nurse is aware of the scope of practice as defined in the state where the nurse
provides care. This nurse’s compliance with the nurse practice act demonstrates adherence to
which of the following?
A) National Council of Nursing’s guidelines for care
B) National League for Nursing’s Code of Conduct
C) American Nurses Association’s Social Policy Statement
D) Department of Health and Human Service’s White Paper on Nursing
Ans: C
Feedback:
Nurses have a responsibility to carry out their role as described in the Social Policy Statement to
comply with the nurse practice act of the state in which they practice and to comply with the
Code of Ethics for Nurses as spelled out by the ANA (2001) and the International Council of
Nurses (International Council of Nurses [ICN], 2006). The other answers are incorrect; the Code
of Ethics for nursing is not included in the ANA’s white paper. The DHHS has not published a
white paper on nursing nor has the NLN published a specific code of conduct.
18.
Nursing is, by necessity, a flexible profession. It has adapted to meet both the expectations and
the changing health needs of our aging population. What is one factor that has impacted the need
for certified nurse practitioners (CNPs)?
A) The increased need for primary care providers
B) The need to improve patient diagnostic services
C) The push to drive institutional excellence
D) The need to decrease the number of medical errors
Ans: A
Feedback:
CNPs who are educationally prepared with a population focus in adult-gerontology or pediatrics
Ans: C
Feedback:
In Maslow’s hierarchy of needs, pain relief addresses the patient’s basic physiologic need.
Activity, such as ambulation, is a higher level need above the physiologic need. Allowing the
patient to see family addresses a higher level need related to love and belonging. Teaching the
patient is also a higher level need related to the desire to know and understand and is not
appropriate at this time, as the basic physiologic need of pain control must be addressed before
the patient can address these higher level needs.
17.
A medical-surgical nurse is aware of the scope of practice as defined in the state where the nurse
provides care. This nurse’s compliance with the nurse practice act demonstrates adherence to
which of the following?
A) National Council of Nursing’s guidelines for care
B) National League for Nursing’s Code of Conduct
C) American Nurses Association’s Social Policy Statement
D) Department of Health and Human Service’s White Paper on Nursing
Ans: C
Feedback:
Nurses have a responsibility to carry out their role as described in the Social Policy Statement to
comply with the nurse practice act of the state in which they practice and to comply with the
Code of Ethics for Nurses as spelled out by the ANA (2001) and the International Council of
Nurses (International Council of Nurses [ICN], 2006). The other answers are incorrect; the Code
of Ethics for nursing is not included in the ANA’s white paper. The DHHS has not published a
white paper on nursing nor has the NLN published a specific code of conduct.
18.
Nursing is, by necessity, a flexible profession. It has adapted to meet both the expectations and
the changing health needs of our aging population. What is one factor that has impacted the need
for certified nurse practitioners (CNPs)?
A) The increased need for primary care providers
B) The need to improve patient diagnostic services
C) The push to drive institutional excellence
D) The need to decrease the number of medical errors
Ans: A
Feedback:
CNPs who are educationally prepared with a population focus in adult-gerontology or pediatrics
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receive additional focused training in primary care or acute care. CNPs help meet the need for
primary care providers. Diagnostic services, institutional excellence, and reduction of medical
errors are congruent with the CNP role, but these considerations are the not primary impetus for
the increased role for CNPs.
19.
A nurse is providing care for a patient who is postoperative day one following a bowel resection
for the treatment of colorectal cancer. How can the nurse best exemplify the QSEN competency
of quality improvement?
A) By liaising with the members of the interdisciplinary care team
B) By critically appraising the outcomes of care that is provided
C) By integrating the patient’s preferences into the plan of care
D) By documenting care in the electronic health record in a timely fashion
Ans: B
Feedback:
Evaluation of outcomes is central to the QSEN competency of quality improvements. Each of the
other listed activities is a component of quality nursing care, but none clearly exemplifies quality
improvement activities.
20.
Professional nursing expands and grows because of factors driven by the changing needs of
health care consumers. Which of the following is a factor that nurses should reflect in the
planning and provision of health care?
A) Decreased access to health care information by individuals
B) Gradual increases in the cultural unity of the American population
C) Increasing mean and median age of the American population
D) Decreasing consumer expectations related to health care outcomes
Ans: C
Feedback:
The decline in birth rate and the increase in lifespan due to improved health care have resulted in
fewer school-age children and more senior citizens, many of whom are women.
The population has become more culturally diverse as increasing numbers of people from
different national backgrounds enter the country. Access to information and consumer
expectations continue to increase.
21.
A public health nurse has been commissioned to draft a health promotion program that meets the
health care needs and expectations of the community. Which of the following focuses is most
likely to influence the nurse’s choice of interventions?
A) Management of chronic conditions and disability
primary care providers. Diagnostic services, institutional excellence, and reduction of medical
errors are congruent with the CNP role, but these considerations are the not primary impetus for
the increased role for CNPs.
19.
A nurse is providing care for a patient who is postoperative day one following a bowel resection
for the treatment of colorectal cancer. How can the nurse best exemplify the QSEN competency
of quality improvement?
A) By liaising with the members of the interdisciplinary care team
B) By critically appraising the outcomes of care that is provided
C) By integrating the patient’s preferences into the plan of care
D) By documenting care in the electronic health record in a timely fashion
Ans: B
Feedback:
Evaluation of outcomes is central to the QSEN competency of quality improvements. Each of the
other listed activities is a component of quality nursing care, but none clearly exemplifies quality
improvement activities.
20.
Professional nursing expands and grows because of factors driven by the changing needs of
health care consumers. Which of the following is a factor that nurses should reflect in the
planning and provision of health care?
A) Decreased access to health care information by individuals
B) Gradual increases in the cultural unity of the American population
C) Increasing mean and median age of the American population
D) Decreasing consumer expectations related to health care outcomes
Ans: C
Feedback:
The decline in birth rate and the increase in lifespan due to improved health care have resulted in
fewer school-age children and more senior citizens, many of whom are women.
The population has become more culturally diverse as increasing numbers of people from
different national backgrounds enter the country. Access to information and consumer
expectations continue to increase.
21.
A public health nurse has been commissioned to draft a health promotion program that meets the
health care needs and expectations of the community. Which of the following focuses is most
likely to influence the nurse’s choice of interventions?
A) Management of chronic conditions and disability
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B) Increasing need for self-care among a younger population
C) A shifting focus to disease management
D) An increasing focus on acute conditions and rehabilitation
Ans: A
Feedback:
In response to current priorities, health care must focus more on management of chronic
conditions and disability than in previous times. The other answers are incorrect because the
change in focus of health care is not an increasing need for self-care among our aging population;
our focus is shifting away from disease management, not toward it; and we are moving away
from the management of acute conditions to managing chronic conditions.
22.
A community health nurse has witnessed significant shifts in patterns of disease over the course
of a four-decade career. Which of the following focuses most clearly demonstrates the changing
pattern of disease in the United States?
A) Type 1 diabetes management
B) Treatment of community-acquired pneumonia
C) Rehabilitation from traumatic brain injuries
D) Management of acute Staphylococcus aureus infections
Ans: A
Feedback:
Management of chronic diseases such as diabetes is a priority focus of the current health care
environment. This supersedes the treatment of acute infections and rehabilitation needs.
23.
The ANA has identified several phenomena toward which the focus of nursing care should be
directed, and a nurse is planning care that reflects these priorities. Which of the nurse’s actions
best demonstrates these priorities?
A) Encouraging the patient’s dependence on caregivers
B) Fostering the patient’s ability to make choices
C) Teaching the patient about nurses’ roles in the health care system
D) Assessing the patient’s adherence to treatment
Ans: B
Feedback:
The ANA identifies several focuses for nursing care and research, including the ability to make
choices. The other answers are incorrect because they are not phenomena identified by the ANA.
24. The role of the certified nurse practitioner (CNP) has become a dominant role for nurses in all
C) A shifting focus to disease management
D) An increasing focus on acute conditions and rehabilitation
Ans: A
Feedback:
In response to current priorities, health care must focus more on management of chronic
conditions and disability than in previous times. The other answers are incorrect because the
change in focus of health care is not an increasing need for self-care among our aging population;
our focus is shifting away from disease management, not toward it; and we are moving away
from the management of acute conditions to managing chronic conditions.
22.
A community health nurse has witnessed significant shifts in patterns of disease over the course
of a four-decade career. Which of the following focuses most clearly demonstrates the changing
pattern of disease in the United States?
A) Type 1 diabetes management
B) Treatment of community-acquired pneumonia
C) Rehabilitation from traumatic brain injuries
D) Management of acute Staphylococcus aureus infections
Ans: A
Feedback:
Management of chronic diseases such as diabetes is a priority focus of the current health care
environment. This supersedes the treatment of acute infections and rehabilitation needs.
23.
The ANA has identified several phenomena toward which the focus of nursing care should be
directed, and a nurse is planning care that reflects these priorities. Which of the nurse’s actions
best demonstrates these priorities?
A) Encouraging the patient’s dependence on caregivers
B) Fostering the patient’s ability to make choices
C) Teaching the patient about nurses’ roles in the health care system
D) Assessing the patient’s adherence to treatment
Ans: B
Feedback:
The ANA identifies several focuses for nursing care and research, including the ability to make
choices. The other answers are incorrect because they are not phenomena identified by the ANA.
24. The role of the certified nurse practitioner (CNP) has become a dominant role for nurses in all
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levels of health care. Which of the following activities are considered integral to the CNP role?
Select all that apply.
A) Educating patients and family members
B) Coordinating care with other disciplines
C) Using direct provision of interventions
D) Educating registered nurses and practical nurses
E) Coordinating payment plans for patients
Ans: A, B, C
Feedback:
This role is a dominant one for nurses in primary, secondary, and tertiary health care settings and
in home care and community nursing. Nurses help patients meet their needs by using direct
intervention, by teaching patients and family members to perform care, and by coordinating and
collaborating with other disciplines to provide needed services. The other answers are incorrect
because NPs do not commonly perform education of nurses and they do not focus on matters
related to payment.
25.
The ANA has identified central characteristics of nursing practice that are applicable across the
wide variety of contexts in which nurses practice. A nurse can best demonstrate these principles
by performing which of the following actions?
A) Teaching the public about the role of nursing
B) Taking action to control the costs of health care
C) Ensuring that all of his or her actions exemplify caring
D) Making sure to carry adequate liability insurance
Ans: C
Feedback:
The ANA emphasizes the fact that caring is central to the practice of the registered nurse. The
ANA does not identify teaching the public about nursing, controlling costs, or maintaining
insurance as a central tenet of nursing practice.
26.
A nurse has accepted a position as a clinical nurse leader (CNL), a new role that has been
launched within the past decade. In this role, the nurse should prioritize which of the following
activities?
A) Acting as a spokesperson for the nursing profession
B) Generating and disseminating new nursing knowledge
C) Diagnosing and treating health problems that have a predictable course
Select all that apply.
A) Educating patients and family members
B) Coordinating care with other disciplines
C) Using direct provision of interventions
D) Educating registered nurses and practical nurses
E) Coordinating payment plans for patients
Ans: A, B, C
Feedback:
This role is a dominant one for nurses in primary, secondary, and tertiary health care settings and
in home care and community nursing. Nurses help patients meet their needs by using direct
intervention, by teaching patients and family members to perform care, and by coordinating and
collaborating with other disciplines to provide needed services. The other answers are incorrect
because NPs do not commonly perform education of nurses and they do not focus on matters
related to payment.
25.
The ANA has identified central characteristics of nursing practice that are applicable across the
wide variety of contexts in which nurses practice. A nurse can best demonstrate these principles
by performing which of the following actions?
A) Teaching the public about the role of nursing
B) Taking action to control the costs of health care
C) Ensuring that all of his or her actions exemplify caring
D) Making sure to carry adequate liability insurance
Ans: C
Feedback:
The ANA emphasizes the fact that caring is central to the practice of the registered nurse. The
ANA does not identify teaching the public about nursing, controlling costs, or maintaining
insurance as a central tenet of nursing practice.
26.
A nurse has accepted a position as a clinical nurse leader (CNL), a new role that has been
launched within the past decade. In this role, the nurse should prioritize which of the following
activities?
A) Acting as a spokesperson for the nursing profession
B) Generating and disseminating new nursing knowledge
C) Diagnosing and treating health problems that have a predictable course
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D) Helping patients to navigate the health care system
Ans: D
Feedback:
The CNL is a nurse generalist with a master’s degree in nursing and a special background in
clinical leadership, educated to help patients navigate through the complex health care system.
The other answers are incorrect because they are not what nursing has identified as the CNL role.
27.
Our world is connected by a sophisticated communication system that makes much health
information instantly accessible, no matter where the patient is being treated. This instant access
to health information has impacted health care delivery strategies, including the delivery of
nursing care. What is one way the delivery of health care has been impacted by this phenomenon?
A) Brisk changes as well as swift obsolescence
B) Rapid change that is nearly permanent
C) Limitations on the settings where care can be provided
D) Increased need for social acceptance
Ans: A
Feedback:
The sophisticated communication systems that connect most parts of the world, with the
capability of rapid storage, retrieval, and dissemination of information, have stimulated brisk
change as well as swift obsolescence in health care delivery strategies. The other answers are
incorrect because, although we have rapid change in the delivery of nursing care, it does not last a
long time; it is evolving as health care itself evolves. Giving nursing care has not become easier,
it becomes more complex with every change; and it does not need to be more socially acceptable;
it needs to be more culturally sensitive.
28.
With the changing population of health care consumers, it has become necessary for nurses to
work more closely with other nurses, as when acute care nurses collaborate with public health and
home health nurses. What nursing function has increased in importance because of this
phenomenon?
A) Prescribing medication
B) Performing discharge planning
C) Promoting family involvement
D) Forming collegial relationships
Ans: B
Feedback:
The importance of effective discharge planning and quality improvement cannot be overstated.
Ans: D
Feedback:
The CNL is a nurse generalist with a master’s degree in nursing and a special background in
clinical leadership, educated to help patients navigate through the complex health care system.
The other answers are incorrect because they are not what nursing has identified as the CNL role.
27.
Our world is connected by a sophisticated communication system that makes much health
information instantly accessible, no matter where the patient is being treated. This instant access
to health information has impacted health care delivery strategies, including the delivery of
nursing care. What is one way the delivery of health care has been impacted by this phenomenon?
A) Brisk changes as well as swift obsolescence
B) Rapid change that is nearly permanent
C) Limitations on the settings where care can be provided
D) Increased need for social acceptance
Ans: A
Feedback:
The sophisticated communication systems that connect most parts of the world, with the
capability of rapid storage, retrieval, and dissemination of information, have stimulated brisk
change as well as swift obsolescence in health care delivery strategies. The other answers are
incorrect because, although we have rapid change in the delivery of nursing care, it does not last a
long time; it is evolving as health care itself evolves. Giving nursing care has not become easier,
it becomes more complex with every change; and it does not need to be more socially acceptable;
it needs to be more culturally sensitive.
28.
With the changing population of health care consumers, it has become necessary for nurses to
work more closely with other nurses, as when acute care nurses collaborate with public health and
home health nurses. What nursing function has increased in importance because of this
phenomenon?
A) Prescribing medication
B) Performing discharge planning
C) Promoting family involvement
D) Forming collegial relationships
Ans: B
Feedback:
The importance of effective discharge planning and quality improvement cannot be overstated.
Loading page 12...
The other answers are incorrect because giving medication and family involvement in the
patient’s care have not grown in importance. Making and maintaining collegial relationships has
become a necessity in working in the health care delivery system. Effective discharge planning
aids in getting patients out of the inpatient setting sooner, cutting costs, and making rehabilitation
in the community and home setting possible.
29.
A nurse has integrated the principles of evidence-based practice into care. EBP has the potential
to help the nurse achieve what goal?
A) Increasing career satisfaction
B) Obtaining federal grant money
C) Ensuring high quality patient care
D) Enhancing the public’s esteem for nursing
Ans: C
Feedback:
Quality improvement is the ultimate goal of EBP. Career satisfaction, public esteem, and grant
money are not priorities.
30.
A case manager has been hired at a rural hospital that has a combined medical-surgical unit.
When defining this new role, which of the following outcomes should be prioritized by the
hospital’s leadership?
A) Decreased need for physician services
B) Improved patient and family education
C) Increased adherence to the principles of EBP
D) Increased coordination of health services
Ans: D
Feedback:
Case management is a system of coordinating health care services to ensure cost-effectiveness,
accountability, and quality care. The case manager coordinates the care of a caseload of patients
through facilitating communication between nurses, other health care personnel who provide
care, and insurance companies. Reducing the need for physician services is not a central goal.
Education and EBP are consistent with case management, but they are not central to this
particular role.
31.
A hospital’s current quality improvement program has integrated the principles of the Institute for
Healthcare Improvement (IHI) 5 Million Lives Campaign. How can the hospital best achieve the
campaign goals of reducing preventable harm and death?
A) By adhering to EBP guidelines
patient’s care have not grown in importance. Making and maintaining collegial relationships has
become a necessity in working in the health care delivery system. Effective discharge planning
aids in getting patients out of the inpatient setting sooner, cutting costs, and making rehabilitation
in the community and home setting possible.
29.
A nurse has integrated the principles of evidence-based practice into care. EBP has the potential
to help the nurse achieve what goal?
A) Increasing career satisfaction
B) Obtaining federal grant money
C) Ensuring high quality patient care
D) Enhancing the public’s esteem for nursing
Ans: C
Feedback:
Quality improvement is the ultimate goal of EBP. Career satisfaction, public esteem, and grant
money are not priorities.
30.
A case manager has been hired at a rural hospital that has a combined medical-surgical unit.
When defining this new role, which of the following outcomes should be prioritized by the
hospital’s leadership?
A) Decreased need for physician services
B) Improved patient and family education
C) Increased adherence to the principles of EBP
D) Increased coordination of health services
Ans: D
Feedback:
Case management is a system of coordinating health care services to ensure cost-effectiveness,
accountability, and quality care. The case manager coordinates the care of a caseload of patients
through facilitating communication between nurses, other health care personnel who provide
care, and insurance companies. Reducing the need for physician services is not a central goal.
Education and EBP are consistent with case management, but they are not central to this
particular role.
31.
A hospital’s current quality improvement program has integrated the principles of the Institute for
Healthcare Improvement (IHI) 5 Million Lives Campaign. How can the hospital best achieve the
campaign goals of reducing preventable harm and death?
A) By adhering to EBP guidelines
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B) By reducing nurse-to-patient ratios and increasing accountability
C) By having researchers from outside the facility evaluate care
D) By involving patients and families in their care planning
Ans: A
Feedback:
The 5 Million Lives Campaign posits that if evidence-based guidelines it advocated were
voluntarily implemented by U.S. hospitals, 5 million lives would be saved from either harm or
death over a two-year period. Nurse-to-patient ratios, family participation, and independent
evaluation are not stated components of the campaign.
32.
Over the past several decades, nursing roles have changed and expanded in many ways. Which of
the following factors has provided the strongest impetus for this change?
A) The need to decrease the cost of health care
B) The need to improve the quality of nursing education
C) The need to increase the number of nursing jobs available
D) The need to increase the public perception of nursing
Ans: A
Feedback:
The role of the nurse has expanded to improve the distribution of health care services and to
decrease the cost of health care. The other answers are incorrect because the expansion of roles in
nursing did not occur to improve education, increase the number of nursing jobs, or increase
public perception.
33.
Advanced practice nursing roles have grown in number and in visibility in recent years. What
characteristic sets these nurses apart from the registered nurse?
A) Collaboration with other health care providers
B) Education that goes beyond that of the RN
C) Advanced documentation skills
D) Ability to provide care in the surgical context
Ans: B
Feedback:
There is wide variety in APRN roles. However, a commonality is that they require education
beyond that of the professional RN. All nurses collaborate with other health care providers to
provide nursing care to their patients. Advanced documentation skills are not what sets advanced
practice nurses apart from the staff nurse. RNs have the ability to provide care in the operating
C) By having researchers from outside the facility evaluate care
D) By involving patients and families in their care planning
Ans: A
Feedback:
The 5 Million Lives Campaign posits that if evidence-based guidelines it advocated were
voluntarily implemented by U.S. hospitals, 5 million lives would be saved from either harm or
death over a two-year period. Nurse-to-patient ratios, family participation, and independent
evaluation are not stated components of the campaign.
32.
Over the past several decades, nursing roles have changed and expanded in many ways. Which of
the following factors has provided the strongest impetus for this change?
A) The need to decrease the cost of health care
B) The need to improve the quality of nursing education
C) The need to increase the number of nursing jobs available
D) The need to increase the public perception of nursing
Ans: A
Feedback:
The role of the nurse has expanded to improve the distribution of health care services and to
decrease the cost of health care. The other answers are incorrect because the expansion of roles in
nursing did not occur to improve education, increase the number of nursing jobs, or increase
public perception.
33.
Advanced practice nursing roles have grown in number and in visibility in recent years. What
characteristic sets these nurses apart from the registered nurse?
A) Collaboration with other health care providers
B) Education that goes beyond that of the RN
C) Advanced documentation skills
D) Ability to provide care in the surgical context
Ans: B
Feedback:
There is wide variety in APRN roles. However, a commonality is that they require education
beyond that of the professional RN. All nurses collaborate with other health care providers to
provide nursing care to their patients. Advanced documentation skills are not what sets advanced
practice nurses apart from the staff nurse. RNs have the ability to provide care in the operating
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room.
34.
CNPs are educated as specialists in areas such as family care, pediatrics, or geriatrics. In most
states, what right do CNPs have that RNs do not possess?
A) Perform health interventions independently
B) Make referrals to members of other health disciplines
C) Prescribe medications
D) Perform surgery independently
Ans: C
Feedback:
In most states, nurse practitioners have prescriptive authority. Surgery is beyond the CNP scope
of practice and all professional nurses may perform interventions and make certain referrals.
35.
A team of community health nurses are planning to draft a proposal for a program that will
increase the community’s alignment with the principles contained in the Healthy People
2020report. Which of the following activities would best demonstrate the priorities identified in
this report?
A)
Addressing determinants of health such as clean environments and safety in the
community
B)
Lobbying for increased funding to the county hospital where many residents receive
primary care
C)
Collaborating with health professionals in neighboring communities to pool resources and
increase efficiencies
D)
Creating clinical placements where nursing students and members of other health
disciplines can gain experience in a community setting
Ans: A
Feedback:
Healthy People 2020 addresses social determinants of health such as safety and the state of the
environment. This report does not specifically address matters such as hospital funding, nursing
education, or resource allocation.
36.
A nurse is aware that an increasing emphasis is being placed on health, health promotion,
wellness, and self-care. Which of the following activities would best demonstrate the principles
of health promotion?
A) A discharge planning initiative between acute care and community care nurses
B) Collaboration between several schools of nursing in an urban area
C) Creation of a smoking prevention program undertaken in a middle school
34.
CNPs are educated as specialists in areas such as family care, pediatrics, or geriatrics. In most
states, what right do CNPs have that RNs do not possess?
A) Perform health interventions independently
B) Make referrals to members of other health disciplines
C) Prescribe medications
D) Perform surgery independently
Ans: C
Feedback:
In most states, nurse practitioners have prescriptive authority. Surgery is beyond the CNP scope
of practice and all professional nurses may perform interventions and make certain referrals.
35.
A team of community health nurses are planning to draft a proposal for a program that will
increase the community’s alignment with the principles contained in the Healthy People
2020report. Which of the following activities would best demonstrate the priorities identified in
this report?
A)
Addressing determinants of health such as clean environments and safety in the
community
B)
Lobbying for increased funding to the county hospital where many residents receive
primary care
C)
Collaborating with health professionals in neighboring communities to pool resources and
increase efficiencies
D)
Creating clinical placements where nursing students and members of other health
disciplines can gain experience in a community setting
Ans: A
Feedback:
Healthy People 2020 addresses social determinants of health such as safety and the state of the
environment. This report does not specifically address matters such as hospital funding, nursing
education, or resource allocation.
36.
A nurse is aware that an increasing emphasis is being placed on health, health promotion,
wellness, and self-care. Which of the following activities would best demonstrate the principles
of health promotion?
A) A discharge planning initiative between acute care and community care nurses
B) Collaboration between several schools of nursing in an urban area
C) Creation of a smoking prevention program undertaken in a middle school
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D) Establishment of a website where patients can check emergency department wait-times
Ans: C
Feedback:
Smoking prevention is a clear example of health promotion. Each of the other listed activities has
the potential to be beneficial, but none is considered health promotion.
37.
A group of nursing students are learning about recent changes in the pattern of disease in the
United States. Which of the following statements best describes these current changes?
A) Infectious diseases continue to decrease in incidence and prevalence.
B) Chronic illnesses are becoming increasingly resistant to treatment.
C) Most acute, infectious diseases have been eradicated.
D) Most, but not all, communicable diseases are declining.
Ans: D
Feedback:
Although some infectious diseases have been controlled or eradicated, others are on the rise.
Antibiotic resistance is a more serious problem in acute, not chronic, illnesses.
38.
The Joint Commission and the Centers for Medicare and Medicaid Services (CMS) are evaluating
a large, university medical center according to core measures. Evaluators should perform this
evaluation in what way?
A) By auditing the medical center’s electronic health records
B) By performing focus groups and interviews with care providers from numerous disciplines
C) By performing statistical analysis of patient satisfaction surveys
D) By comparing the center’s patient outcomes to best practice indicators
Ans: D
Feedback:
Core measures are used to gauge how well a hospital gives care to its patients who are admitted to
seek treatment for a specific disease or who need a specific treatment as compared to evidence-
based guidelines and standards of care. Benchmark standards of quality are used to compare the
care or treatment patients receive with the best practice standards. Patient satisfaction is
considered, but this is not the only criterion.
39.
Leadership of a medical unit have been instructed to integrate the principles of the Quality and
Safety Education for Nurses (QSEN) competency of quality improvement. What action should
the unit’s leaders take?
A) Provide access to online journals and Web-based clinical resources for nursing staff.
Ans: C
Feedback:
Smoking prevention is a clear example of health promotion. Each of the other listed activities has
the potential to be beneficial, but none is considered health promotion.
37.
A group of nursing students are learning about recent changes in the pattern of disease in the
United States. Which of the following statements best describes these current changes?
A) Infectious diseases continue to decrease in incidence and prevalence.
B) Chronic illnesses are becoming increasingly resistant to treatment.
C) Most acute, infectious diseases have been eradicated.
D) Most, but not all, communicable diseases are declining.
Ans: D
Feedback:
Although some infectious diseases have been controlled or eradicated, others are on the rise.
Antibiotic resistance is a more serious problem in acute, not chronic, illnesses.
38.
The Joint Commission and the Centers for Medicare and Medicaid Services (CMS) are evaluating
a large, university medical center according to core measures. Evaluators should perform this
evaluation in what way?
A) By auditing the medical center’s electronic health records
B) By performing focus groups and interviews with care providers from numerous disciplines
C) By performing statistical analysis of patient satisfaction surveys
D) By comparing the center’s patient outcomes to best practice indicators
Ans: D
Feedback:
Core measures are used to gauge how well a hospital gives care to its patients who are admitted to
seek treatment for a specific disease or who need a specific treatment as compared to evidence-
based guidelines and standards of care. Benchmark standards of quality are used to compare the
care or treatment patients receive with the best practice standards. Patient satisfaction is
considered, but this is not the only criterion.
39.
Leadership of a medical unit have been instructed to integrate the principles of the Quality and
Safety Education for Nurses (QSEN) competency of quality improvement. What action should
the unit’s leaders take?
A) Provide access to online journals and Web-based clinical resources for nursing staff.
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B) Use flow charts to document the processes of care that are used on the unit.
C) Enforce continuing education requirements for all care providers.
D) Reduce the use of chemical and physical restraints on the unit.
Ans: B
Feedback:
One of the quality improvement skills is to use tools, such as flow charts and cause-effect
diagrams, to make processes of care explicit. Each of the other listed actions has the potential to
benefit patients and care givers, but none is an explicit knowledge, skill, or attitude associated
with this QSEN competency.
40.
The IOM Report Health Professions Education: A Bridge to Quality issued a number of
challenges to the educational programs that teach nurses and members of other health professions.
According to this report, what activity should educational institutions prioritize?
A) More clearly delineate each profession’s scope of practice during education
B)
Move toward developing a single health curriculum that can be adapted for any health
profession
C) Include interdisciplinary core competencies into curricula
D) Elicit input from patients and families into health care curricula
Ans: C
Feedback:
Health Professions Education: A Bridge to Quality challenged health professions’ education
programs to integrate interdisciplinary core competencies into their respective curricula to include
patient-centered care, interdisciplinary teamwork and collaboration, evidence-based practice,
quality improvement, safety, and informatics. This report did not specify clearer definitions of
scope of practice, patient input, or a single curriculum.
Page 1
Chapter 2
1.
A community health nurse has scheduled a hypertension clinic in a local shopping mall in which
shoppers have the opportunity to have their blood pressure measured and learn about hypertension.
This nursing activity would be an example of which type of prevention activity?
A) Tertiary prevention
B) Secondary prevention
C) Primary prevention
C) Enforce continuing education requirements for all care providers.
D) Reduce the use of chemical and physical restraints on the unit.
Ans: B
Feedback:
One of the quality improvement skills is to use tools, such as flow charts and cause-effect
diagrams, to make processes of care explicit. Each of the other listed actions has the potential to
benefit patients and care givers, but none is an explicit knowledge, skill, or attitude associated
with this QSEN competency.
40.
The IOM Report Health Professions Education: A Bridge to Quality issued a number of
challenges to the educational programs that teach nurses and members of other health professions.
According to this report, what activity should educational institutions prioritize?
A) More clearly delineate each profession’s scope of practice during education
B)
Move toward developing a single health curriculum that can be adapted for any health
profession
C) Include interdisciplinary core competencies into curricula
D) Elicit input from patients and families into health care curricula
Ans: C
Feedback:
Health Professions Education: A Bridge to Quality challenged health professions’ education
programs to integrate interdisciplinary core competencies into their respective curricula to include
patient-centered care, interdisciplinary teamwork and collaboration, evidence-based practice,
quality improvement, safety, and informatics. This report did not specify clearer definitions of
scope of practice, patient input, or a single curriculum.
Page 1
Chapter 2
1.
A community health nurse has scheduled a hypertension clinic in a local shopping mall in which
shoppers have the opportunity to have their blood pressure measured and learn about hypertension.
This nursing activity would be an example of which type of prevention activity?
A) Tertiary prevention
B) Secondary prevention
C) Primary prevention
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D) Disease prevention
Ans: B
Feedback:
Secondary prevention centers on health maintenance aim at early detection and prevention. Disease
prevention is not a form of health care but is a focus on primary prevention.
2.
The nursing instructor is preparing a group of students for their home care rotation. In preparation,
the group discusses the patients that they are most likely to care for in the home. Which of the
following groups are the most common recipients of home care services?
A) Mentally ill patients
B) Patients receiving rehabilitation after surgery
C) Terminally ill and palliative patients
D) Elderly patients
Ans: D
Feedback:
The elderly are the most frequent users of home care services. The patient must be acutely ill,
home bound, and in need of skilled nursing services to be eligible for this service. The other
answers are incorrect because it is the elderly who are seen most frequently in the home health
setting, though each of the other listed groups may sometimes receive home care.
3.
A recent nursing graduate has been surprised at the sharp contrast between some patients’ lifestyles
in their homes and the nurse’s own practices and beliefs. To work therapeutically with the patient,
what must the nurse do?
A) Request another assignment if there is dissonance with the patient’s lifestyle.
B) Ask the patient to come to the agency to receive treatment, if possible.
C) Resolve to convey respect for the patient’s beliefs and choices.
D) Try to adapt the patient’s home to the norms of a hospital environment.
Ans: C
Feedback:
To work successfully with patients in any setting, the nurse must be nonjudgmental and convey
respect for patients’ beliefs, even if they differ sharply from the nurse’s. This can be difficult when
a patient’s lifestyle involves activities that a nurse considers harmful or unacceptable, such as
smoking, use of alcohol, drug abuse, or overeating. The nurse should not request another
assignment because of a difference in beliefs, nor do nurses ask for the patient to come to you at
the agency to receive treatment. It is also inappropriate to convert the patient’s home to a hospital-
like environment.
Ans: B
Feedback:
Secondary prevention centers on health maintenance aim at early detection and prevention. Disease
prevention is not a form of health care but is a focus on primary prevention.
2.
The nursing instructor is preparing a group of students for their home care rotation. In preparation,
the group discusses the patients that they are most likely to care for in the home. Which of the
following groups are the most common recipients of home care services?
A) Mentally ill patients
B) Patients receiving rehabilitation after surgery
C) Terminally ill and palliative patients
D) Elderly patients
Ans: D
Feedback:
The elderly are the most frequent users of home care services. The patient must be acutely ill,
home bound, and in need of skilled nursing services to be eligible for this service. The other
answers are incorrect because it is the elderly who are seen most frequently in the home health
setting, though each of the other listed groups may sometimes receive home care.
3.
A recent nursing graduate has been surprised at the sharp contrast between some patients’ lifestyles
in their homes and the nurse’s own practices and beliefs. To work therapeutically with the patient,
what must the nurse do?
A) Request another assignment if there is dissonance with the patient’s lifestyle.
B) Ask the patient to come to the agency to receive treatment, if possible.
C) Resolve to convey respect for the patient’s beliefs and choices.
D) Try to adapt the patient’s home to the norms of a hospital environment.
Ans: C
Feedback:
To work successfully with patients in any setting, the nurse must be nonjudgmental and convey
respect for patients’ beliefs, even if they differ sharply from the nurse’s. This can be difficult when
a patient’s lifestyle involves activities that a nurse considers harmful or unacceptable, such as
smoking, use of alcohol, drug abuse, or overeating. The nurse should not request another
assignment because of a difference in beliefs, nor do nurses ask for the patient to come to you at
the agency to receive treatment. It is also inappropriate to convert the patient’s home to a hospital-
like environment.
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4.
Infection control is a high priority in every setting where nursing care is provided. When
performing a home visit, how should the nurse best implement the principles of infection control?
A) Perform hand hygiene before and after giving direct patient care.
B) Remove the patient’s wound dressings from the home promptly.
C) Disinfect the patient’s syringes prior to disposal.
D) Establish a sterile field in the patient’s home before providing care.
Ans: A
Feedback:
Infection control is as important in the home as it is in the hospital, but it can be more challenging
in the home and requires creative approaches. As in any situation, it is important to clean one’s
hands before and after giving direct patient care, even in a home that does not have running water.
Removing the wound dressings from the home and disinfecting all work areas in the home are not
the best implementations of infection control in the home. Used syringes are never disinfected and
a sterile field is not always necessary.
5.
An adult patient is ready to be discharged from the hospital after undergoing a transmetatarsal
amputation. When should your patient’s discharge planning begin?
A) The day prior to discharge
B) The day of estimated discharge
C) The day that the patient is admitted
D) Once the nursing care plan has been finalized
Ans: C
Feedback:
Discharge planning begins with the patient’s admission to the hospital and must consider the
possible need for follow-up home care. Discharge planning should begin prior to the other listed
times.
6.
A home health nurse is preparing to make the initial visit to a new patient’s home. When planning
educational interventions, what information should the nurse provide to the patient and his or her
family?
A) Available community resources to meet their needs
B) Information on other patients in the area with similar health care needs
C) The nurse’s contact information and credentials
D) Dates and times of all scheduled home care visits
Ans: A
Infection control is a high priority in every setting where nursing care is provided. When
performing a home visit, how should the nurse best implement the principles of infection control?
A) Perform hand hygiene before and after giving direct patient care.
B) Remove the patient’s wound dressings from the home promptly.
C) Disinfect the patient’s syringes prior to disposal.
D) Establish a sterile field in the patient’s home before providing care.
Ans: A
Feedback:
Infection control is as important in the home as it is in the hospital, but it can be more challenging
in the home and requires creative approaches. As in any situation, it is important to clean one’s
hands before and after giving direct patient care, even in a home that does not have running water.
Removing the wound dressings from the home and disinfecting all work areas in the home are not
the best implementations of infection control in the home. Used syringes are never disinfected and
a sterile field is not always necessary.
5.
An adult patient is ready to be discharged from the hospital after undergoing a transmetatarsal
amputation. When should your patient’s discharge planning begin?
A) The day prior to discharge
B) The day of estimated discharge
C) The day that the patient is admitted
D) Once the nursing care plan has been finalized
Ans: C
Feedback:
Discharge planning begins with the patient’s admission to the hospital and must consider the
possible need for follow-up home care. Discharge planning should begin prior to the other listed
times.
6.
A home health nurse is preparing to make the initial visit to a new patient’s home. When planning
educational interventions, what information should the nurse provide to the patient and his or her
family?
A) Available community resources to meet their needs
B) Information on other patients in the area with similar health care needs
C) The nurse’s contact information and credentials
D) Dates and times of all scheduled home care visits
Ans: A
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Feedback:
The community-based nurse is responsible for informing the patient and family about the
community resources available to meet their needs. During initial and subsequent home visits, the
nurse helps the patient and family identify these community services and encourages them to
contact the appropriate agencies. When appropriate, nurses may make the initial contact. The other
answers are incorrect because it is inappropriate to ever provide information on other patients to a
patient. The nurse’s credentials are not normally discussed. Giving the patient the dates and times
of their scheduled home visits is appropriate, but may not always be possible. It is more important
to provide them with resources available within the community to meet their needs.
7.
The home health nurse receives a referral from the hospital for a patient who needs a home visit for
wound care. After obtaining the referral, what would be the first action the nurse should take?
A) Have community services make contact with the patient.
B) Obtain a physician’s order for the visit.
C) Call the patient to obtain permission to visit.
D) Arrange for a home health aide to initially visit the patient.
Ans: C
Feedback:
After receiving a referral, the first step is to call the patient and obtain permission to make the visit.
Then the nurse should schedule the visit and verify the address. A physician’s order is not
necessary to schedule a visit with the patient. The nurse may identify community services or the
need for a home health aide after assessing the patient and the home environment during the first
visit with the patient. This would not be delegated to a home health aide.
8.
At the beginning of a day that will involve several home visits, the nurse has ensured that the
health care agency has a copy of her daily schedule. What is the rationale for the nurse’s action?
A) It allows the agency to keep track for payment to the nurse.
B) It supports safety precautions for the nurse when making a home care visit.
C)
It allows for greater flexibility for the nurse and his or her colleagues for changes in
assignments.
D) It allows the patient to cancel appointments with minimal inconvenience.
Ans: B
Feedback:
Whenever a nurse makes a home visit, the agency should know the nurse’s schedule and the
locations of the visits. The other answers are incorrect because providing the agency with a copy of
the daily schedule is not for the purpose of correctly paying the nurse or for the ease of the nurse in
changing assignments. It is also not intended for the patient’s ease in canceling appointments.
The community-based nurse is responsible for informing the patient and family about the
community resources available to meet their needs. During initial and subsequent home visits, the
nurse helps the patient and family identify these community services and encourages them to
contact the appropriate agencies. When appropriate, nurses may make the initial contact. The other
answers are incorrect because it is inappropriate to ever provide information on other patients to a
patient. The nurse’s credentials are not normally discussed. Giving the patient the dates and times
of their scheduled home visits is appropriate, but may not always be possible. It is more important
to provide them with resources available within the community to meet their needs.
7.
The home health nurse receives a referral from the hospital for a patient who needs a home visit for
wound care. After obtaining the referral, what would be the first action the nurse should take?
A) Have community services make contact with the patient.
B) Obtain a physician’s order for the visit.
C) Call the patient to obtain permission to visit.
D) Arrange for a home health aide to initially visit the patient.
Ans: C
Feedback:
After receiving a referral, the first step is to call the patient and obtain permission to make the visit.
Then the nurse should schedule the visit and verify the address. A physician’s order is not
necessary to schedule a visit with the patient. The nurse may identify community services or the
need for a home health aide after assessing the patient and the home environment during the first
visit with the patient. This would not be delegated to a home health aide.
8.
At the beginning of a day that will involve several home visits, the nurse has ensured that the
health care agency has a copy of her daily schedule. What is the rationale for the nurse’s action?
A) It allows the agency to keep track for payment to the nurse.
B) It supports safety precautions for the nurse when making a home care visit.
C)
It allows for greater flexibility for the nurse and his or her colleagues for changes in
assignments.
D) It allows the patient to cancel appointments with minimal inconvenience.
Ans: B
Feedback:
Whenever a nurse makes a home visit, the agency should know the nurse’s schedule and the
locations of the visits. The other answers are incorrect because providing the agency with a copy of
the daily schedule is not for the purpose of correctly paying the nurse or for the ease of the nurse in
changing assignments. It is also not intended for the patient’s ease in canceling appointments.
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9.
There are specific legal guidelines and regulations for the documentation related to home care.
When providing care for a patient who is a Medicaid recipient, what is most important for the nurse
to document?
A) The medical diagnosis and the supplies needed to care for the patient
B) A summary of the patient’s income tax paid during the previous year
C) The specific quality of nursing care that is needed
D) The patient’s homebound status and the specific need for skilled nursing care
Ans: D
Feedback:
Medicare, Medicaid, and third-party payers require documentation of the patient’s homebound
status and the need for skilled professional nursing care. The medical diagnosis and specific
detailed information on the functional limitations of the patient are usually part of the
documentation. The other answers are incorrect because nursing documentation does not include
needed supplies, tax information, or the quality of care needed.
10.
Your patient has had a total knee replacement and will need to walk with a two-wheeled walker
for 6 weeks. He is being discharged home with a referral for home health care. What will the
home care nurse need to assess during the initial nursing assessment in the home?
A) Assistance of neighbors
B) Qualification for Medicare and Medicaid
C) Costs related to the visits
D) Characteristics of the home environment
Ans: D
Feedback:
The initial assessment includes evaluating the patient, the home environment, the patient’s self-
care abilities or the family’s ability to provide care, and the patient’s need for additional
resources. Normally an assessment is not made of assistance on the part of neighbors or the costs
of the visit. Medicare and Medicaid qualifications would normally be determined beforehand.
11.
A nurse who has an advanced degree in primary care for a pediatric population is employed in a
health clinic. In what role is this nurse functioning?
A) Nurse practitioner
B) Case coordinator
C) Clinical nurse specialist
D) Clinic supervisor
There are specific legal guidelines and regulations for the documentation related to home care.
When providing care for a patient who is a Medicaid recipient, what is most important for the nurse
to document?
A) The medical diagnosis and the supplies needed to care for the patient
B) A summary of the patient’s income tax paid during the previous year
C) The specific quality of nursing care that is needed
D) The patient’s homebound status and the specific need for skilled nursing care
Ans: D
Feedback:
Medicare, Medicaid, and third-party payers require documentation of the patient’s homebound
status and the need for skilled professional nursing care. The medical diagnosis and specific
detailed information on the functional limitations of the patient are usually part of the
documentation. The other answers are incorrect because nursing documentation does not include
needed supplies, tax information, or the quality of care needed.
10.
Your patient has had a total knee replacement and will need to walk with a two-wheeled walker
for 6 weeks. He is being discharged home with a referral for home health care. What will the
home care nurse need to assess during the initial nursing assessment in the home?
A) Assistance of neighbors
B) Qualification for Medicare and Medicaid
C) Costs related to the visits
D) Characteristics of the home environment
Ans: D
Feedback:
The initial assessment includes evaluating the patient, the home environment, the patient’s self-
care abilities or the family’s ability to provide care, and the patient’s need for additional
resources. Normally an assessment is not made of assistance on the part of neighbors or the costs
of the visit. Medicare and Medicaid qualifications would normally be determined beforehand.
11.
A nurse who has an advanced degree in primary care for a pediatric population is employed in a
health clinic. In what role is this nurse functioning?
A) Nurse practitioner
B) Case coordinator
C) Clinical nurse specialist
D) Clinic supervisor
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Ans: A
Feedback:
Nurse practitioners, educated in primary care, often practice in ambulatory care settings that focus
on gerontology, pediatrics, family or adult health, or women’s health. Case coordinators and
clinical supervisors do not necessarily require an advanced degree, and a clinical nurse specialist
is not educated in primary care. Primary care is the specific focus of CNPs.
12.
A nurse is based in an automotive assembly plant and works with the plant’s employees in the
areas of health promotion and basic primary care. What nursing role is this nurse performing?
A) Occupational health nurse
B) Community nurse specialist
C) Nurse clinician
D) Public health nurse
Ans: A
Feedback:
Occupational health nurses may provide direct care to patients who are ill, conduct health
education programs for the industry staff, or set up health programs. The other answers are
incorrect because they are not consistent with a nurse’s placement in a manufacturing setting.
13.
A school nurse has been working closely with a student who has cystic fibrosis. The nurse is
aware that children with health problems are at major risk for what problem?
A) Mental health disorders
B) Gradual reduction in intelligence
C) Psychological stress due to a desire to overachieve
D) Underachievement in school
Ans: D
Feedback:
School-aged children and adolescents with health problems are at major risk for underachieving
or failing in school. These students do not necessarily have a high risk of mental health disorders
or a desire to overachieve. Health problems do not normally cause a progressive decline in
intelligence.
14.
A community health nurse is aware that restoration of health often depends on appropriate
interventions performed early in the course of a disease. Which patient is most likely to seek
health care late in the course of his or her disease process and deteriorate more quickly than other
patients?
A) A patient who has been homeless for an extended period of time
Feedback:
Nurse practitioners, educated in primary care, often practice in ambulatory care settings that focus
on gerontology, pediatrics, family or adult health, or women’s health. Case coordinators and
clinical supervisors do not necessarily require an advanced degree, and a clinical nurse specialist
is not educated in primary care. Primary care is the specific focus of CNPs.
12.
A nurse is based in an automotive assembly plant and works with the plant’s employees in the
areas of health promotion and basic primary care. What nursing role is this nurse performing?
A) Occupational health nurse
B) Community nurse specialist
C) Nurse clinician
D) Public health nurse
Ans: A
Feedback:
Occupational health nurses may provide direct care to patients who are ill, conduct health
education programs for the industry staff, or set up health programs. The other answers are
incorrect because they are not consistent with a nurse’s placement in a manufacturing setting.
13.
A school nurse has been working closely with a student who has cystic fibrosis. The nurse is
aware that children with health problems are at major risk for what problem?
A) Mental health disorders
B) Gradual reduction in intelligence
C) Psychological stress due to a desire to overachieve
D) Underachievement in school
Ans: D
Feedback:
School-aged children and adolescents with health problems are at major risk for underachieving
or failing in school. These students do not necessarily have a high risk of mental health disorders
or a desire to overachieve. Health problems do not normally cause a progressive decline in
intelligence.
14.
A community health nurse is aware that restoration of health often depends on appropriate
interventions performed early in the course of a disease. Which patient is most likely to seek
health care late in the course of his or her disease process and deteriorate more quickly than other
patients?
A) A patient who has been homeless for an extended period of time
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B) A patient who recently immigrated to the United States
C) A patient who is 88 years old and who has enjoyed relatively good health
D) A teenage boy
Ans: A
Feedback:
Because of numerous barriers, the homeless seek health care late in the course of a disease and
deteriorate more quickly than patients who are not homeless. Many of their health problems are
related in large part to their living situation. The other answers are incorrect because these
populations do not as often seek care late in the course of their disease process and deteriorate
quicker than other populations.
15.
A recent nursing school graduate has chosen to pursue a community nursing position because of
increasing opportunities for nurses in community settings. What changes in the health care
system have created an increased need for nurses to practice in community-based settings? Select
all that apply.
A) Tighter insurance regulations
B) Younger population
C) Increased rural population
D) Changes in federal legislation
E) Decreasing hospital revenues
Ans: A, D, E
Feedback:
Changes in federal legislation, tighter insurance regulations, decreasing hospital revenues, and
alternative health care delivery systems have also affected the ways in which health care is
delivered. Our country does not have an increased rural population nor is our population younger.
16.
A nursing student has taught a colleague that nursing practice is not limited to hospital settings,
explaining that nurses are now working in ambulatory health clinics, hospice settings, and
homeless shelters and clinics. What factor has most influenced this increased diversity in practice
settings for nurses?
A) Population shift to more rural areas
B) Shift of health care delivery into the community
C) Advent of primary care clinics
D) Increased use of rehabilitation hospitals
Ans: B
C) A patient who is 88 years old and who has enjoyed relatively good health
D) A teenage boy
Ans: A
Feedback:
Because of numerous barriers, the homeless seek health care late in the course of a disease and
deteriorate more quickly than patients who are not homeless. Many of their health problems are
related in large part to their living situation. The other answers are incorrect because these
populations do not as often seek care late in the course of their disease process and deteriorate
quicker than other populations.
15.
A recent nursing school graduate has chosen to pursue a community nursing position because of
increasing opportunities for nurses in community settings. What changes in the health care
system have created an increased need for nurses to practice in community-based settings? Select
all that apply.
A) Tighter insurance regulations
B) Younger population
C) Increased rural population
D) Changes in federal legislation
E) Decreasing hospital revenues
Ans: A, D, E
Feedback:
Changes in federal legislation, tighter insurance regulations, decreasing hospital revenues, and
alternative health care delivery systems have also affected the ways in which health care is
delivered. Our country does not have an increased rural population nor is our population younger.
16.
A nursing student has taught a colleague that nursing practice is not limited to hospital settings,
explaining that nurses are now working in ambulatory health clinics, hospice settings, and
homeless shelters and clinics. What factor has most influenced this increased diversity in practice
settings for nurses?
A) Population shift to more rural areas
B) Shift of health care delivery into the community
C) Advent of primary care clinics
D) Increased use of rehabilitation hospitals
Ans: B
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Feedback:
As health care delivery shifts into the community, more nurses are working in a variety of
community-based settings. These settings include public health departments, ambulatory health
clinics, long-term care facilities, hospice settings, industrial settings (as occupational nurses),
homeless shelters and clinics, nursing centers, home health agencies, urgent care centers, same-
day surgical centers, short-stay facilities, and patients’ homes. The other answers are incorrect
because our population has not shifted to a more rural base, and the use of primary care clinics
has not influenced an increase in practice settings or the use of rehabilitation hospitals.
17.
A nurse is collaborating with a team of community nurses to identify the vision and mission for
community care. What is the central focus of community-based nursing?
A) Increased health literacy in the community
B) Distributing ownership for the health of the community
C) Promoting and maintaining the health of individuals and families
D) Identifying links between lifestyle and health
Ans: C
Feedback:
Community-based nursing practice focuses centrally on promoting and maintaining the health of
individuals and families, preventing and minimizing the progression of disease, and improving
quality of life. Health literacy is not a goal in itself, but rather a means to promoting health.
Distributing ownership and identifying links between lifestyle and health are not the essence of
community-based care.
18.
You are the community-based nurse who performs the role of case manager for a small town
about 60 miles from a major health care center. When planning care in your community, what is
the most important variable in community-based nursing that you should integrate into your
planning?
A) Eligibility requirements for services
B) Community resources available to patients
C) Transportation costs to the medical center
D) Possible charges for any services provided
Ans: B
Feedback:
A community-based nurse must be knowledgeable about community resources available to
patients as well as services provided by local agencies, eligibility requirements, and any possible
charges for the services. The other answers are incorrect because they are not the most important
factors about which a community-based nurse must be knowledgeable.
As health care delivery shifts into the community, more nurses are working in a variety of
community-based settings. These settings include public health departments, ambulatory health
clinics, long-term care facilities, hospice settings, industrial settings (as occupational nurses),
homeless shelters and clinics, nursing centers, home health agencies, urgent care centers, same-
day surgical centers, short-stay facilities, and patients’ homes. The other answers are incorrect
because our population has not shifted to a more rural base, and the use of primary care clinics
has not influenced an increase in practice settings or the use of rehabilitation hospitals.
17.
A nurse is collaborating with a team of community nurses to identify the vision and mission for
community care. What is the central focus of community-based nursing?
A) Increased health literacy in the community
B) Distributing ownership for the health of the community
C) Promoting and maintaining the health of individuals and families
D) Identifying links between lifestyle and health
Ans: C
Feedback:
Community-based nursing practice focuses centrally on promoting and maintaining the health of
individuals and families, preventing and minimizing the progression of disease, and improving
quality of life. Health literacy is not a goal in itself, but rather a means to promoting health.
Distributing ownership and identifying links between lifestyle and health are not the essence of
community-based care.
18.
You are the community-based nurse who performs the role of case manager for a small town
about 60 miles from a major health care center. When planning care in your community, what is
the most important variable in community-based nursing that you should integrate into your
planning?
A) Eligibility requirements for services
B) Community resources available to patients
C) Transportation costs to the medical center
D) Possible charges for any services provided
Ans: B
Feedback:
A community-based nurse must be knowledgeable about community resources available to
patients as well as services provided by local agencies, eligibility requirements, and any possible
charges for the services. The other answers are incorrect because they are not the most important
factors about which a community-based nurse must be knowledgeable.
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19.
An urban, community-based nurse is looking for community resources for a patient who has
complex rehabilitation needs coupled with several comorbid, chronic health conditions. Where is
the best place for the nurse to search for appropriate resources?
A) A hospital directory
B) The hospital intranet
C) A community directory
D) The nurse’s own personal network
Ans: C
Feedback:
Most communities have directories of health and social service agencies that the nurse can
consult. The other answers are incorrect because hospital directories and intranets usually only
include people affiliated with the hospital. The nurse’s personal network of contacts may or may
not be of use.
20.
You are a community-based care manager in a medium-sized community that does not have an
up-to-date resource directory available. As a result, you have been given the task of beginning to
compile such a directory. What would be important to include in this directory? Select all that
apply.
A) Links to online health sciences journals
B) Lists of social service workers in the community
C) Eligibility requirements for services
D) Lists of the most commonly used resources
E) Costs associated with services
Ans: C, D, E
Feedback:
If a community does not have a resource booklet, an agency may develop one for its staff. It
should include the commonly used community resources that patients need, as well as the costs of
the services and eligibility requirements. The other answers are incorrect because a community
resource booklet usually would not include links to online professional journals and it would not
identify specific social service workers, only agencies.
21.
You are assessing a new patient and his home environment following the patient’s referral for
community-based care. Which of the following is the most important responsibility that you, as a
community-based nurse, have at this initial visit?
A) Encourage the patient and his family to become more involved in their community.
B) Encourage the patient and his family to delegate someone to contact community resources.
An urban, community-based nurse is looking for community resources for a patient who has
complex rehabilitation needs coupled with several comorbid, chronic health conditions. Where is
the best place for the nurse to search for appropriate resources?
A) A hospital directory
B) The hospital intranet
C) A community directory
D) The nurse’s own personal network
Ans: C
Feedback:
Most communities have directories of health and social service agencies that the nurse can
consult. The other answers are incorrect because hospital directories and intranets usually only
include people affiliated with the hospital. The nurse’s personal network of contacts may or may
not be of use.
20.
You are a community-based care manager in a medium-sized community that does not have an
up-to-date resource directory available. As a result, you have been given the task of beginning to
compile such a directory. What would be important to include in this directory? Select all that
apply.
A) Links to online health sciences journals
B) Lists of social service workers in the community
C) Eligibility requirements for services
D) Lists of the most commonly used resources
E) Costs associated with services
Ans: C, D, E
Feedback:
If a community does not have a resource booklet, an agency may develop one for its staff. It
should include the commonly used community resources that patients need, as well as the costs of
the services and eligibility requirements. The other answers are incorrect because a community
resource booklet usually would not include links to online professional journals and it would not
identify specific social service workers, only agencies.
21.
You are assessing a new patient and his home environment following the patient’s referral for
community-based care. Which of the following is the most important responsibility that you, as a
community-based nurse, have at this initial visit?
A) Encourage the patient and his family to become more involved in their community.
B) Encourage the patient and his family to delegate someone to contact community resources.
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C) Encourage the patient and his family to focus primarily on online supports.
D) Encourage the patient and his family to connect with appropriate community resources.
Ans: D
Feedback:
During initial and subsequent home visits, the nurse helps the patient and family identify
community services and encourages them to contact the appropriate agencies. This is preferable
to delegating another person to make contact. When appropriate, nurses may make the initial
contact. A home-health nurse would not normally encourage the patient to become more involved
in the community as a means of promoting health. Online forms of support can be useful, but they
are not the sole form of support that most patients need.
22.
A nurse is comparing some of the similarities and differences between the care that is provided in
community- and hospital-based settings. What type of care is provided in both of these settings?
A) Dieticians
B) Ambulatory health care
C) Occupational health care
D) Hospice care
Ans: B
Feedback:
Ambulatory health care is provided for patients in community or hospital-based settings. The
types of agencies that provide such care are medical clinics, ambulatory care units, urgent care
centers, cardiac rehabilitation programs, mental health centers, student health centers, community
outreach programs, and nursing centers. Dieticians are not generally community-based and
hospice care is not generally provided in hospital settings. Occupational health care is situated in
workplaces.
23.
A community-based case manager is sending a community nurse to perform an initial home
assessment of a newly referred patient. To ensure safety, the case manager must make the nurse
aware of which of the following?
A) The potential for at-risk working environments
B) Self-defense strategies
C) Locations of emergency services in the area
D) Standard precautions for infection control
Ans: A
Feedback:
Based on the principle of due diligence, agencies must inform employees of at-risk working
D) Encourage the patient and his family to connect with appropriate community resources.
Ans: D
Feedback:
During initial and subsequent home visits, the nurse helps the patient and family identify
community services and encourages them to contact the appropriate agencies. This is preferable
to delegating another person to make contact. When appropriate, nurses may make the initial
contact. A home-health nurse would not normally encourage the patient to become more involved
in the community as a means of promoting health. Online forms of support can be useful, but they
are not the sole form of support that most patients need.
22.
A nurse is comparing some of the similarities and differences between the care that is provided in
community- and hospital-based settings. What type of care is provided in both of these settings?
A) Dieticians
B) Ambulatory health care
C) Occupational health care
D) Hospice care
Ans: B
Feedback:
Ambulatory health care is provided for patients in community or hospital-based settings. The
types of agencies that provide such care are medical clinics, ambulatory care units, urgent care
centers, cardiac rehabilitation programs, mental health centers, student health centers, community
outreach programs, and nursing centers. Dieticians are not generally community-based and
hospice care is not generally provided in hospital settings. Occupational health care is situated in
workplaces.
23.
A community-based case manager is sending a community nurse to perform an initial home
assessment of a newly referred patient. To ensure safety, the case manager must make the nurse
aware of which of the following?
A) The potential for at-risk working environments
B) Self-defense strategies
C) Locations of emergency services in the area
D) Standard precautions for infection control
Ans: A
Feedback:
Based on the principle of due diligence, agencies must inform employees of at-risk working
Loading page 26...
environments. Agencies have policies and procedures concerning the promotion of safety for
clinical staff, and training is provided to facilitate personal safety. The physical location of
emergency services is not important, though methods for contacting emergency services are a
priority. Infection control is part of the nurse’s own professional responsibility. Self-defense
strategies are not always addressed and are not legally mandated.
24.
A home health nurse is making a visit to a new patient who is receiving home care following a
mastectomy. During the visit, the patient’s husband arrives home in an intoxicated state and
speaks to both you and the patient in an abusive manner. What is your best response?
A) Ignore the husband and focus on the patient.
B) Return to your agency and notify your supervisor.
C) Call the police from your cell phone.
D) Remove the patient from the home immediately.
Ans: B
Feedback:
If a dangerous situation is encountered during a visit, the nurse should return to the agency and
contact his or her supervisor or law enforcement officials, or both. Ignoring the husband or
calling the police while in the home or attempting to remove the patient from the home could
further endanger you and the patient.
25.
The community-health nurse has received a referral for a new patient who resides in a high-crime
area. What is the most important request that the nurse should make of the agency to best ensure
safety?
A) An early morning or late afternoon appointment
B) An assigned parking space in the neighborhood
C) A colleague to accompany the nurse on the visit
D) Someone to wait in the car while the nurse makes the visit
Ans: C
Feedback:
When making visits in high-crime areas, visit with another person rather than alone. A person
who is waiting in the car is of little benefit. An early morning or late afternoon appointment
would not necessarily guarantee safety. Similarly, assigned parking would not guarantee the
nurse’s safety while performing the visit.
26.
A home health nurse has been assigned to the care of an 82 year-old woman who has been
discharged home following hip replacement surgery. At what level of care is this nurse most
likely practicing?
clinical staff, and training is provided to facilitate personal safety. The physical location of
emergency services is not important, though methods for contacting emergency services are a
priority. Infection control is part of the nurse’s own professional responsibility. Self-defense
strategies are not always addressed and are not legally mandated.
24.
A home health nurse is making a visit to a new patient who is receiving home care following a
mastectomy. During the visit, the patient’s husband arrives home in an intoxicated state and
speaks to both you and the patient in an abusive manner. What is your best response?
A) Ignore the husband and focus on the patient.
B) Return to your agency and notify your supervisor.
C) Call the police from your cell phone.
D) Remove the patient from the home immediately.
Ans: B
Feedback:
If a dangerous situation is encountered during a visit, the nurse should return to the agency and
contact his or her supervisor or law enforcement officials, or both. Ignoring the husband or
calling the police while in the home or attempting to remove the patient from the home could
further endanger you and the patient.
25.
The community-health nurse has received a referral for a new patient who resides in a high-crime
area. What is the most important request that the nurse should make of the agency to best ensure
safety?
A) An early morning or late afternoon appointment
B) An assigned parking space in the neighborhood
C) A colleague to accompany the nurse on the visit
D) Someone to wait in the car while the nurse makes the visit
Ans: C
Feedback:
When making visits in high-crime areas, visit with another person rather than alone. A person
who is waiting in the car is of little benefit. An early morning or late afternoon appointment
would not necessarily guarantee safety. Similarly, assigned parking would not guarantee the
nurse’s safety while performing the visit.
26.
A home health nurse has been assigned to the care of an 82 year-old woman who has been
discharged home following hip replacement surgery. At what level of care is this nurse most
likely practicing?
Loading page 27...
A) Preventative care
B) Primary prevention
C) Secondary prevention
D) Tertiary prevention
Ans: D
Feedback:
Nurses in community-based practice provide preventive care at three levels: primary, secondary,
and tertiary. Tertiary prevention focuses on minimizing deterioration and improving quality of
life, including rehabilitation to assist patients in achieving their maximum potential by working
through their physical or psychological challenges. Home care nurses often focus on tertiary
preventive nursing care, although primary and secondary prevention are also addressed.
Preventive care is an umbrella term for all three levels of care.
27.
You are admitting two new patients to your local home health care service. These patients live
within two blocks of each other and both homes are in a high-crime area. What action best
protects your personal safety?
A) Drive a car that is hard to break into.
B) Keep your satchel close to you at all times.
C) Do not leave anything in the car that might be stolen.
D) Do not wear expensive jewelry.
Ans: D
Feedback:
Do not drive an expensive car or wear expensive jewelry when making visits. While all of these
answers might be wise precautions to take, the other suggestions address property rather than
personal safety.
28.
In two days you are scheduled to discharge a patient home after left hip replacement. You have
initiated a home health referral and you have met with a team of people who have been involved
with this patient’s discharge planning. Knowing that the patient lives alone, who would be
appropriate people to be on the discharge planning team? Select all that apply.
A) Home health nurse
B) Physical therapist
C) Pharmacy technician
D) Social worker
E) Meal-on-Wheels provider
B) Primary prevention
C) Secondary prevention
D) Tertiary prevention
Ans: D
Feedback:
Nurses in community-based practice provide preventive care at three levels: primary, secondary,
and tertiary. Tertiary prevention focuses on minimizing deterioration and improving quality of
life, including rehabilitation to assist patients in achieving their maximum potential by working
through their physical or psychological challenges. Home care nurses often focus on tertiary
preventive nursing care, although primary and secondary prevention are also addressed.
Preventive care is an umbrella term for all three levels of care.
27.
You are admitting two new patients to your local home health care service. These patients live
within two blocks of each other and both homes are in a high-crime area. What action best
protects your personal safety?
A) Drive a car that is hard to break into.
B) Keep your satchel close to you at all times.
C) Do not leave anything in the car that might be stolen.
D) Do not wear expensive jewelry.
Ans: D
Feedback:
Do not drive an expensive car or wear expensive jewelry when making visits. While all of these
answers might be wise precautions to take, the other suggestions address property rather than
personal safety.
28.
In two days you are scheduled to discharge a patient home after left hip replacement. You have
initiated a home health referral and you have met with a team of people who have been involved
with this patient’s discharge planning. Knowing that the patient lives alone, who would be
appropriate people to be on the discharge planning team? Select all that apply.
A) Home health nurse
B) Physical therapist
C) Pharmacy technician
D) Social worker
E) Meal-on-Wheels provider
Loading page 28...
Ans: A, B, D
Feedback:
The development of a comprehensive discharge plan requires collaboration with professionals at
both the referring agency and the home care agency, as well as other community agencies that
provide specific resources upon discharge. The pharmacy technician does not participate in
discharge planning and there is no indication that Meals-on-Wheels are necessary.
29.
A home health nurse is conducting a home visit to a patient who receives wound care twice
weekly for a diabetic foot ulcer. While performing the dressing change, the nurse realizes that she
forgot to bring the adhesive gauze specified in the wound care regimen. What is the nurse’s best
action?
A) Phone a colleague to bring the required supplies as soon as possible.
B) Improvise, if possible, using sterile gauze and adhesive tape.
C) Leave the wound open to air and teach the patient about infection control.
D) Schedule a return visit for the following day.
Ans: B
Feedback:
Improvisation is a necessity in many home health situations. It would be logistically difficult to
have the supplies delivered and leaving the wound open to air may be contraindicated. A return
visit the next day does not resolve the immediate problem.
30.
Discharge planning is an integral part of community-health nursing and home health. Which of
the following is prioritized in the discharge-planning process?
A) Identifying the patient’s specific needs
B) Making a social services referral
C) Getting physical therapy involved in care
D) Notifying the pharmacy of the discharge date
Ans: A
Feedback:
The discharge planning process involves identifying the patient’s needs and developing a
thorough plan to meet them. The other options might be appropriate for some patients, but they
are not all appropriate for every patient.
31.
Within the public health system there has been an increased demand for medical, nursing, and
social services. The nurse should recognize what phenomenon as the basis for this increased
demand?
A) Increased use of complementary and alternative therapies
Feedback:
The development of a comprehensive discharge plan requires collaboration with professionals at
both the referring agency and the home care agency, as well as other community agencies that
provide specific resources upon discharge. The pharmacy technician does not participate in
discharge planning and there is no indication that Meals-on-Wheels are necessary.
29.
A home health nurse is conducting a home visit to a patient who receives wound care twice
weekly for a diabetic foot ulcer. While performing the dressing change, the nurse realizes that she
forgot to bring the adhesive gauze specified in the wound care regimen. What is the nurse’s best
action?
A) Phone a colleague to bring the required supplies as soon as possible.
B) Improvise, if possible, using sterile gauze and adhesive tape.
C) Leave the wound open to air and teach the patient about infection control.
D) Schedule a return visit for the following day.
Ans: B
Feedback:
Improvisation is a necessity in many home health situations. It would be logistically difficult to
have the supplies delivered and leaving the wound open to air may be contraindicated. A return
visit the next day does not resolve the immediate problem.
30.
Discharge planning is an integral part of community-health nursing and home health. Which of
the following is prioritized in the discharge-planning process?
A) Identifying the patient’s specific needs
B) Making a social services referral
C) Getting physical therapy involved in care
D) Notifying the pharmacy of the discharge date
Ans: A
Feedback:
The discharge planning process involves identifying the patient’s needs and developing a
thorough plan to meet them. The other options might be appropriate for some patients, but they
are not all appropriate for every patient.
31.
Within the public health system there has been an increased demand for medical, nursing, and
social services. The nurse should recognize what phenomenon as the basis for this increased
demand?
A) Increased use of complementary and alternative therapies
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B) The growing number of older adults in the United States
C) The rise in income disparity in the United States
D) Increasing profit potential for home health services
Ans: B
Feedback:
The growing number of older adults in the United States increases the demand for medical,
nursing, and social services within the public health system. Income disparities, profit potential,
and increased use of complementary therapies do not account for this change.
32.
Nursing care is provided in an increasingly diverse variety of settings. Despite the variety in
settings, some characteristics of professional nursing practice are required in any and every
setting. These characteristics include which of the following?
A) Advanced education
B) Certification in a chosen specialty
C) Cultural competence
D) Independent practice
Ans: C
Feedback:
Cultural competence is necessary in any and every care setting. The other answers are incorrect
because an advanced education, specialty certification, and the ability to practice independently
are not consistencies between every nursing care delivery setting.
33.
Medicare is a federal program that finances many Americans’ home health care expenses. The
Medicare program facilitates what aspect of home health care?
A) Providing care without the oversight of a physician
B) Writing necessary medication orders for the patient
C) Ordering physical, occupational, and speech therapy if needed
D) Managing and evaluating patient care for seriously ill patients
Ans: D
Feedback:
Many home health care expenditures are financed by Medicare, which allows nurses to manage
and evaluate patient care for seriously ill patients who have complex, labile conditions and are at
high risk for rehospitalization. Home health nurses, despite who funds their visits, do not provide
care without the oversight of a physician; they do not normally write medication orders; nor do
they order the services of ancillary specialists such as physical, occupational, or speech therapists.
C) The rise in income disparity in the United States
D) Increasing profit potential for home health services
Ans: B
Feedback:
The growing number of older adults in the United States increases the demand for medical,
nursing, and social services within the public health system. Income disparities, profit potential,
and increased use of complementary therapies do not account for this change.
32.
Nursing care is provided in an increasingly diverse variety of settings. Despite the variety in
settings, some characteristics of professional nursing practice are required in any and every
setting. These characteristics include which of the following?
A) Advanced education
B) Certification in a chosen specialty
C) Cultural competence
D) Independent practice
Ans: C
Feedback:
Cultural competence is necessary in any and every care setting. The other answers are incorrect
because an advanced education, specialty certification, and the ability to practice independently
are not consistencies between every nursing care delivery setting.
33.
Medicare is a federal program that finances many Americans’ home health care expenses. The
Medicare program facilitates what aspect of home health care?
A) Providing care without the oversight of a physician
B) Writing necessary medication orders for the patient
C) Ordering physical, occupational, and speech therapy if needed
D) Managing and evaluating patient care for seriously ill patients
Ans: D
Feedback:
Many home health care expenditures are financed by Medicare, which allows nurses to manage
and evaluate patient care for seriously ill patients who have complex, labile conditions and are at
high risk for rehospitalization. Home health nurses, despite who funds their visits, do not provide
care without the oversight of a physician; they do not normally write medication orders; nor do
they order the services of ancillary specialists such as physical, occupational, or speech therapists.
Loading page 30...
34.
You are a school nurse who will work with an incoming kindergarten student who has a diagnosis
of cerebral palsy. Why would you make a home visit before school starts?
A) To provide anticipatory guidance to the family
B) To assess the safety of the child’s assistive devices
C) To arrange for a teaching aide to work with the child
D) To provide follow-up care after the child’s clinic visit
Ans: A
Feedback:
Public health, parish, and school nurses may make visits to provide anticipatory guidance to high-
risk families and follow-up care to patients with communicable diseases. The other answers are
incorrect because they are not functions of the school nurse.
35.
A home health nurse has been working for several months with a male patient who is receiving
rehabilitative services. The nurse is aware that maintaining the patient’s confidentiality is a
priority. How can the nurse best protect the patient’s right to confidentiality?
A) Avoid bringing the patient’s medical record to the home.
B) Discuss the patient’s condition and care only when he is alone in the home.
C) Keep the patient’s medical record secured at all times.
D) Ask the patient to avoid discussing his home care with friends and neighbors.
Ans: C
Feedback:
If the nurse carries a patient’s medical record into a house, it must be put in a secure place to
prevent it from being picked up by others or from being misplaced. This does not mean, however,
that it must never be brought to the home. It is not normally necessary to limit discussions to
times when the patient is alone. The patient has the right to decide with whom he will discuss his
condition and care.
36.
A home health nurse has completed a visit to a patient and has immediately begun to document
the visit. Accurate documentation that is correctly formatted is necessary for which of the
following reasons?
A)
Accurate documentation guarantees that the nurse will not be legally liable for unexpected
outcomes.
B) Accurate documentation ensures that the agency is correctly reimbursed for the visit.
C) Accurate documentation allows the patient to gauge his or her progress over time.
D) Accurate documentation facilitates safe delegation of care to unlicensed caregivers.
You are a school nurse who will work with an incoming kindergarten student who has a diagnosis
of cerebral palsy. Why would you make a home visit before school starts?
A) To provide anticipatory guidance to the family
B) To assess the safety of the child’s assistive devices
C) To arrange for a teaching aide to work with the child
D) To provide follow-up care after the child’s clinic visit
Ans: A
Feedback:
Public health, parish, and school nurses may make visits to provide anticipatory guidance to high-
risk families and follow-up care to patients with communicable diseases. The other answers are
incorrect because they are not functions of the school nurse.
35.
A home health nurse has been working for several months with a male patient who is receiving
rehabilitative services. The nurse is aware that maintaining the patient’s confidentiality is a
priority. How can the nurse best protect the patient’s right to confidentiality?
A) Avoid bringing the patient’s medical record to the home.
B) Discuss the patient’s condition and care only when he is alone in the home.
C) Keep the patient’s medical record secured at all times.
D) Ask the patient to avoid discussing his home care with friends and neighbors.
Ans: C
Feedback:
If the nurse carries a patient’s medical record into a house, it must be put in a secure place to
prevent it from being picked up by others or from being misplaced. This does not mean, however,
that it must never be brought to the home. It is not normally necessary to limit discussions to
times when the patient is alone. The patient has the right to decide with whom he will discuss his
condition and care.
36.
A home health nurse has completed a visit to a patient and has immediately begun to document
the visit. Accurate documentation that is correctly formatted is necessary for which of the
following reasons?
A)
Accurate documentation guarantees that the nurse will not be legally liable for unexpected
outcomes.
B) Accurate documentation ensures that the agency is correctly reimbursed for the visit.
C) Accurate documentation allows the patient to gauge his or her progress over time.
D) Accurate documentation facilitates safe delegation of care to unlicensed caregivers.
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Subject
Nursing