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Chapter 1. Nursing Today
Fundamentals of Nursing 10th Edition Potter Perry Test
Bank LATEST UPDATED (GRADED A]
Fundamentals of Nursing 10th Edition Potter Perry Test
Bank LATEST UPDATED (GRADED A++)
MULTIPLE CHOICE
- Contemporary nursing practice is based on knowledge generated through nursing theories. Florence Nightingales theory introduced the concept that nursing care focuses on:
1 Psychological needs
2 A^ maximal^ level^ of^ wellness
3 Health^ maintenance^ and^ restoration
4 Interpersonal interactions with the client
ANS: 3
Florence Nightingale believed the role of the nurse was to put the clients body in the best state in order to remain free of disease or to recover from disease. Although Florence Nightingale may have addressed meeting the psychological needs of her clients, it is not the focus of her theory. The goal of Nightingales theory is to facilitate the bodys reparative processes by manipulating the clients environment. Florence Nightingale thought the human body had reparative properties of its own if it was cared for in a way to recover from disease. Her theory did not focus on achieving a maximal level of wellness. Florence Nightingale believed the nurse was in charge of the clients health. Although she interacted with her clients by reading to them, her theory of nursing care did not focus upon interpersonal interactions. DIF: A REF: 2 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care
- Nursing education programs in the United States may seek voluntary accreditation by the appropriate accrediting commission council of the:
1 National^ League^ for^ Nursing
2 American Nurses Association
3 Congress for Nursing Practice
4 International Council of Nurses
ANS: 1
The National League for Nursing (NLN) is the professional nursing organization concerned with nursing education. The NLN provides accreditation to nursing programs that seek and meet the NLN accreditation requirements. The American Nurses Association (ANA) is concerned with the nursing profession and issues affecting health care, including standards of care.
The Congress for Nursing Practice is the part of the ANA concerned with determining the legal aspects of nursing practice, the public recognition of the importance of nursing, and the impact of trends in health care on nursing practice. The International Council of Nurses (ICN) is concerned about issues of health care and the nursing profession, including the provision of an international power base for nurses. DIF: A REF: 8 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Coordinated Care
- Risk for injury during client transfer is minimized most effectively by:
1 Implementation of lift teams
2 Yearly personnel training sessions
3 Using mechanical lifts when possible
4 Use of evidence-based techniques
ANS: 4
Injuries to both caregiver and client occur during client transfer. The caregiver is at risk for musculoskeletal injuries. The client is at risk for falls as well as musculoskeletal injuries. There is a shift from ineffective, injury-prone client transfer techniques to evidence-based practices for safe client handling. The implementation of a lift team is directly supported by evidence-based research (EBR). Yearly training sessions are important but the specific training is determined first by EBR. The use of mechanical lifts is directly supported by evidence-based research (EBR). DIF: C REF: 6 OBJ: Analysis TOP: Nursing Process: Planning MSC: NCLEX test plan designation: Safe, Effective Care Environment/Accident Prevention MULTIPLE RESPONSE
- Which of the following activities reflect the nurses role in health promotion and wellness? (Select all that apply.)
1 Screening the local homeless population for head lice
2 Monitoring blood pressures at a community health fair
3 Organizing a foot race to benefit national cancer research
4 Consulting a teenage mother on breast-feeding techniques
2 State limits on health care fees
3 Federal guidelines for treatment
4 Court review of insurance coverage
ANS: 1
As a means to reduce health care costs, in 1983 Congress established the prospective payment system in which hospitals are reimbursed a set dollar amount for each diagnosis-related group, regardless of the length of stay or use of services in the hospital. State limits on health care fees have not been used nationwide to reduce health care costs. Federal guidelines for treatment have not been used to reduce the cost of health care. Rather, the focus has been on financial reimbursement. Court review of insurance coverage has not been a primary intervention to lower health care costs. DIF: A REF: 16 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care
- Levels of prevention are used by the nurse to provide a framework or guide for nursing interventions. Focus is based on the clients needs and the care or service that is provided. An example of a true health promotion service is a(n):
1 Aerobic dance class
2 Immunization clinic
3 Diabetic support group
4 Smoking cessation clinic
ANS: 1
Examples of health promotion activities include exercise classes, prenatal care, well-baby care, nutrition counseling, and family planning. An immunization clinic is an example of an illness prevention service. A diabetic support group may be an example of a rehabilitation service to adapt to a change in lifestyle. A smoking cessation clinic may be a part of rehabilitation or offered as an illness prevention service. DIF: A REF: 19 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care
- There are many types of health care delivery agencies. An example of a secondary level care agency is a:
1 School
2 Nursing home
3 Drug rehabilitation center
4 State-owned psychiatric hospital
ANS: 4
A state-owned psychiatric hospital is an example of the secondary level of care in which clients who present with signs and symptoms of disease are diagnosed and treated. A school is an example of preventive or primary care. A nursing home is an example of continuing care. A drug rehabilitation center is an example of restorative care. DIF: A REF: 20 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care
- Which of the following fits within the occupational safety and health categories?
1 Noise exposure
2 Firearms safety
3 Swimming lessons
4 Motorcycle helmets
ANS: 1
Exposure to environmental hazards within the workplace, such as noise exposure, is one aspect of occupational safety and health. Firearms do not fit within the occupational safety and health category. Swimming lessons do no fit within the occupational safety and health category. Motorcycle helmets do not fit within the occupational safety and health category. DIF: A REF: 20 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care
- A contractual agreement between a hospital and a corporation to pay the health care expenses of the corporations employees is an example of a(n):
1 PPO
2 HMO
3 Private insurance
4 Third-party payment
ANS: 1
A preferred provider organization (PPO) is characterized by a contractual agreement between a set of providers (e.g., hospitals, physicians, or clinics) and a purchaser (e.g., the corporations insurance plan). Comprehensive health services are provided at a discount to the companies
The focus in quality health care is on the outcome, not the process. Quality health care is not used exclusively in the acute care setting. It may be used in various health care settings. Because quality health care is based on achieving outcomes, it does not allow a high degree of flexibility for the nurse in delivering care. DIF: A REF: 27 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care
- Case management is one strategy for coordinating health care services. What best describes this caregiving approach?
1 Continuity of care is the primary concern.
2 This focus of care may be more expensive.
3 The physician is the coordinator of client care.
4 It is designed to provide minimal to moderate levels of care.
ANS: 1
With the case management model of care, the case manager coordinates the efforts of all disciplines to achieve the most efficient and appropriate plan of care. Continuity of care is of primary importance. If the efforts of all disciplines are well managed, repetition or delays may be avoided with a resultant shortened hospital stay. Therefore this focus of care may not be more expensive. The physician may or may not be the coordinator of client care. The case manager typically is a nurse or social worker. Case management is not entirely based on the level of care required. DIF: A REF: 21 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care/ Case Management
- The payment mechanism that Medicare uses within its health care financing is:
1 Capitation
2 Fixed payments
3 Direct contracting
4 Prospective payment
ANS: 2
Inpatient hospital services for Medicare clients are reimbursed a set amount for each DRG, regardless of the clients length of stay or use of services in the hospital. Capitation is the payment mechanism in which providers receive a fixed amount per enrollee of a health care plan.
The payment mechanism that Medicare uses is not direct contracting. Medicare is not based on fixed payments, but rather on a set dollar amount according to the DRG. DIF: A REF: 27 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care
- A student nurse visiting a nurse-managed clinic should expect to see which of the following services offered?
1 Physical therapy
2 Same-day surgery
3 Family support services
4 Ongoing psychiatric therapy
ANS: 3
Nurse-managed clinics focus on health promotion and health education, disease prevention, chronic disease management, and support for self-care and caregivers. Physical therapy is not typically offered in a nurse-managed clinic. Same-day surgery is not offered in a nurse-managed clinic. Psychiatric therapy is not offered in a nurse-managed clinic. DIF: A REF: 21 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care
- A disabled client requiring restorative care should be referred to a(n):
1 Nursing home
2 Subacute care unit
3 Home health care agency
4 Ambulatory health center
ANS: 3
A home health care agency provides health services to individuals and families in their home to promote, maintain, or restore health, or to maximize the level of independence while minimizing the effects of disability and illness. A nursing home is a long-term care setting in which clients receive 24-hour intermediate and custodial care. A subacute care unit is not the best referral for restorative care. An ambulatory health center is not the best referral for restorative care. DIF: A REF: 16 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care
2 Focuses on health maintenance and primary care
3 Allows the individual to go to any physician that he desires
4 Requires a contractual agreement between the health provider
and clients employer
ANS: 2
In a managed care organization (MCO), a primary care physician provides all care and the focus is on health maintenance and primary care. Medicaid reimburses nursing home funding. In a managed care organization, referral by the primary care physician is necessary for access to specialists and for hospitalization. A PPO is limited to a contractual agreement between a set of providers and one or more purchasers. DIF: A REF: 25 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care
- Which form of health care is of primary importance when dealing with managed care?
1 Health promotion
2 Disease prevention
3 Tertiary treatment
4 Secondary treatment
ANS: 1
If people stay healthy, the cost of medical care declines. Systems of managed care focus on containing or reducing costs, increasing client satisfaction, and improving the health or functional status of the individual (Sultz and Young, 2004). Health promotion: Activities that develop human attitudes and behaviors to maintain or enhance well-being. Disease prevention: Activities that protect people from becoming ill because of actual or potential health threats. Tertiary prevention: Care that prevents further progression of disease. Secondary prevention: Early diagnosis and treatment of illness (e.g., screening for hypertension). DIF: C REF: 21 OBJ: Analysis TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment/Management of Care
- A nurse is consulting with a homeless family who has a 12-year-old disabled child. The nurse suggests which of the following services to best assist with the childs health care needs?
1 Medicare
2 Medicaid
3 Long-term care insurance
4 An extended care faculty
ANS: 2
Medicaid is a federally funded, state-operated program that provides (1) health insurance to low- income families and (2) health assistance to low-income people with long-term care (LTC) disabilities. MULTIPLE CHOICE
- The student nurse is investigating different types of practice settings. In looking at community health nursing, the student recognizes that it:
1 Is the same as public health nursing
2 Focuses on the incidence of disease
3 Requires graduate-level educational preparation
4 Includes direct care and services to subpopulations
ANS: 4
Community health nursing strives to safeguard and improve the health of populations in the community as well as providing direct care services to subpopulations within a community. Public health nursing is concerned with trends and patterns influencing the incidence of disease within populations. A community health nurse may be involved in direct client care for disease within a community. Public health nursing focuses on the needs of populations. Community health nursing has a broader focus, with an emphasis on the health of a community. The community health nurse merges public health knowledge with nursing theory. The community health nurse considers the needs of populations and is prepared to provide direct care services to subpopulations within a community. Nurses who become expert in community health practice may have advanced nursing degrees, yet the baccalaureate-prepared generalist also can become quite competent in formulating and applying population-focused assessments and interventions. DIF: A REF: 34 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Safe, Effective Care Environment
- As a community health nurse assisting the client and family with nutritional needs the nurse should first:
1 Identify for the client the best foods to buy
2 Purchase foods at the lowest cost for the client
3 Ask the client and family what they think they should eat
4 Provide information on stores with the most reasonable pricing
ANS: 3
Chapter 3. Community-Based Nursing Practice
ANS: 3
The goal of tertiary prevention is to preclude further deterioration of physical and mental function in a person who has an existing illness, and to have the client use whatever residual function is available for maximum enjoyment of and participation in lifes activities. Health promotion is aimed at reducing the incidence of disease and its impact on people. Primary prevention is aimed at general health promotion. Secondary prevention is aimed at early recognition and treatment of disease. DIF: A REF: 37 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX test plan designation: Health Promotion and Maintenance
- Which of the following statements by the home health nurse best reflects client advocacy in response to the clients concern over the expense of the therapy?
1 Have you considered the possibility of a renal transplant?
2 This peritoneal dialysis is less expensive than hemodialysis.
3 You must feel awful about this situation, but this is the
best course of treatment for you.
4 Lets call the regional dialysis center and explore options for
reducing the cost of your home dialysis.
ANS: 4
Calling the regional dialysis center and exploring options for reducing cost demonstrates the nurse acting as client advocate by identifying and assisting the client in contacting the appropriate agency for information and resources to meet the clients needs. Asking the client whether he has considered renal transplantation does not demonstrate client advocacy. Pointing out the difference in cost for dialysis in the home versus the hospital does not meet the clients need to reduce the expenses of his therapy. The nurse is not demonstrating patient advocacy. Telling the client that this is the best treatment for him does not address his financial concerns. The nurse is not demonstrating patient advocacy with this response. DIF: C REF: 40 OBJ: Analysis TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Health Promotion and Maintenance
- In assessing the structure of the community in order to identify the needs of its population, the nurse will focus on:
1 Collecting demographic data on age distribution
2 Visiting neighborhood schools to review health records
3 Interviewing clients to determine the cultural composition of
the subgroups
4 Observing locations where services, such as water sanitation,
are provided
ANS: 4
When assessing the structure or locale of a community, the nurse should travel around the neighborhood or community and observe its design; the location of services, such as water and sanitation; and the locations where residents congregate. Collecting demographic data on age distribution would be an assessment of the communitys population. Visiting neighborhood schools to review health records is an example of assessing a social system within a community. Interviewing clients to determine the cultural composition of subgroups is an example of assessing the population within a community. DIF: A REF: 41 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Health Promotion and Maintenance
- To facilitate change within a community, the nurse working as an effective change agent should:
1 Inform^ community^ members^ how^ to^ effectively^ manage^ their
health needs
2 Work with clients and groups to select alternative health
care sites and treatments
3 Formulate decisions for individual clients regarding their
health care options
4 Provide instruction in the way the community should address
health issues
ANS: 2
As a change agent, the nurse seeks to implement new and more effective approaches to problems. The nurse creates change by working with and empowering individuals and their families to solve problems or to become instrumental in changing aspects affecting their health care. Telling community members how to manage their health care needs may meet resistance. It also does not enable clients and their families to take responsibility for their health care. Making decisions for clients does not enable individuals to assume responsibility for their health care decisions. The community-based nurse acting as a change agent may be an excellent resource for health information to members of the community. Ultimately; however, the community members will take an active role to create change for themselves and will assume responsibility for their health care decisions. DIF: A REF: 39-40 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Health Promotion and Maintenance
TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Health Promotion and Maintenance
- One of the overall goals of Healthy People 2010 is to:
1 Increase life expectancy
2 Decrease health care costs
3 Promote managed care organizations
4 Establish the credentials of service providers
ANS: 1
The overall goals of Healthy People 2010 are to increase the life expectancy and quality of life and to eliminate health disparities. The initiative of Healthy People 2010 is to improve the delivery of health care services to the general public. The overall goal did not focus on reducing health care costs. Although managed care organizations may increase in number, this was not a goal of the Healthy People 2010 initiative. Establishing the credentials of care providers was not a goal of Healthy People 2010. DIF: A REF: 33 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Health Promotion and Maintenance
- When assessing members of a vulnerable population, the community health nurse should realize that the primary need is to:
1 Provide^ culturally^ competent^ assessment.
2 Organize in your mind exactly what you need to ask.
3 Create a comfortable, nonthreatening environment.
4 Be alert for indications of mental and physical abuse.
ANS: 3
In order to be successful in assessing a member of a vulnerable population, the nurse must first create an environment that is encourages the client to cooperate with and actively participate in the assessment process While it is important that the nurse be cultural considerate of the client, it is not the primary need of those offered as options. While organization to thought is important to the effective use of time needed for an assessment, it is not the primary need of those offered as options. While vulnerable populations may be more susceptible to both mental and physical abuse making observation for signs of abuse important, it is not the primary need of those offered as options DIF: C REF: 35 OBJ: Analysis TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Health Promotion and Maintenance
- The nurse working in a free clinic often utilized by Hispanic immigrants is assessing a client who reports a cough and malaise. The client is hearing impaired, speaks very little English and is currently living in a homeless shelter. The nurses primary concerns should be the clients:
1 Language barrier
2 Risk for tuberculosis
3 Hearing^ impairment
4 Lack of health care resources
ANS: 2
Risk for tuberculosis presents the greatest risk since it is supported by the physical signs, is highly contagious and a risk factor among the homeless and some immigrant populations. The language barrier is a concern since it impacts the communication between the nurse and the client but it is not the primary concern among the options offered. The clients hearing impairment is a concern because it has an impact on the communication between the nurse and the client but it is not the primary concern among the options offered. The clients lack of insurance is a concern because it affects the treatment plan necessary for the clients recovery, but it is not the primary concern among the options offered. DIF: C REF: 36 OBJ: Analysis TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Health Promotion and Maintenance
- A nurse is planning interventions for the clients of a homeless shelter. Which of the activities represents a primary level intervention regarding sexually transmitted diseases?
1 HIV screening for all residents
2 Sex education for teenage residents
3 Treatment for residents diagnosed with AIDS
4 Gynecological referrals for female residences
ANS: 2
Primary level interventions are directed a preventing the disease. Educational programming is generally considered a primary intervention. Screening a disease is generally considered a secondary level intervention. Treatment of the disease is generally considered a tertiary level intervention. Referrals are generally considered a secondary intervention. DIF: A REF: 36 OBJ: Comprehension TOP: Nursing Process: Planning MSC: NCLEX test plan designation: Health Promotion and Maintenance
- The nurse working in a free clinic is caring for a homeless client diagnosed with paranoid schizophrenia who has reported that, I hurt my foot running away from them. It hurts so bad I can hardly walk now. On assessment the nurse notices bruising on the clients back, arms, and
administered. The client will need the antibiotic prescription filled and a dressing change in 3 days. In order to ensure that the client will receive the appropriate follow-up care, the nurse must first act as the clients:
1 Educator
2 Advocate
3 Caregiver
4 Counselor
ANS: 2
Client advocacy perhaps is more important today because of the confusion surrounding access to health care services. Your clients often need someone to help them walk through the system, identify where to go for services and tell them how to reach the individuals with the appropriate authority, what services to request, and how to follow through with the information they received. The role of the educator is to help the client assume responsibility for his or her own health care. This client has been educated to the needs related to caring for the infection but needs the nurse advocate to assist with facilitating the care. As caregiver, the nurse manages and cares for the clients health. You apply the nursing process (see Unit III) in a critical thinking approach to ensure appropriate, individualized nursing care for specific clients and their families. This clients nursing care has been appropriated delivered and so that nursing role has been fulfilled. A counselor assists clients in identifying and clarifying health problems and in choosing appropriate courses of action to solve those problems. The client is first in need of assistance in dealing with the obstacles to the care of the identified probleminfection. DIF: C REF: 37-38 OBJ: Analysis TOP: Nursing Process: Implementation MSC: NCLEX test plan designation: Health Promotion and Maintenance
- A nurse is discussing the need to use a specific cleansing agent when redressing an infected hand. The client prefers using, plain old soap and water. The nurse knows that the primary factor that will affect client compliance is:
1 The^ ease^ with^ which^ the^ client^ can^ use^ the^ special^ agent
2 The clients acceptance of the need for the specialized care
3 The availability and cost of the prescribed cleansing agent
4 The introduction of an incentive to prompt client to comply
ANS: 2
Client must perceive the innovation or change as more advantageous than other alternatives or they will not make the change. Client education is essential in bringing about the change in attitude necessary for change. While the client is more likely to adapt the change if it is perceived as being easy, it is not the primary factor in achieving client compliance provided among the options available because client compliance is primarily a result of the clients understanding of
the need for change. While cost to the client is a factor, it is not the primary factor in achieving client compliance provided among the options available since client compliance is primarily a result of the clients understanding of the need for change. An incentive is sometimes necessary, but it is not the primary factor in achieving client compliance provided among the options available, because client compliance is primarily a result of the clients understanding of the need for change. DIF: C REF: 39 OBJ: Analysis TOP: Nursing Process: Planning/Implementation MSC: NCLEX test plan designation: Health Promotion and Maintenance
- The nurse is assessing a client diagnosed with chronic bronchitis who has been experiencing an increase in dyspnea. The client lives within 2 blocks of a factory that emits pollution into the air. In light of this information, the nurse is primarily concerned with:
1 Performing a complete client health history and physical
assessment
2 Providing the client with assess to all the required breathing
treatments
3 Identifying a correlation between the pollution and the clients
increased dyspnea
4 Determining the availability of alternate housing for the client
away from the factory
ANS: 3
There may be many factors that are affecting the clients breathing. Determining the clients exposure to the pollution and its affects of the clients breathing would be the nurses primary concern for this client. The assessment and history is important but is not the best option available regarding the effects of air pollution on the clients respirations. The availability of required breathing treatments is important but it is not the best option regarding the effects of air pollution of the clients respirations. It may be necessary for the client to consider moving but only if it is determined that the pollution is responsible of the increase in the dyspnea. DIF: A REF: 40 OBJ: Analysis TOP: Nursing Process: Assessment MSC: NCLEX test plan designation: Health Promotion and Maintenance MULTIPLE RESPONSE
- Which of the following clients is a concern for the community health nurse? (Select all that apply.)
1 The homeless woman with a history of congestive heart failure
2 The elderly gentleman who fell while disembarking from a bus
