Deck 1: Health Care Delivery and Evidence-Based Nursing Practice

Question 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.

Answer 1

Health is being connected in body, mind, and spirit.

Question 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

Answer 2

Sensitivity to cultural differences

Question 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

Answer 3

Management of illness

Question 4

The home health nurse is assisting a patient and his family in planning the patients return to work after surgery and the development of postsurgical complications. The nurse is preparing a plan of care that addresses the patients multifaceted needs. To which level of Maslows hierarchy of basic needs does the patients need for self-fulfillment relate?

A) Physiologic
B) Transcendence
C) Love and belonging
D) Self-actualization

Question 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 persons state of health is ever-changing.
C) A person can transition from health to illness rapidly.
D) Care should focus on the patients compliance with interventions.

Question 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.

Question 7

A nurse on a medical-surgical unit has asked to represent the unit on the hospitals 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.

Question 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

Question 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 physicians orders
C) Obtaining a baseline set of vital signs
D) Allowing the family to be with the patient

Question 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 patients response to therapy
D) Staying accountable to the interdisciplinary team

Question 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 $\mathrm{RN}$ 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
B) Contributing to the scientific basis of nursing practice
C) Critiquing the quality of patient care
D) Explaining medical studies to patients and RNs

Question 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 todays 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

Question 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 nurses title?

A)Nursing care expert
B)Clinical nurse specialist
C)Nurse manager
D)Staff nurse

Question 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.

Question 15

A hospice nurse is caring for a patient who is dying of lymphoma. According to Maslows 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

Question 16

A nurse is planning a medical patients care with consideration of Maslows hierarchy of needs. Within this framework of understanding, what would be the nurses first priority?

A) Allowing the family to see a newly admitted patient
B) Ambulating the patient in the hallway
C) Administering pain medication
D) Teaching the patient to self-administer insulin safely

Question 17

A medical-surgical nurse is aware of the scope of practice as defined in the state where the nurse provides care. This nurses compliance with the nurse practice act demonstrates adherence to which of the following?

A) National Council of Nursings guidelines for care
B) National League for Nursings Code of Conduct
C) American Nurses Associations Social Policy Statement
D) Department of Health and Human Services White Paper on Nursing

Question 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

Question 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 patients preferences into the plan of care
D) By documenting care in the electronic health record in a timely fashion

Question 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

Question 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 nurses choice of interventions?

A) Management of chronic conditions and disability
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

Question 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

Question 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 nurses actions best demonstrates these priorities?

A) Encouraging the patients dependence on caregivers
B) Fostering the patients ability to make choices
C) Teaching the patient about nurses roles in the health care system
D) Assessing the patients adherence to treatment

Question 24

The role of the certified nurse practitioner (CNP) has become a dominant role for nurses in all 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

Question 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

Question 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
D) Helping patients to navigate the health care system

Question 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

Question 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

Question 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 publics esteem for nursing

Question 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 hospitals 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

Question 31

A hospitals 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
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

Question 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

Question 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 $\mathrm{RN}$
C) Advanced documentation skills
D) Ability to provide care in the surgical context

Question 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

Question 35

A team of community health nurses are planning to draft a proposal for a program that will increase the communitys 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

Question 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
D) Establishment of a website where patients can check emergency department wait-times

Question 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.

Question 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 centers 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 centers patient outcomes to best practice indicators

Question 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 units leaders take?

A) Provide access to online journals and Web-based clinical resources for nursing staff.
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.

Question 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 professions 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