Question 1

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?

Accepted Answer

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.

Question 2

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?

Accepted Answer

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.

Question 3

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?

Accepted Answer

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.

Question 4

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.

Accepted Answer

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.

Question 5

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?

Accepted Answer

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.

Question 6

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?

Accepted Answer

The CNL is a nurse generalist with a masters 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.

Question 7

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?

Accepted Answer

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.

Question 8

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?

Accepted Answer

The importance of effective discharge planning and quality improvement cannot be overstated. The other answers are incorrect because giving medication and family involvement in the patients 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.

Question 9

A nurse has integrated the principles of evidence-based practice into care. EBP has the potential to help the nurse achieve what goal?

Accepted Answer

Quality improvement is the ultimate goal of EBP. Career satisfaction, public esteem, and grant money are not priorities.

Question 10

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?

Accepted Answer

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.

Question 11

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?

Accepted Answer

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 twoyear period. Nurse-to-patient ratios, family participation, and independent evaluation are not stated components of the campaign.

Question 12

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?

Accepted Answer

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.

Question 13

Advanced practice nursing roles have grown in number and in visibility in recent years. What characteristic sets these nurses apart from the registered nurse?

Accepted Answer

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 room.

Question 14

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?

Accepted Answer

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.

Question 15

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?

Accepted Answer

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.

Question 16

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?

Accepted Answer

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.

Question 17

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?

Accepted Answer

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.

Question 18

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?

Accepted Answer

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.

Question 19

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?

Accepted Answer

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.

Question 20

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?

Accepted Answer

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.

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