Craven Ch 1, 2, 3, 4, Flashcards
According to Patricia Benner’s From Novice to Expert, there are five distinct levels of proficiency. Micah is a nurse with 3 years of experience who is now able to analyze his patient’s heart failure as conceptually related to the renal failure and anemia that are present rather than as separate issues. Which level most appropriately describes his proficiency?
A. Competent
B. Expert
C. Novice
D.Advanced beginner
D. Advanced beginner is identified as being the first 5 years after graduation from nursing school and is described as seeing situations in parts to seeing them more conceptually, or as a whole.
Marcy is aware that nursing responsibilities are related to standards of professional performance. Which are included in these standards? Select all that apply.
A. Collaboration
B. Performances appraisal
C. Outcomes identification
D. Quality of practice
a, b, d. Collaboration, performance appraisal, and quality of care are all elements of professional performance. Other elements include education, collegiality, ethics, research, and use of resources.
Standards of care designate professional nursing responsibilities such as assessment, diagnosis, outcome identification, planning, implementation, and evaluation.
A nurse is found to have performed procedures outside her scope of practice. Identify which element is true related to nursing scope of practice.
A. Scope of practice is defined by each state’s nurse practice act.
B. The ANA sets requirements for licensure.
C. Scope of practice is defined by CNEA-accredited school curricula.
D. Reciprocity explains the relationship between scope of practice and state licensure.
a. The nurse practice act of each state defines the practice of nursing within that area.
An antibiotic is ordered that the patient has had an allergic reaction to in the past. Which would be an appropriate nursing action as determined by the professional nursing role? Select all that apply.
A. Identify that the antibiotic is inappropriate.
B. Document the allergy and call the physician.
C. Administer the drug as ordered.
D. Complain to other nurses about the physician’s poor judgment.
a, b. The nurse should use his or her knowledge of the sciences to make safe judgments on the patient’s behalf. The nurse should also communicate the patient’s needs in written and oral form.
A patient reports frustration that she has been unable to sleep while in the hospital and that she is exhausted. The nurse also notes that the patient has an unreliable social support network, has poor confidence in her ability to care for herself after discharge, and is at risk for a fall. Which of these issues would take priority according to Maslow’s hierarchy of human needs?
A.Sleep
B.Fall risk
C.Social support
D.Doubt related to self-care
a. Sleep is part of the foundation of Maslow’s hierarchy, included in physiologic need.
Safety (fall risk), love and belonging (family, friends, social support), and self-esteem (lack of confidence in self-care abilities) are later considerations according to this model.
Which intervention demonstrates the nurse’s fulfillment of a standard of nursing practice?
A.Preparing to give an end-of-shift report
B.Acting as a preceptor for a senior nursing student
C.Assessing a newly admitted patient for potential fall risks
D.Requesting an interpreter when providing education to a non–English-speaking patient
c. The ANA’s standards include two lists: standards of practice and standards of professional performance. Measurement criteria are printed in the ANA book Nursing: Scope and Standards of Practice (2015). The standards of practice list designates professional nursing responsibilities such as assessment, diagnosis, outcome identification, planning, implementation, and evaluation. Standards of professional performance include culturally congruent practice such as requesting an interpreter; collaboration such as providing an end-of-shift report; and leadership when acting as a preceptor for a nursing student.
Which nursing action demonstrates the role nurses play in addressing collaborative problems arising from delegated medically prescribed interventions?
A.Recognizing that a patient is having an allergic reaction to a prescribed medication and holding the next scheduled dose
B.Noting in the plan of care for an immobile patient that repositioning must occur every 2 hours
C.Requesting a dietary consult for a patient newly diagnosed with type 2 diabetes
D.Raising the head of the bed of a patient reporting difficulty breathing
a. When a provider delegates actions (provider-prescribed interventions) that require nurses to use their own judgment, nurses are addressing collaborative problems. For example, although providers must prescribe medications, they rely on the judgment of nurses to hold a dose of that medication when appropriate.
Initiating a turn and positioning schedule, requesting a dietary consult, and placing a patient in respiratory distress in a high Fowler position are all independent nursing actions that do not require collaboration.
Your nurse manager informs you he is using the tool “Asking Why 5 Times” to investigate medication error in which you were involved. What was the nurse manager doing?
A.Conducting root cause analysis
B.Applying concepts of just culture
C.Assessing outcomes for CMS
D.Using bundles of care
a. The tool “Asking Why 5 Times” is used in root cause analysis.
Which description of value-based purchasing is most accurate?
A.Ensuring “never events” never occur
B.Conducting a thorough investigation to analyze the root cause of all errors
C.Adjusting reimbursement based on measurement of processes, outcomes, and patient satisfaction
D.Determining the actual cost of care to calculate reimbursement
c. CMS adjusts hospital reimbursement based on adherence to guidelines for processes and outcomes of care and patient satisfaction.
Although ensuring “never events” never occur is a goal of healthcare, it is not the basis for value-based purchasing (VBP). Conducting root cause analysis of errors and determining cost of care are not related to VBP.
Which statement about patient safety is correct?
A.Physicians have sole responsibility for patient safety.
B.Safe patient care is the same as quality care.
C.High scores on HCAHPS surveys indicate patient safety.
D.Nurses play an important role in keeping patients safe.
d. Nurses are uniquely prepared to help keep patients safe, and their presence at the bedside 24 hours every day puts them in a position to monitor for and intervene as needed for safety.
You have been asked to participate in a committee writing a policy for the care of a patient with an indwelling catheter. What is most important to include?
A.Information retrieved from a website directed toward the lay public
B.The nationally recognized catheter-associated urinary tract infection prevention bundle
C.The policy from a well-respected nearby hospital
D.Information from a nursing textbook that is more than 10 years old
b. The nationally recognized bundle of care is the most important to include
Which statement is true about latent errors?
A.They are errors whose effects are not known for a long time.
B.Latent errors cause minimal effects to patients.
C.Latent errors are traceable to a particular individual.
D.They are errors that are due to system issues.
d. Latent errors are those due to systems issues; active errors are those attributable to an individual. The effects of latent errors may be apparent immediately and may certainly cause significant harm to patients.
A novice nurse has made what is considered a human error while performing as medication nurse on a busy long-term care nursing unit. What intervention implemented by the unit’s nurse manager would be most appropriate in this situation to help prevent similar errors in the future?
A.The incident is recorded in the nurse’s permanent employee file.
B.The nurse is asked to identify and discuss the factors that contributed to the making of the error.
C.The nurse manager provides a verbal warning to the nurse and explains that another error will result in disciplinary action.
D.The nurse is told by the nurse manager that everyone makes mistakes occasionally but to be more careful in the future.
b. As human beings, healthcare personnel will make errors.
What nursing action best demonstrates an activity focused on the safety goal of reducing the risk of healthcare-associated infections (HAIs)?
A.Providing an in-service on the appropriate technique to be used when providing indwelling catheter care
B.Monitoring all visitors for presence of possible infections and restricting visitation when appropriate
C.Formulating an institutional policy requiring all employees to be vaccinated yearly against the flu
D.Assessing all patients for history of infections within the previous 12 months
a. A common source of HAIs is an indwelling catheter.
A nurse is working in an organization that prescribes and supports Plan B (“the morning after pill”) as a form of contraception. In analyzing the nurse’s role and moral values, the nurse should consider which of the following? Select all that apply:
A.Is the nurse affirming the patient’s desires?
B.Is the nurse upholding the ethics of the profession?
C.What are the nurse’s beliefs/biases related to this medication?
D.What are the consequences and alternatives of giving or not giving this medication?
a, b, c, d. All questions posed should be considered in evaluating values in relation to the professional nursing role.
