Exam 2 Textbook Question

Question 1

Which activity performed by a nurse is related to maintaining competency in nursing practice?
1. Asking another nurse about how to change the settings on a medication pump
2. Regularly attending unit staff meetings
3. Participating as a member of the professional nursing council
4. Attending a review course in preparation for a certification examination

Answer 1

attending a review course in preparation for a certification examination

Question 2

which of the following are examples of a nurse participating in primary care activities?
1. Providing prenatal teaching on nutrition to a pregnant woman during the first trimester
2. Assessing the nutritional status of older adults who come to the community center for lunch
3. Working with patients in a cardiac rehabilitation program
4. Providing home wound care to a patient
5. Teaching a class to parents at the local elementary school about the importance of immunizations

Answer 2

• providing prenatal teaching on nutrition to a pregnant woman during the first trimester
• assessing the nutritional status. of older adults who come to the community center for lunch
• teaching a class to parents at the local elementary school about the importance of immunizations

Question 3

which of the following statements is true regarding Magnet status recognition for a hospital?
1. Nursing is run by a Magnet® manager who makes decisions for the nursing units.
2. Nurses in Magnet® hospitals make all of the decisions on the clinical units.
3. Magnet® is a term that is used to describe hospitals that are able to hire the nurses they need.
4. Magnet® is a special designation for hospitals that achieve excellence in nursing practice.

Answer 3

magnet is a special designation for hospitals that achieve excellence in nursing practice

Question 4

the nurse is working in a tertiary care setting. which activity does the nurse perform while providing tertiary care?
1. Conducting blood pressure screenings at a local food bank
2. Administering influenza vaccines for older adults at the local senior center
3. Inserting an indwelling catheter for a patient on a medical-surgical unit
4. Performing endotracheal suctioning for a patient on a ventilator in the medical ICU

Answer 4

performing endotracheal suctioning for a patient on a ventilator in the medial ICU

Question 5

a nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is most appropriate outcome for this patient’s restorative care?
1. Patient will be able to walk 200 feet without shortness of breath.
2. Wound will heal without signs of infection.
3. Patient will express concerns related to return to home.
4. Patient will identify strategies to improve sleep habits.

Answer 5

patient will be able to walk 200 feet without shortness of breath

Question 6

which of the following describe characteristics of an integrated health are system?
1. The focus is holistic.
2. Participating hospitals follow the same model of health care delivery.
3. The system coordinates a continuum of services.
4. The focus of health care providers is finding a cure for patients.
5. Members of the health care team link electronically to use the EHR to share the patient’s health care record.

Answer 6

• the focus is holistic
• the system coordinates a continuums of services
• members of the health care team link electronically to use the EHR to share the patient’s health care record

Question 7

The school nurse has been following a 9-year-old student who has shown behavioral problems in class. The student acts out and does not follow teacher instructions. The nurse plans to meet with the student’s family to learn more about social determinants of health that might be affecting the student. Which of the following potential social determinant should the nurse assess?
1. The student’s seating placement in the classroom
2. The level of support parents offer when the student completes homework
3. The level of violence in the family’s neighborhood
4. The age at which the child first began having behavioral problems
5. The cultural values about education held by the family

Answer 7

• the level of support parents offer when the student completes homework
• the level of violence in the family’s neighborhood
• the cultural values about education held by the family

Question 8

a nurse is assigned to care for an 82-year-old patient who will be transferred from the hospital to a rehabilitation center. The patient and her husband have selected the rehabilitation center closest to their home. The nurse learns that he patient will be discharged. The nurse reviews the recommendation for physical therapy and applies the information to fall prevention strategies in the hospital. What discharge planning action by the nurse has not been addressed correctly?
1. Patient and family involvement in referral
2. Timing of referral
3. Incorporation of referral discipline recommendations into plan of care
4. Determination of discharge date

Answer 8

• timing of referral

Question 9

which of the following are common barriers to effective discharge planning?
1. Ineffective communication among providers
2. Lack of role clarity among health care team members
3. Number of hospital beds to manage patient volume
4. Patients’ long-term disabilities
5. The patient’s cultural background

Answer 9

• ineffective communication among providers
• lack of role clarity among health care team members

Question 10

a nurse newly hired at a community hospital learns about intentional hourly rounding during orientation. Which of the following are known evidence-based outcome from intentional rounding?
1. Reduction in nurse staffing requirements
2. Improved patient satisfaction
3. Reduction in patient falls
4. Increased costs
5. Reduction in patient use of nurse call system

Answer 10

• improved patient satisfaction
• reduction in patient use of nurse call system

Question 11

A nurse is aware that preschoolers often display a developmental characteristic that makes them treat dolls or stuffed animals as if they have thoughts and feelings. This is an example of:
1. Logical reasoning.
2. Egocentrism.
3. Concrete thinking.
4. Animism.

Answer 11

animism

Question 12

A 9-year-old child has a difficult time making friends at school and being chosen to play on teams. He also has trouble completing his homework and, as a result, receives little positive feedback from his parents or teacher. According to Erikson’s theory, failure at this stage of development results in: (Select all that apply.)
1. Feelings of inadequacy.
2. A sense of guilt.
3. A poor sense of self.
4. Feelings of inferiority.
5. Mistrust.

Answer 12

• feeling of inadequacy
• feelings of inferiority

Question 13

A nurse teaches parents how to have their children learn impulse control and cooperative behaviors. This would be during which of Erikson’s stages of development?
1. Trust versus mistrust
2. Initiative versus guilt
3. Industry versus inferiority
4. Autonomy versus sense of shame and doubt

Answer 13

initiative verses guilt

Question 14

When Ryan was 3 months old, he had a toy train; when his view of the train was blocked, he did not search for it. Now that he is 9 months old, he looks for it, reflecting the presence of:
1. Object permanence.
2. Sensorimotor play.
3. Schemata.
4. Magical thinking.

Answer 14

object permanence

Question 15

When preparing a 4-year-old child for a procedure, which method is developmentally most appropriate for the nurse to use?
1. Allowing the child to watch another child undergoing the same procedure
2. Showing the child pictures of what will be experienced
3. Talking to the child in simple terms about what will happen
4. Preparing the child through play with a doll and toy medical equipment

Answer 15

Preparing the child through play with a doll and toy medical equipment

Question 16

A nurse is caring for a man who is recently retired and who appears withdrawn. He says he is “bored with life.” The nurse helps this individual find meaning in life by:
1. Encouraging him to reflect on his relationships with others.
2. Encouraging relocation to a new city.
3. Explaining the need to simplify life.
4. Encouraging him to adopt a new pet.

Answer 16

Encouraging him to reflect on his relationships with others.

Question 17

According to Piaget’s cognitive theory, a 12-year-old child is most likely to engage in which of the following activities? (Select all that apply.)
1. Using building blocks to determine how houses are constructed
2. Writing a story about a clown who wants to leave the circus
3. Drawing pictures of a family using stick figures
4. Writing an essay about patriotism
5. Hanging out with a best friend

Answer 17

• Writing a story about a clown who wants to leave the circus
• Hanging out with a best friend

Question 18

Elizabeth, who is having unprotected sex with her boyfriend, comments to her friends, “Did you hear about Kathy? You know, she fools around so much; I heard she was pregnant. That would never happen to me!” This is an example of adolescent:
1. Imaginary audience.
2. False-belief syndrome.
3. Personal fable.
4. Sense of invulnerability.

Answer 18

Sense of invulnerability.

Question 19

Which of the following are examples of the conventional reasoning form of cognitive development? (Select all that apply.)
1. A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her.
2. A young father is considering whether or not to return to school for a graduate degree. He considers the impact the time commitment may have on the needs of his wife and infant son.
3. A teenage girl is encouraged by her peers to engage in shoplifting. She decides not to join her peers in this activity because she is afraid of getting caught in the act.
4. A single mother of two children is unhappy with her employer. She has been unable to secure alternate employment but decides to quit her current job.
5. A young man drives over the speed limit regularly because he thinks he is an excellent driver and will not get into a car accident.

Answer 19

• A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her.
• A young father is considering whether or not to return to school for a graduate degree. He considers the impact the time commitment may have on the needs of his wife and infant son.

Question 20

Dave reports being happy and satisfied with his life. What do we know about him?
1. He is in one of the later developmental periods, concerned with reviewing his life.
2. He is atypical, since most people in any of the developmental stages report significant dissatisfaction with their lives.
3. He is in one of the earlier developmental periods, concerned with establishing a career and satisfying long-term relationships.
4. It is difficult to determine Dave’s developmental stage since most people report overall satisfaction with their lives in all stages.b

Answer 20

It is difficult to determine Dave’s developmental stage since most people report overall satisfaction with their lives in all stages.

Question 21

The components of the nursing metaparadigm include:
1. Person, health, environment, and theory.
2. Health, theory, concepts, and environment.
3. Nurses, physicians, health, and patient needs.
4. Person, health, environment, and nursing.

Answer 21

Person, health, environment, and nursing.

Question 22

Theory is essential to nursing practice because it:
1. Contributes to nursing knowledge.
2. Predicts patient behaviors in situations.
3. Provides a means of assessing patient vital signs.
4. Guides nursing practice.
5. Formulates health care legislation.
6. Explains relationships between concepts.

Answer 22

• contributes to nursing knowledge
• predicts patient behaviors in situations
• guides nursing practice
• explains relationships between concepts

Question 23

a nurse ensures that each patient’s room is clean; well ventilated; and free from clutter, excessive noise, and extremes in temperature. Which theorist’s work is the nurse practicing in this example?
1. Henderson
2. Orem
3. King
4. Nightingale

Answer 23

nightingale

Question 24

A nurse is caring for a patient admitted to the neurological unit with the diagnosis of a stroke and right-sided weakness. The nurse assumes responsibility for bathing and feeding the patient until the patient can begin performing these activities. The nurse in this situation is applying the theory developed by:
1. Johnson.
2. Orem.
3. Roy.
4. Peplau

Answer 24

orem

Question 25

middle-range theory

Answer 25

based on the belief that nurses should work with patients to develop goals for care

Question 26

shared theory

Answer 26

applies theory from other disciplines to nursing practice

Question 27

grand theory

Answer 27

very abstract; attempts to describe nursing in a global context

Question 28

practice theory

Answer 28

specific to a particular situation; bring theory to the bedside

Question 29

King

Answer 29

based on the belief that nurses should be work with patients to develop goals for care

Question 30

Henderson

Answer 30

based on 14 activities, the belief that the nurse should assist patients with meeting needs until they are able to do so independently

Question 31

Orem

Answer 31

based on the belief that people who participate in self-care activities are more likely to improve their health outcomes

Question 32

Neuman

Answer 32

Based on the theory that focuses on wellness and prevention of disease

Question 33

Which of the following statements related to theory-based nursing practice are correct?
1. Nursing theory differentiates nursing from other disciplines.
2. Nursing theories are standardized and do not change over time.
3. Integrating theory into practice promotes coordinated care delivery.
4. Nursing knowledge is generated by theory.
5. The theory of nursing process is used in planning patient care.
6. Evidence-based practice results from theory-testing research.

Answer 33

• Nursing theory differentiates nursing from other disciplines.
• Integrating theory into practice promotes coordinated care delivery
• Nursing knowledge is generated by theory.
• Evidence-based practice results from theory-testing research.

Question 34

A nurse is caring for a patient who recently lost a leg in a motor vehicle accident. The nurse best assists the patient to cope with this situation by applying which of the following theories?
1. Roy
2. Watson
3. Johnson
4. Benner

Answer 34

Roy

Question 35

Using Maslow’s hierarchy of needs, identify the priority for a patient who is experiencing chest pain and difficulty breathing.
1. Self-actualization
2. Air, water, and nutrition
3. Safety
4. Esteem and self-esteem needs

Answer 35

Self-actualization

Question 36

A nurse is analyzing data generated during a patient assessment to determine the best plan of care. Which layer of the NCSBN-CJM best describes the cognitive process being used by the nurse at this time?
1. Layer 0
2. Layer 1
3. Layer 2
4. Layer 3
5. Layer 4

Answer 36

Layer 3

Question 37

Match the components of PICO using the question “Does the use of guided imagery compared with standard care affect the postoperative pain in hospitalized adolescents?

(P) Patient/population

Answer 37

Hospitalized adolescents

Question 38

Match the components of PICO using the question “Does the use of guided imagery compared with standard care affect the postoperative pain in hospitalized adolescents?

(I) Intervention

Answer 38

Guided imagery

Question 39

Match the components of PICO using the question “Does the use of guided imagery compared with standard care affect the postoperative pain in hospitalized adolescents?

(C) Comparison

Answer 39

Adolescents receiving standard care

Question 40

Match the components of PICO using the question “Does the use of guided imagery compared with standard care affect the postoperative pain in hospitalized adolescents?

(O) Outcome

Answer 40

Postoperative pain

Question 41

Place the steps of the EBP process in the appropriate order.
1. Critically appraise the evidence you gather.
2. Ask the clinical question in PICOT format.
3. Evaluate the outcomes of the practice decision or change.
4. Search for the most relevant and best evidence.
5. Cultivate a spirit of inquiry.
6. Integrate the evidence.
7. Communicate the outcomes of the EBP change.

Answer 41

1. Cultivate a spirit of inquiry.
2. Ask the clinical question in PICOT format.
3. Search for the most relevant and best evidence.
4. Critically appraise the evidence you gather.
5. Integrate the evidence.
6. Evaluate the outcomes of the practice decision or change.
7. Communicate the outcomes of the EBP change.

Question 42

A nurse is reading a research article discussing a new practice to decrease the incidence of catheter-associated urinary tract infections. One section of the article describes who was studied and how the data were collected to answer the research questions and hypotheses. What section of the research article is currently being read?
1. The literature review
2. The data analysis
3. The methods
4. The implications for practice

Answer 42

The methods

Question 43

A nurse implements an EBP change that teaches patients the importance of taking their diabetes medications correctly and regularly on time using videos streamed on the Internet. The nurse measures the patients’ behavioral outcome from the practice change by using which type of measurement?
1. Measuring the patients’ weight
2. Chart auditing teaching sessions
3. Observing patients viewing the videos
4. Checking patients’ blood sugars

Answer 43

Checking patients’ blood sugars

Question 44

A patient in the ICU experiences a sentinel event related to central line catheter care that resulted in serious injury. What PI model should the unit use to identify errors that led to the sentinel event?
1. Six Sigma
2. Root cause analysis
3. PDSA
4. Balanced scorecard

Answer 44

Root cause analysis

Question 45

The nurse identifies which of the following as outcomes measurements?

Answer 45

• A nurse teaches a patient how to administer an injection and then watches the patient do a return demonstration.
• A nursing unit adopts a set of strategies for reducing pressure injuries, and the UPC members use direct observation of the skin to measure incidence of pressure injuries.
• A nursing unit implements a new fall prevention protocol and checks the monthly performance data for incidence of falls on the unit.

Question 46

The nurses on a medical unit have seen an increase in the number of pressure injuries developing in their patients. The nurses decide to initiate a PI project using the PDSA model. Which of the following is an example of “Plan” from that model?
1. Orienting patients to the unit’s practice of hourly rounding on patients
2. Reviewing the incidence of pressure injuries on patients cared for using the protocol
3. Based on findings from patients who developed injuries, implementing an evidence-based skin care protocol on all units
4. Meeting with all disciplines to develop a multidisciplinary approach for reducing pressure injuries

Answer 46

Meeting with all disciplines to develop a multidisciplinary approach for reducing pressure injuries

Question 47

The nurse is using the QSEN competency of EBP when working with the unit council to initiate a change related to pain management. Which behaviors demonstrate that the nurse is practicing behaviors associated with EBP?

Answer 47

• Reading original research related to pain management
• Valuing EBP as critical to the development of pain management guidelines for the unit
• Describing to the unit council reliable sources for locating clinical guidelines

Question 48

Nurses in a community clinic are conducting an EBP project focused on improving the outcomes of children with asthma. The PICO question asked by the nurses is “In school-age children, does the use of an electronic gaming education module versus educational book affect the usage of inhalers?” In the question, what is the “O”?

Answer 48

use of inhalers

Question 49

A nurse research investigator is explaining a research study to a patient. The patient is interested in participating in the research study. The nurse investigator reviews the informed consent with the patient. The patient asks the nurse why he must sign the consent to participate in the study. What is the nurse’s best response(s) to the patient’s question?

Answer 49

• “The informed consent (IC) provides you with complete information on the research study.”
• “By reviewing the consent with you, I can make sure that you understand the study and what it means for you to participate.”
• “The informed consent provides your voluntary agreement to participate in the research study.”
• “The informed consent explains how the data collected from you will be kept confidential during and after the study.”

Question 50

patient centered care

Answer 50

recognize the patient or designee as the source of control and full partner in providing compassion and coordinated care based on respect for patient’s preferences, values, and needs

Question 51

teamwork and collaboration

Answer 51

function effectively within nursing and inter professional teams, fostering open communication, mutual respect, and shared decision making to achieve high-quality patent care

Question 52

evidence-based practice

Answer 52

integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal care

Question 53

quality improvement

Answer 53

use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems

Question 54

safety

Answer 54

minimize risk of harm to patients and providers through both system effectiveness and individual performance

Question 55

informatics

Answer 55

use information and technology to communicate, manage knowledge, mitigate error, and support decision making

Question 56

A nurse is caring for a patient in the hospital. When should the nurse begin discharge planning?

Answer 56

Upon admission to the hospital

Question 57

A nurse provide immunization through the public health department. Which type of health care is this?

Answer 57

Preventive care

Question 58

A nurse is working at a hospital with Magnet status. Which component below is one of the indicators of this status?

Answer 58

Exemplary professional practice

Question 59

Which behavior demonstrated by a nurse indicates the nurse in using Nightingale’s theory to plan nursing care?

Answer 59

Thinks about the patients and patients’ environments