Nursing Roles and Practice

Question 1

Compassion

Answer 1

sympathy for the suffering of others, often including a desire to help
(sympathy, empathy, care, concern, kindness, benevolence)

Question 2

Associate Degree

Answer 2

• typically 2 year degree
• will graduate with an ADN
• selective admission process
• begain in 1952
• community college

Question 3

Diploma Program

Answer 3

• earliest type of nursing education in the US
• aka “hospital based programs”
• meet accreditation requirements
• 27-36 months
• now 10% of RN programs are diploma programs
• little transferability to other colleges

Question 4

Baccalaureate Degree

Answer 4

• 4yr college or university
• first type of nursing schooling to focus on skills rather than theories
• basic nursing skills, leadership, health promotion, disease prevention
• can advance to higher positions in nursing and/or masters degree

Question 5

ANA definition of nursing

Answer 5

the promotion of health, prevention of illness, alleviation of suffering through diagnosis and treatment of human response and advocacy in the care of individuals, families, and communities

Question 6

AZBN mission statement

Answer 6

“The mission of the Arizona State Board of Nursing is to protect and promote the welfare of the public by ensuring that each person holding a nursing license or certificate is competent to practice safely.”

Question 7

Employment opportunities for nurses

Answer 7

• general med/surg hospitals (private)
• physicians offices
• local hospitals
• home health
• nursing care facilities

Question 8

Case method

nursing care delivery model

Answer 8

• first system used
• nurse works with one client only
• nurse often lived in the client’s home and assumed other household responsibilities as well (cooking, housekeeping)
• long hours and poor pay
• some aspects can be seen in today’s home health model

Question 9

Functional method

nursing care delivery model

Answer 9

• emerged during Great Depression
• greater number of clients and newer technology
• head nurse assigned tasks (one person taking temps, the other doing dressings)
• nursing care was seen as a list of procedures and tasks
• may be used in LTC facilities

Question 10

Team nursing

nursing care delivery model

Answer 10

• introduced in the 1950’s with hopes of more client based care
• team composed of many levels of educated members (aids, LPNs, RNs)
• team leader makes assignments and is responsible for the care of the clients, administers all meds and gives report
• team conference

Question 11

Primary care

nursing care delivery model

Answer 11

• started in 1980s, one nurse responsible for patient from admit to discharge
• associate nurse worked with the client while primary nurse was off
• benefits: care continuity and nurse job satisfaction
• concerns: level of expertise and commitment required by all nurses, less delegation

Question 12

Total client care

nursing care delivery model

Answer 12

• RN or LPN is assigned to all the care needs of 4-6 patients
• requires higher RN staffing
• higher RN staffing is associated with shorter stays, less hospital related mortality, less failure to rescue, less cardiac arrest, and less hospital acquired pneumonia

Question 13

Case management

nursing care delivery model

Answer 13

• not a system of care delivery but involves nurses in the role of managing client care
• healthcare services are controlled carefully to ensure policies are being followed and costs minimized
• case manager follows client from diagnosis through hospitalization, rehab, and back home

Question 14

Guidelines for prioritization

Answer 14

A: airway (foreign body, drowning, swelling in airways)
B: breathing (neurological, trauma to chest, COPD, pneumonia, overdose, seizure)
C: circulation (cardiac failure, fluid overload or deficit, critical electrolyte imbalances. Hgb or Hct)

Question 15

What should an RN not delegate?

Answer 15

• assessment, diagnosis, planning, evaulation
• health teaching and counseling
• complex/complicated activities
• unstable patients

Question 16

5 rights of delegation

Answer 16

1. right task
2. right person
3. right circumstances
4. right communication
5. right supervision

Question 17

For care of patient who has oral cancer, which task would be appropriate to delegate to an LPN?

a. Assist the patient to brush and floss
b. Explain when brushing and flossing is contraindicated
c. Give antacids suspension as ordered
d. Recommend saliva substitutes

Answer 17

C

Question 18

Based on Maslow’s hierarchy of needs, which nursing diagnosis is the highest priority?

a. Diarrhea
b. Deficient knowledge
c. Disturbed body image
d. Deficient fluid volume

Answer 18

D

This is a known/actual issue

Question 19

Which assessment findings of a patient with multiple injuries sustained during a head-on car collision takes priority?

a. Unequal pupils
b. A deviated trachea
c. Irregular apical pulse
d. Ecchymosis in the flank area

Answer 19

B

breathing falls under the airway of ABC prioritization

Question 20

The patient’s nursing diagnosis is Deficient Fluid Volume related to excessive fluid loss. Which action related to fluid management should be delegated to a nursing assistive personnel?

a. Administer intravenous fluids as prescribed by the physician
b. Provide straws and offer fluids between meals
c. Develop a plan for added fluid intake over 24 hours
d. Teach family members to assist the patient with fluid intake

Answer 20

B

Question 21

Which task could be delegated to a nursing assistive personnel when caring for a patient with esophageal cancer?

A. Initiate daily weighings
B. Assist the patient with oral hygiene
C. Facilitate expression of fear and grief
D. Observe the patient’s response to feedings.

Answer 21

B

Question 22

When care assignments are being made for patients with alterations related to GI cancer, which patient would be the most appropriate to assign to an LPN under the supervision of the team leader RN?

a. A patient with severe anemia secondary to GI bleeding
b. A patient who needs enemas and antibiotics to control GI bacteria.
c. A patient who just had a bowel resection surgery
d. A patient who needs central line insertion for chemotherapy

Answer 22

B

Question 23

You are the charge nurse in an emergency department and must assign two staff members to cover the triage area. Which team is the most appropriate for this assignment?

a. An advanced practice nurse and an experienced LPN.
b. An experienced LPN and an inexperienced RN
c. An experienced RN and an inexperienced RN
d. An experienced RN and a nursing assistant

Answer 23

C

Question 24

You are serving as preceptor to a nurse who has recently graduated and passed the NCLEX. The nurse has only been on the unit for 2 days. Which patient should you assign to the new nurse?

A. A 68 year old patient with diabetes who is showing signs of hyperglycemia
B. A 58 year old patient with diabetes who has cellulitis of the left ankle.
C. A 49 year old patient with diabetes who has just returned from a post-anesthesia care unit after a below-the-knee amputation
D. A 72 year old patient with diabetes with diabetic ketoacidosis who is receiving IV insulin.

Answer 24

B