Question

a. the development of esprit de corps.
b. benefits to the organization alone.
c. positive patient outcomes.
d. maintenance of employee satisfaction.

Answer 1

ANS: C

A
Although esprit de corps develops, the ultimate result is for positive patient outcomes.
B
Collaboration benefits the individuals involved, as well as the organization.
C
Making the most of collaborative opportunities enhances positive patient outcomes.
D
Employee satisfaction is greater with more collaboration, but the ultimate value of collaboration is positive patient outcomes.

Answer 2

2
 Rationale: Truth is one of the primary defenses for defamation. Contributory negligence is a defense used when there is a need to identify fault in the injury. Hearsay is not a way of validating truth.

Answer 3

ANS: D
Correct: A proposition is a statement that proposes the relationship between and among concepts.
Incorrect:
a. A model is a visual representation rather than a statement.
b. Leininger's Theory is founded on transcultural nursing.
c. Nothing related to the theory of disease uncertainty occurs in this scenario.

Answer 4

C

Answer 5

3
Rationale: Based on the five rights of delegation, the most important aspect is that the aides are given the correct directions and communications about keeping this patient safe. The other options do not address patient safety.

Answer 6

A, D, E

Answer 7

A, B, D, E
It is important that the nurse understand how important political participation is. The following statements indicate understanding: "It is important for nursing to be presented in a positive light," "Nurses should fight for better health care for all patients," "Nurses should lobby for the availability of health care," and "The public should see what nurses really do.". The statement "Nurses should only worry about what is occurring where they practice nursing" does not indi-cate understanding of the importance of political participation.

Answer 8

ANS: A
Correct: A compulsory license requirement must be met to legally practice or work as a registered nurse in any state or U.S. territory. Licenses are granted only after an applicant has successfully passed the NCLEX-RN® examination.
Incorrect:
b. Licensure is designed to protect the public by providing safe practitioners, but it does not evaluate the individual candidate's mental competency.
c. Preadmission/preemployment physicals are part of the employment process; however, nurses with physical limitations may attain employment.
d. Graduates cannot practice as registered nurses until they pass the NCLEX-RN® exam, even if they have signed an employment contract. Some graduates may not seek employment until after they have successfully completed the NCLEX-RN® and have become licensed.

Answer 9

D
Whereas a manager is assigned or appointed to a role, a leader selects or assume a role. The nurse manager functions differently than a floor nurses, and although the nurse manager has some authority, it is less than the director of the hospital.

Answer 10

3
Rationale: The autonomy model facilitates decision making for the competent patient.

Answer 11

1
Rationale: Criminal law is appropriate in this case because the act against the neighbor was of a nature that was offensive and harmful.

Answer 12

ANS: B

A
Florence Nightingale's paper was on scientific training of nurses.
B
Several influential nursing leaders met at the Chicago World's Fair and started the National League for Nursing Educationâ€"the precursor to the NLN.
C
The NLN, not the ANA, was formed to oversee nursing education in the United States.
D
The ICN was not founded until 1899 and is not involved in U.S. education of nurses.

Answer 13

ANS: B

A
The NCSBN does not have the authority to oversee state boards of nursing.
B
The NCSBN develops the test plan and items for the NCLEX examination.
C
States, not the NCSBN, administer the NCLEX examination.
D
State boards of nursing, not the NCSBN, grant licensure through endorsement.

Answer 14

C

Answer 15

A

Answer 16

C
The graduate nurse should consider rooming alone or with someone who is supportive of a posi-tive environment. The graduate nurse will want a good night's rest before the NCLEX-RN® examination. Staying up late studying defeats the purpose of having a restful night before taking the NCLEX-RN® examination.

Answer 17

ANS: D

A
Health care outcomes are measurable results of the health care system.
B
Population variability relates to the variation of characteristics of the population.
C
Treatment choices are options offered for care of the patient.
D
The differences in disease management and treatment outcomes have been found in different ethnic and racial groups as well as in different gender and age groups.

Answer 18

ANS: C

A
Saying "With today's advanced reconstruction techniques, you'll quickly forget you ever had surgery" discounts the patient's feelings and is false reassurance.
B
The nurse is making an assumption that the patient wants to return to a busy routine. This is false reassurance based on a faulty assumption about the patient.
C
The nurse acknowledges the patient's feelings and uses an open-ended statement to encourage the patient to verbalize further.
D
The nurse should never assume to know how the patient feels. The focus should be on the patient, not the nurse. The nurse's experience is not germane to the nurse-patient relationship.

Answer 19

2,3
Rationale: The patient-home health nurse relationship may end if the patient no longer needs care and is discharged from the service.

Answer 20

ANS: A

Feedback
A
A larger percentage of minorities are enrolled in nursing educational programs than previously.
B
Asians and Native Hawaiian-Pacific Islanders are over represented in nursing compared to their percentage of the general population.
C
Not only would the percentage of African-American and Hispanic nurses need to increase, the percentage of white nurses would have to decrease in order to more accurately reflect the population as a whole.
D
The nonwhite portion of the general population is not likely to decrease.

Answer 21

D
Betty Neuman's conceptual model focuses on prevention of disease and illness. The nurse uses primary prevention when exercising every other day. Eating unhealthy foods, lack of exercise, and sleeping only 4 hours does not support this model or a healthy lifestyle.

Answer 22

C

Answer 23

D

Answer 24

ANS: A
Correct: Altruism is concern for the welfare of others, including willingness to help others when they are unable to get their assignments completed to ensure that the patient receives high-quality care.
Incorrect:
b. Veracity is truth telling, in this situation the staff provided care demonstrating altruism and there was no concern that the truth was spoken.
c. Autonomy is self-determination: the patient was demonstrating autonomy by asking for care, the staff was demonstrating altruism by providing requested care.
d. The staff did not report unsafe or inappropriate, harmful care.

Answer 25

1,4,5
Rationale: Adoptions are under the jurisdiction of family court.

Answer 26

2
 Rationale: The nurse should try other methods of caring for the patient, prior to using either physical or chemical restraints. Since there is no indication that this patient is in danger of getting out of bed or otherwise getting injured, the correct answer is to keep attempting reorientation. Moving the call bell out of the patient's reach is dangerous. Restraints should never be used for the convenience of the staff.

Answer 27

3
Rationale: Legally this is correct, but is not the most ethical option.

Answer 28

1
 Rationale: The best strategy is to be up front about these beliefs and to discuss them at the time of the employment interview. While it is true that these are personal beliefs, they may impact the way the nurse is assigned or able to practice in given environments. While many units would be unlikely to receive such patients, it cannot be guaranteed that the nurse would never come into contact with them. There is no need to document the information in the contract.

Answer 29

C

Answer 30

B

Answer 31

3
 Rationale: The plaintiff has the legal burden of proof to show that an incident occurred and that the incident did, in fact, cause the plaintiff's injury. There is not a burden of proof that requires the plaintiff to prove that the incident was intentional.

Answer 32

A
Ineffective communication was identified as the root cause for nearly 70% of all sentinel events reported. The majority of those untoward events involved communication failure. The other op-tions were not identified as the majority of all sentinel events.

Answer 33

ANS: A
Correct: The experienced and novice nurses have entered into a mutually agreed upon interactive relationship to ease the transition of the novice nurse into the profession.
Incorrect:
b. An interactive relationship is present.
c. A preceptorship is usually a short-term relationship.
d. Socialization is the desired outcome of mentoring but not of actual interactions.

Answer 34

ANS: C

A
The statement and behaviors observed indicate that the patient is experiencing pain.
B
One can make a conclusion because there is sufficient information available.
C
The patient states he/she is in pain and the rigid positioning and shallow breathing are behaviors found when individuals experience pain.
D
The subjective nature of pain requires obtaining the information from the patient if at all possible. The family can be an excellent source of information if the patient is unable to cooperate with the nurse's assessment.

Answer 35

C
The student population tends to be older and married and with families. Minority individuals, foreign students, and poor individuals look to nursing for career opportunities.

Answer 36

ANS: B
Correct: The nurse is experiencing a gradual decline in compassion over time as a result of being exposed to events that have distressed his or her patients, such as working at a young age to support a family while inadvertently being exposed to carcinogens.
Incorrect:
a. Burnout refers to feelings of being overwhelmed and distressed, resulting in poor work quality and symptoms such as insomnia and lack of professional pride.
c. Reality shock occurs when a novice nurse enters the workforce after graduating from school and is not prepared to deal with differences between school and workplace values.
d. Horizontal hostility is to control, diminish, or devalue another peer or person, in this situation the nurse is not displaying nor is not the target of bullying or person insults rather is demonstrating compassion fatigue that is the result of working with complex or patient trauma over time resulting in a decline in empathy.

Answer 37

1
 Rationale: The rights protection model is also known as the autonomy model, in which nurses assist patients in asserting their autonomy rights. In the values-based decision model, the nurse assists the patient by discussing his or her needs and desires and helps the patient make choices that are most consistent with those wishes. In this case, the patient has already made the choice. The patient advocate model is also known as the respect for persons model and focuses on inherent human dignity and respect. This model is not as specific as the other models. The jurisprudence model is not an advocacy model.

Answer 38

ANS: A
Correct: Unfreeze is correct because the change agent promotes problem identification and encourages awareness of the need for change. In alignment with Lewin's stages of change (unfreezing, moving, and refreezing), education and involvement are keys to successful change. People must believe that improvement is possible before they will be willing to consider change.
Incorrect:
b. Move is incorrect because at this stage the change agent clarifies the need to change, explores alternatives, defines goals and objectives, plans the change, and implements the change plan.
c. Refreeze is incorrect because at this stage the change is being integrated into the organization so that it becomes recognized as the status quo. The change agent must facilitate change by monitoring adherence to the new requirements.
d. Acceptance is incorrect because acceptance and integration represent the final aspect of any change.

Answer 39

A, B, E

Answer 40

A

Answer 41

A
State nursing associations have represented nurses since 1946 . They are multipurpose and are involved in many activities such as addressing nursing practice. These organizations do not pro-tect the rights of physicians and are not managed by hospital administrators.

Answer 42

D

Answer 43

B

Answer 44

3
Rationale: Inclusion of additional information such as date and time of admission only makes it easier to identify the patient, which is a HIPAA violation.

Answer 45

C

Answer 46

3
 Rationale: Documentation of admission assessment and nursing needs is the role of the registered nurse. Information may be collected by the nursing assistant or licensed practical or vocational nurse to assist the RN in making patient care decisions. The physician plans medical care, not nursing care.

Answer 47

B
It is important to determine the least stable patient when planning care for multiple patients. Plan and complete the care for the patient who requires multiple treatments or complex nursing care. This patient is most likely to experience physiological problems if the nurse does not address his or her needs. The others are cared for in the priority order determined by their stability and needs. Procrastination and caring for the easiest patient first are not reflective of assessing patient needs and administering patient care management effectively.

Answer 48

A, B, C, E
According to Knight, e-mentoring reflects mentoring that takes place over a distance (learner and faculty are not in face-to-face communication), usually by electronic communication facilitation. More recently, the use of e-mentoring can be via e-mail, smartphone, Skype, and webinars. Meeting in person (coffee shop) and the mentoring program do not describe the virtual compo-nent of e-mentoring.

Answer 49

ANS: A

A
Subacute care is inpatient care that lies between hospital care and long-term care.
B
Primary care is provided at the point at which a person first enters the health care system. Care provided can include emergency care, health maintenance, and chronic care, as well as health promotion.
C
Secondary care involves the prevention of complications from disease. This level of care may occur in hospitals as well as other types of agencies.
D
Tertiary care is provided to the acutely ill, those requiring long-term care, those requiring rehabilitation services, and terminally ill patients.

Answer 50

1
Rationale: When the only ordered service is a rehabilitative therapy, the initial assessment can be done by the appropriate skilled rehabilitation professional, in this case, the physical therapist.

Answer 51

D