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The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career?
A. Clinical nurse specialist
B. Nurse administrator
C. Nurse educator
D. Nurse researcher
D
Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform?
A. Moving from an acute illness to a health promotion, illness prevention model
B. Moving from illness prevention to a health promotion model
C. Moving from an acute illness to a disease management model
D. Moving from a chronic care to an illness prevention model
A
An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, listens to her lung and heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed?
A. Diagnosis
B. Evaluation
C. Assessment
D. Implementation
C
A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with them. The nurse is acting as the patient's:
A. Educator
B. Advocate
C. Caregiver
D. Case manager
B
A nurse meets with the registered dietician and physical therapist to develop a plan of care that focuses on improving nutrition and mobility for a patient. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency?
A. Patient-centered care
B. Safety
C. Teamwork and collaboration
D. Informatics
C
The examination for registered nurse (RN) licensure is exactly the same in every state in the United States. This examination:
a. Guarantees safe nursing care for all patients
b. Ensures standard nursing care for all patients
c. Ensures that honest and ethical care is provided
d. Provides a minimal standard of knowledge for an RN in practice
D
You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which of the following statements best describes this code?
a. Improves self-health care
b. Protects the patient's confidentiality
c. Ensures identical care to all patients
d. Defines the principles of right and wrong to provide patient care
D
Nurses in an acute care hospital are attending a unit based education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education?
a. Continuing education
b. Graduate education
c. In-service education
e. Professional Registered Nurse Education
C
The nurse spends time with the patient and family reviewing the dressing change procedure for the patient's wound. The patient's spouse demonstrates how to change the dressing. The nurse is acting in which professional role?
a. Educator
b. Advocate
c. Caregiver
d. Case manager
A
Which of the following Internet resources available can assist consumers when comparing quality care measures?
Select all that apply.
A. WebMD
B. Hospital Compare
C. Magnet Recognition Program
D. Hospital Consumer Assessment of Healthcare
E. The American Hospital Association's webpage.
B, D
A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed?
a. Planning
b. Evaluation
c. Assessment
e. Implementation
E
Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples?
Select all that apply.
a. Caregiver
b. Autonomy and accountability
c. Patient advocate
d. Health promotion
e. Lobbyist
A, B, C, D
A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency?
a. Patient-centered care
b. Safety
c. Teamwork and collaboration
e. Informatics
D
Which nurse most likely kept records on sanitation techniques and the effects on health?
a.Florence Nightingale
b.Mary Nutting
c.Clara Barton
d.Lillian Wald
A
Nightingale was the first practicing nurse epidemiologist. Her statistical analyses connected poor sanitation with cholera and dysentery. Mary Nutting, Clara Barton, and Lillian Wald came after Nightingale, each contributing to the nursing profession in her own way. Mary Nutting was instrumental in moving nursing education into universities. Clara Barton founded the American Red Cross. Lillian Wald helped open the Henry Street Settlement.
The nurse prescribes strategies and alternatives to attain expected outcome. Which standard of nursing practice is the nurse following?
a.Assessment
b.Diagnosis
c.Planning
d.Implementation
C
In planning, the registered nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes. During assessment, the registered nurse collects comprehensive data pertinent to the patient's health and/or the situation. In diagnosis, the registered nurse analyzes the assessment data to determine the diagnoses or issues. During implementation, the registered nurse implements (carries out) the identified plan.
An experienced medical-surgical nurse chooses to work in obstetrics. Which level of proficiency is the nurse upon initial transition to the obstetrical floor?
a.Novice
b.Proficient
c.Competent
d.Advanced beginner
A
A beginning nursing student or any nurse entering a situation in which there is no previous level of experience (e.g., an experienced operating room nurse chooses to now practice in home health) is an example of a novice nurse. A proficient nurse perceives a patient's clinical situation as a whole, is able to assess an entire situation, and can readily transfer knowledge gained from multiple previous experiences to a situation. A competent nurse understands the organization and specific care required by the type of patients (e.g., surgical, oncology, or orthopedic patients). This nurse is a competent practitioner who is able to anticipate nursing care and establish long-range goals. A nurse who has had some level of experience with the situation is an advanced beginner. This experience may only be observational in nature, but the nurse is able to identify meaningful aspects or principles of nursing care.
A nurse assesses a patient's fluid status and decides that the patient needs to drink more fluids. The nurse then encourages the patient to drink more fluids. Which concept is the nurse demonstrating?
a.Licensure
b.Autonomy
c.Certification
d.Accountability
B
A nurse prepares the budget and policies for an intensive care unit. Which role is the nurse implementing?
a.Educator
b.Manager
c.Advocate
d.Caregiver
B
The nurse has been working in the clinical setting for several years as an advanced practice nurse. However, the nurse has a strong desire to pursue research and theory development. To fulfill this desire, which program should the nurse attend?
a.Doctor of Nursing Science degree (DNSc)
b.Doctor of Philosophy degree (PhD)
c.Doctor of Nursing Practice degree (DNP)
d.Doctor in the Science of Nursing degree (DSN)
B
A nurse attends a workshop on current nursing issues provided by the American Nurses Association. Which type of education did the nurse receive?
a.Graduate education
b.Inservice education
c.Continuing education
d.Registered nurse education
C
A nurse identifies gaps between local and best practices. Which Quality and Safety Education for Nurses (QSEN) competency is the nurse demonstrating?
a.Safety
b.Patient-centered care
c.Quality improvement
d.Teamwork and collaboration
C
A nurse has compassion fatigue. What is the nurse experiencing?
a.Lateral violence and intrapersonal conflict
b.Burnout and secondary traumatic stress
c.Short-term grief and single stressor
d.Physical and mental exhaustion
B
A patient is scheduled for surgery. When getting ready to obtain the informed consent, the patient tells the nurse, "I have no idea what is going to happen. I couldn't ask any questions." The nurse does not allow the patient to sign the permit and notifies the health care provider of the situation. Which role is the nurse displaying?
a.Manager
b.Patient educator
c.Patient advocate
d.Clinical nurse specialist
C
The patient requires routine gynecological services after giving birth to her son, and while seeing the nurse-midwife, the patient asks for a referral to a pediatrician for the newborn. Which action should the nurse-midwife take initially?
a.Provide the referral as requested.
b.Offer to provide the newborn care.
c.Refer the patient to the supervising provider.
d.Tell the patient that is not allowed to make referrals.
B
The nurse has a goal of becoming a certified registered nurse anesthetist (CRNA). Which activity is appropriate for a CRNA?
a.Manages gynecological services such as PAP smears
b.Works under the guidance of an anesthesiologist
c.Obtains a PhD degree in anesthesiology
d.Coordinates acute medical conditions
B
A nurse teaches a group of nursing students about nurse practice acts. Which information is most important to include in the teaching session about nurse practice acts?
a.Protects the nurse
b.Protects the public
c.Protects the provider
d.Protects the hospital
B
A bill has been submitted to the State House of Representatives that is designed to reduce the cost of health care by increasing the patient-to-nurse ratio from a maximum of 2:1 in intensive care units to 3:1. What should the nurse realize?
a.Legislation is politics beyond the nurse's control.
b.National programs have no bearing on state politics.
c.The individual nurse can influence legislative decisions.
d.Focusing on nursing care provides the best patient benefit.
C
A nurse is using a guide that provides principles of right and wrong to provide care to patients. Which guide is the nurse using?
a.Code of ethics
b.Standards of practice
c.Standards of professional performance
d.Quality and safety education for nurses
A
graduate of a baccalaureate degree program is ready to start working as an RN in the emergency department. Which action must the nurse take first?
a.Obtain certification for an emergency nurse.
b.Pass the National Council Licensure Examination.
c.Take a course on genomics to provide competent emergency care.
d.Complete the Hospital Consumer Assessment of Healthcare Providers Systems.
B
While providing care to a patient, the nurse is responsible, both professionally and legally. Which concept does this describe?
a.Autonomy
b.Accountability
c.Patient advocacy
d.Patient education
B
A nurse is teaching the staff about Benner's levels of proficiency. In which order should the nurse place the levels from beginning level to ending level?
1. Expert
2. Novice
3. Proficient
4. Competent
5. Advanced beginner
a.2, 4, 5, 1, 3
b.2, 5, 4, 3, 1
c.4, 2, 5, 3, 1
d.4, 5, 2, 1, 3
B
A nurse is preparing a teaching session about contemporary influences on nursing. Which examples should the nurse include? (Select all that apply.)
a.Human rights
b.Affordable Care Act
c.Demographic changes
d.Medically underserved
e.Decreasing health care costs
A, B, C, D
After licensure, the nurse wants to stay current in knowledge and skills. Which programs are the most common ways nurses can do this? (Select all that apply.)
a.Master's degree
b.Inservice education
c.Doctoral preparation
d.Continuing education
e.National Council Licensure Examination retakes
B, D
A nurse wants to become an advanced practice registered nurse. Which options should the nurse consider? (Select all that apply.)
a.Patient advocate
b.Nurse administrator
c.Certified nurse-midwife
d.Clinical nurse specialist
e.Certified nurse practitioner
C, D, e
The nurse manager from the oncology unit has had two callouts; the orthopedic unit has had multiple discharges and probably will have to cancel one or two of its nurses. The orthopedic unit has agreed to "float" two of its nurses to the oncology unit if oncology can "float" a nursing assistant to the orthopedic unit to help with obtaining vital signs. Which concepts does this situation entail? (Select all that apply.)
a.Autonomy
b.Informatics
c.Accountability
d.Political activism
e.Teamwork and collaboration
A, C, E
