Basic Nursing Chapter 1: Evolution of Nursing Thought & Action

Vocabulary flashcards covering core nursing definitions, theories, care models, healthcare settings, and professional organizations from Chapter 1.

Illness Prevention Activity

A health activity focused on avoiding a specific disease, such as administering an immunization for human papillomavirus (HPV).

Health Promotion Activity

An activity focused on improving overall health and well-being rather than avoiding a specific disease, such as keeping a food diary.

Continuing Education

A professional strategy designed to ensure nurses remain current in their clinical knowledge, with requirements for renewal set in each state's nurse practice act.

Novice Nurse

A stage of Benner's proficiency model where an inexperienced nurse relies heavily on rules and established processes.

Advanced Beginner Nurse

A stage of Benner's proficiency model where the nurse focuses on specific aspects of a situation but is unable to see the comprehensive perspective.

Competent Nurse

A stage of Benner's proficiency model achieved typically after 2 to 3 years of practice, where the nurse can prioritize patient needs but does not fully grasp the total situation.

Expert Nurse

A stage of Benner's proficiency model where the nurse has a deep clinical understanding and often senses potential problems in the absence of classic signs and symptoms.

Standards of Practice

Authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently.

American Nurses Association (ANA)

The official professional organization for nurses in the United States, focused on establishing standards of nursing to promote high-quality care and patient safety.

National League for Nursing (NLN)

A professional nursing organization founded to establish and maintain a universal standard of nursing education and faculty development.

International Council of Nursing (ICN)

A global federation of national nursing organizations representing over 20 million nurses across more than 130 nations aiming to ensure quality nursing care for all.

Sigma Theta Tau International

A global nursing honor society whose goal is to foster nursing scholarship, leadership, service, and research to improve health worldwide.

Tertiary Care

A category of healthcare required for individuals who need long-term care or care for terminal illness, such as after a debilitating stroke.

Secondary Care

Healthcare services provided for patients who require support or rehabilitation over a limited period, such as following a joint replacement.

Primary Care Services

Healthcare services focused on health promotion and disease prevention, such as administering childhood immunizations.

Assisted Living Facility

A facility designed to bridge the gap between independence and institutionalization for older adults who have a decline in health status, providing assistance with meals, housekeeping, or medications.

Skilled Nursing Facility

A setting offering services of trained professionals for a limited period after an injury or illness (e.g., wound care, IV infusions) for clients expected to improve with treatment.

Nursing Home Facility

A facility providing custodial care and continual supervision for individuals who cannot live on their own but do not require hospitalization.

Independent Living Facility

A community setting for seniors 55 years or older who are independent in all aspects and desire socialization and peer support.

Advanced Practice Nurse (APN)

A registered nurse with advanced education, associated with high client satisfaction, outcomes comparable to physicians, improved treatment compliance, and cost-effectiveness.

Children's Health Insurance Program (CHIP)

A joint federal and state program providing health insurance to children whose family income exceeds Medicaid eligibility criteria but who cannot afford private insurance.

Medicare

A federal insurance program created by Title XVIII of the Social Security Act of 1965 to fund healthcare for persons age 65 and older, people with disabilities, and those with end-stage renal disease.

Medicaid

A health program administered by states and funded by federal and state governments under Title XIX of the Social Security Act of 1965 to provide healthcare access for low-income individuals.

Physical Therapist

An interprofessional team member focusing on muscle and bone rehabilitation to help clients use assistive devices and regain physical mobility for ADLs.

Occupational Therapist

An interprofessional team member who helps clients regain function and independence in everyday self-care activities (ADLs).

Speech-Language Pathologist

A healthcare professional providing assistance to clients experiencing swallowing and speech disturbances after neurological impairment.

Respiratory Therapist

A healthcare professional providing prescribed respiratory treatments, such as oxygen therapy and mechanical ventilation.

Social Worker

An interprofessional team member who coordinates services and counsels patients about financial, housing, marital, and family issues impacting healthcare.

Case Method Model

A nursing care delivery model in which one nurse provides total care for one patient during a single shift.

Functional Nursing Model

A care delivery model in which care is compartmentalized and each task is assigned to a staff member based on their specific skill level.

Primary Nursing Model

A care delivery model where one primary nurse plans and manages around-the-clock care for a group of patients throughout their stay.

Team Nursing Model

A care delivery model where a licensed nurse (RN or LPN/LVN) is paired with a nursing assistant to care for an assigned group of patients.

Health Maintenance Organization (HMO)

A managed care model allowing patients to choose a primary care provider to coordinate care, requiring referrals before reimbursing specialist care.

Preferred Provider Organization (PPO)

A form of managed care allowing patients greater choice of in-network providers, medications, and medical devices without strictly requiring primary provider referrals.

Integrated Delivery Network (IDN)

A system combining providers, healthcare facilities, pharmaceuticals, and services into one system where patients must remain within the network to receive care.

State Board of Nursing

The state agency responsible for enacting and enforcing the nurse practice act, determining scope of practice, and protecting public safety.

Direct Nursing Care

Personal care interaction directly between nurses and clients, such as bathing a patient, giving medications, or teaching dressing changes.

Indirect Nursing Care

Activities performed on behalf of clients or unit management without direct patient contact, such as restocking emergency carts or arranging staffing.

Skilled Nursing Care

Care provided by healthcare professionals requiring specialized training, such as IV antibiotic administration, wound dressing changes, and patient teaching.

Critical Thinking

A reflective thinking process in nursing involving collecting, analyzing adequacy and accuracy, and carefully evaluating options for action.

Clinical Judgment

A nursing process involving observing, comparing, contrasting, and evaluating a client's condition to identify changes and determine expected care.

Problem-Solving

A process by which nurses analyze an issue, such as through the nursing process, and attempt to find a satisfactory solution for optimal outcomes.

Which is an example of an illness prevention activity in a community health promotion clinic?

1. Encouraging the use of a food diary

2. Joint a cancer support group

3. Administering immunization for human papillomavirus

4. Teaching a diabetic patient about their diet

3

Illness prevention activities focus on avoiding a specific disease

Which organization can require nurses to obtain a specified amount of continuing education courses for license renewal?

1. ANA

2. NLN

3. Sigma Theta Tau

4. State board of nursing

4

Continuing education is a professional strategy designed to ensure that nurses remain current in their clinical knowledge. Many states require nurses to engage in a certain number of CE.

An experienced nurse uses knowledge of patient medical conditions and intuition to identify patient problems. The nurse often fulfills the role of a resource for other nurses on the unit. At this point, which state of proficiency has this nurse achieved?

1. Novice

2. Advanced beginner

3. Competent

4. Expert

4

Has a deep understanding of the clinical situation based on knowledge and experience. Sense a potential problem in the absence of classic signs and symptoms.

Which statement best explains the importance of standards of practice in the nursing profession?

1. Nurses have the same standards of practice as other healthcare professionals

2. Standards of practice are applied exclusively to nurses working in hospital settings

3. Standards of practice ID the components nurses need to provide safe care

4. Standards of practice differ among RNs based on the population

3

Standards of practice are authoritative statements of the duties that all RNs, regardless of role, population, or specialty, are expected to perform competently. Standards are derived from several sources, including professional organizations and healthcare facilities’ policies and procedures.

Which primary goal of the NLN will most strongly impact a nursing instructors consideration to become a member?

1. Emphasizing the necessity for RNs to promote patient safety

2. Establishing and maintaining identified standards for nursing education

3. Supporting global health policies and improving health worldwide

4. Fostering nursing scholarship, leadership, and service to improve health

2

The NLN was founded to establish and maintain a universal standard of nursing education. The NLN focuses on faculty development in nursing education programs and is the voice for nursing education.

Which type of care will the nurse recognize as the best choice for a patient who experienced a debilitating stroke?

1. Primary care

2. Secondary care

3. Tertiary care

4. Preventative care

3

Primary is acute care (trauma care and acute care surgery, emergency care, urgent care, short-term stabilization, prehospital, critical)

Secondary is rehab over a limited period of time

Tertiary is for long-term care or for those who are dying

The nurse is providing care for an older adult patient in an acute care setting for various age-related health issues. When planning for discharge, the patient states concern about being able to adequately provide for health maintenance and self-care needs. Which type of facility does the nurse recognize as appropriate for this patient?

1. Skilled nursing facility

2. Assisted living facility

3. Nursing home facility

4. Independent living facility

2

Assisted living facilities bridge the gap between independence and institutionalization for older adults who have a decline in health status and cannot live independently. Must be able to perform self-care activities but require assistance with meals, housekeeping, or medications.

Which best describes the most important reason for developing a definition for the profession of nursing?

1. More will be informed about and recruited as a nurse

2. A definition provides a means for evaluating role satisfaction in nurses

3. Stereotypical images about nurses and nursing are dispelled

4. The nursing role is differentiated from the role of other healthcare professions

4

Which outcome demonstrates support for the contribution made by advanced practice nurses within healthcare?

1. Reduced use of diagnostic using advanced tech

2. Decreased number of unnecessary visits to the ER

3. Improved patient compliance with prescribed treatments

4. Increased use of complementary and alternative therapies

3

Studies have demonstrated high client satisfaction with APNs

The nurse is caring for a pediatric patient whose parents express concern about medical costs. The parents state “We have jobs, but we don’t make a lot of money and have no insurance”, which medical assistance program does the nurse recognize as being most appropriate for this family?

1. Children’s health insurance program

2. Medicare

3. Medicaid

4. Local charity

1

CHIP is a venture between the federal government and states

The nurse who is working in a rehab facility has a physician prescription for therapy as needed for the patient. The patient needs assistance with bathing and grooming. Which therapist does the nurse contact to assist the patient to regain these skills?

1. PT

2. OT

3. ST

4. RT

1

PT focuses on rehab of muscles and bones to help clients use assistive devices and gain self-care skills. OTs work closely with them.

An older adult patient is diagnosed with T1DM. The patient can perform self-care activities, but needs help with shopping, meal prep, blood glucose monitoring, and insulin administration. Which type of healthcare facility is most appropriate for the patient?

1. Acute care

2. Ambulatory

3. Extended

4. Assisted living

4

Assisted living facilities are intended for those who are able to perform self-care activities but require assistance with meals, housekeeping, or meds.

Acute= prevent illness and treat acute problems

Ambulatory= outpatient care

Extended care= long-term care

The nurse in the intensive care unit is providing care for only one patient, who was admitted with a diagnosis of septic shock. Which care delivery model is this nurse following?

1. Functional

2. Primary

3. Case method

4. Team

3

One nurse to one patient

The nurse is providing care for a patient who needs extensive actual care; however, the patient is refusing because of financial and family stressors. Which healthcare worker will the nurse consult to counsel this patient?

1. Social worker

2. OT

3. PA

4. Technologist

1

Which type of managed care provides patients with the greatest choice of in-network providers, meds, and medical devices?

1. HMO

2. IDN

3. PPO

4. Employment based

3

HMO= patient chose PCP within org to coordinate care, reimburse after referral

IDN= combine providers, healthcare facilities, pharmacy, and services in one system, patient stays in one system to receive care

Employment= not a managed care org

Which statement by the nurse is the most appropriate to inform the patient about an assisted living facility?

1. Your therapists will work with you daily to help you regain your functional abilities

2. You will be provided with 24 hours nursing care for the next 6 weeks

3. Assistance with meals and housekeeping tasks is available to you

4. A nurse will come to your home and provide you with nursing care

3

Which member of the healthcare team typically serves as the case manager?

1. Social worker

2. Physician

3. PA

4. RN

4

Social= psychosocial support and client services

RN= case managers who provide efficient, good quality, cost-effective care

Which nursing function is considered a primary care service?

1. Providing wound care

2. Admin of childhood vaccines

3. Providing drug rehab

4. Providing outpatient hernia repair

2

Primary= prevent

Secondary= screening

Tertiary= treat

A patient who is 80 years of age is in an acute care facility because of a fractured hip resulting from a fall. Previously, the patient lived at home and managed activities of daily living (ADLs) independently. The patient goal is to return to the previous living style. The patient is to be discharged because of insurance regulations. If the patient cannot walk or provide self-care, to which type of facility will the patient be transferred?

1. Nursing home

2. Rehab center

3. Outpatient therapy center

4. None of these, they should receive home care

2

Rehab center is a skilled facility provided to patients who are expected to improve with treatment

Which characteristic is common among all pathways to achieve initial licensure to practice as an RN?

1. All graduates meet minimum criteria on the NCLEX-RN exam

2. Certifications allowing medication admin are complete

3. Licensure indicates qualifications to practice in acute or long-term care

4. Initial licensure can be for standard or advanced practice roles

1

A nurse who has been practicing for 3 years is caring for post surgical patient. The nurse observes an abnormal change in vital signs and associates these changes with a postoperative bleeding problem. Which level of proficiency is the nurse demonstrating?

1. Advanced beginner

2. Competent

3. Proficient

4. Expert

2

Advanced beginner- can find the abnormal issue, but struggles to figure out significance

Expert- can recognize a problem without signs and symptoms

Proficient- recognizes problems but will immediately gather resources to initiate treatment, no evidence this nurse took action

Which agency is responsible for each state’s nursing practice act?

1. ANA

2. Institute of medicine

3. State board of nursing

4. NLN

3

During orientation to their new position, the nurse is given a chart describing each person’s role on the assigned unit. The chart shows that RNs are responsible for all admission and discharge assessments and patient treatments. Licensed practical nurses admin meds and CNAs obtain vital signs and perform personal care. Which model of care does the nurse recognize?

1. Case method

2. Team

3. Primary

4. Functional

4

Case- one on one

Team- nurse is paired with LPN or can

Primary- one nurse manages care for a group of patients

Which trend is a primary cause for changes in the nursing profession?

1. The expected increase in the number of older adults

2. The large amount of medical info that is technically accessible

3. The increasing demands for more medical care from all aspects of society

4. The multiple medical care expectations implemented by the government

1

A patient is preparing to be discharged after total knee replacement. The patient tells the case manager “I feel pretty good, but I am having a hard time getting in and out of the bathroom”. Which is the most appropriate response?

1. I’ll be sure to teach your family how to help you with this

2. Once you are home for a while, it will get easier

3. I can have a recreational therapist help you take your mind off your concerns

4. A PT can be ordered to assist you in this area

4

An older adult is preparing for discharge and tells the case manager “I don’t know what I am going to do when I get home. I cannot afford the medications the doctor has ordered for me”. What is the most appropriate response?

1. We can have a social worker see you when you get home

2. Medications are expensive, but you will need to take them

3. I will check if some of the medications can be discontinued

4. The home health nurse will address this when they see you

1

A patient in an ambulatory clinic asks the nurse, “why does every visit cost me $10 even though I have insurance”. Which is the most appropriate response?

1. I am not involved in your insurance; you will need to contact the insurance company

2. Let’s check if this is a copayment described by your insurance plan for each visit

3. Healthcare is expensive and insurance companies can’t pay all the costs

4. This charge is actually part of the insurance premium that you pay monthly

2

The nursing staff on a surgical unit expresses to the manager concerns about not having enough time to complete all wound care and dressing changes. Which is the initial action the manager takes?

1. Decrease the patient-to-nurse ratio within budget

2. Offer an in-service session on the time management strategies

3. Suggest a continuing quality improvement committee to assess the issue

4. Report the concerns to the director of nurses at the next meeting

3

TQM (also known as CQI) projects assist in looking at all aspects of quality and safe care practices.

Which activities are included in direct nursing care? Select all that apply

1. Bathing a patient

2. Admin a med

3. Teaching a patient to change a wound dressing

4. Making work assignments for the shift

5. Evaluating patient programs toward the goals

1,2,3

Direct= personal interaction between nurses and clients

Indirect= working on behalf of an individual, group, family, or community to improve their health status

Which actions by the nurse are considered “skilled nursing care”? Select all that apply

1. Changing a wound dressing

2. Assisting with bathing and grooming

3. Monitoring IV antibiotics admin

4. Teaching a patient how to use a blood glucose monitor

5. Helping a patient to get dressed

1,3,4

Skilled nursing care includes services offered by healthcare professionals that are needed for a limited period of time after an injury or illness. Clients are expected to improve. Things like bathing and grooming are considered custodial care.

To reflect the changes in healthcare and nurses’ expanded roles, the ICN revised the definition of nursing. Which statements are consistent with the revised definition of nursing? Select all that apply

1. Nursing encompasses the autonomous and collaborative care of others

2. Nursing includes the care of ill, disabled, and dying

3. Nursing is involved in shaping health policy and system management

4. Nursing involves the use of the nursing process to plan care

5. Nursing requires knowledge regarding the process of nursing education

1,2,3

According to the ANA, which statements best describe the characteristics of RN? Select all that apply

1. Nursing practice is individualized

2. Nursing practice is similar to medical practice

3. Caring is central to the practice of RN

4. Nurses coordinate care by establishing partnerships

5. Nurses promote health through political involvement

1,3,4

The field of nursing has struggled to prove that nursing is a profession. Which strategies assist in promoting professionalism? Select all that apply

1. Standardizing the educational requirements for entry into practice

2. Mandating uniform CE requirements

3. Guaranteeing that all nurses will obtain employment upon graduation

4. Encouraging participation of nurses in professional orgz

5. Educating the public about the true nature of nursing practice

1,2,4,5

Each US state has its own state board of nursing responsible for protecting the health, safety, and welfare of the general public. The state board of nursing meet these responsibilities by performing which functions? Select all that apply

1. Advocating for nursing student issues

2. Determining the nurse’s scope of practice

3. Enforcing the rules

4. Writing the law that regulate nursing

5. Regulating the number of license nurses

2,3

Advocating for student issues is the job of NSNA, and state boards do not write laws, only determine the scope of practice and enforce laws.

The nurse is preparing a prescription for nursing students about the processes of thinking and implemention that apply to nursing. Which topics will the nurse include? Select all that apply

1. Critical thinking

2. Pain evaluation

3. Clinical judgement

4. Problem-solving

5. Sterile tech

1,3,4

Pain evaluation is part of assessment

Sterile technique is a nursing skill