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WorksheetsNCM 103 Lec Activity 1
Total questions: 100
Worksheet time: 8hrs 20mins
A nurse with 2 to 3 years of experience who can coordinate multiple complex nursing care demands is at which stage of Benner’s nursing expertise.
Advanced beginner
Competent
Proficient
Expert
Which professional organization developed a code for nursing students.
ANA
NLN
AACN
NSNA
Which social force is most likely to significantly impact the future supply and demand for nurses.
Aging
Economics
Science/technology
Telecommunications
A registered nurse is interested in functioning as a health care advocate for individuals whose lives are affected by violence. This nurse will be investigating which expanded career role.
Clinical nurse specialist
Forensic nurse
Nurse practitioner
Nurse educator
Which of the following is the lowest level of “best evidence” for evidence‑based practice.
Clinical experiences
Opinions of experts
Client values and preferences
Trial and error
A quantitative research approach is most appropriate for which study.
A study measuring the effects of sleep deprivation on wound healing
A study examining the bereavement process in spouses of clients with terminal cancer
A study exploring factors influencing weight control behavior
A study examining a client’s feelings before and after a bone marrow aspiration
A qualitative research approach is most appropriate for which study.
A study measuring nutrition and weight loss or gain in clients with cancer
A study examining oxygen levels after endotracheal suctioning
A study examining client reactions to stress after open heart surgery
A study measuring differences in blood pressure before, during, and after a procedure
A key function of a study’s methodology is to.
Determine the hypotheses that will be tested in the study
Exercise control over contaminating factors in the study environment
Identify grants and other funding sources for conducting the study
Protect the rights of the study’s participants
In the PICO format for phrasing research questions and identifying key terms for a literature search, what does the “P” stand for.
Patterns
Population
Probability
Purpose
Which of the following is a nursing responsibility when reading published nursing research.
Assume that the research was properly conducted since it has been published
Evaluate whether the findings are applicable to the nurse’s specific clients
Implement the research findings if at least two studies have shown the same results
Request the raw data from the researchers so that the nurse can analyze the statistics again
A research critique can best be defined as an.
Appraisal of a study’s strengths and weaknesses
Conclusion about the utilization potential of a study’s findings
Criticism of a study’s flaws
Summary of a study’s key points
An 85‑year‑old client in a nursing home tells a nurse, “Because the doctor was so insistent, I signed the papers for that research study. Also, I was afraid he would not continue taking care of me.” Which client right is being violated.
Right not to be harmed
Right to full disclosure
Right to privacy and confidentiality
Right to self‑determination
Place each of the following steps of evidence‑based practice change in their usual sequence: Locate the best evidence; Ask the clinical question; Assess the need for change; Integrate the change with client preferences; Analyze the evidence; Implement and evaluate the change.
3 → 2 → 1 → 5 → 4 → 6
2 → 3 → 1 → 5 → 4 → 6
3 → 1 → 2 → 5 → 4 → 6
2 → 1 → 3 → 5 → 4 → 6
A nurse proposes that the hospital apply the findings from a recent research study that shows that clients appreciate classical orchestra music and that playing it frequently lowers clients’ blood pressure. Which aspect of research suggests that it may not be appropriate to implement this as evidence‑based practice.
All research is flawed
The research would not have taken into consideration the cost of acquiring and playing the music in a hospital
One study would not be sufficient to show that all clients would find orchestral music pleasing
Research cannot demonstrate clients’ appreciation of music since research is only appropriate for physiological problems
“A supposition or system of ideas that is proposed to explain a given phenomenon” best defines which of the following.
A concept
A conceptual framework
A theory
A paradigm
“A group of related ideas or statements” best defines which of the following.
A philosophy
A conceptual framework
A theory
A paradigm
“A set of shared understandings and assumptions about reality and the world” is a definition for which of the following.
A concept
A conceptual framework
A practice discipline
A paradigm
Which provides the best explanation for describing nursing as a practice discipline.
Nursing focuses on performing the professional role
It takes time and experience to become a competent nurse
Research and theory development is a central focus
Nurses function as members of a team who form a practice group
Person, environment, health, and nursing constitute the metaparadigm for nursing because they do which of the following.
Provide a framework for implementing the nursing process
Can be utilized in any setting when caring for a client
Can be utilized to determine applicability of a research study
Focus on the needs of a group of clients
Which is an accurate statement about the role of nursing theory.
Practice theories assist nurses to reflect on the effectiveness of what they do
Midlevel theories, describing the interrelationships among a broad range of concepts within nursing, have been well tested through nursing research
All schools of nursing in the United States are organized around one of the conceptual models described in this chapter
Nursing theory guides the direction of research but not that of education or practice
The purpose of theory in science is to.
Build a rationale for programs of research
Explain why scientists do what they do
Help scientists interpret phenomena
Distinguish science from art
A primary care provider’s orders indicate that a surgical consent form needs to be signed. Because the nurse was not present when the primary care provider discussed the surgical procedure, which statement best illustrates the nurse fulfilling the client advocate role?
“The doctor has asked that you sign this consent form.”
“Do you have any questions about the procedure?”
“What were you told about the procedure you are going to have?”
“Remember that you can change your mind and cancel the procedure.”
Although the client refused the procedure, the nurse insisted and inserted a nasogastric tube in the right nostril. The administrator of the hospital decides to settle the lawsuit because the nurse is most likely to be found guilty of which of the following?
An unintentional tort
Assault
Invasion of privacy
Battery
A nurse discovers that a primary care provider has prescribed an unusually large dosage of a medication. Which is the most appropriate action?
Administer the medication.
Notify the prescriber.
Call the pharmacist.
Refuse to administer the medication.
A primary care provider prescribes one tablet, but the nurse accidentally administers two. After notifying the primary care provider, the nurse monitors the client carefully for untoward effects, of which there are none. Is the client likely to be successful in suing the nurse for professional negligence?
No, the client was not harmed.
No, the nurse notified the primary care provider.
Yes, a breach of duty exists.
Yes, foreseeability is present.
A nursing student is employed and working as an unlicensed assistive personnel (UAP) on a busy surgical unit. A nurse asks the UAP to perform a urinary catheterization. What is the best response by the UAP?
“Let me get permission from the client first.”
“Sure. Which client is it?”
“I can’t do it unless you supervise me.”
“I can’t do it. Is there something else I can help you with?”
The primary care provider wrote a do-not-resuscitate (DNR) order. The nurse recognizes that which applies in the planning of nursing care for this client?
The client may no longer make decisions regarding health care.
The client and family know the client will most likely die within 48 hours.
Nurses will continue to implement all treatments focused on comfort and symptom management.
A DNR order from a previous admission is valid for the current admission.
The nurse’s partner/spouse undergoes exploratory surgery at the hospital where the nurse is employed. Which practice is most appropriate?
Access to the chart is allowed because the nurse is an employee.
The relationship provides special access to the chart.
Access to the chart requires a signed release form.
The nurse can ask the surgeon to discuss the outcome of the surgery.
Following a motor vehicle crash, a nurse stops and offers assistance. Which actions are most appropriate? (Select all that apply.)
The nurse needs to know the Good Samaritan Act for the state.
The nurse is not held liable unless there is gross negligence.
After assessing the situation, the nurse can leave to obtain help.
The nurse can expect compensation for helping.
The nurse offers to help but cannot insist on helping.
The nurse notices that a colleague’s behaviors have changed during the past month. Which behaviors could indicate signs of impairment? (Select all that apply.)
Increasingly absent from the nursing unit during the shift.
Interacts well with others.
“Forgets” to sign out for administration of controlled substances.
Offers to administer PRN opioids for other nurses’ clients.
Is able to say “no” to requests to work more shifts.
Which nursing actions could result in professional negligence? (Select all that apply.)
Learns about a new piece of equipment.
Forgets to complete the assessment of a client.
Does not follow up on client’s complaints.
Charts client’s drug allergies.
Questions the primary care provider about an illegible order.
Which of the following is an example of a primary prevention activity?
Antibiotic treatment of a suspected urinary tract infection
Occupational therapy to assist a client in adapting his or her home environment following a stroke
Nutrition counseling for young adults with a strong family history of high cholesterol
Removal of tonsils for a client with recurrent tonsillitis
Which of the following statements is true regarding types of health care agencies?
Hospitals provide only acute, inpatient services.
Public health agencies are funded by governments to investigate and provide health programs.
Surgery can only be performed inside a hospital setting.
Skilled nursing, extended care, and long-term care facilities provide care for older adults whose insurance no longer covers hospital stays.
In most cases, clients must have a primary care provider in order to receive health insurance benefits. If a client is in need of a primary care provider, it is most appropriate for the nurse to recommend which of the following?
Family practice physician
Physical therapist
Case manager/discharge planner
Pharmacist
The most significant method for reducing the ongoing increase in the cost of health care in the United States includes controlling which of the following?
Number of children according to the family’s income
Numbers of uninsured and underinsured persons
Number of physicians and nurses nationwide
Competition among drug and medical equipment manufacturers
A client is seeking to control health care costs for both preventive and illness care. Although no system guarantees exact out-of-pocket expenditures, the most prepaid and predictable client contribution would be seen with which of the following?
Medicare
An individual fee-for-service insurance
A preferred provider organization (PPO)
A health maintenance organization (HMO)
The ANA’s Health System Reform Agenda (2008) included which of the following?
Primary health care should be based in acute care hospitals.
A minimum standard of health care for all persons should be paid for completely with public funds.
Case management should be focused on clients with enduring health care needs.
Essential services should be initiated simultaneously to avoid gaps.
The Pew Commission competencies for future practitioners included the need for providers to become skilled in which of the following?
Use of technology
Emphasizing practice in tertiary settings
Traditional clinical approaches
Making decisions for incompetent clients
Which of the following is characteristic of nursing care provided in community-based health?
Clients are primarily those with identified illnesses.
Clients are individuals in groups according to their geographic commonalities.
Care is paid for by the community as a whole rather than by individuals.
All clients are case managed.
When performing collaborative health care, the nurse must implement which of the following?
Assume a leadership role in directing the health care team.
Rely on the expertise of other health care team members.
Be physically present for the implementation of all aspects of the care plan.
Delegate decision-making authority to each health care provider.
The nurse concludes that effective discharge planning (hospital to home) has been conducted when the client states which of the following?
“As soon as I get home, the nurse will come out, look at where I live, and see what kind of care I will need.”
“All I need are my medications and a ride home. Then I’m all ready for discharge.”
“When I visit my doctor in 10 days, they will show me how to change my bandages.”
“I have the phone numbers of the home care nurse and the therapist who will visit me at home tomorrow.”
A large disaster in a community resulted in the destruction of many family homes and many individuals were injured. The assistance of community health nurses and home health nurses is needed. The home health nurse is most likely to perform which of the following?
Provide for a safe water supply.
Monitor for communicable diseases.
Establish communication and support systems.
Assess and treat individual clients.
A nurse and a primary care provider inform a client that chemotherapy is recommended for a diagnosis of cancer. Which nursing action is most representative of the concept of holism?
Offer to come to the client’s home to provide needed physical care.
Contact the client’s spiritual adviser.
Inquire how this will affect other aspects of the client’s life.
Provide the client with information about how to join a support group.
A nurse is planning a workshop on health promotion for older adults. Which topic will be included?
Prevention of falls
Cardiovascular risk factors
Adequate sleep
How to stop smoking
While hospitalized, a client is very worried about business activities and spends a great deal of time on the phone instead of resting. Which principle of need theory applies to this client?
His higher level need cannot be met unless the lower level physiological need is met.
His lower level physiological needs are being deferred while higher needs are addressed.
The higher need takes precedence and the lower need no longer must be met.
It is necessary for someone else to meet his higher level needs so he can focus on the lower level needs.
Which statement by the client best represents the contemplation stage of the stages of behavior change?
“I currently do not need to exercise and do not intend to start in the next six months.”
“I have tried several times to exercise 30 minutes three times a week but am seriously thinking of trying again in the next month.”
“I currently do not exercise 30 minutes three times a week, but I am thinking about starting to do so within the next six months.”
“I have exercised 30 minutes three times a week regularly for more than six months.”
A client who is 46 pounds overweight states, “I was just born to be fat. I don’t have the willpower.” According to the Health Promotion Model, the nurse should focus on which behavior-specific cognition and affect variable?
Perceived barriers to action
Perceived self-efficacy
Interpersonal influences
Situational influences
Which of the following are overarching goals of Healthy People 2020? Select all that apply.
Raise the education and literacy level.
Increase quality and years of healthy life.
Eliminate health disparities.
Distribute health-related information.
The nurse assisting a client in the action stage of change would use which strategy?
Reinforce the importance of providing rewards for positive behavior.
Ask the client if he or she would like information.
Guide the client to create a plan of action.
Which is the best response by the nurse if a client fails to follow the information or teaching provided?
Give up, because the client doesn’t want to change.
Develop a tough approach.
Reteach the information, because the nurse is the expert.
A client admitted for heart failure has low blood pressure and an apical pulse of 110 bpm. This increase in pulse illustrates which aspect of homeostatic mechanism?
Compensation
Decompensation
Self-regulation
Using Maslow’s framework, which statement characterizes the highest level of need?
“Nurse, my pain is severe…is it time for my shot?”
“I felt welcomed when I first joined the group and I look forward to the monthly meetings.”
“I’m very proud of receiving the Employee of the Month award.”
Which one of the following is an example of the emotional component of wellness?
The client chooses healthy foods.
A new father decides to take parenting classes.
A client expresses frustration with her partner’s substance abuse.
Which individual appears to have taken on the sick role?
An obese client states, “I deserve to have a heart attack.”
A mother is ill and says, “I won’t be able to make your lunch today.”
A man with low back pain misses several physical therapy appointments.
Because a client recently diagnosed with diabetes mellitus is confident that blood sugar control can be improved with diet and exercise alone and checked out a diabetes management video, the client’s actions are most representative of which model?
Health belief model
Clinical model
Role performance model
Because a client with human immunodeficiency virus is scheduled to begin several medications, which client characteristics are most likely to predict adherence with the treatment program? Select all that apply.
Educational level
A trusting relationship with the health care provider
An expectation that the medications will be helpful
Which one of the following might be the best way to measure adherence to a prescribed medication regimen?
Direct observation of medication administration
Evidence of illness complications or exacerbations
Monitoring laboratory values of elements influenced by the medication
Which of the following is least likely to influence a client’s personal definition of health and wellness?
The client’s ability to perform usual activities
Cultural traditions used in everyday life
Availability and accessibility of health care services
Which of the following is an internal variable affecting health status, beliefs, or practices?
Living situation
Socioeconomic status
Family structure
A client recently diagnosed with a chronic illness asks for help understanding the term chronic. It would be correct for the nurse to say which of the following?
Symptoms are always less severe than with an acute illness.
Chronic illnesses are considered incurable.
Signs and symptoms of chronic illnesses tend to be stable for many years.
Although not every client progresses in order through each stage, which sequence best represents the usual order in Suchman’s stages of illness?
Signs and symptoms appear → The client takes on the sick role → The client makes contact with medical care → The client takes on the dependent role
The client makes contact with medical care → Signs and symptoms appear → The client takes on the dependent role → The client takes on the sick role
Signs and symptoms appear → The client makes contact with medical care → The client goes into rehabilitation and recovery → The client takes on the dependent role
A married mother of three small children has frequent immobilizing headaches of unknown cause. The nurse anticipates the woman may have which possible reactions? Select all that apply.
She feels guilty when unable to perform her usual activities.
She is angry and acting out.
She shifts some responsibilities to the spouse.
The major factor contributing to the increased emphasis on the need for proficiency in cultural nursing practice in the United States is which of the following?
An increasing birth rate
Increased access to health care services
Demographic changes
Which behavior is an initial step in culturally responsive nursing practice?
Help the client recognize the need to adapt health practices to fit commonly accepted practices.
Discuss the meaning of the medical regimen with the client.
Inform the client that lack of adherence to the medical regimen may be detrimental.
In initiating care for a client from a different culture than the nurse, which of the following would be an appropriate statement?
“Since, in your culture, people don’t drink ice water, I will bring you hot tea.”
“Do you have any books I could read about people of your culture?”
“Please let me know if I do anything that is not acceptable in your culture.”
Which behavior is most representative of a culturally competent nurse?
Helps clients of Native American heritage identify ways to relate more to their culture.
Helps parents of Latino heritage recognize that their children need to speak English.
Interprets and validates beliefs of a client with African American heritage.
An outcome of achieving national cultural health goals would be which of the following?
All cultures receive the same health care.
All people have the same life expectancy.
All U.S. residents have access to the same quality of health care.
Which nursing action primarily supports restoring health using traditional methods?
Herbal teas
Prayer
Wearing symbolic objects
A client with strong preferences for folk healing methods would prefer which of the following to treat a sinus infection?
Hospitalization
Steam humidifier
Antibiotic therapy
Which of the following factors are most likely to be influenced by culture as opposed to personal characteristics? Select all that apply.
Value of older people in society
Gender roles
Nonverbal gestures
What is the most productive method of gathering assessment data regarding heritage?
Physical exam
Medical history
Blood analysis
A client who speaks limited English requires instructions for a test. No one at the agency speaks the person’s language. What is the nurse’s best approach?
Provide the instructions in writing.
Locate a professional interpreter.
Ask a family member to translate on the phone.
Which example best illustrates the principle of knowing the client?
The nurse provides a back rub to help the client relax, and then makes the bed with clean linen.
The nurse listens as the client describes how he has been caring for his diabetes at home.
The nurse administers a piggyback antibiotic for a client with pneumonia.
The nurse teaches a client with diabetes how to make decisions about insulin management after discharge. This teaching most clearly reflects which caring activity?
Empowering the client
Compassion
Knowing the client
Mayeroff described allowing the other to grow in his own way and time. This behavior most clearly reflects which major ingredient of caring?
Humility
Knowing
Patience
Courage
Leininger’s theory of culture care diversity and universality would provide the best framework for assessing which nursing situation?
The Indonesian parents of an infant prefer hot/cold therapies to prevent seizures and withhold prescribed phenobarbital.
Staff nurses discuss reorganizing care to provide more continuity of staff with clients.
Nurses search for learning resources about IV therapy in the home setting.
A nurse manager explores ways to assist new graduates in developing clinical skills.
In a reflective journal, a nursing student writes: “The DNR order was not on the chart, and none of the nurses knew what measures should be taken if the client stopped breathing.” This statement most clearly reflects which way of knowing?
Empirical
Personal
Ethical
Aesthetic
The nurse sits with the client and holds the client’s hand as his pain decreases. This situation is an example of which caring practice?
Nursing presence
Assessment
Knowing the client
Empowering the client
Which nursing theory is depicted by a model with spiritual–ethical caring in the center, surrounded by technologic, physical, legal, political, economic, social–cultural, and educational systems?
Nursing as caring
Theory of bureaucratic caring
Caring, the human mode of being
Theory of human care
The nursing student reviews the pathophysiology of myocardial infarction in preparation for clinical practice. This activity is an example of which type of knowledge development?
Empirical knowing
Aesthetic knowing
Personal knowing
Ethical knowing
A nurse sits quietly, breathes deeply, and focuses on a mental image of a crystal. Which mind–body therapy is being used?
Storytelling
Yoga
Music therapy
Meditation
A 40-year-old client asks how much exercise is recommended for a healthy lifestyle. Which response is most appropriate?
Moderate activity for 10 minutes daily
Moderate activity for 20 minutes two to three times a week
Vigorous activity for 25 minutes three days a week
Vigorous activity for 30 minutes daily
A student nurse is caring for a 72-year-old client with Alzheimer’s disease who is very confused. Which is the most appropriate communication strategy to be used by the student nurse?
Written directions for bathing
Speaking very loudly
Gentle touch while providing ADLs
Flat facial expression
Place the following descriptions of the helping relationship phases in the correct sequence. 1) After introductions, the nurse asks, “What plans do you have for the upcoming holiday weekend?” 2) The nurse states, “It sounds like you are concerned about the possible complications of having diabetes. What would be the most helpful for you at this time?” 3) The nurse reads in the medical history that the client was diagnosed with diabetes 1 week ago. 4) The nurse states, “When we met, you knew very little about diabetes and now you are able to use your new information and apply it to your own personal situations.”
1 → 3 → 2 → 4
3 → 1 → 2 → 4
3 → 2 → 1 → 4
1 → 2 → 3 → 4
The nurse who uses appropriate therapeutic listening skills will display which behaviors? (Select all that apply.)
Absorb both the content and the feeling the client is conveying.
Presume an understanding of the client needs.
Adopt an open professional posture.
React quickly to the message.
Reassure the client that everything will be fine.
A nurse tells a client with cancer pain, “It is normal to feel frustrated about the discomfort.” Which skill associated with the working phase of the helping relationship is demonstrated?
Respect
Genuineness
Concreteness
Confrontation
A depressed client has not bathed or dressed in clean clothes and cannot decide from the lunch menu. Which is the most appropriate nursing diagnosis?
Anxiety
Powerlessness
Chronic Low Self-Esteem
Social Isolation
After emergency surgery, an 80-year-old client returns from the postanesthesia room. Which nursing interventions are most likely to facilitate effective communication? (Select all that apply.)
Ask the client, “Do you know where you are?”
Ask the client or support person about visual or learning problems.
Inform the client and support person(s) about events likely to occur during the next 2 hours.
Provide the client with instructions about discharge.
Tell the client, “You will feel better soon.”
The nurse is communicating with a well-oriented older adult in a long-term care setting. Which statement best reflects respectful and caring communication?
“Are we ready for our shower?”
“It’s time to go to the dining room, honey.”
“Are you comfortable, Mrs. Smith?”
“You would rather wear the slacks, wouldn’t you?”
The client states, “My doctor just told me he cannot save my leg and I need an above-the-knee amputation.” Which response by the nurse is most appropriate?
“Dr. Jones is an excellent surgeon.”
“Are you in pain?”
“If I were you, I’d get a second opinion.”
“Tell me more . . .”
The nurse is communicating with a primary care provider about prescribed interventions. Which statement best represents a collaborative relationship?
“That new medication you prescribed for Mr. Black is ineffective.”
“I am worried about Mr. Black’s blood pressure. It is not decreasing even with the new antihypertensive medication.”
“Can we talk about Mr. Black?”
“Excuse me doctor. I think we need to talk about Mr. Black’s blood pressure.”
The nurse asks, “What do you fear most about your surgery tomorrow?” This is an example of which communication technique?
Providing general leads
Seeking clarification
Presenting reality
Summarizing
Which learning activity reflects Bloom’s affective domain?
Administering an injection
Accepting the loss of a limb
Inserting a catheter
Learning how to read
Which is the best method of helping a client newly diagnosed with diabetes learn the dietary requirements associated with the disease?
Provide a videotape that addresses dietary requirements.
Ask a nutritionist to visit and present information and handouts.
Ask the client to make a list of her favorite foods and how to work them into her diet.
Have the client attend a diabetes support group.
A nurse is scheduling a teaching situation. Which client is most ready to learn?
A 45-year-old man just informed he has cancer
A 3-year-old child whose parents are reading a hospital storybook
A 60-year-old woman who received pain medication 5 minutes ago
A 70-year-old man recovering from a stroke who has returned from physical therapy
How can the nurse best assess a client’s style of learning?
Ask the client how he or she learns best.
Use a variety of teaching strategies.
Observe the client’s interactions with others.
Ask family members.
A 74-year-old client who takes multiple medications states, “I have no idea what that little yellow pill is for.” What is the best nursing diagnosis?
Deficient Knowledge
Health-Seeking Behavior
Deficient Knowledge (Medication Information)
Noncompliance
A client is scheduled to have a diagnostic procedure. Which questions are most likely to produce a “teachable moment”? (Select all that apply.)
Have you ever had this procedure before?
What are your concerns about this procedure?
What would you like to know about the procedure?
Are you prepared for this procedure?
What have you heard or read about the procedure?
A client needs to learn to self-administer insulin injections. Which statements reflect possible low literacy skills? (Select all that apply.)
“I will read the information later—I’m too tired right now.”
“I watched my brother give his own shots. I know how to do it.”
“Just show my wife.”
“Do you have a video showing how I should give myself the shot?”
“I don’t understand this one section in the handout.”
A client is admitted with hypertensive crisis due to failure to take prescribed medications. To determine learning needs, which client assessment has the highest priority?
Age
Perception of the effects of hypertension
Ability to purchase needed medications
Support system
