Leadership Midterm Review

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quizzes 1-4

A current trend is for students to be evaluated to determine whether they demonstrate competence in the actual client care environment or with a standardized patient. This process occurs in addition to or instead of traditional pencil-and-paper evaluations. This type of evaluation is referred to as: (Points : 1)

performance-based assessment.

2. Although the use of technology and the Internet provides nursing faculty and students with unlimited resources and current information, an outcome associated with this trend is that: (Points : 1)

users of electronic resources spend a disproportionate amount of time looking for pertinent content.

3.The first university to offer nursing graduates a baccalaureate degree was:
(Points : 1)

Yale University.

4. Which trend is an effect of the nursing shortage on nursing education? (Points : 1)

Students may be assigned to preceptors who have not yet developed expertise in the field of interest.

5. The NCLEX examination is created and administered by the: (Points : 1)

National Council of State Boards of Nursing (NCSBN).

6. A student is planning to enroll in prerequisite courses after graduating from high school and is researching options for nursing programs. During a career fair the student compares different types of nursing education programs and discovers that: (Points : 1)

master's programs such as that for the clinical nurse leader provide entry into practice with a focus on interdisciplinary and bedside nursing care for complex client populations.

7.When preparing to complete a competency exam involving a neurologic assessment in a simulation laboratory, the nurse reviews the critical elements, which consist of:
(Points : 1)

essential principles that must be incorporated into the assessment that are established by practice standards.

8. An RN with a diploma preparation wants to participate in decisions about health care and decides the first step is to obtain a BSN. The nurse enrolls in a nursing program offering a flexible program online. This nurse is taking advantage of: (Points : 1)

educational mobility through a distance or mobility program.

9. A nursing student scores 95% on the written examination for the adult health course. To be successful in this course, this same student must then perform an indwelling catheter insertion and wound care in a simulated environment meeting core competencies. The student asks, "What are core competencies?" The nursing instructor replies, "Core competencies are: (Points : 1)

those skills necessary for safe competent nursing practice.

10. The advanced practice nurse who is seeking information about requirements for practice in a specialized area should contact the: (Points : 1)

American Nurses Credentialing Center (ANCC).

11. The primary purpose of licensure for RNs is to: (Points : 1)

protect the public.

12. Nurse practice acts:
(Points : 1)

are written and passed by legislators.

13.To ensure that nursing legislation is current and is reviewed by specific dates, if a nurse practice act fails to be reviewed, it is automatically rescinded under which law?
(Points : 1)

Sunset legislation

14. Current trends in telecommunications and increased mobility of nurses have led to approval of a mutual recognition model of nursing regulation, in which nurses are allowed to practice in states that are compact states without obtaining a license in each state. On which website would a nurse find a list of current compact states? (Points : 1)

National Council of State Boards of Nursing (NCSBN)

15. The first field of nursing to certify practitioners was the field of: (Points : 1)

nurse anesthesia.

16. A graduate of a nursing school in the United States plans to practice nursing in Paris, France. To request licensure to practice in Paris, the nurse: (Points : 1)

should contact the International Council of Nurses or the nursing regulatory board of that country.

17. A nurse who is licensed in Georgia and moves to Oregon:
(Points : 1)

must check Oregon's nurse practice act related to licensure for endorsement.

18.When practicing in a compact state:
(Points : 1)

nursing scope of practice is defined by the state nurse practice act for the state where the nurse is practicing.

19. A nurse holds a license in one state but wishes to practice in a second state that is not participating in a nurse licensure compact agreement. The nurse is granted licensure on payment of a fee but does not retake the licensure exam. The nurse obtains licensure in the second state: (Points : 1)

by licensure and by endorsement.

20. When participating in a nurse licensure compact, the nurse:
(Points : 1)

is held responsible for complying with the nursing practice laws in the state where practicing at the time care is rendered.

1. An older adult client was admitted to the hospital with the condition classified as "pneumonia." Reimbursement was based on a predetermined fixed price. This classification system is referred to as:
(Points : 1)

diagnosis-related groups (DRGs).

2. Diagnosis-related groups (DRGs) have attempted to reduce health care costs by decreasing: (Points : 1)

length of hospital stay.

3. The precise classification of clients according to the highest diagnosis-related group (DRG) has created a new role for nurses, referred to as: (Points : 1)

utilization review nurse.

4. When reviewing the literature on the effects of Medicaid on health care for the poor, the nurse researcher found that the poor: (Points : 1)

lack consistent providers.

5. Lack of insurance, uninsured populations, and uncompensated care are covered by charging more to those who can pay. This practice is referred to as:
(Points : 1)

cost shifting.

6. A student nurse is beginning her community health rotation. She anticipates that her assignment in community-based health care will most likely be at which of the following organizations? (Points : 1)

High school

7. The most important competency in community nursing is which of the following?
(Points : 1)

Caregiver

8.Vulnerable populations of patients are those who are more likely to develop health problems as a result of which of the following?
(Points : 1)

substance abuse

9. Which of these patients being discharged by the acute care nurse meets the requirements for Medicare reimbursement for home health services?
(Points : 1)

A 65-year-old patient with multiple sclerosis and severe weakness who requires sacral dressing changes

10. A client is admitted with chest pain. A series of diagnostic tests are ordered, and the client undergoes coronary artery bypass grafting. The cost of care for this client is increased because of a four-pack-per-day smoking history that resulted in extension of the client's intensive care unit (ICU) stay by 3 days because of respiratory problems. The case manager realizes that under the terms of the diagnosis-related group (DRG) payment system for this diagnosis:
(Points : 1)

although the cost of care for this client was greater than the DRG reimbursement amount, the hospital will be reimbursed only at the set fee.

11. A 78-year-old patient hospitalized for surgical repair of a fractured hip has recovered from the surgery but continues to have a nursing diagnosis of impaired physical mobility related to decreased muscle strength. The nurse will anticipate transferring the patient to (Points : 1)

a transitional care setting.

12. Which of these nursing activities is appropriate for the home care RN who is caring for a newly diagnosed diabetic patient to delegate to a home health aide? (Points : 1)

Taking the patient's vital signs before a daily bath.

13. In describing home care services to a patient requiring extended care, the nurse tells the patient that (Points : 1)

the patient's family will be included in planning and teaching about the patient's care.

14. The home health nurse visits a diabetic patient who has an infected heel wound to perform daily dressing changes and wound assessment. The nursing diagnosis of impaired tissue integrity is developed for the patient. To evaluate the patient outcome, the nurse will collect data about (Points : 1)

the wound appearance and patient temperature.

15. A young mother has detected a lump in her breast, and because she lives at the poverty level, she is covered under Medicaid. This individual: (Points : 1)

is more likely to participate in mammography screening than are individuals covered by private insurance.

16. A client who is reading a newspaper asks, "This article about health care states that many providers of health care lack effectiveness. What is the difference between this and efficiency?" The nurse explains that: (Points : 1)

effective means peforming the correct test or intervention, whereas efficiency refers to the wise use of supplies and resources for the desired outcome.

17. The teen pregnancy rate in one community significantly increased, and, as a result, the school system was seeing an increase in the drop-out rate of teenage mothers. A student nurse recently worked with the local school system to develop a day care program for the children of high school students so that they could return to school. This is an example of which of the following? (Points : 1)

Responding to changes within the community

18. A 56-year-old recent immigrant from the Czech Republic has diabetes and hypertension. She lives with her daughter whose job requires her to travel. The community health nurse knows that she may be a vulnerable patient because of which of the following? (Points : 1)

her immigration status

19. Which of these patients should the nurse refer for Medicare-reimbursed home health services? (Points : 1)

A 79-year-old who needs help with medications

20. What is the primary characteristic of a community health nurse?
(Points : 1)

Providing care to subpopulations

1. All hospitals receiving Medicare and Medicaid funds must ask clients whether they have a living will or a durable power of attorney. This act is known as: (Points : 1)

Patient Self-Determination Act.

A client states, "I am leaving. No one here knows what they are doing." The nurse completing the Against Medical Advice form must: (Points : 1)

inform the client that leaving could result in complications and impairment.

3. When differentiating between slander and libel, the nurse knows that libel: (Points : 1)

results from defamation caused by subjective comments written in the nurse's notes.

4. When can a nurse detain a client by using restraints? (Points : 1)

There are current physician orders following a medical evaluation.

5. A nurse who functions in the role of team leader can be held negligent for matters involving: (Points : 1)

delegation of client care tasks.

6. A client arrives in active labor and exhibits toxemia with irregular fetal heart tones. The client is an immigrant and is uninsured. Which act would prevent the client from being transferred to another facility? (Points : 1)

Emergency Medical Treatment and Active Labor Law

7. Which statement regarding informed consent is correct? Informed consent: (Points : 1)

allows the RN to communicate information needed so that informed consent can be provided.

8. A family requests that no additional heroic measures be instituted for their terminally ill mother who has advance directives in place. The nurse respects this decision in keeping with the principle of: (Points : 1)

autonomy.

9. The physician who insists on providing treatment in spite of the client's wishes because he "knows best" is reflecting: (Points : 1)

paternalism.

10. The nurse who admits making a medication error and immediately files an incident report is demonstrating: (Points : 1)

accountability.

11. A 13-year-old female is brought to the family planning clinic by her enraged father, who has just learned that she is pregnant. The pregnant client states, "I want to have this baby and give it up for adoption;" however, the father is adamant that she will disgrace the family and demands that the health care providers tell his daughter that she has a physical condition that would prohibit her from carrying this baby to a viable stage. The nurse realizes that this is a conflict that involves the ethical principle of: (Points : 1)

veracity

12. Three illegal immigrants with no health insurance or money sustained life-threatening injuries during an automobile accident. Two of these individuals had head trauma and lacerated internal organs. The decision was made to provide extended care in the trauma center after emergency surgery was performed to save their lives. The third individual received only minor injuries, which were treated in the emergency department. The care of the two critical clients was based on the ethical principle of: (Points : 1)

deontology.

13. In attempting to decide which services should be offered to a community, the public health nurse decides to implement hypertension screening and treatment because most of the residents are hypertensive. This decision is based on the principle of: (Points : 1)

utilitarianism.

14. Political action committees (PACs) are established for the purpose of: (Points : 1)

persuading policymakers to support certain policies.

15. A nurse would like to obtain background information and learn the political platform of a candidate who is running for national office. The nurse should contact the: (Points : 1)

American Nurses Association Nurses Strategic Action Team (N-STAT).

16. Throughout the history of health care in our nation, one particular piece of federal legislation provided funds for hospital construction. As the number of hospitals rapidly increased, the need for nurses to staff hospitals also increased, and the shift from community-based nursing care to hospital-based nursing care began. This fundamental piece of legislation was the: (Points : 1)

Hill-Burton Act.

17. A concerned nursing student calls the office of an elected official to voice support for the bill to ban smoking in all public places. The secretary asks, "Are you a constituent?" What does the term constituent mean? (Points : 1)

A citizen who is registered and is eligible to vote for a representative

18. Time is becoming crucial for the nurse to address issues related to sponsoring programs to include hearing aid costs as part of Medicare coverage. The nurse involved in grassroots political actions realizes that the least timely mode by which to reach elected officials would be via: (Points : 1)

letter.

19. A bill is pending in the state legislature that will mandate teaching health promotion related to smoking cessation. Which action by the nurse should have the greatest impact on passage of the bill? (Points : 1)

Contact the elected representative's office by phone to request support for the bill.

20. When the policy process is compared with the nursing process, identifying the issue is consistent with which step of the nursing process? (Points : 1)

Diagnosis

1. A hospital standard states, "All intravenous (IV) sites must be rotated every 72 hours." The nurse who assesses and records variations from this standard is fulfilling which role of nursing?

Quality management

2. A bronze statue of a nurse in battle fatigues who is obviously exhausted but demonstrates caring by holding a soldier's head is an artistic representation of nurses who served in which war?

Vietnam War

3. A nurse notices that care is often withheld until an interpreter arrives, if the nurse is not multilingual. The nurse discusses this with the management team and suggests a three-part series be presented to the nursing staff to teach some commonly used medical terms in Spanish.

change agent

4. Although the media portrayed nursing in a negative light in MAS*H through the character of a promiscuous, uncaring nurse, it also showed Americans:

the ability of nurses to cope with the dreadfulness of war by using humor

5. World War I contributed to the advancement of health care by:

introducing specialists in nursing such as nurse anesthetists

6. A nurse working in a factory performs routine hearing tests for employees. The factory uses 90 dB as the safe limit for an 8-hour day's exposure to machine noise rather than 85 dB as recommended by the Occupational Safety and Health Administration. The nurse is function in the role of:

occupational health nurse

7. Potential nursing students are concerned about choosing a profession with job security and ask, "Because more people are choosing nursing, will I have a job in a few years?" The nurse answers, on the basis of the U.S. Bureau of Labor Statistics prediction, that by 2020,

the total number of RNs will not meet the demand for the workforce number required.

8. What historical event first led to the realization of the contribution of African-Americans to nursing?

Mary Seacole's efforts to care for soldiers during the Crimean War

Which bill provided for construction of hospitals?

Hill-Burton Act

10. An RN testifies at a trial where domestic violence is being investigated. She had previously assisted with specimen collection and had assessed the victim. The nurse is involved in:

forensic nursing

11. The primary focus of the care provider role for the nurse involves:

assessing the client to plan care based on the client's needs

12. What is the purpose of the Nurse Reinvestment Act of 2002?

Focuses on nurse retention and safety enhancement grants

Clara Barton is known for:

founding the American Red Cross

14. With the crisis in health care and the nursing shortage, why is the image of nursing still important?

Nursing care is often delivered during a time of uncertainty, and the image of nurses during this time can reinforce trust in the nurse-patient relationship.

15. Occupational health nursing features beliefs similar to those of which early nursing pioneer?

Lillian Wald

16. Charles Dickens' character Sairy Gamp:

chose nursing because she had no other avenue for employment.

17. What does the Spirit of Nursing statue honor?

All military nurses for their bravery and compassion

18. The practice of public health nursing and the Henry Street Settlement are credited to:

Lillian Wald.

19. A nurse in an acute care facility helps patients understand how to prevent diabetic neuropathies. This nurse is functioning in the role of:

educator.

20. Which item below correctly describes the U.S. Bureau of Labor Statistics predictions by 2020?

The job growth rate for RNs will surpass job growth in all other occupations.

Understand that Medicaid is funded by both state and federal governments but vary from state to state.

...

Know what a constituent is-

A citizen who is registered and is eligible to vote for a representative

What is the purpose of political action committees-

persuading policymakers to support certain policies

Identifying an issue is consistent in diagnosis of the nursing process

...

What is the issue is the-

first question when assessing an ethical situation

Review informed consent-

must reveal expected benefits

The number of men working as Rns has increased to 5.7%

...

Review how DRG's can affect a pts reimbursement related to the patients health habits prior to hospitalization-

although the cost of care for this client was greater than the DRG reimbursement amount, the hospital will be reimbursed only at the set fee.

What is cost shifting-

Lack of insurance, uninsured populations, and uncompensated care are covered by charging more to those who can pay.

Medicaid can affect the patients ability to have a consistent provider

...

How did DRGs effect the length of hospital stay-

Decreasing length of hospital stay

Review what a DRG is about-

Diagnosis Related Groups

Know what the first field of nursing to certify practitioners-

anesthesia

Sunset legislation rescinds nurse practice acts that fail to be reviewed

...

Legislators wire and pass nurse practice acts

...

Primary focus of the nursing care provider is to utilize the nursing process

...

Nurses and physicians should work together to provide improved patient safety and reduce errors.

...

Core competencies are skills necessary for competent nursing care

...

A nurse that enrolls in a nursing program offering self scheduling and self-paced curriculum Is looking for educational mobility.

...

Masters programs focus on interdisciplinary and bedside nursing care for complex client populations

...

Care coordination, direct care for complex clients, and outcome evaluation should be the focus on 21st nursing care

...

Yale was the first university to offer graduates a baccalaureate degree

...

Outcomes in nursing is the current focus in nursing education

...

The use of technology and the electronic health care record causes nurses to spend more time on the computer than with patients

...

Performance based assessment is important to assess the students knowledge in the clinical setting

...

To combat the nursing shortage we must advocate for better funding of nursing education

...

The nursing shortage gives the image of nursing the ability to reinforce trust in the nurse-pt relationship

...

The series MAS*H, portrayed the ability of nurses to cope with war by use of humor

...

Military nurses are honored by the Spirit of nursing statue.

...

It is predicted that the total number of RNs will not be able to meet the demand for the workforce number needed.

...

Focus on nurse retention and safety enhancement was the purpose of the nurse reinvestment act of 2002.

...

Vietnam War was the inspiration for a bronze statue of a nurse representing the courage and dedication

...

Nurse Clara Mass died from yellow fever during the Spanish American war after being bitten by fever carrying mosquitoes in order to save soldiers lives.

...

By 2020 it is predicted that the job growth rate for RN's will be greater than any other profession

...

Prehistoric times and the middle ages utilized herbs in treatments of illness.

...

The Commission on Collegiate Nursing Education is the accrediting body of nursing programs

...

The historical perspective of nursing practice was to meet the needs of individuals and different populations.

...

The economy and concern for health care in the nation led to the demand for advanced practice nurses in the 1980s and 1990s.

...

Social Security Act of 1935 was meant to provide a national insurance system for older adults

...

What is universal health and how is it different from a one payer source-

A health care system is often both single payer and universal. Under such a system, all citizens would have health insurance (the "universal" part) and the funding for all citizens' health insurance would come from a single, usually public or quasi-public, source. This is how the health care systems in Great Britain and Canada work. Though the system is both single payer and universal, the terms mean different things: one refers to the source of funding for health care, while the other refers to the level of health care coverage.

punitive damages-

are intended to punish a wrongdoer and deter others from similar wrongdoing.

national patient safety movement is-

For more than 60 years, The Joint Commission has been a champion of patient safety by helping health care organizations to improve the quality and safety of the care they provide. Our many patient safety-focused initiatives encourage and support organizations in their efforts to make patient safety a continuous priority

Beneficence-

the doing of good; active goodness or kindness; charity.

Nonmaleficence-

a principle of bioethics that asserts an obligation not to inflict harm intentionally. It is useful in dealing with difficult issues surrounding the terminally or seriously ill and injured. Some philosophers combine nonmaleficence and beneficence, considering them a single principle.

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