Nursing mid-term and quizzes following.

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

Focuses on nurse retention and safety enhancement grants

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.

After keeping a log of activities designed to improve time management, the nurse divides the distractions into internal and external sources. The nurse would classify which distraction as internal?

Responding to recurring crises at work or in one's personal life

Time can be maximized to produce the best outcomes by:

making the first hour of each workday productive.

A comparison of nursing in the 1980s versus nursing in the 1990s reveals that:

the demand for advanced practice nurses increased in the 1980s and the 1990s as a result of the economy and concern about the health of the nation.

A client asks the nurse, "Can you explain Medicare, an amendment to the Social Security Act?" The nurse responds that Medicare:

ensured that individuals ages 65 and older and those with end-stage renal disease or permanent disabilities had health care insurance.

A nurse plans to move to an area that is rich in immigrants from several countries and is concerned about respecting others' cultural beliefs. The nurse's first step to ensure cultural competence and sensitivity is to:

conduct a cultural self-assessment.

A nurse gives Dilantin intravenously with lactated Ringer's solution containing multivitamins. The drug precipitates and obstructs the only existing line. When the team leader informs the nurse that these drugs cannot be mixed, the nurse states, "Everyone just pushes the medicine slowly. No one checks for compatibility. There isn't even a compatibility chart on the unit." Which type of logical fallacy has influenced the nurse?

Appeal to common practice

A patient's spouse was just diagnosed with lung cancer although there was no history of tobacco use. The spouse states, "I am so mad, how can you get cancer without smoking?" Which statement by the nurse represents empathy?

"I understand how you could feel angry about the diagnosis."

A teenage patient is using earphones to listen to hard rock music and is making gestures in rhythm to the music. The nurse assesses the amount of urine output in the Foley catheter and leaves the room. What communication technique is demonstrated in both of these situations?

Filtration

According to Kramer, nurses in the shock phase should ask themselves:

"What changes can I make to make me feel good about the choice to become a nurse?"

A nurse is interested in practicing in a faith-based community; when researching the role of the parish nurse, the nurse finds that:

this role is recognized by the American Nurses Association (ANA) as a specialty with a defined set of practice guidelines.

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. This nurse is involved in the role of:

change agent.

The first field of nursing to certify practitioners was the field of:

nurse anesthesia.

The primary purpose of licensure for RNs is to:

protect the public.

The nurse who admits making a medication error and immediately files an incident report is demonstrating:

accountability.

The physician who insists on providing treatment in spite of the client's wishes because he "knows best" is reflecting:

paternalism.

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:

deontology.

Which of the following best represents a cognitive distortion:

"I always do badly on tests"

The ANA first official Code for Professional Nurses was adopted during which era?

In 1950 by the ANA House of Delegates

In the future, when computers have become so commonplace that they are unnoticed but are essential to everyday living, we will have entered the era of ____________________ computing.

ubiquitous

When patient-focused clinical information systems (CISs) are compared with department-focused CISs:

the nurse who wishes to review how a patient's plan of care deviated from the established criteria would use the patient-focused CIS.

During a search for the term informatics, when the nurse finds the domain ".edu," the site is affiliated with a(n):

educational institution

A consumer is learning about electronic health records at a local health fair and states, "I am worried that someone can read my health information and I really don't understand the difference between privacy and confidentiality." The nurse explains that an example of confidentiality is as follows:

a pledge states, "I will hold matters pertaining to my patients in strict intimacy."

A nurse is interested in locating reliable information concerning noninvasive blood glucose monitoring. Information is located, and the author is a scientist who conducted studies within the last year on the effectiveness of a particular noninvasive blood glucose monitor. The scientist received funding from a pharmaceutical company to support the studies. The URL indicates the pharmaceutical company site.com. The nurse is concerned about this information's:

objectivity.

A nurse is preparing a presentation using different websites to collect information. The nurse is concerned that contact information and the author's credentials are not listed for one of the websites reviewed. Which criterion required to establish a reputable website is missing?

Authority

When paper-and-pencil medical records are compared with computer-based records:

patients have the right to know that the confidentiality of their records is strictly maintained, regardless of the type of medical record used.

A nurse who is majoring in informatics learns that clinical information systems (CISs) can be department focused rather than patient focused. Department-focused CIS would include:

Blue Cross/Blue Shield, point of service #TN09874.

Consumers are concerned with security issues related to their confidential health information when placed in an electronic health record (EHR). However, when the security of the EHR is compared with that of paper-and-pencil records, the EHR is:
Correct

more secure.

Software programs that process data to produce or recommend valid choices are known as ____________________.

decision support systems

An advanced practice nurse inputs into a computer software program the following clinical manifestations: open wound with tibia exposed, petechial hemorrhage, and temporary loss of consciousness. The computer diagnosis of fat emboli is generated by a system known as:
A.

decision support.

A nurse who is teaching a class to introduce telehealth to the staff would include which example?

A nurse watches remotely from California while a patient in Wyoming performs peritoneal dialysis to ensure that all steps are being followed correctly.

The key to organizational success for health care facilities is:

retaining professional nurses.

Studies conducted to determine why enrollment in nursing schools has declined found:

fewer young individuals are available to enter the workforce.

Magnet hospitals are those work environments that:

not only attract but also retain professional nurses.

What are some of the driving forces for change to improve the quality and safety competencies for nursing in the United States? (Select all that apply.)
a. The U.S. health care system is one of the world's least technically advanced systems.
b. Health care has led other industries in establishing quality and safety standards.
c. System failures occur regularly.
d. The U.S. public has confidence in its system to reduce morbidity and mortality rates.
e. Outcomes are unpredictable and costly.

C E

During team rounds, a member states, "Ms. Jones has a positive tuberculin skin test and is scheduled for sputum cultures." The nurse notices that the antibiotic infusing has the wrong patient name and the patient is allergic to this particular medication. The nurse tells the team, "I need some clarity" to alert the team:
Correct A.

that there is a safety concern.

While taking a shower, a patient pushes the emergency light. When the nurse arrives the patient complains of feeling dizzy and unsteady. The nurse turns to reach for the patient's walker and the patient falls, hitting the right side of the face resulting in loss of vision in the right eye. This scenario represents a _______ event.

sentinel

Which of the following statements concerning the Institute of Medicine (IOM) competencies is correct?

The competencies address both individual and system approaches to transform care.

During resuscitation efforts, a provider states, "I need to give a 1.5 mg/kg bolus of lidocaine because the patient is in ventricular tachycardia." The nurse responds, "I have a lidocaine bolus equal to 1.5 mg/kg." This communication model is known as:

check-back.

A nurse is preparing to administer a medication by using the vastus lateralis site and is unfamiliar with the process. A step-by-step reference that shows how to complete the process is called a:

top-down flowchart.

Each month data on admission assessments that are based on the following standard are entered: "All patients will be assessed by an RN within 2 hours of admission." The target goal for this standard is 97% compliance. Data are displayed on a graph that shows number and time of admission assessments and compliance variation limits. This pictorial representation is a:

control chart.

An organization's emergency preparedness task force meets to discuss how it should react in case of a terrorist attack and develops a disaster evacuation plan that details how each department will assist individuals in reaching safety. This type of diagram is referred to as a(n):

deployment chart.

In differentiating between early efforts of quality assurance and present-day quality improvement efforts, which statement is correct? Quality assurance:

tended to occur as a reaction to a specific problem.

The ability to clearly demonstrate the knowledge, skills, attitudes, and professional judgment required to practice safely and ethically in a designated role and setting is termed:

competency.

A nonprofit organization that distributes to governmental agencies, the public, business, and health care professionals knowledge related to health care for the purpose of improving health is the:

Institute of Medicine.

Patients with heart failure have extended lengths of stay and are often readmitted shortly after they have been discharged. To improve quality of care, a type of "road map" that included all elements of care for this disease and that standardized treatment by guiding daily care was implemented. This road map is referred to as a(n):

critical pathway.

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:

diagnosis-related groups (DRGs).

A physician bills the insurance company for a computed tomography (CT) scan, laboratory tests, chest x-ray, and an extended visit and receives revenue for each procedure billed. This type of payment system is a:

retrospective payment system.

A contractual agreement between the insurer and the provider in which covered members are encouraged to use specific health care providers in return for reduced rates is which type of arrangement?

Preferred provider organization

When reviewing the literature on the effects of Medicaid on health care for the poor, the nurse researcher found that the poor:

abuse preventive services.

The largest single payer of hospital charges in the United States is ____________________.

Medicare

Which industrialized countries have a national health insurance system? (Select all that apply.)
a. France
b. Canada
c. United States
d. South Africa
e. Great Britain

France, Canada, and Great Britain

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

utilization review nurse.

Medicare would be responsible for: (Select all that apply.)

1. a hospital stay following a total knee replacement for a 70-year-old client.

2. . nursing home cost for a 67-year-old adult receiving hemodialysis.

3. rehabilitation care costs for a 24-year-old client with a broken femur resulting from a fall at work.

4. prescription cost for a young mother who meets eligibility for Aid to Families with Dependent Children (AFDC).

5. home health services to administer heparin to a 27-year-old truck driver following a thrombus.

1, 2

In February 2010, Congress passed legislation to support universal health care for all Americans. At a local health fair, an individual asks about the difference between universal health care and a single payer system. The nurse explains the difference is that:

with universal health, one payer is responsible for all health care costs providing health care to all citizens.

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