Focus on Adult Health Medical Surgical Nursing 2nd Edition Honan Test Bank

Chapter 1 The nurse’s Role in Adult Health Nursing MULTIPLE CHOICE 1.The nurse ensures that a clients bedspace is neat and clean with the call light within easy reach. The nurse is focusing on which nursing theorist who realized the importance of the environment for care? 1. Florence Nightingale 2. Sister Callista Roy 3. Dorothea Orem 4. Martha Rogers ANS: 1 Florence Nightingales theory focused on the environment for care. Sister Callista Roys model is based in systems theory and an individuals ability to adapt. Dorothea Orems model is the selfcare deficit theory. Martha Rogers model is the science of unitary human beings. PTS:1DIF:Apply REF:Emergence of Contemporary Nursing in the United States 2.The nurse is instructing a client on self-administration of insulin so that the client will not need a health care provider to do this activity. The nurse is implementing which of the following aspects of Virginia Hendersons theory of nursing? 1. A caring relationship 2. Helping the client achieve independence from the nurses assistance as quickly as possible 3. Integration of objective and subjective data 4. Application of critical thinking ANS: 2 Virginia Hendersons theory of nursing is to help people achieve health or a peaceful death so that they can be independent from the nurses assistance as quickly as possible. A caring relationship, integration of objective and subjective data, and application of critical thinking are included in the American Nurses Associations essential features of professional nursing. PTS:1DIF:Analyze REF:Emergence of Contemporary Nursing in the United States A. client tells the nurse that he has an HMO for his health insurance. The nurse understands that the purpose of this type of health plan is to: 1. ensure payment is made to Medicare for services rendered. 2. maximize the utilization of health care resources. 3. efficiently manage costs while providing quality care. 4. focus on the illness when providing care. ANS: 3 Health maintenance organizations (HMOs) were created to efficiently manage health care costs while providing quality care. An HMO is a type of managed care plan with the goal of providing wellness care and not focusing on the illness during the provision of care. HMOs do not ensure payment is made to Medicare for services rendered. HMOs also do not maximize the utilization of health care resources but rather uses financial incentives to decrease care costs. PTS: 1 DIF: Understand REF: Cost of Care 4.A client tells the nurse that he does not have a primary care physician but rather makes an appointment with a doctor who specializes in the area in which he is experiencing a problem. The nurse realizes this client is at risk for which of the following? 1. Fragmented care 2. Overpayment of services 3. Inability to sustain health 4. Finding an appropriate general practitioner ANS: 1 In the 1980s, the close and trusting relationship between an individual and the individuals physician waned and was replaced by acquaintances with specialists based upon particular health care problems. These episodes of care cause fragmentation of care. The client who utilizes specialists is not at risk for overpayment of services, the inability to sustain health, or finding an appropriate general practitioner. PTS:1DIF:AnalyzeREFroviders of Care 5.The nurse is attending a masters degree program in efforts to be educationally prepared to serve as a hospital leader. The nurse realizes that this educational preparation will: 1. hinder the nurses ability to work with physicians. 2. be viewed as not supporting the profession of nursing by other nurses. 3. ensure the nurse is biased towards clinicians interests. prepare the nurse to serve as strong clinical support with the ability to integrate business and 4. caring. ANS: 4 The nurse is attending an educational program to serve as a hospital leader. This education will prepare the nurse to serve as strong clinical support with the ability to integrate business and caring. This education will not hinder the nurses ability to work with physicians. This education will not be viewed as unsupportive to the profession of nursing. The education will ensure that the nurse is not biased towards clinicians interests. PTS: 1 DIF: Analyze REF: Clinical Systems Leadership 6.A client tells the nurse that all hospitals care about is doing the minimum for a client regardless of the outcome. Which of the following should the nurse respond to this client? 1. It does feel like that sometimes. 2. Health insurance companies have caused this problem. 3. The doctors will get paid regardless of the clients outcomes. There are quality programs in place to make sure clients receive the best quality of care regardless 4. of the cost. ANS: 4 In response to concerns about safety and quality of care voiced by clients and providers, total quality management and continuous quality improvement programs were initiated. These programs ensure society that cost management is not compromising safety or quality. This is what the nurse should respond to the client. The other choices do not address the clients concerns nor do they explain quality management programs. PTS: 1 DIF: Apply REF: Quality Measure Shift 7.The nurse is providing care at a time that is the most beneficial to the client. The nurse is implementing which of the following Joint Commission Dimensions of Quality Performance? 1. Safety 2. Timeliness 3. Efficiency 4. Availability ANS: 2 The dimension of timeliness means the degree in which interventions are provided at the most beneficial time to the client. Safety means the degree in which the risk of an intervention and risk to the environment are reduced for both client and health care provider. Efficiency means the degree in which care has the desired effect with a minimum of effort, waste, or expense. Availability means the degree in which appropriate interventions are available to meet the clients needs. PTS:1DIF:Analyze REF:Box 1-1 Joint Commission Dimensions of Quality Performance 8.The nurse is providing care while adhering to safety as a Joint Commission Dimension of Quality Performance. Which of the following did the nurse provide to the client? 1. Using a needleless device when providing intravenous medications 2. Keeping the siderails of the bed in the down position after providing a pain medication to a client 3. Having the client sit in a wheelchair with the wheels in the unlocked position 4. Placing cloth towels over a spill in the room of an ambulatory client ANS: 1 The dimension of safety means the degree in which the risk of an intervention and risk to the environment are reduced for both client and health care provider. The nurse who uses a needleless device when providing intravenous medications is adhering to this dimension. Keeping the siderails in the down position is not a safe practice. Having a client sit in a wheelchair with the wheels unlocked is not a safe practice. Placing cloth towels over a spill in the room of an ambulatory client is not a safe practice. PTS:1DIF:Analyze REF:Box 1-1 Joint Commission Dimensions of Quality Performance 9.The nurse is planning and providing care while adhering to the American Nurses Association definition of professional nursing. Which of the following does the nurse include when implementing client care? 1. Follows the NANDA nursing diagnoses process 2. Integrates objective and subjective data 3. Respects cultural diversity of peers 4. Acknowledges the experience and training of physicians ANS: 2 The American Nurses Association acknowledges six essential features of professional nursing. These include: 1) a caring relationship, 2) attention to the full range of human health and illness experiences, 3) integrates objective and subjective data, 4) applies scientific knowledge and critical thinking, 5) advances nursing knowledge through scholarly inquiry, and 6) promotes social justice. The nurse integrating objective and subjective data is implementing one of the six essential features of professional nursing. The other choices are not essential features of professional nursing. PTS:1DIF:Analyze REF:Emergence of Contemporary Nursing in the United States 10.The nurse has shifted her practice from an illness focus to a health focus. Which of the following has this nurse implemented? 1. Standardized care plans 2. Critical pathways 3. Instructing a client on relaxation techniques to aid with sleep 4. Holding around-the-clock medication when a client is asleep ANS: 3 The use of client education as a strategy to attain and maintain the potential for health is an example of the shift of care from an illness focus to a health focus. The nurse instructing a client on relaxation techniques to aid with sleep is implementing a health focus of care. The other choices do not support the shift from an illness focus to a health focus. PTS: 1 DIF: Analyze REF: Leadership 11.A client is admitted with a highly communicable disease. The nurses do not want to participate in the care of this client. Which of the following should be done to ensure the client receives the highest quality of care? 1. Adhere to strict standard precautions. 2. Plan to have the client transferred to another health care organization. 3. Ask the physician if the client can be cared for in the home. 4. Suspend the nurses without pay who refuse to care for the client. ANS: 1 When providing care in a highly global environment, the risks of communicable diseases increases. In the event that a client is admitted with a highly communicable disease and the nurses are fearing for their own health and safety, the only safe approach is to ensure all staff adhere to strict standard precautions. The other choices do not ensure that the client will receive the highest quality of care. The nurses must learn emotional intelligence and resolve issues under fire. PTS:1DIF:AnalyzeREF:Globalization 12.The nurse has been an employee of an organization for 2 years and is considering a job change. Which of the following does this nurses plan suggest to any future employers? 1. The nurse moves to other jobs too frequently. 2. The nurse is inflexible. 3. The nurse is searching for a more challenging environment with career opportunities. 4. The nurse is willing to sacrifice home and personal life for a job. ANS: 3 At one point in time, job changes every 2 or 3 years was considered a red flag for employers. This does not hold true today. The nurse who changes jobs every 2 or 3 years is interested in career advancement and success. Creativity is valued and opportunities are desired. Moving to another job in 2 to 3 years does not mean the nurse is inflexible. The new generation of nurses does not want to sacrifice home and personal life for a job. PTS: 1 DIF: Analyze REF: Care Delivery Models 13.The nurse is experiencing pain and fatigue in both arms when using the computer to document client care. Which of the following can the nurse do to reduce these symptoms? 1. Refuse to use the computer and document using a pen and paper. 2. Stand up when using the computer. 3. Adjust the keyboard and chair to reduce the pressure on the wrists and arms. 4. Ask another nurse to input the information for client care activities. ANS: 3 Ergonomic hazards are increasing with health care providers and nurses in particular. Many of these hazards are because of the implementation of computers for documentation. The nurse should adjust the keyboard and chair to reduce the pressure on the wrists and arms when documenting with the computer. The nurse cannot refuse to use the computer. Standing up may not reduce the nurses symptoms. The nurse cannot legally ask another nurse to document client