Linton: Medical-Surgical Nursing, 7th Edition

The state board of nursing defines the scope of practice for nurses. 2. ANS: 1, 3, 4 Leadership does not require a specific degree in nursing or other field. Various leadership styles may be used depending on the situation. However, an autocratic approach is not always the most effective. 3. ANS: 1 Nonmaleficence means to do no harm. By confirming the right drug and patient identity, the nurse reduces the risk of harm posed by a drug error. 4. ANS: 4 A tort is a civil wrong against a person which can include an invasion of privacy. Posting the patient’s photo on social media violates the patient’s right to privacy in the health care setting. 5. ANS: 1, 2, 3, 5 Only option 4 is incorrect. The nurse is not required to directly supervise tasks assigned to others although he or she may observe at some point to confirm that the individual performs correctly. Chapter 02: Medical-Surgical Practice Settings 1. ANS: 1, 3, 4 Medicare reimburses nursing care in the home as long as the care given is skilled and of a type that only a nurse trained in that kind of care could be expected to do. Sterile technique to clean and dress a wound, performing a venipuncture, and teaching a client how to inject insulin are all skilled nursing care. Taking a frail couple for a walk for exercise and removing outdated food from a refrigerator and pantry are not considered skilled interventions. 2. ANS: 1, 3, 4, 5 Community health nursing focuses on improving the health status of communities or groups of people through public education, screening for early detection of disease, and providing services for people who need care outside the acute care setting. The activities include conducting health education in a senior citizen center, arranging blood pressure screening at a shopping center, seeing clients in a clinic to monitor chronic illness problems, and giving flu vaccines at a public location. Monitoring the recovery of a postoperative client at home is a role for the home health care nurse. 3. ANS: 1 Community-based nursing is based on the delivery of health care services that meet the needs of citizens at certain levels of wellness and illness based on specific community needs. Meeting with residents of low-income housing to identify their health needs is an example of community- based nursing. Phoning a client at home after discharge form the hospital is an example of hospital-based nursing. Asking nurses to identify health services lacking in their communities is not client but nursing directed. Developing a hospital-based home health service is an example of community health nursing. 4. ANS: 2 Handicapped individuals are those who are not able to perform one or more activities of daily living (ADL). Impaired individuals have a disturbance in functioning that could be either physiologic or psychologic. Disabled individuals have a measurable loss of function and generally a diminished capacity to work. Disadvantaged individuals are people who lack certain opportunities and services such as those of the general population. 5. ANS: 2 The Americans with Disabilities Act prohibits private employers with 15 or more employees, state and local governments, employment agencies, and labor unions from discriminating against qualified individuals with disabilities. The Social Security Act gives additional aid to states for both direct relief and vocational rehabilitation. The Rehabilitation Act and the Vocational Act gave a comprehensive approach to problems experienced by the disabled, expanded available resources for vocational training, and defined services to be included in rehabilitation programs. 6. ANS: 2, 3, 4, 5 Medicare reimbursement for home health nursing care must be necessary, skilled, reasonable, and intermittent. Short-term care is not one of the reimbursement criteria for Medicare. 7. ANS: 4 To care for a head injury client who is having difficulty feeding herself, the best response is to be sure that her food is accessible and give her praise for her efforts at self-feeding. Offering to feed her and ordering a liquid diet so she does not have to use utensils does not help the client to rehabilitate herself. Telling the client that the sooner she feeds herself, the sooner she can go home is putting extra stress on the client and is not a therapeutic comment. 8. ANS: 2 Linton: Medical-Surgical Nursing, 7th Edition