Exam (elaborations) STUDY GUIDE FOR BRUNNER AND SUDDARTH ’S TEXTBOOK OF MEDICAL SURGICAL NURSING 12TH EDITION

1. The definition of nursing has evolved over time. According to the Social Policy Statement (2003) of the American Nurses Association (ANA), registered nurses can and should: CHAPTER 1 Health Care Delivery and Nursing Practice a. diagnose human responses to illness. b. promote optimum levels of wellness. c. prevent illness and maintain health. d. do all of the above. 2. An underlying focus in any definition of nursing is the registered nurse’s responsibility to: a. appraise and enhance an individual’s healthseeking perspective. b. coordinate a patient’s total health management with all disciplines. c. diagnose acute pathology. d. treat acute clinical reactions to chronic illness. 3. A Jewish patient who adheres to the dietary laws of his faith is in traction and confined to bed. He needs assistance with his evening meal of chicken, rice, beans, a roll, and a carton of milk. Choose the nursing approach that is most representative of promoting wellness. a. Nurse “A” removes items from the overbed table to make room for the dinner tray. b. Nurse “B” pushes the overbed table toward the bed so that it will be within the patient’s reach when the dinner tray arrives. c. Nurse “C” asks a family member to assist the patient with the tray and the overbed table while the nurse straightens the area in an attempt to provide a pleasant atmosphere for eating. d. Nurse “D” prepares the environment and the overbed table and inspects the contents of the dinner tray. The nurse asks the patient whether he would like to make any substitutions in the foods and fluids he has received. 4. Using the concept of the wellness–illness continuum, a nursing care plan for a chronically ill patient would outline steps to: a. educate the patient about every possible complication associated with the specific illness. b. encourage positive health characteristics within the limits of the specific illness. c. limit all activities because of the progressive deterioration associated with all chronic illnesses. d. recommend activity beyond the scope of tolerance to prevent early deterioration. 10. Common features that characterize managed care include all of the following except: 2 CHAPTER 1 ■ Health Care Delivery and Nursing Practice Copyright © 2010 Wolters Kluwer Health/Lippincott Williams & Wilkins. Study Guide for Brunner and Suddarth’s Textbook of Medical-Surgical Nursing, 12th edition. 5. To be responsive to the changing health care needs of our society, registered nurses will need to: a. focus their care on the traditional diseaseoriented approach to patient care, because hospitalized patients today are more acutely ill than they were 10 years ago. b. learn how to delegate discharge planning to ancillary personnel so that registered nurses can spend their time managing the “high tech” equipment needed for patient care. c. place increasing emphasis on wellness, health promotion, and self-care, because the majority of Americans today suffer from chronic debilitative illness. d. stress the curative aspects of illness, especially the acute, infectious disease processes. 6. Continuous quality improvement (CQI) was mandated in health care organizations in 1992. This system focuses on all of the following processes except: a. analyzing similar clinical situations. b. assessing the impact of financial decisions on patient care delivery. c. examining processes that affect patient care. d. reviewing medication errors for individual patients. 7. Quality assurance programs created in the 1980s required that hospitals be accountable for all of the following except: a. appropriateness of care related to established standards. b. cost of services. c. staff–patient ratios for nursing care. d. quality delivery of services. 8. The primary focus of the nurse advocacy role in managing a clinical pathway is: a. continuity of care. b. cost-containment practices. c. effective utilization of services. d. a patient’s progress toward desired outcomes. 9. Nursing practice in the home and community requires competence and experience in the techniques of: a. decision making. b. health teaching. c. physical assessment. d. all of the above. a. fixed-price reimbursement. b. mandatory precertification. c. preferred provider choice. d. prenegotiated payment rates.