Description
Identify the choice that best completes the statement or answers the question.
____ 1. The nursing student predominantly uses knowledge about the history of nursing for what purpose?
1. To understand the professional choices open to the student 2. To prevent making medication errors in practice 3. To determine what geographical area is the best place to practice 4. To reduce the cost of delivering quality healthcare
____ 2. The nurse is working in an underdeveloped country and observes the natives lighting ritual fires and pounding on primitive drums around the sick person to promote recovery. The nurse interprets this behavior as indicating the natives believe illness results from what?
1. Pathogens and genetics 2. Evil spirits 3. Tides and planets 4. Plants and animals
____ 3. The person credited with making a written record of healthcare practices and removing the mythical aspect of healthcare is who?
1. Hammurabi 2. Florence Nightingale 3. Hippocrates 4. Apollo
____ 4. Who served as the first public health nurses, caring for the sick and the poor?
1. The Presbyterian Church 2. Salerno 3. Jewish scholars 4. Convent deaconesses
____ 5. What is a crucial issue the nurse working in the late industrialization era would need to address in order to promote health?
1. Reducing spread of infection 2. Reducing sedentary lifestyle 3. Teaching proper use of medications 4. Teaching use of car seats
____ 6. What types of skills would a nursing student learn while attending Kaiserworth Deaconess Institution in 1836?
1. Administering immunizations 2. Assisting in surgery 3. Washing and changing bed linens 4. Developing a plan of care
____ 7. The nurse demonstrates Florence Nightingale’s theory of nursing with what intervention?
1. Respecting the patient’s culture and incorporating cultural needs in the plan of care 2. Promoting good health and treating those who are ill in a holistic manner 3. Understanding how to motivate people to practice a healthy lifestyle and reduce risks 4. Teaching other nurses how to deliver the highest quality of nursing care.
____ 8. What action performed by the nurse directly resulted from the contribution made by Linda Richards?
1. Using an antiseptic before administering an injection 2. Exploring the psychosocial needs of the patient 3. Documenting patient care in the medical record 4. Listening to a patient describe his or her condition
____ 9. After graduating from nursing school, the graduate takes a licensure examination as the result of what nurse’s contribution?
1. Florence Nightingale 2. Mary Adelaid Nutting 3. Lavinia L. Dock 4. Isabel Hampton Robb
____ 10. In addition to caring for the sick, what other skills would the first LPN students learn when attending the Ballard School in New York in 1893?
1. Political advocacy 2. Homemaking 3. Communication 4. Carpentry
____ 11. The nurse responds to an alarm on a pulse oximeter and sees the patient’s oxygen saturation is reading 38%. The nurse observes the patient, noting a respiratory rate of 12 breaths per minute, pink mucous membranes, and easy regular respirations. The nurse concludes the pulse oximeter is not reading accurately. Whose theory of nursing is this nurse demonstrating?
1. Annie Goodrich 2. Lillian D. Wald 3. Florence Nightingale 4. Linda Richards
____ 12. What statement describes Florence Nightingale’s beliefs about nursing?
1. Practicing nurses should be licensed. 2. Promotion of good health and treating the ill are nursing priorities. 3. Nurses could simultaneously have a career and a marriage. 4. Organisms cause infection.
____ 13. What was Mary Eliza Mahoney’s contribution to nursing?
1. She organized the first visiting nurse association. 2. She founded the American Journal of Nursing. 3. She founded the National League of Nursing. 4. She worked for the acceptance of African Americans into the nursing profession.
____ 14. What professional organization was the first to focus on licensed practical nurses (LPNs)?
1. National Association for Practical Nurse Education and Services (NAPNES) 2. National Federation of Licensed Practical Nurses (NFLPN) 3. National League for Nursing (NLN) 4. American Nurses Association (ANA)
____ 15. What statement accurately describes the NFLPN?
1. It represents both registered nurses (RNs) and LPNs. 2. It represents LPNs/LVNs only. 3. It is open to anyone interested in nursing. 4. It is open to anyone in the healthcare field.
____ 16. What organizations represent only LPNs/LVNs?
1. ANA and NLN 2. NFLPN and NLN 3. NAPNES and NFLPN 4. NAPNES and ANA
____ 17. The nurse working in mental health nursing honors what historical nurse for working to improve care of the mentally ill?
1. Clara Barton 2. Florence Nightingale 3. Dorothea Dix 4. Lillian D. Wald
____ 18. What is the difference between the LPN and LVN nursing title?
1. LPNs have a longer educational program than LVNs. 2. LVNs and LPNs have the same duties and skills, just different titles. 3. LVNs are able to perform venipuncture and LPNs cannot. 4. LPNs are working toward an RN license while LVNs are not.
____ 19. What mythical god was believed to promote healthcare in ancient times?
1. Apollo 2. Zeus 3. Isis 4. Ares
____ 20. What factor has had the greatest impact on the current nursing shortage?
1. Later age of women having children 2. Fewer women being born 3. Overall unemployment rate 4. More employment options for women
____ 21. What health condition is classified as a World Health Organization priority and a focus of health promotion for nurses?
1. HIV 2. MRSA 3. Natural disasters 4. Terrorism
____ 22. What trend in healthcare has only existed for the past decade and has changed nursing education to prepare student nurses for practice after graduation?
1. Technology 2. Cultural diversity 3. HIV 4. Nursing shortage
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 23. What factors are contributing to the nursing shortage? (Select all that apply.)
1. Increased demand for nurses 2. Shortage of nursing faculty 3. Lack of nursing organizations 4. Nurses leaving the profession due to poor working conditions 5. Not enough interest in nursing
____ 24. The newly licensed LPN joins a professional organization for what benefits? (Select all that apply.)
1. Opportunities to maintain current nursing knowledge 2. Most facilities mandate membership before hiring a nurse. 3. Organizations offer a way for the LPN’s voice to be heard regarding concerns. 4. They advocate for the LPN in professional matters. 5. It is a requirement for licensure in most states.
____ 25. In order to deliver the safest possible care, the nurse needs to understand what? (Select all that apply.)
1. How to perform the procedure correctly 2. Why the procedure is being performed 3. How the procedure will affect the patient 4. The cost of performing the procedure 5. The equipment needed to perform the procedure
Chapter 1: Historical Perspective and Current Trends
Answer Section
MULTIPLE CHOICE
ANS: 1 Understanding nursing history helps the nurse to better recognize the many choices available when choosing their own future path.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 1
KEY: Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying
ANS: 2 A belief that disease was caused by evil spirits would result in lighting fires or candles and making loud noise to try to ward off the spirits.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 2
KEY: Content Area: History | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Analyzing
ANS: 3 Hippocrates wrote the first medical textbook, outlining current healthcare practices and removed the mythical belief that Apollo was responsible for health. Hammurabi wrote a code of laws to protect the patient and define legal limitations of caregivers, Florence Nightingale introduced modern nursing during the Crimean War, and Apollo was a mythical God who was believed to control health and wellness.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 2
KEY: Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding
ANS: 4 Deaconesses from local convents acted as the first public health nurses, providing care for the sick and the poor based on the Christian belief in the importance of caring for one another.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 2
KEY: Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding
ANS: 1 Many deaths resulted from communicable diseases and lack of cleanliness in hospitals, so the nurse’s priority concern with health promotion would be reducing the spread of infection.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 2
KEY: Content Area: History | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Analyzing
ANS: 3 Washing and changing bed linens, mopping floors, and housekeeping tasks were included as part of the nurse’s education. Immunizations did not exist at that time in history, and surgery was uncommon and very primitive with frequent poor outcomes. Thus assistants were rarely required and not part of nursing school. Plan of care considerations were not used until after the mid 1900s.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 2
KEY: Content Area: History | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding
ANS: 2 Nightingale believed the nurse’s primary responsibilities included promoting health and treating the ill.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 3
KEY: Content Area: History | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Applying
ANS: 3 Linda Richards developed a system for recording details about patients and patient care. This system evolved into today’s documentation system.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 3
KEY: Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying
ANS: 4 Isabel Hampton Robb fought for licensing examinations and registration to protect patients from incompetent nurses, in order to raise the standard of the profession.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 3
KEY: Content Area: History | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying
ANS: 2 LPN students learned homemaking skills, because much of the patient care they provided was within the patient’s home.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 4
KEY: Content Area: History | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding
ANS: 3 Florence Nightingale promoted treating the patient based on the patient’s individual needs rather than treating the disease or, in this case, the machinery.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 3
KEY: Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing
ANS: 2 One of Florence Nightingale’s strongest beliefs was that promoting good health and treating the ill were nursing priorities. Throughout her career, Nightingale implemented changes in the nursing practice to enhance the health of all who were ill.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 3
KEY: Content Area: History | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Understanding
ANS: 4 Mary Eliza Mahoney was the first African American nurse in the United States. She spent her life working for the acceptance of African Americans into the nursing profession, and was also the organizer and the first president of the National Association for Colored Graduate Nurses.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 3
KEY: Content Area: History | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding
ANS: 1 NAPNES was the first professional organization to focus on LPNs. NAPNES is very active today, with continuing education opportunities and publications for LPNs. While NFLPN focuses on LPNs, they were not the first to do so. NLN and ANA focus on both RNs and LPNs.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 5
KEY: Content Area: Nursing Organizations | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering
ANS: 2 The NFLPN is considered the official membership organization for the licensed practical nurse/licensed vocational nurse (LPN/LVN); therefore, only the LPN/LVN may join this organization.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 5
KEY: Content Area: Nursing Organizations | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering
ANS: 3 The two vocational LPN organizations are the National Federation for Licensed Practical Nurses (NFLPN) and the National Association for Practical Nurse Education and Service (NAPNES). Both the ANA and the NLN focus on both RNs and LPNs.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 5
KEY: Content Area: Nursing Organizations | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering
ANS: 3 Dorothea Dix championed the development of psychiatric hospitals, and her work also brought about improvement for prisoners in jails.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 3
KEY: Content Area: History | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying
ANS: 2 Both LPNs and licensed vocational nurses (LVNs) are legally recognized and practice in diverse healthcare settings today. LVN education predominantly takes place in California and Texas, whereas LPN education is common in other geographic areas of the country.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 4
KEY: Content Area: Role of LPN | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding
ANS: 1 The primitive healthcare that was available was provided by males, except for the midwives, and was promoted by a belief in Apollo, the mythical Greek healer.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 2
KEY: Content Area: History | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering
ANS: 4 One reality of the nursing shortage is that the 21st century woman has more employment options than women had previously.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 6
KEY: Content Area: Trends | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing
ANS: 1 The prevention and treatment of HIV is a World Health Organization priority. While MRSA is a focus of health promotion for nurses, it is the CDC that is focusing on reducing occurrence. The World Health Organization has not set natural disasters as a priority because they cannot be controlled, and it is not focused on reducing terrorism; nurses respond to terrorist events when they occur, but it is not a source of health promotion.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 6
KEY: Content Area: Trends | Integrated Processes: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Remembering
ANS: 1 The use of technology in healthcare has increased dramatically over the last decade, and has become a major consideration in nursing education.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 6
KEY: Content Area: Trends | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing
MULTIPLE RESPONSE
ANS: 1, 2, 4 Aging Baby Boomers, people living longer, and the increasing complexity of healthcare have all increased the demand for nurses. Insufficient nursing faculty results in turning potential nursing students away from nursing programs because there aren’t enough educated faculty to teach them. Mandatory overtime, working holidays and weekends, long hours without breaks, and other working conditions can cause nurses to leave the profession. There is no lack of nursing organizations and this does not contribute to the nursing shortage, and there is no lack of interest in nursing but not everyone is designed to be a nurse.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 6
KEY: Content Area: Trends | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding
ANS: 1, 3, 4 Professional organizations provide lifelong learning opportunities for the LPN in the form of journals, seminars, and annual meetings. They also provide the LPN a voice for concerns and opinions, and they serve as an advocate for LPNs at the state and national level. Membership in a nursing organization is not usually a requirement for employment, but it can serve as a favorable indicator that the nurse is maintaining current knowledge. While ongoing education is required by some boards of nursing for licensure, there is no requirement the nurse belong to an organization.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 6
KEY: Content Area: Trends | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding
ANS: 1, 2, 3, 5 Understanding how to perform the procedure correctly is important if the nurse is to maintain safety. The nurse should never perform any procedure without understanding why it is being performed and what outcome is desired. The nurse is responsible for teaching the patient what to expect before the procedure is begun, so the nurse must understand how the procedure will impact the patient. The nurse will gather the equipment required to perform the procedure, therefore needs to know what will and what might be needed. The nurse is not responsible for knowing the cost of the procedure.
PTS: 1 REF: Chapter: 1 OBJ: Objective: 6
KEY: Content Area: QSEN | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying
Chapter 3: Understanding the Changing Roles in Nursing
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The nurse is teaching a group about paradigm thinking and defines it as what?
1. One’s mathematical knowledge and ability to solve math problems 2. The ability to see 20 feet away without wearing glasses 3. An individual’s perception or frame of reference about the world 4. A nurse’s ability to solve patient-care problems
____ 2. Most nursing paradigms are based on what?
1. The nurse’s ability to perform procedures with skill 2. Dr. Jean Watson’s transpersonal caring theory 3. Maslow’s theory of hierarchy of needs 4. Learning by studying nursing theories and clinical experiences
____ 3. The increasing use of licensed practical nurses (LPNs) in management positions, especially in long-term care facilities, is an example of what?
1. Assertive management 2. A shifting paradigm 3. Critical thinking 4. Smarter LPN graduates
____ 4. Why is critical thinking necessary for the nurse to identify and understand paradigms that exist in nursing practice?
1. Critical thinking allows the nurse to make superficial decisions. 2. Critical thinking allows the nurse to thoroughly examine situations and issues. 3. Critical thinking provides the nurse with quick answers. 4. Critical thinking allows the nurse to accept information without needing to check its validity.
____ 5. The nurse values respect for the individual, more than anything else, as defining high-quality patient care. What does this describe about the nurse?
1. Critical thinking 2. Caritas 3. Paradigm 4. Hierarchy of needs
____ 6. The nurse reads a peer-reviewed nursing journal article that recommends changing the procedure for caring for a patient with an indwelling urinary catheter. The nurse displays critical thinking with what action?
1. Changing how the nurse provides care for a patient with an indwelling catheter according to the article 2. Taking the journal article to the nurse manager and suggesting the procedure be rewritten 3. Searching for other peer-reviewed articles that support this author’s recommendation 4. Ignoring the article and following the procedure as written at the facility where the nurse works
____ 7. The nurse applies Maslow’s hierarchy of needs to what aspect of care?
1. Judging the patient’s behavior 2. Improving the skillfulness of care 3. Understanding the patient’s behavior 4. Improving communication skills
____ 8. The nurse is caring for a patient who has just received a cancer diagnosis. The patient is crying. The nurse recognizes this patient is operating on what level of Maslow’s hierarchy of needs?
1. Self-esteem 2. Love and belonging 3. Safety 4. Self-actualization
____ 9. The caring LPN manager avoids what approach when dealing with staff?
1. Delegating 2. Understanding 3. Judging 4. Evaluating
____ 10. The student nurse experiences a paradigm shift as a result of increasing knowledge and finds the result of the shift is what?
1. Life changing 2. Temporary 3. Short-lived 4. Overwhelming
____ 11. The nurse is caring for an adolescent who will be hospitalized for several weeks while in traction. The patient frequently has a room full of friends and they can be heard laughing. The nurse recognizes this patient is meeting which of Maslow’s hierarchy of needs?
1. Self-esteem 2. Love and belonging 3. Safety 4. Self-actualization
____ 12. The nurse is providing pre-operative teaching to the anxious patient, who doesn’t seem to be learning. What need must the nurse help this patient meet before continuing to teach?
1. Self-esteem 2. Love and belonging 3. Safety 4. Self-actualization
____ 13. The nurse manager learns that one of the staff nurses on the unit has a substance addiction and is arriving at work under the influence of the substance. Using Watson’s theory, how should the nurse manager deal with this staff member?
1. Send the nurse home with instructions not to return until clear of the substance. 2. Call the police and have the nurse arrested for working while impaired. 3. Confront the nurse privately, order drug testing, and suggest a substance-abuse program. 4. Notify the board of nursing and fire the nurse immediately.
____ 14. The nurse receives a shift report from the nurse going off shift and asks about a patient’s state of mind and emotional needs, which demonstrates what aspect of Dr. Watson’s theory?
1. Intentionality 2. Curiosity 3. Caritas 4. Holism
____ 15. While working in a long-term care facility, the nurse notices that older residents take pleasure in telling stories about their earlier lives and reliving special events. The nurse recognizes this helps residents meet what level of Maslow’s Hierarchy of needs?
1. Self-esteem 2. Love and belonging 3. Safety 4. Self-actualization
____ 16. The nurse makes the decision to return to school to obtain a bachelor of science degree in nursing. What theme of critical thinking is the nurse displaying?
1. Critical thinking is a productive and positive activity. 2. Critical thinking is a process, not an outcome. 3. Manifestations of critical thinking vary, depending on the context in which they occur. 4. Critical thinking is triggered by both positive and negative events.
____ 17. The nursing assistant asks the nurse to explain the meaning of advocacy. The nurse explains the fundamental principle of patient advocacy is what?
1. Independence 2. Caring 3. Competence 4. Protection
____ 18. The nurse listens as the physician asks the patient to participate in a research study and realizes the physician is not adequately explaining the risks of the study. As they leave the patient’s room, the nurse encourages the physician to go back and explain the risks more thoroughly. What role is this nurse playing in patient care?
1. Teacher 2. Caregiver 3. Advocate 4. Communicator
____ 19. The nurse is caring for a patient with HIV who is known to have infected others due to unsafe sexual practices. What is the nurse’s priority action to advocate for this client and others with whom he may have a relationship?
1. Teach the patient of the increased risk to his own health from sexually transmitted diseases. 2. Inform the patient that he can be sued or arrested for endangering the health of others. 3. Explore the patient’s knowledge of safer sexual practices and help him find methods that work for him. 4. Report his behavior to the public health department for follow-up as needed.
____ 20. The charge nurse is preparing assignments when one of the staff nurses requests not to be assigned a specific patient, using a derogatory name to refer to the patient’s ethnicity. What is the charge nurse’s best response?
1. Encourage the nurse to embrace diversity and reject prejudice. 2. Report the nurse to human resources for demonstrating prejudicial behavior. 3. Assign the patient to a different nurse and make a note not to ever assign this patient to this nurse. 4. Schedule a staff meeting to talk to the entire staff about avoiding prejudice.
____ 21. The nurse is caring for a diabetic patient whose religious beliefs require fasting from sun up to sun down on holy days. How can the nurse best advocate for this patient?
1. Teach the patient the importance of eating throughout the day to avoid hypoglycemia. 2. Choose the nursing diagnosis of noncompliance if the patient becomes hypoglycemic due to fasting. 3. Invite the spiritual leader of his faith to talk with him about exceptions to the need to fast. 4. Meet the patient’s caloric needs before sunrise and after sunset and monitor blood sugar closely.
____ 22. The nurse arrives to work impaired and under the influence of alcohol. What patient right has this nurse infringed on?
1. Research-related rights 2. Right to refuse treatment or medication 3. Right to be fully informed about procedures 4. The right to safe care
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 23. Which patient rights is the nurse likely to be called to advocate for? (Select all that apply.)
1. Research-related rights 2. Right to refuse treatment or medication 3. Right to be fully informed about procedures 4. The right to safe care 5. The right to the treating physician of choice
____ 24. The nurse identifies critical thinking through which themes? (Select all that apply.)
1. Critical thinking is a productive and positive activity. 2. Critical thinking is a process, not an outcome. 3. Manifestations of critical thinking vary depending on the context in which they occur. 4. Critical thinking is triggered by both positive and negative events. 5. Critical thinking requires supreme intellect to be effective.
____ 25. The successful nurse manager applies Anderson’s rules for successfully working with people, which include what two statements? (Select all that apply.)
1. It is better to understand people than to judge them. 2. There is a reason for every behavior. 3. Follow the Golden Rule when working with people. 4. The nurse manager must have control of all situations. 5. Set expectations high and people will rise to meet them.
Chapter 5: Nursing and Informatics
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The nurse delivers safer healthcare using electronic medical records because of what feature?
1. Accessibility of medical record by multiple people 2. Improved accuracy in reading documentation 3. Tighter control of data privacy 4. Lowers cost of care delivery
____ 2. The nurse demonstrates compliance with the Health Insurance Portability and Accountability Act (HIPAA) with what action?
1. Logging off the computer before walking away 2. Entering data as soon as it is collected 3. Verifying all medication dosages are within normal range 4. Remembering to charge for all equipment used
____ 3. The nurse protects against self-injury when working with the computer by performing what action?
1. Maintaining the security of the password 2. Using the computer only for work related tasks 3. Becoming familiar with facility policy regarding computer use 4. Maintaining good body mechanics when sitting at the computer
____ 4. How can the nurse reduce the spread of infection related to the use of the computer?
1. By cleaning the mouse and keyboard regularly 2. By turning the monitor so it cannot be seen by visitors 3. By using good body mechanics when sitting at the computer 4. By becoming familiar with facility policies regarding data entry
____ 5. The nurse is sitting down to prepare a presentation on risk reduction in the long-term care facility. What is the first thing the nurse should do?
1. Develop an outline of information to be included 2. Find research articles containing the necessary information 3. State the objectives 4. Plan the ending of the presentation
____ 6. When creating the introduction to a presentation, what is the nurse’s goal?
1. Staying within the designated time frame 2. Grabbing the audience’s attention 3. Not overwhelming the audience with content 4. Providing references
____ 7. The nurse talks to the nurse manager to suggest making changes to the way a procedure is performed, and the manager asks if this change is evidence-based. What does the manager mean by evidence-based?
1. Research findings or other reliable evidence show that the change is appropriate. 2. Another facility is doing it in the manner proposed by the nurse. 3. The nurse performed the procedure the suggested way while in nursing school. 4. Several nurses discussed the new way to perform the procedure and agree it would be better.
____ 8. The nurse assesses the patient’s health literacy through what action?
1. Teaching the patient about health issues and assessing learning 2. Watching the patient read a brochure containing health information 3. Obtaining agreement from the patient to read health information they are given 4. Quizzing the patient about their health knowledge
____ 9. What is the nurse manager likely to use in order to manage numerical data?
1. Statistical analysis 2. Word processors 3. Spreadsheets 4. Graphed tablets
____ 10. The nurse manager is working on compiling a budget for the next fiscal year. What software will work best for this purpose?
1. Word processor 2. Internet explorer 3. Presentation software 4. Spreadsheet software
____ 11. The nurse is working in the hospital when a tornado causes a power outage. How will the nurse manage documentation of care until the computer system returns?
1. Hold off on documenting and wait until the power returns to document care. 2. Write notes as reminders to be transcribed into the computer when the power returns. 3. Record what needs to be documented so the oncoming shift can document when power returns. 4. Document care in a paper patient record according to facility policy.
____ 12. When writing a work-related email, what is the best guideline for the nurse to follow related to length?
1. Write emails the same as writing narrative patient-care records. 2. Get to the point and write only what is necessary. 3. Write a long, detailed letter that restates important points for emphasis. 4. Use multiple colors and fonts to make the letter stand out.
____ 13. The nurse manager writes a business letter to a manager at another facility. What email style is appropriate for this letter?
1. Using several different font colors to make the email friendlier 2. Using all capital letters to make the email more readable 3. Inserting a funny cartoon at the end to create rapport with the reader 4. Running spell-check and reviewing the tone of the letter to avoid misunderstanding
____ 14. The nurse manager is given a fax machine to receive physician orders and fax patient information to physicians’ offices. Where is the best place for the nurse manager to place the new machine?
1. In the hallway away from patient rooms 2. Behind the nurse’s desk on the unit 3. In the manager’s office 4. In the supply room
____ 15. Why does the nurse manager prefer email when communicating with multiple recipients?
1. The letter can be copied and pasted multiple times to send to each recipient. 2. The letter can be sent to multiple recipients at one time with no extra effort. 3. Emails are more private than letters sent through the mail system. 4. The email can be secretly sent to friends.
____ 16. The nursing unit is informed early in the shift that the computers will be unavailable for four hours during the middle of the shift. What will the nurse manager tell the staff to do regarding documentation of patient care during this time period?
1. Make good notes and document care during the next working shift. 2. Anticipate care to be administered during downtime and document before the computers go down. 3. Make notes and document all care as soon as the computers come back up. 4. Use the downtime documentation described in facility policy.
____ 17. The nurse wants to attend a teleconference, but the price is too high. What might the nurse explore to help reduce the cost?
1. Multiple nurses may be able to attend for one fee. 2. Costs may go down closer to the date of the conference. 3. They may give the nurse a discount out of sympathy. 4. Borrow money from others to pay for the conference.
____ 18. The nurse is preparing a presentation using Microsoft PowerPoint software. Where does the nurse write notes to remember what to say when each slide is shown?
1. In the white space under the slide portion 2. In the column at the left of the slide 3. In the actual slide section 4. In a separate Word document
____ 19. What task would the nurse be most likely to perform using spreadsheet software rather than word-processing software?
1. Writing a paper on an assigned topic for school 2. Creating a presentation for an audience 3. Developing a budget for the nursing unit 4. Writing an email to a nurse manager on another unit
____ 20. The nurse interprets what statement from the patient as a possible indication of healthcare illiteracy?
1. “I’ll read this brochure and let you know if I have questions.” 2. “Can you give me another brochure for my wife?” 3. “I’ll read this later. I don’t have my glasses.” 4. “I read this brochure and have some questions about what I read.”
____ 21. What is the nurse’s primary and most essential purpose in reading nursing research on a regular basis?
1. To maintain an evidence-based nursing practice 2. To obtain continuing education credits 3. To teach peers about new findings 4. To obtain a promotion at work
____ 22. The nurse accepts a new job as a manager, spending much more time doing desk work instead of patient care. After a week in the new job, the nurse experiences pain in the right wrist and an ache around the shoulders and back. What is the most likely cause of these discomforts?
1. A stressful work environment 2. Lack of management skills 3. Poor body mechanics when using the computer 4. Lack of cooperation from staff
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 23. What advantages does the nurse identify in providing patient care using an electronic medical record? (Select all that apply.)
1. Accessibility of medical record by multiple people 2. Faster reporting of diagnostic study results 3. Easier readability of documentation 4. Improved privacy of information 5. Error reduction
____ 24. How do computers and nursing informatics improve patient care? (Select all that apply.)
1. Learning more about best practices 2. Acting as a monitor to protect patient safety 3. Providing easy access to new knowledge 4. Delivering hands-on care 5. Using critical thinking to plan care
____ 25. The nurse specializing in nursing informatics uses the computer for what tasks? (Select all that apply.)
1. Documenting patient care 2. Learning about medication side effects 3. Finding evidence-based research related to patient care 4. Scheduling staff work shifts 5. Programming new software
Chapter 7: The Importance of Critical Thinking
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The nurse considers a problem and arrives at one possible solution. What should the nurse do next?
1. Apply the solution to the problem. 2. Continue looking for other solutions. 3. Evaluate the effectiveness of the solution. 4. Ask others for their opinion of the solution.
____ 2. What skill will the nurse need to be an effectively thorough thinker?
1. Quick thinking 2. Sharpened intuition 3. Proactive thinking 4. Creative thinking
____ 3. The nurse displays the essence of critical thinking by doing what?
1. Having all the answers 2. Accepting what is read as true 3. Asking questions 4. Sharpening intuition
____ 4. The instructor asks the student nurse a question, and the student responds by saying, “I studied, but I don’t know the answer to that question.” The student is displaying what?
1. Thorough thinking 2. Creative thinking 3. Reactive thinking 4. Critical thinking
____ 5. The nurse listens as a patient relates having multiple abortions. While the nurse does not personally believe abortion should be legal, the nurse respects the patient’s beliefs and opinion. What is this nurse demonstrating?
1. Tolerance 2. Shyness 3. Bigotry 4. Serendipity
____ 6. Critical thinking is of most value to the nurse who is doing what?
1. Performing a procedure by following the steps in the procedure manual 2. Making decisions about how to handle a patient-based situation 3. Documenting patient care delivered over the past hour 4. Holding the hand of a dying patient who is alone
____ 7. What situation demonstrates that the nurse is thinking critically?
1. Questioning a physician regarding the rationale for an order 2. Performing CPR on a pulseless patient who is not breathing 3. Teaching coworkers how to use a new piece of equipment 4. Attending class on time every day
____ 8. The nurse is dealing with a problem at work and has been focused on finding solutions. After a good night’s sleep the nurse wakes with a solution. How did sleeping help the nurse solve the problem?
1. It was focus time. 2. It was letting-go time. 3. It was time for creative thinking. 4. It provided serendipity.
____ 9. The nurse is one of five nurses selected to brainstorm solutions to a problem on the unit. The group sits quietly to relax for two minutes, then sets a time. What will the group do next?
1. Have someone write down all ideas produced by the group. 2. Review all of the ideas generated by the group. 3. Eliminate ideas that are not usable. 4. Begin to prioritize workable solutions.
____ 10. The nurse is trying to solve a problem and begins by brainstorming, being as creative as possible. Next the nurse looks at all of the ideas to determine if there are any workable solutions in the written list. The nurse decides to take a break from problem solving and returns after a pleasant afternoon with friends to think about the problem more. Which of these actions demonstrates letting go?
1. Brainstorming 2. Reviewing written list for workable solution 3. Spending the afternoon with friends 4. Returning to the problem
____ 11. The graduate nurse takes a new job and meets many nurses who are very knowledgeable and experienced. After one week at the new job, the graduate nurse realizes how much he or she learned. What does this demonstrate?
1. Serendipity 2. Creativity 3. Critical thinking 4. Thorough thinking
____ 12. When a patient complains of sudden onset left-sided chest pain, the nurse asks questions to better understand the pain and collects data such as vital signs, ECG, and breath sounds to determine the possible cause of the pain. Once data is analyzed the nurse develops a plan and begins to intervene. What has this nurse demonstrated?
1. Serendipity 2. Creative thinking 3. Critical thinking 4. Thorough thinking
____ 13. What action would lead a nurse to believe a coworker is not a good critical thinker?
1. Consistently follows the charge nurse’s directions without question 2. Asks many questions when confronted with a new situation 3. Freely admits to not knowing the answer to questions 4. Verifies the meaning of communication to improve understanding
____ 14. The nurse with strong critical thinking skills accepts information without question from what source?
1. Textbook 2. Physician 3. Nursing instructor 4. No one
____ 15. What is the primary reason the nurse needs to be a skilled critical thinker?
1. To earn promotions at work 2. To pass the nurse licensure exam 3. To graduate at the top of the class 4. To provide excellent patient care
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 16. For what purpose does the nurse use brainstorming? (Select all that apply.)
1. To find solutions 2. To create plans 3. To minimize time spent problem solving 4. To discover new ideas 5. To make new friends
____ 17. The nurse uses what approach as a good critical thinker? (Select all that apply.)
1. Following every doctor’s order as written 2. Learning all facts needed to pass a test 3. Applying thorough thinking to complex situations 4. Using creativity in thinking 5. Obediently doing everything asked to do
____ 18. The nurse develops serendipity by doing what? (Select all that apply.)
1. Reading textbooks 2. Being attentive to the world 3. Following all directions 4. Spending time with classmates 5. Learning more about faculty members
Chapter 11: Communication Skills in Leadership and Management
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Therapeutic communication is used when:
1. you ask another student to explain the action of carbamazepine (Tegretol) to you. 2. you spend time talking to patients about their feelings and listening to their concerns. 3. you listen carefully while the doctor explains to you what is to be done for your patient. 4. you and your patient talk about the results of Sunday’s football game.
____ 2. When effective communication occurs, which of the following is true?
1. The message is understood by the sender and the receiver. 2. The message is fully understood by the receiver. 3. The message is fully understood by the sender. 4. Communication is effective by telling someone what to do.
____ 3. You are a charge nurse in a long-term care facility and you have to talk to Betty, a certified nursing assistant, about the care of one of her residents. You and Betty sit in your office, and as you begin to talk with her, she becomes very angry and storms out of the office. What has taken place?
1. Successful communication 2. Social communication 3. Honest communication 4. Failed communication
____ 4. In which of the following situations could failed communication occur?
1. Your instructor tells you to perform a procedure but does not let you ask questions. 2. A family member yells at you because you forgot to go to the dry cleaners. 3. The patient begins to cry when you are caring for them. 4. All of the above.
____ 5. Which of the following situations best describes feedback?
1. The answers the patient gives to your questions. 2. The patient explains what another nurse taught him. 3. The doctor gives you an order and leaves the unit. 4. You recognize the patient does not speak English well, but you explain and hope for the best.
____ 6. Which of the following best describes the most honest form of communication?
1. Your body language as you explain the dressing change you are doing 2. The instructions you give the patient on his or her discharge from the hospital 3. Listening to your instructor as he or she explains directions for the test 4. Talking with your friends at lunch about your final exam results
____ 7. As a manager, it is important for you to develop skills in:
1. social communication with your staff. 2. understanding nonverbal messages from those you manage. 3. understanding nonverbal messages from both those you manage and your leaders. 4. therapeutic communication with patients.
____ 8. Which of the following types of communication often is not a natural behavior for nurses?
1. Assertive communication 2. Aggressive communication 3. Caring communication 4. Subjective communication
____ 9. In the profession of nursing, it is necessary to develop:
1. leadership skills. 2. management skills. 3. assertiveness. 4. aggressive techniques.
____ 10. The use of “I” messages by the nurse means that the nurse has developed the ability to:
1. be assertive. 2. manage others. 3. give excellent directions. 4. be a leader.
____ 11. An important part of assertiveness is the nurse’s ability to say:
1. yes. 2. I don’t understand. 3. Can you help me? 4. no.
____ 12. Passive communication results in:
1. Resolving problems in the long term 2. Positive feelings 3. Keeping the peace 4. Failure to move up Maslow’s hierarchy
____ 13. Passive-aggressive behavior is demonstrated by the nurse who:
1. gossips about other people. 2. constantly complains during shift report. 3. complains to everyone except the right person. 4. all of the above.
____ 14. Which of the following is critical to communication?
1. Using professional terms when talking to a patient 2. Listening carefully to your staff member as he or she shares a problem 3. Hearing what another nurse tells you as you continue to prepare a medication 4. Having the ability to calm an angry family member
____ 15. Other forms of communication by the licensed practical nurse include:
1. charting on the nurse’s notes. 2. reading the patient’s chart. 3. taking notes during a staff meeting. 4. all of the above.
____ 16. Friendly conversation is an important skill for the student. Friendly conversation is best described as:
1. conversing politely in the clinical area. 2. talking to families about a patient’s prognosis. 3. talking cheerfully to friends about your nursing classes and social events. 4. group discussions on nursing topics.
____ 17. When negative or hostile conversation occurs, which of the following actions is most appropriate?
1. Respond immediately to what is said. 2. Always stop and listen rather than responding. 3. React forcefully and negatively to what has been said. 4. Be reactive rather than proactive.
____ 18. One of the strongest communication skills a student can have in any setting is:
1. speaking. 2. hearing. 3. listening. 4. writing.
____ 19. Communication occurs when:
1. the sender understands the meaning of the communication. 2. the receiver understands the meaning of the communication. 3. the sender uses both verbal and nonverbal ways of communicating. 4. both the sender and the receiver have understood the meaning of the communication.
____ 20. It is necessary for the practical nursing student to be _____ in communication with patients and families in the clinical area.
1. friendly and eager 2. cheerful and loud so the patient can hear 3. quiet and gentle 4. firm and strong
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 21. The nurse brings the patient’s lunch tray into the room and sets it on the over-bed table, positioning it so that it is comfortable for the patient to eat. The patient sweeps the tray off the table, screaming “Get this slop out of here! I’m not hungry.” What response by the nurse reflects therapeutic communication? (Select all that apply)
1. “You seem angry. Would you like to talk about what’s bothering you?” 2. “That behavior in unacceptable. You could simply ask me to remove the tray.” 3. “Why did you do that? Now I have to clean up that mess.” 4. “How would you feel in my place if someone did that to you?” 5. “You need to eat to maintain your strength. I’ll get another tray.”
____ 22. The physician stands in the hallway speaking to the nurses in a loud voice saying, “I don’t know why you nurses don’t follow the orders I’ve written. Can’t you read?” Which response by the nurse demonstrates assertiveness? (Select all that apply)
1. “You’re such a jerk. Lower your voice!” 2. “We are all professionals here and there is no need to shout.” 3. “I know you’re angry but your behavior is inappropriate.” 4. “If you would like to discuss the problem professionally we’ll be glad to listen.” 5. “If you treat your wife like this I know why you’re getting a divorce.”
____ 23. What commonly happens when failed communication occurs?
1. Nothing. Most people are able to forget about it. 2. A “mind tape” results, which is played over and over to justify what was done. 3. The reason for the failed communication is determined quickly and dismissed. 4. It can take a lot of energy and time to resolve. 5. People hold grudges against each other for not understanding what was said.
____ 24. An example of a communication block is:
1. preconceived opinions. 2. physical disabilities. 3. good emotional health. 4. bad hygiene. 5. missed phone calls.
____ 25. You are a good listener when:
1. others frequently come to you for advice. 2. you cut off a speaker to tell your own story. 3. you nod along to everything that is said. 4. you always give your opinion. 5. you listen both with your ears and visually.
Chapter 13: Understanding Benefits of Change
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Which of the following is one reason why nurses often resist change?
1. A lack of assertiveness 2. The history of nursing 3. Many nurses are passive–aggressive. 4. Change often does not work.
____ 2. Which of the following is a characteristic of effective people?
1. Opportunity-oriented 2. Problem-oriented 3. Management-oriented 4. People-oriented
____ 3. Another term for accidental change is:
1. unintentional change. 2. unplanned change. 3. short-term change. 4. change by drift.
____ 4. Planned change usually comes from which of the following people?
1. An individual supervisor 2. An administrator 3. An administrative group 4. The director of nursing
____ 5. Kurt Lewin’s theory of change involves three phases. He called these three phases unfreezing, moving, and __________.
1. refreezing 2. completed 3. restraining 4. driving
____ 6. Forces that tell you not to take part in certain behaviors are:
1. subjective forces. 2. restraining forces. 3. objective forces. 4. good forces.
____ 7. Licensed practical nurses (LPNs) need to be able to identify both driving and restraining forces because they:
1. allow the LPN to be a better nurse. 2. allow the LPN to be a better manager. 3. are key factors in making planned changes. 4. allow the LPN to be more qualified for a job.
____ 8. Making a planned change in your job depends on your ability to:
1. be selective in your choices. 2. be the first to apply for a position. 3. effectively use your network. 4. make meaningful decisions.
____ 9. Your long-term care facility is making a change to the team method of caregiving. Administration holds planning meetings for all shifts and keeps all involved employees informed in writing, as well. Which of the following explains the actions of the administrator?
1. Planned change 2. Unfreezing 3. Refreezing 4. Moving
____ 10. What has happened in the process of refreezing?
1. The change has occurred and has been formalized. 2. The change has met resistance and has been suspended. 3. The change has been discussed but has not been implemented. 4. All driving and restraining forces have been identified.
____ 11. Which of the following is a common mistake that can be made during the change process?
1. Failure to provide adequate meeting time 2. Failure to provide psychological safety for the staff 3. Failure to identify a mentor 4. Failure to network
____ 12. Caring theory practice requires:
1. kindness on the part of the nurse manager 2. frequent staff meetings 3. patience by the nurse 4. an awareness of the implications of change on both you and others
____ 13. The nurse working in a long-term care facility has joined a committee with the goal of implementing electronic medical records within the next six months. The committee is planning how best to prepare staff for the change. What type of change is occurring?
1. Planned change 2. Change by drift 3. Accidental change 4. Occidental change
____ 14. The nurses make walking rounds with the physician on the long-term care unit. At the completion of rounds several nurses gather in the break room and agree that they need to be more effective and efficient the next time rounds are performed. What is the first step these nurses need to take?
1. Review the process and define the problem. 2. Suggest ways to improve walking rounds. 3. Develop a plan to change the way walking rounds are performed. 4. Select an informal leader to organize the group.
____ 15. The nurse has worked as a staff nurse in the acute care facility for three years and is considering quitting and taking a job at a large clinic in town. The nurse draws up a list of pros and cons related to the job change. What part of Lewin’s change theory is the nurse demonstrating?
1. Unfreezing 2. Moving 3. Refreezing 4. Identifying driving and restraining forces
____ 16. The staff nurses formed a committee to improve holiday scheduling. After several meetings they have designed a new schedule and are preparing to put it into action today. What phase of Lewin’s change theory is this committee performing?
1. Unfreezing 2. Moving 3. Refreezing 4. Identifying driving and restraining forces
____ 17. The nurses have performed a comprehensive literature review and used their findings to change the facility’s policy for performing tracheostomy care to make it more evidence-based. The new procedure is put in place, and they are receiving a good deal of positive feedback about the new approach. What phase of the change process are these nurses involved in?
1. Unfreezing 2. Moving 3. Refreezing 4. Identifying driving and restraining forces
____ 18. The new graduate LPN accepts a position as a staff nurse in a hospice home-care unit. Upon attending the first staff meeting the nurse learns there has been a problem with keeping nurses safe when visiting certain areas of town, and the nurses are requesting improvement. What role can this new graduate expect to take in the change process?
1. Participate in the change process. 2. Identify needed changes. 3. Recommend changes to improve processes. 4. Evaluate the effectiveness of change.
____ 19. The nurse works on a unit that did not have time to fully implement the change process before changing from written time cards to a time clock. What might the nurse experience as a result of this improper preparation of staff nurses?
1. Reduction in overtime and fewer payroll mistakes 2. Effective use of the time clock and reduced staff morale 3. Vandalism to the time clocks and poor morale 4. Effective use of time clocks and complaints at staff meetings
____ 20. The nurse reads a research article concluding that patients newly diagnosed with diabetes should receive a referral to a nutritionist to avoid complications. What is the nurse’s priority action related to evidence-based practice after reading this article?
1. The nurse should share the article with the nurse manager and suggest changing the procedure to give referrals to all newly diagnosed diabetic patients. 2. Form a committee to talk with the physicians suggesting the need for a referral to a nutritionist for all diabetic patients on the unit. 3. Talk to the dietician and suggest he or she talk to diabetic patients who are admitted to the unit from now on. 4. Conduct a literature search to see if more articles can be found recommending the involvement of a nutritionist in care of the diabetic patient.
____ 21. What is the LPN’s role related to evidence-based practice?
1. Analyze the research to determine its credibility for changing practice. 2. Recommend changes to practice based on the credibility of research. 3. Be aware of research that could influence how care is delivered. 4. Ask peers to provide evidence-based research.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 22. The LPN has worked on this unit at an acute care hospital for the past four years. It is announced that the hospital wants to change the process for admitting new patients. What roles can this nurse serve in the change process? (Select all that apply.)
1. Participate in the change process. 2. Identify needed changes. 3. Recommend changes to improve processes. 4. Participate in evaluating the effectiveness of change. 5. Act as the informal leader of the group researching the needed change.
____ 23. The nurse is serving on a committee to implement new cardiorespiratory monitors in the unit. What actions can the committee recommend to avoid the common mistakes that can occur during the change process? (Select all that apply.)
1. Identify the pros and cons of the new system as compared to the old system. 2. Allow adequate time for the staff to learn how to work the monitors before installing them. 3. Provide a resource person knowledgeable about the new monitors when they are put in use. 4. Keeping the old procedure in place for use of the monitors to prevent confusion 5. Install the new monitors the day after informing the unit about the change.
____ 24. The nurse is caring for a patient whose left leg was amputated below the knee following a skiing accident. The nurse recognizes the patient is experiencing a transition to his new body image when observing what characteristics? (Select all that apply.)
1. Irritability 2. Anxiety 3. Asking how he will do the things he used to do 4. Depression 5. Wanting to spend all his time in physical therapy
____ 25. The LPN manager must support the staff as they make the second phase of change, which is moving. In order for this stage to be effective, the manager should:
1. spend time teaching the staff. 2. implement the change prior to unfreezing. 3. criticize mistakes that are made. 4. pay attention to any signs of hyperenergy.
Chapter 17: Ethics and Law in Nursing Management
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The theory of utilitarianism states that an ethical decision is based on the greatest good for the greatest number of people. This theory often leaves out which of the following groups?
1. Elderly people 2. Those who are in a minority 3. Patients who, for the most part, can independently care for themselves 4. Certain ethnic groups
____ 2. You are a nurse manager on the 11 p.m. to 7 a.m. shift. You periodically make rounds, observing and checking on your staff and residents. You do this on a regular basis throughout your shift because:
1. your facility requires you to do so. 2. the policy manual states this as a regulation. 3. you are responsible for the behavior of those you manage. 4. state law requires this action.
____ 3. Your orientation as a nurse manager in a long-term care facility was done quickly. You are unsure of some of the regulations relating to your new position. As a responsible nurse manager, what should you do to remedy this situation?
1. Review your agency regulations and know the Nurse Practice Act. 2. When a situation comes up, ask the staff what the normal procedure is. 3. Call the state board of nursing. 4. Call the state department of health.
____ 4. You are a student practical nurse assigned to a medical-surgical unit. The night before going to the clinical area, you are very tired and fail to look up your patient’s diagnosis as assigned. Which of the following is appropriate?
1. Ask your friend to quickly give you the information during shift report. 2. Look up the information while your patient is eating breakfast. 3. Use break time to get the information you need. 4. Tell your instructor what happened as soon as you arrive in the clinical area.
____ 5. You are an LPN employed in your first job. A resident complains to you about the care and incompetence of a nurse on the previous shift. Which of the following actions is most appropriate?
1. Discuss the situation with another staff member. 2. Argue with the resident. 3. Agree with the resident. 4. Report the incident to your head nurse or supervisor.
____ 6. Ethical dilemmas are situations that result in a _____ of two or more fundamental values.
1. conflict 2. blending 3. change 4. discussion
____ 7. Your classmate, who is also a good friend, tells you this morning that she didn’t have time to study for the anatomy and physiology test because her daughter was sick all night. She sits next to you in class and asks you to position your answer sheet so that she can copy your answers. You reply that you are very sorry, but that you do not feel it would be appropriate behavior to do so. You suggest that your friend talk to the instructor to see if she can take the test at a later time. Your actions exhibit:
1. ethical behavior. 2. unethical behavior. 3. abuse of power. 4. deontology.
____ 8. Another term for ethical behavior is:
1. mandatory. 2. lawful. 3. appropriate. 4. ideal.
____ 9. David, a student practical nurse, is bathing Mr. Smith. He puts on gloves to brush Mr. Smith’s dentures and keeps the same gloves on throughout the bath. His reasoning is that he will be able to get the bath finished more quickly and allow Mr. Smith to rest. This is an example of:
1. ethical behavior. 2. unethical behavior. 3. abuse of power. 4. deontology.
____ 10. You make an error while caring for a patient. Which of the following is the appropriate person to whom to report the mistake?
1. Your classmate 2. Wait until you go off duty and then report the error to your instructor. 3. Report the error to your instructor immediately. 4. Leave your clinical area immediately and go see the director of the nursing program.
____ 11. Personal values are:
1. customs of society. 2. personal beliefs about truth, behavior, and thoughts. 3. society’s behavioral code. 4. legal standards of an action.
____ 12. When a nurse uses ethical reasoning, the nurse does which of the following?
1. Clearly identifies the issue based on the perspective of the persons involved 2. Follows gut reaction and trusts instincts 3. Ignores personal values 4. Puts a plan into action but does not need to evaluate the plan
____ 13. The LPN is assigned to 30 residents in a LTC facility. She is administering medications and is supposed to administer a heart medication. The apical pulse must be taken before the medication is given. The nurse feels she just doesn’t have time to stop and take the pulse. When she charts, she looks at the record of previous pulse counts and arrives at an average. She charts this pulse with the medication. This is an example of:
1. ethical behavior. 2. unethical behavior. 3. abuse of power. 4. deontology.
____ 14. The night shift nurse is late in coming into work to relieve the evening shift nurse. The evening shift nurse does not leave until a replacement nurse can be found. This is an example of the theory of:
1. unethical behavior. 2. utilitarianism. 3. negligence. 4. deontology.
____ 15. Using animals for research studies for human drugs is an example of which theory?
1. Utilitarianism 2. Deontology 3. Permission to treat 4. Informed consent
____ 16. The Nurse Practice Act is an example of which type of law?
1. Common 2. Statutory 3. Institutional policies and procedures 4. Criminal
____ 17. The rule that states a nurse must delegate care to another nurse while on a lunch break is an example of:
1. regulatory law. 2. statutory law. 3. institutional policies and procedures. 4. criminal law.
____ 18. A nurse works in delivery and is attending two women in labor. The patient in bed A asks how dilated the patient in bed B is. The nurse tells her, “She is farther along than you. She is 7 cm dilated and 100 percent effaced.” This is an example of:
1. standard of care. 2. informed consent. 3. permission to treat. 4. breaking confidentiality.
____ 19. One way to assure that you, as the nurse, have permission to treat a patient is:
1. ask the patient to sign an informed consent document each time you administer medications. 2. explain to patients the procedure you are going to do and what to expect. 3. check admitting documents for permission to treat before entering a patient’s room. 4. have patient cosign physician orders and medication sheets.
____ 20. Prior to surgery, the nurse should assure that which of the following tasks has been completed?
1. Informed consent has been signed by the patient. 2. ID band is attached to the patient. 3. The patient understands the type of surgery that is being performed. 4. All of the above are correct.
____ 21. A nurse writes in the nursing notes that a physician is “unreasonable and refuses to prescribe morphine for a patient in pain.” This is an example of:
1. informed consent. 2. libel. 3. slander. 4. negligence.
____ 22. The purpose of advanced directives is:
1. to give guidance to the person who has durable power of attorney. 2. to give caregivers authority to allow a patient to die with dignity. 3. to allow an individual to instruct caregivers prior to surgery what their wishes are about end-of-life decisions. 4. All of the above are correct.
____ 23. Which of the following individuals cannot be sued for malpractice in the event of a case of negligence?
1. Physician 2. Pharmacist 3. Licensed practical nurse 4. Certified nursing assistant
____ 24. An LPN on the unit has a name tag that has her name and RN listed after it. She doesn’t change it because she is an RN student. This is an example of:
1. fraud. 2. negligence. 3. battery. 4. against medical advice.
____ 25. A nurse asks you to hold a patient down against his wishes while she attempts to start an IV. If you do this, you can be prosecuted for:
1. assault. 2. battery. 3. performing a procedure against medical advice. 4. libel.
____ 26. What best demonstrates the student nurse performing in an ethical manner in the clinical setting?
1. Performing procedures as taught 2. Talking with patients 3. Using the personal cell phone as infrequently as possible 4. Visiting with family members
____ 27. How do novice student nurses make ethical decisions?
1. Based on their intuition 2. Based on the class’s consensus 3. Based on facts and instructor guidance 4. Based on what they think is right
____ 28. A nurse gives a diabetic inpatient an injection of regular insulin as ordered. The patient is not checked for 4 hours. The patient is found dead due to insulin shock. What does this demonstrate?
1. Negligence 2. Libel 3. Slander 4. Acting outside the scope of practice
____ 29. A resident in a long-term care facility is status poststroke and has difficulty swallowing. She is left to eat her meal on her own and has a choking incident in which she aspirates a portion of her meal. What does this constitute?
1. Negligence 2. Libel 3. Slander 4. Acting outside the scope of practice
____ 30. A patient is experiencing delirium tremens as a result of alcohol withdrawal. The nurse applies soft wrist and ankle restraints without an order demonstrating what?
1. Slander 2. Libel 3. False imprisonment 4. Malpractice
