Nursing in Today’s World 10th Edition by Dr. Janice Rider Ellis – Test Bank A+

$35.00
Nursing in Today’s World 10th Edition by Dr. Janice Rider Ellis – Test Bank A+

Nursing in Today’s World 10th Edition by Dr. Janice Rider Ellis – Test Bank A+

$35.00
Nursing in Today’s World 10th Edition by Dr. Janice Rider Ellis – Test Bank A+

Chapter: Chapter 1: Exploring the Growth of Nursing as a Profession

Multiple Choice

1. Which of the following statements most accurately describes the practice of medicine in

Greece from 800 BC to 300 BC?

A) Greek culture stressed natural causes for disease, a patient-centered approach, and the

necessity of accurate observations and record keeping.

B) Greek culture borrowed medical practices from the countries it conquered, and physicians

were often slaves.

C) Major and minor surgery, children’s diseases, and diseases of the nervous and urinary

systems were described in Greek culture.

D) Medicine men (known first as shamans and later as priests) were responsible for curing ills

of body and mind.

Ans: A

Client Needs: B

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 1

Page and Header: 4, Table 1.1

Feedback: Hippocrates, born about 400 BC, was a Greek citizen who became known as the

Father of Modern Medicine. He emphasized natural causes for disease, a patient-centered

approach, and the necessity of accurate observations and record keeping. These priorities

influenced the practice of medicine both in Greece and beyond. Persia was known to utilize

slaves as physicians, and Rome borrowed medical practices from the countries it conquered.

Ancient India emphasized hygiene and prevention of sickness and described major and minor

surgery, children’s diseases, and diseases of the nervous and urinary systems. Medicine men

were characteristic of the Mayan and Aztec civilizations.

2. Florence Nightingale fostered the development of nursing as a profession. What was the

basis of her nursing theory?

A) The nurse’s role is to assist individuals (sick or well) to carry out those activities that they

would perform unaided if they had the necessary strength, will, or knowledge.

B) The goal of nursing is to put the patient in the best condition for nature to act upon him,

primarily by altering the environment.

C) The focus of nursing is the spiritual subjective aspects of both the nurse and the patient and

the “caring moment” relating to the time when the nurse and the patient first come together.

D) The focus of nursing is the care of human beings who are viewed as open systems in

constant interaction with their environments.

Ans: B

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Difficult

Integrated Process: Nursing Process

Objective: 2

Page and Header: 21, Early Definitions of Nursing

Feedback: Florence Nightingale, in her Notes on Nursing: What It Is and What It Is Not,

described the nurse’s role as one that would “put the patient in the best condition for nature to

act upon him” (Nightingale, 1954, p. 133), a definition that often is quoted today. This action

was prioritized over physically assisting the patient. Watson emphasized the spiritual subjective

aspects of the nurse and the patient, and the “open systems” concept is central to King’s theory

of nursing.

3. Which one of the following statements accurately describes an element of the process of

providing a definition of nursing?

A) Researchers can pinpoint the period in history when nursing first evolved.

B) Nurses agree on a single definition of nursing, partly because of the history of nursing.

C) There is an obvious distinction between nursing and medicine.

D) Nursing theorists developed definitions of nursing consistent with their conceptual

frameworks.

Ans: D

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 7, 8

Page and Header: 23, Influences on the Definition of Nursing

Feedback: As nursing has grown into a true profession, many nursing theorists have

developed definitions of nursing consistent with their conceptual frameworks; these

frameworks provide the foundation for any given definition of nursing. The historical

emergence of nursing did not take place at one particular time, and there are multiple definitions

of nursing. While nursing and medicine indeed differ, the distinctions between the two

professions are not always clear.

4. A nurse wishes to document nursing actions using a standardized language. Which of the

following systems might the nurse use?

A) NANDA International (NANDA-I)

B) Nursing Outcomes Classification (NOC)

C) Minimum Data Set for Nursing Home Resident Assessment and Care Screening (MDS)

D) Nursing Interventions Classification (NIC)

Ans: D

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 12

Page and Header: 40, Nursing Interventions Classification

Feedback: Started in 1996 at the University of Iowa, the Nursing Interventions Classification

(NIC) is a comprehensive, standardized language that describes actions that nurses perform in

all settings and in all specialties and includes both physiologic and psychosocial interventions.

NANDA and NOC provide standardized language for nursing diagnoses and outcomes. The

MDS is an assessment tool specific to long-term care settings.

5. An RN who practices in a community clinic recognizes the need for a standardized

classification and documentation system. Which of the following systems of nursing care

classification and documentation would best fit the RN’s needs?

A) NANDA International (NANDA-I)

B) Nursing Outcomes Classification (NOC)

C) The Omaha System

D) Patient Care Data Set (PCDS)

Ans: C

Client Needs: A-1

Cognitive Level: Application

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 13

Page and Header: 41, The Omaha System

Feedback: The Omaha System is a research-based comprehensive practice documentation

standardized taxonomy designed to document client care from admission to discharge. It was

designed as a three-part, comprehensive yet brief approach to documentation and information

management for multidisciplinary healthcare professionals who practice in community settings.

NANDA and NOC provide frameworks only for nursing diagnoses and outcomes, while the

PCDS is specific to hospital settings.

6. The number and size of nursing schools in the United States grew significantly in the years

of the early 20th century. Which of the following characteristics was emphasized in these

schools?

A) A thorough knowledge of anatomy, physiology, and epidemiology

B) Critical thinking, assertiveness, and autonomy

C) An understanding of the relationship among mind, body, and spirit

D) Religious devotion and subservience to authority

Ans: D

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 3

Page and Header: 12, Characteristics of the Early Schools

Feedback: In early nursing schools, the nurse in training was expected to yield to her superiors

and demonstrate the obedience characteristics of a good soldier with actions governed by the

dedication to duty derived from religious devotion. These expectations superseded the

importance of critical thinking, scientific knowledge, or the holistic nature of health.

7. Florence Nightingale is acknowledged as one of the individuals who contributed most

significantly to the development of nursing as a profession. What other phenomenon

contributed most to this development?

A) Labor-saving technology that freed many women from working in the home

B) The social recognition of the importance of public funding for the treatment of disease

C) Increased understanding of the pathophysiology of illness and the importance of infection

control

D) The high mortality rates that existed during times of war

Ans: D

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 4

Page and Header: 8, The Nightingale Influence

Feedback: The death and disease that accompanied conflicts such as the Crimean War and the

Civil War provided the impetus for much of the development of the nursing profession.

Nursing did not primarily grow out of the availability of a female workforce, public funding for

health, or increased scientific knowledge.

8. Nurses have historically had difficulty identifying a single, comprehensive definition of

nursing. What factor most accounts for this difficulty in agreeing on a definition for nursing?

A) It can be challenging to reconcile the theoretical and practical aspects of nursing.

B) Nursing exists in the psychomotor (hands-on) domain rather than in the cognitive domain.

C) Compared with medicine, nursing has a relatively short history.

D) Nurses have traditionally been reluctant to acknowledge the outcomes of their practice.

Ans: A

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 5

Page and Header: 21, Developing a Definition for Nursing

Feedback: A major factor that has made it difficult to define nursing is that it is taught as

encompassing both theoretic and practical aspects, but it is pursued (and continues to be

defined) primarily through practice, until recently a little-studied area. Nursing spans

psychomotor and cognitive domains, and it has a very long history. Nurses have often failed to

document and publish the results of their practice, but there is no indication that nurses tended

not to acknowledge their influence on health.

9. One of the challenges that nurses have faced in the past, and which continues to the present,

is the need to distinguish the practice of nursing from that of medicine. Which of the following

statements best conveys a defining characteristic of nursing?

A) Education within a formal, credential-granting setting

B) An emphasis on objective, rather than subjective, health assessment

C) A holistic perspective on the health of individuals

D) A recognition that health is not always attainable for all individuals

Ans: C

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 6

Page and Header: 22, Distinguishing Nursing from Medicine

Feedback: Nursing is concerned with caring for the person from a holistic perspective in a

variety of health-related situations. Both nursing and medicine are taught in formal educational

settings, though these settings differ. Nursing does not denigrate subjective health assessment

nor does it claim that health is unattainable for some individuals.

10. Society has sometimes questioned whether nursing can be considered to be a true

profession and whether nurses can be considered to be professionals. What characteristic of

nursing is among the characteristics that social scientists use to define a profession?

A) The median annual nursing wage is greater than $45,000.

B) Nurses use the scientific method to enhance their body of knowledge.

C) Nurses can be held legally accountable for their actions.

D) Nursing has a demonstrated commitment to the well-being of the public.

Ans: B

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Difficult

Integrated Process: Nursing Process

Objective: 7

Page and Header: 27, Table 1.8

Feedback: Social scientists have identified seven criteria for a profession, including the use of

the scientific method to enhance knowledge. Earnings and commitment to the public are not

among the defining characteristics of a profession. Autonomy and accountability are criteria

that are used to define a profession, but legal accountability for actions is not restricted to

professionals.

11. Among the traditions that exist in nursing education is a “passing of the lamp” ceremony

that is sometimes conducted during graduation. This ceremony communicates

A) the “light” that nursing provides in communities and society.

B) an acknowledgment of the contributions made by important nurses in history.

C) the continuity of care from practicing nurses to newly graduated nurses.

D) the need to continually build the nurse’s base of knowledge.

Ans: C

Client Needs: A-1

Cognitive Level: Knowledge

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 9

Page and Header: 31, Ceremonies Associated with Nursing Programs

Feedback: Some schools use the tradition of a “passing of the lamp.” A representative of the

graduating class hands a lamp to a representative of the next graduating class, thus reinforcing

the concept of the continual caring represented in nursing. This ceremony does not primarily

emphasize the “light” of the profession, the contribution of nurses in history (though the lamp

symbolizes the lamp carried by Florence Nightingale), or the need to add to existing

knowledge.

12. A nurse who provides care on a medical unit at a community hospital is concerned about

negative portrayals of nurses in the media. Why should this nurse be concerned with the image

of nurses and nursing?

A) A negative image of nursing can dissuade potential nurses from entering the profession.

B) A negative image of nursing reduces patients’ adherence to treatment regimens.

C) A negative image of nursing interferes with professional accountability in hospital settings.

D) A negative image of nursing reduces the development of nursing knowledge.

Ans: A

Client Needs: C

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 10

Page and Header: 32, The Image of Nursing Today

Feedback: Negative attitudes about nursing may discourage many capable prospective nurses,

who will choose another career that offers greater appeal in stature, status, and salary. The

image of nursing is not noted to influence patient adherence to treatment or accountability. A

negative image may indirectly limit nursing knowledge through reduced funding for research,

but this phenomenon is less pronounced than the effect on potential nurses.

13. Megan, a 21-year-old junior college student, has been frustrated by her unsuccessful

attempts to gain entry to the nursing program at the local university despite her strong academic

record and work experience. Which of the following factors has most contributed to the limited

number of seats available in many nursing programs?

A) Technological developments that have decreased the projected need for nurses

B) The tendency of practicing nurses to delay retirement until after the age of 65 years

C) The high cost to educational institutions of providing nursing education

D) The negative image of nursing in the media and popular culture

Ans: C

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 10

Page and Header: Nursing’s Image and the Nursing Shortage

Feedback: A factor affecting the nursing supply is the limited number of spaces in nursing

programs. Because nursing education is costly, many educational institutions have not been

able to increase the size of their programs in the past decade. This trend is not attributable to

technological change, increased length of service, or the negative image of nursing.

14. Mrs. Jimenez is a 28-year-old pregnant woman who is in labor. Due to the fact that her

labor was progressing very slowly, she was started on an infusion of oxytocin, a drug used to

increase the progression of her labor. In the planning of Mrs. Jimenez’s care, the nurse has

documented a “Risk of Fluid Volume Excess” in light of this common adverse effect of

oxytocin. The nurse has demonstrated the use of what nursing classification system?

A) The Minimum Data Set (MDS)

B) Nursing Outcomes Classification (NOC)

C) Nursing Interventions Classification (NIC)

D) NANDA International (NANDA-I)

Ans: D

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 12

Page and Header: 40, NANDA International

Feedback: “Risk of Fluid Volume Excess” is an example of a nursing diagnosis, which is the

focus of NANDA-I. This does not denote an intervention or desired outcome. The MDS is an

assessment tool specific to long-term care settings.

15. During the years of the 20th century, there was exponential growth in the number and

quality of research studies that were conducted about nurses and nursing. What factor provided

the original motivation for these studies?

A) The entry of larger number of men into nursing schools and the nursing profession

B) A desire to lessen the knowledge gap between nurses and physicians

C) The low quality of nursing schools and nursing graduates

D) Allocation of federal and state funding for nursing research

Ans: C

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 11

Page and Header: 35, Studies for and About Nursing

Feedback: In the early 20th century, nurses, doctors, friends, and critics of nursing became

concerned that the preparation being offered was inadequate. Before the problem could be

corrected, it was necessary to learn more about the programs and how nurses were being used

in the employment market. To accomplish this, studies about nursing and nurses were initiated.

These studies did not primarily result from increased funding opportunities, the entry of men

into the profession, or the knowledge gap between doctors and nurses.

Import Settings:

Base Settings: Brownstone Default

Information Field: Client Needs

Information Field: Cognitive Level

Information Field: Difficulty

Information Field: Integrated Process

Information Field: Objective

Information Field: Page and Header

Highest Answer Letter: E

Multiple Keywords in Same Paragraph: No

Chapter: Chapter 2: Educational Preparation for Nursing

Multiple Choice

1. Manuel has a baccalaureate degree in biology and wishes to make a career change to

eventually become an advanced practice RN. Which of the following courses of study would

be the most time-efficient choice to meet his educational goals?

A) Master’s degree in nursing

B) Baccalaureate degree in nursing

C) Doctoral degree in nursing

D) Associate degree in nursing

Ans: D

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 2

Page and Header: 53, Characteristics of Associate Degree Education

Feedback: Students may be admitted to master’s programs in nursing with a baccalaureate

degree in another discipline and are granted a master’s degree in nursing after completing an

established 2-year program of study that prepares them for RN licensure. However, people

who already possess baccalaureate or higher degrees in other fields sometimes seek admission

to an associate degree program, often because it can be completed in a shorter period of time

than would be needed to earn another baccalaureate degree (though accelerated baccalaureate

programs are becoming more common).

2. Which nursing report recommended that nursing education move away from the system of

apprenticeship that predominated at the time and move toward a planned program of education

similar to that offered by other professions?

A) The Surgeon General’s Consultant Group Report on Nursing

B) The Brown Report

C) The American Nurses Association Position Paper

D) The Pew Health Profession Commission Study

Ans: B

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 4

Page and Header: 72, The Brown Report

Feedback: In Nursing for the Future, Brown (1948) recommended that nursing education

move away from the system of apprenticeship that predominated at the time and move toward a

planned program of education similar to that offered by other professions. This predated the

Surgeon General’s Consultant Group Report on Nursing, the American Nurses Association

Position Paper, and the Pew Health Profession Commission Study.

3. Which of the following accurately states a major position of the ANA Position Paper on

Educational Preparation?

A) The education of those who are licensed to practice nursing should take place in hospitals.

B) Minimum preparation for beginning professional nursing practice at the present time should

be an associate degree in nursing.

C) Minimum preparation for beginning technical nursing practice at the present time should be

a baccalaureate degree in nursing.

D) Education for assistants in health service occupations should be short, intensive preservice

programs in vocational educational institutions.

Ans: D

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 5

Page and Header: 74, Display 2.2

Feedback: One of the four major positions of the ANA Position Paper on Educational

Preparation is that education for assistants in the health service occupations should be short,

intensive preservice programs in vocational education institutions, rather than on-the-job

training programs. It also states that the education of all those who are licensed to practice

nursing should take place in institutions of higher education, not in hospitals. The paper

specifies an associate degree as the minimum for technical nursing and a baccalaureate degree

for professional nursing.

4. Sister Calista Roy identified an adaptation model that characterizes the individual as being in

constant interaction with a changing environment, therefore requiring adaptation. Which of the

following identifies an adaptive mode listed in her theory?

A) Role function

B) Nutrition

C) Spirituality

D) Genetic makeup

Ans: A

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Difficult

Integrated Process: Nursing Process

Objective: 9

Page and Header: 84, Table 2.2

Feedback: Roy identifies four adaptive modes, or ways in which a person adapts through: (1)

physiologic needs, (2) self-concept, (3) role function, and (4) interdependence relations.

Nutrition, spirituality, and genetic makeup are not discrete concepts within this theory.

5. Mr. Van is a 79-year-old widower who is being transferred to a long-term facility following

hip replacement surgery. The nurse in charge of his care hopes to provide holistic nursing care

for him based on his response to the interaction between his internal and external environment.

This approach represents the model of care proposed by which of the following theorists?

A) Dorothy Johnson

B) Madeleine Leininger

C) Dorothea Orem

D) Myra Levine

Ans: D

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Difficult

Integrated Process: Nursing Process

Objective: 9

Page and Header: 84, Table 2.2

Feedback: Levine supports a holistic approach to nursing based on recognition of the total

response of the person to the interaction between the internal and the external environment.

This approach is not specified by Johnson, Leininger, or Orem.

Multiple Selection

6. A college sophomore has become disillusioned with her current field of studies and has

begun exploring careers in nursing. To her surprise, she is unable to identify any hospitalbased

programs of study in her home state. Which of the following factors have contributed to

the demise of hospital-based diploma programs? (Select all that apply.)

A) Increased patient acuity in hospitals

B) Increased popularity of college- and university-based nursing programs

C) The growth of managed care and its influence on hospital management

D) Increased costs to hospitals for maintaining nursing programs

E) The emergence of the baccalaureate degree as the entry to technical nursing practice

Ans: B, D

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 1

Page and Header: 52, Hospital-Based Programs Today

Feedback: The elimination of hospital-based programs occurred because hospitals could not

sustain the costs of supporting the programs and because students became more attracted to

programs located in colleges and universities. Patient acuity and managed care have not been

identified as causative factors. The baccalaureate degree has been proposed as the entry to

professional nursing practice, not technical nursing.

Multiple Choice

7. Kirsten is a 22-year-old woman who has just been granted admission to an associate degree

program at a local college. During her course of study, Kirsten should expect to complete

A) the National Council Licensure Examination (NCLEX®).

B) a preceptorship under the direction of a licensed practical (vocational) nurse.

C) a major, original research project immediately prior to graduation.

D) numerous nonnursing courses in a variety of disciplines.

Ans: A

Client Needs: A-1

Cognitive Level: Application

Difficulty: Easy

Integrated Process: Nursing Process

Objective: 1

Page and Header: 53, Characteristics of Associate Degree Education

Feedback: In a typical ADN program, approximately 40% of the credits needed for the

associate degree must be fulfilled by general education courses such as English, anatomy,

physiology, speech, psychology, and sociology; the rest are to be fulfilled by nursing courses.

Original research is not a component of undergraduate nursing education, and preceptorships

are normally completely under the direction of an RN. The NCLEX® is written after

graduation.

8. Ben is a 30-year-old man who has applied for an accelerated baccalaureate program at a

university because the 15-month program of study will allow him to accommodate his family

and financial responsibilities. In order to be granted admission, what will Ben most likely

require?

A) A varied work history that demonstrates initiative and responsibility

B) A baccalaureate degree in another field

C) A mentor or sponsor within the nursing field

D) Volunteer experience in a health-related setting

Ans: B

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 3

Page and Header: 59, Accelerated Programs

Feedback: Building on previous learning experiences, accelerated programs are designed to

transition adults with baccalaureate and graduate degrees in other fields into nursing. A strong

work history, volunteer experience, and an available mentor in the field are all assets for

success, but these are less likely to be absolutely required for admission.

9. Julia has just graduated with her Bachelor of Science in Nursing degree from her state

university and has begun seeking employment. However, she is anxious about her level of

clinical competence due to the fact that she completed far fewer clinical hours than many

practicing nurses. Which of the following has the potential to ease Julia’s transition to practice?

A) Completing a residency or internship at the hospital where she will be employed

B) Auditing courses in a nonnursing, health-related discipline

C) Working for several months as a nursing assistant in order to gain confidence

D) Taking online courses in advanced nursing practice

Ans: A

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 2

Page and Header: 68, Residencies and Structured Orientation for the New Graduate

Feedback: Internships and residencies for new graduates have been instituted by hospitals to

ease the transition from the role of student to that of staff by providing the opportunity to

increase clinical skills and knowledge as well as self-confidence. Taking more academic

courses and/or working as a nursing assistant are unlikely to increase Julia’s confidence and

competence in her clinical nursing role.

10. According to the ANA Position Paper on Educational Preparation, which of the following

four individuals is adequately prepared to provide care?

A) A nursing assistant who has just completed an on-the-job training program in a local

hospital

B) A nurse who graduated from a hospital-based diploma program

C) A nurse in a high-acuity setting who possesses an associate degree in nursing (ADN)

degree

D) A nursing assistant who graduated from the training program at a community college

Ans: D

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 5

Page and Header: 74, Display 2.2

Feedback: The ANA Position Paper specifies that education for assistants in the health service

occupations should be short, intensive preservice programs in vocational education institutions,

rather than on-the-job training programs. The Paper also specifies a minimum of an ADN

degree for all nursing practice and a baccalaureate degree for professional nursing (e.g., in

high-acuity settings).

11. Nurse. L. provides care in a state that has mandatory continuing education requirements for

nurses. What are the consequences of this policy for Nurse L.?

A) Nurse L. must demonstrate a commitment to making practice improvements.

B) Nurse L. must have a baccalaureate degree in order to provide professional nursing care.

C) Nurse L. is obliged to update her diploma to an associate degree.

D) Nurse L. must demonstrate continuing education for license renewal.

Ans: D

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 6

Page and Header: 69, Continuing Education

Feedback: Mandatory continuing education affects licensure, meaning that any nurse renewing

a license in a state requiring (mandating) continuing education will have to satisfy that

requirement. However, this does not necessarily mean that a nurse must update his or her

degree or diploma or undertake practice improvements.

12. The administrators of a large, university hospital have expressed a commitment to

differentiated nursing practice. Which of the following most clearly exemplifies differentiated

practice?

A) Each nurse performs a role that is commensurate with his or her education and experience

level.

B) Each nurse in the hospital is expected to provide competent care in a variety of different

settings.

C) Nurses demonstrate evidence of continuing education in two or more different specialties.

D) Each nurse in the hospital possesses an ADN or baccalaureate degree in nursing.

Ans: A

Client Needs: A-1

Cognitive Level: Application

Difficulty: Difficult

Integrated Process: Nursing Process

Objective: 7

Page and Header: 77, Differentiated Practice

Feedback: Differentiated nursing practice can be defined as the practice of structuring nursing

roles on the basis of education, experience, and competence. It does not necessarily specify the

provision of care in diverse settings, evidence of continuing education, or the possession of a

nursing degree.

13. A nurse manager who oversees the provision of community-based care to a large number

of clients has been mandated to implement differentiated care over the next year. In order to

carry out this directive, the nurse manager must be able to

A) teach each nurse to become a “generalist” rather than a “specialist.”

B) identify the evidence that underlies the nursing care that is provided.

C) clearly identify the specific roles and tasks that these nurses perform.

D) hire more licensed practical (vocational) nurses.

Ans: C

Client Needs: A-1

Cognitive Level: Application

Difficulty: Difficult

Integrated Process: Nursing Process

Objective: 7

Page and Header: 77, Differentiated Practice

Feedback: Differentiated practice requires that the specific roles that are performed in the

provision of care be clearly identified and delineated. This is necessary in order to appropriately

match individual care providers to particular tasks and functions. Nurses do not need to become

“generalists” nor are more practical nurses necessarily required. Evidence underlying nursing

care should be identified, but this is not necessary for differentiated care.

14. Pressure from students and the healthcare industry has prompted the nursing educators at a

college to implement new technology into the nursing education that they provide. Which of the

following statements is true of technological change and nursing education?

A) Technology is typically high in colleges and universities but low in hospitals and other care

settings.

B) Many of the purported educational benefits of technology have not been demonstrated in

the nursing literature.

C) Computer literacy is high among students but most nursing educators lack computer skills.

D) The costs of integrating new technology into nursing education can be prohibitive.

Ans: D

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 8

Page and Header: 80, Computer Technology in the Classroom

Feedback: High-technology equipment is often expensive, a fact that often presents a challenge

to educational institutions. The benefits of technology in learning have been demonstrated and

computer literacy is nearly universal. Hospitals are high-technology work environments.

15. The faculty members of a college-based school of nursing have taken action to increase the

teaching and clinical time in the curriculum that is devoted to community-based nursing. Which

of the following phenomena provides the most valid rationale for this change?

A) Public mistrust of hospitals is increasing and many individuals prefer to remain at home.

B) The number of patients who qualify for Medicare and Medicaid is increasing.

C) Patients are typically discharged from the hospital much earlier than in the past.

D) Evidence demonstrates that students learn more in the community than in the hospital.

Ans: C

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 8

Page and Header: 82, Increasing Community-Based Practice Experiences

Feedback: Earlier hospital discharge to the home and an increasing emphasis on prevention has

created new demands on nursing in the community. This shift is not rooted in mistrust of

hospitals, a lack of learning in hospitals, or trends in Medicare and Medicaid.

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