Professional Nursing Practice Quiz and Key Answer for your nursing exam.
Nursing Practice Quiz
Using the American Nurses Association’s definition of nursing, which activities are within the domain of nursing (select all that apply)?
a. Implementing intake and output for a patient who is vomiting
b. Establishing and implementing a stress management program for family caregivers of patients with Alzheimer’s disease
c. Explaining the risks associated with the planned surgical procedure when a preoperative patient inquires about risks
d. Developing and performing a study to compare the health status of older patients who live alone with the status of older patients who live with family members
e. Identifying the effect of an investigational drug on patients’ hemoglobin levels
f. Using a biofeedback machine to teach a patient with cancer how to manage chronic pain
g. Preventing pneumonia in an immobile patient by implementing frequent turning, coughing, and deep breathing
h. Determining and administering fluid replacement therapy needed for a patient with serious burns
i. Testifying to legislative bodies regarding the effect of health policies on culturally, socially, and economically diverse populations
a, b, d, f, g, I
A nurse who has worked in an orthopedic unit for several years is encouraged by the nurse manager to become certified in orthopedic nursing. What will certification in nursing require and provide (select all that apply)?
a. A certain amount of clinical experience
b. Successful completion of an examination
c. Membership in specialty nursing organizations
d. Professional recognition of expertise in a specialty area
e. An advanced practice role that requires graduate education
a, b, d. Certification usually requires an examination to verify a certain knowledge base and clinical experience in the specialty area to develop the expertise. Certification is a voluntary process that provides recognition of one's expertise.
What accurately describes the health care system in which future nurses will be employed?
a. With improvements in medicine there will be fewer patients with chronic illnesses.
b. Rapidly changing technology and expanding knowledge will simplify the health care environment.
c. Simplifying data collection and information infrastructure will provide more effective planning and policy making.
d. The Joint Commission establishes National Patient Safety Goals and evidence-based solutions for nurses to promote meeting these goals by all caring for the patient.
d. The Joint Commission establishes National Patient Safety Goals (NPSG) and evidence-based solutions to prevent persistent safety problems. Nurses are vital to promoting this culture of safety. Rapidly expanding technology and knowledge are increasing the health care system. With the aging population, there will be more patients with chronic illnesses. Effective workforce planning and policy making require better, not simpler, data collection and information infrastructure.
What six competencies from Quality and Safety Education for Nurses (QSEN) are expected of new nursing graduates?
Key Answer: QSEN's six competencies are (1) Patient-centered care, (2) Teamwork and collaboration, (3) Quality improvement, (4) Safety, (5) Informatics and technology, and (6) Evidence-based practice.
Place the steps of the evidence-based practice (EBP) process in order (0 being the first step; 6 being the last step).
_ Make recommendations for practice or generate data
_ Ask a clinical question
_ Critically analyze the evidence
_ Find and collect the evidence
_ Evaluate the outcomes in the clinical setting
_ Create a spirit of inquiry
_ Use evidence, clinical expertise, and patient preferences to determine care
Numbered in order:
6 Make recommendations for practice or generate data
1 Ask a clinical question
3 Critically analyze the evidence
2 Find and collect the evidence
5 Evaluate the outcomes in the clinical setting
0 Create a spirit of inquiry
4 Use evidence, clinical expertise, and patient preferences to determine care
The following is an example of evidence-based practice (EBP) clinical question. “In adult seizure patients, is restraint or medication more effective in protecting them from injury during a seizure?” Which word(s) in the question identify the C part of the PICOT format?
b. Or medication
c. During a seizure
d. Adult seizure patients
e. Protecting them from injury
b. The C part of the PICOT format stands for Comparison. “Restraint” is the Intervention. “During a seizure” is the Time period. “Adult seizure patients” is the Patient/population. “Protecting them from injury” is the Outcome.
Two nurses are establishing a smoking cessation program to assist patients with chronic lung disease to stop smoking. To offer the most effective program with the best outcomes, the nurses should initially
a. search for an article that describes nursing interventions that are effective for smoking cessation.
b. develop a clinical question that will allow patients to compare different cessation methods during the program.
c. keep comprehensive records that detail each patient’s progress and ultimate outcomes from participation in the program.
d. use evidence-based clinical practice guidelines developed from randomized controlled trials of smoking cessation methods.
d. Evidence-based clinical practice guidelines are developed from summaries of research results and reflect the best-known state of practice at the time. The use of these guidelines leads to more positive outcomes of care and would be best to use in planning care or programs.
Which standardized nursing terminologies specifically relate to the steps of the nursing process (select all that apply)?
a. Omaha System
b. Nursing Minimum Data Set (NMDS)
c. Perioperative Nursing Data Set (PNDS) d. Nursing Outcomes Classification (NOC)
e. Nursing Interventions Classification (NIC) f. NANDA International Nursing Diagnoses
d, e, f. Only standardized terminologies describe and organize nursing practice that includes patient responses, nursing interventions, and patient outcomes.
The nurse working in a health care facility where uniform electronic health records are used explains to the patient that the primary purpose of such a record is to
a. reduce the cost of health care by eliminating paper records.
b. keep the patient’s medical information more private than handwritten records.
c. efficiently improve clinical decision making, patient safety, and quality of patient care.
d. provide a single record, making the patient’s medical information accessible to any caregivers in any health system.
c. An electronic health record (EHR) is being used to efficiently improve clinical decision-making, patient safety, and quality of patient care. The cost is not reduced; more people have access to the records, but this is being monitored to protect patient privacy; all health systems are currently not able to communicate via EHRs.
Match the phases of the nursing process with the descriptions (phases may be used more than once).
- Assessment 2. Diagnosis 3. Planning 4. Implementation 5. Evaluation
a. Analysis of data
b. Priority setting
c. Nursing interventions
d. Data collection
e. Identifying patient strengths
f. Measuring patient achievement of goals
g. Setting goals
h. Identifying health problems
i. Modifying the plan of care
j. Documenting care provided
a. 2; b. 3; c. 4; d. 1; e. 2; f. 5; g. 3; h. 2; i. 5; j. 4
During the diagnosis phase of the nursing process, both nursing diagnoses and collaborative problems are identified. Which statements are collaborative problems (select all that apply)?
a. Fatigue related to sleep deprivation
b. Infection-related to immunosuppression
c. Excess fluid volume related to high sodium intake
d. Constipation related to irregular defecation habits
e. Hypoxia related to chronic obstructive pulmonary disease
f. Risk for cardiac dysrhythmias related to potassium deficiency
b, e, f. Collaborative problems are potential or actual complications of disease or treatment. As stated, fatigue, constipation, and excess fluid volume are not complications of disease or treatment.
For the nursing diagnoses and written patient outcomes listed below, use the Nursing Interventions Classification (NIC) to identify a specific nursing intervention to help the patient reach the outcome.
a. Nursing diagnosis: Risk for impaired skin integrity related to immobility Patient outcome: Patient will demonstrate skin integrity free of pressure ulcers.
b. Nursing diagnosis: Constipation related to inadequate fluid and fiber intake Patient outcome: Patient will have daily soft bowel movements in 1 week.
Many answers may be correct. Examples include the following: a. Turn the patient every 2 hours using the following schedule: L side to back to R side to L side to back. Inspect and document all at-risk areas for blanching and erythema at each position change. b. Provide 8 oz of fluids every 2 hours (even hours) while the patient is awake (the patient prefers 467 cold liquids). Assist the patient in choosing five fresh fruits or vegetables from the menu each day.
A patient with a seizure disorder is admitted to the hospital after a sustained seizure. When she tells the nurse that she has not taken her medication regularly, the nurse makes a nursing diagnosis of Ineffective health management related to lack of knowledge regarding medication regimen and identifies the Nursing Outcomes Classification (NOC) outcome of Compliance behavior: prescribed medications, with the indicator, Takes medication at intervals prescribed, at a target rate of 3 (sometimes demonstrated). When the nurse tries to teach the patient about the medication regimen, the patient tells the nurse that she knows about the medication but does not always have the money to refill the prescription. Where was the mistake made in the nursing process with this patient?
d. The mistake was made during assessment when the nurse did not ask why the patient had not taken her medication regularly and the appropriate etiology for the nursing diagnosis was not validated.
Identify the five rights of delegating nursing care (select all that apply).
a. Right time
b. Right task
c. Right patient
d. Right person
e. Right dosage
f. Right circumstance
g. Right supervision and evaluation
h. Right directions and communication
b, d, f, g, h. The right task, right person, right circumstance, right supervision and evaluation, right directions, and communication.
Delegation is a process used by the RN to provide safe and effective care efficiently. Which nursing interventions should not be delegated to unlicensed assistive personnel (UAP) but should be performed by the RN (select all that apply)?
a. Administering patient medications
b. Ambulating stable patients
c. Performing a patient assessment
d. Evaluating the effectiveness of patient care
e. Feeding patients at mealtime
f. Performing sterile procedures
g. Providing patient teaching
h. Obtaining vital signs on a stable patient
a, c, d, f, g. These actions or interventions require judgment and clinical decision-making; therefore they should be performed by an RN.
Match the following care planning tools to the description statement(s). There may be more than one tool per statement, and the tools will be used more than once.
- Nursing Care Plan 2. Concept Maps 3. Clinical Pathway
___A plan that directs an entire health care team Used as a guide for routine nursing care
___Used in nursing education to teach the nursing process and care planning
___A description of patient care required at specific times during treatment
___Should be personalized and specific to each patient
___A visual diagram representing relationships among patient problems, interventions, and data
___Used for high-volume or high-risk and predictable case types
3 A plan that directs an entire health care team 1 Used as guides for routine nursing care 1, 2 Used in nursing education to teach the nursing process and care planning 3 A description of patient care required at specific times during treatment 1 Should be personalized and specific to each patient 2 A visual diagram representing relationships between patient problems, interventions, and data 3 Used for high-volume and highly predictable case types.
Which nursing actions are in response to the National Patient Safety Goals (select all that apply)?
a. Use restraints to prevent patient falls.
b. Administer all medications ordered by physicians.
c. Wash hands before and after every patient contact.
d. Conduct a “time-out” when too tired to provide care.
e. Quickly communicate test results to the right staff person.
f. Evaluate the initial existence of pressure ulcers before patient dismissal.
c, e. Hands are to be washed with soap and water or gel before and after each patient. Quickly communicating test results to the right staff person increases the effectiveness of patient care by the health care team. Restraints are not suggested as part of the National Patient Safety Goals (NPSG), although evaluating fall risk and taking action to reduce fall risk are included. All medications may not be administered if there is an interaction between them. The HCP would be notified before administering any questionable medications. The “time-out” is not for the nurse's fatigue but to ensure that the correct patient procedure and site are verified before surgical procedures. To prevent healthcare-related pressure ulcers, NPSG suggest assessing patients at risk initially on admission and regularly throughout their care. To improve the accuracy of patient identification, it is suggested that two identifiers are used whenever a patient is identified, including for but not limited to medication administration.
Which quality of care measures influences the payment for health care services by third-party payers (select all that apply)?
a. Clinical outcomes
b. Cultural awareness
c. Use of evidence-based practice
d. Adoption of information technology
e. Occurrence of a serious reportable event
a, b, c, e. Clinical outcomes, cultural awareness, use of the evidence-based practice, and occurrence of serious reportable events are all care and performance initiatives that influence payment for health care services by third-party payers. Adoption of information technology no longer affects payment for care, although requirements for the Affordable Care Act are changing in this area.
The Affordable Care Act (ACA) encourages groups of doctors, hospitals, and other health care providers to unite to coordinate care for Medicare patients. What are these groups called?
a. National Quality Forum (NQF)
b. Preferred Provider Organization (PPO)
c. Accountable Care Organization (ACO)
d. Health Maintenance Organization (HMO)
c. Accountable Care Organizations (ACO) are the groups that coordinate care to ensure the right care is given at the right time. National Quality Forum (NQF) reduces the occurrence of serious reportable events by providing a list of effective Safe Practices to be used in health care settings. Preferred provider organizations (PPOs) and health maintenance organizations (HMOs) provide health care services with charges established with predetermined reimbursement rates or capitation fees in advance of the medical, hospital, and other health care services delivered.
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