https://www.stuvia.com/en-us/doc/8231855/test-bankbrunner-en-suddarths-textbook-of-medical-surgicalnursing-15th-edition-by-janice-l-hinkle-kerry-h.cheever-en-kristen-overbaugh-complete-elaboratedand-latest-test-bank.-all-chapters-1-68-included-andupdated-for-2025
Brunner&Suddarth'sTextbookofMedicalSurgicalNursing 15thEdition
Author(s):JaniceLHinkle,KerryH.CheeverTEST
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BANK
Ⓒ2022
Chapter 1: Health Care Delivery and Evidence-Based Nursing
Practice
1. Thepublichealthnurseispresentingahealthpromotionclasstoa groupofnew
mothers. Howshould thenursebest definehealth?
A) Healthisbeingdiseasefree.
B) Healthishaving fulfillment inall domainsof life.
C) Healthishavingpsychologicalandphysiologicalharmony.
D) Healthisbeingconnectedinbody,mind,andspirit.
Ans: D
Feedback:
The World Health Organization(WHO) defineshealth inthepreambletoitsconstitutionas
aìstateofcompletephysical, mental, and socialwell-being andnot merelytheabsenceof
diseaseandinfirmity.îTheotheranswersareincorrectbecausetheyarenotcongruentwith
the WHOdefinitionofhealth.
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2. Anurseisspeaking toagroupofprospectivenursingstudentsabout whatitisliketobeanurse.
What is one characteristic the nurse would cite as necessary to possess to be an effective
nurse?
A) Sensitivitytoculturaldifferences
B) Team-focusedapproachtoproblem-solving
C) Strictadherencetoroutine
D) Abilitytofacecriticism
Ans: A
Feedback:
Topromotean effectivenurse-patient relationshipand positive outcomes ofcare, nursing
caremustbeculturallycompetent, appropriate, and sensitivetoculturaldifferences.Teamfocusednursingandstrictadherencetoroutinearenotcharacteristicsneededtobean
effectivenurse. Theabilitytohandlecriticismis important, but toa lesserdegreethan
culturalcompetence.
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3. Withincreasesinlongevity, people havehadtobecomemoreknowledgeable abouttheir
health andthe professional health carethattheyreceive. Oneoutcomeofthis
phenomenonisthedevelopmentoforganizedself-careeducationprograms.Whichofthe
followingdothese programsprioritize?
A) Adequateprenatalcare
B) Government advocacyand lobbying
C) Judicioususeofonlinecommunities
D) Managementofillness
Ans: D
Feedback:
Organizedself-care education programsemphasizehealthpromotion, diseaseprevention,
managementofillness,self-care,andjudicioususeoftheprofessional healthcaresystem.
Prenatalcare, lobbying, and Internetactivitiesaresecondary.
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4. The homehealthnurseisassisting apatientand hisfamilyinplanning thepatient'sreturn
toworkaftersurgeryandthedevelopmentofpostsurgicalcomplications.Thenurseis
preparingaplanofcarethat addresses the patient's multifacetedneeds. Towhichlevel
of Maslow'shierarchyofbasic needs does thepatient'sneedforself- fulfillmentrelate?
A) Physiologic
B) Transcendence
C) Love and belonging
D) Self-actualization
Ans: D
Feedback:
Maslow'shighest level ofhuman needsisself-actualization, whichincludesselffulfillment,desiretoknowandunderstand,andaestheticneeds.Theotheranswersare
incorrectbecauseself-fulfillmentdoesnotrelatedirectlytothem.
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5. Theviewthathealthandillnessarenot staticstatesbutthattheyexiston a continuumis
centraltoprofessionalhealthcaresystems. When planningcare, this viewaidsthenurse
in appreciatingwhichofthefollowing?
A) Care shouldfocusprimarilyonthe treatment of disease.
B) Aperson'sstate ofhealth is ever-changing.
C) Aperson can transition from healthtoillnessrapidly.
D) Careshouldfocusonthepatient'scompliancewithinterventions.
Ans: B
Feedback:
By viewinghealth and illnesson acontinuum, it ispossibletoconsiderapersonasbeing
neithercompletelyhealthynorcompletelyill.Instead,aperson's stateofhealthiseverchangingandhasthepotentialtorangefrom high-levelwellnesstoextremelypoorhealth
and imminentdeath. Theotheranswersareincorrect because patient care should notfocus
just on thetreatmentofdisease. Rapid declinesin health andìcomplianceîwithtreatment
are notkeytothisviewofhealth.
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6. Agroupofnursing studentsare participatingin acommunityhealthclinic. Whenproviding
careinthiscontext,whatshouldthestudentsteachparticipantsaboutdisease prevention?
A) It is best achievedthroughattendingself-helpgroups.
B) It isbest achieved byreducing psychologicalstress.
C) It isbest achievedbybeing an active participant inthecommunity.
D) Itisbestachievedbyexhibitingbehaviorsthatpromotehealth.
Ans: D
Feedback:
Today, increasing emphasisis placed on health, health promotion, wellness, andself- care.
Healthisseenasresulting from a lifestyle oriented towardwellness. Nursesincommunity
health clinics donot teachthatdiseasepreventionisbest achievedthrough attending self-help
groups, byreducingstress, orbybeingan active participant in thecommunity, thougheach
ofthese activities isconsistentwithahealthylifestyle.
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7. Anurseona medical-surgicalunit hasaskedtorepresenttheunitonthehospital's
qualitycommittee. When describing qualityimprovementprogramstonursing
colleaguesandmembersofotherhealthdisciplines,whatcharacteristicshouldthe
nursecite?
A) Theseprogramsestablish consequencesforhealthcare professionals'actions.
B) Theseprograms focusontheprocessesusedtoprovidecare.
C) Theseprograms identifyspecificincidentsrelated toquality.
D) Theseprogramsseektojustifyhealthcarecostsandsystems.
Ans: B
Feedback:
Numerousmodelsseek toimprovethequalityof healthcaredelivery. Acommonality
amongthemisa focusontheprocessesthatareusedtoprovidecare.Consequences,afocuson
incidents, andjustification forhealth carecostsarenot universalcharacteristicsofquality
improvementefforts.
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8. Nursesinacute care settingsmust workwithotherhealth care team memberstomaintain
qualitycarewhilefacingpressurestocareforpatientswhoarehospitalized forshorter
periodsoftimethaninthepast.Toensurepositivehealthoutcomeswhenpatientsreturnto
theirhomes, what actionshouldthenurseprioritize?
A) Promotionofhealthliteracyduringhospitalization
B) Close communication withinsurers
C) Thorough andevidence-based dischargeplanning
D) Participationincontinuingeducationinitiatives
Ans: C
Feedback:
Following dischargesthatoccurafterincreasinglyshorthospitalstays, nurses inthe
communitycareforpatientswhoneedhigh-technologyacutecareservicesaswellas
long-term carein thehome. Thisisdependent oneffective discharge planningtoagreater
degreethancontinuing education, communication with insurers,orpromotion ofhealth
literacy.
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9. Youareadmittingapatienttoyourmedicalunitafterthepatienthasbeentransferredfrom
theemergencydepartment. What is yourprioritynursingaction at this time?
A) Identifyingtheimmediate needsofthepatient
B) Checkingtheadmitting physician'sorders
C) Obtaining abaselinesetofvitalsigns
D) Allowingthefamilytobewiththepatient
Ans: A
Feedback:
Amongthenurse'simportantfunctionsinhealthcaredelivery,identifyingthepatient's
immediate needsandworkinginconcert withthepatienttoaddressthemismostimportant.
Theothernursingfunctionsareimportant, but theyarenotthemost important functions.
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10. Anurse onapostsurgicalunitisprovidingcarebasedon aclinicalpathway. When
performingassessmentsandinterventionswiththeaidofapathway,thenurseshould
prioritizewhatgoal?
A) Helpingthepatienttoachievespecificoutcomes
B) Balancingrisksandbenefitsofinterventions
C) Documentingthepatient'sresponse totherapy
D) Stayingaccountabletotheinterdisciplinaryteam
Ans: A
Feedback:
PathwaysareanEBPtoolthat isused primarilytomovepatientstoward predetermined
outcomes. Documentation, accountability, andbalancingrisksand benefitsareappropriate,
but helpingthepatientachieveoutcomesisparamount.
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11. StaffnursesinanICUsettinghavenoticedthat theirpatientsrequiredlowerandfewer
dosesof analgesia whennoiselevelson theunit wereconsciouslyreduced. Theyinformed
an advancedpractice RN ofthisand askedthe APRNtoquantifytheeffectsofnoise onthe
painlevelsofhospitalizedpatients.Howdoesthisdemonstratea roleof the APRN?
A) Involvingpatientsintheircarewhilehospitalized
B) Contributingtothescientificbasisofnursingpractice
C) Critiquingthequalityofpatientcare
D) ExplainingmedicalstudiestopatientsandRNs
Ans: B
Feedback:
Researchiswithin thepurviewoftheAPRN.Theactivitydescribeddoesnotexemplify
explainingstudiesto RNs, critiquing care, or involving patientsin theircare.
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12. Nurses now have the option to practice in a variety of settings and one of the fastest
growing venues of practice for the nurse in today's health care environment is home
health care. Whatisthemain basisforthegrowthinthishealthcaresetting?
A) Chronicnursingshortage
B) Westernfocusontreatmentofdisease
C) Nurses'preferencesfordayshiftsinsteadofeveningornightshifts
D) Dischargeofpatientswhoaremorecriticallyill
Ans: D
Feedback:
Withshorterhospital staysandincreased useofoutpatienthealthcareservices, morenursing
care is provided inthehomeand communitysetting. The otheranswers are incorrectbecause
theyarenot thebasisforthegrowthinnursing caredeliveredin thehomesetting.
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13. Nurseshavedifferenteducationalbackgroundsandfunctionundermanytitlesintheir
practicesetting. Ifanursepracticingin anoncologyclinic had thegoalofimproving
patientoutcomesandnursing carebyinfluencingthe patient,thenurse,andthehealthcare
system, whatwouldmostaccuratelydescribethisnurse'stitle?
A) Nursingcareexpert
B) Clinicalnursespecialist
C) Nursemanager
D) Staffnurse
Ans: B
Feedback:
Clinical nursespecialistsare preparedasspecialistswhopracticewithinacircumscribed
areaofcare(e.g., cardiovascular, oncology). Theydefinetheirroles ashavingfivemajor
components:clinicalpractice,education,management,consultation, andresearch. The
other answers are incorrect becausetheyarenotthemostaccuratetitlesforthisnurse.
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14. Nursing continuestorecognize andparticipate incollaboration withotherhealthcare
disciplinestomeetthecomplexneedsofthepatient.Whichofthefollowing isthebest
exampleofacollaborativepracticemodel?
A) Thenurseandthephysicianjointlymakingclinicaldecisions.
B) The nurse accompanying thephysicianonrounds.
C) The nurse making areferralonbehalfofthepatient.
D) Thenurseattendinganappointmentwiththepatient.
Ans: A
Feedback:
Thecollaborativemodel, oravariationofit, promotesshared participation, responsibility,
andaccountabilityinahealthcareenvironmentthatisstrivingtomeetthe complexhealth
careneedsofthepublic. Theotheranswersareincorrectbecausetheyarenotexamplesofa
collaborativepracticemodel.
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15. Ahospicenurseiscaring forapatient whoisdyingoflymphoma. Accordingto Maslow's
hierarchyofneeds,whatdimensionofcareshouldthenurseconsiderprimary inimportance
whencaring foradyingpatient?
A) Spiritual
B) Social
C) Physiologic
D) Emotional
Ans: C
Feedback:
Maslowranked human needsasfollows: physiologicneeds; safetyandsecurity; senseof
belongingandaffection; esteem andself-respect; andself-actualization, whichincludes
self-fulfillment, desiretoknowandunderstand, and aestheticneeds. Suchahierarchyof
needsisausefulframeworkthatcanbeappliedtothevariousnursing modelsfor
assessmentofapatient'sstrengths, limitations, andneedfornursinginterventions. The
other answers are incorrect because theyarenot ofprimaryimportancewhencaringfora
dyingpatient,thougheachshouldcertainlybeaddressed.
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16. Anurseisplanningamedicalpatient'scarewithconsiderationofMaslow'shierarchyof
needs. Withinthisframework ofunderstanding, what wouldbethenurse'sfirstpriority?
A) Allowing thefamilytoseeanewlyadmittedpatient
B) Ambulating the patient inthehallway
C) Administering pain medication
D) Teachingthepatienttoself-administerinsulinsafely
Ans: C
Feedback:
In Maslow's hierarchyofneeds, pain reliefaddressesthepatient'sbasicphysiologicneed.
Activity, suchasambulation, is ahigherlevelneedabovethephysiologicneed. Allowing
thepatienttoseefamilyaddressesahigherlevelneedrelatedtoloveandbelonging.
Teachingthepatientisalsoahigherlevelneedrelatedtothedesiretoknowandunderstand
andisnot appropriateatthistime,asthebasicphysiologicneedof paincontrolmustbe
addressed beforethe patient canaddress thesehigherlevelneeds.
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17. Amedical-surgicalnurseisawareofthescopeofpracticeasdefinedinthestatewherethe
nurse provides care. This nurse's compliancewiththenursepracticeactdemonstrates
adherencetowhichofthefollowing?
A) National Councilof Nursing'sguidelinesforcare
B) NationalLeague forNursing'sCode of Conduct
C) American NursesAssociation'sSocial PolicyStatement
D) DepartmentofHealthandHuman Service'sWhitePaperonNursing
Ans: C
Feedback:
Nurseshavearesponsibilitytocarryouttheirroleasdescribed inthe Social Policy
Statement tocomplywith thenursepracticeact ofthestatein whichtheypracticeandto
complywiththeCodeofEthicsforNursesasspelled outbytheANA(2001)andthe
International Councilof Nurses (International Councilof Nurses[ICN], 2006). Theother
answersareincorrect;theCodeofEthicsfornursingisnot included intheANA'swhite
paper. The DHHS hasnot published awhitepaperonnursing norhasthe NLNpublisheda
specificcodeofconduct.
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18. Nursing is, bynecessity, aflexibleprofession. Ithasadaptedtomeetboththeexpectations
andthechanginghealthneedsofouragingpopulation.Whatisonefactorthathasimpacted
the needforcertifiednursepractitioners(CNPs)?
A) Theincreased need forprimarycareproviders
B) Theneedtoimprovepatientdiagnosticservices
C) Thepushtodriveinstitutionalexcellence
D) Theneedtodecreasethenumberofmedicalerrors
Ans: A
Feedback:
CNPs whoareeducationally preparedwithapopulationfocusinadult-gerontologyor
pediatricsreceiveadditional focusedtraining in primarycareoracutecare. CNPshelpmeet
theneedforprimarycareproviders.Diagnosticservices,institutionalexcellence, and
reduction ofmedical errorsare congruent withthe CNProle, buttheseconsiderationsarethe
not primaryimpetusfortheincreasedrolefor CNPs.
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19. Anurseisprovidingcareforapatientwhoispostoperativedayonefollowingabowel
resection forthetreatmentofcolorectalcancer. Howcanthenursebestexemplifythe
QSENcompetencyofqualityimprovement?
A) Byliaising withthemembersoftheinterdisciplinarycareteam
B) Bycritically appraisingtheoutcomesofcarethat is provided
C) Byintegrating thepatient'spreferencesintotheplanof care
D) Bydocumentingcareintheelectronichealthrecordinatimelyfashion Ans:
B
Feedback:
EvaluationofoutcomesiscentraltotheQSENcompetencyofqualityimprovements. Eachof
theotherlistedactivitiesisacomponentofqualitynursing care, butnoneclearly
exemplifiesqualityimprovementactivities.
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20. Professional nursing expandsandgrowsbecauseoffactorsdrivenbythechangingneeds
ofhealthcareconsumers.Whichofthefollowingisafactorthat nursesshouldreflect in the
planning andprovision ofhealthcare?
A) Decreased accessto health care information byindividuals
B) Gradualincreasesin thecultural unityof theAmericanpopulation
C) Increasing mean andmedianageofthe American population
D) Decreasingconsumerexpectationsrelatedtohealthcareoutcomes
Ans: C
Feedback:
Thedeclineinbirth rateandtheincreaseinlifespanduetoimproved health carehaveresulted
in fewerschool-age childrenand moreseniorcitizens, manyofwhom arewomen.
Thepopulationhasbecomemoreculturallydiverseasincreasingnumbersofpeople from
different nationalbackgroundsenterthecountry. Accesstoinformationandconsumer
expectationscontinuetoincrease.
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21. Apublic healthnursehasbeencommissioned todraftahealth promotionprogramthat
meetsthehealthcare needsand expectationsof thecommunity.Whichofthefollowing
focusesismostlikelytoinfluencethenurse'schoiceofinterventions?
A) Managementofchronicconditionsand disability
B) Increasing need forself-care amonga youngerpopulation
C) Ashifting focustodisease management
D) Anincreasingfocusonacuteconditionsandrehabilitation
Ans: A
Feedback:
Inresponsetocurrentpriorities, health caremustfocusmoreon management ofchronic
conditionsanddisability thaninprevioustimes. Theotheranswersareincorrectbecause
thechangeinfocusofhealthcareisnotan increasingneedforself- careamongouraging
population;ourfocusisshiftingawayfromdiseasemanagement, not towardit; and we are
moving away from the management ofacuteconditionstomanagingchronicconditions.
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22. Acommunityhealthnursehaswitnessedsignificantshiftsinpatternsofdiseaseoverthe
courseofafour-decadecareer. Whichofthefollowingfocusesmostclearly
demonstrates thechangingpatternofdiseaseinthe United States?
A) Type1diabetesmanagement
B) Treatmentofcommunity-acquiredpneumonia
C) Rehabilitationfrom traumatic brain injuries
D) ManagementofacuteStaphylococcusaureusinfections
Ans: A
Feedback:
Managementofchronicdiseasessuchasdiabetesisapriorityfocusofthecurrenthealth
careenvironment. Thissupersedesthe treatment ofacuteinfectionsandrehabilitation
needs.
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23. The ANA hasidentified several phenomena towardwhich thefocusofnursingcare
shouldbedirected,andanurseisplanningcarethatreflectsthesepriorities.Whichofthe
nurse'sactionsbestdemonstratesthesepriorities?
A) Encouragingthe patient'sdependenceoncaregivers
B) Fostering the patient's abilitytomakechoices
C) Teachingthepatient aboutnurses' rolesin thehealthcaresystem
D) Assessingthepatient'sadherencetotreatment
Ans: B
Feedback:
TheANAidentifiesseveralfocusesfornursingcareandresearch,includingtheabilityto
makechoices. Theotheranswersareincorrectbecausetheyarenotphenomenaidentified
bythe ANA.
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24. Theroleofthecertifiednursepractitioner(CNP) hasbecomeadominantrolefor
nursesinalllevelsofhealthcare.Whichofthefollowingactivitiesareconsidered
integraltothe CNProle? Select all that apply.
A) Educatingpatientsandfamilymembers
B) Coordinatingcare with otherdisciplines
C) Usingdirect provisionofinterventions
D) Educatingregisterednursesandpracticalnurses
E)
Coordinatingpaymentplansforpatients
Ans: A, B, C
Feedback:
Thisroleis adominantonefornurses inprimary, secondary, andtertiaryhealthcaresettings
and inhomecareandcommunitynursing. Nurses helppatientsmeettheirneedsbyusing
directintervention,byteachingpatientsandfamilymembersto performcare, andby
coordinatingand collaboratingwith otherdisciplinestoprovideneededservices. Theother
answers areincorrectbecause NPs donotcommonlyperformeducationofnursesand they
donotfocusonmattersrelatedtopayment.
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25. TheANAhasidentifiedcentralcharacteristicsofnursingpracticethatareapplicable
acrossthewidevarietyofcontextsin whichnursespractice. Anursecan best
demonstrate these principlesbyperformingwhich of the following actions?
A) Teachingthepublicabouttheroleofnursing
B) Taking actiontocontrol thecosts of healthcare
C) Ensuring that allofhisorheractionsexemplifycaring
D) Makingsuretocarryadequateliabilityinsurance
Ans: C
Feedback:
The ANA emphasizesthefactthat caring is centraltothepracticeoftheregistered nurse.
TheANAdoesnotidentifyteachingthe publicabout nursing,controllingcosts, or
maintaining insurance asa central tenet ofnursing practice.
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26. Anurse hasaccepted apositionasaclinicalnurseleader(CNL), anewrolethathasbeen
launchedwithinthepast decade.Inthisrole,thenurseshouldprioritizewhich of the
followingactivities?
A) Actingasa spokesperson forthenursingprofession
B) Generatinganddisseminatingnewnursingknowledge
C) Diagnosing andtreatinghealthproblemsthathaveapredictablecourse
D) Helpingpatientstonavigatethehealthcaresystem
Ans: D
Feedback:
The CNLisanursegeneralistwithamaster'sdegreein nursing andaspecial background in
clinical leadership, educatedtohelppatientsnavigatethroughthecomplexhealthcare
system.Theotheranswersareincorrectbecausetheyarenotwhat nursinghasidentified as
the CNLrole.
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27. Our worldisconnected byasophisticatedcommunicationsystemthatmakesmuchhealth
informationinstantlyaccessible, nomatterwherethepatientisbeingtreated. Thisinstant
accesstohealthinformation hasimpacted healthcaredeliverystrategies, includingthe
deliveryofnursingcare.Whatisonewaythedeliveryofhealthcarehasbeenimpactedby
thisphenomenon?
A) Briskchanges as wellasswiftobsolescence
B) Rapidchangethat is nearlypermanent
C) Limitations on thesettings wherecarecanbeprovided
D) Increasedneedforsocialacceptance
Ans: A
Feedback:
The sophisticatedcommunicationsystemsthat connect most partsoftheworld, withthe
capabilityofrapidstorage, retrieval, and disseminationof information, havestimulated
briskchangeaswell asswift obsolescencein healthcaredeliverystrategies. The other
answersareincorrectbecause,althoughwehaverapid changeinthedelivery ofnursingcare,
itdoesnot last alongtime; it isevolvingas health careitselfevolves. Giving nursingcare
hasnot becomeeasier, it becomesmorecomplexwitheverychange; anditdoesnotneedto
bemoresociallyacceptable; it needstobemoreculturallysensitive.
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28. Withthechangingpopulationofhealthcareconsumers, it hasbecomenecessaryfor
nursestowork morecloselywith othernurses,aswhenacutecarenursescollaboratewith
public healthand homehealthnurses. Whatnursingfunction hasincreasedin
importancebecauseofthisphenomenon?
A) Prescribingmedication
B) Performingdischargeplanning
C) Promotingfamilyinvolvement
D) Formingcollegialrelationships
Ans: B
Feedback:
The importance ofeffective discharge planningand qualityimprovementcannotbe
overstated. Theotheranswersare incorrectbecause givingmedicationandfamily
involvement inthe patient'scare have not grownin importance. Makingand maintaining
collegialrelationshipshasbecomeanecessityinworking in the healthcaredeliverysystem.
Effective discharge planningaidsingetting patientsout oftheinpatient setting sooner,
cutting costs, and makingrehabilitation in thecommunityandhomesettingpossible.
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29. Anursehasintegratedtheprinciplesofevidence-basedpracticeintocare.EBPhasthe
potential tohelpthenurseachieve whatgoal?
A) Increasing careersatisfaction
B) Obtaining federalgrantmoney
C) Ensuring highqualitypatientcare
D) Enhancingthepublic'sesteemfornursing
Ans: C
Feedback:
QualityimprovementistheultimategoalofEBP.Careersatisfaction,publicesteem, and
grantmoneyarenotpriorities.
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30. Acasemanagerhasbeenhiredataruralhospitalthathasacombinedmedical-surgicalunit.
Whendefiningthis newrole, which of the following outcomesshouldbeprioritizedbythe
hospital'sleadership?
A) Decreased needforphysicianservices
B) Improvedpatient and familyeducation
C) Increased adherence totheprinciplesof EBP
D) Increasedcoordinationofhealthservices
Ans: D
Feedback:
Casemanagementisasystem of coordinating health careservicestoensurecosteffectiveness, accountability, andqualitycare. The case manager coordinates thecareofa
caseload ofpatientsthroughfacilitatingcommunicationbetween nurses, otherhealthcare
personnelwhoprovidecare, and insurancecompanies. Reducing theneedforphysician
servicesisnot acentralgoal.Educationand EBPareconsistentwithcasemanagement, but
theyarenotcentraltothisparticularrole.
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31. Ahospital'scurrentqualityimprovementprogramhasintegratedtheprinciples ofthe
Institutefor Healthcare Improvement(IHI) 5 Million Lives Campaign. Howcanthe
hospital bestachieve thecampaign goalsofreducingpreventableharmanddeath?
A) By adhering toEBPguidelines
B) By reducing nurse-to-patient ratiosandincreasingaccountability
C) Byhaving researchersfromoutsidethefacilityevaluatecare
D) Byinvolvingpatientsandfamiliesintheircareplanning
Ans: A
Feedback:
The 5 Million Lives Campaign posits thatif evidence-basedguidelinesit advocated were
voluntarilyimplementedbyU.S.hospitals,5millionliveswouldbesaved fromeitherharm
ordeathovera two-yearperiod. Nurse-to-patient ratios, familyparticipation,and
independentevaluationarenotstatedcomponentsofthecampaign.
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32. Overthepastseveraldecades,nursingroleshavechangedandexpandedinmanyways.
Whichofthefollowing factorshas provided thestrongestimpetusforthischange?
A) The needto decrease the cost of health care
B) The needto improve the qualityof nursingeducation
C) Theneedtoincreasethenumberofnursingjobsavailable
D) Theneedtoincreasethepublicperceptionofnursing
Ans: A
Feedback:
Theroleofthenursehas expandedtoimprovethedistributionofhealthcareservicesandto
decreasethecostofhealthcare. The otheranswers are incorrect because the expansionof
rolesin nursingdid notoccurtoimproveeducation,increase thenumberofnursingjobs, or
increasepublicperception.
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33. Advancedpracticenursingroleshavegrowninnumberandinvisibilityinrecentyears. What
characteristic setsthese nursesapart fromtheregisterednurse?
A) Collaborationwithotherhealth careproviders
B) Educationthat goesbeyond that of the RN
C) Advanceddocumentation skills
D) Abilitytoprovidecareinthesurgicalcontext
Ans: B
Feedback:
There is widevarietyin APRNroles. However, acommonalityisthattheyrequireeducation
beyond thatoftheprofessional RN. All nursescollaborate with otherhealthcareprovidersto
providenursingcaretotheirpatients.Advanceddocumentationskillsare not whatsets
advanced practice nurses apartfrom thestaffnurse. RNshavetheabilitytoprovidecarein
theoperatingroom.
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34. CNPsareeducatedasspecialistsinareassuch asfamilycare,pediatrics,orgeriatrics. In
moststates, whatrightdo CNPshavethat RNsdonotpossess?
A) Performhealthinterventionsindependently
B) Makereferralstomembersofotherhealthdisciplines
C) Prescribemedications
D) Performsurgeryindependently
Ans: C
Feedback:
Inmost states, nursepractitionershaveprescriptiveauthority. Surgeryisbeyondthe CNP
scopeofpracticeandallprofessionalnursesmayperforminterventionsandmakecertain
referrals.
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35. Ateamofcommunityhealthnursesareplanningtodraftaproposalfora programthatwill
increase the community'salignment withthe principles contained inthe Healthy People
2020 report. Whichofthefollowing activitieswouldbestdemonstratethepriorities
identifiedinthisreport?
A) Addressingdeterminantsofhealthsuchascleanenvironmentsandsafetyinthe
community
B) Lobbyingforincreasedfundingtothecountyhospitalwheremanyresidents
receiveprimarycare
C) Collaboratingwithhealthprofessionalsinneighboringcommunitiestopool
resourcesandincreaseefficiencies
D) Creatingclinicalplacementswherenursingstudentsand membersofotherhealth
disciplines can gain experiencein acommunitysetting
Ans: A
Feedback:
HealthyPeople2020addressessocialdeterminantsofhealthsuchassafetyandthestate of
theenvironment. Thisreport does not specificallyaddressmatters suchashospital
funding, nursing education, orresourceallocation.
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36. Anurse isawarethat anincreasingemphasisisbeingplaced onhealth, health
promotion,wellness,andself-care.Whichofthefollowingactivitieswouldbest
demonstratetheprinciplesofhealthpromotion?
A) Adischarge planning initiative between acutecareandcommunitycarenurses
B) Collaborationbetween several schoolsof nursing inanurbanarea
C) Creationofa smoking prevention program undertaken ina middleschool
D) Establishmentofawebsitewherepatientscancheckemergencydepartmentwaittimes
Ans: C
Feedback:
Smoking preventionisaclearexampleofhealthpromotion. Eachoftheotherlistedactivities
has thepotentialtobebeneficial, butnoneisconsidered healthpromotion.
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37. Agroupofnursingstudentsarelearningaboutrecentchangesinthepatternofdisease inthe
United States. Whichofthefollowingstatementsbestdescribesthesecurrentchanges?
A) Infectiousdiseasescontinuetodecreaseinincidence andprevalence.
B) Chronicillnessesare becoming increasinglyresistanttotreatment.
C) Mostacute,infectiousdiseaseshavebeeneradicated.
D) Most,butnotall,communicablediseasesaredeclining.
Ans: D
Feedback:
Althoughsomeinfectiousdiseaseshavebeen controlledoreradicated,othersareontherise.
Antibiotic resistance is amore serious problem in acute, not chronic, illnesses.
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38. TheJoint Commissionand theCentersforMedicareand Medicaid Services(CMS)are
evaluatingalarge, universitymedicalcenteraccordingtocoremeasures. Evaluators
shouldperform thisevaluationin whatway?
A) By auditingthemedicalcenter's electronic health records
B) Byperformingfocusgroupsandinterviewswithcareprovidersfromnumerous
disciplines
C) By performing statistical analysisof patientsatisfactionsurveys
D) Bycomparingthecenter'spatientoutcomestobestpracticeindicators
Ans: D
Feedback:
Core measuresare used togaugehowwella hospital gives caretoitspatientswhoare
admitted toseek treatment foraspecificdiseaseorwhoneed aspecifictreatmentas
compared toevidence-basedguidelinesandstandardsofcare. Benchmark standardsof
qualityareusedtocomparethecareortreatmentpatientsreceivewiththebestpractice
standards. Patientsatisfactionisconsidered, butthis isnot theonlycriterion.
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39. Leadershipofamedical unit have been instructedtointegrate the principles ofthe Quality
and SafetyEducationforNurses(QSEN) competencyofqualityimprovement. Whataction
shouldthe unit's leaderstake?
A) Provideaccesstoonlinejournalsand Web-basedclinicalresourcesfornursing staff.
B) Useflowchartsto document the processes ofcarethat areused ontheunit.
C) Enforcecontinuing education requirements forall careproviders.
D) Reducetheuseofchemicalandphysicalrestraintsontheunit. Ans:
B
Feedback:
Oneofthequalityimprovementskillsistousetools, such asflowchartsandcause- effect
diagrams, tomakeprocessesofcareexplicit. Each of theotherlistedactionshasthepotential
tobenefitpatientsandcaregivers,butnoneisanexplicitknowledge,skill, orattitude
associated withthis QSENcompetency.
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40. TheIOMReportHealthProfessionsEducation:ABridgetoQualityissuedanumberof
challengestothe educational programs that teach nursesandmembersofotherhealth
professions. According tothisreport, what activityshouldeducationalinstitutions
prioritize?
A) Moreclearlydelineate eachprofession'sscopeofpractice duringeducation
B) Movetowarddevelopingasinglehealthcurriculumthatcanbeadaptedforany
healthprofession
C) Includeinterdisciplinarycorecompetenciesintocurricula
D) Elicitinputfrompatientsandfamiliesintohealthcarecurricula
Ans: C
Feedback:
Health Professions Education: ABridgeto Quality challenged healthprofessions'
educationprogramstointegrate interdisciplinary core competencies intotheirrespective
curriculatoincludepatient-centered care, interdisciplinaryteamworkandcollaboration,
evidence-basedpractice,qualityimprovement,safety,andinformatics. Thisreportdidnot
specifyclearerdefinitionsofscopeofpractice, patientinput, ora singlecurriculum.
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Chapter 2: Community-Based Nursing Practice
1. Acommunityhealthnursehasscheduledahypertensionclinic in alocalshoppingmallin
whichshoppershavetheopportunitytohavetheirbloodpressuremeasuredand learn about
hypertension. Thisnursingactivity would beanexampleofwhich typeofprevention
activity?
A) Tertiaryprevention
B) Secondaryprevention
C) Primaryprevention
D) Diseaseprevention
Ans: B
Feedback:
Secondaryprevention centers onhealth maintenanceaim at earlydetectionandprevention.
Diseasepreventionisnotaformofhealthcarebutisafocusonprimaryprevention.
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2. The nursinginstructorispreparingagroupofstudentsfortheirhomecarerotation.In
preparation,thegroupdiscussesthepatientsthattheyaremostlikelytocareforin thehome.
Whichofthefollowinggroupsarethemostcommonrecipientsofhomecareservices?
A) Mentallyillpatients
B) Patientsreceivingrehabilitationafter surgery
C) Terminally ill and palliativepatients
D) Elderlypatients
Ans: D
Feedback:
Theelderlyarethemostfrequentusersofhomecareservices. The patient mustbeacutelyill,
homebound,andinneedofskilled nursingservicestobeeligibleforthisservice. Theother
answers areincorrectbecauseitistheelderlywhoareseenmostfrequentlyinthehome
health setting, though each oftheotherlistedgroupsmaysometimes receivehomecare.
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3. Arecent nursing graduate has been surprised at the sharp contrast between some
patients'lifestylesintheirhomesandthenurse'sown practicesand beliefs.Towork
therapeuticallywiththepatient, what mustthenursedo?
A) Requestanotherassignment ifthereis dissonancewiththepatient'slifestyle.
B) Ask the patient tocometotheagencytoreceivetreatment, ifpossible.
C) Resolveto conveyrespect forthe patient's beliefsand choices.
D) Trytoadaptthepatient'shometothenormsofahospitalenvironment. Ans:
C
Feedback:
Towork successfullywithpatientsinanysetting,thenursemustbenonjudgmentaland
conveyrespectforpatients' beliefs, even if theydiffersharplyfromthenurse's. Thiscan be
difficult whena patient'slifestyle involvesactivitiesthatanurseconsidersharmfulor
unacceptable, suchassmoking, useofalcohol, drugabuse, orovereating.
The nurse should not request another assignment because of a difference in beliefs, nor do
nurses ask for the patient to come to you at the agency to receive treatment. It is also
inappropriate toconvert the patient's hometoahospital-likeenvironment.
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4. Infection controlisa highpriorityineverysetting wherenursingcareisprovided. When
performinga homevisit,howshouldthenursebestimplementtheprinciplesofinfection
control?
A) Perform handhygienebeforeandaftergivingdirectpatientcare.
B) Removethepatient'swounddressingsfromthehomepromptly.
C) Disinfectthepatient'ssyringespriortodisposal.
D) Establishasterile fieldinthepatient'shomebeforeprovidingcare. Ans:
A
Feedback:
Infection controlisasimportantinthehomeasitisin thehospital, but itcanbemore
challenginginthehomeandrequirescreativeapproaches. As inanysituation, it is
important tocleanone'shands before andaftergiving directpatientcare, evenina homethat
doesnot haverunning water.Removing thewounddressings fromthehomeanddisinfecting
allworkareasin thehomearenotthebest implementationsofinfectioncontrolinthehome.
Used syringesare neverdisinfected and asterilefieldisnotalwaysnecessary.
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5. An adultpatientisreadytobedischargedfromthehospitalafterundergoinga
transmetatarsalamputation.Whenshouldyourpatient'sdischargeplanningbegin?
A) Thedaypriortodischarge
B) Thedayofestimateddischarge
C) Thedaythatthepatient isadmitted
D) Oncethenursingcareplanhasbeenfinalized
Ans: C
Feedback:
Discharge planning begins withthe patient'sadmissiontothe hospital andmustconsiderthe
possibleneedforfollow-uphomecare.Dischargeplanningshouldbeginpriortotheother
listedtimes.
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6. Ahomehealthnurseispreparingtomaketheinitialvisittoa newpatient'shome. When
planningeducationalinterventions,whatinformationshouldthenurseprovidetothepatient
and his orherfamily?
A) Availablecommunityresourcestomeet their needs
B) Informationonother patientsinthe area with similarhealthcareneeds
C) The nurse's contactinformationand credentials
D) Datesandtimesofallscheduledhomecarevisits
Ans: A
Feedback:
Thecommunity-basednurseisresponsibleforinformingthepatientandfamilyaboutthe
communityresourcesavailabletomeettheirneeds. Duringinitial and subsequenthome
visits, thenursehelpsthepatientandfamilyidentifythesecommunityservicesand
encouragesthemtocontacttheappropriateagencies. When appropriate, nurses may
maketheinitialcontact.Theotheranswersareincorrectbecauseit isinappropriate toever
provideinformationonotherpatientstoapatient. Thenurse'scredentialsare notnormally
discussed. Giving thepatientthedates andtimes of their scheduled homevisitsis
appropriate, but maynotalways bepossible. It is more important toprovide them with
resourcesavailablewithinthecommunity to meettheirneeds.
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https://www.stuvia.com/en-us/doc/8231855/test-bank-brunner-en-suddarths-textbookof-medical-surgical-nursing-15th-edition-by-janice-l-hinkle-kerry-h.-cheever-enkristen-overbaugh-complete-elaborated-and-latest-test-bank.-all-chapters-1-68included-and-updated-for-2025
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