Chapter 1. Evolution of Nursing Thought & Action

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____	1.	The nurse is working in a community health-promotion clinic. Which is an example of an illness prevention activity?
1.	Encouraging the use of a food diary	
2.	Joining a cancer support group	
3.	Administering immunization for human papillomavirus (HPV)	
4.	Teaching a diabetic patient about their diet	

____	2.	A practicing nurse is aware that continuing education courses may be required for license renewal. Which organization can require nurses to obtain a specified amount of continuing education courses?
1.	American Nurses Association	
2.	National League for Nursing	
3.	Sigma Theta Tau	
4.	State Board of Nursing	

____	3.	An experienced nurse uses knowledge of patient medical conditions and intuition to identify patient problems. The nurse often fulfills the role of a resource for other nurses on the unit. At this point, which stage of proficiency has this nurse achieved?
1.	Novice	
2.	Advanced beginner	
3.	Competent	
4.	Expert	

____	4.	Which statement best explains the importance of standards of practice in the nursing profession?
1.	Nurses have the same standards of practice as other healthcare professionals.	
2.	Standards of practice are applied exclusively to nurses working in hospital settings.	
3.	Standards of practice identify the components nurses need to provide safe-care.	
4.	Standards of practice differ among registered nurses, based on the population they serve.	

____	5.	The nursing instructor is considering becoming a member of the National League for Nursing (NLN). Which primary goal of the NLN will most strongly impact the nurse’s decision to become a member?
1.	Emphasizing the necessity for registered nurses to promote patient safety	
2.	Establishing and maintaining identified standards for nursing education	
3.	Supporting global health policies and improving health worldwide	
4.	Fostering nursing scholarship, leadership, and service to improve health	

____	6.	The nurse is providing care for a patient following a debilitating stroke. Which type of care will the nurse recognize as the best choice for this patient?
1.	Primary care	
2.	Secondary care	
3.	Tertiary care	
4.	Preventive care	

____	7.	The nurse is providing care for an older adult patient in an acute care setting for various age-related health issues. When planning for discharge, the patient states concern about being able to adequately provide for health maintenance and self-care needs. Which type of facility does the nurse recognize for this patient?
1.	Skilled nursing facility	
2.	Assisted-living facility	
3.	Nursing home facility	
4.	Independent living facility	

____	8.	The nurse understands that the most important reason for the development of a definition for the profession of nursing is that it:
1.	Will result in more informed people being recruited as nurses.	
2.	Is a means for evaluating the degree of role satisfaction in nurses.	
3.	Helps dispel the stereotypical images about nurses and nursing.	
4.	Differentiates the nursing role from those of other health professionals.	

____	9.	Which activity provides evidence-based support for the contribution made by advanced practice nurses (APNs) within healthcare?
1.	Reduced use of diagnostics using advanced technology	
2.	Decreased number of unnecessary visits to the emergency department	
3.	Improved patient compliance with prescribed treatments	
4.	Increased use of complementary and alternative therapies	

____	10.	The nurse is providing care for a pediatric patient in an acute care facility. The patient’s parents express concern about the cost of the medical care. The parents state, “We have jobs, but we don’t make a lot of money and have no insurance.” Which medical assistance program does the nurse recognize as being most appropriate for this family?
1.	Children’s Health Insurance Program (CHIP)	
2.	Medicare	
3.	Medicaid	
4.	Local charity	

____	11.	A nurse working in a rehabilitation facility has a physician’s order to contact therapists as required by patient need. A patient has started to have difficulty with bathing and grooming. Which therapist does the nurse contact to assist the patient to regain these skills?
1.	Physical therapist	
2.	Occupational therapist	
3.	Speech-language pathologist	
4.	Respiratory therapist	

____	12.	An older adult patient is diagnosed with type 1 diabetes mellitus. The patient can perform self-care activities but needs assistance with shopping, meal preparation, blood glucose monitoring, and insulin administration. Which type of healthcare facility is most appropriate for the patient?
1.	Acute care facility	
2.	Ambulatory care facility	
3.	Extended care facility	
4.	Assisted-living facility	

____	13.	The nurse in the intensive care unit is providing care for only one patient, who was admitted with a diagnosis of septic shock. Based on this information, which care delivery model is this nurse following?
1.	Functional	
2.	Primary	
3.	Case method	
4.	Team	

____	14.	The nurse is providing care for a patient who needs extensive acute care, which the patient is refusing because of financial and family stressors. Which healthcare worker does the nurse consult to counsel this patient?
1.	Social worker	
2.	Occupational therapist	
3.	Physician’s assistant	
4.	Technologist	

____	15.	Which type of managed care provides patients with the greatest choice of in-network providers, medications, and medical devices?
1.	Health maintenance organization	
2.	Integrated delivery network	
3.	Preferred provider organization	
4.	Employment-based private insurance	

____	16.	The registered nurse is discharging a patient to an assisted-living facility. Which statement by the nurse is most appropriate for the patient?
1.	“Therapists will work with you daily to help you regain your functional abilities.”	
2.	“You will be provided with 24-hour nursing care for the next 6 weeks.”	
3.	“Assistance with meals and housekeeping tasks is available to you.”	
4.	“A nurse will come to your home and provide you with nursing care.”	

____	17.	Which member of the healthcare team typically serves as the case manager?
1.	Social worker	
2.	Physician	
3.	Physician’s assistant	
4.	Registered nurse	

____	18.	The nurse works in a public health department. Which nursing function is considered a primary-care service?
1.	Providing wound care	
2.	Administering childhood immunizations	
3.	Providing drug rehabilitation	
4.	Providing outpatient hernia repair	

____	19.	A patient who is 80 years of age is in an acute care facility because of a fractured hip resulting from a fall. Previously, the patient lived at home and managed activities of daily living independently. The patient goal is to return to the previous living style. The patient is to be discharged because of insurance regulations. If the patient cannot walk or provide self-care, to which type of facility will the patient be transferred?
1.	Nursing home	
2.	Rehabilitation center	
3.	An outpatient therapy center	
4.	None of these; they should receive home-healthcare	

____	20.	A healthcare facility hires new nursing graduates to work on patient care units. The hired nurses come from a variety of accredited nursing programs. Additionally, applicants need to be aware of facility hiring practices based on which criteria?
1.	Graduate of a nursing education program and passed the National Council Licensure Exam (NCLEX)	
2.	Obtained certification permitting the administration of medications in certain healthcare settings	
3.	Specifically licensed to practice in either an acute care setting or in a home environment	
4.	Received advanced education and is licensed to practice under the direct supervision of a physician	

____	21.	A nurse who has been practicing for 3 years in an acute care facility is caring for a postsurgical patient. The nurse observes an abnormal change in vital signs and associates these changes with a postoperative bleeding problem. Which level of proficiency is the nurse demonstrating?
1.	Advanced beginner	
2.	Competent	
3.	Proficient	
4.	Expert	

____	22.	In the United States, each state enacts its own nurse practice acts. Which agency is responsible for nurse practice acts?
1.	American Nurses Association	
2.	Institute of Medicine	
3.	State Board of Nursing	
4.	National League for Nursing	

____	23.	A nurse was recently hired at an acute care facility. During orientation, the nurse is given a chart describing each person’s role on the assigned unit. The chart reflects that registered nurses are responsible for all admission and discharge assessments and patient treatments. Licensed practical nurses (LPNs) administer medications, and certified nursing assistants (CNAs) obtain vital signs and perform personal care. Which model of care does the nurse recognize?
1.	Case method	
2.	Team	
3.	Primary	
4.	Functional	

____	24.	Nurses are aware of the trends that affect contemporary nursing practice. Which trend is a primary cause for changes in the nursing profession?
1.	The expected increase in the number of older adults in society	
2.	The large amount of medical information that is technically accessible	
3.	The increasing demands for more medical care from all aspects of society	
4.	The multiple medical care expectations implemented by the government	

____	25.	A patient is preparing to be discharged after total knee replacement. The patient tells the case manager, “I feel pretty good, but I am having a hard time getting in and out of the bathroom.” Which is the most appropriate response by the case manager?
1.	“I’ll be sure to teach your family how to help you with this.”	
2.	“Once you are home for a while, it will get easier.”	
3.	“I can have a recreational therapist help you take your mind off your concerns.”	
4.	“An occupational therapist can be ordered to assist you in this area.”	

____	26.	An older adult patient is preparing for discharge and tells the case manager, “I don’t know what I am going to do when I get home. I cannot afford the medications the doctor has ordered for me.” Which is the most appropriate response by the case manager?
1.	“We can have a social worker see you when you get home.”	
2.	“Medications are expensive, but you will need to take them.”	
3.	“I will check if some of the medications can be discontinued.”	
4.	“The home-health nurse will address this when they see you.”	

____	27.	A patient in an ambulatory clinic tells the nurse, “Every visit costs me $10, even though I have insurance.” Which is the most appropriate response by the nurse?
1.	“I am not involved in your insurance; you need to contact the insurance company.”	
2.	“Let’s check if this is a co-payment described by your insurance plan for each visit.”	
3.	“Healthcare is expensive, and insurance companies can’t pay all of the costs.”	
4.	“This charge is actually part of the insurance premium that you pay monthly.”	

____	28.	The nursing staff on a surgical unit expresses to the manager concerns about not having enough time to complete all wound care and dressing changes. Which is the initial action the manager takes?
1.	Decrease the patient-to-nurse ratio within budget limits	
2.	Offer an in-service session on time-management strategies	
3.	Suggest a continuing quality improvement committee to assess the issue	
4.	Report the concerns to the director of nurses at the next management meeting	

Multiple Response
Identify one or more choices that best complete the statement or answer the question.

____	29.	Which activities indicate the implementation of direct nursing care? Select all that apply.
1.	Bathing a patient	
2.	Administering a medication	
3.	Teaching a patient to change a wound dressing	
4.	Making work assignments for the shift	
5.	Evaluating patient progression toward goals	

____	30.	Which actions by the nurse are considered “skilled nursing care”? Select all that apply.
1.	Changing a wound dressing	
2.	Assisting with bathing and grooming	
3.	Monitoring intravenous (IV) antibiotic administration	
4.	Teaching a patient how to use a blood glucose monitor	
5.	Helping a patient to get dressed	

____	31.	To reflect the changes in healthcare and nurses’ expanded roles, the International Council of Nurses revised the definition of nursing. Which statements are consistent with the revised definition of nursing? Select all that apply.
1.	Nursing encompasses the autonomous and collaborative care of others.	
2.	Nursing includes the care of ill, disabled, and dying people.	
3.	Nursing is involved in shaping health policy and system management.	
4.	Nursing involves the use of the nursing process to plan care.	
5.	Nursing requires knowledge regarding the process of nursing education.	

____	32.	According to the American Nurses Association, which statements best describe the characteristics of registered nursing? Select all that apply.
1.	Nursing practice is individualized.	
2.	Nursing practice is similar to medical practice.	
3.	Caring is central to the practice of the registered nurse.	
4.	Nurses coordinate care by establishing partnerships.	
5.	Nurses promote health through political involvement.	

____	33.	The field of nursing has struggled to prove that nursing is a profession. Which strategies to improve the status of nursing will promote professionalism? Select all that apply.
1.	Standardizing the educational requirements for entry into practice	
2.	Mandating uniform continuing education requirements for licensure	
3.	Guaranteeing that all nurses will obtain employment upon graduation	
4.	Encouraging participation of nurses in professional organizations	
5.	Educating the public about the true nature of nursing practice	

____	34.	Each U.S. state has its own state board of nursing responsible for protecting the health, safety, and welfare of the general public. The state boards of nursing meet these responsibilities by performing which functions? Select all that apply.
1.	Advocating for nursing student issues	
2.	Determining the nurse’s scope of practice	
3.	Enforcing the rules that govern nursing	
4.	Writing the laws that regulate nursing	
5.	Regulating the number of licensed nurses	

____	35.	The nurse is preparing a presentation for nursing students about the processes of thinking and implementation that apply to nursing. Which topics will the nurse include? Select all that apply.
1.	Critical thinking	
2.	Pain evaluation	
3.	Clinical judgment	
4.	Problem-solving	
5.	Sterile technique	

Completion
Complete each statement.

	36.	____________________ is a health program, administered by the state and funded by federal and state governments, to provide care for low-income people.

	37.	____________________ is a federal insurance program designed to fund healthcare for people age 65 years and older, persons with disabilities, and those with end-stage renal disease.

Chapter 1. Evolution of Nursing Thought & Action
Answer Section

MULTIPLE CHOICE

	1.	ANS:	3
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Name and recognize the four purposes of nursing care.
Page: 1
Heading: Nursing and Illness Prevention
Integrated Processes: Teaching and Learning
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Health Promotion 
Difficulty: Moderate
	Feedback	
1	This is incorrect. Illness-prevention activities focus on avoiding a specific disease. Keeping a food diary is a health-promotion activity. 	
2	This is incorrect. Although cancer is a disease, it is assumed that a person joining a support group would already have the disease; therefore, it would be treatment and not disease prevention. 	
3	This is correct. Administering an immunization for HPV is an example of illness prevention. 	
4	This is incorrect. Teaching a diabetic patient about diet is a treatment for diabetes; the patient already has diabetes, so the teaching cannot prevent diabetes.	

PTS:	1	CON:	Health Promotion	

	2.	ANS:	4
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Explain how nursing practice is regulated.
Page: 5
Heading: Continuing Education
Integrated Processes: Teaching and Learning
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Professionalism
Difficulty: Moderate 

	Feedback	
1	This is incorrect. The American Nurses Association is a professional organization and does not mandate continuing education. However, the organization may offer continuing education units (CEUs) to fulfill education requirements. 	
2	This is incorrect. The National League for Nursing is a professional organization and does not mandate continuing education. However, the organization may offer CEUs to fulfill education requirements.	
3	This is incorrect. Sigma Theta Tau is a professional organization and does not mandate continuing education. However, the organization may offer CEUs to fulfill education requirements.	
4	This is correct. Continuing education is a professional strategy designed to ensure that nurses remain current in their clinical knowledge. Many states require nurses to engage in a certain number of continuing education requirements to renew their license. Requirements for renewal of a nurse’s license can be found in the state’s nurse practice act (state board of nursing).	

PTS:	1	CON:	Professionalism	

	3.	ANS:	4
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Differentiate among the various forms of nursing education.
Page: 5
Heading: Benner’s Model
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Comprehension [Understanding]
Concept: Professionalism 
Difficulty: Moderate
	Feedback	
1	This is incorrect. The novice nurse is inexperienced and relies on rules and processes. 	
2	This is incorrect. The advanced beginner focuses on aspects of a situation and is unable to see the comprehensive perspective.	
3	This is incorrect. A nurse functioning at the competent level is able to prioritize to meet patient needs but does not fully grasp the total situation.	
4	This is correct. The nurse who has reached the expert stage of proficiency has a deep understanding of the clinical situation based on knowledge and experience. The nurse often senses a potential problem in the absence of classic signs and symptoms.	

PTS:	1	CON:	Professionalism	

	4.	ANS:	3
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Explain how nursing practice is regulated.
Page: 13
Heading: Contemporary Nursing: Education, Regulation, and Practice > Standards of Practice
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Professionalism
Difficulty: Moderate
	Feedback	
1	This is incorrect. Nursing standards of practice are exclusive to the profession of nursing; standards of nursing practice are not shared with other healthcare professionals. 	
2	This is incorrect. The standards of practice for nursing are applicable regardless of the setting in which nursing care is provided.  	
3	This is correct. Standards of practice are authoritative statements of the duties that all registered nurses, regardless of role, population, or specialty, are expected to perform competently. Standards are derived from several sources, including professional organizations and healthcare facilities’ policies and procedures.	
4	This is incorrect. The standards of practice for nursing are applicable regardless of the population receiving nursing care. 	

PTS:	1	CON:	Professionalism	

	5.	ANS:	2
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Give four examples of influential nursing organizations.
Page: 8
Heading: Nursing Organization Guidelines
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Moderate
	Feedback	
1	This is incorrect. The American Nurses Association (ANA) is the official professional organization for nurses in the United States. Originally, the ANA focused on establishing standards of nursing to promote high-quality care and working toward licensure as a means to ensure adherence to the standards; both these actions focus on patient safety.  	
2	This is correct. The National League for Nursing (NLN) was founded to establish and maintain a universal standard of nursing education. The NLN focuses on faculty development in nursing education programs and is the voice for nursing education.	
3	This is incorrect. The International Council of Nursing (ICN) represents more than 20 million nurses on a global level. It is composed of a federation of national nursing organizations from more than 130 nations. The ICN aims to ensure quality nursing care for all.	
4	This is incorrect. The goal of Sigma Theta Tau International is to foster nursing scholarship, leadership, service, and research to improve health worldwide.	

PTS:	1	CON:	Professionalism	

	6.	ANS:	3
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Name and recognize the four purposes of nursing care.
Page: 13
Heading: Healthcare Delivery System > How Is Healthcare Categorized?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Health Promotion
Difficulty: Difficult
	Feedback	
1	This is incorrect. The six domains of acute care are (1) trauma care and acute care surgery, (2) emergency care, (3) urgent care, (4) short-term stabilization, (5) prehospital care, and (6) critical care. The goal is to prevent deterioration and restore health. Initially, this patient requires acute care. 	
2	This is incorrect. Secondary care is available for patients who require support or rehabilitation over a limited period of time. A patient may require secondary care following a joint replacement.	
3	This is correct. Tertiary care is required for individuals who need long-term care or for those who are dying. After a debilitating stroke, this patient is most likely to require long-term care.	
4	This is incorrect. Preventive care is provided as an effort to prevent disease and illness; following a stroke, the patient is no longer considered for preventive care alone. 	

PTS:	1	CON:	Health Promotion	

	7.	ANS:	2
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 15
Heading: Where Is Care Provided? > Extended Care Facilities
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Safety
Difficulty: Difficult
	Feedback	
1	This is incorrect. The question does not include information regarding the patient care needs following discharge; therefore, this option is not a good choice. Skilled care facilities include services of trained professionals who are needed for a limited period of time after an injury or illness (e.g., wound care, intravenous infusions). Services are provided to clients who no longer need 24-hour acute care services and who can be expected to improve with treatment. 	
2	This is correct. An assisted-living facility is designed to bridge the gap between independence and institutionalization for older adults who have a decline in health status and cannot live independently. Residents of these facilities are able to perform self-care activities but require assistance with meals, housekeeping, or medications. This is because skilled care is usually not required, nurses have a limited presence at assisted-living sites. The patient expresses concern over the ability to provide adequate self-care. 	
3	This is incorrect. There is no information to support the patient needing nursing home care, which provides custodial care for people who cannot live on their own but are not sick enough to require hospitalization. They may be a permanent home for people who require continual supervision to ensure their safety. Residents are offered a provider to supervise care, recreational activities, and salon services.	
4	This is incorrect. Independent living facilities are designed for seniors 55 years or older who (1) are independent in all aspects and (2) want to live in a community with other senior citizens. Services usually include a peer support network that provides socialization opportunities, structured recreational activities, transportation arrangements, fitness centers, pools, and quiet environments. Nurses may provide periodic health screening and health information. The patient’s expressed concern does not support this extended care type.

PTS:	1	CON:	Safety

	8.	ANS:	4
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Define nursing in your own words.
Page: 10
Heading: Contemporary Nursing: Education, Regulation, and Practice > How Is Nursing Defined?
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Comprehension [Understanding]
Concept: Evidence-Based Practice
Difficulty: Moderate
	Feedback	
1	This is incorrect. A definition of nursing is not likely to increase the number of informed people recruited into nursing. 	
2	This is incorrect. A definition of nursing would do little to improve the nurse’s role satisfaction.	
3	This is incorrect. Although a definition of nursing might contribute to fighting stereotypes of nursing, other, more powerful influences (e.g., media portrayals) exist to counteract it.	
4	This is correct. Nursing organization leaders think it is important to develop a definition of nursing to bring value and understanding to the profession, differentiate nursing activities from those of other healthcare professionals, and help student nurses understand what is expected of them.	

PTS:	1	CON:	Evidence-Based Practice

	9.	ANS:	3
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Delineate the forces and trends affecting contemporary nursing practice.
Page: 22
Heading: Expanded Career Roles for Nurses > Advanced Practice Nurses (APNs)
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Comprehension [Understanding]
Concept: Evidence-Based Practice
Difficulty: Moderate
	Feedback	
1	This is incorrect. No well-known, scientific studies support APNs’ effect on the use of advanced technology. 	
2	This is incorrect. No well-known, scientific studies support APNs’ effect on the frequency of emergency department visits.	
3	This is correct. Studies have demonstrated high client satisfaction with APNs, comparable outcomes to physician-provided care, better compliance with treatment regimens, and greater cost-effectiveness when compared to physicians. 	
4	This is incorrect. No well-known, scientific studies support APNs’ effect on the use of alternative therapies.	

PTS:	1	CON:	Evidence-Based Practice

	10.	ANS:	1
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Discuss issues related to healthcare reform.
Page: 17
Heading: How Is Healthcare Financed? > Government (Public) Financing
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Difficult
	Feedback	
1	This is correct. CHIP is a joint venture between the federal government and states. CHIP provides health insurance to millions of children whose family income exceeds Medicaid eligibility criteria but who cannot afford private insurance and are not covered under a parent’s policy. The nurse recognizes this program as the most appropriate one for this family.	
2	This is incorrect. Medicare is a federal insurance program created by Title XVIII of the Social Security Act of 1965. This act was designed to provide insurance coverage for persons age 65 years and older and later expanded to include younger people with permanent disabilities, such as end-stage renal disease. 	
3	This is incorrect. Medicaid was developed under Title XIX of the Social Security Act of 1965 to provide access to healthcare services for people with low incomes and minimal resources. Medicaid offers a fairly comprehensive set of benefits, including prescription drugs, skilled care, and long-term care.  	
4	This is incorrect. The nurse is aware that charitable organizations are an increasingly important funding source for healthcare. Community agencies that are funded through networks, such as the United Way, Salvation Army, and Red Cross, provide important resources for children, poor families, older adults, and vulnerable populations, such as the homeless, mentally ill, and victims of violence. This is the second-most appropriate program for this family.	

PTS:	1	CON:	Patient-Centered Care	

	11.	ANS:	1
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 19
Heading: Who Are the Members of the Interprofessional Healthcare Team?
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Basic Care and Comfort
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate

	Feedback	
1	This is correct. Physical therapists focus on the rehabilitation of muscles and bones to help clients use assistive devices and gain self-care skills for activities of daily living. 	
2	This is incorrect. Occupational therapists work closely with physical therapists to help clients regain function and independence in everyday activities. 	
3	This is incorrect. Speech-language pathologists provide assistance to clients experiencing swallowing and speech disturbances (e.g., developing speech and language skills after neurological impairment).	
4	This is incorrect. Respiratory therapists provide respiratory treatments that have been prescribed by physicians or advanced practice nurses (e.g., oxygen therapy, mechanical ventilation).  	

PTS:	1	CON:	Patient-Centered Care	

	12.	ANS:	4
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 14
Heading: Where Is Care Provided?
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential 
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Moderate
	Feedback	
1	This is incorrect. Acute care facilities focus on preventing illnesses and treating acute problems. These facilities include physicians’ offices, clinics, and diagnostic centers. 	
2	This is incorrect. Ambulatory care facilities provide outpatient care. Clients live at home or in non-hospital settings and come to the site for care. Ambulatory care facilities include private health and medical offices, clinics, surgery centers, and outpatient therapy centers.	
3	This is incorrect. Extended care facilities typically provide long-term care, rehabilitation, wound care, and ongoing monitoring of patient conditions.	
4	This is correct. Assisted-living facilities are intended for those who are able to perform self-care activities but require assistance with meals, housekeeping, or medications.	

PTS:	1	CON:	Patient-Centered Care	

	13.	ANS:	3
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 18
Heading: What Models of Care Are Used to Provide Nursing Care?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive Level: Comprehension [Understanding]
Concept: Patient-Centered Care
Difficulty: Moderate 
	Feedback	
1	This is incorrect. When the functional nursing model is employed, care is compartmentalized, and each task is assigned to a staff member with the appropriate knowledge and skills. 	
2	This is incorrect. In primary nursing, one nurse plans the care for a group of patients around the clock. The primary nurse assesses the patient and develops the plan of care. When this nurse is working, they provide care for those patients for whom they are responsible. In the absence of this nurse, the associate nurses deliver care. Although the nurse in this case could possibly be a primary nurse, there is not enough data to confidently infer that.	
3	This is correct. The nurse is following the case method model of nursing care. In this model, one nurse cares for one patient during a single shift.	
4	This is incorrect. If the team nursing approach is employed, a licensed nurse (registered nurse or licensed vocational nurse) is paired with a nursing assistant. The pair is then assigned to a group of patients.	

PTS:	1	CON:	Patient-Centered Care	

	14.	ANS:	1
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 16
Heading: Who Are the Members of the Interprofessional Healthcare Team?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate 
	Feedback	
1	This is correct. The social worker coordinates services and counsels patients about financial, housing, marital, and family issues impacting healthcare. 	
2	This is incorrect. The occupational therapist helps patients regain function and independence for activities of daily living.	
3	This is incorrect. Physician’s assistants work under the physician’s direction to diagnose certain diseases and injuries.	
4	This is incorrect. Technologists provide a variety of specific functions in hospitals, diagnostic centers, and emergency care. For example, laboratory technologists aid in the diagnosis and treatment of patients by examining blood, urine, tissue, and body fluids. Radiology technologists perform x-rays and other diagnostic testing.	

PTS:	1	CON:	Patient-Centered Care	

	15.	ANS:	3
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 18
Heading: How Have Healthcare Reform Efforts Affected Care?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Moderate 
	Feedback	
1	This is incorrect. Health maintenance organizations allow the patient to choose a primary care provider within an organization to coordinate their care. This type of program will only reimburse medical care when the patient has first obtained a referral from the primary provider. 	
2	This is incorrect. Integrated delivery networks combine providers, healthcare facilities, pharmaceuticals, and services into one system, and the patient must remain within the system to receive care.	
3	This is correct. Preferred provider organizations are a form of managed care that allows the patient a greater choice of providers, medications, and medical devices within the designated list.	
4	This is incorrect. Employment-based private insurance is not a managed care organization.	

PTS:	1	CON:	Patient-Centered Care	

	16.	ANS:	3
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 15
Heading: Where Is Care Provided?
Integrated Processes: Caring
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate 
	Feedback	
1	This is incorrect. Rehabilitation centers have a team of therapists who work with patients to help them achieve their optimal functional status. This can be an inpatient or outpatient service.	
2	This is incorrect. Hospitals, skilled nursing units, and other acute care facilities provide 24-hour nursing care. 	
3	This is correct. Assisted-living facilities are designed to bridge the gap between independence and institutionalization for persons who have a decline in health status. The assistance available will vary, based on the facility, but commonly involves meals and housekeeping tasks.	
4	This is incorrect. Home care, even with nurse visitations, is not classified as care with assistance. The question states that the patient is being discharged to an assisted-living facility. 	

PTS:	1	CON:	Patient-Centered Care	

	17.	ANS:	4
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 5
Heading: Who Are the Members of the Interprofessional Healthcare Team?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Comprehension [Understanding]
Concept: Patient-Centered Care
Difficulty: Easy 
	Feedback	
1	This is incorrect. Social workers provide psychosocial support and client services throughout the healthcare system to coordinate continuity of care in a cost-effective manner.	
2	This is incorrect. Physicians are considered team leaders for an inpatient, and their primary role is to make a medical diagnosis and outline a treatment plan. Physicians are licensed as medical doctors (MD) or doctors of osteopathy (DO). Their role is to diagnose and treat diseases and illnesses through medical and surgical services.	
3	This is incorrect. Physician’s assistants diagnose and treat certain diseases and injuries. Because they are not independently licensed, they must practice under the supervision of a physician.	
4	This is correct. Many hospitals, home-health agencies, and insurance companies employ nurse case managers to ensure that care is efficient, quality, and cost-effective.	

PTS:	1	CON:	Patient-Centered Care	

	18.	ANS:	2
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 15
Heading: How Is Healthcare Categorized?
Integrated Processes: Caring
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Health Promotion
Difficulty: Moderate 
	Feedback	
1	This is incorrect. Wound care and drug rehabilitation are examples of tertiary care services. 	
2	This is correct. Primary care services focus on health promotion and disease prevention; administering childhood immunizations is one such service.	
3	This is incorrect. Wound care and drug rehabilitation are examples of tertiary care services.	
4	This is incorrect. Outpatient hernia repair surgery is an example of a secondary care service.	

PTS:	1	CON:	Health Promotion	

	19.	ANS:	2
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 15
Heading: Extended Care Facilities
Integrated Processes: Nursing Process
Client Need: Physiological Integrity: Reduction of Risk Potential  
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Difficult
	Feedback	
1	This is incorrect. A nursing home provides custodial care for people who cannot live on their own but who are not sick enough to require hospitalization. It provides a room, custodial care, and opportunity for recreation. 	
2	This is correct. A skilled nursing facility (e.g., a rehabilitation center) primarily provides skilled nursing care for patients who can be expected to improve with treatment. For example, a patient who no longer needs hospitalization may transfer to a skilled nursing facility until able to return home.	
3	This is incorrect. This patient cannot ambulate or perform activities of daily living, so outpatient therapy and home care would not be appropriate.	
4	This is incorrect. This patient cannot ambulate or perform activities of daily living, so outpatient therapy and home care would not be appropriate.	

PTS:	1	CON:	Patient-Centered Care	

	20.	ANS:	1
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Define nursing in your own words.
Page: 8
Heading: How Is Nursing Defined?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive Level: Application [Applying]
Concept: Professionalism
Difficulty: Moderate
	Feedback	
1	This is correct. The best legal description of a nurse is one who has graduated from an accredited nursing education program and has passed the NCLEX exam.  	
2	This is incorrect. Persons certified to administer medications may be certified medication technicians and not necessarily nurses.	
3	This is incorrect. Nurses can practice in a vast variety of settings, and not exclusively in an acute care setting or in home care.	
4	This is incorrect. Practicing under the direct supervision of a physician is descriptive of a physician’s assistant or of a nurse practitioner; both positions require advanced education.	

PTS:	1	CON:	Professionalism	

	21.	ANS:	2
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Define nursing in your own words.
Page: 7
Heading: Benner’s Model
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive Level: Comprehension [Understanding]
Concept: Professionalism
Difficulty: Moderate
	Feedback	
1	This is incorrect. The advanced beginner can distinguish abnormal findings but cannot readily understand their significance. 	
2	This is correct. The nurse is competent, as evidenced by associating abnormal changes in vital signs with postoperative bleeding. Additionally, this nurse has been practicing for 3 years, which is within the range needed for competence	
3	This is incorrect. The proficient nurse recognizes problems but will immediately gather resources to initiate treatment; there is no evidence in the scenario that the nurse took any actions.	
4	This is incorrect. The expert can often recognize a problem in the absence of signs and symptoms.	

PTS:	1	CON:	Professionalism	

	22.	ANS:	3
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Explain how nursing practice is regulated.
Page: 1
Heading: How Is Nursing Practice Regulated?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Nursing Care 
Cognitive Level: Comprehension [Understanding]
Concept: Professionalism
Difficulty: Easy
	Feedback	
1	This is incorrect. The American Nurses Association is a professional organization responsible for guiding and improving nursing practice, usually by setting standards of practice and establishing a nursing code of ethics. 	
2	This is incorrect. The Institute of Medicine provides information and advice concerning health and science policy; for example, its involvement in the project Quality and Safety Education for Nurses.	
3	This is correct. Each state board of nursing is responsible for enacting and enforcing the nurse practice act of its state.	
4	This is incorrect. The National League for Nursing sets standards for all nursing education.	

PTS:	1	CON:	Professionalism	

	23.	ANS:	4
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 13
Heading: What Models of Care Are Used to Provide Nursing Care?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment
Cognitive Level: Application [Applying]
Concept: Professionalism
Difficulty: Moderate

	Feedback	
1	This is incorrect. In the case method model, one nurse cares for one patient during a single shift. 	
2	This is incorrect. In the team model, a nurse is paired with an LPN or a CNA. The team is then assigned to a specific group of patients.	
3	This is incorrect. Primary nursing is a method where one nurse manages care for a group of patients. The primary nurse assesses the patient and develops a plan of care. In the absence of the primary nurse, associate nurses deliver care and implement the plan developed by the primary nurse.	
4	This is correct. The nurse recognizes this practice as the functional model of care in which care is compartmentalized and each employee is assigned specific tasks and roles with the associating knowledge and skill.	

PTS:	1	CON:	Professionalism	

	24.	ANS:	1
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Delineate the forces and trends affecting contemporary nursing practice.
Page: 20
Heading: What Are Some Trends in Society?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Evidence-Based Practice
Difficulty: Difficult

	Feedback	
1	This is correct. With aging, people experience more acute and chronic illnesses and a greater need for medical and nursing care. In 2017, there were 49.2 million individuals aged 65 years and older. This number is expected to increase to 98.2 million by 2060, with 19.7 million of these individuals aged 85 years or older. As the population of older adults grows, little growth is expected in individuals under 20 years of age. The result is fewer younger people who can provide care. This has significant implications for the healthcare system and the profession of nursing.	
2	This is incorrect. It is true that current technology enables vast numbers of people to access medical information. And while the teaching opportunities for nurses expand, this factor alone is not a primary cause for changes in the profession of nursing. 	
3	This is incorrect. Increase in the demands for medical care from all members of society is not specifically a primary cause for changes in the profession of nursing; all aspects of medical care will be affected. This factor alone is not a primary cause for changes in the profession of nursing. 	
4	This is incorrect. Government-implemented medical care expectations will impact all aspects of medical care delivery. This factor alone is not a primary cause for changes in the profession of nursing. 	

PTS:	1	CON:	Evidence-Based Practice

	25.	ANS:	4
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 22
Heading: Who Are the Members of the Interprofessional Healthcare Team?
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate

	Feedback	
1	This is incorrect. Teaching the family how to assist with toileting is not typically the role of the case manager. Additionally, this does not assist the patient regarding the immediate concern of toileting. 	
2	This is incorrect. Reassurance is important and positive, but the patient first needs assistance with toileting.	
3	This is incorrect. Recreational therapists promote patient physical, social, and emotional well-being through the use of leisure activities. There is no indication that this patient is in need of a recreational therapist.	
4	This is correct. The patient is expressing a concern for managing toileting at home. Upon discharge, the therapy that focuses most closely on activities of daily living is occupational therapy.	

PTS:	1	CON:	Communication and Documentation		

	26.	ANS:	1
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 22
Heading: Who Are the Members of the Interprofessional Healthcare Team?
Integrated Processes: Communication and Documentation
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate

	Feedback	
1	This is correct. Social workers counsel patients on financial, housing, marital, and family issues affecting healthcare. Owing to rising healthcare costs and diminished access to healthcare, particularly for aging populations, social workers are increasingly being used to help move clients through the healthcare system. 	
2	This is incorrect. Acknowledging the rising costs of medications does not assist the patient in solving the problem of their ability to pay for medications.	
3	This is incorrect. The case manager cannot make any assumption that to alleviate the patient’s concerns about affording medications, it might be appropriate to have some medications discontinued.	
4	This is incorrect. The home-health nurse typically coordinates the care and services but is not typically the healthcare provider addressing financial concerns.	

PTS:	1	CON:	Patient-Centered Care	

	27.	ANS:	2
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 17
Heading: How Is Healthcare Financed?
Integrated Processes: Communication and Documentation
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Patient-Centered Care
Difficulty: Moderate

	Feedback	
1	This is incorrect. Most facilities have access to the patient’s coverage plan and can answer immediate questions until the patient is able to follow up with their insurance company. 	
2	This is correct. Those who have insurance or government-financed insurance bear some of the expenses of healthcare through cost sharing. Typical cost sharing can be in the form of co-pays, deductibles, paying a portion of one’s insurance premium, or paying costs above a fixed payment amount. Patients do not always understand cost-sharing methods and may need an explanation at the time of the visit. The best response is for the nurse to explain what a co-payment is.	
3	This is incorrect. Stating that healthcare is expensive is merely stating the obvious; it may also be perceived as defensive rather than supportive.	
4	This is incorrect. Co-payments are typically not part of an insurance premium and are only collected at the time of a service.	

PTS:	1	CON:	Patient-Centered Care	

	28.	ANS:	3
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 12
Heading: Nursing Practice: Caring for Clients
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Patient-Centered Care
Difficulty: Difficult

	Feedback	
1	This is incorrect. There may be a need to look at nurse–patient ratios, and there may be a need to provide an in-service session on time management. However, these are not known until some assessment is completed and data are obtained. This is not the manager’s initial action.	
2	This is incorrect. Total Quality Management (TQM) or Continuous Quality Improvement (CQI) projects assist in looking at all aspects of quality and safe care practices. Offering a session on time management may be useful; however, it is not the initial action taken by the manager.	
3	This is correct. The most appropriate action by the nurse manager is to assess the issue through establishing some quality improvement/quality care activities in the form of an appointed committee. Assessment is always the initial action taken when evaluating an issue or concern. 	
4	This is incorrect. Reporting the concern to the director of nurses may be indicated, but this will not immediately address the concerns of the staff. The initial action is for assessment	

PTS:	1	CON:	Patient-Centered Care	

MULTIPLE RESPONSE

	29.	ANS:	1, 2, 3
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 12
Heading: Who Are the Members of the Interprofessional Healthcare Team?
Integrated Processes: Caring
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Difficult

	Feedback	
1.	This is correct. Direct care involves personal interaction between nurses and clients (e.g., bathing a patient, giving medications, dressing a wound, or teaching a client about medicines or care). 	
2.	This is correct. Direct care involves personal interaction between nurses and clients (e.g., bathing a patient, giving medications, dressing a wound, or teaching a client about medicines or care).	
3.	This is correct. Direct care involves personal interaction between nurses and clients (e.g., bathing a patient, giving medications, dressing a wound, or teaching a client about medicines or care).	
4.	This is incorrect. Nurses deliver indirect care when they work on behalf of an individual, group, family, or community to improve their health status (e.g., restocking the code blue cart [an emergency cart], ordering unit supplies, or arranging unit staffing).	
5.	This is incorrect. Nurses deliver indirect care when they work on behalf of an individual, group, family, or community to improve their health status (e.g., restocking the code blue cart [an emergency cart], ordering unit supplies, evaluating the patient, or arranging unit staffing).	

PTS:	1	CON:	Professionalism	

	30.	ANS:	1, 3, 4
Chapter: Chapter 1 Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 8
Heading: How Is Nursing Defined?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Difficult 

	Feedback	
1.	This is correct. Skilled care includes services offered by healthcare professionals who have received the education and are licensed to provide the services. A skilled activity in nursing includes changing a wound dressing. 	
2.	This is incorrect. Assisting with bathing and dressing is characteristic of custodial care that can be done by unlicensed healthcare personnel or the patients themselves.	
3.	This is correct. Skilled care includes services offered by healthcare professionals who have received the education and are licensed to provide the services. A skilled activity in nursing includes monitoring IV antibiotic administration.	
4.	This is correct. Skilled care includes services offered by healthcare professionals who have received the education and are licensed to provide the services. A skilled activity in nursing includes patient teaching.	
5.	This is incorrect. Assisting with bathing and dressing is characteristic of custodial care that can be done by unlicensed healthcare personnel or the patients themselves.	

PTS:	1	CON:	Professionalism	

	31.	ANS:	1, 2, 3
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Define nursing in your own words. 
Page: 7
Heading: How Is Nursing Defined?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Difficult 

	Feedback	
1.	This is correct. The International Council of Nursing (ICN) definition of nursing includes the autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. 	
2.	This is correct. In addition to caring for ill, disabled, and dying persons, nurses are expected to promote health and prevent illness.	
3.	This is correct. Key nursing roles include advocacy, education, research, promotion of a safe environment, and participation in shaping health policy and in healthcare systems management.	
4.	This is incorrect. The ICN definition does not mention that registered nurses use the nursing process to plan and individualized care. 	
5.	This is incorrect. The ICN definition does not mention that registered nurses use the nursing process to plan and individualized care. The acquisition of knowledge regarding the process of nursing education is also not included. 	

PTS:	1	CON:	Professionalism	

	32.	ANS:	1, 3, 4
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Define nursing in your own words. 
Page: 7
Heading: How Is Nursing Defined?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Difficult

	Feedback	
1.	This is correct. In 2010, the ANA acknowledged five characteristics of the registered nurse. Nursing practice is individualized. 	
2.	This is incorrect. The ANA does not acknowledge that nursing practice is similar to medical practice. 	
3.	This is correct. In 2010, the ANA acknowledged five characteristics of the registered nurse. Caring is central to the practice of the registered nurse.	
4.	This is correct. In 2010, the ANA acknowledged five characteristics of the registered nurse. Nurses coordinate care by establishing partnerships with others.	
5.	This is incorrect. The ANA does not acknowledge that nurses promote health through political involvement. 	

PTS:	1	CON:	Professionalism	

	33.	ANS:	1, 2, 4, 5
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Delineate the forces and trends affecting contemporary nursing practice.
Page: 10
Heading: Is Nursing a Profession, Discipline, or Occupation?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care 
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Difficult 

	Feedback	
1.	This is correct. A suggestion to improve the professional status of nursing includes standardizing educational requirements for entry to practice. 	
2.	This is correct. A suggestion to improve the professional status of nursing includes mandating uniform continuing education requirements.	
3.	This is incorrect. There are no regulating bodies or professional organizations that equate guaranteeing employment with improving the status of nursing, nor is it likely it would be possible to do that.	
4.	This is correct. A suggestion to improve the professional status of nursing includes encouraging participation of more nurses in professional organizations.	
5.	This is correct. A suggestion to improve the professional status of nursing includes educating the public about the true nature of nursing practice.	

PTS:	1	CON:	Professionalism	

	34.	ANS:	2, 3
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Explain how nursing practice is regulated.
Page: 10
Heading: How Is Nursing Practice Regulated?
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Difficult 

	Feedback	
1.	This is incorrect. State boards of nursing do not advocate for nursing student issues. This is usually addressed through the National Student Nurses Association. 	
2.	This is correct. State boards of nursing are responsible for determining scope of practice and enforcing the rules that govern nursing.	
3.	This is correct. State boards of nursing are responsible for determining scope of practice and enforcing the rules that govern nursing.	
4.	This is incorrect. State boards of nursing do not write the laws that regulate nursing; rather, they enforce them.	
5.	This is incorrect. State boards of nursing do not regulate the number of licensed nurses. 	

PTS:	1	CON:	Professionalism	

	35.	ANS:	1, 3, 4
Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Delineate the forces and trends affecting contemporary nursing practice.
Page: 9
Heading: Application of Knowledge, Skill, and Caring
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Professionalism
Difficulty: Difficult

	Feedback	
1.	This is correct. Critical thinking is a reflective thinking process that involves collecting information, analyzing the adequacy and accuracy of the information, and carefully considering options for action. Nurses use critical thinking in every aspect of nursing care. 	
2.	This is incorrect. Pain evaluation is a process of assessment involving critical thinking, clinical judgment, and problem-solving. 	
3.	This is correct. Clinical judgment is a process in nursing involving observing, comparing, contrasting, and evaluating the client’s condition to determine whether change has occurred. It also involves careful consideration of the client’s health status in light of what is expected based on the client’s condition, medications, and treatment. These actions are collectively known as the nursing process.  	
4.	This is correct. Problem-solving is a process by which nurses consider an issue and attempt to find a satisfactory solution to achieve the best outcomes. Nurses often use problem-solving in professional life. The nursing process is one type of problem-solving process.	
5.	This is incorrect. Sterile technique is a nursing skill based on critical thinking, clinical judgment, and problem-solving abilities. 	

PTS:	1	CON:	Professionalism	

COMPLETION

	36.	ANS: Medicaid

Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 18
Heading: How Is Healthcare Financed?
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance 
Cognitive Level: Comprehension [Understanding]
Concept: Health Promotion
Difficulty: Moderate 

Feedback: Medicaid is a health program run by the state and funded by the federal and state governments. It is intended to provide preventive and acute healthcare for individuals, in particular pregnant women and children, who are unable to pay for services.

PTS:	1	CON:	Health Promotion	

	37.	ANS: Medicare

Chapter: Chapter 1: Evolution of Nursing Thought & Action
Objective: Describe the healthcare delivery system in the United States, including sites for care, types of workers, regulation, and financing of healthcare.
Page: 18
Heading: How Is Healthcare Financed?
Integrated Processes: Nursing Process
Client Need: Health Promotion and Maintenance
Cognitive Level: Comprehension [Understanding]
Concept: Health Promotion
Difficulty: Moderate 

Feedback: Medicare is a federal insurance program created by Title XVIII of the Social Security Act of 1965. This act was designed to protect people aged 65 years and older from the high cost of healthcare. In 1972, the program was expanded to cover workers with disabilities as well as people with end-stage renal disease.

PTS:	1	CON:	Health Promotion