Chapter 07 My Nursing Test Banks

Kozier & Erbs Fundamentals of Nursing, 10/E
Chapter 07

Question 1

Type: MCSA

A nurse educator is explaining primary health care (PHC) and the extension of its boundaries beyond traditional health care services to a group of community members. What issues related to PHC should the nurse include in this discussion?

1. Distribution and participation

2. Environment, agriculture, and housing

3. Consumerism and governmental subsidies

4. Low life expectancies and high mortality rates among children

Correct Answer: 2

Rationale 1: PHC involves issues of the environment, agriculture, and housing. It also involves other social, economic, and political issues such as poverty, transportation, unemployment, and economic development to sustain the population. Distribution and participation are two of the five principles incorporated in PHC. Consumerism and governmental subsidies are not part of the PHC makeup. Low life expectancies and high mortality rates among children are two concerns about health care that led to the global health strategy of primary health care.

Rationale 2: PHC involves issues of the environment, agriculture, and housing. It also involves other social, economic, and political issues such as poverty, transportation, unemployment, and economic development to sustain the population. Distribution and participation are two of the five principles incorporated in PHC. Consumerism and governmental subsidies are not part of the PHC makeup. Low life expectancies and high mortality rates among children are two concerns about health care that led to the global health strategy of primary health care.

Rationale 3: PHC involves issues of the environment, agriculture, and housing. It also involves other social, economic, and political issues such as poverty, transportation, unemployment, and economic development to sustain the population. Distribution and participation are two of the five principles incorporated in PHC. Consumerism and governmental subsidies are not part of the PHC makeup. Low life expectancies and high mortality rates among children are two concerns about health care that led to the global health strategy of primary health care.

Rationale 4: PHC involves issues of the environment, agriculture, and housing. It also involves other social, economic, and political issues such as poverty, transportation, unemployment, and economic development to sustain the population. Distribution and participation are two of the five principles incorporated in PHC. Consumerism and governmental subsidies are not part of the PHC makeup. Low life expectancies and high mortality rates among children are two concerns about health care that led to the global health strategy of primary health care.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values

AACN Essentials Competencies: VII. 13. Use evaluation results to influence the delivery of care, deployment of resources, and to provide input into the development of policies to promote health and prevent disease

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 1. Discuss factors influencing health care reform.

MNL Learning Outcome: 1.2.4. Compare the frameworks of care.

Page Number: 106

Question 2

Type: MCSA

After a community was hit by a tornado, the nurses of the local Red Cross Chapter helped to make sure people had adequate food and clothing. Which function of community were these nurses focused on restoring?

1. Social control

2. Social interparticipation

3. Mutual support

4. Distribution of goods and services

Correct Answer: 4

Rationale 1: Social control refers to the way in which order is maintained in a community.

Rationale 2: Social interparticipation refers to community activities that are designed to meet peoples needs for companionship.

Rationale 3: Mutual support refers to the communitys ability to provide resources at a time of illness or disaster.

Rationale 4: Production, distribution, and consumption of goods and services are the means by which the community provides for the economic needs of its members. It includes supplying food and clothing as well as providing water, electricity, police and fire protection, and the disposal of refuse.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values

AACN Essentials Competencies: VII. 13. Use evaluation results to influence the delivery of care, deployment of resources, and to provide input into the development of policies to promote health and prevent disease

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5. Discuss competencies community-based nurses need for practice, including the Pew Health Professions Commission recommendations for health competencies for future health practitioners.

MNL Learning Outcome: 1.2.4. Compare the frameworks of care.

Page Number: 108

Question 3

Type: MCSA

A nurse is helping to set up an elder social group at a local senior center where residents can come to play cards or participate in structured activities three times a week. In which community function is this nurse working?

1. Socialization

2. Social control

3. Social interparticipation

4. Mutual support

Correct Answer: 3

Rationale 1: Socialization refers to the process of transmitting values, knowledge, culture, and skills to others.

Rationale 2: Social control refers to the way in which order is maintained in a community.

Rationale 3: Social interparticipation refers to community activities that are designed to meet peoples needs for companionship.

Rationale 4: Mutual support refers to the communitys ability to provide resources at a time of illness or disaster.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values

AACN Essentials Competencies: VII. 13. Use evaluation results to influence the delivery of care, deployment of resources, and to provide input into the development of policies to promote health and prevent disease

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4. Differentiate community-based nursing from traditional institutional-based nursing.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 108

Question 4

Type: MCSA

The nurse is explaining the difference between community and population to a group of community members. What should the nurse use as an example for population?

1. Commuters on the subway

2. A grade school class

3. Graduating nursing students

4. A group of employees at a local plant

Correct Answer: 1

Rationale 1: A population is composed of people who share some common characteristic, but who do not necessarily interact with each otheras people on a subway might behave. They are all riding, but not really interacting.

Rationale 2: A community is a group of people or a social system in which the members interact formally or informally and form networks that operate for the benefit of all people in the community. A grade school class is a community.

Rationale 3: A community is a group of people or a social system in which the members interact formally or informally and form networks that operate for the benefit of all people in the community. Graduating nursing students is an example of a community.

Rationale 4: A community is a group of people or a social system in which the members interact formally or informally and form networks that operate for the benefit of all people in the community. Employees at a local plant are an example of a community.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values

AACN Essentials Competencies: VII. 13. Use evaluation results to influence the delivery of care, deployment of resources, and to provide input into the development of policies to promote health and prevent disease

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6. Explain essential aspects of collaborative health care: definitions, objectives, benefits, and the nurses role.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 108

Question 5

Type: MCSA

When completing a community assessment, the community health nurse will take several aspects into account. What is the first stage of this assessment that the nurse will complete?

1. Learn about the people in the community.

2. Understand the major illnesses present in the community.

3. Identify the boundaries of the community.

4. Make sure resources are available in the community.

Correct Answer: 1

Rationale 1: The first stage in assessment is to learn about the people in the community. When completing a community assessment, the nurse needs to focus on a much larger clientwhich is the whole community.

Rationale 2: Understanding the major illnesses present in the community is not a part of the community assessment.

Rationale 3: Identifying boundaries is part of a community assessment; however, it is not the first stage.

Rationale 4: Community resources include types of dwellings, education system, safety and transportation services, politics and government, health and social services, communication, economics, and recreation.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values

AACN Essentials Competencies: VII. 13. Use evaluation results to influence the delivery of care, deployment of resources, and to provide input into the development of policies to promote health and prevent disease

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2. Describe various community-based health care frameworks, including integrated health care systems, community initiatives and conditions, and case management.

MNL Learning Outcome: 1.2.4. Compare the frameworks of care.

Page Number: 108

Question 6

Type: MCSA

While completing a community assessment, the nurse needs to learn the location of main health facilities and the number of who receive welfare. Where should the nurse access this information?

1. Police department

2. City health planning board

3. County health department

4. State census data

Correct Answer: 3

Rationale 1: The police department has statistics regarding incidence of crime, vandalism, and drug addiction. Rationale 2: The city health planning board has information about health needs and practices.

Rationale 3: The county health department would be able to supply information about location of health facilities, occupational health programs, numbers of health professionals, numbers of welfare recipients, and so on.

Rationale 4: The state census data describe population composition and characteristics.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values

AACN Essentials Competencies: VII. 13. Use evaluation results to influence the delivery of care, deployment of resources, and to provide input into the development of policies to promote health and prevent disease

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 6. Explain essential aspects of collaborative health care: definitions, objectives, benefits, and the nurses role.

MNL Learning Outcome: 1.2.3. Examine the factors affecting health care delivery.

Page Number: 109

Question 7

Type: MCSA

The new community health nurse is compiling information about the community and wants to understand more about services to maintain and promote health. What entity should the nurse access to learn this information?

1. Chamber of commerce

2. Public and university libraries

3. Recreational directors

4. Teachers and school nurses

Correct Answer: 4

Rationale 1: The chamber of commerce can supply statistics about employment, major industries, and primary occupations.

Rationale 2: Public and university libraries contain district social and cultural research reports.

Rationale 3: Recreational directors provide information about programs and participation levels.

Rationale 4: Teachers and school nurses provide information about the incidence of childrens health problems and information on facilities and services to maintain and promote health.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values

AACN Essentials Competencies: VII. 13. Use evaluation results to influence the delivery of care, deployment of resources, and to provide input into the development of policies to promote health and prevent disease

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 6. Explain essential aspects of collaborative health care: definitions, objectives, benefits, and the nurses role.

MNL Learning Outcome: 1.2.3. Examine the factors affecting health care delivery.

Page Number: 109

Question 8

Type: MCSA

A client in the ambulatory clinic asks if there are any community programs to help with health and wellness issues. What should the nurse access to locate these types of activities?

1. Online computer services

2. Recreational directors

3. Local newspapers

4. Telephone book

Correct Answer: 3

Rationale 1: Online computer services may provide access to public documents related to community health.

Rationale 2: Recreational directors have information about programs provided and participation levels.

Rationale 3: Local newspapers contain informationincluding date and timeabout community activities related to health and wellness, such as health lectures or health fairs.

Rationale 4: The telephone book would include the location of social, recreational, and health organizations, as well as committees and facilities.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values

AACN Essentials Competencies: VII. 13. Use evaluation results to influence the delivery of care, deployment of resources, and to provide input into the development of policies to promote health and prevent disease

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 7. Describe the role of the nurse in providing continuity of care.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 109

Question 9

Type: MCSA

Several nurses at the county health department are involved in planning community health. In order to create a plan that will be acceptable to members of the community, who else should be involved in this venture?

1. As many people from the community as possible

2. Physicians and other nurses

3. Members of the chamber of commerce and governing board of the community

4. Just the nurses at the county health department

Correct Answer: 1

Rationale 1: A broadly based planning group is most likely to create a plan that is acceptable to members of the community. People who are involved in planning become educated about problems, resources, and interrelationships within the system. Responsibility for planning at the community level is usually broadly based and needs to include as many of the community partners as possible.

Rationale 2: Physicians and other nurses may not understand the communitys health needs.

Rationale 3: Members of the chamber of commerce and community governing board may not understand the communitys health needs.

Rationale 4: The nurses may not understand the communitys health needs. The plan should include members of the community so that all members are represented and have a voice in planning.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values

AACN Essentials Competencies: VII. 10. Collaborate with others to develop an intervention plan that takes into account determinants of

health, available resources, and the range of activities that contribute to health and prevention of illness, injury, disability and premature death

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2. Describe various community-based health care frameworks, including integrated health care systems, community initiatives and conditions, and case management.

MNL Learning Outcome: 1.2.4. Compare the frameworks of care.

Page Number: 109

Question 10

Type: MCSA

After implementing health promotion activities and plans to prioritize health problems, the community must evaluate the effectiveness of the interventions. Which groups should be involved in this process?

1. Health care providers at the community level

2. Hospital and clinic personnel who administered health care needs

3. Health care providers, consumers, community leaders, and politicians

4. Those consumers who were directly affected by the services provided

Correct Answer: 3

Rationale 1: Because community health is usually a collaborative process between health providers, community leaders, politicians, and consumers, all may be involved in the evaluation process. Often, the community health nurse is the agent of evaluation, collecting and assessing data that determine the effectiveness of implemented programs.

Rationale 2: Because community health is usually a collaborative process between health providers, community leaders, politicians, and consumers, all may be involved in the evaluation process. Often, the community health nurse is the agent of evaluation, collecting and assessing data that determine the effectiveness of implemented programs.

Rationale 3: Because community health is usually a collaborative process between health providers, community leaders, politicians, and consumers, all may be involved in the evaluation process. Often, the community health nurse is the agent of evaluation, collecting and assessing data that determine the effectiveness of implemented programs.

Rationale 4: Because community health is usually a collaborative process between health providers, community leaders, politicians, and consumers, all may be involved in the evaluation process. Often, the community health nurse is the agent of evaluation, collecting and assessing data that determine the effectiveness of implemented programs.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values

AACN Essentials Competencies: VII. 13. Use evaluation results to influence the delivery of care, deployment of resources, and to provide input into the development of policies to promote health and prevent disease

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 6. Explain essential aspects of collaborative health care: definitions, objectives, benefits, and the nurses role.

MNL Learning Outcome: 1.2.3. Examine the factors affecting health care delivery.

Page Number: 109

Question 11

Type: MCSA

A large community clinic provides health education, illness prevention, acute care, screening, and rehabilitation and health promotion services for the chronically ill. What should the community health nurse identify this approach to health care as being?

1. Community-based setting

2. Integrated health care system

3. Wellness center

4. Community outreach center

Correct Answer: 2

Rationale 1: Community-based settings are provided in county and state health departments and may include day-care centers, senior centers, storefront clinics, homeless shelters, and the like.

Rationale 2: An integrated health care system makes all levels of care available in an integrated form, including primary care (education and illness prevention), secondary care (acute care and screening), and tertiary care (rehabilitation and services for the chronically ill).

Rationale 3: A wellness center provides services such as health promotion, maintenance education, counseling, and screening.

Rationale 4: Community outreach centers are small, freestanding clinics providing services similar to those traditionally provided by large public health clinics, but focused on a narrower population.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 2. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values

AACN Essentials Competencies: VII. 13. Use evaluation results to influence the delivery of care, deployment of resources, and to provide input into the development of policies to promote health and prevent disease

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 2. Describe various community-based health care frameworks, including integrated health care systems, community initiatives and conditions, and case management.

MNL Learning Outcome: 1.2.4. Compare the frameworks of care.

Page Number: 109

Question 12

Type: MCSA

A parish health nurse is working with a particular congregation in setting up a support program for shut-ins within the congregation who are not able to come to regular prayer services. In which role is this nurse functioning?

1. Counselor

2. Educator

3. Referral source

4. Facilitator

Correct Answer: 4

Rationale 1: A counselor discusses health issues and problems with individuals and makes home, hospital, and nursing home visits as needed.

Rationale 2: An educator works to support individuals through health education activities that promote an understanding of the relationship between values, attitudes, lifestyle, faith, and well-being.

Rationale 3: A referral source is a liaison to other congregations and community resources.

Rationale 4: A facilitator recruits and coordinates volunteers within the congregation and develops support groups.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: II. B. 4. Function competently within own scope of practice as a member of the health care team

AACN Essentials Competencies: VI. 1. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education and licensure requirements)

NLN Competencies: Teamwork; Knowledge; Scope of practice, roles, and responsibilities of health care team members, including overlaps

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7. Describe the role of the nurse in providing continuity of care.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 111

Question 13

Type: MCSA

A parish nurse is helping a group of new parents within the congregation find appropriate health care providers within the community who specialize in infant/child and family health care needs. In which role is the nurse functioning?

1. Health educator

2. Referral source

3. Facilitator

4. Integrator

Correct Answer: 2

Rationale 1: A health educator supports individuals through health education activities that promote understanding of the relationship between values, attitudes, lifestyle, faith, and well-being.

Rationale 2: A referral source acts as a liaison to other congregational and community resources. Helping new parents find appropriate sources for health care would be an example of a referral source.

Rationale 3: A facilitator recruits and coordinates volunteers within the congregation and develops support groups.

Rationale 4: An integrator brings the entities of faith and health together.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: II. B. 4. Function competently within own scope of practice as a member of the health care team

AACN Essentials Competencies: VI. 1. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e. scope of discipline, education and licensure requirements)

NLN Competencies: Teamwork; Knowledge; Scope of practice, roles, and responsibilities of health care team members, including overlaps

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7. Describe the role of the nurse in providing continuity of care.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 111

Question 14

Type: MCSA

A public health nurse is working with a group of home health nurses in an isolated, mountainous region where access to smaller communities and individuals is quite difficult, especially in the winter and early springseasons when the health needs of these individuals are quite high. The public health nurse has set up video conferencing and video clinics for these home health nurses regarding various client teaching and health promotion activities. What activity did the public health nurse conduct?

1. Community-based nursing

2. Parish nursing

3. Telenursing

4. Collaborative health care

Correct Answer: 3

Rationale 1: Community-based nursing is nursing care directed toward specific individuals.

Rationale 2: Parish nursing focuses on integrating aspects of faith and members of a particular congregation and health care or nursing needs.

Rationale 3: Telehealth projects use communication and information technology to provide health information and health care services to people in rural, remote, or underserviced areas. Video conferences and video clinics enable health care workers to provide distant consultation to assess and treat ambulatory clients who have a variety of health care needs. Telenursing enables nurses to provide client teaching and health promotion to distant clients.

Rationale 4: Collaborative health care describes a process of teamwork in providing comprehensive health care.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: VI. B. 5. Employ communication technologies to coordinate care for patients

AACN Essentials Competencies: IV. 2. Use telecommunication technologies to assist in effective communication in a variety of healthcare settings

NLN Competencies: Quality and Safety; Practice; Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 2. Describe various community-based health care frameworks, including integrated health care systems, community initiatives and conditions, and case management.

MNL Learning Outcome: 1.2.4. Compare the frameworks of care.

Page Number: 111

Question 15

Type: MCSA

Several nurses are working with other health care providers to provide care for a group of community members who have complications of diabetes mellitus and require extensive dressing changes and comprehensive education. In what capacity are the nurses and care providers working?

1. Collaboration

2. Case management

3. Health promotion

4. Health education

Correct Answer: 1

Rationale 1: Collaboration means a collegial working relationship with other health care providers to supply patient care. Collaborative practice requires the discussion of diagnoses and management in the delivery of care.

Rationale 2: Case management involves one person overseeing the needs and requirements of a particular individuals health.

Rationale 3: Health promotion activities include disease prevention and healthy lifestyle interventions.

Rationale 4: Health education would be included in this particular situation but collaboration is a more inclusive definition of what is occurring with these individuals and the care they require.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

QSEN Competencies: II. B. 4. Function competently within own scope of practice as a member of the health care team

AACN Essentials Competencies: VI. 2. Use inter-and intraprofessional communication and collaborative skills to deliver evidence-based, patient-centered care

NLN Competencies: Quality and Safety; Practice; Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 6. Explain essential aspects of collaborative health care: definitions, objectives, benefits, and the nurses role.

MNL Learning Outcome: 1.2.3. Examine the factors affecting health care delivery.

Page Number: 112

Question 16

Type: MCSA

A nurse is working in collaboration with a group of health care providers in a community clinic setting. They have defined a problem and now are focusing on objectives and considering various viewpoints presented by the group. Which collaboration competency is this nurse demonstrating?

1. Mutual respect

2. Trust

3. Communication

4. Decision making

Correct Answer: 4

Rationale 1: Mutual respect occurs when two or more people show or feel honor or esteem toward one another.

Rationale 2: Trust occurs when a person is confident in the actions of another person.

Rationale 3: Communication is necessary in effective collaboration. It occurs only if the involved parties are committed to understanding each others professional roles and appreciating each other as individuals.

Rationale 4: Decision making involves shared responsibility for the outcome. The team must follow specific steps of the decision-making process, beginning with a clear definition of the problem. Team decision making must be directed at the objectives of the effort and requires full consideration and respect for various and diverse viewpoints.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: II. B. 4. Function competently within own scope of practice as a member of the health care team

AACN Essentials Competencies: VI. 2. Use inter-and intraprofessional communication and collaborative skills to deliver evidence-based, patient-centered care

NLN Competencies: Quality and Safety; Practice; Communicate effectively with different individuals (team members, other care providers, patients, families, etc.) so as to minimize risks associated with handoffs among providers and across transitions in care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2. Describe various community-based health care frameworks, including integrated health care systems, community initiatives and conditions, and case management.

MNL Learning Outcome: 1.2.4. Compare the frameworks of care.

Page Number: 112

Question 17

Type: MCSA

The nurse case managers office is in a cluster of offices that share a fax machine. Which action by the nurse ensures that HIPAA requirements are met?

1. Have the client sign a consent form for information to be released.

2. Have sending agencies call ahead before any information is sent.

3. Do not utilize the fax machine; depend on the mail system.

4. Take relevant information over the phone.

Correct Answer: 2

Rationale 1: Signing a consent form for information to be released is necessary to share information, but this would not ensure the privacy aspect of HIPAAonly the disclosure aspect.

Rationale 2: Case manager nurses need to maintain vigilance to protect the privacy of client health care information when sending and receiving messages. In this case, having the sending agency call prior to faxing information would alert the nurse to collect the information from the fax machine at the time it is received, securing that information so others do not have access to it.

Rationale 3: Sending information through the mail takes time and does not ensure the privacy of the information.

Rationale 4: Phone conversations and information taken during the conversation must be protected and taken in a secured way to ensure HIPAA privacy aspects have not been breached.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: VI. B. 5. Employ communication technologies to coordinate care for patients

AACN Essentials Competencies: IV. 8. Uphold ethical standards related to data security, regulatory requirements, confidentiality and clients right to privacy

NLN Competencies: Context and Environment; Knowledge; principles of informed consent, confidentiality, patient self-determination

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6. Explain essential aspects of collaborative health care: definitions, objectives, benefits, and the nurses role.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 113

Question 18

Type: MCSA

The nurse is helping in discharge planning of a client who needs extensive rehabilitation and is on a complicated medication schedule. Which individual should the nurse include in this clients plan?

1. Clients spouse

2. Physician

3. Pharmacist

4. Social worker

Correct Answer: 1

Rationale 1: Effective discharge planning necessitates health team conferences and family conferences and gives the client, family, and health care professionals the opportunity to plan care and set goals. Involving the clients spouse would be important in this situation because of the complexity of the clients situation.

Rationale 2: Effective discharge planning necessitates health team conferences and family conferences and gives the client, family, and health care professionals the opportunity to plan care and set goals The physician, pharmacist, and social worker may also be included, but by their own decisionnot necessarily by the nurses invitation.

Rationale 3: Effective discharge planning necessitates health team conferences and family conferences and gives the client, family, and health care professionals the opportunity to plan care and set goals. The physician, pharmacist, and social worker may also be included, but by their own decisionnot necessarily by the nurses invitation.

Rationale 4: Effective discharge planning necessitates health team conferences and family conferences and gives the client, family, and health care professionals the opportunity to plan care and set goals. The physician, pharmacist, and social worker may also be included, but by their own decisionnot necessarily by the nurses invitation.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7. Describe the role of the nurse in providing continuity of care.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 114

Question 19

Type: MCSA

A client is getting ready to go home from an intermediate care facility following surgery and a lengthy recovery period. On which item should the home health nurse focus to determine effectiveness of discharge teaching?

1. Activity restrictions

2. Follow-up appointment dates

3. Return demonstration of dressing change

4. Signs of complications

Correct Answer: 3

Rationale 1: Activity restrictions are important; however, it would not be possible for the client to demonstrate the expectation to the nurse.

Rationale 2: Knowing when to follow up with a health care provider is important; however, it would not be possible for the client to demonstrate the expectation to the nurse.

Rationale 3: Clients need teaching before discharge that includes information about medications, dietary and activity restrictions, signs of complications that need to be reported to the physician, follow-up appointments, and where supplies can be obtained. Clients, and perhaps caregivers, also need to demonstrate safe performance of any necessary treatments. Clients need help to understand their situation, to make health care decisions, and to learn new health behaviors. All the options would be important for the client to retain, but to determine whether the task of changing the dressing was learned, the client would have to demonstrate the skill back to the nurse.

Rationale 4: Signs of complications are important; however, it would not be possible for the client to demonstrate the expectation to the nurse.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7. Describe the role of the nurse in providing continuity of care.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 115

New Questions:

Question 20

Type: MCMA

A multi-organization medical system is designing a community-based facility to support the health care needs of members who live in an urban area. What should the medical system keep in mind when designing the new facility?

Standard text: Select all that apply.

1. Affordable

2. Easy to travel to the facility

3. A focus on the needs of mothers and children

4. Many services available to meet community members needs

5. Communication of care needs to the community members other health care providers

Correct Answer: 1, 2, 4, 5

Rationale 1: To be effective, a communitybased health care system needs to be affordable.

Rationale 2: To be effective, a communitybased health care system needs to provide easy access to care.

Rationale 3: To be effective, a communitybased health care system needs to focus on the needs of all community members and not just on mothers and children.

Rationale 4: To be effective, a communitybased health care system needs to be flexible in responding to the care needs of individuals and families.

Rationale 5: To be effective, a communitybased health care system needs to promote care between and among health care agencies through improved communication mechanisms.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3. Differentiate community health care settings from traditional settings.

MNL Learning Outcome: 1.2.4. Compare the frameworks of care.

Page Number: 108

Question 21

Type: MCMA

The community health nurse is identifying approaches to support a communitys health care needs. Which programs should the nurse select to support community-based health care?

Standard Text: Select all that apply.

1. Smoking cessation classes

2. Personal safety classes for women

3. Blood pressure measurement clinic

4. Outpatient clinic for minor ailments

5. Allergy injection clinic on weekends

Correct Answer: 1, 2, 3

Rationale 1: Community-based care is holistic and involves a broad range of services designed not only to restore health but also to promote health, prevent illness, and protect the public. This would include smoking cessation classes.

Rationale 2: Community-based care is holistic and involves a broad range of services designed not only to restore health but also to promote health, prevent illness, and protect the public. This would include personal safety classes for women.

Rationale 3: Community-based care is holistic and involves a broad range of services designed not only to restore health but also to promote health, prevent illness, and protect the public. This would include blood pressure measurement clinics.

Rationale 4: The traditional health care system focuses on the ill and injured. An outpatient clinic for minor ailments would be a traditional health care program.

Rationale 5: The traditional health care system focuses on the ill and injured. An allergy clinic on weekends would be a traditional health care program.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient centered care

AACN Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings

NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 3. Differentiate community health care settings from traditional settings.

MNL Learning Outcome: 1.2.4. Compare the frameworks of care.

Page Number: 107

 

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