Chapter 24: Future Career Decisions: Choosing What Is Right for You My Nursing Test Banks

Chapter 24: Future Career Decisions: Choosing What Is Right for You

Test Bank

MULTIPLE CHOICE

1. Based on the expected role of an entry-level LPN/LVN, which patient could be safely assigned to the care of a new LPN/LVN?

a.

A newly hospitalized patient who has disseminated intravascular coagulation syndrome

b.

A patient receiving physical therapy after a total knee replacement in a nursing home rehabilitation unit

c.

A home health care case consisting of a mother and a newborn with spina bifida and a ventricular peritoneal shunt for hydrocephalus

d.

A newly admitted patient experiencing a manic episode who is awaiting test results before beginning lithium therapy

ANS: B

The entry-level LPN/LVN is expected to provide care for patients with common, well-defined health problems with predictable outcomes in structured health care settings under the guidance of an RN or licensed physician or dentist. The patient described in the correct option is the only one who meets these criteria. A newly hospitalized patient with disseminated intravascular coagulation syndrome is unstable and has unpredictable outcomes. The mother of a newborn with spina bifida and a ventricular peritoneal shunt for hydrocephalus requires extensive teaching and anticipatory guidance best given by an RN, whereas the infant requires close assessment of neurological status. A newly admitted patient experiencing a manic episode who is awaiting test results before beginning lithium therapy is unstable and requires skilled nursing interventions.

DIF: Cognitive Level: Analysis REF: p. 327 OBJ: 2

TOP: Work sites and nursing characteristics KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment

2. The home health agency has offered to hire the LPN/LVN applicant as a home health aide. What consideration provides the greatest deterrent to the LPN/LVN accepting the offer?

a.

The LPN/LVN will have difficulty receiving compensation from employers.

b.

Patients will respond less favorably to the individual because of status issues.

c.

Legally, one is always held to the standard of performance of their highest license.

d.

Once employed as a home health aide, the individual cannot be employed as an LPN/LVN.

ANS: C

Such a position offers lower pay than the LPN/LVN scale, yet the individual is held to the requirements established by the highest license held. The LPN/LVN would not have difficulty receiving compensation from the agency; the payment problem is that nonprivate payers do not reimburse for care given by LPN/LVNs. Patients responding less favorably to the individual because of status issues is not a consideration. It is not true that once employed as a home health aide, the individual cannot be employed as an LPN/LVN.

DIF: Cognitive Level: Analysis REF: pp. 327-328 OBJ: 1

TOP: Home health nursing KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

3. What situation is responsible for certain practical/vocational nurse graduates being unprepared to work in a behavioral/mental health clinical setting?

a.

Historically, only RNs have been permitted to work with the mentally ill.

b.

Some practical/vocational nursing programs do not include a specific mental health nursing component.

c.

Practical/vocational nursing students are too fearful of mentally ill patients to learn enough during their programs.

d.

Because the number of mentally ill people in the United States is declining, little emphasis needs to be placed on that portion of the educational program.

ANS: B

Graduates without knowledge of this specialty cannot be expected to function safely and effectively in the clinical setting. Historically, LPN/LVNs have been able to work with the mentally ill. Practical/vocational nursing students are not too fearful of mentally ill patients to learn enough during their programs. Many SP/VNs function without excessive fear in the mental health clinical setting. The number of mentally ill is not declining.

DIF: Cognitive Level: Comprehension REF: p. 328 OBJ: 1

TOP: Work sites KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

4. Which statement explains a major deterrent to setting up LPN/LVN-to-RN programs?

a.

There is a lack of interest by LPN/LVNs in becoming RNs.

b.

There is a belief that practical/vocational nurse courses are inferior (or not sufficient) and must be repeated at the collegiate level.

c.

The abundance of RNs in recent years has crowded the field and created an LPN/LVN job shortage.

d.

Practical/vocational nurse programs have increased curriculum content to make it possible for graduates to function in RN roles.

ANS: B

Many nurse educators believe that a practical nursing program is terminal in scope and does not provide an adequate basis on which to build professional nursing knowledge and skills. There is no lack of interest on the part of LPN/LVNs. There is actually a shortage of RNs. Practical/vocational nurse programs have not increased curriculum content to make it possible for graduates to function in RN roles.

DIF: Cognitive Level: Comprehension REF: p. 335 OBJ: 5

TOP: Educational mobility KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

5. Which area of health care delivery services is the largest employer of LPN/LVNs?

a.

Extended care facilities

b.

Hospitals

c.

Home health

d.

Military services

ANS: A

Extended care facility employment is expected to grow faster than other area of employment in response to the needs of the growing number of elderly and disabled people and the use of nursing homes for recuperation after hospitalization.

DIF: Cognitive Level: Knowledge REF: p. 326 OBJ: 1

TOP: Job outlook KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

6. Which statement is true about mobility from LPN/LVN to RN?

a.

It is possible in many states using career ladder and advanced standing programs.

b.

It is impossible in most states, because LPN/LVN courses cannot be given academic credit in colleges.

c.

It can be accomplished by joining one of the military services and taking challenge examinations.

d.

It requires practice agreements with local physicians and health care agencies to allow the LPN/LVN to work outside the legal job title.

ANS: A

Many states, including New York, Minnesota, and Wisconsin, have removed barriers to LPN/LVN educational mobility. Articulation agreements and challenge examinations take care of courses being given academic credit in colleges. While in the military, one can take courses leading to a higher credential. Practice agreements with local physicians and health care agencies are not required to allow the LPN/LVN to work outside the legal job title.

DIF: Cognitive Level: Comprehension REF: p. 335 OBJ: 5

TOP: Educational mobility KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

7. The quality that is the greatest asset for the LPN/LVN working in home health care is

a.

flexibility.

b.

judgmental attitude.

c.

sympathetic approach.

d.

preference for working alone.

ANS: A

Flexibility is necessary, because the LPN/LVN often has to improvise while still practicing sound nursing principles. A nonjudgmental attitude is desirable. Empathy, rather than sympathy, is needed. The home health LPN/LVN works with a health care team and the family.

DIF: Cognitive Level: Analysis REF: p. 328 OBJ: 1

TOP: Nursing characteristics KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

8. Desirable qualities and skills for the LPN/LVN working in mental health nursing include

a.

a judgmental attitude and sympathetic approach.

b.

preference for working alone and sticking to a routine.

c.

empathy, good communication, and the ability to work on a team.

d.

inflexibility, the ability to jump to conclusions, and sensitivity to change.

ANS: C

These qualities are desirable for working in the mental health setting; empathy and good communication contribute to development of a therapeutic relationship. The ability to work on a team is essential, because this is the structure adopted by mental health agencies. Nonjudgmental attitudes and empathy are necessary. Mental health nursing requires working with other team members. Flexibility, critical thinking, and good mental health are required.

DIF: Cognitive Level: Comprehension REF: p. 328 OBJ: 1

TOP: Mental health nursing KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

9. During an employment interview, the interviewee asks what additional educational experiences the LPN/LVN can count on receiving when employed at the facility. Which continuing education opportunity is the interviewer most likely to say the agency offers?

a.

Annual off-site paid workshops

b.

Orientation and in-service classes

c.

Paid courses at a local 2-year college

d.

Correspondence courses funded by NAPNES

ANS: B

These educational experiences are considered standard benefits at most agencies. The other options are benefits that may or may not be available at a given agency.

DIF: Cognitive Level: Application REF: p. 333 OBJ: 5

TOP: Continuing education KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

10. The LPN/LVN tells a mentor, I want to join the nursing organization that gives me the greatest voice in making policy for LPN/LVN nursing. The mentor can correctly suggest that the LPN/LVN will wish to join the

a.

National League for Nursing (NLN).

b.

National Association for Practical Nurse Education and Services (NAPNES).

c.

National Federation of Practical Nurses (NFPN).

d.

American Nurses Association (ANA).

ANS: C

The NFPN speaks on behalf of LPN/LVNs. It is governed entirely by LPN/LVNs and is the policy-making body and voice of LPN/LVNs. The NLN provides services for LPN/LVN schools of nursing, and NAPNES provides services for individual LPN/LVNs; however, these are not considered policy-making bodies for LPN/LVNs. The ANA is concerned with professional nursing.

DIF: Cognitive Level: Application REF: p. 333 OBJ: 3

TOP: Nursing organizations KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

11. The American Nurses Association (ANA)

a.

represents only registered nurses.

b.

represents only licensed practical nurses.

c.

represents both registered nurses and licensed practical nurses.

d.

has attempted to expand licensed practical nurses scope of practice.

ANS: A

The ANA represents only registered nurses. State affiliates of the ANA are altering bylaws to allow LPN/LVNs to join the association at the state level and pay dues but not to have a voice or vote in the organization. The ANA does not represent licensed practical/vocational nurses and has attempted to limit their scope of practice. In 1965 the ANA set a policy to eliminate LPN/LVNs and attempted to do so again in the 1980s.

DIF: Cognitive Level: Comprehension REF: p. 332 OBJ: 3

TOP: American Nurses Association KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

12. The National League for Nursing (NLN) membership is open

a.

only to registered nurses.

b.

only to licensed practical nurses.

c.

only to advanced practice nurses.

d.

to anyone interested in nursing issues.

ANS: D

The NLN membership is open to all levels of nurses and anyone interested in nursing issues.

DIF: Cognitive Level: Comprehension REF: p. 332 OBJ: 3

TOP: American Nurses Association KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

13. The first college in the United States to have a distance-learning nursing program (online) is:

a.

University of Phoenix

b.

Minneapolis Community Technical College

c.

Excelsior College

d.

Lackawanna College

ANS: C

Excelsior College (previously known as Regents College, in Albany, NY) is the first college in the United States to have a distance-learning (online) nursing program. Minneapolis Community and Technical College has one of the oldest nursing programs in the country, but it was not the first distance-learning college. The University of Phoenix offers distance learning, but was not the first. Lackawanna College does not offer a distance-learning nursing program at this time.

DIF: Cognitive Level: Knowledge REF: p. 336 OBJ: 5

TOP: Educational mobility KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

COMPLETION

1. The area of nursing in which churches employ their own nurse to take care of basic health needs of the congregation is called __________________ nursing.

ANS:

parish

Parish nurses are employed by the church to keep their groups happy and healthy by treating the whole personbody, mind, and spirit.

DIF: Cognitive Level: Knowledge REF: p. 331 OBJ: 1

TOP: Work areas KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

MULTIPLE RESPONSE

1. Helpful qualities for home health nurses include which of the following? (Select all that apply.)

a.

Flexibility

b.

Judgmental attitude

c.

Self-confidence

d.

Ability to deal with emergencies

e.

Communication skills

ANS: A, C, D, E

Flexibility, self-confidence, ability to deal with emergencies, and communication skills are all helpful qualities for home health nurses. A nonjudgmental attitude is a must for the home health nurse, because he or she works in the patients home. If the nurse is comfortable with his or her own values, different values should not be personally threatening.

DIF: Cognitive Level: Comprehension REF: p. 328 OBJ: 1

TOP: Work areas KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

2. Which trends should guide the LPN/LVN in planning for employment over the next 5 years? (Select all that apply.)

a.

Little change in numbers needed or in potential work sites is projected.

b.

The number of LPN/LVN charge positions will increase in mental health care facilities.

c.

The number of LPN/LVN positions available in hospitals will nearly double.

d.

Employment opportunities for LPN/LVNs will increase in long-term care settings due to the care needs of the elderly.

e.

More LPN/LVNs will be needed to work in community-based settings.

f.

LPN/LVNs will provide care for larger numbers of terminally ill and acutely ill patients.

ANS: D, E, F

Nursing home employment of LPN/LVNs is expected to grow in response to the long-term care needs of the growing number of elderly and disabled individuals. The trend to move health care from inpatient to outpatient suggests that more LPN/LVNs will work in community-based agencies. The RN shortage, if unabated, will likely see more LPN/LVNs caring for acutely ill patients, and the LPN/LVN skill set is well matched with care needs of many terminally ill patients in hospice care. Numbers are expected to increase about as fast as the average for all occupations, whereas work sites are likely to become increasingly diverse. The number of LPN/LVN positions available in hospitals are expected to nearly double according to employment projections.

DIF: Cognitive Level: Comprehension REF: p. 330 OBJ: 1

TOP: Work sites KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

3. In which areas may LPN/LVNs obtain certification? (Select all that apply.)

a.

Managed care

b.

Pharmacology

c.

Long-term care

d.

Mental health care

e.

IV therapy

f.

Wound care

g.

Neonatal care

ANS: A, B, C, E, F

Mental health nursing and neonatal nursing are certifications available at this time only to RNs. The remaining options are all areas in which LPN/LVNs may be certified.

DIF: Cognitive Level: Knowledge REF: p. 334 OBJ: 2

TOP: Certification KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

4. Which services does membership in the National Federation of Practical Nurses (NFPN) provide? (Select all that apply.)

a.

Subscription to the American Journal of Nursing

b.

Insurance discounts

c.

Continuing education articles for CEUs

d.

Certification programs in IV therapy and gerontology

e.

Current standards of practice

ANS: B, C, D, E

All options but subscription to the American Journal of Nursing are services provided by NFPN. Membership includes a subscription to the Practical Nursing Journal, rather than the American Journal of Nursing.

DIF: Cognitive Level: Knowledge REF: p. 333 OBJ: 3

TOP: Professional nursing organizations KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

5. Nurse T has decided to seek certification in an area that will enhance employability in a nursing home. Which certifications would be of greatest value to the LPN/LVN working in a nursing home? (Select all that apply.)

a.

IV therapy

b.

Wound care

c.

Long-term care

d.

Managed care

e.

Pharmacology

f.

Gerontology

ANS: B, C, E, F

The majority of nursing home residents are elderly and receive long-term care. Most receive medications. Those who develop pressure sores require wound care. IV therapy is used less in nursing homes than in hospital settings. Managed care is used less in nursing homes than in hospital and community health settings.

DIF: Cognitive Level: Analysis REF: p. 334 OBJ: 2

TOP: Certification KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

6. Select the various continuing education opportunities that are usually available to an LPN/LVN who accepts employment at a long-term care facility in a metropolitan area having a collegiate nursing program. (Select all that apply.)

a.

A competency-based orientation

b.

In-service programs

c.

Workshops

d.

CEUs through nursing publications

e.

Certifications through nursing organizations

ANS: A, B, C, D, E

All of these forms of continuing education would be available in such a setting.

DIF: Cognitive Level: Comprehension REF: pp. 333-334 OBJ: 5

TOP: Continuing education KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

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