Download HESI FUNDAMENTALS OF NURSINGS CARE ASSESSMENT EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS and more Exams Nursing in PDF only on Docsity!
HESI FUNDAMENTALS OF NURSINGS CARE
ASSESSMENT EXAM QUESTIONS WITH CORRECT
VERIFIED ANSWERS GUARANTEED A+.
Which nurse most likely kept records on sanitation techniques and the effects on health? a. Florence Nightingale b. Mary Nutting c. Clara Barton d. Lillian Wald - Answers-a.Florence Nightingale Nightingale was the first practicing nurse epidemiologist. Her statistical analyses connected poor sanitation with cholera and dysentery. Mary Nutting, Clara Barton, and Lillian Wald came after Nightingale, each contributing to the nursing profession in her own way. Mary Nutting was instrumental in moving nursing education into universities. Clara Barton founded the American Red Cross. Lillian Wald helped open the Henry Street Settlement The nurse prescribes strategies and alternatives to attain expected outcome. Which standard of nursing practice is the nurse following? a. Assessment b. Diagnosis c. Planning d. Implementation - Answers-c. Planning In planning, the registered nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes. During assessment, the registered nurse collects comprehensive data pertinent to the patient's health and/or the situation. In diagnosis, the registered nurse analyzes the assessment data to determine the diagnoses or issues. During implementation, the registered nurse implements (carries out) the identified plan. An experienced medical-surgical nurse chooses to work in obstetrics. Which level of proficiency is the nurse upon initial transition to the obstetrical floor? a. Novice
b. Proficient c. Competent d. Advanced beginner - Answers-a. Novice A beginning nursing student or any nurse entering a situation in which there is no previous level of experience (e.g., an experienced operating room nurse chooses to now practice in home health) is an example of a novice nurse. A proficient nurse perceives a patient's clinical situation as a whole, is able to assess an entire situation, and can readily transfer knowledge gained from multiple previous experiences to a situation. A competent nurse understands the organization and specific care required by the type of patients (e.g., surgical, oncology, or orthopedic patients). This nurse is a competent practitioner who is able to anticipate nursing care and establish long-range goals. A nurse who has had some level of experience with the situation is an advanced beginner. This experience may only be observational in nature, but the nurse is able to identify meaningful aspects or principles of nursing care. A nurse assesses a patient's fluid status and decides that the patient needs to drink more fluids. The nurse then encourages the patient to drink more fluids. Which concept is the nurse demonstrating? a. Licensure b. Autonomy c. Certification d. Accountability - Answers-b. Autonomy Autonomy is an essential element of professional nursing that involves the initiation of independent nursing interventions without medical orders. To obtain licensure in the United States, the RN candidate must pass the NCLEX-RN®. Beyond the NCLEX-RN®, the nurse may choose to work toward certification in a specific area of nursing practice. Accountability means that you are responsible, professionally and legally, for the type and quality of nursing care provided.
- A nurse prepares the budget and policies for an intensive care unit. Which role is the nurse implementing? a. Educator b. Manager c. Advocate
any number of graduate fields, including nursing. Inservice education programs are instruction or training provided by a health care facility or institution. Registered nurse education is the education preparation for an individual intending to be an RN. A nurse identifies gaps between local and best practices. Which Quality and Safety Education for Nurses (QSEN) competency is the nurse demonstrating? a. Safety b. Patient-centered care c. Quality improvement d. Teamwork and collaboration - Answers-c. Quality improvement Quality improvement identifies gaps between local and best practices. Safety minimizes risk of harm to patients and providers through both system effectiveness and individual performance. Patient-centered care recognizes the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and needs. Teamwork and collaboration allows effective functioning within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making. A nurse has compassion fatigue. What is the nurse experiencing? a. Lateral violence and intrapersonal conflict b. Burnout and secondary traumatic stress c. Short-term grief and single stressor d. Physical and mental exhaustion - Answers-b. Burnout and secondary traumatic stress Compassion fatigue is a term used to describe a state of burnout and secondary traumatic stress. Compassion fatigue may contribute to what is described as lateral violence (nurse-nurse interactions, not intrapersonal). Frequent, intense, or prolonged exposure to grief and loss places nurses at risk for developing compassion fatigue. Stressors, not a single stressor, contribute to compassion fatigue. Physical and mental exhaustion describes burnout only. A patient is scheduled for surgery. When getting ready to obtain the informed consent, the patient tells the nurse, "I have no idea what is going to happen. I couldn't ask any
questions." The nurse does not allow the patient to sign the permit and notifies the health care provider of the situation. Which role is the nurse displaying? a. Manager b. Patient educator c. Patient advocate d. Clinical nurse specialist - Answers-c. Patient advocate As a patient advocate, the nurse protects the patient's human and legal rights, including the right of the patient to understand procedures before signing permits. Although nurses can be educators, it is the responsibility of the surgeon to provide education for the patient in preparation for surgery, and it is the nurse's responsibility to notify the health care provider if the patient is not properly educated. Managers coordinate the activities of members of the nursing staff in delivering nursing care, and clinical nurse specialists are experts in a specialized area of nursing practice in a variety of settings. The patient requires routine gynecological services after giving birth to her son, and while seeing the nurse-midwife, the patient asks for a referral to a pediatrician for the newborn. Which action should the nurse-midwife take initially? a. Provide the referral as requested. b. Offer to provide the newborn care. c. Refer the patient to the supervising provider. d. Tell the patient that is not allowed to make referrals. - Answers-b. Offer to provide the newborn care. The practice of nurse-midwifery involves providing independent care for women during normal pregnancy, labor, and delivery, as well as care for the newborn. After being apprised of the midwifery role, if the patient insists on seeing a pediatrician, the nurse- midwife should provide the referral. The supervising provider is an obstetric provider, not a pediatrician. A nurse-midwife can make referrals. The nurse has a goal of becoming a certified registered nurse anesthetist (CRNA). Which activity is appropriate for a CRNA? a. Manages gynecological services such as PAP smears b. Works under the guidance of an anesthesiologist
nurses' influence early in the political process. Legislation is not beyond the nurse's control. National program can have bearing on state politics. The question is focusing on legislation and health care costs, not nursing care. A nurse is using a guide that provides principles of right and wrong to provide care to patients. Which guide is the nurse using? a. Code of ethics b. Standards of practice c. Standards of professional performance d. Quality and safety education for nurses - Answers-a. Code of ethics The code of ethics is the philosophical ideals of right and wrong that define the principles you will use to provide care to your patients. The Standards of Practice describe a competent level of nursing care. The ANA Standards of Professional Performance describe a competent level of behavior in the professional role. Quality and safety education for nurses addresses the challenge to prepare nurses with the competencies needed to continuously improve the quality of care in their work environments.
. A graduate of a baccalaureate degree program is ready to start working as an RN in the emergency department. Which action must the nurse take first? a. Obtain certification for an emergency nurse. b. Pass the National Council Licensure Examination. c. Take a course on genomics to provide competent emergency care. d. Complete the Hospital Consumer Assessment of Healthcare Providers Systems. - Answers-b. Pass the National Council Licensure Examination. Currently, in the United States, the most common way to become a registered nurse (RN) is through completion of an associate's degree or baccalaureate degree program. Graduates of both programs are eligible to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to become registered nurses in the state in which they will practice. Certification can be obtained after passing the NCLEX and working for the specified amount of time. Genomics is a newer term that describes the study of all the genes in a person and interactions of these genes with one another and with that person's environment. Consumers can also access Hospital Consumer
Assessment of Healthcare Providers Systems (HCAHPS) to obtain information about patients' perspectives on hospital care. While providing care to a patient, the nurse is responsible, both professionally and legally. Which concept does this describe? a. Autonomy b. Accountability c. Patient advocacy d. Patient education - Answers-b. Accountability Accountability means that the nurse is responsible, professionally and legally, for the type and quality of nursing care provided. Autonomy is an essential element of professional nursing that involves the initiation of independent nursing interventions without medical orders. As a patient advocate, the nurse protects the patient's human and legal rights and provides assistance in asserting these rights if the need arises. As an educator, the nurse explains concepts and facts about health, describes the reasons for routine care activities, demonstrates procedures such as self-care activities, reinforces learning or patient behavior, and evaluates the patient's progress in learning. A nurse is teaching the staff about Benner's levels of proficiency. In which order should the nurse place the levels from beginning level to ending level?
- Expert
- Novice
- Proficient
- Competent
- Advanced beginner a. 2, 4, 5, 1, 3 b. 2, 5, 4, 3, 1 c. 4, 2, 5, 3, 1 d. 4, 5, 2, 1, 3 - Answers-b. 2, 5, 4, 3, 1
delivery system. Inservice education programs are provided by a health care facility to increase the knowledge, skills, and competencies of nurses employed by the institution. Both can help the nurse stay current. Master's degree programs are valuable for those in the role of nurse educator, nurse administrator, or advanced practice nurse. Professional doctoral programs in nursing (DSN or DNSc) prepare graduates to apply research findings to clinical nursing. National Council Licensure Examination retakes are not to keep current; this test is taken to enter RN practice. A nurse wants to become an advanced practice registered nurse. Which options should the nurse consider? (Select all that apply.) a. Patient advocate b. Nurse administrator c. Certified nurse-midwife d. Clinical nurse specialist e. Certified nurse practitioner - Answers-c. Certified nurse-midwife d. Clinical nurse specialist e. Certified nurse practitioner Although all nurses should function as patient advocates, "advanced practice nurse" is an umbrella term for an advanced clinical nurse such as a certified nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, or certified nurse-midwife. A nurse administrator is not an example of advanced practice. The nurse manager from the oncology unit has had two callouts; the orthopedic unit has had multiple discharges and probably will have to cancel one or two of its nurses. The orthopedic unit has agreed to "float" two of its nurses to the oncology unit if oncology can "float" a nursing assistant to the orthopedic unit to help with obtaining vital signs. Which concepts does this situation entail? (Select all that apply.) a. Autonomy b. Informatics c. Accountability d. Political activism e. Teamwork and collaboration - Answers-a. Autonomy
c. Accountability e. Teamwork and collaboration Staffing is an independent nursing intervention and is an example of autonomy. Along with increased autonomy comes accountability or responsibility for outcomes of an action. When nurses work together this is teamwork and collaboration. Informatics is the use of information and technology to communicate, manage knowledge, mitigate error, and support decision making. Political activism usually involves more than day-to-day activities such as unit staffing.
- The nurse is caring for a patient whose insurance coverage is Medicare. The nurse should consider which information when planning care for this patient? a. Capitation provides the hospital with a means of recovering variable charges. b. The hospital will be paid for the full cost of the patient's hospitalization. c. Diagnosis-related groups (DRGs) provide a fixed reimbursement of cost. d. Medicare will pay the national average for the patient's condition. - Answers-c. Diagnosis-related groups (DRGs) provide a fixed reimbursement of cost. In 1983, Congress established the prospective payment system (PPS), which grouped inpatient hospital services for Medicare patients into diagnosis-related groups (DRGs), each of which provides a fixed reimbursement amount based on assigned DRG, regardless of a patient's length of stay or use of services. Capitation means that providers receive a fixed amount per patient or enrollee of a health care plan. DRG reimbursement is based on case severity, rural/urban/regional costs, and teaching costs, not national averages. A nurse is teaching the staff about managed care. Which information should the nurse include in the teaching session? a. Managed care insures full coverage of health care costs. b. Managed care only assumes the financial risk involved. c. Managed care allows providers to focus on illness care. d. Managed care causes providers to focus on prevention. - Answers-d. Managed care causes providers to focus on prevention.
a. Secondary acute b. Continuing c. Restorative d. Tertiary - Answers-b. Continuing Patients recovering from an acute or chronic illness or disability often require additional services (restorative care) to return to their previous level of function or reach a new level of function limited by their illness or disability. Restorative care includes cardiovascular and pulmonary rehabilitation, sports medicine, spinal cord injury programs, and home care. Secondary acute care involves emergency care, acute medical-surgical care, and radiological procedures. Continuing care involves assisted living, psychiatric care, and older-adult day care. Tertiary care includes intensive care and subacute care. A nurse provides immunization to children and adults through the public health department. Which type of health care is the nurse providing? a. Primary care b. Preventive care c. Restorative care d. Continuing care - Answers-b. Preventive care Preventive care includes immunizations, screenings, counseling, crisis prevention, and community safety legislation. Primary care is health promotion that includes prenatal and well-baby care, nutrition counseling, family planning, and exercise classes. Restorative care includes rehabilitation, sports medicine, spinal cord injury programs, and home care. Continuing care is assisted living and psychiatric care and older-adult day care. A nurse is following the PDSA cycle for quality improvement. Which action will the nurse take for the letter "A"? a. Act b. Alter c. Assess d. Approach - Answers-a. Act
There are many models for quality improvement and performance improvement. One model is the PDSA cycle: plan, do, study, and act. "A" does not stand for alter, assess, or approach. The nurse is trying to determine how well a certain health plan compares with other health plans. To gather this type of data, which information will the nurse utilize? a. Pew Health Professions Commission b. Healthcare Effectiveness Data and Information Set (HEDIS) c. American Nurses Credentialing Center (ANCC) Magnet Recognition Program d. Hospital Consumer of Assessment of Healthcare Providers and Systems (HCAHPS) - Answers-b. Healthcare Effectiveness Data and Information Set (HEDIS) Health plans throughout the United States rely on the Healthcare Effectiveness Data and Information Set (HEDIS) as a quality measure. HEDIS compares how well health plans perform key areas: quality/effectiveness of care, access to care, and patient satisfaction with the health plan and doctors. The Pew Health Professions Commission, a national and interdisciplinary group of health care leaders, recommended 21 competencies for health care professionals in the twenty-first century. The Hospital Consumer of Assessment of Healthcare Providers and Systems (HCAHPS) is a standardized survey developed to measure patient perceptions of their hospital experience. The Magnet Recognition Program recognizes health care organizations that achieve excellence in nursing practice An older adult patient has extensive wound care needs after discharge from the hospital. Which facility should the nurse discuss with the patient? a. Hospice b. Respite care c. Assisted living d. Skilled nursing - Answers-d. Skilled nursing An intermediate care or skilled nursing facility offers skilled care from a licensed nursing staff. This often includes administration of IV fluids, wound care, long-term ventilator management, and physical rehabilitation. A hospice is a system of family-centered care that allows patients to live with comfort, independence, and dignity while easing the pains of terminal illness. Respite care is a service that provides short-term relief or "time off" for people providing home care to an individual who is ill, disabled, or frail. Assisted
affecting the world's health. Improved communication, easier air travel, and easing of trade restrictions are making it easier for people to engage in "health tourism." A nurse is using research findings to improve clinical practice. Which technique is the nurse using? a. Performance improvement b. Integrated delivery networks c. Nursing-sensitive outcomes d. Utilization review committees - Answers-a. Performance improvement Performance improvement activities are typically clinical projects conceived in response to identified clinical problems and designed to use research findings to improve clinical practice. Larger health care systems have integrated delivery networks (IDNs) that include a network of facilities, providers, and services organized to deliver a continuum of care to a population of patients at a capitated cost in a particular setting. Nursing- sensitive outcomes are patient outcomes and nursing workforce characteristics that are directly related to nursing care such as changes in patients' symptom experiences, functional status, safety, psychological distress, registered nurse (RN) job satisfaction, total nursing hours per patient day, and costs. Medicare-qualified hospitals had physician-supervised utilization review (UR) committees to review the admissions and to identify and eliminate overuse of diagnostic and treatment services ordered by physicians caring for patients on Medicare. Which finding indicates the best quality improvement process? a. Staff identifies the wait time in the emergency department is too long. b. Administration identifies the design of the facility's lobby increases patient stress. c. Director of the hospital identifies the payment schedule does not pay enough for overtime. d. Health care providers identify the inconsistencies of some of the facility's policy and procedures. - Answers-a. Staff identifies the wait time in the emergency department is too long. The quality improvement process begins at the staff level, where problems are defined by the staff. It is not identified by administration, the hospital director, or health care providers.
A nurse is providing home care to a home-bound patient treated with intravenous (IV) therapy and enteral nutrition. What is the home health nurse's primary objective? a. Screening b. Education c. Dependence d. Counseling - Answers-b. Education Health promotion and education are traditionally the primary objectives of home care, yet at present most patients receive home care because they need nursing care. Screening is preventive care. The home health nurse focuses on patient and family independence. Counseling is through psychiatric care. A nurse hears a co-worker state that anybody could be a nurse since it is so automated with infusion devices and electronic monitoring; technology is doing the work. What is the nurse's best response? a. "Technology use has to be combined with nursing judgment." b. "The focus of effective nursing care is technology." c. "If it's so easy, why don't you do it?" d. "That is true in the 20th century." - Answers-a. "Technology use has to be combined with nursing judgment." In many ways, technology makes work easier, but it does not replace nursing judgment. Technology does not replace your critical eye and clinical judgment. Most importantly, it is essential to remember that the focus of nursing care is not the machine or the technology; it is the patient. Using "why" is not beneficial when communicating with others. Agreeing with the statement furthers misconceptions. A nurse is completing a minimum data set. Which area is the nurse working? a. Nursing center b. Psychiatric facility c. Rehabilitation center d. Adult day care center - Answers-a. Nursing center
A nurse is teaching the staff about the Institute of Medicine competencies. Which examples indicate the staff has a correct understanding of the teaching? (Select all that apply.) a. Use informatics. b. Use transparency. c. Apply globalization. d. Apply quality improvement. e. Use evidence-based practice. - Answers-a. Use informatics. d. Apply quality improvement. e. Use evidence-based practice. The Institute of Medicine competencies include: Provide patient-centered care; work in interdisciplinary teams; use evidence-based practice; apply quality improvement; and use informatics. Transparency is included in the 10 rules of performance in a redesigned health care system, not a competency. While globalization is important in health care, it is not a competency. A nurse is evaluating care based upon the nursing quality indicators. Which areas should the nurse evaluate? (Select all that apply.) a. Patient satisfaction level b. Hospital readmission rates c. Nursing hours per patient day d. Patient falls/falls with injuries e. Value stream analysis for quality - Answers-b. Hospital readmission rates c. Nursing hours per patient day d. Patient falls/falls with injuries The American Nurses Association developed the National Database of Nursing Quality Indicators (NDNQI) to measure and evaluate nursing-sensitive outcomes with the purpose of improving patient safety and quality care. Nursing quality indicators include
the following: Hospital readmission rates, nursing hours per patient day, and patient falls/falls with injuries. While every major health care organization measures certain aspects of patient satisfaction, it is not a nursing quality indicator. Value stream analysis is a method that focuses on improvement of processes in a health care institution. A nurse is working in a health care organization that has achieved Magnet status. Which components are indicators of this status? (Select all that apply.) a. Empirical quality results b. Structural empowerment c. Transformational leadership d. Exemplary professional practice e. Willingness to recommend the agency - Answers-a. Empirical quality results b. Structural empowerment c. Transformational leadership d. Exemplary professional practice The American Nurses Credentialing Center (ANCC) established the Magnet Recognition Program to recognize health care organizations that achieve excellence in nursing practice. The five components are Transformational Leadership; Structural Empowerment; Exemplary Professional Practice; New Knowledge, Innovation, and Improvements; and Empirical Quality Results. Willingness to recommend the hospital/agency is a component of the Hospital Consumer of Assessment of Healthcare Providers and Systems survey. The nurse is caring for a surgical patient, when the family member asks what perioperative nursing means. How should the nurse respond? a. Perioperative nursing occurs in preadmission testing. b. Perioperative nursing occurs primarily in the postanesthesia care unit. c. Perioperative nursing includes activities before, during, and after surgery. d. Perioperative nursing includes activities only during the surgical procedure. - Answers-ANS: C
