Nursing Trends and Issues
Exam Questions
Course Introduction
Nursing Trends and Issues explores the evolving challenges and opportunities within the nursing profession, analyzing contemporary developments in healthcare systems, policy, and practice. The course examines topics such as advances in nursing technology, evidence-based practice, workforce dynamics, ethical considerations, leadership, and the impact of legal and social changes on nursing roles. Emphasis is placed on critical thinking and professional development as students evaluate current issues affecting patient care, professional standards, interdisciplinary collaboration, and the future direction of nursing in diverse settings.
Recommended Textbook
Nursing Today Transition and Trends 8th Edition by Zerwekh
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Page 2
Chapter 1: Role Transitions
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Sample Questions
Q1) The graduate nurse understands that transitions occur throughout life.What major factor does the nurse identify as influential in a successful transition from school to practice?
A) Level of new knowledge and skills required in the new environment
B) Amount of classwork required to obtain a degree
C) Personal history of previous developmental transitions
D) Influence of classmates and their transitional experiences
Answer: A
Q2) A nursing student is nearing the end of his/her clinical experience.The student would like to care for patients who are typically challenging for students in the first year of practice.Which patient would be the best choice for this student?
A) A 62-year-old man with diabetes who needs outpatient care set up
B) A 30-year old woman with a kidney stone requiring IV pain medications
C) A 45-year old man with chest tubes recovering from a car accident
D) A 25-year old woman who received blood yesterday
Answer: C
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Chapter 2: Personal Management: Time and Self-Care Strategies
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Q1) The nurse understands stress-related illness when stating which of the following? (Select all that apply.)
A) "Stress can cause insomnia."
B) "Stress is known to cause muscle and joint pain."
C) "Stress can cause headaches."
D) "Stress is not known to cause any health problems."
E) "Stress can cause gastrointestinal disturbances."
Answer: A,B,C,E
Q2) What actions should a graduate nurse take in the first work experience to avoid problems with burnout?
A) Cross-train to work in different areas of the hospital.
B) Develop a social group of nurses with whom to share work experiences.
C) Plan on several sessions with a counselor regarding managing stress.
D) Develop social contacts outside of nursing and maintain good nutrition and good sleep habits.
Answer: D
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4
Chapter 3: Mentorship, Preceptorship, and Nurse Residency Programs
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Sample Questions
Q1) The nurse manager is presenting at a conference and shows an adequate understanding of a mentoring relationship when giving the following as an example:
A) A coach and a player
B) A teacher and a learner
C) An intern and a resident
D) An advisor and a partner
Answer: D
Q2) Which action by the mentor can help reduce the impact of reality shock on the mentee during the resolution phase?
A) Expect the mentee to problem solve clinical issues independently.
B) Continue to practicing skills that he or she is comfortable with.
C) Reinforce positive qualities that the mentee possesses.
D) Point out negative qualities for the mentee to change.
Answer: C
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Chapter 4: Employment Considerations: Opportunities,
Resumes, and Interviewing
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Sample Questions
Q1) As the interview is drawing to a close,the interviewer asks the applicant,"What questions could I answer for you?" Which of the following questions would it be most advisable to ask to create a favorable impression?
A) "What will happen if I am unable to meet the outcomes for the competency-based orientation?"
B) "Do you still have tuition reimbursement for courses to obtain my next degree?"
C) "How soon will I be responsible for supervision of other staff?"
D) "After completing orientation,when will the first pay raise be given?"
Q2) Which of the following actions by the graduate nurse would not be advised during an interview campaign?
A) Plan 3 interviews in a day,
B) Identify a date to begin employment.
C) Ask questions about the interview process.
D) Research the prospective employer.
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Chapter 5: NCLEX-RN Examination and the New Graduate
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Q1) To adequately prepare for the NCLEX-RN examination,which action by the graduate nurse is advised?
A) Begin planning early at least 6 months ahead.
B) Begin planning no more than 3 months ahead.
C) Wait for the state board of nursing to contact the applicant about filing deadlines.
D) Call the state board of nursing every week to set up a testing time.
Q2) The nurse interprets the Nurse Licensure Compact as
A) an agreement between all states to recognize the license of all graduate nurses.
B) an intrastate agreement for the nurse to practice in any area within the state.
C) an agreement between the state boards of nursing and the National Council regarding foreign nurses.
D) an agreement between compact states to recognize licensure from member states.
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Chapter 6: Historical Perspectives: Influences on the
Present
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Q1) The nursing student has an adequate grasp of nursing history when stating that after the fall of the Roman Empire,the knowledge of health practice was primarily preserved by
A) English monks in cloistered buildings.
B) Jewish physicians who could translate into Latin.
C) Roman priests who practiced medicine.
D) Fortuna,who practiced midwifery.
Q2) Nurses made many contributions to the care of Civil War soldiers.A nurse who understood this,would state which of the following?
A) "Nurses established a safe haven for soldiers from the battlefield."
B) "Nurses provided a clean environment with food and water."
C) "Nurses began medication administration on the battlefield."
D) "Nurses organized the men to care for other injured soldiers."
Q3) Which of the following actions were expected of a nurse coordinator? (Select all that apply.)
A) Improve patient care.
B) Promote harmony within the institution.
C) Arrange for payment of care received by patients.
D) Motivate staff.
E) Arrange salaries of staff.
Page 8
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Chapter 7: Nursing Education
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Sample Questions
Q1) A new graduate wishes to select a program in nursing that will assist in preparation to care for individuals,families,groups,and communities.The new graduate should select a(n)
A) practical nursing school.
B) diploma program in nursing.
C) associate degree program.
D) baccalaureate program.
Q2) Which of the following would be the first action that a foreign nurse should take to practice in the United States?
A) Apply for a hospital job in the personal desired state to practice in.
B) Enroll in a community college to study "American" nursing.
C) Contact NCLEX to set up a testing time.
D) Contact the board of nursing in the personal desired state to practice nursing in.
Q3) Which of the following causes is most likely to contribute to the nursing shortage?
A) The aging of the nurse faculty population
B) General lack of interest in the nursing profession
C) Lack of accredited nursing programs
D) Decreased need for nursing staff
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9
Chapter 8: Nursing Theory
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Q1) A middle-aged patient has experienced a myocardial infarction that has significantly limited activities and lifestyle.The patient is exercising and working with a nurse in the cardiac rehabilitation program.This is an example of the implementation of what nursing theory?
A) Martha Rogers' examination of the phenomena of energy fields
B) Dorothy Orem's interwoven theories of self-care,self-care deficit,and nursing care
C) Dorothy Johnson's theme that the person is a behavior system and is orderly and balanced
D) Sister Callista Roy's theme of coping and adaptation to stimuli and stressors
Q2) A 28-year-old patient is recovering from a femur repair after a traumatic car accident.The following day,lab results indicate that the hemoglobin is dangerously low and the patient needs to receive blood.The patient has identified themself as a Jehovah's Witness and has refused to receive the blood.Which action should the nurse take?
A) Notify the physician of the patient's decision.
B) Administer the blood anyway.
C) Try to convince the patient to receive the blood.
D) Call the patient's family members and alert them to the situation.
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Chapter 9: Image of Nursing: Influences of the Present
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Q1) The nurse is determining which professional organizations to join.The nurse demonstrates an adequate understanding of the International Council of Nursing (ICN)when stating which of the following?
A) "The ICN handles domestic nursing issues."
B) "The ICN is for international nurses only."
C) "The ICN is focused on worldwide health care."
D) "The ICN is focused on foreign issues only."
Q2) Which of the following assesses how nurses can control their profession? (Select all that apply.)
A) Discussing issues on their lunch break
B) Joining a professional organization
C) Through publishing documents
D) Being active in the state boards of nursing
E) Keeping issues to themselves
Q3) Which of the following assesses how nursing has relevance to social values?
A) Nurses have professional degrees.
B) Nurses perform community service.
C) Nursing licensure requires a baccalaureate degree.
D) Nurses are teachers of health promotion and wellness.
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Page 11
Chapter 10: Challenges of Nursing Management and Leadership
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Q1) A nurse manager is in the planning phase in a new job.Which action shows this? (Select all that apply.)
A) Developing goals that reflect the mission and vision of the organization
B) Defining strategies to meet the mission and vision of the organization
C) Providing direction for staff to perform the work of the organization
D) Retaining accountability for all work completed by the staff
E) Planning for contingencies which may interfere with the work of the organization
Q2) The nurse manager is giving a presentation on the disadvantages of democratic leadership in group functioning.Which statement shows an understanding of this type of leadership?
A) "Requires more time and effort to make decisions and accomplish goals"
B) "Discourages participation from quieter members of the group"
C) "Increases the possibility of "scapegoating" or argumentative behavior"
D) "Is difficult to control the outcomes and decisions of the group"
Q3) Which of the following actions is consistent with a nurse leader?
A) A nurse who encourages staff to give excellent patient care
B) A nurse who performs chart audits on her staff
C) A nurse who writes yearly staff evaluations
D) A nurse who gives pain medication to an assigned patient
Page 12
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Chapter 11: Building Nursing Management Skills
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Q1) The nurse manager is in charge of a busy nursing unit.Today the nurse manager is planning to evaluate the work of nurses on the unit.Which of the following actions would help complete this task in an effective manner? (Select all that apply.)
A) Provide feedback as necessary to staff.
B) Verify the tasks are being performed according to standards of practice.
C) Allow nurses to complete all tasks,even if performed incorrectly.
D) Provide directions with clear expectations of how the task is to be performed.
E) Evaluate the performance of the task by the staff.
Q2) A nurse is assigned to care for five patients.The nurse is concerned about the ability to care for this many patients.The nurse needs to
A) delegate one of the patients to someone else.
B) prioritize the needs of the patients and determine the sickest patient.
C) procrastinate and hope that someone will offer assistance.
D) do the easiest patients first to allow more time for sicker patients.
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13
Chapter 12: Effective Communication and Team Building
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Q1) Which actions can the nurse take to improve personal credibility? (Select all that apply.)
A) Wear well-fitting clothes.
B) If female,wear a reasonable amount of make-up.
C) Be as original as possible at work.
D) Maintain a flattering,neat haircut.
E) Maintain a reasonable weight.
Q2) In considering the overall task of the team,what issues should be considered in the care of the patient?
A) Nursing care plan,religious preference,and financial base
B) Physician's orders,nursing actions,and religious preference
C) Family needs,physician's orders,nursing diagnosis,and religious preference
D) Physician's treatment plan,nursing plan of care,and needs of the patient and family
Q3) The graduate nurse has an adequate understanding of effective listening when stating which of the following?
A) "Limited level of vocabulary often affects listening skills,"
B) "Underdeveloped attention span affects listening skills."
C) "External noise distractions affect listening skills."
D) "Emotional reactions interfere with the actual message."
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Page 14
Chapter 13: Conflict Management
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Sample Questions
Q1) A nurse is caring for an older adult patient when conflict regarding treatment arises between the family and the health care provider.What can the nurse do to resolve this conflict? (Select all that apply.)
A) Defend the health care provider's treatment and try to explain it to the family.
B) Try to convince the family that the health care provider knows what is best for the patient.
C) Allow the family to participate in the decision-making process for their loved one.
D) Encourage the family to speak directly to the health care provider regarding treatments.
E) Clarify the health care provider's order with the family.
Q2) What can staff nurses do to reduce conflict with patients and families?
A) Allow nurses to enforce what they feel comfortable with.
B) Keep treatment decisions between the patient and health care team only.
C) Do not allow family to participate in patient care.
D) Maintain consistency in enforcing rules and policies.
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Chapter 14: Delegation in the Clinical Setting
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Q1) A nurse is feeling overwhelmed and has determined to delegate some of the tasks to the LPN he//she is working with.Which of the following would be most appropriate for the nurse to delegate?
A) An initial assessment on a new patient
B) Educational teaching on diabetes management
C) Creating a care plan for a patient
D) Updating the care plan for a patient who is postop day 2
Q2) A female patient in the medical-surgical unit is diagnosed with anemia and complains of weakness.Which of the following assignments could be given to the nursing assistant?
A) Organize the patient's meal tray for dinner.
B) Talk with the patient about managing her rest and activities.
C) Get a diet history and list of the patient's favorite foods.
D) Take an apical pulse and listen to the lungs for crackles.
Q3) Determine how the nurse's role is different from that of the LPN in assessment of the patient.
A) Collects data during the health history and physical exam
B) Contributes to the development of the care plan
C) Assist in updating the care plan
D) Uses findings from the assessment to create a care plan
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Chapter 15: The Health Care Organization and Patterns of Nursing Care Delivery
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Q1) Which statement by the nurse indicates understanding of the case manager's role? The case manager (Select all that apply.)
A) "guides patients through the health care delivery process."
B) "ensures quicker discharge for patients without insurance."
C) "coordinates care for the patient."
D) "assists patients in achieving goals effectively and efficiently."
E) "collaborates with the health care team."
Q2) The nurse understands cost containment when stating which of the following? Major elements of the law that support cost containment include (Select all that apply.)
A) "increased governmental regulation of insurers."
B) "less use of technology."
C) "increasing incentives for coordination of care."
D) "emphasis on physician centered care."
E) "decreasing consumer out of pocket costs."
Q3) Which statement is true about case management?
A) There are two models-traditional and full immersion.
B) It is used to reduce resource utilization only.
C) To be effective,it requires case managers to provide direct patient care.
D) It eliminates the need for other caregivers (LPN,LVNs,nursing assistants).
Page 17
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Chapter 16: Economics of the Health Care Delivery System
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Q1) A nurse is educating a group of students about health care economics.Which statement would the students make if the teaching were effective?
A) "Extrinsic factors include the cost of prescription drugs."
B) "Extrinsic factors include the age of the population."
C) "Extrinsic factors include the demand for health care."
D) Extrinsic factors include employer-paid health insurance."
Q2) The nurse manager receives the budget variance report for the assigned nursing unit.What other critical information must the nurse manager consider to evaluate this report?
A) Projection of costs in the operating budget
B) The amount of money allocated to meet expected costs
C) Figures on which a zero-based budget were determined
D) Planning needs for unit staffing based on patient acuity
Q3) Which of the following statements indicates the nurse's understanding of fiscal responsibility?
A) "Fiscal responsibility should be a concern for all nurses."
B) "Fiscal responsibility is only a concern for the department manager."
C) "Fiscal responsibility is only a concern for the hospital administrators."
D) "Fiscal responsibility is not a concern for the nursing staff."
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Page 18
Chapter 17: Political Action in Nursing
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Sample Questions
Q1) One of the five laws of power is that "power fills a vacuum." Which statement by the nurse best captures that type of power?
A) "An individual who provides leadership and power to create a strategy that will address a problem and get people to contribute to the effort"
B) "People who are willing to give power to someone in order to restore comfort or handle a dilemma"
C) "An individual who takes action to speak and act on behalf of a group
D) A state nursing association that acts on behalf of the nurses within the respective state"
Q2) Legitimate
A)Joining a coalition to lobby for a national health insurance plan
B)Organizing nurses to work for the opponent in the next election
C)The dean of the school discussing the educational program
D)Testifying before a committee on a bill
E)A political action committee's endorsement or financial contribution
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19
Chapter 18: Collective Bargaining: Traditional (Union)and
Nontraditional
Approaches
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Q1) The nurse manager has an adequate understanding of the common issues in nursing when stating which of the following? (Select all that apply.)
A) "There are no common issues in nursing."
B) "Mandated staffing is a common issue."
C) "Unsafe patient assignments are a common issue."
D) "Lack of overtime is a common issue."
E) "Negotiations are a common issue."
Q2) A union nurse is educating a new nurse on common issues faced by nurses today.The union nurse knows that the teaching has been effective when the new nurse states:
A) "There are no common issues; nurses faces different issues based on their job."
B) "Today,there are no issues because of the advancement of technology."
C) "Hospitals are fully staffed at all times."
D) "Hospitals frequently mandated nurses due to staffing shortages."
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Chapter 19: Ethical Issues
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Sample Questions
Q1) A nurse is caring for a patient who has just been diagnosed with cancer.The patient's family has requested that the patient not be told at this time because it would be devastating.The patient asks the nurse if the diagnosis is cancer.If the nurse were to uphold the ethical principle of veracity,what would the response be?
A) "No,you do not have cancer."
B) "The physician is unsure of your diagnosis at this time."
C) "Yes,that is the diagnosis.Let me call the doctor so that we can have a discussion."
D) "Yes,but your family told me that I could not talk to you about the diagnosis."
Q2) What action can the nurse take to uphold the ethical principle of fidelity?
A) Report unscrupulous billing practices.
B) Disclose the results of an HIV test to a patient's family.
C) Make health care decisions for a patient.
D) Accept an assignment that is unsafe.
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21
Chapter 20: Legal Issues
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Q1) The nurse has an adequate understanding of risk management when stating which of the following? (Select all that apply.)
A) "Risk management becomes involved when incidents occur."
B) "Risk management becomes involved when untoward events occur."
C) "Risk management becomes involved to discipline the nurse."
D) "Risk managers gather evidence surrounding the event."
E) "Risk managers will interview those involved in an event."
Q2) Which error in judgment would be the most serious for the nurse defendant in a legal case?
A) Discussing the case with the plaintiff
B) Tampering with the chart
C) Hiding information from the plaintiff's attorney
D) Being discourteous on the witness stand
Q3) Which definition,given by the nurse indicates understanding of malpractice?
A) "Malpractice is a criminal act committed against society."
B) "Malpractice means doing something a reasonable person or nurse would not do."
C) "Malpractice is an intentional professional act of negligence."
D) "Malpractice is a professional act or failure to act that leads to injury of a patient."
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Page 22
Chapter 21: Cultural and Spiritual Awareness
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Q1) Determine which of the following situations would be a provider barrier to the nurse developing cultural competence?
A) A nurse who is unaware of personal biases to other ethnic groups
B) No family rooms to accommodate a critically ill patient's family
C) A nurse who seeks encounters with individuals from other cultures
D) A health care provider who incorporates alternative therapies in health care
Q2) Which of the following actions cause health care disparities?
A) Refusal of treatment
B) Provider-patient relationships
C) Trust in the health care system
D) Provider bias and discrimination
Q3) A nurse has an adequate understanding of the barriers to cultural competence when making which of the following statements?
A) "Barriers to cultural competence no longer exist in today's society."
B) "The barriers to cultural competence cannot be broken down."
C) "Provider barriers include having knowledge about a custom's culture regarding health care."
D) "Systems barriers exist when an agency's structure and policies are not designed to support cultural diversity."
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Page 23
Chapter 22: Quality Patient Care
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Q1) A nurse is a team member assisting with the define-measure-analyze-improve-control (DMAIC)process.Which action would the nurse take during the define phase?
A) Identify the stakeholders.
B) Agree on the key performance indicators.
C) Identify gaps between performance and goals.
D) Identify those responsible for data collection.
Q2) A nurse is preparing a presentation on core measures.Which medical diagnosis should the nurse plan on presenting during the lecture? (Select all that apply.)
A) Myocardial infarction
B) Congestive heart failure
C) Diabetes
D) Pregnancy-related conditions
E) Deep vein thrombosis
Q3) The primary role of The Joint Commission (TJC)is
A) granting magnet status to excellent hospitals.
B) lobbying Congress on behalf of Medicare/Medicaid patients.
C) ensuring medical facilities meet patient safety guidelines.
D) inspecting hospitals for compliance of infection control standards.
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Page 24
Chapter 23: Nursing Informatics
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Q1) A nurse manager is lecturing staff nurses on the barriers to the full integration health information technology.The nurse manager judges the teaching to be effective when a staff nurse states: (Select all that apply.)
A) "Barriers include lack of standardization across care areas."
B) "A barrier to the full integration is funding."
C) "Currently there are no barriers."
D) "A current barrier is privacy laws."
E) "Barriers to full integration are not likely to be overcome."
Q2) How does the IN/INS use HIPPA regulations and TJC requirements in daily practice? (Select all that apply.)
A) Investigation of violations
B) Writing of policies
C) Involvement in the discipline process
D) Writing of procedures
E) Managing the nursing unit
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Chapter 24: Using Nursing Research in Practice
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Q1) The nurse understands the process of research utilization when the nurse does not complete which of the following steps?
A) Assessing patient care
B) Planning for the patient's needs
C) Implementing a plan of care
D) Guessing the extent of care needed
Q2) A staff nurse recognizes the need for a change in practice regarding hand hygiene.How can the nurse implement a change in practice? (Select all that apply.)
A) Ignore the problem until management enforces a change.
B) Ask if the manager can hold a staff in-service.
C) Implement the change on the unit.
D) Monitor the change.
E) Evaluate the effectiveness of the change.
Q3) Which action can the nurse expect in the preutilization step in nursing research utilization?
A) Recognition that some aspect of nursing care could be done in a different way
B) Recognizing that nurses need shortcuts in order to manage their workload
C) Critical evaluation of published research
D) Using electronic databases to search current literature
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Page 26
Chapter 25: Workplace Issues
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Q1) Which statement by the nurse manager indicates understanding of Magnet status?
A) "Hospitals are granted Magnet status by the National League of Nursing."
B) "The American Nurses Association grants Magnet status."
C) "Hospitals are granted Magnet status by the American Nurses Credentialing Center."
D) "The National Council of State Boards of Nursing grants Magnet status."
Q2) A nurse manager is educating new hires on the different perpetrators of bullying.The teaching has been effective when the new hires state: (Select all that apply.)
A) "A perpetrator can be a manager."
B) "A perpetrator can be coworker."
C) "A perpetrator is always the same licensure as the victim."
D) "A perpetrator is never someone in management."
E) "Perpetrators are sometimes supervisors."
Q3) After completing a crisis intervention course,the nurse recognizes the signs of escalating violence as:\
A) pacing and cursing.
B) repeatedly pushing the call bell.
C) crying and complaining of no pain relief.
D) staring out the window and not responding to questions.
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Chapter 26: Emergency Preparedness
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Q1) Which federal program provides a "push-pack" that,when requested,can be transported within 12 hours to an affected community and consists of medical assets such as medications,medical equipment and supplies,and personal protective equipment?
A) Strategic National Stockpile (SNS)
B) CHEMPACK federal program designed to supplement the medical response.
C) Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP)
D) National Incident Management System (NIMS)
Q2) A public health nurse is giving a presentation on the recovery stage of a disaster to a group of nursing managers.The teaching has been effective when one of the nurse managers states:
A) "The recovery stage deals with operations that occur after the disaster."
B) "The recovery stage deals with operations during a disaster."
C) "The recovery stage deals with operations before a disaster."
D) "The recovery stage involves the process of dealing with disasters."
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