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Cherry: Contemporary Nursing, 4th Edition
Chapter 2: The Contemporary Image of Professional Nursing
|A.||Positions that historically required registered nurses will be filled by unlicensed personnel.|
|B.||The job growth rate for RNs will surpass job growth in all other occupations.|
|C.||The need for hospital nurses will dramatically decrease.|
|D.||Hospitals will finally achieve the required registered nurse workforce.|
(B) is correct. In 2020, the United States is projected to have only 64% of the registered nursing workforce required to meet the demand for registered nurses. (A) is incorrect because unlicensed personnel will not be filling positions for nurses because this group does not have the education needed to provide such care. (C) is incorrect because the need for hospital nurses will dramatically increase, not decrease. (D) is incorrect because hospitals will not have enough nurses as stated per statistics.
DIF: Knowledge REF: Page 30
|A.||Funding for mental health care increased, allowing the point of care to change from the community to standardized institutional care.|
|B.||The public and the nursing profession were reminded of patient rights.|
|C.||Nurses were seen as advocates for individuals who cannot advocate for themselves.|
|D.||Funding for nursing traineeships was eliminated.|
(B) is correct because this movie reminded us that all individuals have rights and that it is the responsibility of the public and health care professionals to ensure that these rights are protected. (A) is incorrect because the context for the care of patients with mental disability did not change as a result of this movie. (C) is incorrect because this movie portrayed nurses as the enforcers of the system. (D) is incorrect because the Nurse Training Act was established.
DIF: Application REF: Page 32
(C) is correct because Clara Maas is noted as the nurse who deliberately acquired two bites from yellow fever carrier mosquitoes to enable her to provide care to soldiers with yellow fever. (A) is incorrect because Florence Nightingale is the founder of professional nursing. (B) is incorrect because Margaret Hoolihan is a character on a TV show, not an actual nurse. (D) is incorrect because Sairy Gamp is a character in a Charles Dickens novel.
DIF: Knowledge REF: Page 32
|A.||World War I|
|B.||World War II|
|C.||Spanish American War|
(D) is correct because this statue represents the caring provided by nurses during the Vietnam War. (A) is incorrect because there is no statue that represents nursing during this war. (B) is incorrect because there is no statue that represents nursing during this war. (C) is incorrect because there is no statue that represents nursing during this war.
DIF: Knowledge REF: Page 33
|A.||Provides disability insurance to RNs who contract a life-threatening illness while on duty|
|B.||Funds public service announcements that promote unlicensed caregivers as an alternative to professional nurses|
|C.||Focuses on nurse retention and safety enhancement grants|
|D.||Provides pediatric training grants|
(C) is correct because this act funded $20 million to provide nursing scholarships, public service announcements promoting nursing as a career, faculty loan cancellation programs, geriatric training grants, and nurse retention and safety enhancement grants. (A) is incorrect because this act does not provide disability insurance to RNs. (B) is incorrect because these funds do not promote unlicensed caregivers as an alternative to professional nurses. (D) is incorrect because this act provides for geriatric training grants, not pediatric training grants.
DIF: Knowledge REF: Page 30
|A.||positions that have historically required registered nurses will be filled by foreign nurses.|
|B.||the job growth rate for RNs will surpass job growth in all other occupations.|
|C.||the need for hospital nurses will dramatically decrease.|
|D.||hospitals will finally achieve the required registered nurse workforce.|
(B) is correct because according to the U.S. Bureau of Labor Statistics, the nursing profession is predicted to surpass all other occupations in job growth by 2010. (A) is incorrect because the number of foreign nurses arriving in the United States is not sufficient to cure the shortage, and a large number of these nurses are unsuccessful on the NCLEX-RN, resulting in an inability of foreign RNs to practice. (C) is incorrect because more than half of all nurses practice in hospitals, and it has not been indicated that this will change. (D) is incorrect because even by 2010, it is projected that the United States will achieve only 64% of the needed nursing workforce.
DIF: Comprehension REF: Page 30
|A.||portrayed nurses as trained, professional individuals who put others before themselves.|
|B.||chose nursing because she had no other avenue for employment.|
|C.||was a prostitute who took advantage of sick old men.|
|D.||characterized nurses as being at the forefront of technology and autonomy.|
(B) is correct because Sairy Gamp endured nursing because of the lack of other opportunities. (A) is incorrect because Sairy Gamp did not portray a professional image of nursing, but that of an untrained caregiver who profited from the sick and dying. (C) is incorrect because Sairy Gamp was a nurse who used her position to take advantage of her patients. (D) is incorrect because this portrayal of a nurse does not suggest that the nurse is at the forefront of technology and autonomy.
DIF: Knowledge REF: Page 31
|A.||Florence Nightingales accomplishments in public health|
|B.||Edith Cavells attempt to help the victims of the Tuskegee experiment seek treatment|
|C.||Clara Maas, who found the cure for yellow fever during WWII|
|D.||All military nurses for their bravery and compassion|
(D) is correct because the statue, the Spirit of Nursing was created to honor all military nurses. (A) is incorrect because the statue does not seek to honor Florence Nightingale. (B) is incorrect because Nurse Rivers was the nurse who attempted to help the victims of the Tuskegee experiment. (C) is incorrect because the statue does not honor Clara Maas and Clara Maas did not find the cure for yellow fever.
DIF: Knowledge REF: Page 31
|A.||nurses who can be promiscuous and still help doctors.|
|B.||the fact that caring is not as important as the desire to serve ones country.|
|C.||the ability of nurses to cope with the dreadfulness of war by using humor.|
|D.||the contributions of male military nurses.|
(C) is correct because the sitcom M*A*S*H did show humor as a coping mechanism for nurses in a war setting. (A) is incorrect because this was a negative portrayal in the sitcom and has no merit because nurses assist physicians. (B) is incorrect because the sitcom addressed both factors as part of the nurses role in the military. (D) is incorrect because no male nurses were portrayed in the sitcom.
DIF: Knowledge REF: Page 33
|A.||Nursing care is often delivered during a time of uncertainty, and the image of nurses during this time can reinforce trust in the nurse-patient relationship.|
|B.||Physicians have a distinctive body of knowledge that identifies them as professionals, whereas nursing has yet to develop a unique body of knowledge on which to base practice.|
|C.||Nurses must present a unified image if they hope to ever move nursing to a profession.|
|D.||The dynamic state of todays health care requires nurses to move from a caring image to one of technological competence.|
(A) is correct because when a person seeks health care, he is entering a world of uncertainty. The nurse provides continuity and compassion and stabilizes the environment of the patient. (B) is incorrect because nursing has a unique body of knowledge. (C) is incorrect because nursing is a profession. Unification will enhance the professional goals for nursing. (D) is incorrect because caring will always be part of the nursing image and nurses have already moved into the technological realm.
DIF: Comprehension REF: Pages 29-30
|A.||joining unions, which influence employers to provide incentives such as pay raises and free child care, thus encouraging the large percentage of nonworking nurses to return to the workforce.|
|B.||demanding that the requirements of the qualifying examination for foreign nurses should be reduced, so they are eligible to sit for the licensure examination.|
|C.||working more hours with a higher nurse/patient ratio.|
|D.||advocating for funds to pay for nursing education and a safer work environment.|
(D) is correct because this is a positive strategy as can be seen by results attained after the Reinvestment Act P.L. 107-205 provided $20 million for nursing scholarships, public service announcements, faculty loan cancellation programs, geriatric training grants, and nurse retention and safety enhancement grants. This is the best defense against the nursing shortage. Nursing graduates in many states have increased in number, and enrollment in nursing schools is also on the rise. (A) is incorrect because unions are not the answer to the nursing shortage. This approach would make access to health care more difficult, and the nursing shortage would only increase because efforts to attract nurses from younger generations would be reduced by the fact that funding for exposure to nursing would most likely decrease. (B) is incorrect because lowering standards would increase the chance for errors, cause patient care standards to become lower, and harm the image of nursing. (C) is incorrect because, as the acuity level of patients increases, the nurse/patient ratio should be lowered. Facts reveal that lower nurse/patient ratios reduce errors and decrease mortality rates.
DIF: Application REF: Page 30
|A.||salaries of nurses are competitive with those of other professionals such as teachers.|
|B.||the total number of students who enter nursing has decreased each year, while the number of older adults who require care has increased.|
|C.||overall, nurses are satisfied with their jobs but leave the profession because of fear of contracting fatal diseases.|
|D.||over the next decade, more than half of RNs in the United States will retire.|
ANS: B, D
(B) is correct because nursing enrollments have decreased and the number of older adults has increased, reflecting the aging of America. (D) is correct because nurses are older with a mean age of 46.8 years. (A) is incorrect because salaries are not a problem related to the nursing shortage. Most facilities are willing to increase salaries and benefits for nurses. (C) is incorrect because it has not been documented that nurses are afraid of contracting a fatal disease. Nurses take precautions to reduce this risk.
DIF: Knowledge REF: Page 36
|A.||More RNs are educated to attain an associate degree than a baccalaureate degree or diploma.|
|B.||Because of the push to shorten length of stay in hospitals, more RNs practice in outpatient settings and home health than in acute care settings.|
|C.||The most popular advanced practice specialty is nurse anesthesia.|
|D.||Caucasian nurses are more likely to enter graduate school than nurses from other ethnic groups.|
|E.||Nursing represents the second largest health care professional group, second only to medical doctors.|
|F.||Job satisfaction is high among nurses, despite long hours, high nurse/patient ratios, and lower pay than is often earned by individuals with less education.|
|G.||Even with the popularity of nursing as a career, the nation faces a severe deficit of registered nurses now and even more so in the future.|
ANS: F, G
(F) and (G) are correct. A recent job satisfaction survey found that 78% of RNs were happy with their jobs. Increasing awareness of nursing as a profession has enhanced enrollment in nursing schools and has promoted interest among high school students. (A) is incorrect. Recipients of BSN degrees are younger and represent the largest graduating educational profile. (B) is incorrect. More than half of all nurses practice in acute care hospitals. (C) is incorrect. Nurse practitioners constitute the majority of APRNs. (D) is incorrect because minority nurses are more likely to enter graduate school than Caucasian nurses. (E) is incorrect because nurses make up the largest group of health care professionals.
DIF: Comprehension REF: Pages 30, 36
|A.||Determine why few African-American women enter graduate school.|
|B.||Provide incentives for minorities and males to enter nursing.|
|C.||Obtain grant funding to increase the number of faculty members and scholarship availability for students entering into baccalaureate nursing programs.|
|D.||Survey nurses to determine why their job satisfaction is lower than that of other health care professions.|
|E.||Develop ad campaigns that target younger students.|
ANS: B, C, E
(B), (C), and (E) are correct. These items speak to the core of solutions to the nursing shortage. (A) is incorrect. This would not result in a greater number of nurses entering and staying in practice. (D) is incorrect. Job satisfaction among nurses is currently high.
DIF: Comprehension REF: Pages 30, 36
|A.||Nurses are expert clinicians.|
|B.||A higher nurse/patient ratio is needed.|
|C.||Nurses are invisible in the media.|
|D.||Nurses are caring.|
ANS: A, C
(A) is correct because the campaign was designed to convey to the public that nurses are expert clinicians. (C) is correct because a strategically important part of the campaign raised consciousness among nurses of the invisibility of nursing in the news media. (B) is incorrect because lower nurse/patient ratios are needed (D) is incorrect because it was not a focus of the campaign to let the public know that nurses are caring.
DIF: Comprehension REF: Page 34
Cherry: Contemporary Nursing, 4th Edition
Chapter 12: Workforce Advocacy and the Nursing Shortage
|A.||believe the assignment was right if assigned by a legitimate power.|
|B.||be primarily concerned with the number of patients being assigned.|
|C.||ask how other nurses have handled the assignment in the past.|
|D.||determine whether he or she is familiar with the types of patients being assigned.|
(D) is correct because nurses should always think critically about assignments so they can communicate what makes them uncomfortable about a particular assignment. If nurses do not have the knowledge or experience required for particular patient assignments, then modification of the assignments is in order to ensure patient safety. (A) is incorrect because even if the person who makes the assignment has legitimate power, he or she may not be aware of the nurses work experiences and training. (B) is incorrect because the nurse should not respond on the basis of the actual number of patients assigned but should consider the needs of each patient, his or her age and condition, other factors that contribute to special needs, and the resources available to meet those needs. (C) is incorrect because each nurse possesses individual expertise. Basing decisions on the actions and capabilities of others is incorrect and is potentially unsafe for the patient.
DIF: Application REF: Page 268, Box 12-8 page 270
|A.||movement of nurses into acute care settings.|
|B.||the use of unlicensed assistive personnel to replace RNs.|
|C.||a mass of baby boomers who have chosen nursing as a career.|
|D.||an aging nursing workforce.|
(D) is correct because recent research validates that an aging population and an aging nursing workforce are both significant contributors to the nursing shortage issue. (A) is incorrect because movement of nurses into acute care settings would actually be beneficial in terms of the nursing shortage. As patient care technology increases, the number of nurses needed in acute care settings is increasing. (B) is incorrect because unlicensed assistive personnel cannot be used to replace RNs, although they can be placed in positions that allow them to assist RNs in providing patient care. (C) is incorrect because there has not been a mass of baby boomers who have chosen nursing as a career.
DIF: Comprehension REF: Page 262
|A.||that a greater number of individuals chose nursing as a career but could not meet entrance requirements.|
|B.||fewer young individuals are available to enter the workforce.|
|C.||fewer career opportunities exist for women outside of nursing.|
|D.||men have dominated the profession, and women feel that they have experienced discrimination.|
(B) is correct because younger birth cohorts (those born after 1955) are smaller in population size resulting in fewer potential nursing profession candidates. (A) is incorrect because many qualified nursing candidates are turned away because of limited enrollment in nursing schools. The shortage of nursing school faculty limits the number of applicants that can be accepted for admission. (C) is incorrect because actually, job opportunities are more numerous than ever for women. (D) is incorrect because men remain a minority in the nursing profession.
DIF: Analysis REF: Pages 258-259
|A.||substantial salaries, but the burden of research that leads to burnout.|
|B.||that faculty choose employment where work hours are more flexible.|
|C.||increased enrollment in doctoral programs but only in the areas of research and clinical practice, not in the specialty of education.|
|D.||increasing job competition from higher paying clinical sites.|
(D) is correct because according to Yordy (2006), academic institutions, especially those faced with budget cuts, generally cannot compete with nonacademic employers. Faculty salaries continue to be a major contributor to the nursing shortage. (A) is incorrect because faculty salaries are not substantial, and research is not a job requirement in many nursing faculty positions. (B) is incorrect because the educational setting is so desperate for nursing faculty that scheduling flexibility usually is not an issue. Most nursing faculty members actually have greater flexibility with regard to weekend and holiday scheduling than do clinical nurses. (C) is incorrect because enrollment in doctoral programs has not increased in any specialty area because of the faculty shortage.
DIF: Comprehension REF: Page 260
|A.||hiring younger, more energetic nurses.|
|B.||offering incentives such as sign-on bonuses.|
|C.||hiring highly qualified advanced practice nurses.|
|D.||retaining professional nurses.|
(D) is correct because past nursing shortages have proved that retention of professional nurses is the key to any organizations success. Nurses want to work in an environment that supports decision making and effective nurse-physician relationships. The ability of an organization to retain nurses primarily depends on the creation of an environment that is conducive to professional autonomy. (A) is incorrect because younger nurses want flexible hours and considerable autonomy in the work environment. These options are limited in the current health care environment, where round-the-clock patient care, including on weekends and holidays, is mandatory. (B) is incorrect because offering sign-on bonuses actually results in considerable expenditure by the health care organization. Many believe that these recruitment-related costs could be better spent by increasing basic compensation levels of professional nurses. (C) is incorrect because hiring highly qualified advanced practice nurses does help to improve patient outcomes but does not provide the staffing needed for direct patient care.
DIF: Application REF: Page 260
|A.||attract physicians but repel nurses.|
|B.||lack appreciation for nursing certification.|
|C.||not only attract but also retain professional nurses.|
|D.||discourage nurses from advancing their current level of education.|
(C) is correct because Magnet hospitals are those that have been identified as both attracting and retaining professional nurses. A study conducted in 1983 identified workplace factors such as management style, nursing autonomy, quality of leadership, organizational structure, professional practice, career development, and quality of patient care as influencing nurse job satisfaction and turnover rates (i.e., higher retention). (A) is incorrect because Magnet hospital nurses have higher levels of autonomy, greater control over the practice setting, and better relationships with physicians. Magnet hospitals actually attract both physicians and nurses. (B) is incorrect because Magnet hospitals actually recruit and reward professional nurses with specialty certification. (D) is incorrect because Magnet hospitals have programs that support nurses in advancing their education.
DIF: Comprehension REF: Pages 260-261
|A.||Nurses prefer to wear navy blue scrubs but the institution requires burgundy scrubs, which interferes with autonomy.|
|B.||The cafeteria often serves fried vegetables rather than healthier baked vegetables, causing the potential for hyperlipidemia.|
|C.||The hospital pharmacy does not fill employee prescriptions upon receiving them; instead, they fill employee prescriptions after all inpatient prescriptions have been filled.|
|D.||The key needed to change the sharps container is locked in the supervisors office after 3 PM on weekdays and all day on weekends, which prevents changing of the container when needed and places nurses at risk for needlesticks.|
(D) is correct because a safe work environment is imperative for the safety of both nurses and patients. Correcting this work environment issue promotes job satisfaction and patient outcomes. (A), (B), and (C) are incorrect because these issues do not affect nurse safety or patient outcomes; therefore advocacy intervention is not appropriate.
DIF: Analysis REF: Pages 254-257, 276
|A.||older nurses are being encouraged to retire, so that younger, more efficient nurses can practice.|
|B.||Magnet hospitals are able to attract nurses with sign-on bonuses and flexible work hours but fail to retain nurses because insufficient autonomy over professional practice is provided.|
|C.||multitasking is seldom desired by the younger generation of nurses.|
|D.||many younger workers are less concerned with longevity and are willing to change institutions to achieve professional advancement and flexible work hours.|
(D) is correct because the emerging workforce, aged 18 to 35 years, has compensation expectations that differ from those of previous generations. This younger generation prefers to work in an outcomes-based environment, where pay is based on achievement or merit, not on longevity. (A) is incorrect because older nurses are actually being recruited to stay in the employment arena to improve patient outcomes. Research advancements in ergonomics and workload have made early retirement less appealing. (B) is incorrect because Magnet hospitals definitely retain nurses by offering professional practice autonomy. (C) is incorrect because the younger generation is very adept at multitasking and at using technology.
DIF: Application REF: Page 263
|A.||decreased pay for alternative shifts.|
|B.||that the nurse/patient ratio prevents safe care.|
|C.||that most facilities are choosing an all-RN staff, which decreases opportunities for advancement.|
|D.||that agency and foreign nurses are favored by administration over full-time nursing staff.|
(B) is correct because a number of studies in the late 1990s focused on the work environment as a significant contributor to the difficulties involved in recruiting and retaining RNs. One of the primary factors for the increasing nurse turnover rate was identified as workload and staffing patterns. A more recent study by Aiken (2002) reported higher rates of patient complications and increased death rates when fewer nurses are assigned per patient. (A) is incorrect because substantial monetary compensation is provided for alternative shifts. (C) is incorrect because an all-RN staff would not limit advancement opportunities. (D) is incorrect because use of agency and foreign nurses results in considerable expenditures by health care organizations. Many believe that these recruitment-related costs would be better spent by increasing the basic compensation levels of professional nurses.
DIF: Comprehension REF: Pages 265-266
(C) is correct because in the third developmental phase of shared governance, staff nurse representatives serve on councils that are assigned authority to handle specific functions. At this level, council chairs make up the management committee that is charged with making all final operational decisions. (A) is incorrect because phase 1 includes staff nurse representatives who have the authority to address designated practice issues and some authority to determine roles, functions, and processes. Managers are responsible for facilitating practice through resource management and allocation. The executive committee accepts recommendations from staff nurses and managers. The chief nurse executive retains final decision-making authority. (B) is incorrect because in phase 2, staff nurse representatives serve on committees that are designated for specific management and/or clinical functions. Managers serve on the same committees with staff nurses. Committee chairs are appointed by the chief nurse executive, and the nursing cabinet makes final decisions on the basis of recommendations received from the committees. (D) is incorrect because shared governance has passed through only three developmental phases.
DIF: Application REF: Page 272, Box 12-9
|A.||Reporting unsafe staffing levels to The Joint Commission provides protection from the employer.|
|B.||Keeping copies of inappropriate staffing patterns in the nurses personal file is illegal.|
|C.||When observing inappropriate staffing, the nurse should record her personal thoughts concerning the outcomes.|
|D.||One should seek guidance from a trusted individual who can provide an objective point of view.|
(D) is correct because one of the many guidelines of whistle blowing specifies that one should seek counsel from a trusted individual outside of the situation to gain an objective perspective. (A) is incorrect because private groups such as The Joint Commission do not confer protection in whistle-blowing situations; a nurse must report to a state or national regulator. (B) is incorrect because this action is not illegal. (C) is incorrect because the nurse should record objective information, not personal thoughts or interpretations.
DIF: Analysis REF: Page 275, Box 12-11
(B) is correct because workplace violence has become a major societal issue. Its most extreme form, homicide, is the fourth leading cause of fatal occupational injury in the United States, with 551 workplace homicides reported in 2004 out of a total of 5703 fatal work injuries (OSHA, 2006b). (A) is incorrect because suicide is not a strong mortality issue in the workforce. (C) is incorrect because mortality due to blood-borne pathogen exposure has decreased since the Needlestick Safety and Prevention Act was implemented. (D) is incorrect because ergonomic hazards have decreased since safe patient handling educational programs were implemented.
DIF: Application REF: Page 278
|A.||employers must mandate policies for nonmanagerial employees to prevent patients from being exposed to used needles.|
|B.||employers are not responsible when employees fail to follow universal precautions, resulting in a needlestick.|
|C.||each state must determine the degree of input sought from employees to determine safe workplace policies involving protection from sharps injuries.|
|D.||employers are required to document how and where a sharps injury occurred, including the brand of device that was involved.|
(D) is correct because this act, passed at the federal level, requires the use of safer needle devices to protect from sharps injuries; the law requires employers to maintain a sharps injury log that contains, at a minimum, the brand of device involved in the incident, the department or work area where the exposure incident occurred, and an explanation of how the incident occurred. (A) is incorrect because the law requires employers to solicit the input of nonmanagerial employees responsible for direct patient care who are potentially exposed to sharps injuries in the identification, evaluation, and selection of effective engineering and work practice controls. (B) is incorrect because employers are responsible for the identification, evaluation, and selection of effective engineering and work practice controls to prevent needlesticks. (C) is incorrect because the Needlestick Safety and Prevention Act is a federal law, and all states are held to this statute.
DIF: Comprehension REF: Page 276
|A.||Implement best practices to reduce death related to heart failure caused by cardiomyopathy.|
|B.||Compile the most accurate list of all medications a patient is taking and compare with the physicians admission, transfer, and/or discharge orders.|
|C.||Employ a team of specially trained interdisciplinary providers who can recognize and respond to worsening patient conditions.|
|D.||Decrease nosocomial infections by implementing procedures for central line care based on scientific findings.|
|E.||Reduce the number of nonlicensed personnel who provide direct patient care.|
ANS: B, C, D
(B), (C), and (D) are correct because these are three of the six areas identified by the IHI in 2006 that would improve patient safety and thereby decrease medical errors leading to patient deaths. (A) is incorrect because this is an implementation that specifically relates to the nonpreventable medical diagnosis of heart failure due to cardiomyopathy; it was not a component of the IHI 100,000 Lives Campaign. (E) is incorrect because reducing the number of nonlicensed personnel who provide direct patient care was not a component of the IHI 100,000 Lives Campaign.
DIF: Analysis REF: Page 274
Hazards in the workplace are categorized as follows: biologic, ergonomic, chemical, physical, and psychologic. Included in psychologic hazards are issues such as stress, shift work, mandatory overtime, and verbal abuse by patients and other health care providers.
DIF: Application REF: Page 276, Box 12-12
Cherry: Contemporary Nursing, 4th Edition
Chapter 26: NCLEX-RN Examination
|A.||pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN).|
|B.||provide evidence of mental competency.|
|C.||supply written proof of physical fitness.|
|D.||have signed an employment contract with a health care facility.|
(A) is correct because of the compulsory license requirement that must be met to legally practice or work as a registered nurse in any state or U.S. territory. Licenses are granted only after an applicant has successfully passed the NCLEX-RN examination. (B) is incorrect because licensure is designed to protect the public by providing safe practitioners, but it does not evaluate the individual candidates mental competency. (C) is incorrect because preadmission/preemployment physicals are part of the employment process; however, nurses with physical limitations may attain employment. (D) is incorrect because graduates cannot practice as registered nurses until they pass the NCLEX-RN exam even if they have signed an employment contract. Some graduates may not seek employment until after they have successfully completed the NCLEX-RN and have become licensed.
DIF: Comprehension REF: Page 575
|A.||Graduates from all three types of nursing programs (diploma, associate degree, and baccalaureate degree) take the same examination.|
|B.||The examination is scored on an interval scale rather than on a pass-fail basis.|
|C.||The examination is offered twice a year in major urban areas.|
|D.||The candidate has the option of choosing a pencil-and-paper format.|
(A) is correct because the purpose of the NCLEX-RN is to determine safe practice and the ability of candidates to perform at the entry level. Candidates from all three types of nursing programs must demonstrate the same competencies. (B) is incorrect because the examination is adapted according to the candidates ability to answer questions on the basis of degree of difficulty and area of the nursing process. (C) is incorrect because the examination is offered at more than 3400 Pearson Professional Centers at the candidates convenience. (D) is incorrect because the examination is computerized; however, special accommodations are available for qualifying candidates.
DIF: Knowledge REF: Page 575
|A.||the candidate must be computer literate.|
|B.||competency is determined on the basis of difficulty of questions, knowledge of the nursing process, and the number of questions answered correctly.|
|C.||testing facilities have been adapted for the physically challenged candidate.|
|D.||questions cannot be adapted to the needs of the student.|
(B) is correct because computerized adaptive testing is based on the measurement theory, by which the candidate must prove with a score of 95% that he or she is safe and knowledgeable at entry into the practice level. (A) is incorrect because candidates are required only to click to record an answer or to type in numbers 1 through 5 when prioritizing; they may also ask for assistance at any time during the testing process. Fill-in-the-blank questions at present are limited to entry of numeric values for dosage calculations. (C) is incorrect because although accommodations are available for qualified candidates, computerized adaptive testing is based on how the examination is scored, not on accommodations made for the individual candidate. (D) is incorrect because as a candidate answers questions on the examination, the computer adaptive testing adapts to the level of the candidates knowledge and skills.
DIF: Comprehension REF: Page 576
(B) is correct because setting goals is one of the first steps in the planning process. (A) is incorrect because assessment involves data collection, as is achieved through diagnostic tests and physical assessment. (C) is incorrect because analysis is the breakdown of data to establish a nursing diagnosis. (D) is incorrect because implementation is carrying out the plan of care.
DIF: Application REF: Page 582
|A.||last four numbers of the candidates Social Security number.|
|B.||location of testing.|
|C.||candidates educational preparation.|
|D.||performance of the candidate.|
(D) is correct because the length of the examination is based on the ability of candidates to provide 95% confidence that they are safe practitioners and have acquired a minimal level of knowledge about the nursing process. The length of the examination ranges from 75 to 265 questions, and it takes up to 6 hours to complete. (A) is incorrect because a candidates Social Security number is not part of the evaluation process. (B) is incorrect because the examination is administered at Pearsons facilities, and the examination is comparable across the United States and its territories. (C) is incorrect because all three types of nursing programs have the same criteria for success on the NCLEX-RN.
DIF: Application REF: Page 582
|A.||ensure that practitioners have the minimum skills and knowledge needed to provide care that will produce the best patient care outcomes.|
|B.||regulate nursing education.|
|C.||determine the mandatory educational level required for nurses to practice.|
|D.||accredit schools of nursing.|
(A) is correct because the purpose of the NCLEX-RN examination is twofold: (1) to safeguard the public from unsafe practitioners and (2) to determine whether candidates can perform entry level skills. (B) is incorrect because the NCLEX-RN is based on a survey conducted to determine what skills entry level nurses must perform. This may indirectly guide education but is not the purpose of the NCLEX-RN. (C) is incorrect because all three types of nursing programs have the same criteria for success on the NCLEX-RN. (D) is incorrect because accreditation is provided by the National League for Nursing and the American College of Nurses; however, accreditation may be withheld if a schools pass rate on the NCLEX-RN consistently falls below 85%.
DIF: Comprehension REF: Page 575
|A.||All candidates wishing to take the licensure examination must pass a drug screen.|
|B.||Candidates must not have a felony conviction.|
|C.||To practice as a registered nurse (RN), the nurse must be licensed as an RN.|
|D.||An impaired nurse must sign a legal document to acknowledge limitations on his or her practice.|
(C) is correct because licensure is a prerequisite for practice to ensure public safety. (A) is incorrect because not all states require drug testing prior to licensure. (B) is not correct because, although a background check is performed on all candidates, state boards of nursing evaluate the type and disposition of the crime. (D) is incorrect because impaired nurses must complete a program as specified by the state board of nursing to address limitations, but this is not the meaning of compulsory licensure.
DIF: Knowledge REF: Page 574
|A.||the geographical location of the candidate.|
|B.||research that indicates needed skills for positions in which most entry level nurses are employed.|
|C.||surveys conducted by employers to determine the weaknesses of entry level nurses.|
|D.||surveys of physicians performed to determine what nurses must know to provide safe care.|
(B) is correct because, periodically, the National Council of State Boards of Nursing surveys health care settings to identify nursing care activities of entry level nurses. (A) is incorrect because all candidates in the United States and its territories take comparable examinations. Many states allow nurses once licensed to be licensed in another state without retaking the NCLEX-RN; therefore, examinations cannot be geographically specific. (C) is incorrect because the NCLEX-RN focuses on the skills and knowledge most commonly required for entry level work, not on weaknesses. (D) is incorrect because nursing has its own body of knowledge; however, physicians may serve on advisory boards to suggest changes/additions to nursing preparation.
DIF: Comprehension REF: Page 575
|A.||fill-in-the-blank, because candidates are not provided with clues from distracters.|
|B.||multiple choice question, which allows candidates to select the one correct answer.|
|C.||identification, because these questions require a higher level of critical thinking.|
|D.||prioritization question, because these questions are written at the level of Blooms analysis.|
(B) is correct because most NCLEX-RN questions have three distracters and one correct answer, but the examination allows all four levels of Blooms taxonomy to be tested. (A) is incorrect because, currently, completion or fill-in-the-blank questions focus on entering the correct answer for dosage calculation problems. (C) is incorrect because only about 10% of the NCLEX-RN contains alternate format questions, which are most often written at a higher cognitive level. (D) is incorrect; prioritization is becoming more frequent on the NCLEX-RN because it requires a higher level of critical thinking; however, it is not the most common type of question.
DIF: Knowledge REF: Page 577
|A.||Safe and effective care environment|
|B.||Health promotion and maintenance|
|D.||Teaching and learning|
(A) is correct because the nurse is safeguarding the patient with immunosuppression from the possible transmission of an infection. (B) is incorrect because this category is focused on early detection and prevention of health-related problems. (C) is inc
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