Nursing in Today World 10th Edition by Dr. Janice Rider Ellis Test Bank

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Nursing in Today World 10th Edition by Dr. Janice Rider Ellis Test Bank

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Nursing in Todays World 10th Edition by Dr. Janice Rider Ellis Test Bank

Chapter: Chapter 2: Educational Preparation for Nursing
Multiple Choice
1. Manuel has a baccalaureate degree in biology and wishes to make a career change to
eventually become an advanced practice RN. Which of the following courses of study would
be the most time-efficient choice to meet his educational goals?
A) Masters degree in nursing
B) Baccalaureate degree in nursing
C) Doctoral degree in nursing
D) Associate degree in nursing
Ans: D
Client Needs: A-1
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 53, Characteristics of Associate Degree Education
Feedback: Students may be admitted to masters programs in nursing with a baccalaureate
degree in another discipline and are granted a masters degree in nursing after completing an
established 2-year program of study that prepares them for RN licensure. However, people
who already possess baccalaureate or higher degrees in other fields sometimes seek admission
to an associate degree program, often because it can be completed in a shorter period of time
than would be needed to earn another baccalaureate degree (though accelerated baccalaureate
programs are becoming more common).
2. Which nursing report recommended that nursing education move away from the system of
apprenticeship that predominated at the time and move toward a planned program of education
similar to that offered by other professions?
A) The Surgeon Generals Consultant Group Report on Nursing
B) The Brown Report
C) The American Nurses Association Position Paper
D) The Pew Health Profession Commission Study
Ans: B
Client Needs: A-1
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 4
Page and Header: 72, The Brown Report
Feedback: In Nursing for the Future, Brown (1948) recommended that nursing education
move away from the system of apprenticeship that predominated at the time and move toward a
planned program of education similar to that offered by other professions. This predated the
Surgeon Generals Consultant Group Report on Nursing, the American Nurses Association
Position Paper, and the Pew Health Profession Commission Study.
3. Which of the following accurately states a major position of the ANA Position Paper on
Educational Preparation?
A) The education of those who are licensed to practice nursing should take place in hospitals.
B) Minimum preparation for beginning professional nursing practice at the present time should
be an associate degree in nursing.
C) Minimum preparation for beginning technical nursing practice at the present time should be
a baccalaureate degree in nursing.
D) Education for assistants in health service occupations should be short, intensive preservice
programs in vocational educational institutions.
Ans: D
Client Needs: A-1
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 5
Page and Header: 74, Display 2.2
Feedback: One of the four major positions of the ANA Position Paper on Educational
Preparation is that education for assistants in the health service occupations should be short,
intensive preservice programs in vocational education institutions, rather than on-the-job
training programs. It also states that the education of all those who are licensed to practice
nursing should take place in institutions of higher education, not in hospitals. The paper
specifies an associate degree as the minimum for technical nursing and a baccalaureate degree
for professional nursing.
4. Sister Calista Roy identified an adaptation model that characterizes the individual as being in
constant interaction with a changing environment, therefore requiring adaptation. Which of the
following identifies an adaptive mode listed in her theory?
A) Role function
B) Nutrition
C) Spirituality
D) Genetic makeup
Ans: A
Client Needs: A-1
Cognitive Level: Analysis
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 9
Page and Header: 84, Table 2.2
Feedback: Roy identifies four adaptive modes, or ways in which a person adapts through: (1)
physiologic needs, (2) self-concept, (3) role function, and (4) interdependence relations.
Nutrition, spirituality, and genetic makeup are not discrete concepts within this theory.
5. Mr. Van is a 79-year-old widower who is being transferred to a long-term facility following
hip replacement surgery. The nurse in charge of his care hopes to provide holistic nursing care
for him based on his response to the interaction between his internal and external environment.
This approach represents the model of care proposed by which of the following theorists?
A) Dorothy Johnson
B) Madeleine Leininger
C) Dorothea Orem
D) Myra Levine
Ans: D
Client Needs: A-1
Cognitive Level: Analysis
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 9
Page and Header: 84, Table 2.2
Feedback: Levine supports a holistic approach to nursing based on recognition of the total
response of the person to the interaction between the internal and the external environment.
This approach is not specified by Johnson, Leininger, or Orem.
Multiple Selection
6. A college sophomore has become disillusioned with her current field of studies and has
begun exploring careers in nursing. To her surprise, she is unable to identify any hospitalbased
programs of study in her home state. Which of the following factors have contributed to
the demise of hospital-based diploma programs? (Select all that apply.)
A) Increased patient acuity in hospitals
B) Increased popularity of college- and university-based nursing programs
C) The growth of managed care and its influence on hospital management
D) Increased costs to hospitals for maintaining nursing programs
E) The emergence of the baccalaureate degree as the entry to technical nursing practice
Ans: B, D
Client Needs: A-1
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
Page and Header: 52, Hospital-Based Programs Today
Feedback: The elimination of hospital-based programs occurred because hospitals could not
sustain the costs of supporting the programs and because students became more attracted to
programs located in colleges and universities. Patient acuity and managed care have not been
identified as causative factors. The baccalaureate degree has been proposed as the entry to
professional nursing practice, not technical nursing.
Multiple Choice
7. Kirsten is a 22-year-old woman who has just been granted admission to an associate degree
program at a local college. During her course of study, Kirsten should expect to complete
A) the National Council Licensure Examination (NCLEX).
B) a preceptorship under the direction of a licensed practical (vocational) nurse.
C) a major, original research project immediately prior to graduation.
D) numerous nonnursing courses in a variety of disciplines.
Ans: A
Client Needs: A-1
Cognitive Level: Application
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 1
Page and Header: 53, Characteristics of Associate Degree Education
Feedback: In a typical ADN program, approximately 40% of the credits needed for the
associate degree must be fulfilled by general education courses such as English, anatomy,
physiology, speech, psychology, and sociology; the rest are to be fulfilled by nursing courses.
Original research is not a component of undergraduate nursing education, and preceptorships
are normally completely under the direction of an RN. The NCLEX is written after
graduation.
8. Ben is a 30-year-old man who has applied for an accelerated baccalaureate program at a
university because the 15-month program of study will allow him to accommodate his family
and financial responsibilities. In order to be granted admission, what will Ben most likely
require?
A) A varied work history that demonstrates initiative and responsibility
B) A baccalaureate degree in another field
C) A mentor or sponsor within the nursing field
D) Volunteer experience in a health-related setting
Ans: B
Client Needs: A-1
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 3
Page and Header: 59, Accelerated Programs
Feedback: Building on previous learning experiences, accelerated programs are designed to
transition adults with baccalaureate and graduate degrees in other fields into nursing. A strong
work history, volunteer experience, and an available mentor in the field are all assets for
success, but these are less likely to be absolutely required for admission.
9. Julia has just graduated with her Bachelor of Science in Nursing degree from her state
university and has begun seeking employment. However, she is anxious about her level of
clinical competence due to the fact that she completed far fewer clinical hours than many
practicing nurses. Which of the following has the potential to ease Julias transition to practice?
A) Completing a residency or internship at the hospital where she will be employed
B) Auditing courses in a nonnursing, health-related discipline
C) Working for several months as a nursing assistant in order to gain confidence
D) Taking online courses in advanced nursing practice
Ans: A
Client Needs: A-1
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 68, Residencies and Structured Orientation for the New Graduate
Feedback: Internships and residencies for new graduates have been instituted by hospitals to
ease the transition from the role of student to that of staff by providing the opportunity to
increase clinical skills and knowledge as well as self-confidence. Taking more academic
courses and/or working as a nursing assistant are unlikely to increase Julias confidence and
competence in her clinical nursing role.
10. According to the ANA Position Paper on Educational Preparation, which of the following
four individuals is adequately prepared to provide care?
A) A nursing assistant who has just completed an on-the-job training program in a local
hospital
B) A nurse who graduated from a hospital-based diploma program
C) A nurse in a high-acuity setting who possesses an associate degree in nursing (ADN)
degree
D) A nursing assistant who graduated from the training program at a community college
Ans: D
Client Needs: A-1
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 5
Page and Header: 74, Display 2.2
Feedback: The ANA Position Paper specifies that education for assistants in the health service
occupations should be short, intensive preservice programs in vocational education institutions,
rather than on-the-job training programs. The Paper also specifies a minimum of an ADN
degree for all nursing practice and a baccalaureate degree for professional nursing (e.g., in
high-acuity settings).
11. Nurse. L. provides care in a state that has mandatory continuing education requirements for
nurses. What are the consequences of this policy for Nurse L.?
A) Nurse L. must demonstrate a commitment to making practice improvements.
B) Nurse L. must have a baccalaureate degree in order to provide professional nursing care.
C) Nurse L. is obliged to update her diploma to an associate degree.
D) Nurse L. must demonstrate continuing education for license renewal.
Ans: D
Client Needs: A-1
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 6
Page and Header: 69, Continuing Education
Feedback: Mandatory continuing education affects licensure, meaning that any nurse renewing
a license in a state requiring (mandating) continuing education will have to satisfy that
requirement. However, this does not necessarily mean that a nurse must update his or her
degree or diploma or undertake practice improvements.
12. The administrators of a large, university hospital have expressed a commitment to
differentiated nursing practice. Which of the following most clearly exemplifies differentiated
practice?
A) Each nurse performs a role that is commensurate with his or her education and experience
level.
B) Each nurse in the hospital is expected to provide competent care in a variety of different
settings.
C) Nurses demonstrate evidence of continuing education in two or more different specialties.
D) Each nurse in the hospital possesses an ADN or baccalaureate degree in nursing.
Ans: A
Client Needs: A-1
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 7
Page and Header: 77, Differentiated Practice
Feedback: Differentiated nursing practice can be defined as the practice of structuring nursing
roles on the basis of education, experience, and competence. It does not necessarily specify the
provision of care in diverse settings, evidence of continuing education, or the possession of a
nursing degree.
13. A nurse manager who oversees the provision of community-based care to a large number
of clients has been mandated to implement differentiated care over the next year. In order to
carry out this directive, the nurse manager must be able to
A) teach each nurse to become a generalist rather than a specialist.
B) identify the evidence that underlies the nursing care that is provided.
C) clearly identify the specific roles and tasks that these nurses perform.
D) hire more licensed practical (vocational) nurses.
Ans: C
Client Needs: A-1
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Nursing Process
Objective: 7
Page and Header: 77, Differentiated Practice
Feedback: Differentiated practice requires that the specific roles that are performed in the
provision of care be clearly identified and delineated. This is necessary in order to appropriately
match individual care providers to particular tasks and functions. Nurses do not need to become
generalists nor are more practical nurses necessarily required. Evidence underlying nursing
care should be identified, but this is not necessary for differentiated care.
14. Pressure from students and the healthcare industry has prompted the nursing educators at a
college to implement new technology into the nursing education that they provide. Which of the
following statements is true of technological change and nursing education?
A) Technology is typically high in colleges and universities but low in hospitals and other care
settings.
B) Many of the purported educational benefits of technology have not been demonstrated in
the nursing literature.
C) Computer literacy is high among students but most nursing educators lack computer skills.
D) The costs of integrating new technology into nursing education can be prohibitive.
Ans: D
Client Needs: A-1
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 8
Page and Header: 80, Computer Technology in the Classroom
Feedback: High-technology equipment is often expensive, a fact that often presents a challenge
to educational institutions. The benefits of technology in learning have been demonstrated and
computer literacy is nearly universal. Hospitals are high-technology work environments.
15. The faculty members of a college-based school of nursing have taken action to increase the
teaching and clinical time in the curriculum that is devoted to community-based nursing. Which
of the following phenomena provides the most valid rationale for this change?
A) Public mistrust of hospitals is increasing and many individuals prefer to remain at home.
B) The number of patients who qualify for Medicare and Medicaid is increasing.
C) Patients are typically discharged from the hospital much earlier than in the past.
D) Evidence demonstrates that students learn more in the community than in the hospital.
Ans: C
Client Needs: A-1
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 8
Page and Header: 82, Increasing Community-Based Practice Experiences
Feedback: Earlier hospital discharge to the home and an increasing emphasis on prevention has
created new demands on nursing in the community. This shift is not rooted in mistrust of
hospitals, a lack of learning in hospitals, or trends in Medicare and Medicaid.

 

Chapter: Chapter 14: Facing the Challenges of Todays Workplace
Multiple Choice
1. A nurse begins to feel comfortable on her unit and views client care in terms of long-range
goals. She is able to prioritize among clients and deliberately plan her actions, which may still
lack speed and flexibility. Which of Benners levels of function has this nurse achieved?
A) Novice
B) Advanced beginner
C) Competent
D) Proficient
Ans: C
Client Needs: A-1
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 1
Page and Header: 505, Table 14.1
Feedback: Characteristics of the competent nurse include beginning to see the current situation
in terms of long-range goals. This nurse is able to prioritize among patients and base actions on
conscious deliberate planning but may still lack speed and flexibility. As such, the competent
nurse is more adept than the novice and advanced beginner but less skilled than the proficient
nurse.
2. A novice nurse apprehensively reflects on what she considers to be an impossible task of
delivering quality care on her ward as it is assigned to her. What is the name of this
phenomenon first coined by Marlene Kramer?
A) Burnout
B) Reality shock
C) Culture shock
D) Job disorientation
Ans: B
Client Needs: A-1
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 506, Reality Shock
Feedback: One problem confronted by the new graduate is the seeming impossibility of
delivering quality care within the constraints of the system as it exists. Kramer characterized
this phenomenon as reality shock, not burnout, culture shock or job disorientation.
3. A counselor diagnoses a critical care nurse with having the syndrome known as burnout.
Which of the following is a characteristic of this condition?
A) Burnout occurs when a nurse first enters the workplace and is overwhelmed by the
workload.
B) All of the symptoms of burnout are psychological in nature.
C) Burnout is accompanied by a decreased ability to function on the job and at home.
D) Burnout occurs less often in high-energy areas, such as critical care or burn units.
Ans: C
Client Needs: C
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 5
Page and Header: 511, Burnout
Feedback: Burnout is accompanied by a decreased ability to function both on the job and in the
personal life. Burnout occurs more frequently in nurses who work in particularly stressful
areas of nursing, such as critical care, oncology, or burn units. It does not typically occur early
in a nurses time in a particular setting and it can result in physical manifestations.
4. A hospital manager is accused of quid pro quo sexual harassment. Which of the following
is an action that might have been involved?
A) Making persistent unwanted attempts to initiate a personal relationship
B) Granting job-related benefits in return for sexual favors
C) Using suggestive or obscene language
D) Making direct sexual advances
Ans: B
Client Needs: C
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 8
Page and Header: 523, Sexual Harassment
Feedback: Quid pro quo sexual harassment involves the explicit offer of job-related benefits in
return for sexual favors. It is not defined by direct advances, attempting to initiate a
relationship, or suggestive language, though some or all of these activities may be present in the
exchange.
5. A hospital manager evaluates the workplace to ensure that ergonomics are working. Which
of the following statements describes this scientific theory?
A) Ergonomics is the study of client outcomes related to economic theories in healthcare.
B) Ergonomics empowers clients to have a voice in their own plan of care.
C) Ergonomics ensures that jobs are fitted to the physical abilities of the employees.
D) Ergonomics provides guidelines for delegating responsibilities for client care.
Ans: C
Client Needs: A-2
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 6
Page and Header: 517, Ergonomic Hazards in the Workplace
Feedback: Ergonomics is the science of fitting a task to ones physical characteristics in order
to enhance safety, efficiency, and well-being. When the task does not conform to ones physical
characteristics, musculoskeletal stress and injuries may occur. Ergonomics does not address
client outcomes, delegation, or client autonomy.
6. Researchers have noted a high incidence of burnout among nurses. Which of the following
nurses most likely faces the highest risk of burnout?
A) An experienced nurse who has long neglected her own physical health and who leads a
sedentary lifestyle.
B) A nurse who provides pediatric palliative care and who is disillusioned with the overall
quality of care on the unit.
C) A nurse who has recently graduated with an ADN degree and begun working in a busy,
inner-city emergency department.
D) A nurse who is few months away from retirement from her current position in community
health.
Ans: B
Client Needs: C
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Caring
Objective: 3
Page and Header: 512, Causes of Burnout
Feedback: Prominent among the causes of burnout is a conflict between ideals and reality. As
well, practice environments with high mortality rates are associated with burnout. Poor physical
health predisposes a nurse to burnout, but this is likely less salient than the combination of
disillusionment and high acuity. New graduates and those approaching retirement are not
particularly predisposed to burnout.
7. Melissa is a nurse who graduated earlier this year with a baccalaureate degree in nursing and
immediately began working on a busy surgical unit with a high turnover of both the patients
and the staff. As a result, Melissa has found the adjustment to full-time employment
particularly stressful. Which of the following actions should Melissa take in order to manage
the stress in her life?
A) Schedule a vacation for later in the year and focus on this upcoming trip when she is
experiencing high levels of stress.
B) Reduce her workload to part-time and supplement this with casual employment on a lowerstress
unit.
C) Be vigilant in personal habits that result in adequate rest, a healthy diet, and adequate
physical exercise.
D) Reduce or eliminate the specific interactions in the clinical setting that cause her the most
stress.
Ans: C
Client Needs: C
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 4
Page and Header: 511, Personal Stress Management
Feedback: Attending to diet, rest, and activity is important in the management of job-related
stress. These measures are more likely to be of benefit than trying to endure until a distant
vacation. Adding another workplace has the potential to increase stress and it is not normally
realistic to eliminate stressful interactions in the workplace.
8. A recent nursing graduate has become overwhelmed with reality shock in recent weeks,
despite the fact that he secured a job in the setting that was his first choice. This nurses best
response to his experience with reality shock is to
A) confront the manager of the unit with the details of his experience.
B) reduce the performance expectations that he places on himself.
C) prioritize physical assessments and interventions over patients psychosocial needs.
D) seek input from a trusted nurse who can act as a coach or mentor.
Ans: D
Client Needs: C
Cognitive Level: Application
Difficulty: Easy
Integrated Process: Caring
Objective: 3
Page and Header: 509, Preceptors, Coaches, and Mentors
Feedback: A coach or mentor can be of great assistance when recent nursing graduates are
faced with reality shock. Such a person may be of more benefit than the manager of the unit,
who may be too busy to assist the nurse with his adjustment. Reducing the quality of care or
reducing expectations may place the burden of the nurses reality shock on patients themselves,
which is inappropriate.
9. A nurse who provides care in a busy ambulatory clinic knows that there are numerous
occupational hazards associated with the provision of nursing care. What is the employers
responsibility in minimizing the nurses risk of experiencing an injury or infection?
A) The employer must provide all the necessary supplies and equipment to prevent injuries
and infections.
B) The employer must ensure that staffing levels are maintained at a level specified by the state
board of nursing.
C) The employer must have dedicated occupational health officers present at all times.
D) The employer must release nurses from tasks that may present a threat to their health.
Ans: A
Client Needs: A-2
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 6
Page and Header: 515, Infection as an Occupational Hazard
Feedback: Employers must be held accountable for providing the supplies and environment to
make work settings safe. All risks cannot normally be eliminated and dedicated occupational
health staff may or may not be available or necessary. Safe staffing levels are important, but
these do not necessarily mitigate the risk of workplace injuries and infections.
10. Racial and ethnic discrimination has been identified as a reality within healthcare
institutions. Which of the following goals for the nursing profession is most appropriate?
A) The nursing workforce should transcend racial and ethnic categorization and should not be
appraised through this lens.
B) The nursing workforce should have fewer Caucasian members and more racial/ethnic
minorities.
C) The nursing workforce should be made up of members from as many cultures as possible.
D) The nursing workforce should reflect the population for whom it provides care
Ans: D
Client Needs: C
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Caring
Objective: 7
Page and Header: 520, Racial/Ethnic Discrimination
Feedback: A workforce that reflects the population is more likely to meet the healthcare needs
of that population in a culturally sensitive manner. It is simplistic to presume that the solution to
discrimination lies with fewer Caucasians and more minorities. Similarly, increasing the
number of cultures represented within nursing will not necessarily eliminate discrimination.
11. A nurse who works in a rural hospital has become frustrated and disillusioned at the
steady increases in nurse to patient ratios at the same time that patient acuity has increased.
When planning to address this issue with the hospitals leadership, the nurse should cite which
of the following statements about increased nurse to patient ratios?
A) Increased nurse to patient ratios are associated with a decline in patient outcomes.
B) Reality shock is more common and severe when there are increased nurse to patient ratios.
C) An increased nurse to patient ratio increases the incidence of disruptive behavior in hospital
settings.
D) Discrimination and stress increase when there is an increase in nurse to patient ratios.
Ans: A
Client Needs: A-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Communication and Documentation
Objective: 5
Page and Header: 514, Nurse Staffing Levels
Feedback: Increased nurse to patient ratios have been shown to result in decreased patient
outcomes. There are other deleterious effects on nurses, including reality shock and stress, but
patient outcomes should be the primary consideration.
12. A nurse was helping a colleague boost a patient higher in his bed she felt sudden pain in
her lumbar region. How should the nurse follow up this event?
A) Make an appointment with a physician and document the injury if there are significant
results.
B) Have a trusted colleague perform a musculoskeletal assessment and monitor the nurses
range of motion for the remainder of the shift.
C) Go home immediately and take enough sick time to allow her back to recover completely
before returning to work.
D) Document the event as soon as possible using the hospitals designated forms.
Ans: D
Client Needs: A-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Communication and Documentation
Objective: 6
Page and Header: 519, Workers Compensation
Feedback: A nurse who suspects an injury should report the event promptly using the
appropriate paperwork. A common error is to delay reporting in the belief that you should
report something only if you know it will be serious or require medical care. It is insufficient to
leave work without documenting the event or to rely on a colleagues assessment and care.
13. Three times in the past several weeks a physician has commented on a nurses body and
each comment has been more explicit and sexually suggestive than the last. How should the
nurse first respond to this form of sexual harassment?
A) Avoid contact with the physician except in locations where there are colleagues or other
witnesses.
B) Ignore the physician if more comments are made in the future.
C) Confront the physician directly and explain that such comments are unacceptable and
unwanted.
D) Document the events in detail and inform the state medical board.
Ans: C
Client Needs: A-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Communication and Documentation
Objective: 9
Page and Header: 523, Sexual Harassment
Feedback: Individuals should take steps to stop sexual harassment by giving clear, direct
verbal messages indicating that the behavior in question is unwanted, unpleasant, and must
stop. Sometimes this action alone stops inappropriate behavior. If clear, direct messages are not
successful, the individual then should report the matter in writing to an immediate supervisor.
Simply avoiding the offender or attempting to manage the behavior by reducing opportunities
are not sufficient responses.
14. Despite being seen as a safe environment where victims of violence are treated, hospitals
are the site of a large number of assaults. Which of the following care environments is
associated with the greatest risk of physical violence?
A) Psychiatric mental health
B) Geriatrics and gerontology
C) Critical care and acute medicine
D) Labor and delivery
Ans: A
Client Needs: A-2
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 10
Page and Header: 525, Violence in the Workplace
Feedback: The majority of client assaults occur in psychiatric mental health settings.
15. A string of recent assaults perpetrated on nurses by clients has prompted the hospital
administrators to address this disturbing trend. What action should the administrators prioritize
in an effort to reduce the incidence of workplace violence?
A) Ensure that at least one male nurse is present at all times on each nursing unit.
B) Teach self-defense techniques to all the nurses who provide care in high-risk settings.
C) Train nurses how to effectively manage the behavior of aggressive patients and clients.
D) Withhold care from patients and clients who have a history of aggression.
Ans: C
Client Needs: A-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 10
Page and Header: 525, Violence in the Workplace
Feedback: One form of violence prevention is to train employees in the management of hostile
and violent behavior. Ways of identifying hostile and assaultive clients should be developed so
that staff can be warned to take extra personal safety precautions. This is different from
teaching self-defense techniques, which are normally physical in nature. It is not normally
possible to withhold care from an individual, even if the person has a history of violence or
aggression. The presence of male nurses is not an adequate measure in the prevention of
violence.

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