Test Bank For Professional issues In Nursing Challenges And Opportunities 3rd By Edition Huston

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Test Bank For Professional issues In Nursing Challenges And Opportunities 3rd By Edition Huston




Professional issues in Nursing Challenges and Opportunities 3rd Edition Huston


1. When describing the NCLEX examination, which of the following would the instructor include?
  A) Includes content standardized for baccalaureate education in nursing
  B) Measures minimum technical competencies for safe entry into basic nursing practice
  C) Tests content determined appropriate for practice entry by the American Nurses Association
  D) Requires different passing scores for RNs educated at the ADN level than at the BSN level
  Ans: B



2. Which of the following would a prospective student expect to find when examining a typical associate degree in nursing (ADN) program?
  A) A maximum requirement for 120 semester hours or 180 quarter units
  B) Similar curricular content as BSN programs, with greater clinical hours
  C) Completion possible within 18 months to 2 years
  D) Additional coursework for preparation to practice in multiple settings
  Ans: D



3. Raising the educational level for entry into professional nursing
  A) Should be relatively easy due to unanimous support
  B) Is likely to have a short-term effect of reducing the current nursing shortage
  C) May increase recruitment to and retention in the field in the long run
  D) May destabilize the nursing workforce due to increased job satisfaction for ADNs
  Ans: C



4. Which of the following best reflects most of the RNs working in the United States today?
  A) They have received an associate degree in nursing (ADN).
  B) They have adequate educational preparation for roles in leadership and management.
  C) There are significant differences in care provided by ADN- and BSN-prepared nurses.
  D) Separate NCLEX examinations are supported for BSN- and ADN-educated nurses.
  Ans: A



5. A nursing instructor is teaching a group of students about grandfathering that may result if the entry level to nursing practice is raised. The instructor determines that the teaching was successful when the students describe it as which of the following?
  A) A way to allow an individual to continue to practice his or her profession or occupation after new qualifications has been enacted into law
  B) A mandate for nurses with greater education and knowledge levels to be responsible for supervising those prepared at lower levels
  C) A necessary requirement by state and federal laws when educational entry requirements change
  D) A concept that is not supported by most professional nursing associations that support raising the entry level for professional nursing practice
  Ans: A



6. Transitioning from a predominantly ADN educational model of nursing education to a baccalaureate model
  A) Is already occurring in a seamless, integrated manner that maximizes the use of educational resources
  B) Will be relatively inexpensive, given that adequate institutions of higher learning already exist to meet this need
  C) Will require the development of alternative pathways for RN education for learners who may not otherwise be able to pursue additional nursing education
  D) Is primarily limited to nursing education in the United States
  Ans: C



7. Which of the following would a nurse identify as a positive force for raising the educational entry level in professional nursing?
  A) There is often little if any difference in pay between BSN- and ADN-educated nurses.
  B) Patient outcomes are better when ADN representation in the staffing mix is high.
  C) Consumers generally have no understanding of the entry-to-practice issue in nursing.
  D) The entry level in nursing is significantly lower than for other health professions.
  Ans: D



8. A group of students is reviewing for a test on levels of preparation for nurses. Which of the following if stated by the students as reflecting Mildred Montags view of associate degree educational programs indicates that the students have understood the information?
  A) Preparation for beginning, technical practitioners who would provide direct, safe nursing care under the supervision of the professional nurse in an acute-care setting
  B) Preparation of advanced professional nurses capable of the independent judgment and autonomy required to successfully function as RNs in the 21st century
  C) Preparation of professional registered nurses who could function safely in a variety of health care settings including acute care, home care, and public health
  D) Preparation of broadly educated registered nurses with an understanding of cultural, political, economic, and social issues affecting patients and health care delivery
  Ans: A



9. Which of the following best reflects the suggestions of the 1965 position paper by the American Nurses Association for nursing education?
  A) The education of all those who are licensed to practice nursing should take place ininstitutions of higher education.
  B) Minimum preparation for beginning professional nursing practice should be the associate degree in nursing.
  C) Minimum preparation for beginning technical practice should be the baccalaureate degree in nursing.
  D) There was no need for assistant nurses in the health care occupations.
  Ans: A



10. When reviewing the demographics related to ADN and BSN programs, which of the following would be an expected finding?
  A) ADN program graduates tend to be younger than graduates of baccalaureate programs.
  B) ADN program graduates tend to be more diverse in race, gender, and age than baccalaureate-prepared nurses.
  C) ADN program graduates are more likely to be single or divorced than baccalaureate graduates.
  D) ADN program graduates typically have at least twice as many children as nurses educated in baccalaureate programs.
  Ans: B



11. Which of the following was the most likely cause fueling the debate about entry to practice?
  A) Browns publication of Nursing for the Future
  B) Mildred Montags dissertation
  C) ANAs 1965 position paper
  D) The Veterans Administrations requirement for BSN
  Ans: C



12. A nurse is presenting a discussion to a group of local high school students about nursing and the various types of educational programs available. One of the students asks, Whats the difference between a nurse with an associates degree and one with a baccalaureate degree? Which response would be most appropriate?
  A) Both can be licensed as registered nurses, but an associates degree education requires morenursing coursework units.
  B) Both take the same test for licensure, but a nurse with a baccalaureate degree must get a higher score to pass.
  C) Employers have routinely paid baccalaureate degree nurses a higher starting salary than associates degree nurses.
  D) The outcomes for patients cared for by baccalaureate-prepared nurses appear to be better than those for associates degree nurses.
  Ans: D



13. Which of the following would be considered an important factor related to changes in health care that would emphasize the need for a BSN degree for entry to practice?
  A) Shift from community settings to acute care
  B) Rapid advances in health care technology and complexity
  C) The need to work as a dependent member of the team
  D) Dramatic increase in curative care
  Ans: B



14. After reviewing different health professions and their required entry-level degree, a student identifies which profession as requiring the lowest degree level?
  A) Pharmacy
  B) Social work
  C) Speech pathology
  D) Nursing
  Ans: D



15. Which of the following organizations recommends that the nursing profession have multiple entry points?
  A) American Nurses Association (ANA)
  B) National League for Nursing (NLN)
  C) Nurse Alliance of Service Employees International Union (SEIU)
  D) American Nephrology Nurses Association (ANNA)
  Ans: B



16. When reviewing the factors involved with obtaining advanced education, which of the following would a nurse expect as being the chief obstacle?
  A) Cost
  B) Age of the nurse
  C) Gender
  D) Ethnic minority status
  Ans: A



17. After teaching a group of students about the two levels of preparation for registered nurses, the instructor determines that the teaching was successful when the students identify which of the following as a characteristic of technical nurses?
  A) Four-year program of education in a college or university
  B) Achievement of a baccalaureate degree
  C) In-depth coverage of nursing research
  D) Ability to provide care in acute-care settings
  Ans: D



18. A group of students are reviewing material about the proliferation of ADN education in preparation for a quiz the next day. The students demonstrate understanding of the material when they identify which of the following as a characteristic of the 1960s?
  A) Associates degree programs were just beginning.
  B) Diploma education was on the decline.
  C) The majority of nurses were educated in colleges and universities.
  D) Enrollment in baccalaureate programs was decreasing.
  Ans: A



19. A nurse manager who is preparing a presentation for a group of staff nurses about educational opportunities for returning to school will be integrating research information about incentives for doing so. Which of the following would the nurse include?
  A) Equality of treatment
  B) Lack of recognition for past education
  C) Creation of a credible professional identity
  D) Working within a structured format
  Ans: C



20. Which of the following effects has been identified as reflective of the education gap between nursing and other professions?
  A) The perspective that nursing is elitist due to lack of entry standards
  B) Increased appeal of nursing as an emerging workforce
  C) View of nurses as second-class citizens in health care
  D) Licensure not equating with professional status
  Ans: C


1. A nurse is preparing a presentation for a group of nurses about the need for effective leadership to meet the demands of the current American health care system. When describing issues in the health care system, which of the following would the nurse include?
  A) The doubling of costs over the past 10 years
  B) Improving rates of patients receiving care
  C) Rising medical errors
  D) Increasing surplus of physicians but not nurses
  Ans: C



2. A group of nursing students are reviewing the concept of leadership in preparation for a class discussion on the topic? Which of the following if stated by the students indicates a need for additional review?
  A) Leadership involves solitary, independent action.
  B) Successful leaders use effective communication skills.
  C) Upcoming leaders need to be innovative.
  D) Leadership is embedded in relationships
  Ans: A



3. Which of the following best reflects the leadership challenges in the 21st century? Select all that apply.
  A) Need to increase productivity within budgetary constraints
  B) Maintaining current evidence-based practice recommendations
  C) Embracing multidisciplinary health care
  D) Balancing technology and interpersonal relationships
  E) Encouraging teamwork
  Ans: A, D, E



4. Which of the following best indicates the current status of evidence-based practice (EBP) in health care today?
  A) The majority of nurse leaders are implementing EBP individually.
  B) EBP is the standard of practice in most health care organizations.
  C) Staff members are acting as EBP role models in institutions.
  D) Institutions are fostering cultures for EBP throughout the country.
  Ans: B



5. A nurse leader is working to develop an internal mechanism in the organization that will help in the promotion of nurses from within the organization. The nurse leader is involved in which of the following?
  A) Mentoring
  B) Coaching
  C) Transactional leadership
  D) Succession planning
  Ans: D



6. A nurse is reviewing information from the Institute of Medicine (IOM). Which of the following would the nurse expect to find as one of the markers of safe and highly reliable care?
  A) Team communication
  B) Formal mentorship
  C) Proactive decision making
  D) Innovation
  Ans: A



7. After discussing effective team communication with a group of students, the instructor determines that the discussion was effective when the students state which of the following?
  A) Team communication requires individual commitment.
  B) Worldviews and values are similar among team members.
  C) Team communication is a complex social process.
  D) Effective communication is indirect and broad in scope.
  Ans: C



8. A nurse leader is working as part of a transdisciplinary health care team. Which of the following would be a key component of this team?
  A) Individual disciplines working toward the same goal
  B) Collaboration among all health care providers
  C) Minimal trust among a variety of health care providers
  D) Use of commonalities based on each disciplines specialized knowledge
  Ans: B



9. Which of the following would be most effective in promoting nursings influence in decision making for organizational and health policy?
  A) Providing passive contributions to discussion forums on health care
  B) Being proactive in ensuring representation by the best nurses
  C) Engaging in limited participation in health policy venues
  D) Working from the sidelines to promote health issues
  Ans: B



10. Which of the following would be the first step in creating a culture of innovation and change?
  A) Active participation
  B) Role-modeling
  C) Mentorship
  D) Change in personal leadership practices
  Ans: D



11. As a nurse leader, which of the following would be the primary focus?
  A) Change
  B) The vision
  C) Patient
  D) Trust
  Ans: D



12. A nurse leader, working with the team, understands that trust is essential for effective team functioning. Which of the following would be inappropriate for developing this trust?
  A) Transparency
  B) Pride
  C) Honesty
  D) Integrity
  Ans: B



13. A group of nursing students are reviewing information about the characteristics of a transformative leader? The students demonstrate understanding of the material when they identify which of the following as a characteristic? Select all that apply.
  A) Ability to micromanage
  B) Willingness to take risks
  C) Focus on the team
  D) Satisfaction with the present
  E) Entrepreneurial spirit
  Ans: B, C, E



14. A nursing instructor is describing how technology has impacted health care and leadership. Which of the following would the instructor most likely include in this discussion?
  A) Information transmission, although faster, is less efficient.
  B) Lag times for information have significantly increased.
  C) Work and personal time boundaries have become blurred.
  D) Control of communication pathways remains unchanged.
  Ans: C



15. A group of nursing students are reviewing information about models of leadership and health care. The students demonstrate understanding of these models when they identify which of the following as the most common style used in health care?
  A) Transactional leadership
  B) Inspirational leadership
  C) Transformational leadership
  D) Complexity leadership
  Ans: A



16. A nurse leader is considering using transformational leadership. Which of the following would the nurse leader need to keep in mind?
  A) The locus of power rests with the employees.
  B) Informal leadership is highly recognized.
  C) Empowerment of both the leader and follower occurs.
  D) Employees are expected to lead from their organizational position.
  Ans: C



17. A nurse is reading a journal article on the complexity leadership model. Which of the following would the nurse most likely find as being described in the article?
  A) Positional leaders carry authority focused on managing organizational dynamics.
  B) Control is relatively easy to obtain and maintain.
  C) Power rests solely with specific individuals.
  D) System boundaries are distinct and well defined.
  Ans: A



18. A nurse leader is using the trimodal model of leadership. Which of the following would the nurse be engaged in during innovation planning?
  A) Providing evidence-based patient care
  B) Looking for ways to improve current ineffective processes
  C) Developing suitable pathways to modify roles
  D) Ensuring appropriate funding for services
  Ans: B



19. A nursing instructor is developing a teaching plan for a class on the characteristics of the various leadership models. Which model would the instructor include as having overlapping, informal organizational boundaries?
  A) Transactional
  B) Inspirational
  C) Transformational
  D) Complexity
  Ans: D



20. The transformational leadership model involves which of the following? Select all that apply.
  A) Defined boundaries
  B) Leader in the central position
  C) Communication in multiple directions
  D) Coaching competencies
  E) Planned work
  Ans: A, B, E


1. When reviewing information about mandatory staffing, which of the following would best reflect the current status?
  A) Many of the states in the United States have moved toward imposing mandatory licensed staffing requirements.
  B) Texas has already enacted legislation requiring mandatory staffing ratios affecting hospitals and long-term care facilities.
  C) Research suggests that the average number of patients assigned to RNs for care in acute-care facilities has actually decreased in the past decade, but patients are much sicker.
  D) Consumers and legislators, not nurses, have urged implementation of mandatory staffing ratios because most nurses feel current staffing levels are minimum but adequate.
  Ans: A



2. Benchmark research completed by Aiken and colleagues in 2002 found
  A) There was no significant difference in patient outcomes when staffing at six patients per nurse rather than four.
  B) There was no rise in patient morbidity until patient-to-nurse ratios exceed eight to one.
  C) There is no direct, provable link between nurse-to-patient ratios and mortality rates from preventable complications.
  D) In hospitals with higher patient-to-nurse ratios, the likelihood of dying within 30 days of admission and mortality complications were increased.
  Ans: D



3. When evaluating the pros and cons of mandatory regulation of RN-to-patient ratios, which statement most accurately reflects the beliefs of the critics?
  A) Such ratios protect the most basic elements of the public health care consumers take for granted.
  B) Implementing ratios will improve the nursing shortage, at least temporarily over the short term.
  C) Mandatory staffing will lead to a reduction in hospital services and increased expenses due to the need to pay overtime.
  D) Mandatory staffing ratios create significant opportunity costs that encourage employers and payers to respond to market forces.
  Ans: C



4. Developing draft regulations for minimum staffing ratios was challenging for the California Department of Health Services (CDHS) because
  A) Although standardized patient classification system data were available, hospitals were unwilling to submit the data.
  B) Hospitals had not been required to use patient classification systems prior to the passage of staffing-ratio legislation and had no data.
  C) California Healthcare Association and the California Nurses Association agreed on the minimum ratios, but consumer advocate groups pressed for lower patient-to-nurse ratios.
  D) Proposals received by CDHS suggested a wide range of minimum staffing ratios and even more widely differing estimates of implementation costs.
  Ans: D



5. Implementing the ratio legislation in California proved to be difficult because
  A) Nursing unions balked when courts ruled that both LVNs and RNs could be used to meet minimum staffing ratios.
  B) The current nursing shortage made it impossible to meet the mandated ratios.
  C) Legislation was introduced to delay implementation of the minimum 1:5 nurse-to-patient staffing ratio on medical-surgical units.
  D) A significant number of hospitals in the state had to close their doors due to the cost of implementing staffing ratios.
  Ans: C



6. When reviewing the California legislation, legal clarification became necessary due to the at-all-times clause, which referred to which of the following?
  A) Maintaining minimum staffing ratios throughout the day including during breaks and lunches
  B) Having at least one registered nurse on duty at all times
  C) Ensuring no more than a 1:4 nurse-to-patient ratio on any unit in acute-care hospitals
  D) Having to keep emergency departments open 24 hours a day
  Ans: A



7. Which of the following best describes waivers to the mandatory staffing ratios that were part of the California legislation?
  A) Were typically not allowed for any institution
  B) Were sought by many of the larger hospitals because of the financial costs
  C) Were routinely granted if patient safety was not being compromised
  D) Were allowed but only to rural hospitals under very strict conditions
  Ans: D



8. An instructor is describing compliance oversight by the California Department of Health Services in acute-care hospitals to a group of students. Which of the following would most likely occur if a hospital was found to be out of compliance with the mandatory minimum staffing ratios?
  A) The hospital would be forced immediately to close its doors until it could demonstrate compliance.
  B) The facility is given 48 hours to correct the deficiency after being fined substantially.
  C) The hospital must discharge or transfer patients within 24 hours to reach a level of compliance.
  D) There is no penalty or monetary fine for a violation unless serious injury or death occurs.
  Ans: D



9. Which of the following is suggested based on the initial research findings as to the effectiveness of mandated staffing-ratio implementation in California?
  A) Staffing ratios remained essentially unchanged.
  B) Staffing ratios increased the number of worked nursing hours per patient day in hospitals.
  C) Hospitals had less difficulty meeting ratio requirements than originally anticipated.
  D) The at-all-times clause was not a significant hardship.
  Ans: B



10. Which of the following best reflects the position taken by the Joint Commission on mandated staffing ratios?
  A) Supportive, arguing that more states should follow Californias model
  B) Criticism that ratios as not flexible enough due to failure to address diversity of U.S. hospitals
  C) Watchful waiting by other states until Californias experience can be fully evaluated
  D) Direct opposition to the implementation because of the current nursing shortage
  Ans: B



11. When reviewing the various alternatives to legislated minimum staffing ratios, which of the following would a nurse expect to find as the position of the American Nurses Association?
  A) A workload system that encompasses existing variables for safe staffing
  B) Use of Continuous Quality Improvement to ensure adequate staffing
  C) Use of market-based incentives for hospitals to maximize nurse staffing
  D) Evaluation of number, competency, and skill mix of staff related to needed services
  Ans: A



12. A nursing administration is using the legislation in California as a guide to implement appropriate minimum registered nurse staffing ratios for the labor and delivery area. Which of the following ratios would be most appropriate?
  A) 1:1
  B) 1:2
  C) 1:4
  D) 1:6
  Ans: B



13. Various studies have examined the link between staffing mix and patient outcomes. Which of the following best describes the most common finding associated with this research?
  A) Inadequate numbers of RNs has little effect on patient outcomes.
  B) Mortality dropped with increased staffing numbers of nurse aides.
  C) Increased numbers of RNs in staffing mix led to improved patient outcomes.
  D) A decreased prevalence of infections was found with less staffing.
  Ans: C



14. After describing the arguments for and against mandated minimum staffing, the instructor determines that the teaching was successful when the students identify which of the following as a major argument by critics?
  A) Patient safety is unrelated to the staffing ratios.
  B) Workload of nurses is difficult to translate into numbers.
  C) Standardized ratios do not provide consistency in approach.
  D) Overall cost of care would increase exponentially.
  Ans: D



15. A nurse is reviewing the events leading up to implementing the California legislation. In addition to identifying ratios for safe staffing, the legislation also addressed which of the following?
  A) Use of LPNs/LVNs as part of the staff mix
  B) Possible cost incentives
  C) Restrictions for procedures of unlicensed personnel
  D) Patient classification systems
  Ans: C



16. A nursing student is reading a journal article about mandatory staffing ratios and states that have implemented legislation related to staffing. Which state would the student be least likely to read about?
  A) Ohio
  B) Alabama
  C) Connecticut
  D) Nevada
  Ans: B



17. As student is reviewing the recommendations of the ANA to maintain sufficient staffing. The student demonstrates a need for additional study when the student identifies which of the following as a recommendation?
  A) Creation of staffing plans by administrative personnel
  B) Legislative mandates for regulation of nurse to patient ratios
  C) Staffing plans that reflect the needs of the patient population
  D) Disclosure of staffing levels to a regulatory body
  Ans: A



18. As part of the Hospital Patient Protection Act (2008), which nurse-to-patient ratio would be appropriate for pediatrics?
  A) 1:2
  B) 1:3
  C) 1:4
  D) 1:5
  Ans: B



19. A student is reviewing research in preparation for a debate on minimum mandatory staffing relies on the study by Aiken et al. (2002) as a basis for arguing in support of this issue. Which of the following best describes the students use of this study?
  A) It is considered the seminal work for supporting legislation of minimum staffing ratios.
  B) It provided the most comprehensive study on costs, staffing, and use of unlicensed personnel.
  C) It supported findings from research performed by the Agency for Healthcare Quality and Research.
  D) It reinforced what was already known about the need for mandatory staffing ratios in acute-care facilities.
  Ans: A



20. Which of the following would a nurse identify as the primary driving force in dictating changes in the RN skill mix in hospitals?
  A) Rise in use of unlicensed assistive personnel
  B) Growing nursing shortage
  C) Patient outcomes
  D) Economics
  Ans: D



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