Chapter 01: Professional Nursing
Potter: Essentials for Nursing Practice, 9th Edition

MULTIPLE CHOICE

	1.	Which action by the nurse demonstrates implementation of Florence Nightingale’s original theories about nursing care?
a.	The patient is gently bathed and given fresh linens after giving birth.	
b.	The nurse forms a close therapeutic relationship with the patient.	
c.	The nurse helps the patient conserve energy for healing processes.	
d.	The nurse views the patient as a unique, ever-changing energy field.	

ANS:	A
Florence Nightingale worked to improve sanitation and healing environments for patients. Gently bathing and providing fresh linens to patients is an example of Nightingale’s theory in practice. Formation of a close therapeutic relationship with the patient, energy conservation, and viewing patients as energy fields were not concepts included in Nightingale’s theory of nursing practice.

DIF:	Cognitive Level: Apply (Application)		
OBJ:	Discuss the influence of social, political, and economic changes on nursing practices.
TOP:	Nursing Process: Implementation	MSC:	NCLEX: Basic Care and Comfort

	2.	The nurse is mandated by the state to complete 25 contact hours of nursing education before the nursing license may be renewed. Which term best describes this requirement?
a.	In-service education	
b.	Advanced education	
c.	Continuing education	
d.	Certification education	

ANS:	C
Continuing education is required for professionals in many states. Continuing education involves formal, organized educational programs offered by universities, hospitals, state nurses’ associations, professional nursing organizations, and educational and health care institutions. In-service education programs are instruction or training provided by a health care agency or institution designed to increase the knowledge, skills, and competencies of nurses and other health care professionals employed by the institution. Some roles for RNs in nursing require advanced graduate degrees, such as a clinical nurse specialist or nurse practitioner.

DIF:	Cognitive Level: Apply (Application)		
OBJ:	Discuss the importance of education in professional nursing practice.
TOP:	Nursing Process: Communication and Documentation	
MSC:	NCLEX: Management of Care

	3.	The nurse is caring for a patient who suddenly becomes acutely short of breath. The nurse elevates the head of the patient’s bed, checks the patient’s pulse oximetry, and administers 2 L of oxygen before notifying the patient’s physician. Which term best describes the actions of the nurse?
a.	Accountability	
b.	Autonomy	
c.	Licensure	
d.	Certification	

ANS:	B
Autonomy is essential to professional nursing and involves the initiation of independent nursing interventions without medical orders. Accountability means that you are professionally and legally responsible for the type and quality of nursing care provided. To obtain licensure in the United States, RN candidates must pass the NCLEX-RN® examination administered by the individual State Boards of Nursing to obtain a nursing license. Beyond the NCLEX-RN®, some nurses choose to work toward certification in a specific area of nursing practice.

DIF:	Cognitive Level: Apply (Application)		
OBJ:	Discuss the characteristics of professionalism in nursing.	
TOP:	Nursing Process: Implementation	MSC:	NCLEX: Management of Care

	4.	Which type of program is appropriate to educate staff about new fall prevention protocols that are to be implemented on the nursing unit?
a.	In-service education	
b.	Advanced education	
c.	Continuing education	
d.	Certification education	

ANS:	A
In-service education programs are instruction or training provided by a health care agency or institution designed to increase the knowledge, skills, and competencies of nurses and other health care professionals employed by the institution. Some roles for RNs in nursing require advanced graduate degrees, such as a clinical nurse specialist or nurse practitioner. Continuing education is required for professionals in many states. Continuing education involves formal, organized educational programs offered by universities, hospitals, state nurses’ associations, professional nursing organizations, and educational and health care institutions.

DIF:	Cognitive Level: Apply (Application)		
OBJ:	Discuss the importance of education in professional nursing practice.
TOP:	Nursing Process: Teaching and Learning		
MSC:	NCLEX: Management of Care

	5.	Which program is appropriate for a nurse who wishes to become an expert in ostomy and wound care?
a.	Specialty certification	
b.	Master of Science program	
c.	Doctoral degree program	
d.	Continuing education program	

ANS:	A
Specialty certification programs are appropriate for nurses who wish to become experts in certain areas of nursing care such as perioperative care, wound care, or occupational health. Master of Science programs prepare nurses for advanced practice roles as educators, administrators, or clinical nurse leaders. Doctoral programs prepare nurses for advanced clinical practice and research. Continuing education is required for professionals in many states. Continuing education involves formal, organized educational programs offered by universities, hospitals, state nurses’ associations, professional nursing organizations, and educational and health care institutions.

DIF:	Cognitive Level: Apply (Application)		
OBJ:	Describe the roles and career opportunities for nurses.	
TOP:	Nursing Process: Teaching and Learning		
MSC:	NCLEX: Management of Care

	6.	Which action of the nurse demonstrates coordination of care for the patient?
a.	The nurse creates a warm, therapeutic relationship with the patient by actively listening to what the patient has to say.	
b.	The nurse works with the physical therapist to determine how to best transfer the patient from the bed to the chair.	
c.	The nurse educates the patient about energy conservation techniques to increase activity tolerance.	
d.	The nurse uses clear and objective language when documenting assessment findings in the patient’s medical record.	

ANS:	B
Coordination of care involves working with other health care professionals to meet the needs of the individual patient. The nurse can do this by working with the physical therapist to determine how to best transfer the patient from the bed to the chair. Developing a warm therapeutic relationship demonstrates caring and effective communication. Educating the patient about energy conservation and charting clearly are not examples of coordination of care.

DIF:	Cognitive Level: Apply (Application)		
OBJ:	Describe the roles and career opportunities for nurses.	
TOP:	Nursing Process: Implementation	MSC:	NCLEX: Management of Care

	7.	The nurse feels that an assigned duty is outside the scope of nursing practice. Which document is the best source to answer the nurse’s concern?
a.	ANA Code of Ethics	
b.	State Nurse Practice Act	
c.	QSEN Initiative Act	
d.	Nurse’s Bill of Rights	

ANS:	B
In the United States each State Board of Nursing oversees its Nurse Practice Act (NPA), which regulates the scope of nursing practice for the state and protects public health, safety, and welfare. The ANA’s Code of Ethics for Nurses: Interpretation and Application (2010) provides a guide (not a law) for carrying out nursing responsibilities to ensure high-quality nursing care and provide for the ethical obligations of the profession. The Quality and Safety Education for Nurses (QSEN) initiative responds to reports about safety and quality patient care by the National Academy, Health and Medicine Division. The Nurses’ Bill of Rights is a statement about the professional rights of nurses and does not dictate the scope of practice for nurses.

DIF:	Cognitive Level: Apply (Application)		
OBJ:	Describe the purpose of professional standards of nursing practice.
TOP:	Nursing Process: Implementation	MSC:	NCLEX: Management of Care

	8.	Which professional nursing organization ensures that nursing programs adequately prepare students to enter the nursing profession?
a.	Federal Nurses Association (FNA)	
b.	International Council of Nurses (ICN)	
c.	National League for Nursing (NLN)	
d.	National Student Nurses Association (NSNA)	

ANS:	C
The National League for Nursing (NLN) oversees nursing educational programs to help ensure that students are well prepared to enter the nursing profession. The Federal Nurses Association (FNA) is for nurses who are on active duty within the American Armed Forces. The National Student Nurses Association (NSNA) provides a voice for nursing students and does not oversee nursing programs. The International Council of Nurses (ICN) is a global organization that promotes quality nursing care for all people.

DIF:	Cognitive Level: Understand (Comprehension)	
OBJ:	Discuss the importance of education in professional nursing practice.
TOP:	Nursing Process: Teaching and Learning		
MSC:	NCLEX: Management of Care

MULTIPLE RESPONSE

	1.	Which actions of the nurse demonstrate the nursing role of leader? (Select all that apply.)
a.	The nurse implements a new skin-care protocol to reduce decubitus ulcers.	
b.	The nurse develops a therapeutic relationship with the patient’s family members.	
c.	The nurse ensures that the patient assignments are created fairly for each shift.	
d.	The nurse works to meet the patient’s cultural preferences for personal care.	
e.	The nurse clearly communicates expected standards of care for the patients.	

ANS:	A, C, E
The nurse functions as a leader by implementing new protocols, ensuring that patient assignments are made fairly and clearly communicating the expected standards of care. Developing a therapeutic relationship and meeting the cultural preferences of patients are both caring behaviors of the nurse.

DIF:	Cognitive Level: Apply (Application)		
OBJ:	Describe the roles and career opportunities for nurses.	
TOP:	Nursing Process: Implementation	MSC:	NCLEX: Management of Care

	2.	Which actions of the nurse demonstrate the nursing role of educator? (Select all that apply.)
a.	The nurse teaches the patient’s family how to perform sterile dressing changes.	
b.	The nurse includes the patient in clinical decision making whenever possible.	
c.	The nurse provides written teaching materials in the patient’s preferred language.	
d.	The nurse speaks about diabetes management at a professional conference.	
e.	The nurse assesses for adequate protein intake for a patient on a vegetarian diet.	

ANS:	A, C, D
The nurse acts as an educator by teaching the patient’s family about care and speaking at professional conferences. Written teaching materials should be provided in the patient’s preferred language to maximize learning and retention of information. Determining protein intake is part of the assessment process. Including the patient in clinical decision making demonstrates the role of nurse as advocate.

DIF:	Cognitive Level: Apply (Application)		
OBJ:	Describe the roles and career opportunities for nurses.	
TOP:	Nursing Process: Implementation	MSC:	NCLEX: Management of Care

	3.	. Which nursing actions incorporate informatics into nursing practice? (Select all that apply.)
a.	The nurse uses written materials to teach a patient who is hard of hearing.	
b.	The nurse uses an online database to learn more about the patient’s disease.	
c.	The nurse uses a bar-code scanner to prevent medication administration errors.	
d.	The nurse teaches the patient’s family how to perform range of motion.	
e.	The nurse checks the electronic record to review the patient’s medical history.	

ANS:	B, C, E
Informatics is the use of technology such as electronic medical records, online databases for research and bar-code scanning to prevent medication errors. Informatics does not apply to patient teaching through written materials or demonstration of range of motion.

DIF:	Cognitive Level: Apply (Application)		
OBJ:	Discuss the influence of social, political, and economic changes on nursing practices.
TOP:	Nursing Process: Implementation	MSC:	NCLEX: Management of Care

	4.	Which action of the nurse demonstrates patient-centered care? (Select all that apply.)
a.	The nurse elevates the head of the bed when the patient becomes short of breath.	
b.	The nurse and patient work together to determine the patient’s health goals.	
c.	The nurse checks the patient’s name and birthdate before giving medications.	
d.	The nurse maintains privacy when conversing with the patient and providing care.	
e.	The nurse respects the patient’s choice to refuse transfusion of blood products.	

ANS:	B, D, E
Patient-centered care is demonstrated by maintaining privacy, respecting the patient’s choices and working together to determine the patient’s health goals. Checking the patient’s identifiers and elevating the head of the bed are routine nursing interventions that do not demonstrate patient-centered care.

DIF:	Cognitive Level: Apply (Application)		
OBJ:	Discuss the characteristics of professionalism in nursing.	
TOP:	Nursing Process: Implementation	MSC:	NCLEX: Management of Care