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Test Bank for Medical Surgical Nursing Clinical Reasoning in Patient Care 6th Edition by LeMone

LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank Chapter 1

Question 1 Type: MCSA

The nurse is instructing a patient on the role of diet, exercise, and medication to control type 2 diabetes mellitus. Which core competency for healthcare professionals is the nurse implementing?

Quality improvement

Evidence-based practice

Patient-centered care

Teamwork and collaboration

Correct Answer: 3

Rationale 1: Identifying safety hazards and measuring quality is an example of the core competency quality improvement.

Rationale 2: Using best research when providing patient care is an example of the core competency evidence- based practice.

Rationale 3: The nurse instructing the patient is an example of the competency patient-centered care.

Rationale 4: The core competency teamwork and collaboration involves collaboration between disciplines to provide continuous and reliable care.

Global Rationale: In 2003, the National Academy of Sciences proposed a set of five core competencies that all healthcare professionals should possess to meet the needs of the 21st century. The nurse instructing the patient is an example of the competency patient-centered care. Identifying safety hazards and measuring quality are examples of the core competency quality improvement. Using best research when providing patient care is an example of the core competency evidence-based practice. Collaboration between disciplines to provide continuous and reliable care is an example of the core competency teamwork and collaboration.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient centered care
AACN Essential Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care
NLN Competencies: Relationship Centered Care: Learn cooperatively, facilitate the learning of others
Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 1. Describe the core competencies for healthcare professionals: patient-centered care, interprofessional teams, evidence-based practice, quality improvement, safety, and health information technology. MNL Learning Outcome: 10.5.4. Utilize the nursing process in care of client.
Page Number: 4

Question 2 Type: MCSA

The nurse is planning to utilize the core competency use informatics when providing patient care. Which action should the nurse perform when using this core competency?

Change the sharps container in a patient’s room.

Document the effectiveness of pain medication for a patient.

Discuss the effectiveness of bedside physical therapy with the therapist.

Search through a database of articles to find current research on wound care.

Correct Answer: 4

Rationale 1: Changing the sharps container is an example of quality improvement.

Rationale 2: Documenting the effectiveness of pain medication for a patient is an example of patient-centered care.

Rationale 3: Discussing the effectiveness of bedside physical therapy with the therapist is an example of
teamwork and collaboration.

Rationale 4: Searching through a database of articles to find current research on wound care is an example of use informatics.

Global Rationale: Examples of the nurse using the core competency use informatics include the use of technology to communicate, manage knowledge, reduce errors, and support decision making. The activity of searching through a database of articles to find current research on wound care is an example of use informatics. Changing the sharps container in a patient’s room is an example of quality improvement. Documenting the effectiveness of pain medication for a patient is an example of patient-centered care. Discussing the effectiveness of bedside physical therapy with the therapist is an example of teamwork and collaboration.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
QSEN Competencies: VI.B.2. Apply technology and information management tools to support safe processes of care
AACN Essentials Competencies: IV.1. Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice

NLN Competencies: Knowledge and Science: Electronic databases; literature retrieval; evaluating data for validity and reliability; evidence and best practices for nursing
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1. Describe the core competencies for healthcare professionals: patient-centered care, interprofessional teams, evidence-based practice, quality improvement, safety, and health information technology.
MNL Learning Outcome: 4.3.3. Examine the treatments used for pressure ulcers.
Page Number: 4

Question 3 Type: MCMA

The nurse plans to implement evidence-based practice when providing patient care. Which activities should the nurse perform?

Standard Text: Select all that apply.

Participate in education and research activities when possible.

Integrate research findings with clinical care to maximize patient outcomes.

Serve on the committee to create critical pathways for patient care.

Reinforce hand hygiene techniques with unlicensed assistive personnel.

Contact Environmental Services to report a malfunctioning infusion pump.

Correct Answer: 1, 2

Rationale 1: Participating in education and research activities when possible is an example of implementing
evidence-based practice in the provision of patient care.

Rationale 2: Integrating research findings with clinical care to maximize patient outcomes is an example of implementing evidence-based practice in the provision of patient care.

Rationale 3: Serving on the committee to create critical pathways for patient care is an example of teamwork and collaboration.

Rationale 4: Reinforcing hand hygiene techniques with unlicensed assistive personnel is an example of quality improvement.

Rationale 5: Contacting Environmental Services to report a malfunctioning infusion pump is an example of
quality improvement.

Global Rationale: Participating in education and research activities when possible is an example of implementing evidence-based practice in the provision of patient care. Integrating research findings with clinical care to maximize patient outcomes is an example of implementing evidence-based practice in the provision of patient

care. Serving on the committee to create critical pathways for patient care is an example of teamwork and collaboration. Reinforcing hand hygiene techniques with unlicensed assistive personnel is an example of quality improvement. Contacting Environmental Services to report a malfunctioning infusion pump is an example of quality improvement.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
QSEN Competencies: III.B.6. Participate in structuring the work environment to facilitate integration of new evidence into standards of practice
AACN Essentials Competencies: III.2. Demonstrate an understanding of the basic elements of the research process and models for applying evidence to clinical practice
NLN Competencies: Knowledge and Science; Defining what is evidence-based practice
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1. Describe the core competencies for healthcare professionals: patient-centered care, interprofessional teams, evidence-based practice, quality improvement, safety, and health information technology. MNL Learning Outcome:
Page Number: 4

Question 4 Type: MCSA

The community health nurse is planning to meet with several community members during a health fair. Which nursing activity exemplifies the core competency patient-centered care?

Provide smoking cessation classes and literature.

Increase the hours for the physician to see patients.

Attend a continuing education program on clean water initiatives.

Evaluate the effectiveness of weight reduction strategies.

Correct Answer: 1

Rationale 1: Providing smoking cessation classes and literature is an example of an activity to provide patient- centered care.

Rationale 2: Increasing the hours for the physician to see patients is an activity to support the competency
teamwork and collaboration.

Rationale 3: Attending a continuing education program on clean water initiatives is an activity to support the competency evidence-based practice.

Rationale 4: Evaluating the effectiveness of weight reduction strategies is an activity to support the competency
quality improvement.

Global Rationale: Activities to exemplify the core competency patient-centered care should be focused on disease prevention, wellness, and promotion of healthy lifestyles. Providing smoking cessation classes and literature is an example of patient-centered care. Increasing the hours for the physician to see patients is an activity to support the competency teamwork and collaboration. Attending a continuing education program on clean water initiatives is an activity to support the competency evidence-based practice. Evaluating the effectiveness of weight reduction strategies is an activity to support the competency quality improvement.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience
AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings
NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1. Describe the core competencies for healthcare professionals: patient-centered care, interprofessional teams, evidence-based practice, quality improvement, safety, and health information technology.
MNL Learning Outcome: 5.9.4. Utilize the nursing process in care of client.
Page Number: 4

Question 5 Type: MCSA

The nurse is instructing a patient on weight reduction and smoking cessation. Which code of nursing practice is the nurse implementing?

International Council of Nurses Code of Ethics for Nurses

American Nurses Association Standards of Professional Practice

American Nurses Association Code of Ethics for Nurses

State Board of Nursing Code

Correct Answer: 1

Rationale 1: The International Council of Nurses (ICN) Code of Ethics for Nurses specifies what nurses are accountable for in terms of people, practice, society, coworkers, and the profession. The philosophical basis for this code is that nurses are responsible for promoting health, preventing illness, and alleviating suffering.
Instructing a patient on weight reduction and smoking cessation exemplifies the ICN Code of Ethics for Nurses.

Rationale 2: The American Nurses Association Standards of Professional Practice are standards, not a code, and focus on specific behaviors to address quality practice, practice evaluation, education, collegiality, collaboration, ethics, research, resource utilization, and leadership.

Rationale 3: The American Nurses Association Code of Ethics for Nurses has nine statements that address the nurse’s professional relationships, commitment to patients, patient rights, nursing practice, competency, conditions of employment, and contributions to the science of nursing, collaboration, and nursing values.

Rationale 4: The state boards of nursing do not publish codes for nursing.

Global Rationale: The International Council of Nurses (ICN) Code of Ethics for Nurses specifies what nurses are accountable for in terms of people, practice, society, coworkers, and the profession. The philosophical basis for this code is that nurses are responsible for promoting health, preventing illness, and alleviating suffering.
Instructing a patient on weight reduction and smoking cessation exemplifies the ICN Code of Ethics for Nurses. The American Nurses Association Standards of Professional Practice are standards, not a code, and focus on specific behaviors to address quality practice, practice evaluation, education, collegiality, collaboration, ethics, research, resource utilization, and leadership. The American Nurses Association Code of Ethics for Nurses has nine statements that address the nurse’s professional relationships, commitment to patients, patient rights, nursing practice, competency, conditions of employment, and contributions to the science of nursing, collaboration, and nursing values. The state boards of nursing do not publish codes for nursing.

Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient centered care
AACN Essentials Competencies: VII.4. Use behavioral change techniques to promote health and manage illness NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 4. Explain the importance of nursing and interprofessional codes of ethics and standards of practice as guidelines for clinical nursing practice.
MNL Learning Outcome: 5.9.4. Utilize the nursing process in care of client.
Page Number: 9

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