Advanced Practice Nursing : Essentials for Role Development 4th Edition Joel Test Bank

Advanced Practice Nursing : Essentials for Role Development 4th Edition Joel Test Bank Chapter 1 . Advanced Practice Nursing: Doing What Has to Be Done-Radicals, Renegades, andRebels MULTIPLE CHOICE 1. The ...

Advanced Practice Nursing : Essentials for Role Development 4th Edition Joel Test Bank Chapter 1 . Advanced Practice Nursing: Doing What Has to Be Done-Radicals, Renegades, andRebels MULTIPLE CHOICE 1. The nurse manager of a pediatric clinic could confirm that the new nurse recognized the purposeof the HEADSS Adolescent Risk Profile when the new nurse responds that it is used to assess for needs related to a. anticipatory guidance. b. low-risk adolescents. c. physical development. d. sexual development. ANS: A The HEADSS Adolescent Risk Profile is a psychosocial assessment screening tool which assesseshome, education, activities, drugs, sex, and suicide for the purpose of identifying high-risk adolescents and the need for anticipatory guidance. It is used to identify high-risk, not low-risk, adolescents. Physical development is assessed with anthropometric data. Sexual development is assessed using physical examination. REF: 6 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance 2. The nurse preparing a teaching plan for a preschooler knows that, according to Piaget, theexpected stage of development for a preschooler is a. concrete operational. b. formal operational. c. preoperational. d. sensorimotor. ANS: C The expected stage of development for a preschooler (3 to 4 years old) is preoperational. Concreteoperational describes the thinking of a school-age child (7 to 11 years old). Formal operational describes the thinking of an individual after about 11 years of age. Sensorimotor describes theearliest pattern of thinking from birth to 2 years old. REF: 5 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance 3. The school nurse talking with a high school class about the difference between growth anddevelopment would best describe growth as a. processes by which early cells specialize. b. psychosocial and cognitive changes. c. qualitative changes associated with aging. d. quantitative changes in size or weight. ANS: D Growth is a quantitative change in which an increase in cell number and size results in an increasein overall size or weight of the body or any of its parts. The processes by which early cells specialize are referred to asdifferentiation. Psychosocial and cognitive changes are referred to as development. Qualitative changes associated with aging are referred to as maturation. REF: 2 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance 4. The most appropriate response of the nurse when a mother asks what the Denver II does is that it a. can diagnose developmental disabilities. b. identifies a need for physical therapy. c. is a developmental screening tool. d. provides a framework for health teaching. ANS: C The Denver II is the most commonly used measure of developmental status used by health care professionals; it is a screening tool. Screening tools do not provide a diagnosis. Diagnosis requires athorough neurodevelopment history and physical examination. Developmental delay, which is suggested by screening, is a symptom, not a diagnosis. The need for any therapy would be identified with a comprehensive evaluation, not a screening tool. Some providers use the Denver II as a framework for teaching about expected development, but this is not the primary purpose of the tool. REF: 4 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance 5. To plan early intervention and care for an infant with Down syndrome, the nurse considersknowledge of other physical development exemplars such as a. cerebral palsy. b. failure to thrive. c. fetal alcohol syndrome. d. hydrocephaly. ANS: D Hydrocephaly is also a physical development exemplar. Cerebral palsy is an exemplar of adaptive developmental delay. Failure to thrive is an exemplar of social/emotional developmental delay. Fetal alcohol syndrome is an exemplar of cognitive developmental delay. REF: 9 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance 6. To plan early intervention and care for a child with a developmental delay, the nurse would consider knowledge of the concepts most significantly impacted by development, including a. culture. b. environment. c. functional status. d. nutrition. ANS: C Function is one of the concepts most significantly impacted by development. Others include sensory-perceptual, cognition, mobility, reproduction, and sexuality. Knowledge of these concepts can help the nurse anticipate areas that need to be addressed. Culture is a concept that is considered to significantly affect development; the difference is the concepts that affect development are those that represent major influencing factors (causes), hence determination of development and would bethe focus of preventive interventions. Environment is considered to significantly affect development. Nutrition is considered to significantly affect development. REF: 1 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance 7. A mother complains to the nurse at the pediatric clinic that her 4-year-old child always talks toher toys and makes up stories. The mother wants her child to have a psychologic evaluation. Thenurses best initial response is to a. refer the child to a psychologist. b. explain that playing make believe with dolls and people is normal at this age. c. complete a developmental screening. d. separate the child from the mother to get more information. ANS: B By the end of the fourth year, it is expected that a child will engage in fantasy, so this is normal at this age. A referral to a psychologist would be premature based only on the complaint of the mother. Completing a developmental screening would be very appropriate but not the initial response. The nurse would certainly want to get more information, but separating the child from themother is not necessary at this time. REF: 5 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance 8. A 17-year-old girl is hospitalized for appendicitis, and her mother asks the nurse why she is soneedy and acting like a child. The best response of the nurse is that in the hospital, adolescents a. have separation anxiety. b. rebel against rules. c. regress because of stress. d. want to know everything. ANS: C Regression to an earlier stage of development is a common response to stress. Separation anxiety is most common in infants and toddlers. Rebellion against hospital rules is usually not an issue if the adolescent understands the rules and would not create childlike behaviors. An adolescent may wantto know everything with their logical thinking and deductive reasoning, but that would not explain why they would act like a child. Chapter 2. Emerging Roles of the Advanced Practice Nurse Test Bank Multiple Choice 1. An APRN is about to examine a patient in the emergency department. A colleague states to the APRN “This patient is probably just seeking pain medication.” Regardless of his or her colleague’s comment he or she enter the examination room and treat the patient as if he or sheis trustworthy and has good motives. Which of the ten essential elements of dignity is the APRN utilizing? a. Inclusion b. Benefit of the doubt c. Acceptance of identity d. Recognition ANS: B Treating others as if they are trustworthy, starting with the premise that they have good motives and are acting with integrity are all key points of benefit of the doubt. Benefit of the doubt is one of the ten essential elements of dignity. 2. An APRN approaches his or her patients as neither inferior nor superior and gives others the freedom to express their authentic selves without being judged. Which of the ten essential elements of dignity is the APRN utilizing? a. Safety b. Accountability c. Acceptance of identity d. Benefit of doubt ANS: C The acceptance of identity is one of the ten essential elements of dignity. Approaching people as neither inferior nor superior to you, giving others the freedom to express their authentic selves without fear of being negatively judged, interacting without prejudice or bias, accepting how race,religion, gender, class, sexual orientation, age, disability, and so on are at the core of someone’s identities, and assuming they have integrity are all included in the essential elements of acceptanceof identity. 3. Communication problems often plague ethical dilemmas, which ofthe following is often at theforefront of communication problems regarding clinicians? a. Poor knowledge of the situation b. Language barriers c. Poor independence d. Failure to speak up ANS: D All of the answers may contribute to ethical dilemmas but failure of a clinician to speak up abouta real or potential ethical problem is commonly identified. Erosion of open and honest communication is typically the first theme encountered in many ethical dilemmas. 4. A 76-year-old patient is admitted to the hospital after suffering a spinal compression fracture.The patient is unable to ambulate adequately on his or her own and requires assistance for basicneeds. Your assessment is that the patient will recover their strength within 2 weeks. The billingdepartment at the facility notifies you that the patient may not stay in the hospital for more than2 days. The patient does not wish to be transferred to a nursing facility and wishes to remain inthe hospital for the remaining 12 days to gain strength. Which of the following best defines this scenario? a. Interprofessional conflict b. Communication problems c. Legal issues d. Multiple commitments ANS: A This ethical scenario plays out routinely in medical care as an element of interprofessional conflict.The clinician wishes to respect patient autonomy but must understand and expressthe best interestsofthe patient to a multidisciplinary team. 5. An APRN is scheduled to complete his or her shift at 7 p.m. on a particular day. A new patientarrives 5 minutes prior to the time the APRN is expected to leave. He or she is asked by a supervisor to stay beyond their scheduled time to assess the patient and provide care. Which of the following best defines this scenario? a. Interprofessional conflict b. Multiple commitments c. Communication problems d. Legal issuesANS: B APRNs often fail to practice self-care and it is a significant threat to ethical practice. Multiple commitments including obligations to multiple parties involving the patient, employer, and legal system may create a scenario for ethical issues in nursing practice. Societal issues including cost containment pressures in health systems are likely partially responsible for development of this scenario. 6. An APRN works in a primary care clinic. The APRN wishes to treat a patient’s disease with aspecific medication that is far superior to other treatments. The APRN has never encountered issues prescribing this therapy as first-line treatment in the past. The APRN is informed by this particular patient’s insurance that they require proof that the APRN has tried a far less effective therapy for 1 month prior to paying for the medication. Which of the following best describesthe forces at work in this scenario? a. Communication problems b. Legal issues c. Interprofessional conflict d. Societal issues ANS: D Societal issues including cost containment pressures in health systems are likely responsible for development of this scenario. Interprofessional conflicts would best be involved in this scenario if this is applied in a multidisciplinary team scenario. 7. Which of the following are defined as the four elements of core competency development in ethical decision making for APRNs? a. Knowledge development, knowledge application, creating an ethical environment,promoting social justice b. Knowledge development, educating others, creating an ethical environment, promotingsocial justice c. Knowledge development, knowledge application, effective communication, promotingsocial justice d. Knowledge development, knowledge application, creating an ethical environment,understanding legal barriers ANS: A The core competency of ethical decision making for APRNs is best organized into four key elements: knowledge development, knowledge application, creating an ethical environment, and promoting social justice. 8. Which of the following examples best describes the knowledge development element of core competency development for ethical decision making? a. Analyzing the policymaking process b. Using self-reflection during patient case reviews c. Applying ethical decision-making model to a clinical problem d. Mentoring others to develop ethical practice ANS: B The use of knowledge development is a key element of core competency development for ethicaldecision making. It involves gaining knowledge of ethical theories and developing the ability to distinguish a true ethical dilemma from a situation of moral distress or other clinically problematic situation. Becoming sensitive to ethical dimensions of clinical practice and fidelity conflicts, developing values clarification (self-reflection), and interpreting reactions and emotions of others are all elements of knowledge development and moral sensitivity. 9. An APRN joins a group promoting awareness about abuse in long-term nursing care facilities.He or she advocates for policies that protect the health care rights of individuals who are not able to care for themselves independently. The APRN most likely employed which of the following elements of core competency development for ethical decision making? a. Promoting social justice b. Knowledge development c. Creating an ethical environment d. Knowledge application ANS: A Skills or behaviors for promoting social justice within a health care system include the ability to analyze the policy process and advocacy, communication, and leadership skills that promote involvement in health policy initiatives supporting social justice. 10. An APRN interacts with a patient and another colleague to achieve the best outcome ofan ethical dilemma. The APRN most likely used which of the following elements of core competency development for ethical decision making? a. Knowledge application b. Creating an ethical environment c. Promoting social justice d. Knowledge development ANS: A Applying ethical decision-making models to clinical problems, using skilled communication regarding ethical issues, and facilitating decision making by using select strategies are involved inthe use of knowledge application. 11. An APRN works at a hospital system that provides care to a large proportion of Asian- American citizens. The APRN develops a presentation for newly hired employees about the cultural belief systems held by many in this population group. This describes the use of whichof the following elements of core competency development for ethical decision making? a. Creating an ethical environment b. Promoting social justice c. Knowledge application d. Knowledge development ANS: A Creating an ethical environment may include the use of preventative ethics and awareness of environmental barriers to ethical practice. 12. Application of existing rules and doctrine as a guide for ethical decision making is bestdescribed as which ethical approach? a. Narrative ethics b. Care-based ethics c. Casuistry d. Principle-based ethics e. Virtue-based ethics ANS: D In principle-based ethical decision making, the principles or rules in contention are balanced and interpreted with the contextual elements of the situation. However, the final decision and moral justification for actions are based on principles. 13. Which ethical approach uses comparisons of precedent-setting cases and current scenarios? a. Principle-based ethics b. Casuistry c. Care-based ethics d. Narrative ethics e. Virtue-based ethics ANS: B Casuistry is an ethical approach which uses comparisons of precedent-setting cases and current scenarios. 14. Which approach emphasizes the particulars of a case or story as a vehicle for discerning themeaning and values embedded in the ethical decision making?