Study guide for Kozier & Erb’s Fundamentals of nursing : concepts, process, and practice, tenth edition Berman
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PREFACE Studentsenteringthefieldofnursinghaveatremendousamounttolearninaveryshorttime. Thisconcisestudyguidehasbeendevelopedtohelpyoulearnandapplykeyconceptsand procedures,andmastercriticalthinkingskillsbasedonKozier&Erb’sFundamentalsof Nursing,TenthEdition.
Onthenursingpearsonhighered.comwebsiteyouwillfindavarietyofactivitiessuchasCase StudiesandApplicationActivitiesthathelpyouapplyconceptstoclinicalscenarios.
Inaddition,eachchapterofthisstudyguideincludesavarietyofquestionsandactivitiesto helpyoucomprehenddifficultconceptsandreinforcebasicknowledgegainedfromtextbook readingassignments.Thefollowingisalistoffeaturesincludedinthiseditionthatwillenhance yourlearningexperience:
0 KeyTermReviewhelpyoureviewtheimportanttermsineachchapter.
0 KeyTopicReviewexercisescontainmatching,fill—in-the—blank,andtrue/falsequestions onkeytermsandkeytopicsfromeachchapter.
0 FocusedStudyTipshelpyourecalltheimportantnursingconceptsfromeachchapter.
0 CaseStudiesprovideclinicalsettingsforcriticalthinkingandtheopportunitytoapply learnedprocessesandprocedures.
0 ReviewQuestionsareNCLEX®—stylequestionstohelpyoupreparefortheNCLEX®.
0 Answerswithcompleterationalesareincludedintheanswerkeytoprovideimmediate reinforcementandtopermityoutochecktheaccuracyofyourwork.
Itisourhopethatthisstudyguidewillserveasavaluablelearningtoolandwillcontributeto yoursuccessinthenursingprofession.
CHAPTER1 HISTORICALANDCONTEMPORARY NURSINGPRACTICE KEYTERMREVIEW Degreeofwellnessorwell—beingthattheclient experiences
Rolethenurseassumestohelpclientslearn abouttheirhealthandthehealthcare procedurestheyneedtoperformtorestoreor maintaintheirhealth.
‘.Processofhelpingaclienttorecognizeand copewithstressfulpsychologicalorsocial problems;topromotepersonalgrowth Processbywhichpeoplelearntobecome membersofgroupsandsocieties
.Influencesotherstoworktogetherto accomplishaspecificgoal
Anoccupationthatrequiresextensiveeducation
g.Recipientofnursingcare
.Arolethattraditionallyincludedthoseactivities thatassisttheclientphysically
'. Nursingroleofpleadingthecauseofaclient
'.Nursewhoworkswiththemultidisciplinary healthcareteamtomeasuretheeffectivenessof thecasemanagementplanandtomonitor outcomes.
Arolethatrequiresknowledgeabout organizationalstructure,leadership,advocacy, delegation,supervision,andevaluation
Anindividualwhoisskilledatcommunication andconveyingconcepts
m.Anindividual,agroupofpeople,ora communitythatusesaserviceorcommodity
Referstoformalizedexperiencesdesignedto enhancetheknowledgeorskillsofpracticing professionals
Thestudyofpopulation,includingstatistics aboutdistributionbyageandplaceofresidence, mortality(death),andmorbidity(incidenceof disease)
Alsoknownasthe“LadywiththeLamp”;work duringCrimeanWarestablishedhospitaland procedurereform
Theestablishmentandmaintenanceofsocial, political,andeconomicarrangementsbywhich practitionerscontroltheirpractice,theirselfdiscipline,theirworkingconditions,andtheir professionalaffairs
Requiresthateverycompetentadultbe informedinwritingonadmissiontoahealth careinstitutionabouthisorherrightstoaccept orrefusemedicalcareandtouseadvance directives
KEYTOPICREVIEW Describebehaviorsexpectedintheprofessional nursingrole
AspecifictypeofCEprogramofferedbyan employerthatisdesignedtoupgradethe knowledgeorskillsofemployees,aswellasto validatecontinuingcompetenceinselected proceduresandareasofpractice
Referstoprofessionalcharacter,spirit,or methods;asetofattributes,awayoflifethat impliesresponsibilityandcommitment
'.Providedcareandsafetytoslavesfleeingtothe NorthduringtheCivilWarontheUnderground Railroad
Useofmedicalinformationexchangedfrom onesitetoanotherviaelectroniccommunicationstoimprovethepatient’shealthstatus
Theuseoftelecommunicationsandinformation technologytoprovidenursingpracticeata distance
Describetheresponsibilitiesforwhichnurses areaccountable
1.Thefourfunctionsidentifiedwithinthescopeofnursingpracticeare:
a.
b.
c.
d.
2. Theroleofreligiousordersinthedevelopmentofnursingincludes:
a.
b.
c.
d.
e.
3.Thecontemporarynursingleaderwhodefinednursingis:
a.
b.
c. d. instillingthevaluesofhardwork. influencingtheimageofnursing. identifyinganincreasedneedfornurses. imprintingtheprofessionasinvolvinghardwork. improvingthestatusofnursing. ClaraBarton. FlorenceNightingale. LindaRichards. VirginiaHenderson.
4.Anurseregisteredtopracticeinonestateisrelocatingtoanotherneighboringstate.Whatshouldthisnursedo toensuretheabilitytoworkasanurseinthenewstate?
a.Nothing.Thenurseisregisteredasanurse.
b.Contactthestate’sdepartmentofnursing.
c.Enrollinaschoolofnursinginthenewstate.
(1.Filethepaperworktotakethenewstate’snursinglicensingexamination.
5.Fromthefollowinglist,selectthedefinitionthatbestdefinestheseterms:
a.Caregiver fHelpstheclientmodifybehaviors.
b.Communicator Thiscanbeprovidedbythenurseordelegatedtosomeoneelse.
0.Teacher Supervisesandevaluatesperformance.
d.Clientadvocate #__Usestheoutcomesofscientificstudytoimprovethedeliveryofcare.
e.Counselor Actstoprotecttheclient.
f. Changeagent Influencesotherstoworktogethertoreachacommongoal.
g.Leader Doneverballyorwritten.
h.Manager Careisorientedtotheclientandcontrolscosts.
i. Casemanager Helpspromotepersonalgrowth.
j. Researchconsumer iAAssessesreadinesstolearn.
6.Thetermsusedtoidentifytherecipientsofnursingare:
a.
b.
c.
7.Ofthefollowingnursingroles,selecttheonesthatprovidemoreautonomywithinthepracticeofnursing.
a.Nurseanesthetist
b.Staffnurseonanorthopedicunit
0.Operatingroomnurse
d.Clinicalnursespecialist
e.Nurseinaphysician’soffice
8.Theprocessanurseundergoesinanefforttobeviewedasanintegralmemberofthedisciplineofnursingis termed
9.AnurseisinterestedinparticipatingwiththeAmericanNursesAssociation.Participatingwiththis organizationisanexampleof:
a.autonomy.
b.governance.
0.extendededucation. (1.service.
Thepurposeofnursingstudentsworkingtogetheronprojectsisto: a.begintheprocessofsocializationintotheprofession.
b.getmoreworkdonefaster.
c.helpeachotherthroughdifficultcourses. (1.makenewfriends.
ThepaymentsforhospitalservicesimplementedbyMedicarearetermed (DRGs). Anursewhoprovidescaretoaclientoverthetelephonewillneedto:
a.obtainlicensureintheclient’sstateofresidence.
b,takeacourseintelenursing.
c.findoutiftheclient’sstateisoneofmutualrecognitionforlicensure.
d.donothing.
ThePatientSelf-DeterminationActrequiresthateveryclientbeprovidedwith and a,programsaretheresponsibilityofallnursestomaintainconstantprofessionalupdating andgrowth.
FOCUSEDSTUDYTIPS 1.Whyisitimportanttoreviewthehistoryofnursingasoneofthefirststepsintheeducationofanewnurse? Whatvaluedoesunderstandingthehistoryofnursingprovidetothecontemporarynursingstudent?
Whatarethecharacteristicsofaprofession?Howdoesnursingaddresseachofthesecharacteristics?
WhatareBenner’sfivestagesofnursingpractice?Inwhichstageisanurseconsideredproficient?Why?
Howhaveeconomics,consumerdemands,andthefamilystructureimpactedtheprofessionofnursing?
Anursewhohasbeenintheprofessionforover25yearsdoesnotknowhowtooperateacomputer.What suggestionsdoyouhavetohelpthisnurse?Whyshouldthisnursebeconcernedwiththeinabilitytoutilize currenttechnology?
Identifythereasonsforthecurrentnursingshortage.Howwillthisaffectthefutureeducationofnewnurses enteringtheprofession?
Thenursesinahospitalarecontactingalaborunion.Whydoyouthinkthenursesarecontactingthisunion? Whatbenefitswillbegainedbyworkingwithaunion?Whatdisadvantagesareassociatedwithnurses workingwithaunion?
.WhatdoSigmaThetaTauandtheAssociationofCollegesofNursing(ACN)representinnursing?Whatare thedifferencesbetweenthetwoorganizationsandwhatarethesimilarities?Whichorganizationoffers continuingunitsfornurses?ComparetheseorganizationswithotherssuchastheAmericanNursing Association(ANA)andtheAmericanAcademyofCollegesinNursing(AACN).
Whyisitimportantfornursestopracticeunderalicense?Whyisastandardizedlicensingexamappropriate forallnurses?
CASESTUDY Aclientwithadult-onsetasthmaisattemptingtoquithistwo-pack-per-daytobaccohabit.Thenurse,whohasbeen practicingfor4years,isassistingtheclientwithsupportivemeasurestoimprovehishealthstatus.Thenurseis discussingtheplanofcarewiththephysician.
1.Whatroleisthenurseactinginbyrepresentingtheclient’sneedsandwishesandassistingtheclientin behaviormodificationplans?
2.Thenurseisintheprocessofassistingtheclienttorecognizeandcopewithboththeasthmaconditionandthe tobaccocessationprogram.Thenurseisactingasachangeagent,andwhatotherroleisthenurserepresenting?
3.AccordingtoBenner’sstagesofnursingexpertise,inwhatstageisthenursefunctioning?
REVIEWQUESTIONS 1.Afemaleisconsideringacareerasanursebecauseoftheaspectsofcaringandnurturing.Thisindividualis usingwhichfactorofnursingtobaseherdecision?
1.Women’sroles
2.Religion
3.War
4.Economics
2.Aregisterednurseisconsideringadditionaleducationsothatshecanprovidenonemergentacutecareinan ambulatoryclinic.Thisnurseisconsideringwhichexpandedcareerrole?
1.Nurseanesthetist
2.Clinicalnursespecialist
3.Nursepractitioner
4.Nurseadministrator
3.Anurseisabletoprovidecaretoseveralcomplexclientsandfocusesonthoseitemsthatarethemost important.WithinwhichstageofBenner’sstagesofnursingexpertiseisthisnursefunctioning?
1.StageII
2.StageIII
3.StageIV
4.Stac
4.Theorganizationrecentlyaddedanewwingtothehospital.Whatfactorislikelytobeinfluencingthis organizationrelatedtothenursingshortagetheyareexperiencing?
1.Agingworkforce
2.Agingpopulation
3.Increaseddemandfornurses
4.Workplaceissues
5.Whichofthefollowingactionsperformedbyanorganizationwouldbestimprovetheimageofnursing?
l.Offeringscholarshipstohighschoolstudentstoattendnursingschool
2.Televisioncommercialsshowingnursesanddoctorsprovidingcaretogether
3.Aprintadvertisementwiththestatement“Nursing~Thehardestjobyou’lleverlove”
4.AnANA-sponsoredradiocommercialexplainingtheroleofnursesinsocietytoday
6.Thenurse,whoisworkinginawell-babyclinic,administersroutineimmunizationsandrecognizesthisas practicingwithinwhatareaofnursingpractice?
1.Promotinghealthandwellness
2.Preventingillness
3.Restoringhealth
4.Providingcaretothedying
7.Whileattendingacontinuingeducationseminar,severalnursesfromdifferentstatesarediscussingtheirindi— vidualstaterequirementsfornursinglicensure.Whichofthefollowingistheonecommonthreadbetweenall ofthestates’departmentsofnursing?
1.Protectthepublic.
2.Furthernursingeducation.
3.Obtaincontinuingeducationcontacthours.
4.Gainspecialization.
8.Anewnursingstudentisdisappointedbecauseclassessofararefocusedontopicssuchascommunicationand planning,andshewantedtobeanurseto“providecare.”Thisnursingstudentisdescribingwhichroleofthe nurse?
1.Teacher
2.Clientadvocate
3.Caregiver
4.Counselor
9. Thestudentnurseislearninghowtofitintothenursingprofessionbylearningtherulesdefiningrelationships, thebehaviorexpectedofanurse,andtoseetheworldinamannersimilartoothernurses.Thisisknownas:
1.casemanagement.
2.professionalization.
3.socialization.
4.governance.
10.ThenursemovestoanewareaofthecountryandlearnsthenewareahasmanypeopleofSouthAfrican descent,ahigherincidenceofhypertension,andpeoplewhoseaverageageis37.Thisinformationwouldbe considered:
1.news.
2.healthstatistics.
3.atargetedareaofstudy.
4.demography.
CHAPTER2 EVIDENCE-BASEDPRACTICEAND RESEARCHINNURSING KEYTERMREVIEW
MatcheachtermWithitsappropriatedefinition.
1. Comparativeanalysis
a.Abehavior,characteristic,oroutcomethatthe researcherwishestoexplainorpredict
Detailedinstructions
Completenessandconceptualaccuracyof measures
Thoroughcritiqueofastudyforitsconceptual andmethodologicalintegrity
Resultsthatarenotlikelytohaveoccurredonly bychance
Apredictivestatementabouttherelationship betweentwoormorevariables
Thepresumedcauseoforinfluenceonthe behaviorwishedtobeexplained
‘Referstotheconsistencyofmeasures
'.Involvesassessingstudyfindingsfortheir implementationpotential
‘.Groupofindividualsinwhichinformationis desired
Thelogisticsormechanicsofastudy
Usingresearchfindingsandothersourcesof evidencetoguidedecisionsaboutclientcare
Dataanalysisthatinvolvessearchingforthemes andpatterns
KEYTOPICREVIEW Proceduresthatorganizeandsummarizelarge volumesofdata,includingmeasuresofcentral tendencyandmeasuresofvariability
Involvestestinghypothesesaboutrelationships betweenvariablesordifferencesbetweengroups
.Philosophicalperspectiveofquantitative researchthatmaintainsthe“truth”isabsolute andcanbediscoveredbycarefulmeasurement
.Statisticalprocedurethatprovidesasingle numericalvaluethatdenotesthe“average”value foravariable
Statisticalprocedurethatdescribeshowvalues foravariablearedispersedorspreadout
A“dressrehearsal”beforeanactualstudybegins
Thesystematiccollectionandthematicanalysis ofnarrativedata
Thesystematiccollection,statisticalanalysis, andinterpretationofnumericaldata
Sourceofinformationforastudy;maybe humans,events,behaviors,documents,or biologicalspecimens
Maintainsthatrealityisrelativeorcontextual andconstructedbyindividualswhoare experiencingaphenomenon
l. isclinicaldecisionmakingbasedonthesimultaneoususeofthebestevidence,clinical expertise,andpatients’values.
2.Thefourrightsofhumansubjectsthatnursesmustsafeguardare:
3.Theterm meansthatanyinformationaclientrelateswillnotbemadepublicoravailableto otherswithoutthepatient’sconsent.
4.Whatisthedefinitionofresearch?
5.Accordingtothe“StandardsofClinicalNursing”publishedbytheANA(1998),isincludedasoneofthe standardsofprofessionalperformance.
.Selectandmarkeither(1)forquantitativeresearchor(2)forqualitativeresearchforthefollowingitemswith regardtoresearch:
a. Associatedwithnaturalisticinquirythatexploressubjectiveandcomplexexperiencesof humanbeings
b. Datacollectionandanalysisoccurconcurrently
c. Asystematic,logicalsequencebasedonaspecificplandesignedtocollectinformationin controlledconditions;analyzedusingstatisticalprocedures
d. Theoryorframeworkisdevelopedafterthedataareanalyzedtoidentifypatternsand/or themes
6. Viewedas“hardscience”
Changeinpracticerequires:(Selectallthatapply.)
a.assessingtheneedforchange.
b.locatingandanalyzingthebestevidence.
0.providingnurseswithinformationessentialtonursingpractice.
d.integratingandmaintainingthechange.
e.implementingandevaluatingthepracticechange.
Correctlyidentifytheorderofthestepsinconductingquantitativeresearch. a.Reviewtherelatedliterature.
b.Communicateconclusionsandimplications.
c.Definethestudy’spurposeorrationale.
d.Conductapilotstudy. Analyzethedata. Formulatehypothesesanddefinevariables. Collectthedata.
arrows»
Selectthepopulation,sample,andsetting. Statearesearchquestionorproblem. )—I.
j. Selectaresearchdesigntotestthehypothesis.
.Fromthefollowinglist,selectthedefinitionthatbestdefinestheelementsofanidealstudy.
a.Researchproblem
b.Reviewofliterature
Protectionofhumanrights,standardsofbeneficence, respectforhumandignity,approvedbyInstitutional ReviewBoard
Isappropriate,clearlyinforms,enhancesstudy
c.Studyframework _‘Significant,addressesanissuethatisimportantto nursing,addressesaresearchableproblem,isfeasible toaddressinastudysetting
d.Datacollection
0.Ethicalconsiderations
Relevant,thorough,current,authoritative
Appropriateforvariablesandsample,yieldsappro— priatelevelofmeasure,reliableandvalid,safeand humane
10.Describethetwomajorapproachesnurseresearchersusetoinvestigateclient’sresponsestohealthalterations andnursinginterventions.
a.
b.
11.Thebachelorofscienceinnursing(BSN)istheusuallevelofpreparationfortheresearchnursewho:
a.conductsindependentresearch.
b.focusesontheevaluationanduseofresearch.
0.evaluatesresearchfindings.
d.understandsandappliesresearchfindingsfromnursingandotherdisciplinesinclinicalpractice.
12.Accordingtothe“StandardsofClinicalNursing”publishedbytheANA(1998),researchisincludedasoneof thestandardsofprofessionalperformance.
a.True
b.False
13.Qualitativeresearchusesmeasurementinitsmethods.
a.True
b.False
14. pertainstotheavailabilityoftimeaswellasthematerialandhumanresourcesneededtoinvestigatea researchproblemorquestion.
15.A isconductedpriortotheactualstudytoassesstheadequacyofthedatacollectionplanand toidentifyanypotentialflawsinthestudy.
FOCUSEDSTUDYTIPS 1.Whataredatacollectionstrategiesthatnurseresearchersuse?
Describethreeresearchquestionsforwhichaquantitativeapproachtoresearchisuseful.
QP‘PWNWhilemanybelievethatevidence-basedpracticeisbestpracticefornursing,otherswouldarguethatithasits Listthreeexamplesofdocumentednursingresearchinnursingmagazines. Whichrightofresearehstudyparticipantsdoyouthinkisoverlookedmostoften?Explain, Listfourwaysforanursetoprovideforpatientconfidentiality.
flaws.Whataretwodisadvantagestoevidence-basedpractice?
CASESTUDY Thenurse,whoisworkingonamedicalunitwithalargenumberofolderadultsdiagnosedwithdiabetes,readsa researcharticlethatindicatesadirectcorrelationbetweeninstabilityofbloodglucoselevelsandagewiththeoldest individualsmostlikelytodemonstratethelargestdropinbloodglucoselevelsiftheymustfastfordiagnostictesting.
1.Isthisadequateevidenceforthenursetopromotechangingthepracticeofhavingclientsfastinpreparation fordiagnostictesting?
2.Whatshouldthenursedonext?
3.Theresearcharticleincludesagraphwithageofclientsacrossthebottomandpercentagedecreaseinblood sugarlevelsalongthesideaxis.Whattypeofstudyisthis?
REVIEWQUESTIONS 1.Whichofthefollowingisaviolationofaclient’srighttoself-determination?
1.Hiddeninducements
2.Sharingaclient’sinformationwithapharmaceuticalcompany
3.Providingbasiccaretotheclient
4.Givingtheclientinformationaboutwhatparticipatinginastudywillinvolve
2.UponsuccessfulcompletionoftheNCLEX-RN®,theregisterednurseisaskedtoparticipateinaresearch studyonthecopingandadjustmentskillsofanewlygraduatedregisterednurse.Theplanistouseanoral, recordedinterviewwithagroundedtheory.Whattypeofresearchstudyisbeingconducted?
1.Pilotstudy
2.Quantitativestudy
3.Qualitativestudy
4.Ethnographicstudy
3.Whichofthefollowingactivitiesareexamplesofhowaprofessionalnursemayparticipateinresearch? (Selectallthatapply.)
1.Critiquingresearchforapplicationtopractice
2.Identifyingclinicalproblemssuitablefornursingresearch
3.Encouragingpatientparticipationinastudywithoutinformedconsent
4.Usingresearchfindingsinthedevelopmentofpolicies,procedures,andpracticeguidelinesforpatientcare
4.Anursingstudentdocumentstheclient’sfullnameanddateofbirthontherequiredpaperworkforaclinical courseandturnsitintotheinstructor.Whichofthefollowingclientrightsisbeingviolated?
1.Rightnottobeharmed
2.Righttofulldisclosure
3.Rightofself-determination
4.Rightofprivacyandconfidentiality
5. Whichofthefollowingidentifiesthe“C”inPICO?
1.Comprehension
2.Comparison
3.Challenging
4.Confidentiality
6.Formulatingaresearchproblemisoftenfacilitatedbytheresearcherperforming: l.afeasibilitystudy.
2.aliteraturereview.
3,amethodologyevaluation.
4 apilotstudy.
Dataanalysisinvolvestheapplicationofwhichofthefollowingprocedures?(Selectallthatapply.)
1.Descriptivestatistics
2.Inferentialstatistics
3.Measuresofcentraltendency
4.Measuresofvariability
Continuingeducationistheresponsibilityofthenursetokeepabreastof and changesandalso changeswithinthenursingprofession.
1.Scientificandtechnologic
2.Medicalandtechnologic
3.Scientificandhumanresponses
4.Cardiacandneurologic
Asanurseresearcher,whatisinvolvedinaresearchproject?(Selectallthatapply.)
1.Identifyingaresearchquestionorproblem
Writingathesispaper
9‘95“.“Analyzingthedataandwritinguptheresults Collectingdatausingvariousmeanssuchascomputersearchesand/orquestionnaires
Publishingorpresentingtheresearchfindingstoexpandthebodyofnursingknowledge
Oneofthemajorresponsibilitiesthenursehaswhenconductingnursingresearchis:
l.encouragingthcparticipationofclicntsinnursingresearch.
2.beingawareofandadvocatingonbehalfofclients’rights.
3.exposingclientstothepossibilityofinjuryfromtheresearch.
4.pressuringclientsintoparticipatinginthestudy.
Whatisthetermusedtodescribeabehavior,characteristic,oroutcomethattheresearcherwishestoexplain orpredict?
l.Dependentvariable
2.Independentvariable
3.Hypothesis
4.Sample
CHAPTER3 NURSINGTHEORIESANDCONCEPTUAL FRAMEWORKS KEYTERMREVIEW Matcheachtermwithitsappropriatedefinition.
1. Client
Degreeofwellnessorwell-beingthattheclient ‘ e e'enccs
2 W Conceptualframework Xpr1
Attributes,characteristics,andactionsthatprovidecare
3 Criticaltheories onbehalfof,orinconjunctionWiththeclient
4 Environment
5 Grandtheories
. alth
6 flHe
‘.Focusontheexplorationofconcepts
Abeliefsystem
ThosethatarticulateabroadrangeofSignificant
7 Metaparadigm relationshipsamongtheconceptsofadiscipline
8 Midleveltheories
9 Nursing
Recipientofnursingcare
Asystemofideasthatisproposedtoexplainagiven henomenon
10. Paradigm p
11. Philosophy
1 P t‘ d'ciline
2 racwe 18p
13. Theory
Thosethathelpelucidatehowsocialstructuresaffecta
Widevarietyofhumanexperiences
Agroupofrelatedideas,statements,orconcepts
'. Theinternalandexternalsurroundingsthataffectthe client
Majorconceptsthatcanbesuperimposedonalmostany workofnursing
Apatternofsharedunderstandingsandassumptionsabout realityandtheworld
m.Termusedforfieldsofstudyinwhichthecentralfocusis performanceofaprofessionalrole.
KEYTOPICREVIEW 1.Definetheory.Listtwocharacteristicsofatheory.
2.Whatisthemainfunctionoftheory(andresearch)inapracticediscipline?
3.Duringthelatterhalfofthe20thcentury,disciplinesseekingtoestablishthemselvesinuniversitieshadto demonstratesomethingthatNightingalehadnotenvisionedfornursingw-auniquebodyoftheoretical knowledge.
a. True
b. False
4.Disciplineswithoutastrongtheoryandresearchbasewerereferredtoas“ withthe“ ”naturalsciences. ,”anegativecomparison
5.Whatisthetermencompassingthe“buildingblocks”oftheories?
6.A isagroupofrelatedideas,statements,orconcepts.Itmayalsobecalleda w theoryor
7.Theterm referstoapatternofsharedunderstandingsandassumptionsaboutrealityandtheworld. Itincludesaperson’snotionsofrealitythatarelargelyunconsciousortakenforgranted.
8.Whatfourmajorconceptsarerelatedtothemetaparadigmfornursing?
9.AccordingtoFigure3—1inyourtext,whataresomeoftheprevalentfoundationaltheoriesinnursing?
10.Matcheachtheoristwiththeappropriateterm.
a.Philosophies
b.Conceptualmodels
Orem
Nightingale (3.Midleveltheories
Pcplau
Parse
Henderson
Roy
Neuman
Rogers
Leininger
Watson
King
11.Whoisconsideredtobethefirstnursetheorist?
12.Anearlyefforttodefinenursingphenomena. servesasthebasisforlatertheoreticalformulations.
l3.Debatesabouttheroleoftheoryinnursingpracticeprovideevidencethatnursingismaturingasbothan academicdisciplineandaclinicalprofession.
a. True
b. False
14.Definethefollowingterms:
a.
b.
c.
d. Client(person) Environment Health Nursing
15.Whyisnursingconsideredtobeapracticediscipline?
FOCUSEDSTUDYTIPS 1.Describethetwoparadigmsofnursingtheories.
2.Listthemajorpointsofthefollowingnursingtheories:
a.
b.
C.
j.
k. Nightingale’senvironmentaltheory
Peplau’sinterpersonalrelationsmodel Henderson’sdefinitionofnursing
Roger’sscienceofunitaryhumanbeings
Orem’sgeneraltheoryofnursing
King’sgoalattainmenttheory
Neuman’ssystemsmodel
Roy’sadaptationmodel
Leininger’sculturalcarediversityanduniversalitytheory
Watson’shumancaringtheory
Parse’shumanbecomingtheory
3.ReadtheEvidence-BasedPracticefeaturetitled“HowWellDoesaLevine—BasedTheoryApplytotheCareof PretermInfants?”thatisinthischapterinthetext.Identifytheimplicationsfornursingpractice.
4.Althoughthevariousnursingmodelshavebeenwidelyusedforcenturiestocareforclients,somemay critiquetheuseofnursingtheories.DescribeonecritiqueagainstnursingtheoriesthatMcCraeidentified.
CASESTUDY Thechiefexecutiveofficer(CEO)hasrequestedthatthedirectorofnursing(DON)revisethecurrentphilosophyof nursingthatisbeingusedforbothalong—termcarefacilityandanassistedlivingfacility.TheDONwantsto developthephilosophybasedonanursingtheorythatadequatelyreflectsboththehealthyandillclientshousedin thefacilities.Thefacilities’missionstatementsembracetheidealofclientsimprovingandsustainingindependent functions,andencourageindividualizedgoalsforallclientstomeettheirindividualneeds.TheDONwantsto emphasizethenurses’responsibilitiesduringtheprocessofnurseAclientinteractionsaswellastheoutcomesof nursingcare.
1.Choosethebestnursingtheoryonwhichtobasetherevisedphilosophyofnursingforthisparticularfacility.
2.Explainyourrationaleforusingthetheorythatyouhavechosen.
REVIEWQUESTIONS 1.Asuppositionorsystemofideasthatisproposedtoexplainagivenphenomenonorsomethingsignificantis calleda: l.concept.
2.theory.
3.paradigm.
4.conceptualmodel.
Someexamplesofconcepts,whicharedefinedaslabelsgiventoideas,objects,orevents,are:
1.intelligence,motivation,andobesity.
2.comfort,fatigue,pain,depression,and/orenvironment.
3.self-care,adaptation,caring,behavioralsystem,and/ornurse—clienttransactions.
4.humanisticendeavors,unitaryman,and/orlearnedhelplessness. Whichtheoristaddresseshospicenursingissuesduringend—of—lifecare?
1.ImogeneKing
2.CallistaRoy
3.DorotheaOrem
4.JeanWatson
Anexampleofamiddle-rangenursingtheoryis: l.Peplau’spsychodynamicnursingmodel.
2.JeanWatson’smodelofhumancaring.
3.Roy’sadaptationmodel.
4.ImogeneKing’stheoryofgoalattainment.
Thistheoristbasedhertheoryofnursingontheprinciplethatnursingassistsclientswith14essentialfunctions thatmovethemtowardindependence.
1.MyraEstrinLevine
2.DorotheaOrem
3.MadelineLeininger
4.VirginiaHenderson
OneofthegoalsofBettyNeuman’shealthcaresystemsmodelis: l.maintenanceofsystemequilibrium.
2.assistingtheclienttoachievethehighestlevelofself-care.
3.promotinginternalandexternalstimulithatinfluencetheclient’swell-being.
4 tohealtheclientandmakethebedavailableforsickerclients.
Nightingale,Henderson,andWatsondevelopedphilosophiesofnursing.Whyaretheirworksconsidered philosophieswhendiscussedinnursing?
1.Becausetheywerethefirstthreenursingtheorists.
2.Becauseitwasanearlyefforttodefinenursingphenomenathatservesasthebasisforlatertheoretical Formulations.
3.Becausetheyhadgrandtheoriesofnursingandnotmiddle—leveltheories.
4.Becauseitwasalateefforttodefinenursing.
Disciplineswithoutastrongtheoryandresearchbasewerehistoricallyreferredtoas:
1.hard.
2.concrete.
3.soft.
4.medium.
Aconceptualframeworkisconsideredtobe:
1.agroupofrelatedideas,statements,orconcepts.
2.apatternofsharedunderstandingsandassumptionsaboutrealityandtheworld
3.thewaytoelucidatehowsocialstructuresaffectawidevarietyofhumanexperiences,fromarttosocial practices.
4.abeliefsystem,oftenanearlyefforttodefinenursingphenomenathatservesasthebasisforlater theoreticalformulations.
Inthelate20thcentury,muchofthetheoreticalworkinnursingfocusedonarticulatingrelationshipsamong fourmajorconcepts.(Selectthemajorconcepts.)
1.Person
2.Environment
3.Nursing
4.Professionalism
5.Health
Matchtheearlynursetheoristwhodevelopedthenursingactionstatedbelow.
1.Anurseperformingnoncontacttherapeutictouch. a.FlorenceNightingale
2.Anursemeasuringtheclient’sintakeandoutput b.HildegardPeplau
3.Anursedemonstratingtherapeuticcommunication C.MarthaRogers withaclientwhohasbeendiagnosedwith depression
4.Anursewhoplanscarewiththeclienttoestablish (1.ImogeneKing mutualgoalsandoutcomes
CHAPTER4 LEGALASPECTSOFNURSING KEYTERMREVIEW Matcheachtermwithitsappropriatedefinition.
Assault
Autopsy
Battery
Breachofduty
Burdenofproof
Causation
Civillaw
Commonlaw
Complaint
Contract
Defamation
Euthanasia
Falseimprisonment
Informedconsent
Injury
Interstatecompact
Liability
Libel
Livingwill
Mandatedreporters
Plaintiff
Responded!superior
Right
Tortlaw
Unprofessionalconduct
Lawsevolvingfromcourtdecisions
' Harmthatoccurredasadirectresultoffailureto followstandardsofcare
Examinationofthebodyafterdeath
.Agreementbetweencompetentpersons,on sufficientconsiderationtodoornotdoalegal act
Communicationthatisfalse,andresultsininjury tothereputationofaperson
Definesandenforcesdutiesandrightsamong privateindividualsthatarenotbasedon contractualagreements
Defamationbymeansofprint,writing,or pictures
Therequirementthat,bylaw,requiresnursesto reportabuse,neglect,orexploitation
'. Documentfiledbyapersonclaimingthatlegal rightshavebeeninfringedupon
'. Astandardofcarethatisnotobserved
Thewillfultouchingofapersonthatmayormay notcauseharm
Anattemptorthreattotouchaperson unjustifiably
Dealswithrelationshipsamongindividuals
Thedutyofprovinganassertionofwrongdoing .Theunjustifiabledetentionol‘apersonwithout legalwarranttoconfinetheperson
Typeofharm
Aprivilegeorfundamentalpowertowhichan individualisentitledunlessrevokedbylawor givenupvoluntarily
Stateofbeinglegallyresponsibleforone’s obligationsandactions,andtomakefinancial restitutionforwrongfulacts
Providesspecificinstructionsaboutwhat medicaltreatmenttheclientchoosestoomitor refuseintheeventthattheclientisunableto makethosedecisions
Includesincompetenceorgrossnegligence, convictionforpracticingwithoutalicense, falsificationofclientrecords,illegallyobtaining, using,orpossessingcontrolledsubstances
KEYTOPICREVIEW Personwhoclaimsthathisorherrightshave beeninfringedonbyoneormorepersons
Legalrelationshipbywhichtheemployer assumesresponsibilityfortheconductofthe employee
Agreementbyaclienttoacceptacourseof treatmentalterbeingprovidedcomplete information
Themechanismusedtocreatemutual recognitionamongstates
Theactofpainlesslyputtingtodeathpeople sufferingfromanincurableorchronically painfuldisease
1.Whyisitimportantfornursestoknowthebasicsoflegalconcepts?
2.
Whatisaccountability,andwhataretworeasonsitisneededinnursing?
a.
b. a.
Nametwofunctionsoflawsinnursing.
b.
TheConstitutionoftheUnitedStatesisthesupremelawofthestate.
a. True b. False
Regulationofnursingisafunctionofstatelaw.
a.
Listtwotypesoflawsandgivethedefinitionofeachtype.
a.
b. True b. False
Choosethecorrectdefinitionofcriminalaction,thecorrectexampleofcriminalaction,andthepotential resultsifapersonisfoundguiltyinacriminaltrial.(Selectallthatapply.)
a. b.
C. f. Dealswiththerelationshipsamongindividualsinsociety.
Dealswithdisputesbetweenanindividualandthesocietyasawhole. Iffoundguilty,thedefendantmayhavetopayasumofmoney.
Iffoundguilty,thedefendantmaylosemoney,bejailed,beexecuted,and/orloseanyprofessionallicenses.
Oneexampleofthistypeoflegalinfractionisanursewhodeliberatelydeliversalethaldoseofmedication toaclient.
Oneexampleofthistypeoflegalactionisamalpracticesuit.
8.Theactionofalawsuitiscalled
Organizethefivestepsintheciviljudicialprocessaccordingtotheproceduralrules.
a.Adocument,calledacomplaint,isfiledbyanindividualreferredtoastheplaintiff,whoclaimsthathisor herlegalrightshavebeeninfringedonbyoneormoreotherindividualsorentitiesreferredtoas defendants.
b.Inthetrialofthecase,alltherelevantfactsarepresentedtoajuryoronlytoajudge.
c.Thejudgerendersadecision,orthejuryrendersaverdict.lftheoutcomeisnotacceptabletooneofthe parties,anappealcanbemadeforanothertrial.
d.Bothpartiesengageinpretrialactivities,referredtoasdiscovery,inanefforttoobtainallthefactsofthe situation.
e.Awrittenresponse,calledananswer,ismadebythedefendants.
Whatisthelegalpurposefordefiningthescopeofnursing,licensingrequirements,andstandardsofcare? (Selectallthatapply.)
a.Fortheprotectionofthenurse
b.Fortheprotectionoftheclient
c.Fortheprotectionofthepublic
d.Tomaintainclientconfidentiality
e.Fortheprotectionofthephysician
Eachstatehasanobligationtodefineitsscopeofnursingpracticeandlicensingrequirements.
a.True b. False
Thenameofthenewlydevelopedregulatorymodelisthe model.Itallowsformultistate licensurefornurses.Nursescanpracticeinstatesborderingtheirownstateifbothstateshavean compact.
isthevoluntarypracticeofvalidatingthatanindividualnursehasmetminimumstandardsof nursingcompetenceinspecialtyareassuchasmaternal—childhealth,pediatrics,metalhealth,gerontology, andschoolnursing.
Definestandardsofcareandlistthetwoclassifications.
a.
b. Listfourexamplesofexternalstandardsofcare:
a.
b.
c.
d. Awrittencontractcannotbechangedlegallybyanoralagreement.
a.True b.False
Describethedifferencebetweenanexpressedcontractandanimpliedcontract.Giveanexampleofeachtype. Explainthedifferencebetweenarightandaresponsibilityandgiveanexampleofeach.
A isanorganizedworkstoppagebyagroupofemployeestoexpressagrievance,enforcea demandforchangesinconditionsofemployment,orsolveadisputewithmanagement.Usually,itisaresult offailedcollectivebargainingbetweentheparties.
Whatarethetwotypesofinformedconsent?
a.
b. Itisthenurse’sresponsibilitytohavetheinformedconsentformsignedpriortoaninvasiveprocedure.
a.True b.False
Whatthreethingsdoesthenurse’ssignatureconfirmwiththesignedconsentform?
a.
b.
c. ifaclientrefusestosigntheconsentform,whatactionsdoesthenurseneedtotake?
WhataretworeasonsfornursestobeknowledgeableregardingtheNursePracticeActintheirstateof practice?
Nursesareincludedasmandatedreportersofviolence,abuse,and/orneglect.
a.True
b.False
HowisthenurseinvolvedintheAmericanswithDisabilitiesAct?Explainyouranswer.
Statelawsregulatethedistributionanduseofcontrolledsubstancessuchasnarcotics,depressants,stimulants, andhallucinogens.
a.True b.False iscitedasoneofthemainreasonsforchemicaldependenceinhealthcareworkers.
Definethetermsandlistanynursingresponsibilitiesaboutthefollowinglegalissuessurroundingdeath:
a.Advancedirectives
b.Autopsies
c.Certificationofdeath
d.Do—not—resuscitateorders(DNRs)
e.Euthanasia
f.lnquests
g.Organdonation lawisusuallyinvolvedwithnursingliability.
.Choosethetypesofinvasionfromwhichtheclientmustbeprotected.(Selectallthatapply.)
a.Reportingthenumberofbirthsthatoccurredinthehospitalforstatisticalanalysis
b.Reportingofinfectionsandcommunicablediseases
c.Takingphotographsorhavingnursingstudentsobservetheclient’scarewithouttheclient’sconsent
d.Revealingthenameofaclientwhowastreatedfordomesticviolence
e.Reportingviolentincidentstothelocalauthorities
WhatarethefourspecificareasofHIPAA?RefertotheHIPAAwebsitefoundontheCompanionWebsite.
32. 33. WhatistheHealthInsurancePortabilityandAccountabilityAct(HIPAA)of1996,andwhyisitimportant?
Whatarefourcategoriesthatnursesmustquestiontoprotectthemselveslegallywhencarryingouthealthcare provider’sorders?
FOCUSEDSTUDYTIPS l.
Defineandgiveanexampleofthefollowinglaws.Whichisthehighestleveloflaw?
a.Civillaw
b.Commonlaw
c.Contractlaw
d.Law
e.Privatelaw
f.Publiclaw
Statutorylaw g
h.Tortlaw
.RefertoFigure44inthetext.Describehowlawsarecreatedfromconstitutions,statutes,administrative agencies,anddecisionsofcourts.
Whyisitimportanttoknowthestatelegislatorswhorepresentyourstate?Namethestatelegislatorsforyour state.Howdoyoucontactyourlegislators,andwhyisitnecessarytocontactthemregardingnursingissues?
Stateyourpositiononhavingmalpracticeinsuranceasaregisterednurse.Isityourresponsibilityorthe responsibilityofyouremployer?Underwhatcircumstancescouldyouusethemalpracticeinsurance?Referto theApplicationActivity:NursePracticeActontheCompanionWebsite.
Whataretheproceduresthatoccurwhenanursinglicenseisrevokedinthestateinwhichyouwillpractice?
GototheNCSBNwebsiteandlistthestatesthathavepassedtheNLClegislation.RefertoBox4—linthetext foradditionalinformation.
Whatarethestatutesinyourstatefor“consent”?Whatisconsideredthelegalageofconsent?
Discusstheareasofpotentialliabilityinnursinganddefinethefollowingterms:malpractice,intentionaltorts. crime,felony,manslaughter,misdemeanors,duty,andtorts.
Determinethedifferencebetweendefamationandslander.Giveanexampleofeachthatmightoccurinthe healthcaresetting.Whocouldbringadefamation/slanderlawsuit?
Whataresomelegalprotectionsinnursingpracticetoprotectthenursefromlitigation?IstheGoodSamaritan Actdesignedfornurses?Whataretheresponsibilitiesofnurseswhochoosetorenderemergencycare?Does yourstaterequirenursestoassistinemergencies?
Discussanddefendyourpositiononprofessionalliabilityinsurance.Isitarequirementforallnurses?Listthe advantagesofmaintainingprofessionalliabilityinsurance.
12.Whyisnursedocumentationsoimportant?Whatisthepurposeofnursedocumentation?Howcanitbeused inacourtoflaw?Doesthenurseneedtodocumentifanincidentreportisfilledoutintheclient’schart? Refertothetext,Chapter4,Figure4—5,foradditionalinformation.
13.Whatmeasurescannursingstudentsimplementinordertofulfillresponsibilitiestoclientsandtominimize thechancesforliability?RefertoBoxes45and4—6inChapter4ofthetext.
14.Thenurseiscaringforaclientwhohasbeendeclaredlegallybraindead.Theclientdidnotspecifyifhe wishestobeanorgandonor.Whatisthenurse’sbestaction?
15.Discussthedifferencebetweenacrimeandatort.
CASESTUDY Aclientwasscheduledforthesurgicalremovaloftheleftovary.Duringthesurgery,thesurgeonnoticedthatthe appendixoftheclientwasinflamed.Hedecidestoremoveittopreventfurtherproblems.Theclient’sconsentfor surgeryonlylistedremovaloftheleftovary.
1.Didthesurgeonadheretothesignedconsentformthattheclientsignedbeforethesurgery?
2.Underthecircumstances,whattypeoftortisthesurgeonliablefor?
3.Whatwastheoperatingnurse’sroleinthisincident?
REVIEWQUESTIONS 1.Whichnursewouldbeconsideredtobethe“bestexpertwitness”forthedefenseinacaseregardingan obstetricpatientwhodiedafterdeliverycomplications?
1.Anursewhoholdsabachelor’sdegreeinnursingandhasbeenpracticingfor2years
2.Anursewhoholdsamaster’sdegreeinnursingandhasacertificationinemergencynursing
3.Anursewhoholdsadoctorateofnursingscienceinpediatriccare
4.Anursewhoholdsamaster’sdegreeinnursingandastatecertificationinmatemal—infantnursing
2. Whichclientscouldmakedecisionsregardinghealthcare?(Selectallthatapply.)
1.Awomanwhoarrivesintheemergencydepartmentwithanalteredmentalstateandthearomaofethyl alcohol
2.Theparentsofal4-year—oldgirlinvolvedinacarcollision
3.Amiddle-agedmanwhohasthementalcapacityofan8—year-old
4.A10-year—oldboywhohasarrivedwithfriendsandhasashallowlacerationneedingthreesutures
5.Acompetentolderadultwhorequiressurgeryonaprolapsedbladder
3.Aclientwasdischargedafterhavingal—daysurgeryonhergallbladder.Thenursedischargingtheclient failedtogivetheclientoralorwrittendischargeinstructions.Thisfailuretocarryouttheprovisionof dischargeinstructionscouldresultinchargesof:
l.malpractice.
2.negligence.
3.assault.
4.battery.
4.Whichstatementindicatesthattheclientunderstandsinformedconsentofasurgicalprocedure?
1.Thenursediscoversthesignedinformedconsentformonthebedsidetablebeforethesurgeondiscussesthe procedurewiththeclient.
2.Theclient’soldestsonstatedthatheexplainedtheproceduretotheclientandtheclienttoldhimthathe wantedthesurgery.
3.Theclientstatesthatthesurgeonexplainedtheproceduretohim,allowedhimtoaskquestions,and explainedtherisksofnotpermittingthesurgery.
4.Theclientbeendeclaredlegallyincompetent;however,theclientstatesunderstandingofthesurgical procedure.
5.Whilereviewingthetransferpapersofaclient,thenursenotesthattheclienthasbothalivingwillanda durablepowerofattorney.Alivingwilldiffersfromadurablepowerofattorneyinthatalivingwill:
1.describeshowtheclientwantshiswishescarriedoutintheeventofaterminalillness.
2.designateswhoshouldmakemedicaldecisionsiftheclientisincapableofmakingindependentdecisions.
3.determineswhichrelativegetsthehouse.
4.allowsahealthcareprovidertomakedecisionsiftheclientisunabletomakedecisions.
6.Anursethreatenstogivealoud,disruptiveclientaninjectionthatwill“knocktheclientout.”Thenurse followsthroughonthethreatandgivestheinjectionWithouttheclient’sconsent.Whathasthenurse committed?
l.Threat,assault
2.Battery,invasionofprivacy
3.Assault,invasionofprivacy
4.Assault,battery
7.Anursedocumentsintheclient’schartthatthehealthcareproviderisincompetentbecausethehealthcare providerdidnotrespondpromptlytothenurse’scallregardingtheclient.Thisisanexampleof and 1.defamation slander libel battery Ut-b-UJN unprofessionalconduct
8.Convictionforpracticingnursingwithoutalicense,incompetenceorgrossnegligence,falsificationofclient records,andillegallyobtaining,using,orpossessingcontrolledsubstancesiscalled: 1.libel.
2.slander.
3.unprofessionalconduct.
4 assault.
9.Moststatutesincludeconscienceclausesthataredesignedtoprotecthospitalsandnursesinmattersdealing withabortionservices.Theseclausesallowthenursetobeprotectedfrom:
1.prejudicialstatements.
2.discriminationorretaliation.
3.defamationorunjustprejudice.
4.legalliability.
10.IdentifytheelementthatisNOToneofthefunctionsofthelawinthenursingenvironment.
1.Accountabilityhelpstomaintainaminimumstandardofnursingpractice.
2.Lawdifferentiatesnurses’responsibilitiesfromthoseofotherhealthcareprofessionals.
3.Lawspecifieswhichnursingactionsarelegalincaringforclients.
4.Lawspecifieswhichhospitalpoliciesarelegalincaringforclients.
CHAPTER5 VALUES,ETHICS,ANDADVOCACY KEYTERMREVIEW Matcheachtermwithitsappropriatede
Activeeuthanasia
Advocate
Assistedsuicide
Attitudes
Autonomy
Beliefs
Beneficence
Bioethics
Codeofethics
Fidelity
Justice
Moraldevelopment
Moraldistress
Moralrules
Nonmaleficence
Nursingethics
Passiveeuthanasia
Personalvalues
Veracity
Tellingthetruth
Answerabletoselfandothersforone’sownactions
Donoharm
Onewhoexpressesanddefendsthecauseofanother Actionsthatbringabouttheclient’sdeathdirectly Rulesgoverningthebehaviorofnursesrelatedtothe moralityofhumanbehavior.
Withdrawingorwithholdinglife-sustainingtherapy
Aformalstatementofagroup’sidealsandvalues
Tobefaithfultoagreementsandpromises
Anindividual’senduringbeliefsorattitudesaboutthe worthofaperson,object,idea,oraction
Processofclienttakinghisorherownlifewithhelpfrom anotherindividual
Theconceptof“doinggood”forthebenefitofothers Interpretationsorconclusionsthatpeopleacceptastrue
p.Ethicsasappliedtohumanlifeorhealth
q.Processoflearningtotellthedifferencebetweenright andwrongandoflearningwhatshouldandshouldnotbe done
Specificprescriptionsforactionbasedonanindividual’s principlesorbeliefs.
Therighttomakeone’sowndecisions
Conflictthatariseswhenwhatthenursebelievesneedsto bedonecannotbecarriedoutduetoanobstaclesuchas clientwishes.personalbeliefs,orfacilityregulations.