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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.

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