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A group of nursing students are learning about recent changes in the pattern of disease in the United States. Which of the following statements best describes these current changes?
- A. Infectious diseases continue to decrease in incidence and prevalence.
- B. Chronic illnesses are becoming increasingly resistant to treatment.
- C. Most acute, infectious diseases have been eradicated.
- D. Most, but not all, communicable diseases are declining.
Correct Answer: D
Rationale: Although some infectious diseases have been controlled or eradicated, others are on the rise. Antibiotic resistance is a more serious problem in acute, not chronic, illnesses.
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The view that health and illness are not static states but that they exist on a continuum is central to professional health care systems. When planning care, this view aids the nurse in appreciating which of the following?
- A. Care should focus primarily on the treatment of disease.
- B. A persons state of health is ever-changing.
- C. A person can transition from health to illness rapidly.
- D. Care should focus on the patients compliance with interventions.
Correct Answer: B
Rationale: By viewing health and illness on a continuum, it is possible to consider a person as being neither completely healthy nor completely ill. Instead, a persons state of health is ever-changing and has the potential to range from high-level wellness to extremely poor health and imminent death. The other answers are incorrect because patient care should not focus just on the treatment of disease. Rapid declines in health and compliance with treatment are not key to this view of health.
The IOM Report Health Professions Education: A Bridge to Quality issued a number of challenges to the educational programs that teach nurses and members of other health professions. According to this report, what activity should educational institutions prioritize?
- A. More clearly delineate each professions scope of practice during education
- B. Move toward developing a single health curriculum that can be adapted for any health profession
- C. Include interdisciplinary core competencies into curricula
- D. Elicit input from patients and families into health care curricula
Correct Answer: C
Rationale: Health Professions Education: A Bridge to Quality challenged health professions education programs to integrate interdisciplinary core competencies into their respective curricula to include patient-centered care, interdisciplinary teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. This report did not specify clearer definitions of scope of practice, patient input, or a single curriculum.
The home health nurse is assisting a patient and his family in planning the patients return to work after surgery and the development of postsurgical complications. The nurse is preparing a plan of care that addresses the patients multifaceted needs. To which level of Maslows hierarchy of basic needs does the patients need for self-fulfillment relate?
- A. Physiologic
- B. Transcendence
- C. Love and belonging
- D. Self-actualization
Correct Answer: D
Rationale: Maslows highest level of human needs is self-actualization, which includes self-fulfillment, desire to know and understand, and aesthetic needs. The other answers are incorrect because self-fulfillment does not relate directly to them.
The role of the certified nurse practitioner (CNP) has become a dominant role for nurses in all levels of health care. Which of the following activities are considered integral to the CNP role? Select all that apply.
- A. Educating patients and family members
- B. Coordinating care with other disciplines
- C. Using direct provision of interventions
- D. Educating registered nurses and practical nurses
- E. Coordinating payment plans for patients
Correct Answer: A,B,C
Rationale: This role is a dominant one for nurses in primary, secondary, and tertiary health care settings and in home care and community nursing. Nurses help patients meet their needs by using direct intervention, by teaching patients and family members to perform care, and by coordinating and collaborating with other disciplines to provide needed services. The other answers are incorrect because NPs do not commonly perform education of nurses and they do not focus on matters related to payment.
A case manager has been hired at a rural hospital that has a combined medical-surgical unit. When defining this new role, which of the following outcomes should be prioritized by the hospitals leadership?
- A. Decreased need for physician services
- B. Improved patient and family education
- C. Increased adherence to the principles of EBP
- D. Increased coordination of health services
Correct Answer: D
Rationale: Case management is a system of coordinating health care services to ensure cost-effectiveness, accountability, and quality care. The case manager coordinates the care of a caseload of patients through facilitating communication between nurses, other health care personnel who provide care, and insurance companies. Reducing the need for physician services is not a central goal. Education and EBP are consistent with case management, but they are not central to this particular role.