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A hospice nurse is caring for a patient who is dying of lymphoma. According to Maslows hierarchy of needs, what dimension of care should the nurse consider primary in importance when caring for a dying patient?
- A. Spiritual
- B. Social
- C. Physiologic
- D. Emotional
Correct Answer: C
Rationale: Maslow ranked human needs as follows: physiologic needs; safety and security; sense of belonging and affection; esteem and self-respect; and self-actualization, which includes self-fulfillment, desire to know and understand, and aesthetic needs. Such a hierarchy of needs is a useful framework that can be applied to the various nursing models for assessment of a patients strengths, limitations, and need for nursing interventions. The other answers are incorrect because they are not of primary importance when caring for a dying patient, though each should certainly be addressed.
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A nurse is aware that an increasing emphasis is being placed on health, health promotion, wellness, and self-care. Which of the following activities would best demonstrate the principles of health promotion?
- A. A discharge planning initiative between acute care and community care nurses
- B. Collaboration between several schools of nursing in an urban area
- C. Creation of a smoking prevention program undertaken in a middle school
- D. Establishment of a website where patients can check emergency department wait-times
Correct Answer: C
Rationale: Smoking prevention is a clear example of health promotion. Each of the other listed activities has the potential to be beneficial, but none is considered health promotion.
A hospitals current quality improvement program has integrated the principles of the Institute for Healthcare Improvement (IHI) 5 Million Lives Campaign. How can the hospital best achieve the campaign goals of reducing preventable harm and death?
- A. By adhering to EBP guidelines
- B. By reducing nurse-to-patient ratios and increasing accountability
- C. By having researchers from outside the facility evaluate care
- D. By involving patients and families in their care planning
Correct Answer: A
Rationale: The 5 Million Lives Campaign posits that if evidence-based guidelines it advocated were voluntarily implemented by U.S. hospitals, 5 million lives would be saved from either harm or death over a two-year period. Nurse-to-patient ratios, family participation, and independent evaluation are not stated components of the campaign.
A nurse is planning a medical patients care with consideration of Maslows hierarchy of needs. Within this framework of understanding, what would be the nurses first priority?
- A. Allowing the family to see a newly admitted patient
- B. Ambulating the patient in the hallway
- C. Administering pain medication
- D. Teaching the patient to self-administer insulin safely
Correct Answer: C
Rationale: In Maslows hierarchy of needs, pain relief addresses the patients basic physiologic need. Activity, such as ambulation, is a higher level need above the physiologic need. Allowing the patient to see family addresses a higher level need related to love and belonging. Teaching the patient is also a higher level need related to the desire to know and understand and is not appropriate at this time, as the basic physiologic need of pain control must be addressed before the patient can address these higher level needs.
A medical-surgical nurse is aware of the scope of practice as defined in the state where the nurse provides care. This nurses compliance with the nurse practice act demonstrates adherence to which of the following?
- A. National Council of Nursings guidelines for care
- B. National League for Nursings Code of Conduct
- C. American Nurses Associations Social Policy Statement
- D. Department of Health and Human Services White Paper on Nursing
Correct Answer: C
Rationale: Nurses have a responsibility to carry out their role as described in the Social Policy Statement to comply with the nurse practice act of the state in which they practice and to comply with the Code of Ethics for Nurses as spelled out by the ANA (2001) and the International Council of Nurses (International Council of Nurses [ICN], 2006). The other answers are incorrect; the Code of Ethics for nursing is not included in the ANAs white paper. The DHHS has not published a white paper on nursing nor has the NLN published a specific code of conduct.
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.