2 CHAPTER 1 / Historical and Contemporary Nursing Practice

C. TeacherD. Client AdvocateE. Counselor

F. Change AgentG. Leader

H. ManagerI. Case ManagerJ. Research Consumer

K. Expanded Career RolesIV. Criteria of a Profession

A. Specialized EducationB. Body of KnowledgeC. Service Orientation

D. Ongoing ResearchE. Code of Ethics

F. AutonomyG. Professional Organization

V. Socialization to NursingA. Critical Values of Nursing

KEY TOPIC REVIEW

VI. Factors Influencing Contemporary NursingPracticeA. EconomicsB. Consumer Demands

C. Family StructureD. Science and TechnologyE. Information and Telecommunications

F. LegislationG. DemographyH. The Current Nursing ShortageI. Collective Bargaining1. Nursing Associations

VII. Nursing OrganizationsA. American Nurses AssociationB. Canadian Nurses Association

C. National League for NursingD. International Council of NursesE. National Student Nurses' Association

F. International Honor Society: Sigma Theta Tau

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I. The four functions identified within the scope of nursing practice are:a.b.c.d.

2. The role of religious orders on the development of nursing include:a. instilling the values of hard work.b. influencing the image of nursing.c. identifying an increased need for nurses.d. imprinting the profession as involving hard work.e. improving the status of nursing.

3. The contemporary nursing leader who defined nursing is:a. Clara Barton.

b. Florence Nightingale.c. Linda Richards.

d. Virginia Henderson.4. A nurse registered to practice in one state is relocating to another neighboring state. What should this nurse do

to ensure the ability to work as a nurse in the new state?a. Nothing. The nurse is registered as a nurse.b. Contact the state's department of nursing.c. Enroll in a school of nursing in the new state.d. File the paperwork to take the new state's nursing licensing examination.

5. From the following list, select the definition that best defines the following:a. Caregiver Helps the client modify behaviors.b. Communicator This can be provided by the nurse or delegated to someone else.c. Teacher Supervises and evaluates performance.d. Client advocate Sensitive to protecting the rights of human subjects.e. Counselor Acts to protect the client.f. Change agent Influences others to work together to reach a common goal.

g. Leader Done verbally or written. ~h. Manager Care is oriented to the client and controls costs.i. Case manager Helps promote personal growth.j. Research consumer Assess readiness to learn.

CHAPTER 1 / Historical and Contemporary Nursing Practice 3I

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6. The terms used to identify the recipients of nursing are: I~a.b.

and

(DRGs).

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c.

7. Of the following nursing .roles, select the ones that provide more autonomy within the practice of nursing.a. Nurse anesthetist

b. Staff nurse on an orthopedic unitc. Operating room nursed. Clinical nurse specialiste. Nurse in a physician's office

8. The process a nurse undergoes in effort to be viewed as an integral member of the discipline of nursing istermed _

9. A nurse is interested in participating with the American Nurses Association. Participating with thisorganization is an example of:a. autonomy.b. governance.c. extended education.d. service.

10. The purpose of nursing students working together on projects is to:a. begin the process of socialization into the profession.b. get more work done faster.c. help each other through difficult courses.d. make new friends.

II. The payments for hospital services implemented by Medicare are termed12. A nurse who provides care to a patient over the telephone will need to:

a. obtain licensure in the patient's state of residence.b. take a course in telenursing.c. find out if the patient's state is one of mutual recognition for licensure.d. do nothing.

13. The Patient Self-Determination Act requires that every patient be provided with

FOCUSED STUDY TIPS

1. Why is it important to review the history of nursing as one of the first steps in the education of a new nurse?What value does understanding the history of nursing provide to the contemporary nursing student?

2. What are the characteristics of a profession? How does nursing address each of these characteristics?

3. What are Benner's five stages of nursing practice? In which stage is a nurse considered proficient? Why?

4. How have economics, consumer demands, and the family structure impacted the profession of nursing?

5. A nurse who has been in the profession for over 25 years does not know how to operate a computer. Whatsuggestions do you have to help this nurse? Why should this nurse be concerned with the inability to utilizecurrent technology?

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4 CHAPTER 1 I Historical and Contemporary Nursing Practice

6. Identify the reasons for the current nursing shortage. How will this affect the future education of new nursesentering the profession?

7. The nurses in a hospital are contacting a labor union. Why do you think the nurses are contacting this union?What benefits will be gained by working with a union? What disadvantages are associated with nursesworking with a union?

8. Go to the Companion Website (www.prenhal1.comlberman) and click on the Sigma Theta Tau and theAmerican Association of Colleges of Nursing (AACN) weblinks. What do these two organizations represent innursing? What are the differences between the two sites and what are the similarities? Is there information that

you could refer to if you wanted to continue your education in nursing? Which site offers continuing educationunits (CEUs) for nurses? Explore other nursing sites such as American Nursing Association (ANA) andAmerican Academy of Colleges in Nursing (AACN).

CASE STUDY

A client with adult-onset asthma is attempting to quit his two-pack-per-day tobacco habit. The nurse, who has beenpracticing for 4 years, is assisting the client with supportive measures to improve his health status. The nurse is dis­

cussing the plan of care with the physician.

1. What role is the nurse acting in by representing the client's needs and wishes and assisting the client inbehavior modification plans?

2. The nurse is in the process of assisting the client to recognize and cope with both the asthma condition and thetobacco cessation program. The nurse is acting as a change agent, and what other role is the nurse

representing?3. According to Benner's stages of nursing expertise, in what stage is the nurse functioning?

REVIEW QUESTIONS

1. A female is considering a career as a nurse because of the aspects of caring and nurturing. This individual isusing which factor of nursing to base her decision?1. Women's roles

2. Religion3. War4. Economics

2. A registered nurse is considering additional education so that she can provide non-emergent acute care in anambulatory clinic. This nurse is considering which expanded career role?I. Nurse anesthetist

2. Clinical nurse specialist3. Nurse practitioner4. Nurse administrator

3. A nurse is able to provide care to several complex clients and focuses on those items that are the mostimportant. Within which stage of Benner's stages of nursing expertise is this nurse functioning?1. Stage II2. Stage III3. Stage IV4. Stage V

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CHAPTER 1 / Historical and Contemporary Nursing Practice 5

4. The health care organization is having difficulty recruiting and retaining nurses. Which of the following nursingshortage factors is this organization experiencing?1. Aging workforce2. Aging population3. Increased demand for nurses

4. Workplace issues

5. Which of the following can be viewed as an effort by an organization to improve the image of nursing?1. Offering scholarships to high school students to attend nursing school2. Television commercials showing nurses and doctors providing care together3. A print advertisement with the statement "Nursing-The hardest job you'll ever love"4. An ANA-sponsored radio commercial explaining the role of nurses in society today

6. A nurse providing care in a well-baby clinic is practicing within which area of nursing practice?1. Promoting health and wellness2. Preventing illness3. Restoring health4. Providing care to the dying

7. While attending a continuing education seminar, several nurses from different states are discussing theirindividual state requirements for nursing licensure. Which of the following is the one common thread betweenall of the states' departments of nursing?1. Protect the public.2. Further nursing education.3. Obtain continuing education contact hours.4. Gain specialization.

8. A new nursing student is disappointed because classes so far are focused on topics such as communication andplanning, and she wanted to be a nurse to "provide care." This nursing student is describing which role of thenurse?1. Teacher2. Client advocate

3. Caregiver4. Counselor

9. A graduate nurse is learning different aspects of the nursing profession while maintaining a sense ofresponsibility and accountability. The process this nurse is learning is:1. case manager.2. professionalization.3. socialization.

4. governance.

10. An article appears in a nursing journal identifying one area of the United States with unusually high numbers ofindividuals with type 2 diabetes. This information would be considered:1. news.2. health statistics.

3. a targeted area of study.4. demography.

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CHAPTER 2 / Nursing Education, Research, and Evidence-Based Practice 7

KEY TOPIC REVIEW

1. are responsible for supervising the work of the licensed practical nurse/licensed vocational nurse.2. The four rights of human subjects that nurses must safeguard are:

a.b.

c.d.

3. The term means that any information a client relates will not be made public or available toothers without the patient's consent.

4. What is the definition of research?

5. According to the "Standards of Clinical Nursing" published by the ANA (1998), is included as one ofthe standards of professional performance.

6. Select and mark either (1) for quantitative research or (2) for qualitative research from the following items inregards to research:

a. ______ associated with naturalistic inquiry that explores subjective and complex experiences ofhuman beings

_____ ~data collection and analysis occur concurrently______ a systematic, logical sequence based on a specific plan designed to collect information in

controlled conditions; analyzed using statistical proceduresd. theory or framework is developed after the data is analyzed to identify patterns and/or themese. viewed as "hard science"

7. CEUs meet the following needs of the nurse: (Select all that apply.)a. assists nurses in enriching their professional careers through networking.b. assists nurses in attaining expertise in a specific area of nursing (i.e., wound care).c. provides nurses with information essential to nursing practice.d. provides nurses with opportunities to travel to different areas of the world.e. keeps nurses up to date on new techiques and/or knowledge.

8. Correctly identify the order of the steps in conducting quantitative research:a. Review the related literature.

b. Communicate conclusions and implications.c. Define the study's purpose or rationale.d. Conduct a pilot study.e. Analyze the data.f. Formulate hypotheses and define variables.g. Collect the data.h. Select the population, sample, and setting.i. State a research question or problem.j. Select a research design to test the hypothesis.

9. From the following list, select the definition that best defines the elements to consider in conducting a researchcritique.a. Substantive and theoretical dimensions

b. Methodologic dimensionsc. Ethical dimensions

d. Interpretive dimensionse. Presentation and stylistic dimensions

b.c.

The nurse must determine whether the rights ofhuman subjects were protected during the course ofthe study and whether any ethical problemscompromised the scientific merit of the study or thewell-being of the subjects.For these dimensions, the nurse needs to ascertain theaccurancy of the discussion, conclusions, andimplications of the study results. The findings mustbe related to the original hypotheses and theconceptual framework of the study. The implicationsand limitations of the study should be reviewed,together with the potential for replication orgeneralizability of the findings to similar populations.

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The nurse needs to evaluate the significance of theresearch problem, the appropriateness of theconceptualizations and the theoretical framework ofthe study, and the congruence between the researchquestion and the method used to address it.The dimensions pertain to the appropriateness of theresearch design, the size and representativeness of thestudy sample as well as the sampling design, validityand reliability of the instruments, adequacy of theresearch procedures, and the appropriateness of dataanalysis techniques used in the study.The manner in which the research plan and results arecommunicated refers to the presentation and stylisticdimensions. The research report must be detailed,logically organized, concise, and well written.

10. Measures of central tendency describe the center of a distribution of data, denoting where most of the subjectslie, and variability, which indicates the degree of dispersion or spread of the data. Define the following termsthat describe these measures.a. meanb. medianc. mode

d. rangee. vanancef. standard deviation

11. The Bachelor of Science in nursing (BSN) is the usual degree awarded to participants that have taken Icourses and:

a. successfully completed a basic 2-year degree in a community college as an associate science of nursing. (b. successfully completed a 4- to 5-year program that offered courses in liberal arts, sciences, humanities, and

nursmg.

c. successfully completed 3 years in a hospital-based educational program.d. successfully completed a 9- to 12-month program and can work under the supervision of registered nurses.

12. According to the "Standards of Clinical Nursing" published by the ANA (1998), research is included as oneof the standards of professional performance.a. Trueb. False

13. It is the responsibility of the employer to provide all CEU s for the nursing personnel.a. Trueb. False

14. pertains to the availability of time as well as the material and human resources needed to investigate aresearch problem or question.

15. A is conducted prior to the actual study to assess the adequacy of the data collection plan andto identify any potential flaws in the study.

FOCUSED STUDY TIPS

1. What is the NCLEX®? How is it administered? Who takes the NCLEX®?

2. Describe three educational routes to be eligible for the RN licensure review (NCLEX®). List the majoremphasis of each of the programs.

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CHAPTER 2 / Nursing Education, Research, and Evidence-Based Practice

3. List three examples of documented nursing research in nursing magazines or refer to the weblinks for thischapter on the Companion Website.

4. Which level of nursing do you think should be the entry level into professional practice? Discuss the debateover entry and defend your choice for the entry level for professional practice. Cite two resources in yourresponse using APA style. Refer to the Application Activity: Entry into Practice on the Companion Website.

5. List four ways for a nurse to provide for patient confidentiality.

CASE STUDY

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Go to the Companion Website at www.prenhall.com/berman and locate and read the student research provided. Thenanswer the following critical thinking questions.

I. Which theorist and theory is used as a framework to explore the concept of spirituality? Why do you think thatthe author used that theorist?

2. What was the purpose of this pilot study? Why did the authors use a pilot study instead of doing a more in­

depth research study?3. What were the indications for further study?4. What tools were used in this pilot study? What was the reliability of this study?

REVIEW QUESTIONS

I. A licensed practical nurse can perform which of the following functions?1. Assess the client's condition.

2. Develop a care plan or concept map for the client.3. Provide basic care to the client.

4. Evaluate the outcomes of the nursing plan and revise the care accordingly.

2. Upon successful completion of the NCLEX-RN®, the registered nurse is asked to participate in a research studyon the coping and adjustment skills of a newly graduated registered nurse. The plan is to use an oral, recordedinterview with a grounded theory. What type of research study is being conducted?1. Pilot study2. Quantitative study3. Qualitative study4. Ethnographic study

3. Which of the following activities are examples of how a professional nurse may participate in research? (Selectall that apply.)I. Critiquing research for application to practice2. Identifying clinical problems suitable for nursing research3. Encouraging patient participation in a study without informed consent4. Using research findings in the development of policies, procedures, and practice guidelines for patient care

4. A nursing student documents the client's full name and date of birth on the required paperwork for the clinicalcourse and turns it in to the instructor. Which of the following client rights is being violated?I. Right not to be harmed2. Right to full disclosure3. Right of self-determination4. Right of privacy and confidentiality

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10 CHAPTER 2 / Nursing Education, Research, and Evidence-Based Practice

5. Which of the following topics would be considered an in-service educational opportunity?1. PowerPoint- Tips for Successful Presentations2. How to Knit a Sweater in 3 Hours

3. Fire Safety4. New Techniques to Promote Continence in Older Adults

6. An RN manager is making assignments for an RN and LPN on the unit. Which of the following clients wouldthe manager assign to the RN? (Select all that apply.)1. A newly diagnosed diabetic patient who needs education on foot care, diabetic injections, and a I,800-calorie

ADA diet

2. A patient who is 2 days postop and needs assistance with ambulation in the hallway and to the restroom3. A patient receiving total parental nutrition (TPN)4. A patient who is undergoing a 24-hour urine collection

7. What are the reasons for continually revising nursing education curricula? (Select all that apply.)1. New scientific knowledge acquired with new discoveries regarding health2. Cultural changes that are continuously changing as time progresses3. New nursing instructors began their career in nursing and continuously change the curriculum4. Socioeconomic changes that occur in society

8. Continuing education is the responsibility of the nurse to keep abreast of and changes and alsochanges within the nursing profession.1. Scientific and technological2. Medical and technological3. Scientific and human responses4. Cardiac and neurological

9. As a nurse researcher, what is involved in the research project? (Select all that apply.)1. Identifying a research question or problem2. Writing a thesis paper3. Collecting data using various means such as computer searches and/or questionnaires4. Analyzing the data and writing up the results5. Publishing or presenting the research findings to expand the body of nursing knowledge

10. One of the major nursing responsibilities of nursing research that the nurse has is:1. encouraging participation of the clients in nursing research.2. being aware of and advocating on behalf of the client's rights.3. exposing the client to the possibility of injury from the research.4. pressuring the client into participating in the study.

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