Nursing 1290 Final Exam Questions With Correct Answers

CIVIL WAR 1860 TO 1865 - Answer -No formal training programs and nursing was unorganized-ask for assistance from Nightingale-Wives and mothers cared for the sick and wounded as best they could without any supplies and very limited medical knowledge/assistance-The 'cure' for most injuries to the extremities was amputation without any form of anesthesia expect alcohol and "bite the bullet"-Aseptic techniques were unheard of; most soldiers died from infections secondary to the surgery-Nutrition was very poor; many died of malnutrition and starvation EARLY DEVELOPMENT IN AMERICA - Answer -Early efforts to establish a 'school of nursing' were disorganized and inadequate-Most care administered by either women serving out an arrest sentence or by the work of Catholic sisters or Protestant deaconesses-The New England Hospital of Women and Children in 1872 is credit with establishing a formal 1-year program under the guidance of female physicians: Linda Richards first educated nurse-Schools at Bellevue, Connecticut Training School in New Haven and Boston Training School which only trained women-A Manual of Nursing (1876) Early development in America - Answer -Separate schools were opened to train male nurses and black women-Rules were very strict and the slightest infraction was grounds for dismissal-Very strong military and religious influence over the behavior for the students nurses-'Disciplining' the student was considered a responsibility of the supervisor to ensure that students possessed good morals, were honest, conscientious, obedient, respectful, loyal, passive and devoted to duty; students were expected to be unselfish.-Students were viewed as 'cheap labor' Diploma Programs - Answer Graduate approximately 4% of nurses (approximately 60 schools left in the country as of 2012)Many of the schools have partnered with local colleges so that students earn creditSame courses in nursing and the same number of hours for the courses/clinical experiences as other programsUsually 24-36 months durationTake the NCLEX-RNAccredited by the NLN and ACEN National Student Nurses Association (NSNA) - Answer -Professional organization for students in schools of nursing, established in 1952-It works with the ANA, but is a fully independent group, run and financed by nursing students, with each state having their own organizationMajor project: "Breakthrough into Nursing" focus is on recruiting and maintaining the enrollment of minorities in nursing schools-In 1975, the NSNA developed the Student Bill of Rights-carefully balances the rights of students with the responsibilities of the students Right circumstance - Answer appropriate setting, available resources Hebrew - Answer Kept records: Mosaic Code of hygiene Modern Nursing - Answer -Contributions included the concept of life-long learning so the nurse would not become stagnate-Writings include Notes on Nursing "the act of utilizing the environment of the client to assist him in his recovery" is the bases for the first nursing theory-The week of her birthday is now National Nurses' Week WORLD WAR II: 1939 TO 1945 - Answer -The Nurse Training Act of 1943 (The Bolton Act) provided funds for the U.S. Cadet Nurse Corp. It provided funds for tuition, monthly allowance, uniforms and other expenses for women who would enter nursing and upon completion, would serve in the military or civilian rolls essential of national defense-Nurses were given commissions as officers and held military rank-New method of fighting-the nurses were in the field, not safe in a hospital setting-New specialty-Flight nursing began to monitor patients during air transportation Major Nursing Education Reports - Answer -The Goldmark Report: (Goldmark,1923)-Burgess Report (1928)-Brown Report: (Brown,1948)-Toward Quality in Nursing, Needs and Goals (1964)-American Nurses' Association Position Statement (1965)-Educating Nurses: A Call for Radical Transformation (Benner, Sutphen Leonard & Day, 2010)-The Future of Nursing: Leading the Change, Advancing Health (IOM, 2011) NURSING EDUCATION ASSOCIATIONS - Answer -National League for Nursing Commission for Nursing Education Accreditation : NLN CNEA-accredits ALL nursing programs-American Association of Colleges of Nursing: AACN (CCNE): Only accredits BSN MS/MSN and DNP programs-Accreditation Commission for Education in Nursing (ACEN): accredits all nursing programs and is the gatekeeper for Title IV Federal Funds for all types of programs-National Organization for Associate Degree in Nursing: N-OADN: does not have an accrediting services Accreditation - Answer is a process by whereby educational institutions or programs are surveyed and evaluated against previously determined standard. This is a voluntary process by private agencies, done by peers to assure that an educational program meets established standards for structure, function & performance (Sheets, 2002) SIGMA THETA TAU INTERNATIONAL (SSTI) - Answer Founded in 1922 by nursing studentsMission: To provide leadership and scholarship in practice, education and research to improve the health of all people (STTI, 2011)Publications: Journal of Nursing Scholarship Reflections on Nursing Leadership Worldviews on Evidence-Based NursingJoint project with the United Nations: Sustainable Development Goals SBAR - Answer Situation-what is going on with the patient Background-clinical background Assessment-What I think the problem is Recommendation-what would I do to correct it Egyptians - Answer Magical answers: water as a source ofillness Greek - Answer Health as a balance between body and mindmedical symbol The Caduceus Hippocrates - Answer the Father of Medicine-approach tomedicine that has been used for centuries-epidemiology Romans - Answer Began public health and sanitation systems Early History 1-1500 AD - Answer Catholic Church dictated the role of the "nurse"Deaconess-provided home care (public health)Convents and nuns were where the sick andinjured would come for care-the beginnings ofthe Catholic system of hospitals todayMen cared for the injured during the CrusadesAltruism, charity, service to others andconnecting care to religion was the centraltheme for centuries Protestant Reformation - Answer major impact on health care including: Closing all of theconvents and monasteries; especially in England Care was taken over by the "uncommon woman"-the drunks and prostitutes, in almshouses and municipal hospitals RENAISSANCE: MID 1300 TO 1600 AD - Answer -Major impact on how health was viewed:significant advancement in medicine-Jenner's smallpox vaccinationPsychiatry became a specialtyDevelopment of the watch and stethoscopePasteur and pasteurization of foodLister-Father of surgeryKoch-Father of microbiology-Development of the germ theory INDUSTRIAL REVOLUTION: - Answer -Migration from the farms to the cities-Terrible work conditions; including childlabor-Epidemics were common due to the work and home environments-few public health laws Colonial America - Answer -No formally trained medical or nursing personal-The nuns and deaconess cared for the ill and injured-Female members of the soldiers' families cared for their men or made bandages and other supplies; Barns and homes were converted into hospitals-In 1786, the Philadelphia Dispensary was established. The staff cared for the wounded and disabled for free-the forerunner of today's clinics or hospital outpatient departments Florence Nightingale () - Answer -Florence Nightingale "The Lady with the Lamp" wentagainst the culture of her day to be called the Founder of Modern Nursing-Educated at Deaconess Home and Hospital atKaiserswerth-After the Crimean War (1854) returned to England and in 1860 opened the first modern school of nursing at St. Thomas' Hospital in London-Credited with using public health concepts andstatistical methods to advance and improve the health conditions of the soldiers and then applied these methods to the general population THE BEGINNING OF MODERN NURSING - Answer Basic Principles:-Nurses should be trained in hospital with medical schools-Nurses must be selected carefully and would reside in dorms designed to encourage discipline and form character-School matron would have final authority over curriculum, living arrangements and all other aspects of school-The curriculum would include both theoretic material and practical experience, instructors would be paid and records would be kept on the students. Early development in America - Answer -Public Health, under the leadership of Lillian Ward and Mary Brewster (1893), established the Henry Street Settlement to help care for and educate the residents, mainly immigrates, of the Lower East Side of NYC; School nursing became a subspecialty of public health nursing-Textbooks for the newly established programs were limited and the students were taught by lectures delivered by physicians from their medical student days after they had worked all day on the units; students learned by apprenticeship. Senior students were utilized to staff the nursing units, especially at night-the needs of the hospital outweighed the needs of students' education-No standardization of curriculum or accreditation Spanish-American War (1898) - Answer -Nursing schools were well established, but increased number of students were needed to supply both the needs of the military and civilian population-Nursing was done in central areas or 'camps'-Problems included inadequate water facilities, lack of laundry and inadequate medical supplies-Many of the soldiers and nurses became ill with typhoid fever-Clara Maas-Post-war outcome-formation of the Army (1901) and Navy (1908) Corp of Nursing; Red Cross reorganized under Taft World War I () - Answer -Schools of nursing were well established and the Army and Navy Corp of Nursing programs were in full preparedness-The Influenza epidemic of 1918 caused a major shortage in both military and civilian nurses-Due to this shortage, the Army Nursing Corp started to admit black women-Patient care started to move from the home to the hospital setting-First specialization in nursing-nurse anesthetists GREAT DEPRESSION: 1929 - Answer -Up to this time, hospitals were staffed by students; graduates worked a private duty nurses-Many hospitals and schools of nursing closed and families could no longer afford private care-Hospitals turned to RNs to staff the hospital, and the face of hospital nursing changed forever-very low salaries. Put into place the idea of an 8-hour shift, so that 3 nurses were need for every 24 hours-Others found work under government programs, providing rural and school health care and fighting communicable diseases-Public Health post war developments - Answer -GI Bill enabled veterans to continue their education-Minimal national standards for nursing education were established by the National Nursing Accrediting service and by 1950, all states were participating in the test pool-Hill-Barton Act of 1946 committed federal dollars for the construction of hospitals and public health and public health facilities KOREA (1950) AND VIETNAM (1960s) - Answer -MASH units (mobile army surgical hospital) were minutes from the battles; immediate care was given and then the flight nursing staff would evacuate them to large facilities-Recruitment of nurses was again a major activity, made harder by the lack of support for the Vietnam War-No military front and hazardous terrain and climate made establish permanent structures difficult GULF WAR, WARS IN IRAQ & AFGHANISTAN - Answer -Desert conditions, the need for protective gear, such as gas masks to combat chemical warfare, and caring for injured civilians who might just be the enemy, have added more stress to the already stressful environment-With new methods of wound care in the field, more soldiers are surviving from injuries that in the past they would have died from -PTSD #1 rule - Answer Nursing education is built on the knowledge gain from previous courses-you need to bring with you everything that you have learned from day 1: It's a continuumUnderstanding is more important than rote memorizingApplication of the material becomes more important in both classroom and clinicalClinical or practicum component with or with out didactic component Training - Answer fixed habits and skills; utilizes repetition, authority and coercion-encourages dependency apprenticeship - Answer Diploma Schools- The New England Hospital of Women and Children-1st graduate-Linda Richards education - Answer self-discipline, responsibility, accountability and self-mastery diploma programs - Answer usually based in hospitals. Major program until the 1960s Associates program (ADN) - Answer Community Colleges-started in 1952: attract non-traditional students Baccalaureate Programs (BSN) - Answer Colleges/Universities ANA's Position Paper on Education for Nursing - Answer -Educational Preparation for Nurse Practitioners and Assistants to Nurses: ALL nurses should be educated in institutions of higher learning-Titling became the issue: ADN graduates: technical nursesBSN graduates: professional nurses-Catch-all graduates take the same licensing exam-NCLEX-RN-Movement from hospital-based programs to colleges-now guests at the hospitals-lost some of the partnership and connection of the past-NYS has pass a bill that would require ALL nurses to have a BSN in 10 years post graduation in 2017 Associated Degree (ADN) - Answer -Program started in the early 50's based on a book by Mildred Montag-Program usually 24-36 months; approximately 45.4% are initially enrolled-Take some liberal arts courses; focuses on more technical nursing-Take the NCLEX-RN-Accredited by the NLN and ACEN-Changes in the program include the ADN being a stepping-stone to the BSN-Tuition is lower for the first 2 years Baccalaureate (BSN) - Answer Courses are held in a college/university; 4-5 years duration; take all liberal arts courses that are requirements of the college to graduate plus nursing coursesApproximately 696 programs in the U.S.Take the NCLEX-RNAccredited by NLN, CCNE or ACENMust have a BSN for: school nursing, supervisory position and a requirement for all Magnet hospital RN staff APN - Answer advanced practice nurse CNS - Answer Clinical Nurse Specialist CRNA - Answer certified registered nurse anesthetist CNM - Answer certified nurse midwife CNL - Answer Clinical Nurse Leader DOCTORAL DEGRESS IN NURSING - Answer -Doctoral studies in nursing have increased since 1980s: Earliest PhD in Nursing-1960-Prior to that many doctorate nurses had their degrees in other fields, especially psychology, sociology, anthropology or physiology-Many different types of doctorates that can be conferred: DNSc, DSN, DNEd, PhD, EdD, DPH, DNP-DNP-Practiced-focused degree-Accreditation earned for the DNP programs through ACEN, CCNE and NLN CNEA Five Core competencies as per the IOM - Answer *Work in interdisciplinary teams *Employ evidence-based practice (EBP) *Apply Quality Improvement *Provide Patient Centered Care*Utilize informatics The Nurse Practice Act - Answer -The State Board of Nursing(SBON) is given the responsibility for administering the Nurse Practice Act (NPA) within the act itself.-The purpose of the act is to regulate the protection of the public and to make individual practitioners accountable for their own actions-Provides the legal bases for the regulation of nursing and the responsibility for interpreting the legal scope of nursing practice rests solely with the individual SBON NCSBN (National Council of State Boards of Nursing) - Answer -has members from all 50 states and territories-All NPA have the same basic guiding principals: Protection of the public Competence of all practitioners Due process and ethical decision making Shared accountability Strategic collaboration Evidence-based regulation Response to the marketplace Globalization of nursing Role of State Board of Nursing - Answer establish standard for licensure, enforces disciplinary codes, provides rules for revocation of licensureEstablishes standards and examines applicants for licensure DISCIPLINARY ACTIONS - Answer penalties that may be imposed against an individual who has violated provisions of a licensing law. REASONS OF DISCIPLINARY ACTIONS - Answer Fraud in obtaining a licenseConviction of a felonyUnsafe or unprofessional practice (practicing while chemically impaired)Unethical conductDrug diversionPracticing outside the scope of practice Nurse Licensure Compact (NLC) - Answer -Allows nurses to practice in other states both physically and electronically through multistate privilege-While practicing in another compact state, one must follow the NPA of the state that they are practicing within.-To utilize the licensure compact, your home state must be a participating member of the mutual recognition model; if not then you need to obtain another license for the state that you wish to practice in. Licensure - Answer is a legal credential conferred by an individual state that grants permission to the individual to practice a given profession. The individual has demonstrated an essential degree of competency necessary to perform a unique scope of practice prior to receiving the license. Most states require licensing only of those who have a direct contact with patients/clients. QUALIFICATION FOR LICENSURE - Answer Graduated from an approved educational programProficient in EnglishPassing score on a comprehensive examination/NCLEX"Good moral character""Good physical and mental health"Background check in many states GRANDFATHERING - Answer -When a new law is written, it usually contains a statement specifying that anyone currently holding a license may continue to hold that license if and when requirements for the license change.-When new requirements are instituted, that the legislature believe are important for the safety of the public, all currently licensed individuals may be required to meet the new standard within a given period of time. LICENSE RENEWALS - Answer -The length of time for which a license is valid and any requirements for its renewal. New York is 3 years-Some states license renewals requires only the payment of a fee-Some states require continuing education units (CEUs)*Sunset Legislation: intended to ensure that legislation is current and reflects the needs of the public-the bill must be review and renewed by a specific date Licensure by endorsement - Answer a nurse licensed in one state can seek licensure in another state without repeating the NCLEX. Can be registered in more than one state, but must meet the requirements of and follow the NPA of that state Military and government nurses - Answer practice through out the US and in other countries with one license-must remain 'current' with their 'home' license Internationally educated nurses - Answer show completion of their original program; take an exam administered by the Commission on Graduates of Foreign Nursing Schools & the NCLEX-RN International Practice - Answer need to contact the ICN for information regarding the requirements of the country in which practice is desired Certification - Answer written documents that communicate to others the nature of one's competence and provide evidence of one's preparation to perform in a specific occupation. It provides a standard mechanism for judging competence to protect the safety of the public. It does not conifer any legal status; it is nongovernmental. Licensure establishes the minimal level of practice; while a certification recognizes excellence in practice*ANCC responsible for this* PROFESSIONAL ASSOCIATION ACTIVITIES - Answer Publish journalsContinuing educationDeveloping professional standardsProfessional educationPolicy decisions in government; political actionAdvocacy in work environment INTERNATIONAL COUNCIL OF NURSES (ICN) - Answer -The International Council was founded in 1899.The ANA is a member.-There are 120 member countries.-ICN focuses on health care in general and nursing care throughout the world ICN concerns itself with issues such as the social and economic welfare of nurses throughout the world.-It provides a site where communication for all member countries-ICN meets every 4 years in Geneva, Switzerland AMERICAN NURSES ASSOCIATION (ANA) - Answer -Origins in a meeting of nursing leaders at the World's Fair in Chicago in 1890-Originally called the National Associated Alumnae of the United States and Canada and changed in 1901 to ANA because NY state laws did not permit representatives from more than one country-Membership comprises the 50 state nurses' association (SNA) and four territories ANA - Answer Fewer than half of the RNs participate in the ANA -High cost of dues -Lack of time to participate -Benefits available not personally valuable -Do not agree with ANA position on major issuesActivities and Services -Advancement of the Profession -Legislative Activity -Collective Bargaining -Group professional liability insurance plans -Group health, disability and accident coveragePublications-The American Nurse & Online Journal of Nursing CURRENT ISSUES OF THE ANA - Answer Nursing shortage Patient safety and advocacy Workplace rights Appropriate staffing Environment and occupation health for nurses