Chapter 09: Care and Safety Standards, Competence, and Nurse Accountability

Chapter 09: Care and Safety Standards, Competence, and Nurse Accountability

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A new graduate has been working as an RN for 6 months and is no longer working with a preceptor. However, she still frequently checks with an experienced nurse to validate that she is following the rules and the policies she is still learning. The new graduate in this scenario exhibits the actions of what theoretical level of skill?

ANS:  D

In general, a novice is rule driven, is a concrete thinker, and believes and trusts whomever has authority or whatever direction is perceived to have come from someone in authority. Benner (1984) suggests that with experience and practice, nurses advance through the different levels of nursing knowledge—novice, competent, proficient, and expert.

DIF:    Cognitive Level: Analysis                REF:   Page 133

OBJ:   Compare the theoretical classifications of nursing skill.

TOP:   Classification of Nursing Skill

MSC:  NCLEX: Safe, Effective Care Environment: Management of Care

2. An RN has been working on a cardiac unit for 1 year and has settled comfortably into an efficient, safe, and organized routine for each shift. However, whenever an urgent issue arises, the nurse feels uncomfortable. It is most likely that this nurse is functioning at which skill level?

ANS:  C

A competent nurse has some experience and has developed safe organizational skills to get through the day’s tasks efficiently. Flexibility within the nursing role is difficult to manage at this point, and when deviations from the schedule occur, the nurse generally has a feeling of unease.

DIF:    Cognitive Level: Analysis                REF:   Page 133

OBJ:   Compare the theoretical classifications of nursing skill.

TOP:   Classification of Nursing Skill

MSC:  NCLEX: Safe, Effective Care Environment: Management of Care

3. Which action would indicate that the RN is practicing at the proficient level?

ANS:  C

A proficient nurse is experienced and has a beginning ability to recognize patterns and think critically. This allows her to think critically about situations and anticipate the needs of her patients. Novice nurses may ask the help of other more experienced nurses. Competent nurses have developed skills and are routine driven, often struggling with flexibility. Expert nurses are skilled critical thinkers and handle challenges with ease.

DIF:    Cognitive Level: Application           REF:   Page 133

OBJ:   Compare the theoretical classifications of nursing skill.

TOP:   Classification of Nursing Skill

MSC:  NCLEX: Safe, Effective Care Environment: Management of Care

4. An RN has been practicing for 12 years in pediatrics. Peers often seek out this nurse to help them with complex problems. This experienced nurse is assigned the patients with the highest acuity, and the nurse accepts these assignments with confidence. This nurse is likely practicing at which skill level?

ANS:  D

An expert nurse has had a great deal of experience and is flexible and adaptable, responding to change with ease. According to Benner (1984), the expert nurse is a skilled critical thinker who has gained experience and skills through practice.

DIF:    Cognitive Level: Analysis                REF:   Page 133

OBJ:   Compare the theoretical classifications of nursing skill.

TOP:   Classification of Nursing Skill

MSC:  NCLEX: Safe, Effective Care Environment: Management of Care

5. The nurse is working on a busy cardiac floor. While preparing medications, the nurse is interrupted by a co-worker, who has a question about another patient. After administering the medication, the nurse realizes that she gave the medication to the wrong patient. Which action by the nurse would indicate accountability?

ANS:  D

Accountability is being answerable for the actions or interventions one performs as a nurse. Immediately assessing the patient and reporting the error to a physician demonstrate accountability. Shifting blame, attempting to hide the error, and accepting only partial blame do not.

DIF:    Cognitive Level: Application           REF:   Page 135

OBJ:   Describe accountability as it applies to nursing practice.     TOP:   Accountability

MSC:  NCLEX: Safe, Effective Care Environment: Management of Care