ANCC NPD-BC Exam Questions

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61.

When educating a patient with low health literacy about insulin administration, which teaching strategy is most appropriate?

  • Demonstrating the technique, then observing the patient perform it.

  • Providing detailed, technically correct explanations of insulin action.

  • Offering written instructions that can be referenced at home.

  • Avoiding any teaching method that would require the patient to read.

Correct answer: Demonstrating the technique, then observing the patient perform it.

Demonstration followed by a return demonstration ensures the patient understands and can perform the skill correctly.

Detailed biochemical explanations may overwhelm the patient and detract from the practical skill of administration. Written instructions lack the interactive component of teaching and are not as effective as demonstration then observation of the technique. Written materials are important teaching supports; limited health literacy does not imply limited literacy in general.

62.

What is the most effective strategy for a nurse educator to evaluate the impact of a new Evidence-Based Practice (EBP) training program on patient outcomes?

  • Compare patient outcomes before and after the training using retrospective chart reviews.

  • Survey nurses' satisfaction with the EBP training program.

  • Assess the increase in EBP-related publications by the nursing staff.

  • Monitor the frequency of EBP discussions during team meetings.

Correct answer: Compare patient outcomes before and after the training using retrospective chart reviews.

Comparing patient outcomes before and after the training directly measures the impact of the training on patient care, providing concrete evidence of its effectiveness.

Nurses' satisfaction is important for engagement but does not directly correlate with improved patient outcomes, which is the goal of EBP training programs. While an increase in publications indicates greater engagement with EBP, it does not directly measure the impact on patient care. The frequency of discussions may indicate interest but does not measure the actual application of EBP or its outcomes.

63.

A case manager encounters a situation where the patient's preferred treatment conflicts with the healthcare facility's standard protocol. What is the best way for them to proceed?

  • Seek a collaborative solution that balances the patient’s preference with the facility’s protocol.

  • Adhere to the facility’s protocol, explaining to the patient that their preference is not permitted.

  • Advocate for the patient’s preference as an exception to the facility’s protocol.

  • Transfer the patient to another facility that aligns with the patient’s preference.

Correct answer: Seek a collaborative solution that balances the patient’s preference with the facility’s protocol.

Seeking a collaborative solution respects the patient's autonomy while considering the facility's guidelines, aiming for a solution that addresses both.

While protocols are important, patient preferences should also be considered to provide patient-centered care. Advocacy is important, but it should not disregard established protocols. While transferring to another facility may sometimes be an option, it should not be the first step without attempting to find a collaborative solution within the current facility.

64.

In a study assessing the effect of shift length on nurse burnout, which of the following methods would best ensure the validity of data collection?

  • Use of a standardized burnout inventory completed by nurses at the end of each shift.

  • Interviews with nurses about their perceptions of burnout.

  • Comparison of sick days taken by nurses working different shift lengths.

  • Analysis of turnover rates among nurses working different shift lengths.

Correct answer: Use of a standardized burnout inventory completed by nurses at the end of each shift.

A standardized inventory provides a consistent, reliable, and validated measure of burnout, ensuring that data collection is systematic and comparable across participants.

While interviews can provide in-depth insights, they may introduce interviewer bias and variability in how questions are interpreted by respondents. Sick days may be influenced by many factors other than burnout, such as physical illness or personal obligations, making it an indirect and potentially misleading measure. Turnover rates can be influenced by numerous factors, including but not limited to burnout, and do not directly measure the study's focus.

65.

A nurse leader is dealing with a high turnover rate in their unit. The best initial approach to address this issue would be to do which of the following?

  • Conduct exit interviews to understand the reasons for leaving.

  • Provide improved incentives for the nursing staff immediately.

  • Hire more staff to reduce the workload on current employees.

  • Implement improved overtime incentives to ensure adequate staffing.

Correct answer: Conduct exit interviews to understand the reasons for leaving.

Conducting exit interviews can provide insights into the causes of turnover and inform targeted interventions.

While lack of adequate incentives may be a factor, understanding the underlying reasons is most important for developing a sustainable solution. Hiring more staff may be necessary, but it's important to address the root causes of turnover first. Increased overtime may exacerbate burnout and contribute to higher turnover.

66.

How does role-based access control enhance the security of patient information in a hospital information system?

  • By restricting access to information based on the user’s need to access the information.

  • By encrypting all patient data stored in the system.

  • By providing hospital technology and security staff with better control over the security of patient information.

  • By requiring two-factor authentication for all users.

Correct answer: By restricting access to information based on the user’s need to access the information.

Role-based access control restricts access to information based on the user’s need to access the information and ensures that individuals only access information necessary for their job functions, minimizing exposure of the data and the risk of data breaches.

Encryption secures data but does not manage access based on roles. Role-based access control primarily enhances the security of patient information by limiting the exposure of data, not by providing hospital technology or security staff better control over it. Two-factor authentication adds a layer of security but does not restrict access based on roles.

67.

A nurse educator is teaching new staff about the importance of data security. Which example best illustrates a potential security risk?

  • Sharing passwords with trusted colleagues in limited emergency situations.

  • Using a password that includes letters, numbers, and symbols.

  • Accessing patient records on a secured network within the hospital.

  • Regularly changing passwords according to hospital policy.

Correct answer: Sharing passwords with trusted colleagues in limited emergency situations.

Sharing passwords with colleagues can lead to unauthorized access and compromise the integrity of data security practices, even if the sharing is limited.

Using complex passwords that include letters, numbers, and symbols is a recommended practice for securing accounts. Accessing records on a secured network is a standard and secure practice. Regularly changing passwords is a security measure to prevent unauthorized access.

68.

During a severe staffing crisis, the charge nurse of an ICU must decide how to lead the team effectively. According to contingency theory, which factor should the charge nurse prioritize when determining the most appropriate leadership style to adopt?

  • The factors specific to that particular staffing crisis.

  • The charge nurse's personal preference and comfort with a particular leadership style.

  • The level of stress and anxiety among the staff due to the staffing crisis.

  • The hospital's overall policies and administrative guidelines.

Correct answer: The factors specific to that particular staffing crisis.

According to contingency theory, the leadership style employed should be based on the specific situation. Determining factors specific to that particular staffing crisis is most appropriate to contingency theory.

Contingency theory suggests that the effectiveness of leadership is contingent on the situation rather than the leader's personal preference or comfort level. While staff emotions are important, contingency theory emphasizes the fit between leadership style, task structure, and the leader's position of power in determining effectiveness. Although hospital policies are important, contingency theory focuses more on the immediate situational factors (like task structure and leader-member relations) when choosing a leadership style.

69.

In evaluating the methodology of a research study on the effectiveness of a new wound care protocol, which of the following elements is most critical for a nurse to consider for applicability to clinical practice?

  • The type of research design.

  • The statistical tests used to analyze data.

  • The theoretical framework.

  • The funding source for the research.

Correct answer: The type of research design.

The research design (e.g. randomized controlled trial, cohort study) directly influences the validity of the study's conclusions for clinical practice, making it a critical element for evaluation.

While understanding the statistical tests is important for interpreting results, it does not influence the study's applicability to clinical practice as much as the research design does.  The theoretical framework provides a conceptual basis for the study but is less directly related to practical applicability than the research design. The funding source may raise potential biases but is not the most critical element in determining the study's applicability to clinical practice.

70.

A nurse posts about a challenging day at work on social media without mentioning specific patient details. Which guideline is most important for the nurse to follow to ensure professionalism on social media?

  • Adhere to patient privacy laws and professional standards, even in vague postings.

  • Only post positive experiences about work to avoid public scrutiny.

  • Ensure that all posts are approved by the hospital's public relations department.

  • Avoid posting any work-related content to maintain a clear professional boundary.

Correct answer: Adhere to patient privacy laws and professional standards, even in vague postings.

Maintaining patient privacy and adhering to professional standards is crucial, even when posts do not mention specifics, to uphold the integrity of the profession and comply with legal and ethical guidelines.

It's unnecessary to only post positive experiences; professionalism involves more than simply maintaining a positive image. While some institutions have social media policies, requiring all posts to be approved is impractical and unlikely to be universally required. Although it may be a good practice, avoiding posting any work-related content is overly restrictive and not necessary.

71.

A nurse manager is developing guidelines for end-of-life care in the hospital. According to natural law theory, which principle should be the foundation of these guidelines?

  • The respect for the expected course of life and death, including palliative care and comfort measures.

  • The maximum allocation of resources to extend life at all costs.

  • The prioritization of treatment based on the patient's social status and contribution to society.

  • The use of aggressive interventions to prevent death, regardless of the patient's quality of life.

Correct answer: The respect for the expected course of life and death, including palliative care and comfort measures.

Natural law theory supports actions that respect the natural order and purpose of human life, including the natural process of dying, making palliative care and respect for the natural end of life key components of care guidelines. It supports respecting the natural course of life and death, emphasizing the importance of providing care that aligns with natural processes, such as palliative care and comfort measures.

Natural law theory would not advocate for extending life at all costs, especially if it means disregarding the natural course of life. Natural law theory does not prioritize individuals based on social status or societal contributions but respects the natural dignity of every human life. Natural law theory does not support aggressive interventions that disregard the natural course of life and the quality of the individual's life.

72.

When designing a website for a new nursing education program, what is the most critical element to include to enhance user engagement and learning?

  • Interactive quizzes and feedback mechanisms

  • High-resolution images and videos

  • Frequent pop-up reminders

  • In-depth navigation menus

Correct answer: Interactive quizzes and feedback mechanisms

Interactive quizzes and feedback mechanisms directly engage users by allowing them to test their knowledge and receive immediate feedback, thus enhancing the learning experience.

While high-resolution images and videos can enhance the website and serve as valuable learning tools, they do not actively engage the user in learning. Frequent pop-up reminders are likely to distract and annoy users, negatively impacting the learning experience. Complex navigation menus can make it difficult for users to find the information they need, hindering user engagement and learning.

73.

A case manager has developed a comprehensive care plan for a patient. What is the next step they should take to ensure the effectiveness of the care plan?

  • Regularly monitor progress and adjust the care plan as needed.

  • Have the patient or family self-report any issues or improvements.

  • Immediately start planning for the next phase of care.

  • Use evidence-based practice to refine the care plan.

Correct answer: Regularly monitor progress and adjust the care plan as needed.

Ongoing assessment ensures that the care plan remains relevant and effective, allowing for timely adjustments.

Proactive monitoring is crucial rather than relying solely on patient or family reports. While future planning is important, it should not precede the evaluation of the current plan's effectiveness. Evidence-based practice should be used during the initial development of the care plan and is not something that should be added afterward.

74.

A nursing professional is educating a patient on the confidentiality of their health records. Which of the following statements is accurate regarding the patient's rights under HIPAA?

  • Patients have the right to request an amendment to their medical records if they find inaccuracies.

  • Patients cannot access their own medical records upon request.

  • Healthcare providers can share patient information with those they feel that it's in the best interest of the patient to share the information with.

  • Healthcare providers do not need consent to share medical records that do not include patients’ names or birthdays.

Correct answer: Patients have the right to request an amendment to their medical records if they find inaccuracies.

HIPAA grants patients the right to request amendments to their medical records if inaccuracies are found.

Patients have the right to access their medical records under HIPAA upon request in most situations. Healthcare providers are restricted in who they can share patient information with, and sharing is generally limited to those involved in the patient's care or as authorized by the patient or by law, not by the feelings of the healthcare provider. HIPAA requires specific authorization from the patient before their medical records can be shared. While records can be shared in some circumstances if Protected Health Information (PHI) is removed, PHI includes more than just name and birthday.

75.

In response to a high rate of patient falls, a nurse leader decides to implement a new protocol. According to transactional leadership, which approach should the nurse leader take to effectively reduce the fall rate?

  • Establish a system where staff members receive recognition and rewards for following the protocol and preventing falls.

  • Develop a comprehensive training program that focuses on enhancing the intrinsic motivation of the staff.

  • Focus on transforming the unit's culture to align with the vision of providing the safest patient environment.

  • Encourage open dialogue and feedback from staff about their perceptions and feelings toward the new protocol.

Correct answer: Establish a system where staff members receive recognition and rewards for following the protocol and preventing falls.

Offering recognition and rewards aligns with the principles of transactional leadership, which involve motivating staff through a system of rewards and consequences based on performance.

While training is important, transactional leadership is more about setting clear objectives and using rewards or penalties, not primarily focusing on intrinsic motivation. Transforming the unit's culture aligns more with transformational leadership, which focuses on inspiring and engaging staff to change, rather than the structured reward/penalty system of transactional leadership. Although feedback is valuable, transactional leadership typically emphasizes clear structures and rewards for performance over collaborative dialogue and feedback.

76.

Nurse-sensitive indicators are used to measure which of the following?

  • The impact of nursing care on patient outcomes.

  • The financial health of a healthcare organization.

  • The effectiveness of hospital safety strategies.

  • The satisfaction nurses obtain from their roles.

Correct answer: The impact of nursing care on patient outcomes.

Nurse-sensitive indicators specifically track the impact of nursing interventions on patient health outcomes.

Financial health is measured by financial performance indicators, not nurse-sensitive indicators. Nurse-sensitive indicators measure the impact of nursing interventions specifically, not general safety strategies that are not specific to nursing. Nurse-sensitive indicators are specific patient care outcomes affected by nursing care and do not involve factors that do not affect patient care, like the satisfaction nurses obtain from their roles.

77.

Which of the following best describes the importance of identifying project champions when implementing a new patient care technology?

  • Champions help to drive the project and encourage buy-in from others.

  • Champions are primarily responsible for letting others know about the project.

  • Champions are only necessary if the project faces significant resistance.

  • Champions are needed to perform the technical or clinical tasks related to the project.

Correct answer: Champions help to drive the project and encourage buy-in from others.

Champions are influential in promoting the project, overcoming resistance, and motivating others to support and adopt new practices.

Champions play a key role in supporting and advocating for the project, not just raising awareness about it. While resistance may highlight the need for champions, their role is critical regardless of the level of resistance. Champions' main role is advocacy and support, rather than performing technical or clinical tasks.

78.

A nursing professional is developing a continuing education module on infection control practices. The module incorporates role modeling and peer discussions to enhance learning. According to Bandura's social learning theory, which component is most important for the nurses to effectively learn and adopt the new practices?

  • Observing a respected peer perform the infection control practices correctly.

  • The ability to memorize and recall the steps of infection control.

  • Understanding the consequences of not following infection control practices.

  • The opportunity to practice infection control in a controlled environment.

Correct answer: Observing a respected peer perform the infection control practices correctly.

Social learning theory posits that people learn from one another through observation, imitation, and modeling. Seeing a respected peer perform the practices correctly can lead to observational learning, a key component of Bandura's theory.

While memorization is a part of learning, social learning theory emphasizes learning through observation and imitation rather than just memory recall. Understanding consequences is more aligned with behaviorist theories that focus on reinforcement and punishment, not with social learning theory's emphasis on observational learning. Practice is important, but the critical component of social learning theory highlighted in the question is observational learning from a model, which is not directly addressed by this option.

79.

A nurse is using a decision support system to review potential medication interactions. What is the primary benefit of this technology?

  • It provides evidence-based recommendations to enhance patient safety.

  • It eliminates the need for pharmacists in medication management.

  • It allows nurses to prescribe medications in some situations.

  • It relies on the nurse's judgment to determine the relevance of alerts.

Correct answer: It provides evidence-based recommendations to enhance patient safety.

The primary benefit is to provide evidence-based recommendations and alerts about potential medication interactions, enhancing patient safety by supporting clinical decision-making.

Decision support systems complement the expertise of pharmacists by providing additional safety checks, not replacing them. Nurses use decision support systems as a tool for safety; prescribing medications remains within the purview of licensed prescribers such as physicians. While clinical judgment is vital, the system provides alerts and recommendations based on a vast database of evidence-based information to guide decisions.

80.

A nurse educator is preparing a presentation on patient safety for an upcoming conference. They decide to include several diagrams and models that were published in a nursing journal last year. Which of the following actions should the nurse educator take to comply with copyright law?

  • Obtain permission from the publisher before using the diagrams and models in the presentation.

  • Understand that diagrams and models can be used without permission if they are being used for educational purposes.

  • Modify the diagrams and models slightly before use in the presentation.

  • Use the diagrams and models but cite the nursing journal as the source.

Correct answer: Obtain permission from the publisher before using the diagrams and models in the presentation.

Obtaining permission from the publisher is the legally compliant way to use copyrighted material, ensuring respect for intellectual property rights.

Using copyrighted material without permission, even for educational purposes, can still infringe on copyright laws. Modifying copyrighted material does not automatically negate copyright restrictions and may still constitute infringement. Citing the source of copyrighted material is a good practice but does not replace the need for permission to use the material.