Ch. 21, 22 + 23 Ethics/Legal/Managing Pt. Care Practice Questions
A nurse observes a patient care technician using all these measures when taking vital signs. Which measure requires the nurse to intervene? a. Palpates brachial artery before inflating blood pressure cuff b. Counts respirations while palpating radial pulse c. Inserts thermometer into sublingual pocket after patient sips water d. Asks patient to relax arm before taking blood pressure
C
A home health nurse notices significant bruising on a 2-year-old patient's head, arms, abdomen, and legs. The patient's mother describes the patient's frequent falls. What is the best nursing action for the home health nurse to take? A. Document her findings and treat the patient B. Instruct the mother on safe handling of a 2-year-old child C. Contact a child abuse hotline D. Discuss this story with a colleague
C. Contact a child abuse hotline Nurses are mandated reporters of suspected child abuse. These assessment findings possibly indicate child abuse.
A nurse is planning care for a patient going to surgery. Who is responsible for informing the patient about the surgery along with possible risks, complications, and benefits? A. Family member B. Surgeon C. Nurse D. Nurse manager
C. Surgeon The person performing the procedure is responsible for informing the patient about the procedure and its risks, benefits, and possible complications.
A charge nurse should instruct a new nurse taking care of a patient with hypercholesterolemia to make which of these lifestyle modifications? a. High-protein, high-fat diet b. Decreased walking frequency from three times to two times a week c. Discontinuation of antihypertensive medications d. Smoking cessation
D
The staff on the nursing unit are discussing implementing interprofessional rounding. Which of the following statements correctly describe interprofessional rounding? Select all that apply. A. Allows team members to share information about patients to improve care B. Provides an opportunity for early patient discharge planning C. Improves communication among health care team members D. Allows each of the health care team members to identify separate patient goals E. Allows each health care provider an opportunity to delegate a task.
A, B, C Allowing team members to share information about patients to improve care, providing an opportunity for early patient discharge planning, and improving communication among team members all focus on the benefits of interprofessional rounding. This type of rounding has been found to decrease medication errors and improve quality of patient care. During interprofessional rounding all team members focus on the same patient goals.
Which of the following statements indicate that the new nursing graduate understands ways to remain involved professionally? Select all that apply. A. "I am thinking about joining the health committee at my church." B. "I need to read newspapers, watch news broadcasts, and search the Internet for information related to health." C. "I will join nursing committees at the hospital after I have completed orientation and better understand the issues affecting nursing." D. "Nurses do not have very much voice in legislation in Washington, DC, because of the nursing shortage." E. "I will go back to school as soon as I finish orientation."
A, B, C Nurses need to be actively involved in their community and be aware of current issues in health care. Staying abreast of current news and public opinion through the media is essential. Nurses need to join nursing committees to be involved in decision making. Nurses have a powerful voice in the legislature.
A nurse asks a nursing assistive personnel (NAP) to help the patient in room 418 walk to the bathroom right now. The nurse tells the NAP that the patient needs the assistance of one person and the use of a walker. The nurse also tells the NAP that the patient's oxygen can be removed while he goes to the bathroom but to make sure that it is put back on at 2 L. The nurse also instructs the NAP to make sure the side rails are up and the bed alarm is reset after the patient gets back in bed. Which of the following components of the "Five Rights of Delegation" were used by the nurse? Select all that apply. A. Right task B. Right circumstances C. Right person D. Right direction/communication E. Right supervision/evaluation
A, B, C, D The nurse provided four of the five components but did not provide the right supervision/evaluation. The nurse delegated the task of taking a patient to the bathroom to the NAP, which is in the scope of an NAP's duties and responsibilities and matched to the NAP skill level. The nurse provided clear directions by describing the task and the time period to complete the task. The nurse did not use "please" and "thank you" in the request. The nurse did not ask the if there were any questions, which would provide the NAP an opportunity to get clarification if there were questions. The nurse did not ask the NAP to follow up to check on how the patient did or if there were any problems. The nurse did not provide appropriate monitoring, evaluation, intervention as needed, or feedback.
Which of the following properly applies an ethical principle to justify access to health care? Select all that apply. A. Access to health care reflects the commitment of society to principles of beneficence and justice. B. If low income compromises access to care, respect for autonomy is compromised. C. Access to health care is a privilege in the United States, not a right. D. Poor access to affordable health care causes harm that is ethically troubling because nonmaleficence is a basic principle of health care ethics. E. Providers are exempt from fidelity to people with drug addiction because addiction reflects a lack of personal accountability. F. If a new drug is discovered that cures a disease but at great cost per patient, the principle of justice suggests that the drug should be made available to those who can afford it.
A, B, D Justice is the ethical principle that justifies the agreement to ensure access to care for all, but it does not necessarily clarify how to resolve issues of limited resources such as money or organs available for transplant. Privilege is not an ethical principle. Nonmaleficence means "first do no harm." A lack of care because of poor access causes harm (i.e., no preventive services, no early detection, no risk reduction) and therefore is ethically troubling. The principal of fidelity implies that we agree to ensure access to care even for people whose beliefs and behaviors may differ from our own, including drug addicts.
The nurse manager from the surgical unit was awarded the nursing leadership award for practice of transformational leadership. Which of the following are characteristics or traits of transformational leadership displayed by award winner? Select all that apply. A. The nurse manager regularly rounds on staff to gather input on unit decisions. B. The nurse manager sends thank-you notes to staff in recognition of a job well done. C. The nurse manager sends memos to staff about decisions that the manager has made regarding unit policies. D. The nurse manager has an "innovation idea box" to which staff are encouraged to submit ideas for unit improvements. E. The nurse develops a philosophy of care for the staff.
A, B, D Nurse managers who practice transformational leadership are focused on change and innovation. They motivate and empower their staff with the focus on team development. The manager will spend time on the unit with the staff, sharing ideas and listening to staff input. The manager is enthusiastic about opportunities to enhance the team and shows appreciation and recognizes team members for good work. The manager holds the team accountable and provides support for the team members in the stressful health care environment.
The nurse hears a physician say to the charge nurse that he doesn't want that same nurse caring for his patients because she is stupid and won't follow his orders. The physician also writes on his patient's medical records that the same nurse, by name, is not to care for any of his patients because of her incompetence. What component(s) of defamation has the physician committed? (Select all that apply). A. Slander B. Invasion of privacy C. Libel D. Assault E. Battery
A, C Slander: the action or crime of making a false spoken statement damaging to a person's reputation. Libel: a published false statement that is damaging to a person's reputation; a written defamation
Which of the following actions, if performed by a registered nurse, would result in both criminal and administrative law sanctions against the nurse? Select all that apply. A. Taking or selling controlled substances B. Refusing to provide health care information to a patient's child C. Reporting suspected abuse and neglect of children D. Applying physical restraints without a written physician's order E. Completing an occurrence report on the unit
A, D The inappropriate use of controlled substances is prohibited by every Nurse Practice Act. A physical restraint can be applied only on the written order of a health care provider on the basis of The Joint Commission and Medicare guidelines.
A patient has a fractured femur that is placed in skeletal traction with a fresh plaster cast applied. The patient experiences decreased sensation and a cold feeling in the toes of the affected leg. The nurse observes that the patient's toes have become pale and cold but forgets to document this because one of the nurse's other patients experienced cardiac arrest at the same time. Two days later the patient in skeletal traction has an elevated temperature, and he is prepared for surgery to amputate the leg below the knee. Which of the following statements regarding a breach of duty apply to this situation? Select all that apply. A. Failure to document a change in assessment data B. Failure to provide discharge instructions C. Failure to follow the six rights of medication administration D. Failure to use proper medical equipment ordered for patient monitoring E. Failure to notify a health care provider about a change in the patient's condition
A, E The failure to document a change in assessment data and the failure to notify a health care provider about a change in patient status reflect a breach of duty to the patient.
You are floated to work on a nursing unit where you are given an assignment that is beyond your capability. Which is the best nursing action to take first? A. Call the nursing supervisor to discuss the situation B. Discuss the problem with a colleague C. Leave the nursing unit and go home D. Say nothing and begin your work
A. Call the nursing supervisor to discuss the situation Alerting the nursing supervisor as a representative of the hospital administration is the first step in providing notice that a problem may exist related to insufficient staffing. This notice serves to share the burden of knowledge of the staffing inequity issues that may create an unsafe patient situation for the hospital and nursing staff.
A registered nurse (RN) is providing care to a patient who had abdominal surgery 2 days ago. Which task is appropriate to delegate to the nursing assistant? A. Helping the patient ambulate in the hall B. Changing surgical wound dressing C. Irrigating the nasogastric tube D. Providing brochures to the patient on health diet
A. Helping the patient ambulate in the hall Helping the patient with activity is within the scope of nursing assistive duties. The other activities require the skill and knowledge of the RN.
An elderly adult fell at home and fractured a hip, which requires surgical repair. After admittance to the emergency department, the client was given sedation for pain before a surgical permit was signed. What is the best action necessary to obtain consent? A. The physician should have the client's wife sign the consent form. B. Since the client has been medicated, the nurse should thoroughly explain the consent form to the client. C. The physician should wait until the effects of the medication wear off and have the client sign. D. This would be considered an emergency situation and consent would be implied.
A. The physician should have the client's wife sign the consent form.
Resolution of an ethical dilemma involves discussion with the patient, the patient's family, and participants from all health care disciplines. Which of the following best describes the role of the nurse in the resolution of ethical dilemmas? A. To articulate the nurse's unique point of view, including knowledge based on clinical and psychosocial observations. B. To study the literature on current research about the possible clinical interventions available for the patient in question. C. To hold a point of view but realize that respect for the authority of administrators and physicians takes precedence over personal opinion. D. To allow the patient and the physician to resolve the dilemma on the basis of ethical principles without regard to personally held values or opinions.
A. To articulate the nurse's unique point of view, including knowledge based on clinical and psychosocial observations. A nurse's point of view is essential to full discussion of ethical issues because of the nature of the relationship that nurses develop with patients and the intensity and intimacy of contact with the patient and family.
When designing a plan for pain management for a postoperative patient, the nurse assesses that the patient's priority is to be as free of pain as possible. The nurse and patient work together to identify a plan to manage the pain. The nurse continually reviews the plan with the patient to ensure that the patient's priority is met. Which principle is used to encourage the nurse to monitor the patient's response to the pain? A. Fidelity B. Beneficence C. Nonmaleficence D. Respect for autonomy
A.Fidelity Fidelity means keeping promises. Keeping the promise in this case includes not just tending to the clinical need but evaluating the effectiveness of the interventions.
1. The five rights of delegation include (Select all that apply.) a. Right task. b. Right circumstances. c. Right monetary compensation. d. Right person. e. Right direction. f. Right opinion. g. Right supervision.
ANS: A, B, D, E, G The five rights of delegation are right task, circumstances, person, direction, and supervision.
A staff member verbalizes his satisfaction in working on a particular nursing unit because he appreciates the freedom of choice and responsibility for the choices. This nurse highly values which element of decentralized decision making? a. Responsibility b. Autonomy c. Accountability d. Authority
ANS: B Autonomy is freedom of choice and responsibility for the choices. Responsibility refers to the duties and activities that an individual is employed to perform. Accountability refers to individuals being answerable for their actions. Authority refers to legitimate power to give commands and make final decisions specific to a given position.
In which nursing care model is the RN usually appointed the position of group leader? a. Total patient care b. Primary nursing c. Team nursing d. Case management
ANS: C In the team nursing care model, the RN assumes the role of group or team leader and leads a team made up of other RNs, licensed vocational nurses, and nurse assistants or technicians. Total patient care involves an RN being responsible for all aspects of care for one or more patients. Primary nursing places RNs at the bedside more, assuming responsibility for a caseload of patients over time. This model, however, does not require an all-RN staff as is required for total patient care. Case management is a care approach that coordinates and links health care services to patients and families while streamlining costs.
A client comes to the clinic and is found to have an STD (sexually transmitted disease). The client states to the nurse, "Promise you won't tell anyone about my condition." the nurse, according to the Health Insurance Portability and Accountability (HIPAA) of 1996, must do which of the following? A. Honor the client's wishes B. Communicate only necessary information C. Not disclose any information to anyone D. Respect the client's privacy and confidentiality
B. Communicate only necessary information
A nurse is sued for negligence due to failure to monitor a patient appropriately after a procedure. Which of the following statements are correct about this lawsuit? Select all that apply. A. The nurse does not need any representation. B. The patient must prove injury, damage, or loss occurred. C. The person filing the lawsuit has to show a compensable damage, such as lost wages, occurred. D. The patient must prove that a breach in the prevailing standard of care caused an injury. E. The burden of proof is always the responsibility of the nurse.
B, C, D The patient as plaintiff must prove that the defendant nurse had a duty, breached the duty, and because of this breach caused the patient injury or damage
It can be difficult to agree on a common definition of the word quality when it comes to quality of life. Why? Select all that apply. A. Average income varies in different regions of the country. B. Community values influence definitions of quality, and they are subject to change over time. C. Individual experiences influence perceptions of quality in different ways, making consensus difficult. D. The value of elements such as cognitive skills, ability to perform meaningful work, and relationship to family is difficult to quantify using objective measures. E. Statistical analysis is difficult to apply when the outcome cannot be quantified. F. Whether or not a person has a job is an objective measure, but it does not play a role in understanding quality of life.
B, C, D, E A person's average income and whether the person is employed are incorrect answers because income level is not necessarily a determining factor in measuring quality of life, but the ability to do meaningful work usually does influence the definition.
A nurse is caring for a patient who recently had coronary bypass surgery and now is on the postoperative unit. Which are legal sources of standards of care that the nurse uses to deliver safe health care? Select all that apply. A. Information provided by the head nurse B. Policies and procedures of the employing hospital C. State Nurse Practice Act D Regulations identified in The Joint Commission manual E. The American Nurses Association standards of nursing practice
B, C, D, E All of these sources govern the legal standards of care and are individualized by state and agency. Policies and procedures of employing agencies and standards set by statutes, accrediting agencies, and professional organizations describe the minimum requirements for safe care.
Which of the following are components of interprofessional collaboration? Select all that apply. A. Interprofessional education does not impact the collaboration among interprofessional team members. B. Nurses are often viewed as the team leader because of their coordination of patient care. C. Effective interprofessional collaboration requires mutual respect and trust from all team members. D. Open communication improves the collaboration among the interprofessional team members. E. The goal of interprofessional collaboration is to improve the quality of patient care.
B, C, D, E The nurse plays a critical role within the team and is often viewed as the team leader through coordination of communication and patient care. Open communication, cooperation, trust, mutual respect, and understanding of team member roles and responsibilities are critical for successful interprofessional collaboration. The development of these competencies comes through interprofessional education. A change in education and team training of health care practitioners is needed to build effective teams to improve interprofessional collaboration.
At 1200 the registered nurse (RN) says to the nursing assistive personnel (NAP), "You did a good job walking Mrs. Taylor by 0930. I saw that you recorded her pulse before and after the walk. I saw that Mrs. Taylor walked in the hallway barefoot. For safety, the next time you walk a patient, you need to make sure that the patient wears slippers or shoes. Please walk Mrs. Taylor again by 1500." Which characteristics of positive feedback did the RN use when talking to the nursing assistant? Select all that apply. A Feedback is given immediately. B. Feedback focuses on one issue. C. Feedback offers concrete details. D.Feedback identifies ways to improve. E. Feedback focuses on changeable things. F. Feedback is specific about what is done incorrectly only.
B, C, D, E These are characteristics of positive feedback. The other options (A and F) are not appropriate because the RN did not provide feedback immediately (the NAP performed the task in the morning, but the feedback was not given until the afternoon) and you should give both positive feedback and feedback to improve the incorrectly done tasks.
A nurse notes that an advance directive is on a patient's medical record. Which statement represents the best description of an advance directive guideline that the nurse will follow? A. A living will allows an appointed person to make health care decisions when the patient is in an incapacitated state. B. A living will is invoked only when the patient has a terminal condition or is in a persistent vegetative state. C. The patient cannot make changes in the advance directive once admitted to the hospital. D. A durable power of attorney for health care is invoked only when the patient has a terminal condition or is in a persistent vegetative state.
B. A living will is invoked only when the patient has a terminal condition or is in a persistent vegetative state. A living will does not assign another individual to make decisions for the patient. A durable power of attorney for health care is active when the patient is incapacitated or cognitively impaired. A cognitively intact patient may change an advance directive at any time.
As a nurse, you are assigned to four patients. Which patient do you need to see first? A. The patient who had abdominal surgery 2 days ago who is requesting pain medication B. A patient admitted yesterday with atrial fibrillation with decreased level of consciousness C. A patient with a wound drain who needs teaching before discharge in the early afternoon D. A patient going to surgery for a mastectomy in 3 hours who has a question about the surgery
B. A patient admitted yesterday with atrial fibrillation with decreased level of consciousness This patient is of high priority. The patient is experiencing the physiological problem of decreased level of consciousness, which is an immediate threat to his or her survival and safety. The nurse must intervene promptly and notify the health care provider of the life-threatening problem.
A child's immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation? A. Fidelity B. Beneficence C. Nonmaleficence D. Respect for autonomy
B. Beneficence Beneficence means "doing well" by taking positive actions. It implies that the best interest of the patient (and society) outweighs self-interest.
A 17-year-old patient, dying of heart failure, wants to have his organs removed for transplantation after his death. What action by the nurse is correct? A. Prepare the organ donation form for the patient to sign while he is still oriented. B. Instruct the patient to talk with his parents about his desire to donate his organs. C. Notify the physician about the patient's desire to donate his organs. D. Contact the United Network for Organ Sharing after talking with the patient.
B. Instruct the patient to talk with his parents about his desire to donate his organs.
A patient asks a nurse what the patient-centered care model for the hospital means. What is the nurse's best answer? A. "This model ensures that all patients have private rooms when they are admitted to the hospital." B. "In this model you and the health care team are full partners in decisions related to your health care." C. "This model focuses on making the patient experience a good one by providing amenities such as restaurant-style food service." D. "Patients and families sign a document providing them full access to their medical charts."
C. "In this model you and the health care team are full partners in decisions related to your health care." Patient- and family-centered care is based on the development of mutual partnerships among the patient, family, and health care team to plan, implement, and evaluate the patient's health care. The patient and the family are at the center of the care and are full partners in decision making.
While administering medications, a nurse realizes that a prescribed dose of a medication was not given. The nurse acts by completing an incident report and notifying the patient's health care provider. The nurse is exercising: A. Authority. B. Responsibility. C. Accountability. D. Decision making.
C. Accountability. Accountability is nurses being answerable for their actions. It means that nurses accept the commitment to provide excellent patient care and the responsibility for the outcomes of the actions in providing it. Following institutional policy for reporting medication errors demonstrates the nurse's commitment to safe patient care.
Which example demonstrates a nurse performing the skill of evaluation? A. The nurse explains the side effects of the new blood pressure medication ordered for the patient. B. The nurse asks a patient to rate pain on a scale of 0 to 10 before administering the pain medication. C. After completing the teaching, the nurse observes a patient draw up and administer an insulin injection. D. The nurse changes a patient's leg ulcer dressing using aseptic technique.
C. After completing the teaching, the nurse observes a patient draw up and administer an insulin injection. Evaluation is one of the most important aspects of clinical care coordination, involving the determination of patient outcomes. Observing a patient do a return demonstration of teaching is evaluation to ensure that patient has understood teaching. Asking a patient to rate their pain on a scale is not evaluation but rather an assessment of the patient's pain because it occurs before administering a pain medication. The other options are interventions.
A nurse notes that the health care unit keeps a listing of the patient names at the front desk in easy view for health care providers to more efficiently locate the patient. The nurse talks with the nurse manager because this action is a violation of which act? A. Patient Protection and Affordable Care Act (PPACA) B. Patient Self-Determination Act (PSDA) C. Health Insurance Portability and Accountability Act (HIPAA) D. Emergency Medical Treatment and Active Labor Act
C. Health Insurance Portability and Accountability Act (HIPAA) The Privacy Rule of the HIPAA requires that patient information be protected from unnecessary publication.
A nurse forgets to put the call light within the client's reach and then leaves the room. The client reaches for it and falls out of bed. The nurse could be charged with which of the following? A. Assault B. Battery C. Negligence D. Criminal Intent
C. Negligence
The ANA code of nursing ethics articulates that the nurse "promotes, advocates for, and strives to protect the health, safety, and rights of the patient." This includes the protection of patient privacy. On the basis of this principle, if you participate in a public online social network such as Facebook, could you post images of a patient's x-ray film if you obscured or deleted all patient identifiers? A. Yes, because patient privacy would not be violated since patient identifiers were removed B. Yes, because respect for autonomy implies that you have the autonomy to decide what constitutes privacy C. No, because, even though patient identifiers are removed, someone could identify the patient on the basis of other comments that you make online about his or her condition and your place of work D. No, because the principle of justice requires you to allocate resources fairly
C. No, because, even though patient identifiers are removed, someone could identify the patient on the basis of other comments that you make online about his or her condition and your place of work Information such as comments and photos on social media is widely distributed and becomes a risk for violation of privacy. People often inadvertently give "clues" or hints to the identity of a person, or people accessing your site could know your actual assignment or put "two and two" together.
In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable? A. Nurses understand the principle of autonomy to guide respect for a patient's self-worth. B. Nurses have a scope of practice that encourages their presence during ethical discussions. C. Nurses develop a relationship with the patient that is unique among all professional health care providers. D. The nurse's code of ethics recommends that a nurse be present at any ethical discussion about patient care.
C. Nurses develop a relationship with the patient that is unique among all professional health care providers. A fundamental goal of this chapter is to promote and nurture the value of the nursing voice in ethical discourse.
The nurse received a hand-off report at the change of shift in the conference room from the night shift nurse. The nursing student assigned to the nurse asks to review the medical records of the patients assigned to them. The nurse begins assessing the assigned patients and lists the nursing care information for each patient on each individual patient's message board in the patient rooms. The nurse also lists the patients' medical diagnoses on the message board. Later in the day the nurse discusses the plan of care for a patient who is dying with the patient's family. Which of these actions describes a violation of the Health Insurance Portability and Accountability Act (HIPAA)? A. Discussing patient conditions in the nursing report room at the change of shift B. Allowing nursing students to review patient charts before caring for patients to whom they are assigned C. Posting medical information about the patient on a message board in the patient's room D. Releasing patient information regarding terminal illness to family when the patient has given permission for information to be shared
C. Posting medical information about the patient on a message board in the patient's room Posting the medical condition of a patient on a message board in the patient's room is not necessary for the patient's treatment. Doing so can result in this information being accessed by people who are not involved in the patient's treatment.
A nurse stops to help in an emergency at the scene of an accident. The injured party files a suit, and the nurse's employing institution insurance does not cover the nurse. What would probably cover the nurse in this situation? A. The nurse's automobile insurance B. The nurse's homeowner's insurance C. The Good Samaritan law, which grants immunity from suit if there is no gross negligence D. The Patient Care Partnership, which may grant immunity from suit if the injured party consents
C. The Good Samaritan law, which grants immunity from suit if there is no gross negligence The Good Samaritan law holds the health care provider immune from liability as long as he or she functions within the scope of his or her expertise.
After a nurse receives a change-of-shift report on his assigned patients, he prioritizes the tasks that need to be completed. This is an example of a nurse displaying which practice? A. Organizational skills B. Use of resources C. Time management D. Evaluation
C. Time management Completing a priority to-do list is a useful time-management skill. Change-of-shift report can help you sequence activities on the basis of what you learn about the patients' conditions and the care the patient has received.
A staff nurse delegates a task to a nursing assistant, knowing that the assistant has never performed the task before. As a result, the patient is injured, and the nurse defensively states that the nursing assistant should have known how to perform such a simple task. This nurse is demonstrating lack of a. Responsibility. b. Autonomy. c. Authority. d. Accountability.
D
Which of the following can be delegated to an UAP? A. Giving pain medication. B. Reporting to the doctor for an abnormal laboratory result. C. Inserting an IV catheter. D. Checking oral temperature.
D
Which of these assessments of a patient who is 1 day post surgery to repair a hip fracture requires immediate nursing intervention? a. Patient ate 30% of clear liquid breakfast. b. Oral temperature is 99.2° Fahrenheit. c. Patient states, "Boy, I did not realize I would be so tired after this surgery." d. Patient reports severe pain 30 minutes after receiving pain medication.
D
A client is to undergo an invasive procedure by a physician. The client is questioning some of the terminology in the consent form. Which of the following is the best response by the nurse? A. "You should have asked your physician when he was in here." B. "I'll explain whatever you don't understand." C. "Just sign the form, and I'll make sure your physician talks to you before he begins the procedure." D. "I'll call your physician back in the room to answer your questions."
D. "I'll call your physician back in the room to answer your questions."
A patient is admitted to a medical unit. The patient is fearful of hospitals. The nurse carefully assesses the patient to determine the exact fears and then establishes interventions designed to reduce these fears. In this setting how is the nurse practicing patient advocacy? A. Seeking out the nursing supervisor to talk with the patient B. Documenting patient fears in the medical record in a timely manner C. Working to change the hospital environment D. Assessing the patient's point of view and preparing to articulate it
D. Assessing the patient's point of view and preparing to articulate it Assessing the patient's point of view and preparing to articulate it best reflects the concept of advocacy because it is standing up for the patient and having his or her views and wishes heard.
Although the client refused the procedure, the nurse insisted and inserted a nasogastric tube in the right nostril. The administrator of the hospital decides to settle the lawsuit because the nurse is most likely to be found guilty of which of the following? A. An unintentional tort B. Assault C. Invasion of privacy D. Battery
D. Battery
A nurse assesses patients and uses assessment findings to identify patient problems and develop an individualized plan of care. The nurse is displaying: A. Organizational skills. B. Use of resources. C. Priority setting. D. Clinical decision making.
D. Clinical decision making. Clinical decision making depends on the application of the nursing process. You first complete a patient assessment so you are able to make accurate judgment about the patient's nursing diagnoses and health problems. The next step is to complete a plan of care for the patient. You use critical thinking in the clinical decision process.
You are the night shift nurse caring for a newly admitted patient who appears to be confused. The family asks to see the patient's medical record. What is the priority nursing action? A. Give the family the record B. Discuss the issues that concern the family with them C. Call the nursing supervisor D. Determine from the medical record if the family has been granted permission by the patient to access his or her medical information
D. Determine from the medical record if the family has been granted permission by the patient to access his or her medical information Family members do not have the right to private personal health information without the consent of the patient. Confidentiality protects private patient information once it has been disclosed in health care settings.
A homeless man enters the emergency department seeking health care. The health care provider indicates that the patient needs to be transferred to the City Hospital for care. This action is most likely a violation of which of the following laws? A. Health Insurance Portability and Accountability Act (HIPAA) B. Americans with Disabilities Act (ADA) C. Patient Self-Determination Act (PSDA) D. Emergency Medical Treatment and Active Labor Act (EMTALA) without triage completed
D. Emergency Medical Treatment and Active Labor Act (EMTALA) without triage completed The EMTALA requires that an emergency situation needs to be established and that the patient needs to be stabilized before a transfer is appropriate.
Which task is appropriate for a registered nurse (RN) to delegate to a nursing assistant? A. Explaining to the patient the preoperative preparation before the surgery in the morning B. Administering the ordered antibiotic to the patient before surgery C. Obtaining the patient's signature on the surgical informed consent D. Helping the patient to the bathroom before leaving for the operating room
D. Helping the patient to the bathroom before leaving for the operating room Assisting the patient with toileting activities is within the scope of nursing assistive duties. The other activities require the skill and knowledge of the RN.
A woman has severe life-threatening injuries and is hemorrhaging following a car accident. The health care provider ordered 2 units of packed red blood cells to treat the woman's anemia. The woman's husband refuses to allow the nurse to give his wife the blood for religious reasons. What is the nurse's responsibility? A. Obtain a court order to give the blood B. Coerce the husband into giving the blood C. Call security and have the husband removed from the hospital D. More information is needed about the wife's preference and if the husband has her medical power of attorney
D. More information is needed about the wife's preference and if the husband has her medical power of attorney Adult patients such as those with specific religious objection are able to refuse treatment for personal religious reasons, but there need to be clear directions on who can make the decision.
A nurse is assigned to care for the following patients who all need vital signs taken right now. Which of these patients is most appropriate for the nurse to delegate vital sign measurement to nursing assistive personnel (NAP)? a. Patient scheduled for a procedure in the nuclear medicine department b. Patient transferring from the intensive care unit (ICU) c. Patient returning from cardiac catheterization d. Patient returning from hip replacement surgery
a. Patient scheduled for a procedure in the nuclear medicine department
