Chapter 3,7,8 questions

Charting that follows the nursing process and uses nursing diagnoses while placing the plan of care within the nurses' progress notes is _______ charting.

PIE

When a patient begins crying during a conversation with the nurse about the patient's upcoming surgery for possible malignancy, the nurse's most therapeutic response would be: A) "Your surgeon is excellent, and I know he'll do a great job." B) "Oh, dear, your gown is way too big, let me get you another one." C) "Don't cry; think about something else and you'll feel better." D) "Here is a tissue. I'd like to sit here for a while if you want to talk."

"Here is a tissue. I'd like to sit her for a while if you want to talk"

When the nurse enters the room, the patient is laughing out loud at something on TV. The patient stops and apologizes for the laughter, saying, "I guess I ought not be laughing at all since I am stuck here with two broken legs." The nurse can use evidence-based information when she responds: A) "Laughter is nearly always a cover-up for anxiety when facing a long rehabilitation." B) "Long periods of laughter decrease the amount of oxygen available to your body for healing." C) "Laughter in a hospital is often distracting and depressing to other patients nearby." D) "Laughter truly is the best medicine as it has a positive effect on the immune system."

"Laughter truly is the best medicine as it has a positive effect on the immune system."

The nurse explains that should a patient return to the hospital for treatment within _______ years, the medical chart can be retrieved from medical records for review.

10

Which nursing assessment is an example of brevity and clarity while meeting legal guidelines? A) "4 cm reddened area over sacrum. Skin intact, warm, and dry." B) "Taking fluids poorly, but more than yesterday." C) "Apparently comfortable all night. Offers no complaints of pain." D) "Patient says she is still slightly nauseated, would like to try some toast and tea."

A) "4 cm reddened area over sacrum. Skin intact,warm,and dry"

Which examples of documentation would be most informative to transcribe to the patient's medical record? A) "Patient consumed two slices of bread and a cup of coffee at breakfast." B) "Patient does not appear to be hungry after consuming breakfast." C) "Patient ate a small amount of bread and drank a little coffee for breakfast." D) "Patient ate well for breakfast, lunch, and dinner and seems content."

A) "Patient consumed two slices of bread and a cup of coffee at breakfast"

The method of computer-assisted charting: (Select all that apply.) A) improves communication between departments. B) is less costly to educate personnel to the method. C) speeds reimbursement for services. D) allows electronic records to be retrieved more quickly. E) allows entries to be made at point of care.

A) Improves communication between departments C) speeds reimbursement for services D) allows electronic records to be retrieved more quickly E) allows entries to be made at point of care

A characteristic of an advance directive is that: A) advance directives do not expire. B) only some states recognize advance directives. C) advance directives can be non-verbal. D) advance directives from one state are recognized by another.

A) advance directives do not expire

The nurse chooses to use touch in the nurse-patient relationship because touch: A) can convey caring and support when words are difficult. B) should be avoided because of problems of cultural misinterpretation. C) is appropriate only in special circumstances, such as with young children. D) is a nursing intervention of choice in almost all situations.

A) can convey caring and support when words are difficult

The commonalities of The Codes of Ethics of the National Association for Practical Education and Service (NAPNES) and The National Federation of Licensed Practical Nurses (NFLPN) include: (Select all that apply.) A) commitment to continuing education. B) respect for human dignity. C) maintenance of competence. D) requirement for membership in a national organization. E) preserving the confidentiality of the nurse-patient relationship.

A) commitment to continuing education B) respect for human dignity C) maintenance of competence E) preserving the confidentiality of the nurse-patient relationship

The Ethics Committee of a facility has the responsibility to: (Select all that apply.) A) develop policies. B) address issues in their facility. C) modify the established codes of ethics as suits the situation. D) create a master plan for decision making to be followed in ethical dilemmas. E) help to find a better understanding of ethical dilemmas from different standpoints.

A) develop policies B) address issues in their facility E) help to find a better understanding of ethical dilemmas from different standpoints

A nurse enters a notation in a patient's chart but then discovers that the notation was made in the wrong chart. The nurse correctly: A) draws a single line through the notation so that it is still readable and writes "mistaken entry," his signature, and the date and time. B) removes the page on which the error is written and rewrites the other correct notes. C) blacks out the note to protect the confidentiality of the patient about whom it was written and writes in the margin "wrong patient," his signature, and the date and time. D) whites out the wrong entry and writes the note in the chart of the correct patient.

A) draws a single line through the notion so that it is still readable and writes "mistaken entry", his signature, and the date and time

Advantages of source-oriented or narrative charting include all of the following except that it: A) encourages documentation of normal and abnormal findings. B) gives information on the patient's condition and care in chronological order. C) indicates the patient's baseline condition for each shift. D) includes aspects of all steps of the nursing process.

A) encourages documentation of normal and abnormal findings

A person who has been brought to the emergency room after being struck by a car insists on leaving, although the doctor has advised him to be hospitalized overnight. The nurse caring for this patient should: A) have him sign a Leave Against Medical Advice (AMA) form. B) tell him that he cannot leave until the doctor releases him. C) immediately begin the process of involuntary committal. D) contact the person's health care proxy to assist in the decision-making process.

A) have him sign a Leave Against Medical Advice (AMA) form.

An aspect of computer use in patient care in which the LPN may need to be proficient includes: A) input of data such as requests for radiographs or laboratory services. B) programming the computer to record data from physicians and other health care workers. C) teaching patients how to use hospital computers to access information such as discharge instructions or information relative to specific medications. D) scheduling admissions, discharges, and nurse staffing to keep the unit at the best occupancy and utilization.

A) input of data such as requests for radiographs or laboratory services

A patient has signed a do-not-resuscitate (DNR) order. If a nurse performs cardiopulmonary resuscitation (CPR) when the patient stops breathing and then successfully revives the patient, the: A) nurse could be found guilty of battery. B) patient would have no grounds for legal action. C) patient could charge the nurse with false imprisonment. D) nurse could be found guilty of assault.

A) nurse could be found guilty of battery

Helpful cultural information the nurse should include on the admission note is: (Select all that apply.) A) primary language spoken. B) number of children in the immediate household. C) beliefs about causality of illness. D) level of English literacy. E) dietary concerns.

A) primary language spoken C) beliefs about causality of illness D) level of English literally E) dietary concerns

Advantages of the problem-oriented medical record (POMR) are that this method of charting: (Select all that apply.) A) promotes the problem-solving approach. B) formats charting into chronological order. C) makes tracking trends in patient care easy. D) allows for easy auditing of patient records to evaluate staff performance. E) reinforces application of the nursing process.

A) promotes the problem-solving approach D) allows for easy auditing of patient records to evaluate staff performance E) reinforces application of the nursing process

A nurse remarks to several people that "Dr. X must be getting senile because she makes so many mistakes." If that remark results in some of Dr. X's patients changing to another doctor, Dr. X would have grounds to sue the nurse for: A) slander. B) libel. C) invasion of privacy. D) negligence.

A) slander

When interacting with an elderly patient, the nurse would enhance communication by: A) speaking slowly in order to allow the patient to process the message. B) addressing him by his first name to encourage a therapeutic relationship. C) standing in the doorway rather than entering the room to give the elderly patient more privacy. D) speaking in simple sentences, as if to a child.

A) speaking slowly in order to allow the patient to process the message.

An example of a violation of criminal law by a nurse is: A) taking a controlled substance from agency supply for personal use. B) accidentally administering a drug to the wrong patient, who then has a serious reaction. C) advising a patient to sue the doctor for a supposed mistake the doctor made. D) writing a letter to the newspaper outlining questionable or unsafe hospital practices.

A) taking a controlled substance from agency supply for personal use

The nurse uses the flow sheet in patient care documentation primarily: A) to track routine assessments, treatments, and frequently given care. B) to eliminate written narratives and to save time. C) in computer-assisted charting to create visual graphs showing change. D) to improve continuity of care and exchange of information among disciplines.

A) to track routine assessments, treatments, and frequently given care.

Professional accountability includes: (Select all that apply.) A) understanding theory. B) adhering to the dress code of the facility. C) asking for assistance when unsure of a procedure or physician order. D) participating in continuing education classes. E) meeting the health care needs of the patient. F) reporting patient health status changes to all family members.

A) understanding theory C) asking for assistance when unsure of a procedure or physician order D) participating in continuing education classes E) meeting the health care needs of the patient

A nurse using active listening techniques would: A) use nonverbal cues such as leaning forward, focusing on the speaker's face, and slightly nodding to indicate that the message has been heard. B) avoid the use of eye contact to allow the patient to express herself without feeling stared at or demeaned. C) anticipate what the speaker is trying to say and help the patient express herself when she has difficulty with finishing a sentence. D) ask probing questions to direct the conversation and obtain the information needed as efficiently as possible.

A) use nonverbal cues such as leaning forward, focusing on the speaker's face, and slightly nodding to indicate that the message has been heard

While interviewing a Native American man for the admission history, the nurse should expect to: A) wait patiently through long pauses in the conversation. B) maintain eye contact with the patient. C) give the patient permission to speak. D) have another family member speak for the patient.

A) wait patiently through long pause in the conversation

When the patient says, "I don't want to go home," the nurse's best therapeutic verbal response would be: A) "I'm sure everything will be fine once you get home." B) "You don't want to go home?" C) "Doesn't your family want you to come home? D) "I felt like that when I had surgery last year."

A)"You don't want to go home?"

When the patient says, "I get so anxious just lying here in this hospital bed. I have a million things I should be doing at home," the most empathetic response would be: A) "I'd feel the same way you do. I know just what you're going through." B) "It sounds like you're having a tough time dealing with this situation." C) "It's always darkest before the dawn. Hang in there; it will get better." D) "You sound pretty sorry for yourself. Why don't you look at the positives?"

B) "It sounds like you're having a tough time dealing with this situation"

A resident in a skilled nursing facility for a short-term rehabilitation following a hip replacement says to the nurse, "I don't want to have you draw any more blood for those useless tests." When the nurse fails to convince the patient to have the blood drawn, the most appropriate documentation would be: A) "Refuses to have blood drawn. Doctor notified." B) "Refuses to have blood drawn; says tests are 'useless.' Doctor notified." C) "Doctor notified of failure to draw ordered blood work." D) "Blood not drawn because tests are no longer desired by patient."

B) "Refuses to have blood drawn; says tests are 'useless'. Doctor notified."

To begin talking with a newly admitted patient about pain management, the nurse would most appropriately state: A) "You look pretty comfortable. Are you having any pain?" B) "Tell me about the pain you've been having." C) "Is this pain the same as the pain you had yesterday?" D) "Don't worry; this pain won't last forever."

B) "Tell me about the pain you've been having"

A patient asks the nurse, "What would you do if you had cancer and had to choose between surgery and chemotherapy?" The reply that can best help the patient is: A) "If I were you, I would choose surgery and then consider chemo afterward." B) "What solutions have you considered?" C) "I would talk it over with my friends first." D) "I don't know. I'm glad it isn't my decision."

B) "What solutions have you considered?"

A 48-year-old man refuses to take a medication ordered for the control of his blood pressure. The nurse's most effective response would be: A) "Your doctor expects you to be compliant." B) "You have the right to refuse. This medication keeps your blood pressure under control." C) "Fine. I will document that you are refusing this drug." D) "Are you aware that you could have a stroke?"

B) "You have the right to refuse. This medication keeps your blood pressure under control"

When a student nurse performs a nursing skill, it is expected that the student: A) perform the skill as quickly as the licensed nurse. B) achieve the same result as the licensed nurse. C) not be held to the same standard as the licensed nurse. D) always be directly supervised by an instructor.

B) achieve the same result as the licensed nurse

Ethics and law are different from each other in that ethics: A) bear a penalty if violated. B) are voluntary. C) rarely change. D) can always direct all decisions.

B) are voluntary

A patient with a nursing diagnosis of Skin integrity, impaired, related to surgery as evidenced by disruption of skin surface has the following nursing documentation: "Incision clean, dry, intact. No pain or tenderness. Instructed to keep area dry, may wear light dressing to protect from clothing. Verbalizes understanding of wound care and ability to manage at home. Wound healing without complication." This documentation is: A) an example of charting by exception. B) evidence of the use of the nursing process. C) using the problem-oriented medical record (POMR) format. D) usually entered on a flow sheet for treatments and vital signs.

B) evidence of the use of the nursing process

If an agency is using computer-assisted charting, the nurse is responsible for: A) learning the passwords of the staff nurses and physicians so that they can communicate with one another. B) guarding the confidentiality of the patient record by not leaving the patient screen "on" if he leaves the terminal. C) teaching the patient to input information about herself, such as intake and output or symptoms the patient may experience. D) choosing whether he will use the computer to help in charting or continue to use traditional paper documentation.

B) guarding the confidentiality of the patient record by not leaving the patient screen "on" if he leaves the terminal

The Quality and Safety Education for Nurses (QSEN) project has identified the most important pre-licensing skills for nurses as: A) effective communication. B) informatics. C) familiarity with medical terms. D) writing nursing care plans.

B) informatics

The Health Insurance Portability and Accountability Act's (HIPAA) main focus is in keeping: A) patients safe from harm. B) patient information in a secure office area. C) medications in a locked area. D) hospital infections under control.

B) patient information in a secure office area

A nurse understands that the physician's directives for patient care are also referred to as the: A) history and physical. B) physician's orders. C) progress notes. D) face sheet.

B) physician's orders

An elderly, slightly confused patient sustains an injury from a heating pad that was wrongly applied by the nurse. The nurse should: A) pretend to be unaware of the injury to the patient. B) report the incident to the risk management team via an incident report. C) document in the patient's chart that an incident report was filled out. D) not chart anything about the injury in the patient's chart.

B) report the incident to the risk management team via an incident report.

A patient refuses to take his medications or to eat his breakfast. He is alert, mentally competent, and fairly comfortable. The nurse should: A) give the medications by injection if the patient will not take them orally. B) respect the patient's right to refuse medications or food, because he is competent. C) tell the patient that he must cooperate with his care. D) contact the doctor to insert a feeding tube to supply both medicine and food.

B) respect the patient's right to refuse medications or food, because he is competent

A patient with a nursing diagnosis of Sensory perception, disturbed auditory, would most appropriately require the nurse to: A) obtain a sign language interpreter when a family member is unavailable. B) speak slowly and distinctly, but not shout. C) provide bright lighting without glare and orient frequently. D) reorient frequently to time, place, staff, and events.

B) speak slowly and distinctly, but not shout

A patient who has had a stroke is unable to speak clearly and has right-sided hemiplegia. The nurse will design the approach to the assessment interview by: A) asking questions and explaining procedures to the patient's daughter. B) speaking slowly and giving the patient time to respond. C) telling the patient he will get all necessary information from the daughter. D) prompting the answers and finishing the sentences for the patient.

B) speaking slowly and giving the patient time to respond

If a nurse receives unwelcome sexual advances from a nursing supervisor, the first step the nurse should take is to: A) send an anonymous letter to the nursing administration to alert them to the situation. B) tell the nursing supervisor that she is uncomfortable with the sexual advances and ask the supervisor to refrain from this behavior. C) report the nursing supervisor to the state board for nursing. D) resign and seek employment in a more comfortable environment.

B) tell the nursing supervisor that she is uncomfortable with the sexual advances and ask the supervisor to refrain from this behavior

The nurse explains that the therapeutic nurse-patient relationship differs from the social relationship because: A) a social relationship does not have goals or needs to be met. B) the nurse-patient relationship ends when the patient is discharged. C) the focus is mainly on the nurse in the nurse-patient relationship. D) a social relationship does not require trust or sharing of life experiences.

B) the nurse-patient relationship ends when the patient is discharged

The nurse recognizes a verbal response when the patient: A) nods her head when asked whether she wants juice. B) writes the answer to a question asked by the nurse. C) begins sobbing uncontrollably when asked about her daughter. D) is moaning and restless and appears to be in pain.

B) writes the answer to a question asked by the nurse.

A patient who is very angry and is leaving the hospital against medical advice (AMA) demands to have the medical chart to take, because it is her personal property. An appropriate response would be: A) "Certainly. This hospital doesn't need to keep it if you are leaving and will not be returning here." B) "You are entitled to the information in your chart, but the chart is the property of the hospital. I will see about having a copy made for you." C) "The information in your chart is confidential, and you cannot leave this facility with it." D) "Because you are leaving against the medical advice of your physician, you may not have the chart."

B)"You are entitled to the information in your chart, but the chart is the property of the hospital. I will see about having a copy made for you."

A 67-year-old woman had major abdominal surgery yesterday. She has IV lines, a urinary catheter, and an abdominal wound dressing, and she is receiving PRN pain medication. The end-of-shift report that best conveys the patient status is: A) "Doing great, was up in the chair most of the day. No complaints of pain or discomfort. Voiding adequately." B) "Abdominal surgery yesterday, dressing is dry and intact, her IVs are on time and she's had pain meds twice. Vital signs stable." C) "Abdominal dressing dry, IVs-800 mL left in #6; NS running at 125 mL/hr; urine output 800 mL this shift; had morphine 15 mg for pain at 8:00 AM and at 1:30 PM. She's comfortable now. Vital signs are stable, no fever." D) "Unchanged since this morning. She wanted to know how soon she can have something to eat, so maybe you could check with her doctor this evening. Her husband has been visiting all day and will let you know if she needs anything."

C) "Abdominal dressing dry, IVs-800 mL left in #6; NS running at 125 mL/hr; urine output 800 mL this shift; had morphine 15 mg for pain at 8:00 AM and at 1:30 PM. She's comfortable now. Vital signs are stable, no fever."

The LPN (LVN) assigns part of the care for her patients to a nursing assistant. The LPN is legally required to perform which of the following for the residents assigned to the assistant? A) Toilet the residents every 2 hours and as needed. B) Feed breakfast to one of the residents who needs assistance. C) Give medications to the residents at the prescribed times. D) Transport the residents to the physical therapy department.

C) Give medications to the residents at the prescribed times

Criteria that justify becoming an emancipated minor and able to sign a medical consent include all of the following except: A) independence established through a court order. B) service in the armed forces. C) a 14-year-old whose parents are dead. D) a 17-year-old pregnant female.

C) a 14-year-old whose parents are dead

In a chart for a patient who has had an allergic reaction to a drug and an associated nursing diagnosis of Skin integrity, impaired, related to allergic reaction as evidenced by rash and hives, the nurse charts "Subjective: denies itching. Happy with improvement in skin. Objective: rash fading on face, chest, and back; no hives visible on skin. Skin warm, dry, and intact. Assessment: skin integrity improving. Plan: check rash daily until discharge." This type of charting is an example of: A) charting by exception. B) narrative style. C) a problem-oriented medical record (POMR). D) the case management system.

C) a problem-oriented medical record (POMR)

To enhance the establishment of rapport with a patient, the nurse should: A) identify himself by name and title each time he introduces himself. B) share his own personal experiences so that the patient gets to know him as a friend. C) act in a trustworthy and reliable manner; respect the individuality of the patient. D) share information with the patient about other patients and why they are hospitalized.

C) act in a trustworthy and reliable manner; respect the individuality of the patient

A written statement expressing the wishes of a patient regarding future consent for or refusal of treatment in case the patient is incapable of participating in decision making is an example of: A) a privileged relationship. B) a health care agent. C) an advance directive. D) witnessed will.

C) an advance directive

A patient who is refusing to take his medication is threatened that he will be held down and forced to take the dose. This is an example of: A) battery. B) defamation. C) assault. D) invasion of privacy.

C) assault

The nurse who may be liable for invasion of privacy would be the nurse who is: A) refusing to give patient information to a relative over the phone. B) firmly closing the door prior to bathing the patient. C) discussing her patients with a fellow nurse. D) reporting the patient as a possible victim of elder abuse.

C) discussing her patients with a fellow nurse

A licensed nurse is liable for charges of malpractice when she: A) does not show up for work and fails to call to notify the agency. B) clocks in for another nurse to prevent that nurse from having pay docked. C) falsifies data, causing the patient to suffer problems resulting in death. D) assists in performing CPR that is unsuccessful, and the patient dies.

C) falsified data, causing the patient to suffer problems resulting in death

The nurse is aware that the purpose of therapeutic communication is to: A) gather as much information as possible about the patient's problem. B) direct the patient to communicate about his deepest concerns. C) focus on the patient and the patient needs to facilitate interaction. D) gain specific medical information and history of illness.

C) focus on the patient an the patient needs to facilitate interaction

The nurse recognizes the patient who demonstrates communication congruency when the patient: A) smiles and laughs while speaking of feeling lonely and depressed. B) wrings her hands and paces around the room while denying that she is upset. C) is tearful and slow in speech when talking about her husband's death. D) states she is comfortable while she frowns and her teeth are clenched.

C) is tearful and slow in speech when talking about her husband's death

To best protect himself or herself from being sued, the nurse should: A) continue to do procedures as taught in school. B) purchase malpractice insurance. C) maintain competency. D) use evidence-based practice.

C) maintain competency

To convey the intervention of active listening, the nurse would: A) maintain eye contact by staring at the patient. B) prompt the patient when the patient stops talking for a moment. C) make a conscious effort to block out other sounds in the immediate environment. D) write down remarks on a clipboard to facilitate later topics of conversation.

C) make a conscious effort to block out other sounds in the immediate environment

A patient has advance directives spelled out in a durable power of attorney, with the appointment of his daughter as his health care agent. The daughter will be responsible for: A) paying all the medical bills associated with the father's illness. B) making all informed consent decisions for her father. C) making all choices about her father's health care if the father is unable. D) paying only for those health care decisions based on the advance directives.

C) making all choices about her father's health care if the father is unable

A student nurse who is not yet licensed: A) may not perform nursing actions until he or she has passed the licensing examination. B) is not responsible for his or her actions as a student under the state licensing law. C) may perform nursing actions only under the supervision of a licensed nurse. D) must apply for a temporary student nurse permit to practice as a student.

C) may perform nursing actions only under the supervision of a licensed nurse

When a patient asks a nurse to witness the signing of a will, the nurse should refer the request to the: A) nurse supervisor. B) hospital legal department. C) notary public for the hospital. D) nurse's attorney.

C) notary public for the hospital

A nurse tells her neighbor personal information about a hospitalized patient. Telling her neighbor about this indicates that the: A) nurse is actively promoting nursing as a profession, and it is important to share information that might encourage others to pursue a nursing career. B) actions of the nurse are appropriate since his neighbor is his confidante, and the neighbor has assured him the information provided will not be shared. C) nurse has violated the confidentiality of the patient by discussing personal information about the patient with his neighbor. D) nurse has not violated the confidentiality of the patient because the patient is terminal; sharing this information will not harm the patient.

C) nurse has violated the confidentiality of the patient by discussing personal information about the patient with his neighbor.

In a skilled nursing facility, if all of the following are available, the best way for the new nurse to obtain current information about the needs and abilities of his patients would be to use the: A) physician's order sheets. B) nurse's admission history and physical. C) nursing Kardex. D) most recent nurse's notes.

C) nursing Kardex

The nurse can best ensure that communication is understood by: A) speaking slowly and clearly in the patient's native language. B) asking the family members whether the patient understands. C) obtaining feedback from the patient that indicates accurate comprehension. D) checking for signs of hearing loss or aphasia before communicating.

C) obtaining feedback from the patient that indicated accurate comprehension.

Nursing liability insurance is a policy purchased and put into effect by the nurse for the purpose of: A) providing protection against being sued. B) reducing the chance of litigation. C) paying attorney fees and any award won by the plaintiff. D) providing the hospital with added protection.

C) paying attorney fees and any award won by the plaintiff

When the nurse makes the statement, "We can come back to that later-right now I need to know about when your symptoms started," the nurse is: A) letting the patient know that topic of conversation was inappropriate. B) setting limits on the expression of feelings. C) refocusing the patient to the issue at hand when the conversation has wandered. D) closing off the conversation by quickly getting to the point of the interview.

C) refocusing the patient to the issue at hand when the conversation has wandered

A nurse co-worker arrives at work 30 minutes late, smelling strongly of alcohol. The fellow nurses' legal course of action is to: A) have the nurse lie down in the nurses' lounge and sleep while others do the work. B) state that, if this happens again, it will be reported. C) report the condition of the nurse to the nursing supervisor. D) offer a breath mint and instruct the nurse co-worker to work.

C) report the condition of the nurse to the nursing supervisor

A postoperative patient in the intensive care unit (ICU) is so confused and agitated that staff have not been able to safely care for him. He has pulled out his central line once, and he slides to the bottom of the bed, where he attempts to climb out, pulling and disrupting the various tubes and monitors. The nurse's best course of action is to: A) place him in a protective vest device. B) use a sheet to tie him in a chair at the nurses' station. C) request that the doctor write an order for a protective device and/or medication. D) call a family member to stay with the patient.

C) request that the doctor write an order for a protective device and/or medication

The information in a patient's chart may legally be: A) copied by students for use in school reports or case studies. B) provided to lawyers or insurers without the patient's permission. C) shared with other health care providers at the patient's request. D) withheld from the patient, because it is the property of the doctor or agency.

C) shared with other health care providers at the patient's request

The acronym SBAR is a method to communicate with a physician that clarifies a situation that may result in litigation. The acronym stands for: A) situation, background, alterations, results. B) subjective, believable, actual, recommendation. C) situation, background, assessment, recommendation. D) situation, basis, assessment, recommendation.

C) situation, background, assessment, recommendation

The Occupational Safety and Health Act includes all of the following except: A) regulations for handling infectious materials. B) radiation and electrical equipment safeguards. C) staffing ratios and delegation criteria. D) regulations for handling toxic materials.

C) staffing ratios and delegation criteria

A nurse says to a patient, "I am going to take your TPR, and then I'll check to see whether you can have a PRN analgesic." In considering factors that affect communication, the nurse has: A) used terminology to clearly inform the patient of what she is doing. B) given information that is unnecessary for the patient to know. C) used medical jargon, which might not be understood by the patient. D) taken into consideration the patient's need to know what is happening.

C) used medical jargon, which might not be understood by the patient.

When an office nurse asks the patient to repeat information that he has just given to the patient over the telephone, the nurse is: A) testing the patient's intelligence and memory. B) acting in a cautious way to avoid charges of negligence. C) verifying that the patient understands the information. D) saving the extra time it would take to mail the information.

C) verifying that the patient understands the information

A student nurse is assigned to a clinical unit on which one of the patients is a nationally known celebrity. The student reads the chart to find out why the celebrity is being treated. The student who is not the assigned caregiver is: A) motivated to learn about the health problem of this patient and is appropriately seeking knowledge during his clinical experience. B) doing appropriate research about nursing care as long as information is not divulged. C) violating the confidentiality of the patient's record. D) neglecting the assigned patient load and should read the unassigned patient's chart only after his assigned work is completed.

C) violating the confidentiality of the patient's record

When the nurse is giving direction to a nursing assistant who is being delegated part of the patient care, the nurse's most effective direction would be: A) "Do the morning care first on the patients in 205 and 206 who can't get out of bed." B) "You take care of all the patients in 205 and 206. Let me know how you're doing and whether you need any help." C) "Give the patient in 204A a shower after breakfast, and call me to check her feet before you get her dressed." D) "Take the vital signs on all the patients in the lounge and tell me whether there are problems."

C)"Give the patient in 204A a shower after breakfast, and call me to check her feet before you get her dressed"

The nurse has selected an outcome for the patient to eat all of the food on the breakfast tray each day. Assessing that the patient has eaten all of the breakfast, the nurse would give positive feedback by saying: A) "Wow! That breakfast must have been pretty good." B) "I like pancakes too. Everyone on the hall seemed to enjoy them." C) "I hope you can keep all that breakfast down." D) "Hurray! You finished your whole meal! What would you like for tomorrow?"

D) "Hurray! You finished your whole meal! What would you like for tomorrow?"

If a patient indicates that he is unsure if he needs the surgery he is scheduled for later that morning, the nurse would best reply: A) "Your doctor explained all of that yesterday when you signed the consent." B) "Your doctor is in the operating room; she can't talk to you now." C) "You should have the surgery; your doctor recommended that you have it." D) "I will call the doctor to speak with you before you go to the operating room."

D) "I will call the doctor to speak with you before you go to the operating room"

A clinic nurse is documenting in a patient chart about the pain that brought the patient to seek medical attention. The best description is: A) "Abdominal pain, unrelieved by antacids. Had spaghetti, salad, coffee, and ice cream cake for lunch." B) "Severe pain around umbilicus, unable to sleep because of pain. Started approximately 2 hours after lunch." C) "Pain at level of 7 to 8. Nothing has relieved or lessened pain, it just keeps getting worse." D) "Peri-umbilical sharp pain at pain level of 7 to 8 for last 3 hours, started 2 hours after lunch. No relief from antacids."

D) "Peri-umbilical sharp pain at pain level of 7 to 8 for last 3 hours, started 2 hours after lunch. No relief from antacids.

When the nurse charts in narrative or source-oriented format about the patient's condition and the nursing care provided, it is appropriate for him to record: A) "Patient will go to physical therapy after lunch." B) "Diabetes in excellent control. Continue with current insulin schedule." C) "I gave the patient a thorough bath and cut her fingernails." D) "To x-ray by wheelchair @ 10:30 AM IV infusing in left arm."

D) "To x-ray by wheelchair @10:30 AM IV infusing in left arm."

When a patient states, "I don't feel like walking today," the nurse's most therapeutic verbal response would be: A) "You have to walk today." B) "You don't want to walk today?" C) "I don't feel like walking today either." D) "Why don't you want to walk today?"

D) "Why don't you want to walk today?"

A 36-year-old woman who is in traction for a fractured femur that she received in an auto accident is found crying quietly. The nurse can best address this situation by saying: A) "What's the matter? Why are you crying? Are you in pain?" B) "Stop crying and tell me what your problem is." C) "This could have been much worse. You're lucky no one was killed." D) "You are upset. Can you tell me what's wrong?"

D) "Your are upset. Can you tell me what's wrong?"

During an employment interview, the interviewer asks the nurse applicant about HIV status. The nurse applicant can legally respond: A) "No," even though he or she has a positive HIV test. B) "I don't know, but I would be willing to be tested." C) "I don't know, and I refuse to be tested." D) "You do not have a right to ask me that question."

D) "you do not have the right to ask me that question

A nurse is caring for an unmarried 16-year-old patient who has just given birth to a baby boy. The nurse will get the consent to perform a circumcision on the patient's son from the: A) patient's father. B) patient's physician. C) patient's mother. D) 16-year-old patient.

D) 16-year-old patient

The patient who cannot legally sign his or her own surgical consent is a(n): A) 17-year-old who is serving in the armed forces. B) 16-year-old who is legally married. C) 17-year-old emancipated minor. D) 18-year-old who received a narcotic 30 minutes ago.

D) 18-year-old who received a narcotic 30 minutes ago

A Hispanic patient approaches the Asian nurse and, standing very close, touches the nurse's shoulder during their conversation. The nurse begins to step back to 18 to 24 inches, while smiling and nodding to the patient. This situation is most likely an example of: A) the nurse's need to maintain a professional role rather than a social role. B) a patient's attempt to keep the nurse's attention. C) a nurse's need to establish a more appropriate location for conversation. D) a difference in culturally learned personal space of the nurse and the patient.

D) a difference in culturally learned personal space of the nurse and the patient

A nurse begins the shift caring for a patient who has just returned from the recovery room after surgery. It is most important to document: A) at the end of the shift so that the nurse can give his full attention and time to the patient's needs during the shift. B) a nursing care plan in the chart before assessing the patient so that the nurse can identify priorities. C) at least three times during the shift: at the beginning, in the middle, at the end, and as needed. D) an initial assessment of the patient and a plan based on the needs of the patient as assessed at the beginning of the shift.

D) an initial assessment of the patient and a plan based on the needs of the patient as assessed at the beginning of the shift

When a nurse is conducting an assessment interview, the most efficient technique would be: A) explaining the purpose of the interview. B) excluding relatives and friends from the interaction. C) telling the patient what data are already available. D) asking closed questions to obtain essential information.

D) asking closed questions to obtain essential information

The nurse explains that a sentinel event is a situation in which a patient: A) refuses care. B) is accidentally exposed. C) leaves the hospital against medical advice. D) comes to harm.

D) comes to harm

In an agency that uses specific protocols (Standard Procedures) and charting by exception, an advantage compared with using traditional (narrative or problem-oriented) charting is that charting by exception: A) is well suited to defending nursing actions in court. B) contains important data certain to be noted in the narrative sections. C) allows staff to learn the system quickly and easily. D) highlights abnormal data and patient trends.

D) highlights abnormal data and patient trends

The most frequently cited cause of a sentinel event by the Joint Commission is a problem in: A) applying physical restraints. B) methods of patient transportation. C) medication errors. D) inadequate communication.

D) inadequate communication

A nurse arrives at the scene of a motor vehicle accident. A person in the vehicle mumbles incoherently when asked his name. Which actions are not covered by the Good Samaritan Act? (Select all that apply.) A) Using two magazines and a bandana to splint a broken arm B) Applying a tourniquet to a lacerated leg while awaiting emergency personnel C) Pulling the individual from the surface of the highway D) Initiating an emergency tracheotomy when the individual goes into respiratory arrest E) Compressing a bleeding wound with a soiled shirt

D) initiating an emergency tracheotomy when the individual goes into respiratory arrest

The nurse with a patient who complains of severe pain documents every 15 minutes about the steps taken to try to relieve the pain (without success). The nurse also documents the time and content of two calls made to the patient's physician requesting that the physician examine the patient for unexpected complications. This documentation by the nurse is likely to: A) cause the physician to come to the attention of the hospital administration. B) be questioned by the nurse's supervisor for time inefficiency. C) be used against the nurse if a lawsuit results, because it proves the nurse was not able to relieve the pain. D) justify insurance reimbursement for an extended duration of hospitalization for the patient.

D) justify insurance reimbursement for an extended duration of hospitalization for the patient

A 16-year-old boy is admitted to the emergency room after fracturing his arm from falling off his bike while visiting with his stepfather who is not the custodial parent. The nurse is preparing him to go to the operating room but must obtain a valid informed consent by: A) having the patient sign the consent for surgery. B) obtaining the signature of his stepfather for the surgery. C) declaring the patient to be an emancipated minor. D) obtaining permission of the custodial parent for the surgery.

D) obtaining permission of the custodial parent for the surgery

The nurse understands that a face sheet contains information pertaining to: A) serial measurements and observations, such as temperature, pulse, respiration, blood pressure, and weight. B) plan of care for the patient, including nursing diagnoses, goals/expected outcomes, and nursing interventions. C) written report of the nursing process, record of interventions implemented, and the patient's response to them. D) patient data, including patient's name, address, phone number, insurance company, and admitting diagnosis.

D) patient data, including patient's name, address, phone number, insurance company, and admitting diagnosis

The practical nursing student who is engaged in a therapeutic communication with a patient will have the most difficulty with the technique of: A) closed questions. B) restating. C) using general leads. D) silence.

D) silence

When the nurse observes a resident in a long-term facility pounding his fists on his legs and grinding his teeth, the nurse will validate her perception of the patient's non-verbal expression of anger by: A) documenting that the patient was agitated and appeared angry. B) asking the male nursing assistant if it is his perception that the patient appears angry. C) accessing the nursing care plan to ascertain if there is a nursing diagnosis relative to anger. D) sitting down near the patient and saying, "You seem upset...can I help?"

D) sitting down near the patient and saying, "You seem upset...can I help?

If a nurse is reported to a state board of nursing for repeatedly making medication errors, it is most likely that: A) the nurse will immediately have his or her license revoked. B) the nurse will have to take the licensing examination again. C) a course in legal aspects of nursing care will be required. D) there will be a hearing to determine whether the charges are true.

D) there will be a hearing to determine whether the charges are true

Health care professionals assigned to a patient require access to the chart to review information and to document care given. All contents of the chart must be kept ________. The contents of the chart should not be discussed with persons who are not involved in the care of the patient.

confidential

When using a case management system of charting a(n) __________, an unexpected event in the patient's condition is documented on the back of the pathway sheets.

variance