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How is a client with systemic inflammatory response syndrome (SIRS) differentiated from a client with sepsis? 1 - Client with sepsis has hypotension. 2 - Client with sepsis has a negative fluid balance. 3 - Client with SIRS has hyperglycemia. 4 - Client with SIRS has an elevated creatinine level.

1

The nurse is learning about the effects of pain on the sympathetic system. What are the manifestations of sympathetic stimulation in response to the pain? Select all that apply. 1 Increased heart rate 2 Rapid, irregular breathing 3 Increased glucose level 4 Decreased blood pressure 5 Decreased gastrointestinal motility

1 , 3,5

The nurse is caring for a patient who is on opioid therapy. For which findings is the nurse carefully observing the patient? Select all that apply. 1Decreased pulse rate 2 Increased respiratory rate 3 Decreased blood pressure 4 Pupil dilatation 5 Peripheral edema

1,3,5

Which system of the body is often the first to show signs of dysfunction in systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS)? 1 - Neurologic system 2 - Respiratory system 3 - Cardiovascular system 4 - Gastrointestinal system

2

What is the clinical manifestation of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) on the respiratory system? 1 Pulmonary edema 2 Pulmonary fibrosis 3 Pulmonary embolism 4 Pulmonary hypertension

4

In what order does the nurse recall the steps of how systemic inflammatory response syndrome (SIRS) causes acute kidney injury? 1.Decreased perfusion of the kidney 2.Development of acute kidney injury 3.Systemic vasoconstriction and sodium and water reabsorption 4.Activation of the sympathetic nervous system (SNS) and the renin-angiotensin system 5.Redistribution or shunting of blood flow due to the inflammatory state of the body

5 1 4 3 2

Which of the following is an example of a medical malpractice tort liability?

A surgeon does not complete the post procedure count process, and a sponge is retained in the patients abdominal cavity

You are a team leader RN working with a student nurse. The student nurse is to teach a patient how to use and MDI without a spacer. Put in correct order the steps that the student nurse should teach the patient. A. Remove the inhaler cap and shake the inhaler B. Open your mouth and place the mouthpiece 1 to 2 inches away C. Tilt your head back and breathe out fully D. Hold your breath for at least 10 seconds E. Press down firmly on the canister and breathe deeply through your mouth F. Wait at least 1 minute between puffs.

A, C, B, E, D, F.

Q. The nurse believes that a patient who states he is in pain is "faking it" and is hoping to get "high." The nurse decides to give the patient a placebo instead of the pain medication that was ordered for the patient. The nurse is violating which principle of ethics? (Select all that apply). - Autonomy - Utilitarianism - Beneficence - Dilemmas

A. Autonomy, Utilitarianism, Beneficence

Q. A drug-addicted nurse switches a patient's morphine injection with normal saline so that the nurse can use the morphine. The nurse is violating which principles of ethics? (Select all that apply). -Autonomy. -Utilitarianism. - Beneficence. -Dilemmas.

A. Autonomy, Utilitarianism, Beneficence.

Q. A homeless man presents to the emergency room with hypothermia. He tells the nurse that he is positive for human immunodeficiency virus (HIV) and sought revenge by deliberately having sex with his mate, who does not know of his HIV status. This patient is violating the ethical principles of___________.

A. Beneficence (promoting goodness, kindness, and charity)

Q. Which of the following ethical terms matches this statement: A problem for which in order to do something right you have to do something wrong. - Justice. - Veracity. - Ethical dilemma. - Fidelity.

A. Ethical dilemma.

Q. A patient and her husband used in vitro fertilization to become pregnant. The unused sperm were frozen so the couple could have more children later. They bore a little girl who was diagnosed with leukemia when she was 5 years old. The child now needs a bone marrow transplant (BMT). The best chance of a match for the BMT is a sibling. The couple would like to use the sperm to have another child so that they can increase the likelihood of a match. The nurse realizes that the unborn child poses an ethical dilemma involving -Beneficence. - human dignity. -Justice. -Veracity.

A. Human dignity is the inherent worth and uniqueness of a person. Human rights are the basic rights of each individual.

Q. A valid consent includes all of the following, except - It must be presented to the patient by a nurse. - The consent includes information about the risks and benefits of the procedure. - The patient must have the capacity to give consent. - The patient must voluntarily give consent.

A. It must be presented to the patient by a nurse. Informed consent document must be presented by the provider performing the procedure.

Q. A nurse protecting a patient's right to consent to a procedure is represented in which of the following answers? - Finding that the informed consent document is not with the chart, the nurse gives the patient another consent document to sign before the procedure. - When the nurse finds that the informed consent document is not yet complete, she holds the patient's preprocedure narcotics until the physician can obtain patient consent. - The nurse finds that the consent form is unsigned in the chart and waits until after the procedure to get the document signed. - Knowing the patient is not competent to sign a consent form, the nurse asks the friend who came with the patient to sign it.

A. When the nurse finds that the informed consent document is not yet complete, she holds the patient's preprocedure narcotics until the physician can obtain patient consent.

Q. Which of the following is an example of a medical malpractice tort liability? - A patient is informed of all known side effects of a medication and voluntarily takes the medication. The patient experiences an adverse effect from a medication prescribed by a physician. - A nurse follows the standard of care for initiating an intravenous line, but the patient's vein bursts, causing a hematoma and the need for minor surgery to evacuate the fluid. - A surgeon does not complete the postprocedure count process, and a sponge is retained in the patient's abdominal cavity. - The Department of Justice fines an organization for releasing protected health information to a pharmaceutical company without individual patient consent.

A.surgeon does not complete the postprocedure count process, and a sponge is retained in the patient's abdominal cavity.

Aspects of safety culture that contribute to a culture of safety in a health care organization include a. communication. b. fear of punishment. c. malpractice implications. d. team nursing.

ANS: A Aspects that contribute to a culture of safety include leadership, teamwork, an evidence base, communication, learning, a just culture, and patient-centered care. Fear of professional or personal punishment and concern about malpractice implications are considered barriers to a culture of safety. No model of nursing care has been related to a culture of safety.

A nursing student is doing a survey of fellow nursing students. Which ethical concept is the student following when calculating the risk-to-benefit ratio and concluding that no harmful effects were associated with a survey? a. Beneficence b. Human dignity c. Justice d. Human rights

ANS: A Beneficence is a term that is defined as promoting goodness, kindness, and charity. In ethical terms, beneficence means to provide benefit to others by promoting their good. Human dignity is the inherent worth and uniqueness of a person. Justice involves upholding moral and legal principles. Human rights are the basic rights of each individual.

Critical Thinking: The nurse and the patient are conversing face to face. What communication technique is this? a. linguistic b. paralinguistic c. explicit d. metacommunication

ANS: A Conversing face to face, reading newspapers and books, and even texting are all common forms of linguistic communication. Paralinguistics include less recognizable but important means of transmitting messages such as the use of gestures, eye contact, and facial expressions. Explict communication is not a therapeutic communication technique. Metacommunication factors that affect how messages are received and interpreted would include internal personal states (such as disturbances in mood), environmental stimuli related to the setting of the communication, and contextual variables (such as the relationship between the people in the communication episode).

A patient does not make eye contact with the nurse and is folding his arms at his chest. Which aspect of communication has the nurse assessed? a. Nonverbal communication b. A message filter c. A cultural barrier d. Social skills

ANS: A Eye contact and body movements are considered nonverbal communication. There are insufficient data to determine the level of the patient's social skills or whether a cultural barrier exists.

A nurse on the unit makes a error in the calculation of the dose of medication for a critically ill patient. The patient suffered no ill consequences from the administration. The nurse decides not to report the error or file an incident report. The nurse is violating which principle of ethics? a. Fidelity b. Individuality c. Justice d. Values clarification

ANS: A Fidelity is the principle that requires us to act in ways that are loyal. In the role of a nurse, such action includes keeping your promises, doing what is expected of you, performing your duties, and being trustworthy. Individuality is something that distinguishes one person or thing from others. Injustice is when a person is denied a right or entitlement. Values clarification is a tool that allows the nurse to examine personal values in terms of ethical situations.

A staff nurse reports a medication error, failure to administer a medication at the scheduled time. An appropriate response of the charge nurse would be a. "We'll do a root cause analysis." b. "That means you'll have to do continuing education." c. "Why did you let that happen?" d. "You'll need to tell the patient and family."

ANS: A In a just culture the nurse is accountable for their actions and practice, but people are not punished for flawed systems. Through a strategy such as root cause analysis the reasons for errors in medication administration can be identified and strategies developed to minimize future occurrences. Requiring continued education may be an appropriate recommendation but not until data is collected about the event. Telling the patient is part of transparency and the sharing and disclosure among stakeholders, but it is generally the role of risk management staff, not the staff nurse.

A hospital is experiencing a drop in patient admissions, resulting in the implementation of a hiring freeze. What is a potential critical consequence of this internal organizational decision? a. A decrease in the availability of future nurses to hire b. A savings of salaries and benefits c. Increased scholarships to nursing students from the local high school d. Increased cross-training of current staff

ANS: A In an economic climate where hospitals are not hiring, nursing schools may limit enrollment which will limit the availability of future nurses available to be hired when the current nurses retire or reduce their hours. Salary savings is minimal as the number of patients, staffing, and revenue are closely aligned. Scholarships will decrease as hiring commitments to scholarship holders will no longer be in effect. Cross-training may occur, but it is not a critical consequence of a hiring freeze.

A new registered nurse asks the registered nurse (RN) preceptor what could be done to become more professional. The best response of the preceptor is a. "Attend nursing educational meetings." b. "Listen to other nurses." c. "Read the agency newsletter." d. "Pass the licensing exam."

ANS: A Knowledge and commitment are essential components of professionalism. Attending nursing educational meetings can promote collaborative learning with peers and maintenance of competence in an ever-changing health care environment. Listening can promote professionalism, and communication is certainly a component of professionalism; however, there is also a social sense to listening, and without the educational/learning component, this is not the best answer. An agency newsletter could include information about professional opportunities, but it is not the best answer. The new nurse would have already passed the licensing exam, the legal requirement to be considered a nurse.

Recommendations published in the IOM's report The future of nursing: Leading change, advancing health include that nurses a. teach, advocate, assess, and nurture. b. should have a graduate degree to practice. c. diagnose and recommend treatments. d. must have continuing education.

ANS: A Professional nurses teach, advocate, assess, and nurture. The IOM recommends that 80% of nurses have a minimum baccalaureate degree (not graduate degree) by 2020. Physicians diagnose and recommend treatments, and nurses provide the majority of these treatments. Lifelong learning is recommended, and some, not all, states require continuing education.

A nurse manager recognizes that systems theory identifies that there is a social component within an organization that affects the overall functioning of the system. What indicator would demonstrate to the nurse manager that the social needs of an organization are being met? a. Most employees from the organization attend an annual holiday celebration. b. Separate eating areas for each discipline are set up in the cafeteria. c. Nurse managers are planning to move to a centralized area away from the care units. d. The summer softball teams are canceled due to lack of interest.

ANS: A Systems theory focuses on the needs and desires of people who work in the organization. Good attendance at a work-sponsored function indicates that staff enjoy interacting and are meeting social and relationship roles. Separating disciplines does not foster a sense of team. Moving administration away from staff limits interaction and informal conversations that build trust. Lack of participation in sponsored events such as a softball team indicates that staff relationships are not strong, and a social component is not being achieved within the work environment.

The nurse is presenting an in-service on the importance of collaborative communication. The nurse includes which critical event identified by the Joint Commission as an outcome of poor communication among health care team members? a. The occurrence of a patient event resulting in death or serious injury b. Decreased ability to document expenses of care provided c. Longer time to begin surgical cases d. Increased time to discharge patients to outpatient care

ANS: A The Joint Commission has identified that poor communication is the primary factor in the occurrence of sentinel events, or events resulting in unintended death or serious injury to patients. Lack of documentation, longer time to begin surgery, and increased delays in discharge all contribute to the management of health care, but do not result in critical patient outcomes.

The nurse is faced with an ethical issue. When assessing the ethical issue, the nurse must first a. ask, "What is the issue?" b. identify all possible alternatives. c. select the best option from a list of alternatives. d. justify the choice of action or inaction.

ANS: A The first step in the situational assessment procedure is to find out the technical and scientific facts and assess the human dimension of the situation—the feelings, emotions, attitudes, and opinions. Trying to understand the full picture of a situation is time consuming and requires examination from many different perspectives, but it is worth the time and effort that is required to understand an issue fully before moving forward in the assessment procedure. Identifying alternatives is the second step in the situation assessment procedure. A set of alternatives cannot be established until an assessment has been completed. Selecting the best option is actually the third step in the situation assessment procedure. Options cannot be selected until an assessment has been done to define the issue. Justifying the action or inaction is the final step in the situational assessment procedure. No justification can be made until the assessment and action phases have been completed.

A nurse is conducting a therapeutic session with a patient in the inpatient psychiatric facility. Which remark by the nurse would be an appropriate way to begin an interview session? a. "How shall we start today?" b. "Shall we talk about losing your privileges yesterday?" c. "Let's get started discussing your marital relationship." d. "What happened when your family visited yesterday?"

ANS: A The interview is patient centered; thus, the patient chooses issues. The nurse assists the patient by using communication skills and actively listening to provide opportunities for the patient to reach goals. In the distracters, the nurse selects the topic.

A 28-year-old married woman received word that she is pregnant. Sadly, the patient is not able to carry the pregnancy because she suffers from long QT syndrome, which causes an abnormality of the heart, meaning any rush of adrenaline could prove fatal. The pregnant patient states, "I want to have this baby." The nurse realizes that this is a conflict that involves the ethical principle of a. utilitarianism. b. deontology. c. autonomy. d. veracity.

ANS: A Utilitarianism is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. An attempt is made to determine which actions will lead to the greatest ratio of benefit to harm for all persons involved in the dilemma. Veracity is telling the truth in personal communication as a moral and ethical requirement. Deontology is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. Autonomy is the principle of respect for the individual person. All persons have unconditional intrinsic value. People are self-determining agents who are entitled to decide their own destiny.

Components of a professional identity in nursing include which of the following? (Select all that apply.) a. Accountability b. Advocacy c. Autonomy d. Competence e. Culture

ANS: A, B, C, D The scope of professional identity in nursing includes: autonomy, knowledge, competence, professionalism, accountability, advocacy, collaborative practice, and commitment. Cultural sensitivity is important to professional nursing; however, culture is an inherent quality of nurses and patients, not a component of the professional identity.

The focus of quality health care should be on which of the following items? (Select all that apply.) a. Excellent services b. Comprehensive communication c. Private hospital rooms d. Health team collaboration e. Culturally competent care

ANS: A, B, D, E Excellent services, communication, collaboration, and culturally competent care brings quality to the health care delivered to the patient. Private hospital rooms may be a preference by some patients, but they do not add to the quality of care.

What are the major attributes of health care quality? (Select all that apply.) a. Conforms to standards b. Sound decision making c. High acuity patients d. Low health care costs e. Identifies adverse events

ANS: A, B, E Major attributes of health care quality include conformation to standards set by regulatory agencies, sound decision making regarding care, and identifying potential adverse events. High acuity of patients does not contribute to quality health care, because the care demand is increased, and low health care costs mean fewer services may be available.

Nurses can be health advocates in which of the following ways? (Select all that apply.) a. Supporting their professional nursing organization when discussing upcoming legislation b. Discussing the upcoming classes with a neighbor c. Rallying for coverage for childhood immunizations d. Arranging for a patient to meet with case management for home health care e. Discussing a patient they are concerned about with a fellow student in the public cafeteria

ANS: A, C, D Supporting a professional nursing organization, rallying for coverage for childhood immunizations, and arranging for a patient to meet with case management are examples of how nurses can be a positive influence on health care policy. Discussing an upcoming class with a neighbor is not effective because it could be determined to be negative. Talking about a patient in a public area is an example of inappropriate communication between health care workers and is a violation of patient confidentiality.

A nursing student is preparing a care plan for an assigned patient. When accessing the electronic medical record, what is acceptable information to view? (Select all that apply.) a. Laboratory data of the assigned patient b. Admission diagnosis for a patient who is a former neighbor c. The patient's age, date of birth, and gender d. The history and physical of the assigned patient e. A classmate's brother's chest x-ray report

ANS: A, C, D The laboratory data, age, date of birth, gender, history, and physical of an assigned patient are necessary for identification and care of the patient so it is acceptable to view this information in the electronic medical record. The patient information in the medical record, whether electronic or print, is only to be viewed by those who have a legitimate role in the patient's care. Viewing information on patients other than the assigned patient is not appropriate, because the student does not have a need to view the information for patient care. These are violations of patient privacy.

An unconscious patient is treated in the emergency department for head trauma. The patient is unconscious and on life support for 2 weeks prior to making a full recovery. The initial actions of the medical team are based on which ethical principle? a. Utilitarianism b. Deontology c. Autonomy d. Veracity

ANS: B Deontology is an approach that is rooted in the assumption that humans are rational and act out of principles that are consistent and objective and that compel them to do what is right. Deontologic theory claims that a decision is right only if it conforms to an overriding moral duty and wrong only if it violates that moral duty. Utilitarianism is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. An attempt is made to determine which actions will lead to the greatest ratio of benefit to harm for all persons involved in the dilemma. Autonomy is the principle of respect for the individual person. People are free to form their own judgments and perform whatever actions they choose. Veracity is defined as telling the truth in personal communication as a moral and ethical requirement

A hospital organization is working to improve a feeling of being valued and respected among all staff members. Which action by administration would reinforce the feeling of being valued? a. Create professional pathways that require advanced education for any advancement of staff. b. Seek staff input when planning a remodeling project of patient rooms. c. Form committees that consist of upper management to plan organizational goals. d. Consistently schedule required staff meetings at the same time each month.

ANS: B Including staff at all levels of an organization in planning and projects demonstrates respect for the intelligence and creativity of the individual. Requiring advanced education for any advancement limits those with barriers to attending additional schooling; advancement should be available in a variety of ways to show the value of the individual. Committees that only consist of upper management cause a feeling of disconnect between staff and administration. Scheduling meetings at the same time does not consider those who work shifts and either have to come in on their day off or must disrupt sleep to attend.

A nurse manager has recently overheard several negative comments made by nurses on the unit about other nurses on the unit. The manager recognizes that the nurses are exhibiting what type of behavior that is detrimental to collaboration? a. Vertical violence b. Lateral violence c. Descending violence d. Personal violence

ANS: B Lateral violence undermines collaboration and occurs nurse-to-nurse. Vertical or descending violence implies one participant has a higher status than another. Personal violence falls in a legal category, and while it will hinder collaboration, it is not specific to coworkers.

A nurse is interviewing at an agency owned by a national religious organization that serves homeless and uninsured patients. A large poster display shows a proposed addition that would add 16 beds to the facility that will be funded from profits of the previous 3 years of operation. The nurse recognizes that the agency is most likely what type of agency? a. For-profit b. Not-for-profit c. Publicly-owned d. Investor-owned

ANS: B Many religious organizations are privately owned and administer not-for-profit health facilities, where profits are returned into the facility for improvements or equipment. For-profit agencies distribute profits to shareholders. Publicly-owned facilities are government supported and not linked to religious organizations. Investor-owned agencies would be for-profit agencies with profits distributed to investors.

A patient states that everything has been going great; however, the nurse observe the patient biting his nails and fidgeting. What assessment can the nurse make? The patient's communication type is a. linguistic. b. paralinguistic. c. explicit. d. inadequate.

ANS: B Mixed messages involve the transmission of conflicting or incongruent messages by the speaker. The patient's verbal message that all is well in the relationship is modified by the nonverbal behaviors denoting anxiety. Data are not present to support the choice of the verbal message being clear, explicit, or inadequate.

A patient suffered a brain injury from a motor vehicle accident and has no brain activity. The patient has a living will which states no heroic measures. The family requests that no additional heroic measures be instituted for their son. The nurse respects this decision in keeping with the principle of a. accountability. b. autonomy. c. nonmaleficence. d. veracity.

ANS: B Patients and families must be treated in a way that respects their autonomy and their ability to express their wishes and make informed choices about their treatment. Accountability is inherent in the nurse's ethical obligation to uphold the highest standards of practice and care, assume full personal and professional responsibility for every action, and commit to maintaining quality in the skill and knowledge base of the profession. Nonmaleficence is a principle that implies a duty not to inflict harm. In ethical terms, nonmaleficence means to abstain from injuring others and to help others further their own well-being by removing harm and eliminating threats. Veracity means telling the truth as a moral and ethical requirement.

A student nurse is talking with his instructor. The student asks how quality of care is evaluated. The best response by the instructor is "Quality of care is evaluated a. by the patient getting well." b. on the basis of process and outcomes." c. by the physician's assessment." d. by the patient's satisfaction."

ANS: B Quality of care is evaluated by process and outcomes. If the outcomes are achieved, then the care has achieved what is was designed to do. The patient getting well may be an action of the body doing what it is supposed to do and not quality of care; the same can be said of the physician's assessment. The patient's satisfaction is subjective according to his or her perceptions and not the quality of care.

The management of a community hospital is trying to encourage a more collaborative environment among staff members. Which concept is most important for management to develop first? a. Post educational posters about how well collaboration is being performed b. Highlight that no single profession can meet the needs of all patients c. Provide meetings for each department on how their role affects patients d. Begin implementing evaluations of collaborative skills on annual performance reviews

ANS: B Recognizing that collaboration needs all professions to provide patient-centered care is an important first step to implementing a different philosophy in the hospital. Posting an evaluation of performance before education will not encourage participation. Collaboration requires an understanding of more than your own discipline. It is unfair to evaluate staff on a requirement that they have not been introduced to.

Which level of government is responsible for the regulation of a nurse's license? a. Federal government b. State government c. Local government d. International coalition

ANS: B State boards of nursing oversee the regulation of nursing practice. These agencies are established by legislatures to implement and enforce laws through a rule-making process. Federal, local, and international coalitions are not correct, because they do not have control of the state boards of nursing.

The focus for The Joint Commission (TJC) is _____ and _____ in the delivery of health care. a. cost containment; safety b. safety; quality c. quality; assessment d. assessment; evaluation

ANS: B The focus of TJC is quality and safety for patient care. TJC does not address cost containment, assessment of care, or evaluation of care.

The patient's perception of his or her care is not as important as the outcome of the care. a. True b. False

ANS: B The patient's perception of his or her care is just as important as the outcome of the care. If the patient perceives the care as meeting the aspects of quality, then patient satisfaction increases.

Prior to drug administration the nurse reviews the seven rights, which include right patient, right medication, right time, right dose, right education, right documentation, and right a. room. b. route. c. physician. d. manufacturer.

ANS: B The right route (e.g., oral or intramuscular) is an essential component to verify prior to the administration of any drug. The patient does not need to be in a specific location. There may be a number of physicians caring for a patient who prescribe medications for any given patient. A similar drug may be made by a number of different companies, and checking the manufacturer is not considered one of the seven rights. However, the nurse will want to be aware of a difference, because different companies prepare the same medication in different ways with different inactive ingredients, which can affect patient response.

Which of the following components are included in health policy at the state level? a. Americans with Disabilities Act of 1990 b. Scope of nursing practice c. Health Insurance Portability and Accountability Act (HIPAA) of 1996 d. Patient Safety and Quality Improvement Act of 2005

ANS: B The scope of nursing practice is correct, because it is controlled at the state level by state boards of nursing. The Americans with Disabilities Act of 1990, the HIPAA of 1996, and the Patient Safety and Quality Improvement Act of 2005 are all regulated at the national level.

A male patient suffered a brain injury from a motor vehicle accident and has no brain activity. The spouse has come up to see the patient every day for the past 2 months. She asks the nurse, "Do you think when he moves his hands he is responding to my voice?" The nurse feels bad because she believes the movements are involuntary, and the prognosis is grim for this patient. She states, "He can hear you, and it appears he did respond to your voice." The nurse is violating which principle of ethics? a. Autonomy b. Veracity c. Utilitarianism d. Deontology

ANS: B Veracity is the principle of telling the truth in a given situation. Autonomy is the principle of respect for the individual person; this concept states that humans have incalculable worth or moral dignity. Utilitarianism is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. Giving the spouse false reassurance is not a good consequence. Deontologic theory claims that a decision is right only if it conforms to an overriding moral duty and wrong only if it violates that moral duty. Persons are to be treated as ends in themselves and never as means to the ends of others.

Which activities are appropriate for the nurse to collaborate with a patient? (Select all that apply.) a. Prescribing a new medication dose b. Health promotion activities c. End-of-life comfort decisions d. Interpreting laboratory results e. Lifestyle changes to improve health

ANS: B, C, E Nurses should include patients and their families when exploring health promotion activities, end-of-life decisions, lifestyle changes, and treatment options. Prescribed medication doses are initiated by educated professionals, although the patient gives feedback on the effectiveness of medications. Patients are not trained to interpret lab results, but patients rely on health professionals to explain results to them.

Critical Thinking: The nurse is seeking clarification of a statement that was made by a patient. What is the best way for the nurse to seek clarification? a. "What are the common elements here?" b. "Tell me again about your experiences." c. "Am I correct in understanding that..." d. "Tell me everything from the beginning."

ANS: C Clarification ensures that both the nurse and patient share mutual understanding of the communication. The distracters encourage comparison rather than clarification and present implied questions that suggest the nurse was not listening.

The annual report for a hospital shows that external environment factors are affecting the amount of new staff hired. What is a likely factor contributing to this outcome? a. The recent implementation of becoming a not-for-profit institution b. The implementation of a hospital electronic medical record system c. A national recession that has been occurring for 3 years d. The closure of a hospital-based school of nursing due to lack of funding

ANS: C External environmental factors that affect organizations are conditions or events that occur outside the control of the agency, such as new health laws, governmental regulations, or economic trends. Internal environmental factors occur within the organizational structure and include such factors as technology issues, changes in personnel roles, or the implementation of new policies.

Two nurses are discussing health care quality. They agree on the statement that health care quality requires a. magnet status hospitals. b. fewer adverse events. c. collaboration of multiple health care agencies. d. increased patient education.

ANS: C Multiple health care agencies are able to collaborate and provide better outcomes for health care personnel and patients. Magnet status hospitals may be good, but the status does not always mean a quality outcome. Fewer adverse events and increased patient education are good, but they may be the result of other variables and not just quality of care rendered.

The scope of professional nursing practice is determined by the rules promulgated by which organization? a. American Nurses' Association (ANA) b. Institute of Medicine (IOM) c. State's Board of Nursing d. State's Nursing Association

ANS: C Professional nursing practice is regulated by each state's Board of Nursing. The ANA is the professional organization of registered nursing in the United States and may influence, but it does not regulate. The IOM collaborated with the Robert Wood Johnson Foundation to improve the fractured health care system in the United States, and it makes recommendations, not rules. The state nursing associations are state organizations of the ANA and may collaborate with the public and boards of nursing to promote nursing rules which improve health care.

A student nurse and clinical instructor are discussing quality in health care. The instructor knows the student understands when the student says, "Quality is a. apparent in all health care." b. an outcome of health care." c. seen and unseen in health care." d. achieved by collaboration in health care."

ANS: C Quality in health care is tangible and intangible. Quality in health care is not apparent in all health care, as many areas of health care are lacking. Quality of care does not always affect the outcome of care; the patient may recover no matter what care is given. Quality is not always achieved by collaboration.

A quality improvement committee is reviewing discharge surveys. Results show that patients and their families have difficulty finding departments and areas of the hospital. What action by the committee would best address this concern for the organization? a. Continue to review future surveys to monitor the situation. b. Give additional training to the receptionists and switchboard personnel to give better directions. c. Form a multidisciplinary committee to identify options to help travel through the hospital. d. Send a work order to the maintenance department requesting that brighter lights be installed.

ANS: C Successful organizations respect the input of all disciplines when searching for solutions for problems. Continuing to gather data delays solving a problem. There is no indication that verbal directions will solve the problem; additional measures may be required. Merely providing additional light may not solve the problem—multi-language signs or even remodeling may be identified by the committee as being needed.

Essential elements of a standard order set to verify a medication order include a. volume only. b. number of tablets. c. metric dose/strength. d. hour of administration.

ANS: C The ISMP recommendations for standardized medication order sets include such elements as the drug name (generic followed by brand when appropriate), metric dose/strength, frequency and duration, route, and indication. Although a prescription may include volume or number of tablets, the essential component is dose or strength, because the volume or number of tablets may vary by manufacturer. The exact hour of administration can be based on factors such as the frequency, agency protocols, and patient preferences.

Which branch of government is responsible for the execution of laws passed by legislatures? a. Legislative b. Judicial c. Executive d. Local

ANS: C The executive branch of federal and state governments is responsible for execution of laws passed. The legislative branch is responsible for passing laws. The judicial branch of government determines if rights are being upheld. Local governments are not considered a branch of the government.

Nursing demonstrates dedication to improving public health through a. changing health care standards. b. legal regulations. c. scope of practice. d. technology.

ANS: C Through the scope of practice, specialized knowledge, and code of ethics, the discipline of nursing has demonstrated its dedication to improving public health. The changing health care environment is one of the challenges to nursing, not an indicator of dedication. Legal regulations are generally promulgated by legislators rather than nurses to protect the public. A highly technological environment is considered a challenge to nursing rather than an indicator of dedication.

The nurse is caring for a patient with a progressive, degenerative muscle illness. The patient states that she would like to remain in her home with her daughter as long as possible. What action should the nurse take? a. Teach the patient muscle strengthening and stretching exercises. b. Tell the patient to make plans to move to an assisted-living facility. c. Discuss resources to help the patient and make appropriate referrals. d. Ask the patient to come in for daily physical therapy.

ANS: C To honor the patient's request to stay at home the nurse should make appropriate referrals for needed evaluation and assistance. Most nurses will not have the expertise to teach appropriate exercises for degenerative illness. Asking the patient to move to an assisted-living facility does not account for the patient's request. The patient has not been assessed for the need of daily therapy, and it is not likely that a patient with a degenerative illness will be able to make daily appointments for treatment as the illness progresses.

A hospital organization is applying for Magnet© status to show excellence in nursing practice. What components would indicate that the hospital is meeting Magnet© principles? (Select all that apply.) a. The education budget for nursing has been cut to provide for new laboratory equipment. b. On average, 40% of new nurses are leaving within 1 year of hire. c. Nurses are active participants on all major hospital committees. d. Quality improvement projects are planned and evaluated by nurses. e. Patient care outcome data are reported in the annual executive board meeting.

ANS: C, D To gain Magnet© status, an organization must show that nurses are active participants in the organization administrative structure, fully involved in quality improvement projects, and are recognized as a valuable resource.

A sentinel event refers to an event that a. could have harmed a patient, but serious harm didn't occur because of chance. b. harms a patient as a result of underlying disease or condition. c. harms a patient by omission or commission, not an underlying disease or condition. d. signals the need for immediate investigation and response.

ANS: D A sentinel event is an unexpected occurrence involving death or serious physical or psychologic injury or the risk thereof called sentinel, because they signal the need for immediate investigation and response. A near-miss refers to an error or commission or omission that could have harmed the patient, but serious harm did not occur as a result of chance. Harm that relates to an underlying disease or condition provides the rationale for the close monitoring and supervision provided in a health care setting. An adverse event is one that results in unintended harm because of the commission or omission of an act.

The nurse is admitting a patient to the medical/surgical unit. Which communication technique would be considered appropriate for this interaction? a. "I've also had traumatic life experiences. Maybe it would help if I told you about them." b. "Why do you think you had so much difficulty adjusting to this change in your life?" c. "You will feel better after getting accustomed to how this unit operates." d. "I'd like to sit with you for a while to help you get comfortable talking to me."

ANS: D Because the patient is newly admitted to the unit, allowing the patient to become comfortable with the setting a technique that can assist in establishing the nurse-patient relationship. It helps build trust and convey that the nurse cares about the patient. The nurse should not reveal their life experiences as this is not therapeutic. Asking why the patient is having difficulty may provide insight; however, this would be best saved for an established relationship with the patient. Assuring the patient that they will feel better may not be true depending on the reason for the admission.

A nurse is reported for taking prescribed patient medications for their personal use. Who has direct authority over deciding if the nurse may keep their professional license to continue practicing as a nurse? a. The hospital where the nurse is currently employed b. The American Nurses Association c. The National League for Nursing d. The State Board of Nursing who issued the license

ANS: D Decisions related to practice are the responsibility of the licensing body, or State Board of Nursing, who is charged with protecting the public. The hospital does not determine who is eligible for a professional license. The National League for Nursing is active in nursing education standards. The American Nurses Association helps develop standards of care and is politically active, but it does not enforce standards for individuals.

A definition of health policy includes which of the following elements? a. Funding for public education b. Appropriation of funds for roadwork c. Selection of congressional members of committees d. Public policy made to support health-related goals

ANS: D Health policy is defined as public policies pertaining to health that are the result of an authoritative public decision-making process. Public education funding, appropriation of funding for roads, and selection of members of committees are not part of health care policy. They are under a different funding arm of the government.

To promote a safety culture, the nurse manager preparing the staff schedule considers the anticipated census in planning the number and experience of staff on any given shift. The human factor primarily addressed with this consideration is/are a. available supplies. b. interdisciplinary communication. c. interruptions in work. d. workload fluctuations.

ANS: D Including an adequate number of staff members with experience caring for anticipated patients is a strategy to manage the workload and potential fluctuations. A safety culture requires organizational leadership (e.g., the nurse manager) that gives attention to human factors such as managing workload fluctuations. This strategy also applies principles of crew resource management in that it addresses workload distribution. Lack of supplies can create a challenge for safe care but could not be addressed with the schedule. Concerns with communication and coordination across disciplines, including power gradients, and excessive professional courtesy can create hazards but would not be the best answer. Strategies to minimize interruptions in work are essential but would not be the best answer in this situation.

A newly licensed nurse is assigned to an experienced nurse for training on a medical unit of a hospital. What type of nurse-to-nurse collaboration does this assignment demonstrate? a. Interprofessional collaboration b. Shared governance collaboration c. Interorganizational collaboration d. Mentoring collaboration

ANS: D Mentoring is a collaborative partnership between a novice nurse and an expert nurse to help transition a nurse through career development, personal growth, and socialization into the profession. Interprofessional collaboration is working with several disciplines. Shared governance is a type of management for nursing. Interorganizational collaboration often includes teams from inside and outside an organization to meet a common goal.

Which statement correctly describes the nurses' role in collaboration? a. State boards of nursing mandate that collaboration can only occur in hospitals. b. Collaboration should occur only with physicians. c. Collaboration occurs only between nurses with the same level of education. d. Collaboration may occur in health-related research.

ANS: D Nurses collaborate with many different persons, including patients, managers, educators, and researchers. Collaboration does not occur only with physicians or nurses of equivalent educational background, but with anyone who is working towards meeting patient goals. Collaboration occurs in any health care setting as well as community and home settings.

Which patient scenario describes the best example of professional collaboration? a. The nurse, physician, and physical therapist have all visited separately with the patient. b. The nurse, physical therapist, and physician have all developed separate care plans for the patient. c. The nurse mentions to the physical therapist that the patient may benefit from a muscle strengthening evaluation. d. The nurse and physician discuss the patient's muscle weakness and initiate a referral for physical therapy.

ANS: D Professional collaboration includes team management and referral to needed providers to meet patient needs. Each discipline retains responsibility for their own scope of practice but recognizes the expertise of other providers. Working separately does not develop a comprehensive plan of care. Casual mentioning of patient needs does not follow professional communication channels and frequently delays needed interventions.

The strategy to avoid medication errors endorsed by the Institute for Safe Medication Practices (ISMP) to differentiate products with look-alike names is referred to as a. automatic alerts. b. bar coding. c. computer order entry. d. tallman lettering.

ANS: D Tallman lettering is a term coined by ISMP to describe the practice of using unique letter characteristics of similar drug names known to have been confused with one another. Tallman lettering is used to differentiate products with look-alike names such as BenaDRYL (antihistamine) and BenaZEPRIL (ace inhibitor). The other options are examples of safety-enhancing technologies strategies designed to minimize drug errors, but they are not directed at look-alike medications. Automatic alerts are computer-generated alarms that can be programmed to occur with such things as allergies and incompatible medications. Bar coding is used with medication administration systems that can be programmed to match patient identification bracelets with documentation. Computer order entry systems are designed to include components of a standard medication order.

Which of the following is the intent of HIPAA? a. Release of patient information for purposes of insurance reimbursement b. Prevent health care providers from billing for procedures done for the insured person c. Protect patients from reviewing their own medical records d. Limit the ability of health care providers to sell patient information to outside sources

ANS: D The intent of HIPAA is to protect patient information and prevent it from being sold to outside agencies. The right of heath care providers to bill for services is necessary for patient payment is and not prohibited. Patients have the right to view their own patient information.

To promote safety, the nurse manager sensitive to point of care (sharp end) and systems level (blunt end) exemplars works closely with staff to address the point of care exemplars such as a. care coordination. b. documentation. c. electronic records. d. fall prevention.

ANS: D The most common safety issues at the sharp end include prevention of decubitus ulcers, medication administration, fall prevention, invasive procedures, diagnostic workup, recognition of/action on adverse events, and communication. These are the most common issues the staff nurse providing direct patient care encounters. Each of the other options are classified as systems level exemplars.

The nurse is caring for a patient experiencing an allergic reaction to a bee sting who has an order for BenaDRYL. The only medication in the patient's medication bin is labeled BenaZEPRIL. The nurse contacts the pharmacy for the correct medication to avoid what type of error? a. Communication b. Diagnostic c. Preventive d. Treatment

ANS: D The nurse avoided a treatment error, giving the wrong medication. Benazepril is an ace inhibitor used to treat blood pressure. According to Leape, treatment errors occur in the performance of an operation, procedure, or test; in administering a treatment; in the dose or method of administering a drug; or in avoidable delay in treatment or in responding to an abnormal test. Communication errors refer to those that occur from a failure to communicate. Diagnostic errors are the result of a delay in diagnosis, failure to employ indicated tests, use of outmoded tests, or failure to act on results of monitoring or testing. Preventive errors occur when there is inadequate monitoring or failure to provide prophylactic treatment or follow-up of treatment.

The qualities of leadership, clinical expertise and judgment, mentorship, and lifelong learning would describe a nurse who is a(n) a. administrator. b. certified nurse specialist. c. practitioner. d. professional.

ANS: D The qualities listed are those of a professional nurse. The other options are all nurses who may have these qualities, but the focus of their title includes qualities not essential for the professional nurse. The administrator would have management qualities; the clinical nurse specialist would have specialty area knowledge; and the practitioner would meet legal requirements as a health care provider.

Critical Thinking: A patient states, "I had a bad nightmare. When I woke up, I felt emotionally drained, as though I hadn't rested well." Which response by the nurse would be an example of interpersonal therapeutic communication? a. "It sounds as though you were uncomfortable with the content of your dream." b. "I understand what you're saying. Bad dreams leave me feeling tired, too." c. "So, all in all, you feel as though you had a rather poor night's sleep?" d. "Can you give me an example of what you mean by a 'bad nightmare'?"

ANS: D The technique of clarification is therapeutic and helps the nurse examine meaning. The distracters focus on patient feelings but fail to clarify the meaning of the patient's comment.

A nurse manager finds an unsigned note reporting that patient care standards are not consistently being followed. Within the organizational structure, what is the best action for the manager? a. Schedule a staff meeting to ask staff who left the note. b. Send an email reminder that all staff need to review the policy and procedure book. c. Wait for a staff member to come forward who is willing to be identified. d. Form a small group to explore why staff are not comfortable reporting errors.

ANS: D There are significant problems in an organization where staff are not willing to openly discuss problems, especially problems that affect patient care. A focus group can help identify what is preventing a sense of comfort to reveal problems. Scheduling a meeting is unlikely to have the person admit to complaining about care provided by coworkers in front of coworkers. A request to review policies and procedures is so broad the staff will not be able to identify a specific problem that needs to be corrected. Unless organizational changes are made, it is unlikely that staff will decide to come forward when they would not do so in the first place.

A patient has been admitted to an acute care hospital unit. The nurse explains the hospital philosophy that the patient be an active part of planning their care. The patient verbalizes understanding of this request when they make which statement? a. "I will have to do whatever the physician says I need to do." b. "Once a plan is developed, it cannot be changed." c. "My insurance will not pay if I don't do what you want me to do." d. "We can work together to adjust my plan as we need to."

ANS: D Treatment plans need to be developed, evaluated, and adapted as needed based on the patient status and willingness to complete the prescribed care. Stating that the patient has to do whatever the care provider prescribes does not include the principle of collaboration. Care plans can be altered based on patient status. Insurance providers do not determine a patient's ability to complete prescribed care, although they do reimburse for standard care given.

A nurse follows the standard of care for initiating an intravenous line, but the patients vein bursts is an example of what type of event?

Adverse

A patient was informed of all known side effects of a medication, is prescribed the medication and voluntarily takes the medication is an example of what type of event?

Adverse

The following four patients arrive in the emergency department (ED) after a motor vehicle collision. In which order should the nurse assess them? (Put a comma and a space between each answer choice [A, B, C, D, E].) a. A 74-year-old with palpitations and chest pain b. A 43-year-old complaining of 7/10 abdominal pain c. A 21-year-old with multiple fractures of the face and jaw d. A 37-year-old with a misaligned left leg with intact pulses

C A B D

When assisting with oral intubation of a patient who is having respiratory distress, in which order will the nurse take these actions? (Put a comma and a space between each answer choice [A, B, C, D, E].) a. Obtain a portable chest-x-ray. b. Position the patient in the supine position. c. Inflate the cuff of the endotracheal tube after insertion. d. Attach an end-tidal CO2 detector to the endotracheal tube. e. Oxygenate the patient with a bag-valve-mask device for several minutes

E B C D A

A new nurse needs further teaching when stating a valid consent involves which action?

It must be presented to the patient by a nurse

The ANA outlines expectations of the nursing profession in the a. Gallup poll. b. Goldman report. c. Social Policy Statement. d. social identity theory.

The ANA's Nursing's Social Policy Statement outlines expectations of nurses. The national Gallup poll has found nursing to be one of the most trusted professions for their honesty and ethical standards almost every year, but it does not outline expectations. Emma Goldman was a radical anarchist nurse who advocated and cared for indigent women in New York. She demonstrated the expectations of a professional nurse. Social identity theory posits that social identity is derived from group membership and that most people work to attain a positive social identity, and it not specific to nursing.

The Joint Commission's authority relating to healthcare organizations

The Joint Commission standards do not have the same effect as law; however, they are often utilized as best practice standards in a malpractice case against which negligence is measured. The Joint Commission does not establish fines for noncompliance.

Which of the following would be a violation of the Consolidated Omnibus Budget Reconciliation Act and Emergency Medical Treatment and Active Labor Act of 1986?

The hospital emergency room physician suspects that a patient is not competent in making decisions for his post-care treatment. The physician does not complete a competency evaluation prior to transfer for a non-emergent treatment and allows the patient with suspected incompetence to sign the consent for transfer

Which of the following statements is true regarding The Joint Commissions authority relating to health care organizations?

The joint commission regulations may be seen as having the effect of law because they accredit organizations to bill Medicare and the standards are frequently used in malpractice cases

The nurse and physician are explaining the home care that will be needed by a patient after discharge. The patient's spouse states angrily that it will not be possible to provide the care recommended. What is the best response by the nurse? a. "Let me review what is needed again." b. "It is important that you do what the physician has prescribed." c. "What concerns do you have about the prescribed care?" d. "I can come back after you talk with your spouse about the care."

The patient needs to be the focus of developing care plans, and communication is an important part of collaboration with the patient to discover barriers for the patient to follow recommendations. It is important to either provide solutions to the barriers or present other options. Reviewing the care again does not demonstrate willingness to have the patient be part of the team. Insisting that the patient do what is prescribed is autocratic and does not recognize the role the patient has in their care. Leaving the patient and spouse with the situation unresolved fosters distrust and more anger.

The patient must voluntarily give consent? T/F

True

A nurse protecting a patients right to consent to a procedure is represented in which of the following answers?

When the nurse finds that the informed consent document is not yet complete, she holds the patients pre-procedure narcotics until the physician can obtain patient consent

8. A nurse wants to become involved in community disaster preparedness and is interested in helping set up and staff first aid stations or community acute care centers in the event of a disaster. Which organization is the best fit for this nurse's interests? a. The Medical Reserve Corps b. The National Guard c. The health department d. A Disaster Medical Assistance Team

a

A group of local volunteers respond to a tornado. Volunteers have completed an emergency response course and are able to assist with triage of injured citizens. They also participate in local health fairs to teach residents how to react during tornadoes. The responders are members of the: a. Medical Reserve Corps (MRC). b. Metropolitan Medical Response System (MMRS). c. National Disaster Medical System (NDMS). d. Commissioned Corps Readiness Force (CCRF).

a

The nurse is caring for a patient with sepsis. What is a late clinical manifestation of shock? a Drop in blood pressure b. MAP is decreased by less than 10 mm Hg c. Tachycardia with a boundig pulse d. Increased urine output

a

The home health nurse is visiting a frail older adult patient at risk for sepsis because of failure to thrive and immunosuppression. What does the nurse assess this patient for? ( select all that apply) a Signs of skin breakdown and presence of redness or swelling b Cough or any other symptoms of a cold or the flu c. Appearance and odor of urine, and pain or burning during urination d. Patient's and family's understanding of isolation precautions. e. Availability and type of facilities for hand washing

a b c e

Which information will the nurse consider when deciding what nursing actions to delegate to a licensed practical/vocational nurse (LPN/LVN) who is working on a medical-surgical unit (select all that apply)? a. Institutional policies b. Stability of the patient c. State nurse practice act d. LPN/LVN teaching abilities e. Experience of the LPN/LVN

a b c e

The nurse is conducting a review of the literature for pain management techniques. Which of the following would the nurse consider when conducting research that yields solid EBP? (Select all that apply.) a. Search the literature to uncover evidence to answer the question. b. Evaluate the outcome. c. Use the nursing process to evaluate evidence. d. Evaluate the evidence found. e. Develop an answerable question. f. Develop a question that has not been answered. g. Apply the evidence to the practice situation.

a b d e g

The nurse is preparing a teaching session for a patient at risk for septic shock. Which topics does the nurse include in this teaching? (select all that apply) a Wash hands frequently using antimicrobial soap b. Avoid aspirin and aspirin-containing products. c. Avoid large crowds or gatherings where people might be ill d. Do not share utensils; wash toothbrushes in a dishwasher e Take temperature once a week f Do not change pet litter boxes

a c d f

The nurse on a medical unit is presenting an in-service program on how to recognize sepsis. Which patients are at risk for distributive septic shock? (select all that apply) a. Older adult with urinary tract infection b. Patient with ruptured aortic aneurysm c. Patient with pneumonia d. Patient receiving heparin therapy e Older adult with sacral pressure ulcers

a c e

A patient has a systemic infection with a fever, increased respiratory rate, and change in mental status. Which laboratory values does the nurse seek out that are considered "hallmark" of sepsis? a. increased white blood count and icnreased glucose level b Increased serum lactate level and rising band neutrophils c. increased oxygen saturation and decreased clotting times d. decreased white blood count with increased hematocrit

b

After change-of-shift report in the progressive care unit, who should the nurse care for first? a. Patient who had an inferior myocardial infarction 2 days ago and has crackles in the lung bases b. Patient with suspected urosepsis who has new orders for urine and blood cultures and antibiotics c. Patient who had a T5 spinal cord injury 1 week ago and currently has a heart rate of 54 beats/minute d. Patient admitted with anaphylaxis 3 hours ago who now has clear lung sounds and a blood pressure of 108/58 mm Hg

b

Which set of assessment data is consistent for a patient with severe infection that could lead to system failure? a. Blood pressure (BP) 92/52, pulse (P) 56 beats/min, respiratory rate (RR) 10 breaths/min, urine output 1200 mL in past 24 hours b. BP 90/48, P 112 beats/min, RR 26 breaths/min, urine output 240 mL in past 24 hours c. BP 112/64, P 98 beats/min, RR 18 breaths/min, urine output 2400 mL in past 24 hours d. BP 152/90, P 52 beats/min, RR 12 breaths/min, urine output 4800 mL in past 24 hours

b

Which of the following factors contributes to the nurse having difficulty keeping up with the latest patient care information? (Select all that apply.) a. Implementation delays b. Proliferation of research c. Volume of health care literature d. Hours spent in direct patient care e. The need to read 3 articles every day of the week

b c d

The nurse is caring for a patient at risk for septic shock from a wound infection. In order to prevent systemic inflammatory response syndrome, the nurse's priority is to monitor which factor? a. patients pulse rate and quality b. patients elextrolute imbalanec c. Localized infected area d. patients intake and output

c

The nurse is caring for a patient with sepsis. At the beginning of the shift, the patient is in a hypodynamic state. Several hours later, the patient's blood pressure is elevated and pulse is bounding. How does the nurse interpret this change? a. a postive response and a signal of recovery b. Temporary situation that is likely to normalize c Worsening of the condition rather than improvement d expected resposne to standard therapies

c

The nurse plans to provide instructions about diabetes to a patient who has a low literacy level. Which teaching strategies should the nurse use (select all that apply)? a. Discourage use of the Internet as a source of health information. b. Avoid asking the patient about reading abilities and level of education. c. Provide illustrations and photographs showing various types of insulin. d. Schedule one-to-one teaching sessions to practice insulin administration. e. Obtain CDs and DVDs that illustrate how to perform blood glucose testing.

c, d ,e

The nurse documenting the patient's progress in the care plan in the electronic health record before an interdisciplinary discharge conference is demonstrating competency in which QSEN category? a. Patient-centered care b. Quality improvement c. Evidence-based practice d. Informatics and technology

d

Question: The statements below reflect interventions to address a person's needs. Arrange each need based on Maslow's hierarchy from most basic to highest level. 1 Referring a patient to a cancer support group 2 Providing nasogastric tube feedings 3 Encouraging a patient to start a hobby that he or she has always wanted to try 4 Explaining a new procedure

ng new procedure cancer hobby