Holistic Final Exam

What releases insulin?

pancreas

people with atelectasis usually have a history of what?

pneumonia

The mother of a toddler is deciding if she wants to allow her child to receive the recommended immunizations. The clinic nurse responds, "If you do not immunize your child, you are jeopardizing the health of other children." What type of approach does this response indicate? a. authoritarian or belittling b. guilt inducement d. approval

guilt inducement

HIPAA requires that you protect the patient confidentiality in what forms?

oral, written and electronic

1 tsp = _____ mL

5 mL

1 pint = ____ mL

500 mL

1 grain = ____ mg

60 mg

Do not exceed ___ while applying supplementtary oxygen via nasal cannula

6L/min

The nurse is using the SOAP format of charting during a home visit to a new mother. Which of the following data should the nurse document under the "P" domain of this format? a. "Client states that she has diffuse breast tenderness." b. "Client's breasts appear engorged." c. "Client states that she is having difficulty getting her infant to latch." d. "Client referred to the health unit's drop-in breastfeeding clinic."

"Client referred to the health unit's drop in breastfeeding clinic."

A 78-year-old client who is scheduled for surgery asks about self-care at home after the surgery is complete. Which teaching will the nurse provide? (Select all that apply.) "It may take you longer to heal than someone younger." "Eat nourishing foods after surgery to promote healing." "Try to do everything by yourself at home to build your strength back." "Wound healing can take longer if you have been exposed often to the sun." "Monitor your moods after surgery. Depression after surgery is not normal."

"It may take you longer to heal than someone younger." "Eat nourishing foods after surgery to promote healing." "Wound healing can take longer if you have been exposed often to the sun." "Monitor your moods after surgery. Depression after surgery is not normal."

gr ss = ____ mg

30 mg

1 ounce = ____ mL

30mL

True or False: A Penrose drain typically exits a client's skin through a stab wound created by the surgeon true The nurse is providing education to a client recently diagnosed with psoriasis. The client questions the nurse about the potential for curing the condition. What response by the nurse is most appropriate? "The condition is hard to cure." "You will likely experience periods of increased skin outbreaks and periods of remissions." "You will have this disease for life." "Your personal health habits will dictate how well you handle this condition."

"You will likely experience periods of increased skin outbreaks and periods of remission."

gr 1/150 = ____ mg

0.4 mg

gr 1/100 = ___ mg

0.6 mg

ss = ?

1/2

1 quart = ____ mL

1000 mL

1 gram = ____ grains

15 grains

1 tbsp = _____ mL

15 mL

1 kg = ____ lb

2.2 lb

1 inch = _____ cm

2.5 cm

HIPAA laws went into effect in what year?

2002

consume less than ____ of sodium per day

2300 mg

A client with Type II diabetes has come for an annual wellness check-up with the healthcare provider. Which vaccine will the nurse discuss with the client? DTAP Hepatitis A MMR Prevnar 13 ®

Prevnar 13

During data collection of a 4-year-old client, the nurse notes a respiratory rate of 35 breaths/min and a loud, harsh expiration that is longer than inspiration. The nurse would implement which appropriate nursing intervention next? Administer oxygen therapy Proceed with the data collection Notify the health care provider Obtain arterial blood sampling

Proceed with data collection

What does the R stand for in SBAR?

R- recommendations

When recording data regarding the client's health record, the nurse mentions the analysis of the subjective and objective data, in addition to detailing the plan for care of the client. Which of the following styles of documentation is the nurse implementing? a. FOCUS charting b. SOAP charting c. PIE charting d. Narrative charting

SOAP charting

Home healthcare is a rapidly growing area of the healthcare system. Factors that have influenced the growth of home healthcare include which of the following? Select all that apply. a. Patients have an increased acuity level following earlier hospital discharge. b. People are living longer with multiple chronic illnesses. c. In-hospital reimbursement is limited by DRGs and allowed services. d. Some families do not want their relative institutionalized. e. Telehealth and technological support services allow home health agencies to provide complex in-home care. f. Home health nursing requires that its nurses are prepared at the advanced practice level.

The nurse understands that a diagnostic-related group is one of the reimbursement strategies in a prospective payment system. The diagnostic-related group is a part of which health care system? a. medicare b. medicaid c. capitation d. Americare medicare Home healthcare is a rapidly growing area of the healthcare system. Factors that have influenced the growth of home healthcare include which of the following? Select all that apply. a. Patients have an increased acuity level following earlier hospital discharge. b. People are living longer with multiple chronic illnesses. c. In-hospital reimbursement is limited by DRGs and allowed services. d. Some families do not want their relative institutionalized. e. Telehealth and technological support services allow home health agencies to provide complex in-home care. f. Home health nursing requires that its nurses are prepared at the advanced practice level. a. Patients have an increased acuity level following earlier hospital discharge. b. People are living longer with multiple chronic illnesses. c. In-hospital reimbursement is limited by DRGs and allowed services. d. Some families do not want their relative institutionalized. e. Telehealth and technological support services allow home health agencies to provide complex in-home care.

During data collection of a 4-year-old client, the nurse notes a respiratory rate of 35 breaths/min and a loud, harsh expiration that is longer than inspiration. The nurse would implement which appropriate nursing intervention next? Administer oxygen therapy Proceed with the data collection Notify the health care provider Obtain arterial blood sampling proceed with data collection The nurse sets up an oxygen tent for a client. Which client is the best candidate for this oxygen delivery system? an older adult client who has COPD a child who has pneumonia an adult who is receiving oxygen at home an adolescent who has asthma

a child who has pneumonia

A nursing instructor is discussing differences between nurse-client relationships and social relationships with a group of nursing students. Which statement is a characteristic of a person-centered or helping relationship? a. A person-centered or helping relationship is characterized by an unequal sharing of information. b. A person-centered or helping relationship occurs spontaneously with random individuals. c. A person-centered or helping relationship is built on the needs of the helping person. d. The person being helped in the person-centered or helping relationship is accountable for the outcomes of the relationship.

a. a person-centered or helping relationship is characterized by an unequal sharing of information

The client who experienced a stroke is ready to be discharged to a skilled nursing facility for physical therapy. The type of nursing referral used to accomplish this is called: a. complex referral b. simple referral c. basic discharge referral d. tertiary referral

a. complex referral

The nurse desiring to use laughter as a therapeutic modality for pain should assess for which of the following therapeutic effects? Select all that apply. a. Decreased levels of epinephrine b. Increased pain threshold c. Increased ability to face difficult procedure d. Shallow respirations e. Decreased heart rate

a. decreased levels of epinephrine b. increased pain threshold c. increased ability to face difficult procedure

Nurses today are faced with many adversities. Which challenges have led to the current nursing shortage? Select all that apply. a. heavier workloads and sicker clients b. client satisfaction surveys and insurance reimbursement c. hospital budgetary decline and nursing layoffs d. job dissatisfaction and stress e. continuing education requirements and increasing number of men in nursing

a. heavier workloads and sicker clients c. hospital budgetary decline and nursing layoffs d. job dissatisfaction and stress

the nurse understands that a diagnostic-related group is one of the reimbursement strategies in a prospective payment system. The diagnostic-related group is a part of which health care system? a. medicare b. medicaid c. capitation d. Americare

a. medicare

When developing a plan of care for a client who has been in the (protective) prone position, the nurse recognizes that it is essential to monitor the client for: a. plantar flexion of the feet b. flexion contracture of the neck c. skin breakdown of the sacrum d. hyperextension of the hips

a. plantar flexion of the feet

the nurse manager is reviewing medication order protocols with staff nurses. Which teaching will the nurse include? Select all that apply. a. refrain from using abbreviations b. be mindful of look-alike and sound-alike drugs c. IU and U are acceptable abbreviations to use d. orders can be carried out without provider signatures e. nurses and healthcare providers are accountable for drug safety

a. refrain from using abbreviations b. be mindful of look-alike and sound-alike drugs e. nurses and healthcare providers are accountable for drug dafety

A nurse is providing care for clients in a long-term care facility. Based on the definitions of nursing in the textbook, what should be the central focus of this care? a. the client receiving care b. the nurse as the caregiver c. the nursing actions provided by the nurse d. nursing as a profession

a. the client receiving care

The nurse is teaching a novice nurse about the therapeutic effects of laughter. Which example correctly identifies one of these effects? a. It activates the immune system. b. It increases the level of epinephrine. c. It decreases heart rate. d. It causes shallow breathing. it activates the immune system A client has just been started on opioid analgesia for pain control. The nurse assesses the client's level of sedation using a sedation scale and notes that the client is awake and alert. The nurse would assign which rating? a. S b. 1 c. 2 d. 3

b. 1

A sudden blow to the head results in pain that is transmitted by which type of fibers? a. B-gamma b. A-delta c. C fibers d. D-delta

b. A-delta

Which of the following is NOT an Administrative Simplification Rule? a. Transaction and Code Sets Rule b. Confidentiality Rule c. Enforcement d. Privacy

b. Confidentiality Rule

Which medication would the nurse most likely see on the medication administration record (MAR) of a client with diabetic neuropathy? a. morphine b. Gabapentin c. Hydromorphone d. Lorazepam

b. Gabapentin

a nurse demonstrates understanding of Healthy People 2020: Understanding and Improving Health by supporting which statement? a. establish a set of nursing skills that focuses on quick resolution to clients' needs b. a client's health is affected by social, economic, and political factors c. clinical care supports wellness in the environment d. physical therapy supports client safety at home

b. a client's health is affected by social, economic, and political factors

Which government policy addresses penalizing hospitals for re-admissions of clients with certain diagnoses within 30 days of discharge? a. american disability act b. affordable care act c. american nurses association bylaws d. national commission for minorities

b. affordable care act

A nurse is caring for a client who refuses to take the prescribed medication, stating that she is allergic to it. What should the nurse do when the client refuses to take the medication? Select all that apply. a. Inform the nurse manager about the situation. b. Identify the reason for not administering. c. Circle the scheduled time on the MAR. d. Discuss the reason for refusal with the client. e. Report the situation to the prescriber.

b. identify the reason for not administering c. circle the scheduled time on the MAR e. report the situation to the prescriber

What was one barrier to the development of nursing profession in the US after the Civil War? a. lack of influence b. lack of educational standards c. hospital-based school of nursing d. independence of nursing orders

b. lack of educational standards

Pulse deficit can provide the nurse information regarding the heart's ability to profuse blood to the systems. Which statements describe pulse deficit? Select all that apply. a. the total volume of blood during ventricular contraction b. Report to the health care provider any increase in pulse deficit. c. the difference between apical and peripheral pulse rate d. The apical pulse is higher than the radial pulse. e. the pulse pressure created when there is friction between the blood and the vessel walls

b. report to the health care provider any increase in pulse deficit c. the difference between apical and peripheral pulse rate d. the apical pulse is higher than the radial pulse

A nurse is administering enoxaparin sodium (anticoagulant) to a client with deep vein thrombosis, via the subcutaneous route. What is a recommended guideline when administering a subcutaneous injection? a. Sites commonly used for a subcutaneous injection are the inner surface of the forearm and the upper back, under the scapula. b. Subcutaneous injections are administered into the adipose tissue layer just below the epidermis and dermis. c. Subcutaneous injections are administered at a 30- to 45-degree angle based on the amount of subcutaneous tissue present. d. Pinching is advised for obese clients to lift the adipose tissue away from underlying muscle and tissue.

b. subcutaneous injections are administered into the adipose tissue layer just below the epidermis and dermis

During the course of any given day of work in the acute care setting, the nurse may need to perform which of the following roles. Select all that apply. a. Statiscian b. Teacher c. Communicator d. Counselor e. Financier

b. teacher c. communicator d. counselor

Which pharmacologic considerations should the nurse contemplate before administrating parental medications? Select all that apply. a. The drug will be filtered through the liver. b. The drug will not be filtered through the liver. c. The adverse effects of the drugs can be more pronounced. d. Older adults and children should be monitored closely for drug effects. e. This route of drug administration will be through the gastrointestinal tract.

b. the drug will not be filtered through the liver c. the adverse effects of the drugs can be more pronounced d. older adults and children should be monitored closely

the nurse is preparing to administer insulin to an older client who is frail and has failure to thrive. At what angle will the nurse plan to insert the needle into the client?At what angle will the nurse plan to insert the needle into the client? a. 10-15 degrees b. 20-30 degrees c. 45 degrees d. 90 degrees

c. 45 degrees

The RN communicates with the physical therapist that a client is now on strict bed rest due to bradycardia. Which statement best explains the standard exemplified by the nurse? a. The RN collects client data b. The RN identifies outcomes c. The RN coordinates care delivery d. The RN analyzes client data

c. The RN coordinates care delivery

Which of the following is a fat-soluble vitamin? a. C b. B12 c. E d. B6

c. Vitamin E

The nurse has inserted a peripheral intravenous catheter into a client. What is the appropriate action when a blood return is not obtained? a. insert the IV catheter further b. begin infusing the IV fluid c. change the site of catheter insertion d. pinch IV tubing to prohibit initial infusion

c. change the site of catheter insertion

A nursing student has established a strong therapeutic rapport with a patient who was admitted to the hospital with a perforated appendix. The patient is similar in age to the student and is interested in a career in nursing. Before being discharged, the patient asks if she can add the student as a contact on a social networking site in order to ask her more questions about nursing. How should the student respond to the patient's request? a. Explain why she cannot fulfill the patient's request but offer to meet her in person to answer questions about nursing school. b. Explain why nursing ethics does not allow online contact between nurses and patients. c. Explain that nurses are not permitted to have social contact with patients but offer to answer questions before the patient is discharged. d. Offer to answer the patient's questions by e-mail rather than through contact on a social networking site.

c. explain that nurses are not permitted to have social contact with patients but offer to answer questions before the patient is discharged

A nurse is responsible for changing the dressing on a patient's infected wound, a procedure that has caused the patient significant pain in the past. Which of the nurse's actions best demonstrates an understanding of the pharmacokinetics of the pain medication that the nurse will administer? a. Considering the patient's preferences for analgesia b. Administering the lowest possible dose of the medication in order to achieve a therapeutic effect c. Knowing the onset of the medication when deciding when to administer it d. Giving small, repeated doses of the medication rather than one larger dose

c. knowing the onset of the medication when deciding when to administer it

What laboratory test is the best indicator of a client in need of TPN? a. hemoglobin b. hematocrit c. serum albumin d. creatine

c. serum albumin

A client that has been taught to monitor her pulse calls the nurse because she is having difficulty feeling it strongly enough to count. She states that she takes her pulse before taking her cardiac medication. She sits down with her nondominant arm on a firm service, palm up. She uses her three fingers to feel just below the wrist on the side closest to the body. She does not press hard and she has a watch with a second hand to use to count it, but she has a very difficult time feeling it. What does the nurse recognize that she is doing wrong? a. She needs to take her pulse after her medication so that her pulse is stronger. b. She needs to press harder until she feels a pulse. c. She should stand when taking her pulse to increase blood flow. d. She should place her three fingers just below the wrist on the outside of the arm with the palm up.

d. She should place her three fingers just below the wrist on the outside of the arm with the palm up.

A nurse observes a posthysterectomy patient who is crying hysterically. What type of pain response is this client experiencing? a. behavioral b. physiologic c. parasympathetic d. affective

d. affective

a nurse documents a client's hemoglobin as 80g/L. What nutritional condition does this biochemical data signify? a. dehydration b. malnutrition c. malabsorption d. anemia

d. anemia

When administering a subcutaneous injection to a client, the needle pulls out of the skin when the skin fold is released. What would be the appropriate next action of the nurse in this situation? a. Pull out and discard the needle. c. Discard the equipment and start the procedure from the beginning. d. Engage safety shield on needle guard and discard needle appropriately. e. Document the incident and inform the primary care provider.

d. engage safety shield on needle guard and discard needle appropriately

You are the nurse caring for a client with an enlarged thyroid gland. You anticipate what nutritional deficiency is linked to the client's condition? a. potassium b. sodium c. magnesium d. iodine

d. iodine

When a wound has partial or total separation of the wound layers, this is called what?

dehiscence

What skin disorder is associated with asthma?

eczema

T/F: a person's core body temperature is highest in the early morning and lowest in the late afternoon

false

An older adult client is visibly pale with a respiratory rate of 30 breaths per minute. Upon questioning, the client states to the the nurse, "I can't seem to catch my breath." The nurse has responded by repositioning the client and measuring the client's oxygen saturation using pulse oximetry, yielding a reading of 90%. The nurse should interpret this oxygen saturation reading in light of the client's: hemoglobin level. age. blood pH. sodium and potassium levels.

hemoglobin level

What are the steps to the nursing process? (acronym IEIEC)

identify the patient's needs establish a plan of care implement a plan of care evaluate plan's effectiveness nurses use critical thinking and clinical judgment to carry out a plan of care for patient

A skin infection caused by beta-hemolytic streptococci common in children is: acne vulgaris. impetigo. scabies. herpes.

impetigo

When clients are pulled up in bed rather than lifted, they are at increased risk for the development of a decubitus ulcer. What is the name given to the factor responsible for this risk? friction necrosis of tissue ischemia shearing force

shearing force

What structure in the gastrointestinal system absorbs the majority of digested foods?

small intestine