Midterm/Final Review (Application)

self-expectation

A child lists his favorite sports figures and tells the nurse he is going to be just like them. How does the nurse identify this human need?

Accurately documenting client care on the client record

A client accuses a nurse of negligence when he trips when ambulating for the first time since hip replacement surgery. Which action is the best defense against allegations of negligence?

faith

A client expresses confidence in their traditional healer to relieve symptoms of an illness. What is the client demonstrating?

A sense of self and worth

A nurse always addresses clients by their preferred name when entering a client's home or room. What is the nurse facilitating by this action?

Primary

A nurse is giving a talk to a local community group on the importance of proper diet and regular exercise. This is an example of which type of health promotion?

4,5,6

A nurse is performing health promotion activities for clients at a local health care clinic. Which nursing actions exemplify the focus of secondary preventive care? Select all that apply. 1. Scheduling immunizations for a child 2. Educating parents about child safety in the home 3. Performing range-of-motion exercises on a client 4. Screening clients for hypertension 5. Scheduling a mammogram for a client 6. Referring a client to family counseling

justice

A nurse is providing care for three clients on a medical unit, two of whom are significantly more acute than the third. The nurse is making a concerted effort to ensure that the less acute client still receives a reasonable amount of time, attention, and care during the course of the shift. Which ethical principle is the nurse attempting to practice?

An increase in the incidence of chronic illnesses

A nurse who is working in a long-term care facility is talking with a group of health care workers. One of the health care workers asks about current trends in health care. Which trend should the nurse mention?

a safety event report (incident report).

After a client falls out of bed, the nurse completes:

Asking the LPN/LVN to teach a new diabetic client how to administer insulin

An RN is working on a medical-surgical unit with a licensed practical/vocational nurse (LPN/LVN). Which action by the RN is considered negligent if injury results from this action?

self-expectation

An adolescent states, "I want to go to college and learn to be a chef." This is an example of:

The same standards of care that apply to a registered nurse apply to the student

During a clinical placement on a subacute, geriatric medicine unit, a student nurse fed a stroke client some beef broth, despite the fact that the client's diet was restricted to thickened fluids. As a result, the client aspirated and developed pneumonia. Which statement underlies the student's potential liability in this situation?

It provides quick access to abnormal findings

Nurses at a health care facility maintain client records using a method of documentation known as charting by exception (CBE). What is a benefit of this method of documentation?

Taking a picture of a client with the nurse's cell phone

Nurses must maintain the privacy of clients. Which example is a breach in privacy and would pose an ethical problem?

certification

Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill client. These nurses can validate this specialty competence through what process?

immediately report the suspected abuse of the client

The nurse caring for an older adult client suspects that the client is being neglected at home due to several observations obtained in the ongoing assessment. What is the appropriate nursing action in this situation?

1,2,3,4,5

The nurse is caring for a client who has been physically restrained. Which observation(s) will the nurse include when documenting the client's care? Select all that apply. 1. The client exhibits agitation and shouts at the nurse. 2. The client's blood pressure is 135/82 mm Hg. 3. The client's skin turgor is normal. 4. The client has redness around the ankles bilaterally. 5. The client participates in range-of-motion exercises

1,2,3,5

The nurse is caring for clients in a hospital setting. Which situations encountered by the nurse have a significant ethical component? Select all that apply. 1. Helping a client make end-of-life decisions 2. Addressing a suspected breach in confidentiality 3. Deciding how to reassign staff in light of budget cuts 4. Deciding which continuing education offerings to take 5. Deciding when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest

Assess the client's spiritual needs

The nurse receives a "do not resuscitate" (DNR) order for a dying client. What should the nurse do next?

The nurse researches new technological advances in the treatment of cancer

The nurse uses the QSEN competency of Informatics when planning care for clients. What is an example of the use of this skill?

1,2,5

To ensure accurate charting, which actions should the nurse perform? Select all that apply. 1. Checks to make sure that the nurse has the correct chart prior to making an entry 2. Documents interventions as close as possible to the time of execution 3. Includes interpretations of client behavior 4. Charts that the client is ingesting sufficient quantity of food and fluids 5. Places a label with the client's name and identification number on each page of the client's char

National League for Nursing (NLN)

Which national nursing organization serves as a primary source of research data about nursing education, and is the professional organization for nurse educators?

American Nurses Association (ANA)

Which nursing group provides a definition and scope of practice for nursing?

Clara Barton

Which nursing pioneer established the Red Cross in the United States in 1882?

Using evidence-based practice interventions

Which practice by the nurse indicates that the nurse is a professional?

role performance

Which term refers to our ability to execute societal expectations regarding role-specific behaviors?

1,2

nurse is assessing a client for potential variables that influence the client's health. When assessing the client's self-concept, which area should the nurse include? Select all that apply. 1. The client's feelings about self as a person 2. The client's view of self physically 3. The client's educational level 4. The client's cultural background 5. The client's degree of interaction with family members

nurse case manager

A client cannot afford the treatment prescribed. Who would be the most appropriate professional for the nurse to involve with the client's care?

malpractice

A client has a prescription for amoxicillin 500 mg P.O. every 8 hours. The nurse administers the medication via the intravenous route. Based on the nurse's action, the client develops complications and has an increased length of stay. The client files a lawsuit against the facility and the nurse. Which legal action has the nurse's attorney identified that meets the criteria for the client's lawsuit?

1,2,3,4

A client has been diagnosed with a glioblastoma and the care team has determined that this brain tumor is inoperable. Which aspects of the client's subsequent care demonstrate adherence to the Quality and Safety Education for Nurses (QSEN) competencies? Select all that apply. 1. The care team meets with the client and family promptly to identify their preferences for treatment. 2. The care team balances the best available evidence about glioblastoma treatment with the client's preferences. 3. Nurses proactively identify threats to the client's safety that may occur as treatment is provided. 4. Each member of the care team uses the best available technology to organize and provide care. 5. Treatments are chosen with the goal of minimizing the financial burden on the health care institution.

The nurse faces an ethical dilemma about inconsistent courses of action

A client nearing the end of life requests that the client be given no food or fluids. The health care provider orders the insertion of a nasogastric tube to feed the client. What is the primary concern of the nurse providing care?

culture shock

A client new to a rehabilitation unit is having a difficult time adjusting to the scheduled activities on the unit, as well as being dependent on others for meals and medications. Which word best describes what the client is experiencing?

fidelity

A client rings the call bell to request pain medication. On performing the pain assessment, the nurse informs the client that the nurse will return with the pain medication. After a few moments, the nurse returns with the pain medication. The nurse's returning with the pain medication is an example of which principle of bioethics?

"If you maintain a positive self-concept, you can live as normally as possible."

A client who has recently been diagnosed with a chronic illness appears to be depressed. When the nurse asks if there is something wrong, the client states, "Nothing will ever be the same for me since I have this disease." What is the most appropriate response for the nurse?

values clarification

A client who is having increasing difficulty breathing reports never exercising, eating fast food regularly, and smoking two packs of cigarettes a day. The client tells the nurse practitioner that the client wants to make lifestyle changes. Which would be the most appropriate means of helping the client change behaviors?

Inform the health care provider that client permission is needed to release any information

A health care provider approaches the nurse caring for the client in room 25 and states, "The client is a friend of mine. What treatment is being given?" Which response by the nurse is most appropriate?

1,2,3,5

A health care provider tells the nurse that nursing is a discipline, but not a profession. Which criteria should the nurse utilize to demonstrate that nursing is increasingly recognized as a profession? Select all that apply. 1. Well-defined body of knowledge 2. Code of ethics 3. Ongoing research 4. Regulation by the medical profession 5. Sets standards

New systems are introduced to increase communication between nurses and the members of other health disciplines

A hospital is introducing a program that has the goal of aligning practices more closely with the Quality and Safety Education for Nurses (QSEN) project. What initiative best exemplifies QSEN competencies?

A hospital that is Magnet recognized

A newly licensed nurse would like to work in a hospital that is innovative in the provision of nursing services. The nurse should apply to which institution?

unprofessional

A nurse arrives on the medical unit wearing large, dangling earrings. This is an example of which type of conduct?

"Legal policy requires nursing practice to be permanently integrated into the client record."

A nurse asks a nurse manager why staff nurses on the unit cannot document in a separate record (instead of the client record) to make it easier to find information on nursing-specific actions. What is the best response by the nurse?

charting by exception

A nurse documents hypertension in a woman who is 5 months pregnant and then writes a narrative describing the situation. This type of abnormal status can be seen immediately with narrative easily retrieved in what documentation format?

It is the role of nursing to provide a caring relationship that facilitates health and healing

A nurse educator is discussing the role of nursing based on the American Nurses Association (ANA). Which statement best describes this role?

The nurse documents a complete description of the happenings in the client's records

A nurse enters a client's room and finds that the client is lying on the floor. The nurse makes the client comfortable on the bed and completes an examination. She informs the health care provider and the nursing supervisor about this incident and also completes an incident report. Which action by the nurse indicates correct knowledge of handling an incident report?

A hospital that is Magnet recognized

A nurse graduate applies for a job working in a hospital that achieved Magnet® status. Which conditions would this nurse expect? Select all that apply.

1,3,6

A nurse graduate applies for a job working in a hospital that achieved Magnet® status. Which conditions would this nurse expect? Select all that apply. 1. Focus on positive client care outcomes 2. Centralized decision making 3. Autonomous, accountable professional nursing practice 4. Higher staff turnover 5. Higher levels of staff burnout and exodus from the bedside 6. Supportive nurse managers

Physical, emotional, and spiritual well-being

A nurse in a wellness center is presenting a class on integrating holistic therapies with traditional health care. The nurse talks about the trend in health care to treat each client in a manner that reconnects the total being. Which would best be considered a holistic approach to health?

1,3,4

A nurse is being sued for malpractice in a court of law. What elements must be established to prove that malpractice or negligence has occurred? Select all that apply. 1. Duty 2. Intent to harm 3. Breach of duty 4. Causation 5. Punitive damages 6. Fraud

1,2,3

A nurse is caring for a client in the community who is at risk for sudden death from a chronic health condition. To reduce the legal risks associated with working with this client, the nurse carries out which action(s)? Select all that apply. 1. Follow the prescribed plan of care for the client. 2. Explain every nursing intervention in detail. 3. Document nursing actions shortly after completion. 4. Avoid physically touching the client when possible. 5. Ensure client compliance with safety warnings

confidentiality

A nurse is caring for a client who is a celebrity in the area. A person claiming to be a family member inquires about the medical details of the client. The nurse reveals the information but later comes to find out that the person was not a family member. The nurse has violated:

1,2,4

A nurse is educating staff members about the importance of meeting the spiritual needs of clients on the unit. What spiritual needs should be met in the delivery of care? Select all that apply. 1. need for meaning and purpose 2. need for love and relatedness 3. need for comfort and money 4. need for forgiveness 5. need for complete health and freedom

Continuing intravenous fluids for a client who wants to die

A nurse is most likely to experience ethical distress in which client situation?

the nurse

A nurse is providing client care in a hospital setting. Who has full legal responsibility and accountability for the nurse's actions?

The nurse researches best current practices for prevention of the spread of infection in physician offices

A nurse is using the QSEN competency of evidence-based practice when caring for clients. What is an example of this competency?

code of ethics

A nurse provides client care within a philosophy of ethical decision-making and professional expectations. What is the nurse using as a framework for practice?

Dignity

A nurse pulls the curtains closed before changing the dressing of the surgical wound on the abdomen of a postsurgical client. What value is served?

Strike out the entry with a single line, place initials next to it, and write the correct entry

A nurse realizes that the dosage of the medication administered to the client has been entered incorrectly into the client paper record. Which action would be most appropriate for the nurse to do?

1,2

A nurse seeks to incorporate the principle of bioethics known as nonmaleficence when caring for clients in a long-term care facility. Which nursing action(s) exemplify this principle? Select all that apply. 1. The nurse performs regular client assessments for pressure injuries. 2. The nurse follows "medication rights" when administering medicine to clients. 3. The nurse provides information to clients to help them make decisions about treatment options. 4. The nurse arranges for hospice for a client who is terminally ill. 5. The nurse keeps promises to provide diligent care to clients. 6. The nurse acts fairly when allocating time and resources to clients.

assault

A nurse threatens to restrain a verbally abusive client if the abuse continues. Which legal tort has the nurse committed?

nonmaleficence

A nurse using the principle-based approach to client care seeks to avoid causing harm to clients in all situations. What is this principle known as?

3,4,5

A nurse who is infected with human immunodeficiency virus (HIV) accidentally gets a cut while debriding a wound, exposing the client to possible HIV infection. Failure of the nurse to report this incident violates which ethical principles? Select all that apply. 1. Justice 2. Autonomy 3. Nonmaleficence 4. Veracity 5. Fidelity

source-oriented

A nurse working in a rural setting is documenting care using a paper format. The nurse records the routine care, normal findings, and client problems in a narrative note. The nurse reviews the health care provider's information in the health care provider's progress notes. The nurse is using which method of documentation?

slander

A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS due to exposure to sex workers at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist. With what legal action could the nurse be charged?

1,2,4

A recently graduated nurse is working with a client who is suffering from excruciating pain with no relief. The client tells the nurse that religion and spirituality are a big part of her life. The nurse wants to help nurture this client's spirituality and can do so in which of the following ways? Select all that apply. 1. promoting meaning and purpose 2. promoting love and relatedness 3. promoting pain relief 4. promoting forgiveness 5. promoting independence

3,4,5

A recently licensed registered nurse is preparing to enter practice in an acute care facility and wants to practice within the guidelines of that state. When preparing to research the state nurse practice act, what information is important to obtain? Select all that apply. 1. Content for the NCLEX 2. The members of the state board of nursing 3. Definition of legal scope of nursing practice 4. Definition of important terms related to nursing 5. Establishment of educational criteria

The nurse is legally held to the same standards of care as when staffing levels are normal

After reporting to work for a night shift, the nurse learns that the unit is understaffed because two RNs called out sick. As a result, each nurse on the unit must provide care for four acute clients in addition to the nurse's regular clients. Which statement is true for this nurse when working in understaffed circumstances?

1,3,4

Based on its jurisdiction, which actions may a state licensing board of nursing take? Select all that apply. 1. Allow graduates of approved schools of nursing to take the NCLEX 2. Authorize nurses to practice nursing in any state 3. License nurses during the lifetime of the holder 4. Deny licensing due to criminal actions 5. Protect nurses from being suspended for professional misconduct 6. Issue special licenses to nurses practicing in long-term care facilities as a priority

2,4,5

HIPAA allows incidental disclosures of client health information as long as it cannot reasonably be prevented, is limited in nature, and occurs as a byproduct of an otherwise permitted use or disclosure of client health information. What are examples of this type of client health information disclosure? Select all that apply. 1. The nurse uses sign-in sheets that contain information about the reason for the client visit. 2. A visitor hears a confidential conversation between two nurses in surroundings that are appropriate and with voices that are kept low. 3. The nurse uses white boards on an unlimited basis. 4. The nurse uses x-ray light boards that can be seen by passersby; however, client x-rays are not left unattended on them. 5. The nurse calls out names in the waiting room, but does not disclose the reason for the client visit. 6. The nurse leaves a detailed appointment reminder message on a client's voice mail.

Evidence-based practice

Research has demonstrated that a common source of hospital-acquired infections in clients with intravenous (IV) infusions is the hub on the IV tubing. Which nursing practice competency is displayed when health care institutions recommend that health care providers always wash hands and wear gloves when accessing the hubs of IV tubing?

1,2,3,4

The Quality and Safety Education for Nurses (QSEN) initiative has identified which key competencies for nurses? Select all that apply. 1. Client-centered care 2. Teamwork and collaboration 3. Evidence-based practice 4. Quality improvement 5. Correct documentation

extended care

The client experienced a stroke with left-sided weakness. The case manager determines that the client no longer requires acute care but currently is unable to return to the home environment. Which health care environment will be the appropriate referral option for this client?

Offer a compassionate presence.

The nurse cares for a client diagnosed with end-stage disease. The client states not having seen their parents for years because the parents cut off all contact when the client informed them about being gay man. The client states, "I do not understand why God is punishing me this way." Which is the best intervention to use to meet the client's spiritual needs?

illness prevention

The nurse is administering immunizations to a group of adolescents in a county health clinic. The nurse correctly identifies this action as:

collaborative functioning

The nurse is caring for a postoperative client. The health care provider has written a prescription for a pain medication, and the prescription gives a dosage range for the amount the nurse may give depending on the severity of the client's pain. This type of functioning within the health care team is called:

assisting an older adult client with using the bedside commode

The nurse is delegating tasks to the unlicensed assistive personnel (UAP) prior to beginning the shift on the acute care unit. Which task would be appropriate to delegate to the UAP?

SOAP note

The nurse is documenting a progress note that relates to a client's health problem. What form of documentation is the nurse writing?

4,2,5,3,1

The nurse is involved in making a decision in an ethical dilemma. Place the steps of making this decision in correct order. 1. Identify how this situation can help with future decision-making. 2. Determine that the situation is, indeed, an ethical dilemma. 3. Compare the outcome of actions with what was expected. 4. Describe the situation and the contextual factors involved. 5. Identify personal and professional moral positions of those involved.

Preventing illness

The nurse is providing flu shots to older adult clients at a nurse-managed wellness center. This is an example of which aim of nursing?

Better client outcomes

The nurse is working at a facility that is applying for Magnet® Recognition. The nurse knows that compared with other hospitals, Magnet® hospitals have which direct effect on client care?

1,2,5

The nurse manager is reviewing the QSEN quality and safety competencies for nurses. Which competencies are included in this initiative? Select all that apply 1. Client-centered care 2. Teamwork and collaboration 3. Establishment of clinical career ladders 4. Revamping the licensing requirements for foreign-educated nurses 5. Quality improvement (QI)

narrative notes

The nurse managers of a home health care office wish to maximize nurses' freedom to characterize and record client conditions and situations in the nurses' own terms. Which documentation format is most likely to promote this goal?

vulnerability to legal liability since nurse's safe, routine care is not recorded

The nurses who provide care in a large, long-term care facility utilize charting by exception (CBE) as the preferred method of documentation. This documentation method may have which drawback?

The client has decided to stop chemotherapy treatments

The principle of autonomy by a client is applied in which situation?

1,3,4,5

What are common elements in a state's nurse practice act? Select all that apply. 1. Definition of legal scope of nursing practice 2. Skills allowed for the certified nursing assistant 3. Creation of a state board of nursing 4. Criteria for the education of a licensed practical nurse 5. Requirements for the licensure of the registered nurse

1,3,4

What are credentialing processes used in nursing? Select all that apply. 1. Legal accreditation is the process in which the state evaluates and recognizes an educational nursing program. 2. Voluntary accreditation is available for schools of nursing to bypass the requirement of legal accreditation. 3. A license to practice is earned by an individual and may not be revoked without due process. 4. A nurse holding certification by a U.S. professional nursing organization has demonstrated advanced proficiency. 5. A nurse may be licensed by passing the National Council Licensure Examination (NCLEX) but not completing an accredited nursing program

connectedness with other people

What factor is necessary to express and experience spirituality?

Learn improved ways to promote and maintain health

What is the ultimate goal of expanding nursing knowledge through nursing research?

1,2,3,4

When providing nursing care to clients, the nurse is required to adhere to ethical values and legal rules to guide practice behavior. Which values would be included? Select all that apply. 1. Veracity 2. Fidelity 3. Privacy 4. Confidentiality 5. Safety

Ask the client how he or she expresses spirituality

When reviewing the history of a client admitted to the health care facility, the nurse notes that the client reported being an atheist. Which action will the nurse take to meet spiritual needs when planning nursing care for the client?

including the client in the morning rounds of the health care team

Which action by the nurse is the best indication that the nurse is incorporating the quality and safety education for nursing (QSEN) competency of teamwork and collaboration in the plan of care for a client?

1,4,5

Which actions are examples of an RN participating in illness prevention for a client with hypertension? Select all that apply. 1. Teaching lifestyle modifications 2. Reporting low blood pressure to the health care provider 3. Administering ordered medication 4. Providing literature on heart-healthy diets 5. Performing risk screenings for hypertension

1,2,5

Which actions by the nurse demonstrate the ethical principle of fidelity? Select all that apply. 1. Maintaining current nursing registration and meeting continuing education requirements 2. Performing an intervention for a client at the time that was promised 3. Taking scheduled breaks on time 4. Calling in sick due to a lack of sleep 5. Taking an extra client assignment so that the client will be cared for

A process by which people come to understand their own values and value systems

Which best defines value clarification?

The LPN/LVN should work under the supervision of an RN

Which explanation accurately differentiates the role of the registered nurse (RN) from that of the licensed practical/vocational nurse (LPN/LVN)?

Alienation, despair

Which group of terms best defines spiritual distress?

The nurse asks the client about health goals

Which is the best example of a client-centered approach to care?

competent practice

Which is the nurse's best legal safeguard?

A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home

Which nursing student would most likely be held liable for negligence?

Staff nurses are developing innovative solutions to problems.

Which of these statements reflects the expected functioning at a hospital that has achieved Magnet status?

American Nurses Association (ANA)

Which organization is the best source of information when a nurse wishes to determine whether an action is within the scope of nursing practice?

3,4,5

Which scenario(s) exemplifies shared decision-making? Select all that apply. 1. The client has been diagnosed as having breast cancer. The health care provider informs the client a radical mastectomy is the only surgical procedure available for a good outcome. 2. The client in the emergency department tells the health care provider only an intravenous dose of morphine 10 mg will relieve the back pain. 3. The client expresses a desire to be treated at home but agrees to hospitalization for intravenous antibiotics for cellulitis. 4. The nurse demonstrates to a receptive family member the proper steps to change the leg dressing when the client is at home. 5. The nurse asks the postoperative client which route of opioid medication is preferred for pain relief

1,2,3,4

Which standards are monitored by the Quality and Safety Education for Nurses (QSEN)? Select all that apply. 1. Evidence-based practice 2. Client-centered care 3. Informatics 4. Quality improvement 5. Nursing certification

"I provide indirect care to my clients by coordinating their treatment with other disciplines."

Which statement by a nurse case manager regarding this nurse's role in client care is most accurate?

3,4,5

Which statements are true about informatics in nursing practice? Select all that apply. 1. Computers do not help with communication, but deter it because of the lack of personal interaction. 2. Informatics only involves documentation of timely and accurate charting. 3. Nurses should value technologies that support error prevention and care coordination. 4. The use of informatics can help manage knowledge and mitigate error. 5. Utilization of information services helps to support decision making.

"I cannot give you that information due to client confidentiality"

While a client admitted to the medical-surgical unit is in the radiology department, a visitor claiming to be the client's cousin arrives on the medical-surgical unit and asks the nurse to provide a brief outline of the client's illness. Which response by the nurse would be most appropriate, both legally and professionally?

Slow the pace and allow extra time for answers.

While conducting a health assessment with an older adult, the nurse notices it takes the person longer to answer questions than is usual with younger clients. What should the nurse do?

Florence Nightingale

Who is considered to be the founder of professional nursing?

To set standards for nursing education and practice

Why are nursing organizations important for the continued development and improvement of nursing as a whole?