Module 1 PrepU

2. A nurse has auscultated the abdomen in all four quadrants for 5 minutes and has not heard any bowel sounds. How would this be documented? "All four abdominal quadrants auscultated. Inaudible bowel sounds." "Auscultated abdomen for bowel sounds, bowel not functioning." "Bowel sounds auscultated. Patient has no bowel sounds." "Patient may have bowel sounds, but they can't be heard."

"All four abdominal quadrants auscultated. Inaudible bowel sounds."

12. A nursing instructor is discussing a nursing student's Facebook post about a very interesting client situation that happened during clinical. The student states, "I didn't violate client privacy because I didn't use the client's name." What response by the nursing instructor is most appropriate? "You may continue to post about client you cared for during clinicals, as long as you do not use the client's name." "The information being posted on Facebook is inappropriate. Make sure to discuss information about client's privately with friends and family." "Any information that can identify a person is considered a breach of client privacy." "All aspects of the clinical experience are confidential and should not be discussed."

"Any information that can identify a person is considered a breach of client privacy."

13. A nurse is preparing to perform a physical examination on a postpartum client. The client asks the nurse why gloves are necessary for the examination. What is the nurse's best response? "Gloves guard you against my cold hands." "Gloves help protect you against infectious organisms." "Gloves are required for standard precautions." "Gloves may protect me against infectious organisms."

"Gloves are required for standard precautions."

22. A nurse is transfusing multiple units of packed red blood cells (PRBCs). After the second unit is transfused, the nurse auscultates bilateral crackles at the bases of the client's lungs and the patient reports dyspnea. The nurse telephones the health care provider and provides an SBAR report. Which of the following statements represents the final step in this type of communication? "I think the client would benefit from intravenous furosemide (Lasix)." "I am calling because the client receiving blood has developed dyspnea and had crackles." "It seems like this client has fluid volume overload." "This client has a medical history of heart failure."

"I think the client would benefit from intravenous furosemide (Lasix)."

15. The nurse is planning care for a client with human immunodeficiency virus (HIV). Which statement by the nurse indicates understanding of HIV transmission? Select all that apply. "I will wear a mask, goggles, gown, and gloves when splashing bodily fluids is likely." "I will wash my hands after client care." "I don't need to wear any personal protective equipment due to decreased risk of occupational exposure." "I will wear a mask if the client has a cough caused by an upper respiratory infection." "I will wear a gown, mask, and gloves with all client contact."

"I will wear a mask, goggles, gown, and gloves when splashing bodily fluids is likely." "I will wash my hands after client care." Standard precautions include wearing gloves for any known or anticipated contact with blood, body fluids, tissue, mucous membranes, and nonintact skin. If the task or procedure may result in splashing or splattering of blood or body fluids to the face, the nurse should wear a mask and goggles or face shield. If the task or procedure may result in splashing or splattering of blood or body fluids, the nurse should wear a fluid-resistant gown or apron. The nurse should wash hands before and after client care and after removing gloves. A gown, mask, and gloves are not necessary for all client care unless contact with bodily fluids, tissue, mucous membranes, and nonintact skin is expected. Nurses have an increased, not decreased, risk of occupational exposure to blood-borne pathogens. HIV is not transmitted in sputum unless blood is present.

The nurse is caring for a client at the end stage of life. The client is crying and states to the nurse, "I just cannot believe I am going to be leaving my children without a parent. I am not ready to go." What response by the nurse demonstrates the expression of empathy to the client? "This just is not fair at all and I do not understand why this is happening to you." "This is so sad and I feel so bad that you are in this situation." "It sounds as though you are most concerned about how your children will feel." "I am so sorry that I am crying with you when you need my support the most."

"It sounds as though you are most concerned about how your children will feel."

21. A nurse is requesting to receive change of shift report at the bedside of each client. The nurse giving the report asks about the purpose of giving report at the bedside. Which response by the nurse receiving report is most appropriate? "It will give me a better sense of what my workload will be today." "It will let me see everything that has been done and things that need to be done." "It makes our client feel like we care, especially if we start the day off with a clean room." "It will allow for us to see the client and possibly increase client participation in care."

"It will allow for us to see the client and possibly increase client participation in care."

A nurse is calling a health care provider to communicate a change in the client's condition. According to the ISBARR format for handoff communication among health care personnel, which is the most appropriate way to begin the conversation? "I have a client of yours at Jefferson Hospital who is experiencing a change in condition and needs to be seen immediately!" "My name is Sue, and I am calling about Mrs. Jones, a client of yours at Jefferson Hospital." "My name is Sue Smith, RN, and I am calling regarding Mrs. Jones in room 356 at Jefferson Hospital." "Good morning, I am calling about Mrs. Jones, who is a client of yours."

"My name is Sue Smith, RN, and I am calling regarding Mrs. Jones in room 356 at Jefferson Hospital."

6. The nurse manager overhears a nurse say, "I'm not going to fill out an incident report because it will be used against me." What response by the nurse manager is most appropriate? "If you feel the incident was minor, then you don?t need to fill out a report." "The main purpose of an incident report is for quality improvement, not disciplinary action." "It is the number of incident reports you fill out that will determine if action will be taken against you." "The best way to not fill out an incident report is to not make a mistake."

"The main purpose of an incident report is for quality improvement, not disciplinary action."

A hospital client tells the nurse that they cannot sleep because they keep hearing another client, who is delirious, calling out. How should the nurse best apply the technique of restatement? *"You will hopefully be able to sleep once we help the other patient settle." *"You are upset because you want to sleep but you can't." *"The noise made by another patient is keeping you awake." *"Many people find it hard to sleep on a busy hospital unit."

"The noise made by another patient is keeping you awake."

10. Conflict has emerged on a nursing unit due to the perception by new graduates that some of the more experienced nurses are manipulating the patient assignment to ensure a lighter workload during night shifts. How should the manager of the unit best address this conflict? *Arrange a meeting where the issue can be discussed and addressed by as many of the nurses as possible *Arrange for the newer nurses to organize the patient assignment for a trial period *Gather evidence over the next several weeks in order to determine if the practice is indeed happening *Reassure the new graduates that the more experienced nurses are acting in the interests of both staff and patients

*Arrange a meeting where the issue can be discussed and addressed by as many of the nurses as possible

Nurses who prize their role in securing patient well-being are sensitive to the ethical and legal implications of nursing practice. What are examples of these ethical/legal skills? Select all that apply *Working collaboratively with the health care team as a respected and credible colleague to reach valued goals *Being trusted to act in ways that advance the interests of patients *Using technical equipment with sufficient competence and ease to achieve goals with minimal distress to patients *Selecting nursing interventions that are most likely to yield the desired outcomes *Being accountable for practice to oneself, the patient, the caregiving team, and society *Acting as an effective patient advocate

*Being trusted to act in ways that advance the interests of patients *Being accountable for practice to oneself, the patient, the caregiving team, and society *Acting as an effective patient advocate

6.A nurse working on the adolescent unit has a strained working relationship with a coworker and finds it difficult to work well with the coworker. What is the best way for the nurse to go about defusing this situation? *Talk with the coworker and try to work out differences so they don't affect client care. *Complain to the nurse-manager about the coworker's attitude. *Avoid the coworker by working different shifts. *Ask other nurses assigned to the unit to see what they think might improve the situation.

*Talk with the coworker and try to work out differences so they don't affect client care.

A nurse is assisting with a circumcision. After the physician has started the procedure, the nurse reviews the neonate's medical record and notices that an informed consent form hasn't been signed. What should the nurse do? *Inform the physician and ask the physician to quickly complete the procedure. *Notify the medical director of the physician's negligence. *Tell the physician to stop the procedure immediately because an informed consent form hasn't been signed. *Continue assisting with the circumcision and ask the mother to sign the consent form after the procedure.

*Tell the physician to stop the procedure immediately because an informed consent form hasn't been signed.

15. The nurse gave the client the wrong medication. It is 2 hours later when the nurse realizes the error. What should the nurse do FIRST? -Notify the health care provider (HCP) of the error. -Report the error to the unit manager. -Assess the client's condition. -Complete an incident report.

-Assess the client's condition.

14. The health care provider (HCP) verbally prescribed carboprost tromethamine 0.25 mg intramuscularly stat for a client experiencing a postpartum hemorrhage. The nurse administers the medication but later finds that the HCP has written a prescription for 0.25 mg carboprost tromethamine intravenously stat. How should the nurse respond? -Call the HCP, discuss the prescription, and request a revision if heard correctly. -Initiate an incident report. -Wait until the HCP returns to the unit and discuss the situation in person. -Ask the charge nurse to discuss the prescription with the HCP.

-Call the HCP, discuss the prescription, and request a revision if heard correctly.

10. A nurse administering medications accidentally gives a double dose of blood pressure medications. After ensuring the safety of the client, the nurse would document the error in which documents? -Critical pathway and care plan -Care plan and client's record -Client's record and occurrence report -Occurrence report and critical pathway

-Client's record and occurrence report

9. According to the American Nurses Association (ANA), what is the primary source of evidence to measure performance outcomes against standards of care? -Documentation -Psychomotor skills -Accreditation -Clinical judgment

-Documentation

29. The nurse is administering vancomycin I.V. to a client. The pharmacy sent the correct dose, but it was to be administered 1 hour ago. What should the nurse do? Select all that apply. -Tell the nurse in the "hand-off" report that the medication and any associated labs need to be staggered. -Notify the pharmacy of the late medication so they can change the time of the next dose. -Call the healthcare provider. -Complete any variance reports. -Run the infusion as directed, and document the time it was started.

-Notify the pharmacy of the late medication so they can change the time of the next dose. -Complete any variance reports. -Run the infusion as directed, and document the time it was started. -Tell the nurse in the "hand-off" report that the medication and any associated labs need to be staggered.

25. A nurse forgets to raise the bed railings of a client who is confused after taking pain medications. The client attempts to get out of bed and suffers a minor fall. The nurse asks a colleague who witnessed the fall not to mention it to anyone because the client only had minor bruises. What would be the appropriate action of the colleague? -The colleague should inform the nurse that a full report of the incident needs to be made. -The colleague should monitor the client closely for any adverse effects of the fall. -No other steps need to be taken because the client was not seriously injured. -The colleague should report the incident in a peer review of the nurse.

-The colleague should inform the nurse that a full report of the incident needs to be made.

26. An infant was taken from the ward by the parents without the knowledge of the nurses on the ward. The charge nurse conducts which performance improvement process? -requesting that a documented expert in the field perform a review -evaluating a single incident that resulted in an unanticipated outcome -conducting root cause analysis -randomly observing client care without advance warning

-conducting root cause analysis

23. A nurse has administered one unit of glucose to the client as per order. What is the correct documentation of this information? 1U of glucose 1 Unit of glucose 1 bottle of glucose One U of glucose

1 Unit of glucose

14. The nurse is documenting an assessment that was completed at 9:30 pm. The facility uses military time for documentation. What entry should the nurse make for the time care was given? 1930 2130 930 pm 0930

2130

In which situation would the SBAR technique of communication be most appropriate? A nurse is calling a health care provider to report a client's new onset of chest pain. A nurse is facilitating a family meeting to coordinate a client's discharge planning. A nurse is explaining the process of bone marrow biopsy to a client who is scheduled for the procedure. A nurse is teaching a client about the benefits of smoking cessation and the risks of continuing to smoke.

A nurse is calling a health care provider to report a client's new onset of chest pain.

5. A patient is scheduled for an invasive procedure. Which of the following should the nurse document in the chart regarding the procedure? A signed consent form from the patient A report from the dietician A signed consent form from the patient's family A detailed urinalysis report

A signed consent form from the patient

13. Two nurses are having a disagreement over who will take the next admission to the unit. The nurse manager asks one of the nurses to take the admission and explains that this will be considered a personal favor. Which style of conflict resolution did the nurse manager display? *Avoiding *Accommodating *Competing *Collaborating

Accommodating

13. Upon admission for an appendectomy, the patient provides the nurse with a document that specifies instructions his healthcare team should follow in the event he is unable to communicate these wishes postoperatively. What is the document best known as? An advance directive An informed consent A Patient's Bill of Rights An insurance card

An advance directive

The nurse is performing an assessment for a client with diabetes who has peripheral neuropathy. When the nurse assesses pain response in the lower extremities, the client does not have any reaction. What would the nurse document this response as? Allodynia Hyperalgesia Analgesia Anesthesia

Analgesia Analgesia is the absence of pain from stimuli that normally would be painful. Although this may not be painful, it can be extremely serious, such as in a diabetic person with peripheral neuropathy, because the normally protective early warning system for the presence of tissue injury is absent. Pain from noninjurious stimuli to the skin is called allodynia. Extreme sensitivity to a painful stimulus is called hyperalgesia.

12. The charge nurse on a postoperative surgical unit is responsible for making patient assignments for staff nurses. Two staff nurses have voiced not wanting to assume care for any new postoperative surgical clients during their shift. How can the charge nurse resolve this conflict using the strategy of compromise to address the immediate concerns of the two staff nurses? *Approach both nurses to discuss incentives that can be given for agreeing to accept new postoperative surgical clients. *Coerce the staff by complimenting on them on how well they care for new postoperative surgical clients. *Consult with the nurse manager to decide how postoperative surgical clients should be assigned to the two nurses. *Reassign all nurses? clients in a manner that ensures the two staff nurses will not have to care for new postoperative surgical clients.

Approach both nurses to discuss incentives that can be given for agreeing to accept new postoperative surgical clients.

A nurse researcher is collecting stories from participants about their journey with breast cancer. What is the best intervention researcher could use to mitigate the risk that may occur from the sadness and emotional toll the participant may experience in telling her story? Listen carefully to her story Arrange for a referral to a counselor Document her discomfort Offer Support

Arrange for a referral to a counselor

7. The parent of a 33 year-old client who is admitted to the hospital for drug and alcohol withdrawal asks about the client's condition and treatment plan. What action by the nurse is most appropriate? Ask the client if information can be given to the parent. Take the parent to the client's room and have the client give the requested information. Provide the information to the parent. Explain the reasons for the hospitalization, but give no further information.

Ask the client if information can be given to the parent.

1. A nurse making a home visit for a client living in a high-crime area observes that the apartment building does not have outside lighting. The nurse understands this is an important assessment for which reason? Nurses in home healthcare are not concerned with safety. Although important, this assessment is irrelevant to care. Assessment includes risk factors in the home including individual risk and unsafe environment This assessment finding will make the client less able to go to social gatherings.

Assessment includes risk factors in the home including individual risk and unsafe environment

8. After assessment of a patient in an ambulatory clinic, the nurse records the data on the computer. The nurse recognizes which of the following as objective data? Complaint of nausea Auscultation of the lungs Belief that demons are in her stomach Sensation of burning in her epigastric area

Auscultation of the lungs

11 A home care nurse is visiting a client with AIDS at home. During the visit, the nurse observes the caregiver providing care. Which of the following would alert the nurse to the need for additional teaching for the caregiver? Caregiver washes hands before and after providing care to the client. Caregiver cleans the client's anal area without wearing gloves Caregiver uses a dilute bleach solution to clean up a urine spill. Cargiver disposes of syringe and needle in a metal coffee can with lid.

Caregiver cleans the client's anal area without wearing gloves

A new nurse is considering getting a job in either an acute care setting or a home care setting. Which statement about these care settings is most accurate? *Clients play a large role in helping themselves in the home care setting. *Nurses work more as team members in the home care setting. *Clients are encouraged to help each other in the acute care setting. *Good communication skills are unnecessary in the home care setting.

Clients play a large role in helping themselves in the home care setting.

An 18-year-old client is seen in the emergency department following a fall from a horse. After vigorously cleaning a large, dirty laceration on the leg, a nurse dresses the wound. The client has received the full tetanus-toxoid immunization regimen at 11 years old. How should the nurse proceed with this client's care? Teach the client that the client has life-long immunity to tetanus. Advise the client to get a tetanus shot within the next 3 years. Collaborate with the practitioner for administering a dose of tetanus vaccine. Request the practitioner to order a serum tetanus titer.

Collaborate with the practitioner for administering a dose of tetanus vaccine *If a client who has a wound contaminated with soil that may contain animal excrement has completed the full childhood tetanus immunization regimen, the nurse should collaborate with the practitioner to give the client a dose of tetanus-toxoid if the client's most recent dose was administered 3 or more years earlier

11. Jennifer is a nurse manager who is trying to resolve a conflict between the day and night shifts. She wants to convince the involved persons to set aside their differences, determine a priority common goal having to do with improved patient care, and accept mutual responsibility for achieving this goal. Jennifer is using which of the following types of conflict resolution? Compromising Competing Collaborating Avoiding

Collaborating

8. Derrick is the nurse manager for the psychiatric unit. There are major conflicts between the day and night shift staff. Derrick suggests that each shift put aside their differences for a time and determine a common major goal. Which of the following conflict resolution styles does Derrick display? Avoiding Smoothing Collaborating Competing

Collaborating

7.The nurse is caring for a client who is recovering from a CVA (cerebrovascular accident). When reviewing the client's orders, the nurse notes that one of the physicians wrote orders to ambulate the client while another physician ordered strict bed rest for the client. How would the nurse most appropriately remedy this conflict? *Instruct the client to ask the physicians for clarifications of instructions. *Assess the client to determine if the client is capable of ambulation. *Collaborate with the physical therapist to determine the client's ability. *Communicate with the physicians to coordinate their orders.

Communicate with the physicians to coordinate their orders.

15. A nurse is manually documenting information related to a client's condition. When documenting this information, the nurse makes an error. Which is the best technique for correcting the error made in documentation? Erase the incorrect statement and write the correct one. Use correction fluid to obliterate what has been written. Cross out the wrong statement in a way that is not readable. Cross out the incorrect statement with a single line.

Cross out the incorrect statement with a single line.

Which example most accurately depicts the ethical principle of autonomy? Transporting a client to a scheduled physical therapy appointment Changing a dressing on a wound as needed Describing a surgery to a client before the consent is signed Administering a morning dose of insulin before breakfast

Describing a surgery to a client before the consent is signed

20. A nurse observes a second nurse documenting a peripheral blood glucose level that the second nurse did not actually collect from a client with diabetes. What is the priority action by the nurse observing this situation? Discuss the observation with the other nurse. Do the blood glucose level on the client for the other nurse. Strike through the entry that the nurse documented. Document the nurse's behavior on the client's chart.

Discuss the observation with the other nurse.

9. The nurse notices drops of a liquid on the hallway floor of a health care facility. What should the nurse do first? Place paper towels over the drops of liquid. Post "wet floor" signs around the area. Call the Environmental Services Department. Don clean gloves and wipe up the drops of liquid.

Don clean gloves and wipe up the drops of liquid.

6. A patient informs the nurse that she still uses a mercury thermometer to take the temperature of her children when they are sick. Which of the following is a recommended teaching guideline for patients using these types of thermometers? Tell patients that mercury thermometers should be used only in a hospital setting with appropriate safeguards. Teach patient safety related to accidental breakage of the thermometer. Encourage patients to use alternative devices to assess temperature in their home. Tell patients using mercury thermometers to throw them in the trash and buy a new type of instrument.

Encourage patients to use alternative devices to assess temperature in their home.

10 Which factors have been identified as primary causes of falls? Select all that apply. Chronic illness Environmental hazards Benzodiazepine use Irregular heart rate History of previous falls Poor lighting

Environmental hazards Benzodiazepine use History of previous falls Poor lighting Major causes of falls in the home include slippery surfaces, poor lighting, clutter, and improperly fitting clothing or slippers. Additionally in the healthcare setting, polypharmacy has long been listed as a risk factor, but research has indicated that adverse effects related to the specific medication categories of antiepileptics and benzodiazepine drugs are more predictive of falling. A history of a previous fall has consistently been identified as a predictor of another fall.

8. A group of nursing students are reviewing information about the older adult and mobility. The students demonstrate a need for additional study when they identify which of the following? Falls are the leading cause of death due to injury in individuals who are over the age of 75 years. Medications in the older adult play a major contributing role to the risk for falling. Older adults are faced with challenges related to the fear of falling and striving for independence. An older adult experiences numerous factors that increase the risk for falls.

Falls are the leading cause of death due to injury in individuals who are over the age of 75 years.

Who is considered to be the first nursing researcher?

Florence Nightingale

A nursing theorist examines a hospital environment by studying each ward and how it works individually, and then relates this information to the hospital as a whole working entity. This is an example of the use of which theory? Developmental theory General systems theory Psychosocial theory Adaptation theory

General systems theory

2. A client diagnosed with migraine headaches asks the nurse what he can do to help control the headaches and minimize the number of attacks he is having. What instructions should the nurse give this client? Identify and avoid factors that precipitate or intensify an attack. Write down any adverse drug effects. Keep a record of activities following an attack. When an attack occurs, stay in a brightly lit area.

Identify and avoid factors that precipitate or intensify an attack.

3. One of the leading causes of death in the United States, particularly in southwestern states, is drowning. How can the nurse assist in lowering this statistic? Require fencing around all pools Educate children in cardiopulmonary resuscitation Begin swim lessons with toddlers Implement drowning-prevention strategies

Implement drowning-prevention strategies

24. A doctor approaches the nurse caring for the client in room 25 and states, "The client is a friend of mine. What treatment is being given?" What response by the nurse is most appropriate? Open the medical record so the doctor can review the treatment ordered. Tell the doctor you are busy and unable to answer any questions at this time. Tell the doctor to contact the doctor caring for the client to obtain any information. Inform the doctor you will need to get client permission to release any information.

Inform the doctor you will need to get client permission to release any information.

16. An area of specialization in nursing that is a combination of computer science, information science, and nursing science is termed Intranet Adaptive testing Informatics Distance learning

Informatics

2.The nurse educator is planning a teaching session for nursing students related to treatment and management of gestational diabetes. The nurse educator arranges for a dietitian, pharmacist, and physician assistant to participate in the lesson plan. Which professional nurse competency is the nurse educator demonstrating? Patient-centered care Interdisciplinary teamwork Quality improvement measures Evidence-based practice

Interdisciplinary teamwork

The student nurse tells her family about a client with AIDS cared for in clinical yesterday. Which tort has the student committed?

Invasion of privacy

22. A physician suggests that the nurse use the computer terminal that is available at the point of care or at the client's bedside. What is the probable reason for the physician's suggestion? It solves the space constraint in the hospital. It keeps the nurse close to the source of the data. There are limited computer modules available. The client needs to check the entry as well.

It keeps the nurse close to the source of the data.

19. Besides being an instrument of continuous client care, the client's medical record also serves as a(an) Incident report Kardex Assessment tool Legal document

Legal document

17. An inappropriate nursing action implemented to keep the client safe includes: Screening for latex allergy Accurately identifying the client Moving the client swiftly Protecting bony prominences

Moving the client swiftly National Patient Safety goals for the surgical client include verification of the client and protecting the client from physical harm.

17. A nurse is documenting the effectiveness of a patient's pain management on the patient record. Which documentation is written correctly? Mr. Gray appears to have a low tolerance for pain and complains frequently about the intensity of his pain. Mr. Gray is receiving sufficient relief from pain medication. Mr. Gray reports that on a scale of 1 to 10, the pain he is experiencing is a 3. Mr. Gray appears comfortable and is resting adequately.

Mr. Gray reports that on a scale of 1 to 10, the pain he is experiencing is a 3.

A nurse is planning to conduct a nursing research study and is seeking federal funding. Which institution would be most helpful for the nurse to contact regarding acquiring funding? National Institutes of Health National Institute of Nursing Research Institute of Medicine ANA Cabinet on Nursing Research

National Institute of Nursing Research The nurse would most likely contact the National Institute of Nursing Research (NINR), which was established under the National Institutes of Health in response to a 1983 study by the Institute of Medicine. The institute's purpose was to place nursing securely in the sphere of scientific investigation and to support research and training in client care, health promotion, and disease prevention, as well as the mitigation of effects of acute and chronic disabilities. The NINR has continued to fund and support nursing research and is instrumental in the support and dissemination of seminal work in nursing. The ANA Cabinet on Nursing Research was responsible for establishing priorities for nursing research.

12. A nurse has collected the blood, urine, and stool specimens of a client with meningococcal meningitis. Which of the following precautions should the nurse take when transporting the specimens? Wear gloves and a gown when transporting the specimen Place the specimens into a plastic biohazard bag. Place each of the three sealed specimens in a separate paper bag Swab the outside of each specimen container with alcohol prior to transport

Place the specimens into a plastic biohazard bag.

5. An elderly client recovering from a hip repair becomes disoriented and tries to get out of bed frequently. The client states, "I forget I am in the hospital." The best nursing intervention is to Post a sign stating "You are in the hospital" at the client's eye level. Place the client in a Posey chest restraint with ties attached to the bed frame. Raise the upper and lower side rails of the bed. Administer an oral dose of prescribed alprazolam (Xanax).

Post a sign stating "You are in the hospital" at the client's eye level.

Which of the following are the major roles of nurses working in institutional, community-oriented, or community-based settings? Select all that apply.

Practitioner Researcher Leader

A group of nurses are planning to investigate the effectiveness of turning immobilized stroke patients more frequently in order to prevent skin breakdown. The team has begun by formulating a PICO question. Which of the following will the "O" in the team's PICO question refer to?

Preventing skin breakdown

A group of nurses is planning to investigate the effectiveness of turning immobilized stroke clients more frequently in order to prevent skin breakdown. The team has begun by formulating a PICO question. Which element will the "O" in the team's PICO question refer to? Preventing skin breakdown The currently used turning schedule Turning clients more frequently Clients who have experienced a stroke

Preventing skin breakdown

16. A nurse is transferring a patient from a hospital setting to a long-term care facility. What action is most important to ensure continuity of care for this patient? *Carefully moving all the patient's personal items *Asking family members to take home the patient's jewelry, money, or other valuables *Notifying all departments of the room change *Providing accurate and complete communication to the new facility.

Providing accurate and complete communication to the new facility.

A nurse researcher is planning to test the effect of a breathing exercise on older adults' stamina. What type of research study should the nurse conduct? Qualitative Quantitative Basic Holistic

Quantitative Stamina would be measured quantitatively, likely in the form of time or distance. As such, this is quantitative research. Qualitative research is focused on narratives and interviews, not numbers

20. An experienced nurse has been working with a client with heart failure. The client's lungs were clear to auscultation during the morning assessment, however, the afternoon assessment revealed bibasilar crackles and tachypnea. The nurse calls to give SBAR report to the covering healthcare provider. In the final step of the report the nurse should: Discuss the client's situation and request a chest X-ray to assess lung function. Detail the client's past medical history and active medication orders. Recommend 40 milligrams of furosemide (Lasix) be administered because the client had improvement with past administration. Provide detailed findings of the head to toe assessment.

Recommend 40 milligrams of furosemide (Lasix) be administered because the client had improvement with past administration.

A physician writes an order for a nurse to administer an IV medication which, according to hospital policy, is not a nursing protocol. The nurse informs the physician that it is not a nursing protocol, and the physician states, "Give it and I will cover you." What should the nurse do in this situation?

Refuse to administer the medication

24. The client is being discharged to the home setting following a stroke. Which activity would the occupational therapist take to assist the client? Improve the ability to swallow Relearning how to cook safely Gait training with a walker Improve oral communication.

Relearning how to cook safely

18. The nurse hears a nursing assistant discussing a client's allergic reaction to a medication with another nursing assistant in the cafeteria. What is the highest priority nursing action? Document the nursing assistant's conversation. Notify the client relations department about the breech of privacy. Report the nursing assistant to the nurse manager. Remind the nursing assistant about the client's right to privacy.

Remind the nursing assistant about the client's right to privacy.

5. A hospital is switching to computerized charting. The nurse recognizes that one advantage to an electronic client chart is that Access is open to anyone. Retrieval of information is more efficient. It is less costly to maintain. No other charting method is necessary.

Retrieval of information is more efficient.

10. The nursing is caring for a client who requests to see a copy of his or her medical records. What action by the nurse is most appropriate? Discuss how the hospital can be fined for allowing clients to view their medical records. Explain that only a paper copy of the medical record can be viewed by the client. Access the medical record at the bedside and show the client how to navigate the electronic medical record. Review the hospital's process for allowing clients to view their medical records.

Review the hospital's process for allowing clients to view their medical records.

16. Once the operating team has assembled in the room, the circulating nurse calls for a "time out." What action should the nurse take during the time out? Confirm that informed consent has been obtained. Review the scheduled procedure, site, and client. Ensure that sufficient surgical supplies are available. Check that all surgical personnel are properly attired.

Review the scheduled procedure, site, and client.

Which of the following is a disadvantage to using the IV route of administration for analgesics? Long duration Short duration No risk of respiratory depression Slower entry into bloodstream

Short duration

3. A client is having an increasing amount of difficulty caring for herself in her home alone. She states to the nurse, "I need more help. What am I going to do?" It would be important for the nurse to have the *Social worker visit to discuss care options *Occupational therapist assess for adaptive devices *Home health aide increase visits for bathing *Physical therapist help with rehabilitation

Social worker visit to discuss care options

A 15-year-old client with type 1 diabetes has been noncompliant with the dietary regimen. When educating the adolescent, what is the most important thing the nurse can do to allow the adolescent to be in control and involved in the decision-making process? *Speak directly to the adolescent and consider the client's input in the decisions about care and education. *Offer choices whenever possible. *Praise the adolescent often. *Provide information and allow the adolescent to process and ask questions.

Speak directly to the adolescent and consider the client's input in the decisions about care and education.

Which of the following is the treatment of choice for acoustic neuromas? Surgery Radiation Chemotherapy Palliation

Surgery Surgical removal of acoustic tumors is the treatment of choice because these tumors do not respond well to radiation or chemotherapy. There would be no need for palliation

21. To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups? Advocate for more research into control of environmental toxins. Provide guidance regarding proper nutrition. Teach injury prevention and proper safety practices. Help integrate exercise practices and programs into the lifestyles of individuals and communities.

Teach injury prevention and proper safety practices.

Consent for urgent treatment is needed for a minor. The parents are unable to be at the hospital. What action by the nurse constitutes informed consent? *Treating the minor and obtaining written informed consent when the parent arrives. *Telephone consent with two witnesses listening simultaneously.

Telephone consent with two witnesses listening simultaneously.

14. The registered nurse (RN) notices that client assignments are not being made fairly. The charge nurse is responsible for making the client assignments and has a reputation for being argumentative. Who should the RN consult regarding the unfair client assignments? *The charge nurse *The medical director *The director of nursing *The nursing supervisor

The charge nurse The RN should follow the proper channels for communication and consult the charge nurse. If conflict arises, the RN should then contact the nursing supervisor, director of nursing, and the medical director, respectively.

3. The nurse is about to record the fluid intake for a client with congestive heart failure (CHF). Which of the following documentation is most appropriate? The client consumed 780 ml of fluid for the 8 hour shift The client consumed an adequate fluid intake for the 8 hour shift The client consumed normal amount of fluid for the 8 hour shift The client consumed an average intake for the 8 hour shift

The client consumed 780 ml of fluid for the 8 hour shift

19. A nurse is evaluating a patient's discharge collaboration between the referring agency and the home care agency. What response by the patient would indicate an understanding of the discharge planning process? *"The doctor provided a list of behavioral outcomes for me and his nurse faxed them to the home care agency." *"My daughter is my health care power of attorney and she decided when I left the hospital and selected my home care provider." *"The nurse helped me make a list of my needs and goals for recovery and shared them with the home care team." *"My wife sat down with the discharge planner and established realistic and measurable goals for my recovery."

The nurse helped me make a list of my needs and goals for recovery and shared them with the home care team."

9. Two new graduate nurses are requesting the same preceptor for unit orientation. Both new graduates have been very vocal about being unhappy if they do not receive their choice of preceptors. Which illustrates the nurses using a compromise approach to conflict resolution? *The nurses decide to share the preceptor. The preceptor will precept one nurse at the beginning of the orientation and precept the other nurse at the end of the orientation. *The nurses make an arrangement for the preceptor. One nurse will obtain the preceptor for orientation in exchange for that nurse working each weekend. *The nurses ignore the other nurse?s request for the preceptor. *The nurses will allow the preceptor to decide which nurse she will precept.

The nurses decide to share the preceptor. The preceptor will precept one nurse at the beginning of the orientation and precept the other nurse at the end of the orientation.

4. When a hospitalized patient is in contact precautions, which of the following responses is necessary? The patient should be placed in a private room when possible. Masks are worn when caring for the patient. The patient should be in a room with negative air pressure. The patient's door should be closed.

The patient should be placed in a private room when possible.

20. The nurse is caring for a client who is experiencing hypotension. The nurse is concerned about the significant drop in the client's blood pressure and decides to contact the client's health care provider. When preparing a report for the health care provider using the SBAR format, what will the nurse include? Select all that apply. The primary reason the client was admitted to the hospital. Objective and subjective data from the most recent assessment. A review of the full client Kardex with the health care provider. An explanation of what is needed to improve the hypotensive state. A history of chronic health conditions affecting the client's family. The client's blood pressure trend over the past 24 hours.

The primary reason the client was admitted to the hospital. Objective and subjective data from the most recent assessment. The client's blood pressure trend over the past 24 hours. An explanation of what is needed to improve the hypotensive state.

9. Nurses complete incident reports as dictated by the agency protocol. What is the primary reason nurses fill out an incident report? To improve quality of care To document the need for disciplinary action To document everyday occurrences To initiate litigation

To improve quality of care

A nurse working in a long-established hospital learned a specific approach to administering intravenous injections from the previous generation of nurses at the hospital. This is an example of which type of knowledge? Scientific knowledge Traditional knowledge Authoritative knowledge Philosophy knowledge

Traditional knowledge

1. The RN is working with hospital administration to transform care at their facility. Which of the following nursing competencies will be critical for the nurse to utilize? Correctly utilize and troubleshoot high-tech equipment. Navigate the electronic medical records system. Work effectively in interdisciplinary teams. Do things the way they have always been done.

Work effectively in interdisciplinary teams. The RN working with administration to transform care will need to be able to work effectively as part of an interdisciplinary team. The nurse will need to work as a team member with members of administration, as well as representatives from other health disciplines involved in the project. The ability to use and troubleshoot equipment and to navigate the electronic medical records are important to the nurse, but will not necessarily help when working with administration to transform care. Doing things the way they have always been done is a barrier to transformation of care.

17. A nurse suspects that a client may have a hearing problem. The nurse should attempt to consult: *an ophthalmologist. *a clinical psychologist. *an audiologist. *an optometrist.

an audiologist.

7. What would be an environmental cue that the nurse should use to assist a cognitively impaired client with dementia? verbal reminders about mealtime locked doors to the unit client's name on the bedroom door introduction of self on entering the client's room

client's name on the bedroom door

A client has just learned that she has Stage 2 breast cancer. She appears distant and withdrawn. Her shoulders are slumped. She explains "I just never thought this could happen to me." Which answer best describes the client's response? nonverbal communication verbal communication incongruent communication congruent communication

congruent communication The client's actions, expressions, and words all "fit together" following the receipt of a difficult diagnosis. Her communication would be incongruent in this same scenario if she was described as "beaming from ear to ear." Verbal communication is not the best choice because it does not take into account the whole picture. Although verbal communication is used as a part of the client's response, the nurse must also consider her posture and her facial expressions. Nonverbal communication is not the best choice either because it does not take into account the whole picture. Although nonverbal communication is used as a part of the client's response, the nurse must also consider the client's word

A nurse is preparing to provide discharge instructions to a postpartum client regarding infant care. Before beginning the education session, the nurse should: ask all visitors to leave the room. eliminate as many distractions as possible. ask the client's partner to leave the room to allow the client to focus. ask the client if she is able to read.

eliminate as many distractions as possible.

15. A client has a complex medical history involving consequences of type 1 diabetes. As a result of diabetic nephropathy, the client now is involved in the local hospital's dialysis program and has been referred to an ophthalmologist by the primary care physician following vision problems. In addition, the client receives home care nursing for treatment of a foot ulcer that is slow to heal. This client's situation characterizes which phenomena? managed care primary care fragmentation of care case management

fragmentation of care

One of the primary reasons for conducting nursing research is to: quantify outcomes related to clients. generate knowledge to guide practice. prevent further disease and death. determine outcomes for clients.

generate knowledge to guide practice.

18. The nurse is going to lunch and is conducting a "hand-off of care" to the charge nurse. Which information should the nurse communicate to the charge nurse during the "hand-off of care" communication? *Tell the charge nurse that the nurse is going to lunch. *Give the charge nurse information about what care should be given while the nurse is at lunch. *Verify that the charge nurse has assigned someone else to take care of the client. *Remind the charge nurse about the client's history and current medications.

give the charge nurse information about what care should be given while the nurse is at lunch.

14. Personal protective equipment for use with standard precautions includes which of the following items? Select all that apply. Eye protection Fluid-repellent gown Face mask Disposable head cover Disposable shoe covers Disposable gloves

gloves, gown, mask, eye protection

5. A client admitted to the unit with a diagnosis of end-stage renal disease is scheduled to undergo hemodialysis. The client voices anxiety over shunt placement and management of care at home. A nurse initiates a referral to which members of the interdisciplinary team? *home health nurse, nutritionist, and social worker *dialysis nurse, physician, and family *physical and occupational therapist, dietitian, and home health aide *physician, physical therapist, and family

home health nurse, nutritionist, and social worker

25. When documenting the care of a patient, the nurse is aware of the need to use abbreviations conscientiously and safely. This includes: ensuring that abbreviations are understandable to patients who may seek access to their health records. using only abbreviations whose meaning is self-evident to an educated health professional. using only those abbreviations that are defined in full at another location in the patient's chart. limiting abbreviations to those approved for use by the institution.

limiting abbreviations to those approved for use by the institution.

1. A nurse is using the computer when a client calls for pain medication. Which action by the nurse helps maintain computer security? asking a coworker to log out for the nurse and administering the medicine right away staying logged on, leaving the terminal on, and administering the medication immediately informing the client that he will have to wait 15 minutes while the nurse completes the entry logging out of the computer, then administering the pain medication

logging out of the computer, then administering the pain medication

A client with cystic fibrosis develops pneumonia. To decrease the viscosity of respiratory secretions, the physician orders acetylcysteine. Before administering the first dose, the nurse checks the client's history for asthma. Acetylcysteine must be used cautiously in a client with asthma because it may induce bronchospasm. inhibits the cough reflex. is a respiratory stimulant. is a respiratory depressant.

may induce bronchospasm.

A nurse presents a client with the informed consent form for an abdominal paracentesis. The client asks the nurse what the procedure involves. The nurse should *notify the physician that the client doesn't understand the procedure. *have the client sign the form and ask the physician explain the procedure again. *explain the procedure and the benefits and risks associated with it, then have the client sign the form. *explain the form and have the client's healthcare power of attorney sign it.

notify the physician that the client doesn't understand the procedure.

A nurse is completing a neurological assessment and determines that the client has significant visual deficits. Considering the functions of the lobes of the brain, which area will most likely contain the neurologic deficit? parietal frontal temporal occipital

occipital

Elderly clients who fall are most at risk for which injuries? pelvic fractures cervical spine fractures wrist fractures humerus fractures

pelvic fractures

18. A client is newly diagnosed with Alzheimer's disease. When planning this client's care, the nurse should focus on: helping to reverse the disease. preventing loss of the client's cognitive functions. helping the client recognize physical limitations. providing a safe, structured environment.

providing a safe, structured environment.

19. A hospital has reaffirmed its commitment to meeting National Patient Safety Goals (NPSGs). The hospital is most likely to meet these goals by: involving clients and families in their care planning decreasing the use of unlicensed care providers. reducing the incidence of hospital-acquired infections. encouraging researchers to conduct evidence-based studies within the hospital.

reducing the incidence of hospital-acquired infections.

4. A registered nurse (RN) plans a conference to discuss the care plan for an infant admitted to the hospital with a diagnosis of nonorganic failure to thrive. Appropriate participants in the care conference include the: *registered dietitian, RN, health care provider, and infant's primary caregiver. *infant's primary caregiver, RN, health care provider, and occupational therapist. *social worker, RN, occupational therapist, and dietitian. *RN, health care provider, social worker, and infant's parents.

registered dietitian, RN, health care provider, and infant's primary caregiver. Secondary failure to thrive results from inadequate nutrition related to an underlying disease or disorder, rather than from a metabolic system process or a general lack of intake. The registered dietitian, RN, health care provider, and infant's primary caregiver are crucial interdisciplinary team members who should participate in this care conference. The dietitian can address nutritional needs, which are a central concern in failure to thrive. The primary caregiver can provide input. The social worker and occupational therapist may become involved after the infant's condition improves, but they aren't crucial members of the team at this point.

23. A 6-month-old on the pediatric floor has a respiratory rate of 68, mild intercostal retractions, and oxygen saturation of 89%. The infant has not been feeding well for the last 24 hours and is restless. Using the situation, background, assessment, and recommendation (SBAR) technique for communication, the nurse calls the health care provider (HCP) with the recommendation for which treatment? prescribing a chest CT scan providing sedation transferring the child to pediatric intensive care starting oxygen

starting oxygen The infant is experiencing signs and symptoms of respiratory distress indicating the need for oxygen therapy. Sedation will not improve the infant's respiratory distress and would likely cause further respiratory depression. If the infant's respiratory status continues to decline, they may need to be transferred to the pediatric intensive care unit. Oxygen should be the priority as it may improve the infant's respiratory status. A chest CT is not indicated. However, a CXR would be another appropriate recommendation for this infant.

11. A nurse says she's forgotten her computer password and asks to use another nurse's password to log on to the computer. Which response by the coworker demonstrates safe computer usage? telling the nurse that she may not use the password telling the nurse to ask someone else for their password telling the nurse that she may use the password writing down the password so the nurse won't forget it

telling the nurse that she may not use the password

21. Nurses work with various members of the health team. The nurse understands that the role of the hospitalist is best described as: the doctor who admits the patient, assumes the management of the patient's care, and maintains communication with the primary physician while the patient is hospitalized. the doctor who notifies the primary physician that their patient has been admitted to the hospital, and transfers care to a the referral specialist. the specialist who admits the patient to hospital, and returns care to the primary physician for all other referrals and services. the physician who manages the patient's care in emergency and intensive care units only.

the doctor who admits the patient, assumes the management of the patient's care, and maintains communication with the primary physician while the patient is hospitalized

A neonate requires surgical repair of a patent ductus arteriosus. The neonate's 16-year-old mother is present along with her parents, the neonate's grandparents. The neonate's mother states that she "isn't with the father anymore." The nurse must obtain informed consent for the surgery from *the neonate's mother and father because both parents are minors. *the neonate's grandparents because the mother is a minor. *the neonate's mother because she's considered an emancipated minor. *the court because the neonate's mother hasn't requested legal emancipation.

the neonate's mother because she's considered an emancipated minor

27. The facility is conducting an educational seminar for newly employed nurses. The program addresses the reporting of sentinel events. Which occurrences qualify for this criteria? Select all that apply -A client faints during ambulation with the nurse, resulting in a concussion. -A client's infant is misidentified and receives breast milk from another mother. -A client experiences a reaction to a unit of blood, resulting in itching and hives. -The nurse administers a lethal dosage of medication in error. -A client reports plans to file a complaint concerning the amount of time it took for a nurse to respond to a call light.

-A client's infant is misidentified and receives breast milk from another mother. -The nurse administers a lethal dosage of medication in error. -A client faints during ambulation with the nurse, resulting in a concussion.

13. A nurse is preparing an educational session on the purpose of documentation in medical records. Which topics should the nurse include in the education session? (Select all that apply.) -Assists with clinical research -Facilitates quality -Supports decision analysis -Serves as a financial record -Provides personal communication to family

-Assists with clinical research -Facilitates quality -Supports decision analysis

2. The nurse-manager of an outpatient facility isn't satisfied with discharge planning policies and procedures. Knowing other managers at similar facilities regarded as the "best" in the country, which steps should the nurse-manager take as part of a continuous quality-improvement process? -Ask the staff nurses to form a task force to review and revise discharge policies and procedures. -Ask the nurse-managers at the best facilities for their policies and procedures so she can adopt them. -Contact the nurse-managers at the best facilities and compare their discharge planning policies and procedures with those of her facility. -Ask her staff nurses to investigate discharge policies and procedures at other outpatient facilities and recommend changes.

-Contact the nurse-managers at the best facilities and compare their discharge planning policies and procedures with those of her facility.

21. The nurse understands that research has demonstrated that a common source of hospital-acquired infections in clients with IV infusions is the hub on the IV tubing. Which Quality and Safety Education for Nurses (QSEN) 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? -Person-centered care -Informatics -Teamwork and collaboration -Evidence-based practice

-Evidence-based practice

16. When checking a client's medication profile, a nurse notes that the client is receiving a drug contraindicated for clients with glaucoma. The nurse knows that this client, who has a history of glaucoma, has been taking the medication for the past 3 days. What should the nurse do first? -Continue to give the medication because the client has been taking it for 3 days. -Find out whether there are extenuating reasons for giving the drug to this client. -File an incident report because several other staff members have given the medication to the client. -Hold the medication and report the information to the physician to ensure client safety.

-Hold the medication and report the information to the physician to ensure client safety.

19. At the last hospital unit meeting, the policy for the insertion of Foley catheters was revised based on current evidence. The new graduate on the unit is frustrated because she just learned "the old way" and now has to learn a new methodology. Several other nurses commented that the change is "all about money." The charge nurse must educate her staff about the importance of this new policy. Which of the following explanations is most appropriate? -Because our clients are considered consumers of care, they often understand the need to use specific methods based on research, and they want the best care for the lowest cost. -Using evidence-based practice is the trend in providing quality care and may expose the client to better care implementation. None of our care methods are associated with cost. -Incorporating evidenced-based practice into our care routines links our interventions to valued outcomes, thereby increasing quality care. When we provide quality care, we can decrease cost. -Cost is not a driver in quality health care delivery. SUBMIT ANSWER

-Incorporating evidenced-based practice into our care routines links our interventions to valued outcomes, thereby increasing quality care. When we provide quality care, we can decrease cost.

23. A client who was receiving care on a psychiatric unit died by suicide at a time when nurses are known to have been handing off to nurses on the next shift. What is a responsibility of the organization when responding to this sentinel event? -Change the institution's policies regarding supervision of clients. -Report the event to the Joint Commission. -Appropriately discipline the nurses who were participating in the shift change. -Inform local health care institutions about the event to promote safety.

-Report the event to the Joint Commission.

22. A client on a hospital unit has been infected with hepatitis C virus (HCV) because a nurse mistakenly connected the client with an HCV-positive client's intravenous pump and tubing. What is an appropriate response by the hospital to this incident? -Report this sentinel event to the Joint Commission and to relevant state agencies -Offer compensation to the affected client in a timely manner, while maintaining the client's confidentiality. -File an incident report with the American Nurses Association describing plans for preventing similar events in the future. Inform the public that the incident occurred, while protecting the confidentiality of the clients.

-Report this sentinel event to the Joint Commission and to relevant state agencies

28. A nurse is preparing to administer cardiac medications to two clients with the same last name. The nurse checks the medication three times before entering the room to administer medications to the first client. While leaving the room, the nurse realizes they didn't check the client's identification before administering the medication. Which action should the nurse take first? -Document the medication error and completion of the variance report in the client's chart and notify the physician. -Return to the room, check the client's identification against the medication administration record, and complete a variance report if needed. -Alert the charge nurse that they made a medication error. -Check the second client's identification and administer the remaining medication to him.

-Return to the room, check the client's identification against the medication administration record, and complete a variance report if needed.

7. The nurse manager has noticed a sharp increase in medication errors associated with IV antibiotic administration over the past 2 months. The nurse manager should discuss the situation with each nurse involved and then: -document it on their evaluations. -report them to the supervisor. -report the incidents to the hospital attorney. -ask them to attend in-service training for administration of IV medications.

-ask them to attend in-service training for administration of IV medications.

The health care provider prescribes cold therapy every 4 hours for a client after foot surgery. The nurse places the ice pack directly on the client's skin and returns minutes later. After removal of the ice pack, the skin is pale and cold to the touch. The client develops frostbite and begins a lawsuit for malpractice. When reviewing the case, the nurse attorney recognizes which most important statement about the malpractice suit?

All elements are in place to hold the nurse liable

A hospital's current quality improvement program has integrated the principles of the Institute for Healthcare Improvement (IHI) 5 Million Lives Campaign. How can the hospital best achieve the campaign goals of reducing preventable harm and death?

By adhering to EBP guidelines

A hospital's current quality improvement program has integrated the principles of the Institute for Healthcare Improvement (IHI) 5 Million Lives Campaign. How can the hospital best achieve the campaign goals of reducing preventable harm and death? By reducing nurse-to-patient ratios and increasing accountability By involving patients and families in their care planning By adhering to EBP guidelines By having researchers from outside the facility evaluate care

By adhering to EBP guidelines

A nurse with 20 years' experience attends a hospital-required training session and learns a new method for assessing nasogastric (NG) tube placement. During the training the nurse educator provides the nurse with a bibliography of peer-reviewed articles related to NG tube placement. The nurse recognizes the change in procedure developed from which of the following methods? Institute of Medicine (IOM) research Core measures Knowledge, skills, and attitude Evidence-based practice

Evidence-based practice

Which of the following would be the least important reason that nurses utilize research in nursing practice?

Financial obligation

Who is considered to be the first nursing researcher? Dorothea Dix Lillian Wald Florence Nightingale Clara Barton

Florence Nightingale

Who of the following is considered to be the first nursing theorist who conceptualized nursing in terms of manipulating the environment?

Florence Nightingale

Who of the following is considered to be the first nursing theorist who conceptualized nursing in terms of manipulating the environment? Florence Nightingale Lydia Hall Sister Callista Roy Dorothea Orem

Florence Nightingale

1. The nurse manager on the orthopedic unit is reviewing a report that indicates that in the last month, five clients were diagnosed with pressure ulcers. What should the nurse manager do? -Conduct a chart audit to determine which nurses on which shifts were giving nursing care to the clients with pressure ulcers. -Use benchmarking procedures to compare the findings with other nursing units in the hospital. -Institute a quality improvement plan that identifies contributing factors, proposes solutions, and sets improvement outcomes. -Ask the staff education department to conduct an educational session about preventing pressure ulcers.

Institute a quality improvement plan that identifies contributing factors, proposes solutions, and sets improvement outcomes.

The nurse ascertains that there is a discrepancy in the records of the use of a controlled substance for a client who is taking large doses of narcotic pain medication. What should the nurse do next?

Notify the nursing supervisor of the clinical unit

Nurses in an ICU noticed that their clients required fewer interventions for pain when the ICU was quiet. They then asked a researcher to design a study about the effects of noise on the pain levels of hospitalized clients. How does this demonstrate the ultimate goal of expanding the nursing body of knowledge?

Nursing research helps improve ways to promote and maintain health

There are four common concepts in nursing theory. While all concepts are important, the focus of nursing is always on which of the following?

Person

Which statement is a guideline to help nurses protect themselves from liability?

Practice within the scope of the nursing standards of practice

Which of the following are the major roles of nurses working in institutional, community-oriented, or community-based settings? Select all that apply. Problem-solver Organizer Leader Researcher Healer Practitioner

Problem-solver Leader Researcher Practitioner

When a researcher begins to form plans for a research project, the researcher must decide on the method for conducting the research. The nurse researcher that plans to emphasize collection of narrative data and the analyses would select which of the following methods of research? Qualitative research Quantitative research Applied research Basic research

Qualitative research

A nurse researcher must decide on the method for conducting the research. The researcher that plans to emphasize collection of numerical data and analysis would select which of the following methods of research? Applied research Qualitative research Basic research Quantitative research

Quantitative research

After reviewing several research articles, the clinical nurse specialist on a medicalsurgical unit rewrites the procedure on assessing placement of a nasogastric tube. What source of nursing knowledge did the nurse use in this situation?

Scientific knowledge

The acute care nurse practitioner planning care for a patient with rheumatoid arthritis reviews treatment guidelines developed by the American Nurses' Association (ANA). Which of the following ANA documents is the nurse accessing?

Standards of Professional Performance

The charge nurse is making assignments for a team of two RNs and one LPN. The nurse should delegate the care of which client to the LPN?

The client who had an abdominal hysterectomy 2 days ago; vital signs are stable

A nurse is caring for a client with end-stage heart failure. Which statement by the client best demonstrates a good understanding of an advance directive?

"A living will allows my decisions for health care to be known if I can't speak for myself"

A nurse is preparing a client for surgery and asks if the client has an advance directive. The client asks "What is an advance directive?" What is the nurse's best response?

"An advance directive will communicate your wishes for health care postoperatively in case you are unable to do so"

An adolescent client with ruptured membranes is admitted to the hospital. A few hours after her arrival to the labor and birth unit, the client's parents call to inquire about her condition. What is the nurses' BEST response.

"I cannot give you information on my client"

A patient recently diagnosed with pancreatic cancer asks the nurse not to share the diagnosis with her family members. After visiting the patient, the patient's daughter approaches the nurse and states, "Mom just did not seem herself today. Are biopsy reports back and do they confirm pancreatic cancer?" What is the best response from the nurse to patient's daughter?

"It is unethical and illegal for me to discuss your mother's medical information with you"

5. A nurse administers cefazolin instead of ceftriaxone to an 8-year-old with pneumonia. The client has suffered no adverse effects. The nurse tells the charge nurse of the incident but fears disciplinary action from reporting the error. What should the charge nurse tell the nurse? -"Reporting the error helps to identify system problems to improve client safety." -"If you do not report the error, I will have to." -"This is not a serious mistake, so reporting it will not affect your position." -"Notify the client's health care provider to see if they want this reported."

"Reporting the error helps to identify system problems to improve client safety."

The health care facility is involved in litigation by four clients. When reviewing cases, which legal case would the nurse attorney identify to best describe malpractice?

The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest.

12. A nurse is preparing a seminar on the uses of documentation in client records. Which topics should the nurse include in the seminar? (Select all that apply.) -Financial reimbursement -Market Cost Analysis -Decision Analysis -Research -Quality improvement -Predictive outcome documentation

-Financial reimbursement -Decision Analysis -Research -Quality improvement

While working in an institution that uses computer documentation, the nurse understands the need to log out of the computer if it is not in use. Following this procedure is necessary because of what ethical problem in nurisng?

The right to confidentiality is essential to protect each client's private information

Which statement best explains the importance of theoretic frameworks?

Theoretic frameworks advance nursing knowledge and practice

The nurse is helping a patient with a terminal illness understand advance directives Which statement by the client demonstrates an understanding of these documents?

They guide the client's treatment in certain health care situations.

11. If a manual end-of-shift count of controlled substance isn't correct, the nurse's best action is to -investigate and correct the discrepancy, if possible, before proceeding. -document the discrepancy on a opioid-inventory form. -document the discrepancy on an incident report. -immediately report the discrepancy to the nurse-manager, nursing supervisor, and pharmacy.

-immediately report the discrepancy to the nurse-manager, nursing supervisor, and pharmacy.

18. A nurse on a night shift entered an elderly client's room during a scheduled check and discovered the client on the floor beside the bed after falling when trying to ambulate to the washroom. After assessing and assisting the client back to bed, the nurse has completed an incident report. What is the primary purpose of this particular type of documentation? -gauging the nurse's professional performance over time -protecting the nurse and the hospital from litigation -following up on the incident with other members of the care team -identifying risks and ensuring future safety for clients

-identifying risks and ensuring future safety for clients

17. The charge nurse on a hematology/oncology unit is reviewing the policy for using abbreviations with the staff. The charge nurse should emphasize which information about why dangerous abbreviations need to be eliminated? Select all that apply. -to ensure efficient and accurate communication -to make data entry into a computerized health record easier -to prevent medication errors -to ensure client safety -to make it easier for clients to understand the medication prescriptions

-to ensure efficient and accurate communication -to prevent medication errors -to ensure client safety

Which of the following best reflects the rationale for evidence-based practice?

A means to ensure quality care

Which of the following best reflects the rationale for evidence-based practice? A means to ensure quality care A way to establish accountability A process for accreditation A method for determining reimbursement

A means to ensure quality care

A nursing student is reading a research article from a nursing journal. The student is aware that the paragraph at the beginning of the article that summarizes the article and the findings of the research is a good place to start when reading this article. What part of the article is the nursing student reading?

Abstract

A nursing student is reading a research article from a nursing journal. The student is aware that the paragraph at the beginning of the article that summarizes the article and the findings of the research is a good place to start when reading this article. What part of the article is the nursing student reading? Abstract Results Review of the literature Conclusions

Abstract

A nurse working in an acute care setting volunteers to participate in a research study. The nurse understands that research findings add to the scientific base of nursing practice. Evidence-based practice (EBP) accomplishes which of the following? Select all that apply.

Improve patient outcomes Establish best nursing practices Decrease health care cost

A client admitted to the mental health unit has exhibited physical behaviors that put him and others at risk. The nurse applies four-point restraints on the client without obtaining a physician's order or the client's consent. The nurse is at risk of being accused of which of the following?

Battery

A nurse working in the intensive care unit (ICU) refers to the Institute for Healthcare Improvement (IHI) Ventilator Bundle prior to planning patient care. The nurse realizes nursing interventions outlined in the bundle will improve patients' outcomes. Which of the following statement best describes how IHI-established nursing interventions should be included in each bundle?

Best practice derived from valid and reliable research studies guided nursing interventions being added to the IHI bundles

A nurse working in the intensive care unit (ICU) refers to the Institute for Healthcare Improvement (IHI) Ventilator Bundle prior to planning patient care. The nurse realizes nursing interventions outlined in the bundle will improve patients' outcomes. Which of the following statement best describes how IHI-established nursing interventions should be included in each bundle? -Best practice derived from valid and reliable research studies guided nursing interventions being added to the IHI bundles -Nurse case managers serving as patient advocates recommended nursing interventions to be included in the IHI bundles based on patient preference -Hospitals, physicians, and nurses worked collaboratively to design patient care activities included in IHI bundles -Nursing interventions found within the IHI bundles were selected based on the ability to provide optimal time management for the nurse

Best practice derived from valid and reliable research studies guided nursing interventions being added to the IHI bundles

Which detail of a client's drug therapy is a nurse legally required to document?

Client's reaction to the drug

The nurse working in research correctly identifies which of the following to be mandatory for the ethical conduction of research in a hospital setting?

Clients must grant informed consent if they are to participate.

The primary task of nursing research includes which of the following?

Contributing to the scientific base of nursing practice

The primary task of nursing research includes which of the following? Managing the care of an entire caseload of patients Determining nursing diagnoses Decreasing overall operating costs to the health care system Contributing to the scientific base of nursing practice

Contributing to the scientific base of nursing practice

During rounds, a nurse finds that a client with hemiplegia has fallen from the bed because the nursing assistant failed to raise the side rails after giving a back massage. The nurse assists the client to the bed and assesses for injury. As per agency policies, the nurse fills out an incident report. Which activity should the nurse perform after finishing the incipient report?

Include the time and date of the incident

After reviewing several research articles, the clinical nurse specialist on a medicalsurgical unit rewrites the procedure on assessing placement of a nasogastric tube. What source of nursing knowledge did the nurse use in this situation? Authoritative knowledge Traditional knowledge Scientific knowledge Philosophical knowledge

Scientific knowledge

A nurse fails to alert a physician of a change in a patient's condition for the worse. This is an example of what aspect of malpractice?

Duty

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 Duty Breach of Duty Intent to harm Causation Punitive damages Fraud

Duty Breach of Duty Causation

A nurse has integrated the principles of evidence-based practice into care. EBP has the potential to help the nurse achieve what goal?

Ensuring high quality patient care

A nurse who works in a pediatric practice assesses the developmental level of children of various ages to determine their physchosocial development. These assessments are based on the work of :

Erikson

A nurse is assisting an anesthetist during the intubation of a client. The anesthetist visualizes the vocal cords with the laryngoscope and says to the nurse, "This is an easy one. Why don't you give it a try?" indicating that the nurse should insert the endotracheal tube. What would be the most appropriate response by the nurse?

This procedure is not within my scope of practice

A nurse is discussing dietary issues with a Latino client in the clinic. The client states, "My grandmother always told me that I needed to include beans in my diet so that my muscles would grow." The information that the client is expressing is known as what?

Traditional knowledge

The nursing instructor is explaining sources of knowledge to a group of nursing students. She says, "Some knowledge is passed from one generation to another." One of the students correctly describes this source as being what?

Traditional knowledge

A nurse researcher is reviewing the Privacy Rule under the Health Insurance Portability and Accountability Act (HIPAA) and finds information about handling protected health information (PHI). The nurse researcher would most likely find rules for which aspects of PHI? Select all that apply.

access, sharing, usage

A client with stage IV heart failure has a living will indicating that he does not want to be placed on a ventilator. A nurse is caring for this client when he begins experiencing severe dyspnea. The nurse should:

administer oxygen, morphine, and a bronchodilator for client comfort

A registered nurse is caring for four clients on a med-surg unit. Which task is most appropriate for the nurse to delegate to the LPN?

administering bedside glucose testing

A client who is taking olanzapine states he is being poisoned and refuses to take his scheduled medication. The nurse states, "if you don't take your medication, you'll be put into seclusion." The nurse's statement is an example of which legal concept?

assault

The nurse recognizes liability requires specific elements that must be established to prove that malpractice or negligence has occurred. Identify the specific elements. Select all that apply causation damages duty breach of confidentiality breach of duty

causation damages duty breach of duty

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

certification

20. The nurse is taking care of a client who had a laryngectomy yesterday. To assure client safety, the nurse should give hand-off of care reports at which times? Select all that apply -change of shift -change of nurses -when the nurse goes to lunch -when the unit clerk goes to a staff meeting -when new medication prescriptions are written

change of shift change of nurses when the nurse goes to lunch

While caring for an infant, the nurse hears another child screaming in then next room. She rushes to the other room to check on the screaming child, forgetting to put the side rails up on the infant's crib. She returns to the room to find the infant has fallen out of the crib and sustained a head injury. Based on the nurse's action, which tort is the nurse liable for?

malpracrice

A nursing theorist examines a hospital environment by studying each ward and how it works individually, and then relates this information to the hospital as a whole working entity. This is an example of the use of which theory? Developmental theory General systems theory Psychosocial theory Adaptation theory

General systems theory

A nurse is reluctant to provide care at an accident scene. Which legal definition is true regarding the provision of nursing care?

Good Samaritan laws are designed to protect the caregiver in emergency situations

One of the primary focuses of nursing research is to

Generate knowledge to guide practice

A nurse is using an evidence-based practice tool to plan care for a patient with acute abdominal pain who is admitted to the health care facility. Which tool would the nurse most likely expect to use?

Algorithm

The nursing student studying research exhibits an understanding when informing the instructor that which of the following is the bridge between theory and practice?

Evidence-based research

Nursing students are reviewing the roles that a nurse may assume. The students demonstrate understanding of the information when they identify which of the following as characteristic of the research role?

Replicating findings to further the science of nursing

6. A nurse has come on day shift and is assessing the patient's intravenous setup. The nurse notes that there is a mini-bag of the patient's antibiotic hanging as a piggyback, but that the bag is still full. The nurse examines the patient's medication administration record (MAR) and concludes that the night nurse likely hung the antibiotic but failed to start the infusion. As a result, the antibiotic is 3 hours late and the nurse has consequently filled out an incident report. In doing so, the nurse has exhibited which of the following? -Technical skills -Interpersonal skills -Ethical/legal skills -Cognitive skills

-Ethical/legal skills

4. The nurse manager overhears a nurse say, "I'm not going to fill out an incident report because it will be used against me." What response by the nurse manager is most appropriate? -"The best way to not fill out an incident report is to not make a mistake." -"The main purpose of an incident report is for quality improvement, not disciplinary action." -"It is the number of incident reports you fill out that will determine if action will be taken against you." -"If you feel the incident was minor, then you don?t need to fill out a report."

-"The main purpose of an incident report is for quality improvement, not disciplinary action."

24. The nurse is undergoing peer review after a sentinel event. What might be utilized to perform a nurse peer review? Select all that apply. -An attending physician -A co-worker with the same educational background. -A nursing assistant -Any person working in the facility with the nurse being evaluated -A nursing audit

-A nursing audit -A co-worker with the same educational background.

3. The nurse is designing a benchmarking study to gather information about nursing care practices for wound care. Which sources of information are used for benchmarking? Select all that apply. -government reports -clinical organization recommendations -literature reviews -databases -standard-setting organizations

-government reports -literature reviews -databases -standard-setting organizations

8. The nurse manager is developing a "read-back" procedure to reduce medication administration errors. What are purposes of the "read-back" requirement? Select all that apply. -to prohibit prescriptions and test results from being communicated verbally or by telephone -to make sure that prescriptions and test results that are communicated verbally or by telephone are clear to the receiver of the information -to encourage the use of electronic medical records -to make sure that prescriptions and test results that are communicated verbally or by telephone are confirmed by the individual giving the information -to minimize the risk of nonauthorized personnel from giving prescriptions which are communicated verbally or by telephone

-to make sure that prescriptions and test results that are communicated verbally or by telephone are clear to the receiver of the information -to make sure that prescriptions and test results that are communicated verbally or by telephone are confirmed by the individual giving the information

A nurse on night shift entered an elderly client's room during a scheduled check and discovered the client on the floor beside the bed after falling when trying to ambulate to the washroom. After assessing and assisting the client back to bed, the nurse has completed an incident report. What is the primary purpose of this particular type of documentation?

Identifying risks and ensuring future safety for clients

A nurse is using an evidence-based practice tool to plan care for a patient with acute abdominal pain who is admitted to the health care facility. Which tool would the nurse most likely expect to use? Multidisciplinary action plan Clinical guideline Care map Algorithm

Algorithm

When looking at a model for evidence-based practice, what is the final step of the process? Formulating a clinical question Searching the literature Appraising evidence Evaluating practice change

Evaluating practice change

A nurse with 20 years' experience attends a hospital-required training session and learns a new method for assessing nasogastric (NG) tube placement. During the training the nurse educator provides the nurse with a bibliography of peer-reviewed articles related to NG tube placement. The nurse recognizes the change in procedure developed from which of the following methods?

Evidence-based practice

A nurse researcher must decide on the method for conducting the research. The researcher that plans to emphasize collection of numerical data and analysis would select which of the following methods of research?

Quantitative research