Nature of Nursing Final

Practicing nurses participate in employer-sponsored professional development classes that provide case studies related to ethical situations and decision making. Ethical considerations are debating among teams, and an expert helps the class arrive at the "best practices." The nurses are experiencing ethics ___________________.

Acculturation Reason: Acculturation is the process by which a newcomer adopts the cultural behaviors common in the host country, which may lead to changes in diet, physical activity level, and environmental exposures

Software programs that process data to produce or recommend valid choices are known as

Decision support systems

Although communication varies among members of different cultures, the greatest obstacle to providing multicultural care is differences in _____.

Language

Quality is defined by the______________.

Patient

A person who is recovering from a stroke is becoming more forgetful and is unable to recall peoples names. A friend suggests the use of a natural ingredient, ginkgo bilboa. The nurse is concerned about which serious risk associated with this herb? a. Thromboembolism b. Seizures c. Hypertension d. Photosensitivity

Seizures Reason: Ginkgo Bilboa is treating blood disorders and memory issues. It is best known today as way to potentially keep your memory sharp

While taking a shower, a patient pushes the emergency light. When the nurse arrives, the patient complains of feeling dizzy and unsteady. The nurse turns to reach for the patient's walker and the patient falls, hitting the right side of the face resulting in loss of vision in the right eye. This scenario represents a _______ event.

Sentinel event Reason: A Sentinel event is a patient safety event that results in death, permanent harm, or severe temporary harm

A nurse is asked to "float" to a telemetry floor and is to place a patient on telemetry monitor. The nurse is unfamiliar with placement of EKG leads and would consult which type of chart to learn the correct placement?

The pareto chart is used to prioritize interventions that caused the majority of the problems

During an admission history and physical, a female patient states, "I use 5000 mg/day of calcium to prevent osteoporosis and to maintain health." The nurse should assess for what possible side effect? a. Excessive bleeding b. Kidney stones c. Lower blood sugar d. Jaudice

b. Kidney stones Reason: Too much calcium in the blood can lead to weaken your bones, create kidney stones, and interfere with how your heart and brain work

A young adult experiencing pain states, "I want to see a chiropractor, but I don't have any money. However, I do have health insurance. " What is the most appropriate response the nurse can provide regarding payment for this form of health care service?" a. " Most insurance companies will pay for chiropractic treatment." b. "Because chiropractors are not required to be licensed, services must be paid for by the patient." c. "Chiropractic medicine is a new complementary alternative medicine (CAM) therapy that has not yet been recognized by insurance companies." d. "Chiropractic medicine is more than 100 years old, but because it is preventative in nature, it is not covered by most insurance."

a. "Most insurance companies will pay for chiropractic treatment."

A patient states, "My cancer is in remission finally after all that chemotherapy, my friend used the same chemotherapy and wasn't so lucky. I want to continue participating in spiritual care and 'mind games' to keep my memory intact. I am also enrolled in Thai chi, but I just can't stop thinking about my sick lung." This patient adheres to which principle underlying alternative healing? a. A negative alteration in the body produces a parallel effect on the mind and spirit b. The body can heal itself with the help of complementary alternative therapies c. Approaches to therapy are individual d. There is a focus on the total lifestyle

a. A negative alteration in the body produces a parallel effect on the mind and spirit

The National Database of Nursing Quality Indicators (NDNQI) identifies what client focused events as outcome indicator? (Select all that apply.) a. A patient falls and fractures a hip b. A patient develops bilateral pressure ulcers on their heels c. A patient develops a catheter-associated urinary tract infection d. A patient develops post-surgical delirium e. A patient develops pneumonia related to ventilator use

a. A patient falls and fractures a hip b. A patient develops bilateral pressure ulcers on their heels c. A patient develops a catheter-associated urinary tract infection e. A patient develops pneumonia related to ventilator use

A consumer is learning about EHR at a local health fair and states, "I am worried that someone can read my health information and I really don't understand the difference between privacy and confidentiality." The nurse provides what as an example of confidentiality? a. A pledge that states, "I will hold matters pertaining to my patients in strict intimacy" b. A patient who does not tell the primary health care provider that he or she has been treated for a sexually transmitted disease c. A teenager who sustains a broken arm and in the emergency department and withholds information about personal use of recreational drugs d. Locking medical records in cabinets to prevent unauthorized users from accessing patient information

a. A pledge that states, "I will hold matters pertaining to my patients in strict intimacy" Reason: Privacy is gives you rights over your health information and sets rules and limits on who can look at and receive your health information Confidentiality is don't convey any health information identifiable to a particular patient

Which nursing situation demonstrates the greatest need for individual malpractice insurance to help manage professional legal risk? (Select all that apply.) a. Accepting the role of weekend unit manager b. Delegating health care responsibilities to nursing staff c. Working for the federal government attending to embassy staff d. Being licensed in a state where sovereign immunity is in effect e. Regularly working in the facility's float pool

a. Accepting the role of the weekend unit manager b. Delegating health care responsibilities to nursing staff d. Being licensed in a state where sovereign immunity is in effect e. Regularly working in the facility's float pool

The nurse who admits making a medication error and immediately files an incident report is demonstrating what ethical principle? a. Accountability b. Individuality c. An injustice d. Values clarification

a. Accountability Reason: Accountability is the procedures and processes by which one party justifies and takes responsibility for its activities

The message therapist uses kinesthesia to correct habits that cause poor posture and limited movement. What is this type of massage called? a. Alexander technique b. Feldenhrais method c. Healing touch d. Reiki

a. Alexander technique Reason: Alexander technique is it is a motor skill which helps people how to treat their body. This method corrects body stance, relieves muscle contraction, and makes body movement easier

A patient returning from a procedure was somehow "skipped" when daily baths were performed and requests that care now be provided now. The nurse discovers the bed is rumpled and damp. The RN joins with some other staff to bathe the patient, change the bed, and help make the patient comfortable. These staff members are demonstrating what ethical concept? a. Altruism b. Veracity c. Autonomy d. Whistle-blowing

a. Altruism Reason: Altruism is supporting patients and nurses' concern about the well-being of patients within their professional capacity

What symptom would the nurse caring for a patient who practices Ayurveda assess for? a. An increased stool osmolarity gap resulting from dehydration b. Petechiae resulting from fine-needle punctures c. Use of over-the-counter remedies intended for intended symptom d. Magnets strategically placed on affected joints

a. An increased stool osmolarity gap resulting from dehydration Reason: Ayurveda is a system of traditional medicine native to India, whichuses a range of treatments, including panchakarma ('five actions'), yoga, massage, acupuncture and herbal medicine, to encourage health and wellbeing

During a seminar on ethics, the educator realizes that more information is needed when a participant describes which situation as a violation of the ethical principle of autonomy? a. An older person with advanced stages of Alzheimer's disease is denied the right to ambulate in the hallway. b. A mentally competent adult refuses medical treatment for the autoimmune disease lupus erythematosus, stating that this condition reflects the will of a higher power. c. A mentally competent visitor fell during visiting hours but refused to be examined by the physician on call. d. A mentally competent adult with a broken wrist refuses to be given a local anesthetic prior to a procedure.

a. An older person with advanced stages of Alzheimer's disease is denied the right to ambulate in the hallway Reason: Autonomy is the right of patients to make decisions about their medical care without experiencing undue influence from their health care providers

When assessing an ethical issue, what is the nurse's first intervention? a. Ask, "What is the issue?" b. Identify all possible alternatives c. Select the best option from a list of alternatives d. Justify the choice of action or inaction

a. Ask, "What is the issue?" Reason: If you do not identify the issue then how can you find alternatives

A nurse is preparing a presentation using different websites to collect information. The nurse is concerned that contact information and the author's credentials are not listed for one of the websites reviewed. Which criterion required to establish a reputable website is missing? a. Authority b. Objectivity c. Usability d. Currency

a. Authority

A researcher calculated the risk-to-benefit ration and concluded that no harmful effects were associated with a survey of college sophomores. The researcher was applying which ethical principle? a. Beneficence b. Human dignity c. Justice d. Human rights

a. Beneficence Reason: Beneficence is all medical practitioners have a moral duty to promote the course of action that they believe is in the best interests of the patient.

A new nurse asks, " Since electronic medical records (EMR) can improve quality care by having seamless data available for a patient, why doesn't everyone just replace paper and pencil charts?" What barriers to a universal health information infrastructure exist? (Select all that apply.) a. Competition from individual companies to build EMR prevents a universal infrastructure b. Cost is prohibitive even with federal funding for larger health care systems c. Preventative health reminders for immunizations and yearly screenings such as mammograms are used in clinical decision making d. Insurance companies have halted sharing of some patient data due to fear of law suits e. The full capacity of EHRs has not been realized with only stage 1 of 3 nearing completion

a. Competition from individual companies to build EMR prevents a universal infrastructure e. The full capacity of EHRs has not been realized with only stage 1 of 3 nearing completion

A nurse is assigned to a unit other than the one she is normally assigned due to increased census on the alternative unit. She is assigned to care for seven patients and participates in walking rounds where the patient's condition and needs are discussed between oncoming and off-going shifts of the interdisciplinary team. The nurse carefully makes notes of all pending orders and prioritizes needs. The nurse enters the cafeteria later and the notes accidentally fall from her pocket, which contain the above information that contains patient sensitive data. The liabilities arising from this incident would be covered under what issue? a. Compliance with the Health Insurance Portability and Accountability Act (HIPAA) b. Performance in accordance with the American Nurse's Association (ANA) Scope and Practice Act c. Nursing Role in the securing of implied consent d. Personal liability with floating and cross-training

a. Compliance with the Health Insurance Portability and Accountability Act (HIPAA)

While completing a masters nursing degree in Virginia, a nurse who is interested in teaching in Laredo, Texas, enrolls in Spanish classes for 4 years, knowing that a high number of Mexican-Americans live there. This nurse is demonstrating what social value? a. Cultural competence b. Ethnocentrism c. Prejudice d. Stereotyping

a. Cultural Competence Reason: Cultural competence in health care describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including the tailoring of health care delivery to meet patients' social, cultural and linguistic needs.

An advanced practice nurse inputs into a computer software program the following clinical manifestations: open wound with tibia exposed, petechial hemorrhage, and temporary loss of consciousness. The computer diagnosis of fat emboli is generated by what information associated system? a. Decision support b. Telehealth c. Robotic technology d. Biometric technology

a. Decision support Reason: Decision support is a clinical decision support system (CDSS) is a computerized application that helps clinicians detect and prevent untoward clinical events such as drug interactions, errors of omission, and trends in symptomatology.

When differentiating between slander and libel, the nurse knows that libel is characterized by what action? a. Defamation caused by subjective comments written in the nurse's notes b. Negative subjective comments made to those who are not providing care c. Verbally describing to the oncoming nurse assigned to the client objective data that place the client in a negative light d. Repeating prejudiced comments made by the primary caregiver to a neighbor at the local supermarket

a. Defamation caused by subjective comments written in the nurse's notes Reason: Slander is an untrue defamatory statement that is spoken orally. Libel is an untrue defamatory statement that is made in writing.

The Institute of Medicine (IOM) (2003) recommends that electronic health records (EHR) systems offer eight functionalities. A patient has severe allergy to eggs and penicillin. Which of the eight functions of the EHR would address sharing this information? a. Health information and data capture b. Results/data management c. Provider order entry management d. Clinical decision support

a. Health information and data capture Reason: The eight functions of EHR are: Health information and data. Results management. Order entry and management. Clinical decision support. Electronic communication and connectivity. Patient support. Administrative processes. Reporting and population health management.

Which components must be included regarding informed consent? (Select all that apply.) a. Identification of risks for non-treatment b. Discussion of expected benefits c. Identification of known risks d. Acknowledgement of alternative therapy e. Communication of the estimate cost involved

a. Identification of risk for non-treatment b. Discussion of expected benefits c. Identification of known risks d. Acknowledgement of alternative therapy

A nurse works on a unit where electronic health records (EHR) are being initiated and asks, "What is meant by 'meaningful use' standards that are in our education packet?" The best answer is that "meaningful use": a. identifies a set of EHR proficiencies and benchmarks that EHR systems must meet to be certain that they are functioning to their maximum capacity and meeting this standard allows companies/organizations to qualify for funds to defray cost of the EHR from Medicare. b. refers to training competencies that all users must achieve to be able to access and transfer patient data/information. c. refers to a requirement that at least 50% plus one of all patients have data entered into the EHR. d. the requirement that rigorous confidentiality security is in place to protect all patient information from sources which have no right to the data.

a. Identifies a set of EHR proficiencies and benchmarks that EHR systems must meet to be certain that they are functioning to their maximum capacity and meeting this standard allows companies/organizations to qualify for funds to defray cost of the EHR from Medicare.

Throughout their careers, nurses are in an ongoing state of acculturation, gaining experience from formal nursing school classes, clinical experiences, and ethical issues they encounter in their clinical practice. What are the ideal outcomes of these ongoing experiences with cultural decision making? (Select all that apply.) a. Increased trustworthiness b. Enhanced ability to take into consideration many aspects of ethical situations c. Confidence to make decisions based on experience and ethical intelligence d. Improved clinical decision making and advocacy for patient autonomy e. Authority to make ethical decisions independently that meet personal moral beliefs

a. Increased trustworthiness b. Enhanced ability to take into consideration many aspects of ethical situations c. Confidence to make decisions based on experience and ethical intelligence d. Improved clinical decision making and advocacy for patient autonomy

A patient regularly experiences migraine headaches that are not relieved by traditional Western medical practices. Why does the family physician suggest acupuncture? (Select all that apply.) a. It is based on the belief that meridians are vital for life, and when they are out of balance, pain occurs b. It uses strategically placed, slender needles for pain relief c. It uses breathing exercises and meditation to relieve pain d. It corrects metabolic imbalances through purification regimens e. It determines distinct metabolic body types

a. It is based on the belief that meridians are vital for life, and when they are out of balance, pain occurs b. It uses strategically placed, slender needles for pain relief

A pregnant woman reports back pain and wants to try a complementary alternative medicine (CAM) therapy. The nurse knows that which CAM would be contraindicated? a. Magnet therapy b. Aromatherapy c. Imagery d. Therapeutic touch

a. Magnet therapy Reason: Magnet therapy is uses different kinds of magnets on the body to help boost your overall health.

Consumers are concerned with security issues related to their confidential health information being placed in an electric health record (EHR). However, when the security of the EHR is compared with that of paper-and-pencil records, the EHR has been proven to be what? a. More secure b. Less secure c. Equivalent d. Not comparable

a. More secure

A nurse is caring for a client with malignant hypertension whose blood pressure has increased by 40 mm Hg during the past hour. The nurse goes to lunch and fails to report the change to the physician. The nurse is at risk for being charged with which legal claim? a. Negligence b. Assault c. Defamation of character d. Tort

a. Negligence Reason: Negligence is when a medical or healthcare professional deviates from the care standards of their profession and causes injury to a patient

A nurse investigates energy therapies and learns that which therapies would be included? (Select all that apply.) a. Qi gong b. Osteopathy c. Imagery d. Healing touch e. Magnet therapy

a. Qi gong d. Healing touch e. Magnet therapy Reason: Qi gong is traditional Chinese medicine that combines movement, meditation, and regulation of breathing to enhance the flow of qi (an ancient term given to what is believed to be vital energy) in the body Healing touch is an energy-based complementary therapy fostering that nurse-patient connection. Nurses are beginning to use HT with their patients to assist in easing pain and anxiety, promote relaxation, accelerate wound healing, diminish depression, and increase a patient's sense of well-being Magnet therapy is used to treat different types of pain, such as arthritis or headaches, for hundreds of years. Magnetic therapy devices are marketed widely, and they are most commonly used for pain, inflammatory conditions, and wound healing

A nurse is caring for a client who just consented to an elective abortion. The nurse is unsure of his or her own values as they relate to this issue. What action should the nurse take to address this barrier to providing effective care to the client? a. Reflect on one's personal values and how these values relate to the beliefs and the philosophy of nursing b. Be prepared to defend his or her value system c. Ignore his or her own values and provide care d. Realize that values do not change and that they cannot be influenced by others and so decline this assignment

a. Reflect on one's personal values and how these values relate to the beliefs and the philosophy of nursing

A nurse practices a relaxing massage technique to stimulate and apply pressure to the feet or hands, increasing blood supply circulation to various parts of the body and relieving pain. The massage technique used by the practitioner is referred to by term? a. Reflexology b. Feldenkrais method c. Reiki d. Rolfing

a. Reflexology Reason: Reflexology is applying pressure to specific areas of the body. These are thought to be connected to various parts of the body, such as the muscles, joints, spine and organs.

A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency? a. Safety b. Timely c. Equitable d. Patient-centered care

a. Safety Reason: Safety is to prevent and reduce risks, errors and harm that occur to patients during provision of health care

A patient informs the nurse, "I can't sit in the yard for even 10 minutes without my skin turning red and tender." The nurse would assess for the use of which complementary alternative medicine (CAM)? a. St. John's wort b. Ginkgo bilboa c. Feverfew d. Echinacea

a. St. John's wort Reason: St John's wort adverse effects are stomach upset, hives or other skin rashes, fatigue, restlessness, headache, dry mouth, and feelings of dizziness or mental confusion

A patient diagnosed with kyphosis is visiting a practitioner of chiropractic medicine for the first time and asks, " How does this therapy work?" The practitioner replies, " I will use my hands along with heat to correct the misalignment of your spine by placing pressure on the nerves that have produced pain." What term will the practitioner use to refer to the misalignment of the spine? a. Subluxation b. A sprain c. A fracture d. Epicondylitis

a. Subluxation Reason: Subluxation is a partial or incomplete dislocation

A client arrives in active labor and exhibits toxemia with irregular fetal heart tones. The client is an immigrant and is uninsured. Which act would prevent the client from being transferred to another facility? a. The Emergency Medical Treatment and Active Labor Law b. Health Insurance Portability and Accountability Act c. Patient Self-Determination Act d. The Patient Safety and Quality Improvement Act

a. The Emergency Medical Treatment and Active Labor Law Reason: The Emergency Medical Treatment and Active Labor Law is to provide all patients with a medical screening examination (MSE). Stabilize any patients with an emergency medical condition. Transfer or accept appropriate patients as needed

A patient who is interested in herbal medicine attends a seminar to learn more about complementary alternative medicine (CAM). The nurse discusses what common belief related to all CAMs? (Select all that apply.) a. The body is not able to repair itself; thus, natural remedies are used to inhibit the immune system b. Many different CAMs that focus on specific body parts and the mind are needed c. The focus of CAM is on an intervention for the diseased body part d. The focus of CAM treatment is unique to the person who is being treated e. Health promotion is incorporated into CAM

a. The body is not able to repair itself; thus, natural remedies are used to inhibit the immune system d. The focus of CAM treatment is unique to the person who is being treated e. Health promotion is incorporated into CAM

A nurse testifies at trail that a professional with the knowledge and skill of an RN should understand that, before administering digoxin, the client's potassium level and pulse level is always checked to prevent negative effects on cardiac output. The nurse's testimony as to what constitutes reasonable care is based on what criteria source? a. The legal definition of standard of care b. The legal definition of the informed consent process c. The doctrine of res ipsa loquitur d. The concept of governmental immunity

a. The legal definition of standard of care Reason: Standard of care is defined as what a reasonable and prudent nurse would do when caring for the same or similar patient in the same or similar circumstances, assuming similar education, training, and experience for the same situation

A patient informs the nurse, "I burn a lavender-scented candle for an hour before bedtime to help me relax and sleep." The nurse realizes this patient is using what complementary alternative medicine (CAM)? a. The mind-body intervention of aromatherapy b. An energy technique known as qi gong c. The manipulative method using the alexander technique d. Conventional medicine, also called allopathic

a. The mind-body intervention of aromatherapy

A patient with complicated diabetes is scheduled for a below the knee amputation at 7AM. The surgical team adheres to the 2018 National Patient Safety Goals by implementing which protocols? (Select all that apply.) a. The surgical team asks the patient to verify his or her name, type of surgery, and limb to be removed b. Ask each member of the surgical team to provide a copy of licensure and, if applicable, certification to patient and family c. The surgical team uses the chart number and name/hospital number to ensure they have the correct patient d. Mark the procedure site with "X" and again ask the patient to verify correct site e. After arrival in the operating room, perform a "time-out" for final identification of patient and operative site along with agreement of what procedure is scheduled

a. The surgical team asks the patient to verify his or her name, type of surgery, and limb to be removed c. The surgical team uses the chart number and name/hospital number to ensure they have the correct patient d. Mark the procedure site with "X" and again ask the patient to verify correct site e. After arrival in the operating room, perform a "time-out" for final identification of patient and operative site along with agreement of what procedure is scheduled

The surgical team arrives in the operating room and one-member states, "Everyone stop. Let's identify the patient and the operative site. Now does anyone have any questions or concerns?" This process is referred to by what term? a. Time-out b. A critical pathway c. Special cause variation d. Lean methodology

a. Time-out Reason: A Time-out is when the entire operating room team reviews the patient's identity, the procedure, and the surgical site before surgical incision or the start of the procedure

A patient who is pregnant has used the herb feverfew for a history of migraine headaches. The nurse should provide teaching related to a risk for what side effect? a. Uterine contractions resulting in possible miscarriage b. Reduced fetal growth c. Insomnia d. Tiredness the following day

a. Uterine contractions resulting in possible miscarriage

Regardless of the term used to describe high-quality health care, the primary focus of quality is: a. What the consumer needs and wants. b. Economical care. c. Having the greatest technologic advancement. d. Services equally distributed among populations.

a. What the consumer needs and wants

A nurse is given a referral to make a home visit to a Russian immigrant. The nurse knows very little about the health beliefs of this ethnic group. To research this group, she can use an Internet search engine and enter the term "Russian cultures" or "Russian health beliefs." To obtain more generalized information, she could also search under: a. Federally recognized minorities. b. Marginalized populations. c. Asian/Pacific Islander cultures. d. Latino cultures.

b. Marginalized populations Reason: Marginalized populations are groups and communities which are discriminated against and excluded from mainstream social, economic, cultural, or political life based on a cultural identity or difference

A nurse learns in orientation that an incident report does not "blame" anyone but concisely documents the events leading up to an occurrence. Which events would warrant completion of an incident report? (Select all that apply.) a. The client is crying and distraught when learning of a diagnosis of cancer b. An intravenous antibiotic given preoperatively does not infuse because of a faulty pump c. The nurse is unable to carry out orders written by the specialist because of illegibility d. A client falls while in the shower, after being instructed not to get up alone e. The registered nurse is not available to complete the preoperative checklist

b. An intravenous antibiotic given preoperatively does not infuse because of a faulty pump c. The nurse is unable to carry out orders written by the specialist because of illegibility d. A client falls while in the shower, after being instructed not to get up alone e. The registered nurse is not available to complete the preoperative checklist

A family requests that no additional heroic measures be instituted for their terminally ill mother who has advance directives in place. The nurse respects this decision in keeping with the principle of what client right? a. Accountability b. Autonomy c. Nonmalefiecence d. Veracity

b. Autonomy Reason: Autonomy is the right of competent adults to make informed decisions about their own medical care.

A nurse walks up to a computer in the hallway and presses the index finger to the sensor, thereby gaining access to patient data. A few moments later another nurse performs the same steps and is granted access. A visitor who is watching from a room walks over and places the index finger on the sensor, only to receive an "error and access denied" message. This security feature is a result of what form of technology? a. Robotics b. Biometric c. Telehealth d. Ubiquitous computing

b. Biometric Reason: Biometric is technology that captures a person's physical or behavioral attributes to authenticate his identity

Why is the various forms of complementary alternative medicine (CAM) gaining popularity in Western society? (Select all that apply.) a. Consumers want knowledgeable, trained physicians to control their care. b. CAM consumers want personalized health care. c. Quantity, rather than quality, of life is most important in Western society. d. Consumers have access to evidence that support CAMs. e. Consumers want to remain indifferent to the health care provider.

b. CAM consumers want personalized health care. d. Consumers have access to evidence that support CAMs.

Which types of abuse are the nurse required to report or be subject to fines and imprisonment for not reporting? (Select all that apply.) a. Animal b. Child c. Alcohol d. Infant e. Emotional

b. Child d. Infant

The Health Care Reform Act provides insurance for all U.S. citizens and legal residents presenting far-reaching ethical considerations related to diverse individual patient health care beliefs for those delivering nursing care. Nurses must consider their civil rights of conscience and how new health care agendas such as the Patient Protection and Affordable Care Act (PPACA) could affect their practice in situations that may conflict with their own belief system. What action demonstrates a nurse's attempt to act in accordance with this responsibility? a. Remembering it is one's professional duty to render patient-centered care--even when it is direct conflict with the nurse's own beliefs-- or be held liable for withholding treatment b. Considering whether the right to act according to one's inner beliefs will continue to be permissible when federal health insurance becomes fully enacted c. Discussing with the patient and family different options in hopes they will accept the nurse's health care beliefs d. Suggesting to the hospital administration that they not accept federal funding to prevent controversial health practices

b. Considering whether the right to act according to one's inner beliefs will continue to be permissible when federal health insurance becomes fully enacted Reason: Patient Protection and Affordable Care Act is The law provides numerous rights and protections that make health coverage more fair and easy to understand, along with subsidies (through "premium tax credits" and "cost-sharing reductions") to make it more affordable. The law also expands the Medicaid program to cover more people with low incomes

Each month data on admission assessments that are based on the following standard are entered: "All patients will be assessed by an RN within 2 hours of admission." The target goal for this standard is 97% compliance. Data are displayed on a graph that shows number and time of admission assessments and compliance variation limits. This pictorial representation is: a. Pareto chart. b. Control chart. c. Deployment chart. d. Top-down flowchart.

b. Control chart Reason: Control chart is to help to monitor, control, and improve process performance over time by studying variation and its source

Patient's with heart failure have extended lengths of stay and are often readmitted shortly after they have been discharged. To improve quality of care, a type of "road map" that included all elements of care for this disease and that standardized treatment by guiding daily care was implemented. This road map is referred to using what term? a. Clinical protocol b. Critical pathway c. Algorithm d. Case management

b. Critical pathway Reason: Critical pathway is a clinical management tool that helps medical care providers coordinate the delivery of patient care for a particular case type or condition. As a guide to usual treatment patterns, a CP gives a view of the "big picture." The CP usually recommends a total treatment regimen

A priority action for the nurse who works with culturally diverse clients to complete initially is completion of additional form of support? a. A sign language course b. Cultural self-assessment c. Cultural client assessment d. A conversational Spanish course

b. Cultural self-assessment Reason: Cultural self-assessment is its purpose is to help you consider your own skills, knowledge, and awareness in your interactions with others, and recognize what you can do to become more effective working and living in diverse environments

Two individuals with no health insurance or money sustained life-threatening injuries during an automobile accident. The decision was made to provide extended care in the trauma center after emergency surgery was performed to save their lives. The care of the two critical clients was based on what ethical principle? a. Utilitarianism b. Deontology c. Autonomy d. Veracity

b. Deontology Reason: Deontology is ethics of duty where the morality of an action depends on the nature of the action

When the client is unable to make medical decisions, authorization that allows another person to make these decisions is referred to by what term? a. A living will b. Durable power of attorney c. Informed consent d. Immunity

b. Durable power of attorney Reason: Durable power of attorney is when the client names somebody to make medical decisions any time you are incapable to do it on your own, even if you are expected to make a full recuperation.

A nurse is caring for a recent Asian immigrant client and is over-heard making the following comment, "These rituals you believe in are false. You live in America now and must believe in realistic health practices, like Americans do." The nurse is exhibiting behavior associated with what belief? a. Stereotyping b. Ethnocentrism c. Cultural accommodation d. Empathy

b. Ethnocentrism Reason: Ethnocentrism is evaluation of other cultures according to preconceptions originating in the standards and custom's of one's own culture.

Which complementary alternative medicine (CAM) may interfere with early detection of the dementia? a. Large doses of calcium can cause cerebral plaques to form, thereby disguising atrophy of the brain b. Excess doses of folic acid can mask a vitamin B12 deficiency that led to dementia c. Hypnotherapy focused on current pleasant thoughts can eliminate clue to the past d. The electrical current from magnetic fields can interfere with normal brain waves, resulting in confusion and inability to concentrate

b. Excess doses of folic acid can mask a vitamin B12 deficiency that led to dementia

Which statement is true regarding health care for minorities? a. Federal legislation that provides free health insurance for minorities has resulted in fewer minorities than members of the general population who lack health insurance. b. Higher costs of health care coupled with lower wages for minorities have prevented most minorities from seeking health care. c. Because many Mexican Americans are highly skilled workers with comparable wages, they have the lowest uninsured rate. d. Asians, because of their quiet demeanor and unwillingness to challenge the health care system, have the highest rate of uninsured people.

b. Higher costs of health care coupled with wages for minorities have prevented most minorities from seeking health care.

Nurses working on an orthopedic unit use personal digital assistants (PDAs) to review medications prior to administration to reduce potential drug interactions. Software is also installed that provides video clips of common procedures performed by nurses. Nurses on this unit are best demonstrating which QSEN competencies? a. Patient-centered care b. Informatics c. Teamwork d. Quality improvement

b. Informatics

What nonprofit organization distributes knowledge related to health care for the purpose of improving health to governmental agencies, the public, business, and health care professionals? a. Institute for Safe Medication Practices b. Institute of Medicine (IOM) c. National Committee for Quality Assurance d. The Joint Commission. (TJC)

b. Institute of Medicine (IOM)

A patient observes the practitioner burning a dried herb on the needle during an acupuncture session and asks about this practice. The practitioner responds by referring to this practice using what term? a. Doshas b. Moxibustion c. Yoga d. Kapha

b. Moxibustion Reason: Moxibustion is a treatment within traditional Chinese medicine. A practitioner burns the herb "moxa" on or above the skin to warm and stimulate specific points on the body

A nurse is interested in locating reliable information concerning noninvasive blood glucose monitoring. Information is located, and the author is a scientist who conducted studies within the last year on the effectiveness of a noninvasive blood glucose monitor. The scientist received funding from a pharmaceutical company site .com. The nurse is concerned about what component associated this information? a. Authority b. Objectivity c. Accuracy d. Currency

b. Objectivity Reason: Objectivity is factually verifiable, it's more reliable and consistent in health care situations.

A hospital is concerned that the number of medication errors has increased significantly in the past year. A project revealed four causes of medication errors. The above chart was used to help staff and administration know where to focus efforts to reduce errors. Which process improvement tool is used in this situation? a. Run chart b. Pareto chart c. Flowcharts d. Cause-and-effect diagram

b. Pareto chart Reason: The Pareto chart helps a team focus on problems that offer the greatest potential for improvement, by showing different problems' relative frequency or size in a descending bar graph, which highlights the problems' cumulative impact

A nurse educator is explaining to the licensed staff that health care is no longer safe and describes The Quality and Safety for Nursing (QSEN) recommended competencies for educating nursing professionals. What competency is included? (Select all that apply.) a. Advanced health assessment techniques b. Patient-centered care c. Prescriptive pharmacology content d. Quality improvement e. Safety

b. Patient-centered care d. Quality improvement e. Safety

A nurse is caring for a patient who is to receive an antibiotic drug that causes severe skin damage when infiltrated. The order reads, "infuse over 1 hour by port-a-cath." When the nurse accesses the Personal Digital Assistant that lists the steps to access a port-a-cath, what type pf computer software is being used? a. Electronic health record b. Point-of-care technology c. Data management d. Telehealth

b. Point-of-care technology Reason: Point-of-care technology is also known as point of care testing, is exactly what it sounds like: tests that are performed right where the patient is

What examples should the nurse provide to best describe an advance directive? (Select all that apply.) a. Preserving cord blood for possible future needs of a child b. Providing instructions about personal preferences regarding life-sustaining medical procedures c. Giving someone the legal right to act on one's behalf when one becomes incapacitated d. Completing hospital admission paperwork before being admitted to the hospital

b. Providing instructions about personal preferences regarding life-sustaining medical procedures c. Giving someone the legal right to act on one's behalf when one becomes incapacitated

Although a hospital reversed all charges when a client was the victim of wrong site surgery, the court awarded the client $1.5 million. The client could return to work in 6 weeks and had no permanent damages. This monetary compensation is referred to by what term? a. Liability b. Punitive damages c. Vicarious liability d. Immunity

b. Punitive damages Reason: Punitive damages is damages over and above general compensatory damages. The purpose is to punish or deter wrongful reckless conduct. Punitive damages can be exceedingly difficult to claim and prove in a medical malpractice case

A nurse is assisting with the delivery of twins. The first infant is placed on the scale to be weighed . The physician requests an instrument stat. The nurse turns to hand the instrument to the physician, and the infant falls off the scale. When evaluating the incident, the nurse and her manager list contributory factors such as the need for two nurses when multiple births are known, and the location of the scale so far from the delivery field. These nurses are engaged in what process? a. Standardization of care b. Root cause analysis c. Process variation d. Analysis of a deployment flowchart

b. Root cause analysis Reason: Root cause analysis is a process for identifying the causal factors underlying variations in performance

A nurse is removing a saturated dressing from an abdominal incision and must cut the tape to remove the dressing. The nurse accidentally cuts the sutures holding the incision, and evisceration occurs. In quality improvement, this incident is best identified using what term? a. Root cause b. Sentinel event c. Variation in performance d. Casual factor

b. Sentinel event Reason: Sentinel event is a patient safety event that results in death, permanent harm, severe temporary harm or intervention required to sustain life

An Asian teenager is admitted with an eating disorder which she contributes to not meeting the academic expectations of her parents. The nurse is overheard saying, "That isn't the reason; all Asians are really smart." This nurse is demonstrating which cultural biases? a. Cultural humility b. Stereotyping c. Cultural assimilation d. Acculturation

b. Stereotyping Reason: Stereotyping is making a judgment about an individual that is influenced by a mental state associating members of a group, to which that individual is perceived as belonging, more strongly than members of other groups with particular traits

In which case does the nurse act as "whistle-blower"? a. One staff member on the unit covers for another nurse, who leaves the premises to purchase illegal substances b. The nurse reports that another is taking medications out of stock medicine for herself or himself c. A nurse informs respiratory therapy that a patient is now due a treatment d. The nurse delegating care to unlicensed assistive personnel makes rounds to ensure all care was rendered properly

b. The nurse reports that another is taking medications out of stock medicine for herself or himself Reason: Whistle-blowing is when a worker, including a student nurse or student midwife, raises a concern about wrongdoing in the public interest.

A nurse is preparing to administer a medication by using the vastus lateralis site and is unfamiliar with the process. A step-by-step reference that shows how to complete the process is referred to by what term? a. Deployment flowchart b. Top-down flowchart c. Pareto chart d. Control chart

b. Top-down flowchart Reason: Top-down chart gives you a visual depiction of the steps in a workflow or process by breaking down the requirements in sequential order, including substeps for each.

A 13-year-old female is brought to the family planning clinic by her enraged father, who has just learned that she is pregnant. The pregnant client states, "I want to have this baby and give it up for adoption." However, the father is adamant that she will disgrace the family and demands that the health care providers tell his daughter that she has a physical condition that would prohibit her from carrying this baby to a viable stage. The nurse realizes that this is a conflict that involves what ethical principle? a. Deontology b. Veracity c. Autonomy d. Beneficence

b. Veracity Reason: Veracity is requires that healthcare providers be honest in their interactions with patients

An older adult client is comatose and had one electroencephalogram that indicated no activity. The daughter is very distraught and notices her mother's hand moves when she is talking to her. The daughter asks the nurse, "Is mother responding to my voice?" The nurse, attempting to console the daughter, knows the movement was involuntary but states, "It does appear she did." The nurse is violating which principle of ethics? a. Autonomy b. Veracity c. Utilitarianism d. Deontology

b. Veracity Reason: Veracity, or truth telling, requires that healthcare providers be honest in their interactions with patients.

Which of the following occurrences would be classified as a sentinel event? a. A postpartum patient who elects to breastfeed only twice daily develops mastitis b. A newly diagnosed diabetic patient self-injects insulin in the abdominal area rather than the upper thigh as instructed by the patient educator c. A nurse assisting with the delivery of twins places the "Twin 1" name tag on the second-born twin, causing the first-born twin to undergo surgery that was scheduled for the other twin d. A nurse administers 3 units of regular insulin rather than 3 units of NPH insulin subcutaneously, resulting in a drop in the patients serum glucose from 160 to 100mg

c. A nurse assisting with the delivery of twins places the "Twin 1" name tag on the second-born twin, causing the first-born twin to undergo surgery that was scheduled for the other twin Reason: A sentinel event is a patient safety event that results in death, permanent harm, severe temporary harm or intervention required to sustain life

A client is in extreme pain after he was involved in a motor vehicle accident, and morphine has been ordered every hour for pain. The nurse injects saline into the client's IV line and takes the morphine for herself. The nurse is violating which principle of ethics? a. Autonomy b. Utilitarianism c. Beneficence d. Dilemmas

c. Beneficence Reason: Beneficence is an act of charity, mercy, and kindness with a strong connotation of doing good to others including moral obligation

Six cultural phenomena that vary among cultural groups are known to affect health care. The influence of the consequences of these phenomena can be seen in which of the following? (Select all that apply.) a. Asians and American Indians tend to be nonadherent with medications because they believe that the environment has no control over their fate. b. Some cancers such as stomach cancer occur less frequently among blacks. c. Blacks and American Indians often resist direct eye contact. d. Mexican Americans are more likely to stand close and touch health care providers. e. Whites are often late for health care appointments.

c. Blacks and American Indians often resist direct eye contact d. Mexican Americans are ore likely to stand close and touch health care providers

A nurse interested in quality improvement tools performed a search for cause and effect diagrams using www.ishikawa.com. A page opened that provided images and templates for performing fishbone diagrams. Which type of search did the nurse conduct? a. Quick and dirty b. Advanced c. Brute force d. Link searching

c. Brute force Reason: Brute force searching is a uniformed exploration of the search space and it does not explicitly take into account either planning efficiency or execution efficiency

Institute for Healthcare Improvement (IHI) proposed a process for quality improvement with steps known as "PDCA." What statement should be made when explaining the steps to a group of nurses interested in improving the process of medication reconciliation for heart failure patients with high rates of recidivism? a. P stands for process. Following a top-down flowchart provides the steps for reviewing patient medications taken at home compared to those prescribed during hospitalization b. D stands for deviation, which is an alternative in the expected drugs ordered c. C stands for check if the process for change worked. Was there an improvement in accurate reconciliation? And what was learned? d. A stands for algorithm, which includes all steps of the process

c. C stands for check if the process for change worked. Was there an improvement in accurate reconciliation? And what was learned?

How is the term Ethics as applied to nursing best defined? a. Doing what is best for the client b. Making good decisions about care c. Care based on keeping with the values of the client d. Rules for providing competent care that is based on scientific principles

c. Care based on keeping with the values of the client Reason: Ethics in nursing promotes the consideration of values in the prioritization and justification of actions by health professionals, researchers and policymakers that may impact the health and well-being of patients, families, and communities

A blood reaction occurrence is noted in a client who did not receive pretransfusion care as clearly documented in the facility's policies and procedures. The nurse providing care is liable for which legal tort? a. Comparative negligence b. Punitive damages c. Criminal negligence d. Involuntary tort

c. Criminal Negligence Reason: Criminal negligence is when a health care practitioner intentionally, knowingly, or recklessly commits an act that deviates from the standard of care and harms a patient in some way

A physician shares with the patient's family that, while a central line was being inserted, the patient's lungs were inadvertently punctured, which required oxygen administration. The physician also explains that a chest x-ray indicated the lung remained intact and no additional treatment was required. The physician's role in this instance is based on what legal principle? a. Comparative negligence b. Gross negligence c. Disclosure d. Emergency Medical Treatment and Active Labor Act (EMTALA)

c. Disclosure Reason: Disclosure is release, transfer, provisions of, access to, or divulgence in any manner of information outside the entity holding the information

When can a nurse detain a client by implementing restraints? a. Staffing resources are insufficient to monitor a patient b. The client is demonstrating behaviors associated with confusion c. The family requests the restraints to prevent the client from leaving the facility d. There are current prescribed instructions for their use

c. The family requests the restraints to prevent the client from leaving the facility Reason: Just because the restraints are prescribed, does not mean they are currently needed

A primary health provider prescribes a drug for a patient with a known allergy, it is administered and results in anaphylactic shock. What statement is accurate regarding disclosure of this event? a. Disclosure of the error will result in more severe ramifications for the agency than if the negligence is discovered by the patient or family b. Disclosure of the occurrence should occur before notification of the prescribing health provider c. Disclosure as an essential component of the national patient safety movement d. Disclosure to the patients insurance company is focused on decreasing costs

c. Disclosure as an essential component of the national patient safety movement Reason: National patient safety movement is to improve patient safety. The goals focus on problems in health care safety and how to solve them. Their goals are: Identify patients correctly. Prevent infection. Improve staff communication. Identify patient safety risks. Prevent mistakes in surgery. Use medicines safely. Use alarms safely

A nursing student planning to apply for licensure knows that being charged with which offense would result in a misdemeanor criminal offense? a. Solicitation of illegal drugs b. Stealing a car c. Failing to report elder abuse d. Billing Medicare for services not rendered

c. Failing to report elder abuse

A client states, " I am leaving. No one here knows what they are doing." The nurse completing the Against Medical Advice form must implement what intervention to best assure client safety? a. Notify the primary health care provider of the client's wish to leave b. Alert family that the client will be leaving the facility c. Inform the client that leaving could result in complications and impairment d. Require security staff to accompany the to the facility's main entrance

c. Inform the client that leaving could result in complications and impairment

During a search for the term informatics, what should the nurse determine about the site's affiliation when the domain " .edu, " is noted? a. It's a government agency b. It's a commercial site c. It's an educational institution d. It's an internet service provider

c. It's an educational institution

A nurse who is infected with human immunodeficiency virus (HIV) while working in the operating room seeks revenge by deliberating placing clients at risk by not adhering to universal precautions. This nurse is violating what ethical principle? a. Veracity b. Beneficence c. Nonmaleficence d. Autonomy

c. Nonmaleficence Reason: Nonmaleficence is do no harm intentionally

The number of IV site infections has more than doubled on a nursing unit. The staff determine common causes include the site is cleaned using inconsistent methods, dressing frequently becomes wet when patient showers, IV tubing is not changed every 48 hours per protocol, and inadequate hand washing of RN prior to insertion. A bar graph demonstrates the frequency in descending order, with 80% of infections being attributed to inadequate hand washing. The quality tool used is referred to as what? a. Cause-and-effect diagram b. Run chart c. Pareto chart d. Flowchart

c. Pareto chart Reason: Pareto chart helps a team focus on problems that offer the greatest potential for improvement, by showing different problems' relative frequency or size in a descending bar graph, which highlights the problems' cumulative impact

A nurse providing care at the bedside receives an "alert" that a patient's stat potassium level is 2.5 and a dose of digoxin is scheduled. The nurse holds the medication and prevents a possible complication. This feature of the Electronic Health Record is available through which core function of EHR? a. Order entry/order management b. Decision support c. Patient support d. Administrative support

c. Patient support Reason: Patient support is used to manage patient information, monitor, and measure patient progress, and support the delivery of care

A patient is ordered a low-protein, low-calorie diet but the patient's family brings fish, lentils, and unleavened bread for a meal to observe a cultural practice. The nurse works with the dietitian to adjust the next few meals to accommodate for this variance. What term should be used to identify this situation? a. A sentinel event b. An adverse event c. Patient-centered care d. The communication technique of "call-out"

c. Patient-centered care

What statement accurately describes findings when paper-and-pencil medical records are compared with computer-based records? a. Paper-and-pencil records provide controls to determine who has viewed the health information b. Information contained in a paper-and-pencil record has the capability of being more in-depth than that found in computer-based records c. Patients have the right to know that the confidentiality records is strictly maintained, regardless of the type of medical record used d. Patients must sign for each item of information released computer record

c. Patients have the right to know that the confidentiality records is strictly maintained, regardless of the type of medical record used

A patient is prescribed reserpine to decrease mild anxiety and treat hypertension. The patient researches the medication on the internet and finds that this medication comes from which plant? a. Atropa belladonna b. Digitalis purpurea c. Rauwolfia serpentina d. Cephaelis ipecacuanha

c. Rauwolfia serpentina

A primary health care provider has installed a computer-based patient records system. An outside care provider who requests medical information must obtain the patient's signed consent and then is assigned a password to gain access to the medical information. A monthly audit is conducted to determine for whom and for what purpose patient records have been accessed. What terms is used to refer to this type of protection? a. Privacy b. Confidentiality c. Security d. Data capture

c. Security Reason: Security is "access to information" and "practical use of the security system."

Nurses, physicians, and social workers finalize the plan of care and coordinate discharge for a homeless person who will need wound care and follow up over the next 4 weeks. Each member contributes based on his or her area of expertise but also recognize other members' strengths. Which of the QSEN competencies are being demonstrated? a. Quality improvement b. Evidence-based practice c. Teamwork and collaboration d. Patient-centered care

c. Teamwork and collaboration

Despite the presence of safety aids such as handrails in the bathrooms at an assisted living facility, the number of fractures due to unsteady ambulation upon arising from the bed and when attempting to perform activities of daily living has increased. Which complementary alternative medicine (CAM) would be an effective intervention for this population? a. Yoga b. Acupuncture c. Tai chi d. Magnet therapy

c. Thai chi Reason: Thai chi is a practice that involves a series of slow gentle movements and physical postures, a meditative state of mind, and controlled breathing

A patient has fallen at home and complains that joints are very painful when trying to climb stairs. The patient desires to use an alternative complementary medicine rather than pain medication. The practitioner begins treatment with touch consisting of rocking, rhythmical motions to loosen tense, sore muscles and joints. The patient is receiving which type of treatment? a. Swedish massage b. Rolfing c. Trager approach d. Reflexology

c. Trager approach Reason: The Trager approach is a psychologically grounded physical approach to muscle relaxation, which is induced when a practitioner and patient achieve a state of mind called hook-up. Hook-up is described as a connection to a state of grace or powerful and nourishing life force

All hospitals receiving Medicare and Medicaid funds must ask clients whether they have a living will or a durable power of attorney. What legislative act makes this action mandatory? a. Emergency Treatment and Active Labor Law. b. Americans with Disabilities Act. c. Uniform Health Care Decisions Act. d. Patient Self-Determination Act

c. Uniform Health Care Decisions Act Reason: Uniform Health Care Decisions Act is two qualified healthcare professionals must make an assessment that an adult or emancipated minor lacks capacity to make their own healthcare decisions

In attempting to decide which services should be offered to a community, the public health nurse decides to implement hypertension screening and treatment because most of the residents are hypertensive. This decision is based on what principle? a. Veracity. b. Values. c. Utilitarianism. d. Autonomy.

c. Utilitarianism Reason: Utilitarianism is decisions that are chosen based on the greatest amount of benefit obtained for the greatest number of individuals

A client and her husband used in-vitro fertilization to become pregnant. The unused sperm was frozen so the couple could have more children later. The husband is killed while in combat, and the client journals her choices and the possible ramifications. She comes to the fertility clinic after looking at the situation from many perspectives and after considering many alternatives. She asks that the sperm be destroyed because her husband's faith prohibited remarrying, and allowing another person to use the sperm would conflict with her late husband's beliefs. When considering this scenario, the nurse realizes what? a. The client is in the second step of ethical decision making and that the client's value system is influencing her choices of alternative actions b. A logical line of reasoning has led to validation of the decision to destroy the husband's sperm c. The client has not been able to navigate the complicated issues inherent in this situation d. A rational decision was reached that was based on reflection and on the value systems of the wife and the husband

d. A rational decision was reached that was based on reflection and on the value system of the wife and the husband

The nurse who presents a class on different methods of complementary alternative medicine (CAM) differentiates between imagery and hypnosis in which of the following ways? a. Imagery involves the dependent mental construction of a picture, whereas hypnosis requires the patient to recall and verbally describe difficult times in his or her life b. Hypnosis requires a trained psychologist, but imagery can be performed by any health care practitioner c. Imagery produces a temporary sense of well-being compared with hypnosis, which evokes a permanent positive effect d. Although both therapies focus on specific problems and guide the patient into relaxation, imagery requires the patient to formulate the impression, whereas the hypnotist constructs the image for the patient

d. Although both therapies focus on specific problems and guide the patient into relaxation, imagery requires the patient to formulate the impression, whereas the hypnotist constructs the image for the patient

The use of plants in conventional modern medicine is evidenced by the drug atropine, which is derived from which plant? a. Digitalis purpurea b. Cephaelis ipecacuanha c. Rauwolfia serpentina d. Atropa belladonna

d. Atropa belladonna

An older adult diagnosed with atrial fibrillation uses imagery to alter the dysrhythmia. The client is using which type of complementary alternative medicine (CAM)? a. Ayurveda b. Dosha c. Homeopathy d. Biofeedback

d. Biofeedback Reason: Biofeedback is a type of mind-body technique you use to control some of your body's functions, such as your heart rate, breathing patterns and muscle responses

A nurse is submitting a grant application to improve access to health care and mortality for minority groups. the grant focuses on the six causes of death that are identified as priorities for minorities, which include what medical diagnosis? a. Chronic obstructive pulmonary disease (COPD) b. Malnutrition c. Cirrhosis of the liver d. Breast Cancer

d. Breast Cancer Reason: Six causes of death for minorities are Heart disease, Cancer, Alzheimer's disease, Stroke, Homicide and Diabetes.

The staff on a nursing unit notes that patient satisfaction varies from month to month. They plot the degree of patient satisfaction each month for 1 year to determine when the periods of greatest dissatisfaction are occurring. The staff uses which type of graph to present this information? a. Time plot b. Fish bone diagram c. Flowchart d. Cause-and-effect diagram

d. Cause-and-effect diagram Reason: Cause-and-effect diagram is used to provide a pictorial display of a list in which you identify and organize possible causes of problems, or factors needed to ensure success of some effort

A nurse plans to move to an area that is rich in immigrants from several countries and is concerned about respecting others' cultural beliefs. What is the nurse's first step to ensure cultural competence and sensitivity? a. Enrolling in a nursing theories course to increase knowledge about transcultural practices b. Becoming immersed in nursing literature about culturally diverse clients c. Participating in continuing education that focuses on health assessment variations among cultural groups d. Conducting a cultural self-assessment to identify biases or prejudices

d. Conducting a cultural self-assessment to identify biases or prejudices Reason: Cultural self-assessment is to help you consider your own skills, knowledge, and awareness in your interactions with others, and recognize what you can do to become more effective working and living in diverse environments

A nurse who functions in the role of team leader can be held negligent for matters involving what focus? a. Adequate training b. Policies and procedures c. Staff discipline d. Delegation

d. Delegation Reason: Delegation is assignment of the performance of activities or tasks related to patient care to unlicensed assistive personnel while retaining accountability for the outcome

An organization's emergency preparedness task force meets to discuss how it should react in case of a terrorist attack and develops a disaster evacuation plan that details how each department will assist individuals in reaching safety. This type of diagram is referred to using what term? a. Pareto chart b. Control chart c. Top-down flowchart d. Deployment chart

d. Deployment chart Reason: Deployment chart is flowcharts which organize the flowchart by columns, with each column representing a person or department involved in a process

During the night, a patient fell in the bathroom and sustained a hip injury. The patient was very upset because of being unable to attend a granddaughter's wedding in 2 days. The team looked at the process and determined that the patient had been medicated with a narcotic, had urinary urgency so had not taken the time to put on shoes, failed to turn on the light because the door to the hall let in some light, and stumbled over a towel that had been placed to collect water leaks caused by construction that was in progress to replace damaged sinks. Which factor was a special cause variation? a. Failure to take time to put on shoes due to urgency b. Unsteady gait due to narcotic administration c. Poor lighting that led to decreased vision d. Improper construction that caused the leak and towel placement

d. Improper construction that caused the leak and towel placement

A nurse is preparing a scholarly publication on the worldwide prevalence of hepatitis A. The most efficient and effective means of conducting an internet search to gather information for this publication is to use what resource? a. A search engine such as Google or Yahoo b. A consumer health website c. A decision support system d. MEDLINE database

d. MEDLINE database

A group of nurses are presenting the importance of high-quality care during a system-wide meeting of medical-surgical nurses. They point out a finding of the Quality Chasm that supports what? a. Being insured has little effect on a person's longevity and the quality of care received b. Lobbyists for the drug companies can gain permission for the use of new drugs within 1 year of their discovery c. Although a greater number of lawsuits stem from medication errors, more people actually die from human immunodeficiency virus (HIV) and acquired immunodeficiency disease syndrome (AIDS) d. Medication-related errors place a tremendous financial burden on the U.S. health care system

d. Medication-related errors place a tremendous financial burden on the U.S. health care system Reason: The Quality Chasm is identifies and recommends improvements in six dimensions of health care in the U.S.: patient safety, care effectiveness, patient-centeredness, timeliness, care efficiency, and equity

A nurse is caring for a client who just suffered a stroke and is medicated for pain. The nurse completes the following interventions: places the client on the examining table, completes a thorough history and physical, covers the client with a sheet, places the call button within reach, and goes out in the hall to speak with the client's primary care provider. The client tries to get up to speak with his family and falls, sustaining a hematoma on the head and a broken hip. The nurse's actions reflect which legal claim? a. Invasion of privacy b. Libel c. Slander d. Negligence

d. Negligence Reason: Negligence is when a medical or healthcare professional deviates from the care standards of their profession and causes injury to a patient

The primary health care provider who insists on providing treatment in spite of the client's wishes because "I know best" is reflecting an attitude referred to as what? a. Autonomy b. Beneficence c. Justice d. Paternalism

d. Paternalism Reason: Paternalism is when a physician or other healthcare professional makes decisions for a patient without the explicit consent of the patient

According to the Quality Chasm report what statement is true? a. Health care providers should be proactive rather than reactive to patient needs b. Common needs rather than individual preferences should be the priority c. Medical information should be confined to the primary care provider d. Specialized providers or case managers should control health care decisions

d. Specialized providers or case managers should control health care decisions

Which of the following statements concerning the Institute of Medicine (IOM) competencies is correct? a. Each competency is mutually exclusive b. The competencies focus on individual efforts to reduce errors c. Physicians lead the team to achieve each competency d. The competencies address both individual and system approaches to transform care

d. The competencies address both individual and system approaches to transform care Reason: IOM competencies are: Provide patient-centered care. Work in interdisciplinary teams. Employ evidence-based practice. Apply quality improvement. Utilize informatics

A nurse who is teaching a class to introduce telehealth to the staff would include which example? a. A robot performs menial housekeeping chores for an invalid patient b. A computer software program alerts the nurse or physician who is reviewing orders that an order for a new drug can cause synergy of the theophylline inhaler c. A physician speaks into a computer, and the admission history is recorded and saved in the patient file d. While a patient in Wyoming performs peritoneal dialysis, a nurse watches remotely from California to ensure that all steps are being followed correctly

d. While a patient in Wyoming performs peritoneal dialysis, a nurse watches remotely from California to ensure that all steps are being followed correctly Reason: Telehealth is the provision and management of healthcare services for individuals in their homes, or care support facilitated remotely by healthcare professionals via digital media