NRSG
Prednisone is prescribed for a client with an exacerbation of colitis. What does the nurse teach the client before administering the first dose? 1` The client will be protected from getting an infection. 2 Symptoms associated with the colitis will decrease slowly over time. 3 Although the medication causes anorexia, weight loss may not occur. 4 Although the medication decreases intestinal inflammation, it will not cure the colitis.
Although the medication decreases intestinal inflammation, it will not cure the colitis. Prednisone inhibits phagocytosis and suppresses other clinical phenomena of inflammation; this is a symptomatic treatment that is not curative. The response usually is rapid. The drug suppresses the immune response and increases the potential for infection. Appetite is increased; weight gain may result from this or from fluid retention.
A nurse is recalling common terms that are used in health ethics. What does beneficence in health ethics refer to? 1 Beneficence refers to the agreement to keep promises. 2 Beneficence refers to taking positive actions to help others. 3 Beneficence refers to the ability to answer for one's actions. 4 Beneficence refers to avoiding harming or hurting an individual.
Beneficence refers to taking positive actions to help others. Beneficence refers to taking positive actions to help others. Fidelity refers to the agreement to keep promises. Accountability refers to the ability to answer for one's actions. Nonmaleficence refers to avoiding harming an individual.
Who functions as a liaison between team leaders and other healthcare providers?
Charge Nurse
A nurse helps a client to clarify health problems and choose appropriate courses of action. What competency in community-based practice is the nurse exercising? 1 Educator 2 Caregiver 3 Counselor 4 Epidemiologist
Counselor. When a nurse is helping a client to identify and clarify health problems and choose appropriate courses of action to solve those problems, the nurse is acting as a counselor. The nurse acts as an educator by establishing relationships with community service organizations. The nurse acts as an epidemiologist when he or she is involved in case finding, health teaching, and tracking incident rates of an illness. The nurse acts as a caregiver when he or she provides appropriate, individualized nursing care for specific clients and their families.
A female nurse has been caring for a depressed 75-year-old woman who reminds her of her grandmother. The nurse spends extra time with her every day and brings her home-baked cookies. The nurse's behavior reflects:1 Affiliation 2 Displacement 3 Compensation 4 Countertransference
Countertransference. countertransference the professional provider of care exhibits an emotional reaction to a client based on a previous relationship or on unconscious needs or conflicts. Affiliation is turning to others for support and help when stressed or conflicted. Displacement is the discharge of pent-up feelings onto something or someone else that is less threatening than the original source of the feelings. Compensation is attempting to balance deficiencies in one area by excelling in another area.
The nurse leader is teaching the staff that the health care provider continuously strives to work effectively within the cultural context of a client. Which cultural principle is the nurse leader explaining?
Cultural competenceCultural competence is the process in which the health care provider continuously strives to achieve the ability to effectively work within the cultural context of a client, individual, family, or community. Cultural diversity describes a vast range of cultural differences among individuals or groups. Cultural sensitivity describes the affective behaviors in individuals such as the capacity to feel, convey, and react to ideas, habits, and customs or traditions unique to a group of people. Cultural imposition is defined as the tendency of an individual or group to impose their values, beliefs, and practices on another culture for various reasons.
Which drawback indicates an improper follow-through on the part of a delegatee? 1 Failure to report results and findings 2 Failure to understand the skills and abilities 3 Failure to provide clear and concise directions 4 Failure to cooperate with the other team members
Failure to report results and findings. Improper follow-through on the part of a delegatee is failure to report results and findings. Improper follow-through occurs when the delegator does not understand the skills and abilities of the delegatee and does not provide clear and concise directions to the delegatee. The lack of cooperation with team members may be improved by educating, guiding, and monitoring the delegatee.
A client with internal bleeding is in the intensive care unit (ICU) for observation. At the change of shift an alarm sounds, indicating a decrease in blood pressure. What is the initial nursing action? 1 1 Perform an assessment of the client before resuming the change-of-shift report. 2 Continue the change-of-shift report and include the decrease in blood pressure. 3 Lower the diastolic pressure limits on the monitor during the change-of-shift report. 4 Turn off the alarm temporarily and alert the oncoming nurse to the decrease in blood pressure.
Perform an assessment of the client before resuming the change-of-shift report. cause of the alarm should be investigated and appropriate intervention instituted; after the client's needs are met, then other tasks can be performed. An alarm should never be ignored; the client's status takes priority over the change-of-shift report. The diastolic pressure limit has been prescribed by the primary healthcare provider and should not be changed for the convenience of the nurse. Alarms always should remain on; the alarm indicates that the client's blood pressure has decreased and immediate assessment is required.
To improve client care, the registered nurse (RN) has delegated tasks involved in assisting the client with activities of daily life (ADLs) to a certified nursing aide, and the administration of oral medications to the licensed practical nurse. Which member of the health care team would be accountable for the final client care? 1 Registered nurse 2 Chief nursing officer 3 Licensed practical nurse 4 Unlicensed nursing personnel
Registered Nurse The definition of delegation emphasizes final client care is always the responsibility and accountability of delegator. In this scenario, the delegator is the registered nurse. The chief nursing officer may be accountable for the client care if he or she is the delegator. The licensed practical nurse should perform the task delegated but is not ultimately responsible for final client care. Likewise, the unlicensed nursing personnel is a delegatee and is not ultimately accountable for final client care.
How does a nurse leader effectively implement change in an organization? 1 By avoiding using managerial skills 2 By using personal and professional skills 3 By avoiding giving timely feedback to team members 4 By removing the ineffective team members from the group
A nurse leader should use both personal and professional skills to ensure effective implementation of a change in an organization. A nurse leader should also use managerial skills, not avoid them, to ensure effective implementation of a change in an organization. A nurse leader should give regular and timely feedback to the team members to implement change effectively. A nurse leader should motivate the team members to work effectively rather than removing them from the team.
Which theory states that leaders should expand and respond to a dynamic change rather than prescribing and approaching change as a lock-step, pre-prescribed method? 1 Role theory 2 Chaos theory 3 Complexity theory 4 Organizational theory
Complexity theory states that the leaders should expand and respond to engaging dynamic change and focus on relationships rather than on prescribing and approaching change as a lock-step, pre-prescribed method. Role theory is a framework used to understand how individuals perform within organizations. Chaos is the theoretical construct defining the seemingly random yet deterministic characteristics of complex organizations. Organizational theory is the systematic analysis of how organizations and their component parts act and interact.
Which task can be delegated to a cross-trained technician when paired with a registered nurse? 1 Monitoring vital signs 2 Drawing blood samples 3 Teaching clients directly 4 Administering intravenous medication
Drawing the blood samples, or phlebotomy, can be delegated to cross-trained technicians when paired with the registered nurse. The cross-trained technician can only record the vital signs, monitoring the vital signs is outside the scope of practice for a cross trained technician. Intravenous medication can only be administered by the registered nurse. The cross trained technician is an assistive personnel who can reinforce the teaching but he or she cannot teach the client directly.
What are external barriers that can prevent a nursing professional from making morally correct actions? Select all that apply.
Inadequate staffing, lack of organizational support, poor relationships with colleagues
A nurse is caring for a client with a diagnosis of polycythemia vera. The client asks, "Why do I have an increased tendency to develop blood clots?" Which effect of the polycythemia vera should the nurse include in the teaching session? 1 Elevated blood pressure 2 Increased blood viscosity 3 Fragility of the blood cells 4 Immaturity of red blood cells
Increased blood viscosity. Polycythemia vera results in pathologically high concentrations of erythrocytes in the blood; increased viscosity promotes thrombus formation. Hypertension usually is related to narrowing or sclerosing of arteries, not to an increased number of blood cells. The fragility of blood cells does not affect the viscosity of the blood. Erythrocyte immaturity is not related to increased viscosity.
A nursing assistant is frequently late for work and often tells the nurse manager that although he leaves his apartment early, he is delayed by heavy traffic. What defense mechanism is being used by the nursing assistant? 1 Undoing 2 Repression 3 Rationalization 4 Overcompensation
Rationalization. Rationalization is the use of contrived, socially acceptable, and logical explanations to justify unacceptable behavior and thus keep it out of the consciousness. Undoing is an attempt to compensate for an action or communication that is considered unacceptable—for instance, by giving a gift after a disagreement. Repression is the unconscious and involuntary forgetting of painful ideas, events, or behaviors. Reaction formation, also known as overcompensation, is defined as a conscious behavior that is the opposite of an unconscious feeling.
A client with paralysis of the legs is found to have somatoform disorder, conversion type. What must the nurse consider when formulating a plan of care for this client?The illness is very real to the client and requires appropriate nursing care.Although the client believes that there is an illness, there is no cause for concern.There is no physiological basis for the illness; therefore only emotional care is needed.Nursing intervention is needed even though the nurse understands that the client is not ill.
The illness is very real to the client and requires appropriate nursing care.RationaleIndividuals who have somatoform disorders are really ill; they need care in a nonthreatening environment. The client requires physiological and emotional care for treatment of motor or sensory functional deficits.
A nursing student is evaluating statements regarding the five levels of proficiency set forth by Benner. Which statement indicates that a nurse is in the advanced beginner stage?1The nurse is learning about the profession through a specific set of rules and procedures.2The nurse is able to identify the basic principles of nursing care through careful observation.3The nurse is able to understand the organization and specific care required by certain clients.4The nurse is able to assess the entire situation and transfer knowledge gained from multiple previous experiences.
The nurse is able to identify the basic principles of nursing care through careful observation.According to the levels of proficiency set forth by Benner, a nurse in the advanced beginner stage is able to identify basic principles of nursing care through careful observation. A nurse in the novice stage learns about the profession through a specific set of rules and procedures. After reaching the competent stage, a nurse will be able to understand the organization and specific care required by certain clients. A nurse who has reached the proficient stage is able to assess an entire situation and transfer knowledge gained from multiple previous experiences.
What is the ultimate goal of delegation? 1 To deliver client care as a team 2 To maximize client care outcomes 3 To improve the working ability of the nurse 4 To maintain open lines of communication between delegator and the delegatee
To maximize client care outcomes. The ultimate goal of the delegation is to maximize client care outcomes. Delegation helps to deliver client care as a team and improves the working ability of the nurse but these are not the ultimate goals of delegation. Maintaining open lines of communication between delegator and the delegatee creates a productive work environment in delivering client care.
A student nurse is caring for a client with chronic kidney failure who is to be treated with continuous ambulatory peritoneal dialysis (CAPD). Which statement by the student nurse indicates to the primary nurse that the student nurse understands the purpose of this therapy?
it uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion
The nurse leader teaches about attributes that all change agents possess. Which attribute of a change agent is the key to self-support through challenges?
sense of humor. A sense of humor is the key to self-support through challenges. The caring aspect of the nurse leader is associated with commitment to the clients and their welfare. Humility focuses on the change, not on oneself. Persona is associated with self-motivation.
