NUR 240 EAQ - Management of Care

Which client statement leads the nurse to conclude that the client has been experiencing menorrhagia?

"I have severe bleeding during my menstrual periods."

A student in high school asks the school nurse why a classmate has been absent for so long. Which is the best response?

"I know you're concerned, but you'll need to ask your classmate for yourself."

Which statement by an unlicensed assistive personnel (UAP) who is assisting the nurse in caring for a group of clients indicates a correct understanding of the UAP's role?

"I will take clients' vital signs after their procedures are over."

A child in respiratory distress is admitted to the hospital and diagnosed with acute spasmodic laryngitis (spasmodic croup). At the time of discharge, the mother asks how to handle another attack at home. Which would the nurse recommend?

"Place him near a cool-mist humidifier."

In which order are the steps of a primary survey performed to assess a client with severe injuries from a bomb blast?

1.) Airway 2.) Breathing 3.) Circulation 4.) Disability 5.) Exposure

Which disasters would the nurse categorize as natural events? Select all that apply. One, some, or all responses may be correct.

1.) Blizzard 2.) Droughts 3.) Wildfires

Which employee would be competent in critical thinking, leadership, communication, and time management skills? Select all that apply. One, some, or all responses may be correct.

1.) Charge nurse 2.) Registered nurse (RN)

Which nurse competencies are elements of the Synergy Model of care delivery? Select all that apply. One, some, or all responses may be correct.

1.) Collaboration 2.) Clinical judgement 3.) Cultural competency

Which client conditions if selected by the student nurse as lowest priorities of care would indicate effective understanding of prioritizing care for clients with different conditions in an emergency department? Select all that apply. One, some, or all responses may be correct.

1.) Cystitis 2.) Cold symptoms

Which qualities would an effective leader exhibit? Select all that apply. One, some, or all responses may be correct.

1.) Elicit a vision from people. 2.) Bring out the best in people. 3.) Inspire people to bring the vision into reality.

Which are the elements of discovery of a lawsuit? Select all that apply. One, some, or all responses may be correct.

1.) Experts 2.) Medical records 3.) The depositions of witnesses

Which care settings are more suitable for unlicensed nursing personnel (UNP)? Select all that apply. One, some, or all responses may be correct.

1.) Extended care 2.) Long-term care

Which nursing action is essential when delegating tasks to nursing assistive personnel? Select all that apply. One, some, or all responses may be correct.

1.) Matching tasks to the delegatee's skills. 2.) Assessing knowledge and skills of delegatee. 3.) Clearly communication the task, time frame, and outcome. 4.) Listening attentively to delegatee's response to the task request. 5.) Providing feedback on performance to delegatee after task completion.

Which points noted by the nursing student are accurate regarding the characteristics of middle-range theories? Select all that apply. One, some, or all responses may be correct.

1.) Middle-range theories provide a basis to help nurses understand how clients cope with uncertainty and the illness response. 2.) Middle-range theories include Mishel's theory of uncertainty in illness, which focuses on a client's experiences with cancer while living with continual uncertainty. 3.) These theories tend to focus on a specific field of nursing (such as uncertainty, incontinence, social support, quality of life, and caring) rather than reflect on a wide variety of nursing care situations.

A client is admitted to the hospital with a diagnosis of pneumonia. In which order should the following nursing actions be accomplished?

1.) Obtain assessment information. 2.) Collect a sputum sample for culture and sensitivity. 3.) Administer prescribed antibiotic intravenous piggyback. 4.) Check peak and trough levels of the antibiotic. 5.) Review chest x-ray results on an ongoing basis.

Which elements are integrated into delegacy decisions? Select all that apply. One, some, or all answers may be correct.

1.) Stability 2.) Critical thinking

Which information would support the selection of a care delivery approach other than primary nursing in a 500-bed acute care hospital? Select all that apply. One, some, or all responses may be correct.

1.) The average length of stay per client is 42 hours. 2.) The average experience of registered nurses (RNs) is 16 months. 3.) The budget for salaries is 120% over estimates for the last fiscal quarter.

In which client situations does the process of delegation become more challenging? Select all that apply. One, some, or all answers may be correct.

1.) When the client is pregnant. 2.) When school children are receiving care.

The student nurse is collecting a clean-catch midstream urine specimen from a client suspected of urinary tract infection. After reviewing the results, the head nurse instructs the student nurse to repeat the procedure. Which finding in the urinalysis report supports the head nurse's instruction?

104 organisms/mL

How many levels of critical thinking exist for nursing judgment? Record your answer using a whole number. ______

3

When writing a disaster plan for implementation during a mass casualty incident (MCI), which percentage of victims often require admission to the hospital for further treatment?

30%

When the nurse is performing a newborn assessment, which finding indicates the need for follow-up care?

30-degree abduction of the infant's hips

For which client condition would the nurse provide immediate care?

85% oxygen (O2) saturation

The nurse is caring for a client with severe menstrual bleeding and abdominal cramps. Which task is appropriate to be delegated to the licensed practical nurse (LPN)?

Administration of oral analgesics.

The nurse in a hospital skilled nursing unit witnesses a client's spouse vigorously shaking the elderly client who has dementia after the client has had an episode of incontinence. After discussing concerns with the nurse manager, to whom would the nurse report this observation?

Adult Protective Services

Which certification would the emergency nursing staff member possess to perform defibrillation or cardioversion and special resuscitation for clients who sustained injuries in a tsunami?

Advanced Cardiac Life Support (ACLS)

Which is the most independently functioning nurse?

Advanced practice registered nurse

A client with renal failure wants to go back home, but the family members want the client to undergo a kidney transplant. The nurse gives details about the possible threats and benefits of the surgery to the family and informs them that the client wants to stay home. Which role does the nurse play here?

Advocate

Which assessment would the nurse perform first for a client with severe trauma?

Airway

Why would organizations promote transparency in health care?

Allows continuous feedback for improving client outcomes.

Which critical thinking skill will help a student nurse avoid making assumptions about clients?

Analysis

A client expresses a complete lack of interest in food. How would the nurse document this finding in the client's medical record?

Anorexia

Which intervention is most likely to decrease mortality in the septic client?

Antibiotics

Which is a stressor?

Any stimuli that can produce tension and cause instability within the system.

When caring for an older client who has had multiple recent hospital admissions for heart failure, which action would the nurse take first?

Ask the client about medication use and activity level at home.

According to the Model for Differentiated Nursing Practice, which entry-level nurse is most prepared for prioritization of client care?

Bachelor's degree registered nurse

Which color tag will be given by the triage nurse to a client assigned to class IV during a mass casualty situation?

Black

The nurse is helping a client and her or his family to set and meet goals. Which professional role is the nurse displaying?

Caregiver

Which organization assists in establishing policies related to Medicare and Medicaid payment for meaningful use of electronic health records (EHRs)?

Center for Medicare and Medcaid Services (CMS)

Which health care team member acts as a delegator in the absence of the registered nurse (RN)?

Charge nurse

Which health care team member is responsible for the coordination and assignments of client care?

Charge nurse

Based on the data in the table, which client who arrived at the hospital after a large-scale disaster is appropriately tagged according to the disaster triage tag system?

Client C

Which is the most important skill of the nurse leader?

Clinical care coordination

Which defines assessment?

Collecting comprehensive data pertinent to the client's health and/or situation.

Which aspect of total client care needs to be taken into consideration if used on a 24-bed care area?

Cost of nurses

Which is the function of the medical command physician according to the Emergency Preparedness and Response Plan?

Deciding the number, acuity, and resource needs of clients.

Which point needs correction regarding descriptive theories?

Descriptive theories help direct specific nursing activities.

Which description is correct in defining "accountability"?

Determination of appropriate actions and providing detailed explanations of the actions.

In the team nursing model, which is a priority consideration when the team leader is assigning clients to team members?

Each team member's strengths.

Which action is appropriate for the nurse who is the triage officer after a high-speed commuter train derailment?

Evaluating each client to determine priorities for treatment.

The registered nurse (RN) instructs a nursing student to use knowledge and experience to choose proper strategies to use when caring for clients. Which critical-thinking skill would the RN refer to?

Explanation

Which entity is responsible for activating the disaster plan during a mass casualty incident (MCI)?

Federal emergency management agency

Which color tag would be given to "walking wounded" clients according to the disaster triage tag system?

Green

Which intervention would the nurse add to the plan of care for a client who engages in ritualistic behavior?

Help the client understand that the behavior is caused by maladaptive coping with increased anxiety.

Which strategy would the nurses use to minimize aggressive behaviors from the client with a neurocognitive disorder?

Identify nursing staff members whom the client prefers.

Which surgical procedure involves urinary diversion in which the ureters are transplanted to a resected section of the small intestines, with one end attached to the abdominal wall?

Ileal conduit

The nurse is performing nursing care therapies and including the client as an active participant in the care. Which step in the nursing process is involved in this situation?

Implementation

Which nursing process includes tasks that can be delegated?

Implementation

Which question using the five rights of delegation would the nurse consider before delegating a task to nursing assistive personnel (NAP)? Select all that apply. One, some, or all responses may be correct.

Is the environment conducive to completing the task safely?

Which term refers to the nurse's ability to plan, direct, control, and evaluate others in different situations?

Management

Which nursing professional has the maximum span of control?

Nurse manager

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. Which is the correct nursing action?

Perform an assessment of the client before resuming the change-of-shift report.

Which terminology system would the nurse use to enter nursing diagnoses, interventions, and outcomes in electronic health records?

Perioperative Nursing Data Set (PNDS)

A client with diabetes mellitus experiences a sudden fall in blood glucose levels while traveling by air. The client is not carrying any medications or a copy of a personal medical record. Which type of health information technology would be beneficial for this client?

Personal health record (PHR)

The Magnet Recognition Program® for health care organizations is based on 14 forces of magnetism related to five magnet model components. Which force of magnetism is assessed to review the structural empowerment of the organization?

Personnel policies and programs.

A theory contains a set of components such as concepts, definitions, assumptions, or propositions. Which do these components help explain?

Phenomenom

The nurse manager works on a unit where the nursing staff members are uncomfortable taking care of clients from cultures that are different from their own. Which action would the nurse manager take to address this problem?

Plan a workshop that offers opportunities to learn about the cultures the nurses might encounter while at work.

Which responsibility of the nurse manager differs from the responsibilities of the nurse leader?

Planning the budget.

Which intervention would be classified as an independent nursing care function? Select all that apply. One, some, or all responses may be correct.

Positioning a client to prevent pressure ulcer formation.

After a mass casualty incident related to an accidental fire in a residential area, which condition are the clients experiencing when they present with incoherence, panic attacks, and exaggerated startle responses?

Post-trauma syndrome

Which laboratory result is most important to communicate quickly to the health care provider?

Potassium 3.0 mEq/L (3.0 mmol/L)

In which phase of the disaster management continuum would the nurse state are developing emergency response plans in case of an earthquake alert is included?

Preparedness

What would the nurse include in the plan of care to minimize the potential for a sickling episode in a child with sickle cell anemia?

Promoting adequate oxygenation

In providing effective nursing care to clients from different cultural backgrounds, which strategy would the nurse follow?

Provide care that fits the clients' cultural beliefs.

A nursing student is noting information about the National Database of Nursing Quality Indicators (NDNQI). Which point noted by the nursing student needs correction?

Provides a database for individual hospitals to compare their performance against nursing performance internationally.

Which health care professional would the nurse refer the client who survived a large-scale disaster event, reports a feeling of numbness for 1 month, and has notes a high score of all subscales of the Impact of Event Scale-Revised (IES-R) for further evaluation?

Psychiatrist

Which personnel are appropriate to caution people living in areas hit by a cyclone resulting in injuries through radio and news and to notify other health care facilities?

Public information officer

Which does the nurse understand by the term "regulatory law" as applied to nursing practice?

Reflects the decisions made by administrative bodies such as state boards of nursing.

A client with chronic asthma is being cared for in the inpatient care unit. Which health care team member would be delegated to assess the client on a regular basis?

Registered nurse (RN)

Which health care professional is authorized to delegate work to other health care members?

Registered nurse (RN)

Which characteristic indicates that nursing is a profession?

Required to follow a code of ethics.

Which condition would the nurse consider to require a high intensity of resources to provide effective care?

Respiratory distress

Which component of delegation is considered a "two-way process"?

Responsibility

Which factor would the nurse leader consider when selecting a functional care delivery model for the unit? Select all that apply. One, some, or all responses may be correct.

Responsibility for achieving client outcomes belongs to the nurse manager.

Which component of sea water is known to be responsible for making sea water hypertonic compared with body fluids?

Salt

The nurse determines that an adolescent with newly diagnosed type 1 diabetes has sufficient knowledge of the disorder. Which is the next appropriate action?

Setting goals with the client.

Which action by the student nurse may inhibit clients from disclosing personal information?

Sharing clients' data with family members.

Which nursing action is the priority action for decreasing the risk for a client developing a hospital-acquired infection?

Standard precautions

Which action by the registered nurse (RN) represents her or his leadership ability?

Supervising the tasks assigned to unlicensed nursing personnel.

Which does beneficence in health ethics refer to?

Taking positive actions to help others.

Which member of the health care team, when using the team nursing approach, is responsible for prioritizing client care?

Team leader

Which situation would not cover nurses who respond to a mass casualty incident (MCI) for malpractice or negligent lawsuits under the Good Samaritan Act?

Terrorist act

Which statement is true about prescriptive theories?

They are action-oriented.

Which outcome is the priority for a client with a migraine?

To decrease pain.

Which test is used to confirm cephalopelvic disproportion?

Ultrasound

The health care team is caring for clients in an emergency department. How soon would the clients triaged as an emergency severity index-3 (ESI-3) be seen by the provider according to the five-level triage system?

Within 1 hour