NURS 299 Exam 5

Which of the following statements indicate that the new nursing graduate understands ways to remain involved professionally? (Select all that apply.) 1. "I am thinking about joining the health committee at my church." 2. "I need to read newspapers, watch news broadcasts, and search the Internet for information related to health." 3. "I will join nursing committees at the hospital after I have completed orientation and better understand the issues affecting nursing." 4. "Nurses do not have very much voice in legislation in Washington, DC, because of the nursing shortage." 5. "I will go back to school as soon as I finish orientation."

1, 2, 3

Which statements properly apply an ethical principle to justify access to health care? (Select all that apply.) 1. Access to health care reflects the commitment of society to principles of beneficence and justice. 2. If low income compromises access to care, respect for autonomy is compromised. 3. Access to health care is a privilege in the United States, not a right. 4. Poor access to affordable health care causes harm that is ethically troubling because nonmaleficence is a basic principle of health care ethics. 5. If a new drug is discovered that cures a disease but at great cost per patient, the principle of justice suggests that the drug should be made available to those who can afford it.

1, 2, 4

Which statements reflect the difficulty that can occur for agreement on a common definition of the word quality when it comes to quality of life? (Select all that apply.) 1. Community values influence definitions of quality, and they are subject to change over time. 2. Individual experiences influence perceptions of quality in different ways, making consensus difficult. 3. The value of elements such as cognitive skills, ability to perform meaningful work, and relationship to family is difficult to quantify using objective measures. 4. Statistical analysis is difficult to apply when the outcome cannot be quantified. 5. Whether a person has a job is an objective measure, but it does not play a role in understanding quality of life.

1, 2, 4

A nurse research investigator is explaining a research study to a patient. The patient is interested in participating in the research study. The nurse investigator reviews the informed consent with the patient. The patient asks the nurse why he must sign the consent to participate in the study. What is the nurse's best response(s) to the patient's question? (Select all that apply.) 1. "The informed consent (IC) provides you with complete information on the research study." 2. "By reviewing the consent with you, I can make sure that you understand the study and what it means for you to participate." 3. "The informed consent provides details on the limitations of the study." 4. "The informed consent provides your voluntary agreement to participate in the research study." 5. "The informed consent explains how the data collected from you will be kept confidential during and after the study."

1, 2, 4, 5

A nurse is teaching an older-adult patient about ways to detect a melanoma. Which of the following are age-appropriate teaching techniques for this patient? (Select all that apply.) 1. Speak in a low tone. 2. Begin and end the session with the most important information regarding melanoma. 3. Provide a pamphlet about melanoma with large font in blues and greens. 4. Use basic one- or two-syllable medical terms. 5. Provide specific information in frequent, small amounts. 6. Speak quickly so that you do not take up much of the patient's time.

1, 2, 5

The nurse who works at the local health care agency is transferring a patient to an acute rehabilitation center in another town. To complete the transfer, information from the patient's EHR must be printed and faxed to the acute rehabilitation center. Which of the following actions are appropriate for the nurse to take to maintain privacy and confidentiality of the patient's information when faxing this information? (Select all that apply.) 1. Confirm that the fax number for the acute rehabilitation center is correct before sending the fax. 2. Use the encryption feature on the fax machine to encode the information and make it impossible for staff at the acute rehabilitation center to read the information unless they have the encryption key. 3. Fax the patient's information without a cover sheet so that the person receiving the information at the acute rehabilitation center can identify it more quickly. 4. After sending the fax, place the information that was printed out in a standard trash can after ripping it into several pieces. 5. After sending the fax, place the information that was printed out in a secure canister marked for shredding.

1, 2, 5

Which social media uses can be implemented with patients and families without violating confidentiality? (Select all that apply.) 1. Social media can be used to provide supportive information. 2. Results such as x-ray results can easily be sent via social media. 3. Family and friends who cannot be present can connect with the patient. 4. All health information can be shared on social media. 5. Social media should never be used with patients and families.

1, 3

Medical adhesives, such as tape securing a wound dressing, cause MARSI. Which of the following interventions reduce the risk for MARSI? (Select all that apply) 1. Gently loosen the ends of the tape and gently pull the outer end parallel with the skin surface toward the wound. 2. Change dressing only when saturated. 3. Apply adhesive remover. 4. Use Montgomery ties to secure the dressing. 5. Immobilize area of wound.

1, 3, 4

The ethics of care suggests that ethical dilemmas can best be solved by attention to relationships. How does this differ from other approaches to ethical problems? (Select all that apply.) Ethics of care: 1. pays attention to the context in which caring occurs. 2. is used only by nurses because it is part of the Nursing Code of Ethics. 3. requires understanding the relationships between involved parties. 4. considers the decision maker's relationships with other involved parties. 5. is an approach that suggests a greater commitment to patient care. 6. considers the decision maker to be in a detached position outside the ethical problem.

1, 3, 4

The nurse identifies which of the following as outcomes measurements? (Select all that apply.) 1. A nurse teaches a patient how to administer an injection and then watches the patient do a return demonstration. 2. A nurse implements a new pain-management protocol and checks patients' charts to confirm whether interventions are being provided. 3. A nursing unit adopts a set of strategies for reducing pressure injuries, and the UPC members use direct observation of the skin to measure incidence of pressure injuries. 4. A nursing unit implements a new fall prevention protocol and checks the monthly performance data for incidence of falls on the unit. 5. A nursing unit implements a patient rounding program, and the charge nurse watches the assistive personnel to see whether hourly rounding is being done on patients.

1, 3, 4

You are a nurse who is working in an agency that has recently implemented an EHR. Which of the following are acceptable practices for maintaining the security and confidentiality of EHR information? (Select all that apply.) 1. Using a strong password and changing your password frequently according to agency policy 2. Allowing a temporary staff member to use your computer username and password to access the electronic record 3. Ensuring that work lists (and any other data that must be printed from the EHR) are protected throughout the shift and disposed of in a locked receptacle designated for documents that are to be shredded when no longer needed 4. Ensuring that the patient information that is displayed on the computer monitor that you are using is not visible to visitors and other health care providers who are not involved in that patient's care 5. Remaining logged into a computer to save time if you only need to step away to administer a medication

1, 3, 4

Which of the following are measures to reduce tissue damage from shear? (Select all that apply.) 1. Use a transfer device (e.g., transfer board). 2. Have head of bed elevated when transferring patient. 3. Have head of bed flat when repositioning patient. 4. Raise head of bed 60 degrees when patient is positioned supine. 5. Raise head of bed 30 degrees when patient is positioned supine.

1, 3, 5

After surgery the patient with a closed abdominal wound reports a sudden "pop" after coughing. When the nurse examines the surgical wound site, the sutures are open, and small bowel sections are observed at the bottom of the now-opened wound. Which are the priority nursing interventions? (Select all that apply.) 1. Notify the health care provider. 2. Allow the area to be exposed to air until all drainage has stopped. 3. Place several cold packs over the area, protecting the skin around the wound. 4. Cover the area with sterile, saline-soaked towels immediately. 5. Cover the area with sterile gauze and apply an abdominal binder.

1, 4

Which of the following actions, if performed by an RN, could result in both criminal and administrative law sanctions against the nurse? (Select all that apply.) 1. Reviewing the EHR of a family member who is a patient in the same hospital on a different unit 2. Refusing to provide health care information to an older adult's child 3. Reporting suspected abuse and neglect of children 4. Applying physical restraints without a written order 5. Completing an occurrence report on the unit

1, 4

Which skin-care measures are used to manage a patient who is experiencing fecal and/or urinary incontinence? (Select all that apply.) 1. Frequent position changes 2. Keeping the buttocks exposed to air at all times 3. Using a large absorbent diaper, changing when saturated 4. Using an incontinence cleaner 5. Applying a moisture barrier ointment

1, 4, 5

A patient is in skeletal traction and has a plaster cast due to a fractured femur. The patient experiences decreased sensation and a cold feeling in the toes of the affected leg. The nurse observes that the patient's toes have become pale and cold but forgets to document and report this to the health care provider because one of the nurse's other patients experienced cardiac arrest at the same time. Two days later the patient in skeletal traction has an elevated temperature, and he is prepared for surgery to amputate the leg below the knee. Which of the following statements regarding a breach of duty apply to this situation? (Select all that apply.) 1. Failure to document a change in assessment data 2. Failure to provide discharge instructions 3. Failure to provide patient education about cast care 4. Failure to use proper medical equipment ordered for patient monitoring 5. Failure to notify a health care provider about a change in the patient's condition

1, 5

What is the removal of devitalized tissue from a wound called? 1. Debridement 2. Pressure distribution 3. Negative-pressure wound therapy 4. Sanitization

1. Debridement

You are working on a patient care unit and observe several other nurses who are not following the agency's policy when preparing and administering medications. When you ask them to explain why they are doing this, they state the new medication administration technology installed on the unit takes too much time to use, so they are using workarounds to get their patient medications administered on time. Which is the best action to take first? 1. Discuss the situation with the nursing manager. 2. Call a colleague who works at another institution to talk about the problem. 3. Look for a position on a different nursing unit. 4. Say nothing and begin your work.

1. Discuss the situation with the nursing manager.

The nurse is caring for a patient who needs a liver transplant to survive. This patient has been out of work for several months, does not have health insurance, and cannot afford the procedure. Which of the following statements speaks to the ethical elements of this case? 1. The health care team should select a plan that considers the principle of justice as it pertains to the distribution of health care resources. 2. The patient should enroll in a clinical trial of a new technology that can do the work of the liver, similar to the way dialysis treats kidney disease. 3. The social worker should look into enrolling the patient in Medicaid, since many states offer expanded coverage. 4. A family meeting should take place in which the details of the patient's poor prognosis are made clear to his family so that they can adopt a palliative approach.

1. The health care team should select a plan that considers the principle of justice as it pertains to the distribution of health care resources.

Resolution of an ethical problem involves discussion with the patient, the patient's family, and participants from appropriate health care disciplines. Which statement best describes the role of the nurse in the resolution of ethical problems? 1. To articulate the nurse's unique point of view, including knowledge based on clinical and psychosocial observations 2. To study the literature on current research about the possible clinical interventions available for the patient in question 3. To hold a point of view but realize that respect for the authority of administrators and health care providers takes precedence over personal views 4. To allow the patient and the health care provider private time to resolve the dilemma on the basis of ethical principles

1. To articulate the nurse's unique point of view, including knowledge based on clinical and psychosocial observations

A patient's cultural background affects the motivation for learning. Using the ACCESS model, match the nursing approach with the correct model component. ACCESS Model Component __1.Assessment __2.Communication __3.Cultural __4.Establishment __5.Sensitivity __6.Safety Nursing Approach A. Help patients feel culturally secure and able to maintain their cultural identity. B. Remain aware of verbal and nonverbal responses. C. Be aware of how patients from diverse backgrounds perceive their care needs. D. Become aware of your patient's culture and your own cultural biases. E. Learn about the patient's health beliefs and practices. F. Show respect by creating a caring rapport.

1E, 2B, 3D, 4F, 5C, 6A

Match the following term with its definition: 1. morals 2. value 3. bioethics 4. autonomy 5. beneficence 6. nonmaleficence 7. justice 8. fidelity A. fairness, equal access to care for all B. practice on own accord, protecting patients independence C. unwillingness to abandon patients D. deeply held belief about the worth of an idea, attitude, custom, or object that affect choices and behaviors E. ethics routed in healthcare F. implies best interest of patient before our own self-interest G. the rules, guidelines, or principles that people live by H. avoid harm or hurt, equal commitment to not do harm

1G, 2D, 3E, 4B, 5F, 6H, 7A, 8C

The nurse is writing a narrative progress note. Identify each of the following statements as subjective data (S) or objective data (O): 1. April 24, 2021 (0900) 2. Repositioned patient on left side. 3. Medicated with hydrocodone-acetaminophen 5/325 mg, 2 tablets PO. 4. "The pain in my incision increases every time I try to turn on my right side." 5. S. Eastman, RN 6. Surgical incision right lower quadrant, 3 inches in length, well approximated, sutures intact, no drainage. 7. Rates pain 7/10 at location of surgical incision.

1O, 2O, 3O, 4S, 5O, 6O, 7O

Match the pressure injury stages with the correct definition. ___ 1.Stage 1 ___ 2.Stage 2 ___ 3.Stage 3 ___ 4.Stage 4 ___ 5.Unstageable pressure injury a. Partial-thickness loss of skin with exposed dermis. The wound bed is viable, pink or red, and moist, and may also present as an intact or ruptured serum-filled blister. Adipose tissue (fat) and deeper tissues are not visible. Granulation tissue, slough, and eschar are not present. These injuries commonly result from adverse microclimate and shear in the skin over the pelvis and shear in the heel. This stage should not be used to describe moisture-associated skin damage (MASD), including incontinence-associated dermatitis (IAD), intertriginous dermatitis (ITD), medical adhesive-related skin injury (MARSI), or traumatic wounds (skin tears, burns, abrasions). b. Intact skin with a localized area of nonblanchable erythema, which may appear differently in darkly pigmented skin. Presence of blanchable erythema or changes in sensation, temperature, or firmness may precede visual changes. Color changes do not include purple or maroon discoloration; these may indicate deep-tissue pressure injury. c. Full-thickness skin and tissue loss with exposed or directly palpable fascia, muscle, tendon, ligament, cartilage, or bone in the ulcer. Slough and/or eschar may be visible. Epibole (rolled edges), undermining, and/or tunneling often occurs. Depth varies by anatomical location. If slough or eschar obscures the extent of tissue loss, this is an Unstageable pressure injury. d. Full-thickness loss of skin, in which adipose tissue (fat) is visible in the ulcer, and granulation tissue and epibole (rolled wound edges) are often present. Slough and/or eschar may be visible. The depth of tissue damage varies by anatomical location; areas of significant adiposity can develop deep wounds. Undermining and tunneling may occur. Fascia, muscle, tendon, ligament, cartilage, and bone are not exposed. If slough or eschar obscures the extent of tissue loss, this is an unstageable pressure injury. e. Full-thickness skin and tissue loss in which the extent of tissue damage within the injury cannot be confirmed because it is obscured by slough or eschar. If slough or eschar is removed, a Stage 3 or Stage 4 pressure injury will be revealed. Stable eschar (i.e., dry, adherent, intact, without erythema or fluctuance) on the heel or ischemic limb should not be softened or removed.

1b, 2a, 3d, 4c, 5e

Match the following actions (1 through 4) with the terms (a through d) listed below: ___1. You see an open medical record on the computer and close it so that no one else can read the record without proper access. ___2. You administer a once-a-day cardiac medication at the wrong time, but nobody sees it. However, you contact the provider and your nurse manager and follow agency procedure. ___3. A patient at the end of life wants to go home to die, but the family wants every care possible. The nurse contacts the primary care provider about the patient's request. ___4. You tell your patient that you will return in 30 minutes to give him his next pain medication. a. Advocacy b. Responsibility c. Accountability d. Confidentiality

1d, 2c, 3a, 4b

A nurse sends a text message to the oncoming nurse that states, "Mr. Kodro in room 3348-1 refused to take his sertraline hydrochloride as ordered this morning because he said he was feeling better." What should the oncoming nurse do? (Select all that apply.) 1. Add this information to the board hanging at the patient's bedside. 2. Tell the nurse who sent the text that the text is a HIPAA violation. 3. Inform the nursing supervisor. 4. Forward the text to the charge nurse. 5. Thank the nurse for sending the information.

2, 3

Which of the following nursing activities apply to an MDRPI? (Select all that apply.) 1. Assess skin under devices every 2 hours. 2. Cushion at risk areas (e.g., ears, nose with foam or protective dressing). 3. Choose correct size of device. 4. Observe for erythema or irritation that conforms to pattern or shape of device. 5. Observe under casts and splints.

2, 3, 4, 5

A nurse who works in an outpatient chemotherapy infusion center is assigned to the care of a 56-year-old male patient who is receiving chemotherapy for colon cancer. This is the patient's first clinic visit. The nurse reviews the patient's medical record and sees a note about the patient receiving instruction on how chemotherapy treats cancer, but the note does not summarize the patient's response. The doctor makes a quick visit and tells the patient, "We will get your treatment started today and we will be checking your blood each week for any problems." The doctor leaves and the patient asks the nurse, "What are the blood tests for?" To determine this patient's learning needs, what should the nurse assess? (Select all that apply.) 1. Medical record summary of the stage of the cancer 2. The patient's behavior as the nurse interacts with him 3. The patient's level of knowledge about chemotherapy effects 4. The number of treatments the patient will be receiving 5. The patient's health literacy 6. The patient's self-description of severity of his cancer 7. The date of the medical record note describing patient instruction

2, 3, 5, 6

Which of the following scenarios demonstrate that patient learning has taken place? (Select all that apply.) 1. A patient listens to a nurse's review of the warning signs of a stroke. 2. A patient describes how to set up a pill organizer for newly ordered medicines. 3. A patient attends a spinal cord injury support group. 4. A patient demonstrates how to take his blood pressure at home. 5. A patient reviews written information about resources for cancer survivors.

2, 4

Which of the following is an indication for a binder to be placed around a surgical patient with a new abdominal wound? (Select all that apply.) 1. Collection of wound drainage 2. Provision of support to abdominal tissues when coughing or walking 3. Reduction of abdominal swelling 4. Reduction of stress on the abdominal incision 5. Stimulation of peristalsis (return of bowel function) from direct pressure

2, 4,

The nurse is using the QSEN competency of EBP when working with the unit council to initiate a change related to pain management. Which behaviors demonstrate that the nurse is practicing behaviors associated with EBP? (Select all that apply.) 1. Initiating plan for self-development as a team member 2. Reading original research related to pain management 3. Demonstrating effective use of strategies to reduce risk of harm to self or others 4. Valuing EBP as critical to the development of pain management guidelines for the unit 5. Describing to the unit council reliable sources for locating clinical guidelines 6. Applying technology and information management tools to support safe processes of care

2, 4, 5

A nurse contacts the health care provider about a change in a patient's condition and receives several new orders for the patient over the phone. When documenting telephone orders in the EHR, what should the nurse do? 1. Print out a copy of all telephone orders entered into the EHR in order to keep them in personal records for legal purposes. 2. "Read back" all telephone orders to the health care provider over the phone to verify all orders were heard, understood, and transcribed correctly before entering the orders in the EHR. 3. Record telephone orders in the EHR but wait to implement the order(s) until they are electronically signed by the health care provider who gave them. 4. Implement telephone order(s) immediately but insist that the health care provider come to the patient care unit to personally enter the order(s) into the EHR within the next 24 hours.

2. "Read back" all telephone orders to the health care provider over the phone to verify all orders were heard, understood, and transcribed correctly before entering the orders in the EHR.

The nurse works at an agency where military time is used for documentation and needs to document that a patient was medicated for pain after midnight. Identify the correct military time to document medication administered at 12:05 a.m. 1. 2405 2. 0005 3. 2205 4. 1205

2. 0005

When designing a plan for pain management for a patient following surgery, the nurse assesses that the patient's priority is to be as free of pain as possible. The nurse and patient work together to identify a plan to manage the pain. The nurse continually reviews the plan with the patient to ensure that the patient's priority is met. If the nurse's actions are driven by respect for autonomy, what aspect of this scenario best demonstrates this action? 1. Assessing the patient's pain on a numeric scale every 2 hours 2. Asking the patient to establish the goal for pain control 3. Using alternative measures such as distraction or repositioning to relieve the pain 4. Monitoring the patient for oversedation as a side effect of his pain medication

2. Asking the patient to establish the goal for pain control

A patient in the ICU experiences a sentinel event related to central line catheter care that resulted in serious injury. What PI model should the unit use to identify errors that led to the sentinel event? 1. Six Sigma 2. Root cause analysis 3. PDSA 4. Balanced scorecard

2. Root cause analysis

A nurse is planning care for a patient going to surgery. Who is responsible for informing the patient about the surgery along with possible risks, complications, and benefits? 1. Family member 2. Surgeon 3. Nurse 4. Nurse manager

2. Surgeon

A patient suddenly experienced a severe headache with numbness and decreased movement in the left arm. An emergency brain scan confirmed a cerebral vessel clot. With a stroke confirmed, the emergency room physician consults with a neurosurgeon to schedule an emergent angiogram to remove the clot. Which teaching approach is most appropriate for explaining to the patient what to expect from the procedure? 1. Selling approach 2. Telling approach 3. Entrusting approach 4. Participating approach

2. Telling approach

A 26-year-old patient visits a medical clinic and asks a nurse to provide instruction on how to perform a breast self-examination. "My mom had cancer so I want to learn how." Which domains are required to learn this skill? (Select all that apply.) 1. Affective domain 2. Sensory domain 3. Cognitive domain 4. Attentional domain 5. Psychomotor domain

3, 5

When documenting an assessment of a patient's cardiac system in an EHR, the nurse uses the computer mouse to select the "WNL" statement to document the following findings: "Heart sounds S1 & S2 auscultated. Heart rate between 80 and 100 beats/min, and regular. Denies chest pain." This is an example of using which of the following documentation formats? 1. Focus charting incorporating data, action, and response (DAR) 2. Problem-intervention-evaluation (PIE) 3. Charting by exception (CBE) 4. Narrative documentation

3. Charting by exception (CBE)

The nurse is administering a dose of metoprolol to a patient and is completing the steps of bar-code medication administration within the EHR. As the bar-code information on the medication is scanned, an alert that states, "Do not administer dose if apical heart rate (HR) is <60 beats/min or systolic blood pressure (SBP) is <90 mm Hg" appears on the computer screen. The alert that appeared on the computer screen is an example of what type of system? 1. Electronic health record (EHR) 2. Charting by exception 3. Clinical decision support system (CDSS) 4. Computerized provider order entry (CPOE)

3. Clinical decision support system (CDSS)

A home health nurse notices significant bruising on a 2-year-old patient's head, arms, abdomen, and legs. The patient's mother describes the patient's frequent falls. What is the best nursing action for the home health nurse to take? 1. Document her findings and treat the patient. 2. Instruct the mother on safe handling of a 2-year-old child. 3. Contact a child abuse hotline. 4. Discuss this story with a colleague.

3. Contact a child abuse hotline.

The application of deontology does not always resolve an ethical problem. Which of the following statements best explains one of the limitations of deontology? 1. The emphasis on relationships feels uncomfortable to decision makers who want more structure in deciding the best action. 2. The single focus on power imbalances does not apply to all situations in which ethical problems occur. 3. In a diverse community it can be difficult to find agreement on which principles or rules are most important. 4. The focus on consequences rather than on the "goodness" of an action makes decision makers uncomfortable.

3. In a diverse community it can be difficult to find agreement on which principles or rules are most important.

A nurse received a bedside report at the change of shift with the night-shift nurse and the patient. The nursing student assigned to the patient asks to review the patient's medical record. The nurse lists patients' medical diagnoses on the message boards in the patients' rooms. Later in the day the nurse discusses the plan of care for a patient who is dying with the patient's family. Which of these actions describes a violation of HIPAA? 1. Discussing patient conditions at the bedside at the change of shift 2. Allowing the nursing student to review the assigned patient's chart before providing care during the clinical experience 3. Posting medical information about the patient on a message board in the patient's room 4. Releasing patient information regarding terminal illness to family when the patient has given permission for information to be shared

3. Posting medical information about the patient on a message board in the patient's room

A nurse who works in an outpatient chemotherapy infusion center is assigned to the care of a 56-year-old male patient who is receiving chemotherapy for colon cancer. This is the patient's first clinic visit. The nurse reviews the patient's medical record and sees a note about the patient receiving instruction on how chemotherapy treats cancer; the note does not summarize the patient's response. The nurse's assessment reveals that the patient is motivated to learn more about his chemotherapy and is alert and currently feeling well. The nurse has prepared the first infusion, regulated it, and now takes time to begin instruction. Which teaching approaches are best suited for this situation? 1. Use an entrusting approach in explaining how to monitor for side effects of chemotherapy. 2. Bring the patient together with two other patients in the clinic and conduct a group discussion. 3. Provide verbal one-on-one instruction, with the patient participating in selection of content. 4. Present the patient with a problem situation involving a serious side effect and have the patient decide what to do.

3. Provide verbal one-on-one instruction, with the patient participating in selection of content.

A patient recovering from open heart surgery is taught how to cough and deep breathe using a pillow to support or splint the chest incision. Following the teaching session, which of the following is the best way for the nurse to evaluate whether learning has taken place? 1. Verbalization of steps to use in splinting 2. Selecting from a series of flash cards the images showing the correct technique 3. Return demonstration 4. REALM test

3. Return demonstration

A nurse is preparing to teach a patient who has sleep apnea how to use a continuous positive airway pressure (CPAP) machine at night. Which action is most appropriate for the nurse to perform first? 1. Allow patient to manipulate machine and look at parts. 2. Provide a teach-back session. 3. Set mutual goals for the education session. 4. Discuss the purpose of the machine and how it works.

3. Set mutual goals for the education session.

A nurse is reading a research article discussing a new practice to decrease the incidence of catheter-associated urinary tract infections. One section of the article describes who was studied and how the data were collected to answer the research questions and hypotheses. What section of the research article is currently being read? 1. The literature review 2. The data analysis 3. The methods 4. The implications for practice

3. The methods

Nurses in a community clinic are conducting an EBP project focused on improving the outcomes of children with asthma. The PICO question asked by the nurses is "In school-age children, does the use of an electronic gaming education module versus educational book affect the usage of inhalers?" In the question, what is the "O"? 1. School-age children 2. Educational book 3. Use of inhalers 4. Electronic gaming education

3. Use of inhalers

Place the steps when performing wound irrigation of a large open wound in the correct sequence. 1. Use slow, continuous pressure to irrigate wound. 2. Attach 19-gauge angiocatheter to syringe. 3. Fill syringe with irrigation fluid. 4. Place biohazard bag near bed. 5. Position angiocatheter over wound.

4, 3, 2, 5, 1

When repositioning an immobile patient, the nurse notices redness over the hip bone. What is indicated when a reddened area blanches on fingertip touch? 1. A local skin infection requiring antibiotics 2. Sensitive skin that requires special bed linen 3. A Stage 3 pressure injury needing the appropriate dressing 4. Blanching hyperemia, indicating the attempt by the body to overcome the ischemic episode

4. Blanching hyperemia, indicating the attempt by the body to overcome the ischemic episode

The nurse is discussing the advantages of using CPOE with a nursing colleague. Which statement best describes the major advantage of a CPOE system within an EHR? 1. CPOE reduces the time necessary for health care providers to write orders. 2. CPOE reduces the time needed for nurses to communicate with health care providers. 3. Nurses do not need to acknowledge orders entered by CPOE in an EHR. 4. CPOE improves patient safety by reducing transcription errors.

4. CPOE improves patient safety by reducing transcription errors.

A nurse implements an EBP change that teaches patients the importance of taking their diabetes medications correctly and regularly on time using videos streamed on the Internet. The nurse measures the patients' behavioral outcome from the practice change by using which type of measurement? 1. Measuring the patients' weight 2. Chart auditing teaching sessions 3. Observing patients viewing the videos 4. Checking patients' blood sugars

4. Checking patients' blood sugars

A man who is homeless enters the emergency department seeking health care. The health care provider indicates that the patient needs to be transferred to the city hospital for care before assessing the patient. This action is most likely a violation of which of the following laws? 1. Health Insurance Portability and Accountability Act (HIPAA) 2. Americans With Disabilities Act (ADA) 3. Patient Self-Determination Act (PSDA) 4. Emergency Medical Treatment and Active Labor Act (EMTALA)

4. Emergency Medical Treatment and Active Labor Act (EMTALA)

A woman has severe life-threatening injuries, is unresponsive, and is hemorrhaging following a car accident. The health care provider ordered 2 units of packed red blood cells to treat the woman's anemia. The woman's husband refuses to allow the nurse to give his wife the blood for religious reasons. What is the nurse's responsibility? 1. Obtain a court order to give the blood. 2. Convince the husband to allow the nurse to give the blood. 3. Call security and have the husband removed from the hospital. 4. Gather more information about the wife's preferences and determine whether the husband has her power of attorney for health care.

4. Gather more information about the wife's preferences and determine whether the husband has her power of attorney for health care.

The nurse is reviewing health care provider orders that were handwritten on paper when all computers were down during a system upgrade. Which of the following orders contains an inappropriate abbreviation included on TJC's "do not use" list and should be clarified with the health care provider? 1. Change open midline abdominal incision daily using wet-to-moist normal saline and gauze. 2. Lorazepam 0.5 mg PO every 4 hours prn anxiety 3. Morphine sulfate 1 mg IVP every 2 hours prn severe pain 4. Insulin aspart 8u SQ every morning before breakfast

4. Insulin aspart 8u SQ every morning before breakfast

The nurses on a medical unit have seen an increase in the number of pressure injuries developing in their patients. The nurses decide to initiate a PI project using the PDSA model. Which of the following is an example of "Plan" from that model? 1. Orienting patients to the unit's practice of hourly rounding on patients 2. Reviewing the incidence of pressure injuries on patients cared for using the protocol 3. Based on findings from patients who developed injuries, implementing an evidence-based skin care protocol on all units 4. Meeting with all disciplines to develop a multidisciplinary approach for reducing pressure injuries

4. Meeting with all disciplines to develop a multidisciplinary approach for reducing pressure injuries

A 55-year-old man has been in the hospital for over a week following surgical complications. The patient has had limited activity but is now ordered to begin a mobility program. The patient just returned from several diagnostic tests and tells the nurse he is feeling fatigued. The nurse prepares to instruct the patient on the mobility program protocol. Which of the following learning principles will likely be affected by this patient's condition? 1. Motivation to learn 2. Developmental stage 3. Stage of grief 4. Readiness to learn

4. Readiness to learn

Place the steps of the EBP process in the appropriate order. 1. Critically appraise the evidence you gather. 2. Ask the clinical question in PICOT format. 3. Evaluate the outcomes of the practice decision or change. 4. Search for the most relevant and best evidence. 5. Cultivate a spirit of inquiry. 6. Integrate the evidence. 7. Communicate the outcomes of the EBP change.

5, 2, 4, 1, 6, 3, 7

The following are steps in the process to help resolve an ethical problem. What is the best order of these steps to achieve resolution? 1. List all the possible actions that could be taken to resolve the problem. 2. Articulate a statement of the problem or dilemma that you are trying to resolve. 3. Develop and implement a plan to address the problem. 4. Gather all relevant information regarding the clinical, social, and spiritual aspects of the problem. 5. Take time to clarify values and identify the ethical elements, such as principles and key relationships involved. 6. Recognize that the problem requires ethics.

6, 4, 5, 2, 1, 3

A nurse is caring for a client who is about to undergo an elective surgical procedure. The nurse should take which of the following actions regarding informed consent? (select all that apply.) A. make sure the surgeon obtained the client's consent B. witness the client's signature on the consent form C. explain the risks and benefits of the procedure D. describe the consequences of choosing not to have the surgery E. tell the client about the alternatives to having the surgery

A, B

A charge nurse is reviewing documentation with a group of newly licensed nurses. Which of the following legal guidelines should be followed when documenting in a clients record? (select all that apply.) A. Cover errors with correction fluid and write in the correct information. B. Put the data and time on all entries. C. Document objective data, leaving out opinions. D. Use as many abbreviations as possible. E. Wait until the end of the shift to document.

A, B, C

A nurse is collecting data from a client who is 5 days postoperative following abdominal surgery. The surgeon suspects an incisional wound infection and has prescribed antibiotic therapy for the nurse to initiate after collecting wound and blood specimens for culture and sensitivity. Which of the following findings should the nurse expect? (Select all that apply.) A. increase in incisional pain B. fever and chills C. reddened wound edges D. increase in serosanguineous drainage E. decrease in thirst

A, B, C

A nurse in a clinic is planning health promotion and disease prevention strategies for a client who has multiple risk factors for cardiovascular disease. Which of the following interventions should the nurse include? (Select all that apply.) A. Help the client see the benefits of their actions B. Identify the client's support systems C. Suggest and recommend community resources D. Devise and set goals for the client E. Teach stress management strategies

A, B, C, E

A client who had abdominal surgery 24 hr ago suddenly reports a pulling sensation and pain in their surgical incision. The nurse checks the surgical wound and finds it separated with visceral protruding. Which of the following actions should the nurse take? (Select all that apply.) A. cover the area with saline-soaked sterile dressings B. apply an abdominal binder snugly around the abdomen C. use sterile gauze to apply gentle pressure to the exposed tissues D. position the client supine with the hips and knees bent E. offer the client a warm beverage, such as herbal tea

A, D

A nurse is caring for a client who is at risk for developing pressure injury. Which of the following interventions should the nurse use to help maintain the integrity of the client's skin? (Select all that apply.) A. keep the head of the bed elevated 30 degrees B. massage the client's bony prominences frequently C. apply cornstarch liberally to the skin after bathing D. have the client sit on a gel cushion when in a chair E. reposition the client at least every 3 hr while in bed

A, D

A nurse is discussing occurrences that require completion of an incident report with a newly licensed nurse. Which of the following should the nurse include in the teaching? (select all that apply.) A. Medication error B. Needlesticks. C. Conflict with provider and nursing staff. D. Omission of prescription. E. Missed specimen collection of a prescribed laboratory test.

A, D

A nurse educator is reviewing the wound healing process with a group of nurses. The nurse educator should include in the information which of the following alterations for wound healing by secondary intention? (Select all that apply.) A. stage 3 pressure injury B. sutured surgical incision C. casted bone fracture D. laceration sealed with adhesive E. open burn area

A, E

A nurse is receiving a providers prescription by telephone for morphine for a client who is reporting moderate to severe pain. Which of the following nursing actions are appropriate? (select all that apply.) A. Repeat the details of the prescription back to the provider. B. Have another nurse listen to the telephone prescription. C. Obtain the provider signature on the prescription within 24 hours. D. Decline the verbal prescription because it is not an emergency situation. E. Tell the charge nurse that the provider has prescribed morphine by telephone.

A. Repeat the details of the prescription back to the provider.

A nurse and a health clinic is caring for a 21-year-old client who tells the nurse that their last physical exam was in high school. Which of the following health screenings should the nurse expect the provider to perform for this client? A. Testicular examination B. Blood glucose C. Fecal occult blood D. Prostate-specific antigen

A. Testicular examination

During a teaching session, the nurse tells a patient with a recent neck injury that damage to the nerves is comparable to a water hose that has been pinched off. During this teaching session, the nurse is using the process of: A. analogy. B. discovery. C. role playing. D. demonstration.

A. analogy.

The nursing assistant asks you the difference between a wound that heals by primary or secondary intention. You will reply that a wound heals by primary intention when the skin edges: A. are approximated. B. migrate across the incision. C. appear slightly pink. D. slightly overlap each other

A. are approximated.

A nurse observes an assistive personnel (AP) reprimanding a client for not using the urinal properly. The AP tells the client that diapers will be used next time the urinal is used improperly. Which of the following torts is the AP committing? A. assault B. battery C. false imprisonment D. invasion of privacy

A. assault

Information regarding a patient's health status may not be released to non-health care team members because: A. legal and ethical obligations require health care providers to keep information strictly confidential. B. regulations require health care institutions to document evidence of physical and emotional well-being. C. reimbursement issues related to patient care and procedures may be of concern. D. fragmentation of nursing and medical care procedures may be identified.

A. legal and ethical obligations require health care

A nurse is caring for a competent adult client who tell the nurse, "I am leaving the hospital this morning whether the doctor discharges me or not." The nurse believes that this is not in the client's best interest, and prepares to administer a PRN sedative medication the client has not requested along with the scheduled morning medication. Which of the following types of tort is the nurse about to commit? A. assault B false imprisonment C. negligence D. breach of confidentiality

B false imprisonment

A nurse is caring for a client who is 2 days postoperative following an appendectomy and has type I diabetes mellitus. Their Hgb is 12 g/dL and BMI is 17.1. The incision is approximated and free of redness, with scant serous drainage on the dressing. The nurse should recognize that the client has which of the following risk factors for impaired wound healing? (select all that apply.) A. extremes in age B. chronic illness C. low hemoglobin D. malnutrition E. poor wound care

B, C, D

A nurse manager is discussing the HIPAA privacy rule with a group of newly hired nurses during orientation. Which of the following information should the nurse manager include? (Select all that apply.) A. A single electronic records password is provided for nurses on the same unit. B. Family members should provide a code prior to receiving client health information. C. Communication of client information can occur at the nurses station. D. A client can request a copy of their medical record. E. A nurse can photocopy a clients medical record for transfer to another facility.

B, C, D, E

A nurse at a provider's office is talking about routine screenings with a 45-year-old female client who has no specific family history of cancer or diabetes mellitus. Which of the following client statements indicates that the client understands how to proceed? A. "So I don't need the colon cancer procedure for another two or three years." B. "For now, I should continue to have a mammogram each year." C. "Because the doctor just did a Pap smear, I'll come back next year for another one." D. "I had my blood glucose test last year so I won't need it again for four years."

B. "For now, I should continue to have a mammogram each year."

A nurse in a providers office is collecting from the caregiver of a 12 month old infant, who asks if the child is old enough for toilet training. Following an educational session with the nurse, the client agrees to post pone toilet training until the child is older. Learning has occurred in which of the following domains? A. Cognitive B. Affective C. Psychomotor D. Kinesthetic

B. Affective

A nurse is evaluating how well a client learned the information presented in an instructional session about following a heart healthy diet. Which of the following actions should the nurse take to evaluate the clients learning? A. Encourage the client to ask questions. B. Ask the client to explain how to select or prepare meals. C. Encourage the client to fill out an evaluation form about how the nurse presented the information. D. Ask whether the client has resources for further instruction on this topic.

B. Ask the client to explain how to select or prepare meals.

A nurse at the health department is planning strategies related to heart disease. Which of the following activities should the nurse include as part of a primary prevention? A. Providing cholesterol screening B. Teaching about a healthy diet C. Providing information about anti hypertensive medications D. Developing a list of cardiac rehabilitation programs

B. Teaching about a healthy diet

A nurse is observing a client drawing up and mixing insulin. Which of the following findings should the nurse identify as an indication that psycho motor learning has taken place? A. The client is able to discuss the appropriate technique. B. The client is able to demonstrate the appropriate technique. C. The client states and understanding of the process. D. The client is able to write the steps on a piece of paper.

B. The client is able to demonstrate the appropriate technique.

If a nurse decides to withhold a mediation because it might further lower the patient's blood pressure, the nurse will be practicing the principal of: A. responsibility B. accountability C. competency D. moral behavior

B. accountability

A nurse is caring for a client who decides not to have surgery despite significant blockages of the coronary arteries. The nurse understands that this client's choice is an example of which of the following ethical principals? A. fidelity B. autonomy C. justice D. nonmaleficence

B. autonomy

You are about to administer an oral medication and you question the dosage. You should: A. administer the medication. B. notify the physician. C. withhold the medication. D. document that the dosage appears incorrect.

B. notify the physician.

A nurse has just admitted a patient with a medical diagnosis of congestive heart failure. When completing the admission paper work, the nurse needs to record: A. an interpretation of patient behavior. B. objective data that are observed. C. lengthy entry using lay terminology. D. abbreviations familiar to the nurse.

B. objective data that are observed.

Nurse is providing preoperative education for a client who will undergo a mastectomy the next day. Which of the following statements should the nurse identify as an indication that the client is ready to learn? A. "I don't want my spouse to see my incision." B. "Will you give me the pain medication after the surgery?" C. "Can you tell me about how long the surgery will take?" D. "My roommate listens to everything I say."

C. "Can you tell me about how long the surgery will take?"

A nurse in a surgeon's office is providing preoperative teaching for a client who is scheduled for surgery the following week. The client tells the nurse that "I plan to prepare my advance directives before I come to the hospital." Which of the following statements made by the client should indicate to the nurse an understanding of advance directives? A. "I'd rather have my brother make decisions for me, but I know it has to be my wife." B. "I know they won't go ahead with the surgery unless I prepare these forms C. "I plan to write that I don't want them to keep me on a breathing machine D. "I will get my regular doctor to approve my plan before I hand it in at the hospital."

C. "I plan to write that I don't want them to keep me on a breathing machine

A nurse is preparing information for a change of shift report. Which of the following information should the nurse include in the report? A. Input and output for the shift B. Blood pressure from the previous day. C. Bone scan scheduled for today. D. Medication routine from the medication administration record.

C. Bone scan scheduled for today.

A nurse is caring for a young adult at a college health clinic. Which of the following actions should the nurse take first? A. Give the client information about immunization against meningitis B. Tell the client to have a TB skin test every 2 years C. Determine the client's health risks D. Teach the client about exercise recommendations

C. Determine the client's health risks

A nurse is instructing a group of newly licensed nurses about how to know and what to expect when ethical dilemmas arise. Which of the following situations should the newly licensed nurses identify as an ethical dilemma? A. a nurse on a med-surg unit demonstrates signs of chemical impairment B. a nurse overhears another nurse telling an adult client that is he doesn't stay in bed, she will have to apply restraints C. a family has conflicting feelings about the initiation of enteral tube feedings for their father, who is terminally ill D. a client who is terminally ill hesitates to name their partner on their durable power of attorney form

C. a family has conflicting feelings about the initiation of enteral tube feedings for their father, who is terminally ill

A student nurse employed as a nursing assistant may perform care: A. as learned in school. B. expected of a nurse at that level. C. identified in the hospital's job description. D. requiring technical rather than professional skills.

C. identified in the hospital's job description.

A nurse is instructing a group of newly licensed nurses about the responsibilities organ donation and procurement involve. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the newly licensed nurses should understand that this aspect of care delivery is an example of which of the following ethical principals? A. fidelity B. autonomy C. justice D. nonmaleficence

C. justice

A nurse records that the patient stated his abdominal pain is worse now than last night. This is an example of: A. PIE documentation. B. SOAP documentation. C. narrative charting. D. charting by exception.

C. narrative charting.

A nurse has notices several occasions in the past week when another nurse on the unit seemed drowsy and unable to focus on the issue at hand. Today, the nurse was found asleep in a chair in the break room not during a break time. Which of the following actions should the nurse take? A. alert the ANA B. fill out an incident report C. report the observations to the nurse manager on the unit D. leave the nurse alone to sleep

C. report the observations to the nurse manager on the unit

A nurse is preparing an instructional session for a client about managing stress incontinence. Which of the following actions should the nurse take when meeting with the client? A. Encourage the client to participate actively in learning. B. Select instructional materials. C. Identify goals the nurse and the client agree are reasonable. D. Determine what the client knows about stress incontinence.

D. Determine what the client knows about stress incontinence.

A nurse questions a medication prescription as too extreme in light of the client's advanced age and unstable status. The nurse understands that this action is an example of which of the following ethical principles? A. Fidelity B. Autonomy C. Justice D. Nonmaleficence

D. Nonmaleficence

A nurse is caring for a patient who states, "I just want to die." For the nurse to comply with this request, the nurse should discuss: A. living wills. B. assisted suicide. C. passive euthanasia. D. advance directive

D. advance directive

A patient you are assisting has fallen in the shower. You must complete an incident report. The purpose of an incident report is to: A. exchange information among health care members. B. provide information about patients from one unit to another unit. C. ensure proper care for the patient. D. aid in the hospital's quality improvement program.

D. aid in the hospital's quality improvement program.

A nurse offers pain medication to a client who is postoperative prior to ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principals? A. fidelity B. autonomy C. justice D. beneficence

D. beneficence

A postoperative patient arrives at an ambulatory care center and states, "I am not feeling good." Upon assessment, you note an elevated temperature. An indication that the wound is infected would be: A. it has no odor. B. a culture is negative. C. the edges reveal the presence of fluid. D. it shows purulent drainage coming from the incision site.

D. it shows purulent drainage coming from the incision site.

A surgical wound requires a Hydrogel dressing. The primary advantage of this type of dressing is that it provides: A. an absorbent surface to collect wound drainage. B. decreased incidence of skin maceration. C. protection from the external environment. D. moisture needed for wound healing

D. moisture needed for wound healing

Your patient is about to undergo a controversial orthopedic procedure. The procedure may cause periods of pain. Although nurses agree to do no harm, this procedure may be the patient's only treatment choice. This example describes the ethical principal of: A. autonomy B. fidelity C. justice D. nonmaleficence

D. nonmaleficence

A patient newly diagnosed with diabetes needs to learn how to use a glucometer. Use of a glucometer constitutes: A. affective learning. B. cognitive learning. C. motivational learning. D. psychomotor learning.

D. psychomotor learning.

what is the definition of ethics of care?

Emphasizes the importance of understanding relationships

Match the components of PICO using the question "Does the use of guided imagery compared with standard care affect the postoperative pain in hospitalized adolescents? _____ (P) Patient/population _____ (I) Intervention _____ (C) Comparison _____ (O) Outcome A. Adolescents receiving standard care B. Postoperative pain C. Hospitalized adolescents D. Guided imagery

P (C), I (D), C (A), O (B)

what is the definition of deontology?

actions of being right or wrong

what is the definition of casuistry?

care-based reasoning, promote respect and agreement

The nurse is changing the dressing over the midline incision of a patient who had surgery. Assessment of the incision reveals changes from what was documented by the previous nurse. After documenting the current wound assessment, the nurse contacts the surgeon by telephone to discuss changes in the incision that are of concern. Which of the following illustrates the most appropriate way for the nurse to document this conversation? 1. Health care provider notified about change in assessment of abdominal incision. T. Wright, RN 2. 09-3-21: Notified the surgeon by phone that there is a new area of redness around the patient's incision. T. Wright, RN 3. 1015: Contacted the surgeon and notified about changes in abdominal incision. T. Wright, RN 4. 09-3-21 (1015): Surgeon contacted by phone. Notified about new area of bright red erythema extending approximately 1 inch around circumference of midline abdominal incision and oral temperature of 101.5 F. No orders received. T. Wright, RN

incision. T. Wright, RN 4. 09-3-21 (1015): Surgeon contacted by phone. Notified about new area of bright red erythema extending approximately 1 inch around circumference of midline abdominal incision and oral temperature of 101.5 F. No orders received. T. Wright, RN

what is the definition of futile?

something that is hopeless or serves no purpose

what is the definition of feminist ethics?

type of ethical approach that aims to critique existing patterns of oppression and domination in society, especially as these affect women and the poor

what is the definition of utilitarianism?

value determined by usefulness

what is the definition of just culture?

when mistakes made, don't quickly fire or blame for it, instead support and work through it together