NURS 396 Final

A client who is recovering from coronary bypass surgery is placed on a critical pathway for extended care. Which client statement indicates appropriate understanding of the plan of care?

"The chosen critical pathway can be altered to meet my needs."

The nurse is caring for a client who has chosen to discontinue hemodialysis. The client's family, however, is not supportive of the decision. The nurse who uses the theory of principles-based reasoning would make which statement regarding the current situation?

"This client is of sound mind and is capable of making independent decisions regarding health care. It really is the client's decision to make."

A novice nurse is working with a client who is admitted to a med-surg unit. The nurse is establishing a therapeutic relationship with the client by conveying empathy. Which statement by the nurse best exemplifies empathy?

"You seem to be frightened by the procedure. Tell me how you are feeling."

The nurses on the cardiology unit are unhappy with their nurse manager. The nurses complain that the manager is "inflexible and impersonal." Which type of leadership is this nurse manager most likely using?

Bureaucratic

The student nurse is attending a lecture about commitment to the profession of nursing. The instructor is grading the student's commitment to nursing during this rotation. Which action by the student indicates commitment to the nursing profession?

Calls in sick for clinical because of a respiratory infection.

A client comes to the clinic and is found to have a STI. The client states to the nurse, "Promise you won't tell anyone about my condition." According to HIPAA, which action must the nurse take?

Communicate only necessary information.

A nurse supervisor in a hospital, who is about to vote on unionizing nurses, is told by the hospital CFO to schedule the nurse union organizers for client care during times that have been arranged for union organizational meetings. Which actions by the nurse supervisor are appropriate? Select all that apply.

Continue to implement the usual staffing procedures. Schedule the organizers according to clinical staffing needs. Discuss the need for professional nursing integrity with the CFO.

A nurse working in an outpatient OB-GYN clinic is asked to assume care coordination for the clinic's adolescent clients. Which skills will the nurse need to perform this work?

Critical thinking

A nurse is working as the designated leader of a group of healthcare providers in a community clinic setting. The team members are working to decrease the number of adolescent pregnancies in the community. They have defined the problem and are now focusing on objectives and considering various viewpoints presented by the group. The nurse is tasked with helping the team to stay focused in order to address the defined problem. Which of the competencies of collaboration does this describe?

Decision making

When faced with ethical dilemmas, which are some of the elements of risk management that can assist nurses in decision making? Select all that apply.

Education Resource accumulation Peer support and consultation

An OR nurse notices that the nurse-anesthesiologist for the next scheduled surgery seems to be unsteady. When the OR nurse comes closer to the anesthesiologist, a strong odor of alcohol is noted. Which actions by the OR nurse are appropriate? Select all that apply.

Follow the state board guidelines. Immediately report it to a supervisor.

A nurse manager overhears two staff nurses talking about a third nurse, who has the day off. The nurses are making unflattering comments regarding the nurse in front of several other nurses who work on the unit. The nurse manager discretely asks to speak to the nurses' in private and states, "This behavior isn't OK, especially in a hospital like ours with a 'zero-tolerance policy.' If you have an issue with this nurse, please deal with that nurse directly. If you'd like me to help you with this, please let me know, and the four of us can meet." The nurse manager's behavior modeled strategies for which type of work-place conflict?

Horizontal violence

A community hospital wants to implement a labor/delivery/recovery/postpartum unit to replace the labor/delivery and mother/baby units. The nurses who work on the mother/baby unit are concerned they will not be able to care for a laboring mother and may lose their jobs. The nurse manager for both units supports the plan for an integrated unit, reports that jobs would not be lost, and involves the team members in the planning process, which includes cross-training all nursing staff. Based on the information presented, what causes of conflict may occur in spite of the nurse manager's effort for a smooth transition? Select all that apply.

Mistrust Resistance to change

A newly hired nurse manager believes in the theory of shared governance and directs the unit using that style. Which skills are essential in order for the nurse manager to be an effective nurse leader using this theory? Select all that apply.

Modeling the way Receiving feedback Giving feedback Empowering others

The nurse is caring for a client with cancer who is struggling with chronic pain. The nurse tells the client, "It is normal to feel frustrated about the discomfort." Which skill associated with the working phase of the nurse-client relationship does the nurse's statement best reflect?

Respect

The nurse working in a neonatal intensive care unit (NICU) is caring for a critically ill 28-week-old preemie. The parent calls the nurse and asks if it would be possible to bring the client's 2-year-old sibling to visit because the sibling is having nightmares about the client's death. Small children are not permitted to visit because of the risk of infection to the infants on the unit. Which action by the nurse is appropriate?

Seek permission from unit management and the neonatologist to allow the sibling to visit.

A novice nurse is looking for employment and hopes to find a facility where the nursing staff participates in making, implementing, and evaluating client care policies. Which organizational model implements these practices?

Shared governance

A nurse is volunteering time in a local free clinic that provides care to the underinsured population. By volunteering time to work in the clinic, this nurse is demonstrating which professional value?

Social justice

The nurse educator is presenting a lecture regarding advocacy in nursing. Which interventions will the nurse include as they exemplify client advocacy? Select all that apply.

Speaking out for safe practice conditions when threatened by budget cutbacks Ensuring that clients have the necessary information to make an informed decision or give informed consent Questioning other healthcare professionals when they provide care that is based on stereotypic ideas rather than on an assessment of the individual client's needs Educating clients and their families about their legal rights

The nurses in a nursing home have a unique nursing team consisting of all four generational cohorts. Which is the best use of each generation's contributions by nursing management?

The contributions from each generation's strengths

A nurse has taken a position in the hospital setting. The nurse knows one role of the professional nurse is that of client advocate. Which must the nurse be aware of in preparation to act as a client advocate? Select all that apply.

The hospital's client rights statement State and federal client rights legislation

A nurse is volunteering at a local free clinic. By providing client care to an inadequately insured population, the nurse is demonstrating which value of client advocacy?

The nurse has the responsibility to ensure the client has access to healthcare services.

A client with AIDS is admitted to the acute care floor. According to a 1994 ANA position statement, which stance addressing this bioethical issue is appropriate?

The nurse is morally obligated to care for the client unless the risk exceeds responsibility.

The nurse caring for an adult client in the ICU is given a verbal prescription by a first-year medical resident. The nurse determines that the best course of action is to check with the attending healthcare provider before implementing the prescription. Which is the rationale for why the nurse is experiencing conflict regarding this situation?

The nurse may not trust the resident to make the best care decisions.

The med-surg nurse is habitually late and often leaves work for nurses on the other shift to complete. The nurse has been reprimanded for this behavior. Which action is required by the nurse in order to retain employment?

The nurse must take responsibility and accept any corrective action.

Which statement is a primary and historical barrier to effective nurse-physician collaboration that has persisted over time?

The nurses' and physicians' perceptions of inequity in their roles, with nurses assuming a subservient role and physicians assuming leadership and a superior role in healthcare settings.

The nurse managers in a community hospital have been charged with reviewing job descriptions of UAPS and have questions about the delegation of certain client care activities to UAPs by nurses. To which group, organization, or individual would committee members direct their questions to obtain definitive answers about the parameters of nurse delegation to UAPs?

The state board of nursing

A student nurse is caring for an older adult client with dementia who is confused, agitated, and forgetful. The student leaves for a break and forgets to put the call light within reach of the client. When checking on the student's clients, the instructor discovers the student's negligence. Which conclusion by the instructor is appropriate?

The student is demonstrating inappropriate safety measures for the client.

The nurse is talking with a parent who decides to decline treatment for a 3-year-old client whose cancer has metastasized. There is a conflict between the parents and the rest of the family regarding the withdrawal of care from the child. Which should the nurse consider when determining the appropriate action for this client?

The values of the parents

The case manager interviews an older adult client hospitalized after hip replacement surgery. The client requires in-patient rehabilitation prior to being discharged home. The case manager works with the hospital nursing staff, the rehabilitation center, the client's family members, and other providers to assist with a smooth transition. Which is the primary goal of the care management model described here?

To provide a continuum of clinical services in order to help contain costs and improve client outcomes

A nurse educator is teaching a group of students about therapeutic touch. In which situation is it appropriate to use therapeutic touch as a means of communication?

When an upset spouse is alone and the client has just expired

The nurse is working in a low-income neighborhood as a home health nurse. During one of the home care visits, the nurse notes that the children's playground has broken equipment, which the children continue to play on. The nurse has already contacted the owner of the playground about the issue. What action might the nurse take as a public advocate?

Write an article to the local newspaper to gain public attention.

The nurse performing an admission assessment on a client must inform the client of client rights and responsibilities. Which client rights are considered standard by many healthcare agencies? Select all that apply.

You have the right to know the names of your caregivers. You have the right to be treated with courtesy and respect. You have the right to be informed about the care you receive. You have the right to refuse care.

In arranging community services for a client who is diagnosed with schizophrenia, the nurse case manager discusses options with the Assertive Community Treatment (ACT) team. Which team disciplines should the nurse expect will be part of the client's ACT interdisciplinary team?

Psychiatrists, nurses, social workers, employment specialists, substance abuse specialists

A nurse is completing discharge teaching for a client who is hospitalized for total hip replacement. The client asks the nurse why there is a case manager involved and expresses confusion about who is in charge. The client states, "I thought my doctor manages my care." Which is the best response by the nurse?"

"A case manager coordinates everyone involved in your care to ensure your needs are met."

The nurse educator is teaching a management and leadership class to a group of nursing students. The educator presents information regarding case management and case managers. Which statement, if made by a student, indicates the need for additional education on this subject matter?

"Case managers can only be licensed professional nurses who have extensive patient care experience."

A nurse manager who is employed by a community hospital is asked to implement critical pathways on the medical-surgical unit. When educating the staff nurses about critical pathways, which primary reason for their use would the nurse manager include in the teaching session?

"Critical pathways direct, track, and evaluate care provided to client with certain medical conditions."

The novice nurse is interviewing with managers in the hospital. The nurse has decided that working for a manager who demonstrates an autocratic style of leadership would be the best match for the nurse. To determine the manager's style, which question should the novice nurse ask the manager?

"Do you seek input from staff when implementing new policies?"

The home health nurse is assigned to care for a client who requires wound care. The nurse is assessing the family's ability to change a wound dressing that the client cannot reach. The nurse asks the family to change the dressing during the visit. After the family demonstrates the dressing change, which response by the nurse is appropriate?

"Great job! Let me show you a technique that can make the dressing change more effective."

The nurse is caring for an older adult client in a long-term care facility. Which behavior by the nurse conveys physical attending when communicating with this client?

Leaning toward the client during conversation

The nurse is providing care to a client who is newly diagnosed with HIV. Which statements by the nurse could inhibit the development of therapeutic communication with this client? Select all that apply.

"I am so happy today! I found out that I got accepted into nurse practitioner school, isn't that great?" "One of my cousins has AIDS. It is hard to watch him die." "Well, I guess your homosexual lifestyle finally caught up to you, huh?"

A toddler who is admitted to the pediatric unit is crying and scared. No treatment has been initiated at this point. The nurse needs to start an IV, and the parent asks, "Can I stay with my child and help through the procedure?" In providing care for the family, which response by the nurse is appropriate?

"I can teach you ways to help your child throughout the procedure if you would like to be involved."

A home health nurse is planning care for an adult client being discharged from the hospital after experiencing complications of DM. The client requires an extensive dressing change twice a day, help with activities of daily living, and comprehensive education. The nurse is coordinating home visits from aides and therapists. Which role is the nurse assuming by coordinating this client's care?

Case manager

The nurse is helping in discharge planning for a diabetic client who needs extensive rehabilitation and is on a complicated medication schedule. The client and spouse currently live with their eldest son and the family is very involved in the client's care. The nurse would want to coordinate the client's care by including which priority individuals? Select all that apply.

Client's spouse Client's children

What are some of the rights clients have when receiving care with a healthcare system? Select all that apply.

Clients have the right to refuse care. Clients have the right to know when something goes wrong with their care. Clients have the right to have a personal representative (advocate) with them during their care.

The hospital's nurse case manager has been extensively involved with a shooting victim and members of the client's family in coordinating care of providers from many disciplines as the client progressed from the ED to the ICU and then onto the medical-surgical unit. After 3 weeks of hospitalization, the case manager is helping to prepare the client for discharge to a rehabilitation center where treatment will continue. Which outcomes have been documented in the literature as benefits of such collaboration? Select all that apply.

Decreased client morbidity and mortality Higher level of job satisfaction Improved client outcomes Reduction in duplication of healthcare services

A hospice nurse is working closely with a client who, on several occasions, has asked about guidance and support in ending life. The nurse recognizes which in regard to making ethical and moral decisions in this circumstance?

Euthanasia has legal implications along with moral and ethical ones.

The nurses in the ED and the staff nurses on the neurological unit are experiencing conflict. The ED nurses are not pleased with the amount of time it takes for the neurological unit's admitting nurse to receive face-to-face hand-off communication for clients who are being admitted to that unit. Which type of conflict is being experienced by these nurses?

Intergroup conflict

A nurse educator is talking to a student about how to deal with an ethical dilemma in practice. Which does the nurse educator explain to the student as important regarding actions during an ethical dilemma?

Investigating all aspects of the situation

The nurse is caring for a preschool-age client who suffered brain damage following a car accident. The client has a tracheostomy, is ventilator-dependent, and will be discharged from the hospital into the family's care. The family wants to care for the child at home but does not have the resources for 24-hour care. Which action by the care manager is appropriate?

Making referrals to a variety of community-based agencies that can met the family's needs

A nurse is providing hospice care for an older adult client. The nurse is approached by the client's adult child. The adult child believes that her other parent, who is in a nursing home, is being neglected. What suggestions can the nurse offer in this situation? Select all that apply.

Report suspicions to the licensing agency. Contact the client advocate at the nursing facility.

A nurse has just received a shift report for a 12-hour shift. As the nurse is preparing to enter a client's room, the nurse overhears a coworker telling an offensive joke with a sexual undertone to the client. Which action by the nurse is appropriate?

Tell the nurse, in private, that such conduct is offensive and not professional.

A charge nurse is making assignments for the shift and notes that a client from a different culture was recently admitted and will require a thorough admission assessment during the upcoming shift. Which generation of nurse is likely to be the most culturally sensitive and the best choice for this client assignment?

The Millennial nurse

A client with type 1 DM has developed an open sore on the shin and is having trouble meeting daily goals for exercising. The client is scheduled for discharge in a couple of days. When planning for this client's continued care, who will the nurse notify regarding the client's needs after discharge?

The case manager

Staff at the hospital have decided to strike in order to try to improve working conditions. Which are some of the ethical issues that a nurse working in the hospital will have to consider when deciding whether or not to honor the picket line? Select all that apply.

The need to ensure that clients receive care and are not abandoned The need to support coworkers in their efforts to improve working conditions Loyalty to the nurse's employer

The nurse is providing care for a client who is newly diagnosed with COPD. Which action by the nurse conveys therapeutic communication with the client?

The nurse asks appropriate questions about the client's medical history.

The nurse is providing care to a visually impaired client who is scheduled for a colonoscopy. The client requires a bowel prep prior to the diagnostic test. Which approach will the nurse use to facilitate the client's understanding of the material?

Use layman's terms and ask the client to describe the procedure afterwards.

The nurse is caring for a school-age client who is scheduled to have major heart surgery the next morning. The nurse enters the room to administer a medication and finds the client crying. Which response by the nurse is most therapeutic?

"It is okay to cry. I know this is scary."

A nurse educator is teaching a group of nursing students about the ANA Code of Ethics for professional nurses. Which student nurse response describes the ANA Code of Ethics?

"It provides standards for professional nursing practice."

The nurse on the mother-baby unit is confronted by a client who states, "I know my rights, and you have to do what I tell you!" Which response by the nurse is most appropriate?

"I don't mind doing anything within reason, but you have a responsibility to be considerate to the staff as well."

The nurse is providing care to a client who is diagnosed with hypertension. Which response by the nurse is an appropriate example of informational confrontation with the client?

"I noticed you rubbing you head and your eyes, are you hurting? Let's take your blood pressure."

The nurse is caring for a group of clients on a psychiatric unit. One client has become highly agitated and is threatening other clients and some of the staff. The nurse escorts the client to the isolation room, leaving the door open. Which statement by the nurse is most appropriate?

"I'm going to stay here with you in case you want to talk about what happened."

The nursing instructor is conducting a class regarding nursing ethics with a group of first-year nursing students. The instructor determines that the students have retained the necessary information when the student makes which statement regarding the ANA Code of Ethics?

"It guides nurses in their professional behavior and relationships."

The nurse completes a teaching session on wound care for a client who will require dressing changes after discharge. The nurse evaluates the effectiveness of a teaching session for wound care with the family and determines that more education is required. Which statement by the nurse is appropriate in this situation?

"Let me clarify again some of the steps that are required during wound care."

The nurse is discussing follow-up care with a client who is being discharged. The client and family cross their arms and state angrily that the team's suggestions are not acceptable. Which response by the nurse is appropriate?

"Let's discuss other options that might work well for you and your family."

A nurse is discussing the plan of care with a client who is preparing for discharge. The client has a strong objection to portions of the plan of care. The nurse recognizes that there is a conflict. Which response by the nurse indicates an understanding of the client's position and a willingness to collaborate regarding the discharge plan?

"Let's talk about what your objections are and possible solutions or alternatives."

The nurse educator is teaching a group of nursing students about the benefits of participating in an interdisciplinary team when planning and implementing client care. When quoting research on this subject, which statement by the educator is appropriate?

"Pooling resources and ideas results in greater efficiency in providing care to clients."

The nurse is appointed to a clinical-administrative task force studying critical staffing issues and care delivery models for the hospital. Which evidence on the effects of different staffing choices and care delivery models should the task force consider? Select all that apply.

A higher proportion of registered nurses can reduce the risk of mortality in surgical clients. Higher nurse-client rations have been linked to a decrease in the amount of time clients are hospitalized.

A client who is experiencing an exacerbation of RA will be discharged after a week's stay in the hospital. The client tells the nurse, "I can't believe how much better I am feeling now." Which is the rationale for why the client is feeling better?

Appropriate scheduling of the client's care by all disciplines allowed the client to rest.

The nurse on third shift missed the last chance for the unit competency, stating, "Oh well, it's not like I don't know what I'm doing." Which is the most accurate description of this nurse's behavior?

Arrogance, which keeps the nurse from developing and from accurate assessment of her strengths and weaknesses

The charge nurse working in the ED is preparing to receive a client with traumatic amputation of the lower left arm secondary to shark attack. The nurse assembles appropriate members of the healthcare team to be present when the client arrives with the goal of allowing the client to regain as much upper extremity function as possible. Which is the rationale for why the charge nurse assembled the entire healthcare team upon arrival to the ED?

Healthcare teams utilize collaborative delivery of high-quality, interdisciplinary health services in a shared leadership role, where accountability is both individual and mutual in nature.

A student nurse accidentally left an older adult client's bed up after giving a bed bath. Luckily, another nurse found that the bed was not left in the lowest position and was able to rectify the matter before something happened. The student responded, "I know better. I should've double-checked the bed before I left the room." Which characteristic is this student demonstrating?

Integrity

The Chief Nursing Officer and Chief Medical Officer in an urban teaching hospital are leading a series of meetings with nurses, physicians, hospital lawyers, and risk managers to review and update hospital privileging procedures and requirements for advanced practice RNs and physicians new to the hospital. This is an example of which type of collaborative team?

Interdisciplinary

The client's case manager, diabetes educator, and nutritionist meet to discuss the client's needs in preparation for discharge to home. The client's primary healthcare provider arrives and states, "I will be making all decisions regarding the client's discharge care." With the primary healthcare provider's decision to lead the team, the dynamic has shifted between which two types of teams?

Interdisciplinary to multidisciplinary team

A hospice nurse is working with a client who has ovarian cancer. The client is concerned that her two daughters are at an increased risk for cancer and asks for the nurse's help. Which actions by the nurse are appropriate? Select all that apply.

Provide the family with information on hereditary cancer risks. Offer to refer the daughters to a genetic counselor. Arrange for the client to have genetic testing.

A group of nurses are in a staff meeting on a medical-surgical unit headed by the new unit nurse manager. The manager announces that nurses should not criticize and make fun of other nurses or there will be repercussions. Several nurses at the meeting suggest that the nurse manager talk to the individual nurses who are exhibiting this behavior. When assessing the staff's group dynamics, which action by the nurse manager is appropriate?

Recognize that the group has already defined behavioral norms.

The nurse is caring for a client with rheumatoid arthritis who expresses the desire to remain active as long as possible. In order for the client to meet this goal, what should the nurse prepare to do?

Refer the client to the appropriate professionals.

A pregnant client with a history of drug use refuses testing for HIV, despite the recommendation of her nurse-midwife. Which actions by the nurse are appropriate in this situation? Select all that apply.

Throughout the pregnancy, encourage the client to reconsider the decision not to be tested. Offer counseling. Re-emphasize the importance of HIV testing.

A school-age client is admitted to the PICU, unconscious and with multiple traumatic injuries, after a skateboard accident that included a closed head injury. Many health professionals are involved in the client's care, and the scene is chaotic. The parents are extremely anxious and want to know what's happening. The case manager asks for an interdisciplinary team meeting to speak with the client's parents. Which is the rationale for this meeting?

To share and evaluate information for care planning and implementation, and prevent priority conflicts, redundancy, and omissions in care

A nurse is caring for an older adult client with terminal cancer. The client's family wants to continue treatment, but the client would like to discontinue treatment and go home. The nurse agrees to be present while the client tells the family. Which principle is the nurse supporting?

Autonomy for the client

A nurse mistakenly gives a client, who is NPO for surgery, a morning breakfast tray. After realizing the mistake, the nurse notifies the healthcare provider as well as the client; explains the consequences of this mistake, which includes a delay in the client's surgery; and documents the situation in the client's medical record. Which is demonstrated by the actions of this nurse?

Accountability

A nurse is responsible for the care coordination of a client with multiple sclerosis who is being treated at a multiservice outpatient clinic. The nurse is informed by the occupational therapist that the client needs specialized assistive devices in order to prepare meals but does not have the money to purchase them. The client's insurance company has denied approval to cover the devices. Which is the appropriate action by the nurse?

Advocate with the insurance company to provide the appropriate coverage.

A novice nurse is hired to work in a busy cardiac intensive care unit at the local hospital. The nurse will spend 12 weeks in orientation to the unit. Which action by the novice nurse demonstrates commitment to the new job?

Attending every shift on time

The nurse manager on the neurology unit helps staff nurses become more involved with the local neurological association and schedules participation with in-services to the community. Which type of commitment to the nursing profession is exemplified by this nurse manager?

Affective

A veteran nurse working on the med-surg unit of an urban hospital is frequently consulted by other staff members on clinical issues and new procedures. What characteristics of the informal leader does this veteran nurse demonstrate? Select all that apply.

Age Seniority Special abilities

A nurse educator is explaining the idea of health care as a partnership between provider and client. Which are client responsibilities that some hospitals have included in their client bill of rights? Select all that apply.

Asking questions asked by your healthcare team Reporting accurate and complete information about your health to your healthcare team Accepting the consequences if you fail to comply with instructions given to you

A nurse manager interacts with a particularly difficult healthcare provider who is demanding of and demeaning to the nurses on the unit. Through this situation, the nurse manager has learned that which are characteristics of successful communication? Select all that apply.

Assertiveness Accuracy Honesty

A nurse is caring for a client who had a total hip replacement 14 days ago. The client is preparing for discharge in a few days. The nurse facilitates a care conference with the primary healthcare provider, occupational therapist, physical therapist, and the client and family to develop a plan of care for the client prior to discharge. Which roles are being demonstrated by this nurse? Select all that apply.

Coordinator Collaborator

An older adult client with metastasized breast cancer informs the nurse that her doctor is insisting that she participate in a course of chemotherapy, even though the client does not want to have any further treatment. Which actions by the nurse exemplify advocacy for this client? Select all that apply.

Discuss the implications of various choices with the client. Ascertain whether or not the client has an advanced care directive, and, if not, assist her in creating one. Inform the doctor about the client's clear wishes not to have further chemotherapy.

A staff nurse learns before reporting to work that a close family member has been diagnosed with terminal cancer. The nurse is receiving the shift report and finds the family member has been assigned as a client. The nurse reporting off duty states that the client is very demanding and complains a lot. Which action by the staff nurse who is assigned care for the oncoming shift is appropriate?

Discuss the situation with the charge nurse.

The nurse has been working in a long-term care facility for 1 week. The nurse notes that during the evening meal, an UAP takes a tray to a client who is unable to cut up and eat the food independently. After the nurse assists the client with eating the meal, which action is appropriate to advocate for this client?

Discuss the situation with the director of nursing.

A charge nurse notices that a staff nurse assigned for the evening shift has come to work with a black eye. Which action by the charge nurse is appropriate in this situation?

Discuss the situation with the nurse in a private setting.

The nurse is preparing a client for discharge who will be requiring PT to rehabilitate after a total knee replacement. After reading the healthcare provider's orders for PT, which would be the nurse's initial action?

Discuss the various types of settings for therapy and have the client choose the venue.

A nurse, who works in a clinic environment, places great emphasis on cost control, customer satisfaction, health promotion, and preventive services. The primary focus of this nurse is representative of which type of healthcare system?

Managed care

Nurse leaders in a local hospital created a neurotrauma (NT) unit healthcare team focused on improving outcomes for their stroke clients. This team includes acute care nurses, physicians, other care partners (e.g., physical therapists, social workers, case managers, dieticians), and representatives from the NT outpatient clinic. This team is led by a physician who makes treatment decisions based on the treatment plans developed by individual team members who each communicate with the clients, asking the same or similar questions to obtain data needed for their treatment plan. Which type of communication and action is represented in the scenario described?

Parallel communication

The nurse is caring for a client in the ICU who was in a motor vehicle accident. The healthcare provider asks the nurse to extubate the client because there is no communication between the brain and body due to a cervical fracture. The family agrees with the decision of the healthcare provider, but the nurse is comfortable pulling the tube. Which is the reason the nurse is experiencing difficulty with this task?

Personal values

The case manager assembles a team of healthcare professionals, including the client's primary healthcare provider, physical therapist, and social worker, for the purpose of collaborative discharge planning and decision making. Which type of team did the case manager assemble? Select all that apply.

Primary nursing care team Interdisciplinary team

The home health care nurse is planning care for the older adult client. Which interdisciplinary program would best support the needs of an older adult client within the community? Select all that apply.

Programs of All-Inclusive Care for the Elderly (PACE) Meals on Wheels

The nurse is caring for a terminally ill pediatric client. The parents have decided to remove their child from life support. This decision was met with much opposition from other nurses on the unit. Which action by the nurse displays the role of client advocate?

Respecting the parents' decision

A nurse is on the elevator preparing to start a 12-hour shift after visiting a sick family member when two other nurses enter. The nurses start talking negatively about a client they are caring for on a medical-surgical unit in the hospital. Although there are no clients on the elevator, which action by the first nurse in the elevator is appropriate?

Speak to the nurses in a private place.

The nurse is caring for a client on a medical-surgical unit. The client tells the nurse that the healthcare provider has refused to treat the client further if the client continues to be noncompliant with the healthcare provider's recommendations. Which is the priority nursing action in this situation?

Take the issue to the hospital ethics committee.

The nurse is caring for an older adult client who will undergo surgery in the morning. While assessing the client, the nurse discovers that the client does not have an adequate understanding of the procedure. The nurse discusses the situation with the charge nurse to determine the best course. Which is the reason for the nurse to take action in this situation?

The client has a right to informed consent.