Nursing Exam 5....
The nurse manager of a client care area is preparing the staff for the arrival of nursing students for a clinical rotation. Which statement by the manager reflects support for the Code for Nursing Students? A. "Ask the clients for permission before permitting the students to provide care." B. "Show the students the shortcuts that you use to quickly complete care." C. "Challenge these students to perform tasks for which they might not be prepared." D. "Remind the students that learning does not occur by reading a book."
***A. "Ask the clients for permission before permitting the students to provide care." B. "Show the students the shortcuts that you use to quickly complete care." C. "Challenge these students to perform tasks for which they might not be prepared." D. "Remind the students that learning does not occur by reading a book." The nurse manager should support the Code for Nursing Students by ensuring clients provide authorization before accepting treatment from the students. The students should not perform any tasks for which they are not prepared. Life-long learning should be supported, and it may include reading a book. Care should be provided in a professional manner that may be violated through the use of shortcuts.
Which questions or statements will help clients clarify their values? (Select all that apply.) A. "Do you have a choice?" B. "Do you want to know what I would do?" C. "Tell me how you plan to start doing this?" D. "What does your husband think you should do?" E. "Are you considering other courses of action?"
***A. "Do you have a choice?" B. "Do you want to know what I would do?" ***C. "Tell me how you plan to start doing this?" D. "What does your husband think you should do?" ***E. "Are you considering other courses of action?" Value clarifying questions or statements include "Do you have a choice?" "Are you considering other courses of action?" and "Tell me how you plan to start doing this?" Saying "What does your husband think you should do?" or "Do you want to know what I would do?" does not help clarify the client's values.
While talking with a nursing colleague, the staff nurse states, "I don't drink alcohol, but I smoke marijuana." Which response by the nursing colleague best reflects correct understanding of professional behaviors? A. "Even in your personal life, the same rules of professionalism still apply to your behavior." B. "If you're arrested for smoking marijuana, your professional credibility will be negatively affected." C. "If your client care is negatively affected, then you should stop smoking marijuana." D. "Even though you're a nurse, what you do in your personal life is your business."
***A. "Even in your personal life, the same rules of professionalism still apply to your behavior." B. "If you're arrested for smoking marijuana, your professional credibility will be negatively affected." C. "If your client care is negatively affected, then you should stop smoking marijuana." D. "Even though you're a nurse, what you do in your personal life is your business." Unprofessional behaviors include substance abuse. The rules of professionalism and the dangers of unprofessional behavior extend to social situations. The effects of unprofessional behavior may include adversely affecting client outcomes, but unprofessional behavior is inappropriate with or without consequences. Engaging in unprofessional behavior, regardless of whether it leads to an arrest, can negatively impact the nurse's credibility.
The nurse manager is presenting an in-service for staff nurses about Medicaid insurance coverage. Which statements are appropriate for the nurse manager to include during the in-service? (Select all that apply.) A. "For the client who qualifies for Medicaid, home health services are typically covered." B. "While Medicaid covers inpatient hospital services, it does not cover outpatient care." C. "Individuals with disabilities who meet federal and state eligibility requirements may be covered by Medicaid." D. "Transportation costs to healthcare appointments are not covered by Medicaid." E. "Medicaid provides qualified individuals with cash for basic needs, such as food, housing, and clothing."
***A. "For the client who qualifies for Medicaid, home health services are typically covered." B. "While Medicaid covers inpatient hospital services, it does not cover outpatient care." ***C. "Individuals with disabilities who meet federal and state eligibility requirements may be covered by Medicaid." D. "Transportation costs to healthcare appointments are not covered by Medicaid." E. "Medicaid provides qualified individuals with cash for basic needs, such as food, housing, and clothing." Medicaid is available to certain lower income individuals and families, the elderly, and people with disabilities who meet the eligibility requirements set by federal and state law. Each state sets its own guidelines regarding Medicaid eligibility and covered services. However, federal law requires Medicaid to cover certain services including physician services, inpatient and outpatient hospital care, home health services, and transportation to medical care. Supplemental Security Income (SSI) provides cash for basic needs such as food, housing, and clothing.
The community health nurse is explaining geographic information system (GIS) technology to the student nurse. Which statement is most accurate? A. "GIS technology is not limited to use strictly within health care." B. "GIS technology is not dependent on global positioning systems." C. "GIS technology is not useful in the plotting of lifestyle choices." D. "GIS technology is not useful in analyzing location-based data."
***A. "GIS technology is not limited to use strictly within health care." B. "GIS technology is not dependent on global positioning systems." C. "GIS technology is not useful in the plotting of lifestyle choices." D. "GIS technology is not useful in analyzing location-based data." Geographic information system (GIS) technology has been used both inside and outside of health care. To capture geographical data, GIS relies on satellite imaging and global positioning systems (GPSs). Applications of GIS may include analyzing population- or location-based data, such as disease transmission, obesity rates, cancer rates, trends in diseases such as diabetes, and environmental data. GIS can also be used to plot and analyze lifestyle choices, such as improper nutrition, tobacco use, and physical activity rates.
The client who was recently diagnosed with cancer is making a difficult clinical decision, choosing between surgery or chemotherapy and radiation. The client asks the nurse "What would you do if you were in my shoes?" What is the most appropriate response by the nurse? A. "I am not an expert in treatment outcome research, so I would not want to influence your decision." B. "It really does not matter which way you choose to get treatment; either way works as well." C. "Chemotherapy and radiation take a lot longer to recover from; I would advise against them." D. "I have watched a lot of clients make that decision; the ones that chose surgery seemed the happiest."
***A. "I am not an expert in treatment outcome research, so I would not want to influence your decision." B. "It really does not matter which way you choose to get treatment; either way works as well." C. "Chemotherapy and radiation take a lot longer to recover from; I would advise against them." D. "I have watched a lot of clients make that decision; the ones that chose surgery seemed the happiest." The nurse should not offer an opinion, even when the client asks for it. It is not ethical to rely on previous clinical experience, assume a neutral stance, or use a standard of the fastest recovery time.
A medical-surgical nurse is reviewing online evidence-based guidelines for the care of a client facing a radical prostatectomy. The online package includes discharge instructions to give the client. Which statement by the nurse reflects an understanding of the role of this technology in providing clinical excellence? A. "I can expect my client to progress in healing as shown in the timeline." B. "If I don't agree with a specific guideline, I can't change it." C. "I can hand the discharge instructions to the client straight from the printer." D. "I am not going to tell my client that his care is being guided by the Internet."
***A. "I can expect my client to progress in healing as shown in the timeline." B. "If I don't agree with a specific guideline, I can't change it." C. "I can hand the discharge instructions to the client straight from the printer." D. "I am not going to tell my client that his care is being guided by the Internet." The evidence-based guidelines do have timelines for expected healing. However, individual clients can have other issues, so the discharge instructions might need to be adapted before they are given to the client. The client's care is not being guided by the Internet, but by standards from professional organizations' consensus. Even so, if a nurse does not agree with a specific guideline, the nurse is able to change it.
An emergency department (ED) nurse is approached by the parents of a teen admitted with a uterine hemorrhage. "Is my daughter pregnant?" the father asks. What is the most appropriate response by the nurse to the client's father? A. "I cannot discuss her medical condition with you. All of our clients have privacy rights." B. "I know this situation must be hard for you to deal with. I will let you know when I find out the answer." C. "You can ask the admitting physician. I am sure he will discuss your daughter's condition with you." D. "I don't think you have anything to worry about. She is a lovely young woman."
***A. "I cannot discuss her medical condition with you. All of our clients have privacy rights." B. "I know this situation must be hard for you to deal with. I will let you know when I find out the answer." C. "You can ask the admitting physician. I am sure he will discuss your daughter's condition with you." D. "I don't think you have anything to worry about. She is a lovely young woman." The nurse must uphold the right of the client to privacy, even if the client is not an adult. The nurse cannot promise to disclose private information at a later time. The nurse cannot promise that the ED physician will disclose private information. The nurse also should not dismiss the concerns of the father.
A nurse is an active member of an evangelical church. The nurse prays with some clients. Which statements by the nurse would indicate appropriate considerations? (Select all that apply.) A. "I pray only with clients whose minds can still make choices." B. "I ask clients about wanting to pray together." C. "Before praying, I confirm that it's a convenient time for clients." D. "I tell clients who don't join me that they're on my prayer list." E. "Praying together is the best therapeutic relationship."
***A. "I pray only with clients whose minds can still make choices." ***B. "I ask clients about wanting to pray together." ***C. "Before praying, I confirm that it's a convenient time for clients." D. "I tell clients who don't join me that they're on my prayer list." E. "Praying together is the best therapeutic relationship." It is appropriate for the nurse to ask about clients' desires, to select only those who can make decisions, and to select those for whom it is a convenient time. Being too enthusiastic about the effects of prayer or trying to include those who are opting out is not appropriate.
The student nurse is giving a presentation about the history, role, and functions of Sigma Theta Tau International (STTI). Which statements are appropriate for the student nurse to include in the presentation? (Select all that apply.) A. "Invitations to join are offered to baccalaureate and graduate nursing students who demonstrate scholarship excellence." B. "Membership is offered to nurse leaders who exhibit exceptional nursing achievements." C. "Sigma Theta Tau International (STTI) was the first nursing organization to fund nursing research." D. "Benefits of membership include career services and continuing education opportunities." E. "STTI's vision is to create a local community of nurses who lead in using knowledge, scholarship, service, and learning to improve the health of the world's people."
***A. "Invitations to join are offered to baccalaureate and graduate nursing students who demonstrate scholarship excellence." ***B. "Membership is offered to nurse leaders who exhibit exceptional nursing achievements." ***C. "Sigma Theta Tau International (STTI) was the first nursing organization to fund nursing research." ***D. "Benefits of membership include career services and continuing education opportunities." E. "STTI's vision is to create a local community of nurses who lead in using knowledge, scholarship, service, and learning to improve the health of the world's people." Sigma Theta Tau International (STTI) was the first nursing organization to fund nursing research. Invitations to join are offered to baccalaureate and graduate nursing students who demonstrate scholarship excellence and to nurse leaders who exhibit exceptional nursing achievements. STTI's vision is to create a global community of nurses who lead in using knowledge, scholarship, service, and learning to improve the health of the world's people. Member benefits include career services and continuing education opportunities.
The novice nurse has just completed hospital orientation. Which statements by the nurse best reflect correct understanding of the role of the Occupational Safety and Health Administration (OSHA)? (Select all that apply.) A. "OSHA provides employer and employee with training materials that address workplace safety and health hazards." B. "OSHA requires my employer to provide me with personal protective equipment (PPE) when it is needed to protect my health and safety." C. "According to OSHA regulations, all employers must have an emergency eye wash station." D. "According to OSHA regulations, all employers must reduce or eliminate workplace hazards." E. "According to OSHA regulations, all employers must maintain conditions or adopt practices that are needed to protect workers on the job."
***A. "OSHA provides employer and employee with training materials that address workplace safety and health hazards." ***B. "OSHA requires my employer to provide me with personal protective equipment (PPE) when it is needed to protect my health and safety." C. "According to OSHA regulations, all employers must have an emergency eye wash station." ***D. "According to OSHA regulations, all employers must reduce or eliminate workplace hazards." ***E. "According to OSHA regulations, all employers must maintain conditions or adopt practices that are needed to protect workers on the job." The Occupational Safety and Health Administration (OSHA) requires employers to ensure that employees have and use personal protective equipment (PPE) when required for safety and health. Employers must comply with standards for a wide variety of workplace hazards in industrial and healthcare settings; for example, in some industries, employers are required to provide both PPE and emergency eyewash stations. OSHA requires all employers to maintain conditions or adopt practices that are needed to protect workers on the job. OSHA's strategies for promoting improved workplace safety and health include providing employer and employee with information and training materials that focus on workplace safety and health hazards.
The nurse case manager is reviewing Medicare coverage rules with a client. Which client statement indicates correct understanding of the teaching? A. "Prescription drug coverage is available through Medicare." B. "Medicare covers the costs of long-term care." C. "The cost of my hearing aids is covered by Medicare." D. "Medicare covers my routine dental care."
***A. "Prescription drug coverage is available through Medicare." B. "Medicare covers the costs of long-term care." C. "The cost of my hearing aids is covered by Medicare." D. "Medicare covers my routine dental care." Medicare Part D offers prescription drug coverage. Services that are not covered by Medicare include long-term care, routine dental care, and hearing aids and the exams for fitting them.
During hospital orientation, the human resources specialist is defining and explaining sexual harassment. Which statement should be included in the human resource specialist's discussion of sexual harassment? A. "Sexual harassment interferes with performance in the workplace." B. "Sexual harassment requires the victim and violator to be of different genders." C. "Discrimination is one type of sexual harassment." D. "Physical contact is required for a behavior to be considered sexual harassment."
***A. "Sexual harassment interferes with performance in the workplace." B. "Sexual harassment requires the victim and violator to be of different genders." C. "Discrimination is one type of sexual harassment." D. "Physical contact is required for a behavior to be considered sexual harassment." By definition, sexual harassment interferes with the victim's performance in the workplace. Sexual harassment is one form of discrimination. The victim and violator may or may not be of the same gender. Examples of sexual harassment include requests for sexual favors and unwelcome verbal or physical sexual advances.
The nurse informaticist is summarizing the function and findings of the Technology Informatics Guiding Educational Reform (TIGER) Summit for a group of staff nurses. Which statement should be included in the presentation? A. "TIGER is examining ways to reach out to nurses who lack the informatics skills that are needed to practice." B. "TIGER concluded that knowledge of informatics is important for certain healthcare professionals." C. "TIGER was attended mainly by nurse administrators from major healthcare institutions." D. "TIGER is developing plans to include informatics in all baccalaureate nursing programs."
***A. "TIGER is examining ways to reach out to nurses who lack the informatics skills that are needed to practice." B. "TIGER concluded that knowledge of informatics is important for certain healthcare professionals." C. "TIGER was attended mainly by nurse administrators from major healthcare institutions." D. "TIGER is developing plans to include informatics in all baccalaureate nursing programs." The 2006 Technology Informatics Guiding Educational Reform (TIGER) Summit was attended by nursing informatics leaders from major nursing organizations. TIGER's findings included that knowledge of informatics is mandatory for all healthcare professionals. TIGER is developing plans to include informatics courses in all levels of nursing education. TIGER is also examining the best ways to reach out to nurses who lack skills needed to practice in a healthcare environment that is becoming increasingly more interactive and reliant on technology systems.
The novice nurse asks the nurse preceptor to explain the relationship between the business of health care and the provision of client care. Which response by the nurse preceptor is the most appropriate? A. "The Institute of Medicine compels nurses to preserve a caring model within health care's business model." B. "When nursing standards conflict with organizational standards, the nurse must maintain commitment to the organization's standards." C. "The business of health care is the same thing as the provision of client care." D. "Nurses are morally responsible for recognizing the business of health care as the main priority."
***A. "The Institute of Medicine compels nurses to preserve a caring model within health care's business model." B. "When nursing standards conflict with organizational standards, the nurse must maintain commitment to the organization's standards." C. "The business of health care is the same thing as the provision of client care." D. "Nurses are morally responsible for recognizing the business of health care as the main priority." Because the business of health care and the provision of client care are two distinct issues, corporate goals can collide with nursing ethics. Nurses have the moral responsibility to address client needs and to advocate for safe care within the business of health care. The Institute of Medicine (IOM) compels nurses to lead the healthcare transformation and to preserve a caring model within the business model of health care. The nurse must maintain commitment to the nursing profession even when doing so conflicts with organizational commitment.
A nurse educator is teaching a group of student nurses regarding standards of care. Which statements made by the nursing students are correct regarding standards of care in nursing? (Select all that apply.) A. "The Nurse Practice Act and administrative rules form the basis of the standard of care for nurses." B. "Employers can limit, but not expand, the nursing scope of practice." C. "The Joint Commission is the primary agency responsible for establishing nursing standards of care." D. "The nurse's specific job description will aid in defining the standard of care." E. "The American Nurses Association (ANA) Standards of Practice is the prevailing national nursing standard."
***A. "The Nurse Practice Act and administrative rules form the basis of the standard of care for nurses." ***B. "Employers can limit, but not expand, the nursing scope of practice." C. "The Joint Commission is the primary agency responsible for establishing nursing standards of care." ***D. "The nurse's specific job description will aid in defining the standard of care." ***E. "The American Nurses Association (ANA) Standards of Practice is the prevailing national nursing standard." The American Nurses Association (ANA) Standards of Practice, not The Joint Commission, is primarily responsible for establishing nursing standards of care. All other choices are correct.
The nursing student is giving a presentation on the roles of citizens and government in shaping health policy. Which statements should be included in the presentation? (Select all that apply.) A. "The government official is responsible for identifying political considerations related to each solution." B. "Citizens will evaluate the outcomes of newly implemented laws." C. "The citizen who reports the concern is responsible for choosing the best solution." D. "One role of government officials is hearing citizens' concerns." E. "The citizen's responsibilities include evaluating safety concerns of proposed solutions."
***A. "The government official is responsible for identifying political considerations related to each solution." B. "Citizens will evaluate the outcomes of newly implemented laws." C. "The citizen who reports the concern is responsible for choosing the best solution." ***D. "One role of government officials is hearing citizens' concerns." E. "The citizen's responsibilities include evaluating safety concerns of proposed solutions." Government officials' roles include hearing citizens' concerns about healthcare needs, evaluating safety concerns related to potential solutions, identifying political considerations related to each solution, and choosing the best solution. Federal agencies or departments who are responsible for implementing the new law will evaluate outcomes.
The nurse educator asks the nursing students to describe the stage of commitment development during which the student discovers negative aspects of a chosen profession. Which student's response is accurate? A. "The testing stage." B. "The quiet-and-bored stage." C. "The passionate stage." D. "The integrated stage."
***A. "The testing stage." B. "The quiet-and-bored stage." C. "The passionate stage." D. "The integrated stage." Development begins with the exploratory stage, followed by the testing stage, the passionate stage, the quiet-and-bored stage, and the integrated stage. The testing stage, which is the second stage of professional commitment, involves the individuals' discovery of negative aspects of the profession.
A client in the ambulatory clinic asks the nurse about health information obtained while reading a Web site on the Internet. Which response by the nurse is the most appropriate? A. "There are sites where the information is reliable." B. "The Internet is for entertainment and not for learning." C. "Most information on the Internet is false." D. "Following your physician's advice is better than reading what to do on the Internet."
***A. "There are sites where the information is reliable." B. "The Internet is for entertainment and not for learning." C. "Most information on the Internet is false." D. "Following your physician's advice is better than reading what to do on the Internet." Research has found that a large number of adults use the Internet for medical information. Nurses need to help clients with information access by directing clients to high quality Web sites for information. The nurse should teach the client how to interpret the information and not state that the information is false. The nurse should explain how to evaluate information and not state that it is for entertainment. The nurse should summarize how to determine if information is applicable and not direct the client to follow physician's instructions.
Which client groups are more likely to need an advocate when accessing healthcare resources? (Select all that apply.) A. A family who is living in poverty B. A family whose primary language is Spanish C. A client who has a lower literacy level D. A client in chronic pain E. A client diagnosed with cancer who has family support
***A. A family who is living in poverty ***B. A family whose primary language is Spanish ***C. A client who has a lower literacy level ***D. A client in chronic pain E. A client diagnosed with cancer who has family support Clients who do not speak English, have lower literacy levels, are very ill or in pain, or are of low income levels have more difficulty navigating the healthcare system and would benefit from the assistance of a nurse advocate. Clients who have family support may also have better resources for obtaining information needed for decision making.
Which are true statements about the relationship of ethics and laws. (Select all that apply.) A. A specific situation can be moral, but perhaps not legal. B. An ethical action gives some input into determining the legality of a situation. C. Following the law is making a choice to take an ethical action. D. A specific situation can be legal, but perhaps not moral. E. Laws are enacted to reflect the ethical values of society.
***A. A specific situation can be moral, but perhaps not legal. B. An ethical action gives some input into determining the legality of a situation. C. Following the law is making a choice to take an ethical action. ***D. A specific situation can be legal, but perhaps not moral. ***E. Laws are enacted to reflect the ethical values of society. Laws are enacted to reflect the ethical values of society. A specific situation can be moral, but perhaps not legal, and vice versa. A legal action, not an ethical action, gives some input into determining the morality, not the legality, of a situation. Following the law is making a choice to take a legal, not an ethical, action.
Which statement is a definition of beneficence? A. Actions to promote good B. Upholding fair treatment C. Telling the truth D. Right to self-determination
***A. Actions to promote good B. Upholding fair treatment C. Telling the truth D. Right to self-determination Beneficence concerns actions to promote good. Autonomy is the right to self-determination. Justice upholds fair treatment. Veracity means telling the truth.
The nurse leader is preparing a webinar about how to prevent burnout in nursing. To accurately describe strategies for preventing burnout, which activity should the nurse educator include in the webinar? A. Actively engage in efforts to produce constructive change if organizational policies create stress B. Develop acceptance and recognize that the limitations of any situation can be changed C. Study assertiveness and learn to take on added responsibilities even when feeling overwhelmed D. Learn to depend on oneself and to avoid expressions of emotions toward colleagues
***A. Actively engage in efforts to produce constructive change if organizational policies create stress B. Develop acceptance and recognize that the limitations of any situation can be changed C. Study assertiveness and learn to take on added responsibilities even when feeling overwhelmed D. Learn to depend on oneself and to avoid expressions of emotions toward colleagues Strategies for preventing burnout in nursing include involvement, studying assertiveness techniques, expressing compassion, and developing acceptance. Involvement includes being active in efforts to produce constructive change if organizational policies cause stress. Studying assertiveness techniques, which can help with overcoming feelings of powerlessness in relationships, includes learning to say no. Compassion includes learning to ask for help and expressing emotions toward colleagues. Acceptance includes recognizing the limitations associated with each situation and accepting what cannot be changed.
In the urgent care clinic, Mr. Zachary Taylor, a 39-year-old accountant, is relieved and surprised. His gallbladder surgery is scheduled at a local surgery center, rather than at a hospital. Mr. Taylor asks the clinic nurse "What has changed since the days when my Dad had his gallbladder surgery?" What significant changes could the nurse identify? A. Advances in laparoscopic techniques and safer anesthesia B. Improved surgical preparation and fluid loss prevention C. Health insurance payments and better sterile techniques D. Synthetic blood transfusions and case management methods
***A. Advances in laparoscopic techniques and safer anesthesia B. Improved surgical preparation and fluid loss prevention C. Health insurance payments and better sterile techniques D. Synthetic blood transfusions and case management methods Advances in laparoscopic techniques and safer anesthesia have made a significant difference. None of the other items listed helped move routine procedures out of the hospital setting.
While caring for a client, the nurse meets with the healthcare provider to discuss responses to treatment and explain the client's issues with medication side effects. Which associated concepts of managed care is this nurse demonstrating? (Select all that apply.) A. Advocacy B. Clinical decision-making C. Healthcare systems D. Collaboration E. Ethics
***A. Advocacy B. Clinical decision-making C. Healthcare systems ***D. Collaboration E. Ethics When discussing responses to treatment with the client's other healthcare providers, the nurse is engaging in collaboration. When explaining the client's issues with medication side effects the nurse is engaging in advocacy. The nurse is engaged with healthcare systems when working within the federal, state, local and healthcare organization regulations and requirements. Clinical decision making is prioritizing and providing care. Ethics is adhering to the nursing code of ethics when providing care.
When the assisted living nurse asks the new client about her religious beliefs, the client answers, "I am not convinced that a Higher Power exists. But I am still open to thinking about it." Which category of religious beliefs does the client identify with? A. Agnostic B. Atheistic C. Nontheistic D. Monotheistic
***A. Agnostic B. Atheistic C. Nontheistic D. Monotheistic The client identifies with agnostics, who believe that the existence of a Higher Power has not been proved. The client is not an atheist, who does not believe in any god. The client is not a monotheist, who believes in one god. There is no category called nontheistic.
A nursing instructor is discussing the concept of cultural diversity with a group of nursing students. While discussing broad groups, the instructor realizes she needs to reinforce teaching this concept when her students give which example? A. An example of diversity is the customs of a community. B. A project discussing health care diversity in the inner city versus the suburbs of a major city. C. A subgroup of diversity could include education, or occupation. D. The sexual orientation of a group of college sophomores participating in a birth control study.
***A. An example of diversity is the customs of a community. B. A project discussing health care diversity in the inner city versus the suburbs of a major city. C. A subgroup of diversity could include education, or occupation. D. The sexual orientation of a group of college sophomores participating in a birth control study. The customs of a community are considered part of the culture. Diversity refers to the quality of being different. Characteristics that distinguish broad groups from one another. Examples include age, race, gender, sexual orientation, and religion. Subgroups of diversity include socioeconomic status, education, occupation, interests, marital status, or rural versus urban living situations.
A nurse is reviewing the medical records of a small urgent care clinic. The nurse has been asked to identify clients who may be considered vulnerable. Which clients will the nurse include as those who may be vulnerable? (Select all that apply.) A. An 82-year-old man living alone with no family nearby B. A 17-year-old in an afterschool boys' and girls' program C. A 32-year-old woman who lists the local shelter as her home address D. A 22-year-old woman who is crying and anxious because she is fighting with her roommate E. A 42-year-old man with a history of psychiatric illnesses who lives in his car in a nearby park
***A. An 82-year-old man living alone with no family nearby B. A 17-year-old in an afterschool boys' and girls' program ***C. A 32-year-old woman who lists the local shelter as her home address D. A 22-year-old woman who is crying and anxious because she is fighting with her roommate ***E. A 42-year-old man with a history of psychiatric illnesses who lives in his car in a nearby park Vulnerable populations include the elderly, children, people living in poverty, homeless people, and those who are in abusive relationships, are mentally ill, or chronically ill. An episode of anxiety or an altercation without a history of abuse is not considered evidence of belonging to a vulnerable population. A teenager in an afterschool program is not considered a member of a vulnerable population.
Chen Yong, a 23-year-old Chinese student, goes to the local Chinatown clinic when he hurts his leg playing soccer. He is told that the doctor is not available and he will have to return the following day for treatment. What health care disparity does this incident illustrate? A. Asians have reported problems with receiving timely health care. B. Asians are unlikely to have health insurance. C. Asians do not want to use Western medical services. D. Asians prefer to use acupuncture and herbs for treatment.
***A. Asians have reported problems with receiving timely health care. B. Asians are unlikely to have health insurance. C. Asians do not want to use Western medical services. D. Asians prefer to use acupuncture and herbs for treatment. Asians were 1.5 times as likely as Caucasians to report that they sometimes or never get care for illnesses or injury as soon as they wanted to. Although some Asians may select traditional Chinese medicine in certain situations, that is not a concern in this situation. Health care coverage is not the problem in Chen Yong's case.
The nurse is caring for a client with paranoid schizophrenia who was recently transferred to the facility. Upon assessment, the nurse notes bruising on the client's wrists and ankles. What is the priority action by the nurse? A. Ask the client how the bruising occurred. B. Call the police to report abuse. C. Ask the client's family if they caused the bruises. D. Call the previous facility to determine the causes of the bruising.
***A. Ask the client how the bruising occurred. B. Call the police to report abuse. C. Ask the client's family if they caused the bruises. D. Call the previous facility to determine the causes of the bruising. The priority action of the nurse is to determine the cause of the bruising. This can be accomplished by asking the client how the bruising occurred. If the client is unable to provide information to the nurse, then it is appropriate to ask family members or contact those who cared for the client. Reporting the bruising as abuse should not occur until the nurse has evidence that supports this claim.
The novice nurse has accepted a medical-surgical position after passing the boards and wants to work for an organization that acknowledges the values of the nursing profession. Which values outlined by the organization are consistent with those identified by the American Association of Colleges of Nursing (AACN)? (Select all that apply.) A. Autonomy on behalf of self B. Altruism when dealing with other nurses C. Effectiveness in the new job D. Efficiency when dealing with clients E. Integrity in dealing with clients and co-workers
***A. Autonomy on behalf of self ***B. Altruism when dealing with other nurses C. Effectiveness in the new job D. Efficiency when dealing with clients ***E. Integrity in dealing with clients and co-workers Altruism, autonomy, and integrity are nursing values identified by the AACN. Efficiency and effectiveness are not values chosen by the AACN.
The nurse is caring for a client at a free clinic. When advocating for this client, what does the nurse need to be aware of when planning care? A. Available healthcare options B. Clinic schedule requirements C. Public transportation issues D. Healthcare provider schedule preferences
***A. Available healthcare options B. Clinic schedule requirements C. Public transportation issues D. Healthcare provider schedule preferences The nurse advocate must be aware of available healthcare options for treating the uninsured client. Advocacy does not involve transportation, scheduling, or healthcare provider preferences.
A nurse is observing a newly admitted client for details to add to the spiritual assessment. Which clinical observations would be useful additions? (Select all that apply.) A. Behavior B. Mood C. Interactions with others D. Mealtime choices E. Speech
***A. Behavior ***B. Mood ***C. Interactions with others D. Mealtime choices ***E. Speech Clinical observations of behavior, speech, mood, and interactions with others would be useful. Observing mealtime choices is not an example of a clinical observation the nurse would make. This item would be asked during the initial admission assessment of the client.
The nursing student is experiencing the integrated stage of commitment development. When developing professional commitment, which behavior would the nursing student be most likely to demonstrate during the integrated stage? A. Being eager to take the NCLEX-RN® examination B. Considering switching to a major other than nursing C. Becoming involved in a student nursing association D. Learning about positive aspects of the nursing profession
***A. Being eager to take the NCLEX-RN® examination B. Considering switching to a major other than nursing C. Becoming involved in a student nursing association D. Learning about positive aspects of the nursing profession Being eager to take the NCLEX-RN®examination is reflective of the integrated stage of professional commitment development. The exploratory stage begins when individuals learn about the positive aspects of their profession. During the testing stage, students discover negative aspects of the profession and begin to assess their willingness and ability to cope with those negative aspects. Nursing students who do not move beyond the testing stage may drop out of school or change majors. Becoming involved in a student nursing association best illustrates a behavior demonstrated during the passionate stage of professional commitment development.
The client asks the nurse to explain how Medicare works. Which items should the nurse include in the teaching session? (Select all that apply.) A. Both hospital and medical insurance are offered by Medicare. B. Routine eye care is not covered by Medicare. C. Medicare is a federally funded health insurance program. D. There are four types of Medicare coverage. E. Individuals with end-stage renal disease are not eligible for Medicare coverage.
***A. Both hospital and medical insurance are offered by Medicare. ***B. Routine eye care is not covered by Medicare. ***C. Medicare is a federally funded health insurance program. ***D. There are four types of Medicare coverage. E. Individuals with end-stage renal disease are not eligible for Medicare coverage. Medicare is a federally funded health insurance program available to people age 65 or older, younger people with disabilities, and people with end-stage renal disease. Certain services, including routine eye care, are not covered by Medicare. There are four types of Medicare coverage: Part A (hospital insurance), Part B (medical insurance), Part C (Medicare advantage plans like an HMO or PPO), and Part D (Medicare prescription drug coverage).
The nurse educator is comparing the roles of the case manager and the primary nurse with a group of students. The educator wants to review similarities of these roles in the rehabilitation facility and in the acute care facility. Which student statements are accurate regarding the similarities between these two roles? (Select all that apply.) A. Both roles plan for meeting clients' needs B. Both roles lead a multidisciplinary team C. Both roles plan for meeting families' needs D. Both roles support continuity of care E. Both roles follow the clients across care settings
***A. Both roles plan for meeting clients' needs B. Both roles lead a multidisciplinary team ***C. Both roles plan for meeting families' needs ***D. Both roles support continuity of care E. Both roles follow the clients across care settings The similarities between a case manager and a primary nurse are that they both support continuity of care and plan for meeting the needs of clients and families. Only the case manager follows clients across care settings or leads a multidisciplinary team.
What are characteristics of shared governance? (Select all that apply.) A. Can be used with other care delivery methods B. Based upon competencies needed to provide client care C. Is a precursor to primary nursing D. Encourages decision-making at all organization levels E. Client and family participation in care delivery process
***A. Can be used with other care delivery methods B. Based upon competencies needed to provide client care C. Is a precursor to primary nursing ***D. Encourages decision-making at all organization levels E. Client and family participation in care delivery process Shared governance is an organizational model that encourages nurse participation in decision-making at all levels within an organization. It can be used with other care delivery models. Client and family participation in care delivery is a characteristic of client-focused care. Differentiated practice is based upon competencies needed to provide client care. The case method of care delivery is believed to be a precursor to primary nursing.
The nurse manager is evaluating care coordination actions performed by the nursing staff. Which outcomes indicate that the nursing staff's actions have been effective? (Select all that apply.) A. Care is readily accessible. B. Care is being rationed. C. Care is of the highest quality. D. Care is reliable. E. Care is being provided at the lowest cost.
***A. Care is readily accessible. B. Care is being rationed. ***C. Care is of the highest quality. ***D. Care is reliable. ***E. Care is being provided at the lowest cost. When nurses embrace the expectations of care coordination, care will be provided that is reliable, accessible, of the highest quality, and at the lowest cost. Rationing of care is not an expectation of care coordination.
The clinical nurse educator is designing an online course about the use of patient portals for consumer and client e-health. Which item should be included when designing the online course? A. Clients must provide a user identification and password for each portal visit. B. Protected health information is encrypted and securely transmitted via the portal. C. Prescription refill requests are not permitted when using a portal. D. To use the portal, the client must first register in person at the healthcare facility.
***A. Clients must provide a user identification and password for each portal visit. B. Protected health information is encrypted and securely transmitted via the portal. C. Prescription refill requests are not permitted when using a portal. D. To use the portal, the client must first register in person at the healthcare facility. Patient portals require online registration, and a user identification and password are needed for each visit. Not all portals are encrypted to allow secure transmission of protected health information. Functions offered by certain patient portals include scheduling routine appointments, requesting prescription refills, and communicating electronically with a healthcare provider.
Nancy Garcia is planning care for a client with obesity and realizes she needs the assistance of another healthcare professional. Which action should Nancy take to exemplify the standard of collaboration? A. Contact a dietician to discuss a carbohydrate eating plan with the client B. Telephone physical therapy to have a larger wheelchair delivered to the care area C. Discuss the time breakfast trays arrive with the Dietary Supervisor so that morning medication will be completed D. Ask the social worker to provide materials on advance directives to replenish the stock supply on the care area
***A. Contact a dietician to discuss a carbohydrate eating plan with the client B. Telephone physical therapy to have a larger wheelchair delivered to the care area C. Discuss the time breakfast trays arrive with the Dietary Supervisor so that morning medication will be completed D. Ask the social worker to provide materials on advance directives to replenish the stock supply on the care area Collaboration is part of the American Nurses Association's Scope and Standards of Practice. An example of collaboration would be for the nurse to contact a dietician to discuss the client's eating plan. Telephoning for a wheelchair, timing of breakfast tray delivery, and obtaining materials about advance directives do not exemplify collaborating on client care.
While coordinating the care for Mr. Obertone, an adult client with heart failure, the nurse discovers that home monitoring equipment is not available for several days. Which nursing action is most appropriate to overcome this care coordination barrier? A. Contact another company to obtain the needed resource B. Help the client understand the purpose of monitoring at home C. Teach the client to monitor weight every day at home D. Explain to the physician why the equipment is not available
***A. Contact another company to obtain the needed resource B. Help the client understand the purpose of monitoring at home C. Teach the client to monitor weight every day at home D. Explain to the physician why the equipment is not available When resources are lacking, the nurse can network with another provider to obtain the resource for the client. Explaining to the physician why the equipment is not available, teaching the client to monitor his weight, and helping him understand the need for monitoring at home are important nursing actions but will not help overcome the existing barrier of limited resources.
The nurse is assessing the health status of an adult client. Which aspects of culture will the nurse consider when assessing this client? (Select all that apply.) A. Customs are part of the culture of a client. B. Culture is defined by nonphysical traits. C. A client's culture is determined by race. D. Values are a part of culture. E. Beliefs are a part of culture.
***A. Customs are part of the culture of a client. ***B. Culture is defined by nonphysical traits. C. A client's culture is determined by race. ***D. Values are a part of culture. ***E. Beliefs are a part of culture. The culture that encompasses a client's way of life is based on nonphysical traits. The values and beliefs a client holds are part of culture and can influence health care. Customs can influence a client's attitude toward health. Race refers to physical and genetic heritage and is directly related to such physical traits a client may have as skin color, but it is not related to a client's culture.
The registered nurse team leader is performing gastric lavage for a client who is experiencing an acute gastrointestinal bleed. Which function will the nurse most likely have difficulty completing as the team leader? A. Delegation B. Decision-making C. Client teaching D. Identifying nursing diagnoses
***A. Delegation B. Decision-making C. Client teaching D. Identifying nursing diagnoses Team nursing is not as effective when caring for clients who are acutely ill because the nurse is needed for direct care and will not have time to delegate many tasks. Teaching, identifying nursing diagnoses, and decision-making are skills used within primary nursing and would be required when caring for this client.
The nurse is coordinating care for a client who requires the removal of an uncomplicated basal cell carcinoma. Based on the robust health of this client, which setting would provide the most cost-effective care? A. Dermatologist's office B. Emergency department C. Surgical center D. Urgent care clinic
***A. Dermatologist's office B. Emergency department C. Surgical center D. Urgent care clinic A dermatologist can handle a minor surgical procedure under local anesthesia in the office. A surgical center is a more expensive setting than an office. It would usually not be appropriate to do the procedure in the ED or urgent care clinic.
Which attributes contribute to the socialization of a nursing student? (Select all that apply.) A. Development B. Care planning C. Adaptation D. Learning E. Interaction
***A. Development B. Care planning ***C. Adaptation ***D. Learning ***E. Interaction Socialization to profession includes the attributes of learning, interaction, development, and adaptation. Care planning is an activity within the nursing process.
Which description is a characteristic of professional values? A. Development of socialization to nursing by nursing school faculty B. Influence by insight into clients' values C. Insight into how actions influence values D. Influence by cultural norms
***A. Development of socialization to nursing by nursing school faculty B. Influence by insight into clients' values C. Insight into how actions influence values D. Influence by cultural norms One of the ways that professional values are developed is by socialization to nursing by nursing school faculty. Other ways incude learning from other nurses and from clinical and life experiences. Professional values are influenced by insight into one's own values, not clients' values, and professional values are not influenced by cultural norms. Professional values demonstrate insight into how values influence actions, not how actions influence values.
Two nurses are discussing the ways in which spiritual practices affect individuals. "I can't believe how many different ways they affect people," one concludes. The other nurse agrees. Which individual habits and events could be connected to spiritual practices? (Select all that apply.) A. Diet and nutrition B. Birth and death C. Dress D. Medications E. Healing
***A. Diet and nutrition ***B. Birth and death ***C. Dress D. Medications ***E. Healing All of the above answers are correct. Diet and nutrition, medications, healing, dress, and birth and death all could be connected with spiritual practices.
The staff nurse is planning an educational session about computer systems and infection control. Which item is the most appropriate for the nurse to include in the educational session? A. Disinfect computer keyboards and mice daily. B. Use a diluted bleach solution to clean computer keyboards. C. Avoid using sealed computer keyboards with built-in covers. D. Wear gloves when using a computer keyboard or mouse.
***A. Disinfect computer keyboards and mice daily. B. Use a diluted bleach solution to clean computer keyboards. C. Avoid using sealed computer keyboards with built-in covers. D. Wear gloves when using a computer keyboard or mouse. Because keyboards carry the highest risk for contamination, some manufacturers have built sealed keyboards that can be easily cleaned or can be equipped with covers for easier cleaning and protection of the electronic equipment. Guidelines for preventing the spread of infection due to contaminated computer systems include disinfecting keyboards and mice daily and when visibly soiled with body fluids, and following manufacturer recommendations for cleaning equipment. The nurse should not touch keyboards or mice with gloved hands.
The nurse administrator is teaching an in-service about the function of the Office of the National Coordinator for Health Information Technology (ONC). When listing the meaningful use objectives, which items should be included? (Select all that apply.) A. Engaging clients and their families in the client's care B. Improving care coordination to improve client outcomes C. Ensuring the security and privacy of protected medical information D. Controlling and monitoring clients' healthcare choices E. Reducing health disparities by improving safety and quality of care
***A. Engaging clients and their families in the client's care ***B. Improving care coordination to improve client outcomes ***C. Ensuring the security and privacy of protected medical information D. Controlling and monitoring clients' healthcare choices ***E. Reducing health disparities by improving safety and quality of care The Office of the National Coordinator for Health Information Technology (ONC) monitors achievement of meaningful use objectives, which are reported back to CMS in order to authorize financial reimbursement. Meaningful use objectives include improving care coordination; reducing health disparities among U.S. citizens by improving the safety and quality of care; ensuring the security and privacy of protected medical information; and engaging clients and their families in the client's care. Meaningful use objectives do not include controlling and monitoring clients' healthcare choices.
Two hospice nurses are discussing the ethical implications of not admitting a client with a diagnosis of terminal cancer with a specific estimated number of months to live, which exceeds their facility's guidelines. Which components of ethics are appropriate for these nurses to consider regarding this situation? (Select all that apply.) A. Fairness to this client and other clients B. Efficiency of the hospice functioning C. Rights of this cancer patient D. Benefits to society of having hospice guidelines E. Obligations of the hospice facility
***A. Fairness to this client and other clients B. Efficiency of the hospice functioning ***C. Rights of this cancer patient ***D. Benefits to society of having hospice guidelines ***E. Obligations of the hospice facility The components of ethics include rights, obligations, benefits to society, and fairness. Efficiency is not a component of ethics.
The nurse is caring for a 5-year-old client diagnosed with cancer. Which factors affecting a family's ability to cope should the nurse consider when planning care (Select all that apply.) A. Financial resources of the family B. Strength of the family structure C. Ability to seek services D. Number of dependents living at home E. Country of origin of the family
***A. Financial resources of the family ***B. Strength of the family structure ***C. Ability to seek services D. Number of dependents living at home E. Country of origin of the family A child's illness or hospitalization can create stressful events for the child and family. The family's ability to cope depends on the strength of the family structure, its ability to successfully seek services, its support system, and available resources. The country of origin of the family does not directly affect the ability to cope with a child's illness. The number of dependents living at home and family size do not directly affect the family's ability to cope with a child's illness.
What are the best times to do a nursing assessment of spirituality? (Select all that apply.) A. Following the psychosocial assessment B. Following the health history C. Before the physical assessment D. At the end of the assessment process E. Right after mutual introductions
***A. Following the psychosocial assessment B. Following the health history C. Before the physical assessment ***D. At the end of the assessment process E. Right after mutual introductions The best times to do a nursing assessment of spirituality are at the end of the assessment process or following the psychosocial assessment. Having built up some rapport is important. That rapport will be stronger at those times than right after mutual introductions, following the health history, or before the physical assessment.
The nurse is caring for a 32-year-old client, a partner in a gay marriage, who has just given birth. What does the nurse understand about this family that will affect the plan of care? A. Frustrations about infant care are normal. B. Children in lesbian families are at higher risk for poor health. C. Families have coping strategies. D. The home environment is less supportive and healthy.
***A. Frustrations about infant care are normal. B. Children in lesbian families are at higher risk for poor health. C. Families have coping strategies. D. The home environment is less supportive and healthy. As part of the nursing interventions, the nurse will facilitate the integration of the infant by helping these parents recognize that frustrations about infant care are normal, and encouraging bonding with and care for the infant by both parents. Homosexual adults form gay and lesbian families with goals of caring and commitment, the same as heterosexual couples do. Children in gay and lesbian families have been found to have the same advantages and expectations for development, adjustment and health as children in heterosexual families. Gay and lesbian parents can effectively provide supportive and healthy environments for their children. All families have coping strategies that help them deal with stress and change, which should be encouraged.
A nurse who is being pulled from one unit to another for a shift is being introduced to the nursing staff. Some of the labels that the nurse hears are "medication nurse," "dressing change nurse," "I and O aide," and "vital signs aide." Based on these comments, which nursing care delivery system can the nurse expect to participate in for this shift? A. Functional nursing B. Secondary nursing C. Primary nursing D. Team nursing
***A. Functional nursing B. Secondary nursing C. Primary nursing D. Team nursing The labels the nurse hears are indicating tasks assigned to that person. This is functional nursing. Team nursing has clients assigned to a group of staff. Primary nursing has clients assigned to one main staff person. There is no secondary nursing system.
The nurse is describing applications of telehealth to the client. Which activities should be included? (Select all that apply.) A. Having the client meet with a virtual health coach B. Managing acute and chronic conditions of the client C. Watching clients perform a return demonstration of skills D. Using dual webcams to visually assess the client's condition E. Allowing clients to consult with healthcare providers in any state in the United States
***A. Having the client meet with a virtual health coach ***B. Managing acute and chronic conditions of the client ***C. Watching clients perform a return demonstration of skills ***D. Using dual webcams to visually assess the client's condition E. Allowing clients to consult with healthcare providers in any state in the United States Applications of telehealth include allowing the client to meet with a virtual health coach, managing acute and chronic conditions, using dual webcams to visually assess the client's condition, and watching clients perform a return demonstration of skills. Not all states issue telemedicine licenses that permit healthcare providers to practice telehealth across state lines. As such, not every healthcare provider can consult with out-of-state clients via telehealth.
The nurse is to provide an assessment for a client of Asian descent and his family. What would the nurse need to understand related to the client and his family's worldview? (Select all that apply.) A. Health care beliefs B. Values C. Health care practices D. Language E. Educational level
***A. Health care beliefs ***B. Values ***C. Health care practices ***D. Language E. Educational level Health care beliefs, language, and values are part of a culture's worldview and can influence a client's acceptance of and cooperation with the treatment plan. If the client does not speak the same language as the nurse and the health care provider, an interpreter will be required. Health care practices may differ from what the nurse plans and can include alternative practices that may interfere with the treatment plan. Although not part of the worldview or culture, the client's level of education will be considered when planning teaching for the client.
The nurse is admitting a client whose native language is not English. The nurse is concerned that the client understands the consent-to-treatment document before signing. What factor affecting healthcare delivery is the nurse concerned about? A. Health literacy B. Right to privacy C. Managed care D. Right to confidentiality
***A. Health literacy B. Right to privacy C. Managed care D. Right to confidentiality The nurse is concerned about the client's health literacy. Understanding the consent-to-treatment document is not a matter of privacy or confidentiality. Managed care is not a relevant factor.
The nurse administrator is presenting an educational session about telehealth. Which item should be included when discussing the most significant potential barriers? A. Healthcare provider licensure B. Access to care C. Cost of services D. Healthcare quality
***A. Healthcare provider licensure B. Access to care C. Cost of services D. Healthcare quality Benefits of telehealth include the potential to decrease costs, improve quality of care, and increase access to care for clients in rural, urban, community, and international settings. Barriers to telehealth include healthcare provider licensure restrictions, such as medical boards limiting telemedicine licenses that permit this practice across state lines.
The nurse is involved in the case of a minor client who is placed on life support after complications during surgery left her without neurologic function. The client's parents have retained legal counsel to prevent the hospital from discontinuing life support. Which advocacy concepts must be considered when communicating with the client's family? (Select all that apply.) A. Healthcare systems B. Rehabilitation nursing C. Culture and diversity D. Medical ethics E. Legal issues
***A. Healthcare systems B. Rehabilitation nursing ***C. Culture and diversity ***D. Medical ethics ***E. Legal issues The decision to discontinue life support for any client is handled by the healthcare system, particularly its risk management and legal departments along with the family of the client. Principles of medical ethics and legal issues guide the decision-making process and are intended to protect the client's rights and the healthcare system's interests. Culture and diversity considerations address the values and beliefs of the client and family. Rehabilitation nursing would not be employed in an end-of-life scenario.
The nursing student is designing a poster that outlines strategies through which informatics can address the increasing national problem with prescription opioid addiction and overdose. Which strategy should be included on the poster? A. Improving the ability to identify individuals who engage in "doctor shopping" to obtain narcotics for abuse or illegal sale B. Linking computerized written orders with client electronic health records to identify and monitor healthcare providers who prescribe opioids C. Increasing efforts to enhance electronic tracking of opioid prescriptions at the community level D. Monitoring data to identify clients who sell opioids and their buyers
***A. Improving the ability to identify individuals who engage in "doctor shopping" to obtain narcotics for abuse or illegal sale B. Linking computerized written orders with client electronic health records to identify and monitor healthcare providers who prescribe opioids C. Increasing efforts to enhance electronic tracking of opioid prescriptions at the community level D. Monitoring data to identify clients who sell opioids and their buyers Strategies through which informatics can address the increasing national problem with prescription opioid addiction and overdose include increasing efforts to enhance electronic tracking of opioid prescriptions at the state level; linking computerized written orders with client electronic health records regionally and nationally, to identify and monitor individuals who are at risk for opioid abuse, and potentially to decrease the prevalence of opioid misuse and overdose; improving the ability to identify individuals who engage in open double quote"doctor shoppingclose double quote" to obtain narcotics for abuse or illegal sale; and identifying healthcare providers who write bogus opioid prescriptions in exchange for payment from sellers.
What is a defining characteristic of care coordination? A. Initiation by the nurse B. Initiation by a family member C. Direct client care is delivered D. Direct interaction with other members of the care team
***A. Initiation by the nurse B. Initiation by a family member C. Direct client care is delivered D. Direct interaction with other members of the care team Care coordination is always initiated by the nurse. Care coordination does not necessarily involve direct client care. Collaboration is defined as two or more people working towards a common goal, and may occur in a number of models and settings. In collaboration, a client, family member, or any member of the healthcare team may initiate action. Direct interaction with the client or other individual is a characteristic of collaboration.
Jennifer Calper, the primary nurse, is assigned a client with newly diagnosed type 2 diabetes mellitus. Which nursing action is most appropriate when caring for this client? A. Instructing the client on the role of medications to control the disease process B. Participating on a task force to identify glucometers for use during care C. Providing direct care to the client during the scheduled shift D. Directing nursing assistants to complete morning care on a group of clients
***A. Instructing the client on the role of medications to control the disease process B. Participating on a task force to identify glucometers for use during care C. Providing direct care to the client during the scheduled shift D. Directing nursing assistants to complete morning care on a group of clients Client teaching is a role of the primary nurse. Participation in a task force is an activity within shared governance. Delegating tasks related to a group of clients is not the same as providing direct client care. In this scenario, the nurse is working within the primary nursing method; providing direct care during a scheduled shift is a characteristic of the case method.
The nurse wants to determine the advocacy needs of a client. Which items will the nurse include in the assessment to determine advocacy needs? (Select all that apply.) A. Medical history and family situation B. Food preferences C. Access to transportation D. Ability to cooperate and make decisions E. Reliability of information
***A. Medical history and family situation B. Food preferences C. Access to transportation ***D. Ability to cooperate and make decisions ***E. Reliability of information The three main assessment criteria to determine advocacy needs are the client's ability to cooperate and make decisions; the reliability of information provided by the client, especially if the client exhibits impairment of cognitive function of mental instability; and the client's medical history and family situation. Access to transportation is a service consideration. Food preferences would not determine the need for advocacy.
Which are aspects of organizational governance that should reflect adherence to cultural competence standards? (Select all that apply.) A. Mission statement B. Staff training C. Organizational practice implementation D. Policies and procedures E. Translation services
***A. Mission statement B. Staff training ***C. Organizational practice implementation ***D. Policies and procedures E. Translation services Organizational mission, policies and procedures, and practice implementation should support cultural competence. Translation services and staff training are not part of organizational governance.
What is a difference between morality and ethics? A. Morality refers to private, personal standards of right and wrong; ethics covers a broader range of standards. B. Moral situations are described with words like "ought" and "should;" ethical situations don't use those words. C. Ethical situations are described with words like "ought" and "should;" moral situations don't use those words. D. Ethics refers to private, personal standards of right and wrong; morality covers a broader range of standards.
***A. Morality refers to private, personal standards of right and wrong; ethics covers a broader range of standards. B. Moral situations are described with words like "ought" and "should;" ethical situations don't use those words. C. Ethical situations are described with words like "ought" and "should;"moral situations don't use those words. D. Ethics refers to private, personal standards of right and wrong; morality covers a broader range of standards. Morality refers to private, personal standards of right and wrong; ethics covers a broader range of standards. Both moral and ethical situations are described with words like "ought" and "should."
Which is the definition of the term multiculturalism? A. Multiculturalism describes a society in which many subcultures coexist. B. Multiculturalism describes shared values, beliefs, attitudes, and customs in a community of people. C. Multiculturalism is the process of adapting to local customs. D. Multiculturalism describes the quality of being unlike or different.
***A. Multiculturalism describes a society in which many subcultures coexist. B. Multiculturalism describes shared values, beliefs, attitudes, and customs in a community of people. C. Multiculturalism is the process of adapting to local customs. D. Multiculturalism describes the quality of being unlike or different. Multiculturalism refers to many cultures existing together. Culture describes shared values and customs. Diversity describes the quality of being unlike or different. Assimilation is the process of adapting to local customs.
The department head within a school of nursing is devising a plan to ensure the successful socialization of students into the profession. Which strategies support the department head's goal? (Select all that apply.) A. Negotiating for clinical rotations to be held in high quality organizations B. Approving school policies and procedures that emphasize dress code C. Ensuring curriculum content adheres to professional standards D. Scheduling classroom time for culture and diversity training E. Identifying clinical instructors to serve as positive role models
***A. Negotiating for clinical rotations to be held in high quality organizations B. Approving school policies and procedures that emphasize dress code ***C. Ensuring curriculum content adheres to professional standards D. Scheduling classroom time for culture and diversity training ***`E. Identifying clinical instructors to serve as positive role models Strategies to assist students to develop the attributes of socialization include ensuring that curriculum content adheres to professional standards, that competent role models are selected as clinical instructors, and that clinical rotations are held in high quality organizations. Policies and procedures about dress code and lectures about culture and diversity training will not necessarily ensure the socialization of the students into the profession of nursing.
The staff nurse is caring for a client who has recently undergone surgical repair of an inguinal hernia. Despite administration of pain medications as ordered, the client continues to complain of excruciating pain. When the staff nurse offers to reposition the client, the client states, "You don't have any idea what you're doing. I need more medication. I need a nurse who can help me!" Which behavior best illustrates demonstration of compassion by the staff nurse? A. Notifying the primary care provider about the client's complaints of pain despite receiving medication B. Collaborating with the charge nurse and requesting that another nurse assume the client's care C. Explaining that inguinal hernia repairs usually require significantly less medication for adequate pain relief D. Seeking out a nursing colleague to privately vent about the client's rudeness and inconsideration
***A. Notifying the primary care provider about the client's complaints of pain despite receiving medication B. Collaborating with the charge nurse and requesting that another nurse assume the client's care C. Explaining that inguinal hernia repairs usually require significantly less medication for adequate pain relief D. Seeking out a nursing colleague to privately vent about the client's rudeness and inconsideration Professionalism in nursing requires demonstrating a positive attitude while working with clients, their family members, and other healthcare professionals. Venting to a nursing colleague is not reflective of a positive attitude. Professionalism in nursing also requires compassion, which is an awareness of and concern about other individuals' suffering. Requesting that the client's care be reassigned to another staff nurse is not reflective of compassion. Demonstrations of compassion in nursing include recognizing and meeting clients' needs and treating each client as a unique and special individual and not as a diagnosis (for example, "an inguinal hernia repair") or number. Notifying the primary care provider about the client's complaints of pain despite receiving pain medication best reflects recognizing and meeting the client's needs.
Once a month, the nurses working in case management get together for a potluck lunch. They have found that this informal session promotes a sense of a united community. Which of the International Council of Nurses Code of Ethics' relationships is being enhanced? A. Nurses and coworkers B. Nurses and practice C. Nurses and the profession D. Nurses and people
***A. Nurses and coworkers B. Nurses and practice C. Nurses and the profession D. Nurses and people The relationship that is being enhanced is that of nurses and coworkers. Other activities are more appropriate to enhance the relationships of nurses and people, practice, and the profession.
Which relationships are guided by the Code of Ethics from the International Council of Nurses? (Select all that apply.) A. Nurses and practice B. Nurses and laws C. Nurses and co-workers D. Nurses and people E. Nurses and payment
***A. Nurses and practice B. Nurses and laws ***C. Nurses and co-workers ***D. Nurses and people E. Nurses and payment The relationships that are guided by the Code of Ethics from the International Council of Nurses are that of nurses and people, practice and co-workers. Their Code of Ethics does not concern relationships of nurses and payment or laws.
A nurse who is a certified diabetes specialist is aware of the negative effects of fasting on glucose control. The nurse knows that clients with diabetes and clients with other conditions are often exempt from fasting requirements. Which people have conditions that often exempt them from religious fasting? (Select all that apply.) A. Nursing mothers B. Growing teenagers C. People over 65 D. Marathon runners E. Menstruating women
***A. Nursing mothers B. Growing teenagers C. People over 65 D. Marathon runners ***E. Menstruating women People who are often exempted from fasting, besides diabetics, are nursing mothers and menstruating women. The same exemption is not extended to growing teenagers, marathon runners, or people over 65.
A nurse mentor is explaining the primary benefits of National League for Nursing (NLN) membership to a protégé. Which items should be included? (Select all that apply.) A. Nursing research grants B. Specialty practice cultivation C. Job placement services D. Public policy initiatives E. Faculty development programs
***A. Nursing research grants B. Specialty practice cultivation C. Job placement services ***D. Public policy initiatives ***E. Faculty development programs The National League for Nursing (NLN) encourages the pursuit of high quality nursing education for all types of nursing education programs. NLN member benefits include faculty development programs, networking opportunities, assessment and testing, nursing research grants, and public policy initiatives. Job placement services are not a primary benefit of NLN membership. Professional specialty practice organizations are designed to cultivate specialty practice.
What is one way in which nurses can develop cultural self-awareness? A. Objectively examine own beliefs, values, and practices. B. Realize nothing can be done to change one's values and beliefs. C. Ask peers and colleagues about practicing cultural competence. D. Assert to others that personal biases cannot be changed.
***A. Objectively examine own beliefs, values, and practices. B. Realize nothing can be done to change one's values and beliefs. C. Ask peers and colleagues about practicing cultural competence. D. Assert to others that personal biases cannot be changed. Nurses can develop cultural self-awareness by becoming aware of the role of cultural influences in their own lives; objectively examining their own beliefs, values, and practices; and identifying and reflecting on personal biases.
Which strategies are emphasized in managed care? (Select all that apply.) A. Preventing inappropriate and unnecessary costs B. Delivering preventive services C. Adhering to ethical values D. Promoting health E. Increasing customer satisfaction
***A. Preventing inappropriate and unnecessary costs ***B. Delivering preventive services C. Adhering to ethical values ***D. Promoting health ***E. Increasing customer satisfaction Managed care is a delivery system that focuses on decreasing costs and improving client outcomes. It emphasizes preventing inappropriate and unnecessary costs, increasing customer satisfaction, promoting health, and delivering preventive services. Adhering to ethical values is a nursing action essential to all aspects of nursing care but is not a strategy or goal of managed care.
The novice nurse is trying to remember the different benefits of primary prevention, primary care, primary insurance, and primary nursing. Which two of these activities would the nurse identify as increasing the continuity of care? A. Primary care and primary nursing B. Primary prevention and primary nursing C. Primary prevention and primary insurance D. Primary prevention and primary care
***A. Primary care and primary nursing B. Primary prevention and primary nursing C. Primary prevention and primary insurance D. Primary prevention and primary care Primary care and primary nursing have the benefit of increasing the continuity of care. Primary prevention is about wellness, not continuity. Primary insurance happens when the client has more than one insurer.
A client invites family members into the private hospital room. "I'd like you to meet my nurse" the client says. "My nurse has been with me my whole hospitalization." Which kind of nursing delivery system is most likely in place? A. Primary nursing B. Team nursing C. Relationship nursing D. Functional nursing
***A. Primary nursing B. Team nursing C. Relationship nursing D. Functional nursing The most likely kind of nursing delivery system is primary nursing, where a nurse is accountable for specific clients. In functional and team nursing, the accountability would be shared. There is no relationship nursing system.
In an annual evaluation, the nurse unit leader describes the staff nurse as "skilled at analyzing a complex situation and able to pick out the most important aspects of a clinical scenario." According to Patricia Benner's model of nursing development, which developmental stage best matches the nurse unit leader's evaluation of the staff nurse? A. Proficient B. Novice C. Competent D. Expert
***A. Proficient B. Novice C. Competent D. Expert According to Benner's model, the novice nurse has no experience and relies only on guidelines, policies, and theories. The advanced beginner is starting to gain experience, with a focus on tasks and guidelines as the nurse at this stage does not have the experience to consider complexities. The competent nurse has begun to master some tasks, but does not yet possess the speed and flexibility of the proficient nurse. The proficient nurse is able to view the complexities of a situation, looking at the whole and determining which are the most important aspects. The expert nurse possesses an intuitive understanding of most situations and is able to quickly determine a course of action without much problem solving.
While preparing a performance appraisal for a staff nurse, the manager documents that the nurse is competent. Which nursing behaviors support this level of performance? (Select all that apply.) A. Provided interventions B. Identified appropriate outcomes C. Collected focused data D. Determined nursing diagnoses E. Communicated client requests
***A. Provided interventions ***B. Identified appropriate outcomes ***C. Collected focused data ***D. Determined nursing diagnoses E. Communicated client requests Competent nurses follow the steps of the nursing process when providing client care, specifically, assessment, diagnosis, planning, implementation, and evaluation. Communicating client requests is not a step within the nursing process.
The nurse is describing programs and services offered by the local community health department. Which activities should be included? (Select all that apply.) A. Providing food assistance to pregnant women B. Distributing free infant car seats C. Implementing injury prevention campaigns D. Promoting lead poisoning safety efforts E. Overseeing emergency medical services systems
***A. Providing food assistance to pregnant women ***B. Distributing free infant car seats ***C. Implementing injury prevention campaigns ***D. Promoting lead poisoning safety efforts E. Overseeing emergency medical services systems Local community health programs and services include implementing injury prevention campaigns, promoting lead poisoning safety efforts, distributing free infant car seats, and providing food assistance to pregnant women [often through the Women, Infants, and Children (WIC) supplemental nutrition program]. Oversight of emergency medical services systems is a state responsibility.
A pediatric nurse Jason Mosely is making sure that the activity room of his unit is stocked with crayons, coloring books, and stuffed animals. What is the best reason for Mr. Mosely to take that approach? A. Providing materials for nonverbal expression B. Giving entertaining options to fight boredom C. Allowing hospitalized children to exercise their limbs D. Setting up items to develop fine motor skills
***A. Providing materials for nonverbal expression B. Giving entertaining options to fight boredom C. Allowing hospitalized children to exercise their limbs D. Setting up items to develop fine motor skills Crayons, coloring books, and musical toys provide materials for nonverbal expression by hospitalized children. This is more important during an inpatient stay than entertainment, skill development, or exercise.
A medical-surgical unit utilizes the case method for providing client care. Which actions will the nurse perform when caring for clients using this approach? (Select all that apply.) A. Providing total care to assigned clients for the entire shift B. Overseeing the total care for a number of clients 24 hours a day, 7 days a week C. Assessing, planning, implementing, and evaluating care provided D. Delegating the completion of morning care to unlicensed assistive personnel E. Providing medications to clients for an entire team
***A. Providing total care to assigned clients for the entire shift B. Overseeing the total care for a number of clients 24 hours a day, 7 days a week ***C. Assessing, planning, implementing, and evaluating care provided D. Delegating the completion of morning care to unlicensed assistive personnel E. Providing medications to clients for an entire team The case method is also termed total care and involves one nurse being assigned and responsible for the care of a group of clients over an 8 or 12 hour shift. Nursing responsibilities in the case method include assessing, diagnosing, planning, implementing and evaluating the effectiveness of care. Providing medications to clients for an entire team would be performed in functional nursing. Delegating the completion of morning care to unlicensed assistive personnel is an action within team nursing. In primary nursing, the nurse oversees the total care for a number of clients 24 hours a day, 7 days a week.
The nurse is planning care of a 10-year-old child with an asthma exacerbation whose parents are currently unemployed. Which interventions are the best for the nurse to pursue for this family? (Select all that apply.) A. Reassuring the family of the potential benefits of pursuing the nurse's collaborative interventions B. Identification of areas of knowledge deficiency in cultural competence C. Referral to community wellness clinics D. Avoidance of assumptions or judgments E. Referral to social services experts
***A. Reassuring the family of the potential benefits of pursuing the nurse's collaborative interventions B. Identification of areas of knowledge deficiency in cultural competence ***C. Referral to community wellness clinics D. Avoidance of assumptions or judgments ***E. Referral to social services experts Nurses often need to collaborate with other professionals to help clients regain or maintain health. The nurse's collaborators may include social services experts, community free wellness clinics, food banks, and other community organizations that can meet the family's needs. The nurse teaches the family the value of these resources to their child's and family's health and encourages them to follow through on securing support. Identification of areas of knowledge deficiency in cultural competence and avoiding assumptions or judgments about clients are part of the nurse's own professional development and practice, not a nursing intervention for a client.
The nursing student reviews the National Student Nurses Association Code of Academic and Clinical Conduct prior to beginning a clinical rotation. Which are guiding principles of this code? (Select all that apply.) A. Refuse to perform a task without proper training B. Articulate the values of nursing to shape social policy C. Provide care in a professional manner D. Attain and maintain a maximum level of personal health E. Advocate for the rights of clients
***A. Refuse to perform a task without proper training B. Articulate the values of nursing to shape social policy ***C. Provide care in a professional manner ***D. Attain and maintain a maximum level of personal health ***E. Advocate for the rights of clients The Code for Nursing Students has 18 guiding principles which include advocating for the rights of clients; maintaining confidentiality; ensuring the safety of clients, self, and others; providing care in a professional manner; communicating effectively; promoting a high level of moral and ethical principles; encouraging life-long learning; treating others with respect; collaborating with other nurses; improving others' understanding of the nursing student's learning needs; encouraging others to mentor nursing students; refusing to perform any task in which the student has not been trained; avoiding any act of care that could lead to injury of clients, self, or others; ensuring clients provide authorization before accepting treatment; abstaining from the use of alcohol or substances in the clinical setting; striving to attain and maintain a maximal level of personal health; supporting students who may be experiencing health issues; and supporting school policies and regulations. Articulating the values of nursing to shape social policy is an action within the American Nurses Association's Code of Ethics for Nurses.
A community health nurse is describing the role of the local health department to a student nurse who is shadowing for the day. Which items are appropriate for the nurse to include in the discussion? (Select all that apply.) A. Reporting incidents of disease to state authorities B. Notifying federal authorities about incidents of disease C. Providing community disease monitoring and surveillance D. Offering state-wide disease and injury prevention programs E. Ensuring compliance by local emergency medical services (EMS)
***A. Reporting incidents of disease to state authorities ***B. Notifying federal authorities about incidents of disease ***C. Providing community disease monitoring and surveillance D. Offering state-wide disease and injury prevention programs E. Ensuring compliance by local emergency medical services (EMS) Responsibilities of local health departments include providing community disease monitoring and surveillance; reporting incidents of disease to state and federal authorities; and offering community-wide disease and injury prevention programs. State offices of emergency medical services (OEMSs) ensure that local emergency medical services (EMS) systems comply with all applicable regulations.
The nurse is reviewing a nursing research journal, published by a professional organization, prior to providing client care. Which statements illustrate how nursing research supports the nurse when planning client care? (Select all that apply.) A. Research provides information on evidence-based practice. B. Research supports education needs. C. Research ensures the implementation of ethical principles. D. Research is useful in explaining nursing theories. E. Research supports the nurse's education required for entry into practice.
***A. Research provides information on evidence-based practice. ***B. Research supports education needs. C. Research ensures the implementation of ethical principles. ***D. Research is useful in explaining nursing theories. E. Research supports the nurse's education required for entry into practice. Research is integral to the growth and ongoing professionalism of nursing. The focus of nursing research has progressed to include nursing education, the nursing knowledge base, and practice-related issues. Nursing research emphasizes the development of evidence-based practice. Through research, nursing has several conceptual frameworks and identified theories that are used to guide nursing practice and education. Research does not support any particular point of entry into the profession. Research does not ensure the implementation of ethical principles. The adherence to ethical principles is a characteristic of integrity, which is an aspect of the nursing profession.
The care coordinator is planning actions to overcome a client's knowledge deficit related to the use of a sleep apnea machine at home. Which approach should the nurse use for this situation? A. Review the steps in using the machine again B. Schedule the machine to be delivered at another time of day C. Explain the consequences of not using the equipment correctly D. Discuss the client's non-adherence with the healthcare professional
***A. Review the steps in using the machine again B. Schedule the machine to be delivered at another time of day C. Explain the consequences of not using the equipment correctly D. Discuss the client's non-adherence with the healthcare professional To overcome the barrier of deficient knowledge, the nurse should provide additional teaching to ensure client comprehension of the instructions. Scheduling would address the barrier of limited resources. Discussing the issue with the interdisciplinary team is an action to address limited resources. Explaining the consequences of not using the equipment correctly is not a strategy to overcome any care coordination barriers.
Prior to delivery of client care, the nurse reviews one policy, checks an evidence-based practice guideline, and scans through a list of standards of practice. Which elements of a profession are illustrated through the actions of the nurse? (Select all that apply.) A. Service orientation B. Quality improvement C. Autonomy D. Safety E. Ongoing research
***A. Service orientation B. Quality improvement ***C. Autonomy D. Safety ***E. Ongoing research The elements of any profession include service orientation, ongoing research, and autonomy. By reviewing an evidence-based guideline, the nurse is demonstrating ongoing research. By scanning through a list of standards of practice, the nurse is demonstrating autonomy. By reviewing a policy, the nurse is demonstrating an element of service orientation. Safety and quality improvement are nursing competencies.
A student nurse is reviewing the Nurse Practice Act and its influence on the standards of care for nurses. How does the Nurse Practice Act influence the practice of nursing? A. Sets the requirements for licensure, including educational requirements of nurses B. Regulates institutional policies concerning nurse's job responsibilities C. Regulates the accreditation standing of nursing programs D. Develops client care policies and procedures
***A. Sets the requirements for licensure, including educational requirements of nurses B. Regulates institutional policies concerning nurse's job responsibilities C. Regulates the accreditation standing of nursing programs D. Develops client care policies and procedures The Nurse Practice Act sets the requirements for licensure, including educational requirements of nurses. The Nurse Practice act does not regulate nurses' job responsibilities or the accreditation standing of nursing programs. The Nurse Practice Act does not develop client care policies and procedures.
The nurse unit manager is giving an in-service about sexual harassment in the workplace. When discussing what constitutes sexual harassment, which statement is most appropriate for the nurse unit manager to include in the in-service? A. Sexual harassment must be considered both a form of discrimination and a violation of an individual's rights. B. Behaviors must include unwelcome advances of a sexual nature that are demonstrated through the perpetrator's physical conduct. C. The sexual behaviors must interfere with the victim's work performance and prevent fulfillment of work functions. D. Submitting to requests for sexual behaviors must be explicitly considered a condition of an individual's employment.
***A. Sexual harassment must be considered both a form of discrimination and a violation of an individual's rights. B. Behaviors must include unwelcome advances of a sexual nature that are demonstrated through the perpetrator's physical conduct. C. The sexual behaviors must interfere with the victim's work performance and prevent fulfillment of work functions. D. Submitting to requests for sexual behaviors must be explicitly considered a condition of an individual's employment. Sexual harassment is a form of discrimination, as well as a violation of an individual's rights. The Equal Employment Opportunity Commission (EEOC) defines sexual harassment as "unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature" occurring when submitting to such requests or behavior is considered, either explicitly or implicitly, a condition of an individual's employment; when submission to or rejection of such requests or behavior is used as the basis for employment decisions affecting the individual (e.g., promotion); or when such conduct interferes with an individual's work performance or creates an "intimidating, hostile, offensive working environment."
The unit charge nurse is planning an in-service education program about effective ergonomics during computer use. Which content should be included? (Select all that apply.) A. Shoulders and upper arms should be perpendicular to the floor, and upper arms and elbows should be close to the body. B. Individuals who use the computer for more than 3 hours per day are at risk for computer vision syndrome, or eyestrain. C. While seated, an individual's thighs should be parallel to the floor, and the lower legs should be extended. D. The head and neck should be aligned, and the torso should be relaxed to allow the upper spine to curve outward. E. Repetitive strain injury, or repetitive motion disorder, is the most common consequence of computer use.
***A. Shoulders and upper arms should be perpendicular to the floor, and upper arms and elbows should be close to the body. ***B. Individuals who use the computer for more than 3 hours per day are at risk for computer vision syndrome, or eyestrain. C. While seated, an individual's thighs should be parallel to the floor, and the lower legs should be extended. D. The head and neck should be aligned, and the torso should be relaxed to allow the upper spine to curve outward. E. Repetitive strain injury, or repetitive motion disorder, is the most common consequence of computer use. For proper positioning, the head, neck, and torso should be aligned. Shoulders and upper arms should be perpendicular to the floor and relaxed. Upper arms and elbows should be close to the body. Forearms, wrists, and hands should be straight and in line. While seated, the worker's thighs should be parallel to the floor and the feet should rest flat on the floor or be supported by a footrest. Repetitive strain injury, or repetitive motion disorder, is one of the two most common injuries resulting from prolonged computer use. However, computer vision syndrome, or eyestrain, is the most common consequence. Individuals who use the computer for more than 3 hours per day are at risk for computer vision syndrome.
Which are factors that shape family development? (Select all that apply.) A. Sibling relationships B. Parenting style C. Family-centered care D. Resiliency E. Boundaries
***A. Sibling relationships ***B. Parenting style C. Family-centered care ***D. Resiliency ***E. Boundaries Factors that shape family development are parent-child interaction, family size, sibling relationships, boundaries, family cohesion, resiliency, family coping mechanisms, emotional availability, family flexibility, family communication patterns, parenting style, and genetic considerations and nonmodifiable risk factors. Family-centered care is the partnership between nurses and families when planning care.
Which are examples of nonverbal communication? (Select all that apply.) A. Sitting forward in a chair B. Crossed arms C. Yelling D. Blushing E. Lack of eye contact
***A. Sitting forward in a chair ***B. Crossed arms C. Yelling ***D. Blushing ***E. Lack of eye contact Blushing, lack of eye contact, crossed arms, and sitting forward in a chair are all forms of nonverbal communication. Yelling is verbal.
The clinical nursing instructor is preparing a presentation about societal factors that influence health policy. Which factors should be included? (Select all that apply.) A. Size of a given population B. Population-specific needs C. Degree to which the population's current needs are met D. Level of support for the proposed policy E. Ability of the population to finance the proposed policy
***A. Size of a given population ***B. Population-specific needs ***C. Degree to which the population's current needs are met ***D. Level of support for the proposed policy E. Ability of the population to finance the proposed policy Societal factors that influence health policy include the population's size and specific needs, the degree to which current policy meets the population's needs, and the level of support for the proposed policy. The target population is not required to finance the health policy.
The nurse observes the client in prayer with family members. Which cultural phenomenon would the nurse recognize is occurring? A. Social organization B. Personal space C. Time orientation D. Environmental control
***A. Social organization B. Personal space C. Time orientation D. Environmental control Religious beliefs are part of what may identify the social organization of the culture of a family unit. Although the family members might be close to each other, focus is not on personal space, which refers to the comfortable or appropriate distance for interaction with other people. Time orientation differs among cultures, with some putting more value on the past and present; Anglo-American culture places more emphasis on the future. However, the focus during this client's prayer is not on time. The family is displaying social organization and not controlling the environment around them.
When developing a family plan of care for a pediatric client with a chronic health condition, which areas require an in-depth assessment of all family members? (Select all that apply.) A. Socioeconomic status B. Religious preferences C. Medication schedules D. Culture and social practices E. Education level
***A. Socioeconomic status ***B. Religious preferences C. Medication schedules ***D. Culture and social practices E. Education level A family plan of care requires in-depth assessment of all family members, including their health history, socioeconomic status, religion, culture, nutrition, and social habits and practices. Medication schedules and education/intelligence levels do not need to be assessed unless the nurse becomes aware of a problem in this area.
A young client has just learned of a diagnosis of stage 4 lung cancer. The client was about to graduate from school and get married. "I can't believe in God anymore," the client tells the oncology nurse. "He should be all-loving." Which situation would the nurse identify the client as expressing? A. Spiritual distress B. Fear of unemployment C. Premarital anxiety D. A justice complaint
***A. Spiritual distress B. Fear of unemployment C. Premarital anxiety D. A justice complaint The client is expressing spiritual distress about the loss of hope in his belief system. It is not a complaint about justice, anxiety about a planned marriage, or fear of the job market.
Which actions by professional staff are considered abusive or unprofessional behavior toward clients with mental health disorders? (Select all that apply.) A. Supplying clients with drugs or alcohol in return for favors B. Refusing to share homemade cookies with the client C. Using restraints for a client who is a threat to others D. General threats of harm if clients do not behave as they were told E. Making privileges contingent on favors
***A. Supplying clients with drugs or alcohol in return for favors B. Refusing to share homemade cookies with the client C. Using restraints for a client who is a threat to others ***D. General threats of harm if clients do not behave as they were told ***E. Making privileges contingent on favors Abusive and/or unprofessional behaviors by professional staff include making privileges contingent on favors, supplying clients with drugs or alcohol, and making general threats of harm if clients do not behave as they were told. The advocate would immediately report any of these behaviors to the supervisor. Refusing to share homemade cookies and using restraints are not abusive behaviors.
A nurse in a long-term care facility finds a client unresponsive in bed. The nurse notices a do not resuscitate (DNR) sign at the head of the bed. What is the nurse's priority action? A. Taking the vital signs of the client B. Letting the physician know of the client's condition C. Letting the supervisor know of the client's condition D. Making sure the client is not in pain
***A. Taking the vital signs of the client B. Letting the physician know of the client's condition C. Letting the supervisor know of the client's condition D. Making sure the client is not in pain The nurse needs to check the client's status with the physiological measurements of vital signs. Making sure the client is not in pain is important, but not the priority clinical action. Informing the supervisor and the primary care physician can be done later. The client has a right to assessment, even with a DNR sign.
The public health nurse is conducting a seminar for first-time parents about health insurance coverage. What features of a Health Maintenance Organization (HMO) would the nurse describe as different from those of a Preferred Provider Organization (PPO)? (Select all that apply.) A. The HMO has lower copayments. B. The HMO has lower deductibles. C. The HMO requires selection of a primary care provider. D. The HMO gives wider choices of providers. E. The HMO has higher premiums.
***A. The HMO has lower copayments. ***B. The HMO has lower deductibles. ***C. The HMO requires selection of a primary care provider. D. The HMO gives wider choices of providers. E. The HMO has higher premiums. The HMO has lower copayments, lower deductibles, and requires selection of a primary care provider. The PPO has higher premiums, but gives wider choice of providers than the HMO.
A nurse manager is talking to the night shift staff about the ethical principles supporting education of their preoperative clients. The nurse manager uses the words "beneficence" and "nonmaleficence." Which statements define these two concepts? (Select all that apply.) A. The actions that nurses take should promote good. B. The actions that nurses take should be fair to all possible clients. C. The actions that nurses take should do no harm. D. The actions that nurses take should safeguard clients. E. The actions that nurses take should involve telling the truth.
***A. The actions that nurses take should promote good. B. The actions that nurses take should be fair to all possible clients. ***C. The actions that nurses take should do no harm. ***D. The actions that nurses take should safeguard clients. E. The actions that nurses take should involve telling the truth. Beneficence means the nurse's actions should promote good; nonmaleficence means the nurse should do no harm and safeguard clients. Telling the truth is about "veracity," rather than "beneficence." Being fair to all possible clients is about "justice," rather than "beneficence."
The nurse manager is concerned that client care coordination was not successful. On which observations did the nurse manager base this concern? (Select all that apply.) A. The client's abdominal wound dressing was changed twice in one shift. B. The client's fasting blood glucose level was drawn twice in one day. C. The family is requesting to discuss home care needs. D. Referral for home care has been delayed by two days. E. The client received two doses of a prescribed pain medication.
***A. The client's abdominal wound dressing was changed twice in one shift. ***B. The client's fasting blood glucose level was drawn twice in one day. C. The family is requesting to discuss home care needs. ***D. Referral for home care has been delayed by two days. ***E. The client received two doses of a prescribed pain medication. Care that is not coordinated can lead to fragmented services, medical errors, and unnecessary duplication of tests, services, and treatments, as well as to omission of necessary services. Collaboration can be initiated by the client, family member, or a member of the health care team.
The nurse is performing a cultural assessment on an adult client. What type of information would be used to complete the cultural assessment? (Select all that apply.) A. The language spoken in the home B. Whether the client has insurance C. The client's region or country of residence D. The kinds of food and drink the client prefers E. The cultural or religious influences in decision making
***A. The language spoken in the home B. Whether the client has insurance ***C. The client's region or country of residence ***D. The kinds of food and drink the client prefers ***E. The cultural or religious influences in decision making Subjective data would be gathered by asking questions about cultural beliefs. Objective data would be gathered through observation of the client and the interactions between significant family members who might be present. Discovering the region or country the client originates from and lives in would give clues about the client's culture. It is important to know what language is spoken in the home and whether the client understands English so that communication can be effective. Insurance is not necessarily a question that would come up during a cultural assessment, although socioeconomic status may affect health care delivery.
Two dialysis clinic nurses are discussing the recent death of a client with end stage renal disease. One nurse believed that the client's decision to end treatment was OK. The other nurse thought that the client should have extended life long enough to talk to an estranged child. Which nurse is exhibiting client advocacy? A. The nurse who believed that the client's decision to end treatment is OK. B. Both nurses are advocates; they are proposing choices that the client could have made C. Neither nurse is an advocate; the client had no real choice and would have died soon anyway D. The nurse who thought that the client should have had a chance to reconcile with a child
***A. The nurse who believed that the client's decision to end treatment is OK. B. Both nurses are advocates; they are proposing choices that the client could have made C. Neither nurse is an advocate; the client had no real choice and would have died soon anyway D. The nurse who thought that the client should have had a chance to reconcile with a child An advocate defends the cause of another person, so the nurse supporting the client's decision to end treatment was an advocate. The nurse who proposed an opinion that family reconciliation was a value was not supportive of the client. Advocacy is not limited by the amount of time left in life. An advocate does not propose choices that the client could have made, in the face of choices actually made.
The nursing students are meeting for a post conference following their shift on a medical floor. One of the students is reviewing a client's cultural background. Which statement by the student illustrates the concept of cultural humility? A. The nurse's expression of sensitivity to the differences between her client's culture and her own. B. The nurse's discussion of her cultural superiority over her client's culture. C. The nurse's explanation to her client that his religious beliefs lack scientific validity when discussing his diagnosis D. The nurse's example of her authoritative stance when teaching her client which diet is best for his diagnosis.
***A. The nurse's expression of sensitivity to the differences between her client's culture and her own. B. The nurse's discussion of her cultural superiority over her client's culture. C. The nurse's explanation to her client that his religious beliefs lack scientific validity when discussing his diagnosis D. The nurse's example of her authoritative stance when teaching her client which diet is best for his diagnosis. Cultural humility is displayed when a nurse recognizes that his or her personal cultural values are not superior to the cultural values of another person. The nurse is not demonstrating cultural humility when he or she is claiming cultural superiority over another person. Taking an authoritative stance to influence a client against dietary choices does not reflect cultural humility. Abusing the power of the nurse's position against the client's religion is not using cultural humility. Cultural humility is demonstrated when the nurse is sensitive to the differences in his or her client's culture, even though the nurse's personal values are not the same as the client's.
Which statement describes the overall goal of client advocacy? A. The overall goal of client advocacy is to safeguard the client from harm. B. The overall goal of client advocacy is to educate clients. C. The overall goal of client advocacy is to speak for clients. D. The overall goal of client advocacy can only be achieved by specially trained nurses.
***A. The overall goal of client advocacy is to safeguard the client from harm. B. The overall goal of client advocacy is to educate clients. C. The overall goal of client advocacy is to speak for clients. D. The overall goal of client advocacy can only be achieved by specially trained nurses. The overall goal of client advocacy is to safeguard clients from harm and to represent their needs to other healthcare professionals. Speaking for clients and educating clients are actions that support the protection of the client's rights. All nurses are client advocates, with or without special training.
Medication administration has been identified as a high-risk activity for error. What are the rights of medication administration that every nurse should follow? (Select all that apply.) A. The right drug B. The right room C. The right client D. The right dose E. The right time
***A. The right drug B. The right room ***C. The right client ***D. The right dose ***E. The right time The Six Rights of medication administration include the right drug, the right dose, the right client, the right route, the right time, and the right documentation. The right room is not one of the Six Rights of medication administration.
The staff development educator is preparing a seminar for staff nurses prior to implementing managed care. Which skills should the educator include as necessary when implementing this care delivery system? (Select all that apply.) A. Time management B. Communication C. Medication administration D. Delegation E. Assessment
***A. Time management ***B. Communication C. Medication administration ***D. Delegation ***E. Assessment Learning to manage care takes time because it requires strong communication, assessment, and time management skills. Managing care also requires the ability to appropriately delegate to unlicensed staff. The skill of medication administration is necessary for direct client care, not managed care.
Which action is characteristic of the "planning care" phase of the care coordination process? A. Utilize standard protocols or critical pathways and evidence-based guidelines B. Determine the need for consultation with other healthcare providers C. Adjust the plan in response to changes in the client's condition D. Identify potential challenges
***A. Utilize standard protocols or critical pathways and evidence-based guidelines B. Determine the need for consultation with other healthcare providers C. Adjust the plan in response to changes in the client's condition D. Identify potential challenges In the planning care phase of care coordination, the nurse will utilize standard protocols or critical pathways and evidence-based guidelines. Determining the need for consultation with other healthcare providers is a part of the assessment phase of care coordination. Identifying potential challenges is a part of the problem identification phase when coordinating care. Adjusting the plan in response to a change in the client's condition is an action taken when evaluating care coordination.
Which of the following statements accurately describe a characteristic of ethics? Select all that apply. A. Values are intimately related to, and direct, ethical conduct. B. The ability to be ethical begins in young adulthood. C. It is important to distinguish ethics from religion, law, custom, and institutional practices. D. Ethics cannot be defined as a code of professional conduct. E. Ethics is a systematic inquiry into principles of right and wrong conduct. F. Ethics usually refers to personal or communal standards of right and wrong.
***A. Values are intimately related to, and direct, ethical conduct. ***B. The ability to be ethical begins in young adulthood. ***C. It is important to distinguish ethics from religion, law, custom, and institutional practices. D. Ethics cannot be defined as a code of professional conduct. ***E. Ethics is a systematic inquiry into principles of right and wrong conduct. ***F. Ethics usually refers to personal or communal standards of right and wrong. The ability to be ethical, to make decisions, and to act in an ethically justified manner, begins in childhood and develops gradually. Many people use the term ethics when describing the systematic ethics incorporated into a code of professional conduct, such as nursing codes of ethics. The term morals, although similar in meaning to ethics, usually refers to personal or communal standards of right and wrong. It is important to distinguish ethics from religion, law, custom, and institutional practices. For example, the fact that an action is legal or customary does not in itself make the action ethically or morally right. Since values are beliefs about what is important, they are intimately related to, and direct, ethical conduct. Ethics is a systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil as they relate to conduct and human flourishing.
During the nursing assessment interview, 40-year-old Nirali Dayada states that she follows a strict diet consistent with her Hindu religious beliefs. What hospital menu choices would be most likely for Ms. Dayada's stay? A. Vegetarian entrees B. Gluten-free products C. Noncaffeinated beverages D. Kosher food
***A. Vegetarian entrees B. Gluten-free products C. Noncaffeinated beverages D. Kosher food Vegetarian entrees would be appropriate for a practicing Hindu. The other choices would not be relevant to her religious beliefs.
A head nurse assumes the leadership role when directing and supervising coworkers. Which of the following are attributes of a leader? Select all that apply. A. charismatic B. task-oriented C. dynamic D. philosophical E. intimidating F. self-confident
***A. charismatic B. task-oriented ***C. dynamic ***D. philosophical E. intimidating ***F. self-confident Leadership involves philosophy, perception, and judgment whereas management tasks are the core of the management role. Leaders need to be comfortable with themselves (i.e., have a positive self-image) and present themselves as role models for followers. Ideally, they also have a vision that energizes the group and brings forth the best efforts of members. Leaders may be charismatic, dynamic, enthusiastic, poised, confident, and self-directed.
The nurse is assessing a client of a different culture who has different religious beliefs. Which statements or questions by the nurse would demonstrate cultural competence when assessing the client? (Select all that apply.) A. "How do you feel about taking medications or blood products if they are prescribed?" B. "I understand that you may not believe in receiving human blood products; is that correct?" C. "I apologize for keeping you so long. Would you like some privacy for prayer before continuing the exam?" D. "May I ask what your partner might think about this plan of care?" E. "I cannot continue with this assessment if you are not willing to be compliant with my plan of care."
***A. "How do you feel about taking medications or blood products if they are prescribed?" ***B. "I understand that you may not believe in receiving human blood products; is that correct?" ***C. "I apologize for keeping you so long. Would you like some privacy for prayer before continuing the exam?" ***D. "May I ask what your partner might think about this plan of care?" E. "I cannot continue with this assessment if you are not willing to be compliant with my plan of care." The nurse can show knowledge of a client's culture by asking appropriate questions that are not demeaning or rude. Asking how the client feels about taking medications opens the conversation to what cultural or religious beliefs might interfere with the medical care of the client. Attitudes of acceptance and recognition would help to build rapport with the client. An accepting attitude does not mean the nurse agrees with the client but that the nurse is willing to accept what the client believes, and work it into the plan of care. Communication is an important skill for a nurse when assessing and caring for a client with a different culture to ensure proper care. Asking about family support opens the conversation so the client feels comfortable speaking about family objections. A nurse who does not demonstrate cultural competence would hinder the health care being provided to the client and may hinder the client's compliance. Refusing to work a plan of care around a client's cultural beliefs is unethical and not beneficial to the client.
Scott Nitroskey, a home health nurse, is caring for 67-year-old Martha Miriste, a female client who is diagnosed with diabetes. Scott is completing Mrs. Mireste's client teaching. During the teaching session, which statement might Mrs. Mireste interpret as being Scott's attempt to intimidate her? A. "If you don't stop eating so much candy, your diabetes is going to get much worse." B. "Regular exercise can help with the management of your diabetes." C. "If you cut back on your sugar intake, you might see some improvement in your diabetes." D. "Increased sugar in your diet can cause your blood sugar to go up and impact your diabetes."
***A. "If you don't stop eating so much candy, your diabetes is going to get much worse." B. "Regular exercise can help with the management of your diabetes." C. "If you cut back on your sugar intake, you might see some improvement in your diabetes." D. "Increased sugar in your diet can cause your blood sugar to go up and impact your diabetes." Intimidation may be unintentional on the nurse's part, including making statements such as, "If you do not take your medicine (or go to physical therapy, or follow the treatment plan), you're going to get worse." Although eating excess amounts of candy may cause the client's diabetes to worsen, this approach is intimidating and unprofessional. Encouraging the client through telling her which interventions may improve her condition is not reflective of intimidation, nor is explaining the link between dietary sugar and blood sugar.
The home health nurse is helping a client with congestive heart failure to plan for the future. The client is having difficulty making some final decisions. What question could the nurse ask to help clarify the client's values? A. "What alternative courses of action have you been thinking about?" B. "What do you think your children would like you to do?" C. "Do you want to postpone talking about this difficult matter?" D. "Are you feeling healthy enough to be making decisions?"
***A. "What alternative courses of action have you been thinking about?" B. "What do you think your children would like you to do?" C. "Do you want to postpone talking about this difficult matter?" D. "Are you feeling healthy enough to be making decisions?" The nurse could help the client clarify values by helping the client list alternative courses of action. The nurse should stress that the client is making the decision, not the client's children. The client faces making decisions now, in spite of medical conditions, so talking about difficult matters should not be postponed.
Trace Oliverez, a senior nursing student, is preparing to graduate. Trace asks his mentor, "Which nursing organization offers reviews to help students prepare for the certification exam?" What is the mentor's best response? A. "You should join the National Student Nurses Association (NSNA)." B. "You should join the American Nurses Association (ANA)." C. "You should join the National League for Nursing (NLN)." D. "You should join Sigma Theta Tau International (STTI)."
***A. "You should join the National Student Nurses Association (NSNA)." B. "You should join the American Nurses Association (ANA)." C. "You should join the National League for Nursing (NLN)." D. "You should join Sigma Theta Tau International (STTI)." The National Student Nurses Association (NSNA), a nonprofit organization, mentors nursing students who are preparing for initial registered nurse licensure; membership benefits include certification exam mini-reviews. The National League for Nursing (NLN) promotes excellence in nursing education through strategies that include faculty development programs and public policy initiatives. Sigma Theta Tau International (STTI) membership is by invitation to nursing students who demonstrate academic excellence and nurse leaders who demonstrate exceptional nursing achievements. The American Nurses Association (ANA) represents the nations' registered nurses; its professional mission includes cultivating high standards of nursing practice and advocating for nurses' rights in the workplace.
The nursing instructor asks the students to identify other terms used to describe the computerized medical record. Which student responses are most accurate? (Select all that apply.) A. "Administrative information system." B. "Clinical information system." C. "Computerized patient record." D. "Clinical decision support system." E. "Electronic health records system."
A. "Administrative information system." B. "Clinical information system." ***C. "Computerized patient record." D. "Clinical decision support system." ***E. "Electronic health records system." Other terms commonly used to describe the computerized medical record (CMR) include electronic health records system (EHRS), electronic medical record (EMR), electronic health record (EHR), computerized patient record (CPR), patient medical records software (PMRS), and personal health record (PHR). Clinical decision support systems are a type of artificial intelligence that analyzes data and provides information about evidenced-based practices. A clinical information system allows multiple disciplines to simultaneously access the client's chart and record data that can be viewed and analyzed by multiple healthcare providers in real time. An administrative information system provides support and management for the business aspects of health care.
The nursing student is describing how citizens and government work together to influence health policy. Which statement is most accurate? A. "Citizens who report healthcare concerns must also describe the political considerations associated with the proposed solutions." B. "The government official may draft a law that reflects implementation of the proposed solution." C. "Citizens who propose solutions to healthcare problems must also include an evaluation of the solution's safety." D. "The government official who advocates for passing a new law is responsible for evaluating the outcomes."
A. "Citizens who report healthcare concerns must also describe the political considerations associated with the proposed solutions." ***B. "The government official may draft a law that reflects implementation of the proposed solution." C. "Citizens who propose solutions to healthcare problems must also include an evaluation of the solution's safety." D. "The government official who advocates for passing a new law is responsible for evaluating the outcomes." The government official may draft a law that reflects implementation of the proposed solution. Government officials, not individual citizens, are responsible for evaluating solutions based on safety and for identifying political considerations associated with each solution. Federal agencies or departments who are responsible for implementing the new law are responsible for evaluating outcomes.
The nurse researcher is giving a presentation about the applications of geographic information system (GIS) technology. Which statement is appropriate for the nurse researcher to include in the presentation? A. "GIS technology is not dependent on satellite imaging or global positioning systems (GPSs)." B. "GIS technology can be used to plot and analyze lifestyle choices, such as improper nutrition." C. "GIS technology is used strictly within the healthcare system." D. "GIS technology is not useful for tracking acute health problems."
A. "GIS technology is not dependent on satellite imaging or global positioning systems (GPSs)." ***B. "GIS technology can be used to plot and analyze lifestyle choices, such as improper nutrition." C. "GIS technology is used strictly within the healthcare system." D. "GIS technology is not useful for tracking acute health problems." GIS technology has been used both inside and outside of health care. To capture geographical data, GIS relies on satellite imaging and global positioning systems (GPSs). The many uses of GIS technology include plotting and analyzing lifestyle choices, such as improper nutrition, and tracking acute health problems.
The nurse leader is developing a presentation about the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Which statement should be included? A. "HIPAA requires increased general access to the client's health information in written, oral, or electronic form." B. "HIPAA requires organizations to notify clients of how their information may be used or shared." C. "Because of HIPAA, healthcare providers are able to correct the client's health record." D. "Because of HIPAA, clients are prohibited from accessing their personal medical records."
A. "HIPAA requires increased general access to the client's health information in written, oral, or electronic form." ***B. "HIPAA requires organizations to notify clients of how their information may be used or shared." C. "Because of HIPAA, healthcare providers are able to correct the client's health record." D. "Because of HIPAA, clients are prohibited from accessing their personal medical records." The Health Insurance Portability and Accountability Act of 1996 (commonly referred to as HIPAA) is designed to protect clients through measures including setting limits and rules regarding who may access to a client's health information in written, oral, or electronic form; giving clients the right to view their health records; allowing clients to correct their records; and requiring organizations to notify clients of how their information may be used or shared (for example, for research or marketing purposes).
The nursing instructor asks students to describe health policy. Which student statement is best? A. "Health policy refers to actions taken by populations that consist of individuals who are in need of change." B. "Health policy ensures that healthcare organizations will achieve their goals." C. "Health policy includes governmental choices that affect clients' abilities to reach healthcare goals." D. "Health policy assures that individuals will reach their health-related objectives."
A. "Health policy refers to actions taken by populations that consist of individuals who are in need of change." B. "Health policy ensures that healthcare organizations will achieve their goals." ***C. "Health policy includes governmental choices that affect clients' abilities to reach healthcare goals." D. "Health policy assures that individuals will reach their health-related objectives." Health policy refers to actions and choices by government bodies and professional organizations that affect the ability of healthcare organizations and individuals in the healthcare system to reach their healthcare goals. Health policy does not guarantee achievement of goals.
A group of student nurses is discussing the implementation of new laws based on health policy. Which student statement is the most accurate? A. "If desired outcomes are not achieved, the government official will enact a new law." B. "Implementation of the law does not end the cycle of policy analysis." C. "If the law requires major changes, the affected population will vote to modify the new law's regulations." D. "The purpose of evaluation is to make sure that costs of implementing the law are as low as possible."
A. "If desired outcomes are not achieved, the government official will enact a new law." ***B. "Implementation of the law does not end the cycle of policy analysis." C. "If the law requires major changes, the affected population will vote to modify the new law's regulations." D. "The purpose of evaluation is to make sure that costs of implementing the law are as low as possible." The purpose of evaluation is to ensure achievement of the best possible results. If the new law fails to promote achievement of the desired outcomes, the responsible agency or department can make changes to the rules and regulations within the framework of the law. If major changes are needed, the agency will recommend legislative changes, such as an amendment or a new law, which may or may not be made. Implementation does not end the cycle. Continuous analysis of results by the implementing agency is critical.
The nurse leader is planning an in-service about integrity in nursing practice. Which statement regarding integrity in nursing is most appropriate for the nurse leader to include in the in-service? A. "Integrity means understanding that negative feedback from peers has little value." B. "Integrity means internalizing professional practices that the nurse prefers to follow." C. "Nurses with integrity adhere to a strict moral or ethical code." D. "Nurses with integrity provide excellent care and do not make errors."
A. "Integrity means understanding that negative feedback from peers has little value." B. "Integrity means internalizing professional practices that the nurse prefers to follow." ***C. "Nurses with integrity adhere to a strict moral or ethical code." D. "Nurses with integrity provide excellent care and do not make errors." Integrity requires adherence to a strict ethical or moral code, such as the ANA Code of Ethics for Nurses. Integrity involves practicing consistent behaviors based on the internalization of the ethics, values, and best practices of the nursing profession. Integrity in nursing includes accepting positive or negative feedback as a tool for improving the delivery of client care. Nurses with integrity are not perfect; however, they admit to their mistakes.
During a classroom discussion, the nurse educator asks the nursing students to describe intimidation. Which students' statements most accurately describe intimidation? (Select all that apply.) A. "Intimidation includes having negative thoughts about nursing peers or colleagues." B. "Intimidation can include threatening someone with consequences for disobedience." C. "Intimidation includes experienced nurses who bully new nurses." D. "Covert and overt behaviors may qualify as being intimidation." E. "Nurses always realize when their behaviors toward clients are forms of intimidation."
A. "Intimidation includes having negative thoughts about nursing peers or colleagues." ***B. "Intimidation can include threatening someone with consequences for disobedience." ***C. "Intimidation includes experienced nurses who bully new nurses." ***D. "Covert and overt behaviors may qualify as being intimidation." E. "Nurses always realize when their behaviors toward clients are forms of intimidation." Intimidation includes threatening, bullying, or forcing someone who is emotionally or physically weaker to do something in order to avoid retribution or negative consequences. Subtle, or covert, forms of intimidation may include standing close to someone while maintaining a hostile facial expression. Unexpressed negative thoughts are not reflective of intimidation. Intimidation may be unintentional on the nurse's part, including making statements such as, "If you do not take your medicine (or go to physical therapy, or follow the treatment plan), you're going to get worse." While the nurse's statement may be true, this approach is intimidating and unprofessional.
The novice nurse asks the nurse preceptor to explain the difference between intranets and the Internet. Which response by the nurse preceptor is most accurate? A. "Intranets have mandatory security features that restrict access by the public." B. "Compared to the Internet, intranets are smaller and easier to maintain." C. "Intranets are rarely used due to their limited ability to allow data sharing among users." D. "Compared to the Internet, intranets are less vulnerable to data breeches and do not require firewalls."
A. "Intranets have mandatory security features that restrict access by the public." ***B. "Compared to the Internet, intranets are smaller and easier to maintain." C. "Intranets are rarely used due to their limited ability to allow data sharing among users." D. "Compared to the Internet, intranets are less vulnerable to data breeches and do not require firewalls." Intranets usually have security to restrict access by the public, although some intranets are used purely as file-sharing applications and have little or no security. Intranets are utilized regularly, as they allow collaboration and a high degree of data sharing among users. Because of their smaller size, they are easier to control and maintain. Both intranets and the Internet are vulnerable to data breeches and should utilize firewalls, encryption, and authentication; user passwords that change on a frequent basis; and strict control over which users have access to secure data.
The nurse informaticist is delivering a webinar about electronic medical records (EMRs). Which statement should be included in the webinar? A. "Most EMRs are designed to be portable." B. "EMRs focus on diagnosis and treatment." C. "EMRs are not useful in identifying the need for routine preventive maintenance." D. "The EMR is also called the administrative information system."
A. "Most EMRs are designed to be portable." ***B. "EMRs focus on diagnosis and treatment." C. "EMRs are not useful in identifying the need for routine preventive maintenance." D. "The EMR is also called the administrative information system." Electronic medical records (EMRs), which are similar to electronic charts, help track client data and identify when routine preventive health maintenance (such as vaccines or mammograms) is needed. EMRs focus is on diagnosis and treatment. Most EMRs are designed to stay within a clinical setting, so clients who are referred to other care providers may need printed versions of the EMR to take with them. An administrative information system provides support and management for the business aspects of health care.
The student nurse is evaluating the client's knowledge about proper anatomical positioning when seated at a computer workstation after a teaching session. Which statement indicates the client has adequate knowledge and does not require further instruction? A. "My head and neck should be aligned, and my upper torso should be curved and relaxed." B. "My thighs should be parallel to the floor, and I should avoid using a footrest." C. "My upper arms and elbows should be close to my body." D. "My forearms should be straight and my wrists should be flexed."
A. "My head and neck should be aligned, and my upper torso should be curved and relaxed." B. "My thighs should be parallel to the floor, and I should avoid using a footrest." ***C. "My upper arms and elbows should be close to my body." D. "My forearms should be straight and my wrists should be flexed." The head, neck, and torso should be aligned. Shoulders and upper arms should be perpendicular to the floor and relaxed. Upper arms and elbows should be close to the body. Forearms, wrists, and hands should be straight and in line. While seated, the worker's thighs should be parallel to the floor, and the feet should rest flat on the floor or be supported by a footrest.
The staff development instructor is evaluating the learning of staff nurses after providing a presentation on the Quality and Safety Education for Nurses competencies. Which statements indicate that this training has been effective? (Select all that apply.) A. "Quality improvement is minimized." B. "Evidence-based practice should be used." C. "Client-centered care is the focus." D. "Teamwork and collaboration impact client outcomes." E. "The use of informatics has yet to be determined."
A. "Quality improvement is minimized." ***B. "Evidence-based practice should be used." ***C. "Client-centered care is the focus." ***D. "Teamwork and collaboration impact client outcomes." E. "The use of informatics has yet to be determined." The Quality and Safety Education for Nurses (QSEN) competencies support accountability in nursing practice and include the competencies of client-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. Quality improvement and informatics are integral elements of these competencies.
The nurse educator is describing the role of the American Association of Colleges of Nursing (AACN) to a new educator. Which statement is the most appropriate for the nurse educator to include in the discussion? A. "The AACN is the national voice for America's undergraduate nursing education programs." B. "The AACN is the national voice for America's baccalaureate and graduate nursing education programs." C. "The AACN is the national voice for graduate nursing education programs throughout the United States." D. "The AACN is the national voice for all types of nursing education programs throughout the United States."
A. "The AACN is the national voice for America's undergraduate nursing education programs." ***B. "The AACN is the national voice for America's baccalaureate and graduate nursing education programs." C. "The AACN is the national voice for graduate nursing education programs throughout the United States." D. "The AACN is the national voice for all types of nursing education programs throughout the United States." The American Association of Colleges of Nursing (AACN) is the national voice for America's baccalaureate and graduate nursing education.
The nurse researcher is preparing a webinar about the history of nursing research. Which statement should be included? A. "The American Association of Colleges of Nursing was the first nursing organization to fund nursing research." B. "The National League for Nursing was the first nursing organization to fund nursing research." C. "Sigma Theta Tau International was the first nursing organization to fund nursing research." D. "The American Nurses Association was the first nursing organization to fund nursing research."
A. "The American Association of Colleges of Nursing was the first nursing organization to fund nursing research." B. "The National League for Nursing was the first nursing organization to fund nursing research." ***C. "Sigma Theta Tau International was the first nursing organization to fund nursing research." D. "The American Nurses Association was the first nursing organization to fund nursing research." Sigma Theta Tau International (STTI), which is the second largest nursing organization in the United States, was the first nursing organization to fund nursing research. Although the National League for Nursing, the American Nurses Association, and the American Association of Colleges of Nursing may elect to fund nursing research in areas consistent with their respective missions, none of these was the first nursing organization to fund research in nursing.
The nurse educator asks a group of nursing students how the government affects the process of transitioning to the use of electronic medical records (EMRs). Which student's statement is most accurate? A. "The Center for Medicare and Medicaid Services (CMS) is primarily responsible for monitoring achievement of meaningful use objectives." B. "The Center for Medicare and Medicaid Services (CMS) is responsible for monitoring the transition to the use of electronic medical records (EMRs) at the federal level." C. "The Office of the National Coordinator for Health Information Technology (ONC) is the sole agency responsible for overseeing the process of transitioning to the use of electronic medical records (EMRs)." D. "The Office of the National Coordinator for Health Information Technology (ONC) is responsible for authorizing financial reimbursement."
A. "The Center for Medicare and Medicaid Services (CMS) is primarily responsible for monitoring achievement of meaningful use objectives." B. "The Center for Medicare and Medicaid Services (CMS) is responsible for monitoring the transition to the use of electronic medical records (EMRs) at the federal level." C. "The Office of the National Coordinator for Health Information Technology (ONC) is the sole agency responsible for overseeing the process of transitioning to the use of electronic medical records (EMRs)." D. "The Office of the National Coordinator for Health Information Technology (ONC) is responsible for authorizing financial reimbursement." On a federal level, the Center for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) oversee the process of transitioning to the use of electronic medical records (EMRs). ONC monitors achievement of meaningful use objectives, which are reported to CMS to authorize financial reimbursement.
The staff nurse asks the nursing supervisor, "Which regulatory agency requires hospitals to have personal protective equipment (PPE) ready for us to use when we need it?" Which response is correct? A. "The Centers for Disease Control and Prevention." B. "The Occupational Safety and Health Administration." "The National Institutes of Health." "The Agency for Healthcare Research and Quality."
A. "The Centers for Disease Control and Prevention." ***B. "The Occupational Safety and Health Administration." "The National Institutes of Health." "The Agency for Healthcare Research and Quality." Part of the mission of the Occupational Safety and Health Administration (OSHA) is to help employers fulfill their responsibilities to their employees related to creating safe, healthful workplace environments and reducing or eliminating workplace hazards. OSHA standards include ensuring that employees have and use personal protective equipment (PPE) when required for safety and health. Research conducted or evaluated by the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Centers for Disease Control may inform OSHA regulations and standards, but these agencies do not oversee health and safety in workplace environments.
The nurse educator is explaining the significance of punctuality and attendance in the nursing profession to a class of nursing students. Which statement is most appropriate for the nurse educator to include in the discussion? A. "The most severe consequence of excessive tardiness for the professional nurse is suspension." B. "Chronic tardiness and frequent absenteeism among nurses can compromise client care." C. "Nurses must be flexible about helping colleagues who routinely need to miss work." D. "During a nursing shortage, hospital attendance requirements usually are less strict."
A. "The most severe consequence of excessive tardiness for the professional nurse is suspension." ***B. "Chronic tardiness and frequent absenteeism among nurses can compromise client care." C. "Nurses must be flexible about helping colleagues who routinely need to miss work." D. "During a nursing shortage, hospital attendance requirements usually are less strict." In nursing practice, chronic tardiness and frequent absenteeism place a greater burden on colleagues, compromise client care, and can cause conflict among staff. Just as excessive tardiness to clinicals can lead to severe repercussions, even during a nursing shortage, professional nurses who demonstrate excessive tardiness or absences may face disciplinary actions including suspension and termination.
During a meeting with hospital administrators, the nurse leader is using the Surgical Care Improvement Project (SCIP) to illustrate the use of informatics in quality care. Which statement should the nurse administrator include in the presentation? A. "The study objectives include identifying nurses who make medication errors." B. "The study will not affect reimbursement for hospital stays or surgical procedures." C. "The study's target population is all nurses who work in the surgical setting." D. "The goals of the study include reducing complications among surgical clients."
A. "The study objectives include identifying nurses who make medication errors." B. "The study will not affect reimbursement for hospital stays or surgical procedures." C. "The study's target population is all nurses who work in the surgical setting." ***D. "The goals of the study include reducing complications among surgical clients." The Surgical Care Improvement Project's (SCIP's) target population is all clients who undergo surgery. The goal is to reduce surgical complications and improve surgical care. This collaborative project is administered by The Joint Commission and CMS, and reimbursement for hospital stays and surgical procedures depend on meeting SCIP measures.
The nurse manager is interviewing a candidate for a staff nurse position. During the interview, the nurse manager evaluates the candidate's professional commitment to nursing. Which statement by the staff nurse best reflects commitment to the nursing profession? A. "The values and goals of nursing are honorable, but they are unrealistic and difficult to achieve." B. "I believe the nurse's choices outside of the workplace are unrelated to the nurse's professional role." C. "Whenever possible, the nurse should try to abide by the professional code of ethics for nurses." D. "I'm a member of two national nursing organizations, and I belong to one specialty nursing group."
A. "The values and goals of nursing are honorable, but they are unrealistic and difficult to achieve." B. "I believe the nurse's choices outside of the workplace are unrelated to the nurse's professional role." C. "Whenever possible, the nurse should try to abide by the professional code of ethics for nurses." ***D. "I'm a member of two national nursing organizations, and I belong to one specialty nursing group." Factors associated with professional commitment include desire to maintain membership in the profession; strong acceptance of and belief in a profession's role, code, values, goals, standards; willingness to exert considerable personal effort on behalf of the profession; and a pattern of behaviors that is consistent with the nurses' professional code of ethics. The rules of professionalism in nursing extend to behaviors outside the workplace.
The nurse is teaching a 16-year-old unmarried client who has given birth. What is most important for the nurse to include when discussing care with the client and her extended family? A. "This infant is at risk for health and social problems." B. "It would be better for the child if the mother could marry the father." C. "Family members should become active in bonding with the infant." D. "This infant will strengthen your family ties."
A. "This infant is at risk for health and social problems." B. "It would be better for the child if the mother could marry the father." ***C. "Family members should become active in bonding with the infant." D. "This infant will strengthen your family ties." The nurse's instruction is that family members should become active in caring for, interacting with, and bonding with the infant. Children in adolescent families are at greater risk for health and social problems; however, this infant is currently a part of the mother's family. Parents in these families may be forced to stop their formal education and are more likely to be physically, developmentally, and financially unprepared to care for a child. The nurse understands this and encourages the extended family to provide support for the mother and infant in order to promote health. The nurse provides culturally competent care that includes promoting family competence and health, and being nonjudgmental, regardless of the type of family the client has. Integrating a new infant into any family comes with stressors. A family that is resilient can adapt and transform in response to stress.
A patient tells the nurse, "I am an atheist. I do not believe in God." What would be an appropriate response by the nurse? A. "Well, I believe in God and you should too." B. "I respect what you choose to believe in." C. "How can you deny the existence of God?" D. "What makes you think you are an atheist?"
A. "Well, I believe in God and you should too." ***B. "I respect what you choose to believe in." C. "How can you deny the existence of God?" D. "What makes you think you are an atheist?" An atheist is a person who denies the existence of God, guided by philosophies of living that do not include a religious faith. He or she deserves respect for what they choose to believe.
There are certain relevant factors that contribute to why a client is prone to falling. Which factor is least related to client falls? A. A history of falls B. Genetic trait for falls C. Falls caused by side effects of medication D. Cognition problems causing falls
A. A history of falls ***B. Genetic trait for falls C. Falls caused by side effects of medication D. Cognition problems causing falls While there may be genetic traits that can predispose a client to a fall, this is the least likely reason for a fall to occur. Clients can have a history of falling based on past events. An issue with cognition can subject clients to possible falls—such as forgetting to tie shoe laces—with a resultant fall. Medication side effects, such as dizziness and equilibrium problems, can cause a client to fall.
The nurse is caring for a 10-year-old client with diabetes. The parents of the client do not speak English. How should the nurse best teach the client and family about home care? A. A sibling that speaks fluent English should translate. B. The client should translate. C. An agency translator should be used. D. The nurse should provide written instruction in the family's language.
A. A sibling that speaks fluent English should translate. B. The client should translate. ***C. An agency translator should be used. D. The nurse should provide written instruction in the family's language. Language barriers prevent therapeutic communication that is necessary to providing culturally competent care. It is not uncommon for children to be asked to interpret for the family; however, this exposes them to information they may not understand or know how to communicate. The preferred method for teaching home care is the hospital/agency translator. Information written in the family's language might be useful, after verbal instruction is given.
A client accuses a nurse of incompetency and files a lawsuit of malpractice. If the nurse is found incompetent, what document or act has been broken regarding nursing standards of care? A. Accreditation certification B. The Nurse Practice Act C. National counsel licensure D. The American Nurses Association (ANA) Standards of Practice
A. Accreditation certification B. The Nurse Practice Act C. National counsel licensure ***D. The American Nurses Association (ANA) Standards of Practice Standards of Practice describe the competency level of nursing care as described by the ANA. The Nurse Practice Act regulates the licensing and practice of nursing in each state by describing the scope of practice. Accreditation allows the facility, school, or hospital to operate and be recognized in good standing according to standards set by peers. National council licensure is the standardized national examination that assess for a minimum knowledge base relevant to the client population that the nurse serves.
A group of nursing students are sitting together in the school cafeteria after completing a clinical shift. In which aspect of socialization to nursing is this group currently engaged? A. Adaptation B. Development C. Learning D. Interaction
A. Adaptation B. Development C. Learning ***D. Interaction Socialization to a profession is complex and includes the attributes of learning, interaction, development, and adaptation. Students sitting together after a clinical rotation exemplify interaction. Learning would occur in the classroom or when working together on group projects. Development would occur throughout the course of the students' academic career. Adaptation is the ability to change or be flexible depending upon different situations.
Jasmine Riddle is a novice nurse in the telemetry unit of a large hospital. While assessing her client, 72-year-old Albert Griswald, Jasmine notes that his pulse feels irregular. When she calls the telemetry monitoring station, the monitoring technician, Miguel, tells Jasmine that Mr. Griswald just developed atrial fibrillation. The technician praises Jasmine for catching the change in Mr. Griswald's cardiac rhythm so quickly—even before the telemetry technician recognized it. In her response, which action would reflect Jasmine's nursing integrity? A. Advising the telemetry technician to focus on his job and monitor clients' heart rhythms more closely B. Thanking the telemetry technician for praising her and for being part of the client's care team C. Notifying the telemetry technician's supervisor of his failure to recognize the change in cardiac rhythm D. Telling the telemetry technician that noticing the client's change in cardiac rhythm was "pure luck"
A. Advising the telemetry technician to focus on his job and monitor clients' heart rhythms more closely B. Thanking the telemetry technician for praising her and for being part of the client's care team C. Notifying the telemetry technician's supervisor of his failure to recognize the change in cardiac rhythm D. Telling the telemetry technician that noticing the client's change in cardiac rhythm was "pure luck" Examples of ways in which nurses demonstrate integrity include accepting feedback (positive or negative) as a tool for improving the delivery of client care. Attributing excellent assessment skills to "luck" is not wrong, but it does not reflect integrity. Admonishing the telemetry technician or contacting his supervisor are neither warranted nor appropriate actions.
The nursing administrator is planning an in-service for nurses about Medicare coverage. Which content should be included? (Select all that apply.) A. All individuals ages 62 and older are eligible for Medicare coverage. B. Younger individuals with disabilities are eligible for Medicare coverage. C. Medicare is a form of public health insurance. D. Medicare is a federally funded program. E. Medicare coverage includes individuals with end-stage renal disease.
A. All individuals ages 62 and older are eligible for Medicare coverage. ***B. Younger individuals with disabilities are eligible for Medicare coverage. ***C. Medicare is a form of public health insurance. ***D. Medicare is a federally funded program. ***E. Medicare coverage includes individuals with end-stage renal disease. Medicare is a federally funded public health insurance program available to people age 65 or older, younger people with disabilities, and people with end-stage renal disease.
Stephan Wolters, an emergency department nurse, is caring for John Weatherly, a 78-year-old male client who has just been diagnosed with congestive heart failure. Which nursing action reflects Stephan's achievement of a meaningful use objective as required by the Center for Medicare and Medicaid Services (CMS)? A. Allowing the client's family members to review his electronic health record B. Encouraging the client's family members to be involved in the client's teaching sessions C. Limiting communication between members of the client's healthcare team D. Recognizing that safety and quality of client care are unrelated to health disparities
A. Allowing the client's family members to review his electronic health record ***B. Encouraging the client's family members to be involved in the client's teaching sessions C. Limiting communication between members of the client's healthcare team D. Recognizing that safety and quality of client care are unrelated to health disparities Meaningful use objectives include engaging clients and their families in the client's care, which is illustrated by encouraging the client's family members to be involved in the client's teaching sessions. Improving care coordination, which is another objective, may be impaired by limiting communication between members of the client's healthcare team. Allowing the client's family members to view his electronic health record does not meet the objective related to ensuring the security and privacy of protected medical information. The final meaningful use objective involves reducing health disparities among U.S. citizens by improving the safety and quality of care.
The novice nurse asks the nurse preceptor, "What can I do to help prevent the spread of infection from contaminated computer systems?" Which items should the nurse preceptor's reply include? (Select all that apply.) A. Always wear gloves whenever using the computer equipment. B. Avoid the use of a sealed or covered keyboard that can breed virulent microbes. C. Follow manufacturer guidelines for cleaning the computer equipment. D. Disinfect the keyboard and mouse weekly and when they are soiled with body fluids. E. Recognize that the dry surface of a computer can allow virulent microbes to survive.
A. Always wear gloves whenever using the computer equipment. B. Avoid the use of a sealed or covered keyboard that can breed virulent microbes. ***C. Follow manufacturer guidelines for cleaning the computer equipment. D. Disinfect the keyboard and mouse weekly and when they are soiled with body fluids. ***E. Recognize that the dry surface of a computer can allow virulent microbes to survive. Many virulent microbes can survive for months on dry surfaces. Some manufacturers have built sealed keyboards that can be easily cleaned or can be equipped with covers for easier cleaning and protection of the electronic equipment. Guidelines for preventing the spread of infection due to contaminated computer systems include following manufacturer recommendations for cleaning equipment, avoiding touching the keyboard or mouse with gloved hands, and disinfecting keyboards and mice daily and when visibly soiled with body fluids.
The pediatric nurse wants to confirm national screening standards for infants and toddlers. What resource could the nurse use to find current information? A. American Immunization Systems B. American Vaccine Providers C. U.S. Preventive Services Task Force D. U.S. Pediatric Systems Task Force
A. American Immunization Systems B. American Vaccine Providers ***C. U.S. Preventive Services Task Force D. U.S. Pediatric Systems Task Force The nurse could find current screening standards through the U.S. Preventive Services Task Force. None of the other organizations exist.
The bilingual nurse is caring for a client who speaks only Spanish. What is the best way for the nurse to advocate for this client? A. Arranging for bill payment for the client B. Representing the client's needs and wishes to other healthcare professionals C. Signing consent forms on the client's behalf D. Discussing the client's care with the client's visitors
A. Arranging for bill payment for the client ***B. Representing the client's needs and wishes to other healthcare professionals C. Signing consent forms on the client's behalf D. Discussing the client's care with the client's visitors The nurse would use bilingual skills to interpret medical information for the client and then relay the client's needs and wishes to other healthcare professionals. The nurse would never sign documents on the client's behalf. The nurse would not discuss the client's care with anyone but other healthcare professionals who are involved in the client's care. The nurse would never be involved in the client's financial transactions.
A nurse is reviewing a medication order in the client's health record. The order is illegible, and the nurse calls the ordering healthcare provider to clarify the order. The nurse cannot reach the healthcare provider despite multiple calls and pages. Which action by the nurse is most appropriate in this situation? A. Ask a co-worker to attempt to decipher the order B. Contact the nursing supervisor C. Fax the order to the pharmacy to decipher D. Continue calling the healthcare provider
A. Ask a co-worker to attempt to decipher the order ***B. Contact the nursing supervisor C. Fax the order to the pharmacy to decipher D. Continue calling the healthcare provider The nurse should contact the nursing supervisor after attempting numerous times to reach the healthcare provider. By contacting the supervisor, the nurse is using the negligence prevention strategy of preventing medication errors. Continuing to call the healthcare provider is not effective. Asking a co-worker or pharmacist to decipher the order is inappropriate.
The nurse educator is presenting an in-service to staff nurses regarding the spiritual health of clients admitted to the unit. Which role of the nurse will the educator include in the presentation? A. Asking the client's family for permission before disclosing the client's prognosis B. Declining to discuss spirituality directly out of respect for differing beliefs C. Assisting the client in recalling past experiences in which he or she drew upon hope while in crisis D. Introducing clients to the chaplain, who can assist them in finding religious belief
A. Asking the client's family for permission before disclosing the client's prognosis B. Declining to discuss spirituality directly out of respect for differing beliefs ***C. Assisting the client in recalling past experiences in which he or she drew upon hope while in crisis D. Introducing clients to the chaplain, who can assist them in finding religious belief Spiritual health is the state of wellness encompassing personal fulfillment as well as the fulfillment of life with others. The nurse can support the client's spirituality by assisting the client to recall times when he or she experienced hope. Spirituality is not the same as religious beliefs. The nurse can assist the client in developing spirituality without involving religious practices. The client should be the focus of care and information. It is important to include the family and any source of support, but the focus is the client. The role of the nurse is to support the client's experience of spirituality, not promote religious belief. The chaplain can provide support to the client in the development of his or her personal spiritual development.
Sandra Davis is a registered nurse (RN) who is running behind in administering her medications at a long-term care facility. When she arrives in the last client's room, the client is in the restroom. Sandra asks the nursing assistant if she would mind giving the cardiac glycoside to the client, and leaves the room. The client's pulse was 48 beats per minute. The medication was administered, and the client died. Which unintentional tort did Sandra commit during this incident? A. Assault B. Battery C. False imprisonment D. Malpractice
A. Assault B. Battery C. False imprisonment ***D. Malpractice This offense is classified as malpractice. In order to prove malpractice for this case, it must be proven that a deviation from the standard of care occurred which resulted in this client's death. Assault, battery, and false imprisonment are intentional torts.
What does the open double quote"Aclose double quote" stand for in the LEARN model of cultural competence? A. Assert B. Acknowledge C. Affirm D. Accept
A. Assert ***B. Acknowledge C. Affirm D. Accept Acknowledge and discuss the differences and similarities between the perceptions of the client and that of the health care team. Assert, affirm, and accept are not steps in the LEARN model.
Which nursing actions could be negligence that results in malpractice? (Select all that apply.) A. Assessing and monitoring a client who has returned from surgery B. Using equipment without appropriate training C. Documenting client care in the electronic medical record D. Failing to follow the standard of practice E. Lacking appropriate communication skills
A. Assessing and monitoring a client who has returned from surgery ***B. Using equipment without appropriate training C. Documenting client care in the electronic medical record ***D. Failing to follow the standard of practice ***E. Lacking appropriate communication skills Nursing actions that may be negligent and result in malpractice include failing to follow the standard of practice, lacking appropriate communication skills, and using equipment without appropriate training. Documenting client care in the electronic medical record and assessing and monitoring a client from surgery do not constitute negligence that can result in malpractice.
As the night nurse on the obstetrics unit, Carla has gotten to know one client very well. Sarah Gomez is a 42-year-old elementary teacher. Ms. Gomez was confined to her bed for an extended time, and Carla has found that they know people in common. Ms. Gomez had a successful C-section. Now that she is about to be discharged home, Carla plans to bundle up her own unused newborn clothes to give to Ms. Gomez as a gift. What professional behavior associated with ethical nursing values might Carla's plan violate? A. Attention to professional appearance and demeanor B. Attention to professional boundaries with clients C. Articulation of nursing's professional skills D. Pursuit of professional engagement
A. Attention to professional appearance and demeanor ***B. Attention to professional boundaries with clients C. Articulation of nursing's professional skills D. Pursuit of professional engagement Carla's plan might violate the professionalism that calls for attention to boundaries with clients, by giving a client a personal gift. Carla's plan does not affect her attention to professional appearance and demeanor. Carla's plan does not violate her pursuit of professional engagement. And her plan does not violate her articulation of nursing's professional skills.
The nurse working in an allergy clinic finds that the clinic did not receive enough vials of flu vaccine this year. The nurse devised a decision tree to identify priority clients who have the greatest need for the flu vaccine. Which primary principle guided the nurse's ethical decision making? A. Autonomy B. Veracity C. Justice D. Beneficence
A. Autonomy B. Veracity ***C. Justice D. Beneficence When the nurse has to make challenging, but fair, decisions related to the allocation of scarce resources, the principle of justice prevails. This situation does not call for autonomy, veracity, or beneficence.
Which of the following is unintentional conduct deviating from the standard of nursing practice? A. Battery B. False imprisonment C. Assault D. Malpractice
A. Battery B. False imprisonment C. Assault ***D. Malpractice Malpractice is conduct deviating from the standard of practice that is dictated by one's profession. It is an unintentional tort. Assault, battery, and false imprisonment are torts considered as intentional actions. They are considered willful acts perpetrated by one individual toward another individual(s) or personal property.
Which action by the nurse would indicate further education is necessary for the nursing care to be effective and culturally sensitive? A. Becomes knowledgeable about cultures served B. Becomes an effective communicator C. Puts own personal beliefs aside D. Acknowledges the numerous variations of family structures
A. Becomes knowledgeable about cultures served B. Becomes an effective communicator ***C. Puts own personal beliefs aside D. Acknowledges the numerous variations of family structures To become a culturally competent nurse, you must have the knowledge and skill to take care of families from different cultures. You should find out more about your clients' cultures, be a good communicator, acknowledge the numerous variations in family structure, and become aware of your own cultural beliefs so that you can anticipate possible misunderstandings. However, you do not have to put your own personal beliefs aside completely, but rather your beliefs should not affect the care that you provide.
What is a term for appreciation of a dimension beyond the self? A. Becoming B. Transcendence C. Value D. Meaning
A. Becoming ***B. Transcendence C. Value D. Meaning Transcendence is a term for appreciation of a dimension beyond the self. Meaning is the term for having purpose, making sense of life. Value is the term for having cherished beliefs and standards. Becoming is the term for allowing life to unfold, and knowing oneself.
Which interventions may be most appropriate when divorce alters a family structure? (Select all that apply.) A. Being alert to signs of intense grief reactions B. Considering the nature of the loss C. Providing information about counseling and support groups D. Educating about the importance of health maintenance and nutrition E. Advising about healthy coping mechanisms for stress
A. Being alert to signs of intense grief reactions B. Considering the nature of the loss ***C. Providing information about counseling and support groups ***D. Educating about the importance of health maintenance and nutrition ***E. Advising about healthy coping mechanisms for stress Family-focused interventions that are appropriate when divorce alters the family are providing information, advising about healthy coping mechanisms, and educating about the importance of health maintenance and nutrition. The nurse's being alert to signs of grief and considering what the loss means to the family are part of the nurse's assessment, not interventions.
As a treatment nurse in the oncology outpatient clinic, you are doing the admission paperwork with 28-year-old client Dorothy D'Angelo. Dorothy has a rare form of pancreatic cancer. She qualifies to become part of a clinical trial with a brand new investigational drug that your clinic hasn't used yet. As you give Dorothy complete risk information before she signs up to become a research participant, which principle of ethical decision making are you honoring? A. Beneficence B. Autonomy C. Justice D. Veracity
A. Beneficence B. Autonomy C. Justice ***D. Veracity Veracity is the principle behind giving complete information before obtaining a client's informed consent. Autonomy is the right of self-determination. Justice assures fair treatment opportunities. Beneficence means taking action to promote good, but since you have no experience with the new drug, you don't know whether it will be good for your client or not.
The family of a client who died of heart failure is making arrangements for a ritual bath to be given by a ritual burial society. Nurses are making arrangements for access and privacy. Which religions have this tradition? (Select all that apply.) A. Buddhism B. Baptist Christianity C. Lutheran Christianity D. Islam E. Judaism
A. Buddhism B. Baptist Christianity C. Lutheran Christianity ***D. Islam ***E. Judaism Both the Muslim and Jewish religions have a tradition of a ritual bath after death. That is not true of the Buddhist religion or the Baptist or Lutheran traditions within Christianity.
A nursing student is doing an internship in an inner-city free clinic. As part of the curriculum the nursing student is expected to give a presentation on health care disparities in the United States. Which statistics are appropriate for the student to include in the presentation to classmates? (Select all that apply.) A. Caucasians populations have a worsening health disparity in colorectal cancer mortality than Hispanic or African American populations. B. Asian individuals are more likely not to seek care for an illness or injury. C. African Americans have a higher rate of new AIDS cases than Caucasians. D. Asian adults over the age of 65 are more likely than Caucasians not to be immunized against pneumonia. E. Caucasians were more likely to report poor health care communication than the Hispanic population.
A. Caucasians populations have a worsening health disparity in colorectal cancer mortality than Hispanic or African American populations. ***B. Asian individuals are more likely not to seek care for an illness or injury. ***C. African Americans have a higher rate of new AIDS cases than Caucasians. ***D. Asian adults over the age of 65 are more likely than Caucasians not to be immunized against pneumonia. E. Caucasians were more likely to report poor health care communication than the Hispanic population. Health disparities among non-Caucasian populations are a concern in the United States. According to the 2010 National Health Disparities report, African Americans have a rate of AIDS that is ten times greater than Caucasians. Asian adults were 50% more likely than Caucasians not to be vaccinated for pneumonia. Asians were 1.5 times more likely not to get care for an illness or injury. African American populations have worsening colorectal cancer mortality from 2000dash-2006 than Caucasians. Hispanics are 1.7 times more likely to report poor communication with their health care provider than Caucasians.
Which strategy is useful to overcome barriers related to care coordination? A. Change the client assignment so that licensed personnel will be utilized more effectively B. Discuss a client care issue during a task force meeting C. Organize a client's care needs for a 12 hour shift D. Review the steps in self-administration of insulin with the client before discharge
A. Change the client assignment so that licensed personnel will be utilized more effectively B. Discuss a client care issue during a task force meeting C. Organize a client's care needs for a 12 hour shift ***D. Review the steps in self-administration of insulin with the client before discharge One way to overcome a barrier to care coordination is to address knowledge deficits by providing additional teaching to ensure that the client comprehends discharge instructions. Changing assignments to maximize the use of personnel is an approach for differentiated practice. Task force meetings are a characteristic of shared governance. Organizing a client's care needs for a 12 hour shift is a characteristic of the case method of care delivery.
The nurse leader is evaluating the charge nurse's type of commitment to the nursing profession. Which behavior by the charge nurse is most reflective of affective commitment to nursing? A. Choosing to stay in nursing due to personal experiences with illness B. Joining professional nursing organizations and engaging in nursing service activities C. Remaining in the nursing profession to avoid loss of income D. Expressing a sense of obligation to remain in the nursing profession
A. Choosing to stay in nursing due to personal experiences with illness ***B. Joining professional nursing organizations and engaging in nursing service activities C. Remaining in the nursing profession to avoid loss of income D. Expressing a sense of obligation to remain in the nursing profession Affective commitment develops when professional involvement produces a satisfying experience. Manifestations of affective commitment include engaging in profession-specific organizations and service activities. Normative commitment manifests as a feeling of obligation to continue in one's profession and it develops in response to benefits or positive experiences gained by way of engagement in one's profession. For example, the nurse whose desire to enter nursing stems from personal or family experiences with illness is reflective of normative commitment. Continuance commitment develops when negative consequences of leaving, such as loss of income, are viewed as reasons to stay.
Which religion asks its members to fast during daylight hours for a month? A. Christianity B. Islam C. Buddhism D. Judaism
A. Christianity ***B. Islam C. Buddhism D. Judaism Muslims are asked to fast during daylight hours In the month of Ramadan. This request is not made of people following the religions of Buddhism, Judaism, or Christianity.
Which client should the nurse refer to the case manager for ongoing care? A. Client being treated for deep vein thrombosis B. Client with exacerbation of multiple sclerosis C. Client with hepatitis B D. Client being discharged after a total hip replacement
A. Client being treated for deep vein thrombosis ***B. Client with exacerbation of multiple sclerosis C. Client with hepatitis B D. Client being discharged after a total hip replacement To maximize effectiveness, clients who benefit the most from case management are those with chronic health problems, such as chronic alterations in lung, heart, or neurological health. The client with an exacerbation of multiple sclerosis would benefit the most from case management. Hepatitis B, deep vein thrombosis, and total hip replacement are all acute problems with minimal risk for developing into a chronic disorder.
All clients have the right to care by a competent and safe nurse. What ensures that a nurse is both competent and safe to practice? A. Code of ethics B. Standards of Practice C. Nurse Practice Act D. Licensing process
A. Code of ethics ***B. Standards of Practice C. Nurse Practice Act D. Licensing process Standards of Practice describe the competency level of nursing care as described by the American Nurses Association (ANA). The Nurse Practice Act regulates the licensing and practice of nursing by describing the scope of practice. The licensing process establishes an assessment for a minimum knowledge base relevant to the client population that the nurse serves. The code of ethics is a guide for carrying out nursing responsibilities while maintaining moral principles.
Katie, a student nurse, observes a staff nurse access the locked narcotic cabinet, remove a medication, and place the medication in her uniform pocket before walking away from the cabinet. What should Katie do about this observation? A. Collaborate with other nurses by discussing the observation during change of shift report B. Treat others with respect by ignoring the observation C. Ensure the safety of clients, self, and others by reporting the observation D. Maintain confidentiality by not reporting the observation
A. Collaborate with other nurses by discussing the observation during change of shift report B. Treat others with respect by ignoring the observation ***C. Ensure the safety of clients, self, and others by reporting the observation D. Maintain confidentiality by not reporting the observation One principle within the Code for Nursing Students is ensuring the safety of clients, self, and others. Katie should report the observation since the staff nurse could be providing care as an impaired nurse. Katie has s responsibility to report the observation. Treating others with respect, maintaining confidentiality, and collaborating with other nurses would not be appropriate actions for Katie to take in this situation.
According to the American Association of Colleges of Nursing, which values are essential for the professional nurse to demonstrate? (Select all that apply.) A. Competence B. Self-esteem C. Integrity D. Autonomy E. Altruism
A. Competence B. Self-esteem ***C. Integrity ***D. Autonomy ***E. Altruism The values of autonomy, integrity, and altruism are three of the five essential values for the professional nurse to demonstrate. The other two are human dignity and social justice. Neither competence nor self-esteem are such values.
As a client comes into the admitting area, a nurse notices a jeweled cross on the client's necklace. The nurse comments, "Great look; I can see your religious beliefs are important to you," and starts with the spiritual assessment of the client. How would this approach be evaluated? A. Complimenting the client's appearance is helpful B. A focus on jewelry might appear materialistic C. It is efficient and effective to dive right into the interview D. No time was taken to establish rapport with the client
A. Complimenting the client's appearance is helpful B. A focus on jewelry might appear materialistic C. It is efficient and effective to dive right into the interview ***D. No time was taken to establish rapport with the client Starting with the spiritual assessment of the client leaves no time to establish rapport with the client. It is not about jewelry, compliments, or starting quickly.
The director of an ambulatory care clinic is concerned that economic changes are going to impact the clinic's nursing care over the next fiscal year. Which issues are contributing to the director's concern? (Select all that apply.) A. Consumer representatives on hospital committees B. Concept of health care being a right and not a privilege C. Expectations for out-patient care D. Increased costs for care E. Changing insurance programs and carriers
A. Consumer representatives on hospital committees B. Concept of health care being a right and not a privilege ***C. Expectations for out-patient care ***D. Increased costs for care ***E. Changing insurance programs and carriers The economics of health care impact nursing practice and accountability through insurance programs, the cost of care, and expectations when providing out-patient care. Consumer representatives on hospital committees and the concept of health care being a right and not a privilege are characteristics of consumer demands on nursing accountability.
Tameka Whitt is a nurse who is making rounds on the surgical floor when she notices that one of the staff nurses is in the kitchen drinking from a metal flask. The staff nurse's eyes are glassy, her speech is slurred, and her breath smells like alcohol. Which action by Tameka reflects correct understanding of the ANA's Code of Ethics? A. Contact the hospital administrator B. Tell the staff nurse that she should keep an eye on her C. Contact the supervisor D. Ask the staff nurse if she is intoxicated
A. Contact the hospital administrator B. Tell the staff nurse that she should keep an eye on her ***C. Contact the supervisor D. Ask the staff nurse if she is intoxicated Co-worker impairment, whether by drugs or alcohol, may interfere with job performance and may result in unsafe clinical practice, and must be reported immediately to a supervisor. Nurses are advocates for all clients, not just those in their care. Asking the nurse if she is intoxicated could cause confrontation or provide a chance to destroy evidence. The hospital administrator would be notified by the nursing supervisor.
Abigail, the registered nurse, is meeting with the physical and occupational therapists to discuss outcome achievement for a client recovering from a stroke. Which case management behavior is the nurse demonstrating at this time? A. Coordinating care B. Providing interventions C. Evaluating care provided D. Assessing client needs
A. Coordinating care B. Providing interventions ***C. Evaluating care provided D. Assessing client needs The nurse is meeting with the client's therapists to evaluate the care they have provided in relation to the client's outcomes. Assessment, care coordination, and provision of interventions are a part of the case management model, but these are not occurring at this time.
A nurse is caring for a 5-year-old client from an intergenerational family with 75-year-old grandparents who have provided care since the parents went to prison. Which factor, affecting the families' ability to cope with a young child, should the nurse consider when planning care? A. Decision making that is dispersed throughout the family system B. Family concerns that focus on maintaining functioning C. Family roles that are assigned by age and gender D. Procedures that affect the client, but do not affect the functioning of the family
A. Decision making that is dispersed throughout the family system ***B. Family concerns that focus on maintaining functioning C. Family roles that are assigned by age and gender D. Procedures that affect the client, but do not affect the functioning of the family In order to plan care for the client, the nurse must understand the implications of care giving for the aging grandparents. As well as caring for a young child from a Stage II or IV family, the grandparents are in a Stage VIII family. Among the grandparents' concerns is maintaining function during the aging process, especially since they are caring for a young child. The plan of care must include interventions that comprehensively address family needs. Family role assignment, decision making, and procedures the child will undergo do not directly affect the family's ability to cope.
The nurse is providing care for Mr. Davis, a 72-year-old man who is scheduled for a procedure tomorrow morning. Earlier in the day, Mr. Davis experienced a fall and was examined by the healthcare provider on call who observed no untoward effects. The nurse approaches Mr. Davis for informed consent about his procedure when he complains of dizziness and a headache. Mr. Davis has no memory of the fall that occurred earlier in the day. Which action by the nurse is the most appropriate in regards to obtaining informed consent? A. Delay informed consent, perform a pain assessment, and administer medication B. Have the client sign the consent form without delay C. Alert the primary healthcare provider regarding the client's status D. Read the informed consent to the client and allow the client to rest
A. Delay informed consent, perform a pain assessment, and administer medication B. Have the client sign the consent form without delay ***C. Alert the primary healthcare provider regarding the client's status D. Read the informed consent to the client and allow the client to rest The nurse would alert the primary care provider immediately. The client's level of competency, his age, the fact that he experienced a fall earlier in the day are all issues that should be addressed by the provider prior to informing the client about the procedure. All other options are inappropriate based on the client's current situation.
The nurse preceptor is discussing integrity with the novice nurse. Which examples should the nurse preceptor use to illustrate integrity in nursing? (Select all that apply.) A. Delivering error-free nursing care B. Maintaining accountability for personal actions C. Accepting positive feedback from peers D. Working within the scope of practice E. Accepting negative feedback from clients
A. Delivering error-free nursing care ***B. Maintaining accountability for personal actions ***C. Accepting positive feedback from peers ***D. Working within the scope of practice ***E. Accepting negative feedback from clients Examples of ways in which nurses demonstrate integrity include accepting feedback (positive or negative) as a tool for improving the delivery of client care, maintaining accountability for their actions, following their state's nurse practice act, and working only within their scope of practice. Nursing integrity does not require nurses to be perfect; rather, it requires nurses to admit when they make mistakes.
A nurse is offered a position to provide telenursing client care through a national health insurance provider. Which investigation should take priority before the nurse accepts this position? A. Demography of the client population B. State board of nursing licensing laws C. Current legislation about health care D. Work hours and flexibility with schedules
A. Demography of the client population ***B. State board of nursing licensing laws C. Current legislation about health care D. Work hours and flexibility with schedules Telenursing is the provision of client care through a telecommunication system. This care delivery system has created licensing issues. The nurse needs to investigate the board of nursing licensing laws in the state of residence to determine if another license is needed to provide client care out of state. Legislation about health care includes the PSDA, ACA, and HIPAA. This legislation may or may not impact the nurse's ability to provide telenursing. The demography of the client population is not something that the nurse needs to investigate prior to accepting this position. Determining work hours and schedule flexibility is not something that the nurse needs to make a priority before accepting this position.
The neurological clinical nurse specialist (CNS) visits a client at home one week after the client was discharged from the hospital after a stroke. What can the CNS do after this care visit is complete? A. Discuss the client's care needs with the health care provider B. Discuss the visit with the primary nurse C. Notify the case manager of the visit D. Reimburse for the care visit
A. Discuss the client's care needs with the health care provider B. Discuss the visit with the primary nurse C. Notify the case manager of the visit ***D. Reimburse for the care visit Because care coordination can be a helpful strategy in reducing readmission rates, the Centers for Medicare and Medicaid Services now reimburses clinical nurse specialists if specific criteria are met, such as visiting the client in person within 30 days of discharge. The nurse specialist may or may not need to notify the case manager of the visit. The client's needs may or may not need to be discussed with the health care provider. The visit does not need to be discussed with the primary nurse.
The nurse is coordinating the care for a client recovering from a stroke. Which skills are appropriate for the nurse to use when coordinating care for this client? (Select all that apply.) A. Discuss the client's need for a prescribed medication with the insurance company B. Delegate morning care to unlicensed assistive personnel C. Document the client's responses to care D. Facilitate team and group activities to avoid scheduling conflicts E. Communicate with other disciplines regarding the provision of care
A. Discuss the client's need for a prescribed medication with the insurance company B. Delegate morning care to unlicensed assistive personnel C. Document the client's responses to care ***D. Facilitate team and group activities to avoid scheduling conflicts ***E. Communicate with other disciplines regarding the provision of care When functioning in the role of coordinator, the nurse will facilitate team and group activities and use verbal communication skills with other disciplines to ensure completion of the client's care. Delegation is a skill used in team nursing. Documentation is a basic nursing skill performed by all nurses regardless of the care delivery method used. Discussing the client's need for a medication with the insurance provider is a skill within the role of advocacy.
A home health nurse is caring for a client who requires an appointment with a specialty provider. The client's health insurance is an employer-provided HMO. Based on the client's insurance, what is the first step for the nurse to take to ensure this client is seen by the specialist? A. Discuss the client's options with the insurance company B. Call the specialist directly to make an appointment C. Discuss the client's options with the case manager D. Call the primary care provider for a referral to the specialist
A. Discuss the client's options with the insurance company B. Call the specialist directly to make an appointment C. Discuss the client's options with the case manager ***D. Call the primary care provider for a referral to the specialist Health maintenance organization (HMO) participants must choose a primary care provider (PCP). The PCP serves as the gatekeeper to care, referring the client to in-network hospitals and specialists when needed. Therefore the nurse would need to call the PCP to get a referral for the specialist in order for the visit to be covered under the client's insurance policy. The case manager would not be involved in this process. Because the nurse knows that the client has an HMO, it is not necessary to call the insurance company regarding the client's options.
A nurse is caring for a hospitalized patient. What intervention can the nurse use to help the patient continue normal spiritual practices? A. Discuss the nurse's own religious beliefs with the patient. B. Request medication from the physician to calm the patient. C. Tell the patient that spiritual practices can be resumed later. D. Request dietary consultation for the patient's dietary restrictions.
A. Discuss the nurse's own religious beliefs with the patient. B. Request medication from the physician to calm the patient. C. Tell the patient that spiritual practices can be resumed later. ***D. Request dietary consultation for the patient's dietary restrictions. It is a responsibility of the nurse to help the patient in an unfamiliar environment continue normal spiritual practices. One intervention that can facilitate the practice of religion is to attempt to meet the patient's dietary restrictions.
The nurse leading the clinic-based support group for individuals with chronic diseases was pleased with the number of individuals who showed up for a lecture on "Living with Type 2 Diabetes." Due to time constraints, the nurse planned to limit the talk to describing tertiary prevention activities. Which activities could the nurse include? A. Discussing smoking cessation tips to help smokers quit the habit B. Encouraging a healthy diet to prevent onset of a diabetic condition C. Talking about the role of exercise to maintain blood sugar control D. Showing a video on hand washing techniques to prevent infection
A. Discussing smoking cessation tips to help smokers quit the habit B. Encouraging a healthy diet to prevent onset of a diabetic condition ***C. Talking about the role of exercise to maintain blood sugar control D. Showing a video on hand washing techniques to prevent infection Talking about the role of exercise to maintain blood sugar control is tertiary prevention, meant to avoid complications of uncontrolled hyperglycemia. Wellness advice on topics of a healthy diet, smoking cessation, and hand washing is primary prevention.
Seven-year-old Jermaine Cast has a serious, but not life-threatening, illness. He will need to be kept home from school for a 2-month course of treatment. His parents both work and neither parent has a lot of vacation time. What is the most important information the nurse can give the parents? A. Discuss free, or sliding fee, clinics available to families who are underinsured B. Discuss coping strategies for families facing the stress of caring for a sick child C. Assist family to find a good day care center D. Provide information regarding Family and Medical Leave Act
A. Discuss free, or sliding fee, clinics available to families who are underinsured B. Discuss coping strategies for families facing the stress of caring for a sick child C. Assist family to find a good day care center ***D. Provide information regarding Family and Medical Leave Act Nurses should educate the parents about the Family and Medical Leave Act of 1993, so each could take time without pay to be able to be home with the child after they have exhausted their vacation or sick time. It is always helpful to discuss coping strategies with parents under stress, but it is not the most important information the nurse could offer in this situation. Day care is an appropriate place for preschool-age children while their parents are at work, but is not usually equipped to take care of a child with a serious health issue. Free clinics, or sliding fee clinics are helpful for many uninsured people but would not resolve a need for months of care for a sick child, nor is there evidence that this is an issue for this family.
The nurse is doing an assessment addressing the interaction of members of the family. Which level of family cohesion describes a family where family members cannot develop a separate identity? A. Disengaged B. Separated C. Connected D. Enmeshed
A. Disengaged B. Separated C. Connected ***D. Enmeshed Members of an enmeshed family cannot develop a separate identity. Separated and connected family cohesion is thought to offer optimal family competency in Western developed societies. Disengaged families are like a group of strangers who happen to live together.
The ten-year-old client is very interested in learning about her cancer care and in participating in the decisions about her care. What is the most appropriate action by the pediatric nurse? A. Distracting the child with a video game B. Informing the healthcare team that the child is going to be a problem C. Telling the client's mother that she needs to explain things to her child D. Providing adequate, age-appropriate information about the disease and treatment options
A. Distracting the child with a video game B. Informing the healthcare team that the child is going to be a problem C. Telling the client's mother that she needs to explain things to her child ***D. Providing adequate, age-appropriate information about the disease and treatment options The pediatric nurse would provide adequate, age-appropriate information about the disease and treatment options. The client's mother would be included in the teaching process before being called upon to explain things to her child. A child who wants to be involved in her care is not a problem. Distraction would be inappropriate and counter to the concepts of advocacy.
The nurse is assessing the IV of an adult client who does not speak English. The client seems somewhat uncomfortable. Which method is the most appropriate for the nurse to use when assessing this client's level of pain? A. Do a charade of acting out a person in pain. B. Ask the client to rate pain level from 1 to 10. C. Use a picture scale with faces from sad to happy. D. Point to the operative site with a questioning look.
A. Do a charade of acting out a person in pain. B. Ask the client to rate pain level from 1 to 10. ***C. Use a picture scale with faces from sad to happy. D. Point to the operative site with a questioning look. A picture scale uses pictures, so it does not depend on language or health literacy. The client might not be able to relate to numbers in English, so a pain scale from 1 to 10 would not work. Neither a charade nor pointing will provide effective assessment.
You are conducting an assessment to create a family plan of care for 8-year-old Timothy Lopez. Which question is least appropriate for the nurse to ask his grandmother to help with developing your plan? A. Does either parent have health conditions? B. What are the family's eating habits? C. What is your religion? D. What medical treatments are they interested in?
A. Does either parent have health conditions? B. What are the family's eating habits? C. What is your religion? ***D. What medical treatments are they interested in? Asking what medical treatments interest the family is not a question that would provide information that could be incorporated in a family plan of care. Health beliefs of clients may include folklore and practices from different cultures. A family plan of care requires in-depth assessment of the immediate and extended family, as well as review and consideration of the following factors: health history, socioeconomic status, religion, culture, nutrition, and social habits and practices.
The nurse is caring for a 3-year-old client. The client and the family are immigrants. When assessing the client, the nurse finds that the child has not had immunizations. Which is the best action of the nurse? A. Educate the family about the importance of immunizations B. Identify reasons and beliefs that may be preventing immunization C. Respect the parents' decision not to immunize their child D. Ensure that the client receives immunizations while hospitalized
A. Educate the family about the importance of immunizations ***B. Identify reasons and beliefs that may be preventing immunization C. Respect the parents' decision not to immunize their child D. Ensure that the client receives immunizations while hospitalized The nurse should first assess why the parents have not had the child immunized, which could include the family's cultural practices. The nurse must ensure that immigrant families or clients with views that differ from those of the mainstream culture are aware of the rules and laws governing the care and protection of children against preventable diseases. The first step is to identify why the child has not been immunized; then the family can be educated to promote immunization. Immunizations are given only when parents consent to vaccinations. The nurse cannot administer vaccinations without permission. By respecting the parents' decision without investigating the reasons they have chosen not to vaccinate their child is not appropriate to providing holistic care.
The nurse leader is presenting an in-service about competence in nursing. Which examples should the nurse leader include in the in-service as examples of nursing competence? (Select all that apply.) A. Elimination of factors that negatively influence client care B. Acknowledgement of the client's need for individualized care C. Completion of documentation in an accurate, timely manner D. Awareness of factors that positively affect client care E. Knowledge about the culture of the healthcare institution
A. Elimination of factors that negatively influence client care ***B. Acknowledgement of the client's need for individualized care ***C. Completion of documentation in an accurate, timely manner ***D. Awareness of factors that positively affect client care ***E. Knowledge about the culture of the healthcare institution Competence includes the nurse's awareness of the positive and negative factors that affect client care; however, the inability to eliminate the negative factors does not necessarily reflect a lack of nursing competence. Additional areas of nursing competence include understanding the culture of the client and the institution; acknowledging the client's need for individualized care; and accurate, timely completion of client documentation.
The evening shift nurse is caring for a client, Candace Horn. Mrs. Horn is a 57-year-old woman who is scheduled for discharge in the morning. Hospital protocol dictates that Mrs. Horn receives medication instruction the evening before the scheduled discharge. This policy minimizes incidents of professional negligence through the use of which applicable strategy? A. Employing the use of effective communication as a strategy B. Maintaining client safety as a strategy C. Giving clear directions to the client D. Developing a nurse-pharmacy rapport as a strategy
A. Employing the use of effective communication as a strategy B. Maintaining client safety as a strategy ***C. Giving clear directions to the client D. Developing a nurse-pharmacy rapport as a strategy Giving clear directions to the client is the best answer because it includes considering the client and family as participants in the medication administration process, ensuring that the client understands the medications including proper home administration and identification of potential side effects. While the other strategies may be applicable, they are not the best strategy for this situation.
The nurse provides education to the client who is facing a difficult healthcare choice. What is the intended goal of this action? A. Enabling B. Co-dependency C. Informed consent D. Empowerment
A. Enabling B. Co-dependency C. Informed consent ***D. Empowerment Nurses advocate for clients in order to protect their rights and empower them to participate in making informed healthcare decisions. While enabling is a type of advocacy, it is not the intended goal for this client. Principles of informed consent are not involved here. Co-dependency is the opposite of what advocacy seeks to achieve.
The nurse is caring for 6-year-old Justin Sennet, who has come to the clinic for a physical. His father is impatient and speaks sharply to the child, who is walking around the examination room. The father mentions that his wife died 6 months ago. What is important for the nurse to include during this interview? A. Encouraging the father to set limits with the child B. Assessing for signs of complicated grief C. Providing information about parenting styles D. Telling the father to demonstrate more parental warmth
A. Encouraging the father to set limits with the child ***B. Assessing for signs of complicated grief C. Providing information about parenting styles D. Telling the father to demonstrate more parental warmth The nurse's approach would be to assess how the family is coping with its loss in order to prevent abuse and trauma and promote family competence following this major family alteration. The nurse would assess for signs of complicated or traumatic grief and family violence. It could be appropriate to provide information about therapy and support groups, teach about healthy coping strategies, and facilitate referrals to counselors and other professional resources. Parenting style, emotional availability, family communication patterns, discipline, and limit setting are factors that impact family development; these are at play in this parent-child interaction, and would be noted in the nurse's assessment.
A nurse working in the memory care unit listens as the newly admitted client talks about his work as a pilot as if he had just left the airport. The nurse knows he has been retired for decades. What does the nurse recognize as the benefits of hearing his work life story? (Select all that apply.) A. Entertaining the other clients and families B. Giving the nurse insight into the client's behavior C. Keeping his verbal abilities exercised D. Helping the client maintain a sense of identity E. Focusing on the positive aspects of a past work life
A. Entertaining the other clients and families ***B. Giving the nurse insight into the client's behavior C. Keeping his verbal abilities exercised ***D. Helping the client maintain a sense of identity E. Focusing on the positive aspects of a past work life Hearing details of the client's past work life helps the client maintain a sense of identity, and gives the nurse insight into the client's behavior. It is not a matter of focusing on the positive aspects, exercising verbal ability, or providing entertainment.
A nurse makes the following statement, "Chinese people drink only hot tea, so don't put coffee on their trays. I know this because my last assignment was in San Francisco." The charge nurse identifies this remark as an example of which concept associated with culture? A. Ethnocentrism B. Prejudice C. Diversity D. Stereotyping
A. Ethnocentrism B. Prejudice C. Diversity ***D. Stereotyping Stereotyping is noted when a person assumes all members of a particular group have the same characteristics. This nurse is assuming all members of a group have the same eating habits. Ethnocentrism is the belief in the superiority of one's own culture and lifestyle. This nurse is making a generalization about a culture, not declaring the superiority of her own culture. Prejudice is a judgment about a person, place, or racial background that has no basis in knowledge. This nurse is making an assumption that all Chinese have the same traits. Diversity is a state of being different and occurs between and within cultural groups. It is not related to the statement this nurse made.
A family comes to the hospital for the father's preoperative visit. The nurse notes that the mother and children let the father answer all questions posed to family members. What should the nurse consider as she prepares the plan of care for this family? A. Family is showing self-disclosure B. Family has rigid flexibility C. Family is demonstrating diffuse boundaries D. Family is demonstrating resiliency
A. Family is showing self-disclosure ***B. Family has rigid flexibility C. Family is demonstrating diffuse boundaries D. Family is demonstrating resiliency The deferral of all family members to the father may indicate rigid family flexibility. A family with rigid flexibility demonstrates very low flexibility for change in the family's leadership, relationships, and rules. Low flexibility may impair the family's resiliency; its ability to respond productively to stress through adaptation and change during the father's illness and recovery. Family communication in high functioning families demonstrates self-disclosure in their communication patterns, where family members share personal feelings about themselves and others. Families with diffuse boundaries demonstrate very open contact with each other and outside systems. The nurse does not observe those behaviors in this family.
The community health nurse is speaking with a client about the functions of divisions or departments of health and human services at the federal, state, and local level. Which item should the nurse include in the discussion? A. Federal health departments usually manage the planning of medical facilities. B. County health departments generally oversee child care centers. C. Local departments of health and human services typically monitor clinical laboratories. D. Local departments of social services usually are responsible for administering Medicaid.
A. Federal health departments usually manage the planning of medical facilities. B. County health departments generally oversee child care centers. C. Local departments of health and human services typically monitor clinical laboratories. ***D. Local departments of social services usually are responsible for administering Medicaid. Local departments of social services usually are responsible for administering Medicaid. State divisions or departments of health and human services typically oversee clinical laboratories and child care centers. State divisions of health and health services are also responsible for overseeing the planning and construction of medical facilities.
A staff nurse is upset to learn that several colleagues on the care area are leaving the organization. What can the nurse do to help reduce the number of nurses resigning from their current positions? A. Find out where the nurses are obtaining additional employment B. Discuss the work hours and schedules with the nurse manager C. Encourage students in the community to attend nursing school D. Research scholarships available to obtain further education
A. Find out where the nurses are obtaining additional employment ***B. Discuss the work hours and schedules with the nurse manager C. Encourage students in the community to attend nursing school D. Research scholarships available to obtain further education One effort to counteract the effects of the nursing shortage is to improve the environment for nurses such as providing flexibility with work hours. Finding out where the nurses are obtaining employment is not an action to reduce the number of nurses resigning from their current positions. Researching scholarships for nursing school and encouraging students in the community to attend nursing school are actions to reduce the nursing shortage; however they will not help reduce the number of nurses resigning from their current positions.
A client files a negligence lawsuit against a nurse for the long-term symptoms resulting from a ventilator-acquired pneumonia (VAP). Which element of professional negligence or malpractice will this client have difficulty proving in a court of law? A. Foreseeability B. Causation C. Injury from breach of duty D. Breach of duty
A. Foreseeability ***B. Causation C. Injury from breach of duty D. Breach of duty Typically, a client cannot successfully make a claim for malpractice on acquiring a healthcare-associated infection because the client must show that a specific nurse did not follow the standard of aseptic technique in order to prove cause. A deviation from standard care is a breach of duty, which can be proven in court. Foreseeability means that certain events cause certain outcomes, an aspect that can be proved in court. Injury that was caused by the breach of duty may also be proved.
Which client health problem would benefit the most from case management? A. Fractured leg B. Chronic lung disease C. Minor orthopedic surgery D. Peptic ulcer
A. Fractured leg ***B. Chronic lung disease C. Minor orthopedic surgery D. Peptic ulcer Clients who receive the greatest benefit from managed care usually are those with chronic health alterations, such as chronic lung, heart, or neurological health conditions. Minor orthopedic surgery, peptic ulcer, and limb fractures are not considered chronic health conditions.
The nurse is caring for a 10-year-old client diagnosed with diabetes mellitus. Which assessment findings for this client and family members are teaching opportunities for the nurse? (Select all that apply.) A. Genogram B. Parental structuring C. Poverty-related stress D. Family members with BMI above 30 E. Family history of diabetes
A. Genogram B. Parental structuring ***C. Poverty-related stress ***D. Family members with BMI above 30 ***E. Family history of diabetes A family with a history of diabetes, body mass indices above 30 (indicates obesity), that is experiencing poverty-related stress needs education from the nurse about nutrition and its relationship to disease, as well as referrals to community resources that may be able to assist the family with needed food, medical care, and financial assistance. Parental structuring, an aspect of emotional availability, is the ability of parents to support the child's learning and inquiries without overwhelming the child's autonomy. A genogram is a map of gender, showing lines of descent through the generations of a family.
Jose Cardena is a 48-year-old warehouse worker who has been admitted to the cardiology unit because of chest pain. He has a strong family history of heart attacks before age 50. You are the nurse manager on the cardiology unit, and Jose tells you that he "can load a pallet faster than men half my age." He and his wife Trina are expecting their first grandchild in 3 months, and Jose is already thinking about names for the new baby. His doctor has advised him to begin a program of regular exercise, but Jose counters that he does not need to do that, saying "I'm already strong!" Which of Jose's behaviors may indicate unclear values? A. Having a family history of heart disease B. Ignoring his doctor's advice to exercise regularly C. Looking forward to the birth of his grandchild D. Loading a pallet faster than anyone else
A. Having a family history of heart disease ***B. Ignoring his doctor's advice to exercise regularly C. Looking forward to the birth of his grandchild D. Loading a pallet faster than anyone else Jose's ignoring his doctor's advice to exercise regularly may indicate unclear values. Looking forward to the birth of his grandchild is a clear family value. Having a family history of heart disease is a genetic risk, not a behavior. Loading a palette quickly is a career value.
Which is a core belief about health in non-Western cultures? A. Health is an attribute of youth. B. Health is the absence of disease. C. Health is the strength to do anything you want. D. Health is a state of harmony that encompasses mind, body, and spirit.
A. Health is an attribute of youth. B. Health is the absence of disease. C. Health is the strength to do anything you want. ***D. Health is a state of harmony that encompasses mind, body, and spirit. Non-Western cultures view health as a harmonious state. Western society sees health as the absence of disease. Other views of health are more individual.
Before leaving a room, Tiffany Wilson assists her client by moving his pillows, adjusting the side rails, securing the call light, and providing water. Which concept related to accountability is Tiffany implementing when performing these actions? A. Health policy B. Teaching and learning C. Comfort D. Evidence-based practice
A. Health policy B. Teaching and learning ***C. Comfort D. Evidence-based practice The concept of accountability cannot stand alone but rather is closely associated with all of the concepts. With comfort, the nurse is accountable for managing the client's pain and providing other interventions to ensure comfort for the client such as adjusting pillows, adjusting side rails, securing the call light, and providing water, glasses, and reading material. There is no evidence to support that the nurse was instructing the client. Evidence-based practice is the use of interventions validated through research. Health policy refers to the actions and decisions by government bodies and professional organizations that affect achievement of healthcare goals.
A nurse is admitting 55-year-old librarian Tamura Washington to the rehabilitation unit. The nurse asks Ms. Washington, "Is there a group of like-minded believers with whom you regularly meet?" What aspect of the client's life is the nurse assessing? A. Her ability to work as a member of a team B. Her work at the library affecting her personal life C. Her participation in healthy social activities D. Her membership in a faith community
A. Her ability to work as a member of a team B. Her work at the library affecting her personal life C. Her participation in healthy social activities ***D. Her membership in a faith community The nurse is asking a general question to identify whether the client is a member of a faith community. The nurse is not interested in teamwork, a balanced life, or social activities.
What is not a benefit of electronic medical records? A. Identifying the need for mammograms B. Identifying the need for vaccines C. Notifying clients of upcoming appointments D. Tracking client data over time
A. Identifying the need for mammograms B. Identifying the need for vaccines ***C. Notifying clients of upcoming appointments D. Tracking client data over time Tracking client data over time, identifying the need for vaccines, and identifying the need for mammograms are all benefits of electronic medical records. Notifying clients of upcoming appointments is not a benefit of electronic medical records.
A member of the American Nurses Association (ANA) is giving a presentation about the ANA's primary methods of advancing the nursing profession. Which activities are appropriate to include in the presentation? (Select all that apply.) A. Implementing nurse educator faculty development programs B. Advocating for nurses' rights in and away from the workplace C. Cultivating high standards of nursing practice D. Assisting deans with implementing quality nursing education standards E. Fostering a positive and realistic view of nursing
A. Implementing nurse educator faculty development programs B. Advocating for nurses' rights in and away from the workplace ***C. Cultivating high standards of nursing practice D. Assisting deans with implementing quality nursing education standards ***E. Fostering a positive and realistic view of nursing Primary methods used by the American Nurses Association (ANA) to advance the nursing profession include cultivating high standards of nursing practice, advocating for nurses' rights in the workplace, and fostering a positive and realistic view of nursing. Functions of the National League for Nursing (NLN) include implementing nurse educator faculty development programs and assisting deans with implementing quality nursing education standards.
The nurse manager is preparing a report of staffing needs. What demographic trends could the nurse describe that are expected to produce a high demand for healthcare expertise? (Select all that apply.) A. Increasing ethnic diversity B. Lack of primary care providers C. Lack of specialists D. More long-term illnesses E. Increasing racial diversity
A. Increasing ethnic diversity ***B. Lack of primary care providers C. Lack of specialists ***D. More long-term illnesses E. Increasing racial diversity More long-term illnesses and lack of primary care providers are expected to produce a high demand for healthcare expertise. Although increasing racial and ethnic diversity is expected, those factors do not affect the demand for healthcare expertise. There is no predicted lack of specialists.
The primary nurse is coordinating care for a newly admitted client. Which nursing actions are appropriate when planning this client's care? (Select all that apply.) A. Initiate consultations with other health care providers B. Suggest appropriate referrals for the client's care C. Obtain orders for referrals and consultations from the health care provider D. Select appropriate critical pathways for the client E. Identify applicable evidence-based practice guidelines for the client's care
A. Initiate consultations with other health care providers B. Suggest appropriate referrals for the client's care C. Obtain orders for referrals and consultations from the health care provider ***D. Select appropriate critical pathways for the client ***E. Identify applicable evidence-based practice guidelines for the client's care In the planning phase of care coordination, the nurse should utilize standard protocols, or critical pathways, and evidence-based guidelines, prepare the care plan in consultation with the client, and make the care plan the framework for care coordination. Initiating consultations, suggesting referrals, and obtaining orders for consultations and referrals from the health care provider are actions that occur during the implementation phase of care coordination.
Mrs. Donna Hurlon, a 39-year-old client, has returned to the hospital for the fourth time for surgery after a horrific automobile accident. When the nurse manager greeted her 4 days after admission, Mrs. Hurlon remarked, "Things seem to have changed since my last time here. The same nurse now comes back to take care of me all the time." Which model of nursing care delivery would be likely to cause this continuity of care? A. Inspirational nursing B. Primary nursing C. Functional nursing D. Team nursing
A. Inspirational nursing ***B. Primary nursing C. Functional nursing D. Team nursing In the primary nursing model, a single nurse takes responsibility for the care of each client. This contributes to continuity of care. This feature is not found in team or functional nursing. There is no model on nursing care delivery called inspirational nursing.
As part of hospital orientation for a group of nurses, the human resources representative is discussing intimidation. Which information is most appropriate for the human resources representative to include in the discussion? A. Intimidation may include repeatedly asking another individual for favors. B. Intimidation may include unintentional nursing behaviors and statements made to clients. C. Covert forms of intimidation may include making verbal threats. D. Overt forms of intimidation may include standing too close to someone.
A. Intimidation may include repeatedly asking another individual for favors. ***B. Intimidation may include unintentional nursing behaviors and statements made to clients. C. Covert forms of intimidation may include making verbal threats. D. Overt forms of intimidation may include standing too close to someone. Intimidation includes threatening, bullying, or forcing someone who is emotionally or physically weaker to do something in order to avoid retribution or negative consequences. Asking an individual for favors without any associated retribution or negative consequences is not reflective of intimidation. Subtle, or covert, forms of intimidation include standing close to someone while maintaining a hostile facial expression. Intimidation may also be overt, such as threatening an individual with consequences for not obeying an order. On the nurse's part, intimidation may be unintentional; for example, making statements such as, "If you do not take your medicine (or go to physical therapy, or follow the treatment plan), you're going to get worse."
A nurse has transferred from a clinic setting to an inpatient unit. The nurse notices several questions about spiritual beliefs on the admission form that the nurse had never asked new clinic clients. What is the most likely reason for asking these questions? A. Invitation to attend the hospital's worship services B. The Joint Commission's accreditation requirements C. Identify which members of the clergy to call for spiritual emergencies D. Finding a better match for a semiprivate room
A. Invitation to attend the hospital's worship services ***B. The Joint Commission's accreditation requirements C. Identify which members of the clergy to call for spiritual emergencies D. Finding a better match for a semiprivate room The most likely reason to ask questions about spiritual beliefs is The Joint Commission's requirements for clients admitted to an institution. The requirements are not mandated for clinic clients. It is not about attending worship services, matching roommates, or calling the right clergyperson.
A nurse is considering the delegation of administering medications to an unskilled assistant. What is the first question the nurse must ask herself before doing so? A. Is appropriate supervision available? B. Has the assistant been trained to perform the task? C. Have I evaluated the patient's response to this task? D. Is the delegated task permitted by law?
A. Is appropriate supervision available? B. Has the assistant been trained to perform the task? C. Have I evaluated the patient's response to this task? ***D. Is the delegated task permitted by law? The first question the nurse should always ask of him- or herself before delegating a task is "is the delegated task permitted by law?" In this case, it would not be, and the task (administering medications) would not be delegated.
An experienced nurse is mentoring the new graduate. They talk about how exciting it was to see a successful Heimlich maneuver performed by a nursing colleague. How did that event promote the image of nursing? A. It demonstrated nursing's attitudes. B. It demonstrated nursing's boundaries. C. It demonstrated nursing's values. D. It demonstrated nursing's skills.
A. It demonstrated nursing's attitudes. B. It demonstrated nursing's boundaries. C. It demonstrated nursing's values. ***D. It demonstrated nursing's skills. Resuscitation is an example of demonstrating nursing's skills. It is not a matter of values or attitudes; it is a practiced action. Resuscitation does not have a connection with boundaries.
A student nurse must understand the importance of providing safe nursing care consistent with legal requirements. Which statements are true regarding nursing negligence? (Select all that apply.) A. It is considered an intentional tort. B. It is defined as conduct deviating from the standard of practice dictated by the profession. C. It is defined as conduct that deviates from what a reasonable individual would do in a particular circumstance. D. It is considered an unintentional tort. E. It occurs without the deliberate intent to bring harm against another individual.
A. It is considered an intentional tort. B. It is defined as conduct deviating from the standard of practice dictated by the profession. ***C. It is defined as conduct that deviates from what a reasonable individual would do in a particular circumstance. ***D. It is considered an unintentional tort. ***E. It occurs without the deliberate intent to bring harm against another individual. Negligence is defined as conduct that deviates from what a reasonable individual would do in a particular circumstance and is considered an unintentional tort. Negligence occurs without the deliberate intent to bring harm against another individual. Malpractice is defined as conduct deviating from the standard of practice dictated by the profession.
The novice nurse asks the nurse preceptor to describe normative commitment. Which items should the nurse preceptor include in the description? (Select all that apply.) A. It may be demonstrated by engaging in profession-specific organizations and service activities. B. It develops when professional involvement produces a satisfying experience. C. It creates ties that are similar to those that emerge as a result of continuance commitment. D. It may be reflected by choosing to enter nursing due to experiences with personal illness. E. It can manifest as a feeling of obligation to continue in one's profession.
A. It may be demonstrated by engaging in profession-specific organizations and service activities. B. It develops when professional involvement produces a satisfying experience. C. It creates ties that are similar to those that emerge as a result of continuance commitment. ***D. It may be reflected by choosing to enter nursing due to experiences with personal illness. ***E. It can manifest as a feeling of obligation to continue in one's profession. Normative commitment manifests as a feeling of obligation to continue in one's profession. It develops in response to benefits or positive experiences gained by way of engagement in one's profession. For example, the nurse whose desire to enter nursing or whose choice to remain in the profession stems from personal or family experiences with illness is reflective of normative commitment. Affective commitment develops when professional involvement produces a satisfying experience. Manifestations of affective commitment include engaging in profession-specific organizations and service activities. The ties created by continuance commitment differ from the ties that stem from affective or normative commitment.
The psychiatric nurse practitioner is giving a webinar about prevention of burnout in nursing. Which items should the psychiatric nurse practitioner include when describing tips related to having compassion? (Select all that apply.) A. Joining nursing associations that promote constructive discussion of work issues B. Acknowledging that most individuals do the best they can do C. Learning to ask for help from colleagues or confidantes when needed D. Perceiving errors and failures as opportunities for constructive learning E. Recognizing the limitations associated with any given situation
A. Joining nursing associations that promote constructive discussion of work issues ***B. Acknowledging that most individuals do the best they can do ***C. Learning to ask for help from colleagues or confidantes when needed ***D. Perceiving errors and failures as opportunities for constructive learning E. Recognizing the limitations associated with any given situation Compassion includes learning to accept errors and failures, and recognizing these situations as opportunities for constructive learning. Acknowledging that most individuals do the best they can and learning to ask for help are also reflective of compassion. Participating in professional organizations that promote recognition and constructive discussion of workplace issues is reflective of professional engagement. Recognition of limitations associated with situations is reflective of acceptance.
The nurse educator is teaching a class about professional development in nursing. When describing an area of nursing competence, which component is most appropriate for the nurse educator to include in the teaching? A. Knowing and demonstrating adherence to the ethics of primary care providers B. Recognizing the nurse's responsibility to remain strictly in a client-centered role C. Understanding that client populations tend to demonstrate the same personal needs D. Understanding the culture of the client population and the healthcare institution
A. Knowing and demonstrating adherence to the ethics of primary care providers B. Recognizing the nurse's responsibility to remain strictly in a client-centered role C. Understanding that client populations tend to demonstrate the same personal needs ***D. Understanding the culture of the client population and the healthcare institution Areas of nursing competence include understanding the culture of the client and the institution; knowing and demonstrating adherence to the ethics of the nursing profession; acknowledging the client's need for individualized care; and assuming multiple nursing responsibilities, including legal, professional, ethical, and client-centered roles.
The nurse telephones a health insurance carrier to discuss covering an electric wheelchair for a client with a spinal cord injury. Which barrier of care coordination is the nurse attempting to overcome? A. Knowledge deficit B. Limited resources C. Non-adherence to the plan of care D. Caregiver reluctance
A. Knowledge deficit ***B. Limited resources C. Non-adherence to the plan of care D. Caregiver reluctance To overcome the barrier of limited resources, the nurse may discuss covering the resource with the client's insurance carrier. A strategy to overcome non-adherence to the plan of care would be to identify alternatives to overcome reasons for not following the plan of care. The health insurance carrier would not be involved in this process. To address a knowledge deficit, the nurse would provide additional teaching to help the client comprehend instructions. Caregiver reluctance may impact care delivery, but it is not a barrier to care coordination.
What organizations have embraced the use of care coordination? (Select all that apply.) A. La Leche League B. National League of Nurses C. American Nurses Association D. Centers for Medicare and Medicaid Services E. American Medical Association
A. La Leche League B. National League of Nurses ***C. American Nurses Association ***D. Centers for Medicare and Medicaid Services E. American Medical Association The Centers for Medicare and Medicaid Services (CMS) and the American Nurses Association (ANA) have both embraced the use of care coordination. The CMS considers care coordination as reimbursable due to its ability to reduce rehospitalization rates, and the ANA identifies several positive results related to the implementation of care coordination. The American Medical Association, the National League of Nurses, and La Leche League have not specifically embraced the use of care coordination.
The nurse is caring for a 7-year-old child diagnosed with type 1 diabetes. The client is the only child in a two-parent nuclear family. The parents of this client would most likely be working on which developmental tasks in the family life cycle? (Select all that apply.) A. Learning to manage parental tasks B. Looking to retirement C. Managing external influences of friends D. Managing increased time commitments E. Being involved in child's sports, school, or clubs
A. Learning to manage parental tasks B. Looking to retirement ***C. Managing external influences of friends ***D. Managing increased time commitments ***E. Being involved in child's sports, school, or clubs The parents of a 7-year-old child would be working through Stage IV (family with school-age children). Developmental tasks at this stage of family development are facilitating peer relations, and maintaining family dynamics while adjusting to outside influences. At this stage of family development, parents are involved with school-related activities, sports, and clubs, and managing external influences of friends. Learning to manage parenting tasks and responsibilities occurs in Stage II (childbearing). Looking to retirement occurs in Stage VII (middle-aged parents).
A novice nurse wants to use the nursing process while caring for clients. How can the nurse prevent medicine errors during the implementation phase of the nursing process? A. Leave the client's oral medication at the bedside only if the client is oriented and able to swallow B. Hold the medication if the client is in the bathroom C. Instruct the client to tell the nurse the reason why the client is taking the medication being administered D. Urge the client to question the nurse if a pill being administered looks different from what is normally taken
A. Leave the client's oral medication at the bedside only if the client is oriented and able to swallow B. Hold the medication if the client is in the bathroom C. Instruct the client to tell the nurse the reason why the client is taking the medication being administered ***D. Urge the client to question the nurse if a pill being administered looks different from what is normally taken The nurse should urge the client to question any pill administered that looks different from what is normally taken. With this action, the nurse is acting as a client advocate in preventing medication errors. Asking the client to tell the nurse the reason why the client is taking the medication administered is inappropriate as many clients will not be able to do this, and this is the responsibility of the nurse. Leaving a medication at the client's bedside is never appropriate. Holding the client's medication because the client is in the bathroom is also inappropriate and does not improve the safety of medication administration.
The nurse is discussing Medicaid health coverage with a client. Which information should be included? A. Medicaid provides cash for basic needs, such as food, housing, and clothing. B. Medicaid coverage does not include the client's home health services. C. Medicaid reimbursement does not cover costs related to transportation to medical care. D. Medicaid is available to eligible individuals, families, the elderly, and individuals with disabilities.
A. Medicaid provides cash for basic needs, such as food, housing, and clothing. B. Medicaid coverage does not include the client's home health services. C. Medicaid reimbursement does not cover costs related to transportation to medical care. ***D. Medicaid is available to eligible individuals, families, the elderly, and individuals with disabilities. Medicaid is a state-administered program that is available to certain lower income individuals and families, the elderly, and people with disabilities who meet the eligibility requirements set by federal and state law. Federal laws require Medicaid to cover certain services, including physician services, inpatient and outpatient hospital care, home health services, and transportation to medical care. Social security income (SSI) provides cash for basic needs such as food, housing, and clothing.
The nurse wants to provide culturally competent care to a client who lives on a long-term care unit. Which activities are appropriate for the nurse to implement? (Select all that apply.) A. Memorizing which foods members of each culture eat to restore health B. Educating the client about the U.S. health care system C. Asking the client where he or she thinks illness originates D. Seeking to understand one's own culture, its beliefs, and its assumptions E. Asking the client and his or her family how the illness affects them
A. Memorizing which foods members of each culture eat to restore health B. Educating the client about the U.S. health care system ***C. Asking the client where he or she thinks illness originates ***D. Seeking to understand one's own culture, its beliefs, and its assumptions ***E. Asking the client and his or her family how the illness affects them To provide culturally competent care, the nurse must first understand his or her own culture, its beliefs, and its assumptions. To assist in evaluating a client's culture, the nurse should ask certain questions to understand the client's beliefs. Asking where the client thinks his or her illness comes from will help the nurse understand illness from the client's perspective. Not all members of a culture eat the same thing. Memorizing stereotypes will not help the nurse to provide culturally competent care. Educating the client about the U.S. health care system does not help the nurse in providing culturally competent care.
Which religions have a rule about not eating pork? (Select all that apply.) A. Methodism B. Islam C. Mormonism D. Roman Catholicism E. Orthodox Judaism
A. Methodism ***B. Islam C. Mormonism D. Roman Catholicism ***E. Orthodox Judaism Both Orthodox Jews and Muslims are prohibited from eating pork. That is not true of Mormons, Roman Catholics, or Methodists.
A nurse ignores a client's persistent complaint of back pain because the client open double quote"complains too much.close double quote" The next day the client is diagnosed with kidney stones. What negligence prevention strategy did the nurse fail to implement? A. Minimizing the risk of medication errors B. Maintaining client safety C. Using effective communication D. Minimizing client discomfort
A. Minimizing the risk of medication errors ***B. Maintaining client safety C. Using effective communication D. Minimizing client discomfort The nurse is negligent and has committed malpractice. This type of malpractice is failure to observe and take appropriate action, a breach in maintaining client safety. Minimizing client discomfort is not a negligence prevention strategy, and the other choices do not apply to the scenario described.
During a follow-up visit, the nurse learns that a client is not adhering to the agreed upon plan of care. What outcome should the nurse expect for this client's care? A. Missing a scheduled appointment B. Misinterpretation of teaching C. Misunderstanding of the care plan D. Exacerbation of the health problem
A. Missing a scheduled appointment B. Misinterpretation of teaching C. Misunderstanding of the care plan ***D. Exacerbation of the health problem If the client is not adhering to the plan, the client is at risk for re-hospitalization or exacerbation of the health alteration. Limited access to resources may hinder client progress in the form of missing scheduled appointments or not understanding the plan of care. A client with deficient knowledge may not comprehend information provided during a teaching session.
Which organization mandates that each client admitted to an institution be assessed for spiritual beliefs and practices? A. National Council of Churches B. American Nurses Association C. Nursing Outcomes Classification Project D. The Joint Commission
A. National Council of Churches B. American Nurses Association C. Nursing Outcomes Classification Project ***D. The Joint Commission The Joint Commission mandates that each client admitted to an institution be assessed for spiritual beliefs and practices. That is not the agenda of any of the other organizations.
During a health history interview with a family, the nurse is concerned that a 12-year-old client is experiencing signs of grief reaction. What information from the family would cause the nurse to suspect this condition? A. Nurse observes listening and self-disclosure. B. Nurse observes a family alteration. C. Nurse observes structured family flexibility. D. Nurse observes changes in physical health status.
A. Nurse observes listening and self-disclosure. ***B. Nurse observes a family alteration. C. Nurse observes structured family flexibility. D. Nurse observes changes in physical health status. An alteration in the family, loss of a family member because of death or divorce, could result in a grief reaction, which could manifest in the interview as depression, anger, or anxiety. Communication patterns that include family members listening, speaking, self-disclosing, and tracking, and family flexibility are characteristic of high functioning families. Grief may manifest in weight loss, headaches, sleeplessness and other symptoms, but the nurse would observe that after the health history interview, during the physical examination of family members that would follow.
Which of the following statements accurately describe cultural factors that may influence healthcare? Select all that apply. A. Nurses and patients generally agree upon the health practices that are being instituted. B. In many cultures, the man is the dominant figure and generally makes decisions for all family members. C. Most mental health norms are based on research and observations made of white, middle-class people. D. Although pain affects people differently, most people react to pain in the same manner. E. When people move to the United States, they may speak their own language fluently but have difficulty speaking English. F. Certain racial and ethnic groups are more prone to developing specific diseases and conditions.
A. Nurses and patients generally agree upon the health practices that are being instituted. ***B. In many cultures, the man is the dominant figure and generally makes decisions for all family members. ***C. Most mental health norms are based on research and observations made of white, middle-class people. D. Although pain affects people differently, most people react to pain in the same manner. ***E. When people move to the United States, they may speak their own language fluently but have difficulty speaking English. ***F. Certain racial and ethnic groups are more prone to developing specific diseases and conditions. Nurses and patients do not always agree on health practices; what seems logical to the nurse, may seem ridiculous to the patient and vice versa. Various studies have shown that certain racial and ethnic groups are more prone to developing specific diseases and conditions. People react differently to pain based on their cultural experiences. Most mental health norms are based on research and observations made of white, middle-class people. Many ethnic groups have their own norms or acceptable patterns of behavior for psychological well-being and normal psychological reactions to certain situations. In many cultures, the man is the dominant figure and generally makes decisions for all family members, including healthcare decisions. When people from another part of the world move to the United States, they may speak their own language fluently but have difficulty speaking English.
Which is a barrier to care coordination? A. Nursing assistant scheduled for afternoon shift calls off from work B. Client's abdominal wound becomes infected after surgery C. Client does not have transportation to attend out-patient physical therapy D. Prescribed dose of medication delayed in arriving from the pharmacy
A. Nursing assistant scheduled for afternoon shift calls off from work B. Client's abdominal wound becomes infected after surgery ***C. Client does not have transportation to attend out-patient physical therapy D. Prescribed dose of medication delayed in arriving from the pharmacy Limited access to resources such as a lack of transportation is a barrier to care coordination. A change in a client's condition, a staff member calling out sick, or a delay in medication administration are not barriers to care coordination.
The nurse preceptor and novice nurse are discussing guidelines for protecting the client's privacy when using an electronic health record (EHR). Which guideline is essential for protecting client privacy when using the EHR? A. Only share computer passwords with trusted colleagues or nurse administrators. B. Always obtain written permission before posting client information on any social network. C. Never destroy paper documents that contain protected health information. D. Never leave computer screens with protected health information unattended.
A. Only share computer passwords with trusted colleagues or nurse administrators. B. Always obtain written permission before posting client information on any social network. C. Never destroy paper documents that contain protected health information. ***D. Never leave computer screens with protected health information unattended. Protecting the client's privacy involves following many of the same rules that were in place prior to electronic records, including never discussing client information in public areas and making sure any paper documents that may contain protected health information are placed in designated shred bins. Newer considerations include keeping computer passwords confidential and not sharing them with anyone, ensuring that computer screens with protected health information are never left unattended, and never posting any client information on public social networks, such as Facebook or Twitter.
The staff nurse is responsible for providing care to a group of clients. What should the nurse use to guide the provision of safe quality care? A. PSDA guidelines B. QSEN competencies C. Standards of care D. Standards of practice
A. PSDA guidelines B. QSEN competencies ***C. Standards of care D. Standards of practice Standards of care are guidelines that determine what a nurse can or cannot do. These standards provide guidance to perform an action or a prescribed treatment for a client. QSEN are six competencies that support accountability in practice. The Patient Self-Determination Act (PSDA) is legislation that impacts clients and the profession of nursing. Standards of practice describe responsibilities for which nurses are accountable. These standards have been defined by nursing regulatory bodies and are often used as measures for quality and safety.
Which group is diagnosed with AIDS at a rate that is more than ten times that of Caucasians? A. Pacific Islanders B. Asian Americans C. African Americans D. Hispanics
A. Pacific Islanders B. Asian Americans ***C. African Americans D. Hispanics African Americans have a rate of AIDS infection that is ten times that of Caucasians. Hispanics have a rate three times the Caucasian rate of AIDS infection. Asian Americans and Pacific Islanders do not have higher rates of AIDS.
Which description best depicts a binuclear family? A. Parents with biological children from a previous relationship or marriage B. Two parents with biological or adopted children living together C. Male and female parents, living together outside of marriage D. A family where there is co-parenting with children sharing time between families
A. Parents with biological children from a previous relationship or marriage B. Two parents with biological or adopted children living together C. Male and female parents, living together outside of marriage ***D. A family where there is co-parenting with children sharing time between families Binuclear describes a combination of parenting by two nuclear families, which can happen after a divorce has ended the original nuclear family. Children still spend time with each new family.A nuclear family consists of two parents with biological or adopted children, or children in the new family from a previous relationship or marriage. Male and female parents, living together outside of marriage, are referred to as heterosexual cohabiting.
Before leaving a room, the nurse repositions the client and emphasizes the need to drink more fluids over the next few hours. Which concepts related to accountability did this nurse demonstrate? (Select all that apply.) A. Perfusion B. Comfort C. Fluid and electrolyte balance D. Teaching and learning E. Tissue integrity
A. Perfusion ***B. Comfort C. Fluid and electrolyte balance ***D. Teaching and learning E. Tissue integrity The concept of teaching and learning is related to accountability because nurses are accountable for providing appropriate teaching to clients to ensure the highest quality of care. The concept of comfort is related to accountability because nurses are accountable for managing pain and for other interventions to ensure comfort for the client. Fluid and electrolyte balance is not a concept demonstrated by the nurse's actions. There is not enough information to determine if the nurse is demonstrating the concepts of tissue integrity and perfusion as being related to accountability in this situation.
A public health nurse is planning a health fair to be held at the local community center. The center's advisory board asked for booths with a range of secondary prevention activities. Which activities would the nurse plan to include? (Select all that apply.) A. Physical therapy exhibit of exercise for individuals with arthritis B. Blood pressure measurements with sphygmomanometer C. Glucometer testing of blood sugar levels D. Respiratory therapy exhibit about smoking cessation E. Nutritionist's table of healthy breakfast foods
A. Physical therapy exhibit of exercise for individuals with arthritis ***B. Blood pressure measurements with sphygmomanometer ***C. Glucometer testing of blood sugar levels D. Respiratory therapy exhibit about smoking cessation E. Nutritionist's table of healthy breakfast foods Secondary prevention activities screen for the presence of diseases. Glucometer testing of blood sugar will identify individuals with diabetes. Blood pressure measurements will screen for hypertension. Both the nutritionist's table of healthy breakfast foods and the respiratory therapy exhibit about smoking cessation are primary, not secondary, prevention activities. The physical therapy exhibit of exercise devices for individuals with arthritis is tertiary prevention of complications of that condition.
Which action would be an inappropriate nursing response to a client with a history of long-term narcotic use, who is asking for increased pain medication after surgery? A. Plan on further assessment B. Ask for support from a supervisor C. Counsel client about risks of addictive behavior D. Ask for support from peers
A. Plan on further assessment B. Ask for support from a supervisor ***C. Counsel client about risks of addictive behavior D. Ask for support from peers It would be inappropriate to counsel the client about risks of addictive behavior. The nurse should ask for support from a supervisor or peers, and plan on further assessment.
Claire is a nurse who works on a substance abuse unit. She sees all clients prior to admission and she must determine the last time each client used drugs, determine their drug of choice, and obtain urine and blood samples. Which step of the nursing process is Claire using during this process? A. Planning the client's care (developing a care plan) B. Analyzing the assessment data and choosing a diagnosis C. Evaluating the client's progress indicative of the stated outcomes D. Assessing and collecting comprehensive data
A. Planning the client's care (developing a care plan) B. Analyzing the assessment data and choosing a diagnosis C. Evaluating the client's progress indicative of the stated outcomes ***D. Assessing and collecting comprehensive data The nurse is assessing and collecting comprehensive data during this process, and is in an ideal position to provide the correct level of assessment by collecting comprehensive data surrounding the client's health and life situation. The other steps include analyzing the data once collected, planning appropriate care, coordinating provision of care, and evaluating the client's progress based on the outcomes and care plan.
The community health nurse is designing a presentation about societal factors that influence health policy. Which statement should the nurse include in the presentation? A. Population size does not influence the development of health policy. B. Population-specific needs are too complex to be taken into consideration. C. Considerations include whether or not current policy meets the population's needs. D. Level of support for the proposed policy is not an influencing factor.
A. Population size does not influence the development of health policy. B. Population-specific needs are too complex to be taken into consideration. ***C. Considerations include whether or not current policy meets the population's needs. D. Level of support for the proposed policy is not an influencing factor. Societal factors that influence health policy include population size, population-specific needs, degree to which current policy meets the population's needs, and level of support for the proposed policy.
The nurse administers a dose of the pneumococcal vaccination to an older client prior to the client's discharge from the hospital. Which function of managed care is this nurse performing? A. Preventing unnecessary costs B. Assessing client needs C. Delivering preventive services D. Advocating for client needs
A. Preventing unnecessary costs B. Assessing client needs ***C. Delivering preventive services D. Advocating for client needs Managed care emphasizes preventing inappropriate and unnecessary costs, increasing customer satisfaction, promoting health, and delivering preventive services. Administering a vaccination is the delivery of a preventive service. Assessing client needs is a step within the nursing process and case management. Providing a vaccination is delivering a preventive service and not preventing unnecessary costs. The nurse who is administering a vaccination is not engaged in advocacy.
Which care delivery method uses a task-oriented approach? A. Primary B. Team C. Case D. Functional
A. Primary B. Team C. Case ***D. Functional The functional method uses a task-oriented approach. In the case method, one nurse is assigned and responsible for the care of a group of clients over the course of a shift. In the team method, the RN has the responsibility and authority for client care but delegates tasks to other team members as appropriate. In primary nursing, one nurse is responsible for overseeing the total care for a number of clients 24 hours a day, 7 days a week.
The nurse is planning discharge care for a 10-year-old child with an asthma exacerbation. Which roles in the binuclear family unit of the child should the nurse identify before teaching can begin? (Select all that apply.) A. Primary caregiver for the child B. Financial decision maker for the child C. Legal guardian of the child D. Medical decision maker for the child E. Parent that is working outside home
A. Primary caregiver for the child ***B. Financial decision maker for the child ***C. Legal guardian of the child ***D. Medical decision maker for the child E. Parent that is working outside home Family members take on different roles within the family. The decision maker in the family may not be the primary provider or caregiver, or the working parent. The nurse must identify the legal, medical, and financial decision maker for each family when planning care for a child.
The nurse manager is looking at the quarterly budget for the new clinic. The largest expenses are for personnel. If the nurse is faced with a staff shortage, which nursing care delivery system is the most appropriate choice? A. Primary nursing B. Team nursing C. Functional nursing D. Positive nursing
A. Primary nursing B. Team nursing ***C. Functional nursing D. Positive nursing Functional nursing, which assigns staff to tasks rather than to clients, works well in staff shortages. Both team nursing and primary nursing require more staff to implement. There is no positive nursing system.
A supervisor has asked a nurse to train new nursing staff in culturally competent care. Which information would the nurse include in the training? (Select all that apply.) A. Promoting participation of fathers, as well as mothers, in healthcare visits B. Reasons nuclear families are superior C. Variations in family structure D. Communication skills E. Cultures served by the nursing staff
A. Promoting participation of fathers, as well as mothers, in healthcare visits B. Reasons nuclear families are superior ***C. Variations in family structure ***D. Communication skills ***E. Cultures served by the nursing staff The nurse would include information about the cultures served locally by the healthcare organization, variations in family structure that nurses may encounter, and communications skills. In the training, the nurse would teach avoidance of judgments and assumptions, such as why nuclear families are superior to other family structures. The topic of why fathers and mothers should both participate in healthcare visits would be more appropriate for an educational program about facilitating the transition to parenthood.
The nurse manager in the assisted living facility is finding that ethical issues arise frequently in this setting. The nurse manager empowers the entire clinical team to make suggestions for support activities. Which suggestions by the staff nurses are relevant to ethical issues? (Select all that apply.) A. Protocols for advanced directives for dying clients B. Use of primary nursing teams to facilitate care C. Easy access to the use of counseling professionals D. Availability of mentoring by experienced nurses E. Regular team conferences on subjects selected by the team
A. Protocols for advanced directives for dying clients B. Use of primary nursing teams to facilitate care ***C. Easy access to the use of counseling professionals ***D. Availability of mentoring by experienced nurses ***E. Regular team conferences on subjects selected by the team Support systems that are useful to nurses who work in settings where ethical issues arise frequently include regular team conferences on subjects selected by the team, easy access to the use of counseling professionals, and availability of mentoring by experienced nurses. Protocols for advanced directives support evidence-based practice and primary nursing teams help to facilitate continuity of care, but they do not support the staff who works in an environment with frequent ethical issues.
Which nursing action demonstrates accountability for care provided to a client? A. Providing discharge instructions B. Changing the dressings on the left foot and leg C. Ensuring treatments are completed D. Teaching self-administration of insulin
A. Providing discharge instructions B. Changing the dressings on the left foot and leg ***C. Ensuring treatments are completed D. Teaching self-administration of insulin Accountability is being responsible for the outcome of a completed task or assignment. Standards of care and practice guide the nurse's activities. Ensuring that treatments are completed is an example of accountability. Providing discharge instructions, teaching self-administration of medication, and changing dressings are examples of nursing responsibilities.
The new nurse is reviewing the state board of nursing Web site for information about professional practice. What information should the nurse expect to find during this search? (Select all that apply.) A. Quality improvement findings B. Evidence-based practice guidelines C. Tips for implementing computer applications D. Scope of practice guidelines E. Role definitions
A. Quality improvement findings B. Evidence-based practice guidelines C. Tips for implementing computer applications ***D. Scope of practice guidelines ***E. Role definitions A profession is considered autonomous when it has legal authority to define its own scope of practice, and defines roles, identifies goals, and outlines responsibilities. Individual state boards of nursing support autonomy in nursing. The state boards of nursing do not post evidence-based practice guidelines, quality improvement findings, or tips for implementing computer applications. These items might be found in professional journals or other publications that support nursing practice.
In which circumstance is it the most appropriate for a 17-year-old client to provide informed consent for care? A. Receiving antibiotics for strep throat with a parent present B. Receiving contraceptive services without a parent present C. Bringing a younger sibling to a health assessment visit D. Bringing a grandparent to an urgent care center for a flu shot
A. Receiving antibiotics for strep throat with a parent present ***B. Receiving contraceptive services without a parent present C. Bringing a younger sibling to a health assessment visit D. Bringing a grandparent to an urgent care center for a flu shot A 17-year-old client can provide informed consent for her own care when receiving contraceptive services. A 17-year-old client cannot provide informed consent to receive antibiotics for strep throat as this does not fall into a legal exception category. Consent should be obtained from the client's parent or custodian. The 17-year-old cannot provide consent for a sibling to receive care during a health assessment visit or for a grandparent at an urgent care visit for a flu shot.
The program director at a school of nursing is working with hospital leaders to reduce the impact of a nursing shortage projected to occur within a few years. Which recommendations are appropriate to combat this potential issue? (Select all that apply.) A. Recommend increasing the nurse-to-client staffing ratio B. Discuss increasing nursing salaries to be comparable with similar organizations C. Analyze staffing options to increase flexibility D. Increase recruitment of students into nursing as a second career E. Determine ways to increase the number of nursing scholarships
A. Recommend increasing the nurse-to-client staffing ratio ***B. Discuss increasing nursing salaries to be comparable with similar organizations ***C. Analyze staffing options to increase flexibility D. Increase recruitment of students into nursing as a second career ***E. Determine ways to increase the number of nursing scholarships Efforts to counteract the effects of the nursing shortage include recruiting students into nursing early in their education careers, improving the environment for nurses such as providing flexibility with work hours, increasing salaries, and improving the work load, and increasing the funding for nursing education. Increasing the nurse-to-client staffing ratio will negatively impact the workload. Increasing recruitment of students into nursing as a second career means the students will be older. One issue with the nursing shortage is the aging of the nursing workforce. Older students would mean that the nurse would spend less time in the profession.
The nurse at a community center's health fair is assessing a client who has not seen a healthcare provider in over a decade. The client's blood pressure is 150/95. Which referral is appropriate for this client, as a result of this screening? A. Referral to a vascular specialist B. Referral to an urgent care clinic C. Referral to a primary care provider D. Referral to the emergency department of the county hospital
A. Referral to a vascular specialist B. Referral to an urgent care clinic ***C. Referral to a primary care provider D. Referral to the emergency department of the county hospital The screening found that the client might have hypertension. The appropriate referral is to a primary care provider. The finding does not prompt use of the emergency department, an urgent care clinic, or a vascular specialist.
A county health department nurse is creating a brochure that describes the agency's role. Which activity should be included? A. Regulating child care centers B. Providing community disease monitoring and surveillance C. Enrolling clients in Medicaid D. Overseeing the construction of new medical facilities
A. Regulating child care centers ***B. Providing community disease monitoring and surveillance C. Enrolling clients in Medicaid D. Overseeing the construction of new medical facilities Providing community disease monitoring and surveillance is a function of a county health department. Enrolling clients in Medicaid typically is the responsibility of local departments of social services. Regulation of child care centers and overseeing the construction of new medical facilities are state-level regulatory functions.
A nurse is interviewing for a staff position on a medical-surgical unit. Which portion of the hiring process best represents the hospital's efforts to evaluate the nurse's commitment to the profession? A. Requiring the candidate to provide official copies of college transcripts B. Offering the candidate the option of completing a four-week unit orientation and preceptorship C. Inviting current staff nurses to serve as members of the candidate's interview committee D. Exploring the candidate's desire to maintain membership in the profession
A. Requiring the candidate to provide official copies of college transcripts B. Offering the candidate the option of completing a four-week unit orientation and preceptorship C. Inviting current staff nurses to serve as members of the candidate's interview committee ***D. Exploring the candidate's desire to maintain membership in the profession The candidate's desire to maintain membership in the nursing profession is reflective of professional commitment. The requirement to provide official college transcripts is not directly related to the candidate's commitment to the nursing profession. Inviting current staff nurses to serve as interview committee members and offering a unit orientation and preceptorship are not direct methods of evaluating the candidate's professional commitment to nursing.
The public advocate is providing an educational session to nurses regarding advocacy. Which items are appropriate to include in the teaching session? (Select all that apply.) A. Researching health disparities B. Running for public office C. Using media to inform the public D. Protecting clients' rights E. Making decisions for clients
A. Researching health disparities ***B. Running for public office ***C. Using media to inform the public ***D. Protecting clients' rights E. Making decisions for clients When advocating for clients, it is important for the nurse to protect the clients' rights, and inform the public about issues and concerns through press releases and media. The nurse can also run for public office as a means of advocating for clients. Researching health disparities and making decisions for clients are not topics that would be included in a session about advocating for clients.
The nurse is providing an assessment of a family to determine a need for interventions. Which description is an indication of high functioning family communication? A. Resiliency B. Self-disclosure C. Flexibility D. Emotional availability
A. Resiliency ***B. Self-disclosure C. Flexibility D. Emotional availability In high-functioning families, each family member listens empathically and attentively, speaks for him or herself and not for others, self-discloses by sharing personal feelings about self and other family members, and tracks (stays on topic). Family flexibility is the amount of flexibility in a family's leadership, rules, and roles, and the family's ability to deal with stress. Emotional availability refers to the quality of parent-child interactions. Resiliency is a family's ability to adapt, evolve, and change with circumstances.
Katrina Simons is a nurse who is coordinating the discharge for a client with chronic lung disease. Which nursing action is the priority when coordinating this client's care? A. Responding to family members' questions about the client's needs B. Reviewing the client's nutritional needs with the dietician C. Discussing the client's medications with the pharmacist D. Obtaining an order and organizing the delivery of oxygen to the client's home
A. Responding to family members' questions about the client's needs B. Reviewing the client's nutritional needs with the dietician C. Discussing the client's medications with the pharmacist ***D. Obtaining an order and organizing the delivery of oxygen to the client's home Initiating consultations, identifying the need for referrals, and obtaining orders are all actions the nurse will take when implementing care coordination. However, ensuring the client's ability to maintain adequate perfusion and oxygenation following discharge by obtaining an order and organizing oxygen delivery takes priority over other actions. Discussing the client's medications with the pharmacist, meeting with the dietician to review the client's nutritional needs, and responding to family members' questions are collaborative actions.
The clinical instructor is concerned that a student nurse is having difficulty implementing the Code for Nursing Students. Which student behavior supports this concern? (Select all that apply.) A. Returning money that dropped out of a staff nurse's pocket while reaching for scissors B. Asking a staff nurse for permission to observe a procedure at the bedside C. Stating that a client has to wait for pain medication because there were more important tasks to do D. Requesting assistance to complete a complicated dressing change E. Placing the side rails in the down position for a confused client
A. Returning money that dropped out of a staff nurse's pocket while reaching for scissors B. Asking a staff nurse for permission to observe a procedure at the bedside ***C. Stating that a client has to wait for pain medication because there were more important tasks to do D. Requesting assistance to complete a complicated dressing change ***E. Placing the side rails in the down position for a confused client Behaviors that do not adhere to the Code for Nursing Students include not ensuring the safety of clients by keeping the side rails down in a client with confusion and not acting professionally when telling a client to wait for pain medication. Requesting assistance, asking for permission, and returning found money adhere to the principles of the Code for Nursing Students.
The nurse case manager is assigned a client newly diagnosed with type 2 diabetes mellitus. What is the priority action for the nurse to perform when beginning the care of this client? A. Review nutritional needs with the dietician B. Discuss needs at home C. Complete a health history D. Discuss self-administration of insulin
A. Review nutritional needs with the dietician B. Discuss needs at home ***C. Complete a health history D. Discuss self-administration of insulin Case management is a care delivery approach used to coordinate, facilitate, and track a client's use of healthcare resources. This care delivery approach begins with assessing client needs. Implementing care (e.g., providing teaching on insulin administration) occurs after the assessment and plan is prepared. Discharge planning and collaboration with other healthcare professionals occur after the assessment.
Which nursing action demonstrates autonomy when providing client care? A. Reviewing evidence-based practice guidelines B. Accessing the policy and procedure manual C. Working with clients independently D. Discussing the work schedule with the manager
A. Reviewing evidence-based practice guidelines B. Accessing the policy and procedure manual ***C. Working with clients independently D. Discussing the work schedule with the manager The concept of autonomy is exemplified by independently working with clients, accepting responsibility for behaviors, and being accountable for outcomes. Reviewing evidence-based practice guidelines is an action that supports research in nursing. Accessing the policy and procedure manual is an example of the nurse being guided by rules as part of a service-oriented profession. Discussing the work schedule is an example of nursing controlling its own profession as a part of professional organization.
A nurse at the rehabilitation unit for clients who are blind is meeting with the nurse's mentor. They are discussing best practices in acting as advocates for the autonomy of their clients. Which client rights are they supporting in their dialogue? A. Right to express feelings B. Right to self-determination C. Right to confidentiality D. Right to privacy
A. Right to express feelings ***B. Right to self-determination C. Right to confidentiality D. Right to privacy When nurses act as advocates for their client's autonomy, they are supporting the client's right to self-determination. The right of autonomy is different from the rights to privacy, confidentiality, and expressing feelings.
After administering medications, the staff nurse discusses the status of morning care completed by unlicensed assistive personnel. Which behavior is the staff nurse demonstrating at this time? A. Safety B. Accountability C. Responsibility D. Client-centered care
A. Safety ***B. Accountability C. Responsibility D. Client-centered care Accountability is being responsible for the outcome of a completed task or assignment. Nurses are accountable for their own actions and behaviors, but also accountable for the actions of others, such as unlicensed assistive personnel. Responsibility is the obligation to perform duties within the nursing role. Client-centered care and safety are competencies that support accountability in nursing practice.
Which type of client advocacy concerns itself with growth and development, ensuring good nutrition and exercise, stress management, and preventing disease? A. Safety B. Patient Self-Determination Act (PSDA) C. Bill of Rights D. Health promotion
A. Safety B. Patient Self-Determination Act (PSDA) C. Bill of Rights ***D. Health promotion Health promotion concerns itself with growth and development, ensuring good nutrition and exercise, stress management, and preventing disease. Safety concerns itself with injury prevention, neglect, and abuse. The Bill of Rights helps clients to understand their rights. The PSDA protects the rights of clients to accept or reject aspects of their medical care.
The nurse learns that a client with school-age children is also her mother's caregiver. The client tells the nurse, open double quote"I cannot meet everyone's demands anymore.close double quote" Which is the most appropriate diagnosis for this client? A. Sandwich generation syndrome B. Risk for situational low self-esteem C. Adjusting to outside influences D. Readjustment of marital relationship
A. Sandwich generation syndrome ***B. Risk for situational low self-esteem C. Adjusting to outside influences D. Readjustment of marital relationship A nurse who is assessing an adult family member who cares for both her own children and an aging parent may diagnose any one of several conditions including, but not limited to, ineffective self-health management, interrupted family processes, compromised family coping, or risk for situational low self-esteem. Adults in this group are known as open double quote"The Sandwich Generation,close double quote" which is not a nursing diagnosis. Families in Stage IV of the family life cycle must adjust to outside influences as children start school. Spouses in Stage VI of the family life cycle readjust their marital relationship as the family launches young adults.
Which actions should the nurse take when helping clients access information on the Internet? (Select all that apply.) A. Schedule a virtual visit with the healthcare provider B. Direct to high quality Web sites C. Assist with obtaining a Skype account D. Summarize if the information is applicable E. Teach how to interpret the information
A. Schedule a virtual visit with the healthcare provider ***B. Direct to high quality Web sites C. Assist with obtaining a Skype account ***D. Summarize if the information is applicable ***E. Teach how to interpret the information Nurses need to help clients with information access by directing clients to high-quality web sites for information, teaching clients how to interpret the information, explaining how to evaluate information obtained, and summarizing how to determine if information is applicable. Assisting with obtaining a Skype account and scheduling a virtual visit with the health care provider support telecommunication activities.
The nurse is using an interpreter to discuss the care plan with a client of another culture. What form of communication is the nurse using to communicate with the client? A. Silence B. Touch C. Eye contact D. Verbal
A. Silence B. Touch C. Eye contact ***D. Verbal Verbal communication is an important tool to use when exchanging information about the plan of care. Using an interpreter is an example of using appropriate verbal communication to ensure that the client understands the information. Silence, touch, and eye contact are forms of nonverbal communication.
Which cultural phenomenon that affects health care is classified as an environmental control? A. Skin color B. Emphasis on the past C. Faith healing D. Personal boundaries
A. Skin color B. Emphasis on the past ***C. Faith healing D. Personal boundaries Faith healing is an environmental control. Skin color is a biologic factor. Emphasis on the past is a time orientation. Personal boundaries are space factors.
The nurse manager is reviewing current staff education levels and skill competencies for charge nurses to use when making client assignments. Which care delivery system does this nurse manager's action support? A. Team nursing B. Client-focused care C. Differentiated practice D. Shared governance
A. Team nursing B. Client-focused care ***C. Differentiated practice D. Shared governance Differentiated practice is the use of nurses' education, training, and ability to determine how to best use nurses in the care setting. Client-focused care organizes health care around client physical and emotional needs. Shared governance is an organizational model that ensures nurses have input on policy and decision making related to client care. In team nursing, the RN has the responsibility and authority for client care but delegates tasks to other team members as appropriate.
The nurse is teaching an adolescent client how to perform a thorough breast self-examination using a realistic model of the breast. Which type of prevention activity has the nurse performed with this client? A. Tertiary prevention B. Secondary prevention C. Palliative prevention D. Primary prevention
A. Tertiary prevention ***B. Secondary prevention C. Palliative prevention D. Primary prevention Breast self-examination screens for potential masses. Thus it is a secondary prevention activity. There is no palliative prevention.
Mitchell Asplund, a clinical nursing instructor, is assigned to serve as a student faculty advisor. Mitchell's responsibilities include determining which stage of commitment to nursing his students are experiencing. He is evaluating nursing student Don Rowlands, who is a junior in nursing school. During his evaluation, Don states, "I want to join the National Student Nurses Association. I'm also volunteering to participate in the student health fair. I know I'm really busy, but my schedule will be crazy when I'm working as a nurse, too. It's worth it to me." Mitchell recognizes that Don is in which stage of making a professional commitment to nursing? A. Testing B. Passionate C. Integrated D. Exploratory
A. Testing ***B. Passionate C. Integrated D. Exploratory The passionate stage, which is the third stage of commitment, begins as the individual processes the positive and negative aspects of the profession. At this point, students are willing to commit to their profession and to contribute to its well-being. Examples of student behaviors that are reflective of this stage include serving as a class officer, becoming involved in student nursing associations, and volunteering for activities not associated with a grade. The exploratory stage, which is the first stage of professional commitment, begins when individuals explore the positive aspects of their profession. During the testing stage, which is the second stage of professional commitment, students discover negative aspects of the profession. The quiet-and-bored stage, which is the fourth stage of commitment, involves settling into the nursing program's routines. The integrated stage, which is the fifth and final stage of commitment, requires integration of positive and negative elements of the profession into a more flexible, complex, and enduring form of commitment.
The nurse leader is planning an in-service about the administration of health policy at the federal level. Which content is appropriate for inclusion in the presentation? A. The Administration for Children and Families and the Administration on Aging are mainly responsible for addressing healthcare financing issues. B. The Food and Drug Administration (FDA) is governed by the U.S. Department of Health and Human Services (DHHS). C. The primary role of the Centers for Medicare and Medicaid Services (CMS) is to oversee services for individuals throughout the life span. D. The Centers for Disease Control and Prevention (CDC) is governed by the National Institutes of Health (NIH).
A. The Administration for Children and Families and the Administration on Aging are mainly responsible for addressing healthcare financing issues. ***B. The Food and Drug Administration (FDA) is governed by the U.S. Department of Health and Human Services (DHHS). C. The primary role of the Centers for Medicare and Medicaid Services (CMS) is to oversee services for individuals throughout the life span. D. The Centers for Disease Control and Prevention (CDC) is governed by the National Institutes of Health (NIH). The U.S. Department of Health and Human Services (DHHS) governs more than 300 divisions and programs, including the following: The National Institutes of Health (NIH), which provide health research and other health-related information; the Centers for Medicare and Medicaid Services (CMS), which address healthcare financing issues; and the Administration for Children and Families and the Administration on Aging, which oversee services for individuals throughout the life span. Divisions governed by the DHHS also include the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC).
When initially evaluating the needs of children and families, it is most important for the nurse to have knowledge of which item? A. The Affordable Care Act (ACA) B. Ability to manage symptoms C. The Americans with Disabilities Act (ADA) D. Healthcare options
A. The Affordable Care Act (ACA) B. Ability to manage symptoms C. The Americans with Disabilities Act (ADA) ***D. Healthcare options When assessing a child and family for advocacy needs, it is most important for the nurse to look at the healthcare options available to the child and family. The nurse would take the client's ability to manage symptoms into account when working with a client with a mental health disorder. The nurse would not be involved in health insurance planning through the ACA. The ADA would not be part of the initial assessment of needs.
The nurse preceptor is designing a nursing orientation program that addresses abuse of power in the workplace. Which information should the nurse preceptor include in the program? A. The Joint Commission has not taken an official stand on addressing workplace intimidation. B. Bullying behaviors and incivility are among the leading causes of sentinel client events. C. Nursing research finds limited evidence of bullying and lateral violence among nursing professionals. D. Improper use of authority in the workplace is a form of sexual harassment.
A. The Joint Commission has not taken an official stand on addressing workplace intimidation. ***B. Bullying behaviors and incivility are among the leading causes of sentinel client events. C. Nursing research finds limited evidence of bullying and lateral violence among nursing professionals. D. Improper use of authority in the workplace is a form of sexual harassment. Intimidation, sexual harassment, bullying, and lateral violence are forms of abuse of power. In the healthcare setting, evidence of bullying, lateral violence, and incivility has been well documented in nursing research for more than three decades. The Joint Commission has identified bullying behaviors and incivility in health care as being among the leading causes of sentinel client events. The Joint Commission calls for zero tolerance of workplace bullying and intimidation and recommends that healthcare facilities implement policies to stop such behaviors.
The nurse is caring for a client with Down syndrome. The client was recently denied employment because of the syndrome, and the client and his mother are very upset and are requesting assistance. Which piece of federal legislation is most appropriate for the nurse to refer to when advocating for this client? A. The Social Security Act Amendments of 1965 (SSA) B. The Americans with Disabilities Act of 1990 (ADA) C. The Patient Self-Determination Act of 1991 (PSDA) D. The Patient Protection and Affordable Care Act of 2010 (PPACA)
A. The Social Security Act Amendments of 1965 (SSA) ***B. The Americans with Disabilities Act of 1990 (ADA) C. The Patient Self-Determination Act of 1991 (PSDA) D. The Patient Protection and Affordable Care Act of 2010 (PPACA) The client is afforded protection in the area of employment, public services, and benefits by the Americans with Disabilities Act of 1990. The PPACA is a health insurance and assurance act. The PSDA regards rights to decision-making in medical care. The SSA Amendments introduced the Medicare program.
A client admitted for major cardiac surgery states a religious preference. Then the client lists all the church's rules that the client disagrees with. What does the admitting nurse understand about the client's religious status? A. The client is a former member of that group. B. The client has been excommunicated from that group. C. The client is a dissenting member of that group. D. The client is an outsider trying to be part of that group.
A. The client is a former member of that group. B. The client has been excommunicated from that group. ***C. The client is a dissenting member of that group. D. The client is an outsider trying to be part of that group. The client is a dissenting member of that group. It is not a matter of past membership, of being rejected, or of being an outsider.
During change-of-shift report, two medical-surgical nurses are discussing the pain management situation of a client with a low tolerance for pain. Giving repeated large doses of pain relievers bothered the evening shift nurse, but not the day shift nurse. Which statements about ethical client care are relevant in this situation? (Select all that apply.) A. The day shift nurse has better personal ethical values about pain relief. B. The client should be warned about the dangers of overdosing on pain relievers. C. Each nurse might be operating with a different set of assumptions about pain relievers. D. The evening shift nurse has better personal ethical values about pain relief. E. The client should be helped to make an informed decision about pain relief measures.
A. The day shift nurse has better personal ethical values about pain relief. B. The client should be warned about the dangers of overdosing on pain relievers. ***C. Each nurse might be operating with a different set of assumptions about pain relievers. D. The evening shift nurse has better personal ethical values about pain relief. ***E. The client should be helped to make an informed decision about pain relief measures. Each nurse might be operating with a different set of assumptions about pain relievers. Where one sees pain relief, the other might see addiction potential. Neither nurse has better personal ethical values. The client should be helped to make an informed decision about pain relief measures. This education should not include scaring the client about overdosing.
The clinical nursing instructor is evaluating the student's developmental stage of professional commitment. The student has settled into the nursing program's routine and reports experiencing decreased performance anxiety. Which stage of professional commitment is most appropriate for the clinical nursing instructor to use when describing the student's current level of development? A. The exploratory stage B. The quiet-and-bored stage C. The integrated stage D. The testing stage
A. The exploratory stage ***B. The quiet-and-bored stage C. The integrated stage D. The testing stage Development begins with the exploratory stage, which begins when individuals explore the positive aspects of their profession. Examples include the excitement nursing students experience when first wearing their new uniforms or when purchasing their first stethoscope. The second stage is the testing stage, during which students discover the positive and negative aspects of the nursing profession. During the third stage, which is the passionate stage, students are willing to commit to their profession and to contribute to its well-being. Examples of student behaviors that are reflective of this stage include serving as a class officer and becoming involved in student nursing associations. During the fourth stage, which is the quiet-and-bored stage, students settle into the nursing program's routines, grow more comfortable in their role, and experience decreased performance anxiety. The integrated stage, which is the fifth stage, manifests through the student's demonstration of commitment as a matter of habit. This stage usually begins in the final phases of the nursing program, with students beginning to see themselves as nurses, and growing eager to take the NCLEX-RN® and to begin working.
The nurse is providing care to a client who is newly diagnosed with type 2 diabetes mellitus. The health care provider orders diabetic education, and notes that the client is noncompliant with his medication and diabetic diet. The client recently emigrated from Vietnam to live with his daughter and does not speak English. The client has expressed a desire to use traditional culturally based therapies to treat the diabetes. Repeat testing shows no improvement in glycemic control. Based on the client's culture, what are the barriers to the recommended diabetic care? (Select all that apply.) A. The lack of insurance B. Cultural belief that discussing the disease can influence the disease process C. The importance of the beliefs and cultural practices of the client's family and community D. The belief that illness is not related to pathophysiology E. Lack of trust in the health care system and providers
A. The lack of insurance ***B. Cultural belief that discussing the disease can influence the disease process ***C. The importance of the beliefs and cultural practices of the client's family and community ***D. The belief that illness is not related to pathophysiology ***E. Lack of trust in the health care system and providers Barriers to care that are influenced by cultural differences may include lack of trust in the health care system or the provider; the belief that illness is not related to pathophysiology; the influence of family and community as well as a cultural belief that discussing an illness can influence the disease process. Although a lack of insurance may influence the client's entry into care, it does not have cultural significance.
The nurse is caring for a client who experienced an anaphylactic reaction to a medication. The nurse did not ask the client about allergies prior to administering the medication. Which statement is true regarding this nurse's actions? A. The nurse committed an act of negligence, but not malpractice. B. The nurse committed malpractice, but not an act of negligence. C. The nurse committed acts of negligence and malpractice. D. The nurse committed negligence due to a failure to communicate.
A. The nurse committed an act of negligence, but not malpractice. B. The nurse committed malpractice, but not an act of negligence. ***C. The nurse committed acts of negligence and malpractice. D. The nurse committed negligence due to a failure to communicate. The nurse committed a failure to assess, failure to follow standards of care, failure to document, and failure to act as a client advocate. Therefore, this nurse committed acts of negligence and malpractice.
A nurse is accused of failing to assess and monitor. Which clinical scenario causes this type of malpractice? A. The nurse fails to notify the healthcare provider in a timely manner when conditions warrant it. B. The nurse fails to act on prescribed orders, and the client suffers an adverse event. C. The nurse fails to treat the client complaining of a headache, and the client subsequently has a stroke. D. The nurse fails to document a client's allergy, and the client subsequently has an allergic reaction to a medication administered.
A. The nurse fails to notify the healthcare provider in a timely manner when conditions warrant it. B. The nurse fails to act on prescribed orders, and the client suffers an adverse event. ***C. The nurse fails to treat the client complaining of a headache, and the client subsequently has a stroke. D. The nurse fails to document a client's allergy, and the client subsequently has an allergic reaction to a medication administered. The nurse who fails to treat a client who complains of a headache, and then subsequently suffers a stroke, is failing to assess and monitor. The other clinical scenarios are negligent acts that lead to malpractice. However, they do not fit failing to assess and monitor.
The new nurse observes that her client is becoming upset with his healthcare providers because they disagree with the client's decision to discontinue his cancer treatment. Although the nurse feels conflicted by the client's decision, which moral obligation guides the care that is provided to the client? A. The nurse must defend the healthcare providers' choice to continue cancer therapy because that is what is best for the client. B. The nurse supports the client's right to make his own healthcare decisions. C. The nurse explains to the client that he is making a mistake because his culture and traditions are leading him down the wrong path. D. The nurse respects that the hospital has the final authority to make decisions for the client.
A. The nurse must defend the healthcare providers' choice to continue cancer therapy because that is what is best for the client. ***B. The nurse supports the client's right to make his own healthcare decisions. C. The nurse explains to the client that he is making a mistake because his culture and traditions are leading him down the wrong path. D. The nurse respects that the hospital has the final authority to make decisions for the client. The nurse is morally obliged to support the client's right to make his own healthcare decisions. The healthcare providers' may advise the client about best options, but may not make decisions for the client. The hospital does not have authority to make decisions for the client. The nurse must respect the client's culture and traditions, even if they create conflict with the nurse's own beliefs and values.
Sol, a 47-year-old man, wants to postpone his prostate surgery because his family will be gathering for Yom Kippur on that day. What is an appropriate nursing response? A. The nurse should insist that the client keep the surgery date. B. The nurse should ask the client whether his family will really mind if he doesn't join them for the holy day. C. The nurse should inform the surgeon of the scheduling problem and advocate for rescheduling the nonemergency procedure as soon as possible. D. The nurse should inform the client that his surgery may have to be postponed indefinitely.
A. The nurse should insist that the client keep the surgery date. B. The nurse should ask the client whether his family will really mind if he doesn't join them for the holy day. ***C. The nurse should inform the surgeon of the scheduling problem and advocate for rescheduling the nonemergency procedure as soon as possible. D. The nurse should inform the client that his surgery may have to be postponed indefinitely. Respecting the client's religious beliefs and practices is an important element in culturally competent nursing care. The nurse should not pressure clients about religious beliefs while informing them of medical concerns.
A nurse is administering a medication to a pediatric client. The nurse verifies the client's armband and confirms the correct medication by checking the prescribed order and the medication vial. Which actions by the nurse correctly exemplify the "Six Rights" of medication administration? (Select all that apply.) A. The nurse verifies the right medication by asking the client "is this what you normally take at home?" B. The nurse checks for right frequency by looking at the client's chart. C. The nurse checks for right dose by checking the prescribed order, performing a dose calculation, and checking the medication. D. The nurse checks for right documentation by documenting administration of the prescribed order in the client record. E. The nurse checks for right time by checking the prescribed order and looking at the time.
A. The nurse verifies the right medication by asking the client "is this what you normally take at home?" B. The nurse checks for right frequency by looking at the client's chart. ***C. The nurse checks for right dose by checking the prescribed order, performing a dose calculation, and checking the medication. ***D. The nurse checks for right documentation by documenting administration of the prescribed order in the client record. ***E. The nurse checks for right time by checking the prescribed order and looking at the time. Verifying the right time and dose and documenting the administration of the medication are all included in the rix rights of medication administration. Frequency is not one of the six rights of medication administration. While checking for the right medication is one of the six rights, asking the client if the pill is what they take at home does not constitute checking the right medication. The nurse would need to verify that the medication is the correct by checking the medication against the client's medication administration record.
Social justice is an important value for the nursing profession. Which nurse is exhibiting this value? A. The nurse who treats the very dirty homeless person with respect B. The nurse who honors the decision of a client to reject blood transfusions C. The nurse who offers to work a religious holiday so that others can worship that day D. The nurse who treats the illegal immigrant in the same manner as a citizen
A. The nurse who treats the very dirty homeless person with respect B. The nurse who honors the decision of a client to reject blood transfusions C. The nurse who offers to work a religious holiday so that others can worship that day ***D. The nurse who treats the illegal immigrant in the same manner as a citizen The nurse who treats the illegal immigrant in the same manner as a citizen is demonstrating social justice. The nurse who treats the very dirty homeless person with respect honors human dignity. The nurse who honors the decision to reject blood transfusions is supporting clients' autonmy. The nurse who offers to work a religious holiday so that others can worship is showing altruism.
The nurse is taking care of a 10-year-old client receiving chemotherapy who is experiencing nausea that is distressing the client and parents. Which intervention would be most appropriate in implementing a family- centered plan of care? A. The nurse will provide small nutritious snacks to maintain body weight. B. The nurse will teach distraction techniques to decrease symptoms. C. The nurse will administer intravenous (IV) fluids to prevent dehydration. D. The nurse will administer pain medications as ordered to improve comfort.
A. The nurse will provide small nutritious snacks to maintain body weight. ***B. The nurse will teach distraction techniques to decrease symptoms. C. The nurse will administer intravenous (IV) fluids to prevent dehydration. D. The nurse will administer pain medications as ordered to improve comfort. Interventions are selected because they are related to a specific goal that is shared by the family and healthcare team. All of the interventions mentioned can be effectively used with the client receiving chemotherapy; however, only one intervention (teaching distraction) addresses the goal of decreasing symptoms of nausea.
In deciding to report a co-worker who has engaged in illegal, immoral, or unethical conduct, the nurse can turn to which organizations for guidance? (Select all that apply.) A. The police B. The American Nurses Association C. The state board of nursing D. The National Alliance on Mental Illness E. Nursing school
A. The police ***B. The American Nurses Association ***C. The state board of nursing D. The National Alliance on Mental Illness E. Nursing school The nurse would turn to the state board of nursing or the American Nurses Association for guidance regarding the behavior of a co-worker. Nursing school would not be an official resource. The National Alliance on Mental Illness is an advocacy program. The nurse would not initiate consultation with the police - this would be done by the employer.
The public health nurse is assessing the need for long-term care facilities in the community. What change in population of adults age > 85 years old, between 2008-2050, should the nurse factor in? A. The population of adults age > 85 years old will double. B. The population of adults age > 85 years old will triple. C. The population of adults age > 85 years old will decrease by half. D. The population of adults age > 85 years old will increase by half.
A. The population of adults age > 85 years old will double. ***B. The population of adults age > 85 years old will triple. C. The population of adults age > 85 years old will decrease by half. D. The population of adults age > 85 years old will increase by half. Between 2008-2050, the population of adults age > 85 years old will triple.
When a nurse obtains informed consent, the client should be provided with all pertinent and relevant information. Which information is not relevant? A. The purposes of the treatment B. The intended benefits of the treatment C. The insurance payment methods D. The diagnosis or condition that requires treatment
A. The purposes of the treatment B. The intended benefits of the treatment ***C. The insurance payment methods D. The diagnosis or condition that requires treatment Relevant information that is provided to the client during the informed consent process includes the purpose of the treatmnet, the diagnosis or condition that requires treatment, and the intended benefits of the treatment. The insurance payment methods are not included in the informed consent process.
The nurse practice act and administrative rules form the basis of the standard of care. Which phrase is an aspect of the nurse practice act? A. The scope of the healthcare provider's practice B. The definition of professional conduct for nurses C. The disclosure of NCLEX scores for all nursing personnel employed by the facility D. The identification of activities for all levels of hospital workers, including administrative personnel
A. The scope of the healthcare provider's practice ***B. The definition of professional conduct for nurses C. The disclosure of NCLEX scores for all nursing personnel employed by the facility D. The identification of activities for all levels of hospital workers, including administrative personnel The definition of the professional conduct of nurses is an aspect of the nurse practice act. The scope of the healthcare provider's practice, disclosure of NCLEX scores, and identification of activities for all levels of hospital employees including administrative staff are not aspects of the nurse practice act.
Angela Seitz, age 82, tells the nurse that the surgeon to whom she was referred told her that he does not do hip replacement surgery on someone as old as she. How would the nurse describe the surgeon's attitude? A. The surgeon is demonstrating homophobia. B. The surgeon is demonstrating ageism. C. The surgeon is demonstrating classism. D. The surgeon is demonstrating gender bias.
A. The surgeon is demonstrating homophobia. ***B. The surgeon is demonstrating ageism. C. The surgeon is demonstrating classism. D. The surgeon is demonstrating gender bias. Ageism is discrimination against older adults. Gender bias is demonstrating preferences towards one gender group over another. Classism involves oppressive practices based on socioeconomic status. Homophobia involves negative feelings or behaviors toward gays or lesbians.
Which is an accurate description of the term transsexual? A. Transsexuals are individuals born with anatomical characteristics that do not seem to fit the typical definitions of female or male B. Transsexuals demonstrate preferences toward one gender group over another. C. Transsexuals are individuals who perceive themselves to be in the "wrong body." D. Transsexuals have negative feelings or behaviors toward gays or lesbians.
A. Transsexuals are individuals born with anatomical characteristics that do not seem to fit the typical definitions of female or male B. Transsexuals demonstrate preferences toward one gender group over another. ***C. Transsexuals are individuals who perceive themselves to be in the "wrong body." D. Transsexuals have negative feelings or behaviors toward gays or lesbians. Transsexuals are individuals, of any anatomical gender who perceive themselves to be in the "wrong body." Intersex refers to individuals born with anatomical characteristics that do not seem to fit the typical definitions of female or male. Sexists demonstrate preferences toward one gender group over another. Homophobes have negative feelings or behaviors toward gays or lesbians.
Six-year-old Celine Toussaint has been diagnosed with sickle cell disease. She comes to the clinic with her grandparents and parents for follow-up care. In the assessment interview, the parents mention that they are both looking for work. Which nursing intervention would be appropriate for this family? A. Try to find a way to treat the child with less family involvement B. Facilitate connections with community resources C. Create an ecomap with the family D. Create a genogram with the family
A. Try to find a way to treat the child with less family involvement ***B. Facilitate connections with community resources C. Create an ecomap with the family D. Create a genogram with the family This family is at risk because of stressors related to serious illness and financial issues. The appropriate nursing intervention would be to facilitate connections with community resources that could address the family's immediate needs for employment. Intergenerational family support may be a major strength of this family, which the nurse would encourage. Family ecomaps and genograms are tools that nurses use in their assessments, not nursing interventions.
The nursing student is designing a poster that describes how to recognize burnout among nurses. Which recommendation for identifying manifestations of burnout should be included on the poster? A. Understand that emotional depletion is a natural response to the demands of employment B. Interpret that smoking and an increase in coffee consumption may be potential warning signs C. Recognize that outbursts of anger are normal signs of professional frustration D. Acknowledge feelings of helplessness as signs of inexperience or professional inadequacy
A. Understand that emotional depletion is a natural response to the demands of employment ***B. Interpret that smoking and an increase in coffee consumption may be potential warning signs C. Recognize that outbursts of anger are normal signs of professional frustration D. Acknowledge feelings of helplessness as signs of inexperience or professional inadequacy Manifestations of burnout include physical and emotional depletion, negative attitude and self-concept, and feelings of helplessness and hopelessness. Danger signs that may precede the development of burnout include increased coffee consumption and smoking.
An immigrant Hmong family (parents and two children) comes to a local outpatient clinic in an area where many Hmong have settled. The mother, age 42, has a hacking cough. How should the nurse address the language barrier? A. Use signs and gestures to communicate B. Ask the oldest child to act as translator C. Ask the local immigrant service organization to provide an interpreter D. Conduct a physical assessment with no explanations
A. Use signs and gestures to communicate B. Ask the oldest child to act as translator ***C. Ask the local immigrant service organization to provide an interpreter D. Conduct a physical assessment with no explanations Asking a family member to act as translator may create confidentiality issues. Signs and gestures are inadequate for clear communication. A representative of a local organization will understand the culture and may even have specific helpful knowledge of the family's background. Federal law requires provision of an interpreter.
A nurse administrator is asked to write guidelines for the staff nurses for the use of the hospital's interpreter services for non-English-speaking clients. Which recommendations will the administrator include in the guidelines? (Select all that apply). A. Use technical medical terminology related to the client's diagnosis and treatment B. Provide teaching sheets in the client's language C. Address questions to the client D. Use family members as the first line of interpretation E. Use verbal and nonverbal cues when addressing the client
A. Use technical medical terminology related to the client's diagnosis and treatment ***B. Provide teaching sheets in the client's language ***C. Address questions to the client D. Use family members as the first line of interpretation ***E. Use verbal and nonverbal cues when addressing the client Effective communication with interpreter services includes using nonverbal and verbal communication, including eye contact; speaking in simple, not complex terms; and providing the client with teaching sheets in their language. Family members should not be used as interpreters for confidentiality reasons. Questions should be addressed to the client.
A dialysis nurse does not agree with a client's decision to stop treatment. "I promised my spouse I would try it for a while, but it's too much," the client reveals. In supporting the client's decision, which principle of morality is the nurse honoring? A. Veracity B. Fidelity C. Justice D. Autonomy
A. Veracity B. Fidelity C. Justice ***D. Autonomy In supporting the client's decision, the nurse is honoring the principle of autonomy (the client's right to make decisions). It is not a matter of fidelity (keeping a promise), veracity (telling the truth), or justice (fairness).
The nurse is developing the plan of care for an English-speaking Micronesian man with an 8th grade education who has hypertension. The client is noncompliant with taking medications and is not following up with the healthcare provider as needed. Which criteria indicates the need for an advocate to help the client access the resources he requires? A. Very ill or in pain B. Lower literacy level C. Low income level D. Non-English speaking
A. Very ill or in pain ***B. Lower literacy level C. Low income level D. Non-English speaking Clients with low overall literacy and low health literacy levels have difficulty understanding their medical situation and become easily confused with navigating the healthcare system. Advocacy is needed in that situation. The client speaks English. The client feels well and is not in pain. There is not enough information to determine his income level.
How is culture learned by each new generation? A. ethnic heritage B. belonging to a subculture CorrectC. formal and informal experiences D. involvement in religious activities
A. ethnic heritage B. belonging to a subculture ***C. formal and informal experiences D. involvement in religious activities Culture is a shared system of beliefs, values, and behavioral expectations that provide social structure for daily living. Culture includes the beliefs, habits, likes and dislikes, and customs and rituals learned through formal and informal experiences within one's family and the cultural group to which one belongs.
A patient states that his life has meaning and purpose, he feels loved, and has experienced forgiveness in his life. What is the term that describes this state of spirituality? A. spiritual alienation B. spiritual health C. spiritual bliss D. spiritual belief
A. spiritual alienation ***B. spiritual health C. spiritual bliss D. spiritual belief Defined most simply, spiritual health or well-being is the condition that exists when the universal spiritual needs for meaning and purpose, love and belonging, and forgiveness are met.
Karalynn Templeton, a community health nurse, is preparing to meet with her state representative to discuss the unmet needs of military families whose loved ones are deployed. During the meeting, which statement demonstrates Karalynn understands the process of developing health policy in the U.S.? A. "Along with a description of the healthcare issue, I've also included a list of political considerations related to it." B. "I realize that you are the person who decides whether or not a healthcare solution becomes a law." C. "In addition to other considerations, I'm aware that a proposed solution's anticipated effectiveness must be evaluated." D. "I understand that meeting with citizens about healthcare issues is not part of your role, so I really appreciate your time."
A. "Along with a description of the healthcare issue, I've also included a list of political considerations related to it." B. "I realize that you are the person who decides whether or not a healthcare solution becomes a law." ***C. "In addition to other considerations, I'm aware that a proposed solution's anticipated effectiveness must be evaluated." D. "I understand that meeting with citizens about healthcare issues is not part of your role, so I really appreciate your time." Government officials evaluate proposed solutions based on several factors, including costs and benefits, anticipated effectiveness, efficiency, and safety. Government officials' roles include hearing citizens' concerns about healthcare needs, as well as gathering information about reported issues. Government officials are also responsible for identifying political considerations associated with each healthcare issue and proposed solution. Passage of proposed healthcare solutions into law is not the government official's choice; it is a process that requires collaboration between lawmakers and government officials and adherence to procedures.
As a leader of her unit's quality assurance committee, Lourdes Soto, a critical care nurse, has been conducting reviews of clients' electronic health records. Lately, she has been experiencing sore wrists and dry eyes. Lourdes asks her charge nurse how to avoid complications related to prolonged periods of computer use. What is the best response by the charge nurse? A. "Be sure to keep your wrists flexed when you're working at the computer." B. "Minor aches and pains are commonly caused by prolonged periods of computer work, but they will not lead to disability." C. "Taking a break when using the computer is an important preventive measure." D. "To prevent computer vision syndrome, do not spend more than 6 hours each day working on a computer."
A. "Be sure to keep your wrists flexed when you're working at the computer." B. "Minor aches and pains are commonly caused by prolonged periods of computer work, but they will not lead to disability." ***C. "Taking a break when using the computer is an important preventive measure." D. "To prevent computer vision syndrome, do not spend more than 6 hours each day working on a computer." Common complaints following prolonged computer use include pain or fatigue in the neck, shoulders, back, arms, wrists, and hands. While some of these symptoms can be alleviated by proper ergonomics or breaks from the computer, simple aches and pains can lead to more serious injuries that cause disability. When seated at a computer work station, the worker's thighs should be parallel to the floor and the feet should rest flat on the floor or be supported by a footrest. The forearms, wrists, and hands should be straight and in line. Computer vision syndrome, or eyestrain, is the most common consequence of prolonger computer use. Symptoms include eye fatigue, blurred vision, headaches, dry eyes, and impaired color perception. Individuals who use a computer for more than 3 hours per day are at risk for computer vision syndrome. Positioning computer monitors properly, applying antiglare screen covers, ensuring correct lighting, and using proper document placement can all help reduce the effects of computer vision syndrome. Simple measures such as taking breaks and blinking also are important.
Sari Li-Holt, an experienced pediatric nurse, is applying to become the director of pediatric nursing. During her interview, the hospital administrator asks, "What type of healthcare information system would you suggest using for analysis of risk management and quality performance?" Which response by Sari is the most appropriate? A. "My recommendation would be to use a clinical decision support system." B. "I would recommend using an electronic health records system." C. "I would recommend using a clinical information system." D. "My recommendation would be to use an administrative information system."
A. "My recommendation would be to use a clinical decision support system." B. "I would recommend using an electronic health records system." C. "I would recommend using a clinical information system." ***D. "My recommendation would be to use an administrative information system." An administrative information system provides support and management for the business aspects of health care, including human resources, financial data, materials management, risk management, and quality performance. An electronic health records system (EHRS) is one of many terms that are commonly used to describe the computerized medical record (CMR). Clinical decision support systems are a type of artificial intelligence that analyze data and provide information about evidenced-based practices. A clinical information system allows multiple disciplines to simultaneously access the client's chart and record data that can be viewed and analyzed by multiple healthcare providers in real time.
Sandy Johnson, a 48-year-old public relations executive, has come in for her scheduled annual exam. She compiled a list of questions about her health. Which question would likely trigger a secondary prevention activity? A. "My skin seems very dry and flaky. Is there anything I can do to fix that condition?" B. "Can I get some diet suggestions so that I can lose a few pounds in the next month?" C. "What can I do about my difficulty getting to sleep and staying asleep at night?" D. "Should I worry about being thirsty all the time and urinating more often?"
A. "My skin seems very dry and flaky. Is there anything I can do to fix that condition?" B. "Can I get some diet suggestions so that I can lose a few pounds in the next month?" C. "What can I do about my difficulty getting to sleep and staying asleep at night?" ***D. "Should I worry about being thirsty all the time and urinating more often?" A secondary prevention activity involves screening. Ms. Johnson's increased thirst and urination could signal diabetes, for which she will be screened. There are no routine screens for insomnia, diets, or dry skin.
The nurse educator is giving a presentation on the role and functions of specialty nursing practice organizations to a group of staff nurses. Which statement is the most appropriate for the nurse educator to include in the presentation regarding these organizations? A. "Responsibilities of specialty nursing practice organizations include strengthening members' personal identities." B. "Examples of specialty nursing practice organizations include the American Nurses Association (ANA)." C. "Specialty nursing practice organizations advance nursing practice in the affiliated specialty area." D. "A small number of nursing specialties are supported by a professional specialty practice organization."
A. "Responsibilities of specialty nursing practice organizations include strengthening members' personal identities." B. "Examples of specialty nursing practice organizations include the American Nurses Association (ANA)." ***C. "Specialty nursing practice organizations advance nursing practice in the affiliated specialty area." D. "A small number of nursing specialties are supported by a professional specialty practice organization." Most nursing specialties are supported by a professional specialty practice organization. These organizations advance nursing practice in the affiliated specialty area and support practitioners and their clients. Responsibilities of specialty nursing practice organizations include strengthening members' professional identities. As opposed to being a specialty practice organization, the American Nurses Association (ANA) is the only full-service professional organization representing the nation's 3.1 million registered nurses.
Mr. Thomas is a 38-year-old client who uses a wheelchair as a result of a motorcycle accident 7 months ago. He decided that he will continue his physical therapy, but he will not take any more of the medications prescribed for muscle spasms because they make him feel weak. The nurse has assessed Mr. Thomas and believes that he understands his situation and is making an informed decision, although his healthcare provider disagrees with his choice. Which statement by the nurse is most appropriate? A. "The Americans with Disabilities Act (ADA) protects your right to refuse medications." B. "The Patient Self-Determination Act (PSDA) protects your right to refuse medications." C. "The Affordable Care Act (ACA) protects your right to refuse medications." D. "The Health Insurance Portability and Accountability Act (HIPAA) protects your right to refuse medications."
A. "The Americans with Disabilities Act (ADA) protects your right to refuse medications." ***B. "The Patient Self-Determination Act (PSDA) protects your right to refuse medications." C. "The Affordable Care Act (ACA) protects your right to refuse medications." D. "The Health Insurance Portability and Accountability Act (HIPAA) protects your right to refuse medications." The PSDA protects the rights of clients to accept or reject aspects of their medical care. The ACA is healthcare law that provides for insurance and services. The ADA provides for access to public services, employment and benefits. HIPAA addresses health information privacy.
Karl Jentzenn, a nurse at a county health department, receives a telephone call from Stacie Retellaire, a 22-year-old woman who is 7 months pregnant. Ms. Retellaire reports that she is unable to afford food and asks where she should go to enroll in the Women, Infants, and Children (WIC) supplemental nutrition program. Which response demonstrates that Karl understands the services offered by government agencies? A. "We can connect you to the state health department, who can enroll you in the WIC program." B. "WIC is a federally-administered program, so you'll need to contact the U.S. Department of Health and Human Services (DHHS) to enroll." C. "WIC is administered through the state offices of emergency medical services (OEMSs), so you'll need to enroll through that department." D. "We can provide you with food through the WIC program."
A. "We can connect you to the state health department, who can enroll you in the WIC program." B. "WIC is a federally-administered program, so you'll need to contact the U.S. Department of Health and Human Services (DHHS) to enroll." C. "WIC is administered through the state offices of emergency medical services (OEMSs), so you'll need to enroll through that department." ***D. "We can provide you with food through the WIC program." Local departments of health usually administer the Women, Infants, and Children (WIC) supplemental nutrition program, which provides food assistance to pregnant women and children under age 5 who are at risk for malnutrition. State offices of emergency medical services (OEMS) provide citizens with access to high-quality emergency medical care by ensuring that local emergency medical services (EMS) systems comply with all applicable regulations.
The nurse makes a telephone call to a client who was recently discharged. The nurse wants to assess whether the client has read the discharge material and made appointments with the healthcare provider. Which dimension of advocacy is involved with this intervention? A. Following-up regarding care B. Advising about legal rights C. Enabling self-care D. Going above and beyond
***A. Following-up regarding care B. Advising about legal rights C. Enabling self-care D. Going above and beyond The nurse advocate is following-up, which is one of the four dimensions of advocacy. The other three are being a client advocate, providing resources, and going above and beyond. Routine calls are not going above and beyond. Enabling self-care and advising the client of legal rights are not included in the four dimensions of advocacy.
The public health nurse is discussing immunization choices with the parents of an infant. The parents have decided to decline routine vaccinations. What question could the nurse ask the parents to help them examine possible consequences oftheir choice? A. "How do you feel about your decision to withhold vaccinations?" B. "Do you know any other parents who are withholding vaccinations?" C. "How much research have you done about withholding vaccinations?" D. "What benefits do you foresee from withholding vaccinations?"
A. "How do you feel about your decision to withhold vaccinations?" B. "Do you know any other parents who are withholding vaccinations?" C. "How much research have you done about withholding vaccinations?" ***D. "What benefits do you foresee from withholding vaccinations?" To help the parents examine possible consequences of their choice, the nurse could ask about expected benefits. It is not helpful to challenge the parents about the research basis for their decision. Knowing other parents who have made the same decision does not honor the autonomy of these parents. Clarifying how the parents feel about their decision is different from helping them examine possible consequences.
Mrs. Rodriquez is a 32-year-old Hispanic client who is admitted to the hospital. Mrs. Rodriquez speaks English, yet her husband frequently answers for her and makes decisions about her care. The nurse notices that Mrs. Rodriquez seems to have chosen to have her husband make decisions for her. When caring for Mrs. Rodriquez, which statement by the nurse is most appropriate? A. "I think your husband is too controlling and this is a problem." B. "I understand that you and your husband have decided to let him speak for you." C. "I would like to refer you and your husband to counseling." D. "It is not appropriate for your husband to make your healthcare decisions."
A. "I think your husband is too controlling and this is a problem." ***B. "I understand that you and your husband have decided to let him speak for you." C. "I would like to refer you and your husband to counseling." D. "It is not appropriate for your husband to make your healthcare decisions." The nurse should practice culturally competent care by respecting the cultural values of the clients and advocating for those rights as needed. Telling the client that it is not appropriate for her husband to make her healthcare decision is not appropriate. There is no indication for the need for counseling. The nurse is passing judgment by telling the client that her husband is too controlling.
As the newly hired nurse in the fertility clinic, you feel your own success with in vitro fertilization (IVF) makes you a unique resource for clients. This morning, Helena and Chad Smythe, both 39-year-old accountants, have a scheduled appointment. They have been to the fertility clinic for several years. Each time Helena and her husband find out that the IVF was not successful, her mood spirals downward. Helena and Chad tell you that they have decided to adopt a child, rather than have Helena continue to suffer from increasing depression. "My wife's mental health is so important to me," Chad relates. Helena nods in agreement. Which response would show that you understand the ethical value of advocacy? A. "I would suggest that you try IVF one more time before you give up." B. "I understand why you don't want to continue with IVF and support you in that choice." C. "I kept trying and waited for new developments in IVF." D. "I would like to tell you about my experience with IVF."
A. "I would suggest that you try IVF one more time before you give up." ***B. "I understand why you don't want to continue with IVF and support you in that choice." C. "I kept trying and waited for new developments in IVF." D. "I would like to tell you about my experience with IVF." Advocacy is based on the best interests of the clients. If they have made the decision to stop trying IVF, you support their decision. Telling about your own experience is not advocacy. Suggesting continuing treatment or talking about new developments is not advocacy in the face of the clients' decision to stop treatment.
The nurse is assessing the cultural needs of an adult male client who states that he believes in the hot-cold theory. Which response by the nurse indicates understanding of the basis of this cultural belief? A. "What does this belief have to do with your health care?" B. "I am not familiar with this theory. Would you be willing to share more information about it with me?" C. "That is ridiculous and we cannot agree with this theory." D. "Is this the practice of voodoo?"
A. "What does this belief have to do with your health care?" ***B. "I am not familiar with this theory. Would you be willing to share more information about it with me?" C. "That is ridiculous and we cannot agree with this theory." D. "Is this the practice of voodoo?" Asking the client about his belief ensures that the nurse understands it. The nurse would not be judgmental or enforce beliefs onto the client, and using words like "ridiculous" is unacceptable and shows no cultural knowledge. Asking the client if the practice of the hot-cold theory is voodoo would indicate that the nurse does not have a cultural knowledge or understanding and would not make the client feel comfortable. Asking this client what his belief has to do with his health care would indicate that the nurse does not have an interest in incorporating the cultural beliefs of the client into a health care plan and would be inappropriate.
A client who is blind and has Parkinson disease is assigned a nurse to coordinate care from a number of specialists. What kind of framework is this assignment an example of? A. Client-focused care B. Team nursing C. Case management D. Managed care
A. Client-focused care B. Team nursing ***C. Case management D. Managed care The case management framework assigns a coordinator of care to assure continuity of care. Managed care takes place at the group, not the individual, level. Client-focused care would identify the client as the decision maker. Team nursing is used in hospital settings.
Which criteria are used to measure if a profession is autonomous? (Select all that apply.) A. Self-discipline B. Working conditions C. Self-regulation D. Self-governance E. Standards of practice
A. Self-discipline B. Working conditions ***C. Self-regulation D. Self-governance ***E. Standards of practice There are two criteria used to measure the autonomy of a profession. These criteria are self-regulation and standards of practice. Professional organization differentiates a profession from an occupation. Criteria of a professional organization include self-governance, self-discipline, and control over working conditions.
The nursing instructor is preparing a class for nursing students about types of insurance coverage. When describing private insurance coverage, which item should be included? A. Self-employment-based private insurance policies cover self-employed individuals and their family members. B. Group insurance coverage may be purchased through voluntary and membership associations, such as professional and trade groups. C. Employment-based private health insurance coverage may not be extended to include extended family members. D. Direct-purchase private insurance plans are usually less expensive and less restrictive than group coverage.
A. Self-employment-based private insurance policies cover self-employed individuals and their family members. ***B. Group insurance coverage may be purchased through voluntary and membership associations, such as professional and trade groups. C. Employment-based private health insurance coverage may not be extended to include extended family members. D. Direct-purchase private insurance plans are usually less expensive and less restrictive than group coverage. Employment-based private insurance plans are offered through an individual's employer or union. This type of coverage may be extended to include the spouse and dependents of the employee, as well as the employee's domestic partner. Group coverage may also be purchased through voluntary and membership associations, such as professional and trade groups, bar associations, local chambers of commerce, and AARP. Self-employment-based private insurance plans are available only to individuals who are self-employed and cover only that individual. Direct-purchase private insurance plans allow individuals who need private health insurance and who are ineligible for group coverage to purchase an individual policy. Individual health insurance policies are usually more expensive and coverage is more restricted than under group health coverage.