Nursing Issues Exam #2

A nurse has been studying Levenstein's characteristics of a profession. The nurse demonstrates adequate understanding when interpreting which of the following components as part of the model? a. A code of ethics b. A systematic, defined progression of education c. An accreditation process d. Publications or journal for the profession

A

A nurse manager believes that a nurse is taking breaks that are too frequent and lengthy. Which assertive statement should the charge nurse use to initiate a discussion of the issue? A."I understand you are allowed to take scheduled breaks during each shift, but you are taking more than the number allocated. Let's set a time when we can discuss this behavior." B."You are taking more breaks during each shift than hospital policy allows. You will need to take only the number of breaks specified and ensure you are back on time." C."You have been taking too many breaks during each shift and do not return on time after your break. I will have to make a formal note about this issue that will be reflected on your next performance appraisal." D."Why do you take so many breaks? Are you aware there is a policy that designates how many breaks you can take?"

A

A nurse manager notes that a full-time nurse has been absent from work 6 times over the last 6 weeks. Using a non punitive approach, which of the following actions should the nurse manager take? a. Verbally remind the employee about the facility's employment standards b. Recommend that the employee review the facility's policy regarding absences c. Inform the employee in writing about the facility's employment policy d. Ask the employee for a written action plan after discussing the reasons for these absences

A

A nurse receives the morning change-of-shift report and delegates several tasks to an assistive personnel (AP) on the team. Which of the following tasks should the nurse instruct the AP to perform first? A.Obtain the morning capillary blood glucose tests B.Bathe a client scheduled for physical therapy at 0900 C.Distribute the breakfast trays D.Fill pitchers with fresh water and ice

A

The clinical instructor interprets the development of mutual goals and guidelines as A. norming B. performing C. storming D. informing

A

The nurse interprets which characteristic as the forefront of discussion about nursing's professionalism? a. Education b. Altruism c. Social values d. Code of ethics

A

The nurse manager is updating unit staff on findings by The Joint Commission. Which of the following statements shows an understanding of untoward events in the hospital setting? The primary cause of untoward events isa. "unclear, ineffective communication." b. "unclear chain of communication for reporting." c. "ineffective reporting of the untoward event." d. "lack of consistent supervision of nursing staff."

A

The nursing manager on the cardiothoracic unit has noted increased friction among the nursing staff and physicians and is contemplating taking action to address the problem. What consideration is important when planning a response? A. An emotional bond among team members is important for successful teamwork B. Strong leadership will create an environment where team members must work together. C. Professionals need to be clear about disciplinary boundaries and expectations D. Nursing care should be determined solely by the nursing staff and evidence-based guidelines

A

What do the responsibilities of the nurse manager include? a. Planning and organizing how nursing care can most effectively be delivered b. Establishing the nursing care standards to be implemented on the unit c. Developing educational programs to assist staff to meet licensure requirements d. Assisting staff to adhere to organizational policies and procedures

A

Which action by the nurse shows a major characteristic of aggressive behavior? A. Achievement of personal goals at the expense of others B. Indirect expression of personal feelings C. Communication of personal needs D. Ability to restrict personal rights

A

Which statement would be most appropriate for the nurse to make when practicing assertive behavior? a. "I feel upset when Dr. Smith yells at me in front of my patients." b. "I can't believe what a jerk Dr. Smith is; the doctor should be fired!" c. "Dr. Smith was right in her action." d. "I am reporting Dr. Smith to the medical director."

A

Which term refers to the group member who watches others take the risks and responsibility for group input and agrees with everyone in the group? A. Mouse B. Motor Mouth C. Self-server D. Know-it-all

A

Which of the following assesses how nurses can control their profession? (Select all that apply.) a. Discussing issues on their lunch break b. Joining a professional organization c. Through publishing documents d. Being active in the state boards of nursing e. Keeping issues to themselves

B C D

A member of a nursing committee frequently disregards the rules of the group and feels that the rules do not apply to the member personally. The president of the committee recognizes this person as a A. critical conservative B. motor mouth C. self-server D. mouse

C

A nurse is caring for a client who has breast cancer and is scheduled for a mastectomy. The client tells the nurse she is concerned about how her partner will react to the procedure. Which of the following responses should the nurse make? A."I will inform your surgeon that you are having second thoughts." B."I think you should postpone the surgery until you are certain you want to have it done." C."Would you like me to have a member of a breast cancer support group visit you?" D."This is a common concern of women who will be undergoing a mastectomy."

C

A nurse is performing a safety audit on all equipment used on the unit. Which of the following items should the nurse identify as a safety hazard? A.An electrical cord that is taped to the floor B.A protective cover that is placed over an unused outlet C.An electrical cord that is frayed toward the plug D.An electrical plug that has 3 prongs

C

A nurse is preparing to care for a group of clients after receiving change-of-shift reports. Which of the following clients should the nurse assess first? A.A client who has benign prostatic hyperplasia (BPH) and reports dysuria B.A client who has ulcerative colitis and reports diarrhea C.A client who has emphysema and reports dyspnea D.A client who has esophageal cancer and reports painful swallowing

C

A nurse is teaching a newly licensed nurse about advanced directives. Which of the following statements by the newly licensed nurse indicates an understanding of this teaching? A."Clients are required to complete an advance directive prior to discharge." B."If the client has a health care proxy, he/she is no longer consulted for health care decisions." C."I will assess the client's understanding of life-sustaining measures." D."I will ask the next of kin if I should honor the client's advance directive."

C

A nurse is writing a telephone order for medication. Which written order is the safest? a. Furosemide (Lasix) 10.0 mg b.i.d."furosemide (Lasix) b. Furosemide (Lasix) 10 mg bid PO c. Furosemide (Lasix) 10 mg two times a day orally d. Furosemide (Lasix) 10 mg 2×/day by mouth

C

A nurse manager is participating in a root cause analysis following a sentinel event on the unit. Which of the following statements defines the purpose of a root cause analysis? A.A root cause analysis assists in preparing a legal defense for the event. B.A root cause analysis estimates the costs involved in the event. C.A root cause analysis investigates deviations from standards of care surrounding the event. D.A root cause analysis determines if employees involved in the event should be terminated.

C

An experienced nurse is precepting a new graduate. Prior to charting, the preceptor instructs the new nurse to do which of the following? a. Abbreviate as much as possible to keep records short. b. Do not use any abbreviations at all in patients' charts. c. Look up the facility's list of "do not use" abbreviations. d. Use only abbreviations seen in other nurses' charting.

C

The dean of the nursing school wants to integrate interprofessional teamwork into the curriculum. What action by the dean would best meet this goal? A. Ensure faculty are teaching components of interprofessional practice B. Deliver lectures to the students on interprofessional team dynamics. C. Work with the other professional deans on interprofessional health care. D. Organize a workshop on delivering interprofessional health care.

C

The nurse has an adequate understanding of the four major metaparadigms when making which comment to a colleague? "The four major metaparadigms are a. nursing, environment, health, and illness." b. nursing, environment, person, and society." c. person, environment, health/illness, and nursing." d. person, society, wellness, and health/illness."

C

The nurse interprets assertive behavior as A. apologetic B. coercive C. direct D. self-denying

C

The nurse is determining which professional organizations to join. The nurse demonstrates an adequate understanding of the International Council of Nursing (ICN) when stating which of the following? a. "The ICN handles domestic nursing issues." b. "The ICN is for international nurses only." c. "The ICN is focused on worldwide health care." d. "The ICN is focused on foreign issues only."

C

Which statement by the nurse manager shows understanding of what initiated the development of the team Strategies and Tools to Enhance Performance and Patient Safety (STEPPS)? a. "The increased need for health care coverage" b. "The need for more qualified nurses" c. "A need for improved communication and teamwork" d. "The increased cost of health care"

C

A charge nurse finds an increased incidence of health-care-associated infections (HAIs) on a long-term care unit. Which priority action should the charge nurse take to address the problem? A.Monitor the staff's hand hygiene techniques B.Hold a mandatory in-service training session about hand hygiene and infection rates C.Require nurses to take an online course on HAIs D.Conduct a chart review to gather data about clients who developed HAIs

D

A charge nurse is planning a performance appraisal for a newly hired assistive personnel (AP). Which of the following factors should the charge nurse take into consideration when planning a performance appraisal interview for the AP? A.The performance appraisal interview should be friendly and informal. B.Aside from the charge nurse, no one should have input regarding the AP's appraisal. C.A nursing administrator who does not know the AP should conduct the interview to promote fairness. D.The AP should have a copy of the performance standards before the appraisal interview.

D

A nurse enters a client's room and discovers a small fire in a trash can. Which of the following actions should the nurse take first? A.Place moist towels or blankets at the threshold of the door of the room with the fire. B.Close fire doors and doors to client rooms. C.Pull the fire alarm and notify the hospital operator. D.Move the client out of the room.

D

A nurse is having difficulty completing care and documentation without stating past the end of shift. The nurse manager suggests focusing on time-management skills. Which of the following strategies should the nurse plan to use? a. Practice multi-taking throughout the shift b. Postpone completing documentation until the end of the shift c. Occasionally skip a break time d. ID tasks in order of their priority

D

A nurse is meeting with the nurse supervisor to discuss an issue with a coworker. Which of the following statements would help the nurse effectively communicate with the supervisor? a. "This is all my coworker's fault. I never do anything wrong." b. "My coworker always makes 100 excuses to get out of work." c. "I knew you would be on their side." d. "I feel upset that my coworker seems to have less work than I do."

D

A nurse is prioritizing care for a group of clients. The nurse should plan to attend to which of the following clients first? A.A client who requires a sterile dressing change B.A client who requires gastrostomy tube feeding C.A client who requires urinary catheter care D.A client who requires endotracheal suctioning

D

A nurse manager notes that several staff members are late in completing an annual mandatory educational session about extremity restraint safety. Which of the following actions should the nurse manager plan to take? a. Make a general announcement at the next staff meeting asking all employees to check their adherence to the requirement b. Post a list in the employees' break room naming those whoa re non-adherent and the date by which they must complete the requirement c. Schedule a disciplinary conference with each of the non-adherent employees d. Send an email to each non-adherent employee that includes a link to upcoming educational sessions

D

A nurse manager observes a nurse entering the room of a client who is on contact precautions without donning personal protective equipment (PPE). Which of the following is the priority action for the nurse manager to take? A.Speak with the nurse in a private location. B.Complete an incident report. C.Review competencies with the staff members regarding PPE. D.Have the nurse exit the room and don proper PPE.

D

A nurse on a medical-surgical unit is planning the care of assigned clients. Which of the following clients should the nurse attend to first? A.A client who is newly admitted and is scheduled for indwelling urinary catheter insertion B.A client who has kidney stones and reports flank pain of 6 on a pain scale of 0-10 C.A client diagnosed with early stage chronic kidney disease with a serum creatinine level of 2.0 mg/dL D.A client who has a cast newly applied on the forearm and reports tingling of the fingers

D

Dr. Jones asks you to give a medication to one of the patients, and you know the patient is allergic to it. When you point this out, Dr. Jones says, "Give the medication or I'll report this to your supervisor." What is the best assertive response? a. Agree to give the medication and hope no one finds out. b. Say, "I won't give the medication, and I don't care who you talk to about it." c. Walk away and ignore Dr. Jones. d. Say, "Perhaps you and I could talk this over with my supervisor together."

D

In the 1950s, belonging to a professional organization was popular. What has contributed to the decline in membership of the American Nurses Association? a. The ANA has increased membership dues that nurses cannot afford. b. Nurses do not want to be associated with an organization that represents unions. c. The association does not have state and local organizations. d. The increase in popularity of specialty organizations

D

The graduate nurse has an adequate understanding of effective listening when stating which of the following? A. "Limited level of vocab often affects listening skills." B. "Underdeveloped attention span affects listing skills." C. "External noise distractions affect listening skills." D. "Emotional reactions interfere with the actual message."

D

The nurse is using assertive communication skills to express self-rights when stating which of the following? A. "I shield others from my anger." B. "I do not compromise." C. "I am avoiding direct confrontation." D. "I am responsible for what I say."

D

The nurse receives report on an assigned group of patients. Which patient would the nurse assess first? a. A patient 2 days postoperative who is complaining of pain b. An older adult patient reported to have increasing lethargy and confusion c. A newly admitted patient with a serum blood urea nitrogen (BUN) of 32 mg/dL d. A hypertensive patient complaining of severe mid-sternum pain

D

The student nurse has an adequate understanding of nursing theory when correctly identifying which individual as the first nurse theorist? a. Peplau b. Rogers c. Leininger d. Nightingale

D

Which of the following assesses how nursing has relevance to social values? a. Nurses have professional degrees. b. Nurses perform community service. c. Nursing licensure requires a baccalaureate degree. d. Nurses are teachers of health promotion and wellness.

D

Which of the following organizations would the nursing advisor recommend that the nursing to best meet the student's current needs? a. National League for Nursing b. American Nurses Association c. International Council of Nurses d. National Student Nurses Association

D

Which of the following predicts the outcome if the nursing profession continues to be devalued by demeaning or comical images of nurses? a. Nurses will be able to request higher wages. b. The nursing shortage will end. c. There will not be enough jobs for new graduates. d. The nursing shortage will extend.

D

Which statement by the nurse shows understanding of the primary advantage in using the group process in decision making? "The process a. increases the time spent discussing alternatives." b. eliminates opposition to decisions by administrators." c. allows additional time for the planning process." d. promotes acceptance of the decision by the group."

D

While participating in a continuous quality-improvement program, a nurse is reviewing medical records to determine the time of first postoperative ambulation of clients who had abdominal surgery. In which type of quality audit is the nurse participating? A.Outcome B.Structure C.Strategic planning D.Process

D

Which of the following describe reward power used by the nurse manager? (Select all that apply.) a. A nurse manager who allows employees to initiate schedule changes b. A nurse manager who uses salary increases to motivate staff c. A nurse manager who is perceived as an expert due to specialized knowledge d. A nurse manager who is well liked by the majority of staff e. A nurse manager who has information that others need to perform their jobs

A B

Which actions by the nurse can help create a professional image? (Select all that apply.) a. Maintain effective communication skills. b. Maintain a positive attitude. c. Maintain a professional appearance. d. Be prepared to interact with the public. e. Keep one's head down and opinions to one's self.

A B C D

Which of the following actions is consistent with a manager? (Select all that apply.) a. Planning the agenda for a staff meeting b. Directing nurse assistants in how to divide up patient-care assignments c. Organizing a group of nurses to present a topic at a staff meeting d. Giving blood at the local hospital blood drive e. Assume control of the guidelines for how hourly rounding will work on the unit

A B C E

A nurse manager is in the planning phase in a new job. Which actions show this? (Select allthat apply.) a. Developing goals that reflect the mission and vision of the organization b. Defining strategies to meet the mission and vision of the organization c. Providing direction for staff to perform the work of the organization d. Retaining accountability for all work completed by the staff e. Planning for contingencies that may interfere with the work of the organization

A B E

A nurse manager is delegating a task to another nurse. Which of the following action(s) would help the manager effectively communicate with the nurse? a. Get the full attention of the nurse. b. Ask the nurse to repeat back what he or she heard. c. Believe the nurse has understood if there are no questions. d. Give clear, simple instructions. e. Give instructions while multitasking.

A, B, D

Which of the following actions can the nurse take to communicate with the supervisor? (Select all that apply.) a. Keep the supervisor informed. b. Focus on problem solving. c. Use "you" statements. d. Calm down before speaking. e. Choose words wisely.

A, B, D, E

A nurse manager is evaluating the time-management strategies of a newly licensed nurse on the peds unit. Which of the following actions taking by the nurse are effective time-management strategies? (select all that apply) a. Completing one task before beginning another task b. Documenting client care at the end of the shift c. Taking time to plan care at the beginning of the shift d. Completing more time-consuming tasks at the end of the shift e. Mentally visualizing a procedure prior to gathering equipment

A, C, E

A charge nurse is performing a quality-assurance audit on the documentation of several clients' charts. Which of the following documentation items should the charge nurse identify as a correct entry in the client's medical record? A."The client appeared angry when family members were visiting." B."The client ambulated for 10 min three times during the shift." C."The client seemed to be upset about the diagnosis." D."An incident report was completed when the client fell at 1000."

B

A nurse and health care provider are talking in the hallway about a patient's condition. The health care provider says that the patient needs an x-ray. Which action by the nurse is most appropriate? a. Document the order and facilitate the patient having the x-ray. b. Explain that you will call x-ray when the health care provider inputs the order. c. Inform the health care provider that verbal orders are prohibited now. d. Repeat the order to the health care provider and document it in the chart.

B

A nurse is assigned to care for five patients. The nurse is concerned about the ability to care for this many patients. The nurse needs to a. delegate one of the patients to someone else. b. prioritize the needs of the patients and determine the sickest patient. c. report this situation to the charge nurse. d. do the easiest patients first to allow more time for sicker patients.

B

A nurse is caring for a child who has sustained extensive head injuries. The provider has diagnosed brain death. Which of the following statements should the nurse use to begin a conversation about the option of organ and tissue donation with the child's parents? A."I want to talk to you about the importance of considering the donation of your child's organs for transplantation." B."I want to give you some information about an option that you have regarding donating your child's organs to others who are in need." C."I am legally required to inform you that you can donate your child's organs for transplantation." D."Have you ever considered donating your organs for transplantation?"

B

A nurse is caring for an adult client who has pancreatitis. The client tells the nurse, "I've decided that I want to go home. I don't want any more treatment." The nurse should recognize that which of the following legal principles applies to the client? A.The admitting provider needs to approve the client's request to leave. B.The client has the right to make the decision to leave the hospital. C.The client should be detained if leaving presents a risk of loss of life or limb. D.The client must demonstrate self-care abilities prior to leaving the acute-care facility.

B

A nurse is discussing with a newly licensed nurse about how to obtain informed consent from a client who is scheduled to undergo an epidural procedure. Which of the following ethical principles should the nurse include in the teaching? A.Beneficence B.Autonomy C.Paternalism D.Justice

B

A nurse manager establishes staff nurse committees to address unit issues, institutes an open-door policy for speaking about concerns, and supports professional staff development. Which of the following leadership styles is this nurse manager displaying? A.Laissez-faire B.Democratic C.Autocratic D.Transactional

B

A nurse wishes to incorporate Dorothea Orem's theory into practice. Which action by the nurse encompasses this theory? a. The nurse completes the AM care for a patient. b. The patient gets dressed with help from the nurse aide. c. The patient knows his or her own medication dosages and what time they are due. d. The patient's spouse assumes all responsibility for the patient's medications.

B

During clinical experience, the student nurse is assigned a patient scheduled to undergo numerous treatments. The student decides it is not possible to complete all the needed treatments in the time scheduled for this clinical day. The student nurse consults with the clinical instructor to a. delegate. b. prioritize. c. procrastinate. d. do the easiest treatment first.

B

Staff nurse 1: "You're stomping around and glaring at me. I'm wondering what's going on." Staff nurse 2: "I'm sick of you always going to lunch first. You don't care about anyone but yourself." What assessment can best be made about this exchange? a. Staff nurse 1's remark is challenging and obstructive. b. Staff nurse 1's remark invites clarification of the meaning of the specific behaviors of staff nurse 2. c. Staff nurse 2's remark will facilitate effective problem solving. d. Staff nurse 2's remark will keep anger at a minimum and give incentive for meeting the other's needs.

B

The instructor has suggested that the student nurse could improve organizational skills and manage time better by scheduling selected nursing activities in the daily assignment. Which activity should be scheduled? a. Suctioning the tracheostomy tube of a patient b. Administering medications c. Assessing patient knowledge of colostomy care d. Assisting a patient with personal hygiene

B

The nurse understands the importance of the Employee Retirement Income Security Act(ERISA) of 1974 when stating which of the following? a. "It provided a standard of practice for nursing." b. "It allowed professional nursing organizations to act as unions on behalf of member nurses." c. "It established the framework for political action in legal activities" d. "It financially supports research in nursing and education."

B

Which action shows the cyclical phase of forming? A. A group dissolving B. Individuals coming together with a common bond C. Developing mutual goals D. A group completing tasks together

B

Which of the following actions by the nurse leader is most likely to lead to an effective meeting? A. Creating an atmosphere in which people say very little B. Sending out an agenda ahead of time C. Creating well-designed overhead transparencies D. Completing all the tasks of the group

B

Your team leader reminds you that you have forgotten to complete an assigned task. What is an assertive response? a. "Not now; I'm busy." b. "You're right. I did forget. I'll do it now." c. "It's not my fault. You should have reminded me sooner." d. "I'm so sorry I've disappointed you. It won't happen again."

B