Professional Role Final Exam

A team comprised of nurses and healthcare providers is collaborating to create a policy related to organ transplantation. Which team​ member's statement best represents an ethical​ concern? 1. ​"Clients who undergo organ transplantation must give informed​ consent." ​2. "Client teaching for potential organ transplantation candidates should include the​ client's family​ members." ​3. "Potential candidates for organ transplantation should undergo blood​ tests." ​4. "The client's ability to pay for treatment should influence the plan of​ care."

4 An ethical concern is best illustrated by issues related to whether the​ client's ability to pay should influence the plan of care. Standardizing blood tests for all potential candidates does not reflect an ethical concern. Including a​ client's family members in the teaching process is a principle of client education. Obtaining informed consent prior to a surgical procedure is a standard requirement.

On which preventive measures should an OSHA reviewer focus when conducting a site​ inspection? ​ (Select all that​ apply.) 1. Location of staff break room 2. Ratio of nursing staff to assigned clients 3. Presence of​ puncture-resistant sharps containers 4. Compliance with hand hygiene procedures 5. Use of gloves when caring for clients

3, 4, 5 When conducting an inspection within a healthcare​ organization, OSHA will focus on preventive measures such as hand hygiene​ procedures, use of gloves when caring for​ clients, and the presence of​ puncture-resistant sharps containers. OSHA does not address location of staff break room or staffing levels.

Marc Jaspersen is the clinical instructor for a group of students who are doing their pediatric rotation. Of this group of​ students, only​ one, Benita​ Moore, is a parent. Marc observes that Benita often dismisses comments and observations made by her​ peers, saying things​ like, "You would know that if you had​ children," and,​ "I understand this better because​ I'm a​ parent." What attitude is Benita​ exhibiting? 1. Pessimism 2. Insubordination 3. Arrogance 4. Optimism

3. Arrogance

Which nursing behavior can help reduce a client​'s risk of developing a​ healthcare-associated infection​ (HAI)? 1. Review common side effects of medications. 2. Discuss drug interactions with food. 3. Ensure walkways are clear. 4. Perform thorough hand washing.

4 Nurses can help prevent HAIs by performing thorough and adequate hand hygiene. Reviewing common side effects of medications and discussing drug interactions with food are actions to prevent medication errors. Ensuring walkways are clear is an action to prevent falls.

The nurse is planning interventions to address the National Patient Safety Goal of correct client identification. Which nursing action supports this​ goal? 1. Placing the client​'s name on the room door 2. Asking the client to state their middle name 3. Matching the name on the client​'s wrist band with the medical administration record 4. Writing the client​'s first name next to the assigned staff on the assignment sheet

3 The Joint Commission creates safety goals for every care delivery setting. These goals focus on specific areas in which safety issues arise while delivering client care. One area of focus for acute care hospitals is correct client identification. Placing the​ client's name on the room door is not an acceptable way to identify a​ client, as this violates privacy. Asking the client to state their middle name and writing the​ client's first name on a staff assignment sheet are not acceptable ways to correctly identify a client. The acceptable way to identify a client is to match the name on the​ client's identification band with the name on the medication administration record.

The nurse educator is instructing a group about Madeleine Leininger​'s theory of culture care diversity and universality. The educator asks for an example of culture care repatterning​ and/or restructuring. Which student response is the most​ appropriate? 1. The nursing interventions support the client in acting in accordance with his cultural beliefs. 2. The nursing interventions help the client adapt to the members of the multidisciplinary care​ team, which helps the client achieve the best possible care. 3. The nursing interventions help the client retain her specific cultural values. 4. The nursing interventions help a client evaluate and change his tobacco​ use, which promotes improved health outcomes.

4 Culture care repatterning​ and/or restructuring requires that caregiver interventions support clients in evaluating and changing their approaches to promote improved health outcomes. Culture care accommodation​ and/or negotiation require that caregiver efforts assist clients in adapting to or working with others to achieve the best possible care. Culture care preservation​ and/or maintenance require that the caregiver​'s actions and choices support clients in retaining their specific cultural values and beliefs.

Which agency serves as the official central governmental hub for all HIPAA​ issues? 1. The Joint Commission​ (TJC) 2. Agency for Healthcare Research​ & Quality​ (AHRQ) 3. Department of Health and Human Services​ (DHHS) 4. National Institutes of Health​ (NIH)

3 The Department of Health and Human Services​ (DHHS) serves as the official central governmental hub for all HIPAA issues. The​ NIH, AHRQ, and The Joint Commission are not the HIPAA hub.

In the phrase​ "healthcare advance​ directive," the word​ "advance" has a specific meaning. What does that word​ mean? 1. At a higher level 2. A legal document 3. Using personal values 4. Ahead of time

4 In the phrase​ "healthcare advance​ directive," the word​ "advance" has a specific meaning. What does that word​ mean?

Which description is a characteristic of professional​ values? 1. Influence by insight into clients​' values 2. Insight into how actions influence values 3. Influence by cultural norms 4. Development of socialization to nursing by nursing school faculty

4 One of the ways that professional values are developed is by socialization to nursing by nursing school faculty. Other ways include 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.

Which statements best reflect Western cultural views of asking for help as part of​ self-care? ​(Select all that​ apply.) 1. Asking for help when needed is commonplace in Western culture. 2. In Western​ culture, seeking social support tends to be viewed as a sign of strength. 3. In Western​ culture, coping styles usually are not subject to judgment. 4. Western cultural beliefs may influence an individual to practice ineffective​ self-care. 5. Autonomous coping is highly valued in Western culture.

4, 5 In Western​ culture, autonomous coping is highly valued. As​ such, seeking social support may be viewed as a sign of weakness. To avoid appearing to be​ weak, individuals influenced by Western culture tend to avoid asking for help when​ needed; ineffective​ self-care may result.

Which characteristics are most likely to be demonstrated by the​ self-aware nurse? ​(Select all that​ apply.) 1. Absence of personal limitations and weaknesses 2. Ineffective emotional control 3. Ability to identify personal strengths 4. Capacity to respect others 5. Recognition of prejudices that can impair judgment

3, 4, 5 The​ self-aware nurse recognizes the​ assumptions, beliefs,​ values, and prejudices that can impair judgment. In​ addition, the​ self-aware nurse is capable of identifying personal strengths and is aware of personal limitations and weaknesses. The​ self-aware nurse is capable of​ understanding, respecting, and empathizing with others and is likely to demonstrate effective emotional control.

What is a difference between morality and​ ethics? 1. Ethics refers to​ private, personal standards of right and​ wrong; morality covers a broader range of standards. 2. Ethical situations are described with words like ought and ​should moral situations don​'t use those words. 3. Morality refers to​ private, personal standards of right and​ wrong; ethics covers a broader range of standards. 4. Moral situations are described with words like ought and ​should ethical situations don​'t use those words.

3 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

The critical care nurse is conducting a physical assessment on a sedated client who is tracheally intubated and requires mechanical ventilation. Before the nurse places the diaphragm of his stethoscope on the​ client's abdomen, he​ states, "Mr.​ Ryhlman, I'm going to listen to your stomach now. My stethoscope might be a little bit​ cold." Which way of knowing is best reflected by the​ nurse's actions? 1. Ethical knowing 2. Empirical knowing 3. Personal knowing 4. Aesthetic knowing

3. Personal knowing

A client is admitted to the hospital for an organ transplant. At the time of​ admission, the nurse asks the client if there is a current advance directive. The client states that there is a completed​ one, but a copy is not available. Which response by the nurse is the most​ appropriate? 1. You must fill out a new advance​ directive, so that we can put it into your chart. 2. You are required to revise your advance directive in view of your upcoming surgery. 3. You can give us a copy any time that is convenient for you. 4. You need to give us a copy before you have the transplant surgery.

3 The appropriate response from the nurse is that the client can supply a copy of the advance directive when convenient. A copy is not needed before​ surgery, a new form does not need to be filled​ out, and the fact of the upcoming surgery does not require document revision.

A representative from NIOSH is scheduled to visit a healthcare organization. What should the staff expect to receive from the representative during the​ visit? ​(Select all that​ apply.) 1. Training videos 2. Recommendations for safety procedures 3. Safety information 4. Results of workplace safety hazard evaluations 5.Report of the number of organizational injuries

1, 2, 3, 4 NIOSH conducts research studies with the intention of improving safety in the workplace and the general population. NIOSH also develops recommendations for safety​ procedures, distributes​ information, provides training​ videos, and evaluates workplace health hazards. OSHA would have the statistics about the number of organizational injuries.

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? 1. Justice 2. Autonomy 3. Veracity 4. Beneficence

3. Veracity

Which way of knowing encompasses the​ "art of​ nursing"? 1. Aesthetic knowing 2. Personal knowing 3. Ethical knowing 4. Empirical knowing

1 Aesthetic knowing encompasses the​ "art of​ nursing." Empirical knowing encompasses the​ "science of​ nursing." Ethical knowing is reflective of the​ "moral component" of nursing knowledge. Personal knowing refers to the​ nurse's ongoing​ self-exploration and journey toward​ self-actualization.

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? 1. Alert the primary healthcare provider regarding the​ client's status 2. Read the informed consent to the client and allow the client to rest 3. Have the client sign the consent form without delay 4. Delay informed​ consent, perform a pain​ assessment, and administer medication

1. Alert the primary healthcare provider regarding the​ client's status

During a staff meeting the nurse manager provides information about the client care studies conducted on the​ medical-surgical unit. Which competency is the manager helping the staff​ achieve? 1. Teamwork and collaboration 2. Quality improvement 3. Informatics 4. Safety

2 A skill associated with the competency of quality improvement is studying the outcomes of quality improvement reports. The competency of informatics uses information and technology to further client care and safety efforts. The competency of safety minimizes the risk of dangerous or harmful situations with clients and other healthcare​ professionals, reduces​ healthcare-associated infections, and decreases the possibility for errors in client care. The competency of teamwork and collaboration means that the nurse works effectively with other departments and​ shifts, is accountable for participation as a team​ member, and engages in conflict resolution as needed.

Which conditions or behaviors are most likely to be exhibited by an individual who is​ bullied? ​(Select all that​ apply.) 1. Socialization 2. Anxiety 3. Depression 4. Emotional distress 5. Workaholism

2, 3, 4 For individuals who are​ bullied, effects may include emotional​ distress, anxiety, a sense of​ isolation, depression, and increased work absenteeism.

Ashlee​ Demaris, a certified nurse​ midwife, is reviewing the​ AHA's patient responsibilities with Lara​ Kingston, a​ 19-year-old client who is 34 weeks gestation. As Ashlee is​ speaking, Ms. Kingston interrupts and​ says, "I get it.​ You're in​ charge, and I have to do what you tell​ me." Which response by the nurse midwife is the most​ appropriate? 1. ​"Patient responsibilities are designed to help you and your care providers work together as a​ team." ​2. "Patient responsibilities are intended to help keep you and members of your healthcare team safe and​ comfortable." ​3. "Patient responsibilities are established to make sure you know you can refuse care without suffering any​ consequences." ​4. "Patient responsibilities are meant to help you understand that you are entitled to​ respectful, courteous​ care."

1. ​"Patient responsibilities are designed to help you and your care providers work together as a​ team."

Ten years​ ago, 20-year-old college junior Margo Harrison discovered a lump in her breast. Worried about its​ significance, she completed her​ state-specific documents for an advance directive. The biopsy proved negative. Since​ then, she has​ graduated, gotten​ married, and moved to another state. What is the likely status of her advance​ directive? 1. Since Ms. Harrison is still​ competent, she does not have to review and update it. 2. Since the biopsy proved​ negative, it cancelled Ms.​ Harrison's advance directive. 3. The advance directive document expired when Ms. Harrison moved. 4. Since Ms. Harrison moved and​ married, she should investigate her new​ state's format.

4. Since Ms. Harrison moved and​ married, she should investigate her new​ state's format.

The nurse is explaining The Joint Commission​'s patient rights to the client. Which statement by the nurse is the most​ accurate? 1. If something goes wrong with your​ care, you have the right to know about it. 2. The client must know the educational level of all healthcare providers. 3. If you refuse​ care, the list of client rights no longer applies to you. 4. You have the right to receive pain medication if you are experiencing pain.

1 According to The Joint​ Commission, clients have the right to know if something goes wrong with their care. The Joint​ Commission's patient rights require that client complaints of pain be​ addressed, but do not specify particular methods of treatment. Refusal of care is a client right and does not nullify the​ client's other rights. The client should be aware of who is providing care​ (RN, LPN,​ UAT, NP,​ MD), but not their level of education.

While preparing medications for​ administration, the staff nurse is repeatedly interrupted by the charge​ nurse, as well as by clients who are requesting assistance. Due to being​ distracted, the staff nurse accidentally crushes a tablet that cannot be administered in crushed form. Immediately​ afterward, the staff nurse notifies the charge​ nurse, disposes of the destroyed medication per the hospital​'s ​protocol, and resolves to delegate appropriate tasks to the nursing assistant while preparing and administering the client​'s medications. Which work ethic principle best describes the staff nurse​'s ​behavior? 1. Accountability 2. Optimism 3. Arrogance 4. Reliability

1 Accountability involves accepting responsibility for​ one's actions without blaming others. By reporting the medication preparation error to the charge​ nurse, following protocols for disposing of the​ medication, and forming a plan to prevent the error from happening again instead of blaming the charge nurse or the clients for the​ distraction, the nurse demonstrated accountability. Reliability includes following through on​ commitments, accepting​ assignments, and completing assignments. Optimism is an attitude that is reflective of a belief that circumstances will turn out for the best. Arrogance is a feeling of superiority or excessive pride.

Which behavior best illustrates the impact of inadequate​ self-awareness on the nurse​'s ability to care for​ others? 1. Lack of empathy toward a client 2. Inability to speak the client​'s language 3. Lack of support from nursing team members 4. Failure to recognize a dangerous cardiac rhythm

1 Lack of empathy toward a client best illustrates the impact of inadequate​ self-awareness on the nurse​'s ability to care for others. Failure to recognize a dangerous cardiac rhythm best illustrates the impact of lack of relevant knowledge. Inability to speak the client​'s language is a cultural barrier. Lack of support from nursing team members best reflects impaired interpersonal caring between nursing colleagues.

The nurse educator is teaching about ethical dilemmas related to​ end-of-life issues. When discussing assisted​ suicide, which statement is appropriate for the nurse educator to​ include? 1. ​"Assisted suicide is a variant form of active​ euthanasia." ​2. "Assisted suicide involves taking actions to directly cause​ death, with or without client​ consent." ​3. "Assisted suicide includes administering a lethal dose of medication to end a​ client's suffering." ​4. "Assisted suicide is illegal throughout the entire United​ States."

1 Assisted​ suicide, which is a variation of active​ euthanasia, involves giving clients the means to kill​ themselves, if they request it. Examples of assisted suicide include providing a client with medications or a weapon. Some countrieslong dash—as well as some states in the United Stateslong dash—legally allow assisted suicide for severely ill clients who are near death and who wish to commit suicide. Even​ so, the​ ANA's position statement on assisted suicide states that nurses who perform active euthanasia or who participate in assisted suicide are in violation of the ANA Code of Ethics for Nurses. Euthanasia may include administering a lethal dose of medication to end a​ client's suffering. Active euthanasia involves taking actions to directly cause a​ client's death, with or without client consent.

In which circumstance is it the most appropriate for a​ 17-year-old client to provide informed consent for​ care? 1. Receiving contraceptive services without a parent present 2. Receiving antibiotics for strep throat with a parent present 3. Bringing a younger sibling to a health assessment visit 4. Bringing a grandparent to an urgent care center for a flu shot

1 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 clinical nursing instructor is identifying strategies for promoting intergenerational collaboration between nursing students and staff nurses in the clinical setting. Which strategy is most appropriate for the nursing instructor to implement among the nursing​ students? 1. Acknowledging the value and contribution of each individual member of the nursing care team 2. Promoting competition to help the nursing students build their confidence and​ self-esteem 3. Encouraging the nursing students to recognize their superiority due to advanced knowledge about technology 4. Discouraging the nursing staff from talking about conflicts related to generation gaps

1 Characteristics and behaviors of effective multigenerational teams and their individual members include mutual support and​ positive, optimistic attitudes. As opposed to​ competition, cooperation and collaboration should be emphasized. Rather than promoting any​ individual's or​ group's superiority, effective multigenerational team members acknowledge each team​ member's worth. Effective conflict​ resolution, which is needed to build an effective multigenerational​ team, requires​ professional, constructive discussion about conflicts.

As the nurse is discharging a​ client, the client​ states, open double quote"You​'ve been a great nurse. You​'re knowledgeable and​ skilled, and you have a great attitude. You​'re a real professional.close double quote" Which nursing caring behavior or process is the client best​ describing? 1. Competence 2. Compassion 3. Presencing 4. Empowerment

1 Competence is the nurse​'s ability to effectively demonstrate a set of​ attributes, such as professional attitude and​ knowledge, skills, and​ values, and to fulfill her professional responsibility through nursing practice. Empowerment assists the client to autonomously identify her own health needs in lieu of being instructed how to do so. Compassion develops as a result of being directly involved with the client​'s experience. Presencing involves the nurse​'s immersion in a nursedash-client interaction that helps the client define her health choices while understanding the client​'s authority to make her own decisions.

In the context of​ Leininger's theory of culture care diversity and​ universality, which statement best describes culture care accommodation​ and/or negotiation? 1. Caregiver efforts assist the client in adapting to or working with others to achieve the best possible care Your answer is correct. 2. Caregiver choices promote the​ client's retention of particular cultural beliefs 3. Caregiver interventions support clients in evaluating and changing their approaches to promote improved health outcomes 4. Caregiver actions support the client in maintaining specific cultural values

1 Culture care accommodation​ and/or negotiation require that caregiver efforts assist clients in adapting to or working with others to achieve the best possible care. Culture care preservation​ and/or maintenance require that the​ caregiver's actions and choices support clients in retaining their specific cultural values and beliefs. Culture care repatterning​ and/or restructuring require that caregiver interventions support clients in evaluating and changing their approaches to promote improved health outcomes.

Which statement best describes caring in the context of​ nursing? 1. Caring extends beyond implementing interventions or feeling interest or concern. 2. Concern for the​ client's well-being equates to​ safe, proficient client care. 3. Implementation of nursing interventions always reflects concern for the​ client's well-being. 4. Client care is synonymous with caring.

1 In the context of​ nursing, caring extends beyond simply implementing interventions or feeling interest or concern. In​ nursing, the term​ "care" often equates to​ behaviors, which may or may not reflect caring. In​ particular, client care comprises the implementation of collaborative and independent nursing interventions. Nursing interventions can be implemented even in the absence of genuine interest or concern for the​ client's well-being.​ Likewise, genuine interest or concern for the​ client's well-being does not necessary equate to​ safe, proficient client.

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? 1. Counsel client about risks of addictive behavior 2. Ask for support from a supervisor 3. Plan on further assessment 4. Ask for support from peers

1 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.

The nurse preceptor is explaining the nurse​'s responsibility with regard to ethical dilemmas. Which statement should be​ included? 1. The nurse must tell the client and the healthcare team about ethical issues that may affect the client​'s care. 2. Evaluating interventions taken to promote ethical practice is the nurse unit manager​'s responsibility. 3. The nurse should try to​ follow, when​ possible, an appropriate code of ethics for registered nurses. 4. Avoiding actual or potential ethical dilemmas is a primary responsibility of the nurse.

1 Nursing responsibilities with ethical dilemmas include informing the client and care team members of the ethical issues affecting the​ client's care. The nurse should always adhere to an appropriate code of​ ethics, should recognize actual or potential ethical​ dilemmas, and evaluate the outcomes of interventions taken to promote ethical practice.

Which statement by the nurse best describes personal​ knowing? 1. Knowledge is a journey toward ​self-actualization. 2. My client care is moral and ethical. 3. Nursing is a science. 4. During client​ care, I incorporate what I know about the art of nursing.

1 Personal knowing refers to the nurse​'s ongoing​ self-exploration and journey toward​ self-actualization. Aesthetic knowing encompasses the open double quote"art of nursing.close double quote" Empirical knowing encompasses the open double quote"science of nursing.close double quote" Moral and ethical care reflects ethical knowing.

The nursing student is writing a paper about the relationship between safe client care and sources of ethical conflict in the healthcare setting. Which source of ethical conflict should the nursing student determine is the most significant to client​ safety? 1. Staffing shortages 2. Cost containment 3. Specialists​' services 4. Resource allocation

1 Staffing​ shortages, resource​ allocation, specialists'​ services, and cost containment are all potential sources of ethical conflict in the healthcare setting.​ However, staffing shortages represent a critical​ concern, as numerous studies link staffing levels to safe client care.

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? 1. The American Nurses Association​ (ANA) Standards of Practice 2. National counsel licensure 3. Accreditation certification 4. The Nurse Practice Act

1 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.

What action should the nurse take to transfer a​ bed-bound client from the bed to a​ chair? 1. Attach a mechanical device 2. Pivot to the chair from the side of the bed 3. Use a slide board 4. Ask for assistance by other staff members

1 The Nurse and Health Care Worker Protection Act of 2009 is intended to prevent injuries to​ nurses, other healthcare​ workers, and clients through the use of mechanical devices to move clients unless contraindicated for the client. Asking others for help will not ensure safety for the client or all workers. Using a slide board may or may not be appropriate for the​ bed-bound client. Pivoting from the bed to the chair will not ensure safety for the client or nurse.

The employee health nurse is preparing a presentation for new hires at a local hospital and wants to provide education on injuries that must be reported to OSHA. Which reportable injury would the nurse include in the​ presentation? 1. A nurse who lost three days of work because of tripping over a cord in the hallway 2. A client who developed a​ healthcare-associated urinary tract infection 3. A client who received the correct medication at the wrong time 4. A nurse who experienced a needlestick requiring first aid

1 The incident involving the nurse losing three workdays due to an on the job injury is reportable to OSHA. OSHA mandates that injuries that result in loss of workdays must be reported. The nurse who experienced a needlestick injury which required first​ aid, the client who developed a​ healthcare-associated urinary tract​ infection, and the client who received a medication at the wrong time would not be reported to OSHA.​ However, all these incidences require proper documentation according to hospital policy.

The manager is evaluating the impact of an educational program on the frequency of​ work-related injuries experienced by the nursing staff. Which observation indicates that additional training is​ necessary? 1. Nursing assistant independently repositioning and pulling a client up in a hospital bed 2.Nursing assistant using a cart to distribute newly filled water pitchers to clients 3. Staff nurse placing intravenous fluids on the medical cart to use while passing medications 4. Staff nurse releasing the breaks on a stretcher before transporting a client to the elevator

1 The most common injuries in nursing are sprains and strains to the back followed by injuries to the shoulder and knee. The most common cause of these injuries is from lifting heavy objects. Healthcare staff can experience​ back, shoulder and knee injuries through common activities such as moving clients from one location to​ another, relocating​ equipment, or carrying​ client-care objects to the bedside. Pulling a client up in bed without assistance could cause a back or shoulder injury. Using a medication cart for intravenous fluids would not lead to an injury. Removing the breaks on a stretcher before moving a client would not lead to an injury. Using a cart to distribute filled water pitchers would not lead to an injury.

An emergency department​ (ED) nurse is approached by the parents of a teen admitted with a uterine hemorrhage. open double quote"Is my daughter ​pregnant?close double quote" the father asks. What is the most appropriate response by the nurse to the client​'s ​father? 1. I cannot discuss her medical condition with you. All of our clients have privacy rights. 2. I know this situation must be hard for you to deal with. I will let you know when I find out the answer. 3. I don​'t think you have anything to worry about. She is a lovely young woman. 4. You can ask the admitting physician. I am sure he will discuss your daughter​'s condition with you.

1 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 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? 1. Contact the nursing supervisor 2. Continue calling the healthcare provider 3. Ask a​ co-worker to attempt to decipher the order 4. Fax the order to the pharmacy to decipher

1 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 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 open double quote"What would you do if you were in my ​shoes?close double quote" What is the most appropriate response by the​ nurse? 1. I am not an expert in treatment outcome​ research, so I would not want to influence your decision. 2. I have watched a lot of clients make that​ decision; the ones that chose surgery seemed the happiest. 3. Chemotherapy and radiation take a lot longer to recover​ from; I would advise against them. 4. It really does not matter which way you choose to get​ treatment; either way works as well.

1 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 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? 1. Urge the client to question the nurse if a pill being administered looks different from what is normally taken 2. Instruct the client to tell the nurse the reason why the client is taking the medication being administered 3. Hold the medication if the client is in the bathroom 4. Leave the client​'s oral medication at the bedside only if the client is oriented and able to swallow

1 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 adhering to the competency of​ evidence-based practice while providing client care. Which nursing intervention is an appropriate demonstration of this​ competency? 1. Ensuring a dressing change is completed according to established protocols 2. Asking a nursing assistant to help turn and reposition a client in bed 3. Reviewing the results of a root cause analysis of wound infections 4. Explaining the pathophysiology of a client​'s disease process

1 The purpose of the competency​ evidence-based practice is to ensure that nurses have the most current information to improve or provide quality care. An example of an attitude for this competency would be planning care based upon research evidence. Changing a dressing using the established protocol is an attitude associated with​ evidence-based practice. Explaining the pathophysiology of a​ client's disease process is demonstrating knowledge for the competency of​ client-centered care. Reviewing the results of a root cause analysis is a skill associated with the competency of quality improvement. Asking for help is a skill associated with the competency of teamwork and collaboration.

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? 1. Nurses and coworkers 2. Nurses and people 3. Nurses and the profession 4. Nurses and practice

1 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.

A young couple receives the news of pregnancy. The couple​'s certified nurse midwife is a firm believer in adults having advance directives. What statement by the pregnant client shows the need for further education regarding advance​ directives? 1. I am not at an advanced age. I will make plans when I am older. 2. With my new​ responsibilities, I need to plan for my family​'s future. 3. I just found out about all the different options to prolong my life. 4. My husband and I do not agree about​ end-of-life decisions.

1 The wife needs more education about advance directives if she mistakes the word open double quote"​advance,close double quote" meaning open double quote"​beforehand,close double quote" with the idea of advanced age. She is correct about the need to plan for the​ future, about different medical​ options, and about how she and her husband could disagree about options.

The client tells the​ nurse, open double quote"I want to make my own choices about which healthcare treatments I receive.close double quote" Which ethical principle is the client​ describing? 1. Autonomy 2. Confidentiality 3. Privacy 4. Advocacy

1 The​ client's right to make his own choices about health care is reflective of the ethical principle of autonomy. When the​ client's autonomy is at​ risk, the nurse is ethically obligated to advocate for the client. Confidentiality and privacy pertain to protecting the​ client's personal information from unnecessary or unauthorized access by others.

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? 1. Causation 2. Foreseeability 3. Injury from breach of duty 4. Breach of duty

1 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.

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? 1. Right to​ self-determination 2. Right to privacy 3. Right to confidentiality 4. Right to express feelings

1 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.

The nurse educator is teaching a class about significant changes that influenced workplace interaction between intergenerational team members. Which statement is most appropriate for the nurse educator to include in the​ teaching? 1. ​"Technological advances have decreased younger​ nurses' level of dependence on their older nurse​ colleagues." 2. ​"Due to shared governance​ structures, younger nurses tend to be subordinate to older​ nurses." 3. ​"Because of quality​ improvement, entry-level nurses tend to report to members of the older​ generation." 4. ​"Traditionally, the most reliable information and knowledge were perceived as coming from the newest professional​ nurses."

1 ​Traditionally, individuals from younger generations held​ entry-level positions and reported to people of the older​ generation, who held more senior positions. As a​ result, younger employees were subordinate to older employees.​ However, continuous quality improvement and shared governance structures have changed this​ paradigm, and often individuals from various organizational​ "levels" find themselves equal team members.​ Historically, the most senior members of an organization were viewed as offering the most reliable information and knowledge. With the advent of the information​ age, younger nurses can easily access information from around the world on their computers and smartphones. As a​ result, younger nurses are not as reliant on their older peers.

The novice nurse is paired with a nurse preceptor who is a member of the veteran generation. Which characteristic or behavior is most appropriate for the novice nurse to expect the nurse preceptor to​ demonstrate? 1. Rewarding the novice nurse for working hard 2. Promoting an approach in which the novice nurse politely questions authority 3. Communicating with the novice nurse through​ e-mail 4. Encouraging the novice nurse to quickly seek out a leadership role

1 With regard to work​ ethic, characteristics and behaviors demonstrated by the veteran generation include rewarding sacrifice and hard​ work, believing seniority is important for career​ advancement, and preferring to work in teams with designated leaders. Members of the veteran generation tend to respect​ authority, value​ loyalty, and prefer personal forms of communication.

What actions should the nurse take to reduce the risk of an injury when handling​ sharps? ​(Select all that​ apply.) 1. Ensure sharps containers are puncture resistant 2. Place used needles in sharps containers 3. Recap used needles by guiding the needle into the cap 4. Pick up broken glass with a damp paper towel 5. Recap all needles before disposing

1, 2 Actions that nurses can take when working with used or contaminated sharps include disposing of used needles in the appropriate sharps​ container, ensuring that disposal containers are puncture​ resistant, recapping needles using forceps or tongs or the scoop​ method, never recapping a needle by holding the cap in one hand while guiding the needle into the​ cap, never picking up broken glass by​ hand, and picking up broken glass with a​ broom, dustpan, or forceps and not a damp paper towel.

An advance directive gives the chosen​ agent/surrogate authority to make many kinds of decisions. What kinds of decisions are usually​ included? ​(Select all that​ apply.) 1. Access to all medical records 2. Hire or discharge medical providers 3. Consent to pain relief measures 4. Access to all financial records 5. Consent to transportation alternatives

1, 2, 3 An advance directive usually includes the ability to consent to pain relief​ measures, have access to all medical​ records, and the right to hire or discharge medical providers. It does not usually include having consented to transportation alternatives or access to all financial records.

A terminally ill client says to the hospice​ nurse, open double quote"I​'m afraid to die. Just thinking about it scares me so much. Will you please hold my ​hand?close double quote" When the nurse offers to pray with the​ client, the client​ states, open double quote"I​'m an atheist. I think prayer is a waste of words.close double quote" Which response best demonstrates compassion in nursing​ care? ​(Select all that​ apply.) 1. Maintaining eye contact with the client 2. Holding the client​'s hand 3. Using attentive listening as a communication technique 4. Facilitating a meeting between the client and the hospice organization​'s chaplain 5. Singing a song that the nurse finds comforting

1, 2, 3 Examples of nursedash-client interactions that both reflect and facilitate the development of compassion include validating the client​'s experience through attentive listening and eye contact. Encouraging the atheist client to speak with the hospital chaplain is not congruent with compassionate care. Compassion is reflected when the nurse comforts the client in ways that are meaningful to the client.

A NIOSH representative is scheduled to tour a care area as part of a study on workplace stress. What should the manager prepare to share with the representative who visits the care​ area? ​(Select all that​ apply) 1. Number of reports of verbal abuse 2. Previous three months of work schedules 3. New policies about calling off and use of paid time off 4. Number of employees hospitalized with​ work-related injuries 5. Number of employee​ cuts, sprains, and fractures

1, 2, 3 One topic in which NIOSH focuses research is that of workplace stress. Stress is common in healthcare primarily because of the nature of the work. When studying workplace​ stress, NIOSH focuses on the impact of work​ schedules, the impact of new policies and​ practices, and emotional abuse in the workplace. The number of employees hospitalized with​ work-related injuries and the number of employee​ cuts, sprains, and fractures would be reported to OSHA.

A hospice client has no living relatives except for a nephew who has been put through college by the​ client, his generous uncle. Why would the majority of states have laws that affect the nephew having durable power of attorney for the​ client? 1. The nephew has already received a sizeable amount of money from his uncle. 2. As an​ heir, the nephew might be biased in healthcare decisions. 3. Sharing assets shows a bond exists between client and nephew. 4. In​ hospice, the client is expected to die anyway in less than 6 months.

2 The majority of states reason that an heir might be in a position to benefit from biased healthcare decisions. Previous financial​ contributions, placement in​ hospice, and bonding between people are not issues that states are concerned with.

The staff nurse is teaching the client about patient responsibilities. Which concepts are appropriate for the nurse to include in the teaching​ session? ​ (Select all that​ apply.) 1. Patient responsibilities serve to protect the rights of everyone who is receiving care. 2. Patient responsibilities emphasize the right of all clients to be safe. 3. Patient responsibilities emphasize all clients​' rights to be comfortable. 4. Patient responsibilities emphasize the healthcare provider​'s leadership role. 5. Patient responsibilities include asking about the hospital​'s business relationships.

1, 2, 3 Patient responsibilities emphasize that health care is a partnership between the client and caregivers.​ Additionally, patient responsibilities serve to protect the rights of everyone who is receiving care by emphasizing all the rights of clients to be safe and comfortable. Patient responsibilities also include understanding that there are consequences to declining to comply with treatment plans. Asking and being informed of any business relationships that the hospital may have that could influence the​ client's care and treatment is a patient​ right, not a responsibility.

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 open double quote"Six Rightsclose double quote" of medication​ administration? ​(Select all that​ apply.) 1. The nurse checks for right dose by checking the prescribed​ order, performing a dose​ calculation, and checking the medication. 2. The nurse checks for right documentation by documenting administration of the prescribed order in the client record. 3. The nurse checks for right time by checking the prescribed order and looking at the time. 4. The nurse verifies the right medication by asking the client is this what you normally take at ​home? 5. The nurse checks for right frequency by looking at the client​'s chart.

1, 2, 3 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.

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.) 1. Autonomy on behalf of self 2. Altruism when dealing with other nurses 3. Integrity in dealing with clients and​ co-workers 4. Efficiency when dealing with clients 5. Effectiveness in the new job

1, 2, 3 ​Altruism, autonomy, and integrity are nursing values identified by the AACN. Efficiency and effectiveness are not values chosen by the AACN.

The nurse and the client are reviewing common patient responsibilities. Which items should be​ included? ​(Select all that​ apply.) 1. Submitting any available health insurance information to the healthcare facility 2. Following the treatment plan recommended by the healthcare team 3. Asking the healthcare team whether it is necessary to change medications before a procedure 4. Providing members of the healthcare team with accurate information 5. Designating a family member or personal friend to serve as an advocate

1, 2, 3, 4 Common patient responsibilities include providing members of the healthcare team with accurate​ information; following the treatment plan recommended by the healthcare​ team; providing the facility with health insurance​ information; and asking the healthcare team whether changes to medications are necessary prior to treatments or tests. Designation of a family member or personal friend to serve as an advocate is a patient right.

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.) 1. Fairness to this client and other clients 2. Obligations of the hospice facility 3. Benefits to society of having hospice guidelines 4. Rights of this cancer patient 5. Efficiency of the hospice functioning

1, 2, 3, 4 The components of ethics include​ rights, obligations, benefits to​ society, and fairness. Efficiency is not a component of ethics.

The nurse unit manager is teaching an​ in-service about multigenerational teams in nursing. To best describe an effective multigenerational nursing​ team, which behaviors and characteristics are most appropriate for the nurse unit manager to include in the​ in-service? ​(Select all that​ appy.) 1. Mutual support 2. Collaboration 3. Conflict resolution 4. Competition 5. Cooperation

1, 2, 3, 5 Characteristics and behaviors of effective multigenerational teams and their individual members include mutual​ support, cooperation, effective conflict​ resolution, and​ positive, optimistic attitudes. Rather than encouraging​ competition, effective multigenerational teams promote collaboration. Instead of promoting one group as being superior or better suited for​ leadership, effective multigenerational teams acknowledge each team​ member's worth and recognize the value of each team​ member's strengths and abilities.

The nurse educator is teaching about the forces that shape the nurse​'s identity as a moral agent. Which items should be​ included? ​ (Select all that​ apply.) 1. Organizational roles 2. Work settings 3. Professional roles 4. Public perceptions 5. Government values

1, 2, 3, 5 Despite the general perception of nurses as ethical and​ honest, numerous forces shape the​ nurse's identity as a moral​ agent, including organizational​ roles, professional​ roles, work​ settings, and shifts in government and corporate values. Public perceptions do not shape the​ nurse's identity as a moral agent.

The majority of states have limitations on selecting witnesses for an advance directive. In these​ states, who would be allowed to serve as​ witnesses? 1. Primary care providers 2. Neighbors 3. Relatives 4. Heirs

2 The majority of states would allow neighbors to serve as witnesses for an advance directive. The individuals that the majority of states prohibit serving as witnesses include​ relatives, heirs, and primary care providers

The nurse is creating a brochure about effective​ self-care for nurses. Which statements should the nurse include in the​ brochure? ​(Select all that​ apply.) 1. ​Self-care activities include getting adequate rest. 2. Effective​ self-care builds​ self-esteem. 3. Prayer and meditation are examples of​ self-care activities. 4. Effective​ self-care promotes depersonalization of clients. 5. Effective​ self-care promotes enhanced critical thinking ability.

1, 2, 3, 5 Effective​ self-care leads to more than just physiologic health and physical fitness. Along with enhancing the individual​'s sense of​ well-being, effective​ self-care also builds​ self-esteem, which in turn promotes effective use of problem solving and critical thinking skills. Effective​ self-care reduces the risk for​ burnout, the manifestations of which include depersonalization of clients. General examples of​ self-care activities are eating a balanced​ diet, exercising on a regular​ basis, getting adequate rest and​ sleep, and engaging in recreational activities.

The nurse researcher is designing a poster that describes factors that contribute to the development of ethical issues in nursing. Which items are appropriate for the researcher to include on the​ poster? ​(Select all that​ apply.) 1. Emphasizing healthcare cost containment 2. Conflicting loyalties among nurses 3. Adapting to changing technology 4. Approving adequate nurse staffing 5. Opposing cultural values

1, 2, 3, 5 Factors that contribute to the development of ethical issues in nursing include rapidly changing​ technology, conflicting societal and cultural​ values, conflicting loyalties and obligations among​ nurses, and increasing pressure to contain healthcare costs Approving adequate staffing of nurses would help prevent the development of ethical issues.

What can be done to prevent client falls during​ hospitalization? ​(Select all that​ apply.) 1. Ensure floors are well lit during the night. 2. Remove items from walking paths. 3. Keep eyeglasses within easy reach. 4. Apply restraints as needed to restrict mobility. 5. Assist with putting on​ non-skid footwear.

1, 2, 3, 5 Strategies that the nurse can use to reduce falls include removing obstacles from walking​ paths, ensuring client rooms are well​ lit, making sure clients wear shoes with soles that provide adequate​ traction, and ensuring prescribed eyewear is being used. Physical restraints should be used only when necessary for client safety and only with a healthcare​ provider's order. Restraints cannot be prescribed for use as needed.

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.) 1. The right client 2. The right dose 3. The right drug 4. The right room 5. The right time

1, 2, 3, 5 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 nurse educator is describing the application of moral principles in nursing practice. Which scenarios best illustrate opportunities for the nurse to serve as an advocate for the​ client's autonomy? ​(Select all that​ apply.) 1. Healthcare providers who fail to hear the client​'s concerns 2. Lack of spousal support for the​ client's refusal of care 3. Institutional computerization of the​ client's records 4. Disagreement from family members about the client​'s choices 5. Family members who request access to the​ client's health information

1, 2, 4 The scenarios that best illustrate opportunities to advocate for the​ client's autonomy include disagreement from family members about the​ client's choices, healthcare providers who fail to hear the​ client's concerns, and lack of spousal support for the​ client's refusal of care. Family​ members' requests to access the​ client's information and computerization of the​ client's healthcare record best illustrate scenarios in which the nurse must preserve confidentiality and​ privacy, which pertain to protecting the​ client's personal information from unnecessary or unauthorized access by others.

The nurse educator is teaching a class about the professional nurse​'s work ethic. When describing the nurse with a strong work​ ethic, which characteristics and behaviors are most appropriate for the nurse educator to include in the​ teaching? ​(Select all that​ apply.) 1. Leaving personal problems at home 2. Recognizing and meeting management​'s expectations 3. Demonstrating perfect performance of clinical skills 4. Maintaining a positive attitude at work 5. Valuing hard work and diligence

1, 2, 4, 5

The nursing director of surgical services is preparing an​ in-service about client care protocols related to organ transplantation. Which situations best reflect potential sources of ethical​ conflict? ​ (Select all that​ apply.) 1. Religious beliefs 2. Allocation of organs 3. Harvesting organs from living donors 4. Children as potential organ donors 5. Children as potential organ recipients

1, 2, 4, 5 Organs for transplantation may be harvested from owners who have just died or from living donors. Ethical conflicts related to organ transplantation are client specific and may stem from a variety of​ concerns, including religious beliefs that forbid body mutilation for any​ reason, allocation of​ organs, and involvement of children both as potential donors and recipients.

The nurse educator is teaching about the benefits of effective​ self-care. Which statements by nursing students indicate the benefits of effective​ self-care? ​(Select all that​ apply.) 1. My ​self-esteem is enhanced. 2. My ​problem-solving skills are effective. 3. My diet is healthy and balanced. 4. My sleep and rest are adequate. 5. My critical thinking skills are enhanced.

1, 2, 5 Benefits of effective​ self-care include enhanced sense of​ well-being and greater​ self-esteem. In​ turn, these benefits promote effective use of​ problem- solving and​ critical-thinking skills. Adequate sleep and rest and proper diet and nutrition are elements of effective​ self-care.

Which actions should the nurse perform when implementing standard​ precautions? ​(Select all that​ apply.) 1. Wash hands before and after providing client care 2. Place used syringes and needles in the sharps container 3. Wear a mask and gown upon entering the care area 4. Cleanse blood spills with cold water 5. Apply gloves before emptying urinary catheter drainage bags

1, 2, 5 Measures taken when implementing standard precautions include appropriate hand​ hygiene, use of personal protective​ equipment, safe injection​ practices, and managing contaminated surfaces and equipment. Masks and gowns do not need to be worn upon entering the care area. Blood is a contaminant and would be cleaned with something other than cold water.

The nurse manager is preparing the care area in anticipation of a scheduled OSHA inspection. Which particular areas should the nurse manager focus on in order to prepare for this​ visit? ​ (Select all that​ apply.) 1. ​Water, soap and hand hygiene disinfectant is available at all client bedsides. 2. Glove boxes are filled and placed at each point of client access. 3. Safety information is posted in the staff lounge. 4. Schedule for staff to view the DVD on safety issues is posted. 5. ​Puncture-resistant containers for used sharps are appropriately mounted.

1, 2, 5 When conducting an inspection within a healthcare​ organization, OSHA will focus on preventive measures such as hand hygiene​ procedures, use of gloves when caring for​ clients, and presence of​ puncture-resistant sharps containers. NIOSH distributes safety information and provides training material.

While reviewing the health histories for a group of​ clients, the case manager becomes concerned that several clients are at risk for falls. Which clients would benefit from fall prevention​ interventions? ​(Select all that​ apply.) 1. ​70-year-old female prescribed three blood pressure medications ​2. 55-year-old female recovering from breast cancer surgery ​3. 55-year-old female who lives alone and walks with two canes ​4. 84-year-old male with chronic renal failure and macular degeneration ​5. 47-year-old male recovering from a fractured arm

1, 3, 4 Clients at high risk for falls include those with impaired memory and muscle​ weakness, those who use assistive​ devices, such as canes or​ walkers, and those who use multiple prescription and​ over-the-counter medications. The client with renal failure and macular degeneration is at risk for falling because of electrolyte imbalances and a vision disturbance. The client taking three blood pressure medications is at risk for falling because of the potential for hypotension. The client who walks with two canes is at risk for falling because of the use of assistive devices. The clients recovering from breast cancer surgery and a broken arm are at the least risk for falling.

Considering​ Roach's theory of caring as the human mode of​ being, which attributes are included in the six Cs of​ caring? ​(Select all that​ apply.) 1. Competence 2. Cognizance 3. Confidence 4. Commitment 5. Consciousness

1, 3, 4 In the framework of​ Roach's theory of caring as the human mode of​ being, the six Cs of caring include​ compassion, competence,​ confidence, conscience,​ commitment, and comportment. Cognizance and consciousness are not included.

The nursing instructor asks the class to describe empirical knowing. Which student responses are most​ accurate? ​(Select all that​ apply.) 1. ​"It incorporates​ nursing-related facts." 2. ​"It's subjective in​ nature." 3. ​"It's also called the science of​ nursing." 4. ​"It includes observations related to​ nursing." 5. ​"It can be developed through ongoing academic​ education."

1, 3, 4, 5 Empirical​ knowing, also referred to as open double quote"the science of ​nursing,close double quote" is based in​ nursing-related facts and​ observations, and in nursing theories and analyses that seek to explain these facts and observations. Methods of developing empirical knowing include ongoing academic nursing education. Empirical knowing is objective in nature.

Which goals are included in the National Patient Safety Goals​ (NPSGs) for an acute care​ facility? ​(Select all that​ apply.) 1. Prevent surgical site errors. 2. Use​ evidence-based guidelines. 3. Prevent medication errors. 4. Document client care correctly. 5. Identify clients correctly.

1, 3, 4, 5 Examples of NPSGs for acute care facilities include identifying clients correctly and preventing surgical site and medication errors. Correct documentation is implied to support identification of clients and preventing surgical site and medication errors. Using​ evidence-based guidelines are not NPSGs for an acute care facility.

The school nurse is preparing a program on child safety for community members. Which topics are the most appropriate for the nurse to include in this​ program? ​(Select all that​ apply.) 1. How to avoid and report strangers in the community 2. Reminding to pack fresh fruit and vegetables in school lunches 3. Protective equipment to use when playing 4. Importance of crossing the street at traffic signals 5. Reporting burned out street lights to the municipal building

1, 3, 4, 5 Safety extends beyond the walls of healthcare organizations.​ Community-organized safety programs are often supported by healthcare organizations. These programs contribute to healthier communities by advocating for​ neighborhood, school, and workplace safety. Topics that promote child safety include avoiding and reporting​ strangers, using protective equipment while at​ play, reporting burned out street​ lights, and crossing the street at traffic signals. Packing fresh fruit and vegetables supports a healthier a community.

The staff nurse is writing a journal article that explores the principle of caring as it applies to nursing. Which statements should she include in the​ article? ​(Select all that​ apply.) 1. Caring in nursing extends beyond feelings of interest or concern. 2. In​ nursing, concern for the client​'s ​well-being will produce​ safe, effective care. 3. Nursing interventions can be implemented in the absence of genuine caring. 4. Client care is synonymous with caring in nursing. 5. In​ nursing, demonstration of caring includes the​ safe, proficient implementation of nursing interventions.

1, 3, 5 Client care comprises the implementation of collaborative and independent nursing interventions that are intended to restore​ health, prevent illness or​ injury, or promote wellness. Yet nursing interventions can be implemented even in the absence of genuine interest or concern for the ​client's ​well-being. Likewise, genuine interest or concern for the client​'s ​well-being does not necessarily equate to​ safe, proficient implementation of nursing interventions. In​ nursing, the meaning of caring extends well beyond simply implementing interventions or feeling interest or concern.

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.) 1. The actions that nurses take should promote good. 2. The actions that nurses take should be fair to all possible clients. 3. The actions that nurses take should involve telling the truth. 4. The actions that nurses take should safeguard clients. 5. The actions that nurses take should do no harm.

1, 4, 5 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 team leader for a​ medical-surgical unit is reviewing client assignments made for the staff nurses. Based on the National Patient Safety​ Goals, which clients will the team leader identify as being at risk for safety​ issues? ​(Select all that​ apply.) 1. Client with burning and pain when urinating 2. Client scheduled for discharge after abdominal wound stitches are removed 3. Client who is scheduled for an amputation of the right foot 4. Client recovering from a stroke who is scheduled for physical therapy in the afternoon 5. Client who is depressed and refused antidepressant medication the previous evening

1, 3, 5 Clients at risk for safety issues based on the National Patient Safety Goals include the​ following: The client with depression could be at risk for​ suicide; the client with pain and burning with urination could have a urinary tract​ infection; and the client scheduled for an amputation could be at risk for a surgical error if the wrong limb is amputated. The client being discharged after having abdominal wound stitches removed and the client recovering from a stroke who is scheduled for physical therapy are not at risk for a National Patient Safety Goal issue.

The infection control nurse is reviewing a monthly status report of all clients who were treated for infectious diseases in the organization. Which clients require further investigation to determine whether they have a​ healthcare-associated infection? ​(Select all that​ apply.) 1. Male client being treated for diarrhea after receiving antibiotics for pneumonia 2. Female client receiving antibiotics after having total knee replacement surgery 3. Female client with an indwelling urinary catheter being treated for a urinary tract infection 4. Male client with a leg wound from motor vehicle accident that became infected 5. Male client with sepsis after receiving hyperalimentation infusions

1, 3, 5 Diseases or conditions caused by​ healthcare-associated infection microorganisms include​ catheter-related bloodstream infections​ (CRBIs), healthcare-associated pneumonia​ (HAP) or​ ventilator-associated pneumonia​ (VAP), surgical site infections​ (SSIs), central linedash-associated bloodstream infections​ (CLABSIs), and Clostridium difficiledash-associated infection​ (CDIs). The client with a leg wound after a motor vehicle accident most likely received the infection as a result of the accident and not hospital care. The client with sepsis after receiving hyperalimentation should be investigated as having a​ central-line associated bloodstream infection. The client with the urinary tract infection should be investigated as having a​ catheter-related infection. The client receiving antibiotics after total knee replacement surgery is most likely receiving the antibiotics to prevent a​ post-operative infection. The client being treated for diarrhea after receiving antibiotics should be investigated for a Clostridium difficile infection.

The nurse is providing care for a young adult client who just learned she has breast cancer. The client decides to open double quote"put her house in order.close double quote" She fills out a living will that spells out her future healthcare treatment desires. What kinds of decisions are likely to be covered in the living​ will? ​(Select all that​ apply.) 1. Intubation 2. Funeral home 3. Parenteral nutrition 4. Cremation 5. Resuscitation

1, 3, 5 The kinds of decisions that would be likely to be covered in a living will would be​ intubation, resuscitation, and parenteral nutrition. A living will would not likely record opinions about cremation or funeral home arrangements.

The nurse is caring for a client who is recovering from open heart surgery. The client​'s extended family is​ large, and the nurse has heard heated hallway discussions about the client​'s ​end-of-life care. What is the role of the nurse in this​ situation? ​(Select all that​ apply.) 1. Assess whether clients and families understand​ life-sustaining activities 2. Serve as a peaceful mediator between clients and families 3. Assure both clients and families that written decisions are not irrevocable 4. Contribute the​ nurse's opinion about the​ client's choices 5. Advocate for clients and families to continue discussions

1, 3, 5 The role of the nurse includes assuring both clients and families that written decisions are not​ irrevocable, assessing whether they understand​ life-sustaining activities, and advocating for them to continue discussions. The role of the nurse does not include serving as a peaceful mediator or contributing the​ nurse's own opinion about choices.

Which questions or statements will help clients clarify their​ values? ​ (Select all that​ apply.) 1. Are you considering other courses of ​action? 2. Do you want to know what I would ​do? 3. Do you have a ​choice? 4. What does your husband think you should ​do? 5. Tell me how you plan to start doing ​this?

1, 3, 5 Value clarifying questions or statements include open double quote"Do you have a ​choice?close double quote" open double quote"Are you considering other courses of ​action?close double quote" and open double quote"Tell me how you plan to start doing ​this?close double quote" Saying open double quote"What does your husband think you should ​do?close double quote" or open double quote"Do you want to know what I would ​do?close double quote" does not help clarify the​ client's values.

Which scenarios illustrate a potential contextual influence on​ caring? ​(Select all that​ apply.) 1. A client who perceives that his IV pump alarm requires urgent​ attention, but whose nurse recognizes the situation as being nonurgent 2. A client whose routine includes daily interaction with family​ members, but whose medical condition requires visitor restrictions 3. A client who speaks​ Spanish, but whose nurse speaks only English 4. A nurse who perceives a client​'s symptoms to be manifestations of a​ life-threatening illness, but whose client believes himself to be in no danger 5. A client who prefers being​ alone, but whose hospitalization requires him to have a roommate

1, 4 Contextual influences on caring are illustrated by a client who perceives his IV pump alarm as requiring urgent​ attention, but whose nurse recognizes the situation as being​ nonurgent; and by a nurse who perceives a client​'s condition to be​ life-threatening while the client perceives no personal danger. A client who speaks Spanish but whose nurse speaks only English illustrates a cultural influence on caring. Environmental influences on caring are illustrated by a client who prefers being alone but whose hospitalization requires him to have a​ roommate; and by a client whose routine includes daily interaction with family​ members, but whose medical condition requires visitor restrictions.

correct, 50.3.2rem3 The nursing student is writing a paper about Generation X and work ethic. To describe the work ethic of Generation​ X, which characteristics and behaviors are most appropriate for the nursing student to include in the​ paper? ​(Select all that​ apply.) 1. Possessing limited motivation to stay with one employer 2. Believing seniority is important for career advancement 3. Being prone to developing workaholism 4. Preferring managers to be mentors and coaches 5. Expecting instant access to information

1, 4, 5 Characteristics and behaviors of Generation X related to work ethic include expecting instant access to​ information, preferring managers to be mentors and​ coaches, and demonstrating professional loyalty but possessing limited motivation to remain with the same employer. Veterans tend to believe seniority is important for career advancement. Baby boomers are prone to developing workaholism.

Additional laws have added requirements to the original HIPAA legislation and strengthened administrative simplification. Which laws have done​ that? ​(Select all that​ apply.) 1. 2010 Patient Protection and Affordable Care Act 2. 1996 Health Insurance Portability and Accountability Act 3. 2012 Congressional Reform Act 4. 2000 Reports Consolidation Act 5. 2009 Health Information Technology for Economic and Clinical Health Act

1, 5 Two additional laws have added requirements to the original HIPAA legislation and strengthened administrative​ simplification: 2009 Health Information Technology for Economic and Clinical Health Act and 2010 Patient Protection and Affordable Care Act. The 1996 Health Insurance Portability and Accountability Act was the​ original, not an​ additional, legislation. Neither the 2012 Congressional Reform Act nor the 2000 Reports Consolidation Act are relevant to HIPAA issues.

The nurse preceptor and the novice nurse are discussing how generational differences may influence interaction among team members. When explaining the significance of the generational​ cohort, which statements are most appropriate for the nurse preceptor to include in the​ discussion? ​(Select all that​ apply.) 1. Generational cohorts tend to share very similar key life experiences. 2. Generational cohorts usually do not demonstrate distinct workforce patterns. 3. Conflicts and interpersonal tension develop due to generational cohorts. 4. Generation gap is another term for generational cohort. 5. Generational cohorts are born in the same time span.

1, 5 The term generational cohort is used to describe individuals who are born in the same general time span​ and, as​ such, share key life experiences. Generational cohorts demonstrate distinct values and workforce patterns. Generational differences​ (sometimes called a generation​ gap) can lead to the development of conflicts and interpersonal tension.

Sue​ Nguyen, a nurse in the Employee Health​ Department, is reviewing information to submit to OSHA for the monthly report. Which information about employee health and injuries should the nurse include in this​ report? ​(Select all that​ apply.) 1. 3 incidences of intravenous poles collapsing on nurses necessitating stitches to close arm wounds 2. 6 incidences when staff nurses worked overtime 3. 5 incidences in which client aggression was averted 4. 1 incidence of employee sprained ankle after falling on a wet floor 5. 8 incidences where staff nurses left the unit to obtain flu vaccinations

1. 3 incidences of intravenous poles collapsing on nurses necessitating stitches to close arm wounds 4. 1 incidence of employee sprained ankle after falling on a wet floor

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? 1. Attention to professional boundaries with clients 2. Articulation of​ nursing's professional skills 3. Attention to professional appearance and demeanor 4. Pursuit of professional engagement

1. Attention to professional boundaries with clients

While performing client​ care, Amanda​ Graham, the​ nurse, notes an area of skin breakdown and excoriation along the area where the indwelling urinary catheter is affixed to the​ client's inner thigh. What should the nurse do to help the​ client? 1. Change the catheter using one without latex 2. Cleanse the skin with soap and water 3. Check the acidity level of the​ client's urine 4. Dust the skin with cornstarch

1. Change the catheter using one without latex

Ann​ Jones, RN, is caring for a​ 67-year-old female American Indian client who was recently diagnosed with lung cancer. The surgeon has recommended that the client undergo a right lower lobectomy. When Ms. Jones asks the client how she feels about having​ surgery, the client​ states, "I want to talk with my​ tribe's healer before I make my​ decision, but that surgeon seems like​ she's in a hurry for me to make up my mind. I always speak with my healer about my​ health." In the context of​ Leininger's theory of culture care diversity and​ universality, which nursing action best represents culture care accommodation​ and/or negotiation? 1. Encouraging the client to tell the surgeon that she wants to speak with her tribal healer before deciding whether to have surgery 2. Asking the client if she is comfortable with speaking to the surgeon again to discuss how the surgery may impact her health 3. Talking with the surgeon to advocate for the​ client's desire to speak with her tribal healer before making any decisions 4. Supporting the client in her decision to speak with her tribal healer prior to making any decisions about her health care

1. Encouraging the client to tell the surgeon that she wants to speak with her tribal healer before deciding whether to have surgery

Karen Sanders is a registered nurse who is planning to provide​ pre-operative teaching to a home care client who is scheduled for joint replacement surgery in a few days. What information should the nurse emphasize to reduce the risk of a​ healthcare-associated infection​ (HAI)? 1. Follow the healthcare​ providers' discharge instructions. 2. Expect to take antibiotics for several weeks. 3. Avoid eating fresh fruits and vegetables. 4. Prevent skin drying by limiting hand washing.

1. Follow the healthcare​ providers' discharge instructions.

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? 1. False imprisonment 2. Battery 3. Malpractice 4. Assault

3. Malpractice

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? 1. Ignoring his​ doctor's advice to exercise regularly 2. Looking forward to the birth of his grandchild 3. Having a family history of heart disease 5. Loading a pallet faster than anyone else

1. Ignoring his​ doctor's advice to exercise regularly

Stefani​ Galliardi, an experienced emergency department​ nurse, is caring for three clients. Her first client is intoxicated and​ combative, and requires restraints. Her second client has a migraine headache and is vomiting frequently. Her third client is an older adult who is receiving IV medications for treatment of hypertension. The charge​ nurse, Matt​ Renten, tells Stefani that he plans to assign another client to her​ care--a client who is complaining of chest pain. Stefani already feels overwhelmed and she is not comfortable with accepting another client into her care. Which response suggests that Stefani is a​ self-aware nurse? 1. ​"I'm at my limit right now. I​ don't think I can safely take on another client. I know​ we're really​ busy, but​ I'm asking you to please consider assigning that client to another​ nurse." 2. ​"As charge​ nurse, I would expect you to see that​ I'm overloaded as it is. If you think giving me another client is a wise​ decision, I question your leadership​ abilities." 3. ​"With all due​ respect, I recognize that​ you're assuming I can safely take on another client. That assumption is impairing your​ judgment." 4. ​"I'm really​ busy, but I know everyone else​ is, too. I respect your judgment and I know we all feel overwhelmed at times.​ Yes, I can handle one more​ client."

1. ​"I'm at my limit right now. I​ don't think I can safely take on another client. I know​ we're really​ busy, but​ I'm asking you to please consider assigning that client to another​ nurse."

The nurse unit manager is creating a policy related to the nursing care of clients who are diagnosed with HIV or AIDS. Which item best reflects a standard of nursing care and should be included in the​ policy? 1. All clients and healthcare providers for whom exposure to HIV is known or suspected must undergo mandatory HIV testing. 2. Nurses are morally obligated to care for clients with AIDS unless the​ nurse's safety risks exceed the potential client benefits. 3. For clients who are HIV​ positive, the nurse is legally responsible for notifying the​ client's sexual partners or caregivers. 4. The nurse is responsible for notifying insurance companies of any policy holder whose HIV test is confirmed as being positive.

2 According to an ANA position​ statement, the nurse is morally obligated to care for clients with HIV or AIDS unless the​ nurse's safety risks exceed the potential benefits to the client. Examples of ethical concerns related to HIV and AIDS testing include mandating testing of healthcare providers and clients versus allowing voluntary​ testing; notifying sexual partners or caregivers of clients who are HIV​ positive; and releasing test results to insurance companies.

Which statement best describes the primary goal of Benner and​ Wrubel's theory of​ caring? 1. To determine how care shapes the​ nurse's assessment of the​ client's stress level 2. To explore how care and caring practices affect the​ individual's experience of health and illness 3. To identify the​ nurse's perception of the​ client's coping process 4. To focus on the caregiving of nurses and​ caring's effect on coping

2 As its primary​ goal, Benner and​ Wrubel's theory of caring seeks to explore how care and caring practices affect the​ individual's experience of health and illness. This theory does not focus on the caregiving of nurses. Benner and​ Wrubel's theory of caring examines how care shapes an​ individual's perception of what is​ stressful, along with what qualifies as coping.

Which statement is a definition of​ beneficence? 1. Right to​ self-determination 2. Actions to promote good 3. Telling the truth 4. Upholding fair treatment

2 Beneficence concerns actions to promote good. Autonomy is the right to​ self-determination. Justice upholds fair treatment. Veracity means telling the truth.

What is the purpose of​ community-based safety​ programs? 1. Establish community gardens. 2. Create healthier individuals. 3. Reduce healthcare costs. 4. Improve employment opportunities.

2 Community-organized health and safety programs are often supported by healthcare​ organizations, as these programs contribute to healthier communities. Reduction in healthcare costs might occur if a community is healthier.​ However, this is not identified as the purpose of a​ community-based safety program. The purpose of​ community-based safety programs is not to improve employment opportunities or to establish community gardens.

The nurse educator is instructing a group of students about ways of knowing. Which statement by the student best reflects ethical​ knowing? 1. Ethical knowing relates to the nurse​'s specific personal style during care delivery. 2. Ethical knowing applies to every intentional nursing action that may be subject to being judged right or wrong. 3. Ethical knowing is rooted in​ nursing-related facts and observations. 4. Ethical knowing refers to the nurse​'s ongoing​ self-exploration and journey toward ​self-actualization.

2 Ethical knowing incorporates every intentional action and behavior by the nurse that may be subject to being judged right or wrong. Personal knowing refers to the nurse​'s ongoing​ self-exploration and journey toward​ self-actualization. Empirical knowing is based in​ nursing-related facts and​ observations, and nursing theories and analyses that seek to explain these facts and observations.Aesthetic knowing relates to the nurse​'s specific personal style during care delivery.

A client​'s chemotherapy medication becomes disconnected and fluid is running down the hospital bed onto the floor. What action should the nurse take regarding the spilled​ substance? 1. Apply gloves and wipe the medication with clear water 2. Identify the medication to obtain a safety data sheet 3. Cover the spilled medication with a towel 4. Ask environmental services team to clean the floor

2 Healthcare organizations have Hazard Communication standards to help regulate the exposure to hazardous chemicals. These standards include safety data sheets that provide information as to safe handling of the chemical and measures to limit exposure in the event of a spill. If not handled​ correctly, many chemicals can cause both injury and illness if spilled or ignited. The nurse should identify the medication so that a safety data sheet can be accessed to properly address the spill. Covering the medication with a towel might not be the correct way to clean the spill. Asking the environmental services team to clean the floor does not address exposure to the medication that has spilled. Applying gloves and wiping the medication with clear water might not be the correct way to handle the spill to prevent injury to the​ nurse, client, or other staff.

The nurse case manager is designing a brochure to help older adult clients recognize and protect their rights. Which item is appropriate to include in the​ brochure? 1. County departments of health usually assist clients with issues related to​ long-term care. 2. In many​ states, the governor or secretary of health has an office to assist with issues in​ long-term care. 3. All provider agencies must employ client advocates for older adult clients. 4. Homes for vulnerable older adults are regulated at the federal level.

2 In many​ states, the governor or secretary of health has designated an office to assist clients with issues related to patient rights in​ long-term care. Many hospitals and large provider agencies have client advocates who can intervene and help clients to ensure that their rights are maintained.​ However, employment of a client advocate is not mandatory. The​ state's department of health may also be able to help. Nursing​ homes, homes for vulnerable older adults and licensed facilities for individuals with disabilities are regulated at the state level.

The nursing instructor is teaching a class about the relationship between the concept of​ self-care and the concept of professional behaviors. Which statement should he include in the​ teaching? 1. Focusing on​ self-care diminishes the nurse​'s professionalism toward clients. 2. Inadequate​ self-care can impair professional work performance by leading to decreased physical wellness. 3. Prioritizing​ self-care weakens the nurse​'s professional affiliation with nursing. 4. Psychosocial wellness does not influence professional behaviors.

2 Inadequate​ self-care can lead to decreased physical and psychosocial wellness. In​ turn, decreased wellness may contribute to impaired work performance as well as a weakened affiliation with the profession of nursing. As a​ result, the nurse​'s demonstrated professionalism toward​ clients, peers, and other members of the healthcare team may suffer.

Considering​ Maslow's hierarchy of​ needs, which category of needs includes financial stability and harmonious family​ relationships? 1. ​Self-actualization 2. Safety 3. Esteem 4. Physiologic

2 In​ Maslow's hierarchy of​ needs, safety needs comprise physical​ safety, financial​ stability, harmonious family​ relationships, and freedom from psychological threats. Physiologic needs include​ food, water,​ air, sleep, and shelter.​ Self-actualization is reflective of the​ individual's need to reach his highest level of function and​ fulfillment, both personally and professionally. Esteem needs include​ confidence, independence,​ competence, respect, and achievement.

Which of the following is unintentional conduct deviating from the standard of nursing​ practice? 1. False imprisonment 2. Malpractice 3. Battery 4. Assault

2 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.

While teaching a client about diet and​ nutrition, the nurse is applying Watson​'s theory of human care. Which nursing action best illustrates the carative factor of promoting transpersonal​ teaching-learning? 1. Creating a learning environment that promotes the client​'s physical and nonphysical healing 2. Using examples that are within the client​'s frame of reference 3. Practicing​ loving-kindness within the context of caring during the teaching session 4. Cultivating the nurse​'s own spiritual practice and transpersonal​ self, and going beyond ego self

2 Promoting transpersonal​ teaching-learning includes attempting to stay within others​' frame of reference. Creating a learning environment that promotes physical and nonphysical healing best illustrates the carative factor of attending to​ supportive, protective,​ and/or corrective​ mental, physical,​ societal, and spiritual environments. Practicing​ loving-kindness within the context of caring during the teaching session is most reflective of forming a​ humanistic-altruistic system of values. Cultivating the nurse​'s own spiritual practice and transpersonal​ self, and going beyond ego self illustrates the carative factor of being sensitive to self and others.

Which statement best illustrates awareness of culture​'s influence on nursing behaviors within the framework of Roach​'s theory of caring as the human mode of​ being? 1. To preserve the client​'s ​dignity, the nurse must be aware of the client​'s cultural beliefs. 2. "To achieve cultural​ competence, the nurse must know and incorporate the client​'s cultural beliefs when caring for the client. 3. Caring depends on factors such as the nurse​'s training and​ experience, both of which are shaped by the cultural practices in which training and experience are obtained. 4. Caring depends on the client​'s unique capacities and​ experiences, which requires the nurse to be aware of the client​'s cultural influences.

2 Recognizing that achieving cultural competence requires knowing and incorporating the client​'s cultural beliefs best reflects awareness of culture​'s influence on Roach​'s theory of caring as the human mode of being. Understanding that caring depends on the client​'s unique capacities and​ experiences, which requires the nurse to be aware of the client​'s cultural​ influences, is reflective of awareness of culture​'s influence on Benner and Wrubel​'s theory of caring.​ Likewise, acknowledging caring​'s dependence on factors such as the nurse​'s training and​ experience, both of which are shaped by the cultural practices in which training and experience are​ obtained, is reflective of Benner and Wrubel​'s theory of caring. Awareness that preserving the client​'s dignity requires awareness of the client​'s cultural beliefs best reflects understanding culture​'s influence on Watson​'s theory of human care.

Which nurse​'s statement best illustrates awareness of the importance of culture to Boykin and Schoenhofer​'s nursing as caring​ theory? 1. My client​'s cultural beliefs influence his interpretation of my choice of​ clothing, my​ demeanor, and my word choices. 2. I need to actively engage in the caring​ process; cultural influences may positively or negatively affect the extent of my engagement. 3. Appropriately fulfilling professional demands reflects my​ competence, but my client​'s cultural influences will affect whether or not he perceives my behaviors as being appropriate. 4. Culture care preservation and maintenance require my actions and choices to support my client in retaining his specific cultural values and beliefs.

2 Recognizing the effect of culture on the nurse​'s extent of engagement best reflects awareness of the importance of culture to Boykin and Schoenhofer​'s nursing as caring theory. Considering culture care preservation​ and/or maintenance is reflective of Leininger​'s theory of culture care diversity and universality. Considering culture​'s influence on how the client interprets the nurse​'s comportment​ (demeanor, dress, and​ language) reflect Watson​'s application of culture to Watson​'s theory of human care. Considering that cultural beliefs and influences affect the client​'s perception of which behaviors are appropriate reflects application of culture to the trait of competence within the framework of Watson​'s theory of human care.

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? 1. Nurse Practice Act 2. Standards of Practice 3. Licensing process 4. Code of ethics

2 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.

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? 1. Regulates institutional policies concerning​ nurse's job responsibilities 2. Sets the requirements for​ licensure, including educational requirements of nurses 3. Regulates the accreditation standing of nursing programs 4. Develops client care policies and procedures

2 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.

A staff nurse is assigned to provide client care on a different care area for one shift. While providing​ care, the nurse notes the inappropriate disposal of used needles and syringes. When asking a staff member about this practice the response was open double quote"this is how it is done here.close double quote" What is the most appropriate action by the nurse in this​ situation? 1. Anonymously report the practice to NIOSH 2. Anonymously report the practice to OSHA 3. Collect data on the number of needlestick injuries that occurred during the shift 4. Wear gloves while providing all care

2 The Occupational Safety and Health Act was enacted to improve job safety. This act allows employees to anonymously report hazardous work conditions. Needlestick injuries are a safety hazard to both staff and clients. This practice needs to be reported. Wearing gloves might reduce the risk of infection but will not prevent an accidental needlestick. NIOSH conducts research studies with the intention of improving safety in the workplace and the general population. Counting the number of needlestick injuries that occurred because of an unsafe practice will not help stop the practice.

Which expanded principle of​ Roach's theory of caring as the human mode of being takes into consideration the impact of cultural background and influences on​ attitude? 1. Competence requires the nurse to have the necessary knowledge to respond effectively to​ others' needs;​ however, cultural competence also requires awareness and incorporation of the​ client's cultural beliefs 2. Confidence includes the​ nurse's level of comfort with​ self, client, and​ family, but lack of confidence that creates mistrust may heighten existing cultural barriers between nurse and client 3. Compassion includes participation in the experience of​ another, but understanding the​ client's experience requires consideration of the cultural influences by which it is framed 4. Comportment includes the​ nurse's use of​ demeanor, dress, and language to reflect a caring​ presence; however, interpretation of these components as caring depends on the​ client's cultural influences and beliefs

2 The impact of cultural background and influences on attitude is best reflected by the potential for lack of confidence to create​ mistrust, which may heighten any existing cultural barriers between nurse and client. The expanded principle related to​ competence, knowledge, and the need for cultural awareness best reflects the impact of cultural background and influences on the​ nurse's knowledge. In these​ examples, the expanded principles related to compassion and comportment best reflect the impact of cultural background and influences on the​ nurse's behaviors.

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? 1. ​"Do you want to postpone talking about this difficult​ matter?" ​2. "What alternative courses of action have you been thinking ​about? ​3. "What do you think your children would like you to​ do?" ​4. "Are you feeling healthy enough to be making​ decisions?"

2 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.

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? 1. Letting the physician know of the client​'s condition 2. Taking the vital signs of the client 3. Making sure the client is not in pain 4. Letting the supervisor know of the client​'s condition

2 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.

Social justice is an important value for the nursing profession. Which nurse is exhibiting this​ value? 1. The nurse who honors the decision of a client to reject blood transfusions 2. The nurse who treats the illegal immigrant in the same manner as a citizen 3. The nurse who treats the very dirty homeless person with respect 4. The nurse who offers to work a religious holiday so that others can worship that day

2 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.

Two night shift nurses are talking about the recent discharge of a celebrity from the substance abuse treatment facility where they work. The celebrity disguised his face and used a false name. The nurses did not find out about the celebrity​'s treatment while on duty. They read about it on the front page of a national tabloid. Now that the story has been​ published, is it appropriate for the nurses to discuss this client while on​ duty? 1. After they check out the truth or falsehood of the story with their​ colleagues, they can discuss it. 2. The nurses can discuss what they​ read, since they are not sharing information from the workplace. 3. The nurses should fill out an incident report about the tabloid story. 4. The nurses should not discuss what they​ read, since someone could accuse them of being the information leak.

2 The nurses can discuss what they​ read, since they are not sharing information from the workplace. They do not have to refrain from discussing what they​ read, check out the story with their​ colleagues, or fill out an incident report.

The nursing student is preparing a presentation that describes how varying intergenerational styles can affect peer perceptions. Which example is most appropriate for the nursing student to include in the​ presentation? 1. Younger nurses may view older​ nurses' goals for developing technological competence as unattainable. 2. Older nurses may view younger nurses as having a​ "slacker" attitude. 3. Younger nurses may view older nurses as being arrogant and lacking professional commitment. 4. Older nurses may be intrigued by younger​ nurses' style of dress.

2 Varying intergenerational styles can lead to workplace conflict. For​ example, older nurses may describe younger nurses as​ arrogant, lacking in​ commitment, and having a​ "slacker" attitude, while younger nurses view themselves as​ self-reliant. Older nurses may perceive younger​ nurses' dress,​ hairstyles, piercings, and tattoos as being unprofessional. Younger nurses may be disillusioned by older​ nurses' perceived unwillingness to develop technological competence.

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? 1. Veracity 2. Justice 3. Autonomy 4. Beneficence

2 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.

The nurse is teaching the client about​ self-awareness. Which statement about​ self-awareness should be included in the teaching​ session? 1. Taking a​ self-awareness questionnaire will increase your ​self-esteem. 2. Becoming ​self-aware will increase your empathy for others. 3. Developing ​self-awareness requires you to closely examine others​' beliefs and values. 4. ​Self-awareness does not require you to recognize your emotions.

2 ​Self-awareness development is an ongoing process that requires intense examination of one​'s personal​ perspectives, beliefs, and values. Practicing​ self-awareness incorporates​ self-discovery and produces personal insights. Through​ self-awareness, a nurse gains greater understanding of​ others, as well as increased empathy and respect for them.Taking a​ self-esteem questionnaire helps increase​ self-awareness by helping individuals to recognize their emotions and feelings.

describing individuals who are currently in their 50s and​ 60s? 1. Net generation 2. Baby boomers 3. Survivalists 4. Traditionalists

2 The baby boomers were born between approximately 1945 and 1960 and are currently in their 50s and 60s. Members of the veteran​ generation, which comprises individuals who were born between 1925 and 1944 and who are currently in their 70s and​ 80s, are also known as​ survivalists, traditionalists, and the silent generation. The millennial​ generation, which is made up of individuals who were born between 1981 and​ 2000, is also known as Generation​ Y, Generation​ Next, and the net generation.

During a continuing education​ meeting, the nurse educator is discussing the nurse​'s responsibilities related to ethical dilemmas. Which statements should the nurse educator include in the​ presentation? ​(Select all that​ apply.) 1. It is the nurse​'s responsibility to ensure that ethical challenges do not arise during the client​'s care. 2. Notifying care team members about ethical challenges is the nurse​'s responsibility. 3. Informing the client about ethical issues that affect the client​'s care is part of the nurse​'s job. 4. The nurse should ask the healthcare provider to manage ethical challenges that emerge during client care. 5. Whenever ​possible, the nurse should adhere to the ANA Code of Ethics for nurses.

2, 3 With regard to ethical​ dilemmas, nursing responsibilities include recognizing the actual or potential ethical​ dilemma; informing the client and care team members of ethical issues affecting the​ client's care; always adhering to the ANA Code of Ethics for registered​ nurses; managing ethical​ challenges; and evaluating the outcomes of interventions taken to promote ethical practice. The nurse is not responsible for ensuring that ethical challenges do not occur.

Which statements best describe the concept of​ self-awareness? ​(Select all that​ apply.) 1. ​Self-awareness is unrelated to core beliefs 2. Practicing​ self-awareness incorporates​ self-discovery 3. ​Self-awareness produces personal insights 4. ​Self-awareness increases empathy toward others 5. Developing​ self-awareness requires examination of​ others' beliefs

2, 3, 4 An individual who is​ self-aware understands why he does what he​ does, and his behaviors and actions can be linked to his core beliefs and values. Development of​ self-awareness requires intense examination of​ one's personal​ perspectives, beliefs, and values. Practicing​ self-awareness incorporates​ self-discovery and produces personal insights. Through​ self-awareness, a nurse gains greater understanding of​ others, as well as increased empathy and respect for them.

What conditions can add to the potential risk of nurses not maintaining​ confidentiality? ​(Select all that​ apply.) 1. International travelers 2. Celebrity status 3. Unusual medical conditions 4. Notoriety 5. Previous hospital admissions

2, 3, 4 Celebrity​ status, notoriety, or unusual medical conditions can add to the potential risk of nurses not maintaining confidentiality. The situations of international travelers or previous hospital admissions do not add to the potential risk.

The staff nurse is applying Roach​'s theory of caring as the human mode of being. Which nursing behavior best reflects the caring trait of​ compassion? ​(Select all that​ apply.) 1. Being aware of personal responsibility for meeting the client​'s needs 2. Participating in the client​'s experience 3. Empathizing with the client​'s sorrow about being ill 4. Sharing the client​'s sense of accomplishment regarding smoking cessation. 5. Fostering a trusting relationship with the client

2, 3, 4 Compassion includes participating in the experience of another​ individual, and sharing another individual​'s ​joys, sorrows,​ pain, and accomplishments. Confidence is the quality that fosters trusting relationships. Conscience includes awareness of personal responsibility.

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.) 1. It is defined as conduct deviating from the standard of practice dictated by the profession. 2. It is considered an unintentional tort. 3. It is defined as conduct that deviates from what a reasonable individual would do in a particular circumstance. 4. It occurs without the deliberate intent to bring harm against another individual. 5. It is considered an intentional tort.

2, 3, 4 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.

Which relationships are guided by the Code of Ethics from the International Council of​ Nurses? ​(Select all that​ apply.) 1. Nurses and payment 2. Nurses and​ co-workers 3. Nurses and practice 4. Nurses and people 5. Nurses and laws

2, 3, 4 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.

Which statements best indicate the nurse​'s correct understanding of the principles of​ self-awareness? ​(Select all that​ apply.) 1. Intense examination of the personal perspectives of others raises my ​self-awareness. 2. Self-awareness helps me to better understand others. 3. My empathy for others is greater because of my increased ​self-awareness. 4. Because of​ self-awareness, I have more respect for others. ​5. Self-awareness helps me to better understand myself.

2, 3, 4, 5 An individual who is​ self-aware understands why he does what he​ does, and his behaviors and actions can be linked to his core beliefs and values. Development of​ self-awareness requires intense examination of one​'s personal​ perspectives, beliefs, and values. Practicing​ self-awareness incorporates​ self-discovery and produces personal insights. Through​ self-awareness, a nurse gains greater understanding of​ others, as well as increased empathy and respect for them.

Which nursing action best reflects the principle of aesthetic​ knowing? ​(Select all that​ apply.) 1. Applying​ nursing-related facts to client care 2. Being sensitive to the client​'s needs 3. Demonstrating empathy toward the client 4. Providing compassionate client care 5. Viewing the client holistically

2, 3, 4, 5 Key elements to the pattern of aesthetic knowing include​ empathy, holistic​ thinking, compassion, and sensitivity. Application of​ nursing-related facts is reflective of empirical knowledge.

Stella Martin is the nurse unit manager of an emergency department. The two newest additions to the emergency​ department's nursing​ team, Angelica Babasa and Evan​ Parker, are members of Generation X. When implementing an orientation program for Angelica and​ Evan, which strategy best reflects​ Stella's accurate understanding about the work ethic characteristics of Generation​ X? 1. Using personal forms of communication for notification of employee training sessions 2. Demonstrating a style of management that is reflective of mentorship or coaching 3. Having a tendency to embrace professionalism while questioning managerial and administrative authority 4. Providing an orientation program that includes daily evaluations and performance feedback

2. Demonstrating a style of management that is reflective of mentorship or coaching

The home care nurse is visiting an older client with heart failure. Which interventions are appropriate for the nurse to implement in order to prevent medication errors at​ home? ​(Select all that​ apply.) 1. Explain when to skip medication doses. 2.Review the client​'s list of prescribed medications. 3. Review potential drug interactions with food. 4. Teach how prescribed medications are to be taken. 5. Study the name and purpose of each prescribed medication.

2, 3, 4, 5 Nurses can proactively help prevent medication errors by discussing medications with clients. Actions to take include regularly assessing client medication​ lists, examining the name and function of​ medications, teaching when and how medication should be​ taken, emphasizing common side effects and how to address​ them, and discussing drug interactions with other​ drugs, food, and diseases. Skipping a medication dose is beyond the scope of practice for the nurse. This action would not prevent a medication error at home and might cause an error if the client is instructed to skip certain medications.

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.) 1. The Joint Commission is the primary agency responsible for establishing nursing standards of care. 2. The American Nurses Association​ (ANA) Standards of Practice is the prevailing national nursing standard. 3. Employers can​ limit, but not​ expand, the nursing scope of practice. 4. The Nurse Practice Act and administrative rules form the basis of the standard of care for nurses. 5. The nurse​'s specific job description will aid in defining the standard of care.

2, 3, 4, 5 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 Patient​ Self-Determination Act applies to many entities. Which ones does it apply​ to? ​(Select all that​ apply.) 1. Individual healthcare providers 2. Home health agencies 3. Health maintenance organizations 4. Hospitals 5. Nursing homes

2, 3, 4, 5 The Patient​ Self-Determination Act applies to​ hospitals, nursing​ homes, health maintenance​ organizations, and home health agencies. It does not apply to individual healthcare providers.

The nurse manager determines that a staff nurse is demonstrating the​ knowledge, skills, and attitudes for the competency of safety. Which skills did the manager observe the nurse​ perform? ​ (Select all that​ apply.) 1. Entering​ log-in and password information before documenting in a client​'s medical record 2. Following the identified rights of medication administration before giving a client a pain medication 3. Washing hands before and after providing care to a client with an infection 4. Notifying the environmental services team about a leaking sink in a client​'s bathroom 5. Applying gloves before emptying a client​'s wound drainage device

2, 3, 4, 5 The QSEN competency of safety focuses on sharing knowledge and reporting errors to help improve client safety. This competency enables the nurse to minimize the risk of dangerous or harmful situations with clients and other healthcare​ professionals, reduce​ healthcare-associated infections, and decrease the possibility for errors in client care. This would be exemplified by notifying someone of a leaking bathroom​ sink, washing hands before and after providing​ care, wearing​ gloves, and following the rights of medication administration. Entering​ log-in and password information before documenting in a​ client's medical record is a skill associated with the competency of informatics.

At a nurses​'​ retreat, participants are discussing the characteristics of a​ self-aware nurse. Which descriptions are most​ accurate? ​(Select all that​ apply.) 1. The ​self-aware nurse does not have personal weaknesses. 2. A ​self-aware nurse is more likely to be respectful toward others. 3. The ​self-aware nurse is able to recognize personal strengths. 4. The ​self-aware nurse is free from​ assumptions, beliefs,​ values, and prejudices that can impair judgment. 5. Empathy toward others is a characteristic of the​ self-aware nurse.

2, 3, 5 Characteristics of the​ self-aware nurse include the ability to identify personal strengths and weaknesses. The​ self-aware nurse is aware of​ assumptions, beliefs,​ values, and prejudices that can impair judgment.​ Self-awareness promotes the nurse​'s ​understanding, respect, and empathy for others.

An experienced nurse remembers the many nursing education efforts that took place when the Health Insurance Portability and Accountability Act​ (HIPAA) was passed in 1996. With education​ refreshers, what would the nurse identify as HIPAA​'s ​goals? ​(Select all that​ apply.) 1. Determine reasonable caps for health insurance premiums 2. Help those who lose health insurance coverage 3. Overcome​ pre-existing conditions as a barrier to health insurance 4. Establish universal health insurance coverage 5. Eliminate medical underwriting in group plans

2, 3, 5 HIPAA's goals included overcoming​ pre-existing conditions as a barrier to health​ insurance, helping those who lose health insurance​ coverage, and eliminating medical underwriting in group plans.​ HIPAA's goals did not include establishing universal health insurance coverage or determining reasonable caps for health insurance premiums.

Which nursing actions could be negligence that results in​ malpractice? ​(Select all that​ apply.) 1. Documenting client care in the electronic medical record 2. Failing to follow the standard of practice 3. Lacking appropriate communication skills 4. Assessing and monitoring a client who has returned from surgery 5. Using equipment without appropriate training

2, 3, 5 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.

According to the American Association of Colleges of​ Nursing, which values are essential for the professional nurse to​ demonstrate? ​ (Select all that​ apply.) 1. ​Self-esteem 2. Altruism 3. Integrity 4. Competence 5. Autonomy

2, 3, 5 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.

The nurse educator is leading a class discussion about factors that affect the nurse​'s function as a moral agent. When discussing potential sources of ethical​ challenges, which students​' statements are most​ accurate? ​ (Select all that​ apply.) 1. Staffing shortages have little to no effect on creating ethical conflict. 2. Issues that impact organizational efficiency can create ethical conflict. 3. The traditional focus on palliative treatments can create ethical conflict. 4. Typical power structures in health care can be sources of ethical conflict. 5. Functioning as an ​'​in-between​' helps to prevent ethical conflict.

2, 4 Sources from which ethical conflicts in nursing may arise include staffing shortages or other situations that impact organizational​ efficiency, as well as traditional power structures in health​ care, including the focus on providing curative treatment. Ethical challenges also may stem from nurses functioning as open double quote"​in-betweens,close double quote" during which nurses are caught in between various players including healthcare providers and the​ client, the client and the​ client's family​ members, colleagues, and others.

The staff nurse and the client are discussing patient rights as outlined by The Joint Commission. Which statements are appropriate for the nurses to include in the​ discussion? 1. You have the right to use an advocate who is employed by the hospital. 2. You have the right to refuse care that you do not want. 3. You have the right to receive medication for pain management. 4. You have the right to receive information in your preferred language. 5. You have the right to know the names of the caregivers who treat you.

2, 4, 5 As outlined by The Joint​ Commission, patient rights include the right to have a personal​ representative, also called an​ advocate, who is a family member or friend appointed by the patient. Patients also have the right to know the names of their​ caregivers, the right to refuse​ care, and the right to receive information about their care in their preferred language. While patients have the right to have their pain​ addressed, the method of pain treatment is not specified.

The staff nurse is giving a presentation about factors that contribute to the development of ethical issues in nursing. Which items should be​ included? ​ (Select all that​ apply.) 1. Increased staffing of nurses 2. Conflicting loyalties and obligations among nurses 3. Decreasing emphasis on containing healthcare costs 4. Rapidly changing technology 5. Conflicts between societal and cultural values

2, 4, 5 Factors that contribute to the development of ethical issues in nursing include rapidly changing​ technology, conflicting societal and cultural​ values, conflicting loyalties and obligations among​ nurses, increasing pressure to contain healthcare​ costs, and reduced staffing of nurses.

Which are true statements about the relationship of ethics and laws. ​(Select all that​ apply.) 1. Following the law is making a choice to take an ethical action. 2. A specific situation can be​ legal, but perhaps not moral. 3. An ethical action gives some input into determining the legality of a situation. 4. A specific situation can be​ moral, but perhaps not legal. 5. Laws are enacted to reflect the ethical values of society.

2, 4, 5 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 nursing considerations best reflect the​ nurse's application of Benner and​ Wrubel's theory of​ caring? ​(Select all that​ apply.) 1. The nurse recognizes that his intent to care will not influence the​ client's receipt of care. 2. The nurse is aware that caring is dependent on the context of the situation. 3. The nurse understands that physical environment does not affect caring. 4. The nurse acknowledges that his training influences caring. 5. The nurse knows that caring is dependent on the​ client's capacities.

2, 4, 5 Patricia Benner and Judith​ Wrubel's theory of caring acknowledges the​ nurse's intent to care as impacting both the delivery and the receipt of care. Benner and Wrubel also describe caring as being dependent on other​ factors, including the context of the​ situation, the physical​ environment, the​ nurse's training and​ experience, and the​ client's unique perspectives and capacities.

A healthcare organization implemented the STOP STICKS program on all client care areas. Which observations by the nurse manager indicate the need for additional education about the​ program? ​(Select all that​ apply.) 1. Supplying nursing staff with blunt edged scissors 2. Witnessing a nurse recapping used needles 3. Changing sharps containers when​ 3/4 full 4. Finding sharps containers at the head of every​ client's bed space 5. Finding used syringes and needles on top of medication carts

2, 5 The educational campaign STOP STICKS was created to remind hospital staff of the ways to prevent and report needlestick injuries. This campaign specifically provides resources for exposure prevention​ methods, equipment​ evaluations, and requirements for sharps disposal containers. Nursing staff recapping needles and finding used syringes and needles on top of medication carts indicate that additional training is needed on exposure prevention methods. Changing sharps containers when​ ¾ full and ensuring that sharps containers are at the head of every​ client's bed space would indicate that training has been effective. Providing all staff with blunt edged scissors would not support the STOP STICKS program.

The nurse is caring for a client recently admitted with a stomach virus. Which actions should the nurse take to limit the spread of this infection to other clients and nursing​ staff? ​ (Select all that​ apply.) 1. Cleanse bedside tables and counter tops with rubbing alcohol 2. Wash hands before and after providing care to the client 3. Cover the client​'s bedpan with a sterile towel and place in the bathroom 4. Remove unneeded care items from the client​'s room to decrease clutter 5. Double bag reusable client care equipment before sending out for sterilizing

2, 5 The major preventive measure that all nurses can take to limit the spread of common illnesses is hand hygiene. Thorough sanitation of​ client-care equipment is another action to reduce the spread of highly contagious illnesses.​ Double-bagging the equipment before sending it for sterilization would help reduce the spread of the virus throughout the hospital during transport. Rubbing alcohol might not be effective to disinfect tables and counter tops. Removing unneeded care items from the​ client's room to decrease clutter does not limit the spread of​ infection, but may reduce the risk for falls. Covering a bedpan with a sterile towel is not sufficient to limit the spread of the virus to other clients and nursing staff.

Helen and Chuck Winston are the parents of a​ 4-year-old child with cerebral palsy. They recently received a mailing from a national organization that advocates for children with mobility issues. The mailing was addressed directly to their​ son, and included a request for a donation. They are adamant that their​ child's medical status not be known by anyone outside the immediate family. To which governmental agency could they direct a complaint about possible violation of their​ child's right to​ privacy? 1. Agency for Healthcare Research and Quality 2. Office for Civil Rights 3. National Institute of Disability Health 4. Centers for Disease Control and Prevention

2. Office for Civil Rights

Sam Woods is a registered nurse working with city council members to create a program that supports community safety. What would be a goal of this​ program? 1. Advocate for the opening of a community sports facility for children. 2. Reduce the number of bicycle and pedestrian injuries caused by motor vehicles. 3. Increase the number of​ after-school organized activities for community children. 4. Reduce the number of​ high-calorie snacks in school vending machines.

2. Reduce the number of bicycle and pedestrian injuries caused by motor vehicles.

The clinical nursing instructor is evaluating a nursing student who has been struggling with inserting intravenous catheters. The nursing student​ states, "The other students are so much better at nursing than I am. I love comforting my​ clients, but I would rather be able to start an​ IV." Which response best reflects the relationship between​ competence, compassion, and nursing​ practice? 1. ​"In nursing, technical expertise is more valuable than​ compassion." 2. ​"Safe, effective nursing care requires both compassion and​ competence." 3. ​"Successfully inserting an IV is a direct reflection of compassionate client​ care." 4. ​"Technical expertise is very​ important, but compassion is the key to​ nursing."

2. ​"Safe, effective nursing care requires both compassion and​ competence."

Two nurse case managers are discussing the implications of the Patient Protection and Affordable Care Act​ (ACA). In their​ discussion, what effect on the Health Insurance Portability and Accountability Act​ (HIPAA) standards could they remind each other​ of? 1. ACA exempted health plans from HIPAA compliance. 2. ACA required healthcare providers to follow HIPAA standards. 3. ACA increased penalties for noncompliance with HIPAA. 4. ACA supplanted the previous Privacy Rule.

3 ACA increased penalties for noncompliance with HIPAA. HIPAA already required healthcare providers to follow its standards. ACA did not supplant the Privacy Rule. ACA did not exempt health plans from HIPAA​ compliance, but instead required certification of their HIPAA compliance.

Which nursing intervention most effectively addresses a factor related to the influence of environment on​ caring? 1. Assessing the client​'s pain level 2. Learning about the client​'s physiologic condition 3. Adjusting the temperature of the client​'s room 4. Using an interpreter to communicate with the client

3 Adjusting the temperature of the client​'s room most effectively addresses a factor related to the environment​'s influence on caring. Using an interpreter reflects resolution of a cultural barrier to caring. Learning about the client​'s physiologic condition addresses the influence of knowledge on caring. Assessing the client​'s pain level reflects identification of a barrier to caring related to health status.

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? 1. Neither nurse is an​ advocate; the client had no real choice and would have died soon anyway 2. Both nurses are​ advocates; they are proposing choices that the client could have made 3. The nurse who believed that the client​'s decision to end treatment is OK. 4. The nurse who thought that the client should have had a chance to reconcile with a child

3 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 nurse educator is outlining requirements for nursing students who are completing hospital clinical rotations. Which requirement is likely to be the most challenging to nursing students who are members of the Millennial​ Generation? 1. Students must not administer client care without first socially engaging the client. 2. Students must receive evaluations at the end of each day. 3. Students must not bring cell phones into the clinical setting. 4. Students must collaborate with the clinical nursing instructor when planning client care.

3 Characteristics of the Millennial Generation​ (individuals born between 1981 and​ 2000) include requiring personal cell phones as a necessity for daily life and interpersonal communication. Members of the millennial generation tend to expect daily performance feedback and usually are social and collaborative.

For which QSEN competency should the nurse demonstrate the ability to use electronic client​ records? 1. Teamwork and collaboration 2. Quality improvement 3. Informatics ​4. Patient-centered care

3 Demonstrating the ability to use electronic client records is a skill within the QSEN competency of informatics. The competencies of quality​ improvement, teamwork and​ collaboration, and​ patient-centered care do not address the use of technology for documenting in the client record.

Which caring behavior or process reflects the​ client's development of the ability to autonomously identify her own health needs in lieu of being instructed how to do​ so? 1. Presencing 2. Competence 3. Empowerment 4. Compassion

3 Empowerment reflects the​ client's development of the ability to autonomously identify her own health needs in lieu of being instructed how to do so. Compassion develops as a result of being intimately involved with the​ client's experience. Presencing involves the​ nurse's immersion in a​ nurse-client interaction that helps the client define her health choices while respecting the​ client's authority to make his own decisions. Competence is the​ nurse's ability to effectively demonstrate a set of​ attributes, such as professional​ attitude, personal​ characteristics, knowledge,​ skills, and​ values, and to fulfill the​ nurse's professional responsibility through nursing practice.

The nurse is caring for a client who is in excruciating pain from terminal cancer. The​ client's son has asked that his father receive every effort to prolong his life. The son has durable power of​ attorney, and says that is what his father wants. The oncology nurse disagrees with this decision. Which action by the nurse is the most​ appropriate? 1. Confront the family member about the ramifications of his decision 2. Let the client know how the nurse feels about the situation 3. Continue to follow the documented healthcare directions for the client 4. Refuse to be assigned to the client​'s future care

3 Even if they oncology nurse disagrees with the​ son's decision, the nurse should continue to follow the​ son's healthcare directions. The nurse should not confront the son about the ramifications of his​ decision, refuse to be assigned to the​ client's future​ care, or let the client know how the nurse feels about the situation.

While removing a trash bag from the room of a client in protective​ isolation, the nurse sustains a needlestick to the leg. Which educational topic is a priority for the nurse manager to discuss during the next staff​ meeting? 1. Technique to remove biohazard trash from isolation rooms 2. Actions to take when exposed to contaminated sharps 3. Appropriate disposal of used sharps 4. Personal protective equipment to wear when disposing of trash

3 Even though the safe handling of sharps and needles is an expectation for every healthcare​ professional, accidents can occur because of staff not following proper disposal techniques. The issue was a needle placed in regular trash. A technique to remove biohazard trash from a​ client's room will not address the problem. Reviewing personal protective equipment to wear when disposing of trash will not address the problem. Actions to take when exposed to contaminated sharps would not be necessary if all staff disposed of sharps appropriately.

The nurse researcher is presenting a webinar about the application of the primary risk model for managing ethical dilemmas in nursing. When describing peer​ support, which statement is most​ accurate? 1. ​"Peer support involves acquiring the necessary coping skills prior to experiencing the​ stressor." 2. ​"Peer support should be combined with didactic training for maximum​ effect." 3. ​"Peer support should be combined with consultation to prevent ethical challenges from​ arising." ​4. "Peer support involves developing secondary risk management​ skills."

3 In application of the primary risk management​ model, peer support and consultation are combined to create resources that emphasize primary prevention of ethical challenges. Resource accumulation involves acquiring the needed resources and coping skills prior to experiencing the stressor.​ Education, which should always be combined with didactic​ training, is used to create an additional resource for developing primary risk management skills.

Why might advocating for client confidentiality be difficult for​ nurses? 1. Advocacy can be a lonely position if medical staff does not support nurses. 2. Other ways of maintaining confidentiality are simpler to implement than advocacy. 3. Nurses can control and monitor their own behavior easier than confronting others. 4. Advocacy is always more​ work, since nurses need to join a group.

3 Nurses can control and monitor their own behavior easier than confronting others. Advocacy does not require joining a group or waiting for support from medical staff. Other ways are not necessarily simpler to implement.

The client care coordinator is designing a brochure that describes the purpose of patient responsibilities. Which item regarding patient responsiblities should be​ included? 1. They emphasize the healthcare provider​'s leadership role. 2. They reaffirm the patient​'s right to refuse treatment without consequences. 3. They protect the rights of all patients who are receiving care. 4. They help the healthcare provider to more actively participate in the patient​'s care.

3 Patient responsibilities serve to protect the rights of all clients receiving care by emphasizing every​ client's right to be safe and comfortable. Rather than viewing the healthcare provider as the​ leader, patient responsibilities emphasize health care as a partnership between the client and​ caregivers, and help clients more actively participate in their own health care.​ Additionally, patient responsibilities include understanding that there are consequences to noncompliance with treatment plans.

Which way of knowing refers to the​ nurse's ongoing​ self-exploration and journey toward​ self-actualization? 1. Empirical knowing 2. Aesthetic knowing 3. Personal knowing 4. Ethical knowing

3 Personal knowing refers to the​ nurse's ongoing​ self-exploration and journey toward​ self-actualization. Aesthetic knowing encompasses the​ "art of​ nursing." Empirical knowing encompasses the​ "science of​ nursing." Ethical knowing is reflective of the​ "moral component" of nursing knowledge.

A client is prescribed a chemical restraint for aggressive behavior. When reviewing the client​'s medication administration​ record, which medication should the nurse use to prevent the client from causing harm to self or other staff​ members? 1. amoxicillin​ (Amoxil) 2. warfarin​ (Coumadin) 3. diazepam​ (Valium) 4. digoxin​ (Lanoxin)

3 Pharmacologic agents are used to control hyperactive behavior in agitated clients. Commonly used medications include​ sedatives, hypnotics,​ neuroleptics, and antianxiety medications. Diazepam​ (Valium) is a​ benzodiazepine, which can be prescribed as a sedative or antianxiety medication. Amoxicillin​ (Amoxil) is an antibiotic. Warfarin​ (Coumadin) is considered an anticoagulant. Digoxin​ (Lanoxin) is a cardiac glycoside antiarrhythmic medication.

When a nurse obtains informed​ consent, the client should be provided with all pertinent and relevant information. Which information is not ​relevant? 1. The purposes of the treatment 2. The diagnosis or condition that requires treatment 3. The insurance payment methods 4. The intended benefits of the treatment

3 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.

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? 1. It demonstrated nursing​'s boundaries. 2. It demonstrated nursing​'s values. 3. It demonstrated nursing​'s skills. 4. It demonstrated nursing​'s attitudes.

3 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.

The client asks the nurse to describe the benefits and limitations of the U.S. Advisory Commission on Consumer Protection and Quality in the Health Care Industry​'s Bill of Rights. Which statement is most appropriate for the nurse to include in the​ description? 1. You do not have the right to copy the information contained in your medical records. 2. You do not have the right to receive treatment for severe pain without prior authorization. 3. You have the right to read everything in your medical records. 4. You have the right to change any item in your medical record.

3 The U.S. Advisory Commission on Consumer Protection and Quality in the Health Care​ Industry's Bill of Rights affords clients the right to read and copy their medical records. If clients have severe​ pain, an​ injury, or a sudden illness that leads them to believe that their health is in serious​ danger, they have the right to be screened and stabilized using emergency​ services, which are to be provided whenever and wherever​ needed, without waiting for authorization and without any financial penalty. Although they cannot personally alter their medical​ records, they can ask their healthcare provider to change information that is​ inaccurate, irrelevant, or incomplete.

A client has designated a member of the family as a healthcare surrogate. In making this​ decision, which rationale is the​ priority? 1. The client​'s feeling that the individual would be accepting of death or disability. 2. The individual​'s familiarity with the client​'s complex medical history. 3. The individual​'s knowledge about the client​'s intended decisions. 4. The client​'s feeling that the individual would know the latest medical innovations.

3 The best reason for the client to select an individual for a healthcare surrogate is that​ individual's knowledge about the​ client's intended decision. It is not as important if that individual is familiar with the​ client's entire medical​ history, knows about the latest medical​ innovations, or accepts death or disability.

Which statement best reflects the impact of culture on a principle of​ Watson's theory of human​ care? 1. Caring depends on the​ nurse's training and​ experience, both of which are shaped by the cultural practices of the location in which training and experience are obtained 2. What is considered to be acceptable behavior will vary among​ cultures, so the emphasis on providing quality service to clients and their families might be affected by cultural influences 3. Caring emphasizes preservation of the​ client's dignity, which requires the nurse to be aware of the​ client's cultural beliefs 4. Because caring depends on the​ client's unique capacities and​ experiences, the nurse must be aware of the​ client's cultural influences

3 The impact of culture on a principle of​ Watson's theory of human care is best reflected by the emphasis on preservation of the​ client's dignity leading to a need for awareness of the​ client's cultural beliefs. Statements related to​ culture's impact on the​ client's unique capacities and​ experiences, the​ nurse's training and​ experience, and the emphasis on providing quality service to clients and their families are reflective of principles of Benner and​ Wrubel's theory of caring.

A per diem nurse is assigned to a unit for the first time and is unsure of the names and positions of all the staff on the​ unit, but hears a staff conversation in the hallway about panic lab values for a client. The nurse hears the client​'s name and​ diagnosis, and realizes that everyone in the area can hear that information as well. Which priority action should the nurse take at this​ time? 1. Go to the unit​'s nurse manager and report a breach of privacy 2. Find a colleague to ask about which staff belong on the unit 3. Interrupt the conversation and remind staff about privacy rights 4. Realize staff could get upset at reports of panic lab values

3 The per diem nurse should interrupt the conversation and remind staff about privacy rights. The per diem nurse should not spend time going to the​ unit's nurse manager or consulting a colleague. Even if staff get upset at lab test​ results, they are not allowed to violate privacy.

The family of a client in a skilled care facility is concerned that the client​'s condition is deteriorating because a mechanical lift is being used to transport the client to the bathroom. Which explanation by the nurse is most​ appropriate? 1. The client is weaker and the lift helps improve circulation. 2. The lift is used because there isn​'t enough staff to help move the client. 3. The lift protects both the client and the staff during transfers. 4. The client cannot walk as fast as necessary to make it to the bathroom without having an accident.

3 The use of mechanical aids to move clients promotes client and staff safety. Responding that the mechanical aid is used because the client cannot walk fast enough to the bathroom could support the​ family's concern that the client is deteriorating. Responding that the lift is used because of limited staff could be interpreted that the client is receiving​ sub-standard care or the​ client's condition is deteriorating. The use of a lift will not improve the​ client's circulation although one purpose of its use is to increase rehabilitation efforts.

A pediatric nurse works at a rural hospital that recently changed to an electronic health record​ (EHR) system. On a daily​ basis, how is the​ nurse's access to the EHR affected by a Health Insurance Portability and Accountability Act​ (HIPAA) regulation? 1. Monitor glare filters are required on all screens. 2. Computer screen savers must be used at all time. 3. A password is required to access the system. 4. Parental consent forms are required.

3 The​ nurse's access to the EHR requires a password to prevent unauthorized individuals from accessing client records. The​ nurse's access does not require parental consent​ forms, computer​ screensavers, or monitor glare filters.

Which nurse​'s statement best reflects​ self-awareness? 1. I have no prejudices that can impair my judgment 2. I overcame my personal weaknesses. 3. When I​'m ​challenged, I do not react emotionally. 4. In my professional​ practice, I do not have limitations.

3 The​ self-aware nurse is likely to demonstrate effective emotional control​ and, as​ such, the nurse​'s reaction to a challenge is not based on emotions. The​ self-aware nurse recognizes the​ assumptions, beliefs,​ values, and prejudices that can impair judgment. In​ addition, the​ self-aware nurse is capable of identifying personal strengths and is aware of personal limitations and weaknesses.

The nursing student asks the nurse preceptor to describe the​ nurse's role when caring for clients who request genetic testing. Which statement should the nurse preceptor include in the​ description? 1. ​"Limited media coverage about genetics has minimized client awareness with regard to the potential for inheriting medical​ conditions." ​2. "The nursing Code of Ethics does not address​ clients' rights to receive information about making genetic testing​ decisions." ​3. "Nurses who serve clients who may undergo testing for inherited illnesses should examine the​ clients' personal beliefs about genetic​ testing." ​4. "Parental consent is needed before a minor can choose to undergo genetic testing or to obtain related counseling​ services."

3 When professional practice includes serving clients who may undergo testing for inherited​ illnesses, nurses should examine the​ clients' personal beliefs and values about genetic testing. Increasing media coverage about genetics has led to greater awareness among clients and healthcare consumers regarding the potential for inheriting medical conditions. The nursing Code of Ethics supports​ clients' rights to receive information and counseling about making genetic testing decisions. Nurses should also know their​ state's legal​ requirements, including whether parental consent is required for a minor to seek genetic testing and counseling.

There are certain relevant factors that contribute to why a client is prone to falling. Which factor is least related to client​ falls? 1. A history of falls 2. Falls caused by side effects of medication 3. Genetic trait for falls 4. Cognition problems causing falls

3 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 fallslong dash—such as forgetting to tie shoe laceslong dash—with a resultant fall. Medication side​ effects, such as dizziness and equilibrium​ problems, can cause a client to fall.

Which QSEN competency is exemplified when nurses work with individuals from other departments and disciplines to address conflict​ situations? 1. Quality improvement ​2. Evidence-based practice 3. Teamwork and collaboration 4. Safety

3 Within the competency of teamwork and​ collaboration, the nurse is expected to work effectively with other departments and​ shifts, and engage in conflict resolution as needed. Within the competency of​ evidence-based practice, the nurse recognizes individual knowledge limits and knows how to access current evidence to supplement knowledge. Within the competency of quality​ improvement, adverse events are monitored and reported so safety and quality of care can be improved. The competency of safety focuses on sharing knowledge and reporting errors to help improve client safety.

Which caring behavior or process is sometimes used interchangeably with other​ characteristics, such as​ sympathy, empathy, or​ caring? 1. Competence 2. Empowerment 3. Compassion 4. Presencing

3 ​Often, the terms compassion and compassionate care are used interchangeably with other​ characteristics, such as​ sympathy, empathy, or caring.​ Presencing, empowerment, and competence are not used interchangeably with the terms​ sympathy, empathy, or caring.

Which statements best illustrate the nurse​'s awareness of culture​'s influence on attitude within the framework of Roach​'s theory of caring as the human mode of​ being? ​(Select all that​ apply.) open double quote"My intent to care affects the delivery of care and the client​'s receipt of​ care; caring intentions may be interpretedlong dash—and misinterpretedlong dash—by my client in the context of cultural background and beliefs.close double quote" 1. Caring is a transpersonal​ process, so the client and I both seek meaning and a sense of​ connectedness; a negative attitude on the part of either individual may create barriers to achieving these goals. 2. If my lack of confidence leads the client to mistrust​ me, any existing cultural barriers between myself and the client could become even more significant. 3. Competence includes​ motivation, and my negative attitude toward a client due to conflicting cultural beliefs could challenge my motivation to provide excellent care. 4. I need to conceptualize and engage in caring as a dynamic​ process, taking into account my client​'s cultural influences and background.

3, 4 Considering culture​'s impact on motivation to provide excellent care illustrates awareness of culture​'s influence on attitude within the framework of Roach​'s theory of caring. Understanding that lack of confidence that leads to mistrust can heighten existing cultural barriers also reflects awareness of culture​'s influence on attitude within the framework of Roach​'s theory of caring. Considering culture​'s effect on caring as a dynamic process is suggestive of application of culture to Boykin and Schoenhofer​'s nursing as caring theory. Considering culture​'s effect on caring as a transpersonal process best reflects application of culture to Watson​'s theory of human care. Considering culture​'s impact on the interpretation of caring intentions best illustrates application of culture to Benner and Wrubel​'s theory of caring.

Mr.​ Terisson, a​ 53-year-old male​ client, is diagnosed with pancreatic cancer. His​ nurse, Layne, is with him when he receives the news from the physician. After the physician leaves the​ room, Mr. Terrison slams his fist against the wall and then silently stares out the window. Which nursing behaviors best reflect Layne​'s use of presencing in Mr. Terrison​'s ​care? (Select all that​ apply.) 1. Directing the client to assess his emotional response 2. Gently telling the client that his behaviors are rooted in fear 3. Speaking with the client​ face-to-face 4. Quietly sitting in the client​'s room 5. Privately recognizing the client​'s behaviors as being reflective of powerlessness

3, 4 When​ presencing, the nurse does not direct the​ client; rather, by being​ present, the nurse serves as the client​'s guide. During​ presencing, the nurse remains​ receptive, open, and available without judging or labeling the client​'s ​perceptions, feelings, or behaviors.Forms of presencing include​ face-to-face discussions and lingering presence.

Renee Vasquez is an ED nurse manager and is not an avid​ movie-goer, so she was unprepared for the crowds that packed the parking lot of the hospital when a celebrity was admitted after a car accident. The nurse overhears some personnel talking about getting autographs. What is the best response of the​ nurse? 1. Go to an experienced colleague and ask that individual to take the lead in assuring confidentiality. 2. Go to the​ celebrity's room and make sure that the personnel have not arrived there yet. 3. Go directly to the personnel who plan to get autographs and remind them about confidentiality. 4. Go to the shift supervisor and describe details of the overheard conversation.

3. Go directly to the personnel who plan to get autographs and remind them about confidentiality.

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.) 1. Use of primary nursing teams to facilitate care 2. Protocols for advanced directives for dying clients 3. Availability of mentoring by experienced nurses 4. Easy access to the use of counseling professionals 5. Regular team conferences on subjects selected by the team

3, 4, 5 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.

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.) 1. The evening shift nurse has better personal ethical values about pain relief. 2. The client should be warned about the dangers of overdosing on pain relievers. 3. Each nurse might be operating with a different set of assumptions about pain relievers. 4.The day shift nurse has better personal ethical values about pain relief. 5. The client should be helped to make an informed decision about pain relief measures.

3, 5 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 public affairs administrator at the hospital asks the cardiac care unit nurse if a local TV news anchor is still hospitalized. The public affairs administrator wants to visit the TV news anchor open double quote"to cheer him up.close double quote" Which responses by the nurse are​ appropriate? ​(Select all that​ apply.) 1. ​"I'll check our current census list for his​ name." ​2. "I'll ask him if he wants you to visit​ him." 3. ​"I can't confirm for you if he​'s here or​ not." 4. ​"He's not taking any visitors right​ now." 5. ​"Cheering up a client is not clinical​ care, so I​ can't answer​ you."

3, 5 Two responses are appropriate for the nurse to​ make: the nurse cannot confirm his presence on the​ unit, and a motive of​ "cheering him​ up" does not allow disclosure of confidential information. The nurse cannot confirm or deny his presence​ directly, as in checking the current census list. The nurse cannot talk about having conversations with him or his visitation​ status, because that response reveals his presence on the unit.

The nursing instructor is evaluating the work ethic of nursing students who are finishing a​ medical-surgical clinical rotation. Which nursing student​'s behavior best reflects a strong work​ ethic? 1. Arriving at the clinical site no more than five minutes after the scheduled start time 2. Attending the majority of the scheduled​ pre- and​ post-conferences at the clinical site 3. Having a contingency plan for dealing with transportation issues related to car problems 4. Taking preventative​ measures, such as choosing not to be vaccinated for the flu

3. Behaviors that reflect a strong work ethic among nursing students include having contingency plans for handling circumstances such as an ill child or car​ trouble; attending every​ class, clinical, and scheduled​ activity; arriving on time for all scheduled​ activities; and taking preventative​ measures, such as being vaccinated for the flu.

Hospital nurse leader Jennifer Hsiung is designing a training program that facilitates the development of effective multigenerational nursing teams. Which strategies are most appropriate for Jennifer to include in the training​ program? 1. Emphasizing older team​ members' superior knowledge base and extensive clinical experience 2. Encouraging knowledge and skills competitions between younger and older team members 3. Emphasizing the importance of mutual support and effective conflict resolution 4. Promoting younger team members to leadership positions based on technological expertise

3. Emphasizing the importance of mutual support and effective conflict resolution

The home care nurse visits a client with chronic obstructive pulmonary disease​ (COPD) to complete a scheduled teaching session about how to use a nebulizer. When the nurse greets the​ client, the client​ states, "I'm okay.​ I'm just feeling really depressed​ today." Although the client appears to be calm and in no physical​ distress, the nurse hears a faint wheeze when the client exhales. Which nursing response best reflects a​ competent, caring nursing​ intervention? 1. Asking the client to choose another time for the teaching session and respecting his need for privacy by leaving 2. Assembling the nebulizer for the client and immediately administering a breathing treatment to him 3. Expressing concern for the​ client's depression and asking him if he wants to discuss his​ feelings, but planning to complete the scheduled teaching session 4. Encouraging the client to discuss his feelings and rescheduling the teaching session for the following day

3. Expressing concern for the​ client's depression and asking him if he wants to discuss his​ feelings, but planning to complete the scheduled teaching session

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? 1. Employing the use of effective communication as a strategy 2. Maintaining client safety as a strategy 3. Giving clear directions to the client 4. Developing a​ nurse-pharmacy rapport as a strategy

3. Giving clear directions to the client

Molly Cantrell is a nurse who is planning to incorporate skills that support the competency of​ evidence-based practice when providing client care. Which action supports this​ competency? 1. Document care immediately after providing it. 2. Complete a root cause analysis after a medication error occurs. 3. Include a new process for changing a wound dressing into a​ client's care plan. 4. Meet with physical therapist to discuss a​ client's mobility needs.

3. Include a new process for changing a wound dressing into a​ client's care plan.

Erin Klarke is a staff nurse in a secured critical care unit. Her​ client, Stu​ Willitson, is a​ 58-year-old man who sustained multiple injuries during a motor vehicle accident. Mr. Willitson​ states, "I​ don't want my​ wife, kids, or any other family or friends in my room. I​ don't want them to see me like​ this." Mr.​ Willitson's wife has tearfully asked Erin to allow her and her children to see her​ husband, and her children are demanding to see their father. Mr.​ Willitson's healthcare provider told him he is being unreasonable and insists he see his family. According to the ANA Code of​ Ethics, which action by Erin is the most​ appropriate? 1. Encourage the client to allow his wife and children to briefly visit with him to reassure them that he is okay. 2. Encourage the client to allow his wife to see him​ first, and advise the wife to suggest visiting with the children. 3. Support the client in his decision and encourage him to explore the reasons for his choice. 4. Support the healthcare​ provider, and encourage the client to explore the reasons for his unreasonable behavior.

3. Support the client in his decision and encourage him to explore the reasons for his choice.

The clinical nursing​ instructor, Louisa​ Waters, is teaching nursing students about how to apply​ Roach's theory of caring to clinical practice. Which statement best represents the​ instructor's correct understanding of how cultural influences can affect​ confidence? 1. ​"Confidence includes participating in the​ client's experience, so empathizing with the​ client's experiences requires the nurse to be aware of the​ client's cultural​ influences." 2. ​"Confidence incorporates awareness of personal​ responsibility, which is affected by the​ client's cultural background and​ influences." 3. ​"The nurse's lack of confidence could prevent the client from trusting​ her, which could cause any cultural barriers to be more​ challenging." 4. ​"Morals and ethics are components of​ confidence, so the nurse needs to understand that culture impacts each​ client's moral and ethical​ beliefs."

3. ​"The nurse's lack of confidence could prevent the client from trusting​ her, which could cause any cultural barriers to be more​ challenging."

The mentor of the newly hired nurse is talking about the effects of privacy laws. What personal financial consequence may occur for a nurse who inadvertently violates a​ client's privacy? 1. A nurse might be responsible for calculating the costs of restoring privacy. 2. A nurse might be fined by hospital administration. 3. A nurse might have increased payroll deductions. 4. A nurse might have to defend against a civil lawsuit.

4 A nurse who even inadvertently violates a​ client's privacy might have to defend against a civil lawsuit. The nurse is not responsible for calculating the cost of restoring privacy. Hospital administration does not fine nurses for privacy​ violations, or increase payroll deductions for that mistake.

The nurse preceptor asks the nursing student to give an example of a potential ethical dilemma. Which example given by the nursing student reflects an ethical​ dilemma? 1. A nurse who supports the client​'s right to have an abortion is caring for a client who is considering terminating her pregnancy. 2. A client whose ethical beliefs prohibit eating meat is seeking nutritional counseling from a nurse who is a vegetarian. 3. A client who values free will and independence is cared for by a nurse who promotes the client​'s right to autonomy. 4. A nurse whose religious beliefs prohibit the use of contraception is caring for a client that is seeking birth control.

4 An ethical dilemma exists when two or more​ rights, obligations,​ responsibilities, or values come in conflict. The nurse whose religious beliefs prohibit the use of contraception who is caring for a client that is seeking birth control best reflects a potential ethical dilemma. Ethical beliefs that prohibit eating meat are congruent with​ vegetarianism, supporting the right to abortion is congruent with considering terminating a​ pregnancy, and valuing free will and independence is congruent with autonomy.

The community nurse receives a report from the Department of Public Health about an outbreak of influenza in neighboring counties. Which nursing intervention is appropriate to reduce the risk of a similar outbreak in the​ community? 1. Notify the school to expect a high number of student absences due to influenza. 2. Distribute​ over-the-counter cold and flu medication during the next community meeting. 3. Discuss implementing a community curfew to curtail spread of influenza. 4. Organize an influenza vaccination clinic at the local community center.

4 As a member of the​ community, the nurse should plan an influenza vaccination clinic at the community center to help reduce the risk of an outbreak of influenza in the community. The community does not have an outbreak of the​ flu, so telling the school to expect student absences is premature. A curfew would be needed if community safety is at risk. Distributing​ over-the-counter cold and flu medication during a community meeting is also premature and might be unnecessary if community members receive the flu vaccination.

The staff nurse who is working the day shift is scheduled to attend an important event immediately after work. Five minutes after the day shift​ ends, the evening shift nurse still has not arrived to assume care of the day shift nurse​'s assigned clients. This is the third time in one month that the evening shift nurse has been late to work. Several of the clients are scheduled for medications and treatments. Which action by the day shift nurse is the most​ appropriate? 1. Establish a boundary by leaving prior to the evening shift nurse​'s arrival 2. Inform the clients that administration of their scheduled treatments and medications will be slightly delayed 3. Advise clients that the evening nurse is late and encourage them to report the situation 4. Begin completing the clients​' scheduled treatments and administering their medications as ordered

4 At all​ times, including at the end of the work​ shift, the nurse is legally and morally responsible for ensuring continuity of safe client care. This includes ensuring a smooth transition between shifts and not leaving work for others to finish.​ Therefore, the most appropriate action is to begin completing treatments and administering medications as ordered. The evening​ nurse's tardiness should be addressed using proper​ channels, such as speaking with the charge nurse. Informing clients of the situation is unprofessional and may be distressing to the clients. Failure to effectively transfer the responsibility for a​ client's care to another nurse at the end of shift constitutes client​ abandonment, which is grounds for severe disciplinary action by the​ nurse's state board of nursing. Nurses who commit client abandonment also may face criminal charges.

The nurse manager is preparing an evaluation for a staff nurse who is a member of the baby boomer generation. The staff nurse​'s evaluation includes several recommendations for​ improvement, as well as some negative reports from nursing peers related to the staff nurse​'s work ethic. Based on generational characteristics related to work​ ethic, which response is most appropriate for the nurse unit manager to expect from the staff nurse when reviewing the​ evaluation? 1. Suggesting the manager act as a mentor 2. Asking to receive performance feedback each day 3. Requesting a more personalized work schedule 4. Expressing a sense of low​ self-worth

4 Baby boomers closely link​ self-worth and work ethic. Members of Generation X tend to seek greater control over their own schedule and often prefer that managers act as mentors and coaches. Members of the millennial generation tend to expect daily performance feedback.

Which nursing behavior best reflects caring in​ nursing? 1. Demonstrating success when inserting intravenous access devices on the first attempt for all clients 2. Silently empathizing with a client who complains of pain and hoping the client feels better 3. Repositioning an uncomfortable client with the primary goal of stopping the client​'s complaining 4. Verbalizing concern regarding a client​'s complaint of anxiety and providing a back massage per the client​'s request

4 Caring in nursing combines genuine interest or concern for the client​'s ​well-being with​ safe, proficient implementation of nursing interventions that are intended to restore​ health, prevent illness or​ injury, or promote wellness. Caring in nursing is best reflected by the nurse​'s verbalizing concern regarding a client​'s complaint of anxiety and providing a back massage per the client​'s request. Repositioning an uncomfortable client primarily to prevent the client from complaining suggests an absence of genuine interest or concern. Silently empathizing with a client who is in pain is an incomplete representation of caring in​ nursing, as no nursing intervention is implemented. Taken​ alone, proficiency with clinical skills​ (such as insertion of intravenous access​ devices) does not fully reflect caring in nursing.

The nurse notes skin excoriation on the client​'s abdomen at previous injection sites. Which nursing action is a priority when administering the next dose of​ medication? 1. Cleanse the skin with soap and water before the injection 2. Apply topical antibiotic at the site after the injection 3. Wear gloves when performing injection 4. Use a​ latex-free syringe for the next injection

4 Continuous use of products and items that contain latex increases a​ person's risk of developing a reaction. Some reactions are mild and cause skin irritation. Common items that can contain latex are syringes. The nurse should use a​ latex-free syringe to determine if the areas of skin irritation are being caused by latex. Wearing gloves should be done whether or not the client is experiencing skin irritation at the site of previous injections. Cleansing the skin with soap and water before the next injection or applying a topical antibiotic to the site after the next injection will not help prevent future irritation if it is being caused by a latex allergy.

The client tells her​ nurse, open double quote"You helped me learn how to recognize my own health needs without telling me how I should think.close double quote" Which nursing caring behavior or process is the client best​ describing? 1. Compassion 2. Competence 3. Presencing 4. Empowerment

4 Empowerment assists the client to autonomously identify her own health needs in lieu of being instructed how to do so. Competence is the nurse​'s ability to effectively demonstrate a set of​ attributes, such as a professional attitude and​ knowledge, skills, and​ values, and to fulfill her professional responsibility through nursing practice. Compassion develops as a result of being directly involved with the client​'s experience. Presencing involves the nurse​'s immersion in a nursedash-client interaction that helps the client define her health choices while understanding the client​'s authority to make her own decisions.

The new nurse tells his​ preceptor, I want the other nurses to consider me competent and proficient." Which category of Maslow​'s hierarchy of needs is reflected by the nurse​'s ​statement? 1. ​Self-actualization 2. Safety 3. Love and belonging 4. Esteem

4 In Maslow​'s hierarchy of​ needs, physiologic needs are at the most basic​ level; these needs include​ air, food,​ water, and shelter. The second level is safety​ needs, which comprise physical​ safety, financial​ stability, harmonious family​ relationships, and freedom from psychological threats. The third level is love and belonging​ needs, which include relationships and affection. The fourth​ level, self-actualization, is reflective of the individual​'s need to reach his highest level of function and​ fulfillment, both personally and professionally. The fifth and highest level is esteem​ needs, which include​ confidence, independence,​ competence, respect, and achievement.

During a classroom discussion about Maslow​'s hierarchy of​ needs, a nursing student​ asks, open double quote"What is the most basic level of ​need?close double quote" What is the best response by the nursing​ instructor? 1. Esteem needs are the most​ basic; these include respect and competence. 2. Safety needs are the most​ basic; these include physical and psychological safety. 3. Love and belonging needs are the most​ basic; these include relationships and affection. 4. Physiologic needs are the most​ basic; these include shelter and water.

4 In Maslow​'s hierarchy of​ needs, physiologic needs are at the most basic​ level; these needs include​ air, food,​ water, and shelter. The second level is safety​ needs, which comprise physical​ safety, financial​ stability, harmonious family​ relationships, and freedom from psychological threats. The third level of need encompasses love and belonging and includes relationships and affection. The fourth​ level, self-actualization, is reflective of the individual​'s need to reach his highest level of function and​ fulfillment, both personally and professionally. The fifth and highest level is esteem​ needs, which include​ confidence, independence,​ competence, respect, and achievement.

The risk management coordinator is teaching a seminar about using the primary risk management model to manage ethical dilemmas in nursing. Which component includes developing coping skills prior to experiencing a​ stressor? 1. Consultation 2. Education 3. Peer support 4. Resource accumulation

4 In application of the primary risk management​ model, resource accumulation involves acquiring the needed resources and coping skills prior to experiencing the stressor. Peer support and consultation are combined to create resources for primary prevention of ethical challenges.​ Education, which should always be combined with didactic​ training, is used to create an additional resource for developing primary risk management skills.

Before planning​ care, the nurse asks the client to identify goals and any cultural aspects that should be taken into consideration when providing nursing care. Which competency is this nurse​ demonstrating? 1. ​Evidence-based practice 2. Teamwork and collaboration 3. Quality improvement 4. ​Patient-centered care

4 In​ patient-centered care the​ client's perspectives,​ beliefs, and culture are taken into consideration for all aspects of care. In quality​ improvement, adverse outcomes are studied to improve client safety and the quality of care provided.​ Evidence-based practice is the use of research to guide clinical care. Teamwork and collaboration is working effectively with other departments and​ shifts, being accountable for participation as a team​ member, and engaging in conflict resolution as needed.

The nurse leader is preparing a seminar for nurse administrators about intergenerational collaboration among members of the healthcare team. Which content is most appropriate for the nurse leader to include in the​ seminar? 1. Intergenerational conflicts are always rooted in lack of appreciation or misunderstanding. 2. Intergenerational conflicts in the workplace tend to stimulate enhanced personal growth. 3. Promotion of intergenerational collaboration requires ignoring certain team members​' perspectives. 4. Promotion of intergenerational collaboration may positively affect a client​'s outcome.

4 Learning from the unique strengths of each generation produces multiple benefits for both the individual and the healthcare​ team, including decreased interpersonal​ tension, enhanced​ teamwork, and facilitation of personal growth. Intergenerational conflicts may be due to lack of appreciation or​ understanding, or simply to misinterpretation of​ others' perspectives. Understanding each​ individual's generational perspective and valuing each team​ member's unique contribution promote collaboration and may positively affect client outcomes.

Which type of restraint should the nurse identify as being the most appropriate for an older confused client who is attempting to pull out an indwelling urinary​ catheter? 1. Elbow 2. Belt 3. Mummy 4. Limb

4 Limb restraints are used to immobilize a limb for a therapeutic​ purpose, such as preventing dislodgement of a tube. A belt restraint would not restrict the client from attempting to pull out the urinary catheter. Elbow and mummy restraints are used for infants and children.

Which client​'s statement best illustrates the impact of the client​'s attitude on​ caring? 1. The last time I was in the​ hospital, I got an​ infection; I​'m afraid to be in here. 2. I​'m so weak from my​ surgery, but that pushy nurse keeps trying to get me to exercise. 3. I don​'t think my nurse is telling me the​ truth, so I​'m not listening to her. 4. All the nurse wants to do is poke me with​ needles; I can​'t wait to get out of here.

4 Perceiving the nurse​'s primary goal as being poking the client with needles best illustrates the impact of the client​'s attitude on caring. Doubting the nurse​'s truthfulness reflects an absence of trust. The physically weak client who perceives the nurse​'s attempts to promote mobility as being open double quote"pushyclose double quote" best reflects the impact of physiologic illness on caring. Fearing being in the hospital because of a previous​ healthcare-associated infection best reflects the impact of previous​ healthcare-related experiences.

A code blue is called on an older client in the emergency department. As the code team begins resuscitation​ activities, the​ client's spouse reminds the triage nurse of the do not resuscitate​ (DNR) status of the client. What is the appropriate response from the triage​ nurse? 1. Ask the spouse if a change to the DNR status is wanted 2. Tell the spouse to wait until the code team finishes 3. First verify the advance​ directive's placement in the chart 4. Follow the​ client's DNR wishes by stopping the code

4 The appropriate response from the triage nurse is to follow the​ client's DNR wishes by stopping the code. It is not appropriate to ask the spouse if a change to the DNR status is wanted. It is not appropriate to tell the spouse to wait until the code team finishes. It is not appropriate to first verify the advance​ directive's placement in the chart.

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? 1. The nurse committed​ malpractice, but not an act of negligence. 2. The nurse committed an act of​ negligence, but not malpractice. 3. The nurse committed acts of negligence and malpractice. 4. The nurse committed negligence due to a failure to communicate.

4 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 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? 1. Using effective communication 2. Minimizing client discomfort 3. Minimizing the risk of medication errors 4. Maintaining client safety

4 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.

The dialysis nurse looks across the treatment area and recognizes the pastor of the local church. The pastor is being interviewed by the unit admission nurse. The dialysis nurse knows that the nature of his treatment will bring them into some contact with each other on a regular basis. Which action by the nurse is most appropriate in this​ situation? 1. The nurse should always go over to welcome the​ client, regardless of clinical assignment. 2. The nurse should ask to not be assigned to the care of this client. 3. The nurse should ignore the client​'s presence on the unit if not assigned to him. 4. The nurse should not talk about the care of this client to members of his church.

4 The nurse should not talk about the care of this client to members of his church. The nurse does not have to avoid assignment to his​ care, take the time to always welcome​ him, or ignore his presence on the unit.

A nurse is accused of failing to assess and monitor. Which clinical scenario causes this type of​ malpractice? 1. The nurse fails to act on prescribed​ orders, and the client suffers an adverse event. 2. The nurse fails to document a client​'s ​allergy, and the client subsequently has an allergic reaction to a medication administered. 3. The nurse fails to notify the healthcare provider in a timely manner when conditions warrant it. 4. The nurse fails to treat the client complaining of a​ headache, and the client subsequently has a stroke.

4 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 nursing team of an extended care facility comprises four generations of healthcare providers. Which characteristic is most appropriate for the nurse administrator to expect to observe among healthcare providers who are generational​ cohorts? 1. Technological expertise 2. Opposing personal values 3. Interpersonal tension 4. Shared workforce patterns

4 The term generational cohort is used to describe individuals who are born in the same general time span​ and, as​ such, share key life experiences. Generational cohorts demonstrate and share distinct values and workforce patterns. Rather than being prone to interpersonal​ tension, generational cohorts tend to have reduced interpersonal tension and conflicts. Technological expertise is a characteristic shared by members of specific generations.

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? 1. ​"How much research have you done about withholding​ vaccinations?" ​2. "How do you feel about your decision to withhold​ vaccinations?" ​3. "Do you know any other parents who are withholding​ vaccinations?" ​4. "What benefits do you foresee from withholding​ vaccinations?"

4 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.

The nurse is completing an initial home visit for a client who was recently discharged from the hospital. Which home condition would the nurse report due to client safety​ concerns? 1. Finding prescription drugs in several locations of the home 2.Disposing of needles in a plastic container labeled sharps 3. Using well water for cleaning dishes and for cooking 4. Heating the environment with a kerosene heater

4 When a nurse conducts a home​ visit, it is important to assess the home for safety issues. Heating the environment with a kerosene heater may indicate the home is not properly heated and is a safety concern. The use of well water for cleaning and​ cooking, disposing of needles in a plastic container labeled open double quote"​sharps,close double quote" and finding prescription drugs in several locations of the home are not safety concerns that the nurse would have to report.

During an annual​ evaluation, the nurse manager is assessing the staff nurse​'s work ethic. Which statement by the staff nurse is most reflective of a strong work​ ethic? 1. I believe in the importance of earning a good income. 2. I have never made an error at work. 3. I let others remind me to start an assigned task. 4. I believe in the moral worth of work.

4 Work ethic refers to a belief in the importance and moral worth of work. Earning a good income is not directly related to work ethic. Characteristics of a nurse with a strong work ethic include accepting responsibility for mistakes and willingly accepting consequences of actions. Taking the initiative to begin an assigned task without being directed to do so also is a characteristic of a strong work ethic.

The nurse leader is describing the effects of the shift in the nature of work to the staff nurse. When explaining the shift in the nature of work and its effects on nurses from different generational​ groups, which statement is most appropriate for the nurse leader to include in the​ discussion? 1. ​"The interaction between employees from different generations has​ decreased." ​2. "Traditionally, individuals from the older generation held​ entry-level positions." ​3. "Shared governance structures are no longer used in​ today's organizational​ model." ​4. "Nurses from various organizational levels now function as equal team​ members."

4 ​Traditionally, individuals from younger generations held​ entry-level positions and reported to people of the older​ generation, who held more senior positions. As​ such, younger employees typically were subordinate to older employees. Due to continuous quality improvement and shared governance​ structures, individuals from various organizational​ "levels" are now equal team members. This structural shift has increased the interaction between employees from different generations.

The student nurse asks her nurse mentor to explain the factors that shape the caring process in nursing. Which statements should the nurse mentor include in her​ reply? (Select all that​ apply.) 1. The nurse​'s level of development does not affect the caring process. 2. Perceptions do not affect the caring process. 3. Circumstances such as space do not affect the caring process. 4. The process of caring can be influenced by the client care setting. 5. Factors that influence the caring process may include the timing of the interaction.

4, 5 The caring process is shaped by many​ factors, including an individual​'s ​perceptions, experiences, and values. The nurse​'s level of development also shapes the caring process as do circumstances such as the time and setting of the care being provided.Unseen​ processes, such as thoughts and​ emotions, may affect the client​'s concerns at any given time and impact the nature of care.

A new nurse is meeting with his mentor. During their​ conversation, the new nurse​ states, "I want to be able to take care of my clients without always needing help. I want to feel like I know what I need to​ do, and I want to be able to provide my clients with the best​ care." Considering​ Maslow's hierarchy of​ needs, how should the mentor interpret the new​ nurse's statement? 1. His needs are related to safety. 2. His needs are related to love and belonging. 3. His needs are related to​ self-actualization. 4. His needs are related to​ self-esteem.

4. His needs are related to​ self-esteem.

​Seventy-year-old Mr. John Paul Williams is an older adult in his church. He leads a​ gospel-themed support group for older adults. To help them cope with aging​ issues, he took a course in​ "Tips for Better​ Living" at his senior center. What statement to the support group by Mr. Williams shows his need for additional​ education? 1. ​"If you become incompetent to manage your​ affairs, you cannot write a new living​ will." 2. "I will hand out the living will form that our state has created for us to​ use." ​3. "If you have a living​ will, you will not need a durable power of​ attorney." ​4. "A living will tells what medical treatments you either want or​ don't want."

​3. "If you have a living​ will, you will not need a durable power of​ attorney."

Matthias McPherson is a nursing student at a local university. During a seminar about ethics and​ nursing, the nurse educator asks Matthias to describe an issue that may lead to ethical conflict in the workplace. Which response indicates an issue that may lead to an ethical​ conflict? 1. ​"Focusing on palliative treatment and emphasizing the​ nurse's role leads to ethical conflicts in​ nursing." ​2. "Personnel issues are not a valid source of ethical conflict because they are usually rooted in personality​ clashes." ​3. "Staffing shortages are a critical ethical concern because research shows a link between staffing and safe client​ care." ​4. "Because of more stringent cost containment​ methods, allocating resources is becoming a less urgent ethical​ issue."

​3. "Staffing shortages are a critical ethical concern because research shows a link between staffing and safe client​ care."

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? 1. ​"I would suggest that you try IVF one more time before you give​ up." ​2. "I kept trying and waited for new developments in​ IVF." ​3. "I would like to tell you about my experience with​ IVF." ​4. "I understand why you​ don't want to continue with IVF and support you in that​ choice."

​4. "I understand why you​ don't want to continue with IVF and support you in that​ choice."