CONT exam 4

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clinical reasoning

The process by which nurses (and other clinicians) collect cues, process the information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes, and reflect on and learn from the process.

nursing process

a scientific, clinical reasoning approach to patient care that includes assessment analysis, planning, implementation, and evaluation

A state is devastated by a tornado killing many people, destroying communication systems, utility services, homes, and medical facilities. The state requests immediate assistance from the U.S. Congress and from surrounding states. The affected state should first contact the: a. Emergency Management Assistance Compact (EMAC). b. Institute of Medicine (IOM). c. Red Cross. d. Strategic National Stockpile.

a. Emergency Management Assistance Compact (EMAC). EMAC is an organization authorized by the US congress through which a state impacted by a disaster can request and receive assistance from other member states quickly and efficiently

A novice nurse notices a patient is pacing the floor and twisting his hands. When the nurse enters the room, the patient stares at her and mumbles, "Can't anyone understand what I want?" while smiling and reaching out to shake the nurse's hand. The nurse recognizes a risk for violence based on which clinical findings? (select all that apply) a. Glaring at the nurse b. Nervousness, twisting of hands c. Murmuring when talking d. Diagnosis of a terminal illness e. Isolation, desire to be alone

a. Glaring at the nurse b. Nervousness, twisting of hands c. Murmuring when talking nurses can recognize a risk for workplace violence by using the acronym STAMPEDAR

A group of local volunteers respond to a tornado. Volunteers have completed an emergency response course and are able to assist with triage of injured citizens. They also participate in local health fairs to teach residents how to react during tornadoes. The responders are members of the: a. Medical Reserve Corps (MRC). b. Metropolitan Medical Response System (MMRS). c. National Disaster Medical System (NDMS). d. Commissioned Corps Readiness Force (CCRF).

a. Medical Reserve Corps (MRC). the MRC are local volunteers trained to respond to local emergencies

When the novice nurse asks, "What will happen if this task is not completed," which skill is being demonstrated? a. Priority setting b. Delegation c. Organization d. Clinical skills

a. Priority setting the novice nurse is considering the legal and safety ramifications if the task is not completed

A hospital refused to purchase a better grade of utility gloves, even after learning that the cheaper utility gloves are easily punctured during routine use. This unsafe situation led nurses to seek unionization. During the pre-election phase for unionization, which actions by union representatives are prohibited by the National Labor Relations Board? (select all that apply) a. Scheduling a meeting in the agency's cafeteria to determine employees' interest in unionization b. Distributing nondocumented information that female nurses receive lower annual performance evaluations than do male nurses c. Distributing information about the benefits of unionization and grievances in a public parking garage located across from the hospital d. Suggesting to workers the likelihood of job loss should the union not win the election e. Signing authorization cards for employees who are on leave

a. Scheduling a meeting in the agency's cafeteria to determine employees' interest in unionization b. Distributing nondocumented information that female nurses receive lower annual performance evaluations than do male nurses d. Suggesting to workers the likelihood of job loss should the union not win the election e. Signing authorization cards for employees who are on leave union representatives must meet in nonword areas. union representatives must not spread rumors of prejudices. neither the union nor employers can spread falsehood about potential job loss or repercussion in the event of unionization. union representatives cannot sign cards for employees

Mandatory overtime and reduction in RN staff have resulted in decreased client satisfaction and a sentinel event. Management is unwilling to discuss a change in staffing, and collective bargaining interest is sparked. A nurse is approached to sign a union authorization card. If signed, the card: a. authorizes the union to serve as his or her legal representative. b. indicates that the person is requesting additional information about collective bargaining. c. indicates the nurse desires to share information about grievances. d. gives permission for union dues to be deducted from pay.

a. authorizes the union to serve as his or her legal representative. a signature on a union authorization card indicates that the nurse gives the union the right to serve as legal representation

Several novice nurses share lunch breaks and have comments such as, "I have insomnia from worrying about what I forgot to do for my patient," and "I have no energy," and "I can't believe I can't do my job correctly." These novice nurses are each experiencing different symptoms of: a. burnout. b. low self-esteem. c. lack of confidence. d. resilience.

a. burnout. symptoms of burnout include extreme fatigue, headaches, difficulty sleeping, mood swings, anxiety, poor work quality, depression, and anger

a nurse has been asked to serve as the charge nurse on the evening shift. the agency where the nurse is employed is considering unionization. if the charge nurse position is accepted, this nurse: a. can be represented by the union because charge nurses are not considered part of the management team b. is part of the management team, so union participation would be a conflict of interest c. can file a grievance that will be attributed automatically by the union d. is ineligible for collecting bargaining activities that deal with unfair labor processes

a. can be represented by the union because charge nurses are not considered part of the management team serving as charge nurse is part of a nurses's professional role and not a management function

during orientation, a novice nurse sits and "visually spends" the first few paychecks, envisioning the money going into a personal bank account in the dream state, the nurse smiles and knows that the pain of nursing school was worth it. which phase of reality shock is the nurse experiencing a. honeymoon b. shock or rejection c. recovery d. resolution

a. honeymoon during the honeymoon phase, the novice nurse has a positive image of nursing that coincides with the reason for becoming a nurse; this feeling is experienced immediately after the nurse begins work and often while still in orientation

health care professionals have been activated to respond to a disaster, and the registered nurse who is coordinating the effort realizes: a. in the event of a mass casualty incident, care is prioritized to those who have the greatest chance of surviving b. communities should use their own resources first to attempt to stabilize and organize the response c. state assistance occurs any time a disaster occurs, regardless of the community's resources d. the emergency operating plan developed by one central agency rather than individual facilities should be put into operation e. strict protocols regarding the use of resources must be followed

a. in the event of a mass casualty incident, care is prioritized to those who have the greatest chance of surviving b. communities should use their own resources first to attempt to stabilize and organize the response care is shifted to doing the most good for the most people. efforts begin at the local level

A certified oncology nurse notices that a novice nurse is unsure of decision making and lacks technical skills. The novice nurse gains confidence by sharing and learning with the experienced nurse. This relationship continues and builds, allowing the novice nurse to become more confident. This relationship is known as: a. mentoring. b. role modeling. c. a preceptorship. d. socialization.

a. mentoring. the experienced and novice nurses have entered into a mutually agreed upon interactive relationship to ease the transition of the novice nurse into the profession

physical therapists are represented by a union, nurses are represented by a separate union, and pharmacists have yet another union within a single agency. this type of union representation is known as: a. occupational unionism b. industrial unionism c. union shop d. power sharing

a. occupational unionism occupational unionism indicates separate unions for each occupation in an agency

The novice nurse calls a supervisor and requests that a "float nurse" be assigned to help with all "assessments of new admissions and postoperative patients." The supervisor asks, "How many admissions and surgery patients have you received?" The novice nurse becomes flustered because she has not checked the census but simply bases the need on feeling overwhelmed. This situation best indicates a lack of _____ skills. a. organizational b. communication c. interpersonal d. clinical

a. organizational the novice nurse lacks proficiency, which may be exaggerated by feelings of being overwhelmed by the new environment, causing him or her to not get the facts before asking for help

a group of nurses are assembling outside a hospital protesting the use of foreign nurses after several nurses were terminated due to what the hospital called recurring "decreased census". the nurses carry signs with messages asking potential patients to seek care elsewhere. the local newspaper picked up the story, and the hospital is receiving negative press. the nurses are participating in: a. picketing b. collective bargaining c. a strike d. arbitration

a. picketing picketing is a form of protest in which people congregate outside of a place of work or location where an event is taking place. often this is done in an attempt to dissuade others from going in, but it can also be done to draw public attention to a cause

nurses and community officials are working together to ensure that churches and schools have needed supplies to provide shelter for large numbers of individuals in the event of a natural or manmade disaster. these activities represent which phase of a disaster continuum a. preparedness b. relief response c. recover d. crisis intervention

a. preparedness every disaster response begins at a local event known as the preparedness phase, which consists of planning, preparedness prevention, and warning

Mandatory overtime and reduction in RN staff have resulted in decreased client satisfaction and a sentinel event. Management is unwilling to discuss a change in staffing, and collective bargaining interest is sparked. during the preelection period, what actions by management are prohibited a. seek individuals to spy on coworkers who are possible union supporters b. photograph employees participating in information sessions about unionization c. visit managers outside work to gain their perception of popularity of unionization d. threaten that, should the union win, the company will relocate when there is no intention to relocate e. require employees to declare their position on unionization prior to puck up paychecks

a. seek individuals to spy on coworkers who are possible union supporters b. photograph employees participating in information sessions about unionization d. threaten that, should the union win, the company will relocate when there is no intention to relocate e. require employees to declare their position on unionization prior to puck up paychecks during the pre-election period, management may not solicit spying. during the pre-election period, management may not photograph employees engaged in union activities. during the pre-election period, management may not lie about what will happen if the union is the victor in an election. during the pre-election period, management may not question employees about their preferences regarding union activities

Troops from the United States participating in a peace mission in a foreign country were the victims of suicide bombers and many soldiers were evacuated back home to receive specialized medical care. The nation's medical responses will be augmented by: a. the federally coordinated National Disaster Medical System. b. local homeland communities where troops receive care. c. the Medical Reserve Corps, which organizes and utilizes public health, nursing, medical, and other volunteers. d. the National Incident Management System, which guides government, nongovernmental organizations, and the private sector to work seamlessly during disaster situations.

a. the federally coordinated National Disaster Medical System. the national disaster system supplements care for casualties evacuated back to the US from overseas and federally declared disasters including national disasters, major transportation accidents, technologic disasters, and acts of terrorism

a nurse is interested in learning the phases of disaster continuum and realizes it has many similarities to the nursing process. to better understand the phases of diasaster, which is true when comparing the phases of disaster continuum to the nursing process a. the preparedness phase of the disaster continuum is consisted with the assessment and planning steps of the nursing process b. the recovery phase for the disaster continuum is consistent with the planning step of the nursing process c. the recovery phase is consistent with the implementation phase of the nursing process d. the recovery phase is consistent with the evaluation phase of the nursing process

a. the preparedness phase of the disaster continuum is consisted with the assessment and planning steps of the nursing process the preparedness phase requires assessing possible needs of the community and planning appropriate interventions and is consistent with the assessment and planning steps of the nursing process

During the relief response phase of a disaster resulting from a "dirty bomb": a. treatment for burns and poisoning is provided for victims. b. emergency plans are coordinated between agencies. c. reconstruction of destroyed facilities and homes begins. d. food stores are collected for potential victims.

a. treatment for burns and poisoning is provided for victims. during the relief response phase after a disaster, emergency responders provide assistance to victims and stabilize the scene; with a dirty bomb, radioactive material causes burns and poisoning

in the preparedness phase for disasters, the community plans for a possible terrorist attack using anthrax as the weapon of destruction. what treatments and/or preparations would be needed a. vaccines and level B PPE b. treatment for burns, decontamination and level A PPE c. social distance determination, decontamination for radioactive fallout d. identify and detect incendiary devices, treatment for burns and propellants

a. vaccines and level B PPE anthrax is a biologic weapon and requires level B protection since it is known as an agent and can be carried in wind or surfaces. timing of treatment is critical and vaccines are available

a novice nurse is in the "rejection phase" of stress and wonders if she made the right decision when deciding nursing was her chosen career. which strategy would help the novice nurse cope with transition into practice and reduce stress a. when asked by the charge nurse to accept the new admission even though she had no discharges, the novice nurse stops and considers if this request is accpetable and safe, then accepts the assignment based on two patients having a low acuity level b. refusing to eat anywhere but the hospital cafeteria to ensure a balanced diet and time to socialize with other staff and visitors c. avoid wasting time by listening to coworkers problems or ideas on how to staff the unit during the upcoming holiday since the novice nurses time is valuable and better spent getting her own work completed d. make an effort to "win over" hostile or angry coworkers who find fault with the novice nurses work performance

a. when asked by the charge nurse to accept the new admission even though she had no discharges, the novice nurse stops and considers if this request is accpetable and safe, then accepts the assignment based on two patients having a low acuity level to reduce stress and cope with the rejection of phase of transition, the novice nurse should think before answering - take a few minutes before answering and deciding what is best course of action

clinical judgement

an interpretation or conclusion about a patient's needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improvise new ones as deemed appropriate by the patient's response

the emergency response team responds to a terrorist attack where hundreds of people died following symptoms of chest tightness, palpitations, seizures, and finally paralysis. a colorless odorless liquid known as Sarin was the agent, which is primarily inhaled with limited exposure through the skin. the concentration of Sarin has not been measured. what level is the minimum level of personnel protection and safety equipment that would be needed a. A b. B c. C d. D

b. B level B requires a high level of respiratory protection, but less skin protection, providing a chemical splash-resistant suit with hood and self-contained breathing apparatus. it provides maximum respiratory protection but less skin protection than level A equipment

Faculty comes to class to present information about joining the Student Nurses Association (SNA). A student is heard saying, "Why join this organization? It is just a bunch of students like us. I'll wait and join the real nursing organization after graduation." This student is not aware of which benefits of SNA? (select all that apply) a. Members are eligible to sit for the licensure examination at a reduced rate. b. Leadership skills can be refined by working with other schools of nursing. c. The National SNA provides discounted rates for study abroad opportunities. d. A global view of nursing can be obtained through networking internationally. e. Lobbying efforts are a major benefit of belonging to SNA.

b. Leadership skills can be refined by working with other schools of nursing. d. A global view of nursing can be obtained through networking internationally. leadership opportunities are available as officers and through conferences. SNA members work with other nursing students across the nation and internationally

a nurse is interested in working in a large trauma center that is unionized but does not want to join the union or pay fees. she accepts the position but is not required to join or pay fees to the union based on which law a. National Labor Relations Act b. Right-to-work Law c. National Labor relations Act d. Taft-Hartley Act

b. Right-to-work Law the right-to-work law prohibits membership or payment of union dues or "fees" a condition of employment, either before or after hiring

A community in the New Madrid fault zone experiences an earthquake resulting in injuries from propelled objects and abrasions for many victims. The local supply of antibiotics is quickly exhausted. Local authorities would contact the: a. Commissioned Corps Readiness Force. b. Strategic National Stockpile. c. Department of Homeland Security. d. local Young Men's Christian Association (YMCA).

b. Strategic National Stockpile. the strategic national stockpile provides antibiotics, antidotes, and medical and surgical items when local and state supplies have been exhausted

A concern that nurses were being asked to perform tasks that went beyond the state's nurse practice act was brought to the union's attention. Nurses were informed that either mediation or binding arbitration will be used to resolve the issue. A novice nurse asks about the difference between these techniques and is informed that: a. mediation is sanctioned by the National Labor Relations Board (NLRB) to formally discuss concerns with management and labor. b. binding arbitration is a formal discussion between labor and management in which the arbitrator's recommendations are compulsory. c. mediation uses a trained person to negotiate a legally binding plan. d. binding arbitration requires both labor and management to participate in discussions on the least destructive approach to allow self-governance by employees.

b. binding arbitration is a formal discussion between labor and management in which the arbitrator's recommendations are compulsory. binding arbitration requires that both parties meet in formal talks, and all parties must obey the arbitrators recommendations

A nurse at a school notices that several students have "blisters" on their bodies. Further investigation reveals that a terrorist incident has occurred, causing smallpox. If the chemical, biologic, radiologic, nuclear, and explosive (CBRNE) agent categories are used, this incident would be classified as: a. chemical. b. biologic. c. radiologic. d. nuclear.

b. biologic. the biologic category refers to diseases such as plague or smallpox

an experienced nurse working in oncology is shocked to realize that he feels little empathy when a patient explains, "I developed cancer from having to work in the dry cleaning industry since I was only 8 years old to help support my younger siblings during the depression. now they have all moved away and refuse to help me financially, and it takes everything I have to pay for my chemotherapy medicine". the nurse is experiencing a. burnout b. compassion fatigue c. reality shock d. horizontal hostility

b. compassion fatigue the nurse is experiencing a gradual decline in compassion over time as a result of being exposed to events that have distressed his or her patients, such as working at a young age to support a family while inadvertently being exposed to carcinogens

the metropolitan medical response system: a. is totally finances by the federal government national disaster fund b. consists of responders who have obtained specialized training and equipment to deal with mass casualty events c. has a storehouse of medications and antidotes to be used during response in times of national emergencies d. arranges for patient admissions to federal hospitals

b. consists of responders who have obtained specialized training and equipment to deal with mass casualty events the MMRS responds to disaster with trained individuals who have expertise in this type of situation and who have the equipment required to be effective

the disaster medical assistance team works quickly to contain contaminants form a chemical plant explosion. Afterward, personnel undergo special process to remove harmful chemicals from equipment and supplies this removal process is known as a. containment b. decontamination c. triage d. scene assessment

b. decontamination decontamination is the physical process of removing harmful substances from personnel, equipment, and supplies

in distinguishing between evaluation methods used in school versus those used in the work environment, it is noted that the work environment evaluation includes: a. determining whether steps are logical b. formulating increments in correct order c. efficiently organizing stages of the procedure d. appraising outcomes according to policy

d. appraising outcomes according to policy outcomes are based on meeting existing criteria rather than on knowing how the outcome was achieved

in orientation, a new graduate is surprised to learn of workplace violence in health care agencies and asks, "what kind of violence is common in hospitals?" the educator describes workplace violence as: a. care of patients admitted who are victims of domestic violence b. experienced nurses withholding pertinent information from coworkers to portray them as incompetent c. coworkers participating in an employee assistance program to learn more about anger management for adult children living at home d. care of persons being held for treatment prior to be incarcerated for committing homicide e. statements such as "the new nurse has book sense but can't perform an admission physical without the help of everyone on the unit"

b. experienced nurses withholding pertinent information from coworkers to portray them as incompetent e. statements such as "the new nurse has book sense but can't perform an admission physical without the help of everyone on the unit" withholding information form novices or coworkers to purposefully cause them to appear inadequate or unskilled is considered workplace violence because of the anxiety and stress it produces. this should not be tolerated and should be reported. such statements, which belittle employees, lead to job dissatisfaction, lack of teamwork, and burnout are considered lateral or workplace violence. this should not be tolerated and should be reported

a hospital is seeking a 2.5% wage reduction for all nurses as part of a new balanced budget, however the plan provides for raises for upper-;even management. this plan resulted in a call for a union to protect the nurses. when the union representative arrives, what questions should the nurses ask a. will the dues be used to support charity care when clients are unable to pay b. how effective has the union been in representing the nurses best interest c. what percent of dues pays union personnel shares d. are dues used to promote research for terminally ill clients e. if arbitration is unsuccessful and a strike occurs, will nurses receive compensation during the strike

b. how effective has the union been in representing the nurses best interest c. what percent of dues pays union personnel shares e. if arbitration is unsuccessful and a strike occurs, will nurses receive compensation during the strike laborers want a union with successful track record of improving wages and benefits. union dues are used to support union personnel, and the amount varies among different union groups; the higher the percentage of money that goes to pay union salaries, the less money will be available to support members. employers are not obligated to pay laborers during a strike, and unions may choose to pay employees while striking

A group of RNs wish to seek union representation that would protect all workers in the agency including nonlicensed assistive personnel and non-nursing employees such as nutritionists and dietary workers. The type of union being sought is the strongest collective group and is known as a(n): a. occupational union. b. industrial union. c. union shop. d. right-to-work bargaining organization.

b. industrial union. an industrial unionism is a single union for all workers in the agency

which nurse is more prone to burnout? the nurse who: a. graduated last in the class b. is industrious and conscientious c. refuses to work an extra shift even though he or she needs the money d. volunteers to serve on one one committee and keeps in touch with schoolmates

b. is industrious and conscientious burnout is more common among nurses with type A personalities and those who are overachievers

a student nurse wants to meet other nursing students form different countries and to learn of employment possibilities. the student nurse should a. participate in the clinical facilities employee satisfaction task force b. join the SNA c. take part in self-monitoring d. postpone taking the licensure examination so he or she can take a tour of foreign countries

b. join the SNA students who participate in preprofessional organizations such as the SNA have an opportunity to meet students across the nation and around the world and can network with leaders to gain knowledge about employment possibilities

following a terrorist attack, victims are exhibiting post traumatic stress syndrome, and care providers are exhibiting compassion fatigue. which federal response system should be initiated a. strategic national stockpile b. metropolitan medical response system c. commissioned corps readiness force d. national disaster medical system

b. metropolitan medical response system the MMRS is concerned with developing trained responders who are able to provide mental health care for victims and health care providers

A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed: a. honeymoon. b. shock or rejection. c. recovery. d. resolution.

b. shock or rejection. during the shock or rejection phase, there is inconsistency with what was learned in school and the work environment, and the novice nurse lacks many of the skills needed to be independent in this new role

The novice nurse arrives on the nursing unit, is introduced to the staff, is assigned a preceptor, and is asked to participate in the next staff meeting. This introduction into nursing is appropriately termed: a. biculturalism. b. socialization. c. transition. d. "going native."

b. socialization. socialization involves the acceptance and integration of the novice nurse into the profession of nursing, as well as the identification of the novice nurse with the profession of nursing

when teaching community preparedness for a community group, the nurse explains that components of the National Disaster Medical System provide for: a. a nationwide bomb disposal squad team for the rapid removal of explosive devices b. teams of health care providers who are experts and have specialized supplies and equipment c. structures for patient evacuation from the disaster area to an unaffected area d. arrangements for hospitalization in federal and volunteer nonfederal acute care hospitals e. providing mental health care for the community, for victims, and for health care providers

b. teams of health care providers who are experts and have specialized supplies and equipment c. structures for patient evacuation from the disaster area to an unaffected area d. arrangements for hospitalization in federal and volunteer nonfederal acute care hospitals the NDMS provides specially trained teams of people along with equipment designed for disaster relied. the NDMS is responsible for removing patients from unsafe to safe areas. the NDMS coordinates efforts to evacuate victims to federal or nonfederal volunteer hospitals that can care for disaster victims

during a community health fair the disaster medical assistance team informs participants that every community must be ready to provide disaster care. a participant asks, "in a disaster, the local community cannot possible be effective, so why not have a plan to call federal agencies immediately to provide relief", the correct response by the DMAT is: a. unless known terrorist activities involving mass destruction occur, the federal governmentt does not become involved b. the community is essentially the first responder to any disaster c. the preparedness phase of a disaster is the responsibility of the community, the relief phase is assigned to state agencies, and the recovery phase is the responsibility of federal agencies d. unless local health care facilities are incapacitated, state and federal agencies will withhold assistance

b. the community is essentially the first responder to any disaster each disaster begins locally, and each community responds first and receives assistance from state and federal agencies when local resources are not adequate for the situation

a nurse learns of a mass casualty disaster following a known terrorist attack. on arriving at the scene the nurse must know that: a. the response of local hospitals will be dictated by the federal government b. the same ground rules practices in other settings and during smaller crises will be applicable c. the least experienced nurses will be assigned to low triage victims and victims who have no chance of survival d. multiple incident commanders ensure quick, effective response

b. the same ground rules practices in other settings and during smaller crises will be applicable the fundamentals of nursing applied to other settings and situations can be used in a disaster

According to Kramer, nurses in the shock phase should ask themselves: a. "How can I fit in with other staff?" b. "Why can't I perform as everyone expects?" c. "What changes can I make to make me feel good about the choice to become a nurse?" d. "How can I get the rest of the staff to change?"

c. "What changes can I make to make me feel good about the choice to become a nurse?" during the shock or rejection phase, novice nurses must ask themselves what they must do to become the type of nurse envisioned and to make a contribution

A group of nurses interested in unionizing decides to contact the largest union in the United States representing registered nurses, which is the: a. American Nurses Association. b. United American Nurses. c. National Nurses United. d. National Labor Relations Board.

c. National Nurses United. in 2009, the National Nurses United became the largest union representing nurses RNs as a result of a merger between the United American Nurses, California Nurses Association, National Nurses Organizing Committee, and Massachusetts Nurses Association

In recent Gallop Polls, nurses were voted as the most honest with the highest ethical standards of all professions. How does this degree of professionalism affect nurses' desire to participate in organized strikes? a. Nurses most often turn to collective bargaining strategies such as strikes to emphasize client safety initiatives. b. Nurses use evidence-based studies that reflect both management and labor views to support participation in unionization. c. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession. d. Nurses who strike can be legally punished for abandonment and negligence, considered to be professional misconduct.

c. Nurses often find union activities such as strikes in conflict with the need to serve and protect clients and their profession. nurses are client advocates and promotion of professionalism is valued as evidenced by the publics opinion related to honesty and professionalism

a novice nurse is unsure how to correctly administer an injection using the Z-track method. what is the best approach for learning this procedure A. read the procedure manual and follow the steps exactly b. make an appointment at the skills laboratory of the former nursing school to practice c. ask to observe the skill as it is being performed; then perform it under direct supervision d. try to remember how the task was previously performed during a simulation

c. ask to observe the skill as it is being performed; then perform it under direct supervision the novice nurse can become familiar with the technique, then can perform the skill under the supervision of an experienced nurse, ensuring competency

A novice nurse notices the medication nurse hurriedly gathering medications to be administered for the entire day, removing them from the packages, and placing them in a paper cup with the patient's name and room number on the cup. When one of the patients points at a pill and asks, "What is this?" and "What does this do?" the medication nurse is uncertain, because it has long since been removed from the packaging. The novice nurse speaks to the nurse manager about her observations and describes her concerns. The novice nurse has assumed the role of: a. loner. b. "rutter." c. change agent. d. "native."

c. change agent. the novice nurse is working to improve the safety and patient environment and is a patient advocate

a nurse is informed that the federal bureau of investigation has determined that a bomb has been detected and is in the possession of a known terrorist group. the government buildings in the local community are the target. this situation is termed: a. all-hazards approach b. biologic event c. credible threat d. natural disaster

c. credible threat a credible threat is a situation in which the FBI determines that a terrorist threat is probable and verifies the involvement of a weapon of mass destruction in the developing terrorist incident

Nurses in a nonprofit hospital have expressed an interest in forming a union to secure fair wages and ensure client safety. To form a core support group of nurses, the union organizer can conduct meetings to gather initial information: a. away from the worksite with a group of managers to learn both sides of the situation. b. at the worksite with staff nurses who are respected leaders. c. in homes or local businesses with staff nurses. d. after photographing management meeting to discuss their strategies to decrease interest in unionization.

c. in homes or local businesses with staff nurses. the union representative meets with laborers at a nonword setting to gather information about grievances

nurses caring for the victims of a mass casualty incident: a. determine the common terminology to be used by hospitals and participating agencies b. take charge of communicating with the news media c determine whether there is a credible threat of a terrorist attack d. give priority for care to those with the greatest chance of survival rather than those most critically ill

d. give priority for care to those with the greatest chance of survival rather than those most critically ill care is shifted form categorizing patients at low, intermediate, and critical risk using resources to serve those with the greatest likelihood of survival

it is important to realize that nurses may seek unionization if: a. physicians rotate on-call coverage among group members for complicated longer clients b. scheduling is presented that provides adequate staffing on holidays by rotation of time off for holidays among nurses c. incident report trends indicate medication errors are caused by shift reports being taped and heard after nurses from the prior shift have left the union d. physicians, nurses, nutritionists, and physical therapists visit concurrently with clients to plan care care e. staff development activities are planned daily at 8AM for 2 consecutive days to educate staff on new cardiac monitoring procedures while following normal staffing patterns

c. incident report trends indicate medication errors are caused by shift reports being taped and heard after nurses from the prior shift have left the union e. staff development activities are planned daily at 8AM for 2 consecutive days to educate staff on new cardiac monitoring procedures while following normal staffing patterns policies where shift reports are taped and heard after a prior shift has left have proved to lead to errors and unsafe care. staff development activities should be scheduled to allow nurses to attend, and normal staffing patterns or time of training must coincide with nurses availability and ability to listen to and retain information

a large corporation employs nurses all over the US. Nurses in one agency learned that fellow nurses in another agency are striking because they are required to work 16-hour shifts to cover for nurses who have left due to unsafe staffing practices. the union of the nonstriking agency nurses decide to stop work to support the nurses who are striking; thus, this union: a. is placing nurses at risk for a lawsuit becuase their direct employer did not cause the strike b. must be an industry union representing both parties c. is participating in a sympathy strike, which, if done correctly, is legal d. must pay for any losses incurred by the agency during the strike

c. is participating in a sympathy strike, which, if done correctly, is legal a sympathy strike occurs when a union stops work to support the strike of another union

Nurses in a unionized hospital are paid "compensatory pay" when working holidays equal to the number of hours worked with no extra compensation. Although they have suggested changes during the annual survey of employee satisfaction, management refuses to consider another system for compensatory pay. A trained member listened to both nurses and management to make recommendations that were not legally binding. This type of settlement is termed: a. picketing. b. binding arbitration. c. mediation. d. grievance.

c. mediation. mediation enlists the help of a trained person to listen to both sides; however, recommendations are not legally binding

the crisis communication officer may first inform the public or health care facility of a disaster or an act of terrorism. this representative has the responsibility to: a. contain the facts to within the administration group b. incite the public to quickly take cover and obtain emergency supplies c. provide understandable and straightforward facts about the event within the facility and possible to the news media d. inform the public that no information can be released until it has been confirmed by state and federal agencies

c. provide understandable and straightforward facts about the event within the facility and possible to the news media the crisis communication officer is the first to contact for patients, families, and employees within the facility or news media, so they may better understand the situation and know how to react and protect themselves

historically, what movement most influenced unionization in American Health Care agencies/hospitals? a. immigration laws protected foreign employees from discrimination in hiring or discharge on the basis of national origin and citizenship status b. women entered the workforce, gaining voice to support others c. the Industrial Revolution led to poor working conditions and the need to protect workers d. nurses were exposed to communicable diseases, which led to death and disability

c. the Industrial Revolution led to poor working conditions and the need to protect workers the industrial revolution lead to people working in factories where poor and unsafe working conditions were widespread

when comparing mentoring and role modeling, the role of mentoring is represented by which of the following situations a. the experienced nurse is unaware that the novice nurse is observing him or her gathering supplies needed to start intravenous antibiotics b. the novice nurse mimics conversations with his or her own patients that were unobtrusively overheard between the experienced nurse and his or her patients c. the novice nurse receives feedback from the experienced nurses related to the use of a new occlusive dressing product and is told, "I couldn't have done it better myself" d. an experienced nurse is nominated for outstanding employee of the month by the novice nurse

c. the novice nurse receives feedback from the experienced nurses related to the use of a new occlusive dressing product and is told, "I couldn't have done it better myself" the experienced nurse knowingly enters into a relationship to advocate for an to enhance the self-esteem of the novice nurse

a novice nurse is placed in charge just after orientation ends. which statement by the novice nurse would ensure a smooth delegation experience when delegating to an experienced staff member a. you have the patients in rooms 1-7. these patients require little skill so you should be fine b. your assignments are posted in writing by the nurses station. be certain all your tasks are completed so the next shift is not behind c. you have patients in rooms 5-10 and I will administer all IV meds. I will let you know if I have to adjust. if you see you need help let me know d. everyone is capable of providing the best care, so please sign up for the patients you would like to be assigned to

c. you have patients in rooms 5-10 and I will administer all IV meds. I will let you know if I have to adjust. if you see you need help let me know the nurse is clearly stating the assignments, allowing for a need to adjust both to needs of the unit and the delegate's needs

the emergency preparedness term that is used to describe the process of limiting the emergency situation within a well-defined area is

containment

a nurse who is conducting a staff in-service on the phases of disaster continuum teaches participants that, during the impact/response stage, activities focus on: a. community awareness in anticipation of a terrorist attack or natural disaster b. determining the effectiveness of the disaster medical assistance team c. using all of an all-hazard approach d. initiation response activates

d. initiation response activates response actives during the relief response phase consist of immediate actions to save lives and meet basic human needs

a novice nurse is stressed due to always being behind with her assignments. she is overheard saying, "no one here worries about checking nasogastric tube placment before they give medications and hand feedings. skipping that step would save me an extra 30 minutes to be used for charting. if they can do it so can I". this nurse is experiencing which stage of reality shock a. loner b. rutter c. change agent d. native

d. native the novice nurse is mimicking the actions of the experienced nurse taking shortcuts that were not taught in school and not following policy and procedure

a recruiter is explaining the benefits to a group of nursing externs who are highly sought for employment. the recruiter states, "we are the only hospital in town that offers a residency program". the recruiter further explains that a residency program a. provides housing for the graduate nurse to decrease expenses until income is established b. partners a medical resident with a nurse resident to learn inter-professional care c. allows new graduates to work on a higher degree in nursing while being paid full-time d. offers extended time for both theory and clinical activities that promote problem solving and clinical decision making

d. offers extended time for both theory and clinical activities that promote problem solving and clinical decision making residency programs offer a longer precept orientation period to bridge the gap between classroom and practice

A nurse has heard rumors that other nurses are interested in unionizing but knows little about the purpose of unions. The nurse's first action is to: a. contact an arbitrator who has worked with other nurses in unions. b. picket the agency where employed to gain inside information as to why unionization is sought. c. sign the dual-purpose union authorization card. d. review the National Nurses United website for collective bargaining information.

d. review the National Nurses United website for collective bargaining information. the National Nurses United website gives information about collective bargaining for nurses

it is important for novice nurses to know that self esteem = self-confidence + self ______

respect

The term used during a pandemic disaster that refers to the attempt to contain germs by limiting socialization and personal interactions is ___________.

social distancing

critical thinking

the mental process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and evaluating information to reach an answer or conclusion

noticing

the nurses perception of a situation or encounter

Interpreting

the process of analyzing data to determine the patients problem

reflecting

the process of the nurse thinking about what they learned from a patient situation

responding

to monitor a patient or act on current evidence to prevent, detect early, or resolve patient problems


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