FINAL

Caring

"to feel interest or concern". Appreciating the patient as a human being, showing respect for the patience, being sensitive to the patient, talking with the patient, treating patient information confidentially, treating the patient as an individual, encouraging the patient to call with problems, being honest with the patient, and listening attentively to the patient

The nurse manager of a client care area is preparing the staff for the arrival of nursing students for a clinical rotation. Which statement by the manager reflects support for the Code for Nursing​ Students? A. "Ask the clients for permission before permitting the students to provide care." B. "Show the students the shortcuts that you use to quickly complete care." C. "Challenge these students to perform tasks for which they might not be prepared." D. "Remind the students that learning does not occur by reading a book."

***A. "Ask the clients for permission before permitting the students to provide care." B. "Show the students the shortcuts that you use to quickly complete care." C. "Challenge these students to perform tasks for which they might not be prepared." D. "Remind the students that learning does not occur by reading a book." The nurse manager should support the Code for Nursing Students by ensuring clients provide authorization before accepting treatment from the students. The students should not perform any tasks for which they are not prepared.​ Life-long learning should be​ supported, and it may include reading a book. Care should be provided in a professional manner that may be violated through the use of shortcuts.

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

***A. "Do you have a ​choice?" B. "Do you want to know what I would ​do?" ***C. "Tell me how you plan to start doing ​this?" D. "What does your husband think you should ​do?" ***E. "Are you considering other courses of ​action?" Value clarifying questions or statements include "Do you have a ​choice?" "Are you considering other courses of ​action?" and "Tell me how you plan to start doing ​this?" Saying "What does your husband think you should ​do?" or "Do you want to know what I would ​do?" does not help clarify the​ client's values.

The nurse manager is presenting an​ in-service for staff nurses about Medicaid insurance coverage. Which statements are appropriate for the nurse manager to include during the​ in-service? ​(Select all that​ apply.) A. "For the client who qualifies for​ Medicaid, home health services are typically covered." B. "While Medicaid covers inpatient hospital​ services, it does not cover outpatient care." C. "Individuals with disabilities who meet federal and state eligibility requirements may be covered by Medicaid." D. "Transportation costs to healthcare appointments are not covered by Medicaid." E. "Medicaid provides qualified individuals with cash for basic​ needs, such as​ food, housing, and clothing."

***A. "For the client who qualifies for​ Medicaid, home health services are typically covered." B. "While Medicaid covers inpatient hospital​ services, it does not cover outpatient care." ***C. "Individuals with disabilities who meet federal and state eligibility requirements may be covered by Medicaid." D. "Transportation costs to healthcare appointments are not covered by Medicaid." E. "Medicaid provides qualified individuals with cash for basic​ needs, such as​ food, housing, and clothing." Medicaid is available to certain lower income individuals and​ families, the​ elderly, and people with disabilities who meet the eligibility requirements set by federal and state law. Each state sets its own guidelines regarding Medicaid eligibility and covered services.​ However, federal law requires Medicaid to cover certain services including physician​ services, inpatient and outpatient hospital​ care, home health​ services, and transportation to medical care. Supplemental Security Income​ (SSI) provides cash for basic needs such as​ food, housing, and clothing.

The community health nurse is explaining geographic information system​ (GIS) technology to the student nurse. Which statement is most​ accurate? A. "GIS technology is not limited to use strictly within health care." B. "GIS technology is not dependent on global positioning systems." C. "GIS technology is not useful in the plotting of lifestyle choices." D. "GIS technology is not useful in analyzing​ location-based data."

***A. "GIS technology is not limited to use strictly within health care." B. "GIS technology is not dependent on global positioning systems." C. "GIS technology is not useful in the plotting of lifestyle choices." D. "GIS technology is not useful in analyzing​ location-based data." Geographic information system​ (GIS) technology has been used both inside and outside of health care. To capture geographical​ data, GIS relies on satellite imaging and global positioning systems​ (GPSs). Applications of GIS may include analyzing​ population- or​ location-based data, such as disease​ transmission, obesity​ rates, cancer​ rates, trends in diseases such as​ diabetes, and environmental data. GIS can also be used to plot and analyze lifestyle​ choices, such as improper​ nutrition, tobacco​ use, and physical activity rates.

The client who was recently diagnosed with cancer is making a difficult clinical​ decision, choosing between surgery or chemotherapy and radiation. The client asks the nurse "What would you do if you were in my ​shoes?" What is the most appropriate response by the​ nurse? A. "I am not an expert in treatment outcome​ research, so I would not want to influence your decision." B. "It really does not matter which way you choose to get​ treatment; either way works as well." C. "Chemotherapy and radiation take a lot longer to recover​ from; I would advise against them." D. "I have watched a lot of clients make that​ decision; the ones that chose surgery seemed the happiest."

***A. "I am not an expert in treatment outcome​ research, so I would not want to influence your decision." B. "It really does not matter which way you choose to get​ treatment; either way works as well." C. "Chemotherapy and radiation take a lot longer to recover​ from; I would advise against them." D. "I have watched a lot of clients make that​ decision; the ones that chose surgery seemed the happiest." The nurse should not offer an​ opinion, even when the client asks for it. It is not ethical to rely on previous clinical​ experience, assume a neutral​ stance, or use a standard of the fastest recovery time.

A​ medical-surgical nurse is reviewing online​ evidence-based guidelines for the care of a client facing a radical prostatectomy. The online package includes discharge instructions to give the client. Which statement by the nurse reflects an understanding of the role of this technology in providing clinical​ excellence? A. "I can expect my client to progress in healing as shown in the timeline." B. "If I don​'t agree with a specific​ guideline, I can​'t change it." C. "I can hand the discharge instructions to the client straight from the printer." D. "I am not going to tell my client that his care is being guided by the Internet."

***A. "I can expect my client to progress in healing as shown in the timeline." B. "If I don​'t agree with a specific​ guideline, I can​'t change it." C. "I can hand the discharge instructions to the client straight from the printer." D. "I am not going to tell my client that his care is being guided by the Internet." The​ evidence-based guidelines do have timelines for expected healing.​ However, individual clients can have other​ issues, so the discharge instructions might need to be adapted before they are given to the client. The​ client's care is not being guided by the​ Internet, but by standards from professional​ organizations' consensus. Even​ so, if a nurse does not agree with a specific​ guideline, the nurse is able to change it.

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

***A. "I cannot discuss her medical condition with you. All of our clients have privacy rights." B. "I know this situation must be hard for you to deal with. I will let you know when I find out the answer." C. "You can ask the admitting physician. I am sure he will discuss your daughter​'s condition with you." D. "I don​'t think you have anything to worry about. She is a lovely young woman." The nurse must uphold the right of the client to​ privacy, even if the client is not an adult. The nurse cannot promise to disclose private information at a later time. The nurse cannot promise that the ED physician will disclose private information. The nurse also should not dismiss the concerns of the father.

The student nurse is giving a presentation about the​ history, role, and functions of Sigma Theta Tau International​ (STTI). Which statements are appropriate for the student nurse to include in the​ presentation? ​(Select all that​ apply.) A. "Invitations to join are offered to baccalaureate and graduate nursing students who demonstrate scholarship excellence." B. "Membership is offered to nurse leaders who exhibit exceptional nursing achievements." C. "Sigma Theta Tau International​ (STTI) was the first nursing organization to fund nursing research." D. "Benefits of membership include career services and continuing education opportunities." E. "STTI​'s vision is to create a local community of nurses who lead in using​ knowledge, scholarship,​ service, and learning to improve the health of the world​'s people."

***A. "Invitations to join are offered to baccalaureate and graduate nursing students who demonstrate scholarship excellence." ***B. "Membership is offered to nurse leaders who exhibit exceptional nursing achievements." ***C. "Sigma Theta Tau International​ (STTI) was the first nursing organization to fund nursing research." ***D. "Benefits of membership include career services and continuing education opportunities." E. "STTI​'s vision is to create a local community of nurses who lead in using​ knowledge, scholarship,​ service, and learning to improve the health of the world​'s people." Sigma Theta Tau International​ (STTI) was the first nursing organization to fund nursing research. Invitations to join are offered to baccalaureate and graduate nursing students who demonstrate scholarship excellence and to nurse leaders who exhibit exceptional nursing achievements.​ STTI's vision is to create a global community of nurses who lead in using​ knowledge, scholarship,​ service, and learning to improve the health of the​ world's people. Member benefits include career services and continuing education opportunities.

The nurse is caring for a​ 42-year-old client and her husband who experienced a intrauterine fetal demise at 21 weeks​' gestation. They are holding the​ baby, wrapped in a baby​ blanket, and the husband states that they would like to have the baby blessed. What response indicates that the nurse requires further education in perinatal​ loss? A. "Our chaplain will not bless a baby unless it could have survived outside of the womb when born." B. "If it is okay with​ you, I would like to take some photos of the blessing for the memory book of your ​child?" C. "We have holy water in our perinatal loss bereavement​ kit, would that be something you would want to be used in the ​blessing?" D. "Let me get the operator to call hospital chaplain for this request."

***A. "Our chaplain will not bless a baby unless it could have survived outside of the womb when born." B. "If it is okay with​ you, I would like to take some photos of the blessing for the memory book of your ​child?" C. "We have holy water in our perinatal loss bereavement​ kit, would that be something you would want to be used in the ​blessing?" D. "Let me get the operator to call hospital chaplain for this request." Telling the grieving parents that the chaplain will not bless the baby because it would have been unable to survive outside of the womb is an inaccurate statement. The hospital chaplain is trained to provide comfort to the parents during the grieving process and will bless the baby if asked to do so. All the other statements reflect appropriate understanding regarding perinatal loss and bereavement.

The nurse case manager is reviewing Medicare coverage rules with a client. Which client statement indicates correct understanding of the​ teaching? A. "Prescription drug coverage is available through Medicare." B. "Medicare covers the costs of​ long-term care." C. "The cost of my hearing aids is covered by Medicare." D. "Medicare covers my routine dental care."

***A. "Prescription drug coverage is available through Medicare." B. "Medicare covers the costs of​ long-term care." C. "The cost of my hearing aids is covered by Medicare." D. "Medicare covers my routine dental care." Medicare Part D offers prescription drug coverage. Services that are not covered by Medicare include​ long-term care, routine dental​ care, and hearing aids and the exams for fitting them.

The nurse informaticist is summarizing the function and findings of the Technology Informatics Guiding Educational Reform​ (TIGER) Summit for a group of staff nurses. Which statement should be included in the​ presentation? A. "TIGER is examining ways to reach out to nurses who lack the informatics skills that are needed to practice." B. "TIGER concluded that knowledge of informatics is important for certain healthcare professionals." C. "TIGER was attended mainly by nurse administrators from major healthcare institutions." D. "TIGER is developing plans to include informatics in all baccalaureate nursing programs."

***A. "TIGER is examining ways to reach out to nurses who lack the informatics skills that are needed to practice." B. "TIGER concluded that knowledge of informatics is important for certain healthcare professionals." C. "TIGER was attended mainly by nurse administrators from major healthcare institutions." D. "TIGER is developing plans to include informatics in all baccalaureate nursing programs." The 2006 Technology Informatics Guiding Educational Reform​ (TIGER) Summit was attended by nursing informatics leaders from major nursing organizations.​ TIGER's findings included that knowledge of informatics is mandatory for all healthcare professionals. TIGER is developing plans to include informatics courses in all levels of nursing education. TIGER is also examining the best ways to reach out to nurses who lack skills needed to practice in a healthcare environment that is becoming increasingly more interactive and reliant on technology systems.

The nurse educator asks the nursing students to describe the stage of commitment development during which the student discovers negative aspects of a chosen profession. Which student​'s response is​ accurate? A. "The testing stage." B. "The ​quiet-and-bored stage." C. "The passionate stage." D. "The integrated stage."

***A. "The testing stage." B. "The ​quiet-and-bored stage." C. "The passionate stage." D. "The integrated stage." Development begins with the exploratory​ stage, followed by the testing​ stage, the passionate​ stage, the​ quiet-and-bored stage, and the integrated stage. The testing​ stage, which is the second stage of professional​ commitment, involves the individuals​' discovery of negative aspects of the profession.

A client in the ambulatory clinic asks the nurse about health information obtained while reading a Web site on the Internet. Which response by the nurse is the most​ appropriate? A. "There are sites where the information is reliable." B. "The Internet is for entertainment and not for learning." C. "Most information on the Internet is false." D. "Following your physician​'s advice is better than reading what to do on the Internet."

***A. "There are sites where the information is reliable." B. "The Internet is for entertainment and not for learning." C. "Most information on the Internet is false." D. "Following your physician​'s advice is better than reading what to do on the Internet." Research has found that a large number of adults use the Internet for medical information. Nurses need to help clients with information access by directing clients to high quality Web sites for information. The nurse should teach the client how to interpret the information and not state that the information is false. The nurse should explain how to evaluate information and not state that it is for entertainment. The nurse should summarize how to determine if information is applicable and not direct the client to follow​ physician's instructions.

The nurse is conducting a mental status interview with a new client. Which questions are useful as part of the assessment​ process? Select all that apply. A. "What is your ​name?" B. "What day of the week is ​today?" C. "Where did you go to high ​school?" D. "Do you enjoy ​exercising?" E. "Can you count by 5s from 0 to ​100?"

***A. "What is your ​name?" ***B. "What day of the week is ​today?" ***C. "Where did you go to high ​school?" D. "Do you enjoy ​exercising?" ***E. "Can you count by 5s from 0 to ​100?" "What is your ​name?" and "What day of the week is ​today?" assess orientation. "Where did you go to high ​school?" evaluates memory. "Can you count by 5s from 0 to ​100?" assesses cognitive functioning. "Do you enjoy ​exercising?" does not address a significant element of cognition.

The nurse is conducting a wellness visit with a​ 1-year-old child. The child weighed 8 pounds at birth. After the baby​'s weight is measured at 24​ pounds, the mother states that the child is being put on a diet. What should the nurse respond to the mother at this​ time? A. "Your child is at an ideal weight. There is no need for a diet." B. "That​'s a good idea because childhood obesity causes adult health problems." C. "Reducing calories now will ensure that the child will be healthier when starting school." D. "Children will eat whatever is put in front of them. Just reduce the amount of food each day."

***A. "Your child is at an ideal weight. There is no need for a diet." B. "That​'s a good idea because childhood obesity causes adult health problems." C. "Reducing calories now will ensure that the child will be healthier when starting school." D. "Children will eat whatever is put in front of them. Just reduce the amount of food each day." Children triple their birth weight during the first year of life. Since the child weighed 8 pounds at​ birth, a weight of 24 pounds after 1 year is an appropriate weight. Childhood obesity can cause adult health​ problems; however, this child is at an ideal weight. The child does not need to have its caloric intake reduced. Children do not eat whatever is put in front of them. The child does not need to have the amount of food provided each day reduced.

The son of an older​ client, who was recently diagnosed with breast​ cancer, would like another opinion on the current treatment regimen. His mother has​ agreed, and they have come for an initial appointment to the oncology clinic where you work. Which type of assessment is most appropriate for the nurse to conduct in this​ situation? A. A comprehensive exam B. A psychological exam C. A socioeconomic exam D. A functional exam

***A. A comprehensive exam B. A psychological exam C. A socioeconomic exam D. A functional exam Comprehensive assessments are necessary to ensure the health of older adults. A comprehensive assessment is appropriate for a client whose family would like a second opinion regarding treatment options. Based on the​ scenario, there is no need for a psychological​ exam, a functional​ exam, or to assess the​ client's socioeconomic status.

The nurse is caring for an older adult client who is being visited by her daughter who lives several hundred miles away. The daughter asks the nurse which cognitive alterations she should expect as her mother grows older. Which alterations will the nurse include in the response to the client​'s ​daughter? Select all that apply. A. A decline in mental flexibility B. A decrease in​ long-term memory processing C. A decrease in multitasking abilities D. A decrease in information processing speed E. Difficulty with receptive language

***A. A decline in mental flexibility ***B. A decrease in​ long-term memory processing ***C. A decrease in multitasking abilities ***D. A decrease in information processing speed E. Difficulty with receptive language Cognitive processing alterations that occur with age and are considered minor include a decrease in information processing​ speed, decrease in multitasking​ abilities, a decline in mental​ flexibility, and a decrease in​ long-term memory processing. Difficulty with receptive language is not a part of normal aging.

Which client groups are more likely to need an advocate when accessing healthcare​ resources? ​(Select all that​ apply.) A. A family who is living in poverty B. A family whose primary language is Spanish C. A client who has a lower literacy level D. A client in chronic pain E. A client diagnosed with cancer who has family support

***A. A family who is living in poverty ***B. A family whose primary language is Spanish ***C. A client who has a lower literacy level ***D. A client in chronic pain E. A client diagnosed with cancer who has family support Clients who do not speak​ English, have lower literacy​ levels, are very ill or in​ pain, or are of low income levels have more difficulty navigating the healthcare system and would benefit from the assistance of a nurse advocate. Clients who have family support may also have better resources for obtaining information needed for decision making.

The student nurse is preparing to care for several clients who are experiencing discomfort. Which client is experiencing a sleep disorder that is related to a genetic​ abnormality? A. A male client with narcolepsy B. A female client with sickle cell disease C. A female client with depression D. A male client with muscular dystrophy

***A. A male client with narcolepsy B. A female client with sickle cell disease C. A female client with depression D. A male client with muscular dystrophy While​ narcolepsy, depression, muscular​ dystrophy, and sickle cell disease are all disorders that cause discomfort and may be related to a genetic​ abnormality, the only disorder that affects sleep is narcolepsy.

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

***A. A specific situation can be​ moral, but perhaps not legal. B. An ethical action gives some input into determining the legality of a situation. C. Following the law is making a choice to take an ethical action. ***D. A specific situation can be​ legal, but perhaps not moral. ***E. Laws are enacted to reflect the ethical values of society. Laws are enacted to reflect the ethical values of society. A specific situation can be​ moral, but perhaps not​ legal, and vice versa. A legal​ action, not an ethical​ action, gives some input into determining the​ morality, not the​ legality, of a situation. Following the law is making a choice to take a​ legal, not an​ ethical, action.

A hospitalized client asks the nurse for "something for pain." What information is most important for the nurse to gather before administering the medications? SELECT ALL THAT APPLY. A. ADMINISTRATION TIME OF THE LAST DOSE B. CLIENT'S PAIN LEVEL ON A SCALE OF 1 TO 10 C. TYPE OF MEDICATION THE CLIENT HAS BEEN TAKING D. BEEPER NUMBER OF THE CLIENT'S PHYSICIAN E. CLIENT'S MOST CURRENT HEIGHT AND WEIGHT F. EFFECTIVENESS OF PRIOR DOSE OF MEDICATION

***A. ADMINISTRATION TIME OF THE LAST DOSE ***B. CLIENT'S PAIN LEVEL ON A SCALE OF 1 TO 10 ***C. TYPE OF MEDICATION THE CLIENT HAS BEEN TAKING D. BEEPER NUMBER OF THE CLIENT'S PHYSICIAN E. CLIENT'S MOST CURRENT HEIGHT AND WEIGHT ***F. EFFECTIVENESS OF PRIOR DOSE OF MEDICATION

A nurse is caring for a client with a suspected bowel obstruction. What diagnostic test will aid in confirming this​ diagnosis? A. Abdominal​ X-ray B. Upper GI series C. Barium swallow D. Endoscopy

***A. Abdominal​ X-ray B. Upper GI series C. Barium swallow D. Endoscopy The abdominal​ X-ray will be used to diagnose a suspected bowel obstruction. An upper GI series​ (also known as a barium​ swallow) is conducted to diagnose esophageal​ varices, inflammation,​ ulcerations, hiatal​ hernia, foreign​ bodies, polyps,​ diverticula, and tumors of the​ esophagus, stomach, and duodenal bulb. An endoscopy directly visualizes the mucous membrane lining of the​ esophagus, stomach, and duodenum.

A client in the third trimester of pregnancy has a fever caused by an infected hand wound. Which medication should the nurse expect to be prescribed for this client to treat the​ fever? A. Acetaminophen B. Naproxen C. Acetylsalicylic acid D. Ibuprofen

***A. Acetaminophen B. Naproxen C. Acetylsalicylic acid D. Ibuprofen Acetaminophen is relatively safe in all trimesters of pregnancy. Ibuprofen and Naproxen should be avoided during pregnancy. Acetylsalicylic acid should be avoided during the third trimester of pregnancy.

Which statement is a definition of​ beneficence? A. Actions to promote good B. Upholding fair treatment C. Telling the truth D. Right to​ self-determination

***A. Actions to promote good B. Upholding fair treatment C. Telling the truth D. Right to​ self-determination Beneficence concerns actions to promote good. Autonomy is the right to​ self-determination. Justice upholds fair treatment. Veracity means telling the truth.

In the urgent care​ clinic, Mr. Zachary​ Taylor, a​ 39-year-old accountant, is relieved and surprised. His gallbladder surgery is scheduled at a local surgery​ center, rather than at a hospital. Mr. Taylor asks the clinic nurse​ "What has changed since the days when my Dad had his gallbladder​ surgery?" What significant changes could the nurse​ identify? A. Advances in laparoscopic techniques and safer anesthesia B. Improved surgical preparation and fluid loss prevention C. Health insurance payments and better sterile techniques D. Synthetic blood transfusions and case management methods

***A. Advances in laparoscopic techniques and safer anesthesia B. Improved surgical preparation and fluid loss prevention C. Health insurance payments and better sterile techniques D. Synthetic blood transfusions and case management methods Advances in laparoscopic techniques and safer anesthesia have made a significant difference. None of the other items listed helped move routine procedures out of the hospital setting.

While caring for a​ client, the nurse meets with the healthcare provider to discuss responses to treatment and explain the​ client's issues with medication side effects. Which associated concepts of managed care is this nurse​ demonstrating? ​(Select all that​ apply.) A. Advocacy B. Clinical​ decision-making C. Healthcare systems D. Collaboration E. Ethics

***A. Advocacy B. Clinical​ decision-making C. Healthcare systems ***D. Collaboration E. Ethics When discussing responses to treatment with the​ client's other healthcare​ providers, the nurse is engaging in collaboration. When explaining the​ client's issues with medication side effects the nurse is engaging in advocacy. The nurse is engaged with healthcare systems when working within the​ federal, state, local and healthcare organization regulations and requirements. Clinical decision making is prioritizing and providing care. Ethics is adhering to the nursing code of ethics when providing care.

During a home​ visit, the nurse teaches a family with a​ preschool-aged child about accidental injury prevention. Which observations indicate that teaching has been​ effective? ​(Select all that​ apply.) ​A. Age-appropriate car seat installed in the family car B. Box of small buttons available for play C. Plastic trash bags replaced with paper D. Safety latches secured over gas range controls ​E. Four-gallon drum to accumulate rain water removed

***A. Age-appropriate car seat installed in the family car B. Box of small buttons available for play ***C. Plastic trash bags replaced with paper ***D. Safety latches secured over gas range controls ​***E. Four-gallon drum to accumulate rain water removed Accidental injuries in the preschooler include motor vehicle​ accidents, drowning, fires and​ burns, suffocation, and aspiration of foreign bodies. Evidence that safety teaching was effective would be an​ age-appropriate car​ seat, safety latches over range​ controls, removal of items that could cause accidental​ suffocation, such as plastic trash​ bags, and removal of containers that could cause​ drowning, such as a​ four-gallon drum. Playing with small buttons could increase the​ child's risk of aspiration and indicates additional teaching is needed.

When the assisted living nurse asks the new client about her religious​ beliefs, the client​ answers, "I am not convinced that a Higher Power exists. But I am still open to thinking about it." Which category of religious beliefs does the client identify​ with? A. Agnostic B. Atheistic C. Nontheistic D. Monotheistic

***A. Agnostic B. Atheistic C. Nontheistic D. Monotheistic The client identifies with​ agnostics, who believe that the existence of a Higher Power has not been proved. The client is not an​ atheist, who does not believe in any god. The client is not a​ monotheist, who believes in one god. There is no category called nontheistic.

A nursing instructor is discussing the concept of cultural diversity with a group of nursing students. While discussing broad​ groups, the instructor realizes she needs to reinforce teaching this concept when her students give which​ example? A. An example of diversity is the customs of a community. B. A project discussing health care diversity in the inner city versus the suburbs of a major city. C. A subgroup of diversity could include​ education, or occupation. D. The sexual orientation of a group of college sophomores participating in a birth control study.

***A. An example of diversity is the customs of a community. B. A project discussing health care diversity in the inner city versus the suburbs of a major city. C. A subgroup of diversity could include​ education, or occupation. D. The sexual orientation of a group of college sophomores participating in a birth control study. The customs of a community are considered part of the culture. Diversity refers to the quality of being different. Characteristics that distinguish broad groups from one another. Examples include​ age, race,​ gender, sexual​ orientation, and religion. Subgroups of diversity include socioeconomic​ status, education,​ occupation, interests, marital​ status, or rural versus urban living situations.

A nurse is admitting a child to the pediatric unit with altered bowel elimination. What cause can lead to encopresis that the nurse needs to explore​ further? (Select all that​ apply.) A. Anger issues B. Fecal impaction C. Premature birth D. Stress E. Diet

***A. Anger issues ***B. Fecal impaction C. Premature birth ***D. Stress ***E. Diet Encopresis is characterized by recurrent soiling or passage of stool at inappropriate times by a child who should have achieved bowel continence.The causes of encopresis are stress related to environmental​ changes; anger​ issues; diet; and fecal impaction. Premature birth is not a cause of encopresis.

The nurse is caring for a client dying of a terminal illness that was diagnosed 3 months ago. Which psychosocial behaviors should the nurse expect the client to exhibit at this​ time? Select all that apply. A. Anxiety B. Fear C. Anticipatory grief D. Indifference E. Edema

***A. Anxiety ***B. Fear ***C. Anticipatory grief D. Indifference E. Edema Anticipatory​ grief, anxiety, and fear are three psychosocial responses to the approach of death that the nurse could expect the client to exhibit. Indifference to recent news of one​'s own impending death would not be a typical response. Edema is a physical sign that the client​'s cardiovascular system is failing as death approaches.

A nurse is reviewing the medical records of a small urgent care clinic. The nurse has been asked to identify clients who may be considered vulnerable. Which clients will the nurse include as those who may be​ vulnerable? ​(Select all that​ apply.) A. An​ 82-year-old man living alone with no family nearby B. A​ 17-year-old in an afterschool boys​' and girls​' program C. A​ 32-year-old woman who lists the local shelter as her home address D. A​ 22-year-old woman who is crying and anxious because she is fighting with her roommate E. A​ 42-year-old man with a history of psychiatric illnesses who lives in his car in a nearby park

***A. An​ 82-year-old man living alone with no family nearby B. A​ 17-year-old in an afterschool boys​' and girls​' program ***C. A​ 32-year-old woman who lists the local shelter as her home address D. A​ 22-year-old woman who is crying and anxious because she is fighting with her roommate ***E. A​ 42-year-old man with a history of psychiatric illnesses who lives in his car in a nearby park Vulnerable populations include the​ elderly, children, people living in​ poverty, homeless​ people, and those who are in abusive​ relationships, are mentally​ ill, or chronically ill. An episode of anxiety or an altercation without a history of abuse is not considered evidence of belonging to a vulnerable population. A teenager in an afterschool program is not considered a member of a vulnerable population.

The nurse is preparing a stillborn infant for the parents​' viewing. Prior to this​ viewing, what should the nurse discuss with the​ parents? A. Appearance of the newborn B. Time limitations for visit C. Need to videotape the visit D. The need for taping the hands together

***A. Appearance of the newborn B. Time limitations for visit C. Need to videotape the visit D. The need for taping the hands together The nurse should prepare the parents of a stillborn infant for the way the baby may appear. This includes maceration and discoloration of the skin. The nurse does not place a time limitation on the visit. The viewing of the infant is not videotaped. The newborn​'s hands are not taped together prior to viewing by the parents.

The nurse is caring for a newly admitted client with a body temperature of 103​°F. What actions can the nurse take to help reduce the fever until the healthcare provider completes writing admission​ prescriptions? ​(Select all that​ apply.) A. Apply a cool cloth to the back of the neck B. Administer an average dose of acetaminophen C. Provide the client with cold water to drink D. Turn on the circulating fan in the client​'s room E. Remove unnecessary clothing

***A. Apply a cool cloth to the back of the neck B. Administer an average dose of acetaminophen ***C. Provide the client with cold water to drink ***D. Turn on the circulating fan in the client​'s room ***E. Remove unnecessary clothing Independent nursing interventions for the client with a fever include removing unnecessary​ clothing, applying a cool cloth to the back of the​ neck, providing cold oral​ fluids, and turning on the circulating fan in the client​'s room. A healthcare provider​'s order is needed before administering medications to the client.

Chen​ Yong, a​ 23-year-old Chinese​ student, goes to the local Chinatown clinic when he hurts his leg playing soccer. He is told that the doctor is not available and he will have to return the following day for treatment. What health care disparity does this incident​ illustrate? A. Asians have reported problems with receiving timely health care. B. Asians are unlikely to have health insurance. C. Asians do not want to use Western medical services. D. Asians prefer to use acupuncture and herbs for treatment.

***A. Asians have reported problems with receiving timely health care. B. Asians are unlikely to have health insurance. C. Asians do not want to use Western medical services. D. Asians prefer to use acupuncture and herbs for treatment. Asians were 1.5 times as likely as Caucasians to report that they sometimes or never get care for illnesses or injury as soon as they wanted to. Although some Asians may select traditional Chinese medicine in certain​ situations, that is not a concern in this situation. Health care coverage is not the problem in Chen​ Yong's case.

The novice nurse has accepted a​ medical-surgical position after passing the boards and wants to work for an organization that acknowledges the values of the nursing profession. Which values outlined by the organization are consistent with those identified by the American Association of Colleges of Nursing​ (AACN)? ​ (Select all that​ apply.) A. Autonomy on behalf of self B. Altruism when dealing with other nurses C. Effectiveness in the new job D. Efficiency when dealing with clients E. Integrity in dealing with clients and​ co-workers

***A. Autonomy on behalf of self ***B. Altruism when dealing with other nurses C. Effectiveness in the new job D. Efficiency when dealing with clients ***E. Integrity in dealing with clients and​ co-workers ​Altruism, autonomy, and integrity are nursing values identified by the AACN. Efficiency and effectiveness are not values chosen by the AACN.

A nurse is participating in a free community health clinic. Which clients will the nurse identify as being at risk for compromised​ oxygenation? ​(Select all that​ apply.) A. A​ 56-year-old male who has been working at a textile factory B. A​ 64-year-old female with osteoporosis and limited mobility C. A​ 28-year-old male who smokes with a​ 10-pack/year history D. A​ 70-year-old female who eats a​ well-balanced diet and exercises daily E. A​ 46-year-old female with a history of anxiety attacks

***A. A​ 56-year-old male who has been working at a textile factory ***B. A​ 64-year-old female with osteoporosis and limited mobility ***C. A​ 28-year-old male who smokes with a​ 10-pack/year history D. A​ 70-year-old female who eats a​ well-balanced diet and exercises daily ***E. A​ 46-year-old female with a history of anxiety attacks Clients with occupations that cause them to inhale chemicals and dust are at increased risk for developing lung disease. Individuals who live a sedentary lifestyle have diminished alveolar​ expansion, placing them at risk for altered respiratory function.​ Additionally, musculoskeletal impairment such as kyphosis​ (which may result from​ osteoporosis) diminishes lung capacity. Clients who smoke are at risk for pulmonary and cardiac disease. High levels of anxiety can cause bronchospasms and the onset of bronchial asthma. Some clients hyperventilate in response to stress. The​ client's arterial oxygen levels​ rise, and the arterial carbon dioxide levels decline. Intake of a diet high in fat predisposes clients to cardiovascular disease.

A nurse is caring for a​ client, with a right femur​ fracture, who complains of pain in the right leg. The nurse asks the​ client, "Please tell me how you would rate your pain on a scale of zero to ten." Which method of therapeutic communication is the nurse using with this​ client? A. Being specific B. Seeking clarification C. Providing general leads D. Giving information

***A. Being specific B. Seeking clarification C. Providing general leads D. Giving information The nurse is using the therapeutic communication technique of being specific when the nurse makes statements that are specific rather than general. Providing general leads is using statements or questions that encourage the client to verbalize feelings and encourages further conversation. Seeking clarification occurs when the nurse restates the​ client's message to make it more understandable. Giving information is when the nurse provides the client specific factual information.

The nurse is reviewing the medication record of a client admitted with dehydration. Which medication would cause the nurse​ concern? A. Benzodiazepine B. Vasodilator C. Selective serotonin reuptake inhibitor​ (SSRI) D. Nonsteroidal​ anti-inflammatory drug​ (NSAID)

***A. Benzodiazepine B. Vasodilator C. Selective serotonin reuptake inhibitor​ (SSRI) D. Nonsteroidal​ anti-inflammatory drug​ (NSAID) Clients with dehydration are likely to develop electrolyte imbalances as the body attempts to compensate for the lost fluid. Benzodiazepines are associated with electrolyte imbalances and would cause the nurse concern since they could worsen the​ client's electrolyte imbalances. Antipsychotic​ agents, not antidepressants like​ SSRIs, can affect fluid balance.​ Vasoconstrictors, not​ vasodilators, can also affect fluid balance. NSAIDs are not associated with fluid or electrolyte imbalances.

The nurse educator is comparing the roles of the case manager and the primary nurse with a group of students. The educator wants to review similarities of these roles in the rehabilitation facility and in the acute care facility. Which student statements are accurate regarding the similarities between these two​ roles? ​(Select all that​ apply.) A. Both roles plan for meeting clients​' needs B. Both roles lead a multidisciplinary team C. Both roles plan for meeting families​' needs D. Both roles support continuity of care E. Both roles follow the clients across care settings

***A. Both roles plan for meeting clients​' needs B. Both roles lead a multidisciplinary team ***C. Both roles plan for meeting families​' needs ***D. Both roles support continuity of care E. Both roles follow the clients across care settings The similarities between a case manager and a primary nurse are that they both support continuity of care and plan for meeting the needs of clients and families. Only the case manager follows clients across care settings or leads a multidisciplinary team.

A​ client, updating the health history for a nurse assisting with a comprehensive physical​ exam, says,​ "I thought I had tried every method to get rid of my fatigue. What is the cognitive behavioral therapy that you just asked​ about?" How can the nurse describe the CBT​ approach? ​(Select all that​ apply.) A. CBT helps to identify stressors. B. CBT offers strenuous physical exercise. C. CBT teaches taking responsibility for change. D. CBT is part of complementary medicine. E. CBT uses special healing medications.

***A. CBT helps to identify stressors. B. CBT offers strenuous physical exercise. ***C. CBT teaches taking responsibility for change. D. CBT is part of complementary medicine. E. CBT uses special healing medications. CBT helps to identify stressors and teaches taking responsibility for change. It is a nonpharmacologic​ therapy, which does not use medication or strenuous physical​ exercise, and is not part of complementary medicine.

What are characteristics of shared​ governance? ​(Select all that​ apply.) A. Can be used with other care delivery methods B. Based upon competencies needed to provide client care C. Is a precursor to primary nursing D. Encourages​ decision-making at all organization levels E. Client and family participation in care delivery process

***A. Can be used with other care delivery methods B. Based upon competencies needed to provide client care C. Is a precursor to primary nursing ***D. Encourages​ decision-making at all organization levels E. Client and family participation in care delivery process Shared governance is an organizational model that encourages nurse participation in​ decision-making at all levels within an organization. It can be used with other care delivery models. Client and family participation in care delivery is a characteristic of​ client-focused care. Differentiated practice is based upon competencies needed to provide client care. The case method of care delivery is believed to be a precursor to primary nursing.

The nurse manager is evaluating care coordination actions performed by the nursing staff. Which outcomes indicate that the nursing​ staff's actions have been​ effective? ​(Select all that​ apply.) A. Care is readily accessible. B. Care is being rationed. C. Care is of the highest quality. D. Care is reliable. E. Care is being provided at the lowest cost.

***A. Care is readily accessible. B. Care is being rationed. ***C. Care is of the highest quality. ***D. Care is reliable. ***E. Care is being provided at the lowest cost. When nurses embrace the expectations of care​ coordination, care will be provided that is​ reliable, accessible, of the highest​ quality, and at the lowest cost. Rationing of care is not an expectation of care coordination.

A client asks the home care nurse about the difference between acute and chronic illness. What information can the nurse give the client about the characteristics of chronic​ illness? ​(Select all that​ apply.) A. Chronic illness can have remissions. B. Chronic illness can remain for life. C. Chronic illness usually lasts six months or more. D. Chronic illness has a slow onset. E. Chronic illness does not have exacerbations.

***A. Chronic illness can have remissions. ***B. Chronic illness can remain for life. ***C. Chronic illness usually lasts six months or more. ***D. Chronic illness has a slow onset. E. Chronic illness does not have exacerbations. Chronic illness can have both remissions and exacerbations. It usually lasts six months or​ more, and can remain for life. It has a slow onset.

The nurse is evaluating outcomes of care provided to a client dying from a terminal illness. Which observations indicate that care has been​ effective? Select all that apply. A. Client resting comfortably in bed B. Client requests pain medication every 4 hours C. Client crying and stating that no one will even mourn for him once he dies D. Client talking about leaving pain and sadness behind upon death E. Client​'s family sitting and talking with the client

***A. Client resting comfortably in bed ***B. Client requests pain medication every 4 hours C. Client crying and stating that no one will even mourn for him once he dies ***D. Client talking about leaving pain and sadness behind upon death ***E. Client​'s family sitting and talking with the client Observations that indicate that the care provided to a dying client were effective include the client being comfortable in​ bed, the client informing the nurse about increased​ pain, the client expressing feelings related to death or the dying​ process, and the client​'s family staying informed of changes in the client​'s condition. The client crying about no one mourning for the client once he dies does not indicate that care has been effective.

The clinical nurse educator is designing an online course about the use of patient portals for consumer and client​ e-health. Which item should be included when designing the online​ course? A. Clients must provide a user identification and password for each portal visit. B. Protected health information is encrypted and securely transmitted via the portal. C. Prescription refill requests are not permitted when using a portal. D. To use the​ portal, the client must first register in person at the healthcare facility.

***A. Clients must provide a user identification and password for each portal visit. B. Protected health information is encrypted and securely transmitted via the portal. C. Prescription refill requests are not permitted when using a portal. D. To use the​ portal, the client must first register in person at the healthcare facility. Patient portals require online​ registration, and a user identification and password are needed for each visit. Not all portals are encrypted to allow secure transmission of protected health information. Functions offered by certain patient portals include scheduling routine​ appointments, requesting prescription​ refills, and communicating electronically with a healthcare provider.

A client with a​ life-threatening illness has been treated with repeated doses of opioids over a period of several weeks. Which symptoms obtained in the assessment indicate the client is experiencing side effects related to medication​ administration? ​(Select all that​ apply.) A. Constipation B. Sedation C. Pruritus D. Sweating E. Vomiting

***A. Constipation ***B. Sedation ***C. Pruritus D. Sweating ***E. Vomiting Opioid side effects include​ constipation, sedation,​ pruritus, and vomiting. Sweating can occur with opioid withdrawal but is not a side effect related to opioid administration.

Nancy Garcia is planning care for a client with obesity and realizes she needs the assistance of another healthcare professional. Which action should Nancy take to exemplify the standard of​ collaboration? A. Contact a dietician to discuss a carbohydrate eating plan with the client B. Telephone physical therapy to have a larger wheelchair delivered to the care area C. Discuss the time breakfast trays arrive with the Dietary Supervisor so that morning medication will be completed D. Ask the social worker to provide materials on advance directives to replenish the stock supply on the care area

***A. Contact a dietician to discuss a carbohydrate eating plan with the client B. Telephone physical therapy to have a larger wheelchair delivered to the care area C. Discuss the time breakfast trays arrive with the Dietary Supervisor so that morning medication will be completed D. Ask the social worker to provide materials on advance directives to replenish the stock supply on the care area Collaboration is part of the American Nurses​ Association's Scope and Standards of Practice. An example of collaboration would be for the nurse to contact a dietician to discuss the​ client's eating plan. Telephoning for a​ wheelchair, timing of breakfast tray​ delivery, and obtaining materials about advance directives do not exemplify collaborating on client care.

While coordinating the care for Mr.​ Obertone, an adult client with heart​ failure, the nurse discovers that home monitoring equipment is not available for several days. Which nursing action is most appropriate to overcome this care coordination​ barrier? A. Contact another company to obtain the needed resource B. Help the client understand the purpose of monitoring at home C. Teach the client to monitor weight every day at home D. Explain to the physician why the equipment is not available

***A. Contact another company to obtain the needed resource B. Help the client understand the purpose of monitoring at home C. Teach the client to monitor weight every day at home D. Explain to the physician why the equipment is not available When resources are​ lacking, the nurse can network with another provider to obtain the resource for the client. Explaining to the physician why the equipment is not​ available, teaching the client to monitor his​ weight, and helping him understand the need for monitoring at home are important nursing actions but will not help overcome the existing barrier of limited resources.

The nurse is assessing the health status of an adult client. Which aspects of culture will the nurse consider when assessing this​ client? ​(Select all that​ apply.) A. Customs are part of the culture of a client. B. Culture is defined by nonphysical traits. C. A client​'s culture is determined by race. D. Values are a part of culture. E. Beliefs are a part of culture.

***A. Customs are part of the culture of a client. ***B. Culture is defined by nonphysical traits. C. A client​'s culture is determined by race. ***D. Values are a part of culture. ***E. Beliefs are a part of culture. The culture that encompasses a client​'s way of life is based on nonphysical traits. The values and beliefs a client holds are part of culture and can influence health care. Customs can influence a client​'s attitude toward health. Race refers to physical and genetic heritage and is directly related to such physical traits a client may have as skin​ color, but it is not related to a client​'s culture.

The nurse is providing education to a parent of an adolescent client about sleepdash-rest disorders during puberty. Which risk factor is most appropriate for the nurse to​ include? A. Delayed melatonin release B. Gastroesophageal reflux disease C. Increased urinary frequency D. Decreased lung capacity

***A. Delayed melatonin release B. Gastroesophageal reflux disease C. Increased urinary frequency D. Decreased lung capacity During​ adolescence, puberty may cause changes in the​ body's internal​ clock, leading to delayed nightly release of melatonin. As a​ result, delayed sleep phase syndrome may occur. Increased urinary​ frequency, preexisting gastroesophageal reflux​ disease, and decreased lung capacity are risk factors associated with the development of sleepdash-rest disorders during pregnancy.

The registered nurse team leader is performing gastric lavage for a client who is experiencing an acute gastrointestinal bleed. Which function will the nurse most likely have difficulty completing as the team​ leader? A. Delegation B. ​Decision-making C. Client teaching D. Identifying nursing diagnoses

***A. Delegation B. ​Decision-making C. Client teaching D. Identifying nursing diagnoses Team nursing is not as effective when caring for clients who are acutely ill because the nurse is needed for direct care and will not have time to delegate many tasks.​ Teaching, identifying nursing​ diagnoses, and​ decision-making are skills used within primary nursing and would be required when caring for this client.

The nurse is coordinating care for a client who requires the removal of an uncomplicated basal cell carcinoma. Based on the robust health of this​ client, which setting would provide the most​ cost-effective care? A. Dermatologist​'s office B. Emergency department C. Surgical center D. Urgent care clinic

***A. Dermatologist​'s office B. Emergency department C. Surgical center D. Urgent care clinic A dermatologist can handle a minor surgical procedure under local anesthesia in the office. A surgical center is a more expensive setting than an office. It would usually not be appropriate to do the procedure in the ED or urgent care clinic.

Which attributes contribute to the socialization of a nursing​ student? ​(Select all that​ apply.) A. Development B. Care planning C. Adaptation D. Learning E. Interaction

***A. Development B. Care planning ***C. Adaptation ***D. Learning ***E. Interaction Socialization to profession includes the attributes of​ learning, interaction,​ development, and adaptation. Care planning is an activity within the nursing process.

Which description is a characteristic of professional​ values? A. Development of socialization to nursing by nursing school faculty B. Influence by insight into clients​' values C. Insight into how actions influence values D. Influence by cultural norms

***A. Development of socialization to nursing by nursing school faculty B. Influence by insight into clients​' values C. Insight into how actions influence values D. Influence by cultural norms One of the ways that professional values are developed is by socialization to nursing by nursing school faculty. Other ways incude learning from other nurses and from clinical and life experiences. Professional values are influenced by insight into​ one's own​ values, not​ clients' values, and professional values are not influenced by cultural norms. Professional values demonstrate insight into how values influence​ actions, not how actions influence values.

A client told the nurse doing a health history that she could not provide information about a family history of diseases because she had been adopted immediately after birth. No family health information was provided. For which diseases would having that information be​ useful? ​(Select all that​ apply.) A. Diabetes B. Breast cancer C. Tuberculosis​ (TB) D. Ovarian cancer E. Influenza

***A. Diabetes ***B. Breast cancer C. Tuberculosis​ (TB) ***D. Ovarian cancer E. Influenza There is a genetic component to susceptibility to​ diabetes, breast​ cancer, and ovarian cancer. Influenza is an​ illness, not a​ disease, and does not have a genetic component. TB does not have a genetic component.

The nurse is planning care for a client with a terminal illness who is experiencing skin weeping of the lower​ extremities, coughing when taking oral​ medications, and complaining of limb pain. Which nursing diagnoses should the nurse use to guide this client​'s ​care? ​(Select all that​ apply.) A. Diminished ability to swallow B. Decreased comfort C. Impaired tissue integrity D. Diminished peripheral tissue perfusion E. Potential for anxiety

***A. Diminished ability to swallow ***B. Decreased comfort ***C. Impaired tissue integrity D. Diminished peripheral tissue perfusion E. Potential for anxiety The client is complaining of limb​ pain, which indicates decreased comfort. The​ client's skin is weeping which indicates impaired tissue integrity. The client is having difficulty swallowing oral​ medications, which indicates diminished ability to swallow. There is no information to support potential for anxiety or diminished peripheral tissue perfusion.

The staff nurse is planning an educational session about computer systems and infection control. Which item is the most appropriate for the nurse to include in the educational​ session? A. Disinfect computer keyboards and mice daily. B. Use a diluted bleach solution to clean computer keyboards. C. Avoid using sealed computer keyboards with​ built-in covers. D. Wear gloves when using a computer keyboard or mouse.

***A. Disinfect computer keyboards and mice daily. B. Use a diluted bleach solution to clean computer keyboards. C. Avoid using sealed computer keyboards with​ built-in covers. D. Wear gloves when using a computer keyboard or mouse. Because keyboards carry the highest risk for​ contamination, some manufacturers have built sealed keyboards that can be easily cleaned or can be equipped with covers for easier cleaning and protection of the electronic equipment. Guidelines for preventing the spread of infection due to contaminated computer systems include disinfecting keyboards and mice daily and when visibly soiled with body​ fluids, and following manufacturer recommendations for cleaning equipment. The nurse should not touch keyboards or mice with gloved hands.

While providing care to a 26-year-old married female, a nurse notes multiple ecchymotic areas on her arms and trunk. The color of the ecchymotic areas ranges from blue to purple to yellow. When asked by the nurse how she got these bruises, the client responds, "Oh, I tripped." How should the nurse respond? SELECT ALL THAT APPLY A. Document the client's statement and complete a body map indicating the size, color, shape, location, and type of injuries B. Contact the local authorities to report suspicions of abuse C. Assist the client in developing a safety plan for times of increased violence D. Call the client's husband to arrange a meeting to discuss the situation E. Tell the client that she needs to leave the abusive situation as soon as possible F. Provide the client with telephone numbers of local safe houses

***A. Document the client's statement and complete a body map indicating the size, color, shape, location, and type of injuries B. Contact the local authorities to report suspicions of abuse ***C. Assist the client in developing a safety plan for times of increased violence D. Call the client's husband to arrange a meeting to discuss the situation E. Tell the client that she needs to leave the abusive situation as soon as possible ***F. Provide the client with telephone numbers of local safe houses

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.) A. Double bag reusable client care equipment before sending out for sterilizing B. Cleanse bedside tables and counter tops with rubbing alcohol C. Wash hands before and after providing care to the client D. Cover the client​'s bedpan with a sterile towel and place in the bathroom E. Remove unneeded care items from the client​'s room to decrease clutter

***A. Double bag reusable client care equipment before sending out for sterilizing B. Cleanse bedside tables and counter tops with rubbing alcohol ***C. Wash hands before and after providing care to the client D. Cover the client​'s bedpan with a sterile towel and place in the bathroom E. Remove unneeded care items from the client​'s room to decrease clutter 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.

The nurse is providing education on measures to facilitate defecation to a client who has a history of constipation. Which suggestion does the nurse include when teaching the​ client? (Select all that​ apply.) A. Drink a glass of warm water before breakfast B. Consume up to 1000 mL of fluid per day C. Eat​ high-fiber foods D. Eat a pureed diet E. Take a laxative if a bowel movement does not occur daily

***A. Drink a glass of warm water before breakfast B. Consume up to 1000 mL of fluid per day ***C. Eat​ high-fiber foods D. Eat a pureed diet E. Take a laxative if a bowel movement does not occur daily Increasing water consumption is important to relieve constipation and promote defecation.​ However, the client should consume about 2500​ mL, not 1000 mL of fluid.A pureed diet does not provide adequate dietary fiber. Increasing dietary fiber will help promote defecationDrinking a warm glass of water can stimulate peristalsis and facilitate defecation after food is eaten.It is not necessary to have a daily bowel movement. Taking laxatives frequently is contraindicated because it can make a client dependent on them. Taking excessive amounts of laxatives lessens the possibility of the client returning to a normal pattern of defecation.Eating​ high-fiber foods promotes peristalsis and bowel movements.

The nurse is instructing a client recovering from a fever on ways to prevent fluid imbalance should a fever recur. What should the nurse teach the client to maintain fluid​ balance? A. Drink at least 2 liters of cool fluid each day B. Take a hot shower after spending time outdoors C. Ingest at least 1 liter of hot fluids each day D. Wear sufficient clothing to encourage sweating

***A. Drink at least 2 liters of cool fluid each day B. Take a hot shower after spending time outdoors C. Ingest at least 1 liter of hot fluids each day D. Wear sufficient clothing to encourage sweating To maintain fluid balance during a​ fever, the nurse should instruct the client to drink at least 2 liters of cool fluid each day. Ingesting warm fluids will not help maintain fluid balance during a fever. Wearing clothing to cause sweating could increase insensible fluid loss and contribute to a fluid imbalance during a fever. Taking a hot shower after spending time outdoors could cause the client​'s temperature to rise and further increase insensible water loss.

The nurse is preparing information about safety during hot weather for a community health fair. What information should the nurse include for the community​ members? ​(Select all that​ apply.) A. Drink extra fluids when exercising or working out of doors. B. Limit the intake of alcohol to the end of the day. C. Wear a hat. D. Spend time outdoors during the hours of 10 am-2 pm. E. Drink fluids throughout the day.

***A. Drink extra fluids when exercising or working out of doors. B. Limit the intake of alcohol to the end of the day. ***C. Wear a hat. D. Spend time outdoors during the hours of 10 am-2 pm. ***E. Drink fluids throughout the day. Actions to ensure thermoregulation during hot weather include wearing a​ hat, drinking an adequate amount of​ fluids, and drinking extra fluids when exercising. Alcohol is not recommended for use during hot weather. The sun is hottest between the hours of 10 amdash-2 pm. Being outside during those hours may promote heat related illnesses.

The nurse is teaching an older adult client how to use an incentive spirometer. The client has unsuccessfully attempted to use the device several times. Which is the best response by the nurse ​(Select all that​ apply.) A. Encouraging the client to continue to practice using the spirometer B. Concluding the teaching session C. Telling the client a return demonstration is necessary D. Praising the client for his attempts to use the incentive spirometer and repeating the instructions for its use E. Asking the charge nurse to assume the role of teacher

***A. Encouraging the client to continue to practice using the spirometer B. Concluding the teaching session ***C. Telling the client a return demonstration is necessary ***D. Praising the client for his attempts to use the incentive spirometer and repeating the instructions for its use E. Asking the charge nurse to assume the role of teacher Effective client teaching includes repeating content as needed and providing positive reinforcement. Return demonstration is needed to evaluate the​ client's comprehension of the teaching. The teaching session should not be concluded​ abruptly; instead, the nurse should allow sufficient time for the client to process the information. There is no indication for asking the charge nurse to assume the role of teacher.

A new graduate nurse is excited to put together a plan of care for an anemic teenager with complaints of fatigue. Which independent interventions could the nurse include in the​ plan? ​(Select all that​ apply.) A. Encouraging the teenager to take a yoga class B. Administering medications for​ iron-deficiency anemia C. Talking to the teenager about purchasing a pedometer D. Identifying foods rich in​ nutrients, including iron E. Pointing out methods of good sleep hygiene habits

***A. Encouraging the teenager to take a yoga class B. Administering medications for​ iron-deficiency anemia ***C. Talking to the teenager about purchasing a pedometer ***D. Identifying foods rich in​ nutrients, including iron ***E. Pointing out methods of good sleep hygiene habits Independent interventions include identifying foods rich in​ nutrients, encouraging the teenager to take a yoga​ class, talking to the teenager about purchasing a​ pedometer, and pointing out methods of good sleep hygiene habits. Administering medications for​ iron-deficiency anemia is a collaborative intervention.

The nurse administrator is teaching an​ in-service about the function of the Office of the National Coordinator for Health Information Technology​ (ONC). When listing the meaningful use​ objectives, which items should be​ included? ​(Select all that​ apply.) A. Engaging clients and their families in the client​'s care B. Improving care coordination to improve client outcomes C. Ensuring the security and privacy of protected medical information D. Controlling and monitoring clients​' healthcare choices E. Reducing health disparities by improving safety and quality of care

***A. Engaging clients and their families in the client​'s care ***B. Improving care coordination to improve client outcomes ***C. Ensuring the security and privacy of protected medical information D. Controlling and monitoring clients​' healthcare choices ***E. Reducing health disparities by improving safety and quality of care The Office of the National Coordinator for Health Information Technology​ (ONC) monitors achievement of meaningful use​ objectives, which are reported back to CMS in order to authorize financial reimbursement. Meaningful use objectives include improving care​ coordination; reducing health disparities among U.S. citizens by improving the safety and quality of​ care; ensuring the security and privacy of protected medical​ information; and engaging clients and their families in the​ client's care. Meaningful use objectives do not include controlling and monitoring​ clients' healthcare choices.

The nurse is caring for a client with a thoracic​ catheter, also known as a chest tube. Which interventions are appropriate for this​ client? ​(Select all that​ apply.) A. Ensuring oxygen is available B. Monitoring for air leaks C. Reporting hyperresonance with percussion D. Assessing for pain E. Prescribing prn pain medications

***A. Ensuring oxygen is available ***B. Monitoring for air leaks C. Reporting hyperresonance with percussion ***D. Assessing for pain E. Prescribing prn pain medications When caring for a client with a thoracic​ catheter, the nurse would ensure that oxygen is​ available, monitor tubing for air​ leaks, and assess for pain. The nurse would not report hyperresonance with​ percussion, but would report tymphany or a hollow sound. It is outside the scope of nursing practice to prescribe pain medications.

A clinical nurse educator is preparing to teach a group of novice nurses about the staff​ nurse's professional development responsibilities. Which elements should the nurse educator​ include? ​(Select all that​ apply.) A. Evaluating the effectiveness of professional development activities in meeting staff​ members' needs B. Seeking activities that promote professional and personal growth C. Evaluating staff​ members' professional performance D. Identifying staff​ members' learning needs E. Requesting constructive criticism related to professional performance

***A. Evaluating the effectiveness of professional development activities in meeting staff​ members' needs B. Seeking activities that promote professional and personal growth ***C. Evaluating staff​ members' professional performance D. Identifying staff​ members' learning needs ***E. Requesting constructive criticism related to professional performance Responsibilities of the staff nurse include seeking activities that promote professional and personal growth and requesting constructive criticism related to professional performance. The nurse​ leader's responsibilities include identifying staff​ members' learning​ needs; evaluating staff​ members' professional​ performance; and evaluating the effectiveness of professional development activities in meeting staff​ members' needs.

The nurse is teaching a client prevention methods for pain. Which items will the nurse include in the teaching​ session? ​(Select all that​ apply.) A. Exercising daily B. Avoiding risky behaviors C. Eating a balanced diet D. Taking medications as prescribed E. Ignoring symptoms

***A. Exercising daily ***B. Avoiding risky behaviors ***C. Eating a balanced diet D. Taking medications as prescribed E. Ignoring symptoms Pain prevention methods that the nurse will include in the teaching include the importance of​ exercise, eating a balanced​ diet, and avoiding risky behaviors. Ignoring symptoms is not a prevention strategy. Taking medications as prescribed is a treatment method and not a prevention method.

The nurse is teaching a client with undernutrition about a newly prescribed iron supplement. What information should the nurse include when instructing the client about this​ supplement? (Select all that​ apply.) A. Explain the need to increase fiber in the diet B. Remind the client to ingest adequate amounts of fluid each day C. Expect the stool to turn black D. Suggest that the client avoid ingesting citrus fruits with the supplement E. Explain how the supplement can cause constipation

***A. Explain the need to increase fiber in the diet ***B. Remind the client to ingest adequate amounts of fluid each day ***C. Expect the stool to turn black D. Suggest that the client avoid ingesting citrus fruits with the supplement ***E. Explain how the supplement can cause constipation When iron is​ prescribed, clients should be reminded that iron may turn feces black and may lead to constipation. Suggest ways to increase fiber in diet and increase fluid intake. Vitamin C facilitates the absorption of​ iron, so they should be taken at the same time.

A local hospital is planning a health fair for community members. Which topic should the nurse suggest be included to address a potential health problem that can affect the greatest number of community​ members? A. Exposure to toxins B. Car safety seats C. Risk for head injuries D. Polypharmacy

***A. Exposure to toxins B. Car safety seats C. Risk for head injuries D. Polypharmacy An area that has the potential to impact the safety of all age groups is the risk for exposure to toxins. These toxins include​ tobacco, illicit​ drugs, and alcohol. The risk for head injuries would be appropriate for community members who participate in​ football, soccer,​ hockey, boxing, and wrestling. Participating in these sports would most likely be limited to​ school-age, adolescents and young adults. The older community members would not benefit from this information. Polypharmacy would be appropriate for older community members who might have several health problems. This topic would most likely not be applicable to younger community members and those with young children. Car safety seats would be applicable to community members with small children. This topic would not be applicable to the largest number of community members.

Two hospice nurses are discussing the ethical implications of not admitting a client with a diagnosis of terminal cancer with a specific estimated number of months to​ live, which exceeds their facility​'s guidelines. Which components of ethics are appropriate for these nurses to consider regarding this​ situation? ​ (Select all that​ apply.) A. Fairness to this client and other clients B. Efficiency of the hospice functioning C. Rights of this cancer patient D. Benefits to society of having hospice guidelines E. Obligations of the hospice facility

***A. Fairness to this client and other clients B. Efficiency of the hospice functioning ***C. Rights of this cancer patient ***D. Benefits to society of having hospice guidelines ***E. Obligations of the hospice facility The components of ethics include​ rights, obligations, benefits to​ society, and fairness. Efficiency is not a component of ethics.

The nurse is preparing to assess a client who is experiencing grief and loss. What assessment foci will the nurse include in this​ assessment? Select all that apply. A. Family assessment B. Financial assessment C. Spiritual assessment D. Client assessment E. Community assessment

***A. Family assessment B. Financial assessment C. Spiritual assessment ***D. Client assessment ***E. Community assessment An assessment will be conducted to determine available coping resources for the client. This usually includes a client​ assessment, a family​ assessment, and a community assessment. A spiritual assessment is a part of the community assessment. A financial assessment is not a routine part of an assessment to determine a client​'s coping resources.

While planning care to promote safety for an older​ client, the nurse includes specific interventions to prevent unintentional injury. Which assessment findings support the necessity of these​ interventions? ​(Select all that​ apply.) A. Fatigue when bathing B. Short of breath when walking 15 feet C. Buttons shirt with left hand D. Unable to lift legs onto the bed E. Use of a cane to ambulate

***A. Fatigue when bathing ***B. Short of breath when walking 15 feet C. Buttons shirt with left hand ***D. Unable to lift legs onto the bed ***E. Use of a cane to ambulate In the older​ client, functional decline contributes to the risk for unintentional injuries. Functional decline includes the inability to complete activities of daily​ living, impaired​ mobility, decreased musculoskeletal​ strength, and reduced physical stamina or endurance. Being able to button clothing does not contribute to the risk for an unintentional injury in the older adult.

The nurse is caring for a​ 5-year-old client diagnosed with cancer. Which factors affecting a family​'s ability to cope should the nurse consider when planning care ​(Select all that​ apply.) A. Financial resources of the family B. Strength of the family structure C. Ability to seek services D. Number of dependents living at home E. Country of origin of the family

***A. Financial resources of the family ***B. Strength of the family structure ***C. Ability to seek services D. Number of dependents living at home E. Country of origin of the family A child​'s illness or hospitalization can create stressful events for the child and family. The family​'s ability to cope depends on the strength of the family​ structure, its ability to successfully seek​ services, its support​ system, and available resources. The country of origin of the family does not directly affect the ability to cope with a child​'s illness. The number of dependents living at home and family size do not directly affect the family​'s ability to cope with a child​'s illness.

The nurse is caring for a​ 32-year-old client, a partner in a gay​ marriage, who has just given birth. What does the nurse understand about this family that will affect the plan of​ care? A. Frustrations about infant care are normal. B. Children in lesbian families are at higher risk for poor health. C. Families have coping strategies. D. The home environment is less supportive and healthy.

***A. Frustrations about infant care are normal. B. Children in lesbian families are at higher risk for poor health. C. Families have coping strategies. D. The home environment is less supportive and healthy. As part of the nursing​ interventions, the nurse will facilitate the integration of the infant by helping these parents recognize that frustrations about infant care are​ normal, and encouraging bonding with and care for the infant by both parents. Homosexual adults form gay and lesbian families with goals of caring and​ commitment, the same as heterosexual couples do. Children in gay and lesbian families have been found to have the same advantages and expectations for​ development, adjustment and health as children in heterosexual families. Gay and lesbian parents can effectively provide supportive and healthy environments for their children. All families have coping strategies that help them deal with stress and​ change, which should be encouraged.

A nurse who is being pulled from one unit to another for a shift is being introduced to the nursing staff. Some of the labels that the nurse hears are "medication ​nurse," "dressing change ​nurse," "I and O ​aide," and "vital signs aide." Based on these​ comments, which nursing care delivery system can the nurse expect to participate in for this​ shift? A. Functional nursing B. Secondary nursing C. Primary nursing D. Team nursing

***A. Functional nursing B. Secondary nursing C. Primary nursing D. Team nursing The labels the nurse hears are indicating tasks assigned to that person. This is functional nursing. Team nursing has clients assigned to a group of staff. Primary nursing has clients assigned to one main staff person. There is no secondary nursing system.

A​ 4-year-old child in the emergency department has a body temperature of​ 103°F. Which body systems should the nurse focus on to help determine the cause of this​ fever? ​(Select all that​ apply.) A. Gastrointestinal B. Neurological C. Respiratory D. Musculoskeletal E. Urinary

***A. Gastrointestinal B. Neurological ***C. Respiratory D. Musculoskeletal ***E. Urinary Infections are the most common reason for a fever in this age range. The causes for fever include​ colds, gastroenteritis, ear​ infections, croup,​ bronchiolitis, and urinary tract infections. The nurse should focus on the​ child's respiratory,​ urinary, and gastrointestinal systems. The neurological and musculoskeletal systems are not common systems for infections in children.

A nurse is caring for a pediatric client with possible pneumonia who is about to go for an​ X-ray. The nurse​ states, "The doctor needs to​ X-ray your chest so she can get a picture of what​'s happening in your lungs. Let me tell you what​'s going to happen." Which therapeutic communication technique is the nurse using to develop a therapeutic relationship with the​ client? A. Giving information B. Acknowledging C. Clarifying time D. Focusing

***A. Giving information B. Acknowledging C. Clarifying time D. Focusing The nurse is utilizing the technique of giving information to provide the client with​ specific, accurate information. The technique of clarifying time is used to clarify an event in relationship to time. Focusing is used when the nurse supports the client to expand on and advance a topic of​ importance, which is often an emotion disguised behind words. Acknowledging is used when the nurse gives broadminded recognition to the client for a client effort or change in behavior.

The nurse is describing applications of telehealth to the client. Which activities should be​ included? ​(Select all that​ apply.) A. Having the client meet with a virtual health coach B. Managing acute and chronic conditions of the client C. Watching clients perform a return demonstration of skills D. Using dual webcams to visually assess the client​'s condition E. Allowing clients to consult with healthcare providers in any state in the United States

***A. Having the client meet with a virtual health coach ***B. Managing acute and chronic conditions of the client ***C. Watching clients perform a return demonstration of skills ***D. Using dual webcams to visually assess the client​'s condition E. Allowing clients to consult with healthcare providers in any state in the United States Applications of telehealth include allowing the client to meet with a virtual health​ coach, managing acute and chronic​ conditions, using dual webcams to visually assess the​ client's condition, and watching clients perform a return demonstration of skills. Not all states issue telemedicine licenses that permit healthcare providers to practice telehealth across state lines. As​ such, not every healthcare provider can consult with​ out-of-state clients via telehealth.

The nurse is to provide an assessment for a client of Asian descent and his family. What would the nurse need to understand related to the client and his family​'s ​worldview? ​(Select all that​ apply.) A. Health care beliefs B. Values C. Health care practices D. Language E. Educational level

***A. Health care beliefs ***B. Values ***C. Health care practices ***D. Language E. Educational level Health care​ beliefs, language, and values are part of a culture​'s worldview and can influence a client​'s acceptance of and cooperation with the treatment plan. If the client does not speak the same language as the nurse and the health care​ provider, an interpreter will be required. Health care practices may differ from what the nurse plans and can include alternative practices that may interfere with the treatment plan. Although not part of the worldview or​ culture, the client​'s level of education will be considered when planning teaching for the client.

The nurse is admitting a client whose native language is not English. The nurse is concerned that the client understands the​ consent-to-treatment document before signing. What factor affecting healthcare delivery is the nurse concerned​ about? A. Health literacy B. Right to privacy C. Managed care D. Right to confidentiality

***A. Health literacy B. Right to privacy C. Managed care D. Right to confidentiality The nurse is concerned about the​ client's health literacy. Understanding the​ consent-to-treatment document is not a matter of privacy or confidentiality. Managed care is not a relevant factor.

The nurse administrator is presenting an educational session about telehealth. Which item should be included when discussing the most significant potential​ barriers? A. Healthcare provider licensure B. Access to care C. Cost of services D. Healthcare quality

***A. Healthcare provider licensure B. Access to care C. Cost of services D. Healthcare quality Benefits of telehealth include the potential to decrease​ costs, improve quality of​ care, and increase access to care for clients in​ rural, urban,​ community, and international settings. Barriers to telehealth include healthcare provider licensure​ restrictions, such as medical boards limiting telemedicine licenses that permit this practice across state lines.

The nurse is 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? A. Heating the environment with a kerosene heater B. Using well water for cleaning dishes and for cooking C. Finding prescription drugs in several locations of the home D. Disposing of needles in a plastic container labeled "sharps"

***A. Heating the environment with a kerosene heater B. Using well water for cleaning dishes and for cooking C. Finding prescription drugs in several locations of the home D. Disposing of needles in a plastic container labeled "sharps" 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.

The nurse is planning care for a client who is experiencing overwhelming grief and loss after the death of an elderly parent. Which intervention would the nurse select to help reduce this client​'s ​anxiety? A. Help the client gain insight into maladaptive behaviors. B. Provide teaching about the safe administration and side effects of medications. C. Encourage the client to resume normal activities when he or she is ready to promote physical and psychological health. E. Teach family members to encourage the client​'s expression of grief.

***A. Help the client gain insight into maladaptive behaviors. B. Provide teaching about the safe administration and side effects of medications. C. Encourage the client to resume normal activities when he or she is ready to promote physical and psychological health. E. Teach family members to encourage the client​'s expression of grief. Helping the client gain insight into maladaptive behaviors is an intervention that would help reduce the client​'s anxiety. Providing teaching about medications and side effects would be appropriate only if the client were prescribed antianxiety or other medications to treat stress. Teaching family members to encourage the client​'s expression of​ grief, and encouraging the client to resume activities when ready are appropriate interventions to facilitate the client​'s grief work.

The nurse is planning care for a client who is experiencing overwhelming grief and loss after the death of a parent. Which intervention by the nurse helps reduce this client​'s ​anxiety? A. Helping the client gain insight into maladaptive behaviors. B. Encouraging the client to resume normal activities when​ ready, to promote physical and psychological health. C. Teaching family members to encourage the client​'s expressions of grief. D. Teaching about safe administration and side effects of medications.

***A. Helping the client gain insight into maladaptive behaviors. B. Encouraging the client to resume normal activities when​ ready, to promote physical and psychological health. C. Teaching family members to encourage the client​'s expressions of grief. D. Teaching about safe administration and side effects of medications. Helping the client gain insight into maladaptive behaviors helps reduce the client​'s anxiety. Teaching about medications and side effects is appropriate only when the client is prescribed antianxiety or other medications to treat stress. Teaching family members to encourage the client​'s expressions of grief and encouraging the client to resume activities when ready are appropriate interventions to facilitate the client​'s grief work.

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.) A. How to avoid and report strangers in the community B. Reminding to pack fresh fruit and vegetables in school lunches C. Protective equipment to use when playing D. Importance of crossing the street at traffic signals E. Reporting burned out street lights to the municipal building

***A. How to avoid and report strangers in the community B. Reminding to pack fresh fruit and vegetables in school lunches ***C. Protective equipment to use when playing ***D. Importance of crossing the street at traffic signals ***E. Reporting burned out street lights to the municipal building 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 nurse is caring for a​ school-age client who is prescribed methyphenidate​ (Ritalin) for attention deficit hyperactivity disorder​ (ADHD). Which adverse effects will the nurse include in the medication​ teaching? Select all that apply. A. Hypertension B. Decreased appetite C. Hypothyroidism D. Increased heart rate E. Insomnia

***A. Hypertension ***B. Decreased appetite C. Hypothyroidism ***D. Increased heart rate ***E. Insomnia The nurse would teach the family that​ insomnia, decreased​ appetite, increased heart​ rate, and hypertension are all adverse effects that can occur with the use of Ritalin to treat ADHD. Hypothyroidism is not associated with methylphenidate.

Which are important elements of client and family education that the nurse should provide for individuals with cognitive​ disabilities? Select all that apply. A. Important elements of client care B. Expected course of the condition C. Explanation of the diagnosis D. Referral for residential care E. Stories about neighbors with the same condition

***A. Important elements of client care ***B. Expected course of the condition ***C. Explanation of the diagnosis D. Referral for residential care E. Stories about neighbors with the same condition The nurse should provide an explanation of the client​'s diagnosis and its expected​ course, as well as the important elements of client care. Stories about neighbors are a breach of confidentiality. A referral for residential care is not an educational activity.

The nursing student is designing a poster that outlines strategies through which informatics can address the increasing national problem with prescription opioid addiction and overdose. Which strategy should be included on the​ poster? A. Improving the ability to identify individuals who engage in "doctor shopping" to obtain narcotics for abuse or illegal sale B. Linking computerized written orders with client electronic health records to identify and monitor healthcare providers who prescribe opioids C. Increasing efforts to enhance electronic tracking of opioid prescriptions at the community level D. Monitoring data to identify clients who sell opioids and their buyers

***A. Improving the ability to identify individuals who engage in "doctor shopping" to obtain narcotics for abuse or illegal sale B. Linking computerized written orders with client electronic health records to identify and monitor healthcare providers who prescribe opioids C. Increasing efforts to enhance electronic tracking of opioid prescriptions at the community level D. Monitoring data to identify clients who sell opioids and their buyers Strategies through which informatics can address the increasing national problem with prescription opioid addiction and overdose include increasing efforts to enhance electronic tracking of opioid prescriptions at the state​ level; linking computerized written orders with client electronic health records regionally and​ nationally, to identify and monitor individuals who are at risk for opioid​ abuse, and potentially to decrease the prevalence of opioid misuse and​ overdose; improving the ability to identify individuals who engage in open double quote"doctor shoppingclose double quote" to obtain narcotics for abuse or illegal​ sale; and identifying healthcare providers who write bogus opioid prescriptions in exchange for payment from sellers.

During a meeting to discuss the implementation of a new computerized documentation​ system, one staff nurse asks about the ease of​ use, preloaded​ templates, and online nursing resources. What behavior is the staff nurse​ demonstrating? A. Information seeker B. Opinion giver C. Information giver D. Opinion seeker

***A. Information seeker B. Opinion giver C. Information giver D. Opinion seeker Each member of the group is responsible for individual behavior and participation. Roles that members assume include information​ giver, information​ seeker, and opinion giver. The nurse asking questions is seeking information. Providing information to another is functioning in the role of information giver. Explaining personal views about an issue would be characteristic of an opinion giver. Opinion seeker is not an identified role behavior when working in groups.

What is a defining characteristic of care​ coordination? A. Initiation by the nurse B. Initiation by a family member C. Direct client care is delivered D. Direct interaction with other members of the care team

***A. Initiation by the nurse B. Initiation by a family member C. Direct client care is delivered D. Direct interaction with other members of the care team Care coordination is always initiated by the nurse. Care coordination does not necessarily involve direct client care. Collaboration is defined as two or more people working towards a common​ goal, and may occur in a number of models and settings. In​ collaboration, a​ client, family​ member, or any member of the healthcare team may initiate action. Direct interaction with the client or other individual is a characteristic of collaboration.

The nurse is performing a complete physical examination on a client who was admitted for abdominal pain. What is the most appropriate way for the nurse to proceed with this​ examination? A. Inspect the client​'s abdomen B. Palpate the client​'s lymph nodes C. Auscultate the client​'s bowel sounds D. Listen to the client​'s breath sounds

***A. Inspect the client​'s abdomen B. Palpate the client​'s lymph nodes C. Auscultate the client​'s bowel sounds D. Listen to the client​'s breath sounds The physical​ examination/assessment is a systematic method of collecting data that uses observation​ (sight, hearing,​ smell, and​ touch) to detect health​ problems, utilizing the techniques of​ inspection, auscultation,​ palpation, and percussion. Inspection of the​ client's abdomen should begin the assessment.

Jennifer​ Calper, the primary​ nurse, is assigned a client with newly diagnosed type 2 diabetes mellitus. Which nursing action is most appropriate when caring for this​ client? A. Instructing the client on the role of medications to control the disease process B. Participating on a task force to identify glucometers for use during care C. Providing direct care to the client during the scheduled shift D. Directing nursing assistants to complete morning care on a group of clients

***A. Instructing the client on the role of medications to control the disease process B. Participating on a task force to identify glucometers for use during care C. Providing direct care to the client during the scheduled shift D. Directing nursing assistants to complete morning care on a group of clients Client teaching is a role of the primary nurse. Participation in a task force is an activity within shared governance. Delegating tasks related to a group of clients is not the same as providing direct client care. In this​ scenario, the nurse is working within the primary nursing​ method; providing direct care during a scheduled shift is a characteristic of the case method.

The nurse is caring for a child who is grieving the loss of a beloved grandparent. Which client behaviors observed by the nurse are manifestations of the grieving​ process? Select all that apply. A. Irritability B. Bedwetting C. Changes in sleeping habits D. Changes in eating habits E. Increased socialization

***A. Irritability ***B. Bedwetting ***C. Changes in sleeping habits ***D. Changes in eating habits E. Increased socialization Typical behavior changes in children during the grieving process include​ regression; bedwetting;​ irritability; anger;​ aggression; changes in eating and sleeping​ habits; guilt; and​ decreased, not​ increased, socialization.

A novice nurse is hired to work on the telemetry unit and is reviewing the unit​'s policy on handoff communication and the use of the SHARE method. What is true regarding this​ method? ​(Select all that​ apply.) A. It provides timely feedback to staff who fail to follow the process. B. It ensures that the nurse uses his own narrative and charting during the transfer. C. It ensures that the nurse provides the essential content during the transfer. D. It provides opportunity to ask questions during the transfer. E. It provides standardized training in the handoff process.

***A. It provides timely feedback to staff who fail to follow the process. B. It ensures that the nurse uses his own narrative and charting during the transfer. ***C. It ensures that the nurse provides the essential content during the transfer. ***D. It provides opportunity to ask questions during the transfer. ***E. It provides standardized training in the handoff process. One strategy that can be used to ensure a successful handoff is using the SHARE method. The steps of this method ​are:Standardize critical ​content;Hardwire within your ​system;Allow opportunity to ask ​questions;Reinforce quality and ​measurement;Educate and coach. Hardwiring involves the use of standardized​ forms, such as​ checklists, and methods of conducting a successful handoff. These standardized forms are used instead of the​ nurse's narrative. All other answer choices are true of this method.

The nurse is preparing to perform a​ head-to-toe physical examination on an adolescent client diagnosed with acute renal failure. What is the priority assessment for this​ client? A. Level of development B. Level of spirituality C. Cultural status D. Emotional status

***A. Level of development B. Level of spirituality C. Cultural status D. Emotional status When assessing the adolescent​ client, it is important to assess the​ client's developmental level as this impacts the health assessment​ process, particularly sources of information and communication. While​ spirituality, culture, and emotions all impact​ assessment, these are not the priority in this situation.

A clinical specialist in diabetes care and a nutritionist are discussing the​ 8-week workshop they facilitate for groups of newly diagnosed diabetics. Which type of health promotion program are they​ coordinating? A. Lifestyle changes B. Information dissemination C. Wellness assessment D. Environmental control program

***A. Lifestyle changes B. Information dissemination C. Wellness assessment D. Environmental control program The workshop is aimed at producing lifestyle and behavior changes. Because the workshop audience members have a​ disease, the workshop is not about​ information, assessment of​ wellness, or environmental control.

A nurse in a​ long-term care facility is orienting a new graduate nurse to the institution. In discussing several of the clients​' anger​ issues, the nurse explains that which losses may cause anger as a grief response in an older​ adult? Select all that apply. A. Loss of a friend B. Loss of spouse C. Loss of mobility D. Loss of a pet E. Loss of dependence

***A. Loss of a friend ***B. Loss of spouse ***C. Loss of mobility ***D. Loss of a pet E. Loss of dependence Because many older adults have experienced many losses in their​ life, losing​ friends, spouses,​ pets, physical​ independence, and mobility can initiate the grief process. The loss of dependence is not likely to elicit grief.

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.) A. Male client with sepsis after receiving hyperalimentation infusions B. Female client with an indwelling urinary catheter being treated for a urinary tract infection C. Male client being treated for diarrhea after receiving antibiotics for pneumonia D. Male client with a leg wound from motor vehicle accident that became infected E. Female client receiving antibiotics after having total knee replacement surgery

***A. Male client with sepsis after receiving hyperalimentation infusions ***B. Female client with an indwelling urinary catheter being treated for a urinary tract infection ***C. Male client being treated for diarrhea after receiving antibiotics for pneumonia D. Male client with a leg wound from motor vehicle accident that became infected E. Female client receiving antibiotics after having total knee replacement surgery 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 educating the parents of a​ preschool-age child about the causes of nocturnal enuresis. Which statements are appropriate for the nurse to include in the teaching session with the​ parents? (Select all that​ apply.) A. Many children wet the bed due to difficulties in arousal from sleep. ​B. Bed-wetting is more common in girls than boys. C. Your child is just being lazy. D. This is caused by an overproduction of urine at night. E. Your child may be constipated. Constipation is a known cause for​ bed-wetting.

***A. Many children wet the bed due to difficulties in arousal from sleep. ​B. Bed-wetting is more common in girls than boys. C. Your child is just being lazy. ***D. This is caused by an overproduction of urine at night. ***E. Your child may be constipated. Constipation is a known cause for​ bed-wetting. Nocturnal enuresis occurs more often in boys. It can be the result of overproduction of urine at​ night, difficulties in arousal from​ sleep, and constipation. There is no indication that nocturnal enuresis is caused by the child being too lazy to get up out of bed at night to urinate.

A mother brings her​ 12-year-old son, who has​ cancer, to his oncologist​'s ​office; the client is complaining of severe pain. The nurse knows to incorporate which considerations into the assessment of this​ client? ​(Select all that​ apply.) A. Maslow​'s hierarchy of needs B. Freud​'s latency stage C. Kohlberg​'s theory of moral development D. Psychological factors E. Erikson​'s stages of development

***A. Maslow​'s hierarchy of needs B. Freud​'s latency stage C. Kohlberg​'s theory of moral development ***D. Psychological factors ***E. Erikson​'s stages of development The nurse knows that an adolescent​ client, in acute pain related to his diagnosis of​ cancer, will need to be assessed according to his developmental status and that his pain will add to the emotional distress associated with his illness.​ Kohlberg's theory of moral development and​ Freud's theory of sexual development will not assist the nurse in assessing and prioritizing care for this client.

Which are aspects of organizational governance that should reflect adherence to cultural competence​ standards? ​(Select all that apply​.) A. Mission statement B. Staff training C. Organizational practice implementation D. Policies and procedures E. Translation services

***A. Mission statement B. Staff training ***C. Organizational practice implementation ***D. Policies and procedures E. Translation services Organizational​ mission, policies and​ procedures, and practice implementation should support cultural competence. Translation services and staff training are not part of organizational governance.

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

***A. Morality refers to​ private, personal standards of right and​ wrong; ethics covers a broader range of standards. B. Moral situations are described with words like "ought" and "​should;" ethical situations don​'t use those words. C. Ethical situations are described with words like "ought" and "​should;"moral situations don​'t use those words. D. Ethics refers to​ private, personal standards of right and​ wrong; morality covers a broader range of standards. Morality refers to​ private, personal standards of right and​ wrong; ethics covers a broader range of standards. Both moral and ethical situations are described with words like "ought" and "should."

Which is the definition of the term multiculturalism​? A. Multiculturalism describes a society in which many subcultures coexist. B. Multiculturalism describes shared​ values, beliefs,​ attitudes, and customs in a community of people. C. Multiculturalism is the process of adapting to local customs. D. Multiculturalism describes the quality of being unlike or different.

***A. Multiculturalism describes a society in which many subcultures coexist. B. Multiculturalism describes shared​ values, beliefs,​ attitudes, and customs in a community of people. C. Multiculturalism is the process of adapting to local customs. D. Multiculturalism describes the quality of being unlike or different. Multiculturalism refers to many cultures existing together. Culture describes shared values and customs. Diversity describes the quality of being unlike or different. Assimilation is the process of adapting to local customs.

The department head within a school of nursing is devising a plan to ensure the successful socialization of students into the profession. Which strategies support the department head​'s ​goal? ​(Select all that​ apply.) A. Negotiating for clinical rotations to be held in high quality organizations B. Approving school policies and procedures that emphasize dress code C. Ensuring curriculum content adheres to professional standards D. Scheduling classroom time for culture and diversity training E. Identifying clinical instructors to serve as positive role models

***A. Negotiating for clinical rotations to be held in high quality organizations B. Approving school policies and procedures that emphasize dress code ***C. Ensuring curriculum content adheres to professional standards D. Scheduling classroom time for culture and diversity training ***`E. Identifying clinical instructors to serve as positive role models Strategies to assist students to develop the attributes of socialization include ensuring that curriculum content adheres to professional​ standards, that competent role models are selected as clinical​ instructors, and that clinical rotations are held in high quality organizations. Policies and procedures about dress code and lectures about culture and diversity training will not necessarily ensure the socialization of the students into the profession of nursing.

A POSTOPERATIVE PATIENT HAS AN ABDOMINAL INCISION. While getting out of bed, the client reports feeling a "pulling" sensation in his abdominal wound. The nurse assesses the client's wound an finds that is has separated and the abdominal organs are protruding. Which nursing interventions are most appropriate at this time? Select all that apply. A. Notify the client's primary physician B. Cover the wound with saline-soaked sterile gauze C. Give the client a dose of antibiotics D. Order an abdominal binder from the supply department E. Push the organs back into the abdomen F. Assess the client for signs of shock

***A. Notify the client's primary physician ***B. Cover the wound with saline-soaked sterile gauze C. Give the client a dose of antibiotics D. Order an abdominal binder from the supply department E. Push the organs back into the abdomen F. Assess the client for signs of shock

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) A. Number of reports of verbal abuse B. Previous three months of work schedules C. Number of employees hospitalized with​ work-related injuries D. New policies about calling off and use of paid time off E. Number of employee​ cuts, sprains, and fractures

***A. Number of reports of verbal abuse ***B. Previous three months of work schedules C. Number of employees hospitalized with​ work-related injuries ***D. New policies about calling off and use of paid time off E. Number of employee​ cuts, sprains, and fractures 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.

Once a​ month, the nurses working in case management get together for a potluck lunch. They have found that this informal session promotes a sense of a united community. Which of the International Council of Nurses Code of Ethics​' relationships is being​ enhanced? A. Nurses and coworkers B. Nurses and practice C. Nurses and the profession D. Nurses and people

***A. Nurses and coworkers B. Nurses and practice C. Nurses and the profession D. Nurses and people The relationship that is being enhanced is that of nurses and coworkers. Other activities are more appropriate to enhance the relationships of nurses and​ people, practice, and the profession.

Which relationships are guided by the Code of Ethics from the International Council of​ Nurses? ​(Select all that​ apply.) A. Nurses and practice B. Nurses and laws C. Nurses and​ co-workers D. Nurses and people E. Nurses and payment

***A. Nurses and practice B. Nurses and laws ***C. Nurses and​ co-workers ***D. Nurses and people E. Nurses and payment The relationships that are guided by the Code of Ethics from the International Council of Nurses are that of nurses and​ people, practice and​ co-workers. Their Code of Ethics does not concern relationships of nurses and payment or laws.

A nurse who is a certified diabetes specialist is aware of the negative effects of fasting on glucose control. The nurse knows that clients with diabetes and clients with other conditions are often exempt from fasting requirements. Which people have conditions that often exempt them from religious​ fasting? ​(Select all that​ apply.) A. Nursing mothers B. Growing teenagers C. People over 65 D. Marathon runners E. Menstruating women

***A. Nursing mothers B. Growing teenagers C. People over 65 D. Marathon runners ***E. Menstruating women People who are often exempted from​ fasting, besides​ diabetics, are nursing mothers and menstruating women. The same exemption is not extended to growing​ teenagers, marathon​ runners, or people over 65.

A nurse mentor is explaining the primary benefits of National League for Nursing​ (NLN) membership to a prot​ég​é. Which items should be​ included? ​(Select all that​ apply.) A. Nursing research grants B. Specialty practice cultivation C. Job placement services D. Public policy initiatives E. Faculty development programs

***A. Nursing research grants B. Specialty practice cultivation C. Job placement services ***D. Public policy initiatives ***E. Faculty development programs The National League for Nursing​ (NLN) encourages the pursuit of high quality nursing education for all types of nursing education programs. NLN member benefits include faculty development​ programs, networking​ opportunities, assessment and​ testing, nursing research​ grants, and public policy initiatives. Job placement services are not a primary benefit of NLN membership. Professional specialty practice organizations are designed to cultivate specialty practice.

What is one way in which nurses can develop cultural self-awareness? A. Objectively examine own beliefs, values, and practices. B. Realize nothing can be done to change one's values and beliefs. C. Ask peers and colleagues about practicing cultural competence. D. Assert to others that personal biases cannot be changed.

***A. Objectively examine own beliefs, values, and practices. B. Realize nothing can be done to change one's values and beliefs. C. Ask peers and colleagues about practicing cultural competence. D. Assert to others that personal biases cannot be changed. Nurses can develop cultural self-awareness by becoming aware of the role of cultural influences in their own lives; objectively examining their own beliefs, values, and practices; and identifying and reflecting on personal biases.

A recently admitted terminally ill client has not requested pain medication for several hours. Which action should the nurse​ take? A. Observe for physical clues and assess the client for pain B. Administer pain medication as prescribed C. Assume that the client does not want to take pain medication D. Wait until the client asks for pain medication

***A. Observe for physical clues and assess the client for pain B. Administer pain medication as prescribed C. Assume that the client does not want to take pain medication D. Wait until the client asks for pain medication The nurse needs to ensure for the dying​ client's comfort by assessing for physical clues and verbal response about level of pain. Waiting until the client asks for pain medication could cause the client to suffer unnecessarily. The nurse should not assume that the client does not want pain medication. The nurse should not provide pain medication before assessing pain level.

The community health nurse is working with a school district to prevent the development of obesity in​ school-age and adolescent children. Which strategies should the nurse emphasize as important for these age​ groups? (Select all that​ apply.) A. Offer food choices that are nutritionally sound and help maintain a healthy body weight. B. Notify parents of children who are obese. C. Incorporate 1 hour of physical activity into each child​'s school day. D. Remove sugary beverages from vending machines on school property. E. Encourage parents to provide breakfast for their children before coming to school.

***A. Offer food choices that are nutritionally sound and help maintain a healthy body weight. B. Notify parents of children who are obese. ***C. Incorporate 1 hour of physical activity into each child​'s school day. ***D. Remove sugary beverages from vending machines on school property. E. Encourage parents to provide breakfast for their children before coming to school. Strategies to prevent the development of obesity in​ school-age and adolescent children include incorporating 1 hour of physical activity each​ day; limiting the intake of sugary​ beverages; and offering nutritionally sound food choices at school. Notifying parents of children who are obese may not help to prevent the problem. Encouraging parents to provide breakfast to children before arriving to school might be​ unrealistic, because the nurse and school district might not be aware of each family​'s ability to provide breakfast for children each day.

A pediatric client is alone in the room after the​ client's mother leaves to make a phone call. The client is crying and tells the​ nurse, "I want my mommy to come​ back." The nurse responds by​ stating, "It's okay to cry when you miss your mommy. I will sit with you until she comes back if you​ want." Which therapeutic communication techniques is the nurse using to establish rapport with the​ client? ​(Select all that​ apply.) A. Offering self B. Clarifying C. Accepting D. Exploring E. Broad openings

***A. Offering self B. Clarifying ***C. Accepting D. Exploring E. Broad openings The nurse is using accepting and offering self to establish rapport with the child. By conveying​ acceptance, the nurse respects the​ child's emotions and lets the child know that crying is okay. Offering self indicates that the nurse is accessible and wants to listen to the child. Clarifying is when the nurse asks the child to elaborate in order for the nurse to understand. Broad openings include​ open-ended questions, which allow the child to provide answers that are longer than one or two words. Exploring encourages the child to discuss the issue in more detail.

A student nurse is working with a group of children in a day care center and observes varying grief responses in several of the children. Which situation is not likely to initiate a grieving response in a​ child? A. Parent​'s losing a job B. Terminal or chronic illness C. Deployment of parent D. Divorce of parents

***A. Parent​'s losing a job B. Terminal or chronic illness C. Deployment of parent D. Divorce of parents Divorce of​ parents, deployment of a​ parent, and terminal or chronic illness are all losses that can elicit grief in children. Loss of a parent​'s job would likely affect the adult as a​ loss, but the child would not likely have a grieving response to the parent​'s job loss.

The nurse is conducting preoperative teaching for an adult female client who is scheduled to undergo a biopsy for a breast mass. During the​ session, the nurse notices the client is trembling. Which nursing response is​ best? A. Pausing the teaching session and asking the client how she is feeling B. Canceling the teaching session and leaving the client alone so she can have privacy C. Providing the client with a warm blanket and continuing the teaching session D. Asking the client if she understands the information that has been discussed

***A. Pausing the teaching session and asking the client how she is feeling B. Canceling the teaching session and leaving the client alone so she can have privacy C. Providing the client with a warm blanket and continuing the teaching session D. Asking the client if she understands the information that has been discussed The​ client's trembling may be due to​ cold, anxiety, or another factor. The nurse should pause the teaching session and address the​ client's primary concern​ first, which demonstrates respect for the client and awareness of the​ client's needs. This approach may also reduce anxiety and promote​ comfort, both of which will facilitate learning. Canceling the teaching session may be​ appropriate, but only after assessing the reason for the​ client's trembling and addressing the​ client's primary concern.

A nurse instructor is teaching a group of student nurses about the universal aspects of comfort. Which statements will the instructor​ include? ​(Select all that​ apply.) A. Physiological needs include​ oxygen, shelter,​ food, water, and sleep. B. Giving and receiving respect are aspects of​ self-esteem needs. C. When physiological needs are​ met, other needs can be achieved. D. Emotional needs are higher priority than physiological needs. E. Emotional needs include love and belonging from family and friends.

***A. Physiological needs include​ oxygen, shelter,​ food, water, and sleep. ***B. Giving and receiving respect are aspects of​ self-esteem needs. ***C. When physiological needs are​ met, other needs can be achieved. D. Emotional needs are higher priority than physiological needs. ***E. Emotional needs include love and belonging from family and friends. Physiological needs include​ oxygen, shelter,​ food, water, and sleep. When physiological needs are​ met, other needs can be achieved. Emotional needs include love and belonging from family and friends. Giving and receiving respect are aspects of​ self-esteem needs.

A nurse is caring for a​ very-low-birth-weight (VLBW) newborn with hypothermia. Which nursing intervention is most appropriate to implement especially related to the prevention of heat​ loss? A. Place in polyethylene wrapping. B. Place undressed in radiant warmer. C. Monitor for dysrhythmia. D. Monitor urine output.

***A. Place in polyethylene wrapping. B. Place undressed in radiant warmer. C. Monitor for dysrhythmia. D. Monitor urine output. The nurse should place the newborn in polyethylene wrapping to prevent further heat​ loss, not place the newborn undressed under a radiant warmer. While it is appropriate for the nurse to monitor for dysrhythmia and urine​ output, these interventions do not specifically relate to the prevention of heat loss in the child.

The nurse is teaching an older adult client how to use an incentive spirometer. The client has unsuccessfully attempted to use the device several times. Which is the best response by the nurse ​(Select all that​ apply.) A. Praising the client for his attempts to use the incentive spirometer and repeating the instructions for its use B. Telling the client a return demonstration is necessary C. Encouraging the client to continue to practice using the spirometer D. Asking the charge nurse to assume the role of teacher E. Concluding the teaching session

***A. Praising the client for his attempts to use the incentive spirometer and repeating the instructions for its use ***B. Telling the client a return demonstration is necessary ***C. Encouraging the client to continue to practice using the spirometer D. Asking the charge nurse to assume the role of teacher E. Concluding the teaching session Effective client teaching includes repeating content as needed and providing positive reinforcement. Return demonstration is needed to evaluate the​ client's comprehension of the teaching. The teaching session should not be concluded​ abruptly; instead, the nurse should allow sufficient time for the client to process the information. There is no indication for asking the charge nurse to assume the role of teacher.

A client diagnosed with bowel obstruction is scheduled for surgical resection of the bowel. Which nursing action is the most appropriate for this​ client? A. Prepare needed preoperative instructions B. Prepare instruction on care and cleaning of the ostomy pouch. C. Prepare and administer an enema. D. Prepare information on chemotherapy or radiation therapy

***A. Prepare needed preoperative instructions B. Prepare instruction on care and cleaning of the ostomy pouch. C. Prepare and administer an enema. D. Prepare information on chemotherapy or radiation therapy The client who needs surgical resection of the bowel will need preoperative​ instructions, and it is the nurse​'s role to provide them. Instruction on care and cleaning of the ostomy pouch will depend on whether the resection requires one. Enemas are used for​ impactions, not obstructions. Chemotherapy and radiation therapy are used for bowel cancer.

The nurse is preparing to assess an 18-​month-old ​client's temperature. Which reason should the nurse avoid using the tympanic membrane for this temperature​ measurement? A. Presence of ear drainage tubes B. Demonstrating irritability and crying C. Presence of a total body rash D. Experiencing projectile vomiting

***A. Presence of ear drainage tubes B. Demonstrating irritability and crying C. Presence of a total body rash D. Experiencing projectile vomiting The tympanic route should be avoided in a child with an active ear infection or tympanic membrane drainage tubes. A body​ rash, projectile​ vomiting, or crying and irritability are not contraindications for the use of the tympanic membrane for temperature measurement.

Which strategies are emphasized in managed​ care? ​(Select all that​ apply.) A. Preventing inappropriate and unnecessary costs B. Delivering preventive services C. Adhering to ethical values D. Promoting health E. Increasing customer satisfaction

***A. Preventing inappropriate and unnecessary costs ***B. Delivering preventive services C. Adhering to ethical values ***D. Promoting health ***E. Increasing customer satisfaction Managed care is a delivery system that focuses on decreasing costs and improving client outcomes. It emphasizes preventing inappropriate and unnecessary​ costs, increasing customer​ satisfaction, promoting​ health, and delivering preventive services. Adhering to ethical values is a nursing action essential to all aspects of nursing care but is not a strategy or goal of managed care.

The novice nurse is trying to remember the different benefits of primary​ prevention, primary​ care, primary​ insurance, and primary nursing. Which two of these activities would the nurse identify as increasing the continuity of​ care? A. Primary care and primary nursing B. Primary prevention and primary nursing C. Primary prevention and primary insurance D. Primary prevention and primary care

***A. Primary care and primary nursing B. Primary prevention and primary nursing C. Primary prevention and primary insurance D. Primary prevention and primary care Primary care and primary nursing have the benefit of increasing the continuity of care. Primary prevention is about​ wellness, not continuity. Primary insurance happens when the client has more than one insurer.

A client invites family members into the private hospital room. "I​'d like you to meet my nurse" the client says. "My nurse has been with me my whole hospitalization." Which kind of nursing delivery system is most likely in​ place? A. Primary nursing B. Team nursing C. Relationship nursing D. Functional nursing

***A. Primary nursing B. Team nursing C. Relationship nursing D. Functional nursing The most likely kind of nursing delivery system is primary​ nursing, where a nurse is accountable for specific clients. In functional and team​ nursing, the accountability would be shared. There is no relationship nursing system.

While providing care in the emergency​ department, the nurse asks the victim of a pedestrian accident "why did you cross the street in the middle of the ​block?" Which communication barrier is this nurse​ demonstrating? A. Probing B. Testing C. Challenging D. Being defensive

***A. Probing B. Testing C. Challenging D. Being defensive Probing is asking for information chiefly out of curiosity rather than with the intent to assist the client. This approach is considered prying and violates the​ client's privacy. Asking "why" is often probing and places the client in a defensive position. Challenging is giving a response that makes a client prove his or her statement or point of view. Being defensive is attempting to protect an individual or healthcare service from negative comments. Testing is asking questions that make the client admit to something. These responses permit the client only limited answers and often meet the​ nurse's need rather than the​ client's.

A client and her husband are preparing for the delivery of their son. The client was diagnosed with an intrauterine fetal demise earlier in the day and was admitted for induction of labor and delivery. Which interventions would be appropriate for this​ couple? ​(Select all that​ apply.) A. Provide access to support systems within the hospital to help them manage their grief. B. Secure a private room near the nursery so the couple will not be so sad with other babies around. C. Immediately start the interventions for the induction of labor. D. Ask the mother what sort of music and lighting she wants. E. Encourage the couple to ask questions.

***A. Provide access to support systems within the hospital to help them manage their grief. B. Secure a private room near the nursery so the couple will not be so sad with other babies around. C. Immediately start the interventions for the induction of labor. ***D. Ask the mother what sort of music and lighting she wants. ***E. Encourage the couple to ask questions. A private room allows the parents privacy to grieve.​ However, a room too close to crying babies may increase the distress or anxiety of the family going through the loss. Encourage the couple to ask questions and give them time to discuss the options. The family should be given some time to process their grief before interventions or asking the mother about birthing preferences. Birthing preferences may include lighting and music. Assisting with access to support systems will support the family through the grieving process of their loss.

While preparing a performance appraisal for a staff​ nurse, the manager documents that the nurse is competent. Which nursing behaviors support this level of​ performance? ​(Select all that​ apply.) A. Provided interventions B. Identified appropriate outcomes C. Collected focused data D. Determined nursing diagnoses E. Communicated client requests

***A. Provided interventions ***B. Identified appropriate outcomes ***C. Collected focused data ***D. Determined nursing diagnoses E. Communicated client requests Competent nurses follow the steps of the nursing process when providing client​ care, specifically,​ assessment, diagnosis,​ planning, implementation, and evaluation. Communicating client requests is not a step within the nursing process.

A nurse is participating in a committee that will select a universal nursing documentation for the hospital. What advantages would the committee consider when looking at the focus charting documentation​ format? ​(Select all that​ apply.) A. Provides a structure for the progress notes. B. Allows for checklists or flow sheets to record routine nursing tasks. C. Ensures that each nursing note includes​ data, action, and response. D. Ensures that the nursing focused assessment is the priority of care. E. Offers a complete perspective of the client and the client​'s care needs.

***A. Provides a structure for the progress notes. ***B. Allows for checklists or flow sheets to record routine nursing tasks. C. Ensures that each nursing note includes​ data, action, and response. D. Ensures that the nursing focused assessment is the priority of care. ***E. Offers a complete perspective of the client and the client​'s care needs. Focus charting is aimed at making the client and the​ client's concerns and strengths the focus of​ care, not the​ nurse's focused assessment. The progress notes are organized into​ (D) data,​ (A) action, and​ (R) response, referred to as DAR. Each note does not need to have all three categories. All other choices are correct for focus charting.

The nurse is describing programs and services offered by the local community health department. Which activities should be​ included? ​(Select all that​ apply.) A. Providing food assistance to pregnant women B. Distributing free infant car seats C. Implementing injury prevention campaigns D. Promoting lead poisoning safety efforts E. Overseeing emergency medical services systems

***A. Providing food assistance to pregnant women ***B. Distributing free infant car seats ***C. Implementing injury prevention campaigns ***D. Promoting lead poisoning safety efforts E. Overseeing emergency medical services systems Local community health programs and services include implementing injury prevention​ campaigns, promoting lead poisoning safety​ efforts, distributing free infant car​ seats, and providing food assistance to pregnant women​ [often through the​ Women, Infants, and Children​ (WIC) supplemental nutrition​ program]. Oversight of emergency medical services systems is a state responsibility.

A pediatric nurse Jason Mosely is making sure that the activity room of his unit is stocked with​ crayons, coloring​ books, and stuffed animals. What is the best reason for Mr. Mosely to take that​ approach? A. Providing materials for nonverbal expression B. Giving entertaining options to fight boredom C. Allowing hospitalized children to exercise their limbs D. Setting up items to develop fine motor skills

***A. Providing materials for nonverbal expression B. Giving entertaining options to fight boredom C. Allowing hospitalized children to exercise their limbs D. Setting up items to develop fine motor skills ​Crayons, coloring​ books, and musical toys provide materials for nonverbal expression by hospitalized children. This is more important during an inpatient stay than​ entertainment, skill​ development, or exercise.

A​ medical-surgical unit utilizes the case method for providing client care. Which actions will the nurse perform when caring for clients using this​ approach? ​(Select all that​ apply.) A. Providing total care to assigned clients for the entire shift B. Overseeing the total care for a number of clients 24 hours a​ day, 7 days a week C. ​Assessing, planning,​ implementing, and evaluating care provided D. Delegating the completion of morning care to unlicensed assistive personnel E. Providing medications to clients for an entire team

***A. Providing total care to assigned clients for the entire shift B. Overseeing the total care for a number of clients 24 hours a​ day, 7 days a week ***C. ​Assessing, planning,​ implementing, and evaluating care provided D. Delegating the completion of morning care to unlicensed assistive personnel E. Providing medications to clients for an entire team The case method is also termed total care and involves one nurse being assigned and responsible for the care of a group of clients over an 8 or 12 hour shift. Nursing responsibilities in the case method include​ assessing, diagnosing,​ planning, implementing and evaluating the effectiveness of care. Providing medications to clients for an entire team would be performed in functional nursing. Delegating the completion of morning care to unlicensed assistive personnel is an action within team nursing. In primary​ nursing, the nurse oversees the total care for a number of clients 24 hours a​ day, 7 days a week.

The nurse suspects that a client may have attention deficit hyperactivity disorder​ (ADHD). Upon which assessment technique might the nurse have made this​ diagnosis? A. Questionnaire about study and behavior habits at school and home B. Screening of eye contact and facial expression C. Screening of balance and coordination abilities D. Questionnaire about temper tantrums and aggression

***A. Questionnaire about study and behavior habits at school and home B. Screening of eye contact and facial expression C. Screening of balance and coordination abilities D. Questionnaire about temper tantrums and aggression ADHD is diagnosed via​ questionnaires, observations, and screenings related to client functioning in more than one setting​ (e.g., home,​ school, and​ work). Screenings about eye contact and facial​ expression, temper tantrums and​ aggression, and balance and coordination techniques do not diagnose ADHD.

A nurse is caring for a client who is disoriented to time, place, and person and is attempting to get out of bed and pull out an IV line that is supplying hydration and antibiotics. The client has a vest restraint and bilateral soft wrist restraints. Which actions by the nurse would be appropriate? SELECT ALL THAT APPLY. A. RECHECK AND DOCUMENT THE BEHAVIOR THAT REQUIRES CONTINUED USE OF RESTRAINTS B. TIE THE RESTRAINTS IN QUICK-RELEASE KNOTS C. TIE THE TRESTRAINTS TO THE SIDE RAILS OF THE BED D. ASK THE CLIENT IF HE NEEDS TO GO THE BATHROOM, AND PROVIDE RANGE OF MOTION (ROM) EXERCISES EVERY 2 HOURS. E. POSITION THE VEST RESTRAINTS SO THAT THE STRAPS ARE CROSSED IN THE BACK.

***A. RECHECK AND DOCUMENT THE BEHAVIOR THAT REQUIRES CONTINUED USE OF RESTRAINTS ***B. TIE THE RESTRAINTS IN QUICK-RELEASE KNOTS C. TIE THE TRESTRAINTS TO THE SIDE RAILS OF THE BED ***D. ASK THE CLIENT IF HE NEEDS TO GO THE BATHROOM, AND PROVIDE RANGE OF MOTION (ROM) EXERCISES EVERY 2 HOURS. E. POSITION THE VEST RESTRAINTS SO THAT THE STRAPS ARE CROSSED IN THE BACK.

The nurse is planning care of a​ 10-year-old child with an asthma exacerbation whose parents are currently unemployed. Which interventions are the best for the nurse to pursue for this​ family? ​(Select all that​ apply.) A. Reassuring the family of the potential benefits of pursuing the nurse​'s collaborative interventions B. Identification of areas of knowledge deficiency in cultural competence C. Referral to community wellness clinics D. Avoidance of assumptions or judgments E. Referral to social services experts

***A. Reassuring the family of the potential benefits of pursuing the nurse​'s collaborative interventions B. Identification of areas of knowledge deficiency in cultural competence ***C. Referral to community wellness clinics D. Avoidance of assumptions or judgments ***E. Referral to social services experts Nurses often need to collaborate with other professionals to help clients regain or maintain health. The nurse​'s collaborators may include social services​ experts, community free wellness​ clinics, food​ banks, and other community organizations that can meet the family​'s needs. The nurse teaches the family the value of these resources to their child​'s and family​'s health and encourages them to follow through on securing support. Identification of areas of knowledge deficiency in cultural competence and avoiding assumptions or judgments about clients are part of the nurse​'s own professional development and​ practice, not a nursing intervention for a client.

A nurse is caring for a client who has been diagnosed with liver cancer but has not shared this diagnosis with family members. The client tells the​ nurse, "I can​'t tell my family that I have cancer." The nurse​ replies, "What do you think would be ​best?" Which method of therapeutic communication is the nurse using with this​ client? A. Reflecting B. Presenting reality C. Acknowledging D. Focusing

***A. Reflecting B. Presenting reality C. Acknowledging D. Focusing The nurse is using​ reflecting, a technique that leads the​ client's feelings back to the client to assist the client in discovering his or her own ideas. Focusing is used when the nurse helps the client expand on and develop a topic of​ importance, which is often an emotion disguised behind words. Presenting reality helps the client distinguish the real from the unreal. Acknowledging is used when the nurse gives nonjudgmental recognition to the client for a client effort or change in behavior.

The nursing student reviews the National Student Nurses Association Code of Academic and Clinical Conduct prior to beginning a clinical rotation. Which are guiding principles of this​ code? ​(Select all that​ apply.) A. Refuse to perform a task without proper training B. Articulate the values of nursing to shape social policy C. Provide care in a professional manner D. Attain and maintain a maximum level of personal health E. Advocate for the rights of clients

***A. Refuse to perform a task without proper training B. Articulate the values of nursing to shape social policy ***C. Provide care in a professional manner ***D. Attain and maintain a maximum level of personal health ***E. Advocate for the rights of clients The Code for Nursing Students has 18 guiding principles which include advocating for the rights of​ clients; maintaining​ confidentiality; ensuring the safety of​ clients, self, and​ others; providing care in a professional​ manner; communicating​ effectively; promoting a high level of moral and ethical​ principles; encouraging​ life-long learning; treating others with​ respect; collaborating with other​ nurses; improving​ others' understanding of the nursing​ student's learning​ needs; encouraging others to mentor nursing​ students; refusing to perform any task in which the student has not been​ trained; avoiding any act of care that could lead to injury of​ clients, self, or​ others; ensuring clients provide authorization before accepting​ treatment; abstaining from the use of alcohol or substances in the clinical​ setting; striving to attain and maintain a maximal level of personal​ health; supporting students who may be experiencing health​ issues; and supporting school policies and regulations. Articulating the values of nursing to shape social policy is an action within the American Nurses​ Association's Code of Ethics for Nurses.

A community health nurse is describing the role of the local health department to a student nurse who is shadowing for the day. Which items are appropriate for the nurse to include in the​ discussion? ​(Select all that​ apply.) A. Reporting incidents of disease to state authorities B. Notifying federal authorities about incidents of disease C. Providing community disease monitoring and surveillance D. Offering​ state-wide disease and injury prevention programs E. Ensuring compliance by local emergency medical services​ (EMS)

***A. Reporting incidents of disease to state authorities ***B. Notifying federal authorities about incidents of disease ***C. Providing community disease monitoring and surveillance D. Offering​ state-wide disease and injury prevention programs E. Ensuring compliance by local emergency medical services​ (EMS) Responsibilities of local health departments include providing community disease monitoring and​ surveillance; reporting incidents of disease to state and federal​ authorities; and offering​ community-wide disease and injury prevention programs. State offices of emergency medical services​ (OEMSs) ensure that local emergency medical services​ (EMS) systems comply with all applicable regulations.

The nurse is reviewing a nursing research​ journal, published by a professional​ organization, prior to providing client care. Which statements illustrate how nursing research supports the nurse when planning client​ care? ​(Select all that​ apply.) A. Research provides information on​ evidence-based practice. B. Research supports education needs. C. Research ensures the implementation of ethical principles. D. Research is useful in explaining nursing theories. E. Research supports the nurse​'s education required for entry into practice.

***A. Research provides information on​ evidence-based practice. ***B. Research supports education needs. C. Research ensures the implementation of ethical principles. ***D. Research is useful in explaining nursing theories. E. Research supports the nurse​'s education required for entry into practice. Research is integral to the growth and ongoing professionalism of nursing. The focus of nursing research has progressed to include nursing​ education, the nursing knowledge​ base, and​ practice-related issues. Nursing research emphasizes the development of​ evidence-based practice. Through​ research, nursing has several conceptual frameworks and identified theories that are used to guide nursing practice and education. Research does not support any particular point of entry into the profession. Research does not ensure the implementation of ethical principles. The adherence to ethical principles is a characteristic of​ integrity, which is an aspect of the nursing profession.

The 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.) A. Review potential drug interactions with food. B. Explain when to skip medication doses. C. Teach how prescribed medications are to be taken. D. Review the client​'s list of prescribed medications. E. Study the name and purpose of each prescribed medication.

***A. Review potential drug interactions with food. B. Explain when to skip medication doses. ***C. Teach how prescribed medications are to be taken. ***D. Review the client​'s list of prescribed medications. ***E. Study the name and purpose of each prescribed medication. 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.

The care coordinator is planning actions to overcome a client​'s knowledge deficit related to the use of a sleep apnea machine at home. Which approach should the nurse use for this​ situation? A. Review the steps in using the machine again B. Schedule the machine to be delivered at another time of day C. Explain the consequences of not using the equipment correctly D. Discuss the client​'s ​non-adherence with the healthcare professional

***A. Review the steps in using the machine again B. Schedule the machine to be delivered at another time of day C. Explain the consequences of not using the equipment correctly D. Discuss the client​'s ​non-adherence with the healthcare professional To overcome the barrier of deficient​ knowledge, the nurse should provide additional teaching to ensure client comprehension of the instructions. Scheduling would address the barrier of limited resources. Discussing the issue with the interdisciplinary team is an action to address limited resources. Explaining the consequences of not using the equipment correctly is not a strategy to overcome any care coordination barriers.

The nurse is teaching a course on grieving to new staff members at a local hospital. Which manifestation should the nurse include in the presentation as expected alterations or manifestations of​ grief? Select all that apply. A. Selling the family home B. Becoming distrustful of others C. Having difficulty concentrating D. Moving in with a friend or family member E. Experiencing auditory hallucinations

***A. Selling the family home B. Becoming distrustful of others ***C. Having difficulty concentrating ***D. Moving in with a friend or family member E. Experiencing auditory hallucinations Selling the family​ home, moving in with a friend or family​ member, and having difficulty concentrating are expected alterations or manifestations of grief. Becoming distrustful of others or experiencing auditory hallucinations are manifestations of complicated grief and require immediate intervention by the health care team.

The nurse educator asks a group of students to name the stages of development identified by Piaget. Which responses indicate understanding of Piaget​'s ​theory? Select all that apply. A. Sensorimotor B. Concrete operational C. Preoperational D. Formal operational E. Postoperational

***A. Sensorimotor ***B. Concrete operational ***C. Preoperational ***D. Formal operational E. Postoperational Piaget described four stages of cognitive​ development: sensorimotor,​ preoperational, concrete​ operational, and formal operational. Postoperational is not a stage described by Piaget.

Prior to delivery of client​ care, the nurse reviews one​ policy, checks an​ evidence-based practice​ guideline, and scans through a list of standards of practice. Which elements of a profession are illustrated through the actions of the​ nurse? ​(Select all that​ apply.) A. Service orientation B. Quality improvement C. Autonomy D. Safety E. Ongoing research

***A. Service orientation B. Quality improvement ***C. Autonomy D. Safety ***E. Ongoing research The elements of any profession include service​ orientation, ongoing​ research, and autonomy. By reviewing an​ evidence-based guideline, the nurse is demonstrating ongoing research. By scanning through a list of standards of​ practice, the nurse is demonstrating autonomy. By reviewing a​ policy, the nurse is demonstrating an element of service orientation. Safety and quality improvement are nursing competencies.

The unit charge nurse is planning an​ in-service education program about effective ergonomics during computer use. Which content should be​ included? ​(Select all that​ apply.) A. Shoulders and upper arms should be perpendicular to the​ floor, and upper arms and elbows should be close to the body. B. Individuals who use the computer for more than 3 hours per day are at risk for computer vision​ syndrome, or eyestrain. C. While​ seated, an individual​'s thighs should be parallel to the​ floor, and the lower legs should be extended. D. The head and neck should be​ aligned, and the torso should be relaxed to allow the upper spine to curve outward. E. Repetitive strain​ injury, or repetitive motion​ disorder, is the most common consequence of computer use.

***A. Shoulders and upper arms should be perpendicular to the​ floor, and upper arms and elbows should be close to the body. ***B. Individuals who use the computer for more than 3 hours per day are at risk for computer vision​ syndrome, or eyestrain. C. While​ seated, an individual​'s thighs should be parallel to the​ floor, and the lower legs should be extended. D. The head and neck should be​ aligned, and the torso should be relaxed to allow the upper spine to curve outward. E. Repetitive strain​ injury, or repetitive motion​ disorder, is the most common consequence of computer use. For proper​ positioning, the​ head, neck, and torso should be aligned. Shoulders and upper arms should be perpendicular to the floor and relaxed. Upper arms and elbows should be close to the body. ​Forearms, wrists, and hands should be straight and in line. While​ seated, the worker​'s thighs should be parallel to the floor and the feet should rest flat on the floor or be supported by a footrest. Repetitive strain​ injury, or repetitive motion​ disorder, is one of the two most common injuries resulting from prolonged computer use.​ However, computer vision​ syndrome, or​ eyestrain, is the most common consequence. Individuals who use the computer for more than 3 hours per day are at risk for computer vision syndrome.

Which are factors that shape family​ development? ​(Select all that​ apply.) A. Sibling relationships B. Parenting style C. ​Family-centered care D. Resiliency E. Boundaries

***A. Sibling relationships ***B. Parenting style C. ​Family-centered care ***D. Resiliency ***E. Boundaries Factors that shape family development are​ parent-child interaction, family​ size, sibling​ relationships, boundaries, family​ cohesion, resiliency, family coping​ mechanisms, emotional​ availability, family​ flexibility, family communication​ patterns, parenting​ style, and genetic considerations and nonmodifiable risk factors.​ Family-centered care is the partnership between nurses and families when planning care.

Which are examples of nonverbal​ communication? ​(Select all that​ apply.) A. Sitting forward in a chair B. Crossed arms C. Yelling D. Blushing E. Lack of eye contact

***A. Sitting forward in a chair ***B. Crossed arms C. Yelling ***D. Blushing ***E. Lack of eye contact ​Blushing, lack of eye​ contact, crossed​ arms, and sitting forward in a chair are all forms of nonverbal communication. Yelling is verbal.

The nurse is assessing an​ 8-year-old client during a​ well-child visit at a clinic. Which anatomical differences does the nurse expect to finding during the assessment​ process? ​(Select all that​ apply.) A. Smaller nasopharynx B. Atrophy of the tonsils C. Small mouth with large tongue D. Larynx and glottis lower in the neck E. Soft tracheal cartilage

***A. Smaller nasopharynx B. Atrophy of the tonsils ***C. Small mouth with large tongue D. Larynx and glottis lower in the neck ***E. Soft tracheal cartilage Normal findings for the pediatric client from infancy until the age of 12 include a smaller​ nasopharynx, a small mouth with a large​ tongue, and soft tracheal cartilage. The nurse would expect to find enlarged​ tonsils; atrophy does not occur until after 12 years of age. The nurse would expect the larynx and the glottis to be higher in the​ neck, not lower.

The nurse observes the client in prayer with family members. Which cultural phenomenon would the nurse recognize is​ occurring? A. Social organization B. Personal space C. Time orientation D. Environmental control

***A. Social organization B. Personal space C. Time orientation D. Environmental control Religious beliefs are part of what may identify the social organization of the culture of a family unit. Although the family members might be close to each​ other, focus is not on personal​ space, which refers to the comfortable or appropriate distance for interaction with other people. Time orientation differs among​ cultures, with some putting more value on the past and​ present; Anglo-American culture places more emphasis on the future.​ However, the focus during this client​'s prayer is not on time. The family is displaying social organization and not controlling the environment around them.

When developing a family plan of care for a pediatric client with a chronic health​ condition, which areas require an​ in-depth assessment of all family​ members? ​(Select all that​ apply.) A. Socioeconomic status B. Religious preferences C. Medication schedules D. Culture and social practices E. Education level

***A. Socioeconomic status ***B. Religious preferences C. Medication schedules ***D. Culture and social practices E. Education level A family plan of care requires​ in-depth assessment of all family​ members, including their health​ history, socioeconomic​ status, religion,​ culture, nutrition, and social habits and practices. Medication schedules and​ education/intelligence levels do not need to be assessed unless the nurse becomes aware of a problem in this area.

A client that is 28 weeks pregnant calls the office with some concerns. The OB nurse takes the call and asks what symptoms she is having. What symptoms would indicate that the client requires an examination by the healthcare​ professional? ​(Select all that​ apply.) A. Spotting B. No fetal movement C. Headache D. Severe back pain E. Cramping

***A. Spotting ***B. No fetal movement C. Headache ***D. Severe back pain ***E. Cramping The symptoms of​ spotting, cramping, no fetal movement or change in fetal​ activity, and/or severe back pain may indicate a situation that may lead to serious complications​ and/or fetal death. A headache is a symptom to​ monitor, but unless it is​ severe, suggesting​ preeclampsia, it alone is not a symptom to be extremely concerned about.

A client who is diagnosed with cirrhosis comes into the clinic complaining of shortness of breath. When percussing the client​'s ​liver, which techniques are appropriate for this​ client? ​(Select all that​ apply.) A. Striking the distal phalanx against the dominant phalangeal joint B. Striking the lower right abdomen with the tip of the little finger C. Striking the pleximeter at the distal interphalangeal joint D. Striking the lower left abdomen with the tip of the middle finger E. Striking the lower left flank of the back with the side of the hand

***A. Striking the distal phalanx against the dominant phalangeal joint B. Striking the lower right abdomen with the tip of the little finger ***C. Striking the pleximeter at the distal interphalangeal joint D. Striking the lower left abdomen with the tip of the middle finger E. Striking the lower left flank of the back with the side of the hand Because the liver is an area that cannot be percussed​ directly, the nurse will use indirect percussion to assess the​ client's liver. In indirect​ percussion, the nurse places the middle finger of the nondominant hand​ (the pleximeter) firmly on the​ client's skin. Only the distal phalanx and joint of this finger should be in contact with the skin. Using the tip of the flexed middle finger of the other hand​ (the plexor), the nurse strikes the​ pleximeter, usually at the distal interphalangeal joint. The pads of the fingers are used in direct​ percussion; the side of the hand is not used in either direct or indirect percussion.

A nurse in a​ long-term care facility finds a client unresponsive in bed. The nurse notices a do not resuscitate​ (DNR) sign at the head of the bed. What is the nurse​'s priority​ action? A. Taking the vital signs of the client B. Letting the physician know of the client​'s condition C. Letting the supervisor know of the client​'s condition D. Making sure the client is not in pain

***A. Taking the vital signs of the client B. Letting the physician know of the client​'s condition C. Letting the supervisor know of the client​'s condition D. Making sure the client is not in pain The nurse needs to check the​ client's status with the physiological measurements of vital signs. Making sure the client is not in pain is​ important, but not the priority clinical action. Informing the supervisor and the primary care physician can be done later. The client has a right to​ assessment, even with a DNR sign.

A nurse is caring for a client diagnosed with intractable nausea and vomiting. What independent nursing interventions help to maintain fluid and electrolyte​ balance? ​(Select all that​ apply.) A. Teaching the client to restrict fluid intake for 1 hour before and after meals B. Administering antiemetics as ordered C. Teaching the client to seek additional medical help if unable to take in fluids D. Discussing the need to avoid foods that produce nausea E. Administering IV fluid replacement as ordered

***A. Teaching the client to restrict fluid intake for 1 hour before and after meals B. Administering antiemetics as ordered ***C. Teaching the client to seek additional medical help if unable to take in fluids ***D. Discussing the need to avoid foods that produce nausea E. Administering IV fluid replacement as ordered Independent interventions that help to maintain fluid and electrolyte balance include discussing the need to avoid foods that produce​ nausea, teaching the client to seek additional medical help if unable to take in​ fluids, and teaching the client to restrict fluid intake for 1 hour before and after meals. The other interventions are​ collaborative, not independent interventions.

A child is in the hospital receiving treatment related to injuries sustained in a motor vehicle accident. The child​'s classmate died in the crash. The nurse is explaining to the client​'s parents about the ways in which the child may deal with grief and​ loss, and tells them which factors influence how children cope with​ grief? Select all that apply. A. Temperament B. Cultural influences C. Age D. Family influences E. Nutritional status and eating habits

***A. Temperament ***B. Cultural influences ***C. Age ***D. Family influences E. Nutritional status and eating habits ​Age, temperament, cultural​ influences, and family influences all impact how children cope with grief. Nutritional status does not directly influence how children cope with grief.

The nurse is caring for an adolescent client who is alert but intubated following a​ C7-T1 spinal cord injury. Which communication strategy is the most developmentally appropriate for the nurse to use with this intubated​ client? A. Text messages B. Flash cards C. Grease pencil and white board D. Hand signals

***A. Text messages B. Flash cards C. Grease pencil and white board D. Hand signals The client is an adolescent and has a spinal cord injury that most likely has kept his arm and hand function intact. Text​ messaging, popular among​ adolescents, would be the best communication method for this client. Flash​ cards, hand​ signals, and grease pencil with a white board might work as a method of communication to some​ extent; however, these may or may not support the​ client's physical and developmental needs. With text messaging the client will be able to communicate needs to healthcare staff as well as communicate with friends and family.

The public health nurse is conducting a seminar for​ first-time parents about health insurance coverage. What features of a Health Maintenance Organization​ (HMO) would the nurse describe as different from those of a Preferred Provider Organization​ (PPO)? ​(Select all that​ apply.) A. The HMO has lower copayments. B. The HMO has lower deductibles. C. The HMO requires selection of a primary care provider. D. The HMO gives wider choices of providers. E. The HMO has higher premiums.

***A. The HMO has lower copayments. ***B. The HMO has lower deductibles. ***C. The HMO requires selection of a primary care provider. D. The HMO gives wider choices of providers. E. The HMO has higher premiums. The HMO has lower​ copayments, lower​ deductibles, and requires selection of a primary care provider. The PPO has higher​ premiums, but gives wider choice of providers than the HMO.

A nurse manager is talking to the night shift staff about the ethical principles supporting education of their preoperative clients. The nurse manager uses the words​ "beneficence" and​ "nonmaleficence." Which statements define these two​ concepts? ​(Select all that​ apply.) A. The actions that nurses take should promote good. B. The actions that nurses take should be fair to all possible clients. C. The actions that nurses take should do no harm. D. The actions that nurses take should safeguard clients. E. The actions that nurses take should involve telling the truth.

***A. The actions that nurses take should promote good. B. The actions that nurses take should be fair to all possible clients. ***C. The actions that nurses take should do no harm. ***D. The actions that nurses take should safeguard clients. E. The actions that nurses take should involve telling the truth. Beneficence means the​ nurse's actions should promote​ good; nonmaleficence means the nurse should do no harm and safeguard clients. Telling the truth is about​ "veracity," rather than​ "beneficence." Being fair to all possible clients is about​ "justice," rather than​ "beneficence."

The nurse manager is concerned that client care coordination was not successful. On which observations did the nurse manager base this​ concern? ​(Select all that​ apply.) A. The client​'s abdominal wound dressing was changed twice in one shift. B. The client​'s fasting blood glucose level was drawn twice in one day. C. The family is requesting to discuss home care needs. D. Referral for home care has been delayed by two days. E. The client received two doses of a prescribed pain medication.

***A. The client​'s abdominal wound dressing was changed twice in one shift. ***B. The client​'s fasting blood glucose level was drawn twice in one day. C. The family is requesting to discuss home care needs. ***D. Referral for home care has been delayed by two days. ***E. The client received two doses of a prescribed pain medication. Care that is not coordinated can lead to fragmented​ services, medical​ errors, and unnecessary duplication of​ tests, services, and​ treatments, as well as to omission of necessary services. Collaboration can be initiated by the​ client, family​ member, or a member of the health care team.

The nurse is performing a cultural assessment on an adult client. What type of information would be used to complete the cultural​ assessment? ​(Select all that​ apply.) A. The language spoken in the home B. Whether the client has insurance C. The client​'s region or country of residence D. The kinds of food and drink the client prefers E. The cultural or religious influences in decision making

***A. The language spoken in the home B. Whether the client has insurance ***C. The client​'s region or country of residence ***D. The kinds of food and drink the client prefers ***E. The cultural or religious influences in decision making Subjective data would be gathered by asking questions about cultural beliefs. Objective data would be gathered through observation of the client and the interactions between significant family members who might be present. Discovering the region or country the client originates from and lives in would give clues about the client​'s culture. It is important to know what language is spoken in the home and whether the client understands English so that communication can be effective. Insurance is not necessarily a question that would come up during a cultural​ assessment, although socioeconomic status may affect health care delivery.

During the birth of a postterm infant, the nurse suspects that meconium aspiration may have occurred in utero. What findings would correlate with this suspicion? Select all that apply. A. The newborn has green staining of the fingernails. B. The umbilical cord is stained bright red. C. The newborn has labored abdominal respirations. D. The newborn makes bearing down movements. E. The anterior fontanels are sunken at birth. F. Green amniotic fluid is present at birth.

***A. The newborn has green staining of the fingernails. B. The umbilical cord is stained bright red. ***C. The newborn has labored abdominal respirations. ***D. The newborn makes bearing down movements. E. The anterior fontanels are sunken at birth. ***F. Green amniotic fluid is present at birth.

A nurse is caring for an older adult with hypothermia. The nurse understands that older adults are at greater risk for developing hypothermia than younger adults. Which is true regarding older adults and the risk of​ hypothermia? A. The normal aging process decreases metabolism. B. The normal aging process decreases pain tolerance. C. The normal aging process decreases ability to shiver. D. The normal aging process decreases safety awareness.

***A. The normal aging process decreases metabolism. B. The normal aging process decreases pain tolerance. C. The normal aging process decreases ability to shiver. D. The normal aging process decreases safety awareness. The older adult is at greater risk for developing hypothermia due to the normal aging process of decreased metabolism. Aging does not decrease pain tolerance or the body​'s ability to shiver. While many older adults have alterations of safety​ awareness, this is not necessarily a result of the normal aging process.

Two dialysis clinic nurses are discussing the recent death of a client with end stage renal disease. One nurse believed that the client​'s decision to end treatment was OK. The other nurse thought that the client should have extended life long enough to talk to an estranged child. Which nurse is exhibiting client​ advocacy? A. The nurse who believed that the client​'s decision to end treatment is OK. B. Both nurses are​ advocates; they are proposing choices that the client could have made C. Neither nurse is an​ advocate; the client had no real choice and would have died soon anyway D. The nurse who thought that the client should have had a chance to reconcile with a child

***A. The nurse who believed that the client​'s decision to end treatment is OK. B. Both nurses are​ advocates; they are proposing choices that the client could have made C. Neither nurse is an​ advocate; the client had no real choice and would have died soon anyway D. The nurse who thought that the client should have had a chance to reconcile with a child An advocate defends the cause of another​ person, so the nurse supporting the​ client's decision to end treatment was an advocate. The nurse who proposed an opinion that family reconciliation was a value was not supportive of the client. Advocacy is not limited by the amount of time left in life. An advocate does not propose choices that the client could have​ made, in the face of choices actually made.

The nursing students are meeting for a post conference following their shift on a medical floor. One of the students is reviewing a client​'s cultural background. Which statement by the student illustrates the concept of cultural​ humility? A. The nurse​'s expression of sensitivity to the differences between her client​'s culture and her own. B. The nurse​'s discussion of her cultural superiority over her client​'s culture. C. The nurse​'s explanation to her client that his religious beliefs lack scientific validity when discussing his diagnosis D. The nurse​'s example of her authoritative stance when teaching her client which diet is best for his diagnosis.

***A. The nurse​'s expression of sensitivity to the differences between her client​'s culture and her own. B. The nurse​'s discussion of her cultural superiority over her client​'s culture. C. The nurse​'s explanation to her client that his religious beliefs lack scientific validity when discussing his diagnosis D. The nurse​'s example of her authoritative stance when teaching her client which diet is best for his diagnosis. Cultural humility is displayed when a nurse recognizes that his or her personal cultural values are not superior to the cultural values of another person. The nurse is not demonstrating cultural humility when he or she is claiming cultural superiority over another person. Taking an authoritative stance to influence a client against dietary choices does not reflect cultural humility. Abusing the power of the nurse​'s position against the client​'s religion is not using cultural humility. Cultural humility is demonstrated when the nurse is sensitive to the differences in his or her client​'s ​culture, even though the nurse​'s personal values are not the same as the client​'s.

The nurse is providing care to an older adult client who is experiencing new symptoms of grief. Which item in the client​'s history might be the cause of these​ symptoms? A. The recent move to an assisted living facility B. The loss of a spouse 5 years ago C. The loss of a pregnancy 20 years ago D. Being diagnosed with type 1 diabetes mellitus as a child

***A. The recent move to an assisted living facility B. The loss of a spouse 5 years ago C. The loss of a pregnancy 20 years ago D. Being diagnosed with type 1 diabetes mellitus as a child While the loss of a pregnancy and of a spouse years ago may influence symptoms of​ grief, the recent move to an assisted living facility and the loss of independence associated with this move is the likely cause of the client​'s new symptoms of grief. The diagnosis of type 1 diabetes mellitus in childhood is not a factor in this client​'s grief.

Medication administration has been identified as a​ high-risk activity for error. What are the rights of medication administration that every nurse should​ follow? ​(Select all that​ apply.) A. The right drug B. The right room C. The right client D. The right dose E. The right time

***A. The right drug B. The right room ***C. The right client ***D. The right dose ***E. The right time The Six Rights of medication administration include the right​ drug, the right​ dose, the right​ client, the right​ route, the right​ time, and the right documentation. The right room is not one of the Six Rights of medication administration.

A​ school-age child is brought to the emergency department after falling into a cold lake. Which observations indicate to the nurse that the​ child's body is attempting to regulate​ temperature? ​(Select all that​ apply.) A. The​ child's hands and feet are ice cold. B. The child is sleepy. C. The​ child's respiratory rate is 10 breaths per minute. D. The child is shivering. E. The child is asking for something to drink.

***A. The​ child's hands and feet are ice cold. B. The child is sleepy. C. The​ child's respiratory rate is 10 breaths per minute. ***D. The child is shivering. E. The child is asking for something to drink. When the skin is​ chilled, the body attempts to regulate temperature by vasoconstriction of blood vessels. This could be why the​ child's hands and feet are ice cold. The body also shivers to increase heat production. The body does not regulate temperature through​ sleep, thirst, or by reducing the respiratory rate.

A nurse is caring for an older adult client with cognitive impairment. Which is true regarding this client and pain​ assessment? A. This client is less likely to express pain verbally. B. Pain assessment in this client is similar to that of a client without cognitive impairment. C. This client is more likely to express pain verbally. D. Pain assessment is impossible in this client.

***A. This client is less likely to express pain verbally. B. Pain assessment in this client is similar to that of a client without cognitive impairment. C. This client is more likely to express pain verbally. D. Pain assessment is impossible in this client. An older adult client with cognitive impairment is less likely to express pain verbally. The nurse must be aware of behavioral changes in this client to indicate pain or discomfort. The other statements are incorrect.

A pediatric nurse is encouraging the parents of a child with fatigue to keep a journal about their​ child's behavior. What items should the parents include in that​ diary? ​(Select all that​ apply.) A. Time falling asleep B. Breakfast and other meals C. Time wakening up D. Temper tantrums E. Favorite toys

***A. Time falling asleep ***B. Breakfast and other meals ***C. Time wakening up D. Temper tantrums E. Favorite toys The​ child's diary should include time falling asleep and wakening​ up, as well as breakfast and other meals. Temper tantrums and favorite toys are not relevant to record.

The staff development educator is preparing a seminar for staff nurses prior to implementing managed care. Which skills should the educator include as necessary when implementing this care delivery​ system? ​(Select all that​ apply.) A. Time management B. Communication C. Medication administration D. Delegation E. Assessment

***A. Time management ***B. Communication C. Medication administration ***D. Delegation ***E. Assessment Learning to manage care takes time because it requires strong​ communication, assessment, and time management skills. Managing care also requires the ability to appropriately delegate to unlicensed staff. The skill of medication administration is necessary for direct client​ care, not managed care.

A​ 74-year-old male client is experiencing urinary retention. Which diagnostic test does the nurse anticipate will be ordered for this​ client? A. Ultrasonic bladder scans B. Urinalysis C. Cystoscopy D. Renal ultrasound

***A. Ultrasonic bladder scans B. Urinalysis C. Cystoscopy D. Renal ultrasound Ultrasonic bladder scans are used to evaluate bladder emptying and to examine for residual urine. While a​ cystoscopy, renal​ ultrasound, and urinalysis are often prescribed for clients with alterations in urinary​ function, these tests will not diagnose the cause of the urinary retention the client is experiencing.

The nurse reviews the medical chart for a client who is experiencing urinary incontinence. The healthcare provider​'s admission assessment identifies that the incontinence is related to an overactive detrusor muscle. Based on the provider​'s ​note, which type of urinary incontinence is this client​ experiencing? A. Urge B. Overflow C. Stress D. Functional

***A. Urge B. Overflow C. Stress D. Functional Urge incontinence is related to an overactive detrusor​ muscle, which increases bladder pressure. Stress incontinence is related to pelvic muscle relaxation and a weak urethra and surrounding​ tissues, which cause decreased urethral resistance. Overflow incontinence is related to a lack of normal detrusor muscle​ function, which causes the bladder to overfill and increases bladder pressure. Functional incontinence is related to the inability to respond to the need to urinate.

Which action is characteristic of the​ "planning care" phase of the care coordination​ process? A. Utilize standard protocols or critical pathways and​ evidence-based guidelines B. Determine the need for consultation with other healthcare providers C. Adjust the plan in response to changes in the client​'s condition D. Identify potential challenges

***A. Utilize standard protocols or critical pathways and​ evidence-based guidelines B. Determine the need for consultation with other healthcare providers C. Adjust the plan in response to changes in the client​'s condition D. Identify potential challenges In the planning care phase of care​ coordination, the nurse will utilize standard protocols or critical pathways and​ evidence-based guidelines. Determining the need for consultation with other healthcare providers is a part of the assessment phase of care coordination. Identifying potential challenges is a part of the problem identification phase when coordinating care. Adjusting the plan in response to a change in the client​'s condition is an action taken when evaluating care coordination.

Which of the following statements accurately describe a characteristic of ethics? Select all that apply. A. Values are intimately related to, and direct, ethical conduct. B. The ability to be ethical begins in young adulthood. C. It is important to distinguish ethics from religion, law, custom, and institutional practices. D. Ethics cannot be defined as a code of professional conduct. E. Ethics is a systematic inquiry into principles of right and wrong conduct. F. Ethics usually refers to personal or communal standards of right and wrong.

***A. Values are intimately related to, and direct, ethical conduct. ***B. The ability to be ethical begins in young adulthood. ***C. It is important to distinguish ethics from religion, law, custom, and institutional practices. D. Ethics cannot be defined as a code of professional conduct. ***E. Ethics is a systematic inquiry into principles of right and wrong conduct. ***F. Ethics usually refers to personal or communal standards of right and wrong. The ability to be ethical, to make decisions, and to act in an ethically justified manner, begins in childhood and develops gradually. Many people use the term ethics when describing the systematic ethics incorporated into a code of professional conduct, such as nursing codes of ethics. The term morals, although similar in meaning to ethics, usually refers to personal or communal standards of right and wrong. It is important to distinguish ethics from religion, law, custom, and institutional practices. For example, the fact that an action is legal or customary does not in itself make the action ethically or morally right. Since values are beliefs about what is important, they are intimately related to, and direct, ethical conduct. Ethics is a systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil as they relate to conduct and human flourishing.

A nurse is caring for a client with severe frostbite to the fingers. The nurse understands that excessive handling of the client​'s extremities can result in cardiac alterations. Which is the most common cardiac dysrhythmia that occurs with excessive handling of the client​'s frostbitten​ extremities? A. Ventricular fibrillation B. Premature ventricular contractions​ (PVCs) C. Atrial tachycardia D. Premature atrial contractions​ (PACs)

***A. Ventricular fibrillation B. Premature ventricular contractions​ (PVCs) C. Atrial tachycardia D. Premature atrial contractions​ (PACs) Ventricular fibrillation is a potentially lethal cardiac​ dysrhythmia, which is most commonly found with excessive handling of the client​'s frostbitten extremities. The other dysrhythmias may​ occur; however, they are not the most commonly found dysrhythmia.

Which vitamin should a nurse teach a patient does not require fat in the diet to be absorbed? A. Vitamin C B. Vitamin A C. Vitamin E D. Vitamin K

***A. Vitamin C B. Vitamin A C. Vitamin E D. Vitamin K Vitamin C (ascorbic acid) is a water-soluble vitamin. The presence of fat of bile salts is unnecessary for its absorption.

The nurse is reviewing the intake and output​ (I&O) records of a client. Which entry in the intake record would cause the nurse​ concern? (Select all that​ apply.) A. Vomitus B. Intravenous medications C. Tube feedings D. Tube drainage E. Parenteral fluids

***A. Vomitus B. Intravenous medications C. Tube feedings ***D. Tube drainage E. Parenteral fluids Tube​ feedings, parenteral​ fluids, and intravenous medications should all be documented in the​ client's intake record. Tube drainage and vomitus should be documented in the​ client's output and would cause the nurse concern. Tube drainage and vomitus need to be recorded on the output​ record, not intake record.

A student nurse is performing a clinical rotation and needs to access client information for an assignment at school. In which situations is it appropriate for the student nurse to have access to client​ information? ​(Select all that​ apply.) A. When participating in clinical rounds B. When presenting for clinical conferences C. When studying for exams D. When writing papers E. When presenting client studies

***A. When participating in clinical rounds ***B. When presenting for clinical conferences C. When studying for exams ***D. When writing papers ***E. When presenting client studies Student nurse access to client information can be for written​ papers, clinical rounds and​ conferences, and client studies. Having access to client information to use as study materials is not appropriate for the student nurse.

A head nurse assumes the leadership role when directing and supervising coworkers. Which of the following are attributes of a leader? Select all that apply. A. charismatic B. task-oriented C. dynamic D. philosophical E. intimidating F. self-confident

***A. charismatic B. task-oriented ***C. dynamic ***D. philosophical E. intimidating ***F. self-confident Leadership involves philosophy, perception, and judgment whereas management tasks are the core of the management role. Leaders need to be comfortable with themselves (i.e., have a positive self-image) and present themselves as role models for followers. Ideally, they also have a vision that energizes the group and brings forth the best efforts of members. Leaders may be charismatic, dynamic, enthusiastic, poised, confident, and self-directed.

The nurse is assessing a client of a different culture who has different religious beliefs. Which statements or questions by the nurse would demonstrate cultural competence when assessing the​ client? ​(Select all that​ apply.) A. ​"How do you feel about taking medications or blood products if they are​ prescribed?" B. ​"I understand that you may not believe in receiving human blood​ products; is that​ correct?" C. ​"I apologize for keeping you so long. Would you like some privacy for prayer before continuing the​ exam?" D. ​"May I ask what your partner might think about this plan of​ care?" E. ​"I cannot continue with this assessment if you are not willing to be compliant with my plan of​ care."

***A. ​"How do you feel about taking medications or blood products if they are​ prescribed?" ***B. ​"I understand that you may not believe in receiving human blood​ products; is that​ correct?" ***C. ​"I apologize for keeping you so long. Would you like some privacy for prayer before continuing the​ exam?" ***D. ​"May I ask what your partner might think about this plan of​ care?" E. ​"I cannot continue with this assessment if you are not willing to be compliant with my plan of​ care." The nurse can show knowledge of a client​'s culture by asking appropriate questions that are not demeaning or rude. Asking how the client feels about taking medications opens the conversation to what cultural or religious beliefs might interfere with the medical care of the client. Attitudes of acceptance and recognition would help to build rapport with the client. An accepting attitude does not mean the nurse agrees with the client but that the nurse is willing to accept what the client​ believes, and work it into the plan of care. Communication is an important skill for a nurse when assessing and caring for a client with a different culture to ensure proper care. Asking about family support opens the conversation so the client feels comfortable speaking about family objections. A nurse who does not demonstrate cultural competence would hinder the health care being provided to the client and may hinder the client​'s compliance. Refusing to work a plan of care around a client​'s cultural beliefs is unethical and not beneficial to the client.

An experienced nurse engages in career development by serving as a preceptor. Which statement best describes the responsibilities of a preceptor to the newly employed​ nurse? A. ​"I help the nurse learn​ routines, policies, and​ procedures, and I make sure all nursing care adheres to nursing standards of​ practice." ​B. "I guide the nurse in achieving the highest possible level of personal and professional​ fulfillment." ​C. "I guide the nurse in sharing information and improving interpersonal​ skills." ​D. "I help the nurse learn roles and responsibilities associated with a specific job and encourage professional​ development."

***A. ​"I help the nurse learn​ routines, policies, and​ procedures, and I make sure all nursing care adheres to nursing standards of​ practice." ​B. "I guide the nurse in achieving the highest possible level of personal and professional​ fulfillment." ​C. "I guide the nurse in sharing information and improving interpersonal​ skills." ​D. "I help the nurse learn roles and responsibilities associated with a specific job and encourage professional​ development." The​ preceptor's responsibilities include helping the newly hired or novice nurse learn​ routines, policies, and​ procedures, and making sure nursing care adheres to standards of practice. Guiding the nurse toward achievement of optimal personal and professional fulfillment is reflective of coaching. A mentor helps a nurse learn roles and responsibilities associated with a specific job and encourages professional development. Sharing information and improving interpersonal skills are functions of networking.

The mother of a teenage girl expresses concern that her daughter never spends time with the​ family, preferring to be with friends and to participate in school activities. What should the nurse explain to the​ mother? A. ​"Socializing with friends and participating in activities aids the adolescent in developing an​ identity." ​B. "The adolescent process of sexuality involves growing interactions with members of the opposite​ sex." C. ​"An adolescent's response to environment is believed to be an inborn​ characteristic." D. ​"General temperament is established in earlier stages of development and is relatively stable throughout​ adolescence."

***A. ​"Socializing with friends and participating in activities aids the adolescent in developing an​ identity." ​B. "The adolescent process of sexuality involves growing interactions with members of the opposite​ sex." C. ​"An adolescent's response to environment is believed to be an inborn​ characteristic." D. ​"General temperament is established in earlier stages of development and is relatively stable throughout​ adolescence." The nurse would explain to the mother that peers are an important part of the​ adolescent's life and this is a normal occurrence during this stage of development. The other responses do not address the​ mother's questions or the needs of the adolescent during this stage of development.

During a​ seminar, the nurse educator is asked how the Internet affects the selection of content and teaching methods used in client education. Which is the best​ response? A. ​"The Internet offers content that is both accurate and inaccurate. When choosing client education​ materials, we take this into​ consideration." ​B. "Health-related information on the Internet is​ accurate, and it does not affect the selection of content and teaching​ methods." ​C. "Because the Internet is infrequently used to access​ health-related information, it does not have much effect on selecting content and teaching​ methods." ​D. "Almost all of the information presented on the Internet is​ inaccurate, but it still affects the selection of content used in client​ education."

***A. ​"The Internet offers content that is both accurate and inaccurate. When choosing client education​ materials, we take this into​ consideration." ​B. "Health-related information on the Internet is​ accurate, and it does not affect the selection of content and teaching​ methods." ​C. "Because the Internet is infrequently used to access​ health-related information, it does not have much effect on selecting content and teaching​ methods." ​D. "Almost all of the information presented on the Internet is​ inaccurate, but it still affects the selection of content used in client​ education." Widespread availability and use of Internet resources affects the selection of content and teaching strategies used in client education. Nurses must recognize that Internet users are exposed to information that is both accurate and inaccurate and take that into consideration when choosing client education materials.

A nurse is caring for an adult client who has a vitamin deficiency. The client asks the nurse why​ it's important to have adequate vitamin levels in the body. Which response by the nurse is the most​ appropriate? A. ​"Vitamins support normal​ growth, maintenance, and​ repair." B. ​"Vitamins promote resistance to bacterial​ infection." C. ​"Vitamins are essential enzymes for the​ body." D. ​"Vitamins assist in the digestion of​ nutrients."

***A. ​"Vitamins support normal​ growth, maintenance, and​ repair." B. ​"Vitamins promote resistance to bacterial​ infection." C. ​"Vitamins are essential enzymes for the​ body." D. ​"Vitamins assist in the digestion of​ nutrients." Vitamins are nutrients which are used by the body to support normal​ growth, maintenance, and repair. Vitamins do not promote resistance to bacterial infection.​ Enzymes, not​ vitamins, assist in the digestion of nutrients. Vitamins are​ nutrients, not enzymes.

The home health nurse is helping a client with congestive heart failure to plan for the future. The client is having difficulty making some final decisions. What question could the nurse ask to help clarify the client​'s ​values? A. ​"What alternative courses of action have you been thinking ​about?" B. ​"What do you think your children would like you to​ do?" C. ​"Do you want to postpone talking about this difficult​ matter?" ​D. "Are you feeling healthy enough to be making​ decisions?"

***A. ​"What alternative courses of action have you been thinking ​about?" B. ​"What do you think your children would like you to​ do?" C. ​"Do you want to postpone talking about this difficult​ matter?" ​D. "Are you feeling healthy enough to be making​ decisions?" The nurse could help the client clarify values by helping the client list alternative courses of action. The nurse should stress that the client is making the​ decision, not the​ client's children. The client faces making decisions​ now, in spite of medical​ conditions, so talking about difficult matters should not be postponed.

Trace​ Oliverez, a senior nursing​ student, is preparing to graduate. Trace asks his​ mentor, "Which nursing organization offers reviews to help students prepare for the certification​ exam?" What is the​ mentor's best​ response? A. ​"You should join the National Student Nurses Association​ (NSNA)." B. ​"You should join the American Nurses Association​ (ANA)." C. ​"You should join the National League for Nursing​ (NLN)." D. ​"You should join Sigma Theta Tau International​ (STTI)."

***A. ​"You should join the National Student Nurses Association​ (NSNA)." B. ​"You should join the American Nurses Association​ (ANA)." C. ​"You should join the National League for Nursing​ (NLN)." D. ​"You should join Sigma Theta Tau International​ (STTI)." The National Student Nurses Association​ (NSNA), a nonprofit​ organization, mentors nursing students who are preparing for initial registered nurse​ licensure; membership benefits include certification exam​ mini-reviews. The National League for Nursing​ (NLN) promotes excellence in nursing education through strategies that include faculty development programs and public policy initiatives. Sigma Theta Tau International​ (STTI) membership is by invitation to nursing students who demonstrate academic excellence and nurse leaders who demonstrate exceptional nursing achievements. The American Nurses Association​ (ANA) represents the​ nations' registered​ nurses; its professional mission includes cultivating high standards of nursing practice and advocating for​ nurses' rights in the workplace.

What is a normal bp?

100-119 / 60-79

What is a normal heart rate for newborns?

100-170

What is a normal resp. rate for 17 - older?

12-20

What is a normal resp. rate for 10 year olds?

16-20

What is a normal resp. rate for 6 year olds?

16-22

What is a normal resp. rate for 3 year olds?

20-30

What is a normal resp. rate for 1 year olds?

20-40

What is a normal resp. rate for newborns?

30-80

q.i.d.

4 times each day

What is a normal heart rate for 10-16 year olds?

60-100

What is a normal heart rate for 17-adult?

60-100

What is a normal heart rate for an older adult?

60-100

What is a normal heart rate for 6-10 year olds?

70-110

What is a normal heart rate for 2-6 year olds?

70-120

What is a normal heart rate for infant- 2 year olds?

80-130

Planning

A four-step process: 1. establish objectives 2. Evaluate the present situation and predict future trends and events 3. Formulate a planning statement 4. Convert the plan into an action statement

The nursing instructor asks the students to identify other terms used to describe the computerized medical record. Which student responses are most​ accurate? ​(Select all that​ apply.) A. "Administrative information system." B. "Clinical information system." C. "Computerized patient record." D. "Clinical decision support system." E. "Electronic health records system."

A. "Administrative information system." B. "Clinical information system." ***C. "Computerized patient record." D. "Clinical decision support system." ***E. "Electronic health records system." Other terms commonly used to describe the computerized medical record​ (CMR) include electronic health records system​ (EHRS), electronic medical record​ (EMR), electronic health record​ (EHR), computerized patient record​ (CPR), patient medical records software​ (PMRS), and personal health record​ (PHR). Clinical decision support systems are a type of artificial intelligence that analyzes data and provides information about​ evidenced-based practices. A clinical information system allows multiple disciplines to simultaneously access the​ client's chart and record data that can be viewed and analyzed by multiple healthcare providers in real time. An administrative information system provides support and management for the business aspects of health care.

The nursing student is describing how citizens and government work together to influence health policy. Which statement is most​ accurate? A. "Citizens who report healthcare concerns must also describe the political considerations associated with the proposed solutions." B. "The government official may draft a law that reflects implementation of the proposed solution." C. "Citizens who propose solutions to healthcare problems must also include an evaluation of the solution​'s safety." D. "The government official who advocates for passing a new law is responsible for evaluating the outcomes."

A. "Citizens who report healthcare concerns must also describe the political considerations associated with the proposed solutions." ***B. "The government official may draft a law that reflects implementation of the proposed solution." C. "Citizens who propose solutions to healthcare problems must also include an evaluation of the solution​'s safety." D. "The government official who advocates for passing a new law is responsible for evaluating the outcomes." The government official may draft a law that reflects implementation of the proposed solution. Government​ officials, not individual​ citizens, are responsible for evaluating solutions based on safety and for identifying political considerations associated with each solution. Federal agencies or departments who are responsible for implementing the new law are responsible for evaluating outcomes.

A nursing student is having difficulty differentiating between the appropriate use of the word illness and the word disease. Which statement is confirmation of that​ difficulty? A. "Disease symptoms can disappear." B. "An illness can be either serious or trivial." C. "Disease is an alteration in body function." D. "Illness shortens the normal life span."

A. "Disease symptoms can disappear." B. "An illness can be either serious or trivial." C. "Disease is an alteration in body function." ***D. "Illness shortens the normal life span." Disease, not​ illness, shortens the normal life span. Disease is an alteration in body function and its symptoms can disappear. An illness can be either serious or trivial.

The nurse researcher is giving a presentation about the applications of geographic information system​ (GIS) technology. Which statement is appropriate for the nurse researcher to include in the​ presentation? A. "GIS technology is not dependent on satellite imaging or global positioning systems ​(GPSs)." B. "GIS technology can be used to plot and analyze lifestyle​ choices, such as improper nutrition." C. "GIS technology is used strictly within the healthcare system." D. "GIS technology is not useful for tracking acute health problems."

A. "GIS technology is not dependent on satellite imaging or global positioning systems ​(GPSs)." ***B. "GIS technology can be used to plot and analyze lifestyle​ choices, such as improper nutrition." C. "GIS technology is used strictly within the healthcare system." D. "GIS technology is not useful for tracking acute health problems." GIS technology has been used both inside and outside of health care. To capture geographical​ data, GIS relies on satellite imaging and global positioning systems​ (GPSs). The many uses of GIS technology include plotting and analyzing lifestyle​ choices, such as improper​ nutrition, and tracking acute health problems.

The nurse leader is developing a presentation about the Health Insurance Portability and Accountability Act of 1996​ (HIPAA). Which statement should be​ included? A. "HIPAA requires increased general access to the client​'s health information in​ written, oral, or electronic form." B. "HIPAA requires organizations to notify clients of how their information may be used or shared." C. "Because of​ HIPAA, healthcare providers are able to correct the client​'s health record." D. "Because of​ HIPAA, clients are prohibited from accessing their personal medical records."

A. "HIPAA requires increased general access to the client​'s health information in​ written, oral, or electronic form." ***B. "HIPAA requires organizations to notify clients of how their information may be used or shared." C. "Because of​ HIPAA, healthcare providers are able to correct the client​'s health record." D. "Because of​ HIPAA, clients are prohibited from accessing their personal medical records." The Health Insurance Portability and Accountability Act of 1996​ (commonly referred to as​ HIPAA) is designed to protect clients through measures including setting limits and rules regarding who may access to a client​'s health information in​ written, oral, or electronic​ form; giving clients the right to view their health​ records; allowing clients to correct their​ records; and requiring organizations to notify clients of how their information may be used or shared​ (for example, for research or marketing​ purposes).

The nursing instructor asks students to describe health policy. Which student statement is​ best? A. "Health policy refers to actions taken by populations that consist of individuals who are in need of change." B. "Health policy ensures that healthcare organizations will achieve their goals." C. "Health policy includes governmental choices that affect clients​' abilities to reach healthcare goals." D. "Health policy assures that individuals will reach their​ health-related objectives."

A. "Health policy refers to actions taken by populations that consist of individuals who are in need of change." B. "Health policy ensures that healthcare organizations will achieve their goals." ***C. "Health policy includes governmental choices that affect clients​' abilities to reach healthcare goals." D. "Health policy assures that individuals will reach their​ health-related objectives." Health policy refers to actions and choices by government bodies and professional organizations that affect the ability of healthcare organizations and individuals in the healthcare system to reach their healthcare goals. Health policy does not guarantee achievement of goals.

Several nurse managers are having lunch after attending a shared governance committee meeting. Which manager statement indicates that the committee is​ ineffective? A. "I think the goals are tough but appropriate in the circumstances." B. "I am not sure why the chairperson made all of the decisions." C. "I could have prepared better before today​'s meeting." D. "Who knew we had such a nice conference ​room!"

A. "I think the goals are tough but appropriate in the circumstances." ***B. "I am not sure why the chairperson made all of the decisions." C. "I could have prepared better before today​'s meeting." D. "Who knew we had such a nice conference ​room!" In an ineffective​ group, decision making is made by the individual with the most authority in the​ group, with minimal involvement by members. In an effective​ group, goals are clarified so that all group members commit to completing them. In an effective​ group, self-evaluation of group members occurs often. The atmosphere in an effective group is comfortable and relaxed. The comment about the nice conference room indicates the group members feel comfortable commenting on the accommodations.

A group of student nurses is discussing the implementation of new laws based on health policy. Which student statement is the most​ accurate? A. "If desired outcomes are not​ achieved, the government official will enact a new law." B. "Implementation of the law does not end the cycle of policy analysis." C. "If the law requires major​ changes, the affected population will vote to modify the new law​'s regulations." D. "The purpose of evaluation is to make sure that costs of implementing the law are as low as possible."

A. "If desired outcomes are not​ achieved, the government official will enact a new law." ***B. "Implementation of the law does not end the cycle of policy analysis." C. "If the law requires major​ changes, the affected population will vote to modify the new law​'s regulations." D. "The purpose of evaluation is to make sure that costs of implementing the law are as low as possible." The purpose of evaluation is to ensure achievement of the best possible results. If the new law fails to promote achievement of the desired​ outcomes, the responsible agency or department can make changes to the rules and regulations within the framework of the law. If major changes are​ needed, the agency will recommend legislative​ changes, such as an amendment or a new​ law, which may or may not be made. Implementation does not end the cycle. Continuous analysis of results by the implementing agency is critical.

The novice nurse asks the nurse preceptor to explain the difference between intranets and the Internet. Which response by the nurse preceptor is most​ accurate? A. "Intranets have mandatory security features that restrict access by the public." B. "Compared to the​ Internet, intranets are smaller and easier to maintain." C. "Intranets are rarely used due to their limited ability to allow data sharing among users." D. "Compared to the​ Internet, intranets are less vulnerable to data breeches and do not require firewalls."

A. "Intranets have mandatory security features that restrict access by the public." ***B. "Compared to the​ Internet, intranets are smaller and easier to maintain." C. "Intranets are rarely used due to their limited ability to allow data sharing among users." D. "Compared to the​ Internet, intranets are less vulnerable to data breeches and do not require firewalls." Intranets usually have security to restrict access by the​ public, although some intranets are used purely as​ file-sharing applications and have little or no security. Intranets are utilized​ regularly, as they allow collaboration and a high degree of data sharing among users. Because of their smaller​ size, they are easier to control and maintain. Both intranets and the Internet are vulnerable to data breeches and should utilize​ firewalls, encryption, and​ authentication; user passwords that change on a frequent​ basis; and strict control over which users have access to secure data.

The nurse informaticist is delivering a webinar about electronic medical records​ (EMRs). Which statement should be included in the​ webinar? A. "Most EMRs are designed to be portable." B. "EMRs focus on diagnosis and treatment." C. "EMRs are not useful in identifying the need for routine preventive maintenance." D. "The EMR is also called the administrative information system."

A. "Most EMRs are designed to be portable." ***B. "EMRs focus on diagnosis and treatment." C. "EMRs are not useful in identifying the need for routine preventive maintenance." D. "The EMR is also called the administrative information system." Electronic medical records​ (EMRs), which are similar to electronic​ charts, help track client data and identify when routine preventive health maintenance​ (such as vaccines or​ mammograms) is needed. EMRs focus is on diagnosis and treatment. Most EMRs are designed to stay within a clinical​ setting, so clients who are referred to other care providers may need printed versions of the EMR to take with them. An administrative information system provides support and management for the business aspects of health care.

The student nurse is evaluating the client​'s knowledge about proper anatomical positioning when seated at a computer workstation after a teaching session. Which statement indicates the client has adequate knowledge and does not require further​ instruction? A. "My head and neck should be​ aligned, and my upper torso should be curved and relaxed." B. "My thighs should be parallel to the​ floor, and I should avoid using a footrest." C. "My upper arms and elbows should be close to my body." D. "My forearms should be straight and my wrists should be flexed."

A. "My head and neck should be​ aligned, and my upper torso should be curved and relaxed." B. "My thighs should be parallel to the​ floor, and I should avoid using a footrest." ***C. "My upper arms and elbows should be close to my body." D. "My forearms should be straight and my wrists should be flexed." The​ head, neck, and torso should be aligned. Shoulders and upper arms should be perpendicular to the floor and relaxed. Upper arms and elbows should be close to the body. ​Forearms, wrists, and hands should be straight and in line. While​ seated, the​ worker's thighs should be parallel to the​ floor, and the feet should rest flat on the floor or be supported by a footrest.

The staff development instructor is evaluating the learning of staff nurses after providing a presentation on the Quality and Safety Education for Nurses competencies. Which statements indicate that this training has been​ effective? ​(Select all that​ apply.) A. "Quality improvement is minimized." B. "​Evidence-based practice should be used." C. "​Client-centered care is the focus." D. "Teamwork and collaboration impact client outcomes." E. "The use of informatics has yet to be determined."

A. "Quality improvement is minimized." ***B. "​Evidence-based practice should be used." ***C. "​Client-centered care is the focus." ***D. "Teamwork and collaboration impact client outcomes." E. "The use of informatics has yet to be determined." The Quality and Safety Education for Nurses​ (QSEN) competencies support accountability in nursing practice and include the competencies of​ client-centered care, teamwork and​ collaboration, evidence-based​ practice, quality​ improvement, safety, and informatics. Quality improvement and informatics are integral elements of these competencies.

The father of a​ 3-year-old boy is concerned that his son still wets the bed at night. Which explanation by the nurse is most appropriate regarding​ bedwetting? A. "Sometimes children experience nocturia." B. "Oliguria is not uncommon in children" C. "By 24​ months, children are capable of holding urine beyond the urge to void." D. "Children often achieve daytime bladder control prior to nighttime control."

A. "Sometimes children experience nocturia." B. "Oliguria is not uncommon in children" C. "By 24​ months, children are capable of holding urine beyond the urge to void." ***D. "Children often achieve daytime bladder control prior to nighttime control." Bladder control is attained by ages 2 to 5​ years, often with daytime control attained prior to nighttime control. The other statements by the nurse do not address the father​'s concern.

A Client has just been diagnosed with terminal cancer and is being transferred to home hospice care. The client's daughter tells the nurse, "I don't know what to say to my mother if she asks me if she's going to die." Which responses by the nurse would be appropriate? SELECT ALL THAT APPLY A. "Tell your mother not to worry; she still has sometime left." B. "Let's talk about your mother's illness and how it will progress." C. "You sound like you have some questions about your mother dying. Let's talk about that." D. Don't worry. Hospice will take care of your mother." E. "Tell me how you're feeling about your mother dying."

A. "Tell your mother not to worry; she still has sometime left." ***B. "Let's talk about your mother's illness and how it will progress." ***C. "You sound like you have some questions about your mother dying. Let's talk about that." D. Don't worry. Hospice will take care of your mother." ***E. "Tell me how you're feeling about your mother dying."

The nurse educator is describing the role of the American Association of Colleges of Nursing​ (AACN) to a new educator. Which statement is the most appropriate for the nurse educator to include in the​ discussion? A. "The AACN is the national voice for America​'s undergraduate nursing education programs." B. "The AACN is the national voice for America​'s baccalaureate and graduate nursing education programs." C. "The AACN is the national voice for graduate nursing education programs throughout the United States." D. "The AACN is the national voice for all types of nursing education programs throughout the United States."

A. "The AACN is the national voice for America​'s undergraduate nursing education programs." ***B. "The AACN is the national voice for America​'s baccalaureate and graduate nursing education programs." C. "The AACN is the national voice for graduate nursing education programs throughout the United States." D. "The AACN is the national voice for all types of nursing education programs throughout the United States." The American Association of Colleges of Nursing​ (AACN) is the national voice for​ America's baccalaureate and graduate nursing education.

The nurse researcher is preparing a webinar about the history of nursing research. Which statement should be​ included? A. "The American Association of Colleges of Nursing was the first nursing organization to fund nursing research." B. "The National League for Nursing was the first nursing organization to fund nursing research." C. "Sigma Theta Tau International was the first nursing organization to fund nursing research." D. "The American Nurses Association was the first nursing organization to fund nursing research."

A. "The American Association of Colleges of Nursing was the first nursing organization to fund nursing research." B. "The National League for Nursing was the first nursing organization to fund nursing research." ***C. "Sigma Theta Tau International was the first nursing organization to fund nursing research." D. "The American Nurses Association was the first nursing organization to fund nursing research." Sigma Theta Tau International​ (STTI), which is the second largest nursing organization in the United​ States, was the first nursing organization to fund nursing research. Although the National League for​ Nursing, the American Nurses​ Association, and the American Association of Colleges of Nursing may elect to fund nursing research in areas consistent with their respective​ missions, none of these was the first nursing organization to fund research in nursing.

The nurse educator asks a group of nursing students how the government affects the process of transitioning to the use of electronic medical records​ (EMRs). Which student​'s statement is most​ accurate? A. "The Center for Medicare and Medicaid Services​ (CMS) is primarily responsible for monitoring achievement of meaningful use objectives." B. "The Center for Medicare and Medicaid Services​ (CMS) is responsible for monitoring the transition to the use of electronic medical records​ (EMRs) at the federal level." C. "The Office of the National Coordinator for Health Information Technology​ (ONC) is the sole agency responsible for overseeing the process of transitioning to the use of electronic medical records ​(EMRs)." D. "The Office of the National Coordinator for Health Information Technology​ (ONC) is responsible for authorizing financial reimbursement."

A. "The Center for Medicare and Medicaid Services​ (CMS) is primarily responsible for monitoring achievement of meaningful use objectives." B. "The Center for Medicare and Medicaid Services​ (CMS) is responsible for monitoring the transition to the use of electronic medical records​ (EMRs) at the federal level." C. "The Office of the National Coordinator for Health Information Technology​ (ONC) is the sole agency responsible for overseeing the process of transitioning to the use of electronic medical records ​(EMRs)." D. "The Office of the National Coordinator for Health Information Technology​ (ONC) is responsible for authorizing financial reimbursement." On a federal​ level, the Center for Medicare and Medicaid Services​ (CMS) and the Office of the National Coordinator for Health Information Technology​ (ONC) oversee the process of transitioning to the use of electronic medical records​ (EMRs). ONC monitors achievement of meaningful use​ objectives, which are reported to CMS to authorize financial reimbursement.

The staff nurse asks the nursing​ supervisor, "Which regulatory agency requires hospitals to have personal protective equipment​ (PPE) ready for us to use when we need ​it?" Which response is​ correct? A. "The Centers for Disease Control and Prevention." B. "The Occupational Safety and Health Administration." "The National Institutes of Health." "The Agency for Healthcare Research and Quality."

A. "The Centers for Disease Control and Prevention." ***B. "The Occupational Safety and Health Administration." "The National Institutes of Health." "The Agency for Healthcare Research and Quality." Part of the mission of the Occupational Safety and Health Administration​ (OSHA) is to help employers fulfill their responsibilities to their employees related to creating​ safe, healthful workplace environments and reducing or eliminating workplace hazards. OSHA standards include ensuring that employees have and use personal protective equipment​ (PPE) when required for safety and health. Research conducted or evaluated by the National Institutes of​ Health, the Agency for Healthcare Research and​ Quality, and the Centers for Disease Control may inform OSHA regulations and​ standards, but these agencies do not oversee health and safety in workplace environments.

The 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? A. "The client cannot walk as fast as necessary to make it to the bathroom without having an accident." B. "The client is weaker and the lift helps improve circulation." C. "The lift is used because there isn​'t enough staff to help move the client." D. "The lift protects both the client and the staff during transfers."

A. "The client cannot walk as fast as necessary to make it to the bathroom without having an accident." B. "The client is weaker and the lift helps improve circulation." C. "The lift is used because there isn​'t enough staff to help move the client." ***D. "The lift protects both the client and the staff during transfers." 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.

The daughter of a​ wheelchair-bound older client is concerned because her mother has been experiencing urinary incontinence. Which statement should the nurse use to explain the condition to the ​daughter? A. "The frequency of voiding varies in the elderly and may cause urinary incontinence." B. "Renal blood flow and ability to concentrate urine decrease in the elderly." C. "Mobility issues may cause urinary incontinence." D. "The kidneys reach maximum size at ages 35 to 40."

A. "The frequency of voiding varies in the elderly and may cause urinary incontinence." B. "Renal blood flow and ability to concentrate urine decrease in the elderly." ***C. "Mobility issues may cause urinary incontinence." D. "The kidneys reach maximum size at ages 35 to 40." Both mobility and neurological issues may cause urinary incontinence. The other explanations do not address the daughter​'s concern regarding her mother​'s urinary incontinence.

During a meeting with hospital​ administrators, the nurse leader is using the Surgical Care Improvement Project​ (SCIP) to illustrate the use of informatics in quality care. Which statement should the nurse administrator include in the​ presentation? A. "The study objectives include identifying nurses who make medication errors." B. "The study will not affect reimbursement for hospital stays or surgical procedures." C. "The study​'s target population is all nurses who work in the surgical setting." D. "The goals of the study include reducing complications among surgical clients."

A. "The study objectives include identifying nurses who make medication errors." B. "The study will not affect reimbursement for hospital stays or surgical procedures." C. "The study​'s target population is all nurses who work in the surgical setting." ***D. "The goals of the study include reducing complications among surgical clients." The Surgical Care Improvement​ Project's (SCIP's) target population is all clients who undergo surgery. The goal is to reduce surgical complications and improve surgical care. This collaborative project is administered by The Joint Commission and​ CMS, and reimbursement for hospital stays and surgical procedures depend on meeting SCIP measures.

The nurse is providing home care instruction for a client recently diagnosed with Alzheimer disease​ (AD). Which statement by the client indicates the need for further​ instruction? A. "There are community resources that can help me and my family as the disease progresses." B. "I will monitor my diet and eat foods that are nutritious." C. "I will restrict my fluid intake because it is known to cause symptoms to worsen." D. "I will make sure my wife asks for assistance if my care becomes overwhelming."

A. "There are community resources that can help me and my family as the disease progresses." B. "I will monitor my diet and eat foods that are nutritious." ***C. "I will restrict my fluid intake because it is known to cause symptoms to worsen." D. "I will make sure my wife asks for assistance if my care becomes overwhelming." The client would need further education by stating that he would need to restrict fluid intake. All other statements indicate appropriate understanding of the teaching provided.

A​ 40-year-old female client asks why she has been scheduled for a DEXA scan because she has always believed it was given to older people to detect osteoporosis. What should the nurse explain to this​ client? A. "There must be a mistake. I​'ll check with your health care provider." B. "This scan determines body mass index and protein level." C. "The DEXA scan is used to analyze red blood cells and oxygenation." D. "This scan is also used to measure body composition and body fat."

A. "There must be a mistake. I​'ll check with your health care provider." B. "This scan determines body mass index and protein level." C. "The DEXA scan is used to analyze red blood cells and oxygenation." ***D. "This scan is also used to measure body composition and body fat." A DEXA scan measures body composition and body fat using very​ low-dose x-ray scanning. Height and weight are used to determine body mass index. Serum albumin and prealbumin values determine protein levels in the body. The scan was not a mistake. The DEXA scan is not used to analyze red blood cells and oxygenation. A complete blood count and pulse oximeter would be used to determine these levels.

The nurse is providing care for a pregnant woman and her husband who just learned that their baby may have Down syndrome. The couple asks the nurse what this condition means. Which response by the nurse is the most​ appropriate? A. "This condition occurs due to alcohol consumption prior to pregnancy." B. "This condition occurs because of extra genetic material in chromosome 21." C. "This condition occurs as the result of a traumatic head injury." D. "This condition occurs as a result of maternal substance abuse.

A. "This condition occurs due to alcohol consumption prior to pregnancy." ***B. "This condition occurs because of extra genetic material in chromosome 21." C. "This condition occurs as the result of a traumatic head injury." D. "This condition occurs as a result of maternal substance abuse. Down syndrome is a result of extra genetic material in chromosome 21. Fetal alcohol syndrome is the result of maternal alcohol consumption during pregnancy. Down syndrome does not occur due to maternal substance abuse and is not caused by a traumatic head injury.

The nurse is teaching a​ 16-year-old unmarried client who has given birth. What is most important for the nurse to include when discussing care with the client and her extended​ family? A. "This infant is at risk for health and social problems." B. "It would be better for the child if the mother could marry the father." C. "Family members should become active in bonding with the infant." D. "This infant will strengthen your family ties."

A. "This infant is at risk for health and social problems." B. "It would be better for the child if the mother could marry the father." ***C. "Family members should become active in bonding with the infant." D. "This infant will strengthen your family ties." The nurse​'s instruction is that family members should become active in caring​ for, interacting​ with, and bonding with the infant. Children in adolescent families are at greater risk for health and social​ problems; however, this infant is currently a part of the mother​'s family. Parents in these families may be forced to stop their formal education and are more likely to be​ physically, developmentally, and financially unprepared to care for a child. The nurse understands this and encourages the extended family to provide support for the mother and infant in order to promote health. The nurse provides culturally competent care that includes promoting family competence and​ health, and being​ nonjudgmental, regardless of the type of family the client has. Integrating a new infant into any family comes with stressors. A family that is resilient can adapt and transform in response to stress.

The nurse is evaluating teaching provided to the parents of a toddler about care of the child during a fever. Which statement made by the father indicates that teaching has been​ effective? A. "We should call the doctor within 24 hours if our child has a fever and difficulty breathing." B. "We should call the doctor within 24 hours if our child has a fever and is drooling." C. "We should call the doctor immediately if our child has a fever that lasts 16 hours." D. "We should call the doctor immediately if our child has a fever and purple spots develop on the skin."

A. "We should call the doctor within 24 hours if our child has a fever and difficulty breathing." B. "We should call the doctor within 24 hours if our child has a fever and is drooling." C. "We should call the doctor immediately if our child has a fever that lasts 16 hours." ***D. "We should call the doctor immediately if our child has a fever and purple spots develop on the skin." The parents should be instructed to call the doctor immediately if the child has a fever and develops purple skin spots. The doctor should be called immediately if the child with a fever is drooling or has difficulty breathing. The doctor should be contacted within 24 hours if a child has a fever that lasts longer than 24 hours.

The nurse is providing client teaching about the proper use of a continuous positive airway pressure​ (CPAP) device. Which information is most appropriate for the nurse to​ include? A. "Wear the smallest available face mask." B. "Wear the mask only when the machine is turned on." C. "Avoid using a humidifier." D. "Tighten the face straps so the mask fits you snugly."

A. "Wear the smallest available face mask." B. "Wear the mask only when the machine is turned on." C. "Avoid using a humidifier." ***D. "Tighten the face straps so the mask fits you snugly." Client teaching for using a CPAP or BiPAP machine includes telling the client to ensure proper fitting of the mask to the face by wearing the correct size mask and keeping the facial straps​ tightened, so the mask is snugly fitted to the​ client's face. A humidifier and nasal sprays are recommended for use with CPAP to help prevent drying of the oral and nasal cavities. Clients should be encouraged to become accustomed to the mask by wearing it while awake and when the machine is not in use.

A patient tells the nurse, "I am an atheist. I do not believe in God." What would be an appropriate response by the nurse? A. "Well, I believe in God and you should too." B. "I respect what you choose to believe in." C. "How can you deny the existence of God?" D. "What makes you think you are an atheist?"

A. "Well, I believe in God and you should too." ***B. "I respect what you choose to believe in." C. "How can you deny the existence of God?" D. "What makes you think you are an atheist?" An atheist is a person who denies the existence of God, guided by philosophies of living that do not include a religious faith. He or she deserves respect for what they choose to believe.

A college​ student, who is brought to the emergency department by his​ girlfriend, has a body temperature of 94.8degrees°F. Which question should the nurse ask the girlfriend to help determine the client​'s ​condition? A. "Where did you find ​him?" B. "How long was he ​outside?" C. "Was he drinking ​alcohol?" D. "When did you find ​him?"

A. "Where did you find ​him?" B. "How long was he ​outside?" ***C. "Was he drinking ​alcohol?" D. "When did you find ​him?" Modifiable risk factors for the development of hypothermia include ingestion of alcohol and other substances. The nurse needs to learn if the client was drinking alcohol. The location of the​ client, the time the client was​ found, and the length of time the client was exposed are not as important as knowing whether the client has ingested alcohol.

The brain waves of a client on life support are absent. In response to the family​'s question about the client being​ dead, for how long should the nurse explain that the brain waves must be absent before death can be ​declared? A. 12 hours or longer B. One week or longer C. 1 hour or longer D. 24 hours or longer

A. 12 hours or longer B. One week or longer C. 1 hour or longer ***D. 24 hours or longer If a client dies on life​ support, death is defined as the absence of brain waves for 24 hours or longer. Brain waves must be absent for longer than 1 hour or 12 hours. They do not need to be absent for a week before death is declared.

The nurse is caring for a​ 10-year-old client with diabetes. The parents of the client do not speak English. How should the nurse best teach the client and family about home​ care? A. A sibling that speaks fluent English should translate. B. The client should translate. C. An agency translator should be used. D. The nurse should provide written instruction in the family​'s language.

A. A sibling that speaks fluent English should translate. B. The client should translate. ***C. An agency translator should be used. D. The nurse should provide written instruction in the family​'s language. Language barriers prevent therapeutic communication that is necessary to providing culturally competent care. It is not uncommon for children to be asked to interpret for the​ family; however, this exposes them to information they may not understand or know how to communicate. The preferred method for teaching home care is the​ hospital/agency translator. Information written in the family​'s language might be​ useful, after verbal instruction is given.

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? A. Actions to take when exposed to contaminated sharps B. Technique to remove biohazard trash from isolation rooms C. Personal protective equipment to wear when disposing of trash D. Appropriate disposal of used sharps

A. Actions to take when exposed to contaminated sharps B. Technique to remove biohazard trash from isolation rooms C. Personal protective equipment to wear when disposing of trash ***D. Appropriate disposal of used sharps 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.

A group of nursing students are sitting together in the school cafeteria after completing a clinical shift. In which aspect of socialization to nursing is this group currently​ engaged? A. Adaptation B. Development C. Learning D. Interaction

A. Adaptation B. Development C. Learning ***D. Interaction Socialization to a profession is complex and includes the attributes of​ learning, interaction,​ development, and adaptation. Students sitting together after a clinical rotation exemplify interaction. Learning would occur in the classroom or when working together on group projects. Development would occur throughout the course of the​ students' academic career. Adaptation is the ability to change or be flexible depending upon different situations.

The nurse assesses the interaction between a parent and​ 4-year-old child. The nurse notes that the child is clingy and screaming before the exam begins. Based on this​ assessment, what does the nurse conclude about the parentdash-child ​relationship? ​(Select all that​ apply.) A. Adequate language skills B. Independence C. Lack of social interaction D. Lack of trust E. Lack of communication

A. Adequate language skills B. Independence ***C. Lack of social interaction ***D. Lack of trust ***E. Lack of communication ​Clinging, frightened behavior in a preschooler during a nonthreatening situation may indicate lack of a trusting relationship and communication issues with immediate caregivers. Lack of communication between caregiver and child can limit the​ child's ability to learn social interaction and to practice language skills. The assessment findings cannot be used for the nurse to determine the quality of the​ child's language skills or degree of independence.

A nurse inserts a nasogastric feeding tube for a client with dysphagia. Once the tube is in​ place, the client begins to retch and complains of nausea. What is the priority action by the nurse in response to the​ client's manifestations? A. Administer antiemetic as prescribed B. Reassess placement of the tube C. Provide the client with small sips of water D. Instruct the client on relaxation techniques

A. Administer antiemetic as prescribed ***B. Reassess placement of the tube C. Provide the client with small sips of water D. Instruct the client on relaxation techniques After inserting a nasogastric feeding​ tube, if a client develops nausea or​ retching, the nurse should reassess tube placement prior to performing any additional interventions. Instructing the client on relaxation techniques or administering an antiemetic may be​ appropriate, but only after the tube placement has been reassessed. Providing small sips of water to a client with swallowing difficulties is inappropriate.

The nurse is caring for a client who is experiencing acute pain. Which independent nursing intervention is appropriate for this​ client? A. Administering a nonopioid analgesic B. Asking the client what methods enhance comfort C. Repositioning for comfort D. Placing a transdermal patch

A. Administering a nonopioid analgesic B. Asking the client what methods enhance comfort ***C. Repositioning for comfort D. Placing a transdermal patch Repositioning the client for comfort is an independent intervention that the nurse can implement for this client. Administering a nonopioid analgesic and placing a transdermal patch both require a health care provider prescription. Asking the client what methods enhance comfort is a nursing assessment not intervention.

The nurse is planning a teaching session on diet and nutrition for a group of teenage mothers who are students at a local high school. When planning the​ teaching, which​ client-specific factors should the nurse seek to​ learn? A. Age B. Level of education C. Gender D. Cultural background

A. Age B. Level of education C. Gender ***D. Cultural background The nurse already knows the gender of the clients as well as their approximate age and level of education. To select teaching content and methods of​ teaching, the nurse should seek to find out the​ clients' cultural background.

The community health nurse is teaching a group of adults about risk factors for developing sleepdash-rest disorders. When explaining the risk factors associated with obstructive sleep​ apnea, which item is most appropriate for the community health nurse to include in the​ teaching? A. Age 60 years or older B. Female gender C. Being obese D. Concurrent mental health disorder

A. Age 60 years or older B. Female gender ***C. Being obese D. Concurrent mental health disorder Obesity is the primary risk factor for the development of obstructive sleep apnea. Female​ gender, age 60 years or​ older, and concurrent mental health disorder are risk factors for the development of insomnia.

A nurse is caring for a​ 17-year-old client with hypothermia and frostbite who spent the night outside in the elements after passing out from​ binge- drinking. How does ingestion of alcohol increase the risk of​ hypothermia? A. Alcohol increases the intracellular sodium​ content, lowering the freezing point of the tissues. B. Alcohol increases the viscosity of the​ blood, increasing the risk of ice crystals. C. Alcohol causes peripheral​ vasodilation, causing a faster drop in body temperature. D. Alcohol causes peripheral​ vasoconstriction, causing decreased blood flow to the extremities.

A. Alcohol increases the intracellular sodium​ content, lowering the freezing point of the tissues. B. Alcohol increases the viscosity of the​ blood, increasing the risk of ice crystals. ***C. Alcohol causes peripheral​ vasodilation, causing a faster drop in body temperature. D. Alcohol causes peripheral​ vasoconstriction, causing decreased blood flow to the extremities. Alcohol causes peripheral​ vasodilation, causing a faster drop in body temperature. The other answer choices are incorrect.

The nursing administrator is planning an​ in-service for nurses about Medicare coverage. Which content should be​ included? (Select all that​ apply.) A. All individuals ages 62 and older are eligible for Medicare coverage. B. Younger individuals with disabilities are eligible for Medicare coverage. C. Medicare is a form of public health insurance. D. Medicare is a federally funded program. E. Medicare coverage includes individuals with​ end-stage renal disease.

A. All individuals ages 62 and older are eligible for Medicare coverage. ***B. Younger individuals with disabilities are eligible for Medicare coverage. ***C. Medicare is a form of public health insurance. ***D. Medicare is a federally funded program. ***E. Medicare coverage includes individuals with​ end-stage renal disease. Medicare is a federally funded public health insurance program available to people age 65 or​ older, younger people with​ disabilities, and people with​ end-stage renal disease.

Stephan​ Wolters, an emergency department​ nurse, is caring for John​ Weatherly, a​ 78-year-old male client who has just been diagnosed with congestive heart failure. Which nursing action reflects​ Stephan's achievement of a meaningful use objective as required by the Center for Medicare and Medicaid Services​ (CMS)? A. Allowing the​ client's family members to review his electronic health record B. Encouraging the​ client's family members to be involved in the​ client's teaching sessions C. Limiting communication between members of the​ client's healthcare team D. Recognizing that safety and quality of client care are unrelated to health disparities

A. Allowing the​ client's family members to review his electronic health record ***B. Encouraging the​ client's family members to be involved in the​ client's teaching sessions C. Limiting communication between members of the​ client's healthcare team D. Recognizing that safety and quality of client care are unrelated to health disparities Meaningful use objectives include engaging clients and their families in the​ client's care, which is illustrated by encouraging the​ client's family members to be involved in the​ client's teaching sessions. Improving care​ coordination, which is another​ objective, may be impaired by limiting communication between members of the​ client's healthcare team. Allowing the​ client's family members to view his electronic health record does not meet the objective related to ensuring the security and privacy of protected medical information. The final meaningful use objective involves reducing health disparities among U.S. citizens by improving the safety and quality of care.

The novice nurse asks the nurse​ preceptor, "What can I do to help prevent the spread of infection from contaminated computer​ systems?" Which items should the nurse preceptor​'s reply​ include? ​(Select all that​ apply.) A. Always wear gloves whenever using the computer equipment. B. Avoid the use of a sealed or covered keyboard that can breed virulent microbes. C. Follow manufacturer guidelines for cleaning the computer equipment. D. Disinfect the keyboard and mouse weekly and when they are soiled with body fluids. E. Recognize that the dry surface of a computer can allow virulent microbes to survive.

A. Always wear gloves whenever using the computer equipment. B. Avoid the use of a sealed or covered keyboard that can breed virulent microbes. ***C. Follow manufacturer guidelines for cleaning the computer equipment. D. Disinfect the keyboard and mouse weekly and when they are soiled with body fluids. ***E. Recognize that the dry surface of a computer can allow virulent microbes to survive. Many virulent microbes can survive for months on dry surfaces. Some manufacturers have built sealed keyboards that can be easily cleaned or can be equipped with covers for easier cleaning and protection of the electronic equipment. Guidelines for preventing the spread of infection due to contaminated computer systems include following manufacturer recommendations for cleaning​ equipment, avoiding touching the keyboard or mouse with gloved​ hands, and disinfecting keyboards and mice daily and when visibly soiled with body fluids.

The pediatric nurse wants to confirm national screening standards for infants and toddlers. What resource could the nurse use to find current​ information? A. American Immunization Systems B. American Vaccine Providers C. U.S. Preventive Services Task Force D. U.S. Pediatric Systems Task Force

A. American Immunization Systems B. American Vaccine Providers ***C. U.S. Preventive Services Task Force D. U.S. Pediatric Systems Task Force The nurse could find current screening standards through the U.S. Preventive Services Task Force. None of the other organizations exist.

An adult client returns from the postanesthesia care unit​ (PACU) following a laparoscopic appendectomy. The nurse checks the postoperative notes and determines which factor is most important with regard to the client​'s immediate oxygenation​ status? A. Amount of intravenous fluid infused over the last 2 hr B. Amount of urine output over the past 4 hr C. Amount of narcotics the client received over the last 4 hr D. Amount of drainage on the surgical dressings in the last 1 hr

A. Amount of intravenous fluid infused over the last 2 hr B. Amount of urine output over the past 4 hr ***C. Amount of narcotics the client received over the last 4 hr D. Amount of drainage on the surgical dressings in the last 1 hr The amount of narcotics the client received over the last 4 hr is of most immediate consideration. Narcotics depress the central nervous​ system, decreasing respiratory function and rate and thus placing clients at risk for alterations in respirations. While the other options are important areas to​ assess, they do not directly influence the​ client's respiratory status.

The nurse is providing care to a client who recently lost her child in a car crash. The client presents with difficulty breathing and diaphoresis. Based on these​ symptoms, which nursing intervention is the priority for this​ client? A. Asking the client​ open-ended questions. B. Listening to the client​'s concerns. C. Using body language that encourages the client to talk. D. Staying with the client and treating the symptoms.

A. Asking the client​ open-ended questions. B. Listening to the client​'s concerns. C. Using body language that encourages the client to talk. ***D. Staying with the client and treating the symptoms. The client is experiencing an anxiety​ attack, and the priority intervention is to stay and treat the symptoms. The other interventions may be appropriate for a client experiencing​ grief, but client safety is the first concern.

The nurse educator is presenting an​ in-service to staff nurses regarding the spiritual health of clients admitted to the unit. Which role of the nurse will the educator include in the​ presentation? A. Asking the client​'s family for permission before disclosing the client​'s prognosis B. Declining to discuss spirituality directly out of respect for differing beliefs C. Assisting the client in recalling past experiences in which he or she drew upon hope while in crisis D. Introducing clients to the​ chaplain, who can assist them in finding religious belief

A. Asking the client​'s family for permission before disclosing the client​'s prognosis B. Declining to discuss spirituality directly out of respect for differing beliefs ***C. Assisting the client in recalling past experiences in which he or she drew upon hope while in crisis D. Introducing clients to the​ chaplain, who can assist them in finding religious belief Spiritual health is the state of wellness encompassing personal fulfillment as well as the fulfillment of life with others. The nurse can support the client​'s spirituality by assisting the client to recall times when he or she experienced hope. Spirituality is not the same as religious beliefs. The nurse can assist the client in developing spirituality without involving religious practices. The client should be the focus of care and information. It is important to include the family and any source of​ support, but the focus is the client. The role of the nurse is to support the client​'s experience of​ spirituality, not promote religious belief. The chaplain can provide support to the client in the development of his or her personal spiritual development.

What does the open double quote"Aclose double quote" stand for in the LEARN model of cultural​ competence? A. Assert B. Acknowledge C. Affirm D. Accept

A. Assert ***B. Acknowledge C. Affirm D. Accept Acknowledge and discuss the differences and similarities between the perceptions of the client and that of the health care team.​ Assert, affirm, and accept are not steps in the LEARN model.

A client with renal failure is prescribed hemodialysis by the health care provider. Which independent nursing intervention is the priority for this​ client? A. Assessing medication reactions B. Maintaining aseptic technique C. Assessing urinalysis findings D. Percussing the kidneys for tenderness or pain.

A. Assessing medication reactions ***B. Maintaining aseptic technique C. Assessing urinalysis findings D. Percussing the kidneys for tenderness or pain. The nurse caring for a client who is prescribed hemodialysis must maintain aseptic technique. Hemodialysis increases the client​'s risk of infection. While the other choices are independent nursing​ actions, they are not the priority for this client.

As the night nurse on the obstetrics​ unit, Carla has gotten to know one client very well. Sarah Gomez is a​ 42-year-old elementary teacher. Ms. Gomez was confined to her bed for an extended​ time, and Carla has found that they know people in common. Ms. Gomez had a successful​ C-section. Now that she is about to be discharged​ home, Carla plans to bundle up her own unused newborn clothes to give to Ms. Gomez as a gift. What professional behavior associated with ethical nursing values might​ Carla's plan​ violate? A. Attention to professional appearance and demeanor B. Attention to professional boundaries with clients C. Articulation of​ nursing's professional skills D. Pursuit of professional engagement

A. Attention to professional appearance and demeanor ***B. Attention to professional boundaries with clients C. Articulation of​ nursing's professional skills D. Pursuit of professional engagement Carla's plan might violate the professionalism that calls for attention to boundaries with​ clients, by giving a client a personal gift.​ Carla's plan does not affect her attention to professional appearance and demeanor.​ Carla's plan does not violate her pursuit of professional engagement. And her plan does not violate her articulation of​ nursing's professional skills.

The nurse working in an allergy clinic finds that the clinic did not receive enough vials of flu vaccine this year. The nurse devised a decision tree to identify priority clients who have the greatest need for the flu vaccine. Which primary principle guided the nurse​'s ethical decision​ making? A. Autonomy B. Veracity C. Justice D. Beneficence

A. Autonomy B. Veracity ***C. Justice D. Beneficence When the nurse has to make​ challenging, but​ fair, decisions related to the allocation of scarce​ resources, the principle of justice prevails. This situation does not call for​ autonomy, veracity, or beneficence.

Which statement best describes the influence of the Internet on teaching and learning in the healthcare​ setting? A. Because the Internet offers information that is mostly​ incorrect, the nurse must anticipate the need to reeducate all clients. B. Due to the widespread use of Internet​ technology, the nurse should incorporate​ computer-based learning into every teaching plan. C. Because of​ client-specific variations, the nurse must be skilled at implementing effective teaching strategies for clients who use the Internet as well as for those who do not. D. Due to the widespread use of Internet​ technology, all clients should be trained to use a​ computer-based approach to learning.

A. Because the Internet offers information that is mostly​ incorrect, the nurse must anticipate the need to reeducate all clients. B. Due to the widespread use of Internet​ technology, the nurse should incorporate​ computer-based learning into every teaching plan. ***C. Because of​ client-specific variations, the nurse must be skilled at implementing effective teaching strategies for clients who use the Internet as well as for those who do not. D. Due to the widespread use of Internet​ technology, all clients should be trained to use a​ computer-based approach to learning. The nurse must be skilled at integrating Internet technology into teaching plans for clients who use the​ Internet, while still implementing effective teaching strategies for clients who do not. Because the quality and accuracy of online content​ varies, when assessing the​ client's knowledge​ base, the nurse must be prepared to tactfully dispel myths or inaccuracies.

Which action by the nurse would indicate further education is necessary for the nursing care to be effective and culturally​ sensitive? A. Becomes knowledgeable about cultures served B. Becomes an effective communicator C. Puts own personal beliefs aside D. Acknowledges the numerous variations of family structures

A. Becomes knowledgeable about cultures served B. Becomes an effective communicator ***C. Puts own personal beliefs aside D. Acknowledges the numerous variations of family structures To become a culturally competent​ nurse, you must have the knowledge and skill to take care of families from different cultures. You should find out more about your clients​'​ cultures, be a good​ communicator, acknowledge the numerous variations in family​ structure, and become aware of your own cultural beliefs so that you can anticipate possible misunderstandings.​ However, you do not have to put your own personal beliefs aside​ completely, but rather your beliefs should not affect the care that you provide.

The nurse is performing a​ head-to-toe physical assessment on a client who is ten years old. Which approach is the most appropriate when assessing this​ client? A. Begin the session with the physical examination B. Expect reluctance to cooperate C. Establish a rapport before the physical assessment D. Promise toys for cooperation during the exam

A. Begin the session with the physical examination B. Expect reluctance to cooperate ***C. Establish a rapport before the physical assessment D. Promise toys for cooperation during the exam The nurse should establish rapport with this client prior to initiating the​ head-to-toe physical assessment. While play may be appropriate to use during the assessment​ process, establishing rapport is a priority. The nurse should expect the best from every​ child, but note it is developmentally appropriate for​ toddlers, not​ school-age children, to be reluctant to cooperate during a physical assessment.

Which interventions may be most appropriate when divorce alters a family​ structure? ​(Select all that​ apply.) A. Being alert to signs of intense grief reactions B. Considering the nature of the loss C. Providing information about counseling and support groups D. Educating about the importance of health maintenance and nutrition E. Advising about healthy coping mechanisms for stress

A. Being alert to signs of intense grief reactions B. Considering the nature of the loss ***C. Providing information about counseling and support groups ***D. Educating about the importance of health maintenance and nutrition ***E. Advising about healthy coping mechanisms for stress ​Family-focused interventions that are appropriate when divorce alters the family are providing​ information, advising about healthy coping​ mechanisms, and educating about the importance of health maintenance and nutrition. The nurse​'s being alert to signs of grief and considering what the loss means to the family are part of the nurse​'s ​assessment, not interventions.

As a treatment nurse in the oncology outpatient​ clinic, you are doing the admission paperwork with​ 28-year-old client Dorothy​ D'Angelo. Dorothy has a rare form of pancreatic cancer. She qualifies to become part of a clinical trial with a brand new investigational drug that your clinic​ hasn't used yet. As you give Dorothy complete risk information before she signs up to become a research​ participant, which principle of ethical decision making are you​ honoring? A. Beneficence B. Autonomy C. Justice D. Veracity

A. Beneficence B. Autonomy C. Justice ***D. Veracity Veracity is the principle behind giving complete information before obtaining a​ client's informed consent. Autonomy is the right of​ self-determination. Justice assures fair treatment opportunities. Beneficence means taking action to promote​ good, but since you have no experience with the new​ drug, you​ don't know whether it will be good for your client or not.

The family of a client who died of heart failure is making arrangements for a ritual bath to be given by a ritual burial society. Nurses are making arrangements for access and privacy. Which religions have this​ tradition? ​(Select all that​ apply.) A. Buddhism B. Baptist Christianity C. Lutheran Christianity D. Islam E. Judaism

A. Buddhism B. Baptist Christianity C. Lutheran Christianity ***D. Islam ***E. Judaism Both the Muslim and Jewish religions have a tradition of a ritual bath after death. That is not true of the Buddhist religion or the Baptist or Lutheran traditions within Christianity.

A nursing student is doing an internship in an​ inner-city free clinic. As part of the curriculum the nursing student is expected to give a presentation on health care disparities in the United States. Which statistics are appropriate for the student to include in the presentation to​ classmates? ​(Select all that​ apply.) A. Caucasians populations have a worsening health disparity in colorectal cancer mortality than Hispanic or African American populations. B. Asian individuals are more likely not to seek care for an illness or injury. C. African Americans have a higher rate of new AIDS cases than Caucasians. D. Asian adults over the age of 65 are more likely than Caucasians not to be immunized against pneumonia. E. Caucasians were more likely to report poor health care communication than the Hispanic population.

A. Caucasians populations have a worsening health disparity in colorectal cancer mortality than Hispanic or African American populations. ***B. Asian individuals are more likely not to seek care for an illness or injury. ***C. African Americans have a higher rate of new AIDS cases than Caucasians. ***D. Asian adults over the age of 65 are more likely than Caucasians not to be immunized against pneumonia. E. Caucasians were more likely to report poor health care communication than the Hispanic population. Health disparities among​ non-Caucasian populations are a concern in the United States. According to the 2010 National Health Disparities​ report, African Americans have a rate of AIDS that is ten times greater than Caucasians. Asian adults were​ 50% more likely than Caucasians not to be vaccinated for pneumonia. Asians were 1.5 times more likely not to get care for an illness or injury. African American populations have worsening colorectal cancer mortality from 2000dash-2006 than Caucasians. Hispanics are 1.7 times more likely to report poor communication with their health care provider than Caucasians.

Which strategy is useful to overcome barriers related to care​ coordination? A. Change the client assignment so that licensed personnel will be utilized more effectively B. Discuss a client care issue during a task force meeting C. Organize a client​'s care needs for a 12 hour shift D. Review the steps in​ self-administration of insulin with the client before discharge

A. Change the client assignment so that licensed personnel will be utilized more effectively B. Discuss a client care issue during a task force meeting C. Organize a client​'s care needs for a 12 hour shift ***D. Review the steps in​ self-administration of insulin with the client before discharge One way to overcome a barrier to care coordination is to address knowledge deficits by providing additional teaching to ensure that the client comprehends discharge instructions. Changing assignments to maximize the use of personnel is an approach for differentiated practice. Task force meetings are a characteristic of shared governance. Organizing a client​'s care needs for a 12 hour shift is a characteristic of the case method of care delivery.

A client if ordered to receive a sodium phosphate enema for relief of constipation. Proper administration for the enema includes which steps? SELECT ALL THAT APPLY. A. Chill the solution by placing it in the refrigerator for 10 minutes B. Assist the client into Sims' position C. Wash hands and put on gloves D. Insert the tip of the container ½" into the rectum E. Allow gravity to instill the solution F. Encourage the client to retain the solution for 5-15 minutes

A. Chill the solution by placing it in the refrigerator for 10 minutes ***B. Assist the client into Sims' position ***C. Wash hands and put on gloves D. Insert the tip of the container ½" into the rectum E. Allow gravity to instill the solution ***F. Encourage the client to retain the solution for 5-15 minutes

A client tells the​ nurse, "My blood sugars have been all over the place​ lately." The nurse​ responds, "It sounds like your blood sugar has been difficult to manage. Can I please see your blood sugar​ log?" Which therapeutic communication skills is the nurse displaying during this interaction with the​ client? ​(Select all that​ apply.) A. Clarifying B. Concreteness C. Genuineness D. Paraphrasing E. Confronting

A. Clarifying ***B. Concreteness C. Genuineness ***D. Paraphrasing E. Confronting The nurse paraphrased the​ client's statement by​ re-stating what the client said using the​ client's words. The nurse also used concreteness by encouraging the client to be specific rather than vague. Confronting and clarifying help the client to recognize inconsistencies that inhibit the​ client's self-understanding or exploration of specific areas and ideas.

Which client should the nurse refer to the case manager for ongoing​ care? A. Client being treated for deep vein thrombosis B. Client with exacerbation of multiple sclerosis C. Client with hepatitis B D. Client being discharged after a total hip replacement

A. Client being treated for deep vein thrombosis ***B. Client with exacerbation of multiple sclerosis C. Client with hepatitis B D. Client being discharged after a total hip replacement To maximize​ effectiveness, clients who benefit the most from case management are those with chronic health​ problems, such as chronic alterations in​ lung, heart, or neurological health. The client with an exacerbation of multiple sclerosis would benefit the most from case management. Hepatitis​ B, deep vein​ thrombosis, and total hip replacement are all acute problems with minimal risk for developing into a chronic disorder.

A client with a terminal illness is admitted for worsening symptoms and loss of appetite. After the​ assessment, the nurse determines that the client is in the closed state of awareness. What did the nurse observe to make this​ determination? A. Client suspects that condition is worsening and might be dying B. Client states that the goal of care is to resume strength and return home C. Client is aware of dying but does not want to talk about it D. Client is aware of pending death and asks if pain will be controlled

A. Client suspects that condition is worsening and might be dying ***B. Client states that the goal of care is to resume strength and return home C. Client is aware of dying but does not want to talk about it D. Client is aware of pending death and asks if pain will be controlled In closed​ awareness, the client is unaware of impending death even though the healthcare team and family are aware. In suspected​ awareness, no one directly tells the client about the​ condition, but the client begins to suspect that death is near. In mutual pretense​ awareness, the​ client, family, and healthcare team all know that the​ client's condition is​ terminal, but no one discusses it. In open​ awareness, the​ client, family, and healthcare team know about the​ client's impending​ death, and it is openly discussed as needed.

The nurse is performing a cognitive assessment on an older adult client. The client​'s family is worried because the client forgot to turn off the oven before going on vacation. The nurse plans to administer the​ Mini-Mental Status examination​ (MMSE). What specifically will this MMSE​ assess? A. Client​'s response to​ over-the-counter medication B. Client​'s level of consciousness C. Cognitive changes that occur for the client over time D. The client​'s mood and affect

A. Client​'s response to​ over-the-counter medication B. Client​'s level of consciousness ***C. Cognitive changes that occur for the client over time D. The client​'s mood and affect The​ Mini-Mental Status Examination​ (MMSE) is useful for detecting the early stages of cognitive impairment and dementia in the client. It can also be used to assess the level of​ impairment, cognitive changes over​ time, and the​ client's response to prescribed treatment. The MMSE assesses​ orientation, memory, and language functions. Other assessments are used to determine client mood and​ affect, response to​ medication, and level of consciousness.

All clients have the right to care by a competent and safe nurse. What ensures that a nurse is both competent and safe to​ practice? A. Code of ethics B. Standards of Practice C. Nurse Practice Act D. Licensing process

A. Code of ethics ***B. Standards of Practice C. Nurse Practice Act D. Licensing process Standards of Practice describe the competency level of nursing care as described by the American Nurses Association​ (ANA). The Nurse Practice Act regulates the licensing and practice of nursing by describing the scope of practice. The licensing process establishes an assessment for a minimum knowledge base relevant to the client population that the nurse serves. The code of ethics is a guide for carrying out nursing responsibilities while maintaining moral principles.

​Katie, a student​ nurse, observes a staff nurse access the locked narcotic​ cabinet, remove a​ medication, and place the medication in her uniform pocket before walking away from the cabinet. What should Katie do about this​ observation? A. Collaborate with other nurses by discussing the observation during change of shift report B. Treat others with respect by ignoring the observation C. Ensure the safety of​ clients, self, and others by reporting the observation D. Maintain confidentiality by not reporting the observation

A. Collaborate with other nurses by discussing the observation during change of shift report B. Treat others with respect by ignoring the observation ***C. Ensure the safety of​ clients, self, and others by reporting the observation D. Maintain confidentiality by not reporting the observation One principle within the Code for Nursing Students is ensuring the safety of​ clients, self, and others. Katie should report the observation since the staff nurse could be providing care as an impaired nurse. Katie has s responsibility to report the observation. Treating others with​ respect, maintaining​ confidentiality, and collaborating with other nurses would not be appropriate actions for Katie to take in this situation.

According to the American Association of Colleges of​ Nursing, which values are essential for the professional nurse to​ demonstrate? ​ (Select all that​ apply.) A. Competence B. ​Self-esteem C. Integrity D. Autonomy E. Altruism

A. Competence B. ​Self-esteem ***C. Integrity ***D. Autonomy ***E. Altruism The values of​ autonomy, integrity, and altruism are three of the five essential values for the professional nurse to demonstrate. The other two are human dignity and social justice. Neither competence nor​ self-esteem are such values.

The nurse performs a physical examination on a client who complains of crushing chest pain and​ states, open double quote"I feel like my heart is going to beat out of my chest.close double quote" What is the best way to validate the subjective information received from the client during the assessment​ process? A. Complete all assessment information within 72 hours B. Obtain additional information from the client​'s friends C. Obtain vital signs to determine client status D. Infer conclusions from the client​'s body language

A. Complete all assessment information within 72 hours B. Obtain additional information from the client​'s friends ***C. Obtain vital signs to determine client status D. Infer conclusions from the client​'s body language Validation is the act of​ double-checking or verifying data to confirm that they are accurate and factual. Obtaining vital signs from this client will validate the​ client's subjective reports with a pain scale rating and vital sign measurements. Obtaining information from the​ client's friends and inferring conclusions from body language will not be sufficient to verify the​ client's report of chest pain. Failure to complete the assessment in a timely manner may put the client at unnecessary risk.

The nurse is caring for a client with Alzheimer disease​ (AD). Which assessment findings does the nurse expect while caring for this​ client? Select all that apply. A. Confusion that occurs over a matter of hours. B. Tachycardia C. Trouble finding the right name for an object D. Gradual behavior changes if the nurse was to care for this patient over a course of time. E. Hypotension

A. Confusion that occurs over a matter of hours. B. Tachycardia ***C. Trouble finding the right name for an object ***D. Gradual behavior changes if the nurse was to care for this patient over a course of time. E. Hypotension The nurse would expect this client to have trouble finding the right name for an object and gradual behavioral changes. Confusion occurs over​ weeks, months or​ years, not over a few hours. Tachycardia and hypotension are not expected assessment findings for a client with AD.

A nurse is reviewing the report from a client who just received her​ 20-week ultrasound. The ultrasound report noted a​ two-vessel cord and recommended​ follow-up ultrasounds to follow the fetal growth every 4 weeks until delivery. Based on these​ results, which condition is this client at risk for that may increase the risk of fetal demise and perinatal​ loss? A. Congenital malformation B. Placental abruption C. Umbilical cord abnormality D. Trauma

A. Congenital malformation B. Placental abruption ***C. Umbilical cord abnormality D. Trauma A​ two-vessel cord is considered an umbilical cord abnormality and increases the risk for a perinatal loss. A placental abruption is a condition where the placenta separates from the uterus. This is a condition of the placenta. A congenital anomaly involves a malformation that develops on the​ fetus, not the cord. A​ two-vessel cord is not a result from a trauma. Traumas include falls or accidents.

The director of an ambulatory care clinic is concerned that economic changes are going to impact the clinic​'s nursing care over the next fiscal year. Which issues are contributing to the director​'s ​concern? ​(Select all that​ apply.) A. Consumer representatives on hospital committees B. Concept of health care being a right and not a privilege C. Expectations for​ out-patient care D. Increased costs for care E. Changing insurance programs and carriers

A. Consumer representatives on hospital committees B. Concept of health care being a right and not a privilege ***C. Expectations for​ out-patient care ***D. Increased costs for care ***E. Changing insurance programs and carriers The economics of health care impact nursing practice and accountability through insurance​ programs, the cost of​ care, and expectations when providing​ out-patient care. Consumer representatives on hospital committees and the concept of health care being a right and not a privilege are characteristics of consumer demands on nursing accountability.

A client recovering from a foot wound is resting comfortably in bed. During the last vital signs​ assessment, the client​'s temperature was 38​°C. What action should the nurse provide to this​ client? A. Cooling blanket B. Nothing C. Tepid sponge bath D. Ice pack to the groin

A. Cooling blanket ***B. Nothing C. Tepid sponge bath D. Ice pack to the groin A​ low-grade fever which is under 38.3​°C or 101​°F in an adult may not be treated unless the client is experiencing discomfort. Since the client is resting comfortably in bed and has a temperature of 38​°​C, nothing should be done. A cooling​ blanket, tepid sponge​ bath, and ice pack to the groin would be indicated if the client​'s temperature was higher than low grade.

​Abigail, the registered​ nurse, is meeting with the physical and occupational therapists to discuss outcome achievement for a client recovering from a stroke. Which case management behavior is the nurse demonstrating at this​ time? A. Coordinating care B. Providing interventions C. Evaluating care provided D. Assessing client needs

A. Coordinating care B. Providing interventions ***C. Evaluating care provided D. Assessing client needs The nurse is meeting with the​ client's therapists to evaluate the care they have provided in relation to the​ client's outcomes.​ Assessment, care​ coordination, and provision of interventions are a part of the case management​ model, but these are not occurring at this time.

A male client is experiencing bowel issues that alternate between episodes of constipation and episodes of diarrhea. Which diagnostic test does the nurse anticipate will be ordered for this​ client? A. Cystoscopy B. Urinalysis C. Renal ultrasound D. Blood test

A. Cystoscopy B. Urinalysis C. Renal ultrasound ***D. Blood test Blood tests are used for the identification of systemic causes of alterations in bowel function. A​ cystoscopy, urinalysis, and renal ultrasound would be anticipated for a client who is experiencing alterations in urinary function.

A nurse is caring for a​ 5-year-old client from an intergenerational family with​ 75-year-old grandparents who have provided care since the parents went to prison. Which​ factor, affecting the families​' ability to cope with a young​ child, should the nurse consider when planning​ care? A. Decision making that is dispersed throughout the family system B. Family concerns that focus on maintaining functioning C. Family roles that are assigned by age and gender D. Procedures that affect the​ client, but do not affect the functioning of the family

A. Decision making that is dispersed throughout the family system ***B. Family concerns that focus on maintaining functioning C. Family roles that are assigned by age and gender D. Procedures that affect the​ client, but do not affect the functioning of the family In order to plan care for the​ client, the nurse must understand the implications of care giving for the aging grandparents. As well as caring for a young child from a Stage II or IV​ family, the grandparents are in a Stage VIII family. Among the grandparents​' concerns is maintaining function during the aging​ process, especially since they are caring for a young child. The plan of care must include interventions that comprehensively address family needs. Family role​ assignment, decision​ making, and procedures the child will undergo do not directly affect the family​'s ability to cope.

The home health nurse is assessing an older adult client with a history of diabetes mellitus and hypertension. The client​ states, "I do not let my ailments stop me. I can still cook for​ myself, and go to the toilet and bathe without help." Which aspects of the client​'s functional ability are reflected in this client​'s statement to the​ nurse? ​(Select all that​ apply.) A. Declining physical ability B. Contentment C. Nutrition ​D. Self-care ability E. Continence

A. Declining physical ability ***B. Contentment C. Nutrition ​***D. Self-care ability ***E. Continence A functional assessment is appropriate to conduct in the home setting and assesses areas such as nutrition and​ feeding, sleep,​ self-care, continence,​ mobility, skin​ care, and cognition. The​ client's statement provides information about his​ self-care ability,​ continence, and even contentment with his situation. Although the client reports he can cook for​ himself, this does not necessarily confirm his nutritional​ status, which the nurse should evaluate by asking additional questions. The​ client's statement does not indicate a decline in physical ability.

An older adult client has been taking care of a grandchild with severe autism spectrum disorder. The home care nurse recognizes that this condition has caused the adult client prolonged emotional distress. What effects in the grandparent would concern the​ nurse? ​(Select all that​ apply.) A. Decreased possibility of premature death B. Altered endocrine levels C. Increased susceptibility to infections D. Alterations in the central nervous system E. Increased susceptibility to disease

A. Decreased possibility of premature death ***B. Altered endocrine levels ***C. Increased susceptibility to infections ***D. Alterations in the central nervous system ***E. Increased susceptibility to disease Prolonged emotional distress can cause increased susceptibility to disease and​ infections, as well as alterations in the central nervous system and endocrine levels. Prolonged emotional distress​ increases, not​ decreases, the possibility of premature death.

The nurse is reviewing the medical history of a​ 34-year-old client who is coming to the office for the first prenatal visit at 8 weeks. The nurse notes that this is the client​'s third pregnancy with 1 term birth at 39 weeks and a miscarriage at 8 weeks. Which conclusion does the nurse formulate after reviewing the medical history for this​ client? A. Decreased risk for a miscarriage B. Has an increased risk for infection C. Increased risk for a miscarriage D. Has no impact on future pregnancies

A. Decreased risk for a miscarriage B. Has an increased risk for infection C. Increased risk for a miscarriage ***D. Has no impact on future pregnancies The history of a single miscarriage does not impact future pregnancies. The client has carried one pregnancy to​ term, and is not considered to be at a higher risk or lower risk for future pregnancies. This client is not at risk for infection with no other risk factors in her medical history.

When teaching a client how to perform a breast​ self-examination, the nurse palpates a small nodule. Based on this​ finding, which assessment strategy is most appropriate to determine the detail of the​ mass? A. Deep palpation B. Indirect auscultation C. Direct auscultation D. Superficial palpation

A. Deep palpation B. Indirect auscultation C. Direct auscultation ***D. Superficial palpation Light​ (superficial), where the nurse extends the dominant​ hand's fingers parallel to the skin surface and presses gently while moving the hand in a circle. If it is necessary to determine the details of a​ mass, press lightly several times rather than holding the pressure. Light palpation should always precede deep palpation because heavy pressure on the fingertips can dull the sense of touch.​ Auscultation, direct or​ indirect, is used to elicit sounds from the​ body; it is not used to assess the detail of a mass.

The nurse preceptor is discussing integrity with the novice nurse. Which examples should the nurse preceptor use to illustrate integrity in​ nursing? ​(Select all that​ apply.) A. Delivering​ error-free nursing care B. Maintaining accountability for personal actions C. Accepting positive feedback from peers D. Working within the scope of practice E. Accepting negative feedback from clients

A. Delivering​ error-free nursing care ***B. Maintaining accountability for personal actions ***C. Accepting positive feedback from peers ***D. Working within the scope of practice ***E. Accepting negative feedback from clients Examples of ways in which nurses demonstrate integrity include accepting feedback​ (positive or​ negative) as a tool for improving the delivery of client​ care, maintaining accountability for their​ actions, following their​ state's nurse practice​ act, and working only within their scope of practice. Nursing integrity does not require nurses to be​ perfect; rather, it requires nurses to admit when they make mistakes.

A nurse is offered a position to provide telenursing client care through a national health insurance provider. Which investigation should take priority before the nurse accepts this​ position? A. Demography of the client population B. State board of nursing licensing laws C. Current legislation about health care D. Work hours and flexibility with schedules

A. Demography of the client population ***B. State board of nursing licensing laws C. Current legislation about health care D. Work hours and flexibility with schedules Telenursing is the provision of client care through a telecommunication system. This care delivery system has created licensing issues. The nurse needs to investigate the board of nursing licensing laws in the state of residence to determine if another license is needed to provide client care out of state. Legislation about health care includes the​ PSDA, ACA, and HIPAA. This legislation may or may not impact the​ nurse's ability to provide telenursing. The demography of the client population is not something that the nurse needs to investigate prior to accepting this position. Determining work hours and schedule flexibility is not something that the nurse needs to make a priority before accepting this position.

The nurse is conducting an admission assessment for a client who is diagnosed with delirium of unknown cause. Which item will the nurse include during the health history of this client to determine a cause for the​ diagnosis? A. Determining visual impairments B. Asking about drug and alcohol use C. Assessing orientation D. Conducting a mental status exam

A. Determining visual impairments ***B. Asking about drug and alcohol use C. Assessing orientation D. Conducting a mental status exam The nurse would ask about a history of drug and alcohol use during the health history portion of the nursing assessment. The nurse would assess​ orientation, determine visual​ impairments, and conduct a mental status exam during the physical examination portion of the nursing assessment.

The nurse is conducting an assessment for a client diagnosed with delirium. Which risk factor found in the client​'s health history may have caused the current​ diagnosis? A. Diet high in folic acid B. History of anorexia nervosa C. History of hypertension D. Recent heroin use

A. Diet high in folic acid B. History of anorexia nervosa C. History of hypertension ***D. Recent heroin use The client​'s delirium may be caused by withdrawal from heroin. A history of hypertension and anorexia nervosa are not risk factors for delirium. A diet high in folic acid is a preventive measure to decrease the risk for dementia. This diet is not a risk factor for delirium.

The nurse is planning a teaching session for a​ 6-year-old client who is scheduled to undergo tonsillectomy and adenoidectomy in two weeks. Which strategies reflect the​ nurse's correct understanding of lifespan​ considerations? ​(Select all that​ apply.) A. Discouraging parents from reading story books about the planned​ procedure, as this may frighten the child B. Giving the client a coloring book that depicts the​ hospital, surgical​ team, and client monitoring devices C. Using a doll to demonstrate placement of an oxygen mask D. Including instructions that are geared toward the​ parents' level of comprehension E. Using terms of endearment for the​ child, such as​ "sweetheart," as opposed to addressing the child by name

A. Discouraging parents from reading story books about the planned​ procedure, as this may frighten the child ***B. Giving the client a coloring book that depicts the​ hospital, surgical​ team, and client monitoring devices ***C. Using a doll to demonstrate placement of an oxygen mask D. Including instructions that are geared toward the​ parents' level of comprehension E. Using terms of endearment for the​ child, such as​ "sweetheart," as opposed to addressing the child by name Pediatric clients should be addressed by name.​ Teaching, including​ instructions, should be geared toward the pediatric​ client's comprehension level. The use of coloring books as teaching tools can be an effective way to familiarize pediatric clients with​ facilities, people, and equipment. Parents and caregivers should also be encouraged to prepare the child for hospital admission through reading the child special story books that describe the clinical​ setting, procedures, and staff. Demonstrating relevant treatments or procedures on dolls or stuffed animals can be an effective method for teaching the pediatric client.

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? A. Discuss implementing a community curfew to curtail spread of influenza. B. Notify the school to expect a high number of student absences due to influenza. C. Distribute​ over-the-counter cold and flu medication during the next community meeting. D. Organize an influenza vaccination clinic at the local community center.

A. Discuss implementing a community curfew to curtail spread of influenza. B. Notify the school to expect a high number of student absences due to influenza. C. Distribute​ over-the-counter cold and flu medication during the next community meeting. ***D. Organize an influenza vaccination clinic at the local community center. 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 neurological clinical nurse specialist​ (CNS) visits a client at home one week after the client was discharged from the hospital after a stroke. What can the CNS do after this care visit is​ complete? A. Discuss the client​'s care needs with the health care provider B. Discuss the visit with the primary nurse C. Notify the case manager of the visit D. Reimburse for the care visit

A. Discuss the client​'s care needs with the health care provider B. Discuss the visit with the primary nurse C. Notify the case manager of the visit ***D. Reimburse for the care visit Because care coordination can be a helpful strategy in reducing readmission​ rates, the Centers for Medicare and Medicaid Services now reimburses clinical nurse specialists if specific criteria are​ met, such as visiting the client in person within 30 days of discharge. The nurse specialist may or may not need to notify the case manager of the visit. The​ client's needs may or may not need to be discussed with the health care provider. The visit does not need to be discussed with the primary nurse.

The nurse is coordinating the care for a client recovering from a stroke. Which skills are appropriate for the nurse to use when coordinating care for this​ client? ​(Select all that​ apply.) A. Discuss the client​'s need for a prescribed medication with the insurance company B. Delegate morning care to unlicensed assistive personnel C. Document the client​'s responses to care D. Facilitate team and group activities to avoid scheduling conflicts E. Communicate with other disciplines regarding the provision of care

A. Discuss the client​'s need for a prescribed medication with the insurance company B. Delegate morning care to unlicensed assistive personnel C. Document the client​'s responses to care ***D. Facilitate team and group activities to avoid scheduling conflicts ***E. Communicate with other disciplines regarding the provision of care When functioning in the role of​ coordinator, the nurse will facilitate team and group activities and use verbal communication skills with other disciplines to ensure completion of the​ client's care. Delegation is a skill used in team nursing. Documentation is a basic nursing skill performed by all nurses regardless of the care delivery method used. Discussing the​ client's need for a medication with the insurance provider is a skill within the role of advocacy.

A home health nurse is caring for a client who requires an appointment with a specialty provider. The client​'s health insurance is an​ employer-provided HMO. Based on the client​'s ​insurance, what is the first step for the nurse to take to ensure this client is seen by the​ specialist? A. Discuss the client​'s options with the insurance company B. Call the specialist directly to make an appointment C. Discuss the client​'s options with the case manager D. Call the primary care provider for a referral to the specialist

A. Discuss the client​'s options with the insurance company B. Call the specialist directly to make an appointment C. Discuss the client​'s options with the case manager ***D. Call the primary care provider for a referral to the specialist Health maintenance organization​ (HMO) participants must choose a primary care provider​ (PCP). The PCP serves as the gatekeeper to​ care, referring the client to​ in-network hospitals and specialists when needed. Therefore the nurse would need to call the PCP to get a referral for the specialist in order for the visit to be covered under the​ client's insurance policy. The case manager would not be involved in this process. Because the nurse knows that the client has an​ HMO, it is not necessary to call the insurance company regarding the​ client's options.

A client in the 16th week of gestation begins to cry during the examination because she has no idea how she is going to provide food for her two​ preschool-age children in addition to the new baby. What should the nurse do to help this​ client? (Select all that​ apply.) A. Discuss the financial support provided by the children​'s father B. Encourage the client to obtain additional employment C. Recommend the​ Women, Infants, and Children​ (WIC) program D. Provide information about the Supplemental Nutrition Assistance Program​ (SNAP) E. Review the importance of adequate nutrition during pregnancy

A. Discuss the financial support provided by the children​'s father B. Encourage the client to obtain additional employment ***C. Recommend the​ Women, Infants, and Children​ (WIC) program ***D. Provide information about the Supplemental Nutrition Assistance Program​ (SNAP) E. Review the importance of adequate nutrition during pregnancy Such public programs as​ Women, Infants and Children​ (WIC) and the Supplemental Nutrition Assistance Program​ (SNAP) assist families in poverty with obtaining healthy food for their children. The client is currently​ pregnant, and her employment status is not​ known, so discussing additional employment may be inappropriate. Discussing financial support is also inappropriate. Reviewing the importance of adequate nutrition during pregnancy does not address the client​'s concern about food insecurity with her family.

A nurse is caring for a hospitalized patient. What intervention can the nurse use to help the patient continue normal spiritual practices? A. Discuss the nurse's own religious beliefs with the patient. B. Request medication from the physician to calm the patient. C. Tell the patient that spiritual practices can be resumed later. D. Request dietary consultation for the patient's dietary restrictions.

A. Discuss the nurse's own religious beliefs with the patient. B. Request medication from the physician to calm the patient. C. Tell the patient that spiritual practices can be resumed later. ***D. Request dietary consultation for the patient's dietary restrictions. It is a responsibility of the nurse to help the patient in an unfamiliar environment continue normal spiritual practices. One intervention that can facilitate the practice of religion is to attempt to meet the patient's dietary restrictions.

The nurse leading the​ clinic-based support group for individuals with chronic diseases was pleased with the number of individuals who showed up for a lecture on "Living with Type 2 Diabetes." Due to time​ constraints, the nurse planned to limit the talk to describing tertiary prevention activities. Which activities could the nurse​ include? A. Discussing smoking cessation tips to help smokers quit the habit B. Encouraging a healthy diet to prevent onset of a diabetic condition C. Talking about the role of exercise to maintain blood sugar control D. Showing a video on hand washing techniques to prevent infection

A. Discussing smoking cessation tips to help smokers quit the habit B. Encouraging a healthy diet to prevent onset of a diabetic condition ***C. Talking about the role of exercise to maintain blood sugar control D. Showing a video on hand washing techniques to prevent infection Talking about the role of exercise to maintain blood sugar control is tertiary​ prevention, meant to avoid complications of uncontrolled hyperglycemia. Wellness advice on topics of a healthy​ diet, smoking​ cessation, and hand washing is primary prevention.

​Seven-year-old Jermaine Cast has a​ serious, but not​ life-threatening, illness. He will need to be kept home from school for a​ 2-month course of treatment. His parents both work and neither parent has a lot of vacation time. What is the most important information the nurse can give the​ parents? A. Discuss​ free, or sliding​ fee, clinics available to families who are underinsured B. Discuss coping strategies for families facing the stress of caring for a sick child C. Assist family to find a good day care center D. Provide information regarding Family and Medical Leave Act

A. Discuss​ free, or sliding​ fee, clinics available to families who are underinsured B. Discuss coping strategies for families facing the stress of caring for a sick child C. Assist family to find a good day care center ***D. Provide information regarding Family and Medical Leave Act Nurses should educate the parents about the Family and Medical Leave Act of​ 1993, so each could take time without pay to be able to be home with the child after they have exhausted their vacation or sick time. It is always helpful to discuss coping strategies with parents under​ stress, but it is not the most important information the nurse could offer in this situation. Day care is an appropriate place for​ preschool-age children while their parents are at​ work, but is not usually equipped to take care of a child with a serious health issue. Free​ clinics, or sliding fee clinics are helpful for many uninsured people but would not resolve a need for months of care for a sick​ child, nor is there evidence that this is an issue for this family.

The nurse is doing an assessment addressing the interaction of members of the family. Which level of family cohesion describes a family where family members cannot develop a separate​ identity? A. Disengaged B. Separated C. Connected D. Enmeshed

A. Disengaged B. Separated C. Connected ***D. Enmeshed Members of an enmeshed family cannot develop a separate identity. Separated and connected family cohesion is thought to offer optimal family competency in Western developed societies. Disengaged families are like a group of strangers who happen to live together.

The nurse is assessing the IV of an adult client who does not speak English. The client seems somewhat uncomfortable. Which method is the most appropriate for the nurse to use when assessing this client​'s level of​ pain? A. Do a charade of acting out a person in pain. B. Ask the client to rate pain level from 1 to 10. C. Use a picture scale with faces from sad to happy. D. Point to the operative site with a questioning look.

A. Do a charade of acting out a person in pain. B. Ask the client to rate pain level from 1 to 10. ***C. Use a picture scale with faces from sad to happy. D. Point to the operative site with a questioning look. A picture scale uses​ pictures, so it does not depend on language or health literacy. The client might not be able to relate to numbers in​ English, so a pain scale from 1 to 10 would not work. Neither a charade nor pointing will provide effective assessment.

A client with a terminal illness has just died and the nurse is found in the medication room crying. What should the nurse manager​ do? Select all that apply. A. Document that the nurse is hypersensitive and needs additional training B. Provide the nurse with a sedative and send home C. Ask if there is anyone that the nurse would like to talk to at this time D. Permit the nurse time to grieve E. Remind the nurse that postmortem care needs to be completed

A. Document that the nurse is hypersensitive and needs additional training B. Provide the nurse with a sedative and send home ***C. Ask if there is anyone that the nurse would like to talk to at this time ***D. Permit the nurse time to grieve E. Remind the nurse that postmortem care needs to be completed Nurses can become close to clients and when a client passes​ away, the nurse needs to have time to grieve. The manager should permit the nurse time to grieve and offer the nurse an opportunity to talk with someone about the death. Reminding that postmortem care needs to be completed is a harsh response and inappropriate. Documenting that the nurse is hypersensitive is callous and might not be true. Providing the nurse with a sedative and sending home is not safe. The manager should not administer narcotics without a healthcare provider​'s order and the nurse should not drive while under the influence of a sedative.

The nurse manager of an oncology unit observes a staff nurse say to a dying​ client, "You cannot die now. I don​'t handle death well." What should the manager do at this​ time? A. Document the observation for later discussion during the annual performance appraisal B. Remind the nurse that clients cannot control the time of death C. Suggest the nurse talk with a grief counselor to learn how to handle the care of clients facing death D. Explain to the client that the nurse was just kidding

A. Document the observation for later discussion during the annual performance appraisal B. Remind the nurse that clients cannot control the time of death ***C. Suggest the nurse talk with a grief counselor to learn how to handle the care of clients facing death D. Explain to the client that the nurse was just kidding If a nurse is fearful and anxious about​ death, the client may become more fearful and anxious. The nurse manager needs to help the nurse deal with personal feelings about death so suggesting a talk with a grief counselor is appropriate. Documenting the observation for later use during a performance appraisal is not enough. The manager should not say to the client that the nurse was kidding. Dying is not a funny process. Reminding the nurse that the client cannot control the time of death does not address the nurse​'s comment to the client.

You are conducting an assessment to create a family plan of care for​ 8-year-old Timothy Lopez. Which question is least appropriate for the nurse to ask his grandmother to help with developing your​ plan? A. Does either parent have health​ conditions? B. What are the​ family's eating​ habits? C. What is your​ religion? D. What medical treatments are they interested​ in?

A. Does either parent have health​ conditions? B. What are the​ family's eating​ habits? C. What is your​ religion? ***D. What medical treatments are they interested​ in? Asking what medical treatments interest the family is not a question that would provide information that could be incorporated in a family plan of care. Health beliefs of clients may include folklore and practices from different cultures. A family plan of care requires​ in-depth assessment of the immediate and extended​ family, as well as review and consideration of the following​ factors: health​ history, socioeconomic​ status, religion,​ culture, nutrition, and social habits and practices.

The graduate student seeks help from a nurse at the college health center. Which complaints connected with fatigue would the nurse consider as neurological symptoms of that​ condition? ​(Select all that​ apply.) A. Dyspnea on exertion B. Difficulty concentrating C. Loss of appetite D. Confusion E. Muscle weakness

A. Dyspnea on exertion ***B. Difficulty concentrating C. Loss of appetite ***D. Confusion E. Muscle weakness Difficulty concentrating and confusion are neurological symptoms of fatigue. Muscle​ weakness, dyspnea on​ exertion, and loss of appetite are physical symptoms of fatigue.

The nurse is caring for a​ 3-year-old client. The client and the family are immigrants. When assessing the​ client, the nurse finds that the child has not had immunizations. Which is the best action of the​ nurse? A. Educate the family about the importance of immunizations B. Identify reasons and beliefs that may be preventing immunization C. Respect the parents​' decision not to immunize their child D. Ensure that the client receives immunizations while hospitalized

A. Educate the family about the importance of immunizations ***B. Identify reasons and beliefs that may be preventing immunization C. Respect the parents​' decision not to immunize their child D. Ensure that the client receives immunizations while hospitalized The nurse should first assess why the parents have not had the child​ immunized, which could include the family​'s cultural practices. The nurse must ensure that immigrant families or clients with views that differ from those of the mainstream culture are aware of the rules and laws governing the care and protection of children against preventable diseases. The first step is to identify why the child has not been​ immunized; then the family can be educated to promote immunization. Immunizations are given only when parents consent to vaccinations. The nurse cannot administer vaccinations without permission. By respecting the parents​' decision without investigating the reasons they have chosen not to vaccinate their child is not appropriate to providing holistic care.

The nurse provides education to the client who is facing a difficult healthcare choice. What is the intended goal of this​ action? A. Enabling B. ​Co-dependency C. Informed consent D. Empowerment

A. Enabling B. ​Co-dependency C. Informed consent ***D. Empowerment Nurses advocate for clients in order to protect their rights and empower them to participate in making informed healthcare decisions. While enabling is a type of​ advocacy, it is not the intended goal for this client. Principles of informed consent are not involved here.​ Co-dependency is the opposite of what advocacy seeks to achieve.

The nurse is caring for a client recovering from abdominal surgery. Which intervention is most appropriate when monitoring a client for​ infection? A. Encourage leg exercises while in bed B. Measure temperature every 4 hours C. Assist out of bed to a chair D. Turn and reposition every 2 hours

A. Encourage leg exercises while in bed ***B. Measure temperature every 4 hours C. Assist out of bed to a chair D. Turn and reposition every 2 hours In order to monitor a client for​ infection, the best intervention is assessing temperature at regular intervals. An increased temperature is an indicator of infection. While the other interventions are appropriate for this​ client, they do not allow the nurse to monitor for infection.

The nurse notes that an older resident of a​ long-term care facility is not eating in the dining room with other residents and does not participate in group activities. Which nursing interventions can minimize this resident​'s risk for unintentional​ injuries? ​(Select all that​ apply.) A. Encourage the resident to spend time in bed after meals. B. Find out what activities the resident enjoys and ensure the resident attends. C. Transport the resident in a wheelchair to the dining hall for meals. D. Introduce the resident to other residents. E. Suggest the resident have a consultation with a psychologist.

A. Encourage the resident to spend time in bed after meals. ***B. Find out what activities the resident enjoys and ensure the resident attends. ***C. Transport the resident in a wheelchair to the dining hall for meals. ***D. Introduce the resident to other residents. E. Suggest the resident have a consultation with a psychologist. For older residents and those requiring​ long-term care, the nurse should encourage social contact to reduce the risk for​ isolation, which contributes to functional decline and mortality. The nurse could transport the resident to the dining hall for​ meals, assess the resident to learn activities that the resident​ enjoys, and introduce the client to other residents. Spending time in bed after meals would potentiate social isolation and increase the risk of unintentional injuries. The resident may or may not need a psychology consultation. This​ action, however, would not reduce the risk of unintentional injuries in the resident who is socially isolated.

The nurse is caring for​ 6-year-old Justin​ Sennet, who has come to the clinic for a physical. His father is impatient and speaks sharply to the​ child, who is walking around the examination room. The father mentions that his wife died 6 months ago. What is important for the nurse to include during this​ interview? A. Encouraging the father to set limits with the child B. Assessing for signs of complicated grief C. Providing information about parenting styles D. Telling the father to demonstrate more parental warmth

A. Encouraging the father to set limits with the child ***B. Assessing for signs of complicated grief C. Providing information about parenting styles D. Telling the father to demonstrate more parental warmth The​ nurse's approach would be to assess how the family is coping with its loss in order to prevent abuse and trauma and promote family competence following this major family alteration. The nurse would assess for signs of complicated or traumatic grief and family violence. It could be appropriate to provide information about therapy and support​ groups, teach about healthy coping​ strategies, and facilitate referrals to counselors and other professional resources. Parenting​ style, emotional​ availability, family communication​ patterns, discipline, and limit setting are factors that impact family​ development; these are at play in this​ parent-child interaction, and would be noted in the​ nurse's assessment.

A​ 73-year-old female Native American client is hospitalized with an exacerbation of chronic obsructive pulmonary disease​ (COPD). The​ client, who has a 55​ pack-year history, reports that she still smokes cigarettes. She also reports that she smokes tobacco during certain important religious rituals and tribal celebrations. Which nursing interventions best reflect the​ nurse's application of humanist theory of​ learning? ​(Select all that​ apply.) A. Encouraging the​ client's family members and loved ones to praise the client for not smoking B. Recognizing that the client has personal​ characteristics, such as stoicism and mistrust for traditional​ medicine, that may influence her perception of the​ nurse's teaching C. Explaining to the client how smoking cessation at this stage of life still promotes lung​ healing, and can lead to fewer exacerbations of COPD and improved quality of life D. Exploring how the​ client's cultural background influences her decision to continue to smoke E. Considering the​ client's tobacco use from the standpoint of her religious beliefs

A. Encouraging the​ client's family members and loved ones to praise the client for not smoking B. Recognizing that the client has personal​ characteristics, such as stoicism and mistrust for traditional​ medicine, that may influence her perception of the​ nurse's teaching C. Explaining to the client how smoking cessation at this stage of life still promotes lung​ healing, and can lead to fewer exacerbations of COPD and improved quality of life ***D. Exploring how the​ client's cultural background influences her decision to continue to smoke ***E. Considering the​ client's tobacco use from the standpoint of her religious beliefs Humanist learning theory recognizes the learner as being a unique combination of​ biologic, psychologic,​ cultural, social, and spiritual​ factors; consideration of the​ client's religious and cultural influences best refects this approach. Explaining how smoking cessation can positively impact the client at her stage of life is reflective of adult learning theory. Encouraging the​ client's family members and loved ones to praise her for not smoking reflects behaviorist theory. Recognizing the influence of the​ learner's personal​ characteristics, such as the​ client's stoicism and mistrust for traditional​ medicine, is reflective of cognitive theory.

A nurse executive is asked to describe the responsibilities of a coach. Which statements are the most​ appropriate? ​(Select all that​ apply.) A. Ensuring that the novice​ nurse's client care adheres to professional standards B. Helping one or more individuals accomplish the highest level of achievement C. Teaching an individual about​ job-specific roles and responsibilities D. Assisting an individual with achieving maximum personal and professional fulfillment E. Encouraging accountability for actions and behaviors

A. Ensuring that the novice​ nurse's client care adheres to professional standards ***B. Helping one or more individuals accomplish the highest level of achievement C. Teaching an individual about​ job-specific roles and responsibilities ***D. Assisting an individual with achieving maximum personal and professional fulfillment ***E. Encouraging accountability for actions and behaviors Coaching involves helping one or more individuals to accomplish the highest level of achievement and to experience maximum personal and professional fulfillment. Coaching also includes encouraging accountability for actions and behaviors. Mentoring includes teaching an individual about​ job-specific roles and responsibilities. Preceptorship ensures that the novice​ nurse's client care adheres to professional standards.

A nurse working in the memory care unit listens as the newly admitted client talks about his work as a pilot as if he had just left the airport. The nurse knows he has been retired for decades. What does the nurse recognize as the benefits of hearing his work life​ story? ​(Select all that​ apply.) A. Entertaining the other clients and families B. Giving the nurse insight into the client​'s behavior C. Keeping his verbal abilities exercised D. Helping the client maintain a sense of identity E. Focusing on the positive aspects of a past work life

A. Entertaining the other clients and families ***B. Giving the nurse insight into the client​'s behavior C. Keeping his verbal abilities exercised ***D. Helping the client maintain a sense of identity E. Focusing on the positive aspects of a past work life Hearing details of the client​'s past work life helps the client maintain a sense of​ identity, and gives the nurse insight into the client​'s behavior. It is not a matter of focusing on the positive​ aspects, exercising verbal​ ability, or providing entertainment.

A nurse makes the following​ statement, "Chinese people drink only hot​ tea, so don​'t put coffee on their trays. I know this because my last assignment was in San​ Francisco." The charge nurse identifies this remark as an example of which concept associated with​ culture? A. Ethnocentrism B. Prejudice C. Diversity D. Stereotyping

A. Ethnocentrism B. Prejudice C. Diversity ***D. Stereotyping Stereotyping is noted when a person assumes all members of a particular group have the same characteristics. This nurse is assuming all members of a group have the same eating habits. Ethnocentrism is the belief in the superiority of one​'s own culture and lifestyle. This nurse is making a generalization about a​ culture, not declaring the superiority of her own culture. Prejudice is a judgment about a​ person, place, or racial background that has no basis in knowledge. This nurse is making an assumption that all Chinese have the same traits. Diversity is a state of being different and occurs between and within cultural groups. It is not related to the statement this nurse made.

The nurse is caring for the client who is diagnosed with insomnia. The client reports drinking several cups of coffee each​ day, exercises less than once per​ week, and leaves the television on throughout the night. The healthcare provider prescribes a sleep aid. When providing the client​'s discharge​ teaching, what information is essential for the nurse to​ cover? A. Exercise habits B. Daily caffeine consumption C. Environmental distractions D. Medication side effects

A. Exercise habits B. Daily caffeine consumption C. Environmental distractions ***D. Medication side effects Nursing must implement interventions related to potential safety risks. Exercise​ habits, environmental​ distractions, and daily caffeine consumption are appropriate topics for inclusion in the​ client's discharge teaching.​ However, side effects of sleep aids often include residual drowsiness and​ somnolence, both of which can increase the​ client's risk for injury. As​ such, it is essential to teach the client about the side effects of the medication.

A family comes to the hospital for the father​'s preoperative visit. The nurse notes that the mother and children let the father answer all questions posed to family members. What should the nurse consider as she prepares the plan of care for this​ family? A. Family is showing​ self-disclosure B. Family has rigid flexibility C. Family is demonstrating diffuse boundaries D. Family is demonstrating resiliency

A. Family is showing​ self-disclosure ***B. Family has rigid flexibility C. Family is demonstrating diffuse boundaries D. Family is demonstrating resiliency The deferral of all family members to the father may indicate rigid family flexibility. A family with rigid flexibility demonstrates very low flexibility for change in the family​'s ​leadership, relationships, and rules. Low flexibility may impair the family​'s ​resiliency; its ability to respond productively to stress through adaptation and change during the father​'s illness and recovery. Family communication in high functioning families demonstrates​ self-disclosure in their communication​ patterns, where family members share personal feelings about themselves and others. Families with diffuse boundaries demonstrate very open contact with each other and outside systems. The nurse does not observe those behaviors in this family.

The nurse is caring for a hospitalized client who is experiencing​ anxiety-related hyperventilation. To account for the​ client's hyperventilation, when recording the​ client's fluid intake and​ output, the nurse should adjust the amount of fluid lost through which​ route? A. Feces B. Sweat C. Urine D. Insensible loss

A. Feces B. Sweat C. Urine ***D. Insensible loss With increased​ respirations, the client will experience a​ greater-than-normal insensible loss of fluid through the lungs. Hyperventilation will not affect the amount of fluid lost through the​ urine, sweat, or feces.

The community health nurse is speaking with a client about the functions of divisions or departments of health and human services at the​ federal, state, and local level. Which item should the nurse include in the​ discussion? A. Federal health departments usually manage the planning of medical facilities. B. County health departments generally oversee child care centers. C. Local departments of health and human services typically monitor clinical laboratories. D. Local departments of social services usually are responsible for administering Medicaid.

A. Federal health departments usually manage the planning of medical facilities. B. County health departments generally oversee child care centers. C. Local departments of health and human services typically monitor clinical laboratories. ***D. Local departments of social services usually are responsible for administering Medicaid. Local departments of social services usually are responsible for administering Medicaid. State divisions or departments of health and human services typically oversee clinical laboratories and child care centers. State divisions of health and health services are also responsible for overseeing the planning and construction of medical facilities.

The nurse is preparing to assess a client who is experiencing grief and loss. When the nurse enters the​ room, the client is on his knees at the end of the bed and sobbing "​Why, ​God, ​why?" What should the nurse include in the​ assessment? Select all that apply. A. Financial assessment B. Spiritual assessment C. Family assessment D. Community assessment E. Client assessment

A. Financial assessment B. Spiritual assessment ***C. Family assessment ***D. Community assessment ***E. Client assessment The nurse should conduct an assessment to determine available coping resources for the client. This usually includes a client​ assessment, a family​ assessment, and a community assessment. The client who is sobbing as he cries out to God may need a spiritual​ assessment, but a spiritual assessment is a part of the community assessment. A financial assessment is not a routine part of an assessment to determine a client​'s coping resources.

A staff nurse is upset to learn that several colleagues on the care area are leaving the organization. What can the nurse do to help reduce the number of nurses resigning from their current​ positions? A. Find out where the nurses are obtaining additional employment B. Discuss the work hours and schedules with the nurse manager C. Encourage students in the community to attend nursing school D. Research scholarships available to obtain further education

A. Find out where the nurses are obtaining additional employment ***B. Discuss the work hours and schedules with the nurse manager C. Encourage students in the community to attend nursing school D. Research scholarships available to obtain further education One effort to counteract the effects of the nursing shortage is to improve the environment for nurses such as providing flexibility with work hours. Finding out where the nurses are obtaining employment is not an action to reduce the number of nurses resigning from their current positions. Researching scholarships for nursing school and encouraging students in the community to attend nursing school are actions to reduce the nursing​ shortage; however they will not help reduce the number of nurses resigning from their current positions.

Which client health problem would benefit the most from case​ management? A. Fractured leg B. Chronic lung disease C. Minor orthopedic surgery D. Peptic ulcer

A. Fractured leg ***B. Chronic lung disease C. Minor orthopedic surgery D. Peptic ulcer Clients who receive the greatest benefit from managed care usually are those with chronic health​ alterations, such as chronic​ lung, heart, or neurological health conditions. Minor orthopedic​ surgery, peptic​ ulcer, and limb fractures are not considered chronic health conditions.

The nurse is caring for the client who is diagnosed with a​ sleep-rest disorder. When reviewing the​ client's medication administration record​ (MAR), which drug is used to treat​ narcolepsy? A. Gabapentin enacarbil​ (Horizant) B. Modafinil​ (Provigil) C. Zolpidem​ (Ambien) D. Pramipexole dihydrochloride​ (Mirapex)

A. Gabapentin enacarbil​ (Horizant) B. Modafinil​ (Provigil) C. Zolpidem​ (Ambien) D. Pramipexole dihydrochloride​ (Mirapex) Modafinil​ (Provigil), which is a CNS​ stimulant, may be ordered by the prescribing healthcare provider for clients who are diagnosed with narcolepsy or obstructive sleep apnea. Medications that may be ordered for clients who experience restless leg syndrome include the antiparkinson agent pramipexole dihydrochloride​ (Mirapex) and the anticonvusant medication gabapentin enacarbil​ (Horizant). Zolpidem​ (Ambien) is an anxiolytic medication that may be prescribed as a​ short-term treatment for clients who experience insomnia.

The nurse is assessing an older adult client with a history of cardiovascular disease who complains of "feeling sad and down." Which factors may be contributing to the client​'s ​symptoms? ​(Select all that​ apply.) A. Gait problems B. Major illness C. Isolation D. Response to palliative care services E. Increased risk of falls

A. Gait problems ***B. Major illness ***C. Isolation D. Response to palliative care services E. Increased risk of falls Major illness and isolation are both factors that may contribute to the older​ client's complaints of sadness or depression. Gait​ problems, responses to palliative care​ services, and increased risk for falls may contribute to feeling inadequate to ambulate or perform daily​ self-care tasks.

During a​ check-up, the nurse notes that the client has reached physical growth milestones but has not achieved cognitive developmental milestones. Other than developmental​ disorders, what else should the nurse​ consider? A. Genetic abnormalities B. Child temperament C. Parental interaction D. Cerebral palsy

A. Genetic abnormalities B. Child temperament ***C. Parental interaction D. Cerebral palsy Family is an important environmental factor that plays an essential role in child development. Parenting influences risk and protective​ factors, personality​ characteristics, and developmental outcomes. Cerebral palsy is a physical disability. Genetic abnormalities would typically impact both growth and development. Child temperament is not a known factor that would impact the ability to achieve cognitive developmental milestones.

The nurse is caring for a​ 10-year-old client diagnosed with diabetes mellitus. Which assessment findings for this client and family members are teaching opportunities for the​ nurse? ​(Select all that​ apply.) A. Genogram B. Parental structuring C. ​Poverty-related stress D. Family members with BMI above 30 E. Family history of diabetes

A. Genogram B. Parental structuring ***C. ​Poverty-related stress ***D. Family members with BMI above 30 ***E. Family history of diabetes A family with a history of​ diabetes, body mass indices above 30​ (indicates obesity), that is experiencing​ poverty-related stress needs education from the nurse about nutrition and its relationship to​ disease, as well as referrals to community resources that may be able to assist the family with needed​ food, medical​ care, and financial assistance. Parental​ structuring, an aspect of emotional​ availability, is the ability of parents to support the child​'s learning and inquiries without overwhelming the child​'s autonomy. A genogram is a map of​ gender, showing lines of descent through the generations of a family.

A client has a long list of health protection needs. A parish nurse can provide some of the education but thinks that the client would benefit greatly from collaborative interventions. Which of the following interventions is​ collaborative? A. Giving the family​ in-person counseling B. Scheduling a visit with a nutritionist C. Handing the client a "Choose My Plate" brochure D. Providing individual telephone counseling

A. Giving the family​ in-person counseling ***B. Scheduling a visit with a nutritionist C. Handing the client a "Choose My Plate" brochure D. Providing individual telephone counseling Scheduling a visit with a nutritionist is a collaborative intervention. The other interventions are independent interventions.

The nurse has been determining a method of communicating with a client recovering from a stroke. Which client observation indicates that an effective communication method has been​ established? A. Groaning to get the nurse​'s attention B. Spelling words on a bedside table using tiled letters C. Slapping the nurse​'s hand to refuse an action D. Holding a pen to write on paper

A. Groaning to get the nurse​'s attention ***B. Spelling words on a bedside table using tiled letters C. Slapping the nurse​'s hand to refuse an action D. Holding a pen to write on paper The client using letters to spell words on a bedside table demonstrates that an effective communication method has been established. Groaning and slapping hands are not effective communication methods. Trying to use a paper and pen to write might be premature for this client and does not indicate that an effective communication method has been established.

A school nurse is creating a task force to identify ways to reduce the risk of head injuries when students participate in​ school-sponsored activities. Which school employees are most appropriate for the nurse to recommend as members of this task force because of the high risk for head injuries for the students they​ supervise? ​(Select all that​ apply.) A. Gymnastics coach B. Marching band instructor C. Football coach D. Soccer coach E. Wrestling coach

A. Gymnastics coach B. Marching band instructor ***C. Football coach ***D. Soccer coach ***E. Wrestling coach Sports that have the highest risk for head injuries include​ football, soccer, and wrestling. The​ football, soccer, and wrestling coaches should be members of the task force. Although there may be a risk for head injuries for students who participate in marching band or​ gymnastics, these employees would not need to be members of the task force because the risk for their students is significantly lower.

Jose Cardena is a​ 48-year-old warehouse worker who has been admitted to the cardiology unit because of chest pain. He has a strong family history of heart attacks before age 50. You are the nurse manager on the cardiology​ unit, and Jose tells you that he​ "can load a pallet faster than men half my​ age." He and his wife Trina are expecting their first grandchild in 3​ months, and Jose is already thinking about names for the new baby. His doctor has advised him to begin a program of regular​ exercise, but Jose counters that he does not need to do​ that, saying​ "I'm already​ strong!" Which of​ Jose's behaviors may indicate unclear​ values? A. Having a family history of heart disease B. Ignoring his​ doctor's advice to exercise regularly C. Looking forward to the birth of his grandchild D. Loading a pallet faster than anyone else

A. Having a family history of heart disease ***B. Ignoring his​ doctor's advice to exercise regularly C. Looking forward to the birth of his grandchild D. Loading a pallet faster than anyone else ​Jose's ignoring his​ doctor's advice to exercise regularly may indicate unclear values. Looking forward to the birth of his grandchild is a clear family value. Having a family history of heart disease is a genetic​ risk, not a behavior. Loading a palette quickly is a career value.

The nurse is providing home care instructions to a client with chronic pain. Which items are appropriate for the nurse to include in the teaching​ session? ​(Select all that​ apply.) A. Having resuscitation equipment ready for​ use, if necessary B. Maintaining adequate hydration C. Eating a balanced diet D. Administering pain medications by the intramuscular​ (IM) route E. Using assistive devices

A. Having resuscitation equipment ready for​ use, if necessary ***B. Maintaining adequate hydration ***C. Eating a balanced diet D. Administering pain medications by the intramuscular​ (IM) route ***E. Using assistive devices Appropriate home care instructions for the nurse to provide a client with chronic pain include maintaining adequate​ hydration, eating a balanced​ diet, and appropriate use of assistive devices. The nurse would not provide instruction on administering intramuscular pain medications or having resuscitative equipment ready for use for a client being discharged home.

Which is a core belief about health in​ non-Western cultures? A. Health is an attribute of youth. B. Health is the absence of disease. C. Health is the strength to do anything you want. D. Health is a state of harmony that encompasses​ mind, body, and spirit.

A. Health is an attribute of youth. B. Health is the absence of disease. C. Health is the strength to do anything you want. ***D. Health is a state of harmony that encompasses​ mind, body, and spirit. ​Non-Western cultures view health as a harmonious state. Western society sees health as the absence of disease. Other views of health are more individual.

Before leaving a​ room, Tiffany Wilson assists her client by moving his​ pillows, adjusting the side​ rails, securing the call​ light, and providing water. Which concept related to accountability is Tiffany implementing when performing these​ actions? A. Health policy B. Teaching and learning C. Comfort D. ​Evidence-based practice

A. Health policy B. Teaching and learning ***C. Comfort D. ​Evidence-based practice The concept of accountability cannot stand alone but rather is closely associated with all of the concepts. With​ comfort, the nurse is accountable for managing the​ client's pain and providing other interventions to ensure comfort for the client such as adjusting​ pillows, adjusting side​ rails, securing the call​ light, and providing​ water, glasses, and reading material. There is no evidence to support that the nurse was instructing the client.​ Evidence-based practice is the use of interventions validated through research. Health policy refers to the actions and decisions by government bodies and professional organizations that affect achievement of healthcare goals.

Prior to discharging a client who has recently been diagnosed with​ asthma, the nurse plans to teach the client about health restoration. Which topic is most appropriate for inclusion in the​ teaching? A. Health screenings B. First aid C. Protective health measures D. Medication administration and side effects

A. Health screenings B. First aid C. Protective health measures ***D. Medication administration and side effects The topic of medication administration and side effects falls within the category of health restoration. Health​ screenings, protective health​ measures, and first aid reflect topics included in the category of illness and injury prevention.

The nurse is monitoring the fluid and electrolyte status of a client receiving intravenous colloids. The nurse understands that it is priority to monitor the client for manifestations of which​ imbalance? A. Hyperkalemia B. Fluid overload C. Fluid deficit D. Hypernatremia

A. Hyperkalemia ***B. Fluid overload C. Fluid deficit D. Hypernatremia The client receiving intravenous​ (IV) colloids or any IV fluid is at risk for fluid overload. It is therefore important to monitor the client for manifestations of fluid overload. Fluid​ deficit, hyperkalemia, and hypernatremia do not typically result when infusing colloids.

Nurses taking care of clients experiencing pain should understand that the acute pain stimulates the adrenergic nervous​ system, which will result in which physiologic​ change? A. Hypotension B. Bradycardia C. Pupil constriction D. Increased perspiration

A. Hypotension B. Bradycardia C. Pupil constriction ***D. Increased perspiration Acute pain stimulates the adrenergic nervous system and results in physiologic​ changes, including​ tachycardia, tachypnea,​ hypertension, pupil​ dilation, pallor, increased​ perspiration, and increased secretion of catecholamine and adrenocorticoid hormones.

The nurse is providing care to a client diagnosed with urinary retention. Which medication on the​ client's medical administration record would the nurse question for this​ client? A. Ibuprofen B. Diphenhydramine hydrochloride C. Acetaminophen D. Bethanechol chloride

A. Ibuprofen ***B. Diphenhydramine hydrochloride C. Acetaminophen D. Bethanechol chloride The nurse would question the use of an​ antihistamine, such as diphenhydramine​ hydrocholoride, for a client with urinary retention. Bethanechol chloride is a medication used to treat urinary retention. Aceteminophen and ibuprofen can be administered safely for a client with urinary retention.

What is not a benefit of electronic medical​ records? A. Identifying the need for mammograms B. Identifying the need for vaccines C. Notifying clients of upcoming appointments D. Tracking client data over time

A. Identifying the need for mammograms B. Identifying the need for vaccines ***C. Notifying clients of upcoming appointments D. Tracking client data over time Tracking client data over​ time, identifying the need for​ vaccines, and identifying the need for mammograms are all benefits of electronic medical records. Notifying clients of upcoming appointments is not a benefit of electronic medical records.

The nurse is performing an assessment on an adult client diagnosed with obesity. Which psychological factors must the nurse consider when interpreting the client​'s assessment​ findings? ​(Select all that​ apply.) A. Impaired mobility B. Impaired​ self-esteem C. Stress level D. Emotional​ well-being E. Exercise frequency

A. Impaired mobility ***B. Impaired​ self-esteem ***C. Stress level ***D. Emotional​ well-being E. Exercise frequency When interpreting findings from a health​ assessment, the nurse must consider psychological and emotional factors that can contribute to physiological health. Psychological and emotional factors include alterations of​ stress, emotional​ well-being, and impaired​ self-esteem. These items may interfere with the​ client's ability to accomplish necessary health practices. Impaired mobility and frequency of exercise are​ physical, not​ psychological, factors to consider.

A nurse wrote about a client​'s ​progress, "Even though the client started recording everything she ate in a food​ diary, the client​'s weight increased by 2 lbs. this week." Which phase of the nursing process does this statement​ exemplify? A. Implementation B. Planning C. Evaluation D. Assessment

A. Implementation B. Planning ***C. Evaluation D. Assessment A statement about the client​'s ​outcome, even if the goal is not​ reached, is part of the evaluation phase. The other phases precede it.

The nurse manager is preparing a report of staffing needs. What demographic trends could the nurse describe that are expected to produce a high demand for healthcare​ expertise? ​(Select all that​ apply.) A. Increasing ethnic diversity B. Lack of primary care providers C. Lack of specialists D. More​ long-term illnesses E. Increasing racial diversity

A. Increasing ethnic diversity ***B. Lack of primary care providers C. Lack of specialists ***D. More​ long-term illnesses E. Increasing racial diversity More​ long-term illnesses and lack of primary care providers are expected to produce a high demand for healthcare expertise. Although increasing racial and ethnic diversity is​ expected, those factors do not affect the demand for healthcare expertise. There is no predicted lack of specialists.

During a​ checkup, a pregnant client reports urinary incontinence. Which teaching topic is the most appropriate for the nurse to provide for this​ client? A. Increasing fluid intake B. Avoiding alcohol C. Performing Kegel exercises D. Consuming more fiber

A. Increasing fluid intake B. Avoiding alcohol ***C. Performing Kegel exercises D. Consuming more fiber Kegel exercises may help pregnant women maintain urinary muscle strength and prevent incontinence. Alcohol should be avoided during​ pregnancy, but abstinence will not address the concern of incontinence. Consuming fiber is an appropriate topic for a client experiencing constipation. Increasing fluid intake will not help a client with urinary incontinence.

The nurse is caring for a client who is receiving oxygen. Which intervention is appropriate by the​ nurse? A. Increasing the flow if the client requests B. Ensuring the client is comfortable with the manner of administration C. Suctioning upper airways each shift D. Assessing the client for anxiety

A. Increasing the flow if the client requests ***B. Ensuring the client is comfortable with the manner of administration C. Suctioning upper airways each shift D. Assessing the client for anxiety The nurse ensures that the client is comfortable with the manner in which the oxygen is being administered. There are several choices and the client should be consulted in terms of which method is most comfortable. The nurse should not increase the flow of oxygen at the​ client's request, as the flow is prescribed by the healthcare provider. Clients who are prescribed oxygen are at risk for depression not anxiety. Suctioning the upper airway should only be done as​ required, if at all.

A nurse is caring for an older adult who requests a sleep aid in order to fall asleep. The nurse understands that older adults may have a different reaction to this class of medication than others. Which reaction will the nurse monitor for in this​ client? A. Inflammatory reaction B. Heightened effect C. Paradoxical reaction D. Hepatotoxicity

A. Inflammatory reaction B. Heightened effect ***C. Paradoxical reaction D. Hepatotoxicity The older adult may have a paradoxical reaction to a sleep aid. The other choices are incorrect.

A public health nurse is planning an outreach to residents of subsidized housing. The nurse hopes to invite key members of the housing council to look at their own individual health issues. Which type of health promotion program is​ this? A. Information dissemination B. Behavior change C. Environmental control ​D. Health-risk appraisal

A. Information dissemination B. Behavior change C. Environmental control ​***D. Health-risk appraisal Because the nurse hopes to help clients look at their own individual health​ issues, this is a​ health-risk appraisal program. It is not information​ dissemination, which gives information to the general public. Because the appraisal has not been done​ yet, the program is not about lifestyle and behavior changes. The program is about​ individuals, not about control of the environment.

The primary nurse is coordinating care for a newly admitted client. Which nursing actions are appropriate when planning this​ client's care? ​(Select all that​ apply.) A. Initiate consultations with other health care providers B. Suggest appropriate referrals for the​ client's care C. Obtain orders for referrals and consultations from the health care provider D. Select appropriate critical pathways for the client E. Identify applicable​ evidence-based practice guidelines for the​ client's care

A. Initiate consultations with other health care providers B. Suggest appropriate referrals for the​ client's care C. Obtain orders for referrals and consultations from the health care provider ***D. Select appropriate critical pathways for the client ***E. Identify applicable​ evidence-based practice guidelines for the​ client's care In the planning phase of care​ coordination, the nurse should utilize standard​ protocols, or critical​ pathways, and​ evidence-based guidelines, prepare the care plan in consultation with the​ client, and make the care plan the framework for care coordination. Initiating​ consultations, suggesting​ referrals, and obtaining orders for consultations and referrals from the health care provider are actions that occur during the implementation phase of care coordination.

Mrs. Donna​ Hurlon, a​ 39-year-old client, has returned to the hospital for the fourth time for surgery after a horrific automobile accident. When the nurse manager greeted her 4 days after​ admission, Mrs. Hurlon​ remarked, "Things seem to have changed since my last time here. The same nurse now comes back to take care of me all the​ time." Which model of nursing care delivery would be likely to cause this continuity of​ care? A. Inspirational nursing B. Primary nursing C. Functional nursing D. Team nursing

A. Inspirational nursing ***B. Primary nursing C. Functional nursing D. Team nursing In the primary nursing​ model, a single nurse takes responsibility for the care of each client. This contributes to continuity of care. This feature is not found in team or functional nursing. There is no model on nursing care delivery called inspirational nursing.

When caring for an older adult​ client, what collaborative therapy is utilized in the management of fecal​ impaction? (Select all that​ apply.) A. Intake of cold​ drinks, especially before the usual time of defecation B. Saline enemas C. Digital removal of the impaction D. Intake of​ high-residue foods with decreased fluids E. Bowel training program

A. Intake of cold​ drinks, especially before the usual time of defecation B. Saline enemas ***C. Digital removal of the impaction D. Intake of​ high-residue foods with decreased fluids ***E. Bowel training program For clients with fecal​ impactions, bowel training programs may be helpful. Digital removal of the impaction can be accomplished with administration of an oil retention enema 30 minutes prior to the​ disimpaction, followed by cleansing enemas as indicated. The intake of hot​ drinks, not​ cold, just before defecation is helpful.​ High-residue foods will increase bulk in the colon.​ High-fiber content foods should be consumed.​ High-residue foods and decreased fluid intake will increase the amount of stool in the colon.

A nurse is considering the delegation of administering medications to an unskilled assistant. What is the first question the nurse must ask herself before doing so? A. Is appropriate supervision available? B. Has the assistant been trained to perform the task? C. Have I evaluated the patient's response to this task? D. Is the delegated task permitted by law?

A. Is appropriate supervision available? B. Has the assistant been trained to perform the task? C. Have I evaluated the patient's response to this task? ***D. Is the delegated task permitted by law? The first question the nurse should always ask of him- or herself before delegating a task is "is the delegated task permitted by law?" In this case, it would not be, and the task (administering medications) would not be delegated.

An experienced nurse is mentoring the new graduate. They talk about how exciting it was to see a successful Heimlich maneuver performed by a nursing colleague. How did that event promote the image of​ nursing? A. It demonstrated nursing​'s attitudes. B. It demonstrated nursing​'s boundaries. C. It demonstrated nursing​'s values. D. It demonstrated nursing​'s skills.

A. It demonstrated nursing​'s attitudes. B. It demonstrated nursing​'s boundaries. C. It demonstrated nursing​'s values. ***D. It demonstrated nursing​'s skills. Resuscitation is an example of demonstrating​ nursing's skills. It is not a matter of values or​ attitudes; it is a practiced action. Resuscitation does not have a connection with boundaries.

A student nurse must understand the importance of providing safe nursing care consistent with legal requirements. Which statements are true regarding nursing​ negligence? ​(Select all that​ apply.) A. It is considered an intentional tort. B. It is defined as conduct deviating from the standard of practice dictated by the profession. C. It is defined as conduct that deviates from what a reasonable individual would do in a particular circumstance. D. It is considered an unintentional tort. E. It occurs without the deliberate intent to bring harm against another individual.

A. It is considered an intentional tort. B. It is defined as conduct deviating from the standard of practice dictated by the profession. ***C. It is defined as conduct that deviates from what a reasonable individual would do in a particular circumstance. ***D. It is considered an unintentional tort. ***E. It occurs without the deliberate intent to bring harm against another individual. Negligence is defined as conduct that deviates from what a reasonable individual would do in a particular circumstance and is considered an unintentional tort. Negligence occurs without the deliberate intent to bring harm against another individual. Malpractice is defined as conduct deviating from the standard of practice dictated by the profession.

The nurse telephones a health insurance carrier to discuss covering an electric wheelchair for a client with a spinal cord injury. Which barrier of care coordination is the nurse attempting to​ overcome? A. Knowledge deficit B. Limited resources C. ​Non-adherence to the plan of care D. Caregiver reluctance

A. Knowledge deficit ***B. Limited resources C. ​Non-adherence to the plan of care D. Caregiver reluctance To overcome the barrier of limited​ resources, the nurse may discuss covering the resource with the​ client's insurance carrier. A strategy to overcome​ non-adherence to the plan of care would be to identify alternatives to overcome reasons for not following the plan of care. The health insurance carrier would not be involved in this process. To address a knowledge​ deficit, the nurse would provide additional teaching to help the client comprehend instructions. Caregiver reluctance may impact care​ delivery, but it is not a barrier to care coordination.

What organizations have embraced the use of care​ coordination? ​(Select all that​ apply.) A. La Leche League B. National League of Nurses C. American Nurses Association D. Centers for Medicare and Medicaid Services E. American Medical Association

A. La Leche League B. National League of Nurses ***C. American Nurses Association ***D. Centers for Medicare and Medicaid Services E. American Medical Association The Centers for Medicare and Medicaid Services​ (CMS) and the American Nurses Association​ (ANA) have both embraced the use of care coordination. The CMS considers care coordination as reimbursable due to its ability to reduce rehospitalization​ rates, and the ANA identifies several positive results related to the implementation of care coordination. The American Medical​ Association, the National League of​ Nurses, and La Leche League have not specifically embraced the use of care coordination.

The nurse is reviewing the medical records of several clients. Which condition may have been revealed by genetic testing prior to​ conception? A. Learning disability B. Schizophrenia C. Fetal alcohol syndrome D. Fragile X syndrome

A. Learning disability B. Schizophrenia C. Fetal alcohol syndrome ***D. Fragile X syndrome Fetal alcohol syndrome is not a genetically linked disorder. Although there are genetic associations with learning disabilities and​ schizophrenia, there is no known testable genetic cause. Fragile X syndrome is caused by an abnormal X chromosome.

The nurse is caring for a​ 7-year-old child diagnosed with type 1 diabetes. The client is the only child in a​ two-parent nuclear family. The parents of this client would most likely be working on which developmental tasks in the family life​ cycle? ​(Select all that​ apply.) A. Learning to manage parental tasks B. Looking to retirement C. Managing external influences of friends D. Managing increased time commitments E. Being involved in child​'s ​sports, school, or clubs

A. Learning to manage parental tasks B. Looking to retirement ***C. Managing external influences of friends ***D. Managing increased time commitments ***E. Being involved in child​'s ​sports, school, or clubs The parents of a​ 7-year-old child would be working through Stage IV​ (family with​ school-age children). Developmental tasks at this stage of family development are facilitating peer​ relations, and maintaining family dynamics while adjusting to outside influences. At this stage of family​ development, parents are involved with​ school-related activities,​ sports, and​ clubs, and managing external influences of friends. Learning to manage parenting tasks and responsibilities occurs in Stage II​ (childbearing). Looking to retirement occurs in Stage VII​ (middle-aged parents).

During a recent community survey on local swimming​ pools, the public health nurse becomes concerned about the risk of​ water-related injuries for community members. Which survey result led the public health nurse to have this​ concern? A. Life preservers available at each pool side B. Life guard classes occurring at the community pool C. Home swimming pools lacking​ four-sided barriers ​D. School-age children swimming with several adults in attendance

A. Life preservers available at each pool side B. Life guard classes occurring at the community pool ***C. Home swimming pools lacking​ four-sided barriers ​D. School-age children swimming with several adults in attendance The risk of​ water-related injuries is greater when home swimming pools do not have​ four-sided barriers. The presence of life​ preservers, lifeguard​ classes, and adults in attendance while children are in water or swimming pools would prevent​ water-related injuries.

The nurse is caring for a child experiencing altered bowel elimination. What collaborative therapy could be implemented with a child who has​ encopresis? (Select all that​ apply.) A. Limit fluid intake B. Pharmacologic treatment of constipation C. Collaboration with school nurses and teachers D. Psychological treatment E. Behavioral modification

A. Limit fluid intake ***B. Pharmacologic treatment of constipation ***C. Collaboration with school nurses and teachers ***D. Psychological treatment ***E. Behavioral modification Appropriate therapies include psychological​ treatment, collaboration with school nurses and​ teachers, pharmacologic treatment of​ constipation, a​ high- fiber​ diet, and behavioral modification. A client experiencing encopresis should drink 6dash-8 glasses of fluid per day.

An older adult is admitted to the hospital for multiple health problems. Assessment reveals that the patient has no teeth and is having difficulty eating. Which diet should the nurse encourage the primary health-care provider to order for this patient? A. Liquid B. Mechanical soft C. Pureed D. Soft

A. Liquid ***B. Mechanical soft C. Pureed D. Soft A mechanical soft diet is modified only in texture. It includes moist foods that require minimal chewing and eliminates most raw fruits and vegetables and foods containing seeds, nuts, and dried fruit.

A nurse is caring for a client who reports chronic fatigue. Which diagnostic lab or imaging test aids in determining whether the​ client's fatigue is caused by an underlying biological​ factor? A. Magnetic resonance imaging​ (MRI) B. Hematocrit and hemoglobin tests C. White blood cell count​ (WBC) D. Chemistry panel

A. Magnetic resonance imaging​ (MRI) ***B. Hematocrit and hemoglobin tests C. White blood cell count​ (WBC) D. Chemistry panel Hematocrit and hemoglobin lab tests will determine whether the client has​ iron-deficiency anemia, leading to fatigue. While the client may have the additional tests​ performed, these tests do not help to determine the cause of the​ client's fatigue.

A nurse is caring for a patients with a variety of nutrition-related problems. Which problem eventually may require a patient to have a nasogastric feeding tube inserted? A. Malabsorption in the small intestines B. Difficulty swallowing C. Nausea and vomiting D. Mouth ulcerations

A. Malabsorption in the small intestines ***B. Difficulty swallowing C. Nausea and vomiting D. Mouth ulcerations

The nurse is evaluating outcomes of care for a client from a​ non-American culture who dies in the hospital. Which outcome indicates that the client received culturally competent​ care? A. Medals and bracelets were removed from the client after death B. The client received care by the family after death C. The client was bathed by the nurse after death D. The client was placed on a stretcher and covered with a clean sheet after death

A. Medals and bracelets were removed from the client after death ***B. The client received care by the family after death C. The client was bathed by the nurse after death D. The client was placed on a stretcher and covered with a clean sheet after death The care of the body after death may vary according to the​ client's culture. In some​ cultures, the family washes the body after death. In​ others, items are placed with the body. Nurses must ensure that the​ clients' cultural needs are addressed to the best of their abilities. Evidence that the client received culturally competent care is the body being bathed by the family after death. The nurse bathing the body could violate a cultural action. Removing medals and bracelets after death could violate a cultural action. Moving the client to a stretcher and covering with a sheet could violate a cultural action.

The nurse is discussing Medicaid health coverage with a client. Which information should be​ included? A. Medicaid provides cash for basic​ needs, such as​ food, housing, and clothing. B. Medicaid coverage does not include the client​'s home health services. C. Medicaid reimbursement does not cover costs related to transportation to medical care. D. Medicaid is available to eligible​ individuals, families, the​ elderly, and individuals with disabilities.

A. Medicaid provides cash for basic​ needs, such as​ food, housing, and clothing. B. Medicaid coverage does not include the client​'s home health services. C. Medicaid reimbursement does not cover costs related to transportation to medical care. ***D. Medicaid is available to eligible​ individuals, families, the​ elderly, and individuals with disabilities. Medicaid is a​ state-administered program that is available to certain lower income individuals and​ families, the​ elderly, and people with disabilities who meet the eligibility requirements set by federal and state law. Federal laws require Medicaid to cover certain​ services, including physician​ services, inpatient and outpatient hospital​ care, home health​ services, and transportation to medical care. Social security income​ (SSI) provides cash for basic needs such as​ food, housing, and clothing.

The nurse wants to provide culturally competent care to a client who lives on a​ long-term care unit. Which activities are appropriate for the nurse to​ implement? ​(Select all that​ apply.) A. Memorizing which foods members of each culture eat to restore health B. Educating the client about the U.S. health care system C. Asking the client where he or she thinks illness originates D. Seeking to understand one​'s own​ culture, its​ beliefs, and its assumptions E. Asking the client and his or her family how the illness affects them

A. Memorizing which foods members of each culture eat to restore health B. Educating the client about the U.S. health care system ***C. Asking the client where he or she thinks illness originates ***D. Seeking to understand one​'s own​ culture, its​ beliefs, and its assumptions ***E. Asking the client and his or her family how the illness affects them To provide culturally competent​ care, the nurse must first understand his or her own​ culture, its​ beliefs, and its assumptions. To assist in evaluating a client​'s ​culture, the nurse should ask certain questions to understand the client​'s beliefs. Asking where the client thinks his or her illness comes from will help the nurse understand illness from the client​'s perspective. Not all members of a culture eat the same thing. Memorizing stereotypes will not help the nurse to provide culturally competent care. Educating the client about the U.S. health care system does not help the nurse in providing culturally competent care.

Which religions have a rule about not eating​ pork? ​(Select all that​ apply.) A. Methodism B. Islam C. Mormonism D. Roman Catholicism E. Orthodox Judaism

A. Methodism ***B. Islam C. Mormonism D. Roman Catholicism ***E. Orthodox Judaism Both Orthodox Jews and Muslims are prohibited from eating pork. That is not true of​ Mormons, Roman​ Catholics, or Methodists.

A nurse is documenting client protected health information​ (PHI) at a point of care computer terminal in the client​'s room. Keeping in mind that the client​'s room is​ private, which action by the nurse is acceptable regarding protecting the client​'s PHI once the nurse leaves the client​'s ​room? A. Minimizing the client​'s PHI on the screen but remaining logged in B. Exiting out of the client​'s PHI but remaining logged in C. Exiting out of the client​'s PHI and logging off D. Remaining logged in to the computer because the client's room is private

A. Minimizing the client​'s PHI on the screen but remaining logged in B. Exiting out of the client​'s PHI but remaining logged in ***C. Exiting out of the client​'s PHI and logging off D. Remaining logged in to the computer because the client's room is private To best protect the​ client's PHI, the nurse must exit out of the​ client's PHI and log off of the​ computer, regardless of the degree of privacy of the​ client's room.

During a​ follow-up visit, the nurse learns that a client is not adhering to the agreed upon plan of care. What outcome should the nurse expect for this client​'s ​care? A. Missing a scheduled appointment B. Misinterpretation of teaching C. Misunderstanding of the care plan D. Exacerbation of the health problem

A. Missing a scheduled appointment B. Misinterpretation of teaching C. Misunderstanding of the care plan ***D. Exacerbation of the health problem If the client is not adhering to the​ plan, the client is at risk for​ re-hospitalization or exacerbation of the health alteration. Limited access to resources may hinder client progress in the form of missing scheduled appointments or not understanding the plan of care. A client with deficient knowledge may not comprehend information provided during a teaching session.

During a visit to the home of a new​ mother, the nurse is concerned that the newborn is cold. What did the nurse observe to cause this​ concern? A. Mother rinsing hands with warm water before picking the child up from the crib B. Child wearing a hat before being taken outside for a walk in the stroller C. Child lying in a bassinette without a blanket in an air conditioned room D. Mother covering the child with a towel after providing a morning bath

A. Mother rinsing hands with warm water before picking the child up from the crib B. Child wearing a hat before being taken outside for a walk in the stroller ***C. Child lying in a bassinette without a blanket in an air conditioned room D. Mother covering the child with a towel after providing a morning bath Infants are influenced by environmental temperature. If the baby is lying in an​ air-conditioned room without a​ blanket, the​ child's temperature will fall. Covering the baby with a towel after a bath will keep the baby warm. Wearing a hat will keep the baby warm. Warming hands before picking up the baby will not cause the child to become cold.

The nurse is caring for a client who has cerebral palsy. Which independent intervention is appropriate for the nurse to​ provide? A. Muscle relaxants should be prescribed to control spasms. B. Mood stabilizers should be prescribed to control seizures. C. ​Range-of-motion (ROM) exercises should be used to promote flexibility and prevent contracture formation. D. Speech therapy should be provided to promote communication.

A. Muscle relaxants should be prescribed to control spasms. B. Mood stabilizers should be prescribed to control seizures. ***C. ​Range-of-motion (ROM) exercises should be used to promote flexibility and prevent contracture formation. D. Speech therapy should be provided to promote communication. The nurse should assist the client in​ range-of-motion (ROM) exercises to promote flexibility and prevent contracture formation.​ Additionally, the nurse can provide the family​ and/or caregiver information about injury prevention and the creation of a safe home​ environment, as well as information on support and financial aid services. Nurses cannot provide speech therapy or prescribe muscle relaxants or mood stabilizers.

Which organization mandates that each client admitted to an institution be assessed for spiritual beliefs and​ practices? A. National Council of Churches B. American Nurses Association C. Nursing Outcomes Classification Project D. The Joint Commission

A. National Council of Churches B. American Nurses Association C. Nursing Outcomes Classification Project ***D. The Joint Commission The Joint Commission mandates that each client admitted to an institution be assessed for spiritual beliefs and practices. That is not the agenda of any of the other organizations.

The nurse is caring for a client at risk for urinary retention. Which clinical manifestations does the nurse document during the nursing assessment to support this​ diagnosis? A. Nausea and vomiting B. Hematuria C. Overflow voiding D. Cool and clammy skin

A. Nausea and vomiting B. Hematuria ***C. Overflow voiding D. Cool and clammy skin The nurse should monitor the client for overflow voiding. This is a manifestation associated with urinary retention.​ Cool, clammy​ skin, nausea and​ vomiting, and hematuria are not manifestations associated with urinary retention.

During a health history interview with a​ family, the nurse is concerned that a​ 12-year-old client is experiencing signs of grief reaction. What information from the family would cause the nurse to suspect this​ condition? A. Nurse observes listening and​ self-disclosure. B. Nurse observes a family alteration. C. Nurse observes structured family flexibility. D. Nurse observes changes in physical health status.

A. Nurse observes listening and​ self-disclosure. ***B. Nurse observes a family alteration. C. Nurse observes structured family flexibility. D. Nurse observes changes in physical health status. An alteration in the​ family, loss of a family member because of death or​ divorce, could result in a grief​ reaction, which could manifest in the interview as​ depression, anger, or anxiety. Communication patterns that include family members​ listening, speaking,​ self-disclosing, and​ tracking, and family flexibility are characteristic of high functioning families. Grief may manifest in weight​ loss, headaches, sleeplessness and other​ symptoms, but the nurse would observe that after the health history​ interview, during the physical examination of family members that would follow.

Which of the following statements accurately describe cultural factors that may influence healthcare? Select all that apply. A. Nurses and patients generally agree upon the health practices that are being instituted. B. In many cultures, the man is the dominant figure and generally makes decisions for all family members. C. Most mental health norms are based on research and observations made of white, middle-class people. D. Although pain affects people differently, most people react to pain in the same manner. E. When people move to the United States, they may speak their own language fluently but have difficulty speaking English. F. Certain racial and ethnic groups are more prone to developing specific diseases and conditions.

A. Nurses and patients generally agree upon the health practices that are being instituted. ***B. In many cultures, the man is the dominant figure and generally makes decisions for all family members. ***C. Most mental health norms are based on research and observations made of white, middle-class people. D. Although pain affects people differently, most people react to pain in the same manner. ***E. When people move to the United States, they may speak their own language fluently but have difficulty speaking English. ***F. Certain racial and ethnic groups are more prone to developing specific diseases and conditions. Nurses and patients do not always agree on health practices; what seems logical to the nurse, may seem ridiculous to the patient and vice versa. Various studies have shown that certain racial and ethnic groups are more prone to developing specific diseases and conditions. People react differently to pain based on their cultural experiences. Most mental health norms are based on research and observations made of white, middle-class people. Many ethnic groups have their own norms or acceptable patterns of behavior for psychological well-being and normal psychological reactions to certain situations. In many cultures, the man is the dominant figure and generally makes decisions for all family members, including healthcare decisions. When people from another part of the world move to the United States, they may speak their own language fluently but have difficulty speaking English.

Which is a barrier to care​ coordination? A. Nursing assistant scheduled for afternoon shift calls off from work B. Client​'s abdominal wound becomes infected after surgery C. Client does not have transportation to attend​ out-patient physical therapy D. Prescribed dose of medication delayed in arriving from the pharmacy

A. Nursing assistant scheduled for afternoon shift calls off from work B. Client​'s abdominal wound becomes infected after surgery ***C. Client does not have transportation to attend​ out-patient physical therapy D. Prescribed dose of medication delayed in arriving from the pharmacy Limited access to resources such as a lack of transportation is a barrier to care coordination. A change in a client​'s ​condition, a staff member calling out​ sick, or a delay in medication administration are not barriers to care coordination.

A client is brought into the emergency department​ (ED) with slurred speech and right sided weakness. The client is diagnosed with a stroke. Which documented assessment finding is considered secondary objective​ data? A. Nursing note states​ "Client's husband reports that she​ fell." B. Client​ states, "I had a headache and​ fell." C. Transfer note from the clinic​ states, "Client presented in the clinic with a BP of​ 174/94 mmHg. Client transported to ED by​ ambulance." ​D. Client's husband​ states, "I asked her a​ question, and her speech was​ slurred."

A. Nursing note states​ "Client's husband reports that she​ fell." B. Client​ states, "I had a headache and​ fell." ***C. Transfer note from the clinic​ states, "Client presented in the clinic with a BP of​ 174/94 mmHg. Client transported to ED by​ ambulance." ​D. Client's husband​ states, "I asked her a​ question, and her speech was​ slurred." Any vital sign reading taken by another healthcare professional is considered secondary objective​ data, because the reading is obtained from someone other than the client and can be measured against an accepted standard. The statement from the​ client's husband is secondary subjective​ data, in that it cannot be validated. The statement from the client is primary subjective data. The​ nurse's note is based on subjective​ data, as the nurse cannot verify the​ husband's report.

A​ client, nearing the end of​ life, slept throughout the day but is wide awake at midnight. Which action should the nurse take to support this client​'s ​needs? A. Offer the client reading material B. Provide pain medication earlier than prescribed C. Provide sleeping medication as prescribed D. Turn on the television to keep the client stimulated

A. Offer the client reading material B. Provide pain medication earlier than prescribed ***C. Provide sleeping medication as prescribed D. Turn on the television to keep the client stimulated Pharmacologic interventions for the client nearing death focus on managing pain and other symptoms associated with the end of life. Pharmacological interventions focus on relieving symptoms such as sleep disturbances. The nurse should provide sleeping medication as prescribed. Reading material and television might encourage the client to stay awake but might not meet the​ client's needs for rest. The nurse cannot provide medication without an​ order, so providing the pain medication earlier than prescribed would be a medication error.

The nurse is providing education to a group of volunteers who are planting trees in a city park on a​ hot, sunny day. What teaching should the nurse provide about avoiding​ heat-related illness?​ (Select all that​ apply.) A. Older adults are at less risk B. Wear lightweight clothes C. Take frequent rest breaks D. Avoid participating in the tree planting if ill E. Drink water when they feel thirsty

A. Older adults are at less risk ***B. Wear lightweight clothes ***C. Take frequent rest breaks ***D. Avoid participating in the tree planting if ill E. Drink water when they feel thirsty Individuals should take frequent rest and water​ breaks, and wear lightweight clothes to avoid​ heat-related illness. Those who are ill are at greater risk for​ heat-related illness, so they should avoid participating. Individuals should drink water before they feel​ thirsty, not just when they feel thirsty. Older adults and small children are at greater risk for​ heat-related illness.

The school nurse is preparing a classroom presentation for​ school-age children on MyPlate. Which food items should the nurse include to demonstrate the use of MyPlate for the​ children? (Select all that​ apply.) A. One cupcake B. Sliced peaches C. Slices of roast beef D. Steamed broccoli E. One glass of milk

A. One cupcake ***B. Sliced peaches ***C. Slices of roast beef ***D. Steamed broccoli ***E. One glass of milk MyPlate consists of foods from each of the five food groups. Sliced peaches would be the fruit group. One glass of milk would be the dairy group. Steamed broccoli would be the vegetable​ group, and roast beef would be the protein group. There is no food to represent the grain group. A cupcake is not a grain and does not represent a food from any of the five food groups.

The nurse preceptor and novice nurse are discussing guidelines for protecting the client​'s privacy when using an electronic health record​ (EHR). Which guideline is essential for protecting client privacy when using the​ EHR? A. Only share computer passwords with trusted colleagues or nurse administrators. B. Always obtain written permission before posting client information on any social network. C. Never destroy paper documents that contain protected health information. D. Never leave computer screens with protected health information unattended.

A. Only share computer passwords with trusted colleagues or nurse administrators. B. Always obtain written permission before posting client information on any social network. C. Never destroy paper documents that contain protected health information. ***D. Never leave computer screens with protected health information unattended. Protecting the​ client's privacy involves following many of the same rules that were in place prior to electronic​ records, including never discussing client information in public areas and making sure any paper documents that may contain protected health information are placed in designated shred bins. Newer considerations include keeping computer passwords confidential and not sharing them with​ anyone, ensuring that computer screens with protected health information are never left​ unattended, and never posting any client information on public social​ networks, such as Facebook or Twitter.

Which is unrelated to the balance of calcium in the body? A. Osteoporosis B. Tetany C. Iron D. Vitamin D

A. Osteoporosis B. Tetany C. Iron D. Vitamin D Iron is unrelated to calcium balance. Iron is essential for hemoglobin formation.

The staff nurse is responsible for providing care to a group of clients. What should the nurse use to guide the provision of safe quality​ care? A. PSDA guidelines B. QSEN competencies C. Standards of care D. Standards of practice

A. PSDA guidelines B. QSEN competencies ***C. Standards of care D. Standards of practice Standards of care are guidelines that determine what a nurse can or cannot do. These standards provide guidance to perform an action or a prescribed treatment for a client. QSEN are six competencies that support accountability in practice. The Patient​ Self-Determination Act​ (PSDA) is legislation that impacts clients and the profession of nursing. Standards of practice describe responsibilities for which nurses are accountable. These standards have been defined by nursing regulatory bodies and are often used as measures for quality and safety.

Which group is diagnosed with AIDS at a rate that is more than ten times that of​ Caucasians? A. Pacific Islanders B. Asian Americans C. African Americans D. Hispanics

A. Pacific Islanders B. Asian Americans ***C. African Americans D. Hispanics African Americans have a rate of AIDS infection that is ten times that of Caucasians. Hispanics have a rate three times the Caucasian rate of AIDS infection. Asian Americans and Pacific Islanders do not have higher rates of AIDS.

Which description best depicts a binuclear​ family? A. Parents with biological children from a previous relationship or marriage B. Two parents with biological or adopted children living together C. Male and female​ parents, living together outside of marriage D. A family where there is​ co-parenting with children sharing time between families

A. Parents with biological children from a previous relationship or marriage B. Two parents with biological or adopted children living together C. Male and female​ parents, living together outside of marriage ***D. A family where there is​ co-parenting with children sharing time between families Binuclear describes a combination of parenting by two nuclear​ families, which can happen after a divorce has ended the original nuclear family. Children still spend time with each new family.A nuclear family consists of two parents with biological or adopted​ children, or children in the new family from a previous relationship or marriage. Male and female​ parents, living together outside of​ marriage, are referred to as heterosexual cohabiting.

The nurse is caring for a group of residents in a​ long-term care facility. Which​ condition, if present in a​ resident, would be the most likely cause of fecal​ incontinence? A. Parkinson disease B. Irritable bowel syndrome C. Anorectal injury D. Gastrointestinal reflux disease

A. Parkinson disease B. Irritable bowel syndrome ***C. Anorectal injury D. Gastrointestinal reflux disease Irritable bowel syndrome may cause diarrhea but not necessarily incontinence.If the external anal sphincter is paralyzed by injury or disease​ (anorectal injury), defecation occurs automatically when the internal sphincter relaxes. Parkinson disease is a neurologic disorder caused by a lack of the neurotransmitter dopamine. It results in​ tremor, not fecal incontinence.Gastrointestinal reflux disease is the regurgitation of stomach acids back into the esophagus. It does not cause fecal incontinence.

A nurse is collecting data on a newly admitted client. When filling out the family assessment, who should the nurse consider to be a part of the client's family? SELECT ALL THAT APPLY. A. People related by blood or marriage B. People whom the client views as family C. People who live in the same house D. People who the nurse thins are important to the client E. People who live in the same house with same racial background as the client F. People who provide for the physical and emotional needs of the client

A. People related by blood or marriage ***B. People whom the client views as family C. People who live in the same house D. People who the nurse thins are important to the client E. People who live in the same house with same racial background as the client ***F. People who provide for the physical and emotional needs of the client

Before leaving a​ room, the nurse repositions the client and emphasizes the need to drink more fluids over the next few hours. Which concepts related to accountability did this nurse​ demonstrate? ​(Select all that​ apply.) A. Perfusion B. Comfort C. Fluid and electrolyte balance D. Teaching and learning E. Tissue integrity

A. Perfusion ***B. Comfort C. Fluid and electrolyte balance ***D. Teaching and learning E. Tissue integrity The concept of teaching and learning is related to accountability because nurses are accountable for providing appropriate teaching to clients to ensure the highest quality of care. The concept of comfort is related to accountability because nurses are accountable for managing pain and for other interventions to ensure comfort for the client. Fluid and electrolyte balance is not a concept demonstrated by the​ nurse's actions. There is not enough information to determine if the nurse is demonstrating the concepts of tissue integrity and perfusion as being related to accountability in this situation.

The charge nurse is reviewing​ e-mails and sees a message from the laboratory containing results for a client​'s blood work. What is the priority action by the nurse regarding this​ information? A. Phone the healthcare provider and verbally provide the results B. Print the message and place it in the client​'s medical record C. Forward the message to the client D. Delete the message

A. Phone the healthcare provider and verbally provide the results ***B. Print the message and place it in the client​'s medical record C. Forward the message to the client D. Delete the message Information sent through​ e-mail is considered a part of the​ client's medical record. A copy of each​ e-mail message is to be placed in the​ client's chart. Deleting the message may alter the​ client's medical record. Sending laboratory results by​ e-mail is inappropriate as it denies the client the opportunity to ask questions. The nurse can phone the healthcare provider and verbally provide the​ results; however, the nurse still needs to print the message and place it in the​ client's medical record. The healthcare provider can see the results when reviewing the chart.

A public health nurse is planning a health fair to be held at the local community center. The center​'s advisory board asked for booths with a range of secondary prevention activities. Which activities would the nurse plan to​ include? ​(Select all that​ apply.) A. Physical therapy exhibit of exercise for individuals with arthritis B. Blood pressure measurements with sphygmomanometer C. Glucometer testing of blood sugar levels D. Respiratory therapy exhibit about smoking cessation E. Nutritionist​'s table of healthy breakfast foods

A. Physical therapy exhibit of exercise for individuals with arthritis ***B. Blood pressure measurements with sphygmomanometer ***C. Glucometer testing of blood sugar levels D. Respiratory therapy exhibit about smoking cessation E. Nutritionist​'s table of healthy breakfast foods Secondary prevention activities screen for the presence of diseases. Glucometer testing of blood sugar will identify individuals with diabetes. Blood pressure measurements will screen for hypertension. Both the​ nutritionist's table of healthy breakfast foods and the respiratory therapy exhibit about smoking cessation are​ primary, not​ secondary, prevention activities. The physical therapy exhibit of exercise devices for individuals with arthritis is tertiary prevention of complications of that condition.

A nurse is caring for a client with frostbite to the toes. After​ rewarming, which intervention will the nurse​ implement? A. Place compression stockings on the client​'s legs B. Elevate the client​'s legs on pillows C. Rub the client​'s legs with lotion D. Dangle the client​'s legs off the side of the bed

A. Place compression stockings on the client​'s legs ***B. Elevate the client​'s legs on pillows C. Rub the client​'s legs with lotion D. Dangle the client​'s legs off the side of the bed After​ rewarming, the nurse will elevate the affected extremities to increase blood​ flow, not place extremities in the dependent position​ (off the side of the​ bed). The nurse will not compress or rub the affected​ extremities, as this can further damage tissues.

Which action would be an inappropriate nursing response to a client with a history of​ long-term narcotic​ use, who is asking for increased pain medication after​ surgery? A. Plan on further assessment B. Ask for support from a supervisor C. Counsel client about risks of addictive behavior D. Ask for support from peers

A. Plan on further assessment B. Ask for support from a supervisor ***C. Counsel client about risks of addictive behavior D. Ask for support from peers It would be inappropriate to counsel the client about risks of addictive behavior. The nurse should ask for support from a supervisor or​ peers, and plan on further assessment.

The nurse is caring for a client with a pneumothorax. Based on the client​'s ​history, which is the most likely cause for this alteration in​ oxygenation? A. Pneumonia B. Obesity C. Asthma D. Trauma

A. Pneumonia B. Obesity C. Asthma ***D. Trauma While a pneumothorax may occur​ spontaneously, most occur as the result of trauma. Obesity can cause apnea. Asthma and pneumonia can cause orthopnea.

The community health nurse is designing a presentation about societal factors that influence health policy. Which statement should the nurse include in the​ presentation? A. Population size does not influence the development of health policy. B. ​Population-specific needs are too complex to be taken into consideration. C. Considerations include whether or not current policy meets the population​'s needs. D. Level of support for the proposed policy is not an influencing factor.

A. Population size does not influence the development of health policy. B. ​Population-specific needs are too complex to be taken into consideration. ***C. Considerations include whether or not current policy meets the population​'s needs. D. Level of support for the proposed policy is not an influencing factor. Societal factors that influence health policy include population​ size, population-specific​ needs, degree to which current policy meets the​ population's needs, and level of support for the proposed policy.

The nurse is monitoring a client who has undergone a thyroidectomy. The nurse suspects the parathyroid glands may have been inadvertently removed if imbalances are seen in which serum electrolyte​ level? (Select all that​ apply.) A. Potassium B. Calcium C. Sodium D. Chloride E. Magnesium

A. Potassium ***B. Calcium C. Sodium D. Chloride ***E. Magnesium Parathyroid hormone​ (PTH) regulates serum levels of calcium and magnesium. If imbalances in these electrolytes are​ seen, then PTH may be absent due to inadvertent removal of the parathyroid glands.​ Sodium, potassium and chloride are regulated by​ aldosterone, not PTH.

The public health nurse has been working with a​ mobility-impaired client with chronic fatigue for over a year. What newly arisen issues should the public health nurse address​ immediately? ​(Select all that​ apply.) A. Potential for sleep disruption B. Safety risks C. Reduced coping skills D. Infectious disease transmission E. Impaired activity tolerance

A. Potential for sleep disruption ***B. Safety risks C. Reduced coping skills ***D. Infectious disease transmission E. Impaired activity tolerance The two newly arisen issues that the public health nurse should address immediately are safety risks and infectious disease transmission. The other diagnoses​ (impaired activity​ tolerance, reduced coping​ skills, and potential for sleep​ disruption) do not need immediate attention.

The nurse administers a dose of the pneumococcal vaccination to an older client prior to the client​'s discharge from the hospital. Which function of managed care is this nurse​ performing? A. Preventing unnecessary costs B. Assessing client needs C. Delivering preventive services D. Advocating for client needs

A. Preventing unnecessary costs B. Assessing client needs ***C. Delivering preventive services D. Advocating for client needs Managed care emphasizes preventing inappropriate and unnecessary​ costs, increasing customer​ satisfaction, promoting​ health, and delivering preventive services. Administering a vaccination is the delivery of a preventive service. Assessing client needs is a step within the nursing process and case management. Providing a vaccination is delivering a preventive service and not preventing unnecessary costs. The nurse who is administering a vaccination is not engaged in advocacy.

Which care delivery method uses a​ task-oriented approach? A. Primary B. Team C. Case D. Functional

A. Primary B. Team C. Case ***D. Functional The functional method uses a​ task-oriented approach. In the case​ method, one nurse is assigned and responsible for the care of a group of clients over the course of a shift. In the team​ method, the RN has the responsibility and authority for client care but delegates tasks to other team members as appropriate. In primary​ nursing, one nurse is responsible for overseeing the total care for a number of clients 24 hours a​ day, 7 days a week.

The nurse is planning discharge care for a​ 10-year-old child with an asthma exacerbation. Which roles in the binuclear family unit of the child should the nurse identify before teaching can​ begin? ​(Select all that​ apply.) A. Primary caregiver for the child B. Financial decision maker for the child C. Legal guardian of the child D. Medical decision maker for the child E. Parent that is working outside home

A. Primary caregiver for the child ***B. Financial decision maker for the child ***C. Legal guardian of the child ***D. Medical decision maker for the child E. Parent that is working outside home Family members take on different roles within the family. The decision maker in the family may not be the primary provider or​ caregiver, or the working parent. The nurse must identify the​ legal, medical, and financial decision maker for each family when planning care for a child.

The nurse manager is looking at the quarterly budget for the new clinic. The largest expenses are for personnel. If the nurse is faced with a staff​ shortage, which nursing care delivery system is the most appropriate​ choice? A. Primary nursing B. Team nursing C. Functional nursing D. Positive nursing

A. Primary nursing B. Team nursing ***C. Functional nursing D. Positive nursing Functional​ nursing, which assigns staff to tasks rather than to​ clients, works well in staff shortages. Both team nursing and primary nursing require more staff to implement. There is no positive nursing system.

A staff nurse is overhead counseling a newly hired nurse about limiting suggestions to improve the functioning of the unit because the manager "does not like suggestions" and will "put you down." Which characteristic of an ineffective group is the manager​ influencing? A. Problem solving B. Creativity C. Goal setting D. Cohesion

A. Problem solving ***B. Creativity C. Goal setting D. Cohesion In an ineffective​ group, creativity is discouraged and members fear appearing foolish if they put forth a creative thought. In an ineffective​ group, problem solving is low and criticism may be​ destructive, taking the form of either overt or covert personal attacks. In an ineffective group cohesion is either ignored or used as a means of controlling members and promoting rigid conformity. In an ineffective​ group, goal setting is​ unclear, misunderstood, or imposed goals may be accepted by members. The goals are competitively structured.

A supervisor has asked a nurse to train new nursing staff in culturally competent care. Which information would the nurse include in the​ training? ​(Select all that​ apply.) A. Promoting participation of​ fathers, as well as​ mothers, in healthcare visits B. Reasons nuclear families are superior C. Variations in family structure D. Communication skills E. Cultures served by the nursing staff

A. Promoting participation of​ fathers, as well as​ mothers, in healthcare visits B. Reasons nuclear families are superior ***C. Variations in family structure ***D. Communication skills ***E. Cultures served by the nursing staff The nurse would include information about the cultures served locally by the healthcare​ organization, variations in family structure that nurses may​ encounter, and communications skills. In the​ training, the nurse would teach avoidance of judgments and​ assumptions, such as why nuclear families are superior to other family structures. The topic of why fathers and mothers should both participate in healthcare visits would be more appropriate for an educational program about facilitating the transition to parenthood.

A client with a history of congestive heart failure is undergoing a yearly physical examination. Which positions are most appropriate for placing the client during the rectal​ examination? ​(Select all that​ apply.) A. Prone B. Lithotomy C. Dorsal recumbent D. Supine E. Sims

A. Prone ***B. Lithotomy C. Dorsal recumbent D. Supine ***E. Sims The client may need to maintain several positions during the physical examination. The nurse should assess the​ client's ability to do​ so, taking into consideration the​ client's physical​ condition, energy​ level, and age. Clients with cardiopulmonary disorders may have difficulty with positions such as the dorsal recumbent and prone positioning that would help expose the genital area for examination.​ Therefore, the lithotomy and sims positions are best for this type of exam. The supine position is not tolerated well with cardiopulmonary clients but does provide access to the rectum for examination.

The nurse manager in the assisted living facility is finding that ethical issues arise frequently in this setting. The nurse manager empowers the entire clinical team to make suggestions for support activities. Which suggestions by the staff nurses are relevant to ethical​ issues? ​ (Select all that​ apply.) A. Protocols for advanced directives for dying clients B. Use of primary nursing teams to facilitate care C. Easy access to the use of counseling professionals D. Availability of mentoring by experienced nurses E. Regular team conferences on subjects selected by the team

A. Protocols for advanced directives for dying clients B. Use of primary nursing teams to facilitate care ***C. Easy access to the use of counseling professionals ***D. Availability of mentoring by experienced nurses ***E. Regular team conferences on subjects selected by the team Support systems that are useful to nurses who work in settings where ethical issues arise frequently include regular team conferences on subjects selected by the​ team, easy access to the use of counseling​ professionals, and availability of mentoring by experienced nurses. Protocols for advanced directives support​ evidence-based practice and primary nursing teams help to facilitate continuity of​ care, but they do not support the staff who works in an environment with frequent ethical issues.

The nurse is caring for an older adult client who has been diagnosed with failure to thrive and has a caregiver present at the bedside. What role will the nurse assume in this ​process? A. Provide behavioral therapy to the client B. Prescribe medication for the treatment of FTT C. Provide nutritional education to the caregiver D. Refer client to genetic counseling

A. Provide behavioral therapy to the client B. Prescribe medication for the treatment of FTT ***C. Provide nutritional education to the caregiver D. Refer client to genetic counseling The nurse may provide dietary and nutritional education to the caregiver. The nurse may not prescribe medications or provide behavioral therapy. The referral to genetic counseling is not indicated for an older adult with FTT.

Which nursing action demonstrates accountability for care provided to a​ client? A. Providing discharge instructions B. Changing the dressings on the left foot and leg C. Ensuring treatments are completed D. Teaching​ self-administration of insulin

A. Providing discharge instructions B. Changing the dressings on the left foot and leg ***C. Ensuring treatments are completed D. Teaching​ self-administration of insulin Accountability is being responsible for the outcome of a completed task or assignment. Standards of care and practice guide the​ nurse's activities. Ensuring that treatments are completed is an example of accountability. Providing discharge​ instructions, teaching​ self-administration of​ medication, and changing dressings are examples of nursing responsibilities.

The nurse is planning care for a client who is diagnosed with delirium. Which cognitive intervention is appropriate for this​ client? A. Providing nutrition B. Monitoring intravenous fluids C. Administering oxygen D. Reorienting to time and place

A. Providing nutrition B. Monitoring intravenous fluids C. Administering oxygen ***D. Reorienting to time and place While all of these interventions are appropriate for a client who is diagnosed with​ delirium, the only cognitive intervention that is listed is reorienting to time and place.

A student nurse is writing a research paper on developmental disabilities for a psychology class. Which developmental disability will the student include that is the most​ prevalent? A. Psychosis B. Intellectual disability C. Dementia D. Learning disability

A. Psychosis ***B. Intellectual disability C. Dementia D. Learning disability The most prevalent developmental disability in the United States is intellectual disability. Approximately 6.5 million individuals have these diagnoses. Dementia and psychosis are not developmental disabilities. Statistics on learning disabilities are not reliable.

The nurse is preparing to use the tympanic membrane to measure the temperature of a​ 4-year-old child. Which approach should the nurse take when completing this​ measurement? A. Pull the earlobe back and down. B. Pull the pinna back and up. C. Pull the pinna back and down. D. Pull the earlobe back and up.

A. Pull the earlobe back and down. ***B. Pull the pinna back and up. C. Pull the pinna back and down. D. Pull the earlobe back and up. The pinna is pulled straight back and upward when taking temperature in children over 3 years of age. To measure temperature using the tympanic membrane in an​ infant, the pinna is pulled straight back and slightly downward. The earlobe is not manipulated to measure temperature using the tympanic membrane.

The new nurse is reviewing the state board of nursing Web site for information about professional practice. What information should the nurse expect to find during this​ search? ​(Select all that​ apply.) A. Quality improvement findings B. ​Evidence-based practice guidelines C. Tips for implementing computer applications D. Scope of practice guidelines E. Role definitions

A. Quality improvement findings B. ​Evidence-based practice guidelines C. Tips for implementing computer applications ***D. Scope of practice guidelines ***E. Role definitions A profession is considered autonomous when it has legal authority to define its own scope of​ practice, and defines​ roles, identifies​ goals, and outlines responsibilities. Individual state boards of nursing support autonomy in nursing. The state boards of nursing do not post​ evidence-based practice​ guidelines, quality improvement​ findings, or tips for implementing computer applications. These items might be found in professional journals or other publications that support nursing practice.

The program director at a school of nursing is working with hospital leaders to reduce the impact of a nursing shortage projected to occur within a few years. Which recommendations are appropriate to combat this potential​ issue? ​(Select all that​ apply.) A. Recommend increasing the​ nurse-to-client staffing ratio B. Discuss increasing nursing salaries to be comparable with similar organizations C. Analyze staffing options to increase flexibility D. Increase recruitment of students into nursing as a second career E. Determine ways to increase the number of nursing scholarships

A. Recommend increasing the​ nurse-to-client staffing ratio ***B. Discuss increasing nursing salaries to be comparable with similar organizations ***C. Analyze staffing options to increase flexibility D. Increase recruitment of students into nursing as a second career ***E. Determine ways to increase the number of nursing scholarships Efforts to counteract the effects of the nursing shortage include recruiting students into nursing early in their education​ careers, improving the environment for nurses such as providing flexibility with work​ hours, increasing​ salaries, and improving the work​ load, and increasing the funding for nursing education. Increasing the​ nurse-to-client staffing ratio will negatively impact the workload. Increasing recruitment of students into nursing as a second career means the students will be older. One issue with the nursing shortage is the aging of the nursing workforce. Older students would mean that the nurse would spend less time in the profession.

The nurse is providing home care instructions for a client with fecal incontinence. What information should the nurse​ include? A. Reduce fluid intake B. Eat a​ low-fiber diet C. Maintain good skin care D. Avoid taking​ bulk-forming laxatives

A. Reduce fluid intake B. Eat a​ low-fiber diet ***C. Maintain good skin care D. Avoid taking​ bulk-forming laxatives When providing home care teaching with a client experiencing fecal​ incontinence, the nurse needs to educate the client about maintaining good skin care for fecal incontinence because it can cause skin breakdown. The client should use​ bulk-forming laxatives to provide stool bulk and reduce the number of​ small, liquid stools. The client needs to consume a​ high- fiber diet and drink ample fluids to help in maintaining​ soft, well-formed stools.

The nurse at a community center​'s health fair is assessing a client who has not seen a healthcare provider in over a decade. The client​'s blood pressure is​ 150/95. Which referral is appropriate for this​ client, as a result of this​ screening? A. Referral to a vascular specialist B. Referral to an urgent care clinic C. Referral to a primary care provider D. Referral to the emergency department of the county hospital

A. Referral to a vascular specialist B. Referral to an urgent care clinic ***C. Referral to a primary care provider D. Referral to the emergency department of the county hospital The screening found that the client might have hypertension. The appropriate referral is to a primary care provider. The finding does not prompt use of the emergency​ department, an urgent care​ clinic, or a vascular specialist.

The manager schedules a nursing assistant to attend a basic communication program after observing the assistant provide client care. Which actions would result in this type of​ referral? ​(Select all that​ apply.) A. Referring to a​ 75-year old male client as​ "Mr. Smith" B. Calling an​ 80-year-old client​ "Sweetie" C. Talking with a newly admitted client about his grandchildren D. Referring to a​ 70-year-old client's abdominal wound as a​ "boo-boo" E. Asking a​ 65-year-old client,​ "Are we ready to get out of​ bed?"

A. Referring to a​ 75-year old male client as​ "Mr. Smith" ***B. Calling an​ 80-year-old client​ "Sweetie" C. Talking with a newly admitted client about his grandchildren ***D. Referring to a​ 70-year-old client's abdominal wound as a​ "boo-boo" ***E. Asking a​ 65-year-old client,​ "Are we ready to get out of​ bed?" Elderspeak is a demeaning way of speaking with an older adult client. Use of inappropriate terms of​ endearment, such as​ sweetie, inappropriate use of the first person plural​ ?we? when referring to getting out of​ bed, and using baby talk by referring to a wound as a​ boo-boo are all examples of elderspeak. Using a formal title as Mr. and following it with the​ client's first name is appropriate if the client has asked to be called in this manner. Discussing grandchildren with the client does not demonstrate elderspeak.

A county health department nurse is creating a brochure that describes the agency​'s role. Which activity should be​ included? A. Regulating child care centers B. Providing community disease monitoring and surveillance C. Enrolling clients in Medicaid D. Overseeing the construction of new medical facilities

A. Regulating child care centers ***B. Providing community disease monitoring and surveillance C. Enrolling clients in Medicaid D. Overseeing the construction of new medical facilities Providing community disease monitoring and surveillance is a function of a county health department. Enrolling clients in Medicaid typically is the responsibility of local departments of social services. Regulation of child care centers and overseeing the construction of new medical facilities are​ state-level regulatory functions.

The public advocate is providing an educational session to nurses regarding advocacy. Which items are appropriate to include in the teaching​ session? ​ (Select all that​ apply.) A. Researching health disparities B. Running for public office C. Using media to inform the public D. Protecting clients​' rights E. Making decisions for clients

A. Researching health disparities ***B. Running for public office ***C. Using media to inform the public ***D. Protecting clients​' rights E. Making decisions for clients When advocating for​ clients, it is important for the nurse to protect the​ clients' rights, and inform the public about issues and concerns through press releases and media. The nurse can also run for public office as a means of advocating for clients. Researching health disparities and making decisions for clients are not topics that would be included in a session about advocating for clients.

The nurse is providing an assessment of a family to determine a need for interventions. Which description is an indication of high functioning family​ communication? A. Resiliency B. ​Self-disclosure C. Flexibility D. Emotional availability

A. Resiliency ***B. ​Self-disclosure C. Flexibility D. Emotional availability In​ high-functioning families, each family member listens empathically and​ attentively, speaks for him or herself and not for​ others, self-discloses by sharing personal feelings about self and other family​ members, and tracks​ (stays on​ topic). Family flexibility is the amount of flexibility in a family​'s ​leadership, rules, and​ roles, and the family​'s ability to deal with stress. Emotional availability refers to the quality of​ parent-child interactions. Resiliency is a family​'s ability to​ adapt, evolve, and change with circumstances.

The nurse is teaching a​ 48-year-old client about insulin administration. Which nursing intervention best reflects correct understanding of how to create an atmosphere that is conducive to the​ teaching-learning process? A. Respecting the​ client's time by completing the teaching as quickly as possible B. Minimizing the​ client's boredom by avoiding repetition of information C. Using standardized teaching plans that are designed for all clients with diabetes D. Verbally assessing the​ client's comprehension of the material

A. Respecting the​ client's time by completing the teaching as quickly as possible B. Minimizing the​ client's boredom by avoiding repetition of information C. Using standardized teaching plans that are designed for all clients with diabetes ***D. Verbally assessing the​ client's comprehension of the material Verbally assessing the​ client's comprehension of the material facilitates the​ teaching-learning process. The nurse should avoid rushing. Teaching should include repetition of key information. Rather than using a standardized teaching​ plan, the nurse should adapt the plan based upon the​ client's responses and level of comprehension.

Katrina Simons is a nurse who is coordinating the discharge for a client with chronic lung disease. Which nursing action is the priority when coordinating this​ client's care? A. Responding to family​ members' questions about the​ client's needs B. Reviewing the​ client's nutritional needs with the dietician C. Discussing the​ client's medications with the pharmacist D. Obtaining an order and organizing the delivery of oxygen to the​ client's home

A. Responding to family​ members' questions about the​ client's needs B. Reviewing the​ client's nutritional needs with the dietician C. Discussing the​ client's medications with the pharmacist ***D. Obtaining an order and organizing the delivery of oxygen to the​ client's home Initiating​ consultations, identifying the need for​ referrals, and obtaining orders are all actions the nurse will take when implementing care coordination.​ However, ensuring the​ client's ability to maintain adequate perfusion and oxygenation following discharge by obtaining an order and organizing oxygen delivery takes priority over other actions. Discussing the​ client's medications with the​ pharmacist, meeting with the dietician to review the​ client's nutritional​ needs, and responding to family​ members' questions are collaborative actions.

The​ nurse, who is caring for the spouse of a client who died of traumatic​ injuries, is reviewing Engel​'s theory on the stages of grief. For which stage of grief should the nurse plan priority care based on Engel​'s ​theory? A. Restitution B. Shock C. Outcome D. Idealization

A. Restitution ***B. Shock C. Outcome D. Idealization The nurse should plan priority care based on​ shock, which according to Engel is the first stage of grief that the spouse experiences after the client​'s death.​ Restitution, outcome, and idealization are all later stages of grief in Engel​'s theory.

The clinical instructor is concerned that a student nurse is having difficulty implementing the Code for Nursing Students. Which student behavior supports this​ concern? ​(Select all that​ apply.) A. Returning money that dropped out of a staff nurse​'s pocket while reaching for scissors B. Asking a staff nurse for permission to observe a procedure at the bedside C. Stating that a client has to wait for pain medication because there were more important tasks to do D. Requesting assistance to complete a complicated dressing change E. Placing the side rails in the down position for a confused client

A. Returning money that dropped out of a staff nurse​'s pocket while reaching for scissors B. Asking a staff nurse for permission to observe a procedure at the bedside ***C. Stating that a client has to wait for pain medication because there were more important tasks to do D. Requesting assistance to complete a complicated dressing change ***E. Placing the side rails in the down position for a confused client Behaviors that do not adhere to the Code for Nursing Students include not ensuring the safety of clients by keeping the side rails down in a client with confusion and not acting professionally when telling a client to wait for pain medication. Requesting​ assistance, asking for​ permission, and returning found money adhere to the principles of the Code for Nursing Students.

The nurse case manager is assigned a client newly diagnosed with type 2 diabetes mellitus. What is the priority action for the nurse to perform when beginning the care of this​ client? A. Review nutritional needs with the dietician B. Discuss needs at home C. Complete a health history D. Discuss​ self-administration of insulin

A. Review nutritional needs with the dietician B. Discuss needs at home ***C. Complete a health history D. Discuss​ self-administration of insulin Case management is a care delivery approach used to​ coordinate, facilitate, and track a​ client's use of healthcare resources. This care delivery approach begins with assessing client needs. Implementing care​ (e.g., providing teaching on insulin​ administration) occurs after the assessment and plan is prepared. Discharge planning and collaboration with other healthcare professionals occur after the assessment.

A client receiving palliative care for terminal cancer is experiencing apneic periods and increasing confusion. Which action should the nurse take to ensure for this client​'s social​ needs? A. Review the medical record for resuscitation orders B. Contact the family to be with the client C. Administer pain medication as prescribed D. Notify the client​'s clergy of the change in health status

A. Review the medical record for resuscitation orders ***B. Contact the family to be with the client C. Administer pain medication as prescribed D. Notify the client​'s clergy of the change in health status To support the​ client's social aspect of palliative​ care, the nurse should contact the family to be with the client as death occurs. Administering pain medication supports the​ client's physical aspects of care. Reviewing the medical record for resuscitation orders supports the​ client's ethical and legal aspects of care. Notifying the​ client's clergy supports the​ client's spiritual,​ religious, and existential aspects of care.

Which nursing action demonstrates autonomy when providing client​ care? A. Reviewing​ evidence-based practice guidelines B. Accessing the policy and procedure manual C. Working with clients independently D. Discussing the work schedule with the manager

A. Reviewing​ evidence-based practice guidelines B. Accessing the policy and procedure manual ***C. Working with clients independently D. Discussing the work schedule with the manager The concept of autonomy is exemplified by independently working with​ clients, accepting responsibility for​ behaviors, and being accountable for outcomes. Reviewing​ evidence-based practice guidelines is an action that supports research in nursing. Accessing the policy and procedure manual is an example of the nurse being guided by rules as part of a​ service-oriented profession. Discussing the work schedule is an example of nursing controlling its own profession as a part of professional organization.

A nurse at the rehabilitation unit for clients who are blind is meeting with the nurse​'s mentor. They are discussing best practices in acting as advocates for the autonomy of their clients. Which client rights are they supporting in their​ dialogue? A. Right to express feelings B. Right to​ self-determination C. Right to confidentiality D. Right to privacy

A. Right to express feelings ***B. Right to​ self-determination C. Right to confidentiality D. Right to privacy When nurses act as advocates for their​ client's autonomy, they are supporting the​ client's right to​ self-determination. The right of autonomy is different from the rights to​ privacy, confidentiality, and expressing feelings.

After administering​ medications, the staff nurse discusses the status of morning care completed by unlicensed assistive personnel. Which behavior is the staff nurse demonstrating at this​ time? A. Safety B. Accountability C. Responsibility D. ​Client-centered care

A. Safety ***B. Accountability C. Responsibility D. ​Client-centered care Accountability is being responsible for the outcome of a completed task or assignment. Nurses are accountable for their own actions and​ behaviors, but also accountable for the actions of​ others, such as unlicensed assistive personnel. Responsibility is the obligation to perform duties within the nursing role.​ Client-centered care and safety are competencies that support accountability in nursing practice.

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? A. Safety B. Informatics C. Teamwork and collaboration D. Quality improvement

A. Safety B. Informatics C. Teamwork and collaboration ***D. Quality improvement 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.

The nurse learns that a client with​ school-age children is also her mother​'s caregiver. The client tells the​ nurse, open double quote"I cannot meet everyone​'s demands anymore.close double quote" Which is the most appropriate diagnosis for this​ client? A. Sandwich generation syndrome B. Risk for situational low​ self-esteem C. Adjusting to outside influences D. Readjustment of marital relationship

A. Sandwich generation syndrome ***B. Risk for situational low​ self-esteem C. Adjusting to outside influences D. Readjustment of marital relationship A nurse who is assessing an adult family member who cares for both her own children and an aging parent may diagnose any one of several conditions​ including, but not limited​ to, ineffective​ self-health management, interrupted family​ processes, compromised family​ coping, or risk for situational low​ self-esteem. Adults in this group are known as open double quote"The Sandwich ​Generation,close double quote" which is not a nursing diagnosis. Families in Stage IV of the family life cycle must adjust to outside influences as children start school. Spouses in Stage VI of the family life cycle readjust their marital relationship as the family launches young adults.

Which actions should the nurse take when helping clients access information on the​ Internet? ​(Select all that​ apply.) A. Schedule a virtual visit with the healthcare provider B. Direct to high quality Web sites C. Assist with obtaining a Skype account D. Summarize if the information is applicable E. Teach how to interpret the information

A. Schedule a virtual visit with the healthcare provider ***B. Direct to high quality Web sites C. Assist with obtaining a Skype account ***D. Summarize if the information is applicable ***E. Teach how to interpret the information Nurses need to help clients with information access by directing clients to​ high-quality web sites for​ information, teaching clients how to interpret the​ information, explaining how to evaluate information​ obtained, and summarizing how to determine if information is applicable. Assisting with obtaining a Skype account and scheduling a virtual visit with the health care provider support telecommunication activities.

An occupational nursing is facilitating a weight reduction group discussion. Which should thenurse explain is the most common contributing factor of obesity? A. Sedentary lifestyle B. Low metabolic rate C. Hormonal imbalance D. Excessive caloric intake

A. Sedentary lifestyle B. Low metabolic rate C. Hormonal imbalance ***D. Excessive caloric intake

The nurse is providing education to a client and family regarding complementary therapies that may be useful in the treatment for Alzheimer disease​ (AD). Which response by the family indicates the need for further​ education? A. Selenium is a supplement that is known to support brain function." B. "Huperzine A is an antioxidant that supports brain function." C. "Zinc is a supplement known to support brain function." D. "Coenzyme Q10 naturally occurs in the body and I can take a supplement to support brain function."

A. Selenium is a supplement that is known to support brain function." ***B. "Huperzine A is an antioxidant that supports brain function." C. "Zinc is a supplement known to support brain function." D. "Coenzyme Q10 naturally occurs in the body and I can take a supplement to support brain function." The statement regarding Huperzine A would require additional teaching from the nurse as this is not an​ antioxidant, but a Chinese medicine that acts as an acetylcholinesterase inhibitor. All other statements are accurate and indicate appropriate understanding of the teaching presented by the nurse.

A nurse decides to add narrative charting to the client​'s nursing progress note to make a more complete nursing progress note. The nurse​ writes, "The client wasn​'t hungry and didn​'t eat much." What document guideline is the nurse failing to​ use? A. Sequence B. Accuracy C. Appropriateness D. Conciseness

A. Sequence ***B. Accuracy C. Appropriateness D. Conciseness The nurse is failing to document accurately. In order to adhere to this​ guideline, the nurse must document facts or​ observations, not opinions or interpretations. Documenting events in the order in which they occur is adhering to sequencing. Appropriateness refers to documenting facts regarding the client​ condition, not personal information that is not related to client care. Conciseness is thorough but brief documentation.

The nurse in the emergency department is assessing an adult client with emphysema. What symptoms of emphysema would not be obvious from inspection and direct observation by the​ nurse? A. Shortness of breath B. ​Pursed-lip breathing and clubbing of fingers C. Barrel chest D. Hyperresonance sounds from the lungs

A. Shortness of breath B. ​Pursed-lip breathing and clubbing of fingers C. Barrel chest ***D. Hyperresonance sounds from the lungs Clients with emphysema and COPD would have hyperresonance sounds during an assessment using percussion. These sounds would not be obvious on inspection or observation. A client with emphysema may be obviously short of​ breath, even at rest. A barrel chest is common in those with emphysema and would be obvious on​ inspection, even if the client has a shirt on.​ Pursed-lip breathing and clubbing of the fingers can be observed without​ palpation, auscultation, or percussion.

The nurse is using an interpreter to discuss the care plan with a client of another culture. What form of communication is the nurse using to communicate with the​ client? A. Silence B. Touch C. Eye contact D. Verbal

A. Silence B. Touch C. Eye contact ***D. Verbal Verbal communication is an important tool to use when exchanging information about the plan of care. Using an interpreter is an example of using appropriate verbal communication to ensure that the client understands the information.​ Silence, touch, and eye contact are forms of nonverbal communication.

The nurse is comforting the adult daughter of a client who has just passed away. When planning​ care, the nurse should include interventions based on which type of​ loss? A. Situational B. Anticipatory C. Perceived D. Developmental

A. Situational B. Anticipatory C. Perceived ***D. Developmental A developmental loss is one that is expected to occur throughout the course of​ life, such as the death of aging​ parents; the nurse should provide interventions to address this type of loss. A perceived loss is one that cannot be verified by others. An anticipatory loss is one that is experienced before the loss actually occurs. A situational loss is one that is due to an external circumstance.

Which cultural phenomenon that affects health care is classified as an environmental​ control? A. Skin color B. Emphasis on the past C. Faith healing D. Personal boundaries

A. Skin color B. Emphasis on the past ***C. Faith healing D. Personal boundaries Faith healing is an environmental control. Skin color is a biologic factor. Emphasis on the past is a time orientation. Personal boundaries are space factors.

The nurse is providing care to a client who is diagnosed with delirium. Which assessment finding supports the client​'s ​diagnosis? A. Sleeping heavily night and day B. Lack of ability to remember childhood anecdotes C. Desire to discuss​ his/her opinion on why delirium started D. Obsessive correctness and efficiency with tasks

A. Sleeping heavily night and day ***B. Lack of ability to remember childhood anecdotes C. Desire to discuss​ his/her opinion on why delirium started D. Obsessive correctness and efficiency with tasks Symptoms of delirium include loss of both​ short-term and​ long-term memory. Clients will also have impaired concentration and slow performance of tasks or wandering attention. Their sleep pattern is typically Insomnia at night and drowsiness during the day. They have little or no insight as to the cause of their current condition.

A nurse is unable to secure an intravenous access site due to severe dehydration. Which order does the nurse anticipate receiving from the healthcare​ provider? A. Sodium supplements B. Oral fluid replacement C. Hypodermoclysis D. Diuretics

A. Sodium supplements B. Oral fluid replacement ***C. Hypodermoclysis D. Diuretics When IV access is​ problematic, fluids can be administered​ subcutaneously, a method called hypodermoclysis. Diuretics are used to treat fluid volume​ excess, not dehydration. Oral fluid replacement is ordered for mild​ dehydration, not severe dehydration. Fluid​ replacement, not sodium​ supplements, would be anticipated.

A nurse is documenting client information into the database of a​ problem-oriented medical record. Which client information is the nurse likely​ documenting? A. Spiritual needs B. Nursing diagnosis C. Plan of care D. Health history

A. Spiritual needs B. Nursing diagnosis C. Plan of care ***D. Health history The database of a​ problem-oriented medical record​ (POMR) consists of all information known about the client when the client first enters the healthcare​ agency, including the​ client's health history. The spiritual needs of the client and the nursing diagnosis are documented in the problem list of the POMR. The plan of care has its own section in the POMR.

A nurse working in the intensive care unit​ (ICU) needs to give a​ change-of-shift report. What is the most appropriate action by the nurse for this type of verbal reporting​ system? A. State priorities of client care at the beginning B. Report a client​'s need for special emotional support C. Give details on routine care needs of the client D. Elaborate on client background data

A. State priorities of client care at the beginning ***B. Report a client​'s need for special emotional support C. Give details on routine care needs of the client D. Elaborate on client background data During a​ change-of-shift report, the nurse should include the​ client's need for special support. The nurse should be concise and brief regarding client background data and routine care needs of the client. Priorities of client care should be stated at the end of the​ report, when the receiving nurse will be most likely to remember the information.

A primary health-care provider orders a clear liquid diet for a patient. Which foods should the nurse teach the client to avoid when following this diet? Select all that apply. A. Strawberry gelatin B. Decaffeinated tea C. Strong coffee D. Potatoe soup E. Ice cream

A. Strawberry gelatin B. Decaffeinated tea C. Strong coffee ***D. Potatoe soup ***E. Ice cream

A nurse is caring for an older adult with hypothermia. The nurse suspects that the client is unable to maintain an adequate temperature at the client​'s home due to financial problems. Which intervention is most appropriate for this​ client? A. Suggest a representative from financial services see the client. B. Contact adult protective services. C. Suggest a medical social worker see the client. D. Contact the client​'s utility company.

A. Suggest a representative from financial services see the client. B. Contact adult protective services. ***C. Suggest a medical social worker see the client. D. Contact the client​'s utility company. The nurse should suggest a medical social worker see the client in order to assess the client​'s ability to maintain a safe environment at home. A representative from the hospital​'s financial services usually deals with hospital​ finances, not the client​'s finances at home. Contacting adult protective services or the utility company prior to social worker assessment is inappropriate.

The nurse manager is reviewing current staff education levels and skill competencies for charge nurses to use when making client assignments. Which care delivery system does this nurse manager​'s action​ support? A. Team nursing B. ​Client-focused care C. Differentiated practice D. Shared governance

A. Team nursing B. ​Client-focused care ***C. Differentiated practice D. Shared governance Differentiated practice is the use of​ nurses' education,​ training, and ability to determine how to best use nurses in the care setting.​ Client-focused care organizes health care around client physical and emotional needs. Shared governance is an organizational model that ensures nurses have input on policy and decision making related to client care. In team​ nursing, the RN has the responsibility and authority for client care but delegates tasks to other team members as appropriate.

A​ 21-year-old male pharmacy student is admitted to the ED for treatment of a sprained right ankle. Following ​ treatment, the client is prescribed ibuprofen to reduce pain and swelling. As the nurse begins teaching about the maximum dose of​ ibuprofen, the client​ states, "I already know this stuff. Can you finish my discharge paperwork so I can get out of​ here?" Which nursing approaches reflect the application of cognitive​ theory? ​(Select all that​ apply.) A. Telling the​ client, "If you let me finish teaching you about​ ibuprofen, I'll quickly complete your discharge​ paperwork." B. Recognizing the​ client's disinterest in teaching as being shaped by his history of unpleasant social interactions C. Realizing the effects of the​ client's spiritual beliefs on his learning D. Recognizing the​ client's knowledge base and intelligence level as an important consideration in the​ nurse's choice of teaching content E. Considering the​ client's teaching preferences from the standpoint of his psychologic state

A. Telling the​ client, "If you let me finish teaching you about​ ibuprofen, I'll quickly complete your discharge​ paperwork." B. Recognizing the​ client's disinterest in teaching as being shaped by his history of unpleasant social interactions ***C. Realizing the effects of the​ client's spiritual beliefs on his learning ***D. Recognizing the​ client's knowledge base and intelligence level as an important consideration in the​ nurse's choice of teaching content E. Considering the​ client's teaching preferences from the standpoint of his psychologic state Cognitive theory presents learning as being primarily a​ mental, intellectual, or thinking process during which the learner selectively chooses his​ perceptions; the process is shaped by personal​ characteristics, which impact the​ learner's perception of a given cue. Recognizing the influence of the​ client's knowledge and intelligence level on the​ teaching-learning process reflects application of cognitive​ theory, as does assessing the​ client's knowledge base and adjusting the teaching content as needed. Rewarding the client by finishing his discharge paperwork once he has completed the teaching session best reflects application of behaviorist theory. Humanist theory describes the learner as comprising various​ factors, including spiritual beliefs and psychologic state.

The nurse is teaching an adolescent client how to perform a thorough breast​ self-examination using a realistic model of the breast. Which type of prevention activity has the nurse performed with this​ client? A. Tertiary prevention B. Secondary prevention C. Palliative prevention D. Primary prevention

A. Tertiary prevention ***B. Secondary prevention C. Palliative prevention D. Primary prevention Breast​ self-examination screens for potential masses. Thus it is a secondary prevention activity. There is no palliative prevention.

When initially evaluating the needs of children and​ families, it is most important for the nurse to have knowledge of which​ item? A. The Affordable Care Act​ (ACA) B. Ability to manage symptoms C. The Americans with Disabilities Act​ (ADA) D. Healthcare options

A. The Affordable Care Act​ (ACA) B. Ability to manage symptoms C. The Americans with Disabilities Act​ (ADA) ***D. Healthcare options When assessing a child and family for advocacy​ needs, it is most important for the nurse to look at the healthcare options available to the child and family. The nurse would take the client​'s ability to manage symptoms into account when working with a client with a mental health disorder. The nurse would not be involved in health insurance planning through the ACA. The ADA would not be part of the initial assessment of needs.

The nurse preceptor is designing a nursing orientation program that addresses abuse of power in the workplace. Which information should the nurse preceptor include in the​ program? A. The Joint Commission has not taken an official stand on addressing workplace intimidation. B. Bullying behaviors and incivility are among the leading causes of sentinel client events. C. Nursing research finds limited evidence of bullying and lateral violence among nursing professionals. D. Improper use of authority in the workplace is a form of sexual harassment.

A. The Joint Commission has not taken an official stand on addressing workplace intimidation. ***B. Bullying behaviors and incivility are among the leading causes of sentinel client events. C. Nursing research finds limited evidence of bullying and lateral violence among nursing professionals. D. Improper use of authority in the workplace is a form of sexual harassment. ​Intimidation, sexual​ harassment, bullying, and lateral violence are forms of abuse of power. In the healthcare​ setting, evidence of​ bullying, lateral​ violence, and incivility has been well documented in nursing research for more than three decades. The Joint Commission has identified bullying behaviors and incivility in health care as being among the leading causes of sentinel client events. The Joint Commission calls for zero tolerance of workplace bullying and intimidation and recommends that healthcare facilities implement policies to stop such behaviors.

The nurse is caring for a client with Down syndrome. The client was recently denied employment because of the​ syndrome, and the client and his mother are very upset and are requesting assistance. Which piece of federal legislation is most appropriate for the nurse to refer to when advocating for this​ client? A. The Social Security Act Amendments of 1965​ (SSA) B. The Americans with Disabilities Act of 1990​ (ADA) C. The Patient​ Self-Determination Act of 1991​ (PSDA) D. The Patient Protection and Affordable Care Act of 2010​ (PPACA)

A. The Social Security Act Amendments of 1965​ (SSA) ***B. The Americans with Disabilities Act of 1990​ (ADA) C. The Patient​ Self-Determination Act of 1991​ (PSDA) D. The Patient Protection and Affordable Care Act of 2010​ (PPACA) The client is afforded protection in the area of​ employment, public​ services, and benefits by the Americans with Disabilities Act of 1990. The PPACA is a health insurance and assurance act. The PSDA regards rights to​ decision-making in medical care. The SSA Amendments introduced the Medicare program.

A​ client, who recently was diagnosed with chronic fatigue​ syndrome, elatedly told the clinic​ nurse, "I've just signed up for a gym​ membership!" What information would be appropriate for the nurse to​ share? A. The client should exercise in the morning. B. The client should be cautious about beginning exercise. C. The client should plan to lift weights. D. The client should take aerobic exercise classes.

A. The client should exercise in the morning. ***B. The client should be cautious about beginning exercise. C. The client should plan to lift weights. D. The client should take aerobic exercise classes. With a diagnosis of chronic fatigue​ syndrome, the client should be cautious about beginning exercise. The client should not take aerobic exercise classes or plan to lift weights. Timing exercise for the morning hours does not make a helpful difference.

The nurse is developing client learning outcomes for an adult client who experiences recurrent respiratory infections. The client has smoked 1 pack of cigarettes each day for 20 years. Which learning outcome is most appropiate for inclusion in the teaching​ plan? A. The client will stop smoking today. B. Within two​ weeks, the client will not feel like smoking. C. During the teaching​ session, the client will be taught how cigarette smoke damages the pulmonary structures. D. Upon conclusion of the teaching​ session, the client will correctly state two types of nicotine replacement products.

A. The client will stop smoking today. B. Within two​ weeks, the client will not feel like smoking. C. During the teaching​ session, the client will be taught how cigarette smoke damages the pulmonary structures. ***D. Upon conclusion of the teaching​ session, the client will correctly state two types of nicotine replacement products. Each client learning outcome should reflect a measurable desired client behavior or performance that is both realistic and achievable. Verbalizing alternatives to cigarette smoking is an example of a measurable behavior. Expecting the client to stop smoking on the day of teaching is unrealistic. The​ client's feelings about smoking are not measurable. Statements concerning what the client will be taught reflect the​ nurse's teaching​ goals, not the​ client's learning outcomes.

During​ change-of-shift report, two​ medical-surgical nurses are discussing the pain management situation of a client with a low tolerance for pain. Giving repeated large doses of pain relievers bothered the evening shift​ nurse, but not the day shift nurse. Which statements about ethical client care are relevant in this​ situation? ​ (Select all that​ apply.) A. The day shift nurse has better personal ethical values about pain relief. B. The client should be warned about the dangers of overdosing on pain relievers. C. Each nurse might be operating with a different set of assumptions about pain relievers. D. The evening shift nurse has better personal ethical values about pain relief. E. The client should be helped to make an informed decision about pain relief measures.

A. The day shift nurse has better personal ethical values about pain relief. B. The client should be warned about the dangers of overdosing on pain relievers. ***C. Each nurse might be operating with a different set of assumptions about pain relievers. D. The evening shift nurse has better personal ethical values about pain relief. ***E. The client should be helped to make an informed decision about pain relief measures. Each nurse might be operating with a different set of assumptions about pain relievers. Where one sees pain​ relief, the other might see addiction potential. Neither nurse has better personal ethical values. The client should be helped to make an informed decision about pain relief measures. This education should not include scaring the client about overdosing.

The nurses on a care area are uncharacteristically quiet. There is no friendly​ chatter, and nurses are staying in clients' rooms to document until the end of the shift. Which incident might cause the nurses to demonstrate this​ behavior? A. The director is identifying staff for promotion. B. The nurse manager is working on the annual budget. C. The medical director is making client rounds. D. The charge nurse called everyone incompetent during report.

A. The director is identifying staff for promotion. B. The nurse manager is working on the annual budget. C. The medical director is making client rounds. ***D. The charge nurse called everyone incompetent during report. By calling the nursing staff​ incompetent, the charge​ nurse's aggressive behavior influenced all of the staff during the shift as they tried to avoid another similar encounter. The behavior of the nurse​ manager, director, and medical director did not cause the nurses to be afraid to leave​ clients' rooms.

The nurse is providing care to a client who is newly diagnosed with type 2 diabetes mellitus. The health care provider orders diabetic​ education, and notes that the client is noncompliant with his medication and diabetic diet. The client recently emigrated from Vietnam to live with his daughter and does not speak English. The client has expressed a desire to use traditional culturally based therapies to treat the diabetes. Repeat testing shows no improvement in glycemic control. Based on the client​'s ​culture, what are the barriers to the recommended diabetic​ care? ​(Select all that​ apply.) A. The lack of insurance B. Cultural belief that discussing the disease can influence the disease process C. The importance of the beliefs and cultural practices of the client​'s family and community D. The belief that illness is not related to pathophysiology E. Lack of trust in the health care system and providers

A. The lack of insurance ***B. Cultural belief that discussing the disease can influence the disease process ***C. The importance of the beliefs and cultural practices of the client​'s family and community ***D. The belief that illness is not related to pathophysiology ***E. Lack of trust in the health care system and providers Barriers to care that are influenced by cultural differences may include lack of trust in the health care system or the​ provider; the belief that illness is not related to​ pathophysiology; the influence of family and community as well as a cultural belief that discussing an illness can influence the disease process. Although a lack of insurance may influence the client​'s entry into​ care, it does not have cultural significance.

The manager is concerned that a novice nurse is being made a scapegoat for an event that occurred on the care area. Which observation supports this manager​'s ​concern? A. The novice nurse volunteers to work with other staff on a quality improvement study. B. The charge nurse meets with the oncoming shift to review clients who could be discharged later in the day. C. Nursing assistants are discussing work assignments and suggesting ways to help each other. D. Staff nurses suggest that the novice nurse is responsible for missing narcotics during a shift when the nurse was not at work.

A. The novice nurse volunteers to work with other staff on a quality improvement study. B. The charge nurse meets with the oncoming shift to review clients who could be discharged later in the day. C. Nursing assistants are discussing work assignments and suggesting ways to help each other. ***D. Staff nurses suggest that the novice nurse is responsible for missing narcotics during a shift when the nurse was not at work. Scapegoating occurs when an individual or group forces blame on an individual who is not at fault. People and groups who use this approach focus on​ others' weaknesses. Volunteering to work with other​ staff, discussing work​ assignments, and meeting to discuss possible discharges are all positive actions that do not indicate scapegoating.

​Sol, a​ 47-year-old man, wants to postpone his prostate surgery because his family will be gathering for Yom Kippur on that day. What is an appropriate nursing​ response? A. The nurse should insist that the client keep the surgery date. B. The nurse should ask the client whether his family will really mind if he​ doesn't join them for the holy day. C. The nurse should inform the surgeon of the scheduling problem and advocate for rescheduling the nonemergency procedure as soon as possible. D. The nurse should inform the client that his surgery may have to be postponed indefinitely.

A. The nurse should insist that the client keep the surgery date. B. The nurse should ask the client whether his family will really mind if he​ doesn't join them for the holy day. ***C. The nurse should inform the surgeon of the scheduling problem and advocate for rescheduling the nonemergency procedure as soon as possible. D. The nurse should inform the client that his surgery may have to be postponed indefinitely. Respecting the​ client's religious beliefs and practices is an important element in culturally competent nursing care. The nurse should not pressure clients about religious beliefs while informing them of medical concerns.

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

A. The nurse who treats the very dirty homeless person with respect B. The nurse who honors the decision of a client to reject blood transfusions C. The nurse who offers to work a religious holiday so that others can worship that day ***D. The nurse who treats the illegal immigrant in the same manner as a citizen The nurse who treats the illegal immigrant in the same manner as a citizen is demonstrating social justice. The nurse who treats the very dirty homeless person with respect honors human dignity. The nurse who honors the decision to reject blood transfusions is supporting​ clients' autonmy. The nurse who offers to work a religious holiday so that others can worship is showing altruism.

The nurse is taking care of a​ 10-year-old client receiving chemotherapy who is experiencing nausea that is distressing the client and parents. Which intervention would be most appropriate in implementing a​ family- centered plan of ​care? A. The nurse will provide small nutritious snacks to maintain body weight. B. The nurse will teach distraction techniques to decrease symptoms. C. The nurse will administer intravenous​ (IV) fluids to prevent dehydration. D. The nurse will administer pain medications as ordered to improve comfort.

A. The nurse will provide small nutritious snacks to maintain body weight. ***B. The nurse will teach distraction techniques to decrease symptoms. C. The nurse will administer intravenous​ (IV) fluids to prevent dehydration. D. The nurse will administer pain medications as ordered to improve comfort. Interventions are selected because they are related to a specific goal that is shared by the family and healthcare team. All of the interventions mentioned can be effectively used with the client receiving​ chemotherapy; however, only one intervention​ (teaching distraction) addresses the goal of decreasing symptoms of nausea.

The public health nurse is assessing the need for​ long-term care facilities in the community. What change in population of adults age​ > 85 years​ old, between 2008-​2050, should the nurse factor​ in? A. The population of adults age​ > 85 years old will double. B. The population of adults age​ > 85 years old will triple. C. The population of adults age​ > 85 years old will decrease by half. D. The population of adults age​ > 85 years old will increase by half.

A. The population of adults age​ > 85 years old will double. ***B. The population of adults age​ > 85 years old will triple. C. The population of adults age​ > 85 years old will decrease by half. D. The population of adults age​ > 85 years old will increase by half. Between 2008-​2050, the population of adults age​ > 85 years old will triple.

The nurse is preparing an educational session about nutrition for a community health fair. What information should the nurse include about​ obesity? (Select all that​ apply.) A. The prevalence of obesity has declined over recent years. B. Preventing obesity lowers the risk of developing hypertension. C. Refined​ foods, animal​ proteins, and fats contribute to obesity. D. Portion sizes help control body weight. E. Food choices contribute to the development of obesity.

A. The prevalence of obesity has declined over recent years. ***B. Preventing obesity lowers the risk of developing hypertension. ***C. Refined​ foods, animal​ proteins, and fats contribute to obesity. ***D. Portion sizes help control body weight. ***E. Food choices contribute to the development of obesity. Portion sizes and food choices both help control body weight and may help reduce the incidence of obesity. Refined​ foods, animal​ proteins, and fat intake contribute to obesity. Obesity is linked to the development of hypertension. The prevalence of obesity has increased​ 25% in adults and doubled in children and adolescents.

Angela​ Seitz, age​ 82, tells the nurse that the surgeon to whom she was referred told her that he does not do hip replacement surgery on someone as old as she. How would the nurse describe the​ surgeon's attitude? A. The surgeon is demonstrating homophobia. B. The surgeon is demonstrating ageism. C. The surgeon is demonstrating classism. D. The surgeon is demonstrating gender bias.

A. The surgeon is demonstrating homophobia. ***B. The surgeon is demonstrating ageism. C. The surgeon is demonstrating classism. D. The surgeon is demonstrating gender bias. Ageism is discrimination against older adults. Gender bias is demonstrating preferences towards one gender group over another. Classism involves oppressive practices based on socioeconomic status. Homophobia involves negative feelings or behaviors toward gays or lesbians.

A nurse is caring for a client with​ hepatitis, cirrhosis, and pernicious anemia. What do these conditions have in​ common? A. They are all caused by liver disease. B. They are all alterations of gastric absorption. C. They are all alterations of gastric motility. D. They all cause liver failure.

A. They are all caused by liver disease. ***B. They are all alterations of gastric absorption. C. They are all alterations of gastric motility. D. They all cause liver failure. ​Hepatitis, cirrhosis, and pernicious anemia are all alterations of gastric absorption. The other options are incorrect.

A nurse is caring for a client who sustained a chemical burn in his right eye. She's preparing to irrigate the eye with sterile normal saline solution. Which steps are appropriate when performing the procedure? SELECT ALL THAT APPLY A. Tilt the client's head toward his left eye B. Place absorbent pads in the area of the client's shoulder C. Wash hands and put on gloves D. Place the irrigation syringe directly on the cornea E. Direct the solution onto the exposed conjunctival sac from the inner to outer canthus F. Irrigate the eye for 1 minute

A. Tilt the client's head toward his left eye ***B. Place absorbent pads in the area of the client's shoulder ***C. Wash hands and put on gloves D. Place the irrigation syringe directly on the cornea ***E. Direct the solution onto the exposed conjunctival sac from the inner to outer canthus F. Irrigate the eye for 1 minute

The nurse is interviewing and educating a client about anatomy and knows that the ribs and muscles surround the​ thorax, or the chest. What explanation by the nurse would describe the primary purpose of the ribs in the​ chest? A. To aid in inspiration B. To push the lungs during deflation C. To protect the lungs from external injury D. To aid in exhalation

A. To aid in inspiration B. To push the lungs during deflation ***C. To protect the lungs from external injury D. To aid in exhalation The main job of the ribs is protecting the more fragile lungs and heart from injury during daily activity. Each set of ribs assists with​ respiration, but the primary purpose of ribs is to protect the lungs from​ puncture, bruising, and injury.

The nurse is providing care to a client with urinary incontinence who has been prescribed bladder training behavior modification. Which goal of therapy does the nurse include in the teaching session with the​ client? A. To toilet the client at regular intervals​ (e.g., every​ 2-4 hours) B. To toilet the client on a schedule that corresponds with the normal pattern C. To gradually increase the bladder capacity by increasing the intervals between voiding and resisting the urge to void between scheduled times D. To improve pelvic floor muscle strength by stopping the urine flow during voiding and holding for a few seconds

A. To toilet the client at regular intervals​ (e.g., every​ 2-4 hours) B. To toilet the client on a schedule that corresponds with the normal pattern ***C. To gradually increase the bladder capacity by increasing the intervals between voiding and resisting the urge to void between scheduled times D. To improve pelvic floor muscle strength by stopping the urine flow during voiding and holding for a few seconds Bladder training increases the bladder capacity by increasing the intervals between voiding and resisting the urge to void between scheduled times. Habit training is toileting on a schedule that corresponds with the normal pattern. Scheduled voiding is toileting at regular intervals. Kegel exercise is a technique that is done to identify the pelvic muscles for pelvic floor muscle.

Which is an accurate description of the term transsexual​? A. Transsexuals are individuals born with anatomical characteristics that do not seem to fit the typical definitions of female or male B. Transsexuals demonstrate preferences toward one gender group over another. C. Transsexuals are individuals who perceive themselves to be in the "wrong body." D. Transsexuals have negative feelings or behaviors toward gays or lesbians.

A. Transsexuals are individuals born with anatomical characteristics that do not seem to fit the typical definitions of female or male B. Transsexuals demonstrate preferences toward one gender group over another. ***C. Transsexuals are individuals who perceive themselves to be in the "wrong body." D. Transsexuals have negative feelings or behaviors toward gays or lesbians. Transsexuals are​ individuals, of any anatomical gender who perceive themselves to be in the "wrong body." Intersex refers to individuals born with anatomical characteristics that do not seem to fit the typical definitions of female or male. Sexists demonstrate preferences toward one gender group over another. Homophobes have negative feelings or behaviors toward gays or lesbians.

​Six-year-old Celine Toussaint has been diagnosed with sickle cell disease. She comes to the clinic with her grandparents and parents for​ follow-up care. In the assessment​ interview, the parents mention that they are both looking for work. Which nursing intervention would be appropriate for this​ family? A. Try to find a way to treat the child with less family involvement B. Facilitate connections with community resources C. Create an ecomap with the family D. Create a genogram with the family

A. Try to find a way to treat the child with less family involvement ***B. Facilitate connections with community resources C. Create an ecomap with the family D. Create a genogram with the family This family is at risk because of stressors related to serious illness and financial issues. The appropriate nursing intervention would be to facilitate connections with community resources that could address the​ family's immediate needs for employment. Intergenerational family support may be a major strength of this​ family, which the nurse would encourage. Family ecomaps and genograms are tools that nurses use in their​ assessments, not nursing interventions.

A client nearing the end of life is confused and pulls on the side rails to get out of bed. What action should the nurse take to ensure for the client​'s ​safety? A. Turn on the room lights B. Orient to place and time C. Apply wrist restraints D. Raise the height of the bed

A. Turn on the room lights ***B. Orient to place and time C. Apply wrist restraints D. Raise the height of the bed As sensory perception​ fades, the client is at increased risk for injury. Palliative interventions at this time should focus on maintaining the​ client's safety and orienting during periods of confusion. Wrist restraints cannot be applied without a healthcare​ provider's order. Turning on the room lights may not help orient the client. Raising the height of the bed could lead to an injury if the client attempts to get out of bed and falls.

A female client reports intense​ thirst, weight​ loss, and a large volume of urine when voiding. Which condition should the nurse consider that the client is​ experiencing? A. Urgency B. Polyuria C. Dysuria D. Enuresis

A. Urgency ***B. Polyuria C. Dysuria D. Enuresis Polyuria can cause excessive fluid​ loss, leading to intense​ thirst, dehydration, and weight loss. The assessment findings do not describe​ enuresis, urgency, or dysuria.

An immigrant Hmong family​ (parents and two​ children) comes to a local outpatient clinic in an area where many Hmong have settled. The​ mother, age​ 42, has a hacking cough. How should the nurse address the language​ barrier? A. Use signs and gestures to communicate B. Ask the oldest child to act as translator C. Ask the local immigrant service organization to provide an interpreter D. Conduct a physical assessment with no explanations

A. Use signs and gestures to communicate B. Ask the oldest child to act as translator ***C. Ask the local immigrant service organization to provide an interpreter D. Conduct a physical assessment with no explanations Asking a family member to act as translator may create confidentiality issues. Signs and gestures are inadequate for clear communication. A representative of a local organization will understand the culture and may even have specific helpful knowledge of the​ family's background. Federal law requires provision of an interpreter.

A nurse administrator is asked to write guidelines for the staff nurses for the use of the hospital​'s interpreter services for​ non-English-speaking clients. Which recommendations will the administrator include in the​ guidelines? ​(Select all that​ apply). A. Use technical medical terminology related to the client​'s diagnosis and treatment B. Provide teaching sheets in the client​'s language C. Address questions to the client D. Use family members as the first line of interpretation E. Use verbal and nonverbal cues when addressing the client

A. Use technical medical terminology related to the client​'s diagnosis and treatment ***B. Provide teaching sheets in the client​'s language ***C. Address questions to the client D. Use family members as the first line of interpretation ***E. Use verbal and nonverbal cues when addressing the client Effective communication with interpreter services includes using nonverbal and verbal​ communication, including eye​ contact; speaking in​ simple, not complex​ terms; and providing the client with teaching sheets in their language. Family members should not be used as interpreters for confidentiality reasons. Questions should be addressed to the client.

The nurse suspects that a​ 6-month-old client may be suffering from failure to thrive​ (FTT). What aspects of culture should the nurse take into account when performing an assessment of the​ client? A. Variances in childrearing practices in ethnic groups B. Social interaction patterns in ethnic groups C. Educational motivation among ethnic groups D. Variances in nutritional practices in ethnic groups

A. Variances in childrearing practices in ethnic groups B. Social interaction patterns in ethnic groups C. Educational motivation among ethnic groups ***D. Variances in nutritional practices in ethnic groups The aspects of culture the nurse should take into account when performing an assessment for FTT include nutritional practices. Educational​ motivation, variance in​ childrearing, and social interactions do not apply specifically to the assessment of the client with FTT.

A client who is overweight is upset to learn that she has gained 5 pounds over the past 2 months. The client states that she has been using nutritional bars to replace meals and expected to see a weight loss. What additional information should the nurse obtain from this​ client? A. Whether the nutritional bars are being eaten with calcium supplements B. The calorie content of the nutritional bars C. The time at which the nutritional bars are being eaten D. Whether the nutritional bars are being spaced throughout the day

A. Whether the nutritional bars are being eaten with calcium supplements ***B. The calorie content of the nutritional bars C. The time at which the nutritional bars are being eaten D. Whether the nutritional bars are being spaced throughout the day Nutritional bars provide needed protein and nutrient replacement for individuals who are unable to consume enough through traditional dietary intake. This client is using them as meal replacements to lose weight. Nutritional bars can be high in​ calories, which might be causing the client​'s weight gain. The nurse needs to learn the calorie content of the nutritional bars. The time at which the bars are eaten is not as important as the calories in the bars. The spacing of the bars throughout the day is not important information. Nutritional bars are not usually prescribed to be eaten with calcium supplements.

The nurse is reviewing laboratory values for a client with hyperthyroidism. Which component of the complete blood count will be most useful to the nurse in determining the​ client's fluid​ status? A. White blood cell count B. Platelet count C. Hematocrit D. Red blood cell count

A. White blood cell count B. Platelet count ***C. Hematocrit D. Red blood cell count Hematocrit​ (Hct) and hemoglobin​ (Hb) are useful in assessing a​ client's fluid status because they are influenced by plasma volume. Hct and Hb values are high with dehydration​ (as may occur with uncontrolled​ hyperthyroidism) and low with overhydration. Red and white blood cell and platelet counts are not useful in determining fluid status.

Prior to performing an​ assessment, a nurse states to the​ client, "This weather we are having is​ crazy, isn​'t ​it?" Which phase of the therapeutic relationship is the nurse​ displaying? A. Working B. Introductory C. Termination D. Preinteraction

A. Working ***B. Introductory C. Termination D. Preinteraction In the introductory​ phase, the nurse may discuss the weather or another general topic to put the client at ease. The preinteraction phase occurs prior to any​ face-to-face contact. During the working​ phase, the nurse helps the client identify feelings in order to help the client make decisions. The termination phase occurs at the end of the therapeutic relationship.

A young woman has just consumed a serving of ice cream pie and develops severe cramping and diarrhea. The school nurse suspects the woman is A. allergic to sugar B. experiencing infectious diarrhea C. deficit in fiber D. lactose intolerant

A. allergic to sugar B. experiencing infectious diarrhea C. deficit in fiber ***D. lactose intolerant

How is culture learned by each new generation? A. ethnic heritage B. belonging to a subculture CorrectC. formal and informal experiences D. involvement in religious activities

A. ethnic heritage B. belonging to a subculture ***C. formal and informal experiences D. involvement in religious activities Culture is a shared system of beliefs, values, and behavioral expectations that provide social structure for daily living. Culture includes the beliefs, habits, likes and dislikes, and customs and rituals learned through formal and informal experiences within one's family and the cultural group to which one belongs.

A patient states that his life has meaning and purpose, he feels loved, and has experienced forgiveness in his life. What is the term that describes this state of spirituality? A. spiritual alienation B. spiritual health C. spiritual bliss D. spiritual belief

A. spiritual alienation ***B. spiritual health C. spiritual bliss D. spiritual belief Defined most simply, spiritual health or well-being is the condition that exists when the universal spiritual needs for meaning and purpose, love and belonging, and forgiveness are met.

A nurse is caring for a client who has been diagnosed with autism spectrum disorder. His parents cannot understand how their son developed this disorder since there is no family history of it and the client was not subjected to harmful substances. Which response by the nurse is the most​ appropriate? A. ​"ASD is caused by poor nutritional​ intake." ​B. "Sometimes the specific cause of ASD cannot be​ determined." ​C. "Factors such as radiation​ exposure, parental​ age, or parental disease states can cause chromosomal​ disorders." D. ​"ASD is caused by low birth​ weight."

A. ​"ASD is caused by poor nutritional​ intake." ​***B. "Sometimes the specific cause of ASD cannot be​ determined." ​C. "Factors such as radiation​ exposure, parental​ age, or parental disease states can cause chromosomal​ disorders." D. ​"ASD is caused by low birth​ weight." Although the cause of ASD is​ unknown, it is believed to be associated with a complex interplay between​ genetic, immunologic, and environmental factors. The most appropriate answer from the nurse is that sometimes the specific cause of ASD cannot be determined. While low birth weight may be associated with the development of​ ASD, it is not a direct cause. ASD is not caused by poor nutritional intake. ASD is not a chromosomal​ disorder; therefore, this response is not appropriate for the parents of this child.

Karalynn​ Templeton, a community health​ nurse, is preparing to meet with her state representative to discuss the unmet needs of military families whose loved ones are deployed. During the​ meeting, which statement demonstrates Karalynn understands the process of developing health policy in the​ U.S.? A. ​"Along with a description of the healthcare​ issue, I've also included a list of political considerations related to​ it." B. ​"I realize that you are the person who decides whether or not a healthcare solution becomes a​ law." C. ​"In addition to other​ considerations, I'm aware that a proposed​ solution's anticipated effectiveness must be​ evaluated." D. ​"I understand that meeting with citizens about healthcare issues is not part of your​ role, so I really appreciate your​ time."

A. ​"Along with a description of the healthcare​ issue, I've also included a list of political considerations related to​ it." B. ​"I realize that you are the person who decides whether or not a healthcare solution becomes a​ law." ***C. ​"In addition to other​ considerations, I'm aware that a proposed​ solution's anticipated effectiveness must be​ evaluated." D. ​"I understand that meeting with citizens about healthcare issues is not part of your​ role, so I really appreciate your​ time." Government officials evaluate proposed solutions based on several​ factors, including costs and​ benefits, anticipated​ effectiveness, efficiency, and safety. Government​ officials' roles include hearing​ citizens' concerns about healthcare​ needs, as well as gathering information about reported issues. Government officials are also responsible for identifying political considerations associated with each healthcare issue and proposed solution. Passage of proposed healthcare solutions into law is not the government​ official's choice; it is a process that requires collaboration between lawmakers and government officials and adherence to procedures.

As a leader of her​ unit's quality assurance​ committee, Lourdes​ Soto, a critical care​ nurse, has been conducting reviews of​ clients' electronic health records.​ Lately, she has been experiencing sore wrists and dry eyes. Lourdes asks her charge nurse how to avoid complications related to prolonged periods of computer use. What is the best response by the charge​ nurse? A. ​"Be sure to keep your wrists flexed when​ you're working at the​ computer." B. ​"Minor aches and pains are commonly caused by prolonged periods of computer​ work, but they will not lead to​ disability." C. ​"Taking a break when using the computer is an important preventive​ measure." D. ​"To prevent computer vision​ syndrome, do not spend more than 6 hours each day working on a​ computer."

A. ​"Be sure to keep your wrists flexed when​ you're working at the​ computer." B. ​"Minor aches and pains are commonly caused by prolonged periods of computer​ work, but they will not lead to​ disability." ***C. ​"Taking a break when using the computer is an important preventive​ measure." D. ​"To prevent computer vision​ syndrome, do not spend more than 6 hours each day working on a​ computer." Common complaints following prolonged computer use include pain or fatigue in the​ neck, shoulders,​ back, arms,​ wrists, and hands. While some of these symptoms can be alleviated by proper ergonomics or breaks from the​ computer, simple aches and pains can lead to more serious injuries that cause disability. When seated at a computer work​ station, the​ worker's thighs should be parallel to the floor and the feet should rest flat on the floor or be supported by a footrest. The​ forearms, wrists, and hands should be straight and in line. Computer vision​ syndrome, or​ eyestrain, is the most common consequence of prolonger computer use. Symptoms include eye​ fatigue, blurred​ vision, headaches, dry​ eyes, and impaired color perception. Individuals who use a computer for more than 3 hours per day are at risk for computer vision syndrome. Positioning computer monitors​ properly, applying antiglare screen​ covers, ensuring correct​ lighting, and using proper document placement can all help reduce the effects of computer vision syndrome. Simple measures such as taking breaks and blinking also are important.

A community health nurse is providing teaching to a group of adults on the prevention of digestive disorders. Which statement will the nurse include in the​ teaching? A. ​"Digestive disorders are all inherited and cannot be​ prevented." B. ​"Immunizations help prevent Hepatitis​ A." C. ​"Digestive disorders can be prevented by diligent hand​ washing." D. ​"Immunizations help prevent Crohn​ disease."

A. ​"Digestive disorders are all inherited and cannot be​ prevented." ***B. ​"Immunizations help prevent Hepatitis​ A." C. ​"Digestive disorders can be prevented by diligent hand​ washing." D. ​"Immunizations help prevent Crohn​ disease." Immunizations help prevent Hepatitis A. Preventive methods do exist for digestive disorders and are primarily based on lifestyle​ choices, health​ management, and identifying the cause of the disorders. Immunizations do not help to prevent Crohn disease. While hand washing is important in health promotion and​ maintenance, this action does not prevent all digestive disease.

When discussing the process of developing a client teaching​ plan, the nursing student​ asks, "What's the purpose of the client learning​ outcomes?" How should the nurse educator​ respond? A. ​"Learning outcomes help the nurse to evaluate the​ client's developmental level and select appropriate teaching​ strategies." ​B. "Learning outcomes guide the teaching plan and help the nurse evaluate the effectiveness of the​ plan." ​C. "Learning outcomes help the client set goals and help to evaluate the​ client's degree of satisfaction with the teaching​ plan." ​D. "Learning outcomes identify the nursing interventions and help the client evaluate the effectiveness of the​ plan."

A. ​"Learning outcomes help the nurse to evaluate the​ client's developmental level and select appropriate teaching​ strategies." ​***B. "Learning outcomes guide the teaching plan and help the nurse evaluate the effectiveness of the​ plan." ​C. "Learning outcomes help the client set goals and help to evaluate the​ client's degree of satisfaction with the teaching​ plan." ​D. "Learning outcomes identify the nursing interventions and help the client evaluate the effectiveness of the​ plan." Learning outcomes serve two​ purposes: guiding the teaching plan and helping the nurse to evaluate the effectiveness of the teaching plan.

The staff development trainer provides a program on assertive communication for the staff of a care area. At the end of the​ program, the trainer​ states, "I​ can't believe I had to waste my time on​ this." Which response made by a nurse who attended the training indicates effective teaching has​ occurred? A. ​"Maybe you should read your own​ notes." B. ​"I'm sorry you had to spend so much time with us​ today." C. ​"It's your job. You want to do mine​ instead?" D. ​"I needed this​ training, and it​ wasn't a waste of time for​ me."

A. ​"Maybe you should read your own​ notes." B. ​"I'm sorry you had to spend so much time with us​ today." C. ​"It's your job. You want to do mine​ instead?" ***D. ​"I needed this​ training, and it​ wasn't a waste of time for​ me." Assertive statements use the word​ "I" to voice feelings and wishes without placing blame on someone else. The statement​ "I needed this training and it​ wasn't a waste of time for​ me" also includes a negative assertion in that the nurse repeats the​ trainer's phrase about the training being a waste of time. The statement beginning with​ "I'm sorry" is a passive response. The statements​ "It's your​ job?" and​ "maybe you should read your own​ notes" are both aggressive responses.

Sari​ Li-Holt, an experienced pediatric​ nurse, is applying to become the director of pediatric nursing. During her​ interview, the hospital administrator​ asks, "What type of healthcare information system would you suggest using for analysis of risk management and quality​ performance?" Which response by Sari is the most​ appropriate? A. ​"My recommendation would be to use a clinical decision support​ system." B. ​"I would recommend using an electronic health records​ system." C. ​"I would recommend using a clinical information​ system." D. ​"My recommendation would be to use an administrative information​ system."

A. ​"My recommendation would be to use a clinical decision support​ system." B. ​"I would recommend using an electronic health records​ system." C. ​"I would recommend using a clinical information​ system." ***D. ​"My recommendation would be to use an administrative information​ system." An administrative information system provides support and management for the business aspects of health​ care, including human​ resources, financial​ data, materials​ management, risk​ management, and quality performance. An electronic health records system​ (EHRS) is one of many terms that are commonly used to describe the computerized medical record​ (CMR). Clinical decision support systems are a type of artificial intelligence that analyze data and provide information about​ evidenced-based practices. A clinical information system allows multiple disciplines to simultaneously access the​ client's chart and record data that can be viewed and analyzed by multiple healthcare providers in real time.

Sandy​ Johnson, a​ 48-year-old public relations​ executive, has come in for her scheduled annual exam. She compiled a list of questions about her health. Which question would likely trigger a secondary prevention​ activity? A. ​"My skin seems very dry and flaky. Is there anything I can do to fix that​ condition?" B. ​"Can I get some diet suggestions so that I can lose a few pounds in the next​ month?" C. ​"What can I do about my difficulty getting to sleep and staying asleep at​ night?" D. ​"Should I worry about being thirsty all the time and urinating more​ often?"

A. ​"My skin seems very dry and flaky. Is there anything I can do to fix that​ condition?" B. ​"Can I get some diet suggestions so that I can lose a few pounds in the next​ month?" C. ​"What can I do about my difficulty getting to sleep and staying asleep at​ night?" ***D. ​"Should I worry about being thirsty all the time and urinating more​ often?" A secondary prevention activity involves screening. Ms.​ Johnson's increased thirst and urination could signal​ diabetes, for which she will be screened. There are no routine screens for​ insomnia, diets, or dry skin.

The nurse educator is giving a presentation on the role and functions of specialty nursing practice organizations to a group of staff nurses. Which statement is the most appropriate for the nurse educator to include in the presentation regarding these​ organizations? A. ​"Responsibilities of specialty nursing practice organizations include strengthening​ members' personal​ identities." B. ​"Examples of specialty nursing practice organizations include the American Nurses Association​ (ANA)." C. ​"Specialty nursing practice organizations advance nursing practice in the affiliated specialty​ area." D. ​"A small number of nursing specialties are supported by a professional specialty practice​ organization."

A. ​"Responsibilities of specialty nursing practice organizations include strengthening​ members' personal​ identities." B. ​"Examples of specialty nursing practice organizations include the American Nurses Association​ (ANA)." ***C. ​"Specialty nursing practice organizations advance nursing practice in the affiliated specialty​ area." D. ​"A small number of nursing specialties are supported by a professional specialty practice​ organization." Most nursing specialties are supported by a professional specialty practice organization. These organizations advance nursing practice in the affiliated specialty area and support practitioners and their clients. Responsibilities of specialty nursing practice organizations include strengthening​ members' professional identities. As opposed to being a specialty practice​ organization, the American Nurses Association​ (ANA) is the only​ full-service professional organization representing the​ nation's 3.1 million registered nurses.

Karl​ Jentzenn, a nurse at a county health​ department, receives a telephone call from Stacie​ Retellaire, a​ 22-year-old woman who is 7 months pregnant. Ms. Retellaire reports that she is unable to afford food and asks where she should go to enroll in the​ Women, Infants, and Children​ (WIC) supplemental nutrition program. Which response demonstrates that Karl understands the services offered by government​ agencies? A. ​"We can connect you to the state health​ department, who can enroll you in the WIC​ program." B. ​"WIC is a​ federally-administered program, so​ you'll need to contact the U.S. Department of Health and Human Services​ (DHHS) to​ enroll." C. "WIC is administered through the state offices of emergency medical services​ (OEMSs), so​ you'll need to enroll through that​ department." D. ​"We can provide you with food through the WIC​ program."

A. ​"We can connect you to the state health​ department, who can enroll you in the WIC​ program." B. ​"WIC is a​ federally-administered program, so​ you'll need to contact the U.S. Department of Health and Human Services​ (DHHS) to​ enroll." C. "WIC is administered through the state offices of emergency medical services​ (OEMSs), so​ you'll need to enroll through that​ department." ***D. ​"We can provide you with food through the WIC​ program." Local departments of health usually administer the​ Women, Infants, and Children​ (WIC) supplemental nutrition​ program, which provides food assistance to pregnant women and children under age 5 who are at risk for malnutrition. State offices of emergency medical services​ (OEMS) provide citizens with access to​ high-quality emergency medical care by ensuring that local emergency medical services​ (EMS) systems comply with all applicable regulations.

When documenting the​ client's teaching​ session, which component should the nurse​ include? A. ​Client-specific characteristics, such as cultural background and spiritual beliefs B. A detailed description of each teaching strategy that was used C. Degree to which client outcomes were achieved D. Names of the​ client's healthcare team members

A. ​Client-specific characteristics, such as cultural background and spiritual beliefs B. A detailed description of each teaching strategy that was used ***C. Degree to which client outcomes were achieved D. Names of the​ client's healthcare team members Documentation of the​ client's learning activities must include learning​ outcomes, topics of​ education, degree to which client outcomes were​ achieved, need for additional​ teaching, and resources provided. Identification of the members of the​ client's healthcare team is not necessary.​ Client-specific characteristics and teaching strategies are not included in the required documentation of learning activities.

The nurse is caring for a client receiving analgesics for pain. Which medication is considered a​ coanalgesic? A.Morphine B. Acetaminophen C. Aspirin D. Prednisone

A.Morphine B. Acetaminophen C. Aspirin ***D. Prednisone Prednisone is a corticosteroid that is considered a​ coanalgesic, a medication that may enhance pain relief when used in conjunction with an analgesic. Aspirin and acetaminophen are nonopioid analgesics. Morphine is an opioid analgesic.

A.B.C.

Airway, Breathing, & Circulation

A nurse puts on gloves to perform a fecal occult blood test using a Hemoccult slide. Place these steps in ascending chronological order. Use all the options. Allow the specimens to dry for 3 minutes Apply a drop of Hemoccult-developing solution to box A and box B on the reverse side of the slide Apply a smear of stool to box A on the slide Apply a smear of stool from another part of the specimen to box B on the slide Apply a drop of Hemoccult-developing solution to each control dot on the reverse side of the slide Evaluate the results; remove gloves; wash hands

Apply a smear of stool to box A on the slide Apply a smear of stool from another part of the specimen to box B on the slide Allow the specimens to dry for 3 minutes Apply a drop of Hemoccult-developing solution to each control dot on the reverse side of the slide Apply a drop of Hemoccult-developing solution to box A and box B on the reverse side of the slide Evaluate the results; remove gloves; wash hands

Comportment

Appropriate demeanor, dress, and language, that are in harmony with a caring presence. Presenting oneself as someone who respects others and in turn demands respect

A.D.P.I.E

Assessment, Diagnosis, Plan, Implementation, Evaluation

Ca

Calcium

Cl

Chlorine

Commitment

Convergence between one's desires and obligations and the deliberate choice to act in accordance with them

Dysphonia

Difficulty speaking (ex: jaw wired shut)

Self-Actualization

Fifth step in Maslow's Hierarchy. Achieving one's full potential including creative activities

Competence

Having the knowledge, judgement, skills, energy, experience, and motivation to respond adequately to others within the demands of professional responsibilities

640

How many muscles are in the body?

Maslow's Hierarchy of Needs

Physiological Needs, Safety, Belonging and Love, Self-Esteem, Self-Actualization

A nurse is preparing to leave a contact isolation room. Place the following steps in ascending chronological order as to how protective wear should be removed. USE ALL THE OPTIONS. Remove eyewear Remove gloves Remove mask Remove gown Wash hands for a minimum of 10 seconds

Remove gloves Remove gown Remove eyewear Remove mask Wash hands for a minimum of 10 seconds

A nurse investigates the smell of smoke in the hallway of a long-term care unit. She enters a client's room and finds the wastebasket is on fire. The nurse takes immediate action. Place the nurse's action in proper ascending chronological order. Use all the options. Trigger the alarm Extinguish the fire Rescue the client Confine the fire

Rescue the client Trigger the alarm Confine the fire Extinguish the fire RACE

Five Right of Delegation

Right Task- task is one that can be delegated for specific client Right Circumstances- setting is appropriate and resources are available Right Person- Give the right task to the right delegate for the right client Right Direction- Describe objectives, limits, and expectations Right Supervision- monitor, evaluate, give feedback, and intervene if necessary

crown, root, and pulp

What are the three parts of a tooth?

skeletal, smooth, and cardiac muscle

What are the three types of muscle?

Rest, Ice, Compression, Elevation

What is RICE?

deciduous teeth

What is the name for baby teeth?

Talk Test

When exercising, an individual should experience labored breathing, yet still be able to carry a conversation

A nurse is caring for a client who is terminally ill. Place the symptoms of the five stages of death and dying described by Elisabeth Kubler-Ross in ascending chronological order. USE ALL THE OPTIONS Negotiating, new interest in healthful behaviors Withdrawal, refusal to discuss health issues Calmness, honesty, involved in care management decisions Irritability, complaining, adversarial Loss, grief, intense, sadness

Withdrawal, refusal to discuss health issues Irritability, complaining, adversarial Negotiating, new interest in healthful behaviors Loss, grief, intense, sadness Calmness, honesty, involved in care management decisions

Fracture

a break in the continuity of a bone

Parkinson Disease

a central nervous system disorder caused by degeneration of neurons that produce dopamine

Client-Focused Care

a delivery model that organizes health care around the expressed physical and emotional needs of the client

Managed Care

a healthcare delivery system designed to provide cost-effective, high-quality care for groups of clients from the time of their initial contact with the health system through the conclusion of their health problem

Diagnosis-Related Groups

a hospital is paid a predetermined amount for clients with a specific diagnosis

Clinical decision making

a process nurses use in the clinical setting to evaluate and select the best actions to meet desired goals

Inquiry

a search for knowledge or facts

Critical Pathway

a standardized plan that helps track care provided to clients with similar, predictable medical conditions

Socialized Insurance

a system in which all medically necessary services are covered, including physician care, hospital services, and to some extent, prescription drugs

Differentiated Practice

a system in which each nurse's educational preparation and skill sets are evaluated and used to determine how the nurse will be utilized

Priority Decisions

about which interventions are most urgent and which can be delegated

ADL

activities of daily living

Pyorrhea

advanced periodontal disease-- teeth are loose and pus is evident when gums are pressed

p.c.

after meals

Horizontal Violence (HV)

aggressive acts committed against a nurse by one or more nursing colleagues

Ventilation

air circulating into and out of the lungs

Critical Thinking

all or part of the process of questioning, analysis, synthesis, interpretation, inference, inductive and deductive reasoning, intuition, application, and creativity

Ethical Knowing

all voluntary actions that are deliberate and subject to the judgement of right and wrong

Multiple Sclerosis

an autoimmune disorder that destroys the myelin sheath around nerves, disrupting transmission of nerve impluses

Manager

an individual employed by an organization to accomplish its goals

et

and

q.s.

as much as required, quantity sufficient

hs

at bedtime, hour of sleep

Compassion

awareness of one's relationship to others, sharing their joys, sorrows, pain, and accomplishments. Participation in the experience of another

Halitosis

bad breath

Empirical knowing

based in facts and observations relevant to nursing, as well as the analyses and theories that attempt to explain them

a.c.

before meals

Prospective Payment System

billing is determined before the client is ever admitted to the hospital

Physical Activity

bodily movement produced by skeletal muscle contraction that increases energy expenditure

Functional Strength

body's ability to perform work

Appendicular Skeleton

bones that make up appendages (limbs)

Assignment

bureaucratic functions that reflect job descriptions and client or organizational needs

PO

by mouth

per

by, through

cap or caps

capsule

C

carbon

Epiphyseal Plate

cartilage between the epiphysis and diaphysis

Osteoclast

cell that breaks down bone tissue

Osteoblasts

cells that produce the matrix for bone formation

Positive Feedback

characterized by a communication style that is warm, caring, and respectful

Osteoarthritis

characterized by degeneration of cartilage and bone in a joint, sometimes accompanied by bone spurs, or bony growths on normal bone

Team

comprises individuals who agree to work in tandem to accomplish a common goal

lordosis

concave curvature

Ligament

connects bone to bone

Tendon

connects bone to muscles

Group

consists of three or more individuals who share a common purpose, and who interdependently interact and influence one another

CR

controlled release

kyphosis

convex curvature

Cheilosis

cracking of lips

cc

cubic centimeter

Value Decisions

decisions regarding patient confidentiality

Atrophy

decrease

Collaboration

defined as two or more individuals working toward a common goal by combining their skills, knowledge, and resources while avoiding duplication of effort

Case Management

describes a range of models for integrating healthcare services for individuals or groups

D/C or DC

discontinue

dr or z

dram

gt or gtt

drop(s)

Aerobic Exercise

during this exercise, the amount of oxygen taken into the body is greater than that used to perform the activity. Improve cardiovascular conditioning.

Anaerobic Exercise

during this exercise, the muscles cannot draw out enough oxygen from the bloodstream, and anaerobic pathways are used to provide additional energy for a short time

Isotonic Exercises

dynamic exercises (most physical conditioning exercises) -- running, walking, swimming, cycling, and other activities. ADLs and ROMs initiated b the patient. bed exercises include pushing/pulling against a stationary object, using a trapeze to lift the body off the bed, lifting the buttocks off the bed by pushing with the hands against the mattress, and pushing the body to a sitting position

el or elix

elixir

Hypertrophy

enlarge

EC

enteric coated

q2h

every 2 hours

q3h

every 3 hours

q4h

every 4 hours

q.h.

every hour

Sarcomeres

filaments made of actin and myosin

Creativity

finding unique solutions to unique problems, when traditional interventions are not effective

Physiological Needs

first step in Maslow's Hierarchy. Food, Water, Warmth, Rest

Care Management Model

focuses on the needs of the integrated delivery system

Research

formal systematic way of answering a question or approaching a problem

Intradisciplinary Team

formed by members of the SAME profession

Intradisciplinary Team

formed by members of the same profession who work toward achieving a common goal

Interdisciplinary Team

formed by members of varied professions

Joint

formed where two bones meet

Esteem Needs

fourth step in Maslow's Hierarchy. Prestige and feeling of accomplishment

ad lib.

freely, as desired

GI

gastrointestinal

H2O2

hydrogen peroxide

Root Cause Analysis

identifying the root factor to promote better outcomes

STAT

immediately

Negative Feedback

implies not negative content but rather a negative communication style such as an attitude on condescension

PR or pr

in the rectum

Intellect

includes the ability to learn and understand knowledge; the capacity for thinking and reasoning intelligently

Salient Cues

indicates a negative or positive change in a patient's health status or pattern, varies from norms of the patient's population, or indicates a developmental delay

Gingivitis

inflammation of the gums

Sordes

inflammation of the oral mucosa

Parotitis

inflammation of the parotid salivary glands

Glossitis

inflammation of the tongue

Nursing Diagnostic

information you get from a patient

inj

injection

Public Insurance

insurance financed by the government

Private Insurance

insurance provided by private or publicly owned companies such as Blue Cross Blue Shield, Kaiser Permanente, or Aetna

I&O

intake & output

ID

intradermal

IM

intramuscular

IVPB

intravenous piggy back

Plaque

invisible soft film that adheres to the enamel surface of teeth

Isokinetic Exercises

involve muscle contraction or tension against resistance

KVO

keep vein open

Mandatory Health Insurance

large, nonprofit health insurance organizations called "sickness funds." These sickness funds are usually organized around large employers or work-based associations

LA

long acting

Workplace Bullying

malicious, repeated, harmful mistreatment of an individual with whom one works, regardless of whether that individual is an equal, a superior, or a subordinate

Interprofessional Team

members work together to deliver client care, but a single team member (physician) makes the treatment decisions

m

meter

MDI

metered dose inhaler

mcg

microgram

mEq

milliequivalent

mg

milligram

mL

milliliter

mmol

millimole

-

minus, negative, alkaline reaction

Conscience

morals, ethics, and an informed sense of right and wrong. Awareness of personal responsibility

Interorganizational Conflict

most commonly considered to involve competition between two organizations that exist within one market

Florence Nightingale

mother or modern nursing

Isometric Exercises

muscles contract without moving the joint

NG

nasogastric

NEB

nebulizer

NKA

no known allergies

NKDA

no known drug allergies

NA

not applicable

NPO

nothing by mouth

Intergroup Conflict

occurs between teams that are in competition or opposition to one another. In some cases, the groups are competing for rewards or scarce resources

Interpersonal Conflict

occurs between two or more individuals; sometimes this is due to differences and/or personalities, competition, or concern about territory, control, or loss

Conflict

occurs when agreement cannot be reached with regard to significant issues and concerns or when emotional opposition creates discord within an individual or between individuals, groups or organizations

Xerostomia

occurs when the supply of saliva is reduced

Mutual Respect

occurs when two or more individuals show or feel honor or esteem toward one another

Intrapersonal Conflict

occurs within an individual, is stress or tension that results from real or perceived pressure generated by incompatible expectations or goals

aa

of each

oz

ounce

%

percent

Nursing Vacancy Rate

percentage of unfilled positions for which an organization is recruiting

+

plus, positive, acid reaction

K

potassium

lb or #

pound

Health

presence or absence of disease. State of well-being

Sarcopenia

process in which muscle fibers decrease with age

Empowerment

process whereby the client develops the autonomy to identify her own health needs in lieu of being instructed how to do so

Voluntary Insurance

provides no guarantee of universality because coverage may be expensive and difficult to purchase

Case Management

purpose is to coordinate, facilitate, and follow, over time, a client's use of a variety of health and social services

Activity-Exercise Pattern

refers to an individual's routine of exercise, activity, leisure, and recreation

Care Map

refers to the expected outcomes and care strategies developed through collaboration by the healthcare team

Strategic Planning

refers to the process of continual assessment, planning, and evaluation to guide the future

Isokinetic Exercises

resistive exercises -- special machines/devices provide the resistance to the movement. These exercises are used in physical conditioning and are often done to build up certain muscle groups

Gingiva

scientific name for gum

Safety Needs

second step in Maslow's Hierarchy. Security, Safety

Interdisciplinary Team

seek to achieve a common goal; however, they comprise professionals with varied backgrounds

Na

sodium

Leader

someone who uses interpersonal skills to influence others to accomplish a specific goal

Reverse Delegation

someone with a lower rank delegates to someone with more authority

Benchmarking

standards for structure, process, outcome. indicators of performance

Isometric Exercises

static or setting exercises-- involve exerting pressure against a solid object and useful for strengthening abdominal, gluteal, and quadriceps muscles used in ambulation; for maintaining strength in immobilized muscles in casts or traction; and for endurance training

Strain

stretching or tearing of a muscle or tendon

Sprain

stretching or tearing of ligaments

SC, SQ, or sub q

subcutaneous

Aesthetic Knowing

subjective and relates to the specific personal styles the nurse possesses when delivering care

Scheduling Decisions

such as bathing a client before visiting hours

Time Management Decisions

such as taking clean linens to a room at the same time as medication to be administered

supp

suppository

susp

suspension

S&S

swish and swallow

syr

syrup

tsp

teaspoon

Ambulation

the ability to walk from place to place independently with or without an assistive device

Reflection

the action of making sense of occurrences, situations, or decisions by carefully considering the totality of the experience: what worked or what did not work, what could have been done differently to achieve better outcomes, what was done well, what necessary resources were available

Axial Skeleton

the bones that make up your trunk, head, and vertebral column

Covert Conflict

the conflict is not discussed openly; may be avoided or ignored

Team Nursing

the delivery of individualized nursing care to a group of clients by a team led by a professional nurse

Delegator

the individual who assigns the task and retains accountability for the outcome

Delegate

the individual who assumes responsibility for the actual performance of the task or procedure

Overt Conflict

the individuals or group members who are in conflict address the conflict openly

Contingency Planning

the manager identifies and manages unplanned and unexpected events that interfere with getting work done efficiently, effectively, and in a timely manner

Care Coordination

the means by which an interdisciplinary team works with a client to ensure that the client receives the care necessary to meet his needs across the healthcare continuum

Isotonic Exercises

the muscle shortens to produce muscle contraction and active movement

Presencing

the nurse immerses himself in an interaction with the client that helps the client define her health choices

Inductive Reasoning

the nurse works from the "bottom up" by putting significant cues together to reach a conclusion

Deductive Reasoning

the nurse works from the "top down" by starting with a conclusion and analyzing it for valid significant cues

Personal Knowing

the nurse's ongoing self-exploration and self-actualization

Clinical Judgement

the nurses determination and provision of appropriate care to the patient

Resorption

the process by which bone is broken down and its minerals released into the blood

Confidence

the quality that fosters trusting relationships. Comfort with self, client, and family

Authority

the right to act or accomplish the task

Socialized Medicine

the state owns and controls healthcare services

Norton's Theory of Communicator Style

the style as the manner in which one communicates and includes the way in which one interacts

Delegation

the transference of responsibility and authority for an activity to a competent individual

Activity Tolerance

the type and amount of exercise or daily living activities an individual is able to perform without experiencing adverse effects

Clinical Reasoning

the use of careful reasoning in the clinical setting to improve patient care, is a learned skill that beginning nurses must practice

Intuition

the use of nursing knowledge, experience, and expertise for understanding without the conscious use of reasoning

Belongingness and Love Needs

third step in Maslow's Hierarchy. intimate relationships, friends

TID

three times each day

TKO

to keep open

RX

treatment, "take thou"

BID

twice each day

Cartilage

type of flexible connective tissue found throughout the body

Exercise

type of physical activity defined as a planned, structured, and repetitive bodily movement performed to improve or maintain one or more components of physical fitness

Evidence Based Practice

used to close the gap between research and the actual practice of nursing

Tartar

visible, hard deposit of plaque and dead bacteria that forms at the gum lines

H2O

water

Overdelegation

when the delegator loses control of a situation by providing the delegate with too much authority or too much responsibility

prn or PRN

whenever necessary

A nurse educator is teaching a group of student nurses about correct documentation techniques. Which statements are appropriate for the nurse educator to include in the teaching​ session? ​(Select all that​ apply.) ​A. "Document in a timely​ manner." B. ​"Document the​ client's response to​ interventions." C. ​"Do not document the​ client's actual​ words." D. ​"Use subjective and thorough​ descriptions." E. ​"Follow organizational policies to correct charting​ errors."

​***A. "Document in a timely​ manner." ***B. ​"Document the​ client's response to​ interventions." C. ​"Do not document the​ client's actual​ words." D. ​"Use subjective and thorough​ descriptions." ***E. ​"Follow organizational policies to correct charting​ errors." Nurses should document the​ client's response to​ interventions, follow organizational policies to correct charting​ errors, and document in a timely manner. The nurse should document the​ client's actual words using quotation marks around the client statement. Documentation should be​ objective, not subjective.

The nurse at a college health center is discharging a​ 19-year-old female client following her annual sports physical and gynecological exam. As the nurse is completing the​ client's discharge​ teaching, the client​ states, "I read online that you​ can't get pregnant while​ you're on your​ period." Which information should the nurse include in her​ response? ​(Select all that​ apply.) ​A. "I'm glad you brought this up. A lot of people believe that you​ can't get pregnant while​ you're on your​ period, but you​ can." ​B. "Don't believe what you read on the Internet. Almost all online information is​ incorrect." C. ​"Tell me more about your understanding of the times when a woman is most likely to get​ pregnant." ​D. "Most of what​ you'll find on the Internet is​ accurate, but that is not. Where did you read that you​ couldn't get pregnant while you were on your​ period?" ​E. "That's foolishness. Of course you can get pregnant while​ you're on your​ period."

​***A. "I'm glad you brought this up. A lot of people believe that you​ can't get pregnant while​ you're on your​ period, but you​ can." ​B. "Don't believe what you read on the Internet. Almost all online information is​ incorrect." ***C. ​"Tell me more about your understanding of the times when a woman is most likely to get​ pregnant." ​D. "Most of what​ you'll find on the Internet is​ accurate, but that is not. Where did you read that you​ couldn't get pregnant while you were on your​ period?" ​E. "That's foolishness. Of course you can get pregnant while​ you're on your​ period." By praising the client for bringing up a topic of​ education, the nurse is offering encouragement. By asking the client to share her current​ knowledge, the nurse is attempting to assess the​ client's knowledge base and actively engage the client in the learning​ process, both of which promote effective learning. Instead of referring to the​ client's erroneous belief as​ "foolishness," the nurse should offer nonjudgmental support and teach the client accurate information. The Internet is a source of both accurate and inaccurate information.

The parents of a toddler are concerned that their daughter sits quietly to​ play, but does not actively interact with her playmates who are sitting nearby. What should the nurse explain to the​ parents? ​A. "It is typical for toddlers to engage in parallel​ play." ​B. "It is typical for toddlers to engage in cooperative​ play." ​C. "It is typical for toddlers to engage in solitary​ play." ​D. "It is typical for toddlers to engage in dramatic​ play."

​***A. "It is typical for toddlers to engage in parallel​ play." ​B. "It is typical for toddlers to engage in cooperative​ play." ​C. "It is typical for toddlers to engage in solitary​ play." ​D. "It is typical for toddlers to engage in dramatic​ play." Toddlers engage in both parallel play and imitative play. Responding that it is typical for a toddler to engage in solitary​ play, cooperative​ play, or dramatic play is not correct.

A nurse is caring for a client with a sleep disorder. Which questions by the nurse are most appropriate when asking the client about the current​ problem? ​(Select all that​ apply.) ​A. "Which activities make the discomfort better or​ worse?" ​B. "How long have you had this​ discomfort?" ​C. "Have you had past experiences that affect the way you view this​ discomfort?" D. ​"How would you describe your​ discomfort?" ​E. "When did your discomfort​ start?"

​***A. "Which activities make the discomfort better or​ worse?" ​***B. "How long have you had this​ discomfort?" ​C. "Have you had past experiences that affect the way you view this​ discomfort?" ***D. ​"How would you describe your​ discomfort?" ***​E. "When did your discomfort​ start?" Asking the client about past experiences related to how the client views the current problem would be a question the nurse would ask about health​ history, not the current problem. All other statements are correct.

During a home​ visit, the nurse determines the outcome of care provided to a client who developed a postoperative fever. Which outcome indicates that care has been​ successful? ​A. Client's body temperature is 98.4degrees° F without the use of antipyretics B. Client appears flushed and skin warm to the touch C. Client heart rate is 100 beats per minute and respirations are 28 ​D. Client's temperature spikes occur only during the night

​***A. Client's body temperature is 98.4degrees° F without the use of antipyretics B. Client appears flushed and skin warm to the touch C. Client heart rate is 100 beats per minute and respirations are 28 ​D. Client's temperature spikes occur only during the night Evidence that interventions to reduce a fever were effective would be the client having a normal body temperature without the use of antipyretics. Flushed and warm skin indicates the client is still experiencing a fever. Temperature spikes indicate that the fever is still present. A heart rate of 100 and respiratory rate of 28 indicate the​ client's metabolic rate is still being affected by the fever.

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? ​A. Patient-centered care B. Quality improvement C. Teamwork and collaboration ​D. Evidence-based practice

​***A. Patient-centered care B. Quality improvement C. Teamwork and collaboration ​D. Evidence-based practice 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 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.) ​A. Puncture-resistant containers for used sharps are appropriately mounted. B. Schedule for staff to view the DVD on safety issues is posted. C. Safety information is posted in the staff lounge. D. Glove boxes are filled and placed at each point of client access. ​E. Water, soap and hand hygiene disinfectant is available at all client bedsides.

​***A. Puncture-resistant containers for used sharps are appropriately mounted. B. Schedule for staff to view the DVD on safety issues is posted. C. Safety information is posted in the staff lounge. ***D. Glove boxes are filled and placed at each point of client access. ​***E. Water, soap and hand hygiene disinfectant is available at all client bedsides. 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.

A client with a central venous pressure​ (CVP) of 14 is currently being seen by the cardiologist. Which nursing assessment is the most appropriate for this​ client? ​A. System-specific assessment B. Baseline assessment C. Ongoing reassessment D. Emergency assessment

​***A. System-specific assessment B. Baseline assessment C. Ongoing reassessment D. Emergency assessment The most appropriate nursing assessment for the client being seen at the​ cardiologist's office is a​ system-specific assessment, which is done on an ongoing basis and integrated with current nursing care to determine the status of a specific problem identified earlier. An ongoing assessment is done to compare initial assessment several months later while in a home care setting. An emergency assessment is performed during a physical or psychological​ crisis; and a baseline assessment is an initial assessment identifying problems from data gathered soon after admission to a healthcare agency.

A nurse working in a pediatric clinic receives a call from the parent of a child who is displaying symptoms of influenza. The parent wants to administer aspirin for relief of the​ child's discomfort. Which is the best response by the​ nurse? ​A. "Administer aspirin with caution. Measure the dose​ accurately." B. ​"Administer aspirin with caution. It is best to give the medication with​ food." C. ​"Do not administer aspirin. This medication will damage your​ child's liver." D. ​"Do not administer aspirin. This medication should not be used if your child has​ influenza."

​A. "Administer aspirin with caution. Measure the dose​ accurately." B. ​"Administer aspirin with caution. It is best to give the medication with​ food." C. ​"Do not administer aspirin. This medication will damage your​ child's liver." ***D. ​"Do not administer aspirin. This medication should not be used if your child has​ influenza." Aspirin, an NSAID used to treat​ discomfort, should always be used with caution with​ children, but should never be used in children displaying​ flu-like symptoms.

A nurse educator is asked to describe the responsibilities of an effective mentor. Which statements are the most​ appropriate? ​(Select all that​ apply.) ​A. "During the mentorship​ process, the protege challenges the mentor to advance​ professionally." ​B. "During the mentorship​ process, the protege introduces the mentor to influential individuals who can assist with career​ advancement." ​C. "The mentor assists the protege with learning policies and​ procedures." ​D. "The mentor advises the protege about role​ expectations." ​E. "It is the​ mentor's responsibility to help the protege evaluate ideas in the context of institutional​ policy."

​A. "During the mentorship​ process, the protege challenges the mentor to advance​ professionally." ​B. "During the mentorship​ process, the protege introduces the mentor to influential individuals who can assist with career​ advancement." ​C. "The mentor assists the protege with learning policies and​ procedures." ​***D. "The mentor advises the protege about role​ expectations." ​***E. "It is the​ mentor's responsibility to help the protege evaluate ideas in the context of institutional​ policy." The​ mentor's responsibilities include advising the protege regarding role expectations and helping the protege evaluate ideas in the context of institutional policy. The mentor also introduces the protege to influential individuals who can assist with career advancement and challenges the protege to advance​ professionally, not vice versa. Preceptors assist novice nurses to learn​ routines, policies, and procedures.

A nurse instructor is teaching a group of nursing students about concepts that are related to comfort. Which statements will the nurse include in​ teaching? ​(Select all that​ apply.) ​A. "Grief and loss is related to comfort in that loss or expected loss of a loved one creates physical​ discomfort." B. ​"Tissue integrity is related to comfort in that decreased tissue integrity increases the risk for​ pain." ​C. "Ethics is related to comfort in that healthcare providers may be reluctant to prescribe opioids based on​ race." ​D. "Mobility is related to comfort in that decreased mobility is often caused by​ pain, injury, or​ disease." ​E. "Inflammation is related to comfort in that inflammation causes​ pain."

​A. "Grief and loss is related to comfort in that loss or expected loss of a loved one creates physical​ discomfort." ***B. ​"Tissue integrity is related to comfort in that decreased tissue integrity increases the risk for​ pain." ***​C. "Ethics is related to comfort in that healthcare providers may be reluctant to prescribe opioids based on​ race." ***​D. "Mobility is related to comfort in that decreased mobility is often caused by​ pain, injury, or​ disease." ***​E. "Inflammation is related to comfort in that inflammation causes​ pain." Inflammation is related to comfort in that inflammation causes pain. Mobility is related to comfort in that decreased mobility is often caused by​ pain, injury, or disease. Tissue integrity is related to comfort in that decreased tissue integrity increases the risk for pain. Ethics is related to comfort in that healthcare providers may be reluctant to prescribe opioids based on race. Grief and loss is related to​ comfort; however, the loss or expected loss of a loved one creates​ emotional, not​ physical, discomfort.

The public health nurse is discussing immunization choices with the parents of an infant. The parents have decided to decline routine vaccinations. What question could the nurse ask the parents to help them examine possible consequences oftheir ​choice? ​A. "How do you feel about your decision to withhold​ vaccinations?" B. ​"Do you know any other parents who are withholding​ vaccinations?" C. ​"How much research have you done about withholding​ vaccinations?" D. ​"What benefits do you foresee from withholding​ vaccinations?"

​A. "How do you feel about your decision to withhold​ vaccinations?" B. ​"Do you know any other parents who are withholding​ vaccinations?" C. ​"How much research have you done about withholding​ vaccinations?" ***D. ​"What benefits do you foresee from withholding​ vaccinations?" To help the parents examine possible consequences of their​ choice, the nurse could ask about expected benefits. It is not helpful to challenge the parents about the research basis for their decision. Knowing other parents who have made the same decision does not honor the autonomy of these parents. Clarifying how the parents feel about their decision is different from helping them examine possible consequences.

While transferring a client back into bed after a​ procedure, the client says that it​ wasn't very nice for the nurse to say that the​ "cow" was coming down the hall. Which response by the nurse is most appropriate in this​ situation? ​A. "I was just joking with that​ person!" B. ​"The term​ 'cow' is used for computer on​ wheels." C. ​"You must have misunderstood what I​ said." D. ​"I didn't mean to call someone a​ cow!"

​A. "I was just joking with that​ person!" ***B. ​"The term​ 'cow' is used for computer on​ wheels." C. ​"You must have misunderstood what I​ said." D. ​"I didn't mean to call someone a​ cow!" The nurse should avoid using jargon when communicating with clients. The client did not understand the acronym​ "C.O.W." as meaning a computer on wheels. The nurse needs to explain the term in language the client understands. The nurse should not become argumentative and deny using the term. The client did not misunderstand the nurse. Saying that the nurse was joking with another person supports the​ client's claim that the nurse called someone a​ "cow."

As the newly hired nurse in the fertility​ clinic, you feel your own success with in vitro fertilization​ (IVF) makes you a unique resource for clients. This​ morning, Helena and Chad​ Smythe, both​ 39-year-old accountants, have a scheduled appointment. They have been to the fertility clinic for several years. Each time Helena and her husband find out that the IVF was not​ successful, her mood spirals downward. Helena and Chad tell you that they have decided to adopt a​ child, rather than have Helena continue to suffer from increasing depression.​ "My wife's mental health is so important to​ me," Chad relates. Helena nods in agreement. Which response would show that you understand the ethical value of​ advocacy? ​A. "I would suggest that you try IVF one more time before you give​ up." B. ​"I understand why you​ don't want to continue with IVF and support you in that​ choice." C. ​"I kept trying and waited for new developments in​ IVF." D. ​"I would like to tell you about my experience with​ IVF."

​A. "I would suggest that you try IVF one more time before you give​ up." ***B. ​"I understand why you​ don't want to continue with IVF and support you in that​ choice." C. ​"I kept trying and waited for new developments in​ IVF." D. ​"I would like to tell you about my experience with​ IVF." Advocacy is based on the best interests of the clients. If they have made the decision to stop trying​ IVF, you support their decision. Telling about your own experience is not advocacy. Suggesting continuing treatment or talking about new developments is not advocacy in the face of the​ clients' decision to stop treatment.

A client who is scheduled for a polysomnography​ (PSG) asks the nurse to explain the purpose of using video and audio equipment during the sleep study. Which response by the nurse is most​ appropriate? ​A. "It is useful for evaluating REM sleep​ patterns." B. ​"It can be helpful for identifying restless leg​ syndrome." C. ​"It may be useful for detecting various​ parasomnias." D. ​"It is used to detect periodic limb movement​ disorder."

​A. "It is useful for evaluating REM sleep​ patterns." B. ​"It can be helpful for identifying restless leg​ syndrome." ***C. ​"It may be useful for detecting various​ parasomnias." D. ​"It is used to detect periodic limb movement​ disorder." Monitoring with video and audio equipment may be useful for detecting​ parasomnias, such as​ sleepwalking, sleep​ talking, and night terrors. Leg movements are monitored to detect periodic limb movement disorder and restless leg syndrome. PSG testing also includes electroencephalogram​ (EEG) monitoring to evaluate brain waves associated with NREM and REM sleep​ patterns, which can be analyzed to identify sleep disorders.

The nurse is providing care to a client who is prescribed a complete decompression of bladder using intermittent catheterization. Which explanation about this procedure to the family is the most​ appropriate? ​A. "The postvoiding insertion of a catheter to determine the volume of urine retained in the​ bladder." B. ​"A diagnostic​ uroflowmetry." C. ​"A nonpharmachologic therapy for urinary​ retention." D. ​"A diagnostic urodynamic​ test."

​A. "The postvoiding insertion of a catheter to determine the volume of urine retained in the​ bladder." B. ​"A diagnostic​ uroflowmetry." ***C. ​"A nonpharmachologic therapy for urinary​ retention." D. ​"A diagnostic urodynamic​ test." Complete decompression of bladder using intermittent catheterization or an indwelling catheter is a nonpharmachologic therapy for urinary retention. The postvoiding insertion of a catheter to determine the volume of urine retained in the bladder is used to determine how completely the bladder empties with voiding. Uroflowmetry is used to evaluate voiding patterns. Urodynamic testing measures bladder strength and urinary sphincter health.

A nurse is providing care for a client who is suspected to have Alzheimer disease​ (AD). The client has numerous tests scheduled. The client asks the nurse why there are so many tests ordered. Which response by the nurse is the most​ appropriate? ​A. "There are a number of diagnostic tests that are needed to accurately diagnose Alzheimer​ disease." B. ​"The tests are used to identify which gene is causing Alzheimer​ disease." C. ​"The tests are necessary to determine what is causing Alzheimer​ disease." D. ​"Alzheimer disease is diagnosed in part by ruling out other diseases that affect​ memory."

​A. "There are a number of diagnostic tests that are needed to accurately diagnose Alzheimer​ disease." B. ​"The tests are used to identify which gene is causing Alzheimer​ disease." C. ​"The tests are necessary to determine what is causing Alzheimer​ disease." ***D. ​"Alzheimer disease is diagnosed in part by ruling out other diseases that affect​ memory." AD cannot be definitively diagnosed without examining a piece of brain tissue. This is done at autopsy. AD is diagnosed by excluding other disorders. There are screening tools that identify cognition​ issues, but do not necessarily diagnose AD. The other statements are not appropriate or accurate.

A​ protégé is asked to describe her successful relationship with her nurse mentor. Which statement should she​ include? ​A. "We regularly evaluate professional​ outcomes, but we do not evaluate personal​ outcomes." B. ​"My mentor redefines our relationship as​ necessary." ​C. "To facilitate the​ relationship, we schedule one conversation each​ week." ​D. "When we began the​ mentorship, we set clear definition of goals and​ objectives."

​A. "We regularly evaluate professional​ outcomes, but we do not evaluate personal​ outcomes." B. ​"My mentor redefines our relationship as​ necessary." ​C. "To facilitate the​ relationship, we schedule one conversation each​ week." ***​D. "When we began the​ mentorship, we set clear definition of goals and​ objectives." The​ mentor-protégé relationship is mutually redefined as needed. Early in the​ process, goals and objectives are clearly defined. Evaluation includes both personal and professional outcomes.​ Open, frequent communication is a hallmark of the process.

The nurse is assessing the cultural needs of an adult male client who states that he believes in the​ hot-cold theory. Which response by the nurse indicates understanding of the basis of this cultural​ belief? ​A. "What does this belief have to do with your health​ care?" B. ​"I am not familiar with this theory. Would you be willing to share more information about it with​ me?" C. ​"That is ridiculous and we cannot agree with this​ theory." D. ​"Is this the practice of​ voodoo?"

​A. "What does this belief have to do with your health​ care?" ***B. ​"I am not familiar with this theory. Would you be willing to share more information about it with​ me?" C. ​"That is ridiculous and we cannot agree with this​ theory." D. ​"Is this the practice of​ voodoo?" Asking the client about his belief ensures that the nurse understands it. The nurse would not be judgmental or enforce beliefs onto the​ client, and using words like "ridiculous" is unacceptable and shows no cultural knowledge. Asking the client if the practice of the​ hot-cold theory is voodoo would indicate that the nurse does not have a cultural knowledge or understanding and would not make the client feel comfortable. Asking this client what his belief has to do with his health care would indicate that the nurse does not have an interest in incorporating the cultural beliefs of the client into a health care plan and would be inappropriate.

A client tells the nurse that he engages in prayer and laughter every day. To which stress assessment question is this information​ applicable? ​A. "What stress are you experiencing​ now" B. ​"How long have the stressors been present in your​ life?" C. ​"How do you handle​ stress?" D. ​"How well do your coping strategies​ work?"

​A. "What stress are you experiencing​ now" B. ​"How long have the stressors been present in your​ life?" ***C. ​"How do you handle​ stress?" D. ​"How well do your coping strategies​ work?" Prayer and laughter are two examples of how a client handles stress. These actions do not address what stress the client is experiencing​ now, how long the stressors have been​ present, or how well the client​'s coping strategies work.

A client who is blind and has Parkinson disease is assigned a nurse to coordinate care from a number of specialists. What kind of framework is this assignment an example​ of? ​A. Client-focused care B. Team nursing C. Case management D. Managed care

​A. Client-focused care B. Team nursing ***C. Case management D. Managed care The case management framework assigns a coordinator of care to assure continuity of care. Managed care takes place at the​ group, not the​ individual, level.​ Client-focused care would identify the client as the decision maker. Team nursing is used in hospital settings.

Which criteria are used to measure if a profession is​ autonomous? ​(Select all that​ apply.) ​A. Self-discipline B. Working conditions C. ​Self-regulation D. ​Self-governance E. Standards of practice

​A. Self-discipline B. Working conditions ***C. ​Self-regulation D. ​Self-governance ***E. Standards of practice There are two criteria used to measure the autonomy of a profession. These criteria are​ self-regulation and standards of practice. Professional organization differentiates a profession from an occupation. Criteria of a professional organization include​ self-governance, self-discipline, and control over working conditions.

The nursing instructor is preparing a class for nursing students about types of insurance coverage. When describing private insurance​ coverage, which item should be​ included? ​A. Self-employment-based private insurance policies cover​ self-employed individuals and their family members. B. Group insurance coverage may be purchased through voluntary and membership​ associations, such as professional and trade groups. C. ​Employment-based private health insurance coverage may not be extended to include extended family members. D. ​Direct-purchase private insurance plans are usually less expensive and less restrictive than group coverage.

​A. Self-employment-based private insurance policies cover​ self-employed individuals and their family members. ***B. Group insurance coverage may be purchased through voluntary and membership​ associations, such as professional and trade groups. C. ​Employment-based private health insurance coverage may not be extended to include extended family members. D. ​Direct-purchase private insurance plans are usually less expensive and less restrictive than group coverage. ​Employment-based private insurance plans are offered through an​ individual's employer or union. This type of coverage may be extended to include the spouse and dependents of the​ employee, as well as the​ employee's domestic partner. Group coverage may also be purchased through voluntary and membership​ associations, such as professional and trade​ groups, bar​ associations, local chambers of​ commerce, and AARP. ​Self-employment-based private insurance plans are available only to individuals who are​ self-employed and cover only that individual.​ Direct-purchase private insurance plans allow individuals who need private health insurance and who are ineligible for group coverage to purchase an individual policy. Individual health insurance policies are usually more expensive and coverage is more restricted than under group health coverage.

While talking with a nursing​ colleague, the staff nurse​ states, "I don​'t drink​ alcohol, but I smoke marijuana." Which response by the nursing colleague best reflects correct understanding of professional​ behaviors? A. "Even in your personal​ life, the same rules of professionalism still apply to your behavior." B. "If you​'re arrested for smoking​ marijuana, your professional credibility will be negatively affected." C. "If your client care is negatively​ affected, then you should stop smoking marijuana." D. "Even though you​'re a​ nurse, what you do in your personal life is your business."

***A. "Even in your personal​ life, the same rules of professionalism still apply to your behavior." B. "If you​'re arrested for smoking​ marijuana, your professional credibility will be negatively affected." C. "If your client care is negatively​ affected, then you should stop smoking marijuana." D. "Even though you​'re a​ nurse, what you do in your personal life is your business." Unprofessional behaviors include substance abuse. The rules of professionalism and the dangers of unprofessional behavior extend to social situations. The effects of unprofessional behavior may include adversely affecting client​ outcomes, but unprofessional behavior is inappropriate with or without consequences. Engaging in unprofessional​ behavior, regardless of whether it leads to an​ arrest, can negatively impact the​ nurse's credibility.

A nurse is an active member of an evangelical church. The nurse prays with some clients. Which statements by the nurse would indicate appropriate​ considerations? ​(Select all that​ apply.) A. "I pray only with clients whose minds can still make choices." B. "I ask clients about wanting to pray together." C. "Before ​praying, I confirm that it​'s a convenient time for clients." D. "I tell clients who don​'t join me that they​'re on my prayer list." E. "Praying together is the best therapeutic relationship."

***A. "I pray only with clients whose minds can still make choices." ***B. "I ask clients about wanting to pray together." ***C. "Before ​praying, I confirm that it​'s a convenient time for clients." D. "I tell clients who don​'t join me that they​'re on my prayer list." E. "Praying together is the best therapeutic relationship." It is appropriate for the nurse to ask about clients​'​ desires, to select only those who can make​ decisions, and to select those for whom it is a convenient time. Being too enthusiastic about the effects of prayer or trying to include those who are opting out is not appropriate.

The novice nurse has just completed hospital orientation. Which statements by the nurse best reflect correct understanding of the role of the Occupational Safety and Health Administration​ (OSHA)? ​(Select all that​ apply.) A. "OSHA provides employer and employee with training materials that address workplace safety and health hazards." B. "OSHA requires my employer to provide me with personal protective equipment​ (PPE) when it is needed to protect my health and safety." C. "According to OSHA​ regulations, all employers must have an emergency eye wash station." D. "According to OSHA​ regulations, all employers must reduce or eliminate workplace hazards." E. "According to OSHA​ regulations, all employers must maintain conditions or adopt practices that are needed to protect workers on the job."

***A. "OSHA provides employer and employee with training materials that address workplace safety and health hazards." ***B. "OSHA requires my employer to provide me with personal protective equipment​ (PPE) when it is needed to protect my health and safety." C. "According to OSHA​ regulations, all employers must have an emergency eye wash station." ***D. "According to OSHA​ regulations, all employers must reduce or eliminate workplace hazards." ***E. "According to OSHA​ regulations, all employers must maintain conditions or adopt practices that are needed to protect workers on the job." The Occupational Safety and Health Administration​ (OSHA) requires employers to ensure that employees have and use personal protective equipment​ (PPE) when required for safety and health. Employers must comply with standards for a wide variety of workplace hazards in industrial and healthcare​ settings; for​ example, in some​ industries, employers are required to provide both PPE and emergency eyewash stations. OSHA requires all employers to maintain conditions or adopt practices that are needed to protect workers on the job.​ OSHA's strategies for promoting improved workplace safety and health include providing employer and employee with information and training materials that focus on workplace safety and health hazards.

During hospital​ orientation, the human resources specialist is defining and explaining sexual harassment. Which statement should be included in the human resource specialist​'s discussion of sexual​ harassment? A. "Sexual harassment interferes with performance in the workplace." B. "Sexual harassment requires the victim and violator to be of different genders." C. "Discrimination is one type of sexual harassment." D. "Physical contact is required for a behavior to be considered sexual harassment."

***A. "Sexual harassment interferes with performance in the workplace." B. "Sexual harassment requires the victim and violator to be of different genders." C. "Discrimination is one type of sexual harassment." D. "Physical contact is required for a behavior to be considered sexual harassment." By​ definition, sexual harassment interferes with the victim​'s performance in the workplace. Sexual harassment is one form of discrimination. The victim and violator may or may not be of the same gender. Examples of sexual harassment include requests for sexual favors and unwelcome verbal or physical sexual advances.

The novice nurse asks the nurse preceptor to explain the relationship between the business of health care and the provision of client care. Which response by the nurse preceptor is the most​ appropriate? A. "The Institute of Medicine compels nurses to preserve a caring model within health care​'s business model." B. "When nursing standards conflict with organizational​ standards, the nurse must maintain commitment to the organization​'s standards." C. "The business of health care is the same thing as the provision of client care." D. "Nurses are morally responsible for recognizing the business of health care as the main priority."

***A. "The Institute of Medicine compels nurses to preserve a caring model within health care​'s business model." B. "When nursing standards conflict with organizational​ standards, the nurse must maintain commitment to the organization​'s standards." C. "The business of health care is the same thing as the provision of client care." D. "Nurses are morally responsible for recognizing the business of health care as the main priority." Because the business of health care and the provision of client care are two distinct​ issues, corporate goals can collide with nursing ethics. Nurses have the moral responsibility to address client needs and to advocate for safe care within the business of health care. The Institute of Medicine​ (IOM) compels nurses to lead the healthcare transformation and to preserve a caring model within the business model of health care. The nurse must maintain commitment to the nursing profession even when doing so conflicts with organizational commitment.

A nurse educator is teaching a group of student nurses regarding standards of care. Which statements made by the nursing students are correct regarding standards of care in​ nursing? ​(Select all that​ apply.) A. "The Nurse Practice Act and administrative rules form the basis of the standard of care for nurses." B. "Employers can​ limit, but not​ expand, the nursing scope of practice." C. "The Joint Commission is the primary agency responsible for establishing nursing standards of care." D. "The nurse​'s specific job description will aid in defining the standard of care." E. "The American Nurses Association​ (ANA) Standards of Practice is the prevailing national nursing standard."

***A. "The Nurse Practice Act and administrative rules form the basis of the standard of care for nurses." ***B. "Employers can​ limit, but not​ expand, the nursing scope of practice." C. "The Joint Commission is the primary agency responsible for establishing nursing standards of care." ***D. "The nurse​'s specific job description will aid in defining the standard of care." ***E. "The American Nurses Association​ (ANA) Standards of Practice is the prevailing national nursing standard." The American Nurses Association​ (ANA) Standards of​ Practice, not The Joint​ Commission, is primarily responsible for establishing nursing standards of care. All other choices are correct.

The nursing student is giving a presentation on the roles of citizens and government in shaping health policy. Which statements should be included in the​ presentation? ​(Select all that​ apply.) A. "The government official is responsible for identifying political considerations related to each solution." B. "Citizens will evaluate the outcomes of newly implemented laws." C. "The citizen who reports the concern is responsible for choosing the best solution." D. "One role of government officials is hearing citizens​' concerns." E. "The citizen​'s responsibilities include evaluating safety concerns of proposed solutions."

***A. "The government official is responsible for identifying political considerations related to each solution." B. "Citizens will evaluate the outcomes of newly implemented laws." C. "The citizen who reports the concern is responsible for choosing the best solution." ***D. "One role of government officials is hearing citizens​' concerns." E. "The citizen​'s responsibilities include evaluating safety concerns of proposed solutions." Government​ officials' roles include hearing​ citizens' concerns about healthcare​ needs, evaluating safety concerns related to potential​ solutions, identifying political considerations related to each​ solution, and choosing the best solution. Federal agencies or departments who are responsible for implementing the new law will evaluate outcomes.

The nurse leader is preparing a webinar about how to prevent burnout in nursing. To accurately describe strategies for preventing​ burnout, which activity should the nurse educator include in the​ webinar? A. Actively engage in efforts to produce constructive change if organizational policies create stress B. Develop acceptance and recognize that the limitations of any situation can be changed C. Study assertiveness and learn to take on added responsibilities even when feeling overwhelmed D. Learn to depend on oneself and to avoid expressions of emotions toward colleagues

***A. Actively engage in efforts to produce constructive change if organizational policies create stress B. Develop acceptance and recognize that the limitations of any situation can be changed C. Study assertiveness and learn to take on added responsibilities even when feeling overwhelmed D. Learn to depend on oneself and to avoid expressions of emotions toward colleagues Strategies for preventing burnout in nursing include​ involvement, studying assertiveness​ techniques, expressing​ compassion, and developing acceptance. Involvement includes being active in efforts to produce constructive change if organizational policies cause stress. Studying assertiveness​ techniques, which can help with overcoming feelings of powerlessness in​ relationships, includes learning to say no. Compassion includes learning to ask for help and expressing emotions toward colleagues. Acceptance includes recognizing the limitations associated with each situation and accepting what cannot be changed.

The nurse is caring for a client with paranoid schizophrenia who was recently transferred to the facility. Upon​ assessment, the nurse notes bruising on the client​'s wrists and ankles. What is the priority action by the​ nurse? A. Ask the client how the bruising occurred. B. Call the police to report abuse. C. Ask the client​'s family if they caused the bruises. D. Call the previous facility to determine the causes of the bruising.

***A. Ask the client how the bruising occurred. B. Call the police to report abuse. C. Ask the client​'s family if they caused the bruises. D. Call the previous facility to determine the causes of the bruising. The priority action of the nurse is to determine the cause of the bruising. This can be accomplished by asking the client how the bruising occurred. If the client is unable to provide information to the​ nurse, then it is appropriate to ask family members or contact those who cared for the client. Reporting the bruising as abuse should not occur until the nurse has evidence that supports this claim.

The nurse is caring for a client at a free clinic. When advocating for this​ client, what does the nurse need to be aware of when planning​ care? A. Available healthcare options B. Clinic schedule requirements C. Public transportation issues D. Healthcare provider schedule preferences

***A. Available healthcare options B. Clinic schedule requirements C. Public transportation issues D. Healthcare provider schedule preferences The nurse advocate must be aware of available healthcare options for treating the uninsured client. Advocacy does not involve​ transportation, scheduling, or healthcare provider preferences.

A nurse is observing a newly admitted client for details to add to the spiritual assessment. Which clinical observations would be useful​ additions? ​(Select all that​ apply.) A. Behavior B. Mood C. Interactions with others D. Mealtime choices E. Speech

***A. Behavior ***B. Mood ***C. Interactions with others D. Mealtime choices ***E. Speech Clinical observations of​ behavior, speech,​ mood, and interactions with others would be useful. Observing mealtime choices is not an example of a clinical observation the nurse would make. This item would be asked during the initial admission assessment of the client.

The nursing student is experiencing the integrated stage of commitment development. When developing professional​ commitment, which behavior would the nursing student be most likely to demonstrate during the integrated​ stage? A. Being eager to take the ​NCLEX-RN​® examination B. Considering switching to a major other than nursing C. Becoming involved in a student nursing association D. Learning about positive aspects of the nursing profession

***A. Being eager to take the ​NCLEX-RN​® examination B. Considering switching to a major other than nursing C. Becoming involved in a student nursing association D. Learning about positive aspects of the nursing profession Being eager to take the ​NCLEX-RN​®examination is reflective of the integrated stage of professional commitment development. The exploratory stage begins when individuals learn about the positive aspects of their profession. During the testing​ stage, students discover negative aspects of the profession and begin to assess their willingness and ability to cope with those negative aspects. Nursing students who do not move beyond the testing stage may drop out of school or change majors. Becoming involved in a student nursing association best illustrates a behavior demonstrated during the passionate stage of professional commitment development.

The client asks the nurse to explain how Medicare works. Which items should the nurse include in the teaching​ session? ​(Select all that​ apply.) A. Both hospital and medical insurance are offered by Medicare. B. Routine eye care is not covered by Medicare. C. Medicare is a federally funded health insurance program. D. There are four types of Medicare coverage. E. Individuals with​ end-stage renal disease are not eligible for Medicare coverage.

***A. Both hospital and medical insurance are offered by Medicare. ***B. Routine eye care is not covered by Medicare. ***C. Medicare is a federally funded health insurance program. ***D. There are four types of Medicare coverage. E. Individuals with​ end-stage renal disease are not eligible for Medicare coverage. Medicare is a federally funded health insurance program available to people age 65 or​ older, younger people with​ disabilities, and people with​ end-stage renal disease. Certain​ services, including routine eye​ care, are not covered by Medicare. There are four types of Medicare​ coverage: Part A​ (hospital insurance), Part B​ (medical insurance), Part C​ (Medicare advantage plans like an HMO or​ PPO), and Part D​ (Medicare prescription drug​ coverage).

Two nurses are discussing the ways in which spiritual practices affect individuals. "I can​'t believe how many different ways they affect ​people," one concludes. The other nurse agrees. Which individual habits and events could be connected to spiritual​ practices? ​(Select all that​ apply.) A. Diet and nutrition B. Birth and death C. Dress D. Medications E. Healing

***A. Diet and nutrition ***B. Birth and death ***C. Dress D. Medications ***E. Healing All of the above answers are correct. Diet and​ nutrition, medications,​ healing, dress, and birth and death all could be connected with spiritual practices.

What are the best times to do a nursing assessment of​ spirituality? ​(Select all that​ apply.) A. Following the psychosocial assessment B. Following the health history C. Before the physical assessment D. At the end of the assessment process E. Right after mutual introductions

***A. Following the psychosocial assessment B. Following the health history C. Before the physical assessment ***D. At the end of the assessment process E. Right after mutual introductions The best times to do a nursing assessment of spirituality are at the end of the assessment process or following the psychosocial assessment. Having built up some rapport is important. That rapport will be stronger at those times than right after mutual​ introductions, following the health​ history, or before the physical assessment.

The nurse is involved in the case of a minor client who is placed on life support after complications during surgery left her without neurologic function. The client​'s parents have retained legal counsel to prevent the hospital from discontinuing life support. Which advocacy concepts must be considered when communicating with the client​'s ​family? ​(Select all that​ apply.) A. Healthcare systems B. Rehabilitation nursing C. Culture and diversity D. Medical ethics E. Legal issues

***A. Healthcare systems B. Rehabilitation nursing ***C. Culture and diversity ***D. Medical ethics ***E. Legal issues The decision to discontinue life support for any client is handled by the healthcare​ system, particularly its risk management and legal departments along with the family of the client. Principles of medical ethics and legal issues guide the​ decision-making process and are intended to protect the​ client's rights and the healthcare​ system's interests. Culture and diversity considerations address the values and beliefs of the client and family. Rehabilitation nursing would not be employed in an​ end-of-life scenario.

The nurse wants to determine the advocacy needs of a client. Which items will the nurse include in the assessment to determine advocacy​ needs? ​(Select all that​ apply.) A. Medical history and family situation B. Food preferences C. Access to transportation D. Ability to cooperate and make decisions E. Reliability of information

***A. Medical history and family situation B. Food preferences C. Access to transportation ***D. Ability to cooperate and make decisions ***E. Reliability of information The three main assessment criteria to determine advocacy needs are the​ client's ability to cooperate and make​ decisions; the reliability of information provided by the​ client, especially if the client exhibits impairment of cognitive function of mental​ instability; and the​ client's medical history and family situation. Access to transportation is a service consideration. Food preferences would not determine the need for advocacy.

The staff nurse is caring for a client who has recently undergone surgical repair of an inguinal hernia. Despite administration of pain medications as​ ordered, the client continues to complain of excruciating pain. When the staff nurse offers to reposition the​ client, the client​ states, "You don​'t have any idea what you​'re doing. I need more medication. I need a nurse who can help ​me!" Which behavior best illustrates demonstration of compassion by the staff​ nurse? A. Notifying the primary care provider about the client​'s complaints of pain despite receiving medication B. Collaborating with the charge nurse and requesting that another nurse assume the client​'s care C. Explaining that inguinal hernia repairs usually require significantly less medication for adequate pain relief D. Seeking out a nursing colleague to privately vent about the client​'s rudeness and inconsideration

***A. Notifying the primary care provider about the client​'s complaints of pain despite receiving medication B. Collaborating with the charge nurse and requesting that another nurse assume the client​'s care C. Explaining that inguinal hernia repairs usually require significantly less medication for adequate pain relief D. Seeking out a nursing colleague to privately vent about the client​'s rudeness and inconsideration Professionalism in nursing requires demonstrating a positive attitude while working with​ clients, their family​ members, and other healthcare professionals. Venting to a nursing colleague is not reflective of a positive attitude. Professionalism in nursing also requires​ compassion, which is an awareness of and concern about other​ individuals' suffering. Requesting that the​ client's care be reassigned to another staff nurse is not reflective of compassion. Demonstrations of compassion in nursing include recognizing and meeting​ clients' needs and treating each client as a unique and special individual and not as a diagnosis​ (for example,​ "an inguinal hernia​ repair") or number. Notifying the primary care provider about the​ client's complaints of pain despite receiving pain medication best reflects recognizing and meeting the​ client's needs.

In an annual​ evaluation, the nurse unit leader describes the staff nurse as "skilled at analyzing a complex situation and able to pick out the most important aspects of a clinical scenario." According to Patricia Benner​'s model of nursing​ development, which developmental stage best matches the nurse unit leader​'s evaluation of the staff​ nurse? A. Proficient B. Novice C. Competent D. Expert

***A. Proficient B. Novice C. Competent D. Expert According to​ Benner's model, the novice nurse has no experience and relies only on​ guidelines, policies, and theories. The advanced beginner is starting to gain​ experience, with a focus on tasks and guidelines as the nurse at this stage does not have the experience to consider complexities. The competent nurse has begun to master some​ tasks, but does not yet possess the speed and flexibility of the proficient nurse. The proficient nurse is able to view the complexities of a​ situation, looking at the whole and determining which are the most important aspects. The expert nurse possesses an intuitive understanding of most situations and is able to quickly determine a course of action without much problem solving.

A student nurse is reviewing the Nurse Practice Act and its influence on the standards of care for nurses. How does the Nurse Practice Act influence the practice of​ nursing? A. Sets the requirements for​ licensure, including educational requirements of nurses B. Regulates institutional policies concerning​ nurse's job responsibilities C. Regulates the accreditation standing of nursing programs D. Develops client care policies and procedures

***A. Sets the requirements for​ licensure, including educational requirements of nurses B. Regulates institutional policies concerning​ nurse's job responsibilities C. Regulates the accreditation standing of nursing programs D. Develops client care policies and procedures The Nurse Practice Act sets the requirements for​ licensure, including educational requirements of nurses. The Nurse Practice act does not regulate​ nurses' job responsibilities or the accreditation standing of nursing programs. The Nurse Practice Act does not develop client care policies and procedures.

The nurse unit manager is giving an​ in-service about sexual harassment in the workplace. When discussing what constitutes sexual​ harassment, which statement is most appropriate for the nurse unit manager to include in the​ in-service? A. Sexual harassment must be considered both a form of discrimination and a violation of an individual​'s rights. B. Behaviors must include unwelcome advances of a sexual nature that are demonstrated through the perpetrator​'s physical conduct. C. The sexual behaviors must interfere with the victim​'s work performance and prevent fulfillment of work functions. D. Submitting to requests for sexual behaviors must be explicitly considered a condition of an individual​'s employment.

***A. Sexual harassment must be considered both a form of discrimination and a violation of an individual​'s rights. B. Behaviors must include unwelcome advances of a sexual nature that are demonstrated through the perpetrator​'s physical conduct. C. The sexual behaviors must interfere with the victim​'s work performance and prevent fulfillment of work functions. D. Submitting to requests for sexual behaviors must be explicitly considered a condition of an individual​'s employment. Sexual harassment is a form of​ discrimination, as well as a violation of an​ individual's rights. The Equal Employment Opportunity Commission​ (EEOC) defines sexual harassment as "unwelcome sexual​ advances, requests for sexual​ favors, and other verbal or physical conduct of a sexual nature" occurring when submitting to such requests or behavior is​ considered, either explicitly or​ implicitly, a condition of an​ individual's employment; when submission to or rejection of such requests or behavior is used as the basis for employment decisions affecting the individual​ (e.g., promotion); or when such conduct interferes with an​ individual's work performance or creates an​ "intimidating, hostile, offensive working environment."

The clinical nursing instructor is preparing a presentation about societal factors that influence health policy. Which factors should be​ included? ​(Select all that​ apply.) A. Size of a given population B. ​Population-specific needs C. Degree to which the population​'s current needs are met D. Level of support for the proposed policy E. Ability of the population to finance the proposed policy

***A. Size of a given population ***B. ​Population-specific needs ***C. Degree to which the population​'s current needs are met ***D. Level of support for the proposed policy E. Ability of the population to finance the proposed policy Societal factors that influence health policy include the​ population's size and specific​ needs, the degree to which current policy meets the​ population's needs, and the level of support for the proposed policy. The target population is not required to finance the health policy.

A young client has just learned of a diagnosis of stage 4 lung cancer. The client was about to graduate from school and get married. "I can​'t believe in God ​anymore," the client tells the oncology nurse. "He should be ​all-loving." Which situation would the nurse identify the client as​ expressing? A. Spiritual distress B. Fear of unemployment C. Premarital anxiety D. A justice complaint

***A. Spiritual distress B. Fear of unemployment C. Premarital anxiety D. A justice complaint The client is expressing spiritual distress about the loss of hope in his belief system. It is not a complaint about​ justice, anxiety about a planned​ marriage, or fear of the job market.

Which actions by professional staff are considered abusive or unprofessional behavior toward clients with mental health​ disorders? ​ (Select all that​ apply.) A. Supplying clients with drugs or alcohol in return for favors B. Refusing to share homemade cookies with the client C. Using restraints for a client who is a threat to others D. General threats of harm if clients do not behave as they were told E. Making privileges contingent on favors

***A. Supplying clients with drugs or alcohol in return for favors B. Refusing to share homemade cookies with the client C. Using restraints for a client who is a threat to others ***D. General threats of harm if clients do not behave as they were told ***E. Making privileges contingent on favors Abusive​ and/or unprofessional behaviors by professional staff include making privileges contingent on​ favors, supplying clients with drugs or​ alcohol, and making general threats of harm if clients do not behave as they were told. The advocate would immediately report any of these behaviors to the supervisor. Refusing to share homemade cookies and using restraints are not abusive behaviors.

Which statement describes the overall goal of client​ advocacy? A. The overall goal of client advocacy is to safeguard the client from harm. B. The overall goal of client advocacy is to educate clients. C. The overall goal of client advocacy is to speak for clients. D. The overall goal of client advocacy can only be achieved by specially trained nurses.

***A. The overall goal of client advocacy is to safeguard the client from harm. B. The overall goal of client advocacy is to educate clients. C. The overall goal of client advocacy is to speak for clients. D. The overall goal of client advocacy can only be achieved by specially trained nurses. The overall goal of client advocacy is to safeguard clients from harm and to represent their needs to other healthcare professionals. Speaking for clients and educating clients are actions that support the protection of the​ client's rights. All nurses are client​ advocates, with or without special training.

During the nursing assessment​ interview, 40-year-old Nirali Dayada states that she follows a strict diet consistent with her Hindu religious beliefs. What hospital menu choices would be most likely for Ms.​ Dayada's stay? A. Vegetarian entrees B. ​Gluten-free products C. Noncaffeinated beverages D. Kosher food

***A. Vegetarian entrees B. ​Gluten-free products C. Noncaffeinated beverages D. Kosher food Vegetarian entrees would be appropriate for a practicing Hindu. The other choices would not be relevant to her religious beliefs.

Scott​ Nitroskey, a home health​ nurse, is caring for​ 67-year-old Martha​ Miriste, a female client who is diagnosed with diabetes. Scott is completing Mrs.​ Mireste's client teaching. During the teaching​ session, which statement might Mrs. Mireste interpret as being​ Scott's attempt to intimidate​ her? A. ​"If you​ don't stop eating so much​ candy, your diabetes is going to get much​ worse." B. ​"Regular exercise can help with the management of your​ diabetes." C. ​"If you cut back on your sugar​ intake, you might see some improvement in your​ diabetes." D. ​"Increased sugar in your diet can cause your blood sugar to go up and impact your​ diabetes."

***A. ​"If you​ don't stop eating so much​ candy, your diabetes is going to get much​ worse." B. ​"Regular exercise can help with the management of your​ diabetes." C. ​"If you cut back on your sugar​ intake, you might see some improvement in your​ diabetes." D. ​"Increased sugar in your diet can cause your blood sugar to go up and impact your​ diabetes." Intimidation may be unintentional on the​ nurse's part, including making statements such​ as, "If you do not take your medicine​ (or go to physical​ therapy, or follow the treatment​ plan), you're going to get​ worse." Although eating excess amounts of candy may cause the​ client's diabetes to​ worsen, this approach is intimidating and unprofessional. Encouraging the client through telling her which interventions may improve her condition is not reflective of​ intimidation, nor is explaining the link between dietary sugar and blood sugar.

The nurse leader is planning an​ in-service about integrity in nursing practice. Which statement regarding integrity in nursing is most appropriate for the nurse leader to include in the​ in-service? A. "Integrity means understanding that negative feedback from peers has little value." B. "Integrity means internalizing professional practices that the nurse prefers to follow." C. "Nurses with integrity adhere to a strict moral or ethical code." D. "Nurses with integrity provide excellent care and do not make errors."

A. "Integrity means understanding that negative feedback from peers has little value." B. "Integrity means internalizing professional practices that the nurse prefers to follow." ***C. "Nurses with integrity adhere to a strict moral or ethical code." D. "Nurses with integrity provide excellent care and do not make errors." Integrity requires adherence to a strict ethical or moral​ code, such as the ANA Code of Ethics for Nurses. Integrity involves practicing consistent behaviors based on the internalization of the​ ethics, values, and best practices of the nursing profession. Integrity in nursing includes accepting positive or negative feedback as a tool for improving the delivery of client care. Nurses with integrity are not​ perfect; however, they admit to their mistakes.

During a classroom​ discussion, the nurse educator asks the nursing students to describe intimidation. Which​ students' statements most accurately describe​ intimidation? ​(Select all that​ apply.) A. "Intimidation includes having negative thoughts about nursing peers or colleagues." B. "Intimidation can include threatening someone with consequences for disobedience." C. "Intimidation includes experienced nurses who bully new nurses." D. "Covert and overt behaviors may qualify as being intimidation." E. "Nurses always realize when their behaviors toward clients are forms of intimidation."

A. "Intimidation includes having negative thoughts about nursing peers or colleagues." ***B. "Intimidation can include threatening someone with consequences for disobedience." ***C. "Intimidation includes experienced nurses who bully new nurses." ***D. "Covert and overt behaviors may qualify as being intimidation." E. "Nurses always realize when their behaviors toward clients are forms of intimidation." Intimidation includes​ threatening, bullying, or forcing someone who is emotionally or physically weaker to do something in order to avoid retribution or negative consequences.​ Subtle, or​ covert, forms of intimidation may include standing close to someone while maintaining a hostile facial expression. Unexpressed negative thoughts are not reflective of intimidation. Intimidation may be unintentional on the​ nurse's part, including making statements such​ as, "If you do not take your medicine​ (or go to physical​ therapy, or follow the treatment​ plan), you're going to get​ worse." While the​ nurse's statement may be​ true, this approach is intimidating and unprofessional.

The nurse educator is explaining the significance of punctuality and attendance in the nursing profession to a class of nursing students. Which statement is most appropriate for the nurse educator to include in the​ discussion? A. "The most severe consequence of excessive tardiness for the professional nurse is suspension." B. "Chronic tardiness and frequent absenteeism among nurses can compromise client care." C. "Nurses must be flexible about helping colleagues who routinely need to miss work." D. "During a nursing​ shortage, hospital attendance requirements usually are less strict."

A. "The most severe consequence of excessive tardiness for the professional nurse is suspension." ***B. "Chronic tardiness and frequent absenteeism among nurses can compromise client care." C. "Nurses must be flexible about helping colleagues who routinely need to miss work." D. "During a nursing​ shortage, hospital attendance requirements usually are less strict." In nursing​ practice, chronic tardiness and frequent absenteeism place a greater burden on​ colleagues, compromise client​ care, and can cause conflict among staff. Just as excessive tardiness to clinicals can lead to severe​ repercussions, even during a nursing​ shortage, professional nurses who demonstrate excessive tardiness or absences may face disciplinary actions including suspension and termination.

The nurse manager is interviewing a candidate for a staff nurse position. During the​ interview, the nurse manager evaluates the candidate​'s professional commitment to nursing. Which statement by the staff nurse best reflects commitment to the nursing​ profession? A. "The values and goals of nursing are​ honorable, but they are unrealistic and difficult to achieve." B. "I believe the nurse​'s choices outside of the workplace are unrelated to the nurse​'s professional role." C. "Whenever ​possible, the nurse should try to abide by the professional code of ethics for nurses." D. "I​'m a member of two national nursing​ organizations, and I belong to one specialty nursing group."

A. "The values and goals of nursing are​ honorable, but they are unrealistic and difficult to achieve." B. "I believe the nurse​'s choices outside of the workplace are unrelated to the nurse​'s professional role." C. "Whenever ​possible, the nurse should try to abide by the professional code of ethics for nurses." ***D. "I​'m a member of two national nursing​ organizations, and I belong to one specialty nursing group." Factors associated with professional commitment include desire to maintain membership in the​ profession; strong acceptance of and belief in a​ profession's role,​ code, values,​ goals, standards; willingness to exert considerable personal effort on behalf of the​ profession; and a pattern of behaviors that is consistent with the​ nurses' professional code of ethics. The rules of professionalism in nursing extend to behaviors outside the workplace.

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

A. A history of falls ***B. Genetic trait for falls C. Falls caused by side effects of medication D. Cognition problems causing falls While there may be genetic traits that can predispose a client to a​ fall, this is the least likely reason for a fall to occur. Clients can have a history of falling based on past events. An issue with cognition can subject clients to possible falls—such as forgetting to tie shoe laces—with a resultant fall. Medication side​ effects, such as dizziness and equilibrium​ problems, can cause a client to fall.

A client accuses a nurse of incompetency and files a lawsuit of malpractice. If the nurse is found​ incompetent, what document or act has been broken regarding nursing standards of​ care? A. Accreditation certification B. The Nurse Practice Act C. National counsel licensure D. The American Nurses Association​ (ANA) Standards of Practice

A. Accreditation certification B. The Nurse Practice Act C. National counsel licensure ***D. The American Nurses Association​ (ANA) Standards of Practice Standards of Practice describe the competency level of nursing care as described by the ANA. The Nurse Practice Act regulates the licensing and practice of nursing in each state by describing the scope of practice. Accreditation allows the​ facility, school, or hospital to operate and be recognized in good standing according to standards set by peers. National council licensure is the standardized national examination that assess for a minimum knowledge base relevant to the client population that the nurse serves.

Which type of client advocacy concerns itself with growth and​ development, ensuring good nutrition and​ exercise, stress​ management, and preventing​ disease? A. Safety B. Patient​ Self-Determination Act​ (PSDA) C. Bill of Rights D. Health promotion

A. Safety B. Patient​ Self-Determination Act​ (PSDA) C. Bill of Rights ***D. Health promotion Health promotion concerns itself with growth and​ development, ensuring good nutrition and​ exercise, stress​ management, and preventing disease. Safety concerns itself with injury​ prevention, neglect, and abuse. The Bill of Rights helps clients to understand their rights. The PSDA protects the rights of clients to accept or reject aspects of their medical care.

Jasmine Riddle is a novice nurse in the telemetry unit of a large hospital. While assessing her​ client, 72-year-old Albert​ Griswald, Jasmine notes that his pulse feels irregular. When she calls the telemetry monitoring​ station, the monitoring​ technician, Miguel, tells Jasmine that Mr. Griswald just developed atrial fibrillation. The technician praises Jasmine for catching the change in Mr.​ Griswald's cardiac rhythm so quickly—even before the telemetry technician recognized it. In her​ response, which action would reflect​ Jasmine's nursing​ integrity? A. Advising the telemetry technician to focus on his job and monitor​ clients' heart rhythms more closely B. Thanking the telemetry technician for praising her and for being part of the​ client's care team C. Notifying the telemetry​ technician's supervisor of his failure to recognize the change in cardiac rhythm D. Telling the telemetry technician that noticing the​ client's change in cardiac rhythm was​ "pure luck"

A. Advising the telemetry technician to focus on his job and monitor​ clients' heart rhythms more closely B. Thanking the telemetry technician for praising her and for being part of the​ client's care team C. Notifying the telemetry​ technician's supervisor of his failure to recognize the change in cardiac rhythm D. Telling the telemetry technician that noticing the​ client's change in cardiac rhythm was​ "pure luck" Examples of ways in which nurses demonstrate integrity include accepting feedback​ (positive or​ negative) as a tool for improving the delivery of client care. Attributing excellent assessment skills to​ "luck" is not​ wrong, but it does not reflect integrity. Admonishing the telemetry technician or contacting his supervisor are neither warranted nor appropriate actions.

The bilingual nurse is caring for a client who speaks only Spanish. What is the best way for the nurse to advocate for this​ client? A. Arranging for bill payment for the client B. Representing the client​'s needs and wishes to other healthcare professionals C. Signing consent forms on the client​'s behalf D. Discussing the client​'s care with the client​'s visitors

A. Arranging for bill payment for the client ***B. Representing the client​'s needs and wishes to other healthcare professionals C. Signing consent forms on the client​'s behalf D. Discussing the client​'s care with the client​'s visitors The nurse would use bilingual skills to interpret medical information for the client and then relay the​ client's needs and wishes to other healthcare professionals. The nurse would never sign documents on the​ client's behalf. The nurse would not discuss the​ client's care with anyone but other healthcare professionals who are involved in the​ client's care. The nurse would never be involved in the​ client's financial transactions.

A nurse is reviewing a medication order in the client​'s health record. The order is​ illegible, and the nurse calls the ordering healthcare provider to clarify the order. The nurse cannot reach the healthcare provider despite multiple calls and pages. Which action by the nurse is most appropriate in this​ situation? A. Ask a​ co-worker to attempt to decipher the order B. Contact the nursing supervisor C. Fax the order to the pharmacy to decipher D. Continue calling the healthcare provider

A. Ask a​ co-worker to attempt to decipher the order ***B. Contact the nursing supervisor C. Fax the order to the pharmacy to decipher D. Continue calling the healthcare provider The nurse should contact the nursing supervisor after attempting numerous times to reach the healthcare provider. By contacting the​ supervisor, the nurse is using the negligence prevention strategy of preventing medication errors. Continuing to call the healthcare provider is not effective. Asking a​ co-worker or pharmacist to decipher the order is inappropriate.

Sandra Davis is a registered nurse​ (RN) who is running behind in administering her medications at a​ long-term care facility. When she arrives in the last​ client's room, the client is in the restroom. Sandra asks the nursing assistant if she would mind giving the cardiac glycoside to the​ client, and leaves the room. The​ client's pulse was 48 beats per minute. The medication was​ administered, and the client died. Which unintentional tort did Sandra commit during this​ incident? A. Assault B. Battery C. False imprisonment D. Malpractice

A. Assault B. Battery C. False imprisonment ***D. Malpractice This offense is classified as malpractice. In order to prove malpractice for this​ case, it must be proven that a deviation from the standard of care occurred which resulted in this​ client's death.​ Assault, battery, and false imprisonment are intentional torts.

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

A. Assessing and monitoring a client who has returned from surgery ***B. Using equipment without appropriate training C. Documenting client care in the electronic medical record ***D. Failing to follow the standard of practice ***E. Lacking appropriate communication skills Nursing actions that may be negligent and result in malpractice include failing to follow the standard of​ practice, lacking appropriate communication​ skills, and using equipment without appropriate training. Documenting client care in the electronic medical record and assessing and monitoring a client from surgery do not constitute negligence that can result in malpractice.

Which of the following is unintentional conduct deviating from the standard of nursing​ practice? A. Battery B. False imprisonment C. Assault D. Malpractice

A. Battery B. False imprisonment C. Assault ***D. Malpractice Malpractice is conduct deviating from the standard of practice that is dictated by​ one's profession. It is an unintentional tort.​ Assault, battery, and false imprisonment are torts considered as intentional actions. They are considered willful acts perpetrated by one individual toward another​ individual(s) or personal property.

What is a term for appreciation of a dimension beyond the​ self? A. Becoming B. Transcendence C. Value D. Meaning

A. Becoming ***B. Transcendence C. Value D. Meaning Transcendence is a term for appreciation of a dimension beyond the self. Meaning is the term for having​ purpose, making sense of life. Value is the term for having cherished beliefs and standards. Becoming is the term for allowing life to​ unfold, and knowing oneself.

The nurse leader is evaluating the charge nurse​'s type of commitment to the nursing profession. Which behavior by the charge nurse is most reflective of affective commitment to​ nursing? A. Choosing to stay in nursing due to personal experiences with illness B. Joining professional nursing organizations and engaging in nursing service activities C. Remaining in the nursing profession to avoid loss of income D. Expressing a sense of obligation to remain in the nursing profession

A. Choosing to stay in nursing due to personal experiences with illness ***B. Joining professional nursing organizations and engaging in nursing service activities C. Remaining in the nursing profession to avoid loss of income D. Expressing a sense of obligation to remain in the nursing profession Affective commitment develops when professional involvement produces a satisfying experience. Manifestations of affective commitment include engaging in​ profession-specific organizations and service activities. Normative commitment manifests as a feeling of obligation to continue in​ one's profession and it develops in response to benefits or positive experiences gained by way of engagement in​ one's profession. For​ example, the nurse whose desire to enter nursing stems from personal or family experiences with illness is reflective of normative commitment. Continuance commitment develops when negative consequences of​ leaving, such as loss of​ income, are viewed as reasons to stay.

Which religion asks its members to fast during daylight hours for a​ month? A. Christianity B. Islam C. Buddhism D. Judaism

A. Christianity ***B. Islam C. Buddhism D. Judaism Muslims are asked to fast during daylight hours In the month of Ramadan. This request is not made of people following the religions of​ Buddhism, Judaism, or Christianity.

As a client comes into the admitting​ area, a nurse notices a jeweled cross on the client​'s necklace. The nurse​ comments, "Great ​look; I can see your religious beliefs are important to ​you," and starts with the spiritual assessment of the client. How would this approach be​ evaluated? A. Complimenting the client​'s appearance is helpful B. A focus on jewelry might appear materialistic C. It is efficient and effective to dive right into the interview D. No time was taken to establish rapport with the client

A. Complimenting the client​'s appearance is helpful B. A focus on jewelry might appear materialistic C. It is efficient and effective to dive right into the interview ***D. No time was taken to establish rapport with the client Starting with the spiritual assessment of the client leaves no time to establish rapport with the client. It is not about​ jewelry, compliments, or starting quickly.

Tameka Whitt is a nurse who is making rounds on the surgical floor when she notices that one of the staff nurses is in the kitchen drinking from a metal flask. The staff​ nurse's eyes are​ glassy, her speech is​ slurred, and her breath smells like alcohol. Which action by Tameka reflects correct understanding of the​ ANA's Code of​ Ethics? A. Contact the hospital administrator B. Tell the staff nurse that she should keep an eye on her C. Contact the supervisor D. Ask the staff nurse if she is intoxicated

A. Contact the hospital administrator B. Tell the staff nurse that she should keep an eye on her ***C. Contact the supervisor D. Ask the staff nurse if she is intoxicated ​Co-worker impairment, whether by drugs or​ alcohol, may interfere with job performance and may result in unsafe clinical​ practice, and must be reported immediately to a supervisor. Nurses are advocates for all​ clients, not just those in their care. Asking the nurse if she is intoxicated could cause confrontation or provide a chance to destroy evidence. The hospital administrator would be notified by the nursing supervisor.

The nurse is providing care for Mr.​ Davis, a​ 72-year-old man who is scheduled for a procedure tomorrow morning. Earlier in the​ day, Mr. Davis experienced a fall and was examined by the healthcare provider on call who observed no untoward effects. The nurse approaches Mr. Davis for informed consent about his procedure when he complains of dizziness and a headache. Mr. Davis has no memory of the fall that occurred earlier in the day. Which action by the nurse is the most appropriate in regards to obtaining informed​ consent? A. Delay informed​ consent, perform a pain​ assessment, and administer medication B. Have the client sign the consent form without delay C. Alert the primary healthcare provider regarding the​ client's status D. Read the informed consent to the client and allow the client to rest

A. Delay informed​ consent, perform a pain​ assessment, and administer medication B. Have the client sign the consent form without delay ***C. Alert the primary healthcare provider regarding the​ client's status D. Read the informed consent to the client and allow the client to rest The nurse would alert the primary care provider immediately. The​ client's level of​ competency, his​ age, the fact that he experienced a fall earlier in the day are all issues that should be addressed by the provider prior to informing the client about the procedure. All other options are inappropriate based on the​ client's current situation.

The​ ten-year-old client is very interested in learning about her cancer care and in participating in the decisions about her care. What is the most appropriate action by the pediatric​ nurse? A. Distracting the child with a video game B. Informing the healthcare team that the child is going to be a problem C. Telling the client​'s mother that she needs to explain things to her child D. Providing​ adequate, age-appropriate information about the disease and treatment options

A. Distracting the child with a video game B. Informing the healthcare team that the child is going to be a problem C. Telling the client​'s mother that she needs to explain things to her child ***D. Providing​ adequate, age-appropriate information about the disease and treatment options The pediatric nurse would provide​ adequate, age-appropriate information about the disease and treatment options. The​ client's mother would be included in the teaching process before being called upon to explain things to her child. A child who wants to be involved in her care is not a problem. Distraction would be inappropriate and counter to the concepts of advocacy.

The nurse leader is presenting an​ in-service about competence in nursing. Which examples should the nurse leader include in the​ in-service as examples of nursing​ competence? ​(Select all that​ apply.) A. Elimination of factors that negatively influence client care B. Acknowledgement of the client​'s need for individualized care C. Completion of documentation in an​ accurate, timely manner D. Awareness of factors that positively affect client care E. Knowledge about the culture of the healthcare institution

A. Elimination of factors that negatively influence client care ***B. Acknowledgement of the client​'s need for individualized care ***C. Completion of documentation in an​ accurate, timely manner ***D. Awareness of factors that positively affect client care ***E. Knowledge about the culture of the healthcare institution Competence includes the nurse​'s awareness of the positive and negative factors that affect client​ care; however, the inability to eliminate the negative factors does not necessarily reflect a lack of nursing competence. Additional areas of nursing competence include understanding the culture of the client and the​ institution; acknowledging the client​'s need for individualized​ care; and​ accurate, timely completion of client documentation.

The evening shift nurse is caring for a​ client, Candace Horn. Mrs. Horn is a​ 57-year-old woman who is scheduled for discharge in the morning. Hospital protocol dictates that Mrs. Horn receives medication instruction the evening before the scheduled discharge. This policy minimizes incidents of professional negligence through the use of which applicable​ strategy? A. Employing the use of effective communication as a strategy B. Maintaining client safety as a strategy C. Giving clear directions to the client D. Developing a​ nurse-pharmacy rapport as a strategy

A. Employing the use of effective communication as a strategy B. Maintaining client safety as a strategy ***C. Giving clear directions to the client D. Developing a​ nurse-pharmacy rapport as a strategy Giving clear directions to the client is the best answer because it includes considering the client and family as participants in the medication administration​ process, ensuring that the client understands the medications including proper home administration and identification of potential side effects. While the other strategies may be​ applicable, they are not the best strategy for this situation.

A client files a negligence lawsuit against a nurse for the​ long-term symptoms resulting from a​ ventilator-acquired pneumonia​ (VAP). Which element of professional negligence or malpractice will this client have difficulty proving in a court of​ law? A. Foreseeability B. Causation C. Injury from breach of duty D. Breach of duty

A. Foreseeability ***B. Causation C. Injury from breach of duty D. Breach of duty Typically, a client cannot successfully make a claim for malpractice on acquiring a​ healthcare-associated infection because the client must show that a specific nurse did not follow the standard of aseptic technique in order to prove cause. A deviation from standard care is a breach of​ duty, which can be proven in court. Foreseeability means that certain events cause certain​ outcomes, an aspect that can be proved in court. Injury that was caused by the breach of duty may also be proved.

A nurse is admitting​ 55-year-old librarian Tamura Washington to the rehabilitation unit. The nurse asks Ms.​ Washington, "Is there a group of​ like-minded believers with whom you regularly​ meet?" What aspect of the​ client's life is the nurse​ assessing? A. Her ability to work as a member of a team B. Her work at the library affecting her personal life C. Her participation in healthy social activities D. Her membership in a faith community

A. Her ability to work as a member of a team B. Her work at the library affecting her personal life C. Her participation in healthy social activities ***D. Her membership in a faith community The nurse is asking a general question to identify whether the client is a member of a faith community. The nurse is not interested in​ teamwork, a balanced​ life, or social activities.

A member of the American Nurses Association​ (ANA) is giving a presentation about the ANA​'s primary methods of advancing the nursing profession. Which activities are appropriate to include in the​ presentation? ​(Select all that​ apply.) A. Implementing nurse educator faculty development programs B. Advocating for nurses​' rights in and away from the workplace C. Cultivating high standards of nursing practice D. Assisting deans with implementing quality nursing education standards E. Fostering a positive and realistic view of nursing

A. Implementing nurse educator faculty development programs B. Advocating for nurses​' rights in and away from the workplace ***C. Cultivating high standards of nursing practice D. Assisting deans with implementing quality nursing education standards ***E. Fostering a positive and realistic view of nursing Primary methods used by the American Nurses Association​ (ANA) to advance the nursing profession include cultivating high standards of nursing​ practice, advocating for​ nurses' rights in the​ workplace, and fostering a positive and realistic view of nursing. Functions of the National League for Nursing​ (NLN) include implementing nurse educator faculty development programs and assisting deans with implementing quality nursing education standards.

As part of hospital orientation for a group of​ nurses, the human resources representative is discussing intimidation. Which information is most appropriate for the human resources representative to include in the​ discussion? A. Intimidation may include repeatedly asking another individual for favors. B. Intimidation may include unintentional nursing behaviors and statements made to clients. C. Covert forms of intimidation may include making verbal threats. D. Overt forms of intimidation may include standing too close to someone.

A. Intimidation may include repeatedly asking another individual for favors. ***B. Intimidation may include unintentional nursing behaviors and statements made to clients. C. Covert forms of intimidation may include making verbal threats. D. Overt forms of intimidation may include standing too close to someone. Intimidation includes​ threatening, bullying, or forcing someone who is emotionally or physically weaker to do something in order to avoid retribution or negative consequences. Asking an individual for favors without any associated retribution or negative consequences is not reflective of intimidation.​ Subtle, or​ covert, forms of intimidation include standing close to someone while maintaining a hostile facial expression. Intimidation may also be​ overt, such as threatening an individual with consequences for not obeying an order. On the​ nurse's part, intimidation may be​ unintentional; for​ example, making statements such​ as, "If you do not take your medicine​ (or go to physical​ therapy, or follow the treatment​ plan), you're going to get​ worse."

A nurse has transferred from a clinic setting to an inpatient unit. The nurse notices several questions about spiritual beliefs on the admission form that the nurse had never asked new clinic clients. What is the most likely reason for asking these​ questions? A. Invitation to attend the hospital​'s worship services B. The Joint Commission​'s accreditation requirements C. Identify which members of the clergy to call for spiritual emergencies D. Finding a better match for a semiprivate room

A. Invitation to attend the hospital​'s worship services ***B. The Joint Commission​'s accreditation requirements C. Identify which members of the clergy to call for spiritual emergencies D. Finding a better match for a semiprivate room The most likely reason to ask questions about spiritual beliefs is The Joint Commission​'s requirements for clients admitted to an institution. The requirements are not mandated for clinic clients. It is not about attending worship​ services, matching​ roommates, or calling the right clergyperson.

The novice nurse asks the nurse preceptor to describe normative commitment. Which items should the nurse preceptor include in the​ description? ​(Select all that​ apply.) A. It may be demonstrated by engaging in​ profession-specific organizations and service activities. B. It develops when professional involvement produces a satisfying experience. C. It creates ties that are similar to those that emerge as a result of continuance commitment. D. It may be reflected by choosing to enter nursing due to experiences with personal illness. E. It can manifest as a feeling of obligation to continue in​ one's profession.

A. It may be demonstrated by engaging in​ profession-specific organizations and service activities. B. It develops when professional involvement produces a satisfying experience. C. It creates ties that are similar to those that emerge as a result of continuance commitment. ***D. It may be reflected by choosing to enter nursing due to experiences with personal illness. ***E. It can manifest as a feeling of obligation to continue in​ one's profession. Normative commitment manifests as a feeling of obligation to continue in​ one's profession. It develops in response to benefits or positive experiences gained by way of engagement in​ one's profession. For​ example, the nurse whose desire to enter nursing or whose choice to remain in the profession stems from personal or family experiences with illness is reflective of normative commitment. Affective commitment develops when professional involvement produces a satisfying experience. Manifestations of affective commitment include engaging in​ profession-specific organizations and service activities. The ties created by continuance commitment differ from the ties that stem from affective or normative commitment.

The psychiatric nurse practitioner is giving a webinar about prevention of burnout in nursing. Which items should the psychiatric nurse practitioner include when describing tips related to having​ compassion? ​(Select all that​ apply.) A. Joining nursing associations that promote constructive discussion of work issues B. Acknowledging that most individuals do the best they can do C. Learning to ask for help from colleagues or confidantes when needed D. Perceiving errors and failures as opportunities for constructive learning E. Recognizing the limitations associated with any given situation

A. Joining nursing associations that promote constructive discussion of work issues ***B. Acknowledging that most individuals do the best they can do ***C. Learning to ask for help from colleagues or confidantes when needed ***D. Perceiving errors and failures as opportunities for constructive learning E. Recognizing the limitations associated with any given situation Compassion includes learning to accept errors and​ failures, and recognizing these situations as opportunities for constructive learning. Acknowledging that most individuals do the best they can and learning to ask for help are also reflective of compassion. Participating in professional organizations that promote recognition and constructive discussion of workplace issues is reflective of professional engagement. Recognition of limitations associated with situations is reflective of acceptance.

The nurse educator is teaching a class about professional development in nursing. When describing an area of nursing​ competence, which component is most appropriate for the nurse educator to include in the​ teaching? A. Knowing and demonstrating adherence to the ethics of primary care providers B. Recognizing the nurse​'s responsibility to remain strictly in a​ client-centered role C. Understanding that client populations tend to demonstrate the same personal needs D. Understanding the culture of the client population and the healthcare institution

A. Knowing and demonstrating adherence to the ethics of primary care providers B. Recognizing the nurse​'s responsibility to remain strictly in a​ client-centered role C. Understanding that client populations tend to demonstrate the same personal needs ***D. Understanding the culture of the client population and the healthcare institution Areas of nursing competence include understanding the culture of the client and the​ institution; knowing and demonstrating adherence to the ethics of the nursing​ profession; acknowledging the​ client's need for individualized​ care; and assuming multiple nursing​ responsibilities, including​ legal, professional,​ ethical, and​ client-centered roles.

A novice nurse wants to use the nursing process while caring for clients. How can the nurse prevent medicine errors during the implementation phase of the nursing​ process? A. Leave the client​'s oral medication at the bedside only if the client is oriented and able to swallow B. Hold the medication if the client is in the bathroom C. Instruct the client to tell the nurse the reason why the client is taking the medication being administered D. Urge the client to question the nurse if a pill being administered looks different from what is normally taken

A. Leave the client​'s oral medication at the bedside only if the client is oriented and able to swallow B. Hold the medication if the client is in the bathroom C. Instruct the client to tell the nurse the reason why the client is taking the medication being administered ***D. Urge the client to question the nurse if a pill being administered looks different from what is normally taken The nurse should urge the client to question any pill administered that looks different from what is normally taken. With this​ action, the nurse is acting as a client advocate in preventing medication errors. Asking the client to tell the nurse the reason why the client is taking the medication administered is inappropriate as many clients will not be able to do​ this, and this is the responsibility of the nurse. Leaving a medication at the​ client's bedside is never appropriate. Holding the​ client's medication because the client is in the bathroom is also inappropriate and does not improve the safety of medication administration.

A nurse ignores a client​'s persistent complaint of back pain because the client open double quote"complains too much.close double quote" The next day the client is diagnosed with kidney stones. What negligence prevention strategy did the nurse fail to​ implement? A. Minimizing the risk of medication errors B. Maintaining client safety C. Using effective communication D. Minimizing client discomfort

A. Minimizing the risk of medication errors ***B. Maintaining client safety C. Using effective communication D. Minimizing client discomfort The nurse is negligent and has committed malpractice. This type of malpractice is failure to observe and take appropriate​ action, a breach in maintaining client safety. Minimizing client discomfort is not a negligence prevention​ strategy, and the other choices do not apply to the scenario described.

Claire is a nurse who works on a substance abuse unit. She sees all clients prior to admission and she must determine the last time each client used​ drugs, determine their drug of​ choice, and obtain urine and blood samples. Which step of the nursing process is Claire using during this​ process? A. Planning the​ client's care​ (developing a care​ plan) B. Analyzing the assessment data and choosing a diagnosis C. Evaluating the​ client's progress indicative of the stated outcomes D. Assessing and collecting comprehensive data

A. Planning the​ client's care​ (developing a care​ plan) B. Analyzing the assessment data and choosing a diagnosis C. Evaluating the​ client's progress indicative of the stated outcomes ***D. Assessing and collecting comprehensive data The nurse is assessing and collecting comprehensive data during this​ process, and is in an ideal position to provide the correct level of assessment by collecting comprehensive data surrounding the​ client's health and life situation. The other steps include analyzing the data once​ collected, planning appropriate​ care, coordinating provision of​ care, and evaluating the​ client's progress based on the outcomes and care plan.

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

A. Receiving antibiotics for strep throat with a parent present ***B. Receiving contraceptive services without a parent present C. Bringing a younger sibling to a health assessment visit D. Bringing a grandparent to an urgent care center for a flu shot A​ 17-year-old client can provide informed consent for her own care when receiving contraceptive services. A​ 17-year-old client cannot provide informed consent to receive antibiotics for strep throat as this does not fall into a legal exception category. Consent should be obtained from the​ client's parent or custodian. The​ 17-year-old cannot provide consent for a sibling to receive care during a health assessment visit or for a grandparent at an urgent care visit for a flu shot.

A nurse is interviewing for a staff position on a​ medical-surgical unit. Which portion of the hiring process best represents the hospital​'s efforts to evaluate the nurse​'s commitment to the​ profession? A. Requiring the candidate to provide official copies of college transcripts B. Offering the candidate the option of completing a​ four-week unit orientation and preceptorship C. Inviting current staff nurses to serve as members of the candidate​'s interview committee D. Exploring the candidate​'s desire to maintain membership in the profession

A. Requiring the candidate to provide official copies of college transcripts B. Offering the candidate the option of completing a​ four-week unit orientation and preceptorship C. Inviting current staff nurses to serve as members of the candidate​'s interview committee ***D. Exploring the candidate​'s desire to maintain membership in the profession The​ candidate's desire to maintain membership in the nursing profession is reflective of professional commitment. The requirement to provide official college transcripts is not directly related to the​ candidate's commitment to the nursing profession. Inviting current staff nurses to serve as interview committee members and offering a unit orientation and preceptorship are not direct methods of evaluating the​ candidate's professional commitment to nursing.

Mitchell​ Asplund, a clinical nursing​ instructor, is assigned to serve as a student faculty advisor.​ Mitchell's responsibilities include determining which stage of commitment to nursing his students are experiencing. He is evaluating nursing student Don​ Rowlands, who is a junior in nursing school. During his​ evaluation, Don​ states, "I want to join the National Student Nurses Association.​ I'm also volunteering to participate in the student health fair. I know​ I'm really​ busy, but my schedule will be crazy when​ I'm working as a​ nurse, too.​ It's worth it to​ me." Mitchell recognizes that Don is in which stage of making a professional commitment to​ nursing? A. Testing B. Passionate C. Integrated D. Exploratory

A. Testing ***B. Passionate C. Integrated D. Exploratory The passionate​ stage, which is the third stage of​ commitment, begins as the individual processes the positive and negative aspects of the profession. At this​ point, students are willing to commit to their profession and to contribute to its​ well-being. Examples of student behaviors that are reflective of this stage include serving as a class​ officer, becoming involved in student nursing​ associations, and volunteering for activities not associated with a grade. The exploratory​ stage, which is the first stage of professional​ commitment, begins when individuals explore the positive aspects of their profession. During the testing​ stage, which is the second stage of professional​ commitment, students discover negative aspects of the profession. The​ quiet-and-bored stage, which is the fourth stage of​ commitment, involves settling into the nursing​ program's routines. The integrated​ stage, which is the fifth and final stage of​ commitment, requires integration of positive and negative elements of the profession into a more​ flexible, complex, and enduring form of commitment.

The nurse leader is planning an​ in-service about the administration of health policy at the federal level. Which content is appropriate for inclusion in the​ presentation? A. The Administration for Children and Families and the Administration on Aging are mainly responsible for addressing healthcare financing issues. B. The Food and Drug Administration​ (FDA) is governed by the U.S. Department of Health and Human Services​ (DHHS). C. The primary role of the Centers for Medicare and Medicaid Services​ (CMS) is to oversee services for individuals throughout the life span. D. The Centers for Disease Control and Prevention​ (CDC) is governed by the National Institutes of Health​ (NIH).

A. The Administration for Children and Families and the Administration on Aging are mainly responsible for addressing healthcare financing issues. ***B. The Food and Drug Administration​ (FDA) is governed by the U.S. Department of Health and Human Services​ (DHHS). C. The primary role of the Centers for Medicare and Medicaid Services​ (CMS) is to oversee services for individuals throughout the life span. D. The Centers for Disease Control and Prevention​ (CDC) is governed by the National Institutes of Health​ (NIH). The U.S. Department of Health and Human Services​ (DHHS) governs more than 300 divisions and​ programs, including the​ following: The National Institutes of Health​ (NIH), which provide health research and other​ health-related information; the Centers for Medicare and Medicaid Services​ (CMS), which address healthcare financing​ issues; and the Administration for Children and Families and the Administration on​ Aging, which oversee services for individuals throughout the life span. Divisions governed by the DHHS also include the Food and Drug Administration​ (FDA) and the Centers for Disease Control and Prevention​ (CDC).

A client admitted for major cardiac surgery states a religious preference. Then the client lists all the church​'s rules that the client disagrees with. What does the admitting nurse understand about the client​'s religious​ status? A. The client is a former member of that group. B. The client has been excommunicated from that group. C. The client is a dissenting member of that group. D. The client is an outsider trying to be part of that group.

A. The client is a former member of that group. B. The client has been excommunicated from that group. ***C. The client is a dissenting member of that group. D. The client is an outsider trying to be part of that group. The client is a dissenting member of that group. It is not a matter of past​ membership, of being​ rejected, or of being an outsider.

The clinical nursing instructor is evaluating the student​'s developmental stage of professional commitment. The student has settled into the nursing program​'s routine and reports experiencing decreased performance anxiety. Which stage of professional commitment is most appropriate for the clinical nursing instructor to use when describing the student​'s current level of​ development? A. The exploratory stage B. The​ quiet-and-bored stage C. The integrated stage D. The testing stage

A. The exploratory stage ***B. The​ quiet-and-bored stage C. The integrated stage D. The testing stage Development begins with the exploratory​ stage, which begins when individuals explore the positive aspects of their profession. Examples include the excitement nursing students experience when first wearing their new uniforms or when purchasing their first stethoscope. The second stage is the testing​ stage, during which students discover the positive and negative aspects of the nursing profession. During the third​ stage, which is the passionate​ stage, students are willing to commit to their profession and to contribute to its​ well-being. Examples of student behaviors that are reflective of this stage include serving as a class officer and becoming involved in student nursing associations. During the fourth​ stage, which is the​ quiet-and-bored stage, students settle into the nursing​ program's routines, grow more comfortable in their​ role, and experience decreased performance anxiety. The integrated​ stage, which is the fifth​ stage, manifests through the​ student's demonstration of commitment as a matter of habit. This stage usually begins in the final phases of the nursing​ program, with students beginning to see themselves as​ nurses, and growing eager to take the​ NCLEX-RN® and to begin working.

The nurse is caring for a client who experienced an anaphylactic reaction to a medication. The nurse did not ask the client about allergies prior to administering the medication. Which statement is true regarding this nurse​'s ​actions? A. The nurse committed an act of​ negligence, but not malpractice. B. The nurse committed​ malpractice, but not an act of negligence. C. The nurse committed acts of negligence and malpractice. D. The nurse committed negligence due to a failure to communicate.

A. The nurse committed an act of​ negligence, but not malpractice. B. The nurse committed​ malpractice, but not an act of negligence. ***C. The nurse committed acts of negligence and malpractice. D. The nurse committed negligence due to a failure to communicate. The nurse committed a failure to​ assess, failure to follow standards of​ care, failure to​ document, and failure to act as a client advocate.​ Therefore, this nurse committed acts of negligence and malpractice.

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

A. The nurse fails to notify the healthcare provider in a timely manner when conditions warrant it. B. The nurse fails to act on prescribed​ orders, and the client suffers an adverse event. ***C. The nurse fails to treat the client complaining of a​ headache, and the client subsequently has a stroke. D. The nurse fails to document a client​'s ​allergy, and the client subsequently has an allergic reaction to a medication administered. The nurse who fails to treat a client who complains of a​ headache, and then subsequently suffers a​ stroke, is failing to assess and monitor. The other clinical scenarios are negligent acts that lead to malpractice.​ However, they do not fit failing to assess and monitor.

The new nurse observes that her client is becoming upset with his healthcare providers because they disagree with the client​'s decision to discontinue his cancer treatment. Although the nurse feels conflicted by the client​'s ​decision, which moral obligation guides the care that is provided to the​ client? A. The nurse must defend the healthcare providers​' choice to continue cancer therapy because that is what is best for the client. B. The nurse supports the client​'s right to make his own healthcare decisions. C. The nurse explains to the client that he is making a mistake because his culture and traditions are leading him down the wrong path. D. The nurse respects that the hospital has the final authority to make decisions for the client.

A. The nurse must defend the healthcare providers​' choice to continue cancer therapy because that is what is best for the client. ***B. The nurse supports the client​'s right to make his own healthcare decisions. C. The nurse explains to the client that he is making a mistake because his culture and traditions are leading him down the wrong path. D. The nurse respects that the hospital has the final authority to make decisions for the client. The nurse is morally obliged to support the​ client's right to make his own healthcare decisions. The healthcare​ providers' may advise the client about best​ options, but may not make decisions for the client. The hospital does not have authority to make decisions for the client. The nurse must respect the​ client's culture and​ traditions, even if they create conflict with the​ nurse's own beliefs and values.

A nurse is administering a medication to a pediatric client. The nurse verifies the client​'s armband and confirms the correct medication by checking the prescribed order and the medication vial. Which actions by the nurse correctly exemplify the "Six Rights" of medication​ administration? ​(Select all that​ apply.) A. The nurse verifies the right medication by asking the client "is this what you normally take at ​home?" B. The nurse checks for right frequency by looking at the client​'s chart. C. The nurse checks for right dose by checking the prescribed​ order, performing a dose​ calculation, and checking the medication. D. The nurse checks for right documentation by documenting administration of the prescribed order in the client record. E. The nurse checks for right time by checking the prescribed order and looking at the time.

A. The nurse verifies the right medication by asking the client "is this what you normally take at ​home?" B. The nurse checks for right frequency by looking at the client​'s chart. ***C. The nurse checks for right dose by checking the prescribed​ order, performing a dose​ calculation, and checking the medication. ***D. The nurse checks for right documentation by documenting administration of the prescribed order in the client record. ***E. The nurse checks for right time by checking the prescribed order and looking at the time. Verifying the right time and dose and documenting the administration of the medication are all included in the rix rights of medication administration. Frequency is not one of the six rights of medication administration. While checking for the right medication is one of the six​ rights, asking the client if the pill is what they take at home does not constitute checking the right medication. The nurse would need to verify that the medication is the correct by checking the medication against the​ client's medication administration record.

In deciding to report a​ co-worker who has engaged in​ illegal, immoral, or unethical​ conduct, the nurse can turn to which organizations for​ guidance? ​(Select all that​ apply.) A. The police B. The American Nurses Association C. The state board of nursing D. The National Alliance on Mental Illness E. Nursing school

A. The police ***B. The American Nurses Association ***C. The state board of nursing D. The National Alliance on Mental Illness E. Nursing school The nurse would turn to the state board of nursing or the American Nurses Association for guidance regarding the behavior of a​ co-worker. Nursing school would not be an official resource. The National Alliance on Mental Illness is an advocacy program. The nurse would not initiate consultation with the police - this would be done by the employer.

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

A. The purposes of the treatment B. The intended benefits of the treatment ***C. The insurance payment methods D. The diagnosis or condition that requires treatment Relevant information that is provided to the client during the informed consent process includes the purpose of the​ treatmnet, the diagnosis or condition that requires​ treatment, and the intended benefits of the treatment. The insurance payment methods are not included in the informed consent process.

The nurse practice act and administrative rules form the basis of the standard of care. Which phrase is an aspect of the nurse practice​ act? A. The scope of the healthcare provider​'s practice B. The definition of professional conduct for nurses C. The disclosure of NCLEX scores for all nursing personnel employed by the facility D. The identification of activities for all levels of hospital​ workers, including administrative personnel

A. The scope of the healthcare provider​'s practice ***B. The definition of professional conduct for nurses C. The disclosure of NCLEX scores for all nursing personnel employed by the facility D. The identification of activities for all levels of hospital​ workers, including administrative personnel The definition of the professional conduct of nurses is an aspect of the nurse practice act. The scope of the healthcare provider​'s ​practice, disclosure of NCLEX​ scores, and identification of activities for all levels of hospital employees including administrative staff are not aspects of the nurse practice act.

The nursing student is designing a poster that describes how to recognize burnout among nurses. Which recommendation for identifying manifestations of burnout should be included on the​ poster? A. Understand that emotional depletion is a natural response to the demands of employment B. Interpret that smoking and an increase in coffee consumption may be potential warning signs C. Recognize that outbursts of anger are normal signs of professional frustration D. Acknowledge feelings of helplessness as signs of inexperience or professional inadequacy

A. Understand that emotional depletion is a natural response to the demands of employment ***B. Interpret that smoking and an increase in coffee consumption may be potential warning signs C. Recognize that outbursts of anger are normal signs of professional frustration D. Acknowledge feelings of helplessness as signs of inexperience or professional inadequacy Manifestations of burnout include physical and emotional​ depletion, negative attitude and​ self-concept, and feelings of helplessness and hopelessness. Danger signs that may precede the development of burnout include increased coffee consumption and smoking.

A dialysis nurse does not agree with a client​'s decision to stop treatment. "I promised my spouse I would try it for a​ while, but it​'s too ​much," the client reveals. In supporting the client​'s ​decision, which principle of morality is the nurse​ honoring? A. Veracity B. Fidelity C. Justice D. Autonomy

A. Veracity B. Fidelity C. Justice ***D. Autonomy In supporting the client​'s ​decision, the nurse is honoring the principle of autonomy​ (the client​'s right to make​ decisions). It is not a matter of fidelity​ (keeping a​ promise), veracity​ (telling the​ truth), or justice​ (fairness).

The nurse is developing the plan of care for an​ English-speaking Micronesian man with an 8th grade education who has hypertension. The client is noncompliant with taking medications and is not following up with the healthcare provider as needed. Which criteria indicates the need for an advocate to help the client access the resources he​ requires? A. Very ill or in pain B. Lower literacy level C. Low income level D. ​Non-English speaking

A. Very ill or in pain ***B. Lower literacy level C. Low income level D. ​Non-English speaking Clients with low overall literacy and low health literacy levels have difficulty understanding their medical situation and become easily confused with navigating the healthcare system. Advocacy is needed in that situation. The client speaks English. The client feels well and is not in pain. There is not enough information to determine his income level.

Mr. Thomas is a​ 38-year-old client who uses a wheelchair as a result of a motorcycle accident 7 months ago. He decided that he will continue his physical​ therapy, but he will not take any more of the medications prescribed for muscle spasms because they make him feel weak. The nurse has assessed Mr. Thomas and believes that he understands his situation and is making an informed​ decision, although his healthcare provider disagrees with his choice. Which statement by the nurse is most​ appropriate? A. ​"The Americans with Disabilities Act​ (ADA) protects your right to refuse​ medications." B. ​"The Patient​ Self-Determination Act​ (PSDA) protects your right to refuse​ medications." C. ​"The Affordable Care Act​ (ACA) protects your right to refuse​ medications." D. ​"The Health Insurance Portability and Accountability Act​ (HIPAA) protects your right to refuse​ medications."

A. ​"The Americans with Disabilities Act​ (ADA) protects your right to refuse​ medications." ***B. ​"The Patient​ Self-Determination Act​ (PSDA) protects your right to refuse​ medications." C. ​"The Affordable Care Act​ (ACA) protects your right to refuse​ medications." D. ​"The Health Insurance Portability and Accountability Act​ (HIPAA) protects your right to refuse​ medications." The PSDA protects the rights of clients to accept or reject aspects of their medical care. The ACA is healthcare law that provides for insurance and services. The ADA provides for access to public​ services, employment and benefits. HIPAA addresses health information privacy.

The nurse makes a telephone call to a client who was recently discharged. The nurse wants to assess whether the client has read the discharge material and made appointments with the healthcare provider. Which dimension of advocacy is involved with this​ intervention? ​A. Following-up regarding care B. Advising about legal rights C. Enabling​ self-care D. Going above and beyond

​***A. Following-up regarding care B. Advising about legal rights C. Enabling​ self-care D. Going above and beyond The nurse advocate is​ following-up, which is one of the four dimensions of advocacy. The other three are being a client​ advocate, providing​ resources, and going above and beyond. Routine calls are not going above and beyond. Enabling​ self-care and advising the client of legal rights are not included in the four dimensions of advocacy.

Mrs. Rodriquez is a​ 32-year-old Hispanic client who is admitted to the hospital. Mrs. Rodriquez speaks​ English, yet her husband frequently answers for her and makes decisions about her care. The nurse notices that Mrs. Rodriquez seems to have chosen to have her husband make decisions for her. When caring for Mrs.​ Rodriquez, which statement by the nurse is most​ appropriate? ​A. "I think your husband is too controlling and this is a​ problem." B. ​"I understand that you and your husband have decided to let him speak for​ you." C. ​"I would like to refer you and your husband to​ counseling." D. ​"It is not appropriate for your husband to make your healthcare​ decisions."

​A. "I think your husband is too controlling and this is a​ problem." ***B. ​"I understand that you and your husband have decided to let him speak for​ you." C. ​"I would like to refer you and your husband to​ counseling." D. ​"It is not appropriate for your husband to make your healthcare​ decisions." The nurse should practice culturally competent care by respecting the cultural values of the clients and advocating for those rights as needed. Telling the client that it is not appropriate for her husband to make her healthcare decision is not appropriate. There is no indication for the need for counseling. The nurse is passing judgment by telling the client that her husband is too controlling.