Fundamentals Exam 1
primary care
focus on improved health outcomes for an entire population; includes primary care and health education, proper nutrition, maternal/child health care, family planning, immunizations, and control of disease
Health Services Pyramid
1. manages health instead of illness 2. emphasis is on wellness 3. achievements in lower levels contribute to improved health care in higher level
Nurses in an acute care hospital are attending a unit based education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? a. continuing education b. graduate education c. in-service education d. professional registered nurse education
c
A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with them. The nurse is acting as the patient's a. educator b. advocate c. caregiver d. case manager
b
Nurse Practitioner
Detects and manages self-limiting acute and chronic stable medical conditions
Clinical Nurse Specialist
Expert clinician in a specialized area of practice.
Define Nurse
For the protection, promotion, and optimization of health and abilities Prevention of illness and injury Alleviation of suffering through the diagnosis and treatment of human response Advocacy in the care of individuals, families, communities, and populations
certified nurse midwife
Involves the independent care for women in normal pregnancy, labor, and delivery and care of newborns.
advanced practice nurse
Most independently functioning nurse Advanced education in pathophysiology, pharmacology, physical assessment, certification in a specialized area of practice
Certified Registered Nurse Anesthetist
Provides surgical anesthesia
A charge nurse is observing a newly licensed nurse care for a client who reports pain. The nurse checked the client's MAR and noticed the last dose of pain medication was 6 hours ago. The prescription reads every 4 hours PRN for pain. The nurse administered the medicationand checked with the client 40 minutes later, when the client reported improvement. The newly licensed nurse left out which of the following steps of the nursing process? a. assessment b. planning c. intervention d. evaluation
a
A critical care nurse is using a computerized decision support system to correctly position her ventilated patient to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses competency? a. Patient-centered care b. Safety c. Teamwork and collaboration d. Informatics
a
A nurse is beginning a complete bed bath for a client. After removing the client's gown and placing a bath blanket over the body, which of the following areas should the nurse wash first a. face b. feet c. chest d. arms
a
A nurse is caring for a client who has a new prescription for antihypertensive medication. Prior to administering the medication, the nurse uses an electronic database to gather information about the medication and the effects it might have on this client. Which of the following components of critical thinking is the nurse using when he reviews the medication information? a. knowledge b. experience c. intuition d. competence
a
A nurse is caring for a client who is 24 hr postoperative following an inguinal hernia repair. The client is tolerating clear liquids well, has active bowel sounds, and is expressing a desire for "real food." The nurse tells the client, "I will call the surgeon and ask for a change in diet." The surgeon hears the nurse's report and prescribes a full liquid diet. The nurse used which of the following levels of critical thinking? a. basic b. commitment c. complex d. integrity
a
A nurse is discussing the nursing process with a newly licensed nurse. Which of the following statements by the newly licensed nurse should the nurse identify as appropriate for the planning step of the nursing process? a. I will determine the most important client problems that we should address b. i will review the past medical history on the client's record to get more information c. i will carry out the new prescriptions from the provider d. i will ask the client if their nausea has resolved
a
A nurse is explaining the various types of health care coverage clients might have to a group of nurses. Which of the following health care financing mechanisms should the nurse include as federally funded? (select all that apply) a. preferred provider organization PPO b. medicare c. long-term care insurance d. exclusive provider organization EPO e. medicaid
a
A nurse is performing mouth care for a client who is unconscious. Which of the following actions should the nurse take? a. turn the client's head to the side b. place two fingers in the client's mouth to open it c. brush the client's teeth once per day d. inject a mouth rinse into the center of the client's mouth
a
A nurse is planning care for a client who develops dyspnea and feels tired after completing morning care. Which of the following actions should the nurse include in the client's plan of care? a. schedule rest periods during morning care b. discontinue morning care for 2 days c. perform all care as quickly as possible d. ask a family member to come to bathe the client
a
A nurse manager is developing strategies to care for the increasing number of clients who have obesity. Which of the following actions should the nurse include as a primary health care strategy? a. collaborating with providers to perform obesity screening during routine office visits b. ensuring the availability of specialized beds in rehabilitation centers for clients who have obesity c. providing specialized intraoperative training in surgical treatments for obesity d. educating acute care nurses about postoperative complications related to obesity
a
A nurse observes an assistive personnel reprimanding a client for not using the urinal properly. The AP tells the client that diapers will be used next time the urinal is used improperly. Which of the following torts is the AP committing? a. assault b. battery c. false imprisonment d. invasion of privacy
a
By the second postoperative day, a client has not achieved satisfactory pain relief. Based on this evaluation, which of the following actions should the nurse take, according to the nursing process? A. Reassess the client to determine the reasons for inadequate pain relief. B. Wait to see whether the pain lessens during the next 24 hr. C. Change the plan of care to provide different pain relief interventions. D. Teach the client about the plan of care for managing his pain.
a
Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform? a. moving from acute illness to a health promotion, illness prevention model b. moving from an illness prevention to a health promotion model c. moving from an acute illness to a disease management model d. moving from a chronic care to an illness prevention model
a
The nurse spends time with the patient and family reviewing the dressing change procedure for the patient's wound. The patient's spouse demonstrates how to change the dressing. The nurse is acting in which professional role? a. educator b. advocate c. caregiver d. case manager
a
A nurse is caring for a client who is about to undergo an elective surgical procedure. The nurse should take which of the following actions regarding informed consent? (select all that apply) a. make sure the surgeon obtained the client's consent b. witness the client's signature on the consent form c. explain the risks and benefits of the procedure d. describe the consequences of choosing not to have the surgery e. tell the client about alternatives to having surgery
a b
A newly licenced nurse is considering strategies to improve critical thinking. Which of the following actions should the nurse take? (select all that apply) a. find a mentor b. use a journal to write about the outcomes of clinical judgement c. review articles about evidence-based practice d. limit consultations with other professionals involved in a client's care e. make quick decisions when unsure about a client's needs
a b c
A nurse is explaining the various levels of health care services to a group of newly licensed nurses. Which should the following examples of care or care settings should the nurse classify as tertiary care? (select all that apply) a. intensive care unit b. oncology treatment center c. burn center d. cardiac rehabilitation e. home health care
a b c
A nurse caring for a client who has severe acute respiratory syndrome. The nurse knows that health care professionals are required to report communicable and infectious diseases. Which of the following illustrate the rationale for reporting? (select all that apply) a. planning and evaluating control and prevention strategies b. determining public health priorities c. ensurig proper medical treatments d. identifying endemic disease e. monitoring for common-source outbreaks
a b c e
A nurse is acquainting a group of newly licensed nurses with the roles of the various members of the health care team they will encounter on a medical-surgical unit. When providing examples of the types of tasks certified nursing assistants can perform, which of the following client activities should the nurse include? a. bathing b. ambulating c. toileting d. determining pain level e. measuring vital signs
a b c e
A nurse is caring for a group of clients on a medical-surgical unit. For which of the following client care needs should the nurse initiate a referral for a social worker? (Select all that apply) a. a client who has terminal cancer requests hospice care in the home b. a client asks about community resources available for older adults c. a clients states "i would like to have my child baptized before surgery d. a client requires an electric wheelchair for use after discharge e. a client states, "i do no understand how to use a nebulizer
a b d
A nurse is discussing restorative health care with a newly licensed nurse. Which of the following examples should the nurse include in the teaching? (select all that apply) a. home health care b. rehabilitation facilities c. diagnostic centers d. skilled nursing facilities e. oncology centers
a b d
A charge nurse is reviewing with a newly hired nurse the difference in manifestations of a localized versus a systemic infection. Which of the following are manifestations of a systemic infection? (select all that apply) a. fever b. malaise c. edema d. pain or tenderness e. increase in pulse and respiratory rate
a b e
A nurse is instructing a client who has diabetes mellitus about foot care. Which of the following guidelines should the nurse include? Select all that apply a. inspect the feet daily b. use moisturizing lotion on the feet c. wash the feet with warm water and let them air dry d. use over-the-counter products to treat abrasions e. wear cotton socks
a b e
A client who is postoperative following knee arthroplasty is concerned about the adverse effects of the medication prescribed for pain management. Which of the following members of the interprofessional care team can assist the client in understanding the medication's effect? (Select all that apply) a.provider b. certified nursing assistant c. pharmacist d. registered nurse e. respiratory therapist
a c d
A nurseis reviewing CDC immunization recommendations with a young adult client. Which of the following vaccines should the nurse recommend as routine, rather than catch-up, during young adulthood? Select all that apply a. influenza b. measles, mumps, rubella c. pertussis d. tetanus e. polio
a c d
A nurse is preparing a health promotion course for a group of middle adults. Which of the following strategies should the nurse recommend? Select all that apply a. eye examination every 1 to 3 years b. decrease intake of calcium supplements c. DXA screening for osteoperosis d. increase intake of carbohydrate in the diet e. screening for depressive disorders
a c d e
A nurse is talking with an older adult client about improving nutritional status. Which of the following interventions should the nurse recommend? select all that apply a. increase protein intake to increase muscle mass b. decrease fluid intake to prevent urinary incontinence c. increase calcium intake to prevent osteoporosis d. limit sodium intake to prevent edema e. increase fiber intake to prevent constipation
a c d e
A nurse is collecting history and physical examination data from a middle adult. The nurse should expect to find decreases in which ofthe following physiologic functions. select all that apply a. metabolism b. ability to hear low-pitched sounds c. gastric secretions d far vision e. glomerular filtration
a c e
Which of the following actions should the nurse take when demonstrating an empathic presence to a client? select all that apply a. use an open posture b. write down what the client says to avoid forgetting details c. establish and maintain eye contact d. nod in agreement with the client throughout the conversation e. sit facing the client
a c e
a charge nurse is reviewing the steps of the nursing process witha group of nurses. Which of the following data shold the charge nurse identify as objective date? (select all that apply) a. respiratory rate is 22/min with even, unlabored respirations b. the client's partner states, "they said they hurt after walking about 10 minutes " c. the client's pain rating is 3 on a scale of 0-10 d. the client's skin is pink, warm and dry e. the assistive personennel reports that the client walked with a limp
a d e
Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) A. Caregiver B. Autonomy and accountability C. Patient advocate D. Health promotion E. Lobbyist
a, b, c, d
who regulates nursing
american nurses association (ANA)
A nurse is caring for a client who decides not to have surgery despite significant blockages of the coronary arteries. The nurse understands that this client's choice is an example of which of the following ethical principles a. fidelity b. autonomy c. justice d. nonmaleficence
b
A nurse is caring for a client who states, "i have to check with my partner and see if they think I am ready to go home." The nurse replies, "How do you feel about going home today?" Which clarifying technique is the nurse using to enhance communication with the client? a. pacing b. reflecting c. paraphrasing d. restatin
b
A nurse is caring for a competent adult client who tells the nurse, "I am leaving the hospital this morning whether the doctor discharges me or not." The nurse believes that this is not in the client's best interest, and prepares to administer a PRN sedative medication the cleint has n requested along with the scheduled morning medication. Which of the following types of tort is the nurse about to commit a. assault b. battery c. negligence d. breach in confidentiality
b
An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, listens to her lung and heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? a. diagnosis b. evaluation c. assessment d. implementation
c
A nurse is counseling a middle adult client who describes having difficulty dealing with several issues. Which of the following client statements should the nurse identify as the priorty to assess further?a. I am struggling to accept that my parents are aging and need so much help b. its been so stressfu for me to think about having intimate relationships c. i know i should volunteer my time for a good cause, but maybe I;m just selfish d. I love my grandchildren but my child expect me to relive my parenting days
b
A nurse is discussing the purpose of regulatory agencies during a staff meeting. Which of the following tasks should the nurse identify as the responsibility of state licensing boards? a. monitoring evidence-based practice practice for clients who have specific diagnosis b. ensuring that health care providers comply with regulations c. setting quality standards for accredication of health care facilities d. determining whether medications are safe for administration to clients
b
A nurse is instructing a young adult client about health promotion and illness prevention. Which of the following statements indicates understanding? a. I already had my immunizations as a child, so I'm protected in that area b. It is important to schedule routine health care visits even if I am feeling well c. I will just go to an urgent care center for my routine medical care d. there's no reason to seek help if I am feeling stressed because its just part of life
b
A nurse is preparing to perform denture care for a client. Which of the following actions should the nurse plan to take? a. pull down and out at the back of the upper denture to remove b. brush the dentures with a tooth brush and denture cleaner c. rinse the dentures with hot water after cleaning them d. place the dentures in a clean, dry storage container after cleaning them
b
A nurse receives a prescription for an antibiotic for a client who has cellulitis. The nurse checks the client's medical record, discovers that the client is allergic to the antibiotic, and calls the provider to request a prescription for a different antibiotic. Which of the following critical thinking attitudes did the nurse demonstrate? a. fairness b. responsibility c. risk-taking d. creativity
b
Which of the following strategies should a nurse use to establish a helping relationship with a client? a. make sure the communication is equally distributed between the nurse's and client's desires b. encourage the client to communicate their feelings and thoughts c. give the nurse-client communication no time limits d. allow communication to occur spontaneously throughout the nurse-client relationship
b
A nurse is reviewing safety precautions with a group of young adults at a community health fair. Which of the following recommendations should the nurse include to address common health risks for this age group? select all that apply a. install bath rails and grab bars in bathrooms b. wear a helmet while skiing c. install a carbon monoxide detector d. secure firearms in a safe location e. remove throw rugs from the home
b c d
A nurse is planning a presentation for a group of older adults about health promotion and disease prevention. Which of the following interventions should the nurse plan to recommend? select all that apply a. human papilloma virus immunization b. pneumoccal immunization c. yearly eye examination d. periodic mental health screening e. annual fecal occult blood test
b c d e
A nurse is collecting date to evaluate a middle adult's psychosocial development. The nurse should expect middle adults to demonstrate which of the following developmental tasks. select all that apply a. develop an acceptance of diminished strength and increased dependence on others b. spend time focusing on improving job performance c. welcome opportunities to be creative and productive d. commit to finding friendship and companionship e. become involved with community issues and activities
b c e
A nurse is contributing to the plan of care for a client who is being admitted to the facility w/a suspected diagnosis of pertussis. Which of the following should the nurse include in the plan of care? Select all. A. Place the client in a room that has negative air pressure of at least 6 exchanges/hr B. Wear a mask when providing care within 3 ft of the client C. Place a surgical mask on the client if transportation to another dept is unavoidable D. Use sterile gloves when handling soiled linens E. Wear a gown when preforming care that may result in contamination from secretions
b c e
A nurse is collecting data from an older adult client as part of a comprehensive physical examination. Which of the following findings should the nurse expect as associated with aging? select all that apply a. skin thickening b. decreased height c. increased saliva production d. nail thickening e. decreased bladder capacity
b d e
Which of the following Internet resources can help consumers compare quality care measures? (select all the apply) a. WebMD b. Hospital Compare c. Magnet Recognition Program d. Hospital Consumer Assessment of Healthcare e. The American Hospital Association's webpage
b, d
A charge nurse is explaining the various stages of the lifespan to a group of newly licensed nurses. Which of the following examples should the charge nurse include as a developmental task for a young adult? a. becoming actively involved in providing guidance to the next generation b. adjusting to major changes in roles and relationships due to losses c. devoting time to establishing an occupation d. finding oneself sandwiched between and being responsible for two generations
c
A client who had a cerebrovascular accident has persistent problems with dysphagia. The nurse caring for the client should initiate a referral with which of the following members of the interprofessional care team? a. social worker b. certified nursing assistant c. occupational therapist d. speech-language pathologist
c
A nurse has noticed several occasions in the past week when another nurse on the unit seemed drowsy & unable to focus on the issue at hand. Today, she found the nurse asleep in a chair in the break room when she was not on break. Which of the following actions should the nurse take? a. alert the american nurses association b. fill out an incident report c. report the observations to the nurse manager on the unit d. lave the nurse alone to sleep
c
A nurse in a surgeon's office is providing preoperative teaching for a client who is scheduled for surgery the following week. The clients tells the nurse that, "I plan to prepare my advance directives before I come to the hospital." Which of the following statements made by the client should indicate to the nurse an understanding of advanced directives? a. "I'd rather have my brother make decisions for me, but I know it has to be my wife" b. I know they won't go ahead with the surgery unless I prepare these forms" c. "I plan to write that I don't want them to keep me on a breathing machine" d. " I will get my regular doctor to approve my plan before I hand it in at the hospital"
c
A nurse is counseling a young adult who describes having difficulty dealing with several issues. Which of the following statements should the nurse identify as the priority to assess further? a. I have my own apartment now, but it's not easy living away from my guardians b. its been so stressful for me to even think about having my own family c. i don't even know who I am yet, and now I'm supposed to know what to do d. my partner is pregnant, and I don't think I have what it takes to be a good parent
c
A nurse is instructing a group of newly licensed nurses about how to know and what to exect when ethical dilemmas arise. Which of the following situations should the newly licensed nurses identify as an ethical dilemma? a. a nurse on a medical-surgical unit demonstrates signs of chemical impairment b. a nurse overhears another nurse telling an older adult client that if he doesn't stay in bed, she will have to apply restrains c. a family has conflicting feelings about the initiation of enteral tube feeding for their father, who is terminally ill d. a client who is terminally ill hesitates to name their partner on their durable power of attorney form
c
A nurse is instructing a group of newly licensed nurses about the responsibilities organ donation and procurement involve. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualification, the newly licensed nurses should understand that this aspect of care delivery is an example of which of the following ethical principles? a. fidelity b. autonomy c. justice d. non-maleficence
c
A nurse meets with the registered dietitian and physical therapist to develop a plan of care that focuses on improving nutrition and mobility for a patient. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? a. Patient-centered care b. Safety c. Teamwork and collaboration d. Informatics
c
A charge nurse is talking with a newly licensed nurse and is reviewing interventions that do not require a provider's prescription. Which of the following interventions should the charge nurse include? (select all that apply) a. writing a prescription for morphine sulfate as needed for pain b. inserting a nasogastric tube to relieve gastric distention c. showing a client how to use progressive muscle relaxation d. performing a daily bath after the evening meal e. repositioning a client every 2 hours to reduce pressure injury risk
c d e
A nurse is providing teaching for an older adult client who has lost 4.5kg (9.9lbs) since last admission 6 months ago. Which of the following instructions should the nurse include in the teaching? select all that apply a. eat three large meals a day b. eat your meals in front of the television c. eat foodthat are easy to eat, such as finger food d. invite family members to eat meals with you e. exercise every day to increase appetite
c d e
A charge nurse is explaining the various stages of the lifespan to a group of newly licensed nurses. Which of the following examples should the nurse include as a developmental task for middle adulthood? a. the client evaluates their behavior after a social interaction b. the client states they are learning to trust others. c. the client wishes to find meaningful friendships d. the client expresses concerns about the next generation
d
A goal for a client who has difficulty with self-feeding due to rheumatoid arthritis is to use adaptive devices. The nurse caring for the client should initiate a referral to which of the following members of the interprofessional care team. a. social worker b. certified nursing assistant c. registered dietitian d. occupational therapist
d
A nurse is caring for a client who reports a severe sore throat, pain when swallowing, and swollen lymph nodes. The client is experiencing which of the following stages of infection? a. prodromal b. incubation c. convalescence d. illness
d
A nurse is counseling an older adult who describes having difficulty dealing with several issues. Which of the following problems verbalized by the client should the nurse identify as the priority? a. I spent my whole life dreaming about retirement, and now i wish I had my job back b. Its been so stressful for to have to depend on my child to help around the house c. I just heard my friend Al died. That the third one this month d. I keep forgetting which medications I have taken during the day
d
A nurse offers pain medication to a client who is postoperative prior to ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principles a. fidelity b. autonomy c. justice d. beneficence
d
A nurse questions a medication prescription as too extreme in light of the client's advanced age and unstable status. The nurse understands that this action is an example of which of the following ethical principles? a. fidelity b. autonomy c. justice d. non-maleficence
d
A nurse uses a head-to-toe approach to conduct a physical assessment of a client who will undergo surgery the following week. Which of the following critical thinking attitudes did the nurse demonstrate? a. confidence b. perseverance c. integrity d. discipline
d
A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed? a. planning b. evaluation c. assessment d. implementation
d
The examination for registered nurse licensure is exactly the same in every state in the United States. This examination a. guarantees safe nursing care for all patients b. ensure standard nursing care for all patients c. ensures the honest and ethical care is provided d. provides a minimal standard of knowledge for an RN in practice
d
The nurse is caring for a client who has had a cough for 3 weeks and is beginning to cough up blood. The client has manifestations of which of the following conditions? a. allergic reaction b. ringworm c. systemic lupus erythematosus d. tuberculosis
d
The nurse on an acute medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? a. clinical nurse specialist b. nurse administrator c. nurse educator d. nurse researcher
d
You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which of the following statements best describes this code? a. improves self-health care b. protects the patient's confidentiality c. ensures identical care to all patients d. defines the principles of right and wrong to provide patient care
d
A nurse is caring for a client who is concerned about being discharged to home witha new colostomy because of being avid swimmer. Which of the following statements should the nurse make? Select all that apply a. You will do great! You just have to get used to it b. why are you worried about going home c. your daily routines will be different when you get home d. tell me about the support system you'll have after you leave the hospital e. it sounds like you are not sure how having a colostomy will affect swimming
d c e
secondary care
emergency care, acute medical-surgical care, radiological procedures for acute problems
tertiary care
intensive care, subacute care