Intro final exam
Which intervention should the nurse implement when taking a telephone order from the health care provider? A. The nurse must "read back" the complete order. B. The nurse should refuse to take a telephone order. C. The nurse must have the order co-signed within 8 hours. B. The nurse must have another nurse listen on the phone.
A
Which statement about an institutional ethics committee is correct? A. The ethics committee provides education, policy recommendations, and case consultation B. The ethics committee relieves health care professionals from dealing with ethical issues C. The ethics committee would be the first option in addressing an ethical dilemma D. The ethics committee replaces decision making by the patient and health care providers
A
Which statement best describes the focus of the NPSG? A. Reduce the risk of medical errors and to increase patient safety. B. Encourages patient's active involvement in their own care as a patient safety strategy. C. NPSG allows hospitals to submit alternative approaches to the requirements. D. To prevent sentinel events that has been reported to Joint Commission.
A
What does QSEN stand for? A. Quality and Safety Education for Nurses B. Quality Standards and Equivalencies for Nurses C. Quality and Safety English version D. Quest for Student Efficacy National Organization
A
When using sterile technique for placement of an indwelling urinary catheter, the nurse is incorporating professional guidelines which would fall under which 2018 NPSG? A. Goal 7 B. Goal 10 C. Goal 3 D. Goal 1
A
Which NPSG addresses Use at least two patient identifiers when providing care, treatment and services? A. Patient Identification B. Medication Safety C. Patient Vital Statistics D. Health Care-Associated Infections
A
A home nurse who performs a careful safety assessment of the home of a frail elderly patient to prevent harm to the patient is acting in accord with which of the principles of bioethics? A. Non-maleficence B. Justice C. Beneficence D. Autonomy
A
Appropriate delegation takes into consideration activities that may be assigned to personnel by the RN. The following activities are those you can usually delegate. One of the activities is not you can usually delegate. Which activity is not appropriate? A. Has potential for harm but results are predictable. B. Are performed according to standard procedure requiring little innovation. C. Do not require repeated nursing assessments. D. Require minimal problem solving.
A
Michelle wants to call an ethics consult to clarify treatment goals for a patient no longer able to speak for himself. She believes his dying is being prolonged painfully. She is troubled when the patient's doctor tells her that she'll be fired if she raises questions about his care or calls the consult. This is a good example of: A. Ethical distress B. Ethical dilemma C. Ethical uncertainty D. Ethical confrontation
A
Of the 2 forms of question below, which is formatted better/more explicit? A. Do patients with low back pain requiring imaging benefit from plain radiographs as compared to magnetic resonance imaging (MRI)? B. Should patients with low back pain requiring imaging be offered plain radiographs or magnetic resonance imaging (MRI)?
A
Of the 5 classifications of evidence listed below, which is the strongest form of evidence? A. Strong evidence from at least one systematic review of a number of well-designed randomized controlled trials (RCTs). B. Strong evidence from at least one well-designed RCT. C. Evidence from well-designed non-experimental studies from more than one center or research group. D. Evidence from well-designed trials with no randomization, matched case-control or time series studies, single group pretest only cohort. E. Opinions or reports of expert authorities based on clinical evidence or descriptive studies.
A
QSEN PATIENT-CENTERED CARE definition is: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and needs. All of the following explicitly belong with the QSEN KSA category of Knowledge for PATIENT-CENTERED CARE except_____________________________? A. Analyze differences in communication style preferences among patients and families, nurses and other members of the health team B. Describe how diverse cultural, ethnic and social backgrounds function as sources of patient, family, and community values C. Describe strategies to empower patients or families in all aspects of the health care process D. Examine common barriers to active involvement of patients in their own health care processes
A
The followings are strategies to minimize risks of harm to patients except: A. Reliance on memory B. Computer provider order entry C. Bar codes D. Automatic alerts/alarms
A
The nurse is working with the parents of a seriously ill newborn. Surgery has been proposed for the infant, but the chances of success are unclear. In helping the parents resolve this ethical conflict, the nurse knows that the first step is: A. Collecting all available information about the situation B. Clarifying values related to the cause of the dilemma C. Exploring reasonable courses of action D. Identifying people who can solve the difficulty
A
A client who is in the final stage of cancer is depressed and distant. The client asks the nurse, "Why am I getting punished by a higher being?" Which of the following would be the most appropriate action for the nurse to take? A. Share personal religious belied with the client. B. Be available to the client. C. Call the physician for antianxiety medication orders. D. Tell the client to pray for answers.
B
If the question concerns patients' experiences or perceptions, for example of pain management or quality of life aspects, one would seek the answer in __________________. An example of this type of question phrased using PICO format is: 'How do oncology patients (P) diagnosed with terminal cancer (I) perceive (O) others' perceptions of their physical limitations (C)?' A. quantitative evidence B. qualitative evidence
B
QSEN competencies primarily prepare future nurses with knowledge, skill, and attitudes necessary to: A. Value seeing healthcare situations through the nurses' eyes B. Continuously improve the quality of healthcare systems in which they work C. Effectively implement the nursing care plan D. Provide patient care as a competent expert without limitations
B
The Joint Commission recognizes that organizations face challenges with medication reconciliation Included are the following examples. Which one is inaccurate? A. Accuracy is dependent on the patient's or resident's ability and willingness to provide this information. B. It is not important for clinicians to know what medications the patient or resident is taking when planning care, treatment, and services in situations where medications are not used. C. It can be difficult to obtain a complete list from every patient or resident in an initial encounter D. The best medication reconciliation requires a complete understanding of what the patient or resident was prescribed and what medications the patient or resident is actually taking. E. A good faith effort to collect this information is recognized as meeting the intent of the requirement.
B
The nurse in the surgical unit asks the patient, "Which knee is your doctor going to do Surgery on?" the patient responds, "my right knee" but the surgical permit states left knee. Which action should the surgical nurse take first? A. Notify the operating room of the discrepancy. B. Call a "time out" to clarify the situation. C. Change the surgical permit to read right knee. D. Ask the patient's significant other to clarify.
B
What does QSEN's KSA stand for? A. knowledge, skills and aptitude B. knowledge, skills and attitudes C. knowledge, scholarship and attitudes D. kindness, sympathy and advocacy
B
Which NPSG goal is addressed by the nurse who understands the risks involved with anticoagulation therapy, the precautions they need to take, and the need for regular International Normalized Ratio (INR) monitoring? A. Goal 7 B. Goal 3 C. Goal 10 D. Goal 1
B
Which QSEN skillset does the following belong to; "Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care"? A. QUALITY IMPROVEMENT (QI) B. PATIENT-CENTERED CARE C. AUTONOMY D. TEAMWORK AND COLLABORATION
B
Nurse advocates often are conflicted about respecting a patient's right to self-determination, while at the same time wanting to do everything in their power to promote the patient's best interests. Which is the best general guideline for situations like these? A. Patient rules! "It's my life!" B. Nurse rules! "It may be your life, but in this instance you don't know enough to make the right choice!" C. When in conflict, weigh the benefits and risks of following each option and then choose wisely D. None of the above
C
The NPSG Goal of Improving staff communication may be accomplished by all of the following except: A. Standardizing a list of abbreviations, acronyms, symbols, and dose designations that are to be used throughout the organization B. Handing-off communications, including an opportunity to ask and respond to questions C. Inform the Unit secretary or Nursing assistant of critical results of tests and diagnostic procedures so he/she can inform the doctor ASAP. D. Reading back the complete orders or test results
C
The QSEN competencies include all of the following except: A. quality improvement B. technology and informatics C. mathematical proficiency D. patient safety
C
The QSEN competencies include all of the following except: A. teamwork and collaboration B. patient-centered care C. nursing autonomy D. evidence-based practice
C
The practice of Evidence Based Practice should be as simple as possible. The steps involved in Evidence Based Practice are outlined below but they may not be in order. Which is the first step? A. Evaluating outcomes of decision B. Collecting the most relevant and best evidence critically appraising evidence C. Asking the important clinical question D. Integrating the evidence with one's own clinical expertise and patient preferences to clinical expertise to make a practice decision
C
What does NPSG stand for? A. National Patient Safety Guidelines B. National Patient Sanitary Guidelines C. National Patient Safety Goals D. Nursing and Patient Satisfaction Goals
C
Which QSEN skillset attitude does the following belong to; "appreciate that continuous quality improvement is an essential part of the daily work of all health professionals"? A. VIGILANCE B. INFORMATICS C. QUALITY IMPROVEMENT (QI) D. SAFETY
C
Which question will critique the purpose of a nursing research project? A. What are the philosophic underpinnings of the research method? B. Are the chosen informants appropriate to inform the research? C. What is the significance of the work to nursing? D. Is the strategy used for analysis compatible with the purpose of the study?
C
A health care issue often becomes an ethical dilemma because: A. A patient's legal rights coexist with a health professional's obligations B. Decisions must be made quickly, often under stressful conditions C. Decisions must be made based on value systems D. The choices involved do not appear to be clearly right or wrong
D
A nurse who works in an operating room notices that a pediatric surgeon who has been on the staff for several years and done excellent work suddenly seems not to be concentrating during surgery and to be making more mistakes than usual. Rumors have been circulating about the surgeon having a problem with cocaine abuse after his recent divorce. The parents of one pediatric patient are dissatisfied with the progress the patient is making and ask the nurse for an opinion about the surgeon. What is the best way to resolve this ethical dilemma? A. The nurse should voice personal concerns and report the physician to the medical board B. The nurse should tell the patient's parents that there is no need to worry as everything will just be fine and report the physician to the proper hospital authority for investigation. C. The nurse should voice personal concerns and tell the patient's to report the physician to the hospital authority. D. The nurse should voice personal concerns and report the physician to the proper hospital authority for investigation
D
A professional nurse committed to the principle of autonomy would be careful to: A. Treat each patient fairly, trying to give everyone his or her due B. Avoid causing harm to a patient C. Keep any promises made to a patient or another professional caregiver D. Provide the information and support a patient needed to make decisions to advance his/her own interests
D
How is Nursing Practice changed with evidence? A. Healthcare leadership mandates change B. The professional development specialist or education coordinator makes the change. C. The nurse who read the literature makes the change D. Nurses make the change, discuss it at meetings, and spread the word via classes and in-services
D
Patient-centered Care is Defined as: Recognizing the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and needs. All of the following skills fall under this definition of Patient-centered Care except: A. Communicate patient values, preferences and expressed needs to other members of health care team B. Elicit patient values, preferences and expressed needs as part of clinical interview, implementation of care plan and evaluation of care C. Act with integrity, consistency and respect for differing views D. Demonstrate awareness of own strengths and limitations as a team member
D
The NPSG Patient Safety Advisory Group is comprised of a panel of widely recognized patient safety experts who have hands-on experience in addressing patient safety issues in a wide variety of health care settings. This group may include all of the following except: A. Clinical engineers and other professionals B. Nurses and physicians C. Pharmacists and risk managers D. Randomly selected Patients and Family members
D
The client tells the nurse to not inform family members about the medical diagnosis or to share other details of the medical record. In meeting this request, the nurse would be upholding which of the following A. Advanced directive B. Living will C. Informed consent D. Confidentiality
D
The evidence based practice movement today continues to promote the values that were espoused by _______________, and advocates the critical appraisal of best available evidence to underpin practice decisions. This person's work inspired the creation of the Collaboration, which sets the standard for systematic reviews and provides a repository of up to date reliable information. A. Voronin B. Melnyk C. Nightingale D. Cochrane
D
The following statements are true regarding the use of PICOT in nursing research with the exception of one. One of the statements is NOT true. Which is NOT true? A. Evidence-based models use a process for framing a question, locating, assessing, evaluating, and repeating as needed. PICO (T) elements include: Problem/Patient/Population, Intervention/Indicator, Comparison, Outcome, and (optional) Time element or Type of Study. B. The PICOT question format is a consistent "formula" for developing answerable, researchable questions. C. When you write a good one, it makes the rest of the process of finding and evaluating evidence much more straightforward D. The steps of the PICOT question (meaning P is first I is second and so on) must be in sequential order and all steps must be used.
D
The nurse ensures the patient has sidebars up and call bell within reach. Which NPSG has she/he addressed? A. Pressure Ulcers B. Health Care-Associated Infections C. Universal Protocol for Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery™ D. Reduce Falls
D
Which interventions are included in the NPSG "reduce the risk of health care-acquired infections"? A. Implement a process to mark the surgical site, and involve the patient in the marking process. B. Implement regular preventive maintenance and testing alarm settings. C. Use at least two patient identifiers when providing care, treatment, or services. D. Comply with current CDC hand hygiene guidelines or the current World Health Organization (WHO) hand hygiene guidelines
D
Which of the following belongs under the QSEN knowledge component of Informatics? A. Differentiate clinical opinion from research and evidence summaries B. Delineate general categories of errors and hazards in care. Describe factors that create a culture of safety (such as, open communication strategies and organizational error reporting systems) C. Describe reliable sources for locating evidence reports and clinical practice guidelines. Explain why research skills are essential for safe patient care D. Identify essential information that must be available in a common database to support patient care. Contrast benefits and limitations of different communication technologies and their impact on safety and quality
D
External Evidence is generated through rigorous research and intended to be generalized and used in other settings (e.g. rigorous research) True False
true
The critical appraisal process is used to evaluate the strengths, limitations, and value of the evidence that will positively impact patient outcomes. It is vital to differentiate biased evidence from unbiased; reliable from unreliable. Practice that is based on flawed evidence cannot be considered EBP. True False
true
True or false, the Patient Safety Advisory Group advises the Joint Commission on the development and updating of NPSGs? True False
true