mgmt 2
16. The ethical principle of autonomy is being respected in which situation? a. A patient's right to refuse medications b. The right of a patient with tuberculosis to refuse to wear a mask when leaving the unit c. The right of a family to refuse to wear a gown and gloves when visiting a patient on contact precautions d. The right of a family to refuse to wear masks when visiting a patient on neutropenic precautions
a
. A true electronic health record (EHR) is a complete record of an individual's health-related data. The ____________________is continuing to spearhead the initiative to build a national electronic health care system that would allow patients and their care givers to access their complete health records anytime and anywhere (HealthIT.gov, 2015). A. U.S. Department of Health and Human Services (DHHS) B. American Nurses Association (ANA) C. National Institute for Occupational Safety and Health (NIOSH) D. Centers for Disease Control and Prevention (CDC)
a
. SBAR stands for: A. Situation, Background, Assessment, Recommendation B. Situation, Background, Assessment, Reaction C. Situation, Background, Assessment, Reply D. Situation, Background, Action, Recommendation
a
. When working in team situations, which of the following is the most effective tool to use? A. Team STEPPS (team strategies and tools to enhance performance and patient safety) B. STEP (status of the patient, team members, environment, progress toward goal) C. Huddle D. Situation monitoring
a
1. A nurse is caring for a patient with end-stage heart failure and understands the futility of care for this patient. The family is in denial and refuses to consent to a DNR (do not resuscitate). Their misperceptions regarding the DNR status may be based on which interpretation? a. A DNR order provides minimal care. b. A DNR order allows for pain medication administration. c. A DNR order allows for the administration of antibiotics. d. A DNR order allows for nutrition.
a
1. Health care facilities are incorporating the use of electronic health records (EHRs), and nurses are responsible for entering data on their patients. Nurses understand that there are many advantages to this new form of charting. Which of these factors make the electronic EHR an advantageous health care record for the nurse? a. Record keeping is safe and accurate. b. Documentation is timely. c. Corrections to the record can be made at the end of the shift. d. Coordination of vital signs to prescribed medications is automatic.
a
1. The UAP is given ambulation instructions by a staff nurse for a patient 2 days postoperatively. Which of the following ambulation instructions would require further communication to the UAP to ensure the safety of the patient? a. "Ambulate the patient the length of the hallway and get me if there are any problems." b. "Have you ambulated this type of post-op patient before?" c. "Let me know 1 hour before you are ready to ambulate the patient so I can give him his pain medication." d. "This patient has been ambulating with minimal assistance, but I would like you to walk with him to be sure he is stable."
a
1. When providing care to patients, nurses use evidence-based practice whenever they a. advise patients with musculoskeletal back pain to continue normal daily activities within limits of their pain tolerance. b. advise patients with musculoskeletal back pain to remain on bedrest until pain has been relieved by prescribed back exercise. c. advise patients that early premature activity with musculoskeletal pain may lead to permanent disability. d. advise patients that continued normal activity after a musculoskeletal back injury may result in delayed return to work.
a
10. The American Nurses Association (ANA) Code of Ethics for nurses is primarily a statement in support of a. patient advocacy. b. professional membership. c. missionary work. d. preventative health care.
a
10. When integrating evidence-based research into practice, the nurse understands that the type of research is important to the application of a particular nursing unit. Which of the following factors is most important in determining the usefulness of the research to the needs of the practice? a. Randomized clinical trials b. Case studies c. Anecdotal information d. Single correctional studies
a
10. Which of the following is not a nursing minimum data set under the service element area? A. Nursing outcomes B. Unique facility or service agency number C. Unique health record number of the patient D. The discharge or termination date
a
10. Which of the following is on the list of "do's" regarding the change-of-shift report? A. Provide essential background information about the patient B. Identify the patient's discharge plans C. Share significant information about family friends D. Discuss every routine order for the patient
a
10. Which of the following patients should be seen by the nurse first based on the information provided during the shift report? a. A patient admitted with hypertension complaining of back pain. b. A patient admitted with mental status changes. c. A patient complaining of incisional pain postoperatively. d. A patient asking for assistance in getting back to bed.
a
12. Harm to patients from medication errors is a component to initiation of research in which of the following ways? a. Establishing a question b. Establishing a solution c. Establishing a population sample d. Establishing a cost benefit
a
12. The Nursing Minimum Data Set (NMDS) is a collection of established uniform standards for collecting data. It includes the North American Nursing Diagnosis Association International (NANDA-I)-approved list of nursing diagnoses as well as other sources of nursing language. What is the advantage of the NMDS to the patient? a. Data can be entered from multiple sources into the patient's record. b. Nurses must be able to speak and understand English. c. Nurses must know all the NANDA diagnoses. d. Patient receives a daily update of charges.
a
14. A student nurse is conducting a research project for school. Although this is a new assignment, she understands that the quickest and most dependable source of information is the Internet. Which resources require intervention by the instructor? a. Wikipedia b. CINAHL c. MEDLINE
a
15. A nurse agrees to trade shifts with another nurse. A conflict arises now with the nurse's ability to work that shift. Which ethical principle should the nurse use to make a decision when conflict arises regarding the nurse's inability to honor an agreement to trade shifts? a. Fidelity b. Veracity c. Beneficence d. Justice
a
15. The nurse is admitting a patient who speaks very little English. What is the most appropriate method to use to ensure the patient understands the instructions? a. Obtain a hospital interpreter. b. Ask a family member to interpret. c. Ask other staff for help. d. Incorporate sign language.
a
17. Technology is highly visible and accessible in the health care environment. All members of the health care team provide data to the patient's record. Which of these systems does the nurse understand to be a nursing data entry program? a. Computerized medication administration system b. Computerized provider order entry. c. Pyxis d. Pareto analysis
a
17. Which of the following would be considered a sentinel event? a. Patient who has developed a fatal mediastinal infection 7 days after cardiac surgery b. Patient who experiences a CVA during a cardiac catheterization c. Patient who receives a double dose of a medication in error d. Wrong patient scheduled for a chest radiograph
a
18. A nurse decides to use the ethical principle of deontology to make clinical decisions. This principle is based on treating all people the same regardless of circumstances and on one's duty to do the right thing regardless of circumstances. Which situation would most likely cause an ethical dilemma for this nurse? a. Assisting with a laparoscopy for a tubal pregnancy b. Refusal of a patient to take his medications c. Patient reconsiders surgery for cancer d. Woman refuses to terminate her pregnancy even knowing the fetus has non-life-sustaining defects
a
2. A float nurse is assigned four patients on the day shift. Which of the following reports by the float nurse would require immediate intervention by the charge nurse? a. "Dr. Smith, your patient, Mr. Jones is complaining of a headache." b. "Dr. Smith, this is nurse Sandy from xyz and your patient, Mr. Jones in 222, admitted with hypertension, is complaining of a headache." c. "Dr. Smith, this is nurse Sandy from xyz and your patient, Mr. Jones in 222, admitted with hypertension, is complaining of a headache but has just been started on isosorbide (Isordil). What can I give him to relieve his headache?" d. "Dr. Smith, this is nurse Sandy from xyz and your patient, Mr. Jones in 222, is complaining of a headache but has just been started on isosorbide (Isordil). What can I give him to relieve his headache?"
a
2. The core functionalities for an electronic health information system are: A. Health information, data, and order entry B. Patient census, data, and order entry C. Patient acuities, patient census, and incident report D. Incident reports and outcomes measures
a
3. A surgeon approaches the charge nurse in an angry manner after his patient fell out of bed, requiring further surgery. Which of the following approaches is most appropriate for the charge nurse to use? a. "Can you step over here out of the hearing of the patients and family members?" b. 'I'm sorry, you should have ordered restraints for the patient." c. "We will accept all liability." d. "My nurses are all new on the night shift. They didn't know how to handle him."
a
3. In caring for a baby with non-life-sustaining defects, the nurse will most likely make decisions based on a. personal ethical beliefs and values. b. treating all patients equally. c. treating all patients with respect and courtesy. d. the futility of life issue.
a
3. Issues that are commonly addressed by ethics committees are: A. End-of-life issues, organ donation, futility-of-care issues B. End-of-life issues, organ donation, change in the durable power of attorney C. Organ donation, futility-of-care issues, pediatric patient issues D. Organ donation, do not resuscitate order, Jehovah's Witness issues
a
3. Your patient is coming into the trauma unit and you are the registered nurse for the patient. Example: Leader: "Airway status?"; Resident: "Airway clear"; Leader: "Breath sounds?"; Resident: "Breath sounds decreased on right." Leader: "Blood pressure?"; Nurse: "BP is 90/40." Which strategy is in use? A. Call-out B. Check-back C. SBAR (situation, background, assessment, recommendation) D. STEPPS
a
4. Nursing informatics (NI) is a specialty that integrates: A. Nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. B. Nursing science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. C. Nursing science, computer science, and information science to manage and communicate data, information, and knowledge, in nursing practice. D. Computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice.
a
4. The American Nurses Association approved the revised code of ethics in 2015. There are _________codes. A. 9 B. 10 C. 12 D. 20
a
4. To avoid transcription errors, the current trend in hospitals is to use the Computerized Physician Order Entry (CPOE). Further instructions should be given to the nurses when which statement is made? a. "I don't need to review the new orders for accuracy." b. "The orders will go directly to the appropriate departments." c. "The risk for transcription errors is less." d. "I am still responsible for communicating the changes to the appropriate care givers."
a
4. When providing care to a child requiring temperature measurement, nurses use evidence-based practice whenever they a. understand that a rectal temperature is the most accurate method in a child. b. understand that a rectal temperature is the least accurate method in a child. c. understand that an axillary temperature is the most accurate method in a child. d. understand that adding 1C to an axillary temperature in a child is as accurate as a rectal temperature.
a
4. Which measure can be used to avoid ethical dilemmas in the health care setting? a. Advance directive or living will b. Religious beliefs of the nurse c. Designation of a durable power of attorney d. Values of the care givers
a
6. Duty to do good to others; to maintain a balance between benefits and harm; to provide all patients, including terminally ill, with caring attention; and to treat every patient with respect and courtesy. What is the requirement that care providers contribute to the health and welfare of the patient and not merely attempt to avoid harm to the patient or client? A. Beneficence B. Nonmaleficence C. Personal liability D. Corporate liability
a
6. In the PICO framework for developing the question of concern, "I" stands for: A. Intervention B. Interdisciplinary C. Interrelational D. Integrity
a
6. Maintaining currency in a profession is achieved through (Select all that apply.) a. academic inquiry. b. continuous participation in professional organizations. c. asking questions of other professionals. d. observing your role model's practice. e. participation in evidence based projects.
a,b,e
6. The electronic health record (EHR) provides a particular advantage to those patients with chronic diseases. Which of the following patients would most likely benefit from the use of an EHR by the health care provider? a. A patient with diabetes, heart failure, and end-stage renal disease b. A patient with heart failure following a myocardial infarction c. A patient following an automobile accident with multiple fractures to the lower extremities d. A patient with newly diagnosed hypertension
a
6. The nurse is caring for a patient with heart failure resulting in irreversible kidney damage who decides to go home to die rather than accept hemodialysis. The nurse understands that the patient is practicing which ethical principle? a. Autonomy b. Beneficence c. Justice d. Veracity
a
6. Which of the following is an essential part of the shift report? a. Patient's ECG rhythm b. Patient's marital status c. Patient's occupation d. Patient's insurance status
a
7. Patients are complaining that they are not receiving pain medications on the night shift. The night nurse has charted that they were given. What is the most appropriate action by the charge nurse? a. Notify the nurse manager. b. Confront the nurse about the problem. c. Ask other nurses what they think. d. Report the suspicion to the State Board of Nursing.
a
8. The nurse explains the PICO acronym to colleagues in which of the following ways? a. PICO represents the questions to ask regarding application of the research to the specific setting. b. PICO represents the trigger for initiating the research. c. PICO represents the benchmarking website used in research. d. PICO represents the regulatory guidelines established for practitioners.
a
7. The questions that nurse researchers should ask before beginning their study include which of the following? (Select all that apply.) a. Why are we doing it this way? b. Where is the evidence to support this practice? c. How much will it cost to change? d. Can we as nurses lose our jobs if we implement this? e. What is a better way of doing this?
a,b,e
5. Formal communication in health care is used to properly inform staff of (Select all that apply.) a. changes in CPR certification dates. b. Christmas party celebration. c. patient survey results. d. girl Scout cookie order pick-up. e. termination of an employee.
a,c
2. All treatments and services for patients require two forms of patient identification prior to providing those services. Which is the best method to use to identify the patient who is unable to communicate? (Select all that apply.) a. Patient ID band b. Roommate c. Family member d. Admission photograph e. Asking another nurse who has cared for the patient previously
a,c,d
4. After piloting changes based on evidence-based research, the nurse understands that they will be instituted as a result of the effects on which of the following? (Select all that apply.) a. Staff b. Number of UAPs available c. Cost d. Patient e. Census
a,c,d
6. Nurse managers play an integral role in the adoption of the hospital's information system. There are three levels of competency in this leadership role. What functions can be observed in the modifier level nurse manager? (Select all that apply.) a. Participate in changes processes b. Participate in evaluation of system c. Participate in design of certain tools d. Use the system to evaluate clinical performance e. Use the system to promote research
a,b,c
7. Which of the following are true when communication is effective? (Select all that apply.) a. The sender is credible. b. There is clarity. c. Simple, exact language is used. d. Slang is used. e. The receiver rolls her eyes when asked to complete a task.
a,b,c
1. A staff nurse must leave work for an emergency. The nurse tells the charge nurse that her patients are fine and received all their AM medications. As the day progresses, it becomes apparent to the responsible RN that some things were not completed, especially some necessary AM medications. Which communication principle was not followed in this situation? (Select all that apply.) a. Interaction b. Clarity c. Simple exact language d. Feedback e. Credibility f. Direct communication
a,b,d,f
1. The institutional review board (IRB) is responsible for overseeing biomedical research involving humans. Because most studies are randomized blind studies (patients and providers are unaware of who is receiving treatment and who is receiving a placebo), the risks for harm can be great. Which measure is taken to avoid harm to the subjects during biomedical research? (Select all that apply.) a. The rights and welfare of subjects are protected. b. The benefits of the study to the patient outweigh the risks. c. The patient must agree to complete confidentiality about the study. d. Prisoners are used as subjects because they have no right to sue. e. Patients must sign informed consent forms.
a,b,e
2. It is vital to communicate changes in patient condition to the physician. When using the SBAR process, the nurse knows that what should be included when communicating patient condition? (Select all that apply.) a. Problem b. Current medications c. Assessment d. Diagnosis e. Documentation f. Lab data
a,c,d,f
8. Which observation requires an intervention with a new graduate nurse by his preceptor? (Select all that apply.) a. Data entry on the wrong patient b. Entry of I&O values at end of shift c. Incomplete pain assessment d. Notifying pharmacy of unavailability of a medication e. Failing to complete an admission profile
a,c,e
9. Walking rounds are currently being implemented to avoid errors or omissions in shift reports. Which observations made during walking rounds would be seen as an advantage to the shift report? (Select all that apply.) a. Foley bag is not emptied on a patient on strict I&O. b. Patient needs assistance to bathroom. c. IV infusion bag is nearly dry. d. Patient with a PCA requests instructions to avoid increased pain. e. Patient's family member is caught smoking in the bathroom. f. IV line is not infusing what is currently ordered.
a,c,f
4. Point-of-care systems are currently being used in health care facilities. Which is an advantage of the point-of-care systems to the patients? (Select all that apply.) a. Immediate access to decision support systems b. Rapid accurate charging of services to patients c. Faster discharge d. Documentation at the bedside e. Documentation at the time of care
a,d,e
7. In nursing, clear and precise communication is essential in the care of the patient. As a nurse, you are aware that messages can be: A. Native and foreign B. Verbal and nonverbal C. Coded and encoded D. Clear and unclear
b
11. Another type of technology currently being used in hospitals is the Automated Nurse Staffing System. What is the advantage of this system to the patient? a. Reduces health care costs by predicting supplies needed b. Determines staffing based on acuity of patients c. Determines staffing based on cost of patient care d. Determines order of being floated
b
11. Which response by the patient following discharge teaching would require further teaching? a. "I should weigh myself daily since I started on Lasix (furosemide) for my heart failure." b. "I need to check my blood glucose after eating." c. "I should take my Lanoxin (digoxin) with my morning medications." d. "I need my blood checked frequently now that I am on Coumadin (warfarin)."
b
13. Which responses by nurses incorporate reasons for resistance to research utilization? a. "I want to see the outcomes for the patients." b. "I believe that patients will not benefit from this change." c. "I've grown tired of doing it the same way." d. "I'm ready for a change.
b
14. The nurse informatics (NI) specialist incorporates nursing science, computer science, and information science to support nursing in utilization of the data collection. Priorities for an NI specialist include a. developing computer information systems for the hospital. b. incorporating common nursing nomenclature into the system. c. researching evidence-based practice d. developing restrictions of certain patient information to insurance companies.
b
14. Which ethical principle should help guide the nurse who suspects another nurse is incorrectly charting pain medications and then taking them? a. Autonomy b. Veracity c. Justice d. Beneficence
b
15. Which observation requires an intervention of a new graduate nurse by her preceptor? a. Administering a medication after checking the patient's name and birth date. b. Leaving patient room without charting vital signs. c. Reporting a patient's change in level of consciousness to the nurse practitioner. d. Checking the apical pulse on a patient receiving digoxin (Lanoxin).
b
2. A nurse is caring for a patient who has developed MODS (multiorgan dysfunction syndrome) resulting from septic shock. The patient is ventilator dependent and on vasopressors to maintain a Doppler-measured blood pressure of 80 mm Hg. The family is resistant to permit terminal weaning. The best action by the nurse is to a. insist that the family disconnect the patient from the ventilator. b. ask the family to meet with the hospital's ethics committee c. seek a family member who does agree and have them sign the consent form. d. arrange for the vasopressors to be turned off when the family is not present.
b
2. In the hierarchy of evidence, which of the following has the highest value? A. Single correctional studies B. Randomized clinical trials C. Case study, opinion D. Descriptive studies
b
3. Advantages to using the electronic health record (EHR) include that a. hospitals no longer need to store medical records. b. medical records are complete and easily accessible to health care providers. c. unit secretaries can still call for "old records." d. diagnostic tests are not available for direct visualization.
b
3. When providing care to patients, nurses understand that evidence-based practice supports the concept that a. to avoid atelectasis and pneumonia, use of an incentive spirometer has an outcome equal to coughing for a patient following surgery. b. to avoid atelectasis and pneumonia, use of an incentive spirometer has a better outcome than coughing for a patient following surgery. c. to avoid atelectasis and pneumonia, use of an incentive spirometer has a worse outcome than coughing for a patient following surgery. d. neither coughing nor use of an incentive spirometer will avoid atelectasis or pneumonia in postoperative patients.
b
4. The electronic physician order entry system: A. Prevents all medication errors B. Provides many online alerts and warnings for clinical care givers C. Poses problems when the system is done D. Is not the most acceptable type of physician's orders
b
4. When implementing an evidence-base practice change, the all-important final step is to: A. Pilot the protocol. B. Monitor the results. C. Publish the study. D. Do a cost-benefit analysis.
b
5. Hospitals beginning to use the electronic health record (EHR) for documentation of patient care are sometimes faced with many obstacles. What may be seen when the EHR system is first initiated? a. Limited storage for records b. Resistance from staff c. Many "crashes" of the system d. Many disruptions from the access of multiple users
b
5. The first step in integrating evidence into practice is to convert the clinical concern into a: A. Solution B. Question C. Decision D. Goal
b
5. What is the document that permits an individual to give a surrogate or proxy the authority to make decisions for that person in the event that they become incompetent? A. Living will B. Durable power of attorney for health care decisions C. Advance directive D. Informed consent
b
5. Which of the following is on the list of "don'ts" regarding the change-of-shift report? A. Share significant information about family members B. Relay to staff significant changes in the way therapies are given C. Continually review ongoing discharge plan D. Review all routine care procedures
b
6. When calling the physician and following the SBAR process, which of the following items is included under the Situation criteria? A. Identify the patient's ethnicity and religious affiliation B. Briefly state the problem, what it is, when it happened or started, and its severity C. Inform the physician regarding the patient's roommates D. Describe patient's mental status
b
6. When providing care to patients, nurses use evidence-based practice to avoid urinary tract infections whenever the insertion of a urinary catheter is performed by a. aUAP. b. an RN. c. an LPN. d. a senior nursing student.
b
7. When collecting data for research purposes on patient safety methods, the nurse would use a. maximum census of patients on a specific unit over the course of admissions for 1 year. b. maximum census of the entire hospital over the course of admissions for 1 year. c. information obtained in other, similar research projects. d. appropriate research design.
b
7. Which of the following sets educational standards, examination requirements, and licensing requirements and regulates the nursing profession in each particular state? A. The National League for Nursing (NLN) B. Nurse practice acts C. State board of nursing D. The National Council of State Boards of Nursing
b
8. A hospital has just introduced a new electronic staffing system that allows staff to enter their shift preferences into the computer. What would the nurse identify as an advantage to the staff? a. Decrease in nurse manager availability b. Increase in nurse manager availability c. More available staff d. Requests cannot be entered
b
8. Hospitals are legally and ethically obligated to uphold patient rights, which include the right to: A. Review records; family can also review records B. Participate in treatment decisions and to provide consent to treatment C. Be informed of hospital bylaws and hospital attorneys' names and telephone numbers D. Expect reasonable care after hospitalization
b
8. In reviewing a study for applicability for use on your unit, you need to evaluate the study in terms of: A. The sponsoring agency of the study B. Patient context and assess whether they are similar to patients in your unit C. Whether the sample adequately is described D. Qualifications of the study authors
b
8. Regarding the SBAR process, pertinent background information related to the situation includes: A. Socioeconomic status of the family B. List of current medications allergies, intravenous fluids, and laboratory results C. Patient's dietary needs before hospitalization D. Family history of disease
b
9. A nurse takes a telephone order from a physician. Which procedure is best for the nurse to use to avoid errors? a. Ask another nurse to listen to the conversation on another telephone. b. Repeat the order, write the order verbatim, and read the order back to the physician. c. Ask the physician to come to the unit to write the order. d. Hold implementation of the order until the order is written by the physician.
b
3. All treatments and services for patients require two forms of patient identification prior to providing those services. Which would require an intervention if used by the nurse to identify a patient? (Select all that apply.) a. Referring to the patient ID band b. Asking the roommate c. Asking another nurse on the unit d. Asking the patient e. Asking a family member
b,c
1. Health care facilities are incorporating the use of electronic health records (EHRs), and nurses are responsible for entering data on their patients. Nurses understand that there are many advantages to this new form of charting. Which of these is an advantage to the nurse when using the EHR? (Select all that apply.) a. Not all documentation is accessible to the nurse. b. Documentation occurs at the patient's bedside. c. Corrections are easily made when errors are inadvertently made. d. Coordination of vital signs to prescribed medications is easy and quick. e. Nurses must identify the assessment parameters to be included.
b,c,d
3. Based on the Iowa model for evidence-based practice, research is initiated because of either problem- or knowledge-based triggers. The nurse understands that these triggers may arise as a result of (Select all that apply.) a. staff complaints. b. an increase in surgical infection rates. c. an increase in chronic renal failure following use of dye during radiographic procedures in diabetic patients. d. medicare reimbursement changes.
b,c,d
5. Nurse managers play an integral role in the adoption of the hospital's information system. There are three levels of competency in this leadership role. What functions can be observed in an initial-level nurse manager? (Select all that apply.) a. Entry of incident reports b. Use applications for data entry c. Use applications for administration data entry d. Actively involve nurses in the overall use of the system e. Use system for email to other managers
b,c,d
7. Nurse managers play an integral role in the adoption of the hospital's information system. There are three levels of competency in this leadership role. What functions can be observed in the innovator level nurse manager? (Select all that apply.) a. Stress importance of the ergonomic work station importance b. Develop and design programs to be used c. Implement initiatives related to practice d. Protect the patient's rights to confidentiality e. Use research in managing the system
b,c,d
4. In the change of shift report, what should be included? (Select all that apply.) a. Family contact telephone numbers b. Current assessment c. Plan of care d. Change in condition e. Discharge plan f. Personal comments
b,c,d,e
6. Informal ("grapevine") communication in health care is used to properly inform staff of (Select all that apply.) a. changes in practice. b. Christmas party celebration. c. patient survey results. d. girl Scout cookie order pickU-upS e. termination of an employee
b,d,e
1. When providing care to patients, nurses make patient care decisions based on which of the following? (Select all that apply.) a. Resource availability b. Nurse practice act c. Shared governance d. Managerial leadership style e. Tradition f. Clinical circumstances
b,e,f
1. A key component of evidence-based practice is: A. Traditional practice B. Organizational commitment C. Patient preference D. Nurse ability
c
1. Automated systems for providers to enter patient care orders and to access decision support databases are called: A. Clinical information systems B. Decision support C. Computerized provider order entry (CPOE) D. Electronic health records
c
1. What is the transfer of information (along with authority and responsibility) during transitions in care across the continuum, to include an opportunity to ask questions, clarify, and confirm? A. Communications B. Change-of-shift report C. Handoff D. Physician order entry
c
1. You are the nursing supervisor and there is a patient that will be going to the operating room for a kidney transplantation. It is the ultimate responsibility of ______________to check and ensure that the organ donor and recipient are correct. A. Surgeon B. Anesthesiologist C. Registered nurse and surgeon D. Surgeon and anesthesiologist
c
11. The International Council of Nurses (ICN) Code of Ethics for nurses is primarily a statement in support of a. environmental protection. b. professional membership. c. everyday decision making. d. collective bargaining.
c
12. In addition to the organ procurement coordinator, which other resource is the best resource for the nurse to use in helping the family make a decision when there is disagreement among family members regarding organ donation? a. Nurse manager b. Physician c. Ethics committee d. Social worker
c
12. Which exchange between the RN and the UAP requires intervention by the charge nurse? a. "Take the patient's blood pressure every 15 minutes and inform me of the results." b. "Check the patient's blood glucose before breakfast and lunch and inform me of the results." c. "Ambulate the patient in 2210 as far as he can walk." d. "Shave the patient in 2210. His beard is long
c
14. A UAP becomes sick at work and asks to leave. Which response by the charge nurse is most appropriate? a. "You can't leave until all the baths are completed." b. "Write down what needs to be completed." c. "Tell me what responsibilities still need to be completed."
c
15. A nurse involved in evaluating the validity of research prior to implementation should consider which of the following as the most important hierarchical evidence for effectiveness? a. Opinions from experts b. Single observational studies c. Randomized controlled versus nonrandomized trials d. Systematic review study
c
16. A patient is inappropriate when speaking to a UAP. What is the most appropriate action by the nurse? a. Change the assignment. b. Ask the UAP what they did to precipitate this. c. Explain to the patient how what they say is being interpreted
c
16. What is the greatest benefit to the nurse of technology in the health care setting? a. Patient acuity is reduced. b. Determination of the time of discharge of patient is aided. c. There is easy, quick access to relevant data. d. Data may be more difficult to interpret.
c
17. A nurse renewing advanced cardiac life support is practicing which ethical principle? a. Veracity b. Fidelity c. Nonmaleficence d. Beneficence
c
18. Which of the following would most likely present the most difficult step in research utilization? a. Monitoring outcomes b. Determining the research question c. Instituting the change d. Piloting the project
c
2. When providing care to postoperative patients, nurses use evidence-based practice whenever they a. continue bedrest after surgery until the pain level is 1 on a scale of 1 to 10. b. continue bedrest after surgery until the pain level is 2 on a scale of 1 to 10. c. ambulate patients as soon as possible after surgery. d. ambulate patients as soon as they are awake from anesthesia.
c
3. The experienced nurse can do the following to use evidence-based practice in their own practice: A. Use textbooks from school for reference. B. Maintain membership in alumni organization C. Review professional journals. D. Go back to school for an advanced degree.
c
4. A health care facility is using an electronic health record (EHR) system for documentation purposes. Every Thursday from 11:00 to 12:00 PM, the EHR shuts down for maintenance. Which would be of concern to the nurse during that weekly downtime? a. Illegal access to records can take place. b. Loss of previous documentation can occur. c. Loss of coordination of medication list and vital signs can occur. d. Sometimes passwords are lost.
c
7. As a nurse, you have just read about a change in intervention insertion practice that sounds like it would work on your unit. Before suggesting such a change in practice, you need to: A. Perform a cost-benefit analysis of the new practice. B. Talk with the nurse manager to gain his or her opinion. C. Conduct a further review of the literature. D. Contact the nursing research committee.
c
7. The computerized provider order entry (CPOE) is a component of the electronic health care system being used in hospitals. This system allows prescriptions to be written electronically and automatically sent to the pharmacy or other necessary facilities. The nurse understands that the greatest benefit of the CPOE is a. lowered cost of prescriptions. b. faster delivery of medications from pharmacy. c. that fewer errors occur. d. that the nurse must confirm prescriptions directly with physician
c
8. A basis for ethical dilemma can result from a request for organ donation. Which factor may contribute to this conflict? a. The patient is ventilator dependent. b. The patient has signed her driver's license giving consent. c. The patient has not previously expressed her wishes on organ donation. d. The patient's religion is unclear about organ donations.
c
9. If a patient does not have an advance directive or has not expressed his wishes regarding end of life care, what ethical principle may help the family to make the right decision? a. Autonomy b. Fidelity c. Beneficence
c
9. The Organ Procurement and Transplantation Network (OPTN) is a(n)________network. A. State B. Local C. National D. International
c
9. Use of the Internet for health care information has produced a more-educated patient. What is the greatest benefit to the patient? a. Background information on physician b. Reduced health care costs c. Health care provider access to current peer-reviewed information for clinical decision making d. Anecdotal information
c
3. SBAR is a convenient tool to use when notifying physicians of a change in patient condition. In which of the following situations could it also be appropriately used? a. Communication with radiology scheduling b. Communication with case manager c. Transferring patient d. Change of shift report e. Rapid response team (RRT)
c,d,e
8. The end of shift report is the appropriate time to communicate (Select all that apply.) a. the frequency of which the call light was used. b. patient's relationship to a staff member. c. new patient orders. d. impending procedures. e. evaluation of medication response.
c,d,e
10. An example of a knowledge trigger for an evidence-based research question is: A. Patient fall data B. Database review C. Benchmark information D. Research study
d
10. The Pyxis Specialty Station system automates the distribution, management, and control of medications and supplies. An advantage of this system to the patient is which of the following? a. Accurate charging of supplies b. Accurate dosage of medications c. Separate storage for each patient d. Availability of medications and supplies
d
10. The difference between bioethics and ethics is: A. Bioethics is specific to health care; ethics deals with the principles of right and wrong. B. Bioethics is specific to health care; ethics deals with the principles of right and wrong, good and bad. C. Bioethics is specific to health care; ethics deals with the principles of right and wrong, good and bad with no issues of beliefs and values. D. Bioethics is specific to health care, ethics is the science that deals with the principles of right and wrong and of good and bad, and governs our relationships with others. It is based on personal beliefs and values.
d
11. A novice nurse observes change differences in practice from what was taught in nursing school and expresses confusion to the nurse manager. The nurse manager suggests which of the following methods as the best resource to determine best practice in the clinical setting? a. Ask a former faculty member. b. Review the textbook used during nursing school. c. Research electronic databases such as CINAHL. d. Attend professional conferences.
d
13. To practice as a nursing informatics specialist, what must the nurse accomplish first? a. Pass the NCLEX exam. b. Be actively involved in research. c. Demonstrate practice by working for a minimum of 2 years in an intensive care unit. d. Achieve certification from the ANCC.
d
13. When nurses are confronted with ethical dilemmas that challenge their values and beliefs, what is the best source to rely on to make the right decision? a. Personal religious beliefs b. Hospital chaplain c. Family interactions d. Belief in patient advocacy
d
13. Which patient should the charge nurse direct the RN to see immediately after the shift report? a. Patient with a blood sugar of 240 mg/dL b. Patient complaining of burning on urination c. Patient in a Posey vest who is trying to get out of bed d. Patient with a temperature of 38°C who is scheduled for surgery later that day
d
16. Of the steps to implementation, research is not complete until which of the following steps is accomplished? a. Synthesizing relevant research b. Determining the sufficiency of the sample c. Instituting the change d. Monitoring the outcome
d
19. A nurse decides to use the ethical principle of teleology to make clinical decisions. This principle is based on the premise that actions are determined by their consequences. Which situation would most likely cause an ethical dilemma for this nurse? a. Assisting with a laparoscopy for a tubal pregnancy b. Refusal of a patient to take his medications c. Patient reconsiders surgery for cancer d. Woman refuses to terminate her pregnancy even knowing the fetus has non-life-sustaining defects
d
2. Another name is added to the organ donation list every ________minutes A. 5 B. 6 C. 7 D. 12
d
2. The electronic health record (EHR) provides information to all members of the health care team on their patients. The nurse manager and other team members recognize the advantages of the EHR, which include a. being handy for patients to carry with them. b. protecting patient privacy. c. being easier for patients to read d. making data available for research and continuous performance improvement.
d
20. A nurse decides to use the ethical principle of utilitarianism to make clinical decisions. This principle is based on the greatest good for the greatest number. Which situation would most likely cause an ethical dilemma for this nurse? a. Triaging a disaster scene b. Maintaining ventilatory support on a patient with six children c. Evacuation of all mobile patients during a flood d. Allowing a patient with influenza to return home from the clinic after diagnosis
d
3. Nursing informatics is a specialty that integrates nursing science, computer science, and information science to: A. Maintain and communicate data information, knowledge, and wisdom in nursing practice B. Manage and calculate data information, knowledge, and wisdom in nursing practice C. Manage and communicate data information, knowledge, and accountability in nursing practice D. Manage and communicate data information, knowledge, and wisdom in nursing practice
d
5. A nurse observes unsafe practice by a physician and reports it to the risk management department of the hospital. Which ethical principle does this represent? a. Autonomy b. Beneficence c. Justice d. Veracity
d
5. One key feature of an electronic health record (EHR) is that it can be created, managed, and consulted by authorized providers and staff across ________other organization(s). A. 1 B. 2 C. 3 D. Many
d
5. The end of shift report is vital for the coordination of patient care. Which of these statements would require an intervention if overheard by the charge nurse during report? a. "Mr. Smith is quite afraid of the outcome of his procedure today. I had to give him an anti-anxiety medication." b. "Mr. Smith is quite afraid of the outcome of his procedure today. I called his wife to come in early." c. "Mr. Smith is quite afraid of the outcome of his procedure today. I called the chaplain to see him and his wife today." d. "Mr. Smith is quite afraid of the outcome of his procedure today. I was in the room most of the day."
d
5. When providing care to patients at risk for ARDS, nurses use evidence-based practice whenever they a. suction a patient at high risk for developing ARDS every 2 hours. b. suction a patient at high risk for developing ARDS whenever crackles are auscultated. c. turn a patient at risk for developing ARDS every 2 hours. d. turn a patient at risk for developing ARDS every 5 minutes.
d
6. Another use for computerized information is: A. Finances B. Billing C. Inventory tracking D. All of the above
d
7. Autonomy is an ethical principle that can be applied to which clinical situation? a. A nurse acts as a whistleblower in reporting unsafe practices observed on a clinical area. b. A nurse administers an IV morphine drip for a patient being terminally weaned. c. A nurse adheres to the HIPAA law when asked to reveal information on a patient to a nurse's family member. d. A nurse permits a patient to refuse a medication.
d
7. Over 144,000 payments totaling ______________have already been issued to professionals and hospitals by the Centers for Medicare & Medicaid Services (CMS) to have sharing of patient data on a nationwide level. A. $4.1 billion B. $5.1 billion C. $6.1 billion D. $7.1 billion
d
8. A staff nurse complains to the nurse manager about an employee of another department constantly asking her out on a date even though she has told him she is not interested. Which action by the nurse manager is most appropriate? a. Confront the employee and ask him to stay away from the staff nurse. b. Observe future interaction to confirm the reported harassment. c. Contact the supervisor to decide on the next step. d. Review the personnel manual to decide on the next step.
d
9. As per Rundio and Wilson (2013, p. 64), informatics is a core competency of all health care professionals. The key areas of focus center on: A. National information infrastructure, computerized clinical data B. Clinical decision support, use of Internet C. Integration of evidence-based practice D. All of the above
d
9. When making clinical practice changes, nurses should make permanent changes based on a. reviewing other unit practices. b. reviewing case reports. c. obtaining expert opinions. d. implementing piloting changes
d
9. Which of the following would be a reliable source of information for a change in pediatric practice? A. Physician/staff discussion B. Editorial in Pediatric Nursing C. Growth and development charts D. Clinical trial results
d
