Module 11 Practice Quizzes

Suggest the client purchase a self-monitoring cuff

A 27-year-old client is a regular smoker, has diabetes, and has been diagnosed with hypertension. The client says it is cumbersome and time consuming to visit the doctor regularly just for a blood pressure check. Which aspect of teaching would the nurse use with this client?

blow a pinwheel and bubbles with the child.

A 6-year-old needs to cough and deep breathe following surgery. To accomplish this, the nurse will:

Prepare the child for hospitalization by explaining what to expect and showing him or her around the hospital.

A 6-year-old will be hospitalized for a surgical procedure. How can the nurse best ease the stress of hospitalization for this child?

Social worker

A client diagnosed with terminal leukemia is receiving home health care services to assist in her care. After assessing the client, the home health care nurse determines that the client needs assistance with financial concerns. The nurse would enlist the support of which member of the home health care team?

ability to perform daily activities

A client has severe pain related to degenerative joint disease. On which aspect of care will the nurse need to focus first?

Provide early, thorough discharge planning.

A client in an acute care facility is assigned a case manager to oversee and coordinate care. What important function does a case manager have?

1. Determine their emotional readiness to learn. 2. Draft learning outcomes. 3. Select educational strategies. 4. Implement various educational techniques. 5. Revise the learning plan if needed.

A couple has just learned that their newborn infant has a congenital cardiac anomaly that will require many lifestyle modifications, surgical corrections, and hospital stays. Place the following aspects of the couple's client education in the correct order that nurses should conduct them.

Increased emphasis on patient involvement in their own care.

A current trend in health education that significantly influences nursing practice is:

Smell of natural gas

A home care nurse has completed a home assessment. Of the following findings, which should be reported to service providers immediately?

"Your wound is healing nicely. It is draining less and it is smaller by a half centimeter."

A home care nurse has just completed a dressing change on her client. Which statement best describes the termination phase?

Ankle wound with quarter-sized amount of yellow drainage; irrigated with normal saline and redressed

A home care nurse has just completed the initial visit and is documenting the findings. Which of the following would best support reimbursement by the client's third-party payer?

The nurse removes her shoes and announces her arrival.

A home care nurse is planning to visit a client newly diagnosed with diabetes. Further review of the chart reveals the client is of Japanese heritage. Upon arriving at the home, the home care nurse observes several pairs of shoes on a mat next to the door. Which of the following actions by the nurse demonstrates cultural competence?

Enter the home and continue to treat the client.

A home care nurse is visiting a new client and notes that the client's home is very messy. There are dirty dishes piled everywhere, the house smells of garbage, and there are very few surfaces that are clean. How should the nurse respond?

"The client and family are in control of the setting, not the nurse."

A home health care nurse is discussing home health care during a presentation for a group of senior nursing students, as part of a Career Day seminar. One of the students asks, "How is home health care different from care in a hospital?" Which response by the nurse would be most appropriate?

Children this age often show regressive behaviors and have nightmares following hospitalization due to fear of another separation.

A mother of a recently discharged preschooler calls the pediatric floor that provided care to her child a week ago. She reports that the child is having elimination accidents, temper tantrums and is waking up at night with nightmares. How should the nurse respond to the mother's concerns?

"Make sure you find out things that the child is interested in. This will give you things to talk about."

A new home healthcare nurse asks her preceptor for some hints to help establish a good relationship with her pediatric clients and their families. What is the best response by the preceptor?

"Discharge planning occurs when the patient is discharged."

A nurse acts as preceptor to a student nurse who is performing discharge planning for a client. What statement made by the student nurse about discharge planning indicates that the student needs additional teaching?

"Can you teach me what I just showed you?"

A nurse has been assigned to care for a client with newly diagnosed insulin-dependent diabetes mellitus. When teaching the client proper injection techniques, which statement will the nurse use to promote emotional readiness in the client?

Clients in the "Hospital at Home" program have been found to require shorter lengths of stay than when admitted to the acute care setting.

A nurse working for a home health agency is scheduled to evaluate a client with worsening heart failure to determine if he is a candidate for the new "Hospital at Home" program. Which of the following accurately reflects an outcome for this program?

1. The nurse, a guest in the home, needs the client's permission to visit. 2. The nurse has minimal control over the health practices of the client visited. 3. Infection control is as important in the home as in the acute care facility.

A nurse working in an acute care facility is preparing to start a new job as a home care nurse. Which facts would be important for the nurse to keep in mind when transitioning to this new role? Select all that apply.

Strong communication and counseling skills

A nurse works with clients in a crisis intervention center. What ability would be most important for this nurse to develop?

Documentation

According to the Candian Nurses Association (CNA), what is the primary source of evidence to measure performance outcomes against standards of care?

Analyze and Plan

An informatics nurse specialist has completed the evaluation of an update to a current clinical information system used by the staff at the local hospital and has documented the results. Documentation reveals the need for an improvement in the screen display. Which action would be next?

MaFrN610#

An informatics nurse specialist is conducting a program for facility staff about creating strong passwords to promote secure and private data. The nurse determines that the teaching was successful when the staff identify which password as a strong password?

collaborating with all agencies to provide for the client's home health needs

Based on the Patient Protection and Affordable Care Act (ACA), nurses are to assume an important role in health care. Which is an example of the change in the nurse's role?

Keep the crib side rails up at all times.

Caregivers of a hospitalized toddler are being given safety instructions upon admission to the pediatric floor. Which action by the caregiver would be most important to the toddler's safety?

"Can you repeat for me the information I just reviewed about weighing food portions?"

Choose the nursing statement that would best reflect the final component of the "Ask-Tell-Ask-Close" technique of communication and demonstration.

providing client education

In preparation for discharge, the nurse is reviewing information related to new dietary guidelines with the client. This is an example of which step in discharge planning?

Teaching rehabilitation exercises to a client after a mastectomy

In which situation is the nurse providing tertiary prevention?

It provides quick access to abnormal findings.

Nurses at a health care facility maintain client records using a method of documentation known as charting by exception (CBE). What is a benefit of this method of documentation?

Focus on cost containment with improved access and quality of services for everyone.

Nurses have an important role in health care reform. The goals of health care reform include which of the following?

prepare the client for home care.

Prior to the client's discharge from an acute care facility, the nursing case manager has the nursing staff, client, client's family, physical therapist, and home health nurse meet. The purpose of this is to:

provides health care for the community.

Public health nursing is the branch of nursing that:

A higher acuity client requires a greater need for highly skilled care.

The charge nurse is making assignments for a group of clients on a medical unit. When reviewing the acuity of the clients, the charge nurse assigns the RN to the clients with higher acuity levels. Why would the charge nurse assign the RN to the clients with a higher acuity?

Respiratory

The charge nurse is planning staffing on a pediatric unit. The charge nurse is aware that the majority of admissions for children under the age of 5 years are for diseases of which body system?

discharge planning.

The exchange of information among the client, the caregivers, and those responsible for care while the client is in a care setting (and after the client returns home) is key to successful:

Medicare pays only the amount of money preassigned to a treatment for a diagnosis.

The implementation of diagnosis-related groups (DRGs) by Medicare in 1983 affected hospitals in which of the following ways?

Gown, gloves and mask

The nurse approaches a client room and notes a sign stating the client is in droplet isolation. Which precautions would be appropriate for this client?

1. assesses the needs of the patient and family throughout the hospitalization. 2. collaborates with the healthcare team to obtain referrals the patient will need. 3. teaches the patient and family about medications and treatments. 4. supports the caregivers as they adjust to the discharge

The nurse is assigned to care for an older adult client that had a stroke and will be soon discharged from the acute care facility. What action by the nurse will help meet the client's outcomes for discharge?

andragogy

The nurse is assisting a male client 55 years of age to understand the anatomy and physiology of the heart following a heart attack. What type of learning is taking place?

therapeutic play.

The nurse is caring for a 10-year-old child admitted for a surgical procedure to be done the next day. The nurse takes the child to a special area in the playroom and lets the child "start" an IV on a stuffed bear. This is an example of:

Lipid panel

The nurse is caring for a 33-year-old male client. Which clinical screening should the client have, based on his age?

Write the name of his nurse on a board and identify all staff on each shift, every day.

The nurse is caring for a 7-year-old boy in a body cast. He is shy and seems fearful of the numerous personnel moving in and out of his room. How can the nurse help reduce his fear?

1. Assist the child to choose from the facility menu foods they like. 2. Encourage the child to eat several small meals instead of fewer larger meals. 3. Ask the dietitian to visit the child to help determine foods the child prefers. 4. If approved by the physician, allow the parents to bring food from home for the child.

The nurse is caring for a 9-year-old child on an inpatient pediatric unit who is admitted for an extended stay. The child continually refuses meals. What can the nurse do to help increase the child's intake? Select all that apply.

Second stage

The nurse is caring for a child admitted to the hospital. The child's mother had to go home to take care of her other children. The child has become quiet, is not crying and is refusing to eat. The nurse would document the child is in which stage of separation anxiety?

Determine how much the child knows and is capable of understanding.

The nurse is caring for a preoperative pediatric client. What would it be best for the nurse to do with this client?

Discussing care and treatment with the parent and child together

The nurse is caring for a technology-dependent school-aged child in his home. Which action best builds a trusting relationship?

Crying and acting out

The nurse is caring for an 18-month-old boy hospitalized with a gastrointestinal disorder. The nurse knows that the child is at risk for separation anxiety. The nurse watches for behaviors that indicate the first phase of separation anxiety. For which behavior should the nurse watch?

Parenting issues

The nurse is developing a health-promotion program at a company in which many employees are women in their 20s and 30s. For this population, the nurse plans to include information about

The frail and elderly who need skilled care

The nurse is making an initial home visit to assess a patient for home health services. Which patients most frequently require home health services?

79-year-old who has slight cognitive changes

The nurse is preparing to teach four clients. Which client will the nurse plan to teach using principles associated with gerogogy?

an older adult client who fell at home and required a hip replacement

The nurse is providing care to several clients on a medical-surgical unit. For which client's plan of care should the nurse include information regarding extended care?

Have the client return demonstrate.

The nurse is teaching a client with diabetes how to perform checks of blood glucose level. To optimize learning, it is best for the nurse to

Review the hospital's process for allowing clients to view their health care records.

The nursing is caring for a client who requests to see a copy of his health care records. What action by the nurse is most appropriate?

Although not written, the nurse must know or question the rationale before performing an action.

The nursing student is reading the plan of care established by the RN in the clinical facility. The students ask the nursing instructor why rationales are not written on the hospital care plan. The nursing instructor states:

shift from hospitals to community-based care

What is one of the most significant trends in health care today?

Improvises when providing care

Which capability corresponds with home health care?

Rehabilitation facility

Which facility is an example of a tertiary health care setting?

Affordable Care Act

Which government policy addresses penalizing hospitals for readmissions of clients with certain diagnoses within 30 days of discharge?

Allow ample time for psychomotor skills.

Which guideline is most important for the nurse to keep in mind when planning to teach an exercise class to a group of older adults?

Supports suggested safety precautions for the nurse when making a home care visit

Why is it important for the home health nurse to inform the health care agency of the nurses' daily itinerary?

The case manager identifies dates when oxygen should be discontinued, bronchodilators changed to self-administered inhalers, and antibiotics changed from intravenous to oral treatment.

A client is admitted to the acute care facility for the treatment of pneumonia. What exemplifies the nurse-managed care approach?

administering medications, wound care, and numerous other personal interventions

A client is being treated for injuries resulting from a skateboarding accident and is very agitated as the nurse cleans several gashes on the client's head. Which of the nursing responsibilities outlined by the American Nurses Association is the nurse fulfilling?

"According to HIPAA legislation, you have a right to request changes to inaccurate information."

A client made a formal request to review his or her medical records. With review, the client believes there are errors within the medical record. What is the most appropriate nursing response?

past interventions for weight loss

A client with a body mass index of 40.3 kg/m2 states, "I know I need to get rid of this fat. I just don't know how." Which is the best assessment for the nurse to make at this time?

When members of the community share a heritage that is unfamiliar to the nurse

A community health nurse understands the importance and impact of cultural competence when caring for clients in the community. In what situation will the nurse find that cultural competence is particularly important?

A client's health is affected by social, economic, and political factors.

A nurse demonstrates understanding of Healthy People 2020: Understanding and Improving Health by supporting which statement?

Problem-oriented method

A nurse documents the following data in the client record according to the SOAP format: Client reports unrelieved pain; client is seen clutching the side and grimacing; client pain medication does not appear to be effective; Call in to primary care provider to increase dosage of pain medication or change prescription. This is an example of what charting method?

"The nurse helped me make a list of my needs and goals for recovery and shared them with the home care team"

A nurse is evaluating a client's discharge collaboration between the referring agency and the home care agency. What response by the client would indicate an understanding of the discharge planning process?

The client constructs a plan to change behavior.

A nurse is evaluating a client's motivation to make decisions that promote healthy behavior change, using the transtheoretical model of change. Which description best describes the decision making stage of this model?

Has tuberculosis and is taking multiple antitubercular medications

A nurse is evaluating education provided to various clients being discharged to home. The nurse assesses that client most likely to be nonadherent with treatment is the one who

The nurse gathers evidenced-based information related to texting and driving and coordinates the education with the school.

A nurse is planning a health education program for a group of high school students regarding the dangers of texting and driving. Which action by the nurse illustrates the understanding of health education as a primary nursing responsibility?

Repeat and reinforce words frequently.

A nurse is preparing teaching for a client with an auditory perceptual disorder. Which educational strategy will be most effective?

"Tell me about your cute stuffed dog."

A nurse is preparing to admit a child for a tonsillectomy. How should the nurse establish rapport?

1. Homeless people often have no or insufficient health insurance. 2. Health problems are often related to a person's living situation. 3. Ill homeless people often deteriorate more rapidly than those who are not homeless.

A nurse is working as part of a team developing a community-based care program for the local homeless population. Which of the following would be important to keep in mind when developing the program? Select all that apply.

Injuries

A nurse is working in a school health program that provides care to elementary school-aged children. The nurse would focus teaching on which area as being most problematic?

Need for control over a situation

A nurse who is considering the possibility of becoming involved in home care asks a home care nurse about the characteristics needed for this practice area. Which of the following would the home care nurse be least likely to include?

"Clipboards with client data should not leave the unit."

A nursing student is making notes that include client data on a clipboard. Which statement by the nursing instructor is most appropriate?

Patient instruction related to self-care activities promotes patient independence

A nursing student observes the home care nurse provide education to a client with congestive heart failure (CHF). The nurse teaches the client how to read food labels and calculate sodium content. The nursing student recognizes that the home care nurse is aware of which basic principle of patient education?

School-age children

A pediatric nurse provides education to numerous clients in their care. Which group of children benefits most from being involved in the teaching-learning process?

Florence Nightingale

An informatics nurse is participating in an online continuing education course about nursing informatics. The nurse demonstrates successful comprehension of the course by identifying which individual as being considered the first informatics nurse?

Have client rate pain level and reschedule the teaching session.

As the nurse enters the room to teach the client about self-care at home, the client states, "I am glad you are here. I need some pain medicine. I can't stand it anymore." What is the best action of the nurse?

Speech pathologist/therapist

The nurse is a member of the multidisciplinary team in a large primary healthcare setting. The nurse understands that which healthcare team member is responsible for a client's swallow evaluation following a CVA (cerebral vascular accident)?

is to perform daily foot checks as a result of diabetes

The nurse is assigned to a group of clients and will be providing education to all of them. The client most in need of teaching is the client who

"Why don't you sit on your mom's lap?"

The nurse is caring for a preschooler who is hospitalized with a suspected blood disorder and receives an order to draw a blood sample. Which approach is best?

Ask the client if information can be given to the parent.

The parent of a 33-year-old client who is admitted to the hospital for drug and alcohol withdrawal asks about the client's condition and treatment plan. Which action by the nurse is most appropriate?

Deficient Knowledge: Imbalanced nutrition: more than body requirements, and ineffective health maintenance.

The parents of a school-age child are meeting with the nurse for health promotional education for their child. The child has the following assessment data: 7-year-old male, diabetes mellitus type 1 with a hemoglobin A1C of 8.3%, BMI of 31.7, BMI percentile of 99. What are the most appropriate learning diagnoses for this first session?

Remove one restraint at a time on a regular basis to check for skin irritation.

The toddler needs elbow restraints to keep his hands away from a facial wound. What will the nurse do to best ensure their safe use?

1. Managed care 2. Case management 3. Primary health care

What methods are used to ensure that clients have continuity of care and cost-effective care during movement throughout the health care system? Select all that apply.

Motivational counseling

When a client says, "I don't care if I get better; I have nothing to live for, anyway," which type of counseling would be appropriate?

Maintenance

When a person works to prevent relapse and to sustain the gains made from actions taken, he or she is in which stage of the Transtheoretical Model of Change?

A prospective payment plan based on a predetermined fixed cost.

When conducting an education program for a group preparing for retirement, the nurse would include information about applying for Social Security benefits and Medicare insurance. The nurse would include in the education that Medicare is a federally funded insurance program which bases the fee for payment on what?

Include educational strategies that encourage clients to be active participants.

When providing client education it is essential for the nurse to incorporate what action so that learning can be optimized?

omitting clients' responses to nursing interventions

Which action by the nurse could result in the accrediting body withdrawing the health agency's accreditation?

A 66-year-old client with diabetes

Which client would a nurse correctly refer to Medicare services?

1. avoiding the use of materials printed on glossy paper 2. using a lamp that shines over the client's shoulders 3. ensuring that the client is wearing prescriptive eyeglasses

Which considerations should the nurse ensure are in place before conducting teaching sessions for clients with visual impairment? Select all that apply.

Monitoring immunization status

Which is a role of a school nurse?

Behavioral observation

Which of the following is an example of a direct measurement technique for evaluation of the teaching--learning process?

1. Maintaining a healthy diet 2. Self-monitoring for signs and symptoms of illness 3. Taking prescribed medications 4. Increasing daily activities

Which of the following is an example of adherence to treatment? Select all that apply.

Perform thorough, accurate, and timely documentation.

Which of the following measures should a home health care nurse implement into his or her practice to minimize the potential for lawsuits?

1. Personal attitudes 2. Self-concept 3. Social support 4. Emotional make-up

Which of the following variables significantly influence non-adherence to a prescribed regimen? Select all that apply.

Inpatient units

Which setting has been the traditional site for the nursing work force?

Contemplation

Which stage of the transtheoretical model occurs when the patient has serious consideration of change, but it is sometime in the future?

"I will see you next year for my prostate exam."

Which statement made by the client indicates understanding of the Centers for Disease Control and Prevention and U.S. Preventive Services Task Force recommendation for prostate screening frequency?

An occupational therapist

Which therapist is most likely to focus on teaching a client to hold a toothbrush with an adaptive device and brush his teeth?

Official or public agency

Which type of home healthcare agency is a local health department?

"The medicine and blood work for atrial fibrillation can help prevent blood clots that have the potential to cause debilitating strokes. What have you heard about warfarin therapy?"

A 56-year-old executive meets with the nurse for education about recently diagnosed atrial fibrillation. He verbalizes concerns about the time he will spend away from his work, and that he is not sure it is necessary to have blood tests every week. He feels it is a waste of time when he does not have any symptoms. Which is the best motivational statement by the nurse for this client?

Accurately documenting client care on the client record

A client accuses a nurse of negligence when he trips when ambulating for the first time since hip replacement surgery. Which action is the best defense against allegations of negligence?

Enroll the client in Meals on Wheels.

A nurse has an older adult home care client who lives alone with no family nearby. On a recent visit, the nurse notices that his clothes are very loose, and he has difficulty letting the nurse leave when the visit is ending. After talking with him, the nurse learns that he has not been cooking for himself and he can't get to the grocery store easily. What service could the nurse suggest as an immediate response until a long-term plan can be formed?

a client who is homebound and needs skilled nursing care

A nurse is arranging for home care for clients and reviews the Medicare reimbursement requirements. Which client meets one of these requirements?

Coordinator of care

Nurses in various health care settings provide services to prevent the fragmentation of care that is occurring as a health care trend in today's society. What role of the nurse is most important in preventing this effect?

Clients play a large role in helping themselves in the home-care setting.

A new nurse is considering a job either in an acute care setting or a home-care setting. Which statement is accurately stated?

Rates pain 8/10, states nauseated for last 30 minutes.

A nurse administered oral pain medication 1 hour ago. Which documentation by the nurse best reflects the effectiveness of the pain medication?

Go slowly with the acquaintance process.

A nurse is admitting a 7-year-old to the pediatric unit of the hospital. While the nurse is showing the child and parents the room and explaining where things are, the child becomes upset and frightened. What is the best action by the nurse?

"Would you like to read or play video games?"

A nurse is caring for a 6-year-old boy hospitalized due to an infection requiring intravenous antibiotic therapy. The child's motor activity is restricted and he is acting out, yelling, kicking, and screaming. How should the nurse respond to help promote positive coping?

"The system should be safe, effective, efficient, patient centered, timely, and equitable."

A nurse is conducting a class about health care trends for a group of newly graduated registered nurses at the community hospital. Which of the following six trends stated by the nurse reflects the Institute of Medicine's (IOM) focus?

clearly defining the purpose and expectations of the admission

A nurse is covering all aspects of admission procedures for a client who is receiving home health services. The nurse explains what procedures will be covered during his visits. Which aspect of the admission process does this represent?

blocking 30 minutes of time for skill teaching

A nurse is educating a 4-year-old client about cast care following a tibia-fibula fracture. Which action is not developmentally appropriate to include in the nurse's education?

The treatment room

A nurse is preparing to start an intravenous (IV) line on a 5-year-old. Where does the nurse understand the procedure should be performed so that the child's "safe place" will not be disrupted?

PubMed

An informatics nurse is reading a journal article about standard terminologies. The nurse demonstrates a need to reread the article when identifying which example as reflecting a standard terminology?

Clients with high home care needs are being discharged into the community.

Many significant changes have been made to the health care delivery system in recent years. Earlier hospital discharges is one of them. What is one result of earlier hospital discharges?

the discharge home of clients who are more critically ill

Nurses now have the option to practice in a variety of settings. One of the fastest growing venues of practice for the nurse in today's health care climate is home health care. What is the basis for the growth in this health care setting?

cognitive learning theory

The nurse has educated the client on the pathophysiology of osteoarthritis and degenerative joint disease. This is an example of what learning theory?

"It is best to wait and let him bring up the surgery or any questions he has"

The nurse is educating the parents of a 7-year-old boy, scheduled for surgery, to help prepare the child for hospitalization. Which statement by the parents indicates a need for further teaching?

"Client and spouse taught how to use phone app to count carbohydrates; client return demonstrated carb counting for a hypothetical meal."

Which documentation example best reflects the complexity of client teaching by the nurse?

observing a mother expressing the breast milk

Which nursing action is applicable to the psychomotor domain of learning when conducting a teaching session for breastfeeding mothers?

Hospitals

Which of the following is the acute care setting for people who are too ill to care for themselves at home, who are severely injured, or who require surgery?

Sophisticated technology generally allows client care to be managed safely in the home environment.

A client with a recent total knee replacement (TKR) is about to be discharged home with home health services and states, "I think it is too soon for me to go home." What should the nurse explain to the client is the primary reason for the implementation of this level of care?

The nurse writes one long-term objective for each diagnosis, followed by several specific objectives.

A nurse is writing learner objectives for a client who was recently diagnosed with type 2 diabetes. Which statement best describes the proper method for writing objectives?

Short-term counseling

A nurse may attempt to help a client solve a situational crisis during what type of counseling session?

Home care

A woman living alone has degenerative joint disease, hypertension, and neuropathy. It is difficult for her to bathe herself, and her blood pressure is unstable. What type of care would this client benefit from most?

Personal perception of health and aging

An active, otherwise healthy, older adult client presents to the clinic with severe osteoarthritis in the bilateral knees. The nurse knows this client does not want to be a burden on his family, and he remains stoic even though he reports the pain as severe. He avoids the topic of surgery and attends church weekly. His family is supportive of any decisions he makes regarding his health. Which of the assessment data are most important to forming an individualized education plan for this client concerning treatment for his osteoarthritis?

1. The correct information appears on the screen. 2. All information is included. 3. There are no typographical errors. 4. Information is in its proper location on screen.

An informatics nurse specialist is involved in the testing of a new clinical information system that is being planned for use by the health network. The system is currently undergoing unit testing. Which information would be addressed during this phase? Select all that apply.

Health teaching and health promotion

An informatics nurse specialist is recommending the addition of an alert system tool to the facility's patient portal. The tool would be designed to send alerts to the client to schedule routine screenings and immunizations. This recommendation most likely reflects which ANA informatics competency?

Medicare

Which of the following is the largest single source of reimbursement for home health care services?