N3010: Exam 3

Which is the major goal of ambulatory care facilities? A. To reduce costs by providing care at a lower rate than hospital rates B. To perform major surgery in a community setting C. To perform tests prior to the client being admitted to the hospital D. To provide care to clients capable of self-care at home

D. To provide care to clients capable of self-care at home

The procedural physician has initiated performance of a time-out in the operating room before surgery. The student nurse asks the operating room nurse why this is important. What is the operating room nurse's best response? A. "The time-out checks to be sure that we have the right client and procedure." B. "We need to be sure the client has had the preoperative antibiotic." C. "We are checking the client's baseline vital signs during the time-out." D. "The time-out allows us to make sure that the client has had adequate anesthesia."

A. "The time-out checks to be sure that we have the right client and procedure."

A clinic-based nurse in a sparsely populated remote area far from a regional hospital is working with other local health care team members on a plan to improve client health and outcomes. The team has decided that which health care delivery system would best meet the population's needs? A. A health clinic run by an advanced practice registered nurse (APRN) B. A multi-specialty group practice C. A medical neighborhood D. A preferred provider organization (PPO)

A. A health clinic run by an advanced practice registered nurse (APRN)

In which setting is a nurse practitioner most likely to have the opportunity to provide primary care for clients? A. A rural health center B. A community hospital C. A long-term care facility D. A university hospital

A. A rural health center

The new nurse is having difficulty managing the time required to care for a group of complex clients and is several hours behind in completing nursing interventions. Which intervention should the nurse complete first? A. Administer a dose of digoxin that is two hours behind schedule. B. Perform a dressing change to an abdominal abscess that is three hours behind schedule. C. Obtain discharge orders for a client who is ready to be transferred to a long-term nursing facility. D. Complete a medication reconciliation form on a client who has recently been admitted to the hospital.

A. Administer a dose of digoxin that is two hours behind schedule.

An older adult has total care of the spouse, who has debilitative rheumatoid arthritis. The couple voices concern over the pain and stress associated with the condition. What type of care might the nurse suggest to help the couple? A. Palliative care B. Respite care C. Bereavement care D. Primary care

A. Palliative care

What is the rationale for conducting discharge planning? A. To ensure that client and family needs are met consistently B. To enlist family members in providing home care C. To provide a means of documenting nursing care D. To ensure the best possible care in the acute care setting

A. To ensure that client and family needs are met consistently

A nurse leader on a unit allows the staff to make all decisions and direct themselves, including filling out the work schedule. The nurse leader is practicing which leadership style? A. Transformational B. Laissez-faire C. Democratic D. Autocratic

B. Laissez-faire

Which type of home healthcare agency is a local health department? A. Private, proprietary agency B. Official or public agency C. Institution-based agency D. Private not-for-profit agency

B. Official or public agency

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 cerebral vascular accident? A. Physician assistant B. Speech pathologist/therapist C. Physical therapist D. Occupational therapist

B. Speech pathologist/therapist

A nurse arranges all the resources available to teach a teenage client how to manage asthma. Which role is this nurse performing? A. Controlling B. Directing C. Organizing D. Planning

C. Organizing

What is the result of increasing health care costs on hospital admissions? A. There is an increase in hospital admissions. B. Fewer surgeries are being performed at ambulatory centers. C. The number of surgeries has decreased. D. The length of hospital stay has decreased.

D. The length of hospital stay has decreased.

Nurses are socialized into the: A. diagnostic process. B. caring paradigm. C. nursing specialties. D. healthcare culture.

D. healthcare culture.

The primary nurse shares with the health care team the need for a client, diagnosed with cancer, to go out on a pass to attend a daughter's wedding. What role is this nurse serving in? A. Advocate B. Caregiver C. Counselor D. Educator

A. Advocate

A nurse is caring for an older adult client in the home. The nurse concludes that the client needs an X-ray to determine whether the client has pneumonia and requires oxygen for shortness of breath. The nurse calls to inform the physician of the client's status and then makes arrangements to carry out the physician's orders. In this scenario, what role does the nurse play? A. Clinical nurse specialist B. Case manager C. Advanced practitioner D. Nurse practitioner

B. Case manager

A nurse strives to establish trusting interpersonal relationships with clients, peers, subordinates, and superiors to facilitate goal achievement and personal growth of all participants. Which type of skill is this nurse demonstrating? A. Management B. Communication C. Self-evaluation D. Problem solving

B. Communication

Which two areas of knowledge are most important when providing nursing care to clients in the home? A. Computers and cultural diversity B. Communication and technical skills C. Physical assessment and infection control D. Documentation and problem solving

C. Physical assessment and infection control

Which government policy addresses penalizing hospitals for readmissions of clients with certain diagnoses within 30 days after discharge? A. Affordable Care Act B. Americans with Disabilities Act C. American Nurses Association Bylaws D. National Commission for Minorities

A. Affordable Care Act

The home health nurse is making a home visit for an older adult client recently discharged from the hospital after suffering a stroke. Which finding would most concern the nurse? A. Area rugs are present in multiple areas throughout the house. B. The client is living with an adult child's family. C. The client's home has a basement with small staircase. D. Medication bottles are on the counter without safety caps.

A. Area rugs are present in multiple areas throughout the house.

The nurse is delegating care to an unlicensed assistive personnel (UAP). Which intervention would be most important for the nurse to perform independently? A. Assess the client with difficulty breathing B. Obtain a postprandial blood sugar reading C. Assist the client with turning in bed D. Measure the client's blood pressure

A. Assess the client with difficulty breathing

A nurse is caring for clients at an ambulatory care facility. Which care intervention is least likely to be provided by the nurse in this setting? A. Crisis management B. Treatment of minor trauma C. Patient education D. Medication administration

A. Crisis management

Which is a current trend to watch in health care delivery? A. Current nursing shortage B. Lower costs of health care C. Uneducated consumers D. Decreasing diversity

A. Current nursing shortage

A registered nurse is making a visit to a client in the home. What actions should the home health care nurse expect to accomplish? A. Document actions regarding client, activities, and progress. B. Prescribe a pain medication to increase the client's comfort. C. Complete an assessment on each visit. D. Administer treatments and medications. E. Provide support to the client and family.

A. Document actions regarding client, activities, and progress. C. Complete an assessment on each visit. D. Administer treatments and medications. E. Provide support to the client and family.

The nursing student asks the home health nurse what data is required for a Medicare home plan of care. Which item would be incorrect for the nurse to include when responding to the student? A. Documented need for a speech pathologist B. Medications and treatments C. Types of services and equipment required D. Functional limitations

A. Documented need for a speech pathologist

A registered nurse is providing community-based health care for a client diagnosed with early onset dementia. Which strategy is best for the nurse to employ to facilitate the family participating in the client's care? A. Encourage active participation of the client and family in health care decisions. B. Create a care plan based on the client's requests and inform the family of the client's wishes. C. Provide referrals for health care professionals to perform the client's activities of daily living (ADLs). D. Reinforce the care plan to the family if it is determined the client is not properly cared for.

A. Encourage active participation of the client and family in health care decisions.

Which is the primary goal of continuity of care? A. Ensuring a smooth and safe transition between different health care settings B. Controlling costs and maximizing client outcomes after discharge from the hospital C. Minimizing nurses' legal liability during client transitions between health care institutions D. Increasing clients' knowledge base and improving their health maintenance behaviors

A. Ensuring a smooth and safe transition between different health care settings

What role does the nurse assume when gathering information for a community assessment? A. Epidemiologist B. Thanatologist C. Oncologist D. Transcriptionist

A. Epidemiologist

A nurse can improve one's skill with time management by taking which action? A. Evaluating success with accomplishment of goals in client care B. Setting priorities without involving clients or their families C. Allowing the flow of the day to control how time is managed D. Starting each day as a new day without considering the previous day

A. Evaluating success with accomplishment of goals in client care

Which quality is essential to being a nurse leader? A. Flexibility B. Physical stamina C. Independence D. Vulnerability

A. Flexibility

A client is having an increasing amount of difficulty caring for oneself in the home alone. The client states to the nurse, "I need more help. What am I going to do?" Which action would be the most appropriate for the nurse to take? A. Have the social worker visit the client to discuss care options. B. Have the home health aide increase visits for bathing the client. C. Have the physical therapist help the client with rehabilitation. D. Have the occupational therapist assess for the client's need for adaptive devices.

A. Have the social worker visit the client to discuss care options.

Which are components of the nursing case management process? Select all that apply. A. Monitoring medical progress B. Filing and completing paperwork C. Making referrals D. Coordinating E. Prescribing medications F. Driving a client to appointments

A. Monitoring medical progress B. Filing and completing paperwork C. Making referrals D. Coordinating

A nurse is researching health care in rural areas. Based on a 2013 U.S. Subcommittee on Primary Health and Aging, which statement regarding access to primary health care is correct? A. One in five Americans lives in an area without adequate access to primary health care due to a shortage of primary care providers. B. Fewer than one in five physicians specializes in primary care. C. Over 100,000 people die each year because they do not have health insurance and do not get to a doctor on time. D. Although over half of client visits are for primary care, only 17% of the nation's medical school graduates now choose a primary care career.

A. One in five Americans lives in an area without adequate access to primary health care due to a shortage of primary care providers.

A nurse is helping a client choose a new health care plan. The client states a preference being able to choose a physician. Which plan would be the best option for this client based on the stated preferences? A. PPO B. HMO C. LTC D. POS

A. PPO

A client is admitted to the facility after fracturing a hip. The client has undergone surgery to repair the fracture and is receiving services to promote healing of the surgical site and regain mobility. Which discussion should the nurse have with a member of the interdisciplinary team member to promote the goal of regaining mobility? A. Speak with the physical therapist about exercises to strengthen muscles. B. Discuss oxygen administration with the respiratory therapist. C. Discuss transfer to a rehabilitation facility with the social worker. D. Talk with the occupational therapist about providing assistance with activities of daily living.

A. Speak with the physical therapist about exercises to strengthen muscles.

Which statement most accurately reflects the intent of secondary care? A. Specialists provide psychiatric care, same-day surgery, and general hospital care. B. Nurse midwives provide outpatient care. C. Advanced practice nurses and specialist physicians treat rare and complex disease states. D. Primary care physicians and nurse practitioners care for clients with common health problems.

A. Specialists provide psychiatric care, same-day surgery, and general hospital care.

Which organization has established safety standards about the use of electrical equipment, isolation techniques, and toxic chemicals? A. The Occupational Safety and Health Administration (OSHA) B. The Centers for Disease Control and Prevention (CDC) C. The Nurse Practitioner Data Bank D. Equal Employment Opportunity Commission (EEOC)

A. The Occupational Safety and Health Administration (OSHA)

Who provides physicians with the authority to admit and provide care to clients requiring hospitalization? A. The health care institution itself B. State Board of Nursing C. American Medical Association D. Board of Healing Arts

A. The health care institution itself

A client has suddenly become very ill and needs to be transferred to the intensive care unit (ICU). Which action by the nurse would most ensure continuity of care? A. The nurse provides an SBAR report to the nurse in the ICU. B. The nurse asks the family to provide information about the client to the ICU nurse. C. The nurse ensures that the client's chart and belongings are moved with the client. D. The nurse writes down the information for the nursing assistant to give to the ICU nurse.

A. The nurse provides an SBAR report to the nurse in the ICU.

When a multidisciplinary team is involved in meeting the home care needs of a client, who is the person responsible for the coordination of the care provided? A. The registered nurse B. The social worker C. The home health care aide D. The chaplain or minister

A. The registered nurse

A registered nurse is delegating activities to unlicensed assistive personnel (UAP) on a hospital unit. Which activities could this nurse normally delegate? Select all that apply. A. Transferring a client to another floor B. Giving a bed bath to a client C. Administering medications to clients D. Taking routine vital signs E. The determination of a nursing diagnosis for a client with breast cancer F. Planning education for a client with a colostomy

A. Transferring a client to another floor B. Giving a bed bath to a client D. Taking routine vital signs

Community-based health care is best defined as: A. health care developed in partnership with communities. B. health care directed to members of a community who are currently healthy. C. health care in a non-hospital setting. D. health care that is not provided to specific individuals.

A. health care developed in partnership with communities.

When the client's primary care physician does not have hospital privileges, a service is available to provide the client's care and communicate with the client's physician. This service is provided by physicians called: A. hospitalists. B. on-call physicians. C. admitting physicians. D. referral specialists.

A. hospitalists.

When preparing to transfer an older adult client back to the long-term care facility where the client has been for several years, it is the primary responsibility of the nurse to: A. provide for the coordination and continuity of care by the health care providers. B. communicate to the next of kin so they are aware of the transfer. C. discuss the return to familiar surroundings with the client. D. ensure that the current health state of the client is maintained.

A. provide for the coordination and continuity of care by the health care providers.

Public health nursing is the branch of nursing that: A. provides health care for the community. B. assesses individuals for community care. C. administers care for a defined geographic community. D. provides primary care to individuals.

A. provides health care for the community.

The nurse is caring for a client admitted to home care after total knee replacement surgery. Which home health care goal for the client will be the nurse's priority? A. Facilitate deep breathing exercises to prevent pneumonia B. Help the client regain mobility and independence C. Minimize the risk of infection D. Assist the client in achieving consistent bowel movements.

B. Help the client regain mobility and independence

A nurse is leaving a primary health care system to practice in a tertiary health care system. Which area of nursing would the nurse most likely be entering in this new job? A. Education B. Hospice care nursing C. Emergency room nursing D. Community clinic nursing

B. Hospice care nursing

The nurse is having difficulty managing time while caring for a group of clients with complex needs. Medications are several hours behind schedule and several nursing procedures have not be performed. What is the first step that the nurse needs to take to resolve the time management issue? A. Establish a timeline to get the nursing interventions completed. B. Identify which nursing interventions are priority. C. Evaluate the potential to successfully complete the nursing interventions. D. Identify which nursing interventions can be delegated to other members of the health care team.

B. Identify which nursing interventions are priority.

Which attributes should be characteristic of a nurse mentor? Select all that apply. A. Deconstructs health care networks B. Is resourceful C. Is an experienced, licensed professional D. Embraces disruptive conflict E. Is driven by financial reward F. Demonstrates leadership abilities G. Is supportive

B. Is resourceful C. Is an experienced, licensed professional F. Demonstrates leadership abilities G. Is supportive

The nurse and unlicensed assistive personnel (UAP) are working together to admit a client newly diagnosed with diabetes to a nursing unit. Which task would be inappropriate to delegate to the UAP? A. Measuring blood pressure B. Monitoring insulin requirements C. Performing a fingerstick blood glucose test D. Offering sugar-free popsicles

B. Monitoring insulin requirements

Which is a task that the nurse can delegate to the unlicensed assistive personnel (UAP)? A. Monitoring vital signs on a client with an active gastrointestinal bleed B. Obtaining intake and output on a client with a foley catheter C. Teaching a client with diabetes how to inject insulin subcutaneously D. Assisting a client with orthostatic hypotension to get out of bed

B. Obtaining intake and output on a client with a foley catheter

Which action by the home health care nurse illustrates the role of coordinator of services? A. Educating the client and caregiver about wound care B. Providing information about community resources C. Providing direct physical care to the client D. Providing certification for home care

B. Providing information about community resources

A nurse is providing care to a client recently admitted to the health care facility for treatment of an infection. The client experienced a traumatic brain injury several months ago that resulted in paralysis of both lower extremities and difficulty swallowing and speaking. The client's spouse is the primary caregiver. The client's spouse says to the nurse, "It's been really tough this last month caring for my spouse. Even though I have an aide who comes in to help for a couple of hours a week, I'm just spent, physically and emotionally." A referral for which service would be appropriate? A. Parish nursing services B. Respite care C. Hospice care D. Palliative care

B. Respite care

The registered nurse (RN) has received orders to perform an unsafe practice on a client. The RN voices concern with the physician who gave the order, but the physician refuses to change the order. Whom should the nurse consult next regarding the order? A. The nurse manager B. The charge nurse C. The client D. The licensed practice nurse (LPN)

B. The charge nurse

The nurse is preparing to begin the discharge planning process with a client whose pulmonary embolism has recently resolved. Which factor should the nurse prioritize during this process? A. The nurse's knowledge base and experience level B. The client's identified needs and goals C. The client's potential for recurrence D. The NANDA diagnoses relevant to the client's condition

B. The client's identified needs and goals

Hospice nurses provide care in a variety of settings, including clients' homes, long-term-care facilities, and hospice residences. After the client dies, what happens next? A. The hospice nurse assists the family in working through their grief during the period of mourning, for 1 week after the death. B. The hospice nurse continues to care for the client's family for up to 1 year. C. The hospice services continue for family and friends during the bereavement period, up to 1 month after the death. D. If the client was in a hospice residence, hospice services continue for the family for up to 6 months; otherwise, hospice services end immediately.

B. The hospice nurse continues to care for the client's family for up to 1 year.

A client has a private insurance policy that pays for most health care costs and services. Why is this plan called a third-party payer? A. Medicare and Medicaid will pay most of the costs. B. The insurance company pays all or most of the costs. C. The client gets the bill and pays out-of-pocket costs. D. The family of the client is required to pay costs.

B. The insurance company pays all or most of the costs.

The nurse is conducting discharge education on dressing change to a postoperative client and the spouse. The client's spouse appears anxious about changing the dressing correctly. Which is the best indicator that the spouse is competent to perform the dressing change? A. The spouse is able to list the steps to changing the dressing. B. The spouse is able to correctly demonstrate performing the procedure. C. The spouse is able to list all of the supplies needed for the dressing change. D. The spouse listens attentively as the nurse describes the procedure.

B. The spouse is able to correctly demonstrate performing the procedure.

The nurse is caring for a client who would benefit from home health care services. In preparing for discharge, the nurse is aware that home health care can only be initiated if the: A. appropriate transfer forms are completed. B. physician writes an order for home care. C. home health care agency evaluates the client and determines the need for services. D. social worker assesses the need and Medicare agrees to pay for home health care services.

B. physician writes an order for home care.

The nurse understands that planning for discharge actually begins at admission to the facility. The purpose of discharge planning is best described as: A. promoting less dependence on others. B. providing continuity of care that is goal directed. C. decreasing stress for client and family members. D. ensuring client safety and health maintenance.

B. providing continuity of care that is goal directed.

One of the newest concepts in providing long-term care is called "aging in place." What is the best description of this type of care? A. Clients move into a long-term care facility permanently but may receive acute care at a hospital as needed and then return to the long-term care facility. B. Clients move into a nursing home and access more and more services as required in the same facility. C. Clients remain in their home of choice and live there independently, with access to health care services as needed, provided within the community. D. Clients are maintained in their own homes with home health care.

C. Clients remain in their home of choice and live there independently, with access to health care services as needed, provided within the community.

A nurse manager is trying to resolve a conflict between the day and night shifts. The nurse manager wants to convince the involved persons to set aside their differences, determine a priority common goal having to do with improved client care, and accept mutual responsibility for achieving this goal. The nurse manager is using which type of conflict resolution? A. Avoiding B. Compromising C. Collaborating D. Competing

C. Collaborating

Two new nurses are requesting the same preceptor for unit orientation and say they'll be unhappy if they do not receive their choice of preceptor. The nurse manager sets up a meeting with the two new nurses to come to a resolution regarding the preceptor. Which conflict resolution style is the nurse manager using? A. Accommodating B. Compromising C. Collaborating D. Avoiding

C. Collaborating

Based on the Patient Protection and Affordable Care Act (ACA), nurses are to assume an important new role in health care. Which is an example of this new role? A. Identifying individuals who are at risk of developing diabetes mellitus B. Providing client education related to colostomy care C. Collaborating with all agencies to provide for the client's home health needs D. Verifying that all documentation is updated prior to surgery

C. Collaborating with all agencies to provide for the client's home health needs

A nurse is caring for a client who has a PPO health care plan. What is the greatest advantage of this type of plan? A. Improved health outcomes B. Ease of referrals C. Cost effectiveness D. Care coordination

C. Cost effectiveness

A nurse is considering the delegation of administering topical medications to an unlicensed assistive personnel (UAP). What is the first question the nurse must ask oneself before doing so? A. Have I evaluated the client's response to this task? B. Is appropriate supervision available for the UAP? C. Do the nurse practice act and agency policy allow this delegation? D. Has the UAP been trained to perform the task?

C. Do the nurse practice act and agency policy allow this delegation?

Which qualities are essential for a community-based nurse? Select all that apply. A. Competence in assisting with minor surgical procedures B. Ability to delegate client care tasks to unlicensed assistive personnel C. Effective communication skills D. Keen physical assessment skills E. Strong knowledge foundation

C. Effective communication skills D. Keen physical assessment skills E. Strong knowledge foundation

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. Suggest he go to an assisted living facility. B. Have the social worker counsel him. C. Enroll the client in Meals on Wheels. D. Refer him to the dietitian.

C. Enroll the client in Meals on Wheels.

During the entry phase of a home visit, the nurse is most likely to perform which task? A. Makes calls to establish initial contact with the client and schedule a visit B. Gathers supplies and equipment needed for the first visit C. Establishes nursing diagnoses based on client needs D. Obtains directions to the client's home

C. Establishes nursing diagnoses based on client needs

What are chief tasks of the home health care nurse? Select all that apply. A. Collecting payment for nursing care B. Providing for a dignified death at home C. Providing client education and counseling D. Developing a nursing care plan E. Administering medications F. Providing continuity of care

C. Providing client education and counseling D. Developing a nursing care plan E. Administering medications F. Providing continuity of care

What nursing function would be most commonly found in an ambulatory care facility? A. Assessing the home environment B. Serving as an administrator or manager C. Providing direct client care D. Educating individuals or groups

C. Providing direct client care

The client is being discharged to the home setting following a stroke. Which activity would the occupational therapist assist the client with? A. Improving the ability to swallow B. Improving oral communication C. Relearning how to cook safely D. Gait training with a walker

C. Relearning how to cook safely

A nurse manager must provide care to the unit's clients and employees under the constraints of the resources. This involves maintaining the financial constraints of the division. What term best describes this scenario? A. Management B. Financial management C. Resource management D. Allocation

C. Resource management

A series of classes on the dangers of smoking are being prepared for children between ages 8 and 10. Which professional would be the one to most likely develop the classes? A. Teacher B. Pediatric nurse C. School nurse D. Outside consultant

C. School nurse

A nurse is a member of an interdisciplinary team providing home health care to a client who was discharged home after experiencing a stroke. The client has been receiving services to assist with swallowing. The nurse would collaborate with which member of the team to discuss the client's progress? A. Physical therapist B. Social worker C. Speech therapist D. Occupational therapist

C. Speech therapist

Which is the best example of a nurse providing continuity of care? A. The nurse attending an appointment with the client in some place other than where the nurse works B. The nurse accompanying the physician on rounds C. The nurse collaborating with other members of the health care team in caring for a client D. The nurse taking detailed notes on how each client wants to continue care

C. The nurse collaborating with other members of the health care team in caring for a client

Continuity of care is an important concept for quality nursing practice. The responsible nurse understands the best description of the process of continuity of care is to: A. teach the client self-care regarding medications and plan of care. B. assist the client to focus on health goals and reach outcomes. C. coordinate uninterrupted care and facilitate transfer between units and levels of care. D. manage the individual care needs of the client throughout the hospital stay.

C. coordinate uninterrupted care and facilitate transfer between units and levels of care.

When educating clients in the community on health promotion and prevention of disease, it is important to stress: A. health promotion may not be possible for many of the older members of a community. B. the ideal location for education is in a health care institution. C. health education can benefit individuals and groups. D. strenuous exercise is necessary for health.

C. health education can benefit individuals and groups.

At the last hospital unit meeting, the policy for the insertion of Foley catheters was revised based on current evidence. The new nurse on the unit just learned "the old way" and is frustrated to now have to learn a new methodology. Several other nurses comment that the change is "all about money." The charge nurse must educate the staff about the importance of this new policy. Which explanation by the charge nurse is most appropriate? A. "Using evidence-based practice is the trend in providing quality care and may expose the client to better care implementation. None of our care methods are associated with cost." B. "Because our clients are considered consumers of care, they often understand the need to use specific methods based on research, and they want the best care for the lowest cost." C. "Cost is not a driver in quality health care delivery." D. "Incorporating evidenced-based practice into our care routines links our interventions to valued outcomes, thereby increasing quality care. When we provide quality care, we can decrease cost."

D. "Incorporating evidenced-based practice into our care routines links our interventions to valued outcomes, thereby increasing quality care. When we provide quality care, we can decrease cost."

It is recommended that a client go to a convalescent center upon discharge following a minor stroke. The client says, "I don't want to go anywhere, I want to go home." Which information should the nurse offer? A. "You may go home if you wish." B. "You are not able to care for yourself anymore and need help." C. "There are so many activities that I think you will like the nursing home." D. "You will only stay until you are well enough to go home."

D. "You will only stay until you are well enough to go home."

A client is having problems with insurance reimbursement. The home health care nurse discusses the client's need for home health services with the insurance company. What role is the nurse demonstrating? A. Direct care provider B. Coordinator of services C. Educator D. Advocate

D. Advocate

A nurse in a walk-in health care setting provides technical services (e.g., administering medications), determines the priority of care needs, and provides client teaching on all aspects of care. Which term best describes this type of health care setting? A. Long-term care B. Hospital C. Physician's office D. Ambulatory center

D. Ambulatory center

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? A. A middle-aged client who had a knee replacement B. A client who had a cholecystectomy C. A client who developed sepsis after a ruptured polyp D. An older adult client who fell at home and required a hip replacement

D. An older adult client who fell at home and required a hip replacement

In the hospital setting, a nurse is responsible for overseeing the quality and financial outcomes of client care while working collegially with health care providers. What type of professional nursing practice is this considered? A. Functional nursing B. Primary nursing C. Nurse mentorship D. Case management

D. Case management

Which is a key resposibility of a home health nurse? A. Provide all care and services. B. Advise clients on financial matters. C. Maintain a clean home environment. D. Collaborate with other care providers.

D. Collaborate with other care providers.

Which is the primary goal of home health care? A. Provision of palliative care B. Prevention of disease C. Treatment of illness D. Functioning within limitations

D. Functioning within limitations

Which is a current trend in health care consumers? A. Decreased engagement with health care providers B. Decreased concern about the costs of health care services C. Increased dependence on health care providers to make decisions for them D. Increased knowledge of health care

D. Increased knowledge of health care

The registered nurse (RN) and unlicensed assistive personnel (UAP) are working together to admit a pediatric client to a nursing unit. Which task would be inappropriate for the RN to delegate to the UAP? A. Soothing the client during the procedure B. Securing the client on a papoose board C. Gathering equipment needed for intravenous therapy D. Initiating intravenous therapy

D. Initiating intravenous therapy

The client is being discharged to the home setting following a stroke. The client requires assistance in relearning how to cook safely. To which home health care team member should the nurse refer the client? A. Home health aide B. Physical therapist C. Social worker D. Occupational therapist

D. Occupational therapist

What is the priority nursing responsibility when transferring a client from one unit in the hospital to another? A. Transport the completed client chart to the receiving unit. B. Bring all of the client's belongings to the new unit. C. Help the client become familiar with the new unit. D. Provide a verbal report of the client's status to the admitting nurse.

D. Provide a verbal report of the client's status to the admitting nurse.

A client diagnosed with terminal leukemia is receiving home health care services to assist in the client's care. After assessing the client, the home health care nurse determines that the client is unable to afford needed medical supplies. Which is the best strategy for the nurse to implement to assist the client? A. Discuss the client situation with the provider for possible therapies that are more cost-conscious. B. Refer the client to a local religious organization or non-profit agency for support. C. Enlist the services of the client's family for some components of care, such as dressing changes and physical therapy. D. Refer the client to a social worker to determine eligibility for assistance.

D. Refer the client to a social worker to determine eligibility for assistance.

A nurse working in a primary health care facility would most likely provide which service? A. Treatment B. Acute care C. Rehabilitation D. Screening

D. Screening

A nurse coordinator for a busy hospital provides for continuity of care for clients using the hospital services. Which cognitive skill would this nurse need to ensure continuity of care? A. The commitment to securing the best setting for care to be provided for clients and the best coordination of resources to support the level of care needed B. The ability to provide technical nursing assistance to meet the needs of clients and their families C. The ability to establish trusting professional relationships with clients, family caregivers, and health care professionals in different practice settings D. The knowledge of how to communicate client priorities and the related plan of care as a client is transferred between different settings

D. The knowledge of how to communicate client priorities and the related plan of care as a client is transferred between different settings

The role of the hospitalist is best described as: A. the physician who notifies the primary physician that the client has been admitted to the hospital and then transfers care to a referral specialist. B. the specialist who admits the client to the hospital and then returns care to the primary physician for all other referrals and services. C. the physician who manages the client's care in emergency and intensive care units only. D. the physician who admits the client, assumes the management of the client's care, and maintains communication with the primary physician while the client is hospitalized.

D. the physician who admits the client, assumes the management of the client's care, and maintains communication with the primary physician while the client is hospitalized.

Which member of the health care team is most often responsible for providing the order that will begin a client's course of home health care? A. The case manager B. The registered nurse C. The hospital discharge planner D. The physician

D. The physician

Which is the largest single source of reimbursement for home health care services? A. Private insurance B. Client's self-pay C. Medicaid D. Medicare

D. Medicare

Which action must the nurse perform on discharge of a client from an acute care facility? A. Writing any orders for future home visits that may be necessary for the client B. Coordinating future care for the client C. Sending the client's records to the attending physician D. Writing a discharge order for the client

B. Coordinating future care for the client

The growth in home health care is largely attributed to which factor? A. The inability of hospitals to care for an increasing number of clients B. Nurses' desire to work in the community C. Early discharge of clients from the hospital setting D. The nursing shortage in hospitals

C. Early discharge of clients from the hospital setting

The nurse is working to enhance time management skills and has to administer pain medications to several patients, obtain vital signs, and assist clients with bathing. What should the nurse do next? A. Administer pain medications. B. Delegate bathing and vital signs tasks. C. Obtain vital signs. D. Bathe clients.

B. Delegate bathing and vital signs tasks.

Which statement is most accurate in discussing the difference between nursing care provided in the acute care setting and that provided in the home care setting? A. Both settings focus on the holistic care of an individual. B. The acute care setting, unlike the home care setting, focuses on the client's needs. C. Both care settings require the participation of the client's family. D. The home care setting can only be initiated when the client returns to full function.

A. Both settings focus on the holistic care of an individual.

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 the nurse's visits. Which aspect of the admission process does this represent? A. Clearly defining the purpose and expectations of the admission B. Documenting the procedure C. Establishing rapport and showing willingness to listen D. Assisting in participation of the care-related decisions

A. Clearly defining the purpose and expectations of the admission

Which type of health problem requires both physician- and nurse-prescribed actions to address? A. Collaborative health problem B. Physician-developed problem C. Interdisciplinary health problem D. Independent health problem

A. Collaborative health problem

What type of leader shares decisions and activities with group participants? A. Autocratic B. Democratic C. Laissez-faire D. Situational

B. Democratic

Medicare part A is: A. an insurance program that pays a set amount based on the diagnosis and approved care for in-hospital services. B. a health insurance program administered locally to cover visits to physicians, medications, and home health. C. a plan for seniors that limits providers to those within the group plan. D. a federally funded public assistance program for low-income people.

A. an insurance program that pays a set amount based on the diagnosis and approved care for in-hospital services.

A nurse and a client are discussing managed care. The nurse explains that the managed care model was designed for which reason? A. Increasing client satisfaction B. Controlling costs while maintaining quality of care C. Providing an all-RN staff D. Providing a distinct area of care

B. Controlling costs while maintaining quality of care

Which statement by a registered nurse (RN) represents appropriate delegation to a nursing assistant? A. "Check the infusion rate." B. "Dispose of the disconnected IV set." C. "Discontinue the IV solution." D. "Inspect the site for thrombophlebitis."

B. "Dispose of the disconnected IV set."

Which statement regarding health care reform trends is most accurate? A. "Distinctive to the United States is the dominance of the public element over the private one." B. "Systems are in place to pay for performance and penalize hospitals for excessive readmissions." C. "Spending on medical services will rise to almost 32% of the U.S. gross domestic product by 2021." D. "The United States is secnd in the world in total health care dollars spent annually."

B. "Systems are in place to pay for performance and penalize hospitals for excessive readmissions."

The initial step in discharge planning is: A. providing home health care referrals. B. collecting and organizing data about the client. C. establishing goals with the client. D. teaching the client self-care activities that are to be conducted in the home setting.

B. collecting and organizing data about the client.

A hospital has begun to expand home health services to its clients. Which reason is the most likely cause for the expansion of these services? A. Changes to the structure of Medicare and Medicaid B. The need for decreased financial expenditures C. The change to shorter hospital stays D. The increase in the incidence and prevalence of infectious diseases

C. The change to shorter hospital stays

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? A. Educator B. Care provider C. Counselor D. Coordinator of care

D. Coordinator of care

Regardless of the type of ambulatory care facility, what need is common to all clients who are given care? A. Stress reduction B. Surgery C. Referrals D. Education

D. Education

Which phrase best describes hospitals today? A. Focus on chronic illnesses B. Primary care centers C. Voluntary agencies D. Focus on acute care needs

D. Focus on acute care needs

The nurse is planning discharge of the client who had surgery for a left hip replacement. The client is being discharged from the hospital to the home and requires home medical services. Which item would be provided by home medical services? A. Homemaking B. Pain management C. Intravenous therapy D. High-rise toilet seat

D. High-rise toilet seat

The nurse is providing care to an older adult client approaching discharge following a surgical procedure to repair a fractured hip. The client requires continued skilled nursing care and physical therapy to improve mobility. When planning care for this client, which prescription should the nurse anticipate? A. Discharge to home with home health care B. Admission to hospice care C. Move to an intermediate care facility D. Transfer to an extended care facility

D. Transfer to an extended care facility

A new client arrived on the unit while the nurse was obtaining the end-of-shift report from the night nurse. This client is admitted walking and is here for a cardiac workup; the client is assigned to the nurse. The nursing assistant has settled the client in the room and oriented the client to the surroundings, call system, bathroom, bedside supplies, and where to place clothes. The priority nursing action is to: A. ask the nursing assistant to obtain vital signs. B. obtain the physician's orders. C. call the dietary department to get breakfast for the client. D. gather information and complete the admission database.

D. gather information and complete the admission database.

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:

discharge planning.

Which consultation or referral by the nurse is most appropriate for a client who is obese and demonstrates poor wound healing? A. Nutritional consult B. Podiatry referral C. Pulmonologist referral D. Social services consult

A. Nutritional consult

Nurses who assist clients to deal holistically with their health care needs at the end of their lives work primarily in which health care delivery system? A. Hospice B. Rehabilitation C. Acute care D. Primary care

A. Hospice

How might one define leadership? A. Leadership is the process of guiding, educating, motivating, and directing others. B. Leadership is the process of interviewing, hiring, and firing personnel. C. Leadership is the process by which the leader shares power with others. D. Leadership is the process of planning, organizing, directing, and controlling activities.

A. Leadership is the process of guiding, educating, motivating, and directing others.

A nurse is caring for a 17-year-old pregnant client who is unable to afford health care. Which resource should the nurse suggest to the client to obtain support? A. A social services office to inquire about Medicaid benefits B. The visiting nurse association C. The local acute care facility D. A local religious organization

A. A social services office to inquire about Medicaid benefits

The older client tells the nurse that the client needs to use the restroom. Which safety intervention must the nurse perform first? A. Assess the need for assistance with ambulation. B. Ask a family member to help the client to the restroom. C. Offer the bedpan to keep the client safe. D. Ask the unlicensed assistive personnel (UAP) to help the client to the restroom.

A. Assess the need for assistance with ambulation.

The home care nurse asks the client and family about their socioeconomic status, culture, and beliefs. This occurs during which phase of care? A. Assessment B. Nursing diagnosis C. Outcome criteria D. Implementation

A. Assessment

Which nursing care task is acceptable for a registered nurse to delegate to an unlicensed assistive personnel (UAP)? A. Assisting a client with ambulation B. Initial and ongoing assessments C. Evaluation of nursing care delivered to a client D. Development of a client teaching plan

A. Assisting a client with ambulation

Which preoperative task can the nurse delegate to the UAP (unlicensed assistive personnel)? A. Assisting the client to the bathroom before surgery B. Teaching about use of the incentive spirometer C. Checking to be sure all diagnostic tests are completed D. Auscultating of the client's breath sounds

A. Assisting the client to the bathroom before surgery

The nurse is caring for a client who is recovering from a cerebrovascular accident. When reviewing the client's orders, the nurse notes that one of the physicians wrote orders to ambulate the client, whereas another physician ordered strict bed rest for the client. How would the nurse most appropriately remedy this conflict? A. Communicate with the physicians to coordinate their orders. B. Assess the client to determine whether the client is capable of ambulation. C. Collaborate with the physical therapist to determine the client's ability. D. Instruct the client to ask the physicians for clarifications of instructions.

A. Communicate with the physicians to coordinate their orders.

A client on the medical-surgical unit is scheduled for several diagnostic tests. The nurse is concerned that the tests will be too tiring for the client. What would be the nurse's most appropriate action? A. Coordinate with the other disciplines to schedule the tests with adequate rest for the client. B. Instruct the client to refuse the diagnostic tests if the client becomes too fatigued. C. Coordinate with the other disciplines to determine if all the tests scheduled are necessary. D. Review the physician's progress notes to determine if any of the tests are not indicated.

A. Coordinate with the other disciplines to schedule the tests with adequate rest for the client.

A nurse manager has encountered resistance to a planned change. What is one way the nurse can overcome the resistance? A. Encourage open communication and feedback. B. Let the staff know that the change is mandated. C. Implement change rapidly and all at once. D. Tell the staff that if they don't like it, they can quit.

A. Encourage open communication and feedback.

The goals of health care reform include which? A. Focussing on cost containment with improved access and quality of services for everyone B. Controlling health care costs by providing limited services for more consumers of health care C. Improving quality of care while limiting access for the uninsured to control rising costs D. Decreasing health care services to provide all citizens with some access to care but control escalating costs

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

When doing discharge planning for an older adult client who had a stroke, what is the nursing priority? A. Plan reachable goals with the client and family. B. Help the client after discharge to establish goals. C. Realize that goals may not be met after discharge. D. Involve the family in discussing when the client will go home.

A. Plan reachable goals with the client and family.

A nurse recommends palliative care for a client who is being discharged following a diagnosis of cancer. What is the chief focus of this type of care? A. Relief from physical, mental, and spiritual distress B. Provision of a dignified death experience C. Occupational therapy D. Physical rehabilitation

A. Relief from physical, mental, and spiritual distress

A registered nurse is delegating activities to unlicensed assistive personnel (UAP) on a hospital unit. Which activities could this nurse normally delegate? Select all that apply. A. Transferring a client to another floor B. Giving a bed bath to a client C. Administering medications to clients D. Taking routine vital signs E. The determination of a nursing diagnosis for a client with breast cancer F. Planning education for a client with a colostomy

A. Transferring a client to another floor B. Giving a bed bath to a client D. Taking routine vital signs

A nurse suspects that a client may have a hearing problem. The nurse should attempt to consult: A. an audiologist. B. a clinical psychologist. C. an ophthalmologist. D. an optometrist.

A. an audiologist.

A client is being discharged from the hospital with terminal brain cancer and a life expectancy of 1 month. When planning this client's discharge, it is most important for the nurse to include a referral to which agency? A. hospice B. outpatient rehab C. support group D. home health

A. hospice

What intervention should be included in a plan of care to prevent pressure injury development in health care settings? A. implementing an every-2-hours turning schedule B. using a pressure-relieving support surface instead of turning the client C. using ring cushions for heels and elbows D. changing position at least once each shift

A. implementing an every-2-hours turning schedule

The nurse recognizes that the goals established for a client's discharge are more likely to be accomplished when: A. the client assists in developing the goals. B. the multidisciplinary team develops the goals. C. the nurse develops the goals. D. the physician develops the goals.

A. the client assists in developing the goals.

Which statement by a nurse case manager regarding this nurse's role in client care is most accurate? A. "Even though I do not provide care to clients, my work is very important." B. "I provide indirect care to my clients by coordinating their treatment with other disciplines." C. "Moving away from client care is a necessary step to advancing my career." D. "I provide a critical service that is necessary for financial reimbursement."

B. "I provide indirect care to my clients by coordinating their treatment with other disciplines."

A nurse has been asked to speak to a high school health class about expected trends in health care. Which statement should the nurse include when speaking to this class? A. "Client care is expected to become less complex as consumers call for excellence in basic care." B. "We can expect that technology is going to continue to change health care delivery." C. "Costs of health care are expected to plateau in the next 10 years." D. "Our country's demographics are beginning to stabilize."

B. "We can expect that technology is going to continue to change health care delivery."

Which therapist is most likely to focus on teaching a client to hold a toothbrush with an adaptive device and brush the teeth? A. A speech therapist B. An occupational therapist C. A respiratory therapist D. A physical therapist

B. An occupational therapist

An Indian client is admitted to a facility for treatment of pneumonia. Since admission, she has been unwilling to participate in care offered by the nursing staff but is too weak to provide her own care. The nurse is planning care for this client with a diagnosis of Bathing/Hygiene: Self-Care Deficit. What would the priority nursing intervention be? A. Assess the skin every day using the Braden scale. B. Assess the client's cultural views regarding hygiene and self-care. C. Assign a care provider who shares the same culture as the client. D. Delegate hygiene/bathing to an unlicensed assistive personnel (UAP).

B. Assess the client's cultural views regarding hygiene and self-care.

The nurse manager for the psychiatric unit sees that there are major conflicts between the day and night shift staff. The nurse manager suggests that each shift put aside their differences for a time and determine a common major goal. Which conflict resolution style does the nurse manager display? A. Competing B. Collaborating C. Smoothing D. Avoiding

B. Collaborating

Florence Nightingale introduced the concept of apprenticeship for nurses. Which statement is an example of this? A. Taking an online class at a university B. Completing clinical hours supervised by a nursing instructor C. Participating in a paid internship D. Passing the NCLEX exam

B. Completing clinical hours supervised by a nursing instructor

In anticipation of discharge, a nurse is teaching the daughter of an older adult client how to change the dressing on the client's venous ulcer. Which teaching strategy is most likely to be effective? A. Use a multimedia strategy that combines animation with narration. B. Demonstrate and explain the procedure and then have the daughter perform it. C. Explain the procedure clearly and slowly while providing multiple opportunities for the daughter to ask questions. D. Provide explicit written and verbal instructions and ask the daughter to explain back to the nurse how to perform the procedure.

B. Demonstrate and explain the procedure and then have the daughter perform it.

Which phrase best describes continuity of care? A. Serving the needs of children B. Facilitating transition between settings C. Providing single-episode care services D. Focusing on acute care in the hospital

B. Facilitating transition between settings

A client living alone has degenerative joint disease, hypertension, and neuropathy. It is difficult for the client to bathe, and the client's blood pressure is unstable. Which type of care would this client benefit from most? A. Ambulatory care B. Home care C. Respite care D. Acute care

B. Home care

A client has had a total knee replacement and will need to walk with crutches for six weeks. The client is being discharged home with a referral for home health care. What will the home care nurse need to assess during the initial assessment? A. Previous health status B. Home environment C. Costs of the visits D. Assistance of neighbors

B. Home environment

Which health care insurance program is most suitable for a client 68 years of age? A. Capitation B. Medicare C. Medicaid D. AmeriCare

B. Medicare

Which measure should a home health care nurse integrate into routine practice to minimize the potential for lawsuits? A. Integrate the client's learning needs and goals into plans of care. B. Perform thorough, accurate, and timely documentation. C. Have the client sign a waiver prior to the entry phase of a visit. D. Apply more conservative interventions than those used in a hospital setting.

B. Perform thorough, accurate, and timely documentation.

What role will the nurse play in transferring a client to a long-term care facility? A. Arrange for the client's belongings to remain at the hospital until discharge from the long-term care facility. B. Provide a verbal report to the nurse at the long-term care facility on the client, the hospital care, and the client's current condition. C. Inform the client that transferring should be a stress-free situation. D. Assure that the client's original chart accompanies the client.

B. Provide a verbal report to the nurse at the long-term care facility on the client, the hospital care, and the client's current condition.

Nurses with varying levels of experience possess leadership skills. A registered nurse walks out of the nurse manager's office after a meeting. The nurse reflects on the positive and negative feedback received from the manager regarding the nurse's three months of working on the unit. What nursing leadership skill is best illustrated by the nurse in this scenario? A. Problem solving B. Self-evaluation C. Communication D. Management

B. Self-evaluation

A hospitalized client asks the nurse for "some aspirin for my headache." There is no order for aspirin for this client. What will the nurse do? A. Ask the client's visitors if they have any aspirin for the client. B. State that an order from the doctor is legally required and check with the doctor. C. Go ahead and give the client aspirin, a common self-prescribed drug. D. Ask the client's family to bring some aspirin from home.

B. State that an order from the doctor is legally required and check with the doctor.

A nurse works with clients in a crisis intervention center. What ability would be most important for this nurse to develop? A. Ability to relate to coworkers on a professional level B. Strong communication and counseling skills C. High tolerance for frustration D. Well-developed technical skills

B. Strong communication and counseling skills

What is one way in which nurses can help shape health care reform? A. Do their job and do it well. B. Support legislation to improve care. C. Refuse to participate in organizations. D. Become a member of a support group.

B. Support legislation to improve care.

The nurse is caring for a client newly diagnosed with diabetes mellitus. Which is an appropriate element of discharge planning for the nurse to use? A. Create a complete plan for the client and inform them of what has been decided. B. Teach the client about prescribed medications and how to monitor blood sugars. C. Provide a plan that addresses all the client's current problems. D. Prepare the client for subsequent hospital admissions.

B. Teach the client about prescribed medications and how to monitor blood sugars.

Which type of skills is not needed for nursing leadership? A. Self-evaluation skills B. Technical skills C. Communication skills D. Problem-solving skills

B. Technical skills

The nurse is met in the staff lounge by the nurse who has been caring for the client team on this shift. The off-going nurse says, "Sorry, but I have to get out of here." The nurse then gives a quick overview of each client on the team and says, "All the rest is in the chart if you need anything." Which essential part of the handoff is missing? A. The oncoming nurse's chance to check intravenous (IV) sites and fluids B. The opportunity for the oncoming nurse to ask questions C. The chance for the oncoming nurse to assess the clients D. The oncoming nurse's opportunity to meet new clients

B. The opportunity for the oncoming nurse to ask questions

A client is diagnosed with mild dementia while in the hospital. In preparing for discharge, what should the nurse discuss with the family? A. The lack of free resources for care B. The possible need for home care C. The need for transfer to a long-term care facility D. Legal responsibility for the future

B. The possible need for home care

A new graduate is working at a first job. Which statement is most important for the new nurse to follow? A. Document lengthy entries using complete sentences. B. Use abbreviations approved by the facility. C. Use PIE charting, even if it is not the institution's charting method. D. Only document changes in the client's status.

B. Use abbreviations approved by the facility.

The medical chart of a newly admitted client notes a penicillin allergy, yet the physician has just written an order for an antibiotic in the same drug family after reviewing the client's wound culture and sensitivity. How should the nurse respond to this situation? A. Discuss the severity, signs, and symptoms of the drug allergy with the client in order to ascertain the risks of administration. B. Withhold the medication until the potential drug allergy has been addressed by the care team. C. Substitute an antibiotic with similar action, but one that is from a different drug family. D. Administer the medication and increase the frequency of assessments in the hours that follow.

B. Withhold the medication until the potential drug allergy has been addressed by the care team.

A community health nurse provides information to a client with newly diagnosed multiple sclerosis about a support group at the local hospital for clients with the disease and their families. Providing this information is an example of: A. conferring. B. a referral. C. reporting. D. a consultation.

B. a referral.

The nurse notices a student preparing to enter the room of a client with pulmonary tuberculosis with only gloves on. What is the appropriate nursing intervention? A. teach that a gown and shoe coverings must be worn in addition to gloves B. remind the student that a fitted N95 respirator is required C. offer the student a mask D. do nothing, as the precautions observed are appropriate

B. remind the student that a fitted N95 respirator is required

A nurse is caring for a 17-year-old pregnant teenager who needs to obtain assistance with essential baby items such as a crib. The client mentions not having any income from a job. The nurse should encourage the client to go to a: A. resale or thrift shop. B. social welfare office. C. rental equipment store. D. visiting nurse from a clinic.

B. social welfare office.

Which is the most accurate definition of urgent care? A. Care provided in an office that is staffed by several doctors B. Medical and nonmedical care for chronic illnesses C. A type of ambulatory care that treats people who walk in with illnesses and minor trauma D. Care provided to clients in their homes after they are discharged

C. A type of ambulatory care that treats people who walk in with illnesses and minor trauma

Which refers to a person's ability to find and to receive care from a health care provider? A. Access to clinics B. Access to doctors C. Access to health care D. Access to nurses

C. Access to health care

The nurse is using an interpreter to communicate with a client who speaks a different language. What would be the best way to choose an interpreter for this client? A. The interpreter should speak in a loud voice. B. The interpreter should conduct the conversation quickly to avoid misinterpretation. C. The interpreter should understand the health care system. D. The interpreter should always make direct eye contact.

C. The interpreter should understand the health care system.

A client informs the nurse about leaving the health care facility because the client is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and further testing and evaluations are scheduled. Which action by the nurse would be most appropriate to prevent false imprisonment? A. Call the health care provider to speed up the discharge process. B. Restrain the client to prevent from leaving. C. Ask the client to sign a release without medical approval. D. Tell the client that the client will not be able to get access again.

C. Ask the client to sign a release without medical approval.

The charge nurse on a unit receives a report that a licensed practical nurse (LPN) is taking clients' narcotics and hiding them in the nurses' lounge. The charge nurse disregards the report and continues to work on a scheduled task. Which conflict resolution style is the charge nurse using? A. Compromising B. Collaborating C. Avoiding D. Accommodating

C. Avoiding

A new nurse is considering getting a job in either an acute care setting or a home care setting. Which statement about these care settings is most accurate? A. Clients are encouraged to help each other in the acute care setting. B. Nurses work more as team members in the home care setting. C. Clients play a large role in helping themselves in the home care setting. D. Good communication skills are unnecessary in the home care setting.

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

A single parent age 17 years, with one child and pregnant with a second, has the mental age of a 12-year-old. The home care nurse's greatest concern in caring for this client should be the client's ability to do which? A. Bond with the children B. Physically perform care needed by the children C. Cognitively understand how to care for the children D. Receive financial aid

C. Cognitively understand how to care for the children

A community-based nurse acts as a case manager for a small town about 60 miles from a major healthcare center. What is the most important factor of community-based nursing for this nurse to be knowledgeable about? A. Possible charges for any services provided B. Transportation costs to the healthcare center C. Community resources available to clients D. Eligibility requirements for services

C. Community resources available to clients

The nurse is having an exceptionally busy shift on an obstetrical unit. Which task is the nurse justified in delegating to an unlicensed care provider? A. Assessing the size and quantity of clots that are in a client's bedpan and informing the nurse B. Giving an anti-inflammatory medication to a client who is eight hours postdelivery C. Emptying a client's Foley catheter bag and reporting the volume to the nurse D. Helping a first-time mother achieve a good latch when breastfeeding the infant

C. Emptying a client's Foley catheter bag and reporting the volume to the nurse

The community-based nurse is assessing a new client and the home environment. What is a responsibility of the community-based nurse at this initial visit? A. Encourage the client and family to use local stores to support their community. B. Encourage the client and family to use the internet to find local resources. C. Encourage the client and family to contact appropriate community resources. D. Encourage the client and family to contact their religious group as a resource.

C. Encourage the client and family to contact appropriate community resources.

Which is the acute care setting for people who are too ill to care for themselves at home, are severely injured, or require surgery? A. Day care centers B. Primary care centers C. Hospitals D. Ambulatory care centers

C. Hospitals

A nurse is caring for a client with pneumonia. Which task is most appropriate for the nurse to delegate to an experienced unlicensed assistive personnel (UAP)? A. Instructing the client about the need to alternate activity with rest B. Administering nebulizer treatments as needed C. Obtaining vital signs every 4 hours D. Assessing for shortness of breath

C. Obtaining vital signs every 4 hours

A nurse working on a medicine unit is mentoring a new graduate. The new nurse asks why it is necessary to perform an assessment on the same client twice during a 12-hour shift. What would be the nurse's best response to the new graduate? A. We have always done it this way for as long as I have worked here. B. It is policy and we have to follow the facility's rules. C. Ongoing data collection is critical to the deletion or modification of old problems and finding new ones. D. It will give you lots of chances to practice your assessment skills.

C. Ongoing data collection is critical to the deletion or modification of old problems and finding new ones.

The nurse is providing care for a client who is ordered nothing by mouth (n.p.o.). What is an important nursing intervention? A. Encourage the family to eat at the bedside. B. Keep the water pitcher at the bedside. C. Provide frequent mouth care. D. Have the client fill out a menu in advance.

C. Provide frequent mouth care.

A recently graduated nurse is caring for a client who was just given the diagnosis of pancreatic cancer. The client asks the nurse to help her understand this death sentence and tell her why God did this to her, as she has lived a good life all along. The nurse, not being comfortable as a spiritual counselor, should do which of the following? A. Tell the client she does not want to talk about this because she is not comfortable doing so B. Tell the client that she will talk about this later C. Suggest to the client that she can call her spiritual advisor to help give her counsel D. Change the subject to avoid focusing on the new diagnosis

C. Suggest to the client that she can call her spiritual advisor to help give her counsel

Which organization audits charts regularly? A. National League for Nursing B. Sigma Theta Tau International C. The Joint Commission D. American Nurses Association

C. The Joint Commission

A client diagnosed with lung cancer has been given a prognosis of 3 to 4 months of life. The nurse discusses hospice care with the client and family. Which aspect of the client's health status indicates that hospice care is appropriate? A. The client has a diagnosis of metastatic cancer B. The client wishes to treat disease with complementary alternative medicine C. The client has a life expectancy of less than 6 months D. The client does not have family or a support system to provide care

C. The client has a life expectancy of less than 6 months

In general, how do most people view change? A. By how it affects the cohesiveness of the group B. By how much it will cost in time and resources C. By how it will affect others on the staff D. By how they are affected personally

D. By how they are affected personally

The registered nurse (RN) wants to delegate measuring a client's urinary output to an unlicensed assistive personnel (UAP). Which factors should the nurse consider before delegating the task? A. The context of the other patient needs, the desired outcome, and autonomy of the patient B. Predictability of the UAP, the amount of time required for the task, and RN's skill level C. The stability of the patient's condition, potential for harm, and complexity of the activity D. The complexity of the activity, age of the UAP, and predictability of the outcome

C. The stability of the patient's condition, potential for harm, and complexity of the activity

The nurse knows the term perioperative phase refers to care given to the client: A. immediately after the operative phase. B. from the start of surgery until its conclusion. C. before, during, and after the operative phase. D. immediately before an operative procedure.

C. before, during, and after the operative phase.

A BSN nurse is discussing the benefits of a BSN to high school students. Which statement made by the nurse would be most appropriate? A. "Most nontraditional students obtain a BSN." B. "BSN nurses only work in the hospital." C. "BSN programs attract the most males." D. "Many nursing management jobs require a BSN."

D. "Many nursing management jobs require a BSN."

Which client would a nurse correctly refer to Medicare services? A. A low-income family with infants needing immunizations B. A client with a disability C. A client with cancer D. A 66-year-old client with diabetes

D. A 66-year-old client with diabetes

The nurse is caring for several clients with chronic conditions that need to be evaluated for long-term care. After evaluating each client, the nurse determines which client is most appropriate to receive long-term care? A. A client newly diagnosed with rheumatoid arthritis requiring medication monitoring. B. A client with severe back injury as a result of a car accident needing ongoing physical therapy. C. A client diagnosed with pneumonia requiring mechanical ventilation. D. A client who suffered a stroke who has mobility issues and problems completing activities of daily living (ADLs).

D. A client who suffered a stroke who has mobility issues and problems completing activities of daily living (ADLs).

The nurse is evaluating charts of clients who are to be discharged to outside care. Which client would the nurse feel is most appropriate for a referral to hospice care? A. A frail older adult with Alzheimer disease requiring long-term care and family. B. A child diagnosed with Turner syndrome with cardiomyopathy. C. A postoperative client with diabetes who requires wound care and monitoring for infection. D. A client with terminal pancreatic cancer and loved ones.

D. A client with terminal pancreatic cancer and loved ones.

The nurse has recently been promoted to nurse manager on an oncology unit and has decided to be the sole decision maker regarding issues that concern the unit. Which type of leadership style is the nurse embodying? A. Democratic B. Laissez-faire C. Quantum D. Autocratic

D. Autocratic

The registered nurse on a busy telemetry floor is delegating tasks to an unlicensed assistive person (UAP). Which task is appropriate for the UAP to complete? A. Taking an order over the telephone from a physician B. Assessing a client's wound C. Inserting an indwelling urinary catheter D. Bathing a combative client

D. Bathing a combative client

A client who does not speak the dominant language is admitted to the hospital. Which cultural intervention would be most appropriate by the nurse? A. Minimize eye contact to avoid being offensive. B. Speak loudly and slowly so that the client can better understand. C. Ask the closest family member to interpret. D. Call for an interpretor who is familiar with health care.

D. Call for an interpretor who is familiar with health care.

Two staff nurses on a unit disagree with one another over certain key aspects of providing client care. The nurse manager of the unit arranges a meeting with the charge nurse and the two staff nurses at a mutually agreed-upon time to discuss this situation. This activity is most accurately described as what? A. Problem solving B. Delegation C. Client protection D. Conflict resolution

D. Conflict resolution

A client is diagnosed with a terminal illness. Who is usually responsible for deciding what, when, and how the client should be told? A. Family B. Clergy C. Nurse D. Health care provider

D. Health care provider

The nurse is planning the discharge of a client who had surgery for a left hip replacement. The client is being discharged from the hospital to the home and requires a walker and high-rise toilet seat. Which type of home health care service does the client require? A. Custodial services B. Hospice services C. High-technology pharmacology services D. Home medical services

D. Home medical services

A client being prepared for discharge to home will require several interventions in the home environment. The nurse informs the discharge planning team—consisting of a home health care nurse, physical therapist, and speech therapist—of the client's discharge needs. This interaction is an example of which professional nursing relationship? A. Nurse-client B. Nurse-client-family C. Nurse-nurse D. Nurse-health care team

D. Nurse-health care team

Which action by the nurse could result in the accrediting body withdrawing the health agency's accreditation? A. Recording nursing interventions B. Documenting clients' health histories and discharge planning C. Identifying nursing diagnoses or clients' needs D. Omitting clients' responses to nursing interventions

D. Omitting clients' responses to nursing interventions

The nurse manager for a surgical unit is planning a significant change in how the unit functions. Which action by the nurse manager would be most effective in helping overcome resistance to the planned change? A. Refuse to hear any discussion about adopting the change. B. Demand loyalty and commitment from the staff in adopting the change. C. Threaten to end the staff's employment if they do not adopt the change. D. Provide incentives for adopting the change, such as time off.

D. Provide incentives for adopting the change, such as time off.

A new unlicensed assistive personnel (UAP) is preparing to ambulate an obese client. The registered nurse (RN) is concerned about the UAP's ability to safely ambulate the client. Which would be the nurse's most appropriate action? A. Tell the UAP to ask the client whether the client is comfortable with the UAP assisting ambulation. B. Tell the UAP that a different UAP should ambulate the client. C. Tell the UAP not to ambulate the client at this time. D. Tell the UAP that the RN will assist the UAP with the client's ambulation.

D. Tell the UAP that the RN will assist the UAP with the client's ambulation.

The registered nurse (RN) wants to delegate a task to an unlicensed assistive personnel (UAP) but is unsure if the task can be delegated. What is the best resource for the RN to use in determining if the task is appropriate? A. A more experienced nurse working on the same unit B. The medical practice act website C. A nurse mentor or a nurse preceptor D. The nurse practice act or facility's policy and procedures

D. The nurse practice act or facility's policy and procedures

Which is a cultural norm of the health care system? A. There is a tolerance of tardiness, disorderliness, and disorganization. B. The omnipotence of technology is yet to be recognized. C. There are rigid procedures attending birth and death. D. There is the use of a systematic approach and problem-solving methodology.

D. There is the use of a systematic approach and problem-solving methodology.

Why are quality-assurance programs important in nursing? A. They allow increased retention of qualified nurses. B. They specify how resources are used or not used. C. They facilitate increased enrollment in educational programs. D. They enable nursing to be accountable for the quality of care.

D. They enable nursing to be accountable for the quality of care.

The Nursing Agenda for Health Care Reform (American Nurses Association [ANA]) identifies the recipients of health care. This reform's main focus is on: A. accurate assessment in the acute health care setting. B. high-quality disease management. C. better connectivity through the use of technology. D. health promotion.

D. health promotion.

A nurse is caring for a client with severe lower back pain. The doctor orders administration of an analgesic as a stat dose. When should the nurse administer the medication? A. once B. as needed C. for a specified number of days D. immediately

D. immediately

A nurse is successful in promoting change on the nursing division. This nurse would be considered a: A. manager. B. specialist. C. guide. D. leader.

D. leader.

The nurse is caring for a 65-year-old widower whose wife died 4 months ago. He tells the nurse that he is not doing well and that no one will talk with him about his wife. What could the nurse do to help the client? A. refer him to a religious support group B. refer him to a consciousness-raising group C. refer him to an encounter group D. refer him to a support group

D. refer him to a support group