NCLEX-RN

What is one of the most significant trends in health care today? increased length of hospital stays shift from hospitals to community-based care emphasis on disease management narrowing of the areas for nursing practice

The shift to community-based care is related to the public's desire to participate more actively in health care decisions, issues, and choices.

The nurse is providing health-promotion teaching to a group of parents of preschoolers at a local day care. What information would the nurse include in this education session? Select all that apply. Preschoolers are capable of taking a bath independently. Encourage children to select their own clothing to wear each day. Parents will need to supervise tooth-brushing and be responsible for flossing. Treat any toileting accidents in a matter-of-fact manner and assist the child in getting dry clothing. Preschoolers only need to wear bicycle helmets if they are going on long rides.

Preschoolers are becoming more independent and need to be allowed to pick out their own clothing, brush their teeth with adult supervision, and take care of their own toileting. If the child has an accident, treat it in a matter-of-fact manner and do not make a big deal out of it. Helmets are worn every time the child rides a bicycle, regardless of distance.

An employer establishes a physical exercise area in the workplace and encourages all employees to use it. This is an example of which level of health promotion? primary prevention secondary prevention tertiary prevention passive prevention

Primary prevention precedes disease and applies to healthy clients. Secondary prevention focuses on clients who have health problems and are at risk for developing complications. Tertiary prevention focuses on rehabilitating clients who already have a disease or disability. Passive prevention enables clients to gain health as a result of others' activities without doing anything themselves.

A client's surgical wound dehisced when a nurse removed the staples before a health care provider prescription was given. Following root cause analysis, which organizational response is appropriate? Select all that apply. The nurse's actions will be deemed intentionally reckless. The nurse will be found to have committed a human error. Systems around the documentation of prescriptions will be reviewed. The nurse will be disciplined by an impartial review board. The nurse will be sued by the hospital for malpractice.

The nurse's action will likely be categorized as a human error. There is no evidence of malice (intentional recklessness) or failing to appreciate the gravity of an action (at risk behavior). As such, legal or disciplinary actions are an unlikely response. As with any error, systemic factors must be examined. There is no suggestion in this scenario that there was any confusion with the applicable provider prescription for care.

Which individual has experienced the consequences of deinstitutionalization? A man who was denied inpatient psychiatric treatment by his health maintenance organization (HMO) A woman who was transferred from a psychiatric hospital to the community because of the hospital's impending closure A man who has been unable to obtain health insurance but who receives Medicare benefits A woman who has been the frequent object of stigma due to her history of psychiatric illness

The process of deinstitutionalization involves moving chronically mentally ill clients from state psychiatric hospitals back to their homes or to community-supervised facilities. Deinstitutionalisation is the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability.

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? Need for control over a situation Nonjudgmental attitude Respect for client's differences Ability to improvise

A nurse working in home care needs to be comfortable with the minimal control that he or she has over the lifestyle, living situation, and health practices of the clients being served. In addition, the home care nurse must demonstrate a nonjudgmental attitude and convey respect for the clients' beliefs, even if they differ sharply from those of the nurse. Moreover, the home care nurse must be able to improvise when providing care in the home because the kind of equipment and supplies or resources usually available in acute care settings are often not available in the home.

The hospital nurse is providing discharge instructions to the caregivers of a 10-year-old child with a new prosthetic limb. Which finding will cause the nurse to contact the primary health care provider? The child was diagnosed with hypothyroidism as an infant. The child is being discharged home with the caregiver. The child's white blood cell (WBC) count is 9,000/mm3 (9 x 109/L). The child's blood pressure is 115/75 mm Hg.

The nurse would question the child with a new prosthetic limb being sent home immediately from the hospital. Sending the child to a rehabilitation unit is best to facilitate usage of the prosthetic limb. The care in a rehabilitation unit involves an interdisciplinary approach that assists the child to reach his or her potential and achieve developmental skills. A diagnosis of hypothyroidism in infancy would not be concerning to the use of a prosthetic. The WBC and blood pressure are both within normal range for a client of this age. The normal WBC is 5,000 to 10,000 mm3 (5 to 10 x 109/L) and blood pressure range is 95-120/55-76 mm Hg.

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

Use abbreviations, but only those that are commonly accepted and approved by the facility. All documentation requires proper grammar and writing techniques. The nurse should be using the particular charting method for the employing institution. All care and observations should be documented - not only changes in a client's status.

Which circumstance likely requires the most documentation and communication by the nurse? An older adult is being transferred from a subacute medical unit to a new long-term care facility following recovery from pneumonia. A client is being discharged home following a laparoscopic appendectomy 2 days earlier. A client is being transferred from one medical unit of the hospital to another to accommodate another client on isolation precautions. A client is returning to an assisted-living facility following a colonoscopy earlier that day.

Transfer from the hospital setting to a long-term care facility is likely to require significant documentation and communication from the nurses facilitating the transfer. This may include copying the chart or summarizing a large amount of relevant data. Transfers within a hospital typically require somewhat less documentation and communication, while discharges home or to an existing facility may not require a formal report of any type.