NUR 212 exam 2 practice questions

A client has been admitted in the emergency care unit with conditions of respiratory distress and pneumonia. The client's condition worsens and requires mechanical ventilation. While visiting this client in the hospital, the family observes members of the health care team washing their hands upon entering and leaving the room. By implementing recommended hand hygiene measures, which organization's goals is the health care team supporting? A. The Joint Commission B. The National Council of State Boards of Nursing (NCSBN) C. Institute of Medicine (IOM) D. Agency for Healthcare Research and Quality (AHRQ)

A. The Joint Commission One of The Joint Commission National Patient Safety Goals (NPSGs) prioritizes the reduction of health care-associated infections.

A client who has no health insurance asks if there is any chance that they will benefit from healthcare reform. What should the nurse tell the client about the goal of the Patient Protection and Affordable Care Act (PPACA)? A. The goal of the Patient Protection and Affordable Care Act is to provide affordable healthcare to U.S. citizens who previously had no access to health insurance. B. The Patient Protection and Affordable Care Act applies only to people who are eligible for Medicaid, so it will not apply to the client's situation. C. The Patient Protection and Affordable Care Act applies only to people who are eligible for Medicare, so it will not apply to the client's situation. D. The goal of the Patient Protection and Affordable Care Act is to provide affordable healthcare to U.S. citizens who have at least three dependents.

A. The goal of the Patient Protection and Affordable Care Act is to provide affordable healthcare to U.S. citizens who previously had no access to health insurance. PPACA's goal is to provide affordable health care to citizens who previously had no access to health insurance. Additionally, its goal is to reduce insurance companies' control on health care and to provide more assistance to senior citizens on fixed incomes. The PPACA does not apply only to those on Medicaid or those eligible for Medicare, and it does not affect eligibility based on the number of children a person has.

Which intervention best demonstrates the L & D nurse is respectful of a client who is deaf and in early labor? A. Write down information on a piece of paper that the client can keep. B. Seek assistance from another healthcare professional who can converse in sign language. C. Utilize the labor coach so he or she can interpret and relay information to the client. D. Utilize hand signals like in charades to try to communicate important pieces of information.

B. Seek assistance from another health care professional who can converse in sign language. Cultural differences occur across not only different ethnic backgrounds but also different sociodemographic groups. A parent who has been deaf since birth, for example, expects her deaf culture to be respected by having health care professionals locate a sign language interpreter for her while she is in labor. If an interpreter cannot be located, writing down questions and answers is an alternative, assuming the parent has the ability to read and comprehend while dealing with labor contractions. Use of friends and family members is not considered to be the best option since many family/friends find it difficult to interpret medical terms. Hand signals can help in an emergency; however, it not the best way to interpret questions/comments from a laboring woman who is deaf.

A registered nurse(RN) on the oncology floor is busy with another client, so the RN delegates care of a client to a coworker, a licensed practical nurse (LPN). The client that the LPN begins caring for requires a three-hour chemotherapy infusion. Which statement is in accordance with the Nurse Practice Act? A. The LPN may administer the chemotherapy drug if the LPN passed the hospital's chemotherapy administration course. B. The chemotherapy will need to be held until another RN can care for the client. C. A chemotherapy certified RN must begin the chemotherapy, then the LPN may monitor the client. D. The physician must administer the drug.

C. A chemotherapy certified RN must begin the chemotherapy, then the LPN may monitor the client. According to the Nurse Practice Act, a specially trained RN (not LPN) must begin the chemotherapy infusion. The LPN can then monitor the client while the drug infuses

The nurse is preparing a hospitalized child for a lumbar puncture. The health care provider states the procedure will be performed in the child's hospital room. To advocate for the child, what should the nurse inform the health care provider? A. "We will have to have the parents hold the child down because there is not enough assistance on the floor." B. "The parents want to be present during the procedure, and I informed them that this is not the policy of our facility." C. "I will prepare the hospital room for the child, because that room is where the child will feel most comfortable." D. "I will have the procedure prepared in the treatment room, so that the child may view the hospital room as safe and secure."

D. "I will have the procedure prepared in the treatment room, so that the child may view the hospital room as safe and secure." In the hospital, all invasive procedures should be performed in the treatment room or a room other than the child's room. The child's room should remain a safe and secure area.

A nursing student is preparing for a class presentation addressing the collaborative practice model. Which of the following would the student expect to include? A. A discussion of a centralized organizational structure B. Participation in decision making that is shared by all involved C. Accountability that is primarily attributed to the patient D. Nurses and physicians playing major roles in clinical decisions

B. Participation in decision-making that is shared by all involved The collaborative practice model involves all care providers, including nurses, physicians, and ancillary health personnel as well as the patient functioning within a decentralized organizational structure to collaboratively make clinical decisions. The collaborative model promotes shared participation, responsibility, and accountability in a health care environment that strives to meet the complex health care needs of the public.

A healthcare team has been challenge to determine what other facilities are doing to decrease the number of hospital-acquired infections so that an action plan can be created to decrease the rate in their facility. What will the healthcare team do to achieve this challenge? A. Root cause analysis B. Best Practices C. Benchmarking D. Patient outcome evaluation

C. Benchmarking

A Nurse Manager would like to determine how well the team is doing in terms of meeting the hospital's goal of increased patient satisfactory. What action should manager take after determining best practices? A. Re-evaluate B. Make a judgement about the quality of the team's work C. Capture when the team is and is not using best practices and the outcomes D. Take corrective action

C. Capture when the team is and is not using best practices and the outcomes

uses statistical analysis to calculate the degree of deviation from the standard. A. Total Quality Management (TQM) B. Toyota Production System (TPS) C. Six Sigma D. Lean

C. Six Sigma

When a hospitalized client is in contact precautions, which action is necessary? A. The client's door should be closed. B. Masks should be worn when caring for the client. C. The client should be placed in a private room when possible. D. The client should be in a room with negative air pressure.

C. The client should be placed in a private room when possible. When possible, the client requiring contact isolation is placed in a private room to facilitate hand hygiene and decreased environmental contamination. Masks are not needed and doors do not need to be closed.

What is priority for the nurse to do when transporting a newborn back to the mother after completing the hearing test? A. Inform the mother of the results of the hearing test completed on the newborn. B. Compare the identification bracelets prior to leaving the newborn with the mother. C. Explain the procedure completed on the newborn to the mother. D. Determine if it is time for the mother to breastfeed the newborn and assist as needed.

B. Compare the identification bracelets prior to leaving the newborn with the mother. Accurate infant identification is imperative in hospital protocols. The nurse should always compare the newborn's identification bracelet with that of the mother to ensure that the correct newborn is being given to the correct mother. The nurse will provide the results of the test and assist with breastfeeding; however, these are not priority as the nurse could come back if needed. The nurse should explain a procedure before it is completed.

A woman in her 20s or 30s with no symptoms or family history of breast cancer should have a clinical breast examination every _____ years. A. 10 B. 5 C. 1 D. 3

D. 3 The American Cancer Society (ACS) recommends that a woman who is in her 20s or 30s have a clinical breast examination every 3 years.

When comparing the theories of mental illness popular in ancient Greece with those popular in the Middle Ages, which is more applicable to the Middle Ages? A. Emotional disorders were believed to be an organic dysfunction. B. Treatment included sedation, good nutrition and hygiene, and music and recreation. C. Mental illness was considered a disturbance of the four body fluids, or "humors." D. Belief in demonic possession and exorcism was common.

D. Belief in demonic possession and exorcism was common. While some of these answers are true of both ancient Greece and the Middle Ages, belief in demonic possession and exorcism was more common in the Middle Ages.

A nurse is working on developing cultural humility. In what sequence, from first to last, would the nurse apply the steps for developing cultural humility? All options must be used.. -Seek resources to increase understanding of different sociocultural groups -Recognize the influence of clients' culture on their health status. -Engage in cross-cultural interactions with others from diverse backgrounds. -Advocate for social justice to eliminate health disparities.

1Recognize the influence of clients' culture on their health status. 2Seek resources to increase understanding of different sociocultural groups. 3Advocate for social justice to eliminate health disparities. 4Engage in cross-cultural interactions with others from diverse backgrounds.

A nurse manager is discussing a nurse's social media post about an interesting client situation. The nurse states, "I didn't violate client privacy because I didn't use the client's name." What response by the nurse manager is most appropriate? A. "Any information that can identify a person is considered a breach of client privacy." B. "You may continue to post about a client, as long as you do not use the client's name." C. "All aspects of clinical practice are confidential and should not be discussed." D. "The information being posted on social media is inappropriate. Make sure to discuss information about clients privately with friends and family."

A. "Any information that can identify a person is considered a breach of client privacy."

Which is a result of deinstitutionalization? A. A "revolving door" of repetitive hospital admissions B. An increase in available community resources C. The improvement of the ability of people diagnosed with mental illness to achieve independence D. An improvement in community-based programs' ability to get funding

A. A "revolving door" of repetitive hospital admissions One result of deinstitutionalization is the "revolving door" of repetitive hospital admission without adequate community follow-up.

A nurse is providing care to several assigned clients and decides to delegate the task of morning vital signs to unlicensed assistive personnel. The nurse would assume responsibility and refrain from delegating this task for which client? A. A client with a high fever receiving intravenous fluids, antibiotics, and oxygen B. An older adult with pneumonia who is being discharged to the son's home tomorrow C. A middle-aged client who had abdominal surgery 3 days ago and is ambulating in the hall D. An adult client who is being treated for kidney stones

A. A client with a high fever receiving intravenous fluids, antibiotics, and oxygen For delegation, the circumstances must be right. The health condition of the client must be stable. The client with a high fever receiving intravenous fluids, antibiotics, and oxygen is the least stable of the clients listed and should be assessed by the nurse. Delegation of taking vital signs would be appropriate for all of the other client's described.

Which is the most restrictive setting in the continuum? A. Acute inpatient hospitalization B. Crisis intervention C. Residential care D. Partial hospitalization

A. Acute inpatient hospitalization Of the settings listed, acute inpatient hospitalization involves the most intensive treatment and is considered the most restrictive setting in the continuum. Inpatient treatment is reserved for acutely ill clients who, because of a mental illness, meet one or more of three criteria: (1) high risk for harming themselves, (2) high risk for harming others, or (3) unable to care for their basic needs.

What action by a nurse best promotes the ethical principle of justice? A. Advocating for enhanced mental health services in an underserved neighborhood B. Informing a client who is competent that the client has the right to discontinue treatment C. Clearly describing the potential adverse effects of a client's new pharmacologic treatment D. Obtaining written, informed consent from a client who has agreed to be in a research study

A. Advocating for enhanced mental health services in an underserved neighborhood Justice focuses on the fair and equitable distribution of risks and benefits, such as advocating for necessary care among a population or community.

A home health care nurse is providing visits for a 65-year-old widower who needs some assistance with performing activities of daily living (ADLs) but is living independently. What option might the nurse recommend that would enable the client to maintain independence for as long as possible? A. Aging in place B. Medical home C. Long-term care facility D. Transitional subacute care facility

A. Aging in place The nurse might recommend for this client aging in place. In this type of care, clients remain in their homes or move to a living space, such as an apartment, while they are still physically able to care for themselves, and then have access to services that are a part of the health care community as needed.

A nurse was informed that a family member was involved in a car accident and transported to the emergency department in the same facility. What action by the nurse best demonstrates understanding of client privacy? A. Calling the client information desk to find out the room number of the family member B. Finding the emergency medical technicians who transported the family members and inquiring about the injuries C. Asking the emergency department nurse for information on the family member D. Accessing the electronic health record of the family member to find out extent of injury

A. Calling the client information desk to find out the room number of the family member Getting information from other health care providers violates client privacy. Health care workers must follow the same guidelines to accessing health information on people not assigned to their care.

An older adult client in the hospital has not had a bowel movement for 3 days and the nurse planned to give the client a stool softener this morning. The client declined the medication, however, stating that the client's spouse will be bringing the client a herbal medication later in the day that is often used by members of their ethnic group. Which reaction demonstrates cultural care accommodation/negotiation? A. Documenting the client's wishes and informing the client's care team what the client will be taking B. Teaching the client about the risks associated with nonstandard doses of herbal remedies C. Teaching the client about the benefits of the medication that was ordered for the client D. Ensuring that the herbs are sent to the hospital pharmacy for clearance before the client is allowed to take them

A. Documenting the client's wishes and informing the client's care team what the client will be taking In cultural care accommodation/negotiation, the nurse adapts nursing care to accommodate the client's beliefs or negotiate aspects of care that would require the client to change certain practices.

An adolescent receiving chemotherapy has lost all hair and is sad about self-image. Which action should the nurse take to support this adolescent and involve the client in decision making? A. Encourage the adolescent to select hats or wigs to fit one's personality. B. Refer the adolescent to a peer support group. C. Have a Child Life specialist work with the adolescent. D. Support the adolescent's choice of comfortable clothing.

A. Encourage the adolescent to select hats or wigs to fit one's personality. the nurse should encourage the adolescent to choose wigs, hats, or scarves that fit his or her personality or even meet a goal of doing something the adolescent would not have dared to before. This could be a wig of different hair color or a big floppy hat with sequins. Whatever the choice, this gives the adolescent a feeling of being in control of the situation and able to make the decisions

A male nurse is assigned to care for a female client with a new colostomy. Upon entering the room, the spouse tells the nurse that it is considered immodest for a woman's body to be seen by any male that is not her husband in their Muslim culture. Which actions demonstrate culturally competent nursing care in this situation? Select all that apply. A. Explore the possibility of a female nurse being willing to swap clients. B. Explain that it is discriminatory to not accept male nursing care. C. Report to the charge nurse to make them aware of the situation. D. Notify the facility patient-advocate to make them aware of the situation. E. Explain that the unit is made up of mostly male nurses so it may not be possible.

A. Explore the possibility of a female nurse being willing to swap clients. C. Report to the charge nurse to make them aware of the situation. D. Notify the facility patient-advocate to make them aware of the situation.

Sylvia was informed that a student nurse failed to report a blood glucose level of 49 to the primary nurse. The primary nurse blamed the student nurse for putting the patient at risk. Which force is most influential? A. Nurse Practice Act B. Shared Governance C. Magnet Status

A. Nurse Practice Act In this case, the NPA states that the primary licensed nurse is responsible for all aspects of patient care and therefor should have ask the student for a report on the BG levels

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

A. Official or public agency

Which type of setting is used for clients who continue to need supervision but not long-term admission? A. Partial (day) hospitalization B. Acute care C. Voluntary commitment D. Nursing home

A. Partial (day) hospitalization

A client who just underwent a mastectomy is due to arrive at the post-surgical care unit. Which actions should the nurse prioritize when attempting to establish an effective relationship with the client? A. Recognize and address the client's anxiety. B. Address the client's potential learning needs. C. Assess the client's knowledge of their activity limitations. D. Explain and answer questions about the Health Insurance Portability and Accountability Act (HIPAA).

A. Recognize and address the client's anxiety.

The is a mindset and a cultural approach to innovation, that establishes mechanisms to encourage and reward innovative ideas. A. Total Quality Management (TQM) B. Toyota Production System (TPS) C. Six Sigma D. Lean

A. Total Quality Management (TQM)

A middle-aged nurse is concerned about a potential shortage of nurses when the baby boomer generation retires. What proactive intervention can the nurse take to address this anticipated deficit of nurses? A. develop a community program related to healthy nutrition and exercise B. recruit more nurses to the acute care facility C. encourage parents to immunize their children D. lobby to increase the retirement age

A. develop a community program related to healthy nutrition and exercise Promotion of healthy habits and nutrition/exercise will be able to decrease some of the risk factors leading to acute and chronic illnesses and will lead to a decrease in hospital admissions. If effective, it would contribute to the management of issues that require an increase in the number of nurses required.

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 physician develops the goals. C. the nurse develops the goals. D. the multidisciplinary team develops the goals.

A. the client assists in developing the goals.

The nurse is caring for a child who is nearing death. When assisting the child and family to make end-of-life decisions, what practices should be incorporated? Select all that apply. A. Limit the amount of time spent discussing this topic with the child's siblings. B. Ask the child what things he or she would like to see done. C. Assess the family's cultural requests. D. Encourage the child's parents to make the decisions to limit possible conflict with the child. E. Ask the child what concerns or fears he or she may have.

B. Ask the child what things he or she would like to see done. C. Assess the family's cultural requests. E. Ask the child what concerns or fears he or she may have. Open communication during the period leading up to the child's death is important. The child's preferences, concerns, fears, and beliefs need to be assessed. The findings should be incorporated into the plan of care whenever possible. Limiting communication is problematic. The child — with age and maturity taken into account — should be engaged in the decision making.

A terminally ill client has a health care directive (advanced directive) that indicates "do not intubate" in the event of respiratory failure. The client is now unresponsive and the family requests that "everything be done" to support the client's breathing. What action(s) should the nurse take in this situation? Select all that apply. A. Arrange with the team to perform a "slow code" to alleviate the family's fears about nothing being done while still complying with the client's wishes. B. Request the health care provider speak with the family related to prognosis and realistic expectations should intubation be performed for the client. C. Show the health care directive to family members and explain that their wishes are not the team's concern. The client's wishes must be respected. D. Interview the family members about their wishes for spiritual and psychological supports related to the anticipated death and dying process. E. Request a consult with the ethics team to speak with the nurses and health care providers involved in the client's care to resolve the ethical dilemma.

B. Request the health care provider speak with the family related to prognosis and realistic expectations should intubation be performed for the client. D. Interview the family members about their wishes for spiritual and psychological supports related to the anticipated death and dying process. Because the client has a health care directive (advanced directive) in place, this document guides the treatment provided. However, the health care team still engages with the family about their concerns and wishes for the client's care rather than dismissing them.

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? A. The child was diagnosed with hypothyroidism as an infant. B. The child is being discharged home with the caregiver. C. The child's white blood cell (WBC) count is 9,000/mm3 (9 x 109/L). D. The child's blood pressure is 115/75 mm Hg.

B. The child is being discharged home with the caregiver. 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.

The goal of is to find deviations from consistent quality and take action at the root cause to prevent those deviations from happening. A. Total Quality Management (TQM) B. Toyota Production System (TPS) C. Six Sigma D. Lean

B. Toyota Production System (TPS)

Quality monitoring tools include the use of to measure deviation of quality against standards and guidelines. A. Surveys B. Test C. Audits D. Money

C. Audits Audits determine a point of focus, define what data to collect and how to collect it, and decide how deviation will be measured.

According to the Institute of Medicine, which of the sources caused the most deaths in 1999? A. Motor vehicle accidents B. Breast cancer C. Medical Errors D. AIDS

C. Medical Errors since 1999 quality management programs have produced a number of innovations across the industry to reduce these errors

A nurse is working at a facility that provides care to children with developmental disabilities. Which role would be the nurse's most important? A. educator B. care provider C. advocate D. counselor

C. advocate Although the nurse would fulfill the roles of educator, care provider, and counselor, the nurse's most important role would be that of an advocate. Children with developmental disabilities often have special health needs. If so, they often interact with many different health care professionals (nurses, pediatricians, occupational therapists, physical therapists, psychologists, and speech and language pathologists) and may require adaptive modifications for school to maximize attendance and learning (e.g., assistance from health aides, nursing care, modifications for regular classes, special education classes, barrier-free facilities). A key nursing role is advocating to obtain services and care that will enable these children to fully participate in and benefit from their educational experiences.

A nurse is caring for a client with advanced cancer. Based on the accompanying nursing progress notes, what should be the nurse's next intervention? A. Reread the document on patient/client rights to the client. B. Call the client's spouse to discuss the client's statements. C. Tell the client that only in the hospital can there be adequate pain relief D. Explain the use of an advance directive to express the client's wishes.

D. Explain the use of an advance directive to express the client's wishes.

What statement describes a required characteristic of all generic drugs? A. Generic drugs are required to be protected by a current American patent. B. Generic drugs are designated and patented exclusively by the manufacturer. C. Generic drugs are categorized according to overall usefulness and potential for abuse. D. Generic drugs must be therapeutically equivalent to brand name drugs.

D. Generic drugs must be therapeutically equivalent to brand name drugs.

The model was derived from the manufacturing and services industries and attempts to eliminate any part of a process that is not adding value to the customer. A. Total Quality Management (TQM) B. Toyota Production System (TPS) C. Six Sigma D. Lean

D. Lean

One of the fastest growing venues of practice for the nurse is home health care. What is the basis for the growth in this health care setting? A. The chronic nursing shortage B. The focus on treatment of disease C. The preference of nurses to work during the day instead of evening or night shifts D. The discharge home of clients who are more critically ill

D. The discharge home of clients who are more critically ill

The mother of a 1-month-old baby is scheduling the next well-child visit for her baby. Which statement by the mother indicates an understanding of the recommended appointment schedule? A. "My baby will need to again be seen when he is 2 months old." B. "I will need to schedule an appointment for my baby to be seen when he is 3 months old." D. "Unless there is a problem I do not need to bring my baby back to be seen until he is 6 months old." E. "My baby should be seen monthly for the first year of life."

A. "My baby will need to again be seen when he is 2 months old." Health supervision visits for children without health problems and appropriate growth and development are recommended at birth, within the first week of life, by 1 month, then at 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 24 months, 30 months, and then yearly until age 21.

A client states, "I have never taken a yellow pill before for my blood pressure. Why are you giving me this pill?" After verifying that the nurse has prepared the correct medication, which statement by the nurse would be accurate? A. "This is the same medication that you take at home but in generic form." B. "We use all kinds of brands at the hospital so I am sure it is correct." C. "You can refuse to take this medication if you wish." D. "I think you must be confused; this is the right medication."

A. "This is the same medication that you take at home but in generic form." Once the nurse has verified that the medication is correct, the client can be informed that it looks different because it is in generic form. The other options may hinder the development of trust in the nurse. Stating that the client can refuse the medication is not appropriate in this situation.

A community nurse arrives at the home of a client. The client is in soiled clothes due to the inability to make it to the bathroom in time. The nurse overhears the unregulated care provider (UCP) scolding the client for the soiled clothes. What is the most appropriate response by the nurse to the UCP? A. "Your behavior in this situation is considered verbal abuse." B."You need to have more training in therapeutic communication." C. "I'm sure you didn't mean to hurt the client's feelings, but you did." D. "Why weren't you there to help the client get to the bathroom?"

A. "Your behavior in this situation is considered verbal abuse." Reprimanding a client for something that is beyond the client's control is considered abusive. The other options do not help the UCP understand the abusive behavior.

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

A. Early discharge of clients from the hospital setting The prospective payment system of reimbursement encourages early discharge from the hospital and has created a new, acutely ill population that needs skilled nursing care at home.

A newly employed nurse is reviewing the organizational chart of the facility, observing that there is shared governance. What type of organizational chart does the nurse recognize the facility follows? A. Matrix B. Traditional C. Flat D. Magnet

A. Matrix

The nurse is caring for a client after having various diagnostic tests. The client discusses a proxy being in attendance for the health care provider's diagnosis. The nurse requests a copy for the file, and allows the proxy to be in attendance with what type of document? A. durable power of attorney B. living will C. patient rights D. informed consent

A. durable power of attorney A durable power of attorney for health care appoints a proxy, usually a relative or trusted friend, to make health care decisions on an individual's behalf.

A nurse leader at a long-term care facility wants to determine if vitals are being checked according to policy. What can the leader do to measure this process of care? A. Benchmarking B. A process audit C. Patient outcome evaluation D. A critical event analysis

B. A process audit

Which of these roles would be considered an expanded nursing role? A. Certified nurse's aide (CNA) B. Certified nurse practitioner (CNP) C. Respiratory therapist D. Social worker

B. Certified nurse practitioner (CNP) The nurse practitioner (NP) is considered an expanded nursing role. Nurses who function in these roles provide direct care to patients through independent practice, in a practice within a health care agency, or by collaborating with a physician. CNAs, respiratory therapists, and social workers do not perform in an expanded nursing role.

The nurse is legally obligated to report suspected child abuse to local authorities. Which information is essential? A. Proof that the child has been recently abused B. Child's name, location, age, and suspected perpetrator C. Child's current school, grade, and teacher D. Therapist's name and client address

B. Child's name, location, age, and suspected perpetrator Registered nurses are legally mandated to report child abuse. When reporting, the nurse must provide the child's name, location, age, and the suspected perpetrator. The nurse is not required to prove that abuse has occurred. Reference:

Nurse leaders need to understand that in order to be effective the quality control process must be . A. Reflective B. Ongoing C. Formative D. Cyclical

B. Ongoing If the quality control process is stopped the quality of patient care may suffer.

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

D. Coordinator of care The most important role of the nurse in preventing fragmentation of care would be coordinator of care. Care coordination is the deliberate organization of client care activities between two or more participants (including the client) involved in a client's care to facilitate the appropriate delivery of health care services. The roles of care provider, counselor, and educator are all important roles, but the priority role is as the coordinator of care.

The nurse is providing support to the parents of a 10-year-old boy receiving emergency care. The boy is their foster child. Which statement by the nurse would be most effective? A. "Your child is hypovolemic and he really needs fluid." B. "You can hold your child's hand while this is going on." C. "I think you had better stay out here and wait to hear from us." D. "Because you are not his biological parents, you must wait outside."

B. "You can hold your child's hand while this is going on."

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

B. Affordable Care Act As part of the Affordable Care Act, hospitals may accrue penalties for readmissions of clients with certain diagnoses within 30 days of discharge.

A nurse has just finished a presentation on hospice and palliative care. Which statement by a participant would indicate a need for further education? A. "Palliative care provides relief from pain and other distressing symptoms." B. "Hospice care programs focus on quality rather than length of life." C. "In hospice care, nurses take on the responsibility of making care decisions for clients." D. "Palliative care affirms life and regards dying as a normal process."

C. "In hospice care, nurses take on the responsibility of making care decisions for clients."

Which clients would be at high risk for developing varicose veins? Select all that apply. A. A 47-year-old waitress who works 12-hour shifts three or four times/week B. A morbidly obese (>100 pounds overweight) male who works behind the counter of a convenience store 10 hours/day, 5 days/week C. A 56-year-old male who has been immobile due to back surgery and has developed a deep vein thrombosis D. A marathon runner who has completed three marathons in the past 3 months E. A new peritoneal dialysis client who has been utilizing a home machine and performing dialysis every evening beginning at 8 PM

A. A 47-year-old waitress who works 12-hour shifts three or four times/week B. A morbidly obese (>100 pounds overweight) male who works behind the counter of a convenience store 10 hours/day, 5 days/week

The nurse manager has recently promoted a staff nurse to the charge nurse position. Which type of power does the charge nurse now have? A. Explicit B. Implied C. Reward D. Coercive

A. Explicit Explicit power is determined by virtue of the nurse's position. A charge nurse is responsible for making decisions and carrying out tasks not performed by staff nurses.

Several families arrive at the scene of a disaster and are asking for information about their family members. Which person would be most appropriate to provide them with any information? A. Security personnel B. Public Information Officer C. Incident Commander D. Hospital Safety Officer

B. Public Information Officer When dealing with family members requesting information about loved ones, the Public Information Officer would be the person who provides this information. Security personnel would be used to maintain order and keep media and others away from client care areas. The Incident Commander would be the person in charge of the Incident Command System and is responsible for the entire operation at the scene. The Hospital Safety Officer is a member of the hospital Incident Command System who reports directly back to the Incident Commander.

Which of the following is considered a nursing leadership role with regard to quality control? A. Establishes measurable patient outcomes B. selects and uses quality control tools C. uses finding to determine educational staff needs D. embraces, supports and champions the quality improvement process

D. embraces, supports and champions the quality improvement process Other choices of functions of management but not the role of the nurse leading

A nurse is preparing a presentation about risk reduction for breast cancer incorporating the recommendations from the American Institute for Cancer Research (AICR). Which recommendations would the nurse most likely include? Select all that apply. A. Consume at least five servings of fruits and vegetables daily. B. Limit the intake of processed foods. C. Limit the use of salt. D. Restrict red meat intake to approximately 4 ounces daily. E. Limit the intake of complex carbohydrates.

A. Consume at least five servings of fruits and vegetables daily. B. Limit the intake of processed foods. C. Limit the use of salt.

An older adult patient fell out of bed 2 days after a hip replacement and had to return to surgery. What process should be done in order to prevent future negative outcomes such as this? A. Critical event analysis B. Patient outcome evaluations C. Benchmarking D. An Audit

A. Critical event analysis

The six aims for improving quality healthcare as directed by the Institute of Medicine include safe, effective, patient-centered, timely, efficient, and . A. Equitable B. Alternative C. Holistic D. Naturalistic

A. Equitable Six aims Effectiveness. Relates to providing care processes and achieving outcomes as supported by scientific evidence. Efficiency. Relates to maximizing the quality of a comparable unit of health care delivered or unit of health benefit achieved for a given unit of health care resources used. Equity Relates to providing health care of equal quality to those who may differ in personal characteristics other than their clinical condition or preferences for care. Patient centeredness. Relates to meeting patients' needs and preferences and providing education and support. Safety. Relates to actual or potential bodily harm. Timeliness. Relates to obtaining needed care while minimizing delays.

Which action most clearly demonstrates a nurse's commitment to social justice? A. Lobbying for an expansion of healthcare resources and benefits to those in poverty B. Ensuring that a hospital client's diet is culturally acceptable C. Answering a client's questions about care clearly and accurately D. Documenting client care in a timely, honest, and thorough manner

A. Lobbying for an expansion of healthcare resources and benefits to those in poverty Social justice is a professional value that encompasses efforts to promote universal access to health care, such as the expansion of publicly funded programs like Medicare. Culturally competent care is a reflection of human dignity.

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? A. Need for control over a situation B. Nonjudgmental attitude C. Respect for client's differences D. Ability to improvise

A. Need for control over a situation 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.

A nursing student shares that he read that chronic conditions are costly to people, families, and society, and that one of the major goals of nursing today should be the prevention of chronic conditions and the care of people with them. The student asks the instructor what can nurses do to help. Which of the following is a correct answer given by the instructor? A. Promote wearing seat belts. B. Teach avoidance of immunizations. C. Promote dependence on health care professionals. D. Begin teaching prevention and promotion of health near mid-life.

A. Promote wearing seat belts. Prevention of chronic conditions and the care of people with them requires promoting healthy lifestyles and encouraging the use of safety and disease-prevention measures, such as wearing seat belts and obtaining immunizations. Prevention should also begin early in and continue throughout life.

A nurse has completed 4 hours of an 8-hour shift on a medical-surgical unit when the nurse receives a phone call from the nursing supervisor. The nursing supervisor informs the nurse that the nurse needs to give report to the other two nurses on the medical-surgical unit and immediately report to the telemetry unit to assist with staff needs on that unit. The nurse informs the supervisor that the nurse has been busy with the current client assignment and feels this will overwhelm the nurses on the medical-surgical unit. The supervisor informs the nurse that the need is greater on the telemetry unit. This is an example of which type of ethical problem? A. allocation of scarce nursing resources B. advocacy in a market-driven economy C. conflicts concerning new technology D. deception

A. allocation of scarce nursing resources

A nurse is preparing to lead a community discussion related to the Dietary Supplement Health and Education Act (DSHEA). Which factors concerning the Act should the nurse be prepared to include in the discussion? Select all that apply. A. Allows for DEA enforcement of the act. B. Gives the FDA power to enforce the laws governed by the act. C. Permits general health claims. D. Permits curative health claims. E. Defines specific substances as "dietary supplements"

B. Gives the FDA power to enforce the laws governed by the act. C. Permits general health claims. E. Defines specific substances as "dietary supplements"

A client with metastatic brain cancer is admitted to the oncology floor. What action will the admitting nurse take regarding an advanced directive for this client? A. Decide on a treatment plan if the client cannot. B. Inform the client or legal guardian of the right to execute an advance directive. C. Respect the individuals' moral rights. D. Advise the client to refuse medical treatment if unable to make health care decisions.

B. Inform the client or legal guardian of the right to execute an advance directive. All clients have a right to execute an advance directive.

A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons? A. To prevent adverse reactions B. To prevent resistance C. To decrease length of drug therapy D. To decrease allergic response of medications

B. To prevent resistance The CDC recommends multi-drug therapy to slow the development of bacterial resistance.

The financial stability of health maintenance organizations (HMOs) is based on which factor? A. Maintaining the statistics and records of all the patients admitted in hospitals on a regular basis B. Keeping patients satisfied by providing them regular financial assistance and looking after their medical requirements C. Keeping patients healthy and out of the hospital through periodic screening, health education, and preventive services D. Providing entertainment programs for patients in order to distract them from their illness

C. Keeping patients healthy and out of the hospital through periodic screening, health education, and preventive services

An older adult patient recently had a hip replacement with an indwelling catheter inserted. The patient developed symptoms of a UTI postoperatively, and the nurse placing the catheter was re-educated by the Nurse Leader regarding avoidance of UTIs when inserting catheters. Which quality approach did the Nurse Leader use? A. Total quality management techniques B. Continuous quality management techniques C. Quality assurance techniques D. Continuous quality improvement techniques

C. Quality assurance techniques The leader reacted and reviewed proper procedure which is in keeping with quality assurance

A client has been using Chinese herbs and acupuncture to maintain health. What is the best response by the nurse when asked if this practice could be continued during recuperation from a long illness? A. "Have you spoken to the physician about using the Chinese herbs and acupuncture?" B. "What do you want to accomplish by using these methods rather than researched practices?" C. "Once you have recovered from this illness, you can go back to your traditional ways." D. "Let's discuss your desire to integrate these practices with the physician and advocate on your behalf."

D. "Let's discuss your desire to integrate these practices with the physician and advocate on your behalf."

The healthy adult client is given an opioid prior to a surgical procedure. The nurse is completing the chart and notices the consent form was not signed by the client. Which of the following should the nurse do first? A. Immediately have the client sign the consent form. B. Have the client's family member sign the consent form. C. Ask the client if he still wants to proceed with the procedure. D. Notify the healthcare provider of the oversight.

D. Notify the healthcare provider of the oversight. Do not administer any medications that might alter judgment or perception before the client signs the consent form because many drugs commonly administered as preoperative medications, such as opioids or barbiturates, can alter cognitive abilities and invalidate informed consent.

A family member of a resident in a long-term care facility reports to the nurse that her mother's diamond ring is missing. Another resident reported a day earlier that a twenty-dollar bill was missing from his/her night table. What should the nurse do in this situation? A. Report the incidents to the facility's lawyer. B. Remind the residents and family members not to leave valuables unattended. C. Pass the information on to the doctor and the next shift staff. D. Notify the supervisor and call the police.

D. Notify the supervisor and call the police. The supervisor should be made aware of the situation and the police should be called to investigate the potential theft. The other answers do not advocate for the clients and their families. It is the responsibility of the nurse to take action because the nurse was the person to receive the information. This is known as due diligence.

A nurse is evaluating findings from the Nurses' Health Study, a study that has followed a group of nurses since 1976 to study the relationship between oral contraceptive use and breast cancer. The nurse evaluates the findings using criteria for which type of study? A. Cohort B. Cross-sectional C. Case control D. Qualitative

A. Cohort A cohort study, also known as a longitudinal study, follows a group of people over a period of time to observe specific health outcomes. Because the Nurses' Health Study followed the same group of nurses since 1976, it is an example of a cohort, or longitudinal, study.

A nurse practitioner is working in a crowded neighborhood where the population is primarily immigrants from China. The nurse has designed a research study to follow children from kindergarten to the age of 25. She is going to be looking at their diet, successful progression in school, health practices, and development of disease, to name a few items. This type of research is known as: A. Cohort study B. Cross-sectional study C. Case-control study D. Epidemiologic study

A. Cohort study In this cohort study, a group of people who were born at approximately the same time or share some characteristics of interest is the focus of the research

The Chief Nursing Officer (CNO) at an acute care facility has weekly mandatory meetings with all managers and staff members to discuss what is going well, what could be better, and communication from the executive team. This CNO is part of what type of organization? A. Flat B. Mission C. Traditional D. Matrix

A. Flat

The Patient Protection and Affordable Care Act (ACA) was passed in 2010 and aims to provide affordable health care to everyone. Which are goals of the ACA? Select all that apply. A. Healthcare affordability B. High-quality insurance C. Ability to compare insurance options D. Accessibility to insurance services E. Decreased number of uninsured

A. Health care affordability C. Ability to compare insurance options D. Accessibility to insurance services E. Decreased number of uninsured The ACA does not support high-quality insurance and allows the insurance companies to regulate themselves as they compete for uninsured clients in the various states.

A client involved in a motor vehicle collision has awakened from a coma and asks for his wife, who was killed in the same accident. The family does not want the client to know at this time that his wife was killed. The family wants all nursing staff to tell the client that the wife was air lifted to another hospital, has a severe head injury, and is in the ICU. Because the American Nurses Association Code of Ethics requires the nurse to preserve integrity, but the nurse wants to follow the family's instructions, the nurse faces an ethical dilemma. The steps of ethical analysis can assist the nurse with decision making. Select from the list below all the steps that are correct. A. Recognize the ethical, legal, and professional dimensions involved. B. Collect information. C. List the alternatives. D. Coordinate an ethics committee. E. Decide and evaluate the decision.

A. Recognize the ethical, legal, and professional dimensions involved. B. Collect information. C. List the alternatives. E. Decide and evaluate the decision. Assess the ethical/moral situations of the problem. This step entails recognition of the ethical, legal, and professional dimensions involved. The second step is to collect information. The next step is to list the alternatives. Compare alternatives with applicable ethical principles and professional code of ethics. The last step is to decide and evaluate the decision. The steps of an ethical analysis are for individual nurses to be able to process an ethical dilemma on their own.

The adolescent comes to the clinic seeking information about sexuality concerns. The clinic nurse assures the adolescent that confidentiality and privacy will be maintained unless a life-threatening situation occurs. Which nursing goal(s) is the nurse highlighting in this process? Select all that apply. A. development of a trusting relationship B. compliance with existing laws C. inappropriate response because adolescents are minors D. an environment where adolescents can be truthful E. concern from parents who pay the office visit bill

A. development of a trusting relationship B. compliance with existing laws D. an environment where adolescents can be truthful Adolescents may seek a health care appointment for an unrelated health concern as a reason to discuss a sexual health question with a health care professional. Reassurance should be given to the adolescent that all questions and concerns will be addressed and will be kept confidential. This is the basis for the nurse-client relationship. All questions and concerns do not involve treatment and, therefore, do not involve parental consent.

A nurse is a member of which entity within the larger healthcare environment? A. health care team B. health care delivery system C. health maintenance organization D. physician hospital organization

A. health care team The healthcare team includes nurses, physicians, pharmacists, psychologists, social workers, healthcare administrators, and various other health professionals, such as physical therapists. The healthcare delivery system is the entire range of services available to clients. A health maintenance organization is a type of managed care insurance plan. A physician hospital organization is a corporate structure involving a hospital and groups of physicians.

The nurse is reviewing the Healthy People 2030 objectives regarding mental health. Which objective(s) will the nurse identify that affects the school population? Select all that apply. A. reduce suicide attempts by adolescents B. reduce suicidal thoughts in LGBTQ students C. increase preventative mental health care for children D. reduce anxiety and depression in family caregivers E. increase screening for depression by primary care providers

A. reduce suicide attempts by adolescents B. reduce suicidal thoughts in LGBTQ students C. increase preventative mental health care for children Reducing anxiety and depression in family caregivers and increasing screening for depression by primary care providers do not specifically target the school population.

While a client admitted to the medical-surgical unit is in the radiology department, a visitor claiming to be the client's cousin arrives on the medical-surgical unit and asks the nurse to provide a brief outline of the client's illness. Which response by the nurse would be most appropriate, both legally and professionally? A. "I will call the client and ask for permission to share this information with you." B. "I cannot give you that information due to client confidentiality." C. "Do you have any identification proving that you are related to the client?" D. "I'm busy right now but can talk later."

B. "I cannot give you that information due to client confidentiality." Sharing a client's information without the client's consent is an invasion of privacy. The nurse should not give out the information even if the visitor provides proof of a relationship without the client's consent. It is inappropriate to call the client to ask for permission. The nurse claiming to be busy and offering to talk later does not address the issue but only delays it, perhaps leading the visitor to assume that the nurse will disclose information then.

A client in a long-term care facility signed a form requesting not to be resuscitated. The client develops pneumonia, and the client's health rapidly deteriorates. The client is no longer competent, but the family wants everything possible done for the client. When the family asks the nurse what will be done, what is the best response by the nurse? A. "We will resuscitate the client only if there is a respiratory arrest." B. "We will continue to use antibiotics to treat the pneumonia." C. "We will honor the family's wishes because the client cannot make decisions." D. "We will not provide any pharmacologic intervention at this time."

B. "We will continue to use antibiotics to treat the pneumonia." The client has signed a document indicating a wish not to be resuscitated. Treating the client's pneumonia with antibiotics would not be considered a resuscitation measure. The other options do not respect the client's choice.

A depressed client on a psychiatric unit asks the nurse to call the hospital lawyer to discuss writing out a will. What is the nurse's priority intervention? A. Call a lawyer as requested by the client. B. Discuss thoughts and explore intent for suicide with the client. C. Inform the physician first, and place the client on suicide watch. D. Offer the client medication for anxiety.

B. Discuss thoughts and explore intent for suicide with the client. Exploration of thoughts and intent are a priority based on lethality of plan for suicide. Calling the lawyer is incorrect because it does not explore the intent of the client's question. The nurse would discuss the intent with the client prior to calling the physician. Administering anxiety medication does not address the problem.

When describing influences on health care delivery, a nurse cites information about current population demographics. Which of the following would be most accurate? A. Increased birth rate B. Fewer school-aged children C. Fewer elderly persons D. More people living in rural areas

B. Fewer school-aged children Population demographics reveal that the birth rate has declined, school-aged children are fewer, older adults are more numerous, and greater numbers of people live in urban areas.

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. health promotion. C. better connectivity through the use of technology. D. high-quality disease management.

B. health promotion. Recent health care reform efforts, in particular the Affordable Care Act (ACA), have made strides toward realizing nursing's vision of health care that is focused on health promotion, delivered where the individual needs it, and focused on wellness rather than disease management

A client is 36 weeks' gestation and has been admitted to the antenatal unit for gestational hypertension. The client states that she is alone because she has recently moved from another country, and she begins to cry. What is the best response by the nurse? A. "Do you belong to any community groups that may be able to support you?" B. "It appears that you are concerned about where your friends and family are living right now." C. "Tell me more about how you are feeling." D. "Would you like to speak to the hospital social worker?"

C. "Tell me more about how you are feeling." Recent immigrants may be separated from their friends, family, and support systems. There are many variations in how cultural and ethnic beliefs and practices impact how individuals respond to the experience of pregnancy and birth. This nurse's response further explores the client's feelings to assist in a culturally competent and sensitive manner. It would be inappropriate to assume that the client is concerned about the family's living arrangements. It would be inappropriate to ask the client about belonging to any support groups or to refer the client to a social worker at this time. It would be most beneficial at this time to explore the client's feelings to identify what the concerns are and how the client believes the nurse may be able to help.

A coordinator from an organ procurement agency is leading a meeting with a physician, a nurse, and the parent of a client with confirmed brain death. The client's driver's license indicates that they are an organ donor. After the meeting, the client's parent states, "I just can't make the decision to let him die." Which response by the nurse is best? A. "I understand it's a hard choice." B. "You can't let them live like this." C. "The decision is whether you want to honor their wishes concerning organ donation." D. "Organ donation brings a positive to death."

C. "The decision is whether you want to honor their wishes concerning organ donation." Because the client meets the criteria for brain death, the client can be pronounced dead. The parent should be redirected to the decision at hand, which is whether they want to honor the son's decision to be an organ donor. Even though the client indicated that they wish to be a donor on their driver's license, the family is still asked to sign a consent form.

Which nurse response to the parent indicates that the nurse recognizes the importance of the child's increasing responsibility for his or her personal heath choices? A. "I am so glad you are reading to your baby, especially during feeding time." B. "I suggest you offer your toddler healthy snacks after school and at bedtime rather than after dinner." C. "If your school-aged child isn't current on immunizations, we can work to get them caught up." D. "I recommend you talk with your adolescent child and discuss their preference for which dentist to visit."

D. "I recommend you talk with your adolescent child and discuss their preference for which dentist to visit." The child's participation in his or her health choices increases as the child grows and develops. By asking the adolescent for input, the nurse is encouraging the parent to include the child in responsible decision making.

A nurse volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee? A. Assist in decision making based on the client's best interests. B. Decide the care for a client who is unable to voice an opinion. C. Convince the family to choose a specific course of action. D. Present options about the type of care.

A. Assist in decision making based on the client's best interests. One reason an ethics committee convenes is when a client is unable to make an end-of-life decision and the family cannot come to a consensus. In this case, the committee members are there to advocate for the best interest of the client and to promote shared decision making between the client (or surrogates, if the client is legally incapacitated) and the clinicians. The committee would not convince, decide, or present options about the type of care. This is not the role of an ethics committee.

The health care provider is in a hurry to leave the unit and tells the nurse to give morphine 2 mg IV every 4 hours as needed for pain. What action by the nurse is appropriate? A. Inform the health care provider that a written order is needed. B. Write the order in the client's record. C. Call the pharmacy to have the order entered in the electronic record. D. Add the new order to the medication administration record.

A. Inform the health care provider that a written order is needed. Verbal orders should only be accepted during an emergency. No other action is correct other than asking the health care provider to write the order.

In the role of entrepreneur, the nurse's primary responsibility is: A. managing a health-related business. B. administering resources. C. managing personnel involved in client care. D. teaching in a clinical setting.

A. managing a health-related business. A nurse entrepreneur is primarily concerned with organizing, developing, and managing a clinic or health-related business. Although a nurse entrepreneur may also administer resources, manage personnel, and teach, the primary responsibility of this role is managing a health-related business. A nurse administrator is primarily concerned with administering resources and managing personnel. A nurse educator is primarily concerned with teaching in a clinical setting.

A community-based nurse is assessing the needs of a family of four, which includes a physically challenged 9-year-old. Which activity would the nurse prioritize to be an advocate for this family? A. Ensure case history is complete for all family members. B. Establish eligibility for assistive devices for child. C. Ensure the client follows physical therapy recommendations. D. Train the school nurse on the needs of the child.

B. Establish eligibility for assistive devices for child. Client advocacy is acting on behalf of the client. Making calls to arrange for special equipment is one role of a nurse who is acting on behalf of the client

The obstetric nurse is caring for a woman in the delivery room who has tested positive for the HBsAg. Which intervention does the nurse recognize is indicated? A. Vaccination of the mother for hepatitis A B. Vaccination of the newborn with immunoglobulin C. Vaccination of the mother with hepatitis C vaccine D. Vaccination of the newborn for hepatitis A

B. Vaccination of the newborn with immunoglobulin In individuals with hepatitis B, the HBsAg is the viral antigen measured most routinely in blood. It appears before onset of symptoms, peaks during overt disease, and then declines to undetectable levels in 3 to 6 months. The CDC also recommends that infants born to HBsAg positive mothers receive appropriate doses of hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine.

A client has designated a family member to make healthcare decisions for the client if the client is not able to do so. What type of advance directive is this considered? A. Power of attorney B. Do-not-resuscitate order (DNR) C. Living will D. Durable power of attorney (DPOA) for healthcare

D. Durable power of attorney (DPOA) for healthcare A client may designate another person to be the DPOA for healthcare or healthcare proxy. This person has the authority to make healthcare decisions for the client if the client is no longer competent or able to make these decisions. A general power of attorney does not give that designated person the ability to make healthcare decisions. In a DNR order, the client wishes to have no resuscitative action taken in the event of a cardiac or respiratory arrest. A living will is a document that states a client's wishes regarding healthcare if the client is terminally ill.

While attending an international nursing conference, many discussions and break-out sessions focused on the World Health Organization's (WHO) views on health. Of the following comments made by nurses during a discussion session, which statements would be considered a good representation of the WHO definition? Select all that apply. A. Interests in keeping the older adult population engaged in such activities as book reviews and word games during social time B. Increase in the number of chair aerobics classes provided in the skilled care facilities C. Interventions geared toward keeping the older adult population diagnosed with diabetes mellitus under tight blood glucose control by providing in-home cooking classes D. Providing transportation for renal dialysis clients to and from their hemodialysis sessions E. Providing handwashing teaching sessions to a group of young children

A. Interests in keeping the older adult population engaged in such activities as book reviews and word games during social time B. Increase in the number of chair aerobics classes provided in the skilled care facilities C. Interventions geared toward keeping the older adult population diagnosed with diabetes mellitus under tight blood glucose control by providing in-home cooking classes E. Providing handwashing teaching sessions to a group of young children

The nurse is explaining the purpose of the Healthy People 2030 initiative to a client. Which goal(s) will the nurse point out as included? Select all that apply. A. increase the number of people with health insurance B. decrease incidence of client with new cancer diagnosis C. increase the number of various medical degrees among the underrepresented racial and ethnic groups D. improve hearing and visual health with prevention education E. ensure more facilities are built to cater specifically to people with disabilities

A. increase the number of people with health insurance B. decrease incidence of client with new cancer diagnosis C. increase the number of various medical degrees among the underrepresented racial and ethnic groups D. improve hearing and visual health with prevention education

In many institutions, which telephone or fax orders requires a signature within 24 hours by the ordering physician or nurse practitioner? A. orders for antibiotics B. orders for diagnostic studies C. orders for dietary changes D. orders for respiratory treatments

A. orders for antibiotics Many institutional policies dictate that orders for restraints, narcotics, anticoagulants, and antibiotics require the ordering physician or nurse practitioner to sign the order within 24 hours.

Circumcision is a very personal decision for parents, and the nurse's major responsibility is to inform the parents of the risks and benefits of the procedure. The nurse needs to recognize that this is mainly which type of decision? A. social decision B. difficult decision C. family decision D. legal decision

A. social decision The decision to circumcise is often a social one. The discussion involves cultural, religious, medical, and emotional considerations. Nurses must remain unbiased and unemotional as they present the facts to the parents.

A client was admitted to the hospital 2 weeks ago following an ischemic stroke. Following the early introduction of stroke rehabilitation, the client has seen significant improvements in both medical status and activities of daily living (ADLs). This morning, however, the nurse notes that the client has been coughing since eating a minced and pureed breakfast. Auscultation of the chest reveals coarse crackles. Which practitioners should the nurse liaise with to obtain a swallowing assessment? A. speech therapist B. respiratory therapist C. physical therapist D. physician

A. speech therapist The diagnosis and treatment of dysphagia (swallowing problems) is within the purview of speech therapists. The physician should be made aware and respiratory therapy may be involved with assessing and promoting the client's oxygenation but swallowing assessment is a task most often performed by a speech therapist.

The client is brought to the hospital in a coma. The nurse understands that when a person is incapacitated, the document used to dictate the patient's written instructions for health care is called: A. patient rights B. durable power of attorney C. advance directive D. informed consent

C. advance directive Advance care directives are written instructions for health care when individuals are incapacitated. Informed consent, durable power of attorney, and patient rights are not instructions for health care when individuals are incapacitated. A durable power of attorney means that the advance care directives stays in effect if you become incapacitated and unable to handle matters on your own. Informed consent is the permission granted in the knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits. Patient rights are those basic rule of conduct between patients and medical caregivers as well as the institutions and people that support them.

A nurse working in the operating room is assigned to the suite where therapeutic abortions are to be performed throughout the day. The nurse feels that participation in these procedures conflicts with personal religious beliefs. What should the nurse do after notifying the operating room supervisor? A. Continue working in the suite because that is the assignment for the shift. B. Complete a work refusal form and leave the surgical suite immediately. C. Contact the local right-to-life association and inform them of the procedures. D. Remain in the operating room suite until another nurse arrives to take that assignment.

D. Remain in the operating room suite until another nurse arrives to take that assignment. If nursing care is requested that is contrary to the nurse's personal values, the nurse must provide appropriate care until alternative care arrangements are in place to meet the client's needs. The other options are not correct, and if the nurse left the suite, it could result in the accusation that the nurse abandoned the client. The nurse should be aware of potential conflicts before accepting an assignment.

The nurse is caring for a parent of a 10-month-old infant. The parent is upset and states, "I have so many questions, but the doctor seems too busy to answer my questions." What is the best action by the nurse? A. Assist the parent in preparing a list of questions for the health care provider's next visit. B. Explain to the parent that the health care provider will be back and will answer questions at that time. C. Encourage the parent to remain at the infant's bedside so as not to miss any future consultant visits. D. Ask the parent if he or she would like the nurse to ask the health care provider the questions when the provider visits next.

A. Assist the parent in preparing a list of questions for the health care provider's next visit. Empowering parents so that they can be active partners in their child's care is part of family-centered care. Helping the parent state and write questions will provide information to which the nurse can respond; it will also help the parent interact more effectively with the health care provider and other health team members. Relaying the parent's questions may be helpful on limited occasions but places the nurse between the parent and the health care provider, relaying information in a "third party" manner. Keeping the parent at the bedside watching and waiting causes unnecessary stress. Supporting the busy schedule of the health care provider burdens the parent further.

A current trend in health education that significantly influences nursing practice is: A. Increased emphasis on patient involvement in their own care. B. Improved distribution of health information materials. C. Increased numbers of health care providers. D. Increased emphasis on the diversity of patient needs.

A. Increased emphasis on patient involvement in their own care. Much of the core of health education today is focused on increasing patient involvement and accountability for their care and treatment plans

During the moral treatment period, clients were routinely placed into which environment? A. asylums B. community mental health centers C. psychosocial rehabilitation centers D. group homes

A. asylums In the moral treatment period (1790-1900), moral treatment and the use of kindness, compassion, and a pleasant environment was adopted. Clients were routinely removed from their communities and placed in asylums, which was thought to be best for their safety and comfort.

The nurse is conducting an educational program for unlicensed personnel on the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The nurse determines that the unlicensed personnel understand HIPAA when they state that it prohibits A. the use of genetic information to establish insurance eligibility. B. two physicians from discussing their patient's condition. C. interdisciplinary team care-planning sessions. D. insurance coverage exclusions based on specific conditions.

A. the use of genetic information to establish insurance eligibility. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 prohibits the use of genetic information to establish insurance eligibility. It does not prohibit physicians involved in a client's care from discussing the client's condition, interdisciplinary team care-planning sessions, or insurance coverage exclusions based on specific conditions.

Which of these patient safety solutions that you as the Nurse Leader have the power to implement and measure team performance against demonstrate the ability to prevent mitigate patient harm? select all that apply A. look alike, sound alike medication names B. Patient identification C. Communication during patient hand overs D. Performance of correct procedure at correct body site E. Control of concentrated electrolyte solutions F. Assuring medication accuracy at transition in care G. Avoiding catheter and tubing misconnections H. Single use of injection devices I. Improved hand hygiene to prevent health-care-associated infections

B. Patient identification C. Communication during patient hand overs D. Performance of correct procedure at correct body site E. Control of concentrated electrolyte solutions F. Assuring medication accuracy at transition in care G. Avoiding catheter and tubing misconnections H. Single use of injection devices I. Improved hand hygiene to prevent health-care-associated infections As a nurse leader can impact all these situations except look-alike, sound-alike medications, however you can still make a difference in this area by not overriding the barcode administration system and double checking medications

A nurse is providing home care to a client with a foot ulcer related to diabetes. The client needs daily insulin injections. Family caregivers do not possess the technical skills to inject insulin. Which should the nurse keep in mind? A. The current reimbursement system recognizes the family's nontechnical value priorities. B. Nurses should avoid asking the family caregivers to conduct the skilled task. C. Family caregivers are always perceived to be supportive of good care. D. The nurse needs to be creative in integrating the technical and relational aspects of care.

D. The nurse needs to be creative in integrating the technical and relational aspects of care. The nurse needs to be creative in integrating the technical and relational aspects of care. The current reimbursement system does not recognize the family's nontechnical value priorities. Nurses are expected to educate the family caregivers to conduct the skilled task where possible. In this case, the nurse can teach the family caregivers to inject insulin. Family caregivers can be perceived to be unsupportive of good care if the families do not follow through.