NUR 212 Final

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

The Nurse observes that an older patient's gait and balance appear to be slightly unsteady. What assessment should the nurse perform next? 1) Perform the Get Up and Go Test. 2) Ask the patient if he has fallen in the past year. 3) Refer the patient for a comprehensive fall evaluation. 4) Administer the Timed Up and Go Test.

2) Ask the patient if he has fallen in the past year.

Which teaching technique is best for teaching a nursing assistant how to perform finger stick glucose testing? 1) Provide a manufacturer's pamphlet with detailed instruction. 2) Explain the best technique for performing glucose testing. 3) Demonstrate the procedure; then ask for a return demonstration. 4) Suggest that the assistant watch a DVD showing the procedure.

3) Demonstrate the procedure; then ask for a return demonstration.

A student reports to the teacher that her grade has been recorded as a 98 but she really made an 88. The student is displaying: a. Veracity b. Nonmaleficence c. Reparation d. Fidelity

a. Veracity

What would the nurse working in the emergency department identify as clinical priorities for the treatment of a patient with a gunshot wound? Select all that apply. 1) Airway maintenance 2) Obtaining medical history 3) Ventilation assistance 4) Hemorrhage control 5) Hyperthermia prevention

1) Airway maintenance 3) Ventilation assistance 4) Hemorrhage control 5) Hyperthermia prevention

Which intervention by the nurse would be best to motivate a patient newly diagnosed with hypertension to learn about the prescribed treatment plan? 1) Explain that when left untreated, hypertension may lead to stroke. 2) Ask the patient to let you know when he is ready to learn. 3) Encourage the patient to learn about various treatment options. 4) Reassure the patient that adhering to the treatment produces a good outcome.

1) Explain that when left untreated, hypertension may lead to stroke.

Physiological changes associated with aging place the older adult especially at risk for which nursing diagnosis? 1) Risk for Falls 2) Risk for Ineffective Airway Clearance (choking) 3) Risk for Poisoning 4) Risk for Suffocation (drowning)

1) Risk for Falls

The registered nurse (RN) is the team leader for a group of patients using the functional model of nursing. The team of nurses includes two licensed practical nurses (LPNs) and an unlicensed assistive personnel (UAP). Which task will the RN delegate to the UAP? 1) Taking vital signs 2) Providing wound care 3) Conducting discharge teaching 4) Administering oral medications

1) Taking vital signs

The patient takes anticoagulants. Which instruction is most important for the nurse to include on the patient's care plan? 1) Use an electric razor for shaving. 2) Apply skin moisturizer. 3) Use less soap when bathing. 4) Floss teeth daily.

1) Use an electric razor for shaving.

At 9:00 am a patient has 750 ml Lactated Ringers remaining which must end at 3:00 pm. Drop factor is 20gtt/ml. Calculate the flow rate on how many ml/hr. Type only the numerical answer.

125

There is an order for digoxin 0.5 mg PO. The nurse has 250 mcg tablets on hand. How many tablets will the nurse give?

2

Order: Phenytoin 300 mg PO each day. Supplied: Phenytoin 0.1 gram capsules. How many capsules will be administered? Numerical number only.

3

A patient with morbid obesity who attended four meetings of a weight loss program wants to quit the program because he has already learned what to do. What should the nurse tell him? 1) "By now you have successfully completed the steps of the change process. You should be able to successfully lose the rest of the weight on your own." 2) "Although you have learned some healthy habits, you will need at least another 6 weeks before you can quit the program and have success." 3) "You have done well in this program. However, it is important to continue in the program to learn how to maintain weight loss. Otherwise, you are likely to return to your previous lifestyle." 4)"You have entered the 'determination stage' and are ready to make positive changes that you can keep for the rest of your life. If you need additional help, you can come back at a later time."

3) "You have done well in this program. However, it is important to continue in the program to learn how to maintain weight loss. Otherwise, you are likely to return to your previous lifestyle."

The school nurse at a local elementary school is performing physical fitness assessments on the third-grade children. Which test should the nurse use to assess the students' cardiorespiratory fitness? 1) Step up and down on a 12-inch bench 2) Perform the sit-and-reach test 3) Run a mile without stopping, if they can 4) Perform range-of-motion exercises

3) Run a mile without stopping, if they can

The physician calls the unit and leaves an oral order for a patient. The order is for Cefaclor 0.1g PO. The dose available is 125 mg/5 ml. How many milliliters will the nurse administer?

4

A proposed change in the management structure of the nursing unit is explained during a staff meeting, and several nurses express antagonistic comments to the nurse manager. Identify the best response by the nurse manager. a. "Let's consider the potential positives and negatives to the proposal." b. "We need to look at all aspects of the proposal even though some of you may not think it is wise." c. "If you cannot hold your comments until the end of the presentation, please leave now." d. "I will not continue with the presentation until the room is quiet."

a. "Let's consider the potential positives and negatives to the proposal."

A patient is receiving Intravenously (IV) antibiotic therapy. The order is for methicillin 750 mg IV. The nurse has a 1-gm vial on hand. The instructions for reconstitution say to add 1.5 ml sterile water. Re-constituted solution will contain approximately 500mg methicillin solution per milliliter. How much will the nurse give? a. 1.5 ml b. 1 vial c. 2 ml d. 1 ml

a. 1.5 ml

Order: Nitroglycerine (NTG) drip @13 ml/hr. Supplied: NTG 100 mcg/ml. Calculate the infusion rate. a. 22 mcg/min b. 27 mcg/min c. 25 mcg/min d. 30 mcg/min

a. 22 mcg/min

Because of short staffing in the Intensive Care Unit (ICU), a labor and delivery nurse is floated to the unit. Identify the most appropriate assignment for this nurse. a. A 23-year-old man from a motor cycle accident requiring multiple wound care dressings. b. A 36-year-old woman with steroid-induced cardiomyopathy. c. A 32year-old woman with an overdose of barbiturates on life support. d. An 85-year-old man in cardiogenic shock.

a. A 23-year-old man from a motor cycle accident requiring multiple wound care dressings.

A nurse manager is reviewing the admission history of four adults who were admitted to the medical-surgical unit during the shift. Which of the following situations is the nurse required to disclose information to an outside agency about the client or the client's circumstances? a. A dependent adult admitted for the treatment of a spiral fracture. b. A young adult client admitted for asthma and has track marks that may indicate Intravenous (IV) drug abuse. c. A young adult client admitted for acute glomerulonephritis following a viral infection. d. An emancipated minor who has acute appendicitis and wants to leave the facility without treatment.

a. A dependent adult admitted for the treatment of a spiral fracture.

A nurse witnesses an assistive personnel (AP) they are supervising reprimanding a client for not using the urinal properly. The AP threatens to put a diaper on the client if the urinal is not used more carefully next time. Which of the following torts is the AP committing? a. Assault b. Battery c. False imprisonment d. Invasion of privacy

a. Assault

A patient in the intensive care unit has a "do not resuscitate" (DNR) order on his chart. What does the nurse caring for him need to recognize about DNR orders? a. DNR orders must be written by the physician. b. DNR orders protect the patient's family from making difficult decisions. c. DNR orders may be given orally by the health care provider to staff. d. There is no specific time limit on DNR orders.

a. DNR orders must be written by the physician.

A nurse working for a home health agency is assessing an older adult male patient. The nurse determines the priority assessment data to address is: a. Dysphagia b. Swollen gums c. Urinary Hesitancy d. Pruritis

a. Dysphagia

As nurses achieve increased professional autonomy, what must they also accept? a. Ethical accountability b. Decrease in workload c. Ethical freedom d. Legal immunity

a. Ethical accountability

As a part of orientation for new graduate Registered Nurses (RNs), which of the following educational items should be included? (Select All the Apply) a. Facility polices and procedures. b. Skill proficiency c. Assignment to a preceptor. d. Budgetary principles. e. Computerized charting.

a. Facility polices and procedures. b. Skill proficiency c. Assignment to a preceptor. E. Computerized charting.

A nurse is planning safety interventions at a new clinic. Which of the following interventions should the nurse include? a. Have staff who will be performing x-rays wear dosimeters. b. Provide both latex and non-latex gloves for employees. c. Place sharps containers outside client rooms. d. Provide electrical tape for staff to repair frayed cords.

a. Have staff who will be performing x-rays wear dosimeters.

A woman of Mexican-American background who is in labor asks that her husband not be al-lowed in the delivery room and that he not see the baby until after the baby has had his or her initial bath. How can the nurse best respond to this request? a. Honor the request by recognizing that these are the cultural norms of the patient. b. Explain that the first hour after the birth of the baby is the most critical to promote bonding. c. Ask the husband if he is willing to wait in the waiting room until the delivery is completed. d. Insist that it is the hospital policy for the husband to be present during the delivery.

a. Honor the request by recognizing that these are the cultural norms of the patient.

The need for enhanced communication has created a new emphasis on health promotion. One example is the Healthy People 2020 objectives; Healthy People 2020 set two main goals. Which of the following best identify those two goals? (Select all that apply.) a. Increase the quality and the length of healthy lives. b. Increase education related to the right to die. c. Eliminate the violence in our country. d. Eliminate health-care disparities.

a. Increase the quality and the length of healthy lives. d. Eliminate health-care disparities.

Which of the following statements are true related to SBAR (Situation, Background, Assessment, and Recommendation) as a communication/collaboration tool? (Select all that apply) a. It works well for care giver to care giver communication. b. It is not helpful when notifying physicians. c. It communicates more complete information for Rapid Response Teams when activated. d. It ensures more accurate hand-off communications from a Med-Surg Unit to an Intensive Care Unit when transferring a patient.

a. It works well for care giver to care giver communication. c. It communicates more complete information for Rapid Response Teams when activated. d. It ensures more accurate hand-off communications from a Med-Surg Unit to an Intensive Care Unit when transferring a patient.

The purpose of the National Patient Safety Goals is to improve patient safety. The Goals focus on problems in healthcare safety and how to solve them. Which of the following nursing interventions help achieve these goals to improve patient safety? (Select all that apply.) a. Make sure that it is safe for patients to take any new medicines with their current medications. b. Take extra care with patients who take medicines to thin their blood. c. Identify the patients that are the least likely to kill themselves. d. Use at least two ways to identify patients.

a. Make sure that it is safe for patients to take any new medicines with their current medications. b. Take extra care with patients who take medicines to thin their blood. d. Use at least two ways to identify patients.

A Registered Nurse (RN) on a medical-surgical unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse delegate to the Licensed Practical Nurse (LPN)? a. Obtain vital signs for a client who is 2 hours post-procedure following a cardiac catheterization. b. Administer a unit of packed red-blood cells (RBCs) to a client who has cancer. c. Instruct a client who is scheduled for discharge in the performance of wound care. d. Develop a plan of care for a newly admitted client who has pneumonia.

a. Obtain vital signs for a client who is 2 hours post-procedure following a cardiac catheterization.

Which of the following support interdisciplinary decision making? (Select all that apply.) a. Open communication and collaboration between team members. b. Rely solely on the physician's knowledge. c. Submission of consult information by fax. d. Involvement of the patient and family.

a. Open communication and collaboration between team members. d. Involvement of the patient and family.

A patient who has recently traveled to China comes to the emergency department (ED) with increasing shortness of breath and is strongly suspected of having severe acute respiratory syndrome (SARS). Which of these prescribed actions will you take first? a. Place the patient on airborne and contact precautions b. Infuse normal saline at 75mL/hr c. Obtain blood, urine, and sputum for cultures d. Give methylprednisolone (Solu-Medrol) 1g intravenously (IV)

a. Place the patient on airborne and contact precautions

Identify a typical response for a manager who uses the laissez-faire approach to leader-ship when faced with a difficult decision. a. Postpone making the decision in the hopes that it will resolve itself. b. Appeal to a higher authority to make the decision. c. Consult with coworkers on the best way to resolve the problem. d. Makes the tough decisions by himself or herself and accepts the responsibility.

a. Postpone making the decision in the hopes that it will resolve itself.

The community health nurse is implementing health programs with several populations in the local area. In which of the following situations is the nurse using primary prevention? a. Providing influenza vaccines to employees at a local elementary school. b. The nurse completes a home safety check at a patient's home. c. Teaching healthy nutrition to patients who have hypertension. d. Implementing a program to notify individuals exposed to a communicable disease.

a. Providing influenza vaccines to employees at a local elementary school.

As nurses accept the responsibility of implementing research findings, they will begin a plan to implement changes in their practice setting. What suggestion might help smooth the transition on a hospital unit? a. Seek input from all nurses who have a stake in the intervention or changes. b. Have a staff education meeting, talk about great change, and serve pizza. c. Involve the nursing leaders to plan how the changes will be implemented. d. Have the unit manager include the changes in the policy and procedure manual.

a. Seek input from all nurses who have a stake in the intervention or changes.

A newly hired occupational health nurse at an industrial facility is performing an initial workplace assessment. Which of the following information should the nurse determine when conducting a work site survey? a. Work practices of employees b. Past exposure to specific agents c. Past jobs of individual employees d. Length of time working in current role

a. Work practices of employees

A nurse is conducting health screenings at a statewide health fair and identifies several clients who require referral to a provider. Which of the following statements by a client indicates a barrier to accessing health care? a. "I have made a list of local doctors but I am having trouble narrowing it down to the one I believe that would be best for me." b. "I can't take off during the day, and the local after-hours clinic is no longer in operation." c. "Only one doctor in my town is a designated provider by my health maintenance organization." d. "I would like to schedule an appointment with the local doctor in my town who speaks Spanish and English."

b. "I can't take off during the day, and the local after-hours clinic is no longer in operation."

Select the statement by a unit manager to the vice president for nursing during a budget meeting that would be most effective in decreasing the staffing ratio on her unit from one (1) nurse for every nine (9) patients to one (1) nurse to every seven (7) patients. The proposed change will: a. "Help with recruitment of new nurses to the facility." b. "Improve the quality of care for the patients on the unit." c. "Have a positive effect on the use of institutional resources." d. "Better meet current national standards of practice."

b. "Improve the quality of care for the patients on the unit."

A case manager is discussing critical pathways with a group of newly hired nurses. Which of the following statements indicates understanding? a. "The time to fill out the pathways often increases the cost of care." b. "The pathway shows an estimate of the number of days the client will be hospitalized." c. "Deviance from the pathway is a sign of improved care quality." d. "The pathway includes information about the client's history."

b. "The pathway shows an estimate of the number of days the client will be hospitalized."

A community experiences an outbreak of meningitis, and hospital beds are urgently needed. Which of the following clients should the nurse recommend for discharge? a. A client newly admitted with angina and a history of myocardial infarction 1 year ago b. A client who was pre-admitted for rotator cuff surgery and has diabetes mellitus type II c. A client admitted the day before with pneumonia and dehydration d. A client who has a fractured hip and is scheduled for total hip replacement the next day

b. A client who was pre-admitted for rotator cuff surgery and has diabetes mellitus type II

A home health nurse has adjusted his schedule to visit the following four (4) patients today. Which patient will he see first? a. A patient with schizophrenia who will need a risperidone injection b. A patient who has Chronic Obstructive Pulmonary Disease (COPD) and increased shortness of breath c. A patient receiving chemotherapy who will need blood drawn d. A patient with a recent Myocardial Infarction who will need an initial assessment

b. A patient who has Chronic Obstructive Pulmonary Disease (COPD) and increased shortness of breath

Toward the end of a shift, an Licensed Practical Nurse (LPN) reports to an Register Nurse (RN) that a recently hired assistive personnel (AP) has not totaled patients' Intake and Output (I&O) for the past 8 hours. Which of the following actions should the RN take? a. Notify the nurse manager to include this on the AP's evaluation b. Ask the AP if he needs assistance completing I&O records. c. Confront the AP and instruct him to complete I&O measurements. d. Delegate this task to the LPN.

b. Ask the AP if he needs assistance completing I&O records.

A nurse who works on the night shift enters the medication room and finds a co-worker with a tourniquet wrapped around the upper arm. The co-worker is about to insert a syringe containing a clear liquid, into the antecubital area. The appropriate initial action by the nurse is which of the following? a. Call security. b. Call the nursing supervisor. c. Lock the co-worker in the medication room until help arrives. d. Call the police.

b. Call the nursing supervisor.

A community health nurse is determining available and needed supplies in the event of a bioterrorism attack. The nurse should be aware that community members exposed to anthrax will need access to which of the following medications? a. Metronidazole b. Ciprofloxacin c. Zanamivir d. Fluconazole

b. Ciprofloxacin

A nurse on a quality control committee is evaluating the results of recently implemented measures designed to reduce client medication errors. Which of the following methods should the nurse use to evaluate the success of the changes? a. Establish a benchmark to identify a standard of performance. b. Compare the number of medication errors before and after the action was implemented. c. Provide the staff with a questionnaire to quantify staff satisfaction with the changes. d. Conduct a study about the time and money costs of implementing the change.

b. Compare the number of medication errors before and after the action was implemented.

The doctor has indicated that ampicillin and gentamicin are to be given piggyback in the same hour, every 6 hours (12-6-12-6). How would the nurse administer these drugs? a. One drug every 4 hours and one every 6 hours. b. Each drug separately, flushing between drugs. c. Retrograde both drugs into the tubing. d. Both drugs together IV push.

b. Each drug separately, flushing between drugs.

A nurse is caring for a client who is from a different culture than the nurse. When beginning the cultural assessment, which of the following actions should the nurse take first? a. Determine the client's perception of their current health status. b. Gather data about the client's cultural beliefs. c. Determine how the client's culture can affect the effectiveness of nursing actions. d. Gather information about previous client interactions with the health care system.

b. Gather data about the client's cultural beliefs.

A newly hired public health nurse is reviewing the disaster management cycle. Which of the following actions is a component of disaster prevention? a. Outlining specific roles of community agencies b. Identifying community vulnerabilities c. Prioritizing care of individuals d. Providing stress counseling

b. Identifying community vulnerabilities

An 18-year-old female who has a recent history of repeated emergency department visits for numerous fictitious disorders has appeared in the Emergency Department (ED) today with small superficial cuts on both arms. She reports that she awakened this morning to find these on her arms. She tells the nurse she is concerned about getting "lock jaw" and needs to be hospitalized. The nurse would anticipate the diagnosis of this patient to be: a. Narcissistic personality disorder. b. Munchausen's syndrome. c. Family neglect and abuse. d. Munchausen's by proxy.

b. Munchausen's syndrome.

A public health nurse is planning several initiatives for a city. Which of the following interventions should the nurse include as part of public health assurance? a. Meeting with city officials to propose changes to health laws. b. Partnering with a laboratory company to provide free HIV screening for the public. c. Reviewing data for incidence of influenza over 25-year span. d. Providing medical facilities with information accidental injury rates.

b. Partnering with a laboratory company to provide free HIV screening for the public.

A student nurse asks the Registered Nurse (RN) staff nurse how he assures if patient teaching is effective. The best response by the RN is: a. Patients who do not have objectives will learn material poorly. b. Patient learning is evaluated based on achievement of learning outcomes. c. Patient learning objectives help the nurse organize the teaching material. d. Patient learning will occur when the nurse makes an educational diagnosis.

b. Patient learning is evaluated based on achievement of learning outcomes.

After her first week working on a busy medical/surgical unit, a new nurse manager notes that the individual nurses are highly competent but unable to function as a team. Select the action by the nurse manager that would facilitate team building among the staff. a. Allow the staff more input into important policy decision-making. b. Provide an opportunity for the nurses to express their feelings and emotions. c. Hire more staff members to reduce stress and fatigue from understaffing. d. Give the staff members more time to adjust to the change in nurse manager.

b. Provide an opportunity for the nurses to express their feelings and emotions.

The nurses on the 7am to 7pm shift have complained to the nurse manager that the nurses on the 7pm to 7am shift have not recorded patient daily weights, and the physicians are upset when making morning rounds. Identify the initial action the nurse manager should take to resolve this conflict. a. Post a stern memo that reminds the night shift nurses to do the daily weights. b. Review the daily weight flow sheet. c. Hold a meeting with the physicians to discuss their attitudes. d. Change the time for daily weights to the late morning.

b. Review the daily weight flow sheet.

A public health nurse is planning an in-service on older adult health. Which of the following information should the nurse include? a. The percentage of older adults in the population is decreasing. b. The proportion of older adults who live alone is increasing. c. Older adults take one-half of all prescription medications. d. Older adults have a decreased recovery time following injury.

b. The proportion of older adults who live alone is increasing.

The first nursing intervention for the patient who has been sexually assaulted is to: a. Contact a support person for the patient. b. Treat urgent medical problems. c. Document bruises and lacerations of the perineum. d. Provide supplies for the patient to cleanse self.

b. Treat urgent medical problems.

A nurse terminates employment without giving the facility the required 2-week notice. One month later, the nurse manager receives a call from the personnel director at a different hospital requesting a reference for this nurse. How can the nurse manager best respond to this request? a. "The nurse worked here for several months before leaving abruptly." b. "The nurse was irresponsible and did not give a 2-week notice." c. "The nurse worked here from November 1, 1993, to April 9, 2012." d. "You will be lucky to hire a nurse of his caliber."

c. "The nurse worked here from November 1, 1993, to April 9, 2012."

Order: Cefazolin 2g in 100 ml D5W to be infused over 30 minutes. Drop factor is 10gtt/ml. You will administer how many gtt/min? a. 12 gtt/min b. 15 gtt/min c. 33 gtt/min d. 22 gtt/min

c. 33 gtt/min

A client is prescribed 1 g potassium phosphate IV to be infused continuously over 6 hr. Available is 1 g potassium phosphate in 250 mL dextrose 5% water (D5W). The nurse should set the Intravenous (IV) pump to run at how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) a. 30 ml/hr b. 40 ml/hr c. 42 ml/hr d. 43 ml/hr

c. 42 ml/hr

Order: Lidocaine 2 mg/min. Supply is Lidocaine 4 g/250ml. The pump should be set at what rate? a. 7.7 ml/hr. b. 7.1 ml/hr c. 7.5 ml/hr d. 6.1 ml/hr

c. 7.5 ml/hr

The Register Nurse (RN) is providing an educational session to new employees, and the topic is abuse of the older patient. The nurse helps the employees identify which patient as most typically a victim of abuse? a. A 68-year-old man who has newly diagnosed cataracts. b. A 70-year-old woman who has early diagnosed Lyme disease. c. 90-year-old woman who has advanced Parkinson's disease d. A 75-year-old man who has moderate hypertension.

c. 90-year-old woman who has advanced Parkinson's disease

An important principle that guides managers who use the democratic leadership style of management is: a. The members of the group must carry out decisions of the leader without question. b. The leader performs the same tasks as the rest of the members of the group. c. Each member of the group respects all the other members as unique and valuable. d. The leader must be methodical and able to sift through complicated information.

c. Each member of the group respects all the other members as unique and valuable.

Which of the following elements in managed care has contributed to the need for in-creased patient education? a. Physician control of the health-care environment. b. High rates of nosocomial infections. c. Emphasis on increased patient responsibility for care. d. Use of the team method of nursing care.

c. Emphasis on increased patient responsibility for care.

A nurse is caring for an elderly patient who has been in a healthcare facility for 3 weeks due to hip replacement and pulmonary complications. The nurse notes development of decubitus ulcer on his coccyx area. Which action would be appropriate to obtain a collaborative plan of care? a. Notify the unit manager that staff may not be consistently or effectively carrying out the skin care protocol for high-risk patients. b. Develop a nursing care plan for "Risk for impaired skin integrity. c. Facilitate a consult with the wound care nurse d. Bring the problem to the attention of the surgeon during rounds.

c. Facilitate a consult with the wound care nurse

Evidence-Based Practice (EBP) is a thoughtful integration of the best available evidence, coupled with clinical expertise. EBP allows the practitioner to assess current and past research, clinical guidelines, and other information resources. The practice of EBP includes five (5) fundamental steps. Which of the following is considered step one (1) of the process? a. Applying the evidence b. Diagnose the practice in question c. Formulating a well-built question d. Re-evaluating the application of evidence

c. Formulating a well-built question

When interviewing for employment as a new graduate staff nurse, the interviewee is asked to identify her own weaknesses in performance of skills. She knows from role-play of interviewing skills that a positive response to the question may be to share: a. That she is competent in all skills. b. A list of skills that she is not competent in. c. Her ability to learn quickly any skills that are lacking. d. A specific skill, such as medication administration, that is lacking.

c. Her ability to learn quickly any skills that are lacking.

A nurse is participating in a quality improvement study of a procedure frequently performed on the unit. Which of the following information will provide data regarding the efficacy of the procedure? a. Frequency with which procedure is performed b. Client satisfaction with performance of procedure c. Incidence of complication related to procedure d. Accurate documentation of how procedure was performed

c. Incidence of complication related to procedure

The nursing instructor gives the entire class a grade of 100 on their project for participation, she is displaying: a. Autonomy b. Fidelity c. Justice d. Veracity

c. Justice

A nurse is working with an intersexed baby and family. The baby has both an ovary and testes and ambiguous genitalia. The doctor recommends doing surgery to make the child a female, rationalizing that is the easiest change to get a desirable physical result. The nurse realizes the ethical principle that may be violated is: a. Confidentiality b. Fidelity c. Nonmaleficence d. Veracity

c. Nonmaleficence

An older adult patient who is on fall precautions is found lying on the floor of his hospital room. Which of the following actions is most appropriate for the nurse to take first? a. Ask the patient why he got out of bed without assistance. b. Complete a facility incident report. c. Palpate the patient's wrist and evaluate his/her pulse. d. Carefully move the patient to the bed.

c. Palpate the patient's wrist and evaluate his/her pulse.

A nurse is planning measures to reduce the incidence of obesity. Which of the following interventions affects the environment, according to the epidemiological triangle? a. Determine whether clients have a family history of obesity. b. Measure clients' Body Mass Index (BMI). c. Provide low-fat meal options at public schools. d. Ask affected adults to keep a diary of food intake.

c. Provide low-fat meal options at public schools.

A community health nurse is implementing health programs with several populations in the local area. In which of the following situations is the nurse using primary prevention? a. Performing a home safety check at a client's home. b. Teaching healthy nutrition to clients who have hypertension. c. Providing influenza immunizations to employees at a local preschool. d. Implementing a program to notify individuals exposed to a communicable disease.

c. Providing influenza immunizations to employees at a local preschool.

A nurse who works in a federally funded abortion clinic becomes aware that aborted second-trimester fetuses are being sent to a nearby university for research and transplantation. What should this nurse do with this knowledge? a. Keep quiet about the finding because she might lose her job. b. Confront the medical director of the clinic that this practice is both illegal and unethical. c. Report the practice to the Department of Health and Human Services. d. Tell the supervisor about what is going on and ask for a raise.

c. Report the practice to the Department of Health and Human Services.

A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first? a. Provide an in-service on medication administration to all the nurses. b. Require staff nurses to demonstrate competency by passing a medication administration examination. c. Review the events leading up to each medication administration error. d. Develop a quality improvement program for nurses involved in medication administration errors.

c. Review the events leading up to each medication administration error.

It is the Mission of the Board of Nursing to protect the public by assuring licensed nurses are safe and competent to practice nursing. When there is a violation of the Nurse Practice Act, the Board must investigate to seek resolution to the complaint. When the violation is related to chemical dependence including alcohol. a. The nurse is given disciplinary action. b. The nurse is sent to a drying out facility. c. The nurse is offered the alternative program. d. The nurse's license is revoked for life.

c. The nurse is offered the alternative program.

A nurse is accused of professional negligence. In determining if he or she is guilty, a jury would compare the nurse to what standard? a. What a lawyer would have done in the same situation. b. What a physician would have done in the same situation. c. What a reasonable and prudent nurse would have done in the same situation. d. What a well-educated layperson would have done in the same situation.

c. What a reasonable and prudent nurse would have done in the same situation.

The nurse is assigned to care for four clients. In planning client rounds, which client should the nurse assess first? a. A postoperative client preparing for discharge with a new medication. b. A client requiring daily dressing changes of a recent surgical incision. c. A client scheduled for a chest x-ray after insertion of nasogastric tube. d. A client with asthma who requested a breathing treatment during the previous shift

d. A client with asthma who requested a breathing treatment during the previous shift

The nurse recognizes the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirement for patient education by which of the following? a. Delegating patient education to other staff. b. Reminding physicians to educate the patient. c. Attempting to provide some type of education for patients. d. Acting as a skilled patient educator.

d. Acting as a skilled patient educator.

A patient tells the nurse that he does not want to have a painful procedure. By respecting and supporting the patient's right to make decisions, what is the nurse demonstrating? a. Justice b. Altruism c. Confidentiality d. Advocacy

d. Advocacy

During a staff meeting, an elderly physician is very negative and disagrees with any proposals for change, directing belittling statements at the unit manager, such as, "No wonder this hospital is such a mess. You young nurses have no commitment to working hard!" How can the unit manager most appropriately deal with this situation? a. Walk out of the room and report the physician to the hospital's chief of medicine. b. Reply to the physician with equally belittling remarks. c. Ask the physician to leave the meeting before proceeding. d. Allow the physician to express his or her opinions, and then ask for input from others at the meeting.

d. Allow the physician to express his or her opinions, and then ask for input from others at the meeting.

A community health nursing case manager is assigned the case of a 12-year-old boy diagnosed with diabetes mellitus. He is unreceptive to learning and does not want to learn to read the glucometer or give his own insulin injections; he eats what he wants without regard for his blood sugar. Which of the following would be the most appropriate to arrange to help keep this child from feeling alone with regard to his diabetes? a. Allow his parents to home school him. b. Encourage the school nurse to discuss his diabetes with him. c. Attend a diabetic support group of all ages. d. Attend a diabetic camp for preteens.

d. Attend a diabetic camp for preteens.

A nurse reviewing a patient's chart discovers that the patients Do Not Resuscitate (DNR) order has expired. The patient's condition has not been stable today. The most appropriate action for the nurse to take at this time to: a. Write a note on the front of the primary care provider order sheet asking that the DNR be reordered. b. Assume that the patient still wishes to be a DNR. c. Anticipate that CPR will be instituted if the patient goes into cardiopulmonary arrest. d. Call the primary care provider to get the order immediately reinstated.

d. Call the primary care provider to get the order immediately reinstated.

A unit manager is preparing the time schedule for the summer holiday season. Approximately half of the staff has requested 1 to 2 weeks' vacation. Granting all the requested time will lead to severe staffing shortages. What is the nurse manager's primary consideration in developing this schedule? a. Granting requests by seniority. b. Nurses' satisfaction and work performance. c. Establishing good communication with staff members to reduce resentment. d. Client safety needs.

d. Client safety needs.

Identify the term used when an ethical situation arises in which there is a choice between two equally unfavorable alternatives. a. Ethical antagonism b. Contraindication c. A tort d. Ethical dilemma

d. Ethical dilemma

The changes in practice guidelines for placing a baby supine to rest to prevent Sudden Infant Death Syndrome (SIDS) versus prone to prevent aspiration is reflective of: a. Healthy People 2020. b. Infant Mortality rates. c. Traditional Practices. d. Evidenced Based Practice.

d. Evidenced Based Practice.

A nurse is developing a community health education program for a group of clients who have a new diagnosis of diabetes mellitus. Which of the following learning strategies should the nurse include for clients who are auditory learning? a. Showing photographs of sites for injection b. Providing equipment to practice hands-on skills c. Supplying outlines for note-taking d. Facilitating small group discussions

d. Facilitating small group discussions

A patient has asked the nurse to explain her laboratory results. The nurse tells the patient that he must first assist another patient to the bathroom and then he will explain the results. The nurse assists the other patient to the bathroom and then returns to explain the results. What moral principle has the nurse displayed? a. Nonmaleficence b. Confidentiality c. Autonomy d. Fidelity

d. Fidelity

When interviewing for employment as a new graduate staff nurse, the interviewee is asked to identify his own weaknesses. He knows that a weakness that could be perceived as strength by the employer is to share: a. His lack of experience in the work area. b. His lack of laboratory skills. c. Nothing. No weakness could be perceived as strength. d. His desire for perfectionism in his work.

d. His desire for perfectionism in his work.

A case management nurse is preparing to initiate referrals for a client as part of discharge planning. Which of the following actions should the nurse take first? a. Monitor the client's satisfaction with the referral. b. Provide the client information to referral agencies. c. Review available resources with the client. d. Identify referrals that the client needs.

d. Identify referrals that the client needs.

Evidenced Based Practice can be compared to the process of critical thinking in that the first step in the process is: a. Identify the value systems' conflicts. b. Identify the underlying causes. c. Identify the best solution to the conflict. d. Identify the problem.

d. Identify the problem.

What is the most important reason why nurses should be familiar with health-care reimbursement methods? a. Nurses can decide which test should be performed. b. Nurses can base discharge on reimbursement restrictions. c. Nursing care can be developed based on financial incentives to lower cost. d. It allows nurses to be informed patient advocates.

d. It allows nurses to be informed patient advocates.

A nurse at your facility has been observed diverting drugs. The supervisor has been notified. In order for the nurse to receive the best help with this problem, the healthcare facility should? a. Insist the nurse seek the guidance from a personal counselor or treatment program. b. Refer the nurse to the Employee Assistance Program (EAP) provided by the hospital. c. Suggest that the nurse obtain the council of a lawyer for a charge of steeling. d. Notify the Board of Nursing for a referral to the Alternative Program.

d. Notify the Board of Nursing for a referral to the Alternative Program.

A nurse has just assisted a patient back to bed after a fall. The nurse and physician have assessed the patient and have determined that the patient does not appear to be injured. After completing the incident report, the nurse implements which action next? a. Conduct a staff meeting to discuss the fall. b. Contact the nursing supervisor. c. Document in the electronic chart the incident report was completed. d. Reassess the patient.

d. Reassess the patient.

The newborn nursery is desperately short of staff. A nurse agrees to work an extra shift. During the 14th hour on duty, the nurse makes a medication error. Because the nurse was filling a "desperate" need, and therefore was fatigued, what is the legal responsibility of the nurse? a. The nurse's legal responsibilities are met if an incident report is filed. b. No legal action can be brought against the nurse because it was an issue of extreme need. c. The hospital accepts full responsibility for the negligent act. d. The nurse is held to the same standard of care as any nurse with her education and experience.

d. The nurse is held to the same standard of care as any nurse with her education and experience.

When conducting a patient language assessment, which of the following is the most important for the nurse to assess? a. The cultural health-care practices used on a regular basis. b. The presence of the patient's personal interpreter from home. c. The length of time the patient has lived in America. d. The patient's fluency in both primary and secondary languages.

d. The patient's fluency in both primary and secondary languages.

A Registered Nurse (RN) is assigned to a step-down coronary care unit with 20 patients in various stages of recovery. What is the primary consideration in assigning the unit's staff that includes two RNs, two Licensed Practical Nurses (LPNs) Licensed Vocational Nurses (LVNs), and one Certified Nursing Assistant (CNA)? a. Developmental needs of patients. b. Staff preferences for specific patients. c. The distance of patient rooms from the nurses' station. d. The skill level of each staff member.

d. The skill level of each staff member.

During an interview for employment as a new graduate staff nurse, the interviewer asks how the new graduate feels about working a night shift. The new graduate knows that night shift may not be the best fit for her schedule. Her best response to further the interview process would be: a. To ask to speak to the supervisor. b. To inform the interviewer that she will only think about working night shift once she has been hired for the position. c. To share that she could never work a night shift because of child care. d. To share that she is willing to consider any employment opportunities.

d. To share that she is willing to consider any employment opportunities.

Which of the following is an ethical dilemma for a nurse: a. Receiving pay from the employer for working a scheduled shift b. Counseling and providing support c. Medicating a patient who requests pain medicine d. Working with a patient receiving futile treatments

d. Working with a patient receiving futile treatments

A patient has sustained a spinal cord injury and is no longer able to get in and out of the bathtub without assistance. Which nursing diagnosis appropriately addresses this problem? 1) Feeding Self-care Deficit 2) Bathing Self-care Deficit 3) Dressing Self-care deficit 4) Activity Intolerance

2) Bathing Self-care Deficit

Select the personal characteristic of an Registered Nurse (RN) that would tend to render his or her delegation ineffective. a. Demands perfection of employees b. Trusts in the abilities of others c. Many years of experience in delegation d. Feels self-confident in his or her ability as a leader

a. Demands perfection of employees

An older adult patient who is on fall precautions is found lying on the floor of his hospital room. The patient is assessed and no injuries are noted. Which of the following are to be documented in the patient's record? a. Physician notified and no new orders received. b. Patient found lying on the floor beside his bed. c. Patient fell out of bed by crawling over the side rail. d. Occurrence/incident report completed.

b. Patient found lying on the floor beside his bed.


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