roles exam 1 questions nclex
A medical - surgical nurse arrives on the unit and is assigned to care for four patients, which patient would the nurse attend to that falls under the second level of priority setting? A)A 16 year old female patient who is 24 hours post appendectomy who is requesting for pain medications and rates her pain level of 7/10 B)A 37 year old female patient concerned about her new mastectomy and states to you, "I can't stand to look at my body right now. I don't feel like I am attractive anymore." C)A 15 year old male patient who has sudden onset of wheezing and whose oxygenation levels show 88% upon assessment D)A 65 year old male patient who is ready to be discharged and receive teaching about his low - sodium diet after experiencing an episode of his medical condition of congestive heart failure
A
A nursing instructor defined the concept of healthcare quality to her class. Which response by one of the students would show that the student understood the definition of healthcare quality. A)Health care quality is described as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. B)Health care quality is described by patient satisfaction only. C)Health care quality is described as a goal directed decision making about health that is the result of an authorized, public decision -making process. D)Health care quality is described as a behavioral science that begins with two propositions about human behavior
A
According to the National Quality Forum, care coordination seeks to deliver: A). The right care to the right patient at the right time B). The safest care possible C). The most up-to-date research on patient care D). The best value to the patient E). The advantages of total care nursing
A
What are the goals of care coordination? (SATA) A)Improve and optimize care B)Promote health and independence C)Reduce unnecessary service utilization D)Focuses strictly on the younger population
A,B,C
Define and describe health care quality. Question: Which statements define and describe health care quality? (Select all that apply) A) Improves self-health care. B) Protects the client from harm. C) Ensures identical care to all clients. D) Defines the principles by which nurses' provide care to their clients. E) Choosing which patients to care for based on their condition
A,B,C,D
A nurse understands the following as key attributes of care coordination: (Select All That Apply) A. Clinical decision making B. Priority setting C. Use of organizational skills and resources D. Time management E. Evaluation
A,B,C,D,E
A student nurse asks the RN she is working with to give her examples of healthcare quality. The RN demonstrates an understanding of healthcare quality when she gives the following examples: (select all that apply) A. Positive outcomes after successful interventions B. The patient feels they have received exceptional care because the nurse was knowledgeable. C. A nurse tells her charge nurse that she didn't use sterile gloves when inserting a patient's Foley catheter. D. After teaching a patient how to properly administer their insulin, the nurse asks for the patient to demonstrate this back. E. The nurse uses SBAR format while communicating with the doctor.
A,B,C,D,E
Which are examples of Supportive & Ancillary Organizations? SATA A)Centers for Medicare & Medicaid services B)TJC- an accrediting body C)Medline- a medical supply company D)A local hospital E)A private insurance company
A,B,C,E
A student nurse is learning about the five key attributes of care coordination and how to appropriately deliver necessary services and information to support quality health and care across settings. The student demonstrates their understanding of the key attributes of care coordination by selecting the following: (Select all that apply.) A)A proactive plan of care B)Communication C)A set of activities that the patient believes is "fun" to do D)Proactive follow-up E)A team of personnel that includes the patient's neighbor
A,B,D
A recent graduate, Sarah, is having her first performance meeting with the Manager of the unit. Sarah confidentially tells the manager that she believes she is being bullied by the other nurses on the unit. Which of the following scenarios depicts Sarah is being bullied? (Select all that apply): A)The other nurses on the unit congregate in the hall by the breakroom and talk quietly while looking in the direction of the Sarah. B) While Sarah was precepting with another nurse, she failed to take a patient's blood glucose level before administering insulin causing a near miss event. The experienced nurse told the manager about the situation. C)A nurse on the unit told the entire team that Sarah failed her NCLEX 4 times and shouldn't be a nurse. This was untrue information and Sarah passed the NCLEX on the first try. D) The team of nurses were all making plans to hang out and let off steam when their shift was over. Sarah walked in the room while they were all making plans and asked what they were all talking about. The nurses stated nothing and all walked out at once. E)A nurse on the unit observed Sarah putting the wrong 'change by date' sticker on a piggyback IV tubing. She then took Sarah aside and privately gave her feedback about the error and reminded her about the facilities policy on labeling IV tubing.
A,C,D
Describe effective delegation in the clinical setting. If need be, which of the following can the nurse delegate to the licensed practical nurse (LPN)? Select All That Apply. A. Administering an IM medication B. Initiating a primary IV medication C. Administering oral medication D. Urinary catheterization
A,C,D
What are the main goals of care coordination? Select all that apply. A. Promote health and independence B. Maintain physician job satisfaction C. Improve and optimize holistic care D. Provide cost effective care
A,C,D
Which of the following are examples of lateral violence? Select all that apply. A) A veteran nurse tells a new grad nurse that they won't last a year in this field and that she would never want the new grad nurse to care for her family member. B) A new grad nurse seeks advice from his preceptor on the best way to describe his assessment objectively in his care note. C)A charge nurse is creating the assignments for the day and assigns a 57 year old male patient that came in for alcohol detoxification and pancreatitis to a new grad nurse. The patient has had several verbal conflicts with members of the healthcare team and had security called on him four times during this hospitalization. The charge nurse tells another nurse on the unit that, "The new grad nurse needs to sink or swim. She deserves to get slapped around a bit to see if this is the right field." D)A nurse asks another nurse on the unit to help with a complicated dressing change on his patient. The coworker refuses to help him because he would not go on a date with her. E)An interdisciplinary team meets together to create a discharge plan for a patient who has been hospitalized for an extended period of time and will have various medical needs once he is back home.
A,C,D
Name the 3 major attributes and 4 minor attributes of HCOs and briefly discuss their importance.
A: Major-1) HCOs have the unique purpose of helping others to achieve good health by providing the necessary services to do so. HCOs assist persons in maintaining the health, improving their health, restoring their health or helping them to die with dignity. This requires knowledgeable individuals to provide the care. HCOs bring together the knowledgeable people required to administer such care. The mission, vision and values help to determine the HCOs purpose. 2) HCOs require a specialized workforce- Nurses comprise the largest population of that specialized workforce. There are also doctors, pharmacist, medical assistants, patient care technicians, phlebotomist and physical therapists to name a few others. Each of these workers require a level of education and expertise in order to help the patient safely. This interprofessional approach helps to ensure the whole person is treated and not just a disease process. Within some HCOs there are also many less skilled people needed to care for patients. This could include cleaning people, cooks and meal servers, laundry personnel, billing specialist and secretaries, 3) Public Trust- The health care industry has historically been one of the most trusted for the general population. Patients talk with physicians and nurses about deeply intimate subjects and rely on pharmacists to give them exactly the right medication at the pharmacy. As organizations grow larger, some of that trust has eroded. It is up to all of us in health care to regain that trust through competent and compassionate care. Minor-1)Structure-All organizations have a structure. In health care the structure can differ some depending on the type of organization. The workforce in the organization needs structure so that workers have a clear understanding of the expectations and directions for providing the care. Structure brings rules and policies to help guide behavior. There needs to be a balance in structure between too much structure and too much freedom. 2) Bureaucracy- Within the organizational structure there is a need to have those that are in charge of making decisions.This helps to make health care more streamlined and efficient. Bureaucracy can sometime be too machine like and not take into account the human element of the workers and the patients. 3) Organizational environments-This is the culture of the organization. A culture can drive the workforce to achieve their best or it can bring down the workforce to complacency. A positive work environment is essential in providing quality health care. 4) Theoretical links- Many of the HCOs are organized based on theories developed by social scientists.
A nurse is explaining to a student nurse about the different behaviors between nurses that lead to the undermining of a healthy collaborative work environment also known as horizontal violence. The student demonstrates their understanding of this violence by naming the different types of horizontal violence (SATA): A)Withholding information B)Sabotage C)Verbal affront D) Undermining activities
ABCD
Define and describe health care quality. Question: Which statements define and describe health care quality? (Select all that apply) A) Improves self-health care. B) Protects the client from harm. C) Ensures identical care to all clients. D) Defines the principles by which nurses' provide care to their clients. E) Choosing which patients to care for based on their condition.
ABCD
What are strategies for reducing Healthcare Errors? (SATA) a) Checklists b) Shared Rounds c) Implementing Technology d) Using chlorhexidine with alcohol prep e) Using patient facial recognition technology to order meds and reduce errors
ABCD
A nurse understands the following as key attributes of care coordination: (Select All That Apply) A. Clinical decision making B. Priority setting C. Use of organizational skills and resources D. Time management E. Evaluation
ABCDE
Question: What are the ways to measure and evaluate quality of care? (SATA) A. Through the usage of patient care outcomes B. Analyzing patient satisfaction C. Utilizing resources in an effective manner D. Delivering care through the most recent evidence-based practice E. Delivering safe care
ABCDE
What are the ways to measure and evaluate quality of care? (SATA) A. Through the usage of patient care outcomes B. Analyzing patient satisfaction C. Utilizing resources in an effective manner D. Delivering care through the most recent evidence-based practice E. Delivering safe care
ABCDE
A clinical instructor is teaching a nursing student about lateral violence. The student indicates she has a clear understanding of lateral violence when she states which of the following? (Select all that apply) A). Lateral violence is a major cause of interpersonal conflict. B). Heavy workload and short staffing are situations that may lead to lateral violence. C). Lateral violence includes a real or perceived power difference between the instigator and recipient. D). Newly licensed nurses and nursing students are especially vulnerable to lateral violence. E). Lateral violence is between doctors who show hostile behavior or psychological harassment to nurses.
ABD
A new nurse goes in for a job interview. The interviewer asks why the nurse would be a good fit for the healthcare team. The nurse discusses these key attributes of healthcare quality when stating why they would be a good fit for the team. (Select All That Apply) A)Safety B)Efficiency C)Speed D)Effectiveness E)Organization F)A Positive Attitude
ABD
Which of the following may contribute to a toxic environment and foster increased incivility among staff? (Select all that apply) A. High stress level B. Inadequate staffing C. A residency program for newly hired nurses D. Organizational change E. Unrealistic expectations
ABDE
Mr. Smith, a 75-year-old male, recently had his right hip replaced. He is to be discharged from the hospital tomorrow to his home. Mr. Smith lives in a 2-story house by himself. He has several steps on his porch leading to his front door. Mr. Smith is worried about going home by himself and feels lonely. What members of the health-care team are most important involving the coordination of Mr. Smith's care before he leaves the hospital and when he returns home? (Select all that apply) A)Social worker B)Physical therapist C)Dietician D)Mr. Smith's nurse E)Mr. Smith's patient care technician F)Occupational therapist
ABDF
Q. What are the main goals of care coordination? Select all that apply. A. Promote health and independence B. Maintain physician job satisfaction C. Improve and optimize holistic care D. Provide cost effective care
ACD
What are examples of specialty care services that an institutional provider can provide? SATA. A. Burn care B. Medical and surgical care C. Woman and infant's care D. Psychiatric care
ACD
The major or minor attributes of health care quality include: (Select all that apply) a. Integrates curative and preventive services b. Patient needs or values are not a priority when providing care c. Provides sound decision making in care of individuals/groups d. Being timely, patient centered and partial towards the patient(s) receiving care. e. Ensures that transitions between providers, departments, and health care settings are respectful, coordinated, and efficient
ACE
A student nurse asks the RN she is working with to give her examples of healthcare quality. The RN demonstrates an understanding of healthcare quality when she gives the following examples: (select all that apply) A. Positive outcomes after successful interventions B. The patient feels they have received exceptional care because the nurse was knowledgeable. C. A nurse tells her charge nurse that she didn't use sterile gloves when inserting a patient's Foley catheter. D. After teaching a patient how to properly administer their insulin, the nurse asks for the patient to demonstrate this back. E. The nurse uses SBAR format while communicating with the doctor.
ALL
Compare the categories and characterisitcs of health care organizations Question: Which of the following statements is true about the characteristics of health care organizations? A) The mission of a health care organization is not always related to the focus of care. B) Privately owned health care organizations are funded by the government. C) The difference between non-profit and for profit health care organizations is how the profits are distributed.
Answer: C. The difference between non-profit and for profit health care organizations is how the profits are distributed. Rationale: The financial classification of health care organizations can be broken up into two parts: For profit and for non-profit. The major difference between the two is how profits are distributed. For profit organizations generate funds for share holders while providing health related services. Non-profit organizations do not benefit the share holders. This revenue goes towards new facilities and equipment (Giddens 2012).
Define and describe horizontal violence. Question: A nursing student is experiencing horizontal violence from a staff nurse at her clinical site. Which step should the student take in addressing this problem? A.) Ignore it and go on about her day. B.) Confront the nurse in front of the floor staff at the nurses station. C.) Inform her instructor or floor manager and ask for assistance in handling this issue. D.) Avoid the staff nurse for the rest of the day.
Answer: C.) Inform your instructor or floor manager in charge and ask for assistance in handling this issue. Rationale: Incorporating workplace civility in nursing orientation programs and modeling professional behaviors provides a foundation to promote a healthy work culture. Nursing students and new graduates often lack the confidence and skill set to prevent interpersonal conflict and must rely on experienced nurse managers and leaders to reduce the likelihood of horizontal violence or bullying. Nurse educators have a similar responsibility to develop nursing curricula that educate and encourage dialogue about horizontal violence to increase awareness and provide nursing students the skills to combat horizontal violence (Yoder-Wise, 2015).
A nurse is preparing to discharge a patient. The patient still has an IV access that needs to be removed. While preparing the discharge instructions, the nurse should delegate this task to which of the following personnel? A. The charge nurse B. A licensed vocational or practical nurse C. The discharging physician D. The unit's medical receptionist
B
A nurse just came on the floor at the hospital. She has been assigned the following 4 patients. Which patient should the nurse see first? A. A 75 year old male that has just returned from hip surgery complaining of a headache. B. A 25 year old female who was in a motorcycle accident with a BP of 88/48, R 8, SPO2 85%. C. A 50 year old female who is requesting to be discharged. D. A 37 year old who has acute kidney failure and a potassium level of 5.6.
B
A student nurse has asked her nurse how she should prioritize care on the unit. How should the nurse best respond to the student? A). Assess patients who are closest to the nurse's station first. B). Decide which needs or problems require immediate action and which ones could be delayed until a later time because they are not urgent. C). Facilitate the appropriate delivery of the necessary services and information to support optimal health and care across settings and over time. D). Rank the patients from easiest to hardest to assess.
B
Describe effective prioritization in the clinical setting Question: The ED nurse is caring for the following patients. Which does the nurse prioritize to see first? A. 22 year-old with a painful and swollen right wrist. B. 45 year-old reporting chest pain and diaphoresis. C. 60 year-old reporting severe dizziness and nausea. D. 81 year-old with a respiratory rate of 21 breaths/minute and a temperature of 100.
B
The difference between bullying in the workplace and lateral violence is that: A. lateral violence is verbal harassment whereas bullying is both verbal and physical harassment. B. bullying occurs when there is a real or perceived power difference between the people involved. C. bullying only occurs when the people involved are at different levels of authority. D. bullying only happens in grade school.
B
Which patient would be considered an intermediate priority? A. Patient with a broken femur who is complaining of pain. B. A postoperative patient who has a family member who is questioning a new dosage of medication. C. A patient who is questioning where she will be discharged tomorrow. D. A patient with a change in LOC.
B High priority - patients that have an immediate threat to their survival, airway, LOC, or psychological attack. Intermediate priority - nonemergency, non life threatening needs that patient or family are experiencing. Teaching needs for a new drug or postoperative complications. Low priority are events that are not directing related to the patients current health. Such as long term care needs
Define and describe bullying Question: Bullying in the workplace leads to which of the following? A) Hardworking employees B) Increased job turnover C) Positive attitudes D) Improved quality of care
B) Increased job turnover
What were some ways Chasing Zero discussed in their video to reduce errors and promote safe patient care? (Select All That Apply). A) Have a 1:1 nurse-to-patient ratio in all units to ensure the patient is getting the safest and most attentive care they deserve. B) Share Rounds (Bedside report), this helps nurses to include the patients and their family in the process of passing on information during shift change. C) Check a Box, Save a Life. Checklists help make things simple, predictable, standardized, and enhances communication. D) Have an Unlicensed Assistive Personnel (UAP) check and report vitals before the nurse administers medication to improve time management. E) Using bar code technology helps to guarantee the 5 rights for medication administration.
B, C, E.
A healthcare organization is defined by having which of the following? (SATA) Profit People Purpose Goals Social structure Formal properties
B,C,E,F
Which of the following is an example of a healthcare organization? A.) A registered nurse B.) World Health Organization C.) A doctor D.) A certified nurse assistant
B.) World Health Organization
A nursing student is experiencing horizontal violence from a staff nurse at her clinical site. Which step should the student take in addressing this problem? A.) Ignore it and go on about her day. B.) Confront the nurse in front of the floor staff at the nurses station. C.) Inform her instructor or floor manager and ask for assistance in handling this issue. D.) Avoid the staff nurse for the rest of the day.
C
Describe the key attributes of health care quality Question: A new nurse graduate is hired to work for a health care facility. The nurse understands from his/her learned knowledge that key attributes of health care quality include: A). providing/delivering efficient care only to mobile patients B). providing care that is proven to be effective according to the Internet C). providing/delivering patient care in a safe, timely, and effective manner D). providing patient centered care only to patients that can afford a private room
C
Which of the following statements is true about the characteristics of health care organizations? A) The mission of a health care organization is not always related to the focus of care. B) Privately owned health care organizations are funded by the government. C) The difference between non-profit and for profit health care organizations is how the profits are distributed.
C
You are getting ready to discharge your patient who has COPD. He is a 78 year-old male who has been disgruntled during his hospital stay. When planning your discharge for him, what is important to keep in mind? A). Set up all of the discharge planning yourself so you don't have to ask anyone for help. B). Ask the physical therapist if the patient would benefit from home health care C). Talk to the patient about discharge planning D). Have the physician write an order for the patient to go to a rehab center
C
Which patients have the most immediate need for intravenous (IV) access to deliver analgesia, medications or IV fluids? Select all that apply. A. A 70 year old COPD patient who has chest and back pain when coughing B. A 21 year old female patient who experiences burning sensations, hematuria and "excruciating" pain when urinating C. A 52 year old patient admitted with myocardial infarction complaining of severe chest pain D. A 48 year old male patient with a history of hypertension experiencing migraine E. A 27 year patient brought to the ER with the second degree burns affecting 50% of his body F. A 60 year old patient with a history of diabetes complaining of "annoying and painful" numbness and tingling sensations in his lower extremities
C & E
At shift change in the ED, several call lights are waiting to be answered. Which one should the nurse see first? A. A 36 year old, 26 weeks pregnant female with severe abdominal pain and vaginal bleeding. B. A 52 year old male who was admitted to the ED 2 hours ago with no history of heart problems complaining of severe chest pain. C. A 78 year old female with a history of diet controlled diabetes who has fruity smelling breath. D. An 18 year old male with complaints of a severe headache, fever, vomiting, and a stiff neck.
D
Lateral violence in nursing can result in the following EXCEPT? A) Reduced retention rates B) Decreased safety C) Decreased job satisfaction D) Reduced costs E) Negative outcomes
D
The nurse is assigned to care for four patients. In planning patient rounds, which of the four patients should the nurse care for first? a) A postoperative patient who is getting ready to get discharged with a new medication. b) A patient who has a fever of 103°F. c) A patient who needs daily dressing changes of a recent surgical incision. d) An asthma patient who requested a breathing treatment during the past shift
D
Which of the following is NOT one of the key attributes of care coordination? a. Targeted set of meaningful activities b. Proactive and goal oriented plan of care c. Professional team which involves the patient d. Provide cost effective care to patient e. Effective and therapeutic communication
D
Which of the following is the best definition of a health care organization? A.) It is the nurses responsibility to organize the patients health care, but a signed consent form is required. B.) A purposefully designed, structured social system developed for the delivery of health care service by specialized workforces to defined communities, populations, or markets. C.) The term "health care organization" is culturally insensitive, because it exists in some cultures but not in others. D.) A purposefully designed, structured social system developed for the delivery of health care services by specialized workforces to defined communities, populations, or markets.
D
Which of the following statements is true regarding the characteristics of organizations in the "for-profit" category of health care organizations? A. For-profit organizations can afford to provide uncompensated care. B. For-profit organizations are exempt from complying with standards set by regulatory agencies. C. For-profit organizations are typically so profitable that they do not need to worry about financial viability. D. Any profits earned (in excess of expenses) by for-profit organizations may be distributed to shareholders.
D
In the video Chasing Zero, what changes were initiated to improve patient safety and decreased the number of medical errors? (SATA) A)Smart pumps to infuse fluids B)Allowing nurses to work doubles to remain with their patients longer C)Barcodes on medications D)IHI's "Check a box, save a life" E)Nurse report at bedside
a,c,d,e
Describe effective delegation in the clinical setting Question: For effective delegation to occur, what are the five "rights" of delegation? (Select all that apply) A). task B). circumstance C). person D). direction E). supervision F). attitude
abcde
Discuss ways to measure and evaluate quality of care Question: Which of the following are effective ways to evaluate health care quality? (Select all that apply) A). Patient surveys B). Patient outcomes C). Leadership D). NDNQI (National Database for Nursing Quality Indicator E). Root cause analysis
abd
Question: Describe the key attributes of care coordination. (Select all that apply) A) An interprofessional team of personnel that includes the patient B) A proactive plan of care C) A targeted set of purposeful activities D) Proactive follow-up E) Communication
all
