Test 7 study guide

A client with impaired hearing is scheduled for a test to measure the compliance of the middle ear to sound transmission. For which diagnostic test will the nurse instruct the client? A) Tympanometry B) Weber test C) Rinne test D) Whisper test

A) Tympanometry

A nurse is working with a number of clients at a free clinic. Which client population is at a high risk for low levels of health care? A) Undocumented immigrants B) Men who have protected sex with men C) Men who have sex with women D) Teenagers

A) Undocumented immigrants

A new graduate nurse is working in a busy Emergency Department of a hospital, situated in a culturally diverse area of the city. What should the nurse do when providing culturally competent care? A) Possess the underlying background knowledge that will provide these clients with the best possible health care. B) Understand and attend to the total context of the client's situation, using knowledge, attitudes, and skills. C) Strive to be culturally sensitive, culturally appropriate, and culturally competent. D) Try to learn about the attitudes toward health care and traditions of the different cultures in that area.

A) Possess the underlying background knowledge that will provide these clients with the best possible health care.

The nurse has identified the diagnosis Disturbed Sensory Perception: Auditory for a client. Which intervention would be the most appropriate for this client? A) Replace batteries in hearing aids every week. B) Use facial expressions or gestures when talking. C) Face the client when speaking. D) Use a low voice pitch with normal loudness when talking

A) Replace batteries in hearing aids every week.

The nurse is evaluating the care a client with a hearing deficit has received. Which client statement indicates that care has been effective? A) "I ask others to face me when they talk, as I can hear them better." B) "I hear better when the television volume is raised." C) "I will change the battery in my hearing aid once a month." D) "I might use the hearing aid when I go shopping."

A) "I ask others to face me when they talk, as I can hear them better."

The nurse determines that a client is at risk for developing cataracts. What did the nurse assess in this client? A) Age 75 years B) Hypertension C) Minimal direct sun exposure D) Nonsmoker

A) Age 75 years

The nurse conducting nursing audits to help increase efficiency and reduce costs wants to suggest a better contribution to quality care. What should the nurse suggest be performed instead? A) Conduct a wound care study to enhance client outcomes. B) Install cameras to detect abuse of the clients. C) Acquire new client care equipment. D) Decrease staffing on the unit.

A) Conduct a wound care study to enhance client outcomes.

A nurse is preparing to teach a group of college students about organ donation. What should the teaching include to follow andragogic concepts? A) Directions about how to become an organ donor B) Past statistics about organ donors C) Information on how this group can influence their parents about organ donation D) Written pamphlets on organ donation

A) Directions about how to become an organ donor

A nurse faculty member is speaking to prospective students of the BSN program at their educational institution. Which of the following is a major incentive for students to select a BSN program over an ADN program? Select all that apply. A) Greater autonomy in the practice setting B) Liberal arts education C) Easier transition to graduate school D) Ability to work in critical care areas E) Better opportunity for career advancement

A) Greater autonomy in the practice setting E) Better opportunity for career advancement

A nurse is explaining the need to obtain laboratory tests on client who has an infection and is of a cultural group different from the nurse's. During the interview, the client averts her eyes and refrains from answering questions for long periods of time. What does this behavior indicate to the nurse? A) In this client's culture direct eye contact may show disrespect. B) Come back at a different time, when the client is feeling more communicative. C) Have another nurse finish the interview, because there is something uncomfortable the client senses. D) Leave the room and come back after having learned more about this particular culture.

A) In this client's culture direct eye contact may show disrespect.

The nurse is planning care for a client scheduled for cataract surgery. Which interventions should the nurse include in this client care plan? Select all that apply. A) Instruct on the administration of eye drops. B) Wear sunglasses if necessary. C) Avoid strenuous activity until seen by the ophthalmologist after the surgery. D) Resume normal activities of daily living after the procedure. E) Limit food and fluids until fully recovered from anesthesia.

A) Instruct on the administration of eye drops. C) Avoid strenuous activity until seen by the ophthalmologist after the surgery.

The nurse on a medical-surgical unit is asked to participate in data collection on skin care for the unit. What purpose will it serve for the nurse to cooperate with this request? A) Participate in the quality improvement process B) Advance the nurse's practice C) Prevent problems from arising in the unit D) Fulfill legal requirements

A) Participate in the quality improvement process

A new graduate nurse on a medical-surgical unit has been just been released from the orientation phase of training. The nurse is able to care for a four- to five-client assignment independently. She is assigned a coach on the unit who will help with problem solving, if needed. According to Benner's stages of nursing expertise, this nurse would belong to which stage? A) Stage II B) Stage V C) Stage III D) Stage IV

A) Stage II

A nursing instructor has assigned a group of students to perform a literature review on evidence-based practice (EBP). Which of the following statements demonstrates that the student understands the benefits of EBP? A) "This project will allow me to teach other students about literature searches." B) "Clients at risk for skin breakdown should be repositioned every 2 hours." C) "Literature searches allow nurses to find problems to implement EBP." D) "I will be able to present a paper about skin assessment from my query."

B) "Clients at risk for skin breakdown should be repositioned every 2 hours."

The nurse caring for an adult client from another country notices that the client consults with her mother on all healthcare decisions. What action by the nurse is the most culturally competent? A) Ask the client why the parent is being consulted for every decision. B) Accept the behavior of the client and family member. C) Ask the client's mother to leave the room to provide the client with more privacy. D) Confront the client's mother to state the importance of the client making her own decisions.

B) Accept the behavior of the client and family member.

A nurse educator is teaching a group of students about professionalism. The educator teaches the students that a profession is distinguished from other kinds of occupations through which of the following methods? Select all that apply. A) By being economically responsible B) By participating in ongoing research C) By acquiring specialized education D) By being autonomous E) By socializing with other nurses

B) By participating in ongoing research C) By acquiring specialized education D) By being autonomous

The nurse is reviewing discharge instructions with a client recovering from out-client cataract removal surgery. What should these instructions include? A) Phone the physician with any signs of eye drainage. B) Do not bend to pick up objects. C) Healing will be complete in 2 weeks. D) Wear the eye patch the day of surgery only.

B) Do not bend to pick up objects.

A nurse is caring for a client who is receiving IV tobramycin for the treatment of a respiratory infection. On which sensory factor will the nurse focus when concerned about this medication's toxic effects on the body? A) Taste B) Hearing C) Vision D) Swallowing

B) Hearing

The nurse instructor is preparing a teaching session for staff nurses on intradisciplinary assessments. Which information should the instructor consider when preparing this presentation? Select all that apply. A) Utilization reviews B) Peer review C) Audits D) Performance appraisals E) Outcomes management

B) Peer review C) Audits E) Outcomes management

The quality assurance officer notes that one particular nursing unit has received a higher-than-usual number of negative client responses about aspects of the nursing care during the previous quarter. To which component of care should the quality assurance officer pay particular attention when benchmarking this issue? A) Structure B) Process C) Outcome D) Competency

B) Process

A client has been diagnosed with cataracts of both eyes. What should the nurse realize that the treatment of choice for this client will be? A) Treat the cataracts with corrective lenses. B) Remove one cataract and then, in a few weeks, remove the other cataract. C) Remove both cataracts at the same time. D) Treat the cataracts with eye drops.

B) Remove one cataract and then, in a few weeks, remove the other cataract.

During an assessment, the nurse determines that a client is at an increased risk for the development of macular degeneration. What did the nurse assess in this client? A) Fibromyalgia B) Smoking C) Arthritis D) Acid reflux disease

B) Smoking

A client is recovering from cochlear implant surgery. What is true regarding cochlear implants? A) They restore normal hearing to those who could not hear any sound prior to implantation. B) Their function is more similar to the way the ear normally receives and processes sounds than it is to that of a hearing aid. C) They may be the only hope for restoring sound perception for the client with a total and permanent hearing loss. D) With implantation, the structures of the middle ear are reconstructed to improve conductive hearing deficits.

B) Their function is more similar to the way the ear normally receives and processes sounds than it is to that of a hearing aid.

The nurse is planning care for a client with an uncorrectable hearing loss. Which strategies for communication should the nurse add to the client's plan of care? Select all that apply. A) Magic slate B) Total communication C) Hearing aids D) Cued speech E) Sign language

B) Total communication D) Cued speech E) Sign language

The nurse is caring for an African-American male client who had a myocardial infarction and is receiving atorvastatin (Lipitor). The nurse assesses the client's diet to be very high in fat. What is the best plan by the nurse to improve the client's diet and reduce the risk that the client may need additional medications? A) Ask another nurse to speak to him about a low-fat diet. B) With the client's permission, discuss his diet with whoever prepares meals for the family. C) Consult a dietician to teach the client about low-fat diets. D) Give the client information specific to African Americans about low-fat diets.

B) With the client's permission, discuss his diet with whoever prepares meals for the family.

A client who has read several articles about the need to contain healthcare costs asks how a quality improvement program can contain cost of care. What should the nurse respond to this client's question? Select all that apply. A) "Promoting safety increases the cost of care." B) "Medication errors decrease the cost of care." C) "High nurse-to-client ratios result in decreased length of stay." D) "Increased nursing staff has been linked to decreased infection rates." E) "Use of computers increases the number of lawsuits."

C) "High nurse-to-client ratios result in decreased length of stay." D) "Increased nursing staff has been linked to decreased infection rates."

The nursing instructor is speaking to a group of nursing students about standards of care. Which comment made by the nursing student indicates the need for further education about the standards of care? A) "Standards of care are based on models of high-quality performance." B) "Process standards focus on the steps used to lead to a particular outcome." C) "Process standards focus on human resources, and general organizational structure." D) "Outcome standards focus on the performance of a process."

C) "Process standards focus on human resources, and general organizational structure."

The nurse is providing instruction to the parents of a 7-month-old child who has just been diagnosed with hearing loss. What guidance should the nurse provide? A) Hearing loss is not serious until 1 year of age. B) Interventions to support hearing are not useful until the child is at least 9 months old. C) Expect that your child will be enrolled in a special hearing intervention program immediately. D) Keep your child in a quiet environment until additional testing is done.

C) Expect that your child will be enrolled in a special hearing intervention program immediately.

The nurse notices that a client, who is from another country, appears uncomfortable when the nurse asks to look at the client's abdominal incision from a recent surgery. Which nursing action is the most culturally competent? A) Close the client's curtain to maintain privacy. B) Ask the client to explain why she is uncomfortable. C) Explain the reason for the intervention using lay terms. D) Wait until the next assessment time to observe the incision.

C) Explain the reason for the intervention using lay terms.

The nurse is providing care to a client with a hearing deficit. Which intervention should the nurse use when providing care to this client? A) Overarticulate words. B) Vary the volume of voice through sentences. C) Face the client during conversation. D) Use short phrases.

C) Face the client during conversation.

What is the most powerful factor in encouraging adoption of the attitudes and behaviors that characterize nursing professionalism? A) Employment opportunities B) Licensure requirements C) Interaction with peers D) Specialized training

C) Interaction with peers

An older client, reporting a significant loss of hearing after being involved in an explosion, asks when hearing will return. Which response by the nurse is most appropriate at this time? A) Surgery will help restore the hearing you have lost. B) The most common cause of hearing impairments is exposure to loud noises. C) Loud noises can cause immediate, permanent loss of hearing. D) Hearing loss attributed to loud noises is normally reversible.

C) Loud noises can cause immediate, permanent loss of hearing.

Andrea became a licensed nurse 4 years ago and is employed at a small rural hospital. Because of her effective decision-making abilities, she has been asked to participate in an interdisciplinary task force to work on improving patient care. Andrea's skill level is demonstrating which of Benner's Stages of Nursing Expertise? A) Advanced beginner B) Competent C) Proficient D) Expert

C) Proficient

An older client with bilateral cataracts, arthritis, and a hearing deficit is scheduled for cataract surgery. Which nursing diagnosis would be a priority for this client? A) Disturbed Sensory Perception: Visual B) Decisional Conflict C) Risk for Ineffective Health Maintenance D) Ineffective Coping

C) Risk for Ineffective Health Maintenance

The nurse is identifying diagnoses appropriate for a client with severe symptoms of tinnitus, vertigo, sensorineural hearing deficit, nausea, and vomiting. Which diagnosis would be a priority for this client? A) Imbalanced Nutrition: Less than Body Requirements B) Disturbed Sleep Pattern C) Risk for Injury D) Disturbed Sensory Perception: Auditory

C) Risk for Injury

The nurse provides postoperative teaching to a client recovering from cataract removal surgery. Which client statement indicates that preoperative teaching has been effective? A) "I will be hospitalized for several days recovering from this surgery." B) "I will need to return to activity as soon as possible." C) "I will use the eye drops if I have eye pain" D) "I will notify the doctor if I have itching or redness of the eye after the surgery."

D) "I will notify the doctor if I have itching or redness of the eye after the surgery."

A client asks the nurse how glaucoma develops. Which response should the nurse make to this client? A) "Blue eyes are a risk factor in the development of glaucoma." B) "Heart disease is a risk factor in the development of glaucoma." C) "People with arthritis develop glaucoma most often." D) "When the pressure in the eye is high enough to cause optic nerve damage, glaucoma can develop."

D) "When the pressure in the eye is high enough to cause optic nerve damage, glaucoma can develop."

The ANA's proposal for entry level for professional practice initiated debate among nurses. Which would be most at risk if the ANA proposal were implemented? A) An RN with a diploma who works in a critical care area B) An RN with a BSN who is a staff nurse C) An RN with an associate degree who is currently in school D) An RN with an associate degree who is a nurse manager

D) An RN with an associate degree who is a nurse manager

The nurse provides medication to a client at the wrong time. No harm came to the client as a result of the nurse's error and the nurse files a report about the medication error. What should the risk management team do? A) Discipline the nurse appropriately. B) Report the nurse to the board of nursing. C) Monitor all nurses on the unit to ensure this does not occur again. D) Attempt to implement policy changes to prevent future errors.

D) Attempt to implement policy changes to prevent future errors.

A nursing student has been assigned to present a teaching project to the class, using each of Bloom's domains. The student has planned several activities to include when presenting the project to the class. Which activity or activities are within the affective domain? Select all that apply. A) Class members must read a paragraph about a new clinical trial, summarize the information, and present it to the rest of the class. B) Class members must list the technical skills they have learned. C) Class members must demonstrate a favorite nursing skill for the class. D) Class members must reflect on how they felt the first time they provided direct client care. E) Class members must identify two attitudinal changes that have occurred in their lives since beginning their nursing education.

D) Class members must reflect on how they felt the first time they provided direct client care. E) Class members must identify two attitudinal changes that have occurred in their lives since beginning their nursing education.

The nurse manager is planning to implement the Lean Six Sigma system on the care area to improve the quality of care. When following this model, what should the manager implement? A) Shortening break time B) Ordering more supplies than needed on the unit to ensure they never run out C) Replacing a licensed staff member with unlicensed assistive personnel D) Decreasing staff when the census is low

D) Decreasing staff when the census is low

The nurse places a client in a treatment room of the Emergency Department for treatment of abdominal pain and vaginal bleeding. The client is a female of the Islamic culture. The husband of the client speaks for the woman and asks that only a female doctor examine his wife for the pelvic exam. What should the nurse explain to provide culturally appropriate care for this client? A) The client will be covered with a sheet so it will not matter whether the examiner is male or female. B) The male and female doctors both respect the client's privacy. C) The request is unreasonable and cannot be honored. D) Every attempt will be made to honor their request.

D) Every attempt will be made to honor their request.

The nurse is preparing a seminar for community members on actions to protect sensory functioning when aging. What should the nurse recommend regarding hearing tests for older adults? A) Schedule an annual hearing test until the age of 50 and then have a test every 6 months. B) A hearing test is needed when changing medications. C) A hearing test should be done biannually after the age of 60. D) Have a hearing test every 10 years until age 50 and then every 3 years.

D) Have a hearing test every 10 years until age 50 and then every 3 years.

One of the roles of the community health nurse is to educate the community about health promotion and wellness. Which activity would the nurse dismiss as not being relevant to health promotion and wellness? A) Holding classes on prevention of sexually transmitted infections for teenagers B) Teaching a class about smoking cessation C) Initiating infant care classes for new parents D) Implementing an exercise class for clients who have had a heart attack

D) Implementing an exercise class for clients who have had a heart attack

The nurse suspects that a client has a hearing disorder; however, the client denies not being able to hear. What initial action should the nurse take to assess the client's hearing? A) Use an otoscope to visualize the inner ear. B) Schedule a Weber and Rinne test. C) Confront the client with the suspicion. D) Observe the client's interaction with family.

D) Observe the client's interaction with family.

Which nursing action is most appropriate when communicating with a client who has a hearing deficit? A) Overarticulating words in order for the client to understand B) Using shorter phrases, which tend to be easier to understand than longer ones C) Varying the volume of voice, which is easier to understand than one consistent volume D) Writing ideas or pantomiming as appropriate in order for the client to understand

D) Writing ideas or pantomiming as appropriate in order for the client to understand