Test Review # 1 Scored 96%
How old do you have to be to sign the consent form and does the individual be both mentally and legally fit?
All persons who sign the consent form must be at least 18 years old and competent, both mentally and legally fit. UNLESS: The only legal way for an individual younger than 18 years to sign their own consent form is if the individual is an emancipated minor.
HIPPA Safety?
Always check the patient record to see who is approved to receive health information about the patient.
How much are TVCC replacement cards?
$20 and card will deactivated at the end of each semester.
residential care facilities TYPES-Long periods of time
- Long-term-AKA Nursing home, live many years, provide 24/7 nursing care, PT.s chronic/ disabilities. - Assisted living; less nursing care, 24hr protective oversight, assisted w/meds, personal care. - Memory care; Cognitive issues, 24/7 CNA care part-time RN/LVN daytime care, on call night care. - Independent living; -DOES NOT provide nursing care. -staff is available 24/7 emergencies
formal code of ethics was developed by who and what era?
-ANA and has undergone numerous modifications since. -developed in the 1950s
9 principles of the Nursing Code of Ethics: Questions: enter a patient's room and tell him he is going go for an epi-test down at 7 and I need to get him in a gown. He gives you a puzzled look, what should you do?
-Are you aware that you have a test scheduled at 7. -Make sure patients are fully informed, include patients in all of the bits of information.
Informed consent has three elements: what is the #2 element?
-Consent must be signed before analgesics or sedatives are given. -Patients must demonstrate to a witness that they are informed and understand the surgery.
You go into the room and to turn a patient in bed, and she says, "Don't touch I just got comfortable", do you do it anyway? how would you document these scenario?
-DO NOT SAY "REFUSE" because they have a choice instead, we would chart "DECLINED". -Let them know the necessity to be turned however still declined. -If there is an order on stating to turn every 2 hours and pt. Decline you need to document CYA. -If pt. Keeps declining need to notify the Doctor
9 principles of the Nursing Code of Ethics: patient that is quadriplegic asks you will I ever be able to feel my legs again? They are reaching for hope and you can't tell them. What do you say?
-Has the doctor discussed this with you? Be specifically we are not allowed to diagnosis; but ----then you don't want to disregard just say I'm not allowed to discuss this with you.
9 principles of the Nursing Code of Ethics: your walking down the hall you see a PT. Sitting on the bedside commode; bedside exposed these okay and how would you handle these?
-I would walk over and say here I'll close this door for you. -Let the other nurse know discretely and professionally.
Nurses are sued the most for these?
-Impairment of Alcohol & prescriptions. -illegal use of drugs -Using narcotics by taking from Pt. and using for your own. -Serve Fatigue -Nurses have a high rate of of drug use & abuse. Burton,.., et al.(p.207)
home health care
-Many types of health/medical services -provided to patients b/c of confinement to their homes by illness/disability. -provide Skilled care nursing SCN at home. visits. -perform; IV meds, Assessments, dressing changes. -provided by community Meals on wheels.
9 principles of the Nursing Code of Ethics: Questions: A new patient is admitted his name listed is John Bounce. You enter the room and answer the call light, how would you address him?
-Mr. Bounce, my name is Laura. I am your vocational nursing student; -how would you like to be addressed while you are staying here? -Always start with MR. Or MRS.
9 principles of the Nursing Code of Ethics: Questions: How would handle it when a Nurse ask you to put 548 on the bedpan, what is wrong with this?
-One you DO NOT address your patients as numbers. Wrong -Clarify what they mean.
Skilled Nursing Facility (SNF)
-Provide less intensive care. -HCP usually only visits Weekly than daily. -Usually transitional care setting pt. transfer to LTCH/Nursing home. -MAX stay time 100. -Requirements to stay per Medicare & private Insurance: -hospitalized at least 3 days. - MUST enter a LTHC within 30 days.
9 principles of the Nursing Code of Ethics: you walk into a PT first time on a shift you say My name is Nancy and I'm your vocational nursing student; the PT looks at your name tag and say "oh yes Nancy I'm Mrs.fields, what are you going to do for me today?
-Usually inside the room at the bedside. -LOOK get report from a nurse, looked at charts and Doctors Orders. -You should have already looked at the chart and know what you will be doing
HIPPA NEVER do by phone?
-You may not tell a person making a telephone inquiry that a person is a patient in the hospital unless you have permission to do so. -You may not give a visitor or family member information about a patient's condition unless you have permission to do so.
True or False: Can An Emergency Consent be allowed and given by phone?
-may also allow parental permission to be given via the telephone. -must be witnessed by two individuals who heard the permission granted over the phone. Burton.,et.al. (p.38)
legalities of documentation HIPPA: What you're accountable for as far as your charting.
-patient EHR, keep in mind that it is a legal document and can be used as evidence in a court of law. Do not leave patient health records visible on any computer screen. Charts and items such as laboratory reports must be secured so they are never visible to the public. All patient information is considered confidential. -Failure to handle charts appropriately breaches HIPPA
Hospital outpatient Dept.
-wide range of outpatient service. -Ex: Cardio, pulmonary, physical, occupational. -Stay 24-72 hours -usually outpatient in hospital patient can return same-day post-op. Ambulatory Surgery Centers (ASC) -free standing
how much is the copy/printer copies and its code?
0.05 cents per copy. the code for students is 55555.
What are the usual hours for HSC building Monday-Friday?
0730-1630/1700
what is Non-maleficence?
DO NO HARM, MOST WELL KNOWN of nursing ethics -every nurse should be aware of in their daily nursing practice -provide the best, safest, and most humane care to all patients. -Nurses are responsible to report treatment options that are causing harm to a patient, which may include suicidal thoughts or homicidal thoughts.
Safety: What should a student NOT do when handling Patients records?
Do not write the patient's name and identifying numbers on any of your paperwork that will be taken outside the facility. -ONLY Initial's for clinical purpose
patient centered care
Empowers patients to take control and manage of their care. Acute care hospital setting. -goal is decrease numbers people caring for them in order to decrease contamination. -Disadvantage- time & education each staff member cross-TRAIN all areas. -take on more duties.
What is true about cell phone usage/ technology in general? Select all that apply a. Cell phones must be silenced and put away unless needed for classroom activities. b. A laptop computer may be brought to class and should be used for notetaking and classroom activities only. c. No technical media (cell phones, iwatch, cameras, tape recorders, etc. are allowed during test review d.Must understand/ recognized; that there is an ethical and legal obligation to maintain patient privacy. e. Treat my manakins as patients, skills lab is treated like clinicals and real life NO social media!d. all the above f.all the above
F. All the above
True or false: Nurses can Answers any questions pre-surgery they are responsible?
False, CAN NOT at any time say answers questions for patients. PHYSICIAN RESPONSIBILITY TO DO SO. NOT THE NURSES!
True or false: tabacco and e-cigars are permitted in building and outside of building?
False, Only permitted inside students car.
True or false: The development of math competency in dosage calculation DO NOT occur every semester?
False, The VN program requires to take Math Exam during each of the 3 semesters because it's imperative.
True or false: it's okay to leave all electronics on vibrate?
False, no all electronics must be silenced during all classes.
True or false: it is considered an absence if student misses to go to a mandatory court duty?
False, not considered an absence just notify instructor with before the scheduled duty date. FYI; skills lab is considered clinical time.
True or false: Meds can be given in level 1 ?
False, only finger sticks will be allowed to be given by student nurse.
True or false: student is NOT expected to pass math test and can give medication's during clinical for Levels 2 & 3?
False, you do have to pass each Math test.
True or False: its okay to park in the faculties parking space?
False: DO NOT park in faculty or fire lane areas. -Will be fined fi not payed will not be able to register in the future.
True or false: Arriving late 1 minute is considered okay?
False: arriving late 1 minute is considered a TARDY. -counsel record will be written after the 4th & 5th tardy. -6th tardy will be termination of the program. -3 absence's will be counted as one absence.
Medical office
HCP specialize 1 particular area. -seeing patients for specific conditions. -HCP, NPs, MAs
Hospice
Interdisciplinary program of palliative care -Patient No Longer seeking treatment. -life expectancy 6 months or less. -Treatment: -Comfort, pain & symptoms, leads to emotional health.
What is Beneficence?
Is acting for the good and welfare of others and including such attributes as kindness and charity
What is Justice?
Is that there should be an element of fairness in all medical & nursing decisions and care. Nurses must care for all patients with the same level of fairness despite the individual's financial abilities, race, religion, gender and /or sexual orientation.
What is autonomy?
It is recognizing each individual patient's right to self-determination and decision-making.
What is the purpose and whys is there a bill of rights?
It's a constitutional law To protect people's rights.
HIPPA Privacy rule?
Law that regulates the use and disclosure of patients' protected health information (PHI).
outpatient care
Meets needs for patients in 24 hours. -less expensive ofter preferred b/c decreased cost. Mental Outpatient care; -intensive outpatient programs for mental & chemical dependency. -Therapy sessions-2-3 hours. daily. -partial day-7-8 hrs daily.
What should student do if they have missed a total of 4 days?
Must immediately make an appointment to see his/her instructor for written counsel record.
9 principles of the Nursing Code of Ethics: You go into the room and turn a patient in bed, and she says, "Don't touch I just got comfortable", do you do it anyway?
NO, patient has right to refuse Nurses' responsibility to explain to them they can possibly get bed sores it's been 3 hours since you have not been turned in in a rational calm way.
History of the nursing Code of ethics: Nightingale Pledge founded in 1893.
Nightingale pledge has been recited by nursing students at graduations with the littles changed since inception.
In case of absence what should a student do?
Notify, the campus prior.
Rehabilitation
Short-ended:part of a hospital; or Free Standing. -Physical, occupational, speech therapy therapies. -Rule of thumb: Must be capable/ participate @least 3hrs of therapy a day to be admitted. -Another type DETOX for chemical dependency.
Long-term Care Hospital (LTCH)
Similar to an acute care hospital. -focus serious medical problems. -Stay 20-30 days -Transfer to bigger hospital usually b/c PT. needs Ventilator/ other.
how many absenteeism before dropped from the course?
Student misses a total of 6 days will automatically be dropped.
True or false: Seating arrangements, leaving the room, and stopping an examination are violations of the test taking policy are at the option of the proctor? If the course allows for a test grade to be dropped, the student may elect not to take the test, take a 0, and have that test grade dropped.
True, Once a test has begun, students who come in late will not be given extra time and will automatically receive a counseling record and lose 5 points on that test grade. and Deduction of 5 points on a test can cause the student to fail the course.
True or False: No student will be admitted into classroom if arrived 1 min or more late?
True, in addition they will have to wait in student library then may join class after first break. -Same policy will apply to lunch. -small breaks don't come back before break is over left out.
True or false: level 1, 2, and 3 does a student have 3 attempts each semester to take math proficiency test and if fail they may drop before the end date for withdrawal?
True, in addition will be given a written warning.
True or False: during test will All students are to remain seated during a testing situation?
True, should raise his/her hand if there is a need to communicate with the instructor.
True or false: failure to notify faculty is considered NO CALL/NO SHOW?
True, will be an automatic contract and probation in addition 2nd one and it will be termination of program.
What is ethics and Describe it?
What it is generally are moral principles that dictate how a person will conduct themselves.
In this scenario Is it an ethical dilemma or ethical behavior? Nurse walks into a new patient's room you introduce yourself and I'm the new nurse for the night the pt. Family member tell you ethical dilemma the doc called me earlier today letting me know that the pt has cancer, but we don't want them to know?" what should the nurse do?
When your torn and need to seek help from HCP, Ethical committee. in private area.
What is the legality?
subject matter must be legal.
9 principles of the Nursing Code of Ethics: In the elevator and two people behind you are in discussion about Mrs. Bound a difficult PT., what is this an example of? HIPPA Violation
yes it's a HIPPA violation Let them know you should not be discussing this.
How long does a pre-op consent valid for?
1.) 30 days after signing 2.) can be withdrawn at anytime, even after signing.
Why is a preoperative consent for?
1.) Before surgery, the surgeon must obtain written informed consent. 2.) It gives legal permission for surgery. 3.) needed for all invasive procedures including: -anesthesia -surgery -blood administration
What are the two purposes for pre-op consent?
1.) Is to protect the patient from unauthorized procedures. 2.) To protect the surgeon, anesthesia provider, agency, and agency employees from claims of performing unauthorized procedures.
What is an Acute Care, or AKA Medical center Hospital?
1.) Maybe the only hospital in the region for many miles. 2.) Maybe 1 of complex center where as number of many different hospitals, grouped together. 3.) Provide: Emergency care, surgeries, inpatient care, diagnostic testing, some types of outpatient care. RURAL HOSPITAL
Informed consent has three elements: what is the # 1 element?
1.) Surgeon must explain in terms the patient understands about the diagnosis. -the proposed treatment and who will perform it. -The likely outcome. -possible risks -complications of treatment -alternative treatments -prognosis w/o treatment -if PT. has any questions before signing the consent -If the PT. has anymore questions before signing the consent, Nurse MUST go get the Surgeon. -NOT written in the Nurses Scope of practice. -CAN NOT say answer anything it is the Surgeons RESPONSIBILITY to do so by LAW.
How many interceptive statements or provisions were added to the code of ethics by ANA; help guide nursing practice in a more definitive way?
9 interceptive statements/provisions
What grade should a student get in the math proficiency make?
90% or above
What is an Advance Directive?
A written statement indicating a patients wishes regarding future medical care in the event the patient becomes unable to voice their decisions. it may give consent for certain aspects of care. as well as refusal of specific care. Examples: WILL or POA
Who can sign a informed consent form?
All must be mental & legally fit ONLY time a minor can sign for themselves if they are an emancipated minor. -Legal Gaurdian -18 & over Patient -Health care provider.
Case Mgt.
Associated with managed care strategy. -provide case mgt. simultaneously as coordinators, facilities, impartial advocates. -Goal is to assist patients who are vulnerable, at risk or cost-intensive , meet specific needs, cost-effect, while still bringing them to OPTIUM health
Go into the room and a man loves to flirt and makes a dirty comment and very vocal and inappropriate. How would you handle these scenario?
Be direct and say: "Mr. Taylor that is not appropriate please don't talk to me like that. " -Don't scold him -Don't ignore the problem -Don't tell other people
Safety: Consent forms
Consent forms must never be signed after the patient has received mind-altering medications or has consumed alcohol.
Informed consent has three elements: what is the #3 element?
Consent must be given voluntarily. Persuasion or threats must never be used to influence PT.
Team nursing
Consists of nurses, CNAs. -Type of settings; LTHC, Rehab, AHC. -RN-IVs/sites, communication HCPs -LVN; All other meds, dressing change, assessing baselines, pain levels, & Pt. Teaching. -UAPs;Clean up work. communication is a must.
What is true about TEST Taking policy in general? Select all that apply a. cell phone rings or vibrates or is found by the test proctor, the student's test will be stopped, and it will be submitted and graded to the point it was completed at that time. b. NOT an automatic zero If on Question 10 and CELL PHONES VIBRATES, MS. Anderson is only getting graded for those 10 questions. c. Not personal belongings- jackets & sweater leave in locker room included, purses, backpacks, nothing rest leave in car. D. All the above
D. All the above
Primary nursing care Burton, etal(p22)
One nurse is responsible for all aspects of nursing care for his or her assigned patients. -NO UAP, No other nurses to assist call HCP. -ICU mainly RN's are hired to because they can ONLY do IVs push.
legalities of documentation HIPPA: Who can or can't read the chart?
Only me and the HCP, other coworker team members that are working on the same patient. -In addition I'm NOT ALLOWED to see another's patients records that is not my patient.
Who is legally responsible informing a patient about procedure and risks to the patient be sure patient understands?
Physician
In this scenario Is it an ethical dilemma or ethical behavior? when Nurse's Ex-Husband was admitted to the hospital in Kaufman in the same floor she worked at, and she was ON SHIFT/working; she had to make sure NOT: To ask the other nurses/coworkers what Ex-Husband was in for. Would NOT walk into the room NOT mean just civil she did not want to be in that type of situation Told someone else to check on him NEVER touch his chart Always be above approach always do right and keep yourself out of trouble.
The nurse was showing was showing ETHICAL BEHAVIOR, she did not want to get fired or for it to come back to haunt her.
Implied consent?
The only time that medical treatment may be provided without written consent is when a life-threatening emergency exists.
HIPPA Security rules?
This rule requires reasonable safeguards to ensure the confidentiality and security of protected health information. Examples: EHRs on them cannot be left visible to the public. All computers must be password protected.
ethical behavior: "is the right thing to do" or "ethical choice" The nurse walks into a restaurant and someone needing CPR you don't have to do it you can sneak out but the "right thing to do"?
To help and perform CPR and help that person.
True or False: Are fire drills held each semester?
True
True or false: ALL surgery need written informed consent.?
True
True or false: If the student fails to properly notify the instructor about being absent and is not in good standing academically/clinically, can the instructor drop student?
True
True or false: math questions are included in unit test?
True
True or false: If PT. Is still not comprehending, then the nurse must go get Doctor to educate?
True, Doctor cannot get mad because he/she knows it's legal.
Informed Consent True or false are Physicians are responsible for obtaining chemo. Therapy, surgery, etc. And informing the patient of procedure NOT the nurse?
True, NURSE is only witness
Informed consent minors & legal Rep.
if a minor Legal REP. Must have complete understanding before signing for minor.
Which statement is true: What should a student do in case of a tornado select all that apply? a. Take immediately shelter. b. park in the student parking lot only c. close all windows. d. seek refuge in a small room of the structure, or hallway away from windows. e. be near windows. f. sit with back against the wall & with knees drawn into chest. G. All the above
a., b. d. f.
Where do Vocational, meet, exit do ? select all that apply a. Grassy area across from main entrance. b. Go to the main entrance in the grassy area across the street; where a big tree and the black bench is. c. The teacher must take a role. d. All the above
d. All the above
which statement is true: What should a student do in case of a fire drill? Select all that apply a. when you hear the fire alarm initiate the evacuation procedure. b. All person should exit the building safely. c. the elevator can be used d. All the above
d. All the above
