Transitions final
Q: After a nursing student has graduated from their program, what is the timeframe the applicant has to take and pass the NCLEX-RN?
5 years
Q: The health care team responsible for deciding whether to move a critically ill patient out of the ICU so that a new patient may be admitted to the unit is faced with what principle of an ethical dilemma?
Justice (The principle of justice is involved in the allocation of scarce and/or expensive health care resources.)
Q: Which of the following actions by the nurse manager would indicate an autocratic management style?
Makes most of the decisions without input from the staff members (The autocratic manager uses an authoritarian approach to direct the activities of others. This manager would make most of the decisions without input from the staff members. Allowing staff members to make most of the decisions and exerting little control over staff is a laissez-faire management style. Emphasizing effective group functioning is common for a democratic management style.)
Q: What is a correct statement regarding a nurse who acts beyond the scope of practice?
May be disciplined by the board of nursing
Q: What is a correct statement regarding a nurse who acts beyond the scope of practice?
May be disciplined by the board of nursing (States may regulate nursing practice by controlling the scope of practice and determining the specific activities for each level of nursing. In most states, the Nurse Practice Act provides definitions and scope of practice for each level of nursing practice. The power of the board to discipline can have an adverse affect on the nurse's ability to practice.)
Q: The nurse is reviewing categories for improving client safety. Which categories should the nurse review? Select all that apply
Medication management ......Facilitating information transfer and clear communication......Prevention of hospital-related infections
Q: The soon to graduate nurse would like information about what to expect on the NCLEX-RN exam and how to apply to take the exam. Where would the student find information?
NCSBN website
Q: A nurse manager is giving a presentation at a local community college. The nurse manager understands the job expectations of a new graduate when making which of the following statements?
"A graduate nurse should be able to function competently as an advanced beginner as a registered nurse at the entry level." (The job expectations of a new graduate nurse are those of an entry-level new employee. This frequently includes an extended orientation to assist the new graduate to transition into the independent role of the nurse. The new graduate nurse is not expected to function independently with the ability to make clinical nursing judgments. School curriculum and how one functioned the last semester of school are usually not considered in the job expectations of a new graduate.)
Q: A nurse is teaching a group of newly hired nurses about the requirements for disaster planning. Which of the following statements by one of the newly hired nurses indicates an understanding of the teaching?
"Disaster drills should be held on a regular basis."
Q: A student in the last semester of nursing school has established a goal of making a successful role transition to graduate nurse. Which statement by the student indicates his/her understanding of how to achieve this goal during the capstone experience?
"I should care for increased numbers of patients to enhance work organization skills." (It is important for the student to start taking care of increased numbers of patients to help with time management and work organization. The student should also be able to function without close guidance from the nursing instructor. Although it is good for students to observe staff, a student in the final semester should be able to perform tasks with minimal observation and should instead focus on implementing care and time management. Waiting 7 weeks to evaluate progress would not be helpful to the student. Although regular self-evaluation is an important process, it is the actual experience of taking realistic patient assignments and working typical shift hours that assists with successful role transition.)
Q: During a job interview, the interviewee is asked, "What do you believe your weaknesses to be?" What is the best reply?
"I'm looking forward to strengthening my ability to plan care for a group of patients." (It is important to develop responses to probable interview questions. This is not an uncommon question, and the graduate nurse should prepare a positive response, such as "strengthening ability to plan for a group of patients." Telling the interviewer that you never thought about your weaknesses or that you need help with planning and implementing discharge teaching does not indicate that you are prepared for the interview. The other option about admitting disorganization is not a positive response.)
Q: Which statement by the graduate nurse indicates understanding of the importance of a cover letter?
"It should introduce you to the reader." (Along with your resume, the nurse should enclose a cover letter that gives a brief introduction. The cover letter should summarize important strengths or give information regarding change of specialty (after you graduate and have experience). Remember that this letter should not be longer than one page.)
Q: An experienced nurse overhears a new graduate giving instructions to an unlicensed nursing assistant. What statement by the new graduate would cause the experienced nurse to be concerned?
"Let me know if any of my patients has a fever"
Q: Which of the following represents appropriate feedback for an assignment to an LPN?
"The patient in Room 430 looks much better, and you did a good job of making her comfortable."
Q: Which statement by the nursing student indicates an understanding of the purpose in setting a career goal?
"To help you define the direction of your career"
Q: As the interview is drawing to a close, the interviewer asks the applicant, "What questions could I answer for you?" Which of the following questions would it be most advisable to ask to create a favorable impression?
"What is the orientation process and what is the length of orientation?" (Prepare a few questions!. This will be the applicant's opportunity to gather important details and possibly impress the interviewer by showing interest in the position. Keep questions on the positive side and inquire about responsibilities of the position. It would be inappropriate to inquire about pay raises at this time. Inquiries about pay and tuition reimbursement would be appropriate after the job offer has been provided.)
Q: The nurse manager is updating unit staff on findings by The Joint Commission. Which of the following statements shows an understanding of the primary cause of untoward events in the hospital setting?
"unclear, ineffective communication." (Ineffective communication was identified as the root cause for nearly 70% of all sentinel events reported. The majority of those untoward events involved communication failure. The other options were not identified as the majority of all sentinel events.)
Q: A nurse in a community health center is assessing the results of a tuberculin skin test she performed for a client. Which of the following results indicates exposure to and a possible infection with tuberculosis (TB)?
15 mm induration
Q: According to the Utah Nurse Practice Act Rule, how many hours must a licensed nurse practice without an additional requirement of contact hours to renew their license?
400
Q: A nurse is performing triage for a group of clients following a mass casualty incident (MCI). Which of the following clients should the nurse plan to care for first?
A client experiencing a tension pneumothorax
Q: Which of the following describes reward power used by the nurse manager? (Select all that apply.)
A nurse manager who uses salary increases to motivate staff....A nurse manager who uses fear of consequences to motivate staff
Q: Which of the following actions is consistent with a nurse leader?
A nurse who encourages staff to give excellent patient care (A nurse leader is someone who influences others, such as a nurse who encourages staff to give excellent patient care. A nurse who performs chart audits and writes staff evaluations is functioning as a nurse manager. Giving pain medications is a function of the staff or bedside nurse.)
Q: Following an earthquake, patients are triaged by emergency medical personnel and are transported to the hospital. Which of these patients will the nurse need to assess first?
A patient with a red tag (The red tag indicates a patient with a life-threatening injury requiring rapid treatment. The other tags indicate patients with less urgent injuries or those who are likely to die.)
Q: What is the best definition of malpractice?
A professional act or failure to act that leads to injury of a patient (Malpractice may be defined as doing something outside your scope of practice or something that is unsafe for the patient and could cause injury.)
Q: The nursing student is preparing an application for employment. Who would be the best reference for the student to include? Select all that apply
A recent clinical instructor .....Their preceptor .......A previous employer
Q: When performing a cultural assessment with a patient of a different culture, the nurse's first action should be to.....
Ask the patient about any affiliation with a particular cultural group. (An early step in performing a cultural assessment is to determine whether the patient feels an affiliation with any cultural group. The other actions may be appropriate if the patient does identify with a particular culture.)
Q: Which of the following is the most frequent reasons for revocation or suspension of a nurse's license?
Alcohol or drug abuse
Q: A nurse is caring for a client following exposure to inhalational anthrax due to bioterrorism. Which of the following medications should the nurse expect as a common medication to treat anthrax? (Select all that apply.)
Amoxicillin......Doxycycline....Ciprofloxacin
Q: What would be the most effective way for a nurse to validate "informed consent?"
Ask the patient what he understands regarding the procedure. (Informed consent in the health care setting is a process whereby a patient is informed of the risks, benefits, and alternatives of a certain procedure and then gives consent for the procedure to be done. The piece of paper is simply evidence that the informed consent process has been completed.)
Q: A nurse tells a patient, "If you don't stop getting out of that chair, I'm going to put some restraints on you." What may this nurse be accused of?
Assault (Assault and battery are the legal terms applied to nonconsensual threat of touch (assault) or the actual touching (battery). Use of restraints may also be interpreted as false imprisonment.)
Q: A nurse is teaching a class about preventive care to clients who are at risk for acquiring viral hepatitis. Which of the following information should the nurse include in the presentation?
Avoid foods prepared with tap water
Q: The nurse is considering strategies to increase nurses' time at the bedside. Which strategies should be included? Select all that apply
Bedside change of shift report.......Effectiveness in medication administration......Hourly rounding by staff members......Standardized documentation tools
Q: A nurse is among the first responders to a mass-casualty incident and does not know what type of personal protective equipment (PPE) is needed. Which of the following actions should the nurse take?
Choose the highest level of protection equipment available.
Q: The nurse manager needs to let a nurse know that he will be put on probation if he continues to be tardy to work. Which type of power is the nurse manager using?
Coercive power (Coercive power is power derived from fear of consequences.)
Q: Which task could a staff nurse delegate to a certified nursing assistant (CNA)?
Collecting a routine urine sample (The majority of state boards have addressed the issue of delegation and have developed rules that offer specific guidelines regarding who can do what. The scope of practice for each level-of-care provider usually includes a description of the tasks that may be performed at that level. Collecting a urine sample)
Q: The student nurse is reviewing sentinel events in healthcare. According to the Joint Commission which of the following is considered the main reason for Sentinel Events?
Communication errors
Q: What is the best legal safeguard for a nurse?
Competent practice (Practicing within the parameters of the state's Nurse Practice Act, performing care based on established policies and procedures, and performing as a reasonable nurse are the best ways for a nurse to safeguard against legal action.)
Q: How does the Utah Nurse Practice Act Rule define a Comprehensive nursing assessment?
Conducting extensive initial and ongoing data collection
Q: According to the American Hospital Association, what is a basic right of patients?
Considerate and respectful care from all care providers
Q: Which of the following statement by the nurse reflect transformational leaders? (Select all that apply.)
Courageous change agents...Lifelong learners....Value-driven visionaries
Q: The new graduate nurse would like to pursue a career in the Intensive Care Unit (ICU). What goal might be appropriate for this career?
Credentialing as a Certified Critical Care Nurse (CCRN)
Q: George the construction worker tells the Ameritech students preparing for a quiz on ethics: "I find it easy to make the right decision. All life is sacred, and all decisions must be made with the intent to continue life." What do we call the framework from which George approaches ethical reasoning?
Deontological
Q: Which action would help the graduate nurse when seeking out employment? (Select all that apply.)
Determine the length of orientation.....Find out what type of nursing care is delivered......Ask to speak to nurses who work on the unit.....Plan out interviews.
Q: A nurse is gathering data on a patient of a different culture. Which action can the nurse take to enhance communication while gathering cultural data?
Determine the patient's level of fluency in English (The nurse should determine the patient's level of fluency in English to enhance communication. The nurse should not avoid the patient's culture during the assessment. Hand gestures should not be used because they could be offensive to the patient. The nurse should use open-ended questions or questions phrased in different ways as a method to gather data.)
Q: How is assertive behavior described?
Direct (A person exhibiting assertive behavior would express his or her true feelings in an honest, direct manner)
Q: The nurse has several tasks to complete. Which task would the nurse NOT delegate to a certified nursing assistant?
Discussing the importance of deep breathing to a pre-operative patient (Pre-Operative teaching cannot be delegated to the nursing assistant. The RN must determine what needs to be done and then identify whether this is a task that can be delegated to someone else. The role of the RN involves the coordination and planning of care, with the primary focus on identifying with the patient and the physician the desired outcomes for the patients. Bathing a patient is within the role and responsibilities of the CNA.)
Q: The student nurse is preparing a resume. Which elements would he/she include?
Experience and education
Q: A nurse is respected by peers for clinical skills and effective interpersonal relationships. The nurse has studied diabetic patient educational needs and consults with several units. What type of power does this nurse possess?
Expert (Expert power is based on specialized knowledge, skills, or abilities that are recognized and respected by others. Those who have information that others need to perform their duties have informational power. Legitimate power is based on the person's position within an organization. Reward power occurs when an individual has the power to give or withhold rewards.)
Q: In a malpractice suit, how may a breach of duty be established?
Expert testimony (The duty of a nurse is to act as a reasonable nurse would under the same or similar circumstances. An expert witness may testify as to what a reasonable nurse in the same or similar circumstances would be expected to do).
Q: George was taken to the emergency room after falling off a crane in the Ameritech construction site. George's buddies came to the emergency room to visit. A doctor told George's buddies that George is HIV-positive. What ethical principle did the doctor violate?
Fidelity
Q: A nurse is caring for a client who suspects recent exposure to inhalation anthrax. Which of the following findings indicate possible exposure..
Flu-like symptoms
Q: The nurse understands that delegation and supervision are two concepts that go hand-in-hand. Which is the best example of the concept of supervision?
Following up with a CNA on the assigned task of ambulation and feeding of two patients (Supervision is the provision of guidance, direction, and follow-up for the accomplishment of an assigned task. The nurse would follow up with the CNA to determine whether the tasks were completed and whether any problems occurred.)
Q: A nurse is developing an education program for a community group about dietary intake of vitamins and minerals in the diet. The nurse should include which of the following foods as sources of vitamin C? (Select all that apply.)
Green pepper.....Orange......Cabbage.....Strawberries
Q: A nurse manager needs to purchase new thermometers for the nursing unit. What technique would demonstrate a laissez-faire style of leadership?
Having the nurses on the day shift order any thermometer that they want (A laissez faire manager maintains a permissive climate with little direction or control. They allow staff members to make and implement decisions independently and relinquishes most of their power and responsibility to them.)
Q: An occupational health nurse in the clinic of an industrial plant is developing a guidebook for clinic workers. Which of the following actions should the nurse include as a secondary prevention strategy?
Help plant workers identify signs of carpal tunnel syndrome
Q: A charge nurse is discussing staff nurses' responsibilities in preplanning for response to a disaster. Which of the following responsibilities should the nurse include in the discussion?
Identify potential community disasters.
Q: George the construction worker decided to leave the emergency room against medical advice. His nurse is an incredibly ethical AmeriTech graduate. What did the nurse do in this situation?
Informed George that he could return to the hospital if he changes his mind
Q: A nurse is preparing to care for a client who has suspected exposure to plague as a result of bioterrorism. Which of the following actions should the nurse plan to take first?
Initiate contact precautions.
Q: In a legal suit, what element is necessary to prove a tort has been committed?
Injury (There are four elements that need to be present in a malpractice case, one of which is patient injury. The patient will have to prove that the specific nursing action caused injury or harm. The nurse, as a defendant, does not have a "burden of proof.")
Q: Which organization developed the most definitive statement on the competencies needed by the newly license RN?
National Council of State Boards of Nursing (NCSBN)
Q: George the construction worker fell off a crane while working on the Ameritech roof. The students rushed to his aid, and decided not to move him in case he had sustained a neck injury. What ethical principle were the students following?
Non-maleficence
Q: The nursing student is studying about root cause analysis (RCA) Which of the following is a critical element in error reporting?
Non-punitive action when errors are reported.
Q: A nurse is discussing emergency response with a newly licensed nurse. The nurse should identify which of the following as a triage officer during the time of a disaster?
Nurses and other emergency medical personnel
Q: What aspects define nursing as a profession?
Nurses possess a specialized body of knowledge....Nurses have developed a code of ethics...Nurses serve the public
Q: What are the key messages that structure the discussion and recommendations presented in the Robert Wood Johnson Institute of Medicine Report?
Nurses should achieve higher levels of education and training through the improved education system that promotes seamless academic progression...Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the U.S.....Nurses should practice to the full extent of their education and training ....Effective workforce planning and policy making require better data collection and an improved information infrastructure
Q: When caring for a patient who is Native American, the best initial action by the nurse is to....
Observe the patient's use of eye contact (Observation of the patient's use of eye contact will be most useful in determining the best way to communicate effectively with the patient. Looking directly at the patient or avoiding eye contact may be appropriate, depending on the patient's individual cultural beliefs. The nurse should assess the patient, rather than asking family members about the patient's beliefs.)
Q: A nurse is working with an interdisciplinary disaster committee to develop a community-wide emergency response plan in the event of a nonbiological or chemical incident. The nurse should include which of the following agencies to be notified immediately after calling 911?
Office of Emergency Management (OEM)
Q: What are the factors that contribute to medication errors? Select all that apply
Overly tired nurses......High client - nurse ratios.......Inadequate staffing
Q: A nurse is caring for a patient from Taiwan who constantly requests pain medication. What should the nurse consider when assessing the patient's pain?
Pain is what the patient says it is (Pain is what the patient says it is, and nursing care should always be individualized. The nurse respects the patient's right to respond to pain in whatever manner is culturally and individually appropriate and never stereotypes a patient's perceptions or responses to pain.)
Q: George and his fellow construction workers were listening to the Trends class study for a quiz on ethics. What is NOT an ethical dilemma that the students are discussing?
Parking
Q: A nurse is educating community members about how to prepare for a disaster. Which of the following supplies should the nurse instruct the clients to include in a disaster preparedness kit? (Select all that apply.)
Personal identification ....Prescription medications......Three quarts of water per person.....Clean clothing
Q: A nurse is triaging clients injured during a tornado. The nurse assesses a client who has an open fracture of his arm. Which of the following tags would the nurse place on the client?
Place a red tag on the client's upper body.
Q: A community health nurse is reviewing the levels of disease prevention. Which of the following activities is an example of tertiary prevention?
Providing treatment for clients who have chronic obstructive pulmonary disease
Q: After receiving report on 4 patients, the RN may delegate which client's needs to an assitive personel?
Reapplying a condom catheter for a client who has urinary incontinence (All of the tasks require an RN except the condom catheter. Assistive personnel can feed clients, however this client has feeding problems and has aspirated previously. Assistive personnel cannot reinforce teaching - LPNs can. Assistive personnel are not trained in sterile technique.)
Q: Which of the following actions best reflects maintaining accountability for the nursing process?
Reassessing a client's BP when the reported value is higher than usual (Accountability refers to individuals being responsible for their actions. It means that a nurse accepts the commitment to provide excellent client care and the responsibility for the outcomes of the actions in providing that care. Reassessing an abnormally high BP is the best example of nursing accountability because it shows the nurse being responsible for the accuracy of the assessment. The remaining options better reflect nursing responsibility.)
Q: The nurse is receiving a phone order from a health care provider. How will the nurse make sure that the provider's order is received without error?
Repeat the order, write the order verbatim, and read it back to the provider. (Repeat the order, write the order verbatim, and read it back to the provider are the steps recommended to confirm that the order was understood correctly, as well as communicated correctly. The question is in regard to the receiving of the order, not specifically how it is written. The nurse will write the phone order on the chart, and later the health care provider will co-sign the order. The charge nurse does not have to take the phone order; any licensed nurse can take the phone order.)
Q: The nurse manager is giving a presentation on the disadvantages of democratic leadership in group functioning. Which statement shows an understanding of this type of leadership?
Requires more time and effort to make decisions and accomplish goals (Because of the encouragement of participation in decision making and the democratic leadership's emphasis on group function, decision making becomes more involved with consensus and is less timely. Democratic leadership encourages group participation and works to reduce any type of scapegoating behavior among members because everyone has equal voice. The group democratically makes decisions and determines outcomes that are not controlled by management.)
Q: Which of the following actions by the graduate nurse would be advised during an interview campaign?
Research the prospective employer and evaluate their mission statement. (The graduate nurse should identify a desirable date to begin employment, ask questions about the interview process, research the prospective employer, and plan no more than 2 interviews in one day.)
Q: 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?
Review the events leading up to each medication administration error.
Q: Which does not reflect one of the "five rights" of delegation?
Right route
Q: A charge nurse explains to a student: "I tend to act differently depending on which nurses are working that particular shift. Some nurses need more direction from me than others." What type of leadership style best describes this charge nurse's approach?
Situational
Q: A nurse is caring for a client involved in a suspected bioterrorism event involving exposure to cutaneous anthrax. Which of the following manifestations should the nurse anticipate?
Skin lesions with pruritus
Q: A nurse is reviewing treatment protocols for clients exposed to bioterrorism agents. For which of the following agents should the nurse plan to administer a vaccine following exposure?
Smallpox
Q: What does the "scope of nursing practice" refer to?
The activities legally permissible for a nurse to perform in a particular state
Q: What does the "scope of nursing practice" refer to?
The activities legally permissible for a nurse to perform in a particular state (Defining the scope of nursing practice is part of the responsibility of the state board of nursing. This involves determining the specific activities for each level of nursing and who can perform what functions.)
Q: An older adult woman of Chinese ancestry refuses to eat at the nursing home, stating, "I'm just not hungry." What factors should the staff assess for this problem?
The food served may not be culturally appropriate (Residents in long-term care settings often do not have much choice of foods. As a result, they may not be able to select cultural food preferences. When assessing the cause of decreased appetite in patients, the nurse should determine whether the problem may be related to culture.)
Q: Where should a nurse go if they are facing a dilemma in patient care with no absolute right or wrong answer?
The hospital Ethics Committee
Q: The nurse is reviewing I-SBAR-R with a coworker at the end of the shift. Which statement indicates that they are discussing the Situation component?
The nurse states that the patient was hospitalized for a broken tibia and that surgery is scheduled for later today. (In the Situation component of I-SBAR-R, the nurse states what is going on with the patient. In this situation, the patient was hospitalized with a broken tibia, and surgery is planned for later today. The Identification component involves stating the patient's name, the Assessment component involves the nurse discussing what the nurse thinks is happening with the patient, and the Read-Back or Response component involves that the oncoming nurse repeating what the nurse has heard from the nurse who is reporting at the end of the shift.)
Q: A nurse is being sued for assault and battery. What does this mean?
The nurse, without consent, touched the patient in an offensive, insulting, or injurious way. (Assault and battery are the legal terms applied to nonconsensual threat of touch (assault) or the actual touching (battery).)
Q: The ethical principle of autonomy is not applicable in which patient situation?
The patient is unaware of who he is and where he is. (This principle assumes rational thinking on the part of the individual.)
Q: Which situation could lead to performance inadequacy?
The person to whom the task was assigned did not understand what the task involved...........(The person who delegates a task must ensure clear direction and communication. The person to whom the task is assigned should verify that he or she understands and can perform the task.)
Q: A nurse who commits an infraction of the Nurse Practice Act may be subject to discipline by what group?
The state board of nursing (State Nurse Practice Acts regulate nursing by controlling the scope of practice and determining the specific activities for each level of nursing. Some states control who may use the titles registered nurse (RN) and licensed practical nurse (LPN) or licensed vocational nurse (LVN). The Nurse Practice Act is regulated and enforced by the state board of nursing.)
Q: What is the purpose of the nurse's Code of Ethics?
To guide the behavior of the professional nurse
Q: What is the purpose of the Robert Wood Johnson Institute of Medicine report?
To make recommendations for the nursing profession to transform healthcare
Q: What is expected of the new graduate across healthcare agencies? Select all that apply
To work effectively with assistive personnel, delegating and supervising nursing care tasks in an appropriate manner......Use communication skills effectively with clients and coworkers.......Possess theoretic background for safe client care and for decision making.......Recognize own abilities and limitations.....Use the nursing process in a systematic way.
Q: A nurse is interested in moving into a management position. Which action would assist with accomplishing this?
Use of expert power
Q: The new graduate nurse is working to create culture of safety on the unit. What actions will exemplify a culture of safety? Select all that apply
Using Universal Protocol 3 steps prior to surgery and procedures.......look at systems and processes to identify areas that need to be changes.....Refusing to be interrupted during medication administration.......Using the I-SBARR when collaborating with a provider.
Q: The nurse on the unit is determining which activities may be delegated to assistive personnel. Assuming that the nurse assistant is competent, which one of the following activities may be safely delegated by the registered nurse?
Vital signs on a stable client
Q: What is the primary role of The Joint Commission (TJC)?
ensuring medical facilities meet patient safety guidelines. (The Joint Commission (TJC) is the primary accrediting body for health care institutions. Its standards directly address patient safety issues. Magnet status is approved by the American Nurses Association. TJC does not lobby Medicare/Medicaid issues. The CDC is the agency that maintains standards regarding infection control for hospital compliance.)
Q: The nurse is implementing fall prevention protocol. What would be included in the protocol?
thorough and sound assessment of clients abilities and limitations....toileting every 2 hours and visual hourly checks.....bed and chair alarms.....assessment of medication side effects