204 QUIZLET QUESTIONS

A home health care nurse is discussing home health care during a presentation for a group of senior nursing students, as part of a Career Day seminar. One of the students asks, "How is home health care different from care in a hospital?" Which response by the nurse would be most appropriate?

"The client and family are in control of the setting, not the nurse." In home health care, the nurse is a "guest" in the client's home. Thus, the client and family retain the power and control that they relinquish to providers in other settings, such as an acute care facility. A generalist background and focus are useful, as well as broad assessment skills and a knowledge base to provide clients with appropriate education that will keep them as independent as possible. Graduate degree and high-level critical care skills are not necessary. Collaboration among team members is essential.

Which of the following is an example of certification?

A nurse who demonstrates advanced expertise in a content area of nursing through special testing. Certification is a voluntary process whereby a person who has met criteria established by a nongovernmental association is granted special recognition in a specified practice area. Licensure is granted by the state to a graduate of a nursing education program who passes NCLEX-RN. Accreditation is a voluntary process by which a nursing education program is recognized as having met certain standards by the National League for Nursing Accrediting Commission and/or the American Association of Colleges of Nursing. The Joint Commission can also accredit health care agencies.

Which nursing student would most likely be held liable for negligence?

A nursing student administers medication to a resident, while working as an unlicensed assistive personnel (UAP) at a local nursing home. The nursing student who administers medication to a resident, while working as an unlicensed assistive personnel (UAP) at a local nursing home, is performing a task outside the scope of the job responsibilities of a UAP. The other options demonstrate legally defensible actions by the nursing student.

When conducting an education program for a group preparing for retirement, the nurse would include information about applying for Social Security benefits and Medicare insurance. The nurse would include in the education that Medicare is a federally funded insurance program which bases the fee for payment on what?

A prospective payment plan based on a predetermined fixed cost. The nurse must understand that Medicare is a federal insurance program for the elderly. It is based on a prospective payment plan which pays a predetermined fixed amount for in-hospital costs. Medicare does not pay physician groups, and is not for the poor or indigent to save on costs. Retrospective payment plans pay for services after they have been received.

When talking with a client, the nurse notes that the client keeps backing up. What would be the most appropriate cultural response?

Ask the client about his personal space preferences. It is most appropriate to ask the client what he prefers in regard to personal space. If the nurse needs to invade the client's personal space, it is important to discuss the matter. It is not appropriate to back away without assessing preference. It may make the client feel judged if the nurse asks him why he is backing away. Moving closer to the client just perpetuates the problem.

The nurse is performing an assessment on a client who presents with a rash. The client states that the rash is on his back and is red and raised. What would be the most appropriate nursing action?

Assess the client's back visually. Assessment is the collection of data that enables the nurse to make judgments about the level of care the client needs. Assessment should be documented accurately, completely, concisely, factually, and timely. For the nurse to document an accurate and concise assessment, a visual assessment of the rash is necessary. This assessment should be performed before it is reported or documented and before a nursing diagnosis can be formulated.

A nurse has recently decided to seek employment in a tertiary health center. Which of the following services should the nurse anticipate would be provided in tertiary care?

Cardiovascular surgery Same-day surgery, chronic disease, and psychiatric care are typically associated with secondary care centers. Subspecialty care, such as cardiovascular surgery, is generally available in tertiary care centers.

Which of the following does the nurse incorporate with outcome identification and planning in the nursing process?

Develops an individualized plan of nursing care Outcome identification and planning specify the nursing diagnosis to the client's strengths, thereby individualizing the plan of care. Assessment is the process by which a nurse collects information from a database to determine a client's need for nursing health care. Diagnosing as part of the nursing process is meant to establish priorities of current and possible health problems of the client. Evaluation is used to determine the extent to which the client has met the outcome and drives the nurse to continue, modify, or terminate the plan of care

The nurse has developed a strong therapeutic partnership with a 44-year-old electrician who suffered severe burns while working on an industrial site. Which of the nurse's following actions most directly addresses the patient's self-actualization needs?

Discussing the patient's strengths and dialoguing with him about his body image Aspects of self-actualization include focusing on patients' strengths and fostering a positive body image. Addressing accomplishments and goals is likely to meet patients' self-esteem needs. Facilitating contact and connection between patients and their families is an action that promotes love and belonging needs.

A nurse working on a critical care unit was informed by a client with multiple sclerosis that she did not wish to be resuscitated in the event of cardiac arrest. The client is no longer able to express her wishes, and the family has informed the physician that they want the client to be resuscitated. Aware of the client's wishes, the nurse is involved in a situation that may involve what?

Ethical distress The nurse is involved in a situation that involves ethical distress. Ethical distress occurs when the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action. Paternalism is acting for clients without their consent to secure good or prevent harm. Deception and confidentiality can result in ethical problems for nurses when there is a conflict between the client's and nurse's values and interests. In this scenario, the nurse is aware of the client's wishes, but the conflict lies with the family and thus the nurse will experience ethical distress

A client who was admitted to a drug treatment center 3 days ago is boasting to the other residents that he used drugs for 2 years, and that his former employer never suspected that he was using drugs. Which action, if taken by the nurse, would be most appropriate for this client?

Have the client assume responsibility for the cleanliness of the day-room. Having the client assume responsibility for the cleanliness of the day-room would increase his sense of belonging and meet his basic need for acceptance of others without affecting the other clients. Asking the client to mentor another client is not appropriate at the start of treatment. Insisting that the client not talk about his past drug abuse would discourage therapeutic communication and trust between the nurse and the client.

What is a dynamic state in which a person constantly adapts to changes in the internal and external environment?

Health Health is a dynamic state in which a person constantly adapts to changes in the internal and external environment.

The nurse is aware that a community health center provides which of the following?

Mostly primary care and education regionally for vulnerable geographic populations These centers are mostly primary care and education centers for vulnerable populations. They are open to patients of any age and are not primarily OB/GYN centers. The centers provide care to 22 million clients in 9000 centers.

Which of the following measures should a home health care nurse implement into his or her practice to minimize the potential for lawsuits?

Perform thorough, accurate, and timely documentation. The need for thorough documentation is especially high in home health care settings, both to ensure continuity of care and to provide a legally acceptable record of what occurred during nurse-patient interactions. The nurse should not implement more conservative interventions solely to minimize liability. A waiver of rights is not a component of home health care. The client's learning needs and goals should indeed be integrated into plans of care, but this action does not protect against lawsuits.

The nurse enters the client's room in the acute care unit immediately after he experiences a generalized tonic-clonic type seizure in bed. What is the first action the nurse should take?

Position the client in a side-lying position. The need for oxygen is the most essential of all physiological needs. Aspiration is a risk for the client after a seizure because of lethargy and increased oral secretions. The client will need to be positioned on his side to allow the secretions to drain from his mouth. Immediately following a seizure the client will experience postictal confusion, which usually resolves in 1 hour unless complicated by a head injury or hypoxia. Notifying the physician and documenting the type of seizure are good interventions after the client's airway is secure and breathing is normal

What level of prevention is noted when the nurse educates a group of mothers of school-age children on self breast examinations?

Primary prevention Primary prevention focuses on the health of a person with the goal of preventing disease or illness. Self-breast examination education is primary prevention.

A nurse is caring for an adolescent who lost a leg in a motor vehicle accident. Which human need would the nurse most likely need to address?

Self-esteem needs The options listed are stages of Maslow's hierarchy of needs. The adolescent would have issues and concerns in the self-esteem stage. Self-esteem needs would include fear, sadness, loneliness, and accepting self; all would be appropriate with this client. Love and belonging would focus on the sociocultural aspect and would include areas such as relationships with others, communications with others, support systems, being part of a community, and feeling loved by others. Safety and security would focus on the environmental aspect and would include areas such as housing and community/ neighborhood to name a few. Self-actualization needs are in the intellectual and spiritual dimension and would include areas such as thinking, learning, decision making, values, beliefs, and helping others.

The home health nurse is making an initial assessment visit to a family that consists of two parents and twin 3-year-old boys. During the interview, the nurse is most concerned if the client makes which statement?

The father states, "I don't discuss money matters with my wife because I don't want her to worry." Effective and healthy families exhibit open communication among its members. Protecting the spouse from worry by not discussing money matters stifles communication and jeopardizes the family's affective and coping functions. It is appropriate for a father to provide emotional comfort to his son by allowing him to sit on his lap during the interview. Paying cash is an appropriate way to manage family finances. The mother is stating her personal belief about housework in a clear and open manner.

The nurse administered acetaminophen 15 mg/kg to a 2-year-old with a sore throat. After charting the medication, the nurse realized that the client has a documented allergy to the medication. The client breaks out in a rash 15 minutes later, his throat swells, and he must be intubated. Which best describes the nurse's actions?

The nurse is guilty of malpractice. This example illustrates the four components of nursing malpractice. The nurse had a duty to this client as she was assigned to the client's care. The nurse did not act in a manner that a reasonably prudent nursing professional would do by failing to check the client's allergies prior to administering a medication. The act of the nurse resulted in harm to the client as he was intubated. It is clear that causation exists because the client had a documented allergy and exhibited signs of an allergic reaction.

A group of nursing students has attended a presentation about the National Student Nurses' Association (NSNA). Which statement by the group indicates that they have understood the information presented?

The organization provides programs of current professional interest. The National Student Nurses' Association provides programs of current professional interest. It is not run by a group of registered nurses, but by nursing students themselves. It is student-funded, not funded by the national government. The Commission on Collegiate Nursing Education, not the National Student Nurses' Association, contributes to the improvement of public health.

Which is not true regarding Nurse Practice Acts?

They describe what medications nurses can prescribe. Prescribing and dispensing medications are not legal practices for registered nurses, with the exception of nurses in advance practice roles

What is the term for the beliefs held by the individual about what matters?

Values Values are ideals and beliefs held by an individual or group; values act as a standard to guide one's behavior. Ethics are moral principles and values that guide the behavior of honorable people. A moral is a standard for right and wrong. Bioethics is related to ethical questions surrounding life and death, as well as questions and concerns regarding quality of life as it relates to advanced technology

The client is a 2-month-old infant extremely ill from HSV sepsis. Her mother and father have decided to stop additional medical intervention and allow the infant to pass away naturally. The mother does not want her relatives to know that they plan to stop pursuing aggressive medical treatment because it is against their family's religious beliefs to withdraw medical support. What does the nurse tell the client's mother?

Yes, it is her decision who to inform about the family's medical decision. The United States health care system allows the client to make medical decisions. In the case of a minor, the client is the 2-month-old infant and her primary caregivers are her parents. United States law also gives clients the autonomy to make decisions about medical care that are culturally appropriate. This affords clients the right to share or not share any information about treatment. It is the responsibility of the health care team to uphold the request of clients

A client has had major abdominal surgery and just returned to the unit from the operating room. The nursing priority is to:

complete postoperative assessment. Assessment is the first priority, which would include breathing, level of consciousness (LOC), vital signs, dressing check, IVs, and pain level. After assessing, pain medication may be needed. The nurse may expect him to be drowsy but ongoing assessment is required.

A nursing student is studying the principle of autonomy. Which example most accurately depicts this principle?

describing surgery to a client before the consent is signed Describing surgery to a client before a consent is signed provides the client with all of the information needed to make an informed decision, thus an autonomous one. The other choices are not reflective of client decision making.

The exchange of information among the patient, the caregivers, and those responsible for care while the patient is in a care setting and after the patient returns home is key to a successful:

discharge planning. The key to successful discharge planning is an exchange of information among the patient, the caregivers, and those responsible for care while the patient is in a care setting and after the patient returns home. This coordination of care is usually the nurse's responsibility.

Florence Nightingale introduced the concept of apprenticeship for nurses. Which of the following statements is an example of this?

Completing clinical hours supervised by a nursing instructor Florence Nightingale's concept of apprenticeship involved training student nurses in a hospital setting. Completing clinical hours is an example of this. The other choices do not reflect this concept.

The nurse makes a home visit to evaluate a 3-week-old baby. Upon arrival at the family's home, the nurse discovers that the parents of the baby are a lesbian couple. When planning appropriate nursing interventions for this family, which of the following must the nurse do first?

Confront personal biases about this type of family structure. Nurses must remember that there are no absolute "rights" or "wrongs" about what makes a family, and one person's values should not be imposed on another person. Nurses must confront their own biases and prejudices in order to provide holistic, comprehensive, and individualized care to all families. The legality of the union is not an issue. All new parents, including gay and lesbian families, have fears and concerns about their parenting skills just like any other family structure may have. Addressing the fears about being new parents would be important, but is not the first step. Research studies have concluded that family processes such as the quality of parenting and harmony between parents, rather than family structures, contribute to a child's well-being.

Which statement best conveys the concept of ethical agency?

Ethical practice requires a skill set that must be conscientiously learned and nurtured. Ethical agency must be cultivated in the same way that nurses cultivate the ability to do the scientifically right thing in response to a physiologic alteration. It is inaccurate to assume that it will passively develop from the presence of other ethical practitioners, or from years of experience. It is not an innate characteristic of personality.

A nurse is thinking about pursuing a master's degree in nursing (MSN) and is reviewing information about various programs. What would the nurse expect to find about such programs?

Nurses pursuing such programs require solid scholastic abilities. Nurses pursuing master's degree programs need solid scholastic abilities. Master's degree nursing education began in the 19th century, not the late 18th century. Though such degrees can be attained in a certain specific area of interest, generic master's degree courses are also offered. Students need to take the licensure examination after a baccalaureate degree, not after a master's degree

What nursing function would be most commonly found in an ambulatory care facility?

Providing direct patient care Ambulatory care centers and clinics (agencies that deliver outpatient medical care) may be located in hospitals, may be a freestanding service provided by a group of health care providers who work together, or may be managed by an APRN.

A client with a recent total knee replacement (TKR) is about to be discharged home with home health. When discussing this with the client's wife, who is concerned that her husband is "being sent home too soon." Which of the following does the nurse understand is the primary, client-centered reason for the implementation of this level of care?

Sophisticated technology generally allows client care to be managed safely in the home environment. Although the payment reimbursement system encourages early discharge when safe to do so, it is not generally a requirement. Home health agencies are able to provide many services, but these services are not necessarily more easily done in the home than in an acute care setting. The best answer is that technology allows select patients to receive quality care in the home.

The nurse is a member of the multidisciplinary team in a large primary healthcare setting. The nurse understands that which healthcare team member is responsible for a client's swallow evaluation following a CVA (cerebral vascular accident)?

Speech pathologist/therapist It is within the speech pathologist's/therapist's scope of practice to conduct a swallow evaluation for a patient. The other possible answers are outside the scope of the occupational therapist, the physical therapist, and the physician's assistant

Which of the following actions by the nurse demonstrates the nurse's efforts to meet the client's self-actualization needs?

The nurse arranges for the client's clergy to visit after visiting hours. Self-actualization needs encompass the intellectual and spiritual dimensions of the individual, which is reflected in the nurse arranging for the client's clergy to visit after visiting hours. Arranging for the client's medicine man and teaching how to administer the client's tube feeding meet the physiologic needs of the individual. Love and belonging needs are met by eliciting support from the family.

Nursing students are socialized into the:

health care culture. Culture enables people of similar cultural heritage to understand the meanings of each other's words as part of the particular context, to read each other's nonverbal behavior fairly accurately, and to communicate through symbols.

A community health nurse arranges for a dental checkup camp for the local children in the school district. Which of the following would most likely be the nurse's goal for this health camp?

health promotion The education on lifestyle choices is part of health promotion activity, which focuses on protecting the person's health. The goal of the prevention of illness is to detect and prevent the illness. High-level wellness focuses on maximizing the person's highest potential for functioning. Reversal of self-care deficits would involve therapeutic interventions that are directed at contributing factors.

In preparation for discharge, the nurse is reviewing information related to new dietary guidelines with the client. This is an example of which step in discharge planning?

providing client education The nurse is teaching the client important information about self-care at home prior to the client's discharge. The initial step in discharge planning is collecting and organizing data about the client, as this provides information on the client's health care needs. Home referrals may be made after the education process, based upon orders provided by the physician. Developing goals may occur after the education process, as the goals need to be realistic.

The nurse's priority of care includes oxygen, food, water, elimination, activity, rest, temperature maintenance, and sexuality. Which of the following should be next on the list?

requiring parents to be by the toddler's crib at all times After meeting basic physiologic needs, the person must address safety needs. Humans need to be physically safe and free from the fear and anxiety that result from a lack of security and protection. Safety is often a dominant motivator.

What is the primary purpose of standards of nursing practice?

to ensure knowledgeable, safe, comprehensive nursing care Each nurse is accountable for her own quality of practice and is responsible for using standards to ensure knowledgeable, safe, comprehensive care. Standards of practice do not provide the ability to safely perform skills, establish nursing as a profession and discipline, or enable nurses to have a voice in health care policy.

Priority nursing interventions are geared to meeting the physiologic needs of patients. What are examples of physiologic needs according to Maslow's hierarchy of needs? (Select all that apply.)

• A nurse administers pain medication to a postoperative patient. • A home care practitioner requests a quiet environment so her elderly patient can get some rest. Physiologic needs—for oxygen, water, food, elimination, temperature, sexuality, physical activity, and rest—must be met at least minimally to maintain life. These needs are the most basic in the hierarchy of needs, are the most essential to life and, therefore, have the highest priority. Physiological needs would be administering pain medication to a postoperative client and requesting a quiet environment for an elderly client. The nurse washing her hands would be Level 2, safety and security. The nurse inviting a client's estranged son to visit would be Level 3, love and belonging. The nurse counseling an overweight teenager would be Level 4, self-esteem. A nurse attains a master's degree would be Level 5, self-actualization but for the nurse. This would not address Level 5 for the client.

A nurse applies for membership in a professional nursing organization that is operating in the United States. To which organizations might this nurse apply? Select all that apply.

• ANA • ICN • AACN The American Nurses Association (ANA), International Council of Nurses (ICN), and American Association of Critical-Care Nurses (AACN) are three examples of organization to which a nurse might apply. The NNO, NASN and ANO are not professional nursing organizations

Nurses practice within the legal and mandatory standards of the nursing profession. What are examples of voluntary standards in nursing? (Select all that apply.)

• American Nurses Association Standards of Practice • Professional standards for certification of individual nurses in general practice • Process of certification Voluntary standards in nursing would include the American Nurses Association (ANA) Standards of Practice, the process of certification, and professional standards for certification of individual nurses in general practice. State nurse practice acts is not an example of voluntary standards in nursing. Rules and regulations of nursing are not examples of voluntary standards in nursing.

The nurse is teaching a group of nursing students about how health of community members is affected. Which community characteristics affect the health of individuals? Select all that apply.

• Education programs • Communication facilities • Transportation services • Recreation programs Characteristics of a community that influence the health of the members of the community include: education and recreation programs; transportation and communication facilities; healthcare resources; production of services and goods; prevailing values and beliefs; and protection, safety, and aesthetic concerns. Genetic testing is a resource available to families for the diagnosis of a hereditary disorder.

The nurse discussing emergent pathways to the nursing profession includes which of the following? Select all that apply.

• Entry level masters degree programs • RN completion programs for LPNs A number of new pathways into nursing are emerging and attracting new audiences into the nurse career field. These include: accelerated programs for graduates of non-nursing disciplines, entry level masters degree programs, RN completion programs for LPNs, and community college-based baccalaureate programs. Three-year diploma programs, RN to BSN completion programs, and entry level associate degree programs are all traditional pathways into the nursing profession

Which of the following activities does the nurse engage in during the entry phase of the home visit? Select all that apply.

• Establish rapport with client and family. • Assess the client and home situation. • Educate the client and family about promoting self-care. During the pre-entry phase of the home visit, the nurse would review client information, including client's diagnoses, surgical experience, socioeconomic status, and treatment orders. The nurse would gather supplies in preparation for the visit. During the entry phase, the nurse makes a home visit to establish rapport with the client and family. The nurse makes an assessment, determines nursing diagnoses, establishes desired outcomes with input from the client and family, implements prescribed care, and provides education.

The nurse is reviewing the medical records of several families from the Medical Clinic. The nurse identifies which of the following families as having risk factors that may affect their health? Select all that apply.

• Family is vegan • Family uses herbal medicine • Family fasts for religious purposes • Family receives public assistance • Family is headed by a single mother A vegan diet will affect health because it is low in protein, which is a dietary necessity. Use of herbal medicine and fasting for religious purposes can pose health risk factors, so the nurse should further assess the impact of these factors on the family members' overall health. A family on public assistance is in a lower socioeconomic status. A family headed by a single parent may have financial concerns and role shifts (i.e., having the roles of both parents). A family that has had their children vaccinated have no risk factors that would affect their health.

Nurses provide care for clients as they move throughout the health care system. What are methods used to ensure continuity of care and cost-effective care during this process? Select all that apply.

• Managed care • Case management • Primary health care Methods to ensure continuity of care and cost-effective care would include managed care, case management, and primary health care. Rural health centers are often located in geographically remote areas that have few health care providers. The primary focus of rural health centers is providing primary care. Parish nursing is an expanding area of specialty nursing practice that emphasizes holistic health care, health promotion, and disease-prevention activities. The focus of parish nursing is not continuity of care or cost-effective care. Primary care center services include the diagnosis and treatment of minor illnesses; performing minor surgical procedures; and providing obstetric care, well-child care, counseling, and referrals. The primary care center's main focus is not continuity of care and cost-effective care.

A nurse is providing family-centered care to patients in a community health care clinic. Which statements about the family unit are accurate? (Select all that apply.)

• The family is a buffer between the needs of individual members and society. • Duvall (1977) identified critical family developmental tasks and stages in the family life cycle. • The nuclear family is composed of two parents and their children. A family can be defined simply as any group of people who live together and depend on one another for physical, emotional, and financial support. Families are essential to the health and survival of the individual family members, as well as to society as a whole. The family is a buffer between the needs of the individual member and the demands and expectations of society. The nuclear family, also called the traditional family, is composed of two parents and their children. Duvall's theory, based on Erikson's theory of psychosocial development, states that all families have certain basic tasks for survival and continuity as well as specific tasks related to developmental stages throughout the life of the family. Friedman identified the importance of family-centered nursing care. He identified the family as composed of interdependent members who affect one another. If some form of illness occurs in one member, all other members become involved in the illness. His work does not limit the definition of family to blood relatives, so therefore a group home could potentially be identified as a family. A blended family is another form of a nuclear family, formed when parents bring unrelated children from previous relationships together to form a new family.

Students nurses need to know about the Code of Ethics for Nurses. The Code of Ethics includes a set of principles to follow. Identify the tenets of the Code of Ethics for Nurses. Select all that apply.

• The nurse maintains standards of personal conduct. • The nurse is active in developing a core of research based principles. • The nurse holds personal information as confidential. Standards of personal conduct, developing research, and confidentiality are all tenets of the Code of Ethics for Nurses. The other choices are not included in the Code of Ethics for Nurses.

A nurse is discharging a client from the hospital. Which nursing actions should occur when a client is discharged from a health care setting? Select all that apply.

• The nurse performs discharge planning, which begins upon admission to the facility to ensure continuity of care. • The nurse ensures that the family members are taught the knowledge and skills needed to care for the client. • Preferably, the nurse who conducts the initial nursing assessment will determine the special needs of the client being discharged. Discharge planning is started as soon as possible after admission in order to provide adequate time for education and arranging any necessary care following discharge from a facility. The nurse must validate that any family members that are going to be caring for the client understand and can perform necessary care. Continuity of care is improved if the nurse that performed the detailed admission assessment determines the discharge needs. The nurse, not the hospital administrator, prepares and performs the client handoff to the new facility. As long as family members are capable and are adequately taught and evaluated, they may perform complicated procedures required for caring for the client.

The nursing instructor is discussing holistic health care with her nursing students. The instructor talks about the different factors the nurse must consider when creating a holistic plan of care. What are these factors? (Mark all that apply.)

• The patient's developmental life stage • The patient's emotional context • The patient's physiologic health condition It is the nurse's conceptual integration of the physiologic health condition within the emotional and social context, along with the patient's developmental life stage, that allows for the development of a holistic plan of nursing care. The patient's physical environment and their "conceptual integration of life" are not factors the nurse would take into account when creating a holistic plan of care.

Nurses use the nursing process to solve problems in their practices. Which statements describe the common use of problem solving in the nursing process? Select all that apply.

• The scientific problem-solving method is closely related to the more general problem-solving process (the nursing process) commonly used by health care professionals as they work with clients. • Today, nurses acknowledge the positive role of intuitive thinking in clinical decision making. • Critical thinking in nursing can be intuitive or logical or a combination of both. The scientific problem-solving method is a systematic 7-step problem solving method that may be used in conjunction with the nursing process. Intuitive thinking and clinical decision making utilize intuitive problem solving as a direct understanding of a situation based on a background of experience, knowledge, and skill that makes expert decision making possible. Logic provides a safer approach to decision making, but intuition provides a creative approach to decision making; therefore, a combination of both is a part of the nursing process. Trial-and-error is not used extensively in the nursing process because it involves testing any number of solutions until finding one that works for that particular problem, which can be dangerous for the client

When providing nursing care to clients, nurses are required to adhere to ethical values and legal rules to guide behavior. Which values would be included? Select all that apply.

• Veracity • Fidelity • Privacy • Confidentiality The American Hospital Association (AHA) created a brochure with six basic rights for clients and families during hospitalization. In addition to these rights, there are ethical values and legal rules that guide the behavior of health care professionals toward clients and their families. These include veracity, fidelity, privacy, and confidentiality.

Client education is a major nursing responsibility. The education that the nurse must accomplish prior to discharge includes:

• a review of the appointment schedule for follow-up care. • when to take medications, their purpose, side effects, and appropriate administration. • a family member's practice of dressing changes. • information about home care/physical therapy with appropriate phone numbers. Client education prior to discharge is essential and should include written information to support the lesson. This may include information about appointments, medications, information regarding specific conditions, and so on. The nurse must evaluate that the caregiver is adequately prepared to do dressing changes or provide other care safely. If the client needs help from the dietitian, the nurse should make the referral prior to discharge.

In addition to understanding the culture of the client, what other action is required to provide culturally competent nursing care? Select all that apply.

• recognizing one's own culture and biases • recognizing the culture of the health care system The emphasis of culturally competent nursing is the need for the nurse to understand the culture of the client, including being able to recognize his own culture and biases as well as the culture of the health care system. Although information can be found in the literature about culture, the nurse obtains key cultural information from the client, who is the expert in his culture. Although culture shapes all learned human responses, it does not determine them. Individuals reflect the influence of their cultures; however, they do not share the same culture equally.