330
The primary nurse is coordinating care for a newly admitted client. Which nursing actions are appropriate when planning this client's care? (Select all that apply.) -Initiate consultations with other health care providers -Select appropriate critical pathways for the client -Identify applicable evidence-based practice guidelines for the client's care -Suggest appropriate referrals for the client's care -Obtain orders for referrals and consultations from the health care provider
-Select appropriate critical pathways for the client -Identify applicable evidence-based practice guidelines for the client's care
An older adult client asks the nurse why a needed total hip replacement cannot be performed for six months. What should the nurse include when responding to this client? (Select all that apply.) -Rationing of expensive health care surgeries is being done in the United States. -Being evaluated by another healthcare provider would cut the waiting time. -The waiting list may be shorter if the client is willing to pay more out of pocket. -Reducing availability of some procedures helps reduce healthcare costs. -Health care is provided according to need, and the client's need is not great at this time.
-The waiting list may be shorter if the client is willing to pay more out of pocket. -Reducing availability of some procedures helps reduce healthcare costs.
What does the acronym PPE stand for? 1Personal protective equipment 2Personal protective equipment Pending practice experience Preparedness phase event
1Personal protective equipment
The sperm and ovum each contain how many autosomes? 46 44 24 22
22
The nurse is educating a couple who are asking questions about fertilization. How long are sperm considered fertile in the female reproductive tract? 12 hours 36 hours 24 hours 48 hours
24 hours
Oligohydramnios is diagnosed when the amniotic fluid is less than which percent expected for gestational age? 80 65 35 50
50
Critical pathways share certain common features regardless of the healthcare setting. Which statements by the nurse illustrate the common features of critical pathways? (Select all that apply.) A timeline for goal achievement is a common feature of critical pathways. The determination of predictable characteristics of the medical illness or injury is a common feature of a critical pathway. A fire escape plan for all clients on the unit is a common feature of a critical pathway. Utilization of appropriate resources for the care needed is a common feature of a critical pathway. The ability to monitor variances and trends is a common feature of a critical pathway.
A timeline for goal achievement is a common feature of critical pathways. The determination of predictable characteristics of the medical illness or injury is a common feature of a critical pathway. Utilization of appropriate resources for the care needed is a common feature of a critical pathway. The ability to monitor variances and trends is a common feature of a critical pathway.
Which nursing intervention best reflects a strategy that is conducive to the teaching-learning process? Asking the client to perform a return demonstration of skills Avoiding repetition of information Explaining the content as quickly as possible Disregarding the client's facial expressions
Asking the client to perform a return demonstration of skills
What action should the nurse take to transfer a bed-bound client from the bed to a chair? Use a slide board Ask for assistance by other staff members Attach a mechanical device Pivot to the chair from the side of the bed
Attach a mechanical device
Mark Whetstone, 63, is a client whose care is being administered by an interdisciplinary team. A novice nurse, Judy Williams, is assigned to the interdisciplinary team. What does Judy anticipate as her role on this team? Attending team meetings to discuss the client's care Taking full responsibility for providing direct care to the client Making independent decisions regarding the client's medical care Prescribing medications that are appropriate for the client's care
Attending team meetings to discuss the client's care
As the night nurse on the obstetrics unit, Carla has gotten to know one client very well. Sarah Gomez is a 42-year-old elementary teacher. Ms. Gomez was confined to her bed for an extended time, and Carla has found that they know people in common. Ms. Gomez had a successful C-section. Now that she is about to be discharged home, Carla plans to bundle up her own unused newborn clothes to give to Ms. Gomez as a gift. What professional behavior associated with ethical nursing values might Carla's plan violate? Attention to professional appearance and demeanor Attention to professional boundaries with clients Articulation of nursing's professional skills Pursuit of professional engagement
Attention to professional boundaries with clients
Which statement best describes the influence of the Internet on teaching and learning in the healthcare setting? Due to the widespread use of Internet technology, all clients should be trained to use a computer-based approach to learning. Because of client-specific variations, the nurse must be skilled at implementing effective teaching strategies for clients who use the Internet as well as for those who do not. Due to the widespread use of Internet technology, the nurse should incorporate computer-based learning into every teaching plan. Because the Internet offers information that is mostly incorrect, the nurse must anticipate the need to reeducate all clients.
Because of client-specific variations, the nurse must be skilled at implementing effective teaching strategies for clients who use the Internet as well as for those who do not.
Which learning theory proposes that positively or negatively reinforcing an individual's response to a stimulus produces learning? Adult learning theory Cognitive theory Humanist theory Behaviorist theory
Behaviorist theory
Two hospice nurses are discussing the ethical implications of not admitting a client with a diagnosis of terminal cancer with a specific estimated number of months to live, which exceeds their facility's guidelines. Which components of ethics are appropriate for these nurses to consider regarding this situation? (Select all that apply.) Benefits to society of having hospice guidelines Obligations of the hospice facility Rights of this cancer patient Efficiency of the hospice functioning Fairness to this client and other clients
Benefits to society of having hospice guidelines Obligations of the hospice facility Rights of this cancer patient Fairness to this client and other clients
Two nurses are attending a workshop updating clinicians about the provisions of the Patient Protection and Affordable Care Act (ACA). They are discussing how they appreciated learning about how this new legislation strengthened an older law. For what situation did the ACA encourage reporting? Wasteful supply ordering Intravenous medication errors Careless sterile techniques Billing agency fraud
Billing agency fraud
A newly hired nurse made a medication error in her first week on the job. The nurse soon learned that her facility had a strong policy in which errors or near misses could be reported without the fear of punishment. Which concept supports this attitude toward mistakes? Blame-free environment Just culture Accountability Responsibility
Blame-free environment
You enter the room and introduce yourself to Mrs. Moore. You place the external uterine contraction monitor on her fundus and perform Leopolds to determine where to place the external fetal monitors. You place the monitors where you find the strongest heart beats, and you count the heart beats to ensure you are not monitoring the same baby in two places on her abdomen.Ultimately, you place one monitor on the right upper quadrant of Mrs. Moores abdomen and the other one on the left upper quadrant. What are the potential implications of where you are tracing the fetal heartbeats? Both twins are vertex. Both twins are breech. Both twins are transverse. Both twins are cephalic.
Both twins are breech.
A night nurse makes two telephone calls to the covering healthcare provider during the early morning hours of the shift. Then the nurse discovers an order for a stat laboratory test that was requested, but not done, during daytime hours. Which action by the nurse is the most appropriate in this situation? Communicate the missed order to the next shift Call the healthcare provider to clarify the need for the stat lab test Write up an incident report about the error Wake up the client for transport to the lab
Call the healthcare provider to clarify the need for the stat lab test
A client files a negligence lawsuit against a nurse for the long-term symptoms resulting from a ventilator-acquired pneumonia (VAP). Which element of professional negligence or malpractice will this client have difficulty proving in a court of law? Causation Breach of duty Foreseeability Injury from breach of duty
Causation
Which agencies identify national threats and create emergency management plans at the national level? (Select all that apply.) Centers for Disease Control and Prevention Department of Homeland Security The Joint Commission National Institutes of Health Federal Emergency Management Agency
Centers for Disease Control and Prevention Department of Homeland Security Federal Emergency Management Agency
Which change of pregnancy involves a brownish discoloration of the forehead? Chloasma Lordosis Linea nigra Striae gravidarum
Chloasma
A collaborative case management team is providing care for a high risk client with hypertension. What intervention is appropriate for the nurse case manager to implement as a member of this team? Determining whether the client represents high risk, high cost, or high volume Prescribing medical orders for the client Allowing unlicensed assistive personnel to develop the plan of care Choosing appropriate interventions related to diagnoses within a specified time frame
Choosing appropriate interventions related to diagnoses within a specified time frame
Continuous Quality Improvement (CQI) is a client-driven process. In a rehabilitation facility, which individuals are examples of internal clients who drive the CQI process? (Select all that apply.) Clinical nurse specialist Parents of a child with spina bifida Client after hip replacement Physical therapist Head of Management of Information Systems (MIS) department
Clinical nurse specialist Physical therapist Head of Management of Information Systems (MIS) department
In which disaster zone is personal protective equipment worn just in case conditions change? Cold Neutral Hot Warm
Cold
When documenting the client's teaching session, which component should the nurse include? Names of the client's healthcare team members Degree to which client outcomes were achieved Client-specific characteristics, such as cultural background and spiritual beliefs A detailed description of each teaching strategy that was used
Degree to which client outcomes were achieved
The nurse administers a dose of the pneumococcal vaccination to an older client prior to the client's discharge from the hospital. Which function of managed care is this nurse performing? -Delivering preventive services -Advocating for client needs -Assessing client needs -Preventing unnecessary costs
Delivering preventive services
Which description is a characteristic of professional values? Insight into how actions influence values Influence by cultural norms Development of socialization to nursing by nursing school faculty Influence by insight into clients' values
Development of socialization to nursing by nursing school faculty
Which fetal abnormalities are more likely when the mother is over 35 years of age? Macrosomia Club feet Down syndrome Polydactyly
Down syndrome
During a routine prenatal visit, a client who is 24 weeks gestation is found to have glycosuria. After notifying the healthcare provider, which action should the nurse take? Instruct the client to increase fluid intake. Evaluate the client for gestational diabetes. No action needs to be taken, as this is a normal finding. Inform the client of the need for bed rest.
Evaluate the client for gestational diabetes.
Abigail, the registered nurse, is meeting with the physical and occupational therapists to discuss outcome achievement for a client recovering from a stroke. Which case management behavior is the nurse demonstrating at this time? -Assessing client needs -Coordinating care -Evaluating care provided -Providing interventions
Evaluating care provided
The nurse is planning a teaching session for a 6-year-old client who is scheduled to undergo tonsillectomy and adenoidectomy in two weeks. Which strategies reflect the nurse's correct understanding of lifespan considerations? (Select all that apply.) Using terms of endearment for the child, such as "sweetheart," as opposed to addressing the child by name Giving the client a coloring book that depicts the hospital, surgical team, and client monitoring devices Using a doll to demonstrate placement of an oxygen mask Discouraging parents from reading story books about the planned procedure, as this may frighten the child Including instructions that are geared toward the parents' level of comprehension
Giving the client a coloring book that depicts the hospital, surgical team, and client monitoring devices Using a doll to demonstrate placement of an oxygen mask
Which cardiac disorders may result in maternal death in the perinatal period? Select all that apply. Mitral valve prolapse Marfan syndrome Beta-thalassemia Peripartum cardiomyopathy Surgically corrected congenital anomalies
Marfan syndrome Peripartum cardiomyopathy
A NIOSH representative is scheduled to tour a care area as part of a study on workplace stress. What should the manager prepare to share with the representative who visits the care area? (Select all that apply) New policies about calling off and use of paid time off Number of reports of verbal abuse Previous three months of work schedules Number of employee cuts, sprains, and fractures Number of employees hospitalized with work-related injuries
New policies about calling off and use of paid time off Number of reports of verbal abuse Previous three months of work schedules
Which rights should the nurse follow when delegating a task to unlicensed assistive personnel (UAP)? Select all that apply. Right supervision Right task Right documentation Right person Right direction
Right supervision Right task Right person Right direction
The nurse is participating in an interdisciplinary team meeting regarding a client with cirrhosis. Which communication technique illustrates the principles of collaboration? Reminding the team that the client is hard of hearing and cannot understand his plan of care Sharing information with the team while serving as a client advocate Telling the team that the client only wants treatment with alternative and complementary therapies Withholding input because the meeting is running over
Sharing information with the team while serving as a client advocate
When a nurse obtains informed consent, the client should be provided with all pertinent and relevant information. Which information is not relevant? The intended benefits of the treatment The diagnosis or condition that requires treatment The insurance payment methods The purposes of the treatment
The insurance payment methods
When formulating learning outcomes, which nursing guideline is most appropriate? Including statements about what the client will understand Identifying the desired nursing action Avoiding the use of client-specific characteristics Using measurable data in each statement
Using measurable data in each statement
Which potential barrier to learning is culturally based? Shortened attention span Critical illness Values Sensorimotor deficits
Values
A nurse is receiving training during a hospital simulation experience on the deliberate release of biological agents. The nurse is given a scenario to provide care to a client who is exposed to inhaled anthrax. Which IV medication does the nurse anticipate the client will be prescribed by the healthcare provider? ampicillin 500 mg every 6 hours morphine 0.05-0.2 mg/kg/dose every 4 hours ciprofloxacin 400 mg every 12 hours sulfamethoxazole 15-20 mg/kg/day
ciprofloxacin 400 mg every 12 hours
A client is prescribed a chemical restraint for aggressive behavior. When reviewing the client's medication administration record, which medication should the nurse use to prevent the client from causing harm to self or other staff members? amoxicillin (Amoxil) warfarin (Coumadin) digoxin (Lanoxin) diazepam (Valium)
diazepam (Valium)
Which statement is a definition of beneficence? Upholding fair treatment Actions to promote good Right to self-determination Telling the truth
Actions to promote good
A client's chemotherapy medication becomes disconnected and fluid is running down the hospital bed onto the floor. What action should the nurse take regarding the spilled substance? Identify the medication to obtain a safety data sheet Ask environmental services team to clean the floor Cover the spilled medication with a towel Apply gloves and wipe the medication with clear water
Identify the medication to obtain a safety data sheet
Mr. and Mrs. Woodard are expecting their first child. They share with you that they have a fear of sexual intercourse and believe it could harm the fetus. Which phase of paternal bonding does this represent? Focusing phase Moratorium phase Announcement phase Newborn phase
Moratorium phase
During a staff meeting the nurse manager provides information about the client care studies conducted on the medical-surgical unit. Which competency is the manager helping the staff achieve? Informatics Teamwork and collaboration Quality improvement Safety
Quality improvement
The walk-in clinic staff nurse is preparing to submit a mandatory report related to a client's newly diagnosed Escherichia coli infection. Which client information must the staff nurse include in the report? Religion Marital status Race Sexual orientation
Race
A client at 32 weeks gestation is ambulating with a waddling gait. The nurse explains that this gait is due to which musculoskeletal change? Relaxation of the pelvic joints Low calcium intake Changes in the center of gravity Underlying musculoskeletal disorder
Relaxation of the pelvic joints
The nurse and the client are reviewing common patient responsibilities. Which items should be included? (Select all that apply.) Submitting any available health insurance information to the healthcare facility Asking the healthcare team whether it is necessary to change medications before a procedure Providing members of the healthcare team with accurate information Following the treatment plan recommended by the healthcare team Designating a family member or personal friend to serve as an advocate
Submitting any available health insurance information to the healthcare facility Asking the healthcare team whether it is necessary to change medications before a procedure Providing members of the healthcare team with accurate information Following the treatment plan recommended by the healthcare team
A veteran nurse is showing the new graduate nurse how to practice lavage on a mannequin in the simulation lab. In which situation during a mass casualty incident could that technique be used? To treat fractures To treat wounds To treat dehydration To treat coma
To treat wounds
Tina, a staff nurse, is attending an in-service about evidence-based practice (EBP). The unit nurse leader, Maria, asks Tina how she supports the development of EBP. Which response best reflects Tina's misperception about a barrier to implementing EBP? "I've been picking up a lot of extra shifts-I'm too busy to take on another work-related responsibility." "I've taken extra clients almost every night this month-I can't handle the thought of adding one more thing to my to-do list." "I think what we're doing now works just fine-why fix what isn't broken?" "I'm not certified in research and I don't have time to take a course right now-EBP is outside my scope of practice."
"I'm not certified in research and I don't have time to take a course right now-EBP is outside my scope of practice."
While teaching a 32-year-old client about colostomy care, the nurse notes the client has tears in his eyes. The client states, "I can't believe I have to live with this thing for the rest of my life." Which nursing response best reflects the nurse's understanding of factors that inhibit learning? "You've been through a lot. As soon as we're finished, I'd like to ask your nurse practitioner to give you a counseling referral." "Let's reschedule this teaching session for later. I'll check back with you to pick a time. Right now, please tell me more about what you're feeling." "I'm sorry you have to go through this. Understanding how to take care of yourself should make it a little easier for you, so let's talk a little more about how to clean your colostomy site." "I hear you saying that you're upset. I'll reschedule your teaching for tomorrow morning. Now, please tell me more about how you feel."
"Let's reschedule this teaching session for later. I'll check back with you to pick a time. Right now, please tell me more about what you're feeling."
The nurse educator is teaching about ethical dilemmas related to end-of-life issues. When discussing assisted suicide, which statement is appropriate for the nurse educator to include? "Assisted suicide is a variant form of active euthanasia." "Assisted suicide is illegal throughout the entire United States." "Assisted suicide involves taking actions to directly cause death, with or without client consent." "Assisted suicide includes administering a lethal dose of medication to end a client's suffering."
"Assisted suicide is a variant form of active euthanasia."
What is the purpose of community-based safety programs? Reduce healthcare costs. Create healthier individuals. Improve employment opportunities. Establish community gardens.
Create healthier individuals.
Sue Nguyen, a nurse in the Employee Health Department, is reviewing information to submit to OSHA for the monthly report. Which information about employee health and injuries should the nurse include in this report? (Select all that apply.) 3 incidences of intravenous poles collapsing on nurses necessitating stitches to close arm wounds 1 incidence of employee sprained ankle after falling on a wet floor 5 incidences in which client aggression was averted 6 incidences when staff nurses worked overtime 8 incidences where staff nurses left the unit to obtain flu vaccinations
3 incidences of intravenous poles collapsing on nurses necessitating stitches to close arm wounds 1 incidence of employee sprained ankle after falling on a wet floor
The nurse is educating a group of women about conception. During the session, the nurse identifies that implantation occurs how long after fertilization? 3-5 days 24 hours 7-10 days 2 weeks
7-10 days
The nursing director of surgical services is preparing an in-service about client care protocols related to organ transplantation. Which situations best reflect potential sources of ethical conflict? (Select all that apply.) Allocation of organs Children as potential organ recipients Children as potential organ donors Harvesting organs from living donors Religious beliefs
Allocation of organs Children as potential organ recipients Children as potential organ donors Religious beliefs
Which diseases have been identified as high risk for bioterrorism threats? (Select all that apply.) Botox Staphylococcus Anthrax Smallpox Chicken pox
Anthrax Smallpox
Which nursing action is appropriate when collaborating within the clinical environment? Taking full responsibility for the client's outcome Communicating with other members of the team Enforcing perceptions of inequality among the team Expressing priority respect and trust to the physician
Communicating with other members of the team
The nurse is caring for a 52-year-old male following a total knee replacement. Which are appropriate actions regarding collaborative care for this client? Consulting the pharmacist regarding the interaction of the client's pain medication with his other medications Changing the medication order after speaking with the client about adverse effects Informing the dietician that the client is on a cardiac diet and needs re-teaching about the diet Informing the pharmacist that the client's blood pressure has been low and to hold his blood pressure medications Updating the physical therapist regarding the client's physical activity and tolerance earlier in the day
Consulting the pharmacist regarding the interaction of the client's pain medication with his other medications Informing the dietician that the client is on a cardiac diet and needs re-teaching about the diet Updating the physical therapist regarding the client's physical activity and tolerance earlier in the day
The nurse is planning a teaching session on diet and nutrition for a group of teenage mothers who are students at a local high school. When planning the teaching, which client-specific factors should the nurse seek to learn? Level of education Age Gender Cultural background
Cultural background
Which factors affect the ability of the pregnant woman to adapt to pregnancy? Select all that apply. Cultural beliefs Psychosocial support Socioeconomic status Gender of the fetus Maternal age
Cultural beliefs Psychosocial support Socioeconomic status Maternal age
Mrs. Chan is coming to the clinic for an initial prenatal visit. The nurse is teaching Mrs. Chan about process of fetal circulation. The nurse would explain to Mrs. Chan that most of the fetal blood bypasses the liver through which fetal shunt? Ductus venosus Ductus arteriosus Foramen ovale Umbilical vein
Ductus venosus
The nurse is adhering to the competency of evidence-based practice while providing client care. Which nursing intervention is an appropriate demonstration of this competency? Asking a nursing assistant to help turn and reposition a client in bed Reviewing the results of a root cause analysis of wound infections Explaining the pathophysiology of a client's disease process Ensuring a dressing change is completed according to established protocols
Ensuring a dressing change is completed according to established protocols
A nurse moved with family members into an area of the county that has a "tornado alley." Shortly after the nurse's arrival, the town was hit by a tornado. Which activities constituted the community's emergency response phase? (Select all that apply.) Establishing critical care services Repairing utilities Implementing warning systems Opening shelters Establishing emergency operations centers
Establishing critical care services Repairing utilities Opening shelters
Which teaching strategy best exemplifies a characteristic of effective teaching? Evaluating the client's comprehension of the content Minimizing question-answer interactions to avoid distracting the client Avoiding goal-setting to prevent intimidating the client Using one teaching method for the client
Evaluating the client's comprehension of the content
In a disaster drill, a nurse is portraying a contaminated victim. In this portrayal, which color of disaster zone would the nurse be prohibited from entering? Yellow zone Red zone Blue zone Green zone
Green zone
Gerald DeMarco, a hospice nurse, is caring for Alyce Greinberg, a 38-year-old woman whose pancreatic cancer has spread throughout her body. Although Ms. Greinberg has refused all medical treatments, she has been eating and drinking normally and remains alert and oriented. During Gerald's most recent visit, Ms. Greinberg declined her meal and stated, "I'm not eating or drinking anymore. I'm ready to die." What is the most appropriate action for Gerald to take at this time? Obtain a medical order to administer intravenous fluids to the client. Honor the client's wishes and encourage her to verbalize her feelings and concerns. Respect the client's choice and explain that refusal of nutrition is grounds for termination of care. Notify the client's family members and ask them to encourage the client to take some nutrition.
Honor the client's wishes and encourage her to verbalize her feelings and concerns.
The nurse educator is preparing a lecture regarding settings that use critical pathway implementation. Which settings are appropriate for the educator to include in the presentation? (Select all that apply.) Hospitals Senior centers Day care centers Rehabilitation facilities Assisted living facilities
Hospitals Rehabilitation facilities Assisted living facilities
A nurse recently attended the hospital's mandatory annual education series about filling out incident reports. At the end, knowledge was tested using a True-False posttest. Which item would the nurse circle as being false? Most incidents do not result in the filing of a civil lawsuit in court. Incident reports should be written as though discoverable. If follow-up treatment was needed, the chart should not record that fact. If an incident report was written, the chart should not record that fact.
If follow-up treatment was needed, the chart should not record that fact.
What is used as a reflection of institutional accountability? Philosophy and objectives of the nursing department Ethical integrity Standards of practice Legislated nurse practice acts
Philosophy and objectives of the nursing department
The nurse is writing a plan of care for a client. Which statement best reflects correct application of the guidelines for writing learning outcomes? Within 30 days, the client will feel less pain and will be exercising more frequently. Upon conclusion of the teaching session, the client will verbally identify three types of low-impact exercise. The client will no longer be depressed and will believe that she is valuable. The client will be taught the signs and symptoms of diabetes.
Upon conclusion of the teaching session, the client will verbally identify three types of low-impact exercise.
A client who is interested in becoming pregnant is keeping a menstrual calendar and has a 29-day cycle. She asks the nurse when her ovaries are likely to be releasing an ovum. What is the nurse's best response? "You will ovulate within a week after the end of your period." "You have an abnormal menstrual cycle, so you may need medication in order to produce mature ova." "The most likely time for ovulation to occur is about two weeks after the start of your period." "There is no way to tell when the ovum will be released. It may happen at any time."
"The most likely time for ovulation to occur is about two weeks after the start of your period."
The public health nurse is discussing immunization choices with the parents of an infant. The parents have decided to decline routine vaccinations. What question could the nurse ask the parents to help them examine possible consequences of their choice? "Do you know any other parents who are withholding vaccinations?" "What benefits do you foresee from withholding vaccinations?" "How do you feel about your decision to withhold vaccinations?" "How much research have you done about withholding vaccinations?"
"What benefits do you foresee from withholding vaccinations?"
While caring for a client, the nurse meets with the healthcare provider to discuss responses to treatment and explain the client's issues with medication side effects. Which associated concepts of managed care is this nurse demonstrating? (Select all that apply.) -Advocacy -Healthcare systems -Clinical decision-making -Ethics -Collaboration
-Advocacy -Collaboration
What are characteristics of shared governance? Select all that apply. -Can be used with other care delivery methods -Based upon competencies needed to provide client care -Is a precursor to primary nursing -Encourages decision-making at all organization levels -Client and family participation in care delivery process
-Can be used with other care delivery methods -Encourages decision-making at all organization levels
The nurse manager is evaluating care coordination actions performed by the nursing staff. Which outcomes indicate that the nursing staff's actions have been effective? (Select all that apply.) -Care is reliable. -Care is being rationed. -Care is readily accessible. -Care is of the highest quality. -Care is being provided at the lowest cost.
-Care is reliable. -Care is readily accessible. -Care is of the highest quality. -Care is being provided at the lowest cost.
What organizations have embraced the use of care coordination? Select all that apply. -National League of Nurses -American Medical Association -Centers for Medicare and Medicaid Services -American Nurses Association -La Leche League
-Centers for Medicare and Medicaid Services -American Nurses Association
Which client should the nurse refer to the case manager for ongoing care? -Client with exacerbation of multiple sclerosis -Client being discharged after a total hip replacement -Client being treated for deep vein thrombosis -Client with hepatitis B
-Client with exacerbation of multiple sclerosis
The nurse is coordinating the care for a client recovering from a stroke. Which skills are appropriate for the nurse to use when coordinating care for this client? (Select all that apply.) -Communicate with other disciplines regarding the provision of care -Delegate morning care to unlicensed assistive personnel -Document the client's responses to care -Facilitate team and group activities to avoid scheduling conflicts -Discuss the client's need for a prescribed medication with the insurance company
-Communicate with other disciplines regarding the provision of care -Facilitate team and group activities to avoid scheduling conflicts
The registered nurse team leader is performing gastric lavage for a client who is experiencing an acute gastrointestinal bleed. Which function will the nurse most likely have difficulty completing as the team leader? -Delegation -Client teaching -Decision-making -Identifying nursing diagnoses
-Delegation
Which strategies are emphasized in managed care? Select all that apply. -Delivering preventive services -Preventing inappropriate and unnecessary costs -Promoting health -Adhering to ethical values -Increasing customer satisfaction
-Delivering preventive services -Preventing inappropriate and unnecessary costs -Promoting health -Increasing customer satisfaction
The nurse manager is reviewing current staff education levels and skill competencies for charge nurses to use when making client assignments. Which care delivery system does this nurse manager's action support? -Differentiated practice -Client-focused care -Shared governance -Team nursing
-Differentiated practice
When preparing an annual performance appraisal, the nurse manager rates a staff nurse as "outstanding" with providing cost-effective quality client care. What did the manager observe the nurse perform to provide this level of rating? (Select all that apply.) -Following evidence-based guidelines when providing wound care -Washing hands before and after providing client care -Documenting medication as being provided prior to giving the medication to the client -Expecting unlicensed assistive personnel to provide report to the oncoming staff on skills performed -Spending time with a confused client to reduce the need for physical restraints
-Following evidence-based guidelines when providing wound care -Washing hands before and after providing client care -Spending time with a confused client to reduce the need for physical restraints
How does the use of diagnosis-related groups (DRGs) act to control healthcare costs? Select all that apply. -Hospitals are reimbursed for actual expenses once a client has been discharged. -The client's level of acuity determines the payment the hospital will receive. -Hospitals are paid a fixed rate based on a client's diagnosis regardless of the services rendered. -They limit reimbursement to physicians and hospitals providing care to Medicare clients. -Rates for client services are set in advance.
-Hospitals are paid a fixed rate based on a client's diagnosis regardless of the services rendered. -They limit reimbursement to physicians and hospitals providing care to Medicare clients. -Rates for client services are set in advance.
Which factors affect nursing shortages? Select all that apply. -Increased use of outpatient and long-term care facilities -Equal ability of employers of nurses to offer high wages -Development of Advanced Practice Nurse and Nurse Practitioner roles -Increased reliance on unlicensed assistive personnel -Vacant nursing positions
-Increased use of outpatient and long-term care facilities -Development of Advanced Practice Nurse and Nurse Practitioner roles -Increased reliance on unlicensed assistive personnel -Vacant nursing positions
The nurse telephones a health insurance carrier to discuss covering an electric wheelchair for a client with a spinal cord injury. Which barrier of care coordination is the nurse attempting to overcome? -Knowledge deficit -Limited resources -Non-adherence to the plan of care -Caregiver reluctance
-Limited resources
A client whose employer is transferring her to Canada asks if there are many differences between health care in the United States and Canada. What characteristics of the Canadian healthcare industry should the nurse review with this client? (Select all that apply.) -Physician care is covered under a government-funded insurance plan. -Some prescription medications are covered under a government-funded insurance plan. -Hospitalization is covered under a government-funded insurance plan. -The client will continue to receive health insurance through her employer. -Healthcare needs will be paid through a sickness fund.
-Physician care is covered under a government-funded insurance plan. -Some prescription medications are covered under a government-funded insurance plan. -Hospitalization is covered under a government-funded insurance plan.
A medical-surgical unit utilizes the case method for providing client care. Which actions will the nurse perform when caring for clients using this approach? (Select all that apply.) -Providing medications to clients for an entire team -Delegating the completion of morning care to unlicensed assistive personnel -Assessing, planning, implementing, and evaluating care provided -Overseeing the total care for a number of clients 24 hours a day, 7 days a week -Providing total care to assigned clients for the entire shift
-Providing total care to assigned clients for the entire shift -Assessing, planning, implementing, and evaluating care provided
Which outcomes may be expected from an integrated system of healthcare? Select all that apply. -Quality of care improves. -Costs are controlled. -Clients are more likely to meet outcomes. -Clients' satisfaction with care increases. -Client-physician relationships are strengthened.
-Quality of care improves. -Costs are controlled. -Clients are more likely to meet outcomes. -Clients' satisfaction with care increases.
The nurse manager has been tasked to determine the cost of providing nursing care to clients on a 10-bed transitional care unit. What resources should the manager use to make this calculation? (Select all that apply.) -Ratio of RNs to licensed and unlicensed assistive personnel -Number of attending healthcare providers that admit clients to the care area -Care delivery system that provides the best quality and uses the fewest nursing hours -The number of nursing care hours for each diagnosis-related group -Location of the pharmacies where the clients have prescriptions filled upon discharge
-Ratio of RNs to licensed and unlicensed assistive personnel -Care delivery system that provides the best quality and uses the fewest nursing hours -The number of nursing care hours for each diagnosis-related group
The neurological clinical nurse specialist (CNS) visits a client at home one week after the client was discharged from the hospital after a stroke. What can the CNS do after this care visit is complete? -Reimburse for the care visit -Notify the case manager of the visit -Discuss the client's care needs with the health care provider -Discuss the visit with the primary nurse
-Reimburse for the care visit
Which statements are true of socialized insurance? Select all that apply. -Socialized insurance covers hospitalization. -Socialized insurance covers physician care. -Socialized insurance is a type of employer-based insurance. -Socialized insurance is expensive and difficult to purchase. -Socialized insurance covers elective surgery.
-Socialized insurance covers hospitalization. -Socialized insurance covers physician care.
The nurse manager is concerned that client care coordination was not successful. On which observations did the nurse manager base this concern? (Select all that apply.) -The client received two doses of a prescribed pain medication. -The client's fasting blood glucose level was drawn twice in one day. -The client's abdominal wound dressing was changed twice in one shift. -The family is requesting to discuss home care needs. -Referral for home care has been delayed by two days.
-The client received two doses of a prescribed pain medication. -The client's fasting blood glucose level was drawn twice in one day. -The client's abdominal wound dressing was changed twice in one shift. -Referral for home care has been delayed by two days.
The nurse is caring for a client who has voluntary health insurance. What will the nurse prepare for when planning this client's long-term care needs? -The client's physician may change based upon government contracts. -The client's health insurance provider may decline to cover prescribed medications. -Hospitalization costs and services will be covered by a government-funded plan. -Rehabilitation services will be covered through the client's sickness fund.
-The client's health insurance provider may decline to cover prescribed medications.
The nurse manager plans to inform the staff that the organization is going to provide a group self-insurance health plan for all employees effective in the new year. What should the manager include when explaining this health plan? (Select all that apply.) -Rates for care are set in advance of the year in which they apply. -A pre-determined amount of money will be paid to the hospital based upon a diagnosis. -The group will assume all or part of the costs of healthcare for the employees. -It is a prospective payment system that determines costs before care is provided. -Coverage will cost the organization less because of lower fees and tax exemptions.
-The group will assume all or part of the costs of healthcare for the employees. -Coverage will cost the organization less because of lower fees and tax exemptions.
The staff development educator is preparing a seminar for staff nurses prior to implementing managed care. Which skills should the educator include as necessary when implementing this care delivery system? (Select all that apply.) -Time management -Delegation -Communication -Medication administration -Assessment
-Time management -Delegation -Communication -Assessment
How much more percentage of oxygen is carried in fetal hemoglobin when compared with adult hemoglobin? 25 50 75 10
50
A nurse manager is recruiting team members for an intradisciplinary team to compose a new unit policy for the nursing staff. Which members should be asked to join this team? Select all that apply. A charge nurse A pharmacist A physical therapist A physician A staff nurse
A charge nurse A staff nurse
The clinical nurse educator is giving a presentation to emergency department nurses about injuries and illnesses that are subject to mandatory reporting by healthcare providers. Which examples are most appropriate for the clinical nurse educator to include when describing injuries and illnesses that the healthcare provider must report? (Select all that apply.) A client whose knife wound was sustained during food preparation A client whose vomiting and diarrhea are believed to be due to ingestion of a poisonous substance A client whose small caliber gunshot wound was sustained while cleaning a weapon A client whose powder burns were sustained during target practice A client whose newly diagnosed HIV infection is causing minimal symptoms
A client whose vomiting and diarrhea are believed to be due to ingestion of a poisonous substance A client whose small caliber gunshot wound was sustained while cleaning a weapon A client whose powder burns were sustained during target practice A client whose newly diagnosed HIV infection is causing minimal symptoms
The nurse leader is creating a poster that summarizes guidelines related to reporting nurses who are in violation of the Nurse Practice Act. To give examples of situations in which the individual who makes the report is protected by an immunity clause, which scenarios are most appropriate for inclusion on the poster? (Select all that apply.) A nurse administrator who reported a staff nurse for incompetent client care A client who knowingly issued a false report against an emergency department staff nurse A client who acted without concern for the validity of reported allegations against a home health nurse A nurse who reported a nurse colleague for illegal activities in the workplace A staff nurse who reported a nurse supervisor for unethical behavior
A nurse administrator who reported a staff nurse for incompetent client care A nurse who reported a nurse colleague for illegal activities in the workplace A staff nurse who reported a nurse supervisor for unethical behavior
The employee health nurse is preparing a presentation for new hires at a local hospital and wants to provide education on injuries that must be reported to OSHA. Which reportable injury would the nurse include in the presentation? A client who developed a healthcare-associated urinary tract infection A client who received the correct medication at the wrong time A nurse who lost three days of work because of tripping over a cord in the hallway A nurse who experienced a needlestick requiring first aid
A nurse who lost three days of work because of tripping over a cord in the hallway
The nurse preceptor asks the nursing student to give an example of a potential ethical dilemma. Which example given by the nursing student reflects an ethical dilemma? A nurse who supports the client's right to have an abortion is caring for a client who is considering terminating her pregnancy. A nurse whose religious beliefs prohibit the use of contraception is caring for a client that is seeking birth control. A client who values free will and independence is cared for by a nurse who promotes the client's right to autonomy. A client whose ethical beliefs prohibit eating meat is seeking nutritional counseling from a nurse who is a vegetarian.
A nurse whose religious beliefs prohibit the use of contraception is caring for a client that is seeking birth control.
The school nurse is developing a client teaching plan for high school students that addresses the prevention of sexually transmitted infections. Which resources are appropriate for use when designing the plan? (Select all that apply.) A nursing colleague An infectious disease textbook written by a physician A family practice physician An article in a nursing journal An online blog with no stated author
A nursing colleague An infectious disease textbook written by a physician A family practice physician An article in a nursing journal
The healthcare team is meeting to discuss the care plan for Mr. Robert Ivey, a 76-year-old client with hip replacement following a fall at home. A conflict occurs during the meeting between the physician and the nurse case manager regarding client feedback. What is the best course of action for the nurse case manager? Asking the unit manager to discuss the feedback with the physician Prioritizing objectives of the client's care plan without considering the feedback Deciding not to attend care plan meetings with this physician Accepting the feedback in a professional manner without becoming defensive
Accepting the feedback in a professional manner without becoming defensive
The nurse case manager has selected an education pathway for the client's course of care and will utilize actual and potential nursing diagnoses and timelines for goal achievement. Which activities may be selected for this pathway? (Select all that apply.) Financial planning Activity restrictions & instructions Dietary planning and instruction Medication administration Safety issues
Activity restrictions & instructions Dietary planning and instruction Medication administration Safety issues
The nurse in the emergency department works closely with emergency medical services (EMS). Some EMS personnel have certifications in Advanced Life Support techniques. Which personnel can operate on that level? (Select all that apply.) Emergency medical technicians Advanced emergency medical technicians Emergency medical responders Ultrasound technicians Paramedics
Advanced emergency medical technicians Paramedics
The nurse is calling a client to review lab results from the previous prenatal visit. The results include a 1-hr glucose tolerance test showing 154 mg/dL, hemoglobin of 12 g/dL, a negative HIV screen, and a nonreactive VDRL test. What counseling will the nurse include during this encounter? Reassuring the client that all screening tests are normal, and she should continue prenatal visits as scheduled Giving the client contact information for the diabetes educator Advising the client to take an iron supplement Advising the client to make an appointment as soon as possible for additional testing for gestational diabetes
Advising the client to make an appointment as soon as possible for additional testing for gestational diabetes
What is a characteristic of government rationing of health care? -Services are available immediately when needed. -Age may be used to set limits for care. -Services are based on healthcare premiums. -More expensive services are available to those who can pay.
Age may be used to set limits for care.
A public health nurse reads updates from the Centers for Disease Control and Prevention (CDC). Which guidelines are used by the CDC to prioritize responses to biological agents? (Select all that apply.) Agents with a significant impact on public health Agents that cause mass exodus Agents that cause public panic Agents with a high suspicion index Agent easily transmitted from individual to individual
Agents with a significant impact on public health Agents that cause public panic Agent easily transmitted from individual to individual
Kim is a nurse working on a medical-surgical unit. Kim delegates a task to Mitchell, the unlicensed assistive personnel (UAP). After Kim delegates the task to Mitchell, she receives a call from the client requesting assistance related to the task that Kim delegated. What is the most appropriate action for Kim at this time? Respond to the call and assist the client Ask another UAP to assist the client Reprimand the UAP for not assisting the client Alert the UAP that the client is asking for assistance
Alert the UAP that the client is asking for assistance
The nurse is providing care for Mr. Davis, a 72-year-old man who is scheduled for a procedure tomorrow morning. Earlier in the day, Mr. Davis experienced a fall and was examined by the healthcare provider on call who observed no untoward effects. The nurse approaches Mr. Davis for informed consent about his procedure when he complains of dizziness and a headache. Mr. Davis has no memory of the fall that occurred earlier in the day. Which action by the nurse is the most appropriate in regards to obtaining informed consent? Delay informed consent, perform a pain assessment, and administer medication Read the informed consent to the client and allow the client to rest Have the client sign the consent form without delay Alert the primary healthcare provider regarding the client's status
Alert the primary healthcare provider regarding the client's status
The home health nurse suspects that a pediatric client is being abused by the client's father. In addition, the home health nurse has overheard the client's father seemingly discussing purchasing cannabis (marijuana). Which statement by the home health nurse best reflects correct understanding of the boundaries set forth by good faith immunity? I am protected by good faith immunity laws regarding any information I report to law enforcement. When reporting suspected abuse, I am not required to protect the client's confidentiality. All states protect healthcare workers who, in good faith, report suspected child abuse. Good faith immunity laws do not apply if an investigation fails to support allegations of abuse.
All states protect healthcare workers who, in good faith, report suspected child abuse.
The charge nurse is preparing to discuss plans to improve the unit with the staff. Based on the concept of peer collaboration, which plan will she discuss? (Select all that apply.) Implementing open visitation hours for families to increase client satisfaction Allowing nurses to volunteer to prepare brief presentations on clinical topics seen on the unit Discussing starting a journal club for interested staff members to discuss new evidence-based practice findings Asking for volunteers to go from the day shift to night shift to cover a temporary staff shortage Encouraging nurses to eat meals at their desks so they will be more accessible to physicians
Allowing nurses to volunteer to prepare brief presentations on clinical topics seen on the unit Discussing starting a journal club for interested staff members to discuss new evidence-based practice findings Asking for volunteers to go from the day shift to night shift to cover a temporary staff shortage
According to the American Association of Colleges of Nursing, which values are essential for the professional nurse to demonstrate? (Select all that apply.) Self-esteem Competence Altruism Integrity Autonomy
Altruism Integrity Autonomy
The novice nurse has accepted a medical-surgical position after passing the boards and wants to work for an organization that acknowledges the values of the nursing profession. Which values outlined by the organization are consistent with those identified by the American Association of Colleges of Nursing (AACN)? (Select all that apply.) Altruism when dealing with other nurses Autonomy on behalf of self Effectiveness in the new job Efficiency when dealing with clients Integrity in dealing with clients and co-workers
Altruism when dealing with other nurses Autonomy on behalf of self Integrity in dealing with clients and co-workers
A client presents to the prenatal clinic and tells the nurse that she thinks she is pregnant. Which symptom described by the client would be considered a presumptive indicator of pregnancy? Select all that apply. Amenorrhea Breast tenderness Fetal heartbeat detected with a Doppler Enlargement of the abdomen A positive home pregnancy test
Amenorrhea Breast tenderness
The nurse is providing care to support and treat individuals with serious mental illness. Which interdisciplinary team will the nurse collaborate with to provide client care in the community? An Alcoholics Anonymous team An assertive community treatment team A school-based team An elder care team
An assertive community treatment team
I think my water broke! Mrs. Moore tells you.You look at her chux and note clear, copious fluid and bloody show. Twin As fetal heart tones are 140/s with average long term variability, although you are now locating them in the lower left quadrant of Mrs. Moores abdomen. Twin Bs heart rate is 150/s and in the upper right quadrant. You observe that Mrs. Moores contractions are every 2-3 minutes and call for assistance.The charge nurse comes into the room and tells you that anesthesia is occupied in another cesarean section. You check Mrs. Moores cervix and note that she is 6 cm dilated, 100% effaced, and Twin A is breech. You alert the health care provider and move Mrs. Moore to the operating room, which has been set up for both vaginal birth and cesarean birth. By the time you get to the OR, Mrs. Moore is pushing.Twin A is born frank breech via a precipitous vaginal delivery. The health care provider places the ultrasound to check the position of Twin B, who is now transverse. The health care provider places her hand in Mrs. Moores vagina. Which action do you anticipate the health care provider willperform? Select all that apply: Placement of an internal uterine pressure catheter An amniotomy A vaginal ultrasound An internal podalic version
An internal podalic version
A staff nurse is assigned to provide client care on a different care area for one shift. While providing care, the nurse notes the inappropriate disposal of used needles and syringes. When asking a staff member about this practice the response was "this is how it is done here." What is the most appropriate action by the nurse in this situation? Wear gloves while providing all care Collect data on the number of needlestick injuries that occurred during the shift Anonymously report the practice to OSHA Anonymously report the practice to NIOSH
Anonymously report the practice to OSHA
A group of nursing students are discussing clinical research questions. In describing the difference between background questions and foreground questions, which student's statement is the most appropriate? Answers to background questions may be found in drug guides. The answer to a foreground question addresses multiple clinical issues. Background questions address a range of clinical issues. Foreground questions are knowledge-based.
Answers to background questions may be found in drug guides.
The director of nursing is reviewing the impact of increased delegation within the organization. Which observations indicate that delegation is benefiting nurses? (Select all that apply.) Applications to the organization's "nurse as leader" program have increased by 20%. Safety errors have decreased by 8%. Requests from nurses to transfer units have decreased by 20%. Client satisfaction with services as reflected on post discharge surveys has increased by 18%. Overall expenses have decreased 5%.
Applications to the organization's "nurse as leader" program have increased by 20%. Safety errors have decreased by 8%. Requests from nurses to transfer units have decreased by 20%. Client satisfaction with services as reflected on post discharge surveys has increased by 18%.
Which actions should the nurse perform when implementing standard precautions? (Select all that apply.) Apply gloves before emptying urinary catheter drainage bags Wash hands before and after providing client care Cleanse blood spills with cold water Wear a mask and gown upon entering the care area Place used syringes and needles in the sharps container
Apply gloves before emptying urinary catheter drainage bags Wash hands before and after providing client care Place used syringes and needles in the sharps container
The nurse manager determines that a staff nurse is demonstrating the knowledge, skills, and attitudes for the competency of safety. Which skills did the manager observe the nurse perform? (Select all that apply.) Applying gloves before emptying a client's wound drainage device Notifying the environmental services team about a leaking sink in a client's bathroom Following the identified rights of medication administration before giving a client a pain medication Washing hands before and after providing care to a client with an infection Entering log-in and password information before documenting in a client's medical record
Applying gloves before emptying a client's wound drainage device Notifying the environmental services team about a leaking sink in a client's bathroom Following the identified rights of medication administration before giving a client a pain medication Washing hands before and after providing care to a client with an infection
The nurse manager is completing a contingency plan that is due to the director of nursing before the end of the business day. Which plan is appropriate for the nurse manager to submit? Cost analysis to replace older computers in advance of software upgrades Preparation of staff nurses to attend charge nurse classes Schedule to renovate four step-down bays on the unit Approach to staffing if adverse weather conditions prevent staff from arriving for scheduled shifts
Approach to staffing if adverse weather conditions prevent staff from arriving for scheduled shifts
While removing a trash bag from the room of a client in protective isolation, the nurse sustains a needlestick to the leg. Which educational topic is a priority for the nurse manager to discuss during the next staff meeting? Actions to take when exposed to contaminated sharps Appropriate disposal of used sharps Personal protective equipment to wear when disposing of trash Technique to remove biohazard trash from isolation rooms
Appropriate disposal of used sharps
Cherralene Lyons is a 22-year-old client who is currently trying to become pregnant. She asks the nurse to explain the time frame between ovulation and fertilization. The nurse bases the response to Cherralene on which rationale? Approximately 1 day before or after ovulation is optimal for fertilization. The ovum is fertile for only 18 hours. Three days on either side of ovulation is optimal for fertilization. A period of 48-72 hours after ovulation is ideal for fertilization.
Approximately 1 day before or after ovulation is optimal for fertilization.
Which questions or statements will help clients clarify their values? (Select all that apply.) Do you want to know what I would do? Are you considering other courses of action? Tell me how you plan to start doing this? What does your husband think you should do? Do you have a choice?
Are you considering other courses of action? Tell me how you plan to start doing this? Do you have a choice?
A client scheduled for emergency surgery needs a bowel preparation. The assistant with the necessary experience to complete this task is currently working with another client. Which nursing action is the most appropriate? Notify the surgical suite that the client will be delayed Ask if other assistants have experience in the bowel preparation Reassign the task that the assistant is completing to someone else Assign the task to the assistant to complete as soon as possible
Ask if other assistants have experience in the bowel preparation
Claire is a nurse who works on a substance abuse unit. She sees all clients prior to admission and she must determine the last time each client used drugs, determine their drug of choice, and obtain urine and blood samples. Which step of the nursing process is Claire using during this process? Evaluating the client's progress indicative of the stated outcomes Planning the client's care (developing a care plan) Analyzing the assessment data and choosing a diagnosis Assessing and collecting comprehensive data
Assessing and collecting comprehensive data
Kevin is the nurse manager for a long-term care unit. He wants to share the management function of controlling with the staff nurses. Which action should Kevin take to share this function? Assign staff to peer review groups Coach the staff on ways to achieve the organization's objectives Explain the contingency plan to the staff nurses Divide client care assignments among the staff
Assign staff to peer review groups
After shift report, the registered nurse directs a nursing assistant to provide morning care to four clients. What behavior did the nurse demonstrate with the nursing assistant? Delegating Assigning Dumping Collaborating
Assigning
The client tells the nurse, "I want to make my own choices about which healthcare treatments I receive." Which ethical principle is the client describing? Advocacy Autonomy Confidentiality Privacy
Autonomy
A client in her second trimester of pregnancy tells the nurse that her spouse is demonstrating signs of pregnancy as well. The nurse identifies this as couvade syndrome. Which symptom is the spouse most likely experiencing? Select all that apply. Back pain Increased appetite Fatigue Breast tenderness Nausea and vomiting
Back pain Increased appetite Fatigue Nausea and vomiting
During a home visit, the client asks the nurse to explain the bill for care performed by the hospital. In which part of the bill should the nurse identify the charges for nursing care while the client was hospitalized? Meals and nutrition services Basic room rate Medical consultations Pharmacy services
Basic room rate
Teresa Gray is 15 years old and 36 weeks pregnant with her first baby. She lives with her mother and grandmother, who plan to help her with the baby. She tells the nurse that she has a hard time getting to the pregnancy classes that the nurse scheduled for her because her mother is at work during those times and Teresa doesn't like taking the bus. Which class should the nurse encourage Teresa to attend if she can get to only one of them? Baby care Participation for teen fathers Driver's education Birth control class
Birth control class
The nurse preceptor is explaining mandatory reporting guidelines to the nursing student. Which statement is most appropriate for the nurse preceptor to include in the explanation? Venereal diseases do not have to be reported. Each institution determines which situations must be reported. Births and deaths must be reported. Abortions never have to be reported.
Births and deaths must be reported.
Sarah Simpson, an 8-year-old girl living on a large sheep and cattle ranch in the foothills, came into the emergency department with double vision and neurological symptoms. Her family preserves a lot of the food they grow, and they believe that Sarah was exposed to a "bad batch" ofhome-canned greens beans. As the ED triage nurse, which biological pathogen do you suspect might be the cause of her symptoms? Botulism Tularemia Smallpox Anthrax
Botulism
The CDC is most concerned about six biological pathogens that might be used in a bioterrorism attack. Which biological agent is the only one caused by a toxin? Smallpox Botulism Bubonic plague Tularemia
Botulism
How are case management critical pathways chosen in healthcare delivery? By the facility administrator By the primary provider By the nurse case manager By the collaborative healthcare team
By the collaborative healthcare team
A nurse midwife assesses a client at 14 weeks gestation. She inspects the mucous membranes of the cervix and finds them to be bluish-purple. The nurse would expect which sign as being documented by the nurse midwife? Goodell sign Hegar sign Ballottement sign Chadwick sign
Chadwick sign
The nurse is meeting with the care team to discuss the client's care. Based on the concept of collaboration, which action by the nurse indicates a lack of trust and respect for a team member? Making notes of follow-up needed as recommended by the physician Challenging the recommendations of the physical therapist with his supervisor Agreeing with the social worker's plan for nursing home placement. Nodding in agreement with the recommendations of the nutritionist
Challenging the recommendations of the physical therapist with his supervisor
While performing client care, Amanda Graham, the nurse, notes an area of skin breakdown and excoriation along the area where the indwelling urinary catheter is affixed to the client's inner thigh. What should the nurse do to help the client? Check the acidity level of the client's urine Change the catheter using one without latex Dust the skin with cornstarch Cleanse the skin with soap and water
Change the catheter using one without latex
A healthcare provider prescribes oxygen to be administered at 4 liters per minute to the client, a retired registered nurse. When the cardiac unit nurse checks on the client, during regular rounds, the cardiac unit nurse finds that the client had changed the oxygen setting. The client reports, "The change makes me more comfortable." Which action by the cardiac unit nurse is the priority? Contact the healthcare provider to change the prescribed order to the client's preference Encourage the client to make nonmedical changes to increase comfort level Explain to the client the career consequences of not following prescribed orders Change the setting of the oxygen flow to match the prescribed order
Change the setting of the oxygen flow to match the prescribed order
A client is seen for a prenatal visit at 18 weeks gestation and is scheduled for a glucose tolerance test (GTT) in the next month to determine if the client has developed gestational diabetes mellitus (GDM). Which item in the client's history places her at risk for developing GDM? Average weight for height Chronic hypertension Maternal age less than 25 years History of sexually transmitted infection
Chronic hypertension
Which client health problem would benefit the most from case management? -Chronic lung disease -Fractured leg -Peptic ulcer -Minor orthopedic surgery
Chronic lung disease
The nurse notes skin excoriation on the client's abdomen at previous injection sites. Which nursing action is a priority when administering the next dose of medication? Cleanse the skin with soap and water before the injection Wear gloves when performing injection Apply topical antibiotic at the site after the injection Use a latex-free syringe for the next injection
Cleanse the skin with soap and water before the injection Use a latex-free syringe for the next injection
Which is a barrier to care coordination? -Prescribed dose of medication delayed in arriving from the pharmacy -Client's abdominal wound becomes infected after surgery -Nursing assistant scheduled for afternoon shift calls off from work -Client does not have transportation to attend out-patient physical therapy
Client does not have transportation to attend out-patient physical therapy
The nurse team leader for a medical-surgical unit is reviewing client assignments made for the staff nurses. Based on the National Patient Safety Goals, which clients will the team leader identify as being at risk for safety issues? (Select all that apply.) Client recovering from a stroke who is scheduled for physical therapy in the afternoon Client who is depressed and refused antidepressant medication the previous evening Client with burning and pain when urinating Client scheduled for discharge after abdominal wound stitches are removed Client who is scheduled for an amputation of the right foot
Client who is depressed and refused antidepressant medication the previous evening Client with burning and pain when urinating Client who is scheduled for an amputation of the right foot
Which elements are commonly found in an incident report? (Select all that apply.) Client's health insurance Client's account of event Client's home address Location of event Date and time of event
Client's account of event Location of event Date and time of event
Collaborative care has many benefits for both the client and the healthcare provider. Which outcomes are characteristic of collaborative care? Healthcare providers report hierarchy-based relationships and increased job satisfaction. Client adherence to therapeutic regimens increases, and overall system costs increase. Clients become informed consumers and actively participate in the decision-making process. Client morbidity rates decrease, while mortality rates remain unchanged.
Clients become informed consumers and actively participate in the decision-making process.
The nurse is discharging a client who has had an organ transplant. To accurately summarize the client's complex treatments, the nurse is carefully entering data into an electronic health record (EHR). How does that activity affect continuity of care? Clinical information is available to collaborating healthcare providers. The software will scan for grammatical errors. The EHR documents actions at the point of care. The nurse follows guidelines encouraging use of EHRs.
Clinical information is available to collaborating healthcare providers.
The director evaluates a nurse manager's time management skills as being "outstanding." Which actions by the manager would the nursing director identify as being worthy of an outstanding rating? (Select all that apply.) Closed the office door when discussing performance appraisals Declined participation in a newly formed task force Returned phone calls and emails before attending change of shift report Cleared off the desk and focused on one project at a time Used the software program to run a productivity report
Closed the office door when discussing performance appraisals Declined participation in a newly formed task force Cleared off the desk and focused on one project at a time Used the software program to run a productivity report
Jonathan Barton, a 12-year-old home-schooled boy, was pulled from the basement area rubble of his home after a severe tornado. He had survived for 2 days, living on food that he had brought downstairs for an early dinner. Locating him brought joy to his rural community, which lost over one hundred lives. As the nurse manager of his unit, which required nursing education competency will you use to manage the media wanting to interview him? Assessment Critical thinking Communication Technical skills
Communication
A client who is waiting to be seen in the emergency department tells the nurse that a walk-in clinic is the primary source for health care. The popularity of walk-in clinics is partly a result of which factor? -Price controls -Collaboration -Competition -Diagnosis-related groups
Competition
The nurse case manager is assigned a client newly diagnosed with type 2 diabetes mellitus. What is the priority action for the nurse to perform when beginning the care of this client? -Discuss needs at home -Complete a health history -Review nutritional needs with the dietician -Discuss self-administration of insulin
Complete a health history
The mental health nurse enjoys working at a community health center (CHC). Part of the nurse's satisfaction comes from helping provide the required services for CHC facilities. Which services are required? Chemotherapy On-site pharmacy Comprehensive primary care Emergency Department (ED)
Comprehensive primary care
The nurses on the orthopedic surgical unit have collected data on correct surgical site operations on a routine basis. If they find an exception to following their procedures for identifying the intended limb, what would The Joint Commission require them to do? Identify the responsible individual(s) Change their preoperative preparation procedure File a breach of duty report Conduct a root cause analysis
Conduct a root cause analysis
The unit clerk hands the telephone to the nurse manger of the geriatric unit. A healthcare provider, having received panic value laboratory results for a client, gives a verbal order to the nurse manager. The nurse records the date and time, the healthcare provider's name, and the orders. What other facts must the nurse record? (Select all that apply.) Confirmation by the healthcare provider of the read-back orders Reason the healthcare provider called with new orders Current vital signs of the client Name of unit clerk answering the healthcare provider's call Title of nurse manager, not a staff nurse, who took the verbal order
Confirmation by the healthcare provider of the read-back orders Reason the healthcare provider called with new orders
The nurse researcher is designing a poster that describes factors that contribute to the development of ethical issues in nursing. Which items are appropriate for the researcher to include on the poster? (Select all that apply.) Approving adequate nurse staffing Conflicting loyalties among nurses Emphasizing healthcare cost containment Opposing cultural values Adapting to changing technology
Conflicting loyalties among nurses Emphasizing healthcare cost containment Opposing cultural values Adapting to changing technology
The nurse is attending a team meeting regarding the care of a client. During the meeting, the nurse has a heated discussion with a peer. Which factors would be likely to impede effective communication and collaboration in this situation? (Select all that apply.) Trusting the peer to make the right decision Understanding cultural differences with the peer Providing feedback to the peer Confusing roles among team members Having a lack of respect for the peer
Confusing roles among team members Having a lack of respect for the peer
A 73-year-old female Native American client is hospitalized with an exacerbation of chronic obstructive pulmonary disease (COPD). The client, who has a 55 pack-year history, reports that she still smokes cigarettes. She also reports that she smokes tobacco during certain important religious rituals and tribal celebrations. Which nursing interventions best reflect the nurse's application of humanist theory of learning? (Select all that apply.) Considering the client's tobacco use from the standpoint of her religious beliefs Exploring how the client's cultural background influences her decision to continue to smoke Encouraging the client's family members and loved ones to praise the client for not smoking Recognizing that the client has personal characteristics, such as stoicism and mistrust for traditional medicine, that may influence her perception of the nurse's teaching Explaining to the client how smoking cessation at this stage of life still promotes lung healing, and can lead to fewer exacerbations of COPD and improved quality of life
Considering the client's tobacco use from the standpoint of her religious beliefs Exploring how the client's cultural background influences her decision to continue to smoke
While coordinating the care for Mr. Obertone, an adult client with heart failure, the nurse discovers that home monitoring equipment is not available for several days. Which nursing action is most appropriate to overcome this care coordination barrier? -Contact another company to obtain the needed resource -Help the client understand the purpose of monitoring at home -Teach the client to monitor weight every day at home -Explain to the physician why the equipment is not available
Contact another company to obtain the needed resource
A nurse is reviewing a medication order in the client's health record. The order is illegible, and the nurse calls the ordering healthcare provider to clarify the order. The nurse cannot reach the healthcare provider despite multiple calls and pages. Which action by the nurse is most appropriate in this situation? Fax the order to the pharmacy to decipher Contact the nursing supervisor Continue calling the healthcare provider Ask a co-worker to attempt to decipher the order
Contact the nursing supervisor
What are the activities that a nurse case manager can employ to facilitate the goals of the case management group? (Select all that apply.) Coordinating and monitoring care provided by a medical assistant Engaging the client in planning care Providing appropriate educational activities related to the diagnosis Prioritizing case management activities using an appropriate diagnosis-related group Scheduling client activities around the nurse's schedule
Coordinating and monitoring care provided by a medical assistant Engaging the client in planning care Providing appropriate educational activities related to the diagnosis Prioritizing case management activities using an appropriate diagnosis-related group
The nurse on a case management team must teach the client and family about the goals of care for the client. What is a priority goal for the nurse to share with the client and his family members? Setting medical goals with the client and family. Receiving all medical reports from one physician Coordinating medical visits on the same date Determining independently the type of care the client will need
Coordinating medical visits on the same date
What is a goal of the multidisciplinary collaborative care team? Improved client nutrition Extended hospitalization Paternalistic decision-making Cost containment
Cost containment
Which action would be an inappropriate nursing response to a client with a history of long-term narcotic use, who is asking for increased pain medication after surgery? Ask for support from a supervisor Counsel client about risks of addictive behavior Ask for support from peers Plan on further assessment
Counsel client about risks of addictive behavior
What resources could an emergency plan name to address the immediate and long-term psychological impacts of a disaster? (Select all that apply.) Counselors Mental health nurse practitioners Critical Incidents Stress Debriefing teams Acupuncturists Physical therapists
Counselors Mental health nurse practitioners Critical Incidents Stress Debriefing teams
An expecting father experiences weight gain and nausea. Which phenomenon is this client experiencing? Focusing phase Moratorium phase Couvade syndrome Pseudopregnancy
Couvade syndrome
The nurse leader is providing an in-service for nurse unit managers about mandatory reporting of specific illnesses and injuries. Which client data should the nurse manager include when describing the main components of a healthcare provider's mandatory report? (Select all that apply.) Current location Religious affiliation Race Gender Age
Current location Race Gender Age
In a disaster drill, a nurse is selected by her peers to lead the practice response team. Their support was acknowledgment of the nurse's evident critical thinking skills. What kind of skills was the team looking for? (Select all that apply.) Poise Decision making Clinical judgment Prioritizing Enthusiasm
Decision making Clinical judgment Prioritizing
A nurse is shadowing an emergency department nurse manager during the evening shift. They discussed the commonalities of prioritizing between triage and reverse triage. What are the bases for these commonalities? (Select all that apply.) Decisions based on severity of injury Estimated distance from home Availability of supplies and resources Decisions based on severity of illness Access to health insurance coverage
Decisions based on severity of injury Availability of supplies and resources Decisions based on severity of illness
Which strategies are appropriate for inclusion in the teaching plan for a pediatric client? (Select all that apply.) Demonstrating relevant treatments or procedures using stuffed animals Gearing instructions toward the comprehension level of the pediatric client's parent or caregiver Including the pediatric client's caregiver in the teaching session Exposing the pediatric client to healthcare personnel who are dressed in uniforms, surgical masks, and scrubs prior to the client's hospital admission Addressing the pediatric client primarily through the use of terms of endearment, such as "sweetheart"
Demonstrating relevant treatments or procedures using stuffed animals Including the pediatric client's caregiver in the teaching session Exposing the pediatric client to healthcare personnel who are dressed in uniforms, surgical masks, and scrubs prior to the client's hospital admission
The home health nurse is teaching an older adult client how to use an automatic blood pressure monitoring device. Which teaching strategy reflects the nurse's correct application of lifespan considerations for this client? Using written materials that feature large print, black ink, and reflective, bright white paper Designing content that targets individuals with a fifth- to sixth-grade reading level Encouraging the client to rest as opposed to asking her to perform a return demonstration of skills Scheduling the session as a one-on-one meeting between the nurse and the client
Designing content that targets individuals with a fifth- to sixth-grade reading level
A client who has not been taking medication explains that the price of the medication has increased and become unaffordable. Which action should the nurse consider to support this client's healthcare needs? -Document the client's non-adherence to prescribed medication regimen -Explain the long-term effects of medication non-adherence to the client -Discuss comparable medications with the healthcare provider that have less of a demand -Suggest ways to increase income to have resources to purchase the medication
Discuss comparable medications with the healthcare provider that have less of a demand
Anita is the nurse manager for an oncology unit. She is concerned that a staff nurse, Marc, is overdelegating tasks to an unlicensed assistive personnel (UAP). What is the most appropriate action for Anita at this time? Discuss the delegated tasks with the nurse Direct all nurses to complete individual tasks Tell UAP to stop performing the tasks Reassign the UAP to complete other tasks
Discuss the delegated tasks with the nurse
Which action can the nurse take to prevent a needlestick injury? Place the used needle in the client's trash Take the used needle to the medication room Place the used needle on the medication cart Dispose of the used needle in the appropriate container
Dispose of the used needle in the appropriate container
The nurse is performing a telephone follow-up with a client who received teaching about the use of assistive hearing devices. During the call the client states, "My hearing aids are working just fine. I have no trouble at all adjusting them, and they really help me hear better. I don't have any questions." When considering documentation of client teaching, which nursing action is best? Document the client's reported success with the use of assistive hearing devices and note that the client denied the need for additional teaching. Document the client's reported successful achievement of learning objectives, but require a face-to-face appointment with her physician to demonstrate proficiency with the use of the devices. Do not document anything; telephone conversations are not considered to be official forms of follow-up. Do not document anything; only formal, in-person meetings qualify as follow-up evaluations.
Document the client's reported success with the use of assistive hearing devices and note that the client denied the need for additional teaching.
You auscultate Mrs. Moores lungs and note she is taking very deep breaths. You ask her how she is feeling. Mrs. Moore answers, I feel like I am having a hard time catching my breath.Do you have any chest pain? you ask. She shakes her head. You place a pulse oximeter on her finger and note that her SpO2 on room air is 98%.As you notify the health care provider of Mrs. Moores symptoms, what factors will you incorporate into her plan of care? Select all that apply. You should place her on her back to relieve her dyspnea. Mrs. Moores IUD has perforated her uterus. Dyspnea with a twin pregnancy is normal. She is at high risk of thromboembolism. Mrs. Moore is hypoxic.
Dyspnea with a twin pregnancy is normal. She is at high risk of thromboembolism.
The nursing instructor is explaining evidence-based practice (EBP) to nursing students. Which statements are appropriate to include in the explanation? (Select all that apply.) EBP considers the client's needs, values, and choices. EBP is reflective of the best evidence from current research. EBP promotes generalization of client care. EBP incorporates the nurse's clinical expertise. EBP tests hypotheses about health-related conditions.
EBP considers the client's needs, values, and choices. EBP is reflective of the best evidence from current research. EBP incorporates the nurse's clinical expertise.
A nursing student is giving a classroom presentation about evidence-based practice (EBP). Which statement best reflects the student's correct understanding of EBP? EBP uses a systematic and strict scientific process to test hypotheses about health-related conditions and nursing care. EBP involves combining quality research, clinical expertise, and client preferences to achieve the best client outcomes. EBP incorporates clinical knowledge, expert opinion, or information resulting from research. EBP is the gathering of objective facts and information to advance knowledge about a specific topic.
EBP involves combining quality research, clinical expertise, and client preferences to achieve the best client outcomes.
The staff nurse asks the nurse supervisor to explain requirements related to mandatory reporting of nurses who are in violation of the Nurse Practice Act. Which statement by the nurse supervisor is most appropriate for inclusion in the explanation? Disciplinary action is administered to all nurses who receive complaints against them. Each individual case against a nurse is decided on its own merits. All complaints against nurses must be resolved through a formal administrative hearing. Individuals who file complaints against nurses must first conduct a preliminary investigation.
Each individual case against a nurse is decided on its own merits.
During change-of-shift report, two medical-surgical nurses are discussing the pain management situation of a client with a low tolerance for pain. Giving repeated large doses of pain relievers bothered the evening shift nurse, but not the day shift nurse. Which statements about ethical client care are relevant in this situation? (Select all that apply.) The day shift nurse has better personal ethical values about pain relief. Each nurse might be operating with a different set of assumptions about pain relievers. The client should be helped to make an informed decision about pain relief measures. The client should be warned about the dangers of overdosing on pain relievers. The evening shift nurse has better personal ethical values about pain relief.
Each nurse might be operating with a different set of assumptions about pain relievers. The client should be helped to make an informed decision about pain relief measures.
Which collaborative care team activities provided by the nurse case manager would be considered client-centered? Select all that apply. Monitoring care provided by unlicensed personnel Educating about the disease process Collecting baseline data for decision-making Planning care and decision-making Organizing case management priorities by DRG
Educating about the disease process Planning care and decision-making
Dorothy Jones, 78, has been admitted to the unit with chest pain. Her physician, Dr. Tate, orders consults with the cardiologist, dietician, social services, and a nurse case manager. The team works together to establish a plan of care based on the client's goals. This type of collaboration is likely to result in which outcome for the client? Decreased adherence with the plan of care Increased healthcare costs Enhanced continuity of care Improved relationship between the physician and the client
Enhanced continuity of care
What actions should the nurse take to reduce the risk of an injury when handling sharps? (Select all that apply.) Ensure sharps containers are puncture resistant Pick up broken glass with a damp paper towel Recap used needles by guiding the needle into the cap Place used needles in sharps containers Recap all needles before disposing
Ensure sharps containers are puncture resistant Place used needles in sharps containers
Anika Winters recently discovered that she is pregnant. During her first office visit, she complains that her external genitalia have enlarged since finding out she was going to be a mother. The nurse informs Anna that this enlargement has occurred because of which hormone that is stimulated during pregnancy? Estrogen Human placental lactogen (hPL) Human chorionic gonadotropin (hCG) Progesterone
Estrogen
The nurse case manager is providing care to a client with uncontrolled diabetes. What intervention is appropriate for the case manager to provide for this client? Prescribing medications to control the clients blood glucose levels Evaluating whether the client has met documented outcomes Billing the client for hospital services related to care Diagnosing the client with a medical diagnosis based on lab values
Evaluating whether the client has met documented outcomes
Ellen Watson, the nurse manager, is evaluating the success of actions taken to reduce the incidence of staff illnesses on the care area. Which information suggests that the manager's actions have been successful? Paper towels are delivered daily on the supply cart Every staff nurse has received the annual flu vaccination Towels are hung to dry by the nurse in the client bathrooms Soap dispensers are refilled during the night shift
Every staff nurse has received the annual flu vaccination
During a follow-up visit, the nurse learns that a client is not adhering to the agreed upon plan of care. What outcome should the nurse expect for this client's care? -Exacerbation of the health problem -Misinterpretation of teaching -Missing a scheduled appointment -Misunderstanding of the care plan
Exacerbation of the health problem
What should the nurse expect a meta-analysis study to offer? A detailed description that is specific to one individual, issue, or event A study that uses a control group and an experimental group to illustrate a cause-and-effect relationship A study that follows two groups over a period of time measures the outcomes of an exposure group with those of a nonexposure group Examination of a group of studies on a given topic, followed by combination and analysis of the results as if they were from one large study
Examination of a group of studies on a given topic, followed by combination and analysis of the results as if they were from one large study
Mary is a nurse working with unlicensed assistive personnel (UAP) during a busy shift on a medical-surgical unit. Mary has delegated certain aspects of care for her clients to the UAP. During the third step of the delegation process, what is the most appropriate action for Mary to complete? Check the medical record for documentation of a client's urine output Explain the importance of correctly measuring a client's urine output Determine that one UAP is qualified to measure urine output Decide that help is needed to measure a client's urine output
Explain the importance of correctly measuring a client's urine output
A 64-year-old male client is admitted for treatment of dehydration and diagnosed with diabetes. While the nurse is teaching the client about the signs and symptoms of hypoglycemia, the client's wife states, "While you two are talking, I'm going to get some coffee." Which nursing action best reflects application of the adult learning theory? Giving the client's wife a cup of coffee if she stays for the teaching Considering the wife's lack of interest in the teaching from the standpoint of biologic, psychologic, cultural, social, and spiritual perspectives; including her marital beliefs and social status Recognizing that the client's wife has personal characteristics, such as impatience and appreciation for coffee, that influence her perception of the nurse's teaching Explaining to the client's wife that she may be the first to recognize the signs and symptoms of her husband's hypoglycemia, which may help him get treatment sooner
Explaining to the client's wife that she may be the first to recognize the signs and symptoms of her husband's hypoglycemia, which may help him get treatment sooner
Which sign and symptom is considered a presumptive indicator of pregnancy? Select all that apply. Fatigue Amenorrhea Breast tenderness Abdominal enlargement Urinary frequency
Fatigue Amenorrhea Breast tenderness Urinary frequency
Why would a nurse hesitate to delegate a task to another member of the healthcare team? Select all that apply. Fear of liability or being blamed for the delegate's mistakes Fear of competition and criticism Fear of making mistakes Fear of loss of control Fear of overburdening others
Fear of liability or being blamed for the delegate's mistakes Fear of competition and criticism Fear of loss of control Fear of overburdening others
What is a likely characteristic of a just culture? Nurses will need to fill out far fewer incident reports. Fear of termination for nursing mistakes will decrease. Civil lawsuit filing rates will increase. Nurses will not have to report near-misses.
Fear of termination for nursing mistakes will decrease.
Which factors influence the nurse's choice of educational content and have the most impact on required documentation of educational sessions? Widespread availability of Internet resources Advances in health care and research Federal regulations Client-specific characteristics
Federal regulations
A client learns that she is pregnant. Which indicator will the nurse anticipate as being positive? Select all that apply. Presence of linea nigra Fetus observed by ultrasound Fetal movement detected by a health care provider Presence of Goodell sign Detection of a fetal heartbeat
Fetus observed by ultrasound Fetal movement detected by a health care provider Detection of a fetal heartbeat
Which task should the nurse question before delegating it to unlicensed assistive personnel (UAP)? Flushing an arterial line Measuring intake and output Ambulating a client with a walker Providing a gastrostomy feeding
Flushing an arterial line
Karen Sanders is a registered nurse who is planning to provide pre-operative teaching to a home care client who is scheduled for joint replacement surgery in a few days. What information should the nurse emphasize to reduce the risk of a healthcare-associated infection (HAI)? Avoid eating fresh fruits and vegetables. Expect to take antibiotics for several weeks. Follow the healthcare providers' discharge instructions. Prevent skin drying by limiting hand washing.
Follow the healthcare providers' discharge instructions.
In addition to assessing, monitoring, and evaluating the client's care, what other aspects of care are responsibilities of the nurse case manager? Select all that apply. Writing discharge orders for hospitalized patients Following continuous quality improvement principles (CQI) Collaborating with other health professionals Ensuring that the client is billed appropriately Coordinating and planning care
Following continuous quality improvement principles (CQI) Collaborating with other health professionals Coordinating and planning care
Eldredge Marain is the nurse manager of a home health care agency. One of the agency's home health staff nurses notifies Eldredge that she believes a client is being abused by the client's family member. The staff nurse states, "The client has bruises all over her arms. When I asked her how she got the bruises, she looked away from me and would not respond. Today, I noticed that she seems nervous when her daughter is in the room. I also overheard her daughter saying that her mother is a burden and that she's tired of dealing with her." Which action from Eldredge is most appropriate? Following the agency's protocols for reporting suspected abuse of vulnerable adults Conducting an investigation to confirm that the client is being abused Encouraging the client to report the abuse to local law enforcement officials Advising the staff nurse that she could be charged with false reporting
Following the agency's protocols for reporting suspected abuse of vulnerable adults
What are the steps that a nurse manager uses when planning? Select all that apply. Formulating a planning statement Establishing objectives and goals Evaluating the present situation and predicting future trends and events Coordinating the work to be done Converting the plan into an action statement
Formulating a planning statement Establishing objectives and goals Evaluating the present situation and predicting future trends and events Converting the plan into an action statement
Which care delivery method uses a task-oriented approach? -Team -Functional -Primary -Case
Functional
Which are risk factors for gestational diabetes mellitus (GDM)? Select all that apply. GDM in previous pregnancy GDM Maternal age less than 25 Family history of diabetes Chronic hypertension Underweight for height
GDM in previous pregnancy GDM Family history of diabetes Chronic hypertension
There are certain relevant factors that contribute to why a client is prone to falling. Which factor is least related to client falls? Cognition problems causing falls Falls caused by side effects of medication Genetic trait for falls A history of falls
Genetic trait for falls
The evening shift nurse is caring for a client, Candace Horn. Mrs. Horn is a 57-year-old woman who is scheduled for discharge in the morning. Hospital protocol dictates that Mrs. Horn receives medication instruction the evening before the scheduled discharge. This policy minimizes incidents of professional negligence through the use of which applicable strategy? Giving clear directions to the client Employing the use of effective communication as a strategy Maintaining client safety as a strategy Developing a nurse-pharmacy rapport as a strategy
Giving clear directions to the client
The nurse is teaching a 7-year-old client about hand washing. The client is resistant to washing her hands after playing with her pet hamster. Which teaching strategy reflects the nurse's application of the behaviorist theory of learning? Explaining to the client how the benefits of handwashing apply to her Recognizing that the client has personal characteristics, such as shyness and love of animals, that influence her perception of the nurse's teaching Giving the client a healthy treat each time she washes her hands after playing with her pet hamster Assessing the client's aversion to handwashing through viewing her from biologic, psychologic, cultural, social, and spiritual standpoints, including her health status and psychologic state
Giving the client a healthy treat each time she washes her hands after playing with her pet hamster
What is the cervical softening of pregnancy called? Brudzinski sign Chadwick sign Goodell sign Hegar sign
Goodell sign
For his senior project, Ben, a graduate nurse, is designing a study intended to explore how certification exam preparation courses affect nursing students' success rates in passing the exam. Which element best reflects Ben's use of a randomized control trial (RCT) design? He compares graduate nurses who successfully passed the certification exam with graduate nurses who did not pass the exam in order to determine whether or not completing a certification exam preparation course was a variable that contributed to test performance He examines a group of studies on graduate nurses who completed certification exam preparation courses, and then combines and analyzes the results as if they were from one large study He interviews five graduate nurses who completed a certification exam preparation course and details their experiences with the course, and then identifies the number of graduate nurses who successfully completed the certification exam He compares the exam performance of a control group of graduate nurses who did not complete any certification exam preparation course to a group of graduate nurses who completed a specific certification exam preparation course prior to taking the exam
He compares the exam performance of a control group of graduate nurses who did not complete any certification exam preparation course to a group of graduate nurses who completed a specific certification exam preparation course prior to taking the exam
A nurse manager discovers that a front line staff member failed to report a safety error due to fear of termination. The nurse manager believes that such an omission may hamper ongoing quality improvement (QI) efforts. Why would this omission become a QI obstacle? Quality improvement efforts cause more fear of termination. Safety errors can best be discovered by nurse managers. Healthcare managers would not have an accurate picture of risks. Omission of reporting a single safety error is grounds for firing.
Healthcare managers would not have an accurate picture of risks.
The nurse is completing an initial home visit for a client who was recently discharged from the hospital. Which home condition would the nurse report due to client safety concerns? Using well water for cleaning dishes and for cooking Finding prescription drugs in several locations of the home Disposing of needles in a plastic container labeled Heating the environment with a kerosene heater
Heating the environment with a kerosene heater
What is the definition of anemia in pregnancy? Hemoglobin of less than 11 g/dL Hemoglobin of less than 7 g/dL Hemoglobin of less than 13 g/dL Exhibiting symptoms of anemia regardless of laboratory values
Hemoglobin of less than 11 g/dL
Sunil Gupta, a 30-year-old international student, was admitted to the hospital with excruciating stomach pain. He experienced a longer length of stay (LOS) than usual after his ulcer surgery. His stay was extended due to a wound infection that responded well to antibiotics. He expressed his displeasure at missing so many of his academic commitments. Which characteristic of Mr. Gupta's care would be seen in a Six Sigma program as a defect? His response to prescribed antibiotics His unrelieved stomach pain His choice of surgical, rather than medical, intervention His dissatisfaction with his extended hospital stay
His dissatisfaction with his extended hospital stay
The nurse is designing a nursing clinical research study. Which research questions are most appropriate for this type of study? (Select all that apply.) How do environmental noise levels affect the client's pain perception postanesthesia? How do communication styles influence the nurse's perception of nurse educators? Is there a relationship between acupressure and incidence of nausea in clients who are receiving chemotherapy medications? What is the relationship between the duration of nurse-client interaction and the client's level of satisfaction with nursing care? What factors influence an individual's choice to enroll in online nursing education?
How do environmental noise levels affect the client's pain perception postanesthesia? Is there a relationship between acupressure and incidence of nausea in clients who are receiving chemotherapy medications? What is the relationship between the duration of nurse-client interaction and the client's level of satisfaction with nursing care?
The nursing instructor asks students to develop examples of background questions. Which student responses are the most accurate? (Select all that apply.) How does incentive spirometry help prevent collapse of the small airways in the lungs? How does acupuncture compare to pain medication for treating chronic knee pain? What is the pathophysiology of left ventricular heart failure? Why isn't long-acting insulin administered via the IV route? What is the link between care providers' stethoscopes and healthcare-acquired infections?
How does incentive spirometry help prevent collapse of the small airways in the lungs? What is the pathophysiology of left ventricular heart failure? Why isn't long-acting insulin administered via the IV route?
The nurse is aware that a client with gestational diabetes mellitus is most likely to exhibit which alteration in vital signs in the third trimester? Fever Decreased oxygen saturation Tachycardia Hypertension
Hypertension
Which condition occurs in the initial newborn period due to maternal diabetes? Hypoglycemia Hypoxia Hypobilirubinemia Hypertension
Hypoglycemia
The client who was recently diagnosed with cancer is making a difficult clinical decision, choosing between surgery or chemotherapy and radiation. The client asks the nurse "What would you do if you were in my shoes?" What is the most appropriate response by the nurse? Chemotherapy and radiation take a lot longer to recover from; I would advise against them. I am not an expert in treatment outcome research, so I would not want to influence your decision. It really does not matter which way you choose to get treatment; either way works as well. I have watched a lot of clients make that decision; the ones that chose surgery seemed the happiest.
I am not an expert in treatment outcome research, so I would not want to influence your decision.
An emergency department (ED) nurse is approached by the parents of a teen admitted with a uterine hemorrhage. "Is my daughter pregnant?" the father asks. What is the most appropriate response by the nurse to the client's father? I don't think you have anything to worry about. She is a lovely young woman. I know this situation must be hard for you to deal with. I will let you know when I find out the answer. You can ask the admitting physician. I am sure he will discuss your daughter's condition with you. I cannot discuss her medical condition with you. All of our clients have privacy rights.
I cannot discuss her medical condition with you. All of our clients have privacy rights.
The nurse reports a case of suspected abuse of an adult client with a disability. Subsequently, a law enforcement investigation finds no evidence to support the nurse's allegations of abuse. Which statement by the nurse best reflects correct understanding of how good faith immunity applies to unproven reports of suspected abuse of an adult client with a disability? I need to check my state's laws to see if I am protected by good faith immunity. Criminal charges will be filed against me for making a false report. I am protected from repercussions based on federal laws that guarantee all mandatory reporters good faith immunity. Civil charges will be filed against me for alleged defamation of character.
I need to check my state's laws to see if I am protected by good faith immunity.
Which elements of client teaching should the nurse document in the client's record of care? (Select all that apply.) Identified learning needs Learning outcomes Client's reading level Degree to which client learning outcomes were achieved Need for additional teaching
Identified learning needs Learning outcomes Degree to which client learning outcomes were achieved Need for additional teaching
The emergency department manager is notified that victims of a train derailment are due to arrive in 30 minutes. Which action should the manager take when organizing for this influx of clients? Reviewing staff performance of care provided during last month's hurricane Notifying human resources of the need for additional staff during the next 24 hours Identifying staff available to triage the victims as they arrive Telling assistants to place extra blankets and dressing supplies in each bed space
Identifying staff available to triage the victims as they arrive
The nurse is explaining The Joint Commission's patient rights to the client. Which statement by the nurse is the most accurate? The client must know the educational level of all healthcare providers. If something goes wrong with your care, you have the right to know about it. You have the right to receive pain medication if you are experiencing pain. If you refuse care, the list of client rights no longer applies to you.
If something goes wrong with your care, you have the right to know about it.
Jose Cardena is a 48-year-old warehouse worker who has been admitted to the cardiology unit because of chest pain. He has a strong family history of heart attacks before age 50. You are the nurse manager on the cardiology unit, and Jose tells you that he "can load a pallet faster than men half my age." He and his wife Trina are expecting their first grandchild in 3 months, and Jose is already thinking about names for the new baby. His doctor has advised him to begin a program of regular exercise, but Jose counters that he does not need to do that, saying "I'm already strong!" Which of Jose's behaviors may indicate unclear values? Loading a pallet faster than anyone else Having a family history of heart disease Looking forward to the birth of his grandchild Ignoring his doctor's advice to exercise regularly
Ignoring his doctor's advice to exercise regularly
Which is an example of cost-conscious nursing practice? -Receiving report at the bedside -Printing lab results prior to physician rounds -Sharing a medication cart with other nurses -Implementing quality study results in client care
Implementing quality study results in client care
The nurse case manager is designing a brochure to help older adult clients recognize and protect their rights. Which item is appropriate to include in the brochure? County departments of health usually assist clients with issues related to long-term care. All provider agencies must employ client advocates for older adult clients. Homes for vulnerable older adults are regulated at the federal level. In many states, the governor or secretary of health has an office to assist with issues in long-term care.
In many states, the governor or secretary of health has an office to assist with issues in long-term care.
The nurse is educating a group of women about conception. During the session, the nurse explains that fertilization of the ovum occurs in which part of the female reproductive tract? In the space between the ovary and the fimbria of the fallopian tube In the uterus Fertilization may occur at any location in the female reproductive tract. In the ampulla of the fallopian tube
In the ampulla of the fallopian tube
A nurse complains to another nurse about the length of time it took to write up an incident report. The second nurse offers a solid explanation of why the time spent is worthwhile as far as client care is concerned. Which explanation by the second nurse is the most appropriate reason why incident reports are so important? Incident reports let lawyers know nurses care about client care. Incident reports withhold information about mistakes in client care. Incident reports can protect the hospital in case of future client care events. Incident reports can be used to improve the delivery of future client care.
Incident reports can be used to improve the delivery of future client care.
Molly Cantrell is a nurse who is planning to incorporate skills that support the competency of evidence-based practice when providing client care. Which action supports this competency? Meet with physical therapist to discuss a client's mobility needs. Document care immediately after providing it. Include a new process for changing a wound dressing into a client's care plan. Complete a root cause analysis after a medication error occurs.
Include a new process for changing a wound dressing into a client's care plan.
When organizing the client's learning experience, which guideline should the nurse implement in the teaching plan? Include casual conversation as a form of assessing the client's knowledge base. Ensure that all teaching sessions are formal in nature. Avoid documentation of informal or unscheduled teaching sessions, such as during medication administration. Introduce educational content, then assess the client's current knowledge level.
Include casual conversation as a form of assessing the client's knowledge base.
A visitor to the dermatology clinic slips on moisture on the floor of the waiting room, on a stormy, rainy day. "There was a puddle caused by someone's umbrella," the visitor complained, while being helped to his feet. What should the nurse do with that statement? Put that statement in the chart of the client whose umbrella shed water Ignore the statement, since it points a finger of liability to an individual Include the statement about the umbrella in quotes in an incident report Report that statement to the Risk Manager only orally, not in written form
Include the statement about the umbrella in quotes in an incident report
Which strategies are appropriate for inclusion in the teaching plan for the older adult client? (Select all that apply.) Including the older adult client's caregiver in the teaching session Pacing the teaching session with respect to the client's energy level Using teaching materials that feature multicolored print Gearing teaching content toward individuals with a tenth- to twelfth-grade reading level Providing written materials that use non-reflective (e.g., off-white, matte) paper
Including the older adult client's caregiver in the teaching session Pacing the teaching session with respect to the client's energy level Providing written materials that use non-reflective (e.g., off-white, matte) paper
Which strategies are appropriate for inclusion in the teaching plan for a pediatric client? (Select all that apply.) Gearing instructions toward the comprehension level of the pediatric client's parent or caregiver Including the pediatric client's caregiver in the teaching session Exposing the pediatric client to healthcare personnel who are dressed in uniforms, surgical masks, and scrubs prior to the client's hospital admission Addressing the pediatric client primarily through the use of terms of endearment, such as "sweetheart" Demonstrating relevant treatments or procedures using stuffed animals
Including the pediatric client's caregiver in the teaching session Exposing the pediatric client to healthcare personnel who are dressed in uniforms, surgical masks, and scrubs prior to the client's hospital admission Demonstrating relevant treatments or procedures using stuffed animals
The nurse is caring for a client with class II heart disease who is at 28 weeks gestation with her first pregnancy. The nurse teaches the client to immediately contact the healthcare provider if which condition occurs? Increased dyspnea at rest Weight gain of 1 pound in a week Emotional stress on the job Mild ankle edema
Increased dyspnea at rest
What are the benefits of delegation to the nurse? Select all that apply. Increases job satisfaction Improves client care Provides more time to complete complicated tasks Increases cooperation and enhances teamwork Helps build self-esteem and confidence
Increases job satisfaction Improves client care Provides more time to complete complicated tasks
The nurse unit manager is designing a brochure for healthcare providers that describes the illnesses and injuries that are subject to mandatory reporting. Which statement is most appropriate for the nurse unit manager to include in the brochure? Infectious diseases that are subject to mandatory reporting include tuberculosis, HIV, AIDS, and Escherichia coli. Injuries sustained during a suspected criminal act are reported only if the crime can be proven. Powder burns sustained during discharge of a gun or firearm are not subject to mandatory reporting. All wounds that are caused by a knife or a sharp object are subject to mandatory reporting.
Infectious diseases that are subject to mandatory reporting include tuberculosis, HIV, AIDS, and Escherichia coli.
For which QSEN competency should the nurse demonstrate the ability to use electronic client records? Patient-centered care Informatics Teamwork and collaboration Quality improvement
Informatics
What is a defining characteristic of care coordination? -Direct interaction with other members of the care team -Initiation by the nurse -Initiation by a family member -Direct client care is delivered
Initiation by the nurse
Jennifer Calper, the primary nurse, is assigned a client with newly diagnosed type 2 diabetes mellitus. Which nursing action is most appropriate when caring for this client? -Providing direct care to the client during the scheduled shift -Directing nursing assistants to complete morning care on a group of clients -Instructing the client on the role of medications to control the disease process -Participating on a task force to identify glucometers for use during care
Instructing the client on the role of medications to control the disease process
The nurse is educating his peers on interdisciplinary teams. Which teaching point is appropriate based on the concept of team collaboration? Pharmacists are excluded from serving on interdisciplinary teams. Interdisciplinary teams are exclusive to healthcare settings. Interdisciplinary teams are also referred to as interprofessional teams. A limited range of expertise is provided by interdisciplinary teams.
Interdisciplinary teams are also referred to as interprofessional teams.
While making morning rounds, the charge nurse observes an assistant irrigating a nasogastric tube of a client recovering from gastric surgery. What is the most appropriate action by the charge nurse at this time? Intervene and complete the irrigation of the tube for the assistant Discuss the issue of overdelegation with the nurse Ask the assistant if help is needed Ask the assistant of the location of the nurse
Intervene and complete the irrigation of the tube for the assistant
The nursing student is writing a report about ethical issues related to organ transplantation. Which items should be included? (Select all that apply.) Involvement of children as donors Allocation to recipients Involvement of children as recipients Family member donation Definition of death
Involvement of children as donors Allocation to recipients Involvement of children as recipients Definition of death
Which questions are most appropriate for the nurse to consider during the evaluation of the impact of evidence-based practice on client outcomes? (Select all that apply.) Is the new practice being implemented correctly? Is the new practice beneficial to the nurse? Is the practice in accordance with the state's nurse practice act? Does the practice adhere to the American Nurses Association (ANA) standards of nursing care? Does the change in practice yield the intended results?
Is the new practice being implemented correctly? Does the change in practice yield the intended results?
The nurse educator is leading a class discussion about factors that affect the nurse's function as a moral agent. When discussing potential sources of ethical challenges, which students' statements are most accurate? (Select all that apply.) Functioning as an 'in-between' helps to prevent ethical conflict. The traditional focus on palliative treatments can create ethical conflict. Staffing shortages have little to no effect on creating ethical conflict. Issues that impact organizational efficiency can create ethical conflict. Typical power structures in health care can be sources of ethical conflict.
Issues that impact organizational efficiency can create ethical conflict. Typical power structures in health care can be sources of ethical conflict.
The novice nurse asks the nurse preceptor to define active euthanasia. Which response is best? It may involve providing a client with medications or a weapon. It can involve directly causing death without client consent. It is legal in some countries and in some states within the United States. It is the same thing as assisting a client with suicide.
It can involve directly causing death without client consent.
Which statement best describes The American Hospital Association's publication, A Patient's Bill of Rights? It identifies client teaching as a nursing function. It declares that clients have a right to be educated about their health care. It requires evidence that clients and their significant others collaborate in the provision of care. It qualifies client teaching as a nursing responsibility within both the professional and legal domains.
It declares that clients have a right to be educated about their health care.
An experienced nurse is mentoring the new graduate. They talk about how exciting it was to see a successful Heimlich maneuver performed by a nursing colleague. How did that event promote the image of nursing? It demonstrated nursing's skills. It demonstrated nursing's values. It demonstrated nursing's boundaries. It demonstrated nursing's attitudes.
It demonstrated nursing's skills.
A student nurse must understand the importance of providing safe nursing care consistent with legal requirements. Which statements are true regarding nursing negligence? (Select all that apply.) It is defined as conduct that deviates from what a reasonable individual would do in a particular circumstance. It is considered an unintentional tort. It occurs without the deliberate intent to bring harm against another individual. It is considered an intentional tort. It is defined as conduct deviating from the standard of practice dictated by the profession.
It is defined as conduct that deviates from what a reasonable individual would do in a particular circumstance. It is considered an unintentional tort. It occurs without the deliberate intent to bring harm against another individual.
In consideration of the evaluation of research evidence, which statement best describes validity? It is the degree to which the study measured what it intended to measure. It is used to determine the strengths and weaknesses of a study and its resulting evidence. It is reflective of the study's application to clinical practice. It is the study's ability to produce consistent results with each use.
It is the degree to which the study measured what it intended to measure.
In the context of nursing, which statement best describes qualitative research? An example of a qualitative question is "Are there differences in skin breakdown between premature infants who are bathed with plain water and those who are bathed with bacteriostatic soap?" It uses precise measurement to statistically analyze data. It is used to clarify the nurse's understanding of the client's perspective. It is used to test relationships between variables.
It is used to test relationships between variables.
The ultrasonographer notes that Twin A is a girl, but she is having a hard time seeing the genitalia of Twin B.I have all girls at home, says Mrs. Moore. I hope the other twin is a boy.What is your best response? I hope it is a boy, too. We cant tell the gender of Twin B. It looks like youll have two more daughters. Its possible the other one is a boy.
It looks like youll have two more daughters.
The nurse is teaching a group of high school students about reproduction and shows a slide featuring an image of a placenta. A student exclaims, "What is that for?" What can the nurse tell the group about the function of the placenta? Select all that apply. It filters out everything in the mother's system that could harm the baby. It secretes hormones that help maintain the pregnancy. It uses resources from the mother's body to produce fatty acids that provide energy for the baby. It has blood vessels that bring oxygenated blood to the baby and carry deoxygenated blood away from it. It provides a cushion to protect the baby from injury.
It secretes hormones that help maintain the pregnancy. It uses resources from the mother's body to produce fatty acids that provide energy for the baby. It has blood vessels that bring oxygenated blood to the baby and carry deoxygenated blood away from it.
The nurse working in an allergy clinic finds that the clinic did not receive enough vials of flu vaccine this year. The nurse devised a decision tree to identify priority clients who have the greatest need for the flu vaccine. Which primary principle guided the nurse's ethical decision making? Autonomy Beneficence Justice Veracity
Justice
Which activity is required of the delegate who accepts a task? (Select all that apply.) Keep the delegator informed of progress Clarify how to report completion of the task Clarify the time frame to complete the task Report concerns Define the task
Keep the delegator informed of progress Clarify how to report completion of the task Clarify the time frame to complete the task Report concerns
Which statements most accurately describe potential barriers to implementation of evidence-based practice (EBP)? (Select all that apply.) Lack of access to continuing education programs Client workload demands Providing accountability for nursing care Ensuring credibility of the nursing profession Nursing misperceptions about EBP
Lack of access to continuing education programs Client workload demands Nursing misperceptions about EBP
The nurse educator is describing the application of moral principles in nursing practice. Which scenarios best illustrate opportunities for the nurse to serve as an advocate for the client's autonomy? (Select all that apply.) Lack of spousal support for the client's refusal of care Family members who request access to the client's health information Disagreement from family members about the client's choices Healthcare providers who fail to hear the client's concerns Institutional computerization of the client's records
Lack of spousal support for the client's refusal of care Disagreement from family members about the client's choices Healthcare providers who fail to hear the client's concerns
Which nursing actions could be negligence that results in malpractice? (Select all that apply.) Assessing and monitoring a client who has returned from surgery Lacking appropriate communication skills Documenting client care in the electronic medical record Failing to follow the standard of practice Using equipment without appropriate training
Lacking appropriate communication skills Failing to follow the standard of practice Using equipment without appropriate training
The nurse is caring for a client who is experiencing nausea and vomiting. The nurse believes the client could be pregnant. Which subjective change should the nurse assess for in this client? A pregnancy test Presence of Chadwick sign Abdominal enlargement Last menstrual period
Last menstrual period
Which are true statements about the relationship of ethics and laws. (Select all that apply.) An ethical action gives some input into determining the legality of a situation. Following the law is making a choice to take an ethical action. Laws are enacted to reflect the ethical values of society. A specific situation can be legal, but perhaps not moral. A specific situation can be moral, but perhaps not legal.
Laws are enacted to reflect the ethical values of society. A specific situation can be legal, but perhaps not moral. A specific situation can be moral, but perhaps not legal.
The nurse in the blood bank is part of a team effort to reduce the costs of collecting and storing blood components. The nurse conducts an inventory to check for expired sterile supplies. In seeking to reduce waste, which quality improvement (QI) method is the team using? Lean Six Sigma Quality assurance Root cause analysis Utilization review
Lean Six Sigma
Which type of restraint should the nurse identify as being the most appropriate for an older confused client who is attempting to pull out an indwelling urinary catheter? Limb Mummy Elbow Belt
Limb
The nurse is delegating a task to an assistant. Which factors should the nurse include when describing the task to be completed? (Select all that apply.) The need to complete the task when possible Location of the nurse if there are any issues with completing the task The need to complete the task before the client attends physical therapy Expectation that the task is completed within 1 hour The fact that the client's family is not local
Location of the nurse if there are any issues with completing the task The need to complete the task before the client attends physical therapy Expectation that the task is completed within 1 hour
A client's ultrasound report indicates dysfunction of the ductus arteriosus in the fetus. The nurse anticipates that this abnormality may cause problems with blood flow to which part of the body? Liver Lower body Brain Lungs
Lower body
During fetal circulation, most fetal blood is shunted away from which organ? Brain Kidneys Lungs Heart
Lungs
A nurse ignores a client's persistent complaint of back pain because the client "complains too much." The next day the client is diagnosed with kidney stones. What negligence prevention strategy did the nurse fail to implement? Maintaining client safety Using effective communication Minimizing the risk of medication errors Minimizing client discomfort
Maintaining client safety
The infection control nurse is reviewing a monthly status report of all clients who were treated for infectious diseases in the organization. Which clients require further investigation to determine whether they have a healthcare-associated infection? (Select all that apply.) Male client with a leg wound from motor vehicle accident that became infected Female client receiving antibiotics after having total knee replacement surgery Male client being treated for diarrhea after receiving antibiotics for pneumonia Female client with an indwelling urinary catheter being treated for a urinary tract infection Male client with sepsis after receiving hyperalimentation infusions
Male client being treated for diarrhea after receiving antibiotics for pneumonia Female client with an indwelling urinary catheter being treated for a urinary tract infection Male client with sepsis after receiving hyperalimentation infusions
Sandra Davis is a registered nurse (RN) who is running behind in administering her medications at a long-term care facility. When she arrives in the last client's room, the client is in the restroom. Sandra asks the nursing assistant if she would mind giving the cardiac glycoside to the client, and leaves the room. The client's pulse was 48 beats per minute. The medication was administered, and the client died. Which unintentional tort did Sandra commit during this incident? Battery Assault Malpractice False imprisonment
Malpractice
Which of the following is unintentional conduct deviating from the standard of nursing practice? False imprisonment Battery Assault Malpractice
Malpractice
As the nurse manager of the emergency department, you have pulled together your staff for an impromptu disaster drill dialogue. You want to emphasize the difference between your team's usual triage routine, and the reverse triage decision making needed to deal with mass casualties. Which client would you tell your staff should receive priority treatment during a disaster? Teenager with type 1 diabetes with severe food allergies Dialysis client who has recently refused continuing treatment Woman who carries an oxygen generator with her for COPD Man with angina with no previous history of cardiovascular disease
Man with angina with no previous history of cardiovascular disease
The nurse is planning interventions to address the National Patient Safety Goal of correct client identification. Which nursing action supports this goal? Asking the client to state their middle name Matching the name on the client's wrist band with the medical administration record Placing the client's name on the room door Writing the client's first name next to the assigned staff on the assignment sheet
Matching the name on the client's wrist band with the medical administration record
Once the ultrasound is completed, you replace the external uterine and fetal monitors and place Mrs. Moore at a left tilt. You note 1+ pedal edema bilaterally.You obtain her vital signs: T 98.8°F, P 120 bpm, R 24/min, and BP132/76 mmHg.Twin As fetal heart rate is 145 bpm with average long term variability and 10 x 10 accelerations. Twin Bs heart rate is 132 bpm with long term variability. No accels or decels are noted for Twin B at this time. You observe contractions every 10 to 12 minutes on the monitor, lasting 15-20 seconds.Which assessment finding concerns you the most? Maternal temperature Maternal pulse Twin Bs lack of accels and decels Pedal edema
Maternal pulse
Which nursing activity is a common cause of pediatric medical errors? Communication with children Mathematical calculation Administration of drugs in suspension Monitoring adverse events
Mathematical calculation
The registered nurse is determining tasks to delegate to a licensed practical nurse (LPN) and nursing assistant (NA). Which tasks should the nurse delegate to the nursing assistant? (Select all that apply.) Discharge teaching about comfort measures for a client who had a tonsillectomy Measuring output on a client with heart failure Feeding a client with expressive aphasia after a stroke Administering intravenous pain medication to a client transferred from the recovery room after thoracic surgery Nasotracheal suctioning of a client recovering from a stroke
Measuring output on a client with heart failure Feeding a client with expressive aphasia after a stroke
Prior to discharging a client who has recently been diagnosed with asthma, the nurse plans to teach the client about health restoration. Which topic is most appropriate for inclusion in the teaching? Protective health measures First aid Health screenings Medication administration and side effects
Medication administration and side effects
The pediatric oncology nurse is assigned to give medications to several children. For which medications would the nurse face an increased risk of making a medication error? (Select all thatapply.) Medication in the form of a tablet to be crushed Medication needed in small dosage for an infant Medication calculated based on child's weight Medication produced in adult concentrations Medication measured with an eye dropper dispenser
Medication needed in small dosage for an infant Medication calculated based on child's weight Medication produced in adult concentrations
Two veteran staff nurses on a care area have resigned their positions to begin employment with an insurance company to provide case management. Which action should Michael, the nurse manager, take to address the vacancies created by their resignations? -Hold a staff meeting to announce the resignations of the staff nurses -Encourage the nurses to reconsider their decision to leave -Post the open positions within the organization -Meet with Human Resources to discuss nursing salaries
Meet with Human Resources to discuss nursing salaries
An operating room nurse is participating in a training activity to help the local community get more surge capacity in case of emergency. How does the training activity accomplish this function? Satisfying need for current recovery operations Helping shelters house more evacuated individuals Meeting increased demand for qualified personnel Opening off-site operating rooms for emergencies
Meeting increased demand for qualified personnel
The nurse manager is performing responsible actions associated with a delicate client care situation. Which actions are appropriate for the nurse manager to complete? (Select all that apply.) Directing nursing staff to check expiration dates before using intravenous fluids Referring to the nurse practice act before delegating a task to a nurse Meeting with staff about the need to maintain client confidentiality Notifying central storage of stock items no longer needed for the care area Ensuring paper work is completed and submitted to the security department as required
Meeting with staff about the need to maintain client confidentiality Notifying central storage of stock items no longer needed for the care area Ensuring paper work is completed and submitted to the security department as required
Which statements are true regarding teams? Select all that apply. Accountability among team members is only individual. Members agree to work together to accomplish a common goal. Task completion is delegated to team members. The terms team and group are synonymous. Team members often share the leadership role.
Members agree to work together to accomplish a common goal. Team members often share the leadership role.
Antonio Silvio, a 40- year-old immigrant from Italy, is being treated for hypothermia after he had to flee his home through the cold, raging waters of a spring flood. Mr. Silvio's home and cabernet vineyard were located in a known flood plain. As a condition of his mortgage, Mr. Silvio was required to buy flood insurance. As his case manager, which phase of emergency management would you know protected him against complete financial loss? Recovery phase Emergency response phase Mitigation phase Preparedness phase
Mitigation phase
One phase of emergency management is unique in that it takes place both before and after an emergency event. Which phase has that dual timing? Preparedness phase Mitigation phase Recovery phase Learning phase
Mitigation phase
What is a difference between morality and ethics? Moral situations are described with words like "ought" and "should;" ethical situations don't use those words. Ethical situations are described with words like "ought" and "should;"moral situations don't use those words. Morality refers to private, personal standards of right and wrong; ethics covers a broader range of standards. Ethics refers to private, personal standards of right and wrong; morality covers a broader range of standards.
Morality refers to private, personal standards of right and wrong; ethics covers a broader range of standards.
The nurse is preparing a health program for high school students. What should the nurse include as factors contributing to pregnancy in this age group? Select all that apply. Multiple sex partners Drug use Attendance at community college Lack of family support Poverty
Multiple sex partners Drug use Lack of family support Poverty
Several nurses attend an educational lecture by an official from the Occupational Safety and Health Administration (OSHA) and are reminded about the Whistleblower Protection Program. They hear about the various forms that job discrimination could take, which is prohibited by law. What are some forms of job discrimination? (Select all that apply.) No answer text provided. No answer text provided. Decreasing scheduled hours that a nurse works Assigning a new graduate nurse to the night shift Not rehiring a nurse into a former position Reducing the salary that a nurse is paid Putting a nurse on the weekend coverage schedule
No answer text provided. No answer text provided. Decreasing scheduled hours that a nurse works Not rehiring a nurse into a former position Reducing the salary that a nurse is paid
On which preventive measures should an OSHA reviewer focus when conducting a site inspection? (Select all that apply.) No answer text provided. Use of gloves when caring for clients Presence of puncture-resistant sharps containers Ratio of nursing staff to assigned clients Location of staff break room
No answer text provided. Use of gloves when caring for clients Presence of puncture-resistant sharps containers
Michaela Reston, a 42-year-old woman with multiple sclerosis, has been receiving infusions in the outpatient clinic to treat her severe dehydration. When the nurse checked her IV functioning, she found Ms. Reston in distress. Ms. Reston developed a rapidpulse, chest pain, and a cough. What immediate action should the nurse take? Increase the rate of Ms. Reston's IV infusion Offer Ms. Reston a glass of water to drink Notify Ms. Reston's healthcare provider of her current status Document Ms. Reston's vital signs and complaints
Notify Ms. Reston's healthcare provider of her current status
During a continuing education meeting, the nurse educator is discussing the nurse's responsibilities related to ethical dilemmas. Which statements should the nurse educator include in the presentation? (Select all that apply.) Notifying care team members about ethical challenges is the nurse's responsibility. Whenever possible, the nurse should adhere to the ANA Code of Ethics for nurses. The nurse should ask the healthcare provider to manage ethical challenges that emerge during client care. It is the nurse's responsibility to ensure that ethical challenges do not arise during the client's care. Informing the client about ethical issues that affect the client's care is part of the nurse's job.
Notifying care team members about ethical challenges is the nurse's responsibility. Informing the client about ethical issues that affect the client's care is part of the nurse's job.
The emergency department staff nurse is caring for a 6-year-old male client who sustained a fractured right radius. Upon physical examination, the nurse notes scattered bruising across the client's back. When asked what caused the bruising, the client silently stares at the floor. Based on physical assessment findings, the nurse suspects the client may be a victim of abuse. Which action is the priority for the nurse to implement? Notifying the immediate nurse supervisor Reporting the abuse to local law enforcement officials Obtaining a referral to a hospital social worker Contacting federal law enforcement officials
Notifying the immediate nurse supervisor
A nurse receives specialized training to better help the local community in a mass casualty incident. The training team used the acronym CBRNE to remind the audience about the different types of exposure to agents. Which agents did they include? (Select all that apply.) Breaking agents Exodus agents Nuclear agents Caustic agents Radiological agents
Nuclear agents Radiological agents
The nurse case manager, Candace, evaluates Clark Jones, a 52-year-old male client. Mr. Jones has been hospitalized for the fourth time this year with diabetic ketoacidosis and a left foot infection that is developing gangrene. Candace discovers that Mr. Jones has type 2 diabetes with a long history of not participating in his disease management. Mr. Jones skipped his last four diabetes clinic appointments, takes his insulin when he "feels like it," smokes tobacco, and eats a high fat, high sugar diet. Which factor indicates that Mr. Jones has a need for case management? Number of hospitalizations Diagnosis Client age Lack of cooperation with care
Number of hospitalizations
What facts would disqualify nurses for protection when reporting observed misconduct under the Whistleblower Protection Act? (Select all that apply.) Nurse following employer's internal reporting procedures Nurse making a verbal complaint to administration Employer not knowing that the activity was a violation of law Employer engaging in retaliation against the nurse Nurse giving employer time to correct the issue
Nurse making a verbal complaint to administration Employer not knowing that the activity was a violation of law
Once a month, the nurses working in case management get together for a potluck lunch. They have found that this informal session promotes a sense of a united community. Which of the International Council of Nurses Code of Ethics' relationships is being enhanced? Nurses and people Nurses and coworkers Nurses and the profession Nurses and practice
Nurses and coworkers
Which relationships are guided by the Code of Ethics from the International Council of Nurses? (Select all that apply.) Nurses and co-workers Nurses and payment Nurses and practice Nurses and laws Nurses and people
Nurses and co-workers Nurses and practice Nurses and people
The nurse unit manager is creating a policy related to the nursing care of clients who are diagnosed with HIV or AIDS. Which item best reflects a standard of nursing care and should be included in the policy? For clients who are HIV positive, the nurse is legally responsible for notifying the client's sexual partners or caregivers. The nurse is responsible for notifying insurance companies of any policy holder whose HIV test is confirmed as being positive. All clients and healthcare providers for whom exposure to HIV is known or suspected must undergo mandatory HIV testing. Nurses are morally obligated to care for clients with AIDS unless the nurse's safety risks exceed the potential client benefits.
Nurses are morally obligated to care for clients with AIDS unless the nurse's safety risks exceed the potential client benefits.
A rehabilitation clinic nurse created an emergency plan for the nurse's immediate family. How does this personal plan best fit into the larger picture of the community's preparedness phase? Personal plans are only practice for the larger plans. Nurses must limit facing issues of their own grief. Larger plans are based on consolidating personal plans. Nurses need to know their families can survive emergencies.
Nurses need to know their families can survive emergencies.
The manager is evaluating the impact of an educational program on the frequency of work-related injuries experienced by the nursing staff. Which observation indicates that additional training is necessary? Staff nurse releasing the breaks on a stretcher before transporting a client to the elevator Nursing assistant independently repositioning and pulling a client up in a hospital bed Staff nurse placing intravenous fluids on the medical cart to use while passing medications Nursing assistant using a cart to distribute newly filled water pitchers to clients
Nursing assistant independently repositioning and pulling a client up in a hospital bed
The nurse in the emergency department (ED) has several tasks that can be delegated to unlicensed assistive personnel (UAP). One of these tasks involves sitting with an older adult client who has dementia. The client was found wandering out of doors, and law enforcement transported him to the ED for a medical evaluation while they located his family, who are on their way to pick up the client. To which employee should the nurse delegate this assignment? Nursing assistant whose father recently passed away Nursing assistant who is floating from the pediatrics department Nursing assistant with a good safety record Nursing assistant who is helping another complete morning care
Nursing assistant with a good safety record
The nurse utilizes critical paths in deciding the outcomes to be achieved by the client that day. What role does nursing diagnosis play in the process? Nursing diagnoses are used to help explain the medical diagnoses. Nursing diagnoses are followed by all the members of the collaborative team. Nursing diagnoses are not a part of the critical path process. Nursing diagnoses identify the overall outcomes needed.
Nursing diagnoses identify the overall outcomes needed.
The nursing student is giving a presentation about nursing research. Which statement is most appropriate for the student to include in the presentation? Nursing research tests hypotheses about health-related conditions and nursing care. Nursing research is clinical knowledge, expert opinion, or information resulting from research. Nursing research combines the best evidence from current studies, clinical nursing expertise, and client preferences. Nursing research is illustrated by the client's choice to use an alternative treatment.
Nursing research tests hypotheses about health-related conditions and nursing care.
Which are the metabolic functions of the placenta? Select all that apply. Nutrition Excretion Fetal gas exchange Red blood cell production Hormone production
Nutrition Excretion Fetal gas exchange
Katrina Simons is a nurse who is coordinating the discharge for a client with chronic lung disease. Which nursing action is the priority when coordinating this client's care? -Discussing the client's medications with the pharmacist -Reviewing the client's nutritional needs with the dietician -Responding to family members' questions about the client's needs -Obtaining an order and organizing the delivery of oxygen to the client's home
Obtaining an order and organizing the delivery of oxygen to the client's home
Which of the nurse's statements correctly reflects the use of learning evaluation methods? Oral questioning is an acceptable method of learning evaluation. Self-reports and self-monitoring are not valid forms of evaluation. Written or online tests are not effective evaluation tools. Direct observation of the client's behavior is the only appropriate method of evaluation.
Oral questioning is an acceptable method of learning evaluation.
Which healthcare provider's orders should nurses question, to protect themselves legally? (Select all that apply.) Orders written after client's condition improved Orders that a client questions Orders calling for a medication with a decimal point Orders written before client's condition changed Orders for expensive in-house laboratory tests
Orders that a client questions Orders written before client's condition changed
The graduate nurse is unable to find employment within local healthcare organizations despite being informed of a nursing shortage in the area. On which type of organization should the nurse focus the search to help secure employment? -Community organizations -Organizations with high vacancy rates -Organizations that provide a higher hourly wage for nurses -Organizations with low vacancy rates
Organizations with high vacancy rates
The community nurse receives a report from the Department of Public Health about an outbreak of influenza in neighboring counties. Which nursing intervention is appropriate to reduce the risk of a similar outbreak in the community? Distribute over-the-counter cold and flu medication during the next community meeting. Discuss implementing a community curfew to curtail spread of influenza. Notify the school to expect a high number of student absences due to influenza. Organize an influenza vaccination clinic at the local community center.
Organize an influenza vaccination clinic at the local community center.
A nurse educator is planning a seminar about the mentorship process. Which techniques reflect correct understanding of factors that promote learning? (Select all that apply.) Organizing the content in a simple-to-complex order Actively engaging the participants in the learning process Ensuring that the content is relevant to the nurse educator's personal experience Repeating key concepts and facts throughout the teaching/learning process Adjusting the temperature of the learning environment so that the participants are comfortable
Organizing the content in a simple-to-complex order Actively engaging the participants in the learning process Repeating key concepts and facts throughout the teaching/learning process Adjusting the temperature of the learning environment so that the participants are comfortable
The nurse working in the assisted living facility is reviewing the weekly report of the number of bedridden clients who developed pressure ulcers. The facility uses the Donabedian model of QI. Which standard is the nurse using with this data review? Process standard Decubiti standard Outcome standard Structure standard
Outcome standard
Critical pathways assist nurse managers and nursing staff to increase their awareness in which aspect of client care? Deficiencies in care provided by other healthcare providers Privacy and confidentiality considerations in providing care Outcomes the client should achieve on a given day Potential complications that may be encountered when providing care
Outcomes the client should achieve on a given day
The emergency department nurse manager is sharing the most recent client satisfaction data and statistics with the evening shift staff. As a team, they are using the total quality management (TQM) approach. Which process organizes their efforts? PDSA DMADV DMAIC LEED
PDSA
Which assignment pattern is the ideal approach to delegation? Functional Partnering Pairing Unit-based
Partnering
The staff nurse is teaching the client about patient responsibilities. Which concepts are appropriate for the nurse to include in the teaching session? (Select all that apply.) Patient responsibilities include asking about the hospital's business relationships. Patient responsibilities emphasize the healthcare provider's leadership role. Patient responsibilities serve to protect the rights of everyone who is receiving care. Patient responsibilities emphasize the right of all clients to be safe. Patient responsibilities emphasize all clients' rights to be comfortable.
Patient responsibilities serve to protect the rights of everyone who is receiving care. Patient responsibilities emphasize the right of all clients to be safe. Patient responsibilities emphasize all clients' rights to be comfortable.
The nurse is conducting preoperative teaching for an adult female client who is scheduled to undergo a biopsy for a breast mass. During the session, the nurse notices the client is trembling. Which nursing response is best? Pausing the teaching session and asking the client how she is feeling Providing the client with a warm blanket and continuing the teaching session Canceling the teaching session and leaving the client alone so she can have privacy Asking the client if she understands the information that has been discussed
Pausing the teaching session and asking the client how she is feeling
Which nursing behavior can help reduce a client's risk of developing a healthcare-associated infection (HAI)? Perform thorough hand washing. Discuss drug interactions with food. Review common side effects of medications. Ensure walkways are clear.
Perform thorough hand washing.
The Quality Improvement Committee is looking at the pattern of medication errors committed by nurses from the medical-surgical hospital unit. What kind of activity is being conducted? Benchmarking Asset allocation Effectiveness evaluation Performance improvement
Performance improvement
A healthy, 34-year-old African American woman with a history of regular prenatal care during her pregnancy with twins is undergoing an induction of labor. She calls the nurse to her room and reports difficulty breathing and chest pain. The nurse suspects she may be experiencing which condition? Sickle cell crisis Asthma attack Peripartum cardiomyopathy Mitral valve prolapse
Peripartum cardiomyopathy
An emergency department nurse found the following waiting times for the last five clients admitted from the ED to the cardiology unit: 20 minutes at 2 p.m. 40 minutes at 3:30 p.m. 60 minutes at 4 p.m. 20 minutes at 7:30 p.m. 10 minutes at 9:15 p.m. What phase of the TQM process is the nurse engaged in? Do Plan Act Study
Plan
What are risk factors for adolescent pregnancy? Select all that apply. Poor self-esteem Excessive focus on sports Dysfunctional family relationships Previous pregnancy Poverty
Poor self-esteem Dysfunctional family relationships Previous pregnancy Poverty
The nurse is educating women about the physiological changes that occur during delivery. What role does the pelvic floor have in this process? Places pressure on the fetal head to stimulate newborn neurologic function Protects the maternal urethra Secretes hormones that soften connective tissue Positions the fetal head for descent into the pelvic outlet
Positions the fetal head for descent into the pelvic outlet
The nurse is teaching an older adult client how to use an incentive spirometer. The client has unsuccessfully attempted to use the device several times. Which is the best response by the nurse (Select all that apply.) Praising the client for his attempts to use the incentive spirometer and repeating the instructions for its use Encouraging the client to continue to practice using the spirometer Telling the client a return demonstration is necessary Concluding the teaching session Asking the charge nurse to assume the role of teacher
Praising the client for his attempts to use the incentive spirometer and repeating the instructions for its use Encouraging the client to continue to practice using the spirometer Telling the client a return demonstration is necessary
Mrs. Hernandez presents to the clinic stating that she believes she is pregnant. You note the following during assessment: client reports of nausea and vomiting, abdominal enlargement, and palpable fetal movement during the pelvic exam. Based on the indicators, which diagnosis do you anticipate for Mrs. Hernandez? Presumptively pregnant Not pregnant Probably pregnant Pregnant
Pregnant
Which goals are included in the National Patient Safety Goals (NPSGs) for an acute care facility? (Select all that apply.) Prevent surgical site errors. Document client care correctly. Use evidence-based guidelines. Identify clients correctly. Prevent medication errors.
Prevent surgical site errors. Document client care correctly. Identify clients correctly. Prevent medication errors.
A client reports a positive pregnancy test at home. This is considered which type of pregnancy indicator? Probable Positive Possible Presumptive
Probable
What does the legal term "discovery" mean? Process of filing of a civil lawsuit to recover punitive damages Process of finding out the individual to blame for the unfortunate event Process of obtaining information before a trial Process of putting a witness on the stand to testify
Process of obtaining information before a trial
The nurse educator is teaching about the forces that shape the nurse's identity as a moral agent. Which items should be included? (Select all that apply.) Professional roles Work settings Government values Organizational roles Public perceptions
Professional roles Work settings Government values Organizational roles
The Department of Health and Human Services developed a National Quality Strategy to prioritize quality improvement activities. Which activities are part of that effort? (Select all that apply.) Promoting best practices for healthy living Supporting new cancer clinical trials Developing new healthcare delivery models Engaging individuals as partners in their care Reducing harm
Promoting best practices for healthy living Developing new healthcare delivery models Engaging individuals as partners in their care Reducing harm
The nurse is reviewing the medications for a client who is 14 weeks pregnant with her first child. The client's medical history is positive for mitral valve prolapse. Which medication would the nurse expect to be ordered for this client? Propranolol hydrochloride Warfarin (Coumadin) Heparin Ardeparin (Normiflo)
Propranolol hydrochloride
As part of a class project, the nursing student is designing a research study. Which consideration best reflects adherence to the principle of justice? Protecting participants' anonymity Preventing exploitation of participants during or as a result of the study Requiring that the study be conducted for the benefit of others Ensuring that participation is not coerced
Protecting participants' anonymity
Ms. Radford tells you she is experiencing some gastrointestinal problems during her pregnancy. You anticipate she may report with which symptom? Urinary frequency Ptyalism Decreased salivation Diarrhea
Ptyalism
The nurse is reviewing the structures of the bony pelvis and recognizes which structures as making up the innominate bones? Select all that apply. Pubis Acetabulum Ischium Ilium Sacrum
Pubis Ischium Ilium
The dialysis nurse manager decides to evaluate the sterility processes the renal unit staff follows, compared to accepted standards of care. Which term best describes that effort? Performance improvement Quality management Quality improvement Process standards
Quality management
During a class about research methods, a nursing student asks the instructor, "What is the difference between qualitative and quantitative research?" Which response by the instructor is the most appropriate? Quantitative research explores individuals' subjective experiences. Qualitative research is used to test relationships between variables. Quantitative research uses precise measurement to collect data and analyze it statistically. Qualitative research does not use the scientific method.
Quantitative research uses precise measurement to collect data and analyze it statistically.
A community health nurse is designing a teaching plan for college students about smoking cessation. What information would be most appropriate for the nurse to include? Quizzes and verbal assessments Accurate educational content that is at least 10 years old General information that applies to learners of all ages and backgrounds Client goals, including that all smokers will stop smoking within one week of completing the class
Quizzes and verbal assessments
Amalia Moore is a 40-year-old gravida 6 para 2123 African American woman who presents to the high-risk unit of a large urban hospital at 32 weeks gestation for monitoring. Her first clinic visit was at 30 weeks. She was found to have a fundal height of 36 cm and had a brief clinic ultrasound that confirmed twins. Today she was contracting in the clinic, and she was sent to the hospital for evaluation.While this is her sixth pregnancy, she has had two term vaginal deliveries and one preterm birth via cesarean section for ruptured membranes and breech presentation at 34 weeks gestation. Mrs. Moore discovered she was pregnant when she was approximately 18 weeks gestation but was unable to secure health insurance until later in her pregnancy. She was not having regular menses, but attributed the irregularity to using a levonorgestrel intrauterine device (IUD). Which factors in her health history place Mrs. Moore at increased risk for having twins? Select all that apply. Age Previous history of cesarean section Race Parity Levonorgestrel intrauterine device (IUD)
Race Parity
The staff nurse is giving a presentation about factors that contribute to the development of ethical issues in nursing. Which items should be included? (Select all that apply.) Decreasing emphasis on containing healthcare costs Rapidly changing technology Increased staffing of nurses Conflicts between societal and cultural values Conflicting loyalties and obligations among nurses
Rapidly changing technology Conflicts between societal and cultural values Conflicting loyalties and obligations among nurses
Abby Porland is a nurse working in a local clinic. One of her clients, Norma Bruner, has severe persistent asthma and requires daily doses of oral steroids to help manage her asthma. Mrs. Bruner's physician would like for her to try a new, expensive asthma medication that just came on the market. Mrs. Bruner has health insurance through her employer. She tells Abby that her health insurance plan has informed her that the new asthma medication will not be covered. What is the best description of what has occurred with Mrs. Bruner's coverage? -Rationing -Separate billing -Vertically integrated health services -Diagnosis-related groups
Rationing
Which action will the nurse perform in the fourth step of the delegation process? Review the expected outcome and the timeline for completion Reach an agreement regarding the task that will be performed Identify routine, low priority tasks Match the task to an individual
Reach an agreement regarding the task that will be performed
The nurse case manager is providing care to a client with a complex history. Which action is important when collaborating on this client's care? Reassessing the client when the client's condition improves Diagnosing the client with a new medical problem when the client's condition worsens Prescribing a medication for treatment when the client's condition worsens Cancelling respiratory therapy when the client's breathing improves
Reassessing the client when the client's condition improves
In which circumstance is it the most appropriate for a 17-year-old client to provide informed consent for care? Receiving contraceptive services without a parent present Bringing a younger sibling to a health assessment visit Bringing a grandparent to an urgent care center for a flu shot Receiving antibiotics for strep throat with a parent present
Receiving contraceptive services without a parent present
A 21-year-old male pharmacy student is admitted to the ED for treatment of a sprained right ankle. Following treatment, the client is prescribed ibuprofen to reduce pain and swelling. As the nurse begins teaching about the maximum dose of ibuprofen, the client states, "I already know this stuff. Can you finish my discharge paperwork so I can get out of here?" Which nursing approaches reflect the application of cognitive theory? (Select all that apply.) Considering the client's teaching preferences from the standpoint of his psychologic state Recognizing the client's disinterest in teaching as being shaped by his history of unpleasant social interactions Recognizing the client's knowledge base and intelligence level as an important consideration in the nurse's choice of teaching content Realizing the effects of the client's spiritual beliefs on his learning Telling the client, "If you let me finish teaching you about ibuprofen, I'll quickly complete your discharge paperwork."
Recognizing the client's knowledge base and intelligence level as an important consideration in the nurse's choice of teaching content Considering the client's teaching preferences from the standpoint of his psychologic state
What steps are used to support communication between disciplines? Select all that apply. Recommendation Background Assessment Situation Efficiency
Recommendation Background Assessment Situation
The case manager is determining price control strategies to reduce the cost of care for several clients. Which actions should reduce the cost of these clients' health care? (Select all that apply.) Admitting the client to the hospital the evening before surgery the next day Recommending that a client be treated in the office setting to eliminate an admission to the hospital Discharging the client to home with out-patient physical therapy scheduled Discussing lower-cost medications that produce the same effects with the healthcare provider Scheduling a minor surgical procedure to be completed in the ambulatory care center
Recommending that a client be treated in the office setting to eliminate an admission to the hospital Discharging the client to home with out-patient physical therapy scheduled Discussing lower-cost medications that produce the same effects with the healthcare provider Scheduling a minor surgical procedure to be completed in the ambulatory care center
Sam Woods is a registered nurse working with city council members to create a program that supports community safety. What would be a goal of this program? Increase the number of after-school organized activities for community children. Reduce the number of high-calorie snacks in school vending machines. Reduce the number of bicycle and pedestrian injuries caused by motor vehicles. Advocate for the opening of a community sports facility for children.
Reduce the number of bicycle and pedestrian injuries caused by motor vehicles.
The nurse manager in the assisted living facility is finding that ethical issues arise frequently in this setting. The nurse manager empowers the entire clinical team to make suggestions for support activities. Which suggestions by the staff nurses are relevant to ethical issues? (Select all that apply.) Protocols for advanced directives for dying clients Regular team conferences on subjects selected by the team Use of primary nursing teams to facilitate care Availability of mentoring by experienced nurses Easy access to the use of counseling professionals
Regular team conferences on subjects selected by the team Availability of mentoring by experienced nurses
The infection control nurse is giving an in-service about issues that raise ethical concerns related to testing for HIV and AIDS. Which item should be included? Supporting clients who want to notify sexual partners that they are HIV positive Releasing results of HIV tests to insurance companies Testing healthcare providers for HIV on a voluntary basis Allowing clients who are HIV positive to tell caregivers about their HIV status
Releasing results of HIV tests to insurance companies
The oncology nurse is reviewing the Department of Health and Human Services (HHS) National Strategy for Quality Improvement in Health Care. In evaluating the nurse's cancer center facility, which descriptions of that healthcare system fit the HHS criteria? (Select all that apply.) Compliant Sensitive Reliable Accessible Safe
Reliable Accessible Safe
What can be done to prevent client falls during hospitalization? (Select all that apply.) Remove items from walking paths. Keep eyeglasses within easy reach. Assist with putting on non-skid footwear. Ensure floors are well lit during the night. Apply restraints as needed to restrict mobility.
Remove items from walking paths. Keep eyeglasses within easy reach. Assist with putting on non-skid footwear. Ensure floors are well lit during the night.
The nurse is developing a teaching plan for a client with asthma. To promote client learning, which strategy should the nurse implement? Repeat the key concepts and facts. Instruct the client to wait until the teaching session has ended before asking questions about the content. Organize the teaching content in a complex-to-simple fashion. Encourage the client to wait at least 24 hours before applying new knowledge and skills.
Repeat the key concepts and facts
The nurse is teaching a postoperative client about using incentive spirometry to prevent pulmonary atelectasis. Upon conclusion of the session, the client points to the incentive spirometer and asks, "What is that thing"? Which nursing response is the most appropriate? Conclude the session and schedule an additional teaching session for a later time. Ask another healthcare provider to assist with teaching the client. Repeat the needed content and ask the client to demonstrate use of the incentive spirometer. Provide the client with written instructions that describe using the incentive spirometer.
Repeat the needed content and ask the client to demonstrate use of the incentive spirometer.
The nurse administrator is explaining the concept of mandatory reporting to a group of staff nurses. Which information is most appropriate for the nurse administrator to include when defining mandatory reporting? (Select all that apply.) Reportable events are designated by local law. Mandatory reporting includes reporting certain events, acts, and situations. Reportable events are designated by healthcare institutions. Reportable events are designated by state law. Mandatory reporting is a legal requirement.
Reportable events are designated by local law. Mandatory reporting includes reporting certain events, acts, and situations. Reportable events are designated by state law. Mandatory reporting is a legal requirement.
The school nurse is preparing a program on child safety for community members. Which topics are the most appropriate for the nurse to include in this program? (Select all that apply.) Reporting burned out street lights to the municipal building Protective equipment to use when playing Importance of crossing the street at traffic signals How to avoid and report strangers in the community Reminding to pack fresh fruit and vegetables in school lunches
Reporting burned out street lights to the municipal building Protective equipment to use when playing Importance of crossing the street at traffic signals How to avoid and report strangers in the community
The nurse is teaching a preoperative client methods to avoid infection of his surgical incision during the postoperative period. The client is scheduled for surgery the following day. As the nurse is speaking, the client begins to fall asleep. Which nursing response is best? Awaken the client and politely ask him to pay attention. Gently awaken the client and continue teaching. Reschedule the teaching session for a time that is acceptable to the client. Allow the client to nap for five minutes, then awaken him and resume teaching.
Reschedule the teaching session for a time that is acceptable to the client.
The risk management coordinator is teaching a seminar about using the primary risk management model to manage ethical dilemmas in nursing. Which component includes developing coping skills prior to experiencing a stressor? Consultation Resource accumulation Education Peer support
Resource accumulation
The oncology nurse interviews all the mastectomy clients 2 weeks after they leave the hospital. Before discharge, clients gave their consent to be contacted. The interview consists of ten exploratory questions about factors in their satisfaction before and after surgery. What kind of assessment is going on? Benchmarking Concurrent audit Utilization review Retrospective audit
Retrospective audit
The urology nurse is reviewing medical records of the last five clients discharged after transurethral resection of the prostate (TURP). The nurse uses a checklist to look at the completeness of documentation of postsurgical pain relief. Which activity is the nurse participating in with this review process? Concurrent audit Root cause analysis Utilization review Retrospective audit
Retrospective audit
The care coordinator is planning actions to overcome a client's knowledge deficit related to the use of a sleep apnea machine at home. Which approach should the nurse use for this situation? -Review the steps in using the machine again -Schedule the machine to be delivered at another time of day -Discuss the client's non-adherence with the healthcare professional -Explain the consequences of not using the equipment correctly
Review the steps in using the machine again
Which strategy is useful to overcome barriers related to care coordination? -Organize a client's care needs for a 12 hour shift -Discuss a client care issue during a task force meeting -Review the steps in self-administration of insulin with the client before discharge -Change the client assignment so that licensed personnel will be utilized more effectively
Review the steps in self-administration of insulin with the client before discharge
A nurse at the rehabilitation unit for clients who are blind is meeting with the nurse's mentor. They are discussing best practices in acting as advocates for the autonomy of their clients. Which client rights are they supporting in their dialogue? Right to confidentiality Right to privacy Right to self-determination Right to express feelings
Right to self-determination
A client called Patient Relations after being discharged to report that a skin infection developed around the IV catheter insertion site on the client's right arm. Which process would likely prevent a similar recurrence in the future? Peer review Utilization review Risk management Root cause analysis
Risk management
Julia Jones-March, a 58-year-old female real estate agent, was admitted to the hospital 3 days ago for treatment of Chronic Obstructive Pulmonary Disease (COPD). She has had a hospital stay full of negative events. She fell in the shower on her first night. She had an allergic reaction to her hospital gown fabric by the second night. Now, as she is about to be discharged, she has spiked a high temperature. What type of assessment would most likely be used to collect data about the three complications Ms. Jones-March experienced during her visit? Root cause analysis Blame-free environment Utilization review Risk management
Risk management
A representative from NIOSH is scheduled to visit a healthcare organization. What should the staff expect to receive from the representative during the visit? (Select all that apply.) Safety information Recommendations for safety procedures Training videos Results of workplace safety hazard evaluations Report of the number of organizational injuries
Safety information Recommendations for safety procedures Training videos Results of workplace safety hazard evaluations
The nurse manager is planning to implement partnering in the medical-surgical care area. Which actions should the manager perform to support this approach to delegation? (Select all that apply.) Schedule nurses and assistants to work the same shifts Prepare a task list for each shift Assign a designated group of nurses and assistants to attend a training session together Direct nurses to ask for help when necessary Assign a nurse to an assistant for every shift
Schedule nurses and assistants to work the same shifts Assign a designated group of nurses and assistants to attend a training session together
The nurse is preparing to collaborate with other members of the healthcare team in order to provide the best care for Sylvie Soloren, who is admitted with terminal cancer. Which nursing actions are consistent with providing collaborative care? Giving the physician priority when delivering care Seeking expertise from an oncology-certified nurse when planning care Assessing the client's preferences regarding care Providing comfort interventions
Seeking expertise from an oncology-certified nurse when planning care
Which nursing actions indicate collaboration with the healthcare team? Select all that apply. Seeking expertise from the team Planning care with the client Exploring options with the client Sharing expertise with peers Setting independent goals with the client
Seeking expertise from the team Planning care with the client Exploring options with the client Sharing expertise with peers
A student nurse is reviewing the Nurse Practice Act and its influence on the standards of care for nurses. How does the Nurse Practice Act influence the practice of nursing? Regulates the accreditation standing of nursing programs Regulates institutional policies concerning nurse's job responsibilities Develops client care policies and procedures Sets the requirements for licensure, including educational requirements of nurses
Sets the requirements for licensure, including educational requirements of nurses
The nurse manager complimented the night staff on recent data about reducing noise. The day shift nurses asked each client about obstacles to sleep the previous night. They recorded the clients' responses as either achieving the goal of sleep or being disrupted by the defect of loud sounds or other obstacles. Which kind of quality improvement activity is taking place? Performance improvement Continuous quality improvement Six Sigma Benchmarking
Six Sigma
A postal worker seeks advice from a public health nurse after contact with a white powder leaking from an envelope. The public health nurse looks for signs of cutaneous anthrax. Which early symptom will the public health nurse assess for with this exposed client? Bloody diarrhea and high fever Sore throat, mild fever, and muscle aches Nausea and loss of appetite Small sores that become blisters
Small sores that become blisters
When planning client education activities, which factors would affect the nurse's choice of content and teaching method? (Select all that apply.) Socioeconomic background of the client Cultural background of the nurse Federal and state regulations Advances in health care and research Widespread availability of Internet resources
Socioeconomic background of the client Federal and state regulations Advances in health care and research Widespread availability of Internet resources
The nursing student is writing a paper about the relationship between safe client care and sources of ethical conflict in the healthcare setting. Which source of ethical conflict should the nursing student determine is the most significant to client safety? Specialists' services Resource allocation Staffing shortages Cost containment
Staffing shortages
All clients have the right to care by a competent and safe nurse. What ensures that a nurse is both competent and safe to practice? Licensing process Nurse Practice Act Code of ethics Standards of Practice
Standards of Practice
The nurse is educating a group of new nurses about placental development. What role does human placental lactogen (hPL) play in placental function? Preserves the corpus luteum, making the endometrium more hospitable to the pregnancy. Maintains the endometrium and reduces uterine muscle contractions to prevent spontaneous abortion. Enlarges the uterus, external genitalia, and the ductal system of the breasts. Stimulates maternal tissue insulin resistance during the second half of pregnancy.
Stimulates maternal tissue insulin resistance during the second half of pregnancy.
Which measure has the federal government taken to ensure availability of medical supplies in case of a disaster? Medical Supply Inventory Central Materials Storage Federal Disaster Relief Strategic National Stockpile
Strategic National Stockpile
The nurse is planning a seminar that emphasizes health promotion. Which topics are most appropriate for inclusion in the teaching? (Select all that apply.) Stress management Grief and loss Nutrition Fertility Growth and development
Stress management Nutrition Fertility Growth and development
The clinical nursing instructor is designing a presentation about evidence-based practice (EBP). Which example best illustrates evidence derived from research? In certain cultures, male clients accept massage treatment only from male therapists. A nurse reads studies about the effects of massage on back pain. The client may refuse to have back surgery. Studies suggest medical massage effectively reduces lower back pain.
Studies suggest medical massage effectively reduces lower back pain.
The home care nurse is visiting an older client with heart failure. Which interventions are appropriate for the nurse to implement in order to prevent medication errors at home? (Select all that apply.) Study the name and purpose of each prescribed medication. Review the client's list of prescribed medications. Review potential drug interactions with food. Explain when to skip medication doses. Teach how prescribed medications are to be taken.
Study the name and purpose of each prescribed medication. Review the client's list of prescribed medications. Review potential drug interactions with food. Teach how prescribed medications are to be taken.
The primary nurse is reviewing a list of tasks to delegate to a nursing assistant. Which tasks should the nurse avoid delegating to this level of personnel? (Select all that apply.) Suctioning a client recovering from radical neck surgery Assessing limb pulses on a client recovering from a cardiac catheterization Applying dry gauze dressings over a client's skin tears after morning care Removing limb restraints in order to ambulate a client with confusion Discussing a care error made by another nursing assistant
Suctioning a client recovering from radical neck surgery Assessing limb pulses on a client recovering from a cardiac catheterization Discussing a care error made by another nursing assistant
Erin Klarke is a staff nurse in a secured critical care unit. Her client, Stu Willitson, is a 58-year-old man who sustained multiple injuries during a motor vehicle accident. Mr. Willitson states, "I don't want my wife, kids, or any other family or friends in my room. I don't want them to see me like this." Mr. Willitson's wife has tearfully asked Erin to allow her and her children to see her husband, and her children are demanding to see their father. Mr. Willitson's healthcare provider told him he is being unreasonable and insists he see his family. According to the ANA Code of Ethics, which action by Erin is the most appropriate? Support the healthcare provider, and encourage the client to explore the reasons for his unreasonable behavior. Encourage the client to allow his wife and children to briefly visit with him to reassure them that he is okay. Encourage the client to allow his wife to see him first, and advise the wife to suggest visiting with the children. Support the client in his decision and encourage him to explore the reasons for his choice.
Support the client in his decision and encourage him to explore the reasons for his choice.
A nurse in a long-term care facility finds a client unresponsive in bed. The nurse notices a do not resuscitate (DNR) sign at the head of the bed. What is the nurse's priority action? Letting the supervisor know of the client's condition Letting the physician know of the client's condition Taking the vital signs of the client Making sure the client is not in pain
Taking the vital signs of the client
The new nurse case manager, Claire, has been asked to identify a critical pathway for the care of an older adult client, Mildred Daugherty. Mrs. Daugherty's osteoarthritis has caused severe limitations in mobility, leading to a fall injury. While performing a home assessment, Claire determines that Mrs. Daugherty lives at home with her son and has to walk up a flight of stairs to gain entry. The house is cluttered with small throw rugs, excess furniture, and stacks of old newspapers and magazines. What is Claire's priority when formulating a treatment plan for Mrs. Daugherty? Contacting the local authorities because of suspected elder abuse Teaching the client about activity restrictions and safety measures Setting a timeline for goal achievement Contacting the physician regarding the client's diagnosis
Teaching the client about activity restrictions and safety measures
Which QSEN competency is exemplified when nurses work with individuals from other departments and disciplines to address conflict situations? Safety Quality improvement Teamwork and collaboration Evidence-based practice
Teamwork and collaboration
In which phase of cellular division does the cell divide into two daughter cells, each containing its own nucleus with 46 chromosomes and the same genetic makeup as its parent? Telophase Interphase Anaphase Metaphase
Telophase
A client accuses a nurse of incompetency and files a lawsuit of malpractice. If the nurse is found incompetent, what document or act has been broken regarding nursing standards of care? Accreditation certification The American Nurses Association (ANA) Standards of Practice The Nurse Practice Act National counsel licensure
The American Nurses Association (ANA) Standards of Practice
A nurse educator is teaching a group of student nurses regarding standards of care. Which statements made by the nursing students are correct regarding standards of care in nursing? (Select all that apply.) The American Nurses Association (ANA) Standards of Practice is the prevailing national nursing standard. The Nurse Practice Act and administrative rules form the basis of the standard of care for nurses. The nurse's specific job description will aid in defining the standard of care. The Joint Commission is the primary agency responsible for establishing nursing standards of care. Employers can limit, but not expand, the nursing scope of practice.
The American Nurses Association (ANA) Standards of Practice is the prevailing national nursing standard. The Nurse Practice Act and administrative rules form the basis of the standard of care for nurses. The nurse's specific job description will aid in defining the standard of care. Employers can limit, but not expand, the nursing scope of practice.
The staff nurse is notified of an impending investigation related to charges that the staff nurse violated the state's Nurse Practice Act (NPA). To understand the board of nursing's (BON's) process of addressing allegations of nursing misconduct, which principles are most appropriate for the staff nurse to consider? (Select all that apply.) The BON is obligated to respect the staff nurse's right to due process. The staff nurse will be offered an opportunity to respond to the allegations. The staff nurse is automatically required to attend a formal administrative BON hearing. The BON will not disclose the specific allegations made against the staff nurse. The BON will consider the staff nurse guilty based solely on the allegations.
The BON is obligated to respect the staff nurse's right to due process. The staff nurse will be offered an opportunity to respond to the allegations.
Which factor is contributing to a healthcare crisis in the United States and developed countries? -The Internet -Physician training -Professional degrees -Rise of the middle class
The Internet
The nurse educator is presenting information to a group of students related to sources of payment for healthcare services. The educator wants to highlight differences between the values of the United States versus other countries. Which statement by the educator is appropriate to include in the presentation? -The United States has global budgets to pay for the health care of citizens. -The United States values universality in providing health care to citizens, which lowers costs. -The United States values individual accountability for retaining and paying for health care. -The United States rations care in order to control costs.
The United States values individual accountability for retaining and paying for health care.
Which statements are true regarding the nurse as a collaborator? Select all that apply. The ability to independently set goals and objectives for client care The ability to seek opportunities to work with and within professional organizations The ability to recognize the contributions of team members by virtue of experience The ability to share and receive clinical expertise with other nurses The ability to participate in policy formation to increase knowledge of a clinical problem
The ability to seek opportunities to work with and within professional organizations The ability to recognize the contributions of team members by virtue of experience The ability to share and receive clinical expertise with other nurses
A nurse manager is talking to the night shift staff about the ethical principles supporting education of their preoperative clients. The nurse manager uses the words "beneficence" and "nonmaleficence." Which statements define these two concepts? (Select all that apply.) The actions that nurses take should promote good. The actions that nurses take should be fair to all possible clients. The actions that nurses take should do no harm. The actions that nurses take should involve telling the truth. The actions that nurses take should safeguard clients.
The actions that nurses take should promote good. The actions that nurses take should do no harm. The actions that nurses take should safeguard clients.
The charge nurse observes a registered nurse delegate tasks to a nursing assistant. What did the charge nurse observe that indicates additional information about delegation is required? (Select all that apply.) The assistant was unable to recognize a change in a client's condition. The assistant asked another nurse to assist with the delegated task. The nurse provided direction and feedback on task progress and completion. The assistant and nurse discussed completion of delegated tasks. The nurse did not have complete information about the status of delegated tasks at the change-of-shift report.
The assistant was unable to recognize a change in a client's condition. The assistant asked another nurse to assist with the delegated task. The nurse did not have complete information about the status of delegated tasks at the change-of-shift report.
An older adult client is scheduled for a surgical procedure that is typically performed on individuals who are decades younger with less health problems. What should the nurse conclude from this observation? The health care provider withheld the client's health status from the payer. The surgery is needed to save the client's life. The client maybe opting to pay for the surgery (surgical procedure) out of pocket. The health insurance plan approved the surgery in error.
The client maybe opting to pay for the surgery (surgical procedure) out of pocket.
The nurse case manager is assigned a client who is frequently admitted to the hospital with the same diagnosis related to hypertension and diabetes. Which criteria indicate the need for case management? (Select all that apply.) The client receives care from a single provider. The client takes multiple prescription medications. The client arrived at the hospital via ambulance. The client has a history of falls. The client has been hospitalized several times in the past year.
The client takes multiple prescription medications. The client has a history of falls. The client has been hospitalized several times in the past year.
The collaborative care team for a 44-year-old client admitted two days ago following a diagnosis of diabetic ketoacidosis is reviewing the client's progress since admission. The nurse on the team requests a consultation with the dietician for the client. Which is an expected outcome of the consultation? The client will become an informed consumer. The client will have to eat foods she does not like. The client will have many questions about insulin. The client will be more likely to adhere to her treatment regimen.
The client will become an informed consumer.
The nurse practice act and administrative rules form the basis of the standard of care. Which phrase is an aspect of the nurse practice act? The identification of activities for all levels of hospital workers, including administrative personnel The definition of professional conduct for nurses The disclosure of NCLEX scores for all nursing personnel employed by the facility The scope of the healthcare provider's practice
The definition of professional conduct for nurses
A clinic nurse discovers that all the fire extinguishers on the top two floors of the clinic are way past their expiration date. The nurse writes a letter to the clinic's Risk Manager and to the Safety Officer. After waiting a month, and receiving no reply from either individual, the nurse wrote again. This time the nurse added a statement about making a report to a state agency. What additional event must happen to have the nurse qualify for protection under the Whistleblower Protection Act? The nurse must make appointments with the Risk Manager and the Safety Officer. The nurse must request an OSHA inspection of the clinic. The nurse must leave work, and resign the clinic position immediately. The employer must threaten or engage in retaliation against the nurse for complaining.
The employer must threaten or engage in retaliation against the nurse for complaining.
A nurse is filling out an incident report for the first time. The nurse wants to make sure that the report is complete. What elements must be included to give the best picture of the event? (Select all that apply.) The identification of equipment if involved in the event Names of all staff on duty at the time of the event The exact location in the facility of the event Witnesses to the event, except for other clients The name of the nurse completing the report
The identification of equipment if involved in the event The exact location in the facility of the event The name of the nurse completing the report
The nurse is participating in conducting a research study and needs to determine if an individual qualifies to be a participant. Which criteria must be met for inclusion in a research study? (Select all that apply.) The individual has given informed consent. The individual receives payment for participation. The individual meets all the inclusion criteria. The individual is informed of all aspects of the study. The individual must waive the right to anonymity.
The individual has given informed consent. The individual meets all the inclusion criteria. The individual is informed of all aspects of the study.
The family of a client in a skilled care facility is concerned that the client's condition is deteriorating because a mechanical lift is being used to transport the client to the bathroom. Which explanation by the nurse is most appropriate? The client is weaker and the lift helps improve circulation. The lift protects both the client and the staff during transfers. The client cannot walk as fast as necessary to make it to the bathroom without having an accident. The lift is used because there isn't enough staff to help move the client.
The lift protects both the client and the staff during transfers.
A nurse case manager must initiate a case management team for a client with multiple medical disorders. Which team members does the nurse plan to invite to the initial care planning meeting? (Select all that apply.) The hospital attorney The medical assistant The hospital administrator The client's physician The hospital pharmacist
The medical assistant The client's physician The hospital pharmacist
A hematology unit nurse is filling out an incident report about a medication error concerning Ernie Harris' drugs. Mr. Harris is a 30-year-old African-American admitted with sickle cell disease. The name of the wrong medication and the name of the correct medication are quite similar. What information should the nurse include in Mr. Harris' medical record? The fact that an incident report was completed The name and dosage of the medication administered The name of the nurse who discovered the error The fact that the medication names are quite similar
The name and dosage of the medication administered
A nurse educator is presenting information to a group of students regarding successful implementation of the nurse case management model. What teaching points will the educator include in the presentation? (Select all that apply.) The need for all team members to collaborate The requirement that the client must be disabled to qualify The importance of identifying expected outcomes with time frames The role of continuous quality improvement and variance analysis The need to adhere to the standards of professional practice
The need for all team members to collaborate The importance of identifying expected outcomes with time frames The role of continuous quality improvement and variance analysis The need to adhere to the standards of professional practice
A collaborative care team has been formed to assist with the care management of Ray Southard, who is 58 years old. Mr. Southard's recovery from cardiac bypass surgery has been complicated by postoperative gastric bleeding and bilateral pneumonia. The team consists of a physical therapist, respiratory therapist, dietitian, physician, and nurse case manager. Which topic is the priority for the nurse case manager to discuss while facilitating this meeting? The client's goals for physical therapy The client's respiratory interventions Prescriptions allowed by the client's health insurance company The need to update the diagnosis-related groups
The need to update the diagnosis-related groups
The hospital quality improvement committee, which had been using the Six Sigma approach to quality improvement, added a "lean" component. After the change, what new data would be most likely to be collected? The number of clients discharged on weekends The number of I and O records not completed correctly The number of admissions asking about the fifth vital sign The number of expired sterile instruments
The number of expired sterile instruments
A nurse is administering a medication to a pediatric client. The nurse verifies the client's armband and confirms the correct medication by checking the prescribed order and the medication vial. Which actions by the nurse correctly exemplify the "Six Rights" of medication administration? (Select all that apply.) The nurse checks for right time by checking the prescribed order and looking at the time. The nurse checks for right dose by checking the prescribed order, performing a dose calculation, and checking the medication. The nurse verifies the right medication by asking the client "is this what you normally take at home?" The nurse checks for right documentation by documenting administration of the prescribed order in the client record. The nurse checks for right frequency by looking at the client's chart.
The nurse checks for right time by checking the prescribed order and looking at the time. The nurse checks for right dose by checking the prescribed order, performing a dose calculation, and checking the medication. The nurse checks for right documentation by documenting administration of the prescribed order in the client record.
The nurse is caring for a client who experienced an anaphylactic reaction to a medication. The nurse did not ask the client about allergies prior to administering the medication. Which statement is true regarding this nurse's actions? The nurse committed malpractice, but not an act of negligence. The nurse committed negligence due to a failure to communicate. The nurse committed an act of negligence, but not malpractice. The nurse committed acts of negligence and malpractice.
The nurse committed acts of negligence and malpractice.
A nurse is accused of failing to assess and monitor. Which clinical scenario causes this type of malpractice? The nurse fails to notify the healthcare provider in a timely manner when conditions warrant it. The nurse fails to act on prescribed orders, and the client suffers an adverse event. The nurse fails to document a client's allergy, and the client subsequently has an allergic reaction to a medication administered. The nurse fails to treat the client complaining of a headache, and the client subsequently has a stroke.
The nurse fails to treat the client complaining of a headache, and the client subsequently has a stroke.
Which of the following statements best describes what happens if an official investigation does not support the healthcare provider's report of suspected child abuse? The nurse is subject to civil prosecution for making a false report. The nurse is protected by state laws related to good faith immunity. The nurse's employer is required to substantiate the charges of abuse. The nurse's employer is liable for the cost of the investigation.
The nurse is protected by state laws related to good faith immunity.
The nurse attended a workshop on collaboration provided by the unit manager. Which actions indicate the nurse understood the material? (Select all that apply.) The nurse joins a committee in a professional nursing organization. The nurse reports practicing autonomously within her scope of practice. The nurse reports experiencing less job satisfaction but enjoys working autonomously. The nurse assumes accountability and increased authority in her practice. The nurse conducts a length-of-stay study on the unit, revealing longer client stays.
The nurse joins a committee in a professional nursing organization. The nurse reports practicing autonomously within her scope of practice. The nurse assumes accountability and increased authority in her practice.
Which nursing implication is true regarding collaboration? The nurse maintains open communication with other team members. The nurse does not need to attend scheduled interdisciplinary team meetings. The nurse relies on the physician to question apparent duplications in the client's plan of care. The nurse recognizes that collaboration has little effect on job satisfaction in nursing.
The nurse maintains open communication with other team members.
The nurse manager for the acute care wing of an assisted living center has several meetings with different groups of people. Which group would be considered an interdisciplinary team? The respiratory, occupational, speech, and physical therapy managers The social worker and the nurse manager for the chronic care wing The nurse managers for the memory care wing and the chronic care wing. The facility physician and pharmacy manager
The nurse managers for the memory care wing and the chronic care wing.
The nurse preceptor is explaining the nurse's responsibility with regard to ethical dilemmas. Which statement should be included? The nurse should try to follow, when possible, an appropriate code of ethics for registered nurses. The nurse must tell the client and the healthcare team about ethical issues that may affect the client's care. Evaluating interventions taken to promote ethical practice is the nurse unit manager's responsibility. Avoiding actual or potential ethical dilemmas is a primary responsibility of the nurse.
The nurse must tell the client and the healthcare team about ethical issues that may affect the client's care.
Two dialysis clinic nurses are discussing the recent death of a client with end stage renal disease. One nurse believed that the client's decision to end treatment was OK. The other nurse thought that the client should have extended life long enough to talk to an estranged child. Which nurse is exhibiting client advocacy? The nurse who thought that the client should have had a chance to reconcile with a child Neither nurse is an advocate; the client had no real choice and would have died soon anyway The nurse who believed that the client's decision to end treatment is OK. Both nurses are advocates; they are proposing choices that the client could have made
The nurse who believed that the client's decision to end treatment is OK.
Social justice is an important value for the nursing profession. Which nurse is exhibiting this value? The nurse who treats the very dirty homeless person with respect The nurse who honors the decision of a client to reject blood transfusions The nurse who offers to work a religious holiday so that others can worship that day The nurse who treats the illegal immigrant in the same manner as a citizen
The nurse who treats the illegal immigrant in the same manner as a citizen
The unit nurse manager is preparing to give a performance review to a new nurse who has performed below expectations in multiple areas. Which factor does the nurse manager anticipate will impact the way that this employee receives the feedback? The nurse's lack of time management skills The nurse's religious beliefs The nurse's lack of experience The nurse's self-esteem
The nurse's self-esteem
Medication administration has been identified as a high-risk activity for error. What are the rights of medication administration that every nurse should follow? (Select all that apply.) The right drug The right time The right room The right dose The right client
The right drug The right time The right dose The right client
The nurse is preparing to meet with the healthcare team to discuss the client's progress. Which situation would adversely affect the collaborative process among the team members? The nurse reports a decrease in client's pain over the last two days. The physician shares details of the family's wishes for the client to receive aggressive care. The physical therapist reports that the client has failed to make progress with therapy. The social worker told the nurse that the client had attempted suicide, but it was not noted in the chart.
The social worker told the nurse that the client had attempted suicide, but it was not noted in the chart.
The nurse has received antenatal testing results on her client's fetus; they show a chromosomal nondisjunction. How can the nurse explain this phenomenon to the client? There was a problem with the meiotic division of the ovum and an extra chromosome was added. The blastocyst was damaged during implantation. A broken chromosomal segment became attached to another chromosome. A section of the chromosome is broken.
There was a problem with the meiotic division of the ovum and an extra chromosome was added.
The client care coordinator is designing a brochure that describes the purpose of patient responsibilities. Which item regarding patient responsibilities should be included? They help the healthcare provider to more actively participate in the patient's care. They reaffirm the patient's right to refuse treatment without consequences. They emphasize the healthcare provider's leadership role. They protect the rights of all patients who are receiving care.
They protect the rights of all patients who are receiving care.
The nurse is reviewing fetal development with a woman who is 24 weeks pregnant. Which milestone should the nurse expect at this stage of the pregnancy? Fetal heart tones are audible. Threshold of fetal viability. Lungs are producing surfactant. Vernix caseosa is disappearing.
Threshold of fetal viability.
Why does a mass casualty response team implement reverse triage? To best utilize emergency department personnel To prevent complications of toxic infected wounds To allow greatest number of victims to get treated To make the assessment process efficiently move faster
To allow greatest number of victims to get treated
The nurse understands that collaborative practice models attempt to achieve which objective? To limit client interaction with members of the healthcare team to decrease costs To provide physician-directed and client-centered care using a multidisciplinary framework To deliver high-quality, cost-effective care using experimental techniques To enhance continuity of care across the continuum of health
To enhance continuity of care across the continuum of health
Melinda is the nurse who is coordinating care for a client scheduled for knee replacement surgery. Which action demonstrates vertical integration of care for this client? -Transfer to long-term care facility for rehabilitation -Review of the importance of low dose heparin injections to reduce complications -Demonstration of knee wound dressing changes -Use of passive range of motion device to maximize knee mobility
Transfer to long-term care facility for rehabilitation
You evaluate the external fetal monitors and note her contractions are now every three minutes, lasting approximately one minute each. Oh, wow, Mrs. Moore says. My babies are so active.You note that Twin As heart rate is 150/s with average long-term variability and occasional variable decelerations down to 100 bpm. Twin Bs heart rate is 130/s with minimal variability.The twins heart rates suggest which finding? Twin As heart rate indicates cord compression. Twin Bs heart rate indicates twin-to-twin transfusion. Twin As heart rate indicates utero-placental insufficiency. Twin Bs heart rate indicates a sinusoidal pattern.
Twin As heart rate indicates cord compression.
The health care provider notes the presence of the IUD behind the placenta and observes both babies arebreech, as you suspected. She continues to evaluate the twins and notes that Twin B is missing one kidney and the other kidney is extremely underdeveloped. What is the relationship between the twins sharing a chorion and amnion and Twin B lacking adequate kidney function? Select all that apply. The twins must be delivered immediately. This is a fatal situation for Twin B. Twin A will also lack a kidney. Twin As kidneys will benefit Twin B. Twin A has produced more of the amniotic fluid in the sac than Twin B has.
Twin As kidneys will benefit Twin B. Twin A has produced more of the amniotic fluid in the sac than Twin B has.
The nurse is developing client learning outcomes for an adult client who experiences recurrent respiratory infections. The client has smoked 1 pack of cigarettes each day for 20 years. Which learning outcome is most appropriate for inclusion in the teaching plan? Upon conclusion of the teaching session, the client will correctly state two types of nicotine replacement products. During the teaching session, the client will be taught how cigarette smoke damages the pulmonary structures. Within two weeks, the client will not feel like smoking. The client will stop smoking today.
Upon conclusion of the teaching session, the client will correctly state two types of nicotine replacement products.
A novice nurse wants to use the nursing process while caring for clients. How can the nurse prevent medicine errors during the implementation phase of the nursing process? Hold the medication if the client is in the bathroom Urge the client to question the nurse if a pill being administered looks different from what is normally taken Instruct the client to tell the nurse the reason why the client is taking the medication being administered Leave the client's oral medication at the bedside only if the client is oriented and able to swallow
Urge the client to question the nurse if a pill being administered looks different from what is normally taken
The nurse is aware that additional laboratory screening is needed for clients with sickle cell disease. In addition to routine tests, which screening test would be appropriate? Amylase Urine culture Direct bilirubin Liver function tests
Urine culture
The hospital administrator is evaluating the impact of vertical integration on the organization on client care. Which outcomes indicate that the integration has been successful? (Select all that apply.) Use of stock supplies for the care areas decreased by 32%. 85% of clients rated care provided as outstanding on the last month's discharge surveys. 20% of used equipment was repurposed for home care needs. 15% of staff resigned during the last quarter. A 20% reduction in the number of medication errors occurred over the last month.
Use of stock supplies for the care areas decreased by 32%. 85% of clients rated care provided as outstanding on the last month's discharge surveys. 20% of used equipment was repurposed for home care needs. A 20% reduction in the number of medication errors occurred over the last month.
Which nursing action reflects correct understanding of the principles related to implementing a teaching plan? Using teaching methods that engage more than one of the client's senses Scheduling teaching sessions at times that are most convenient for the nurse Avoiding summarizing content that has already been discussed Using professional healthcare terminology with all clients
Using teaching methods that engage more than one of the client's senses
The nurse is completing an assessment on a woman who is at 10 weeks gestation. The nurse is aware that which anatomic and physiologic changes occur in pregnancy? Select all that apply. Vaginal tissue firms with a decrease in vascularity. Uterine enlargement occurs with an increase in uterine muscle fibers. Superficial veins on the breasts become more prominent. Corpus luteum secretes progesterone that supports the pregnancy. Progesterone triggers the cervix to produce thick mucus.
Uterine enlargement occurs with an increase in uterine muscle fibers. Superficial veins on the breasts become more prominent. Corpus luteum secretes progesterone that supports the pregnancy.
Which action is characteristic of the "planning care" phase of the care coordination process? -Determine the need for consultation with other healthcare providers -Utilize standard protocols or critical pathways and evidence-based guidelines -Identify potential challenges -Adjust the plan in response to changes in the client's condition
Utilize standard protocols or critical pathways and evidence-based guidelines
As a treatment nurse in the oncology outpatient clinic, you are doing the admission paperwork with 28-year-old client Dorothy D'Angelo. Dorothy has a rare form of pancreatic cancer. She qualifies to become part of a clinical trial with a brand new investigational drug that your clinic hasn't used yet. As you give Dorothy complete risk information before she signs up to become a research participant, which principle of ethical decision making are you honoring? Beneficence Veracity Justice Autonomy
Veracity
The nurse is teaching a 48-year-old client about insulin administration. Which nursing intervention best reflects correct understanding of how to create an atmosphere that is conducive to the teaching-learning process? Using standardized teaching plans that are designed for all clients with diabetes Verbally assessing the client's comprehension of the material Minimizing the client's boredom by avoiding repetition of information Respecting the client's time by completing the teaching as quickly as possible
Verbally assessing the client's comprehension of the material
The nurse educator is preparing a seminar for employees on strategies to address the healthcare crisis. What should the educator include in this presentation? (Select all that apply.) Viewing healthcare as a universal expectation for all individuals Explaining how higher health care costs widen the gap between the rich and poor in society Considering the government as a partner in health care Identifying approaches to improve equity in healthcare services Using the Internet to learn more about care options
Viewing healthcare as a universal expectation for all individuals Considering the government as a partner in health care Identifying approaches to improve equity in healthcare services
The nurse is caring for a client recently admitted with a stomach virus. Which actions should the nurse take to limit the spread of this infection to other clients and nursing staff? (Select all that apply.) Wash hands before and after providing care to the client Double bag reusable client care equipment before sending out for sterilizing Cover the client's bedpan with a sterile towel and place in the bathroom Cleanse bedside tables and counter tops with rubbing alcohol Remove unneeded care items from the client's room to decrease clutter
Wash hands before and after providing care to the client Double bag reusable client care equipment before sending out for sterilizing
The nurse is caring for a client with the flu. What can the nurse do to prevent the spread of this infection to others? Avoid sneezing in the client's room Wash hands frequently when caring for this client Cover the mouth when coughing Change clothing at the end of the scheduled shift
Wash hands frequently when caring for this client
A pregnant client wants to know what substances cross the placenta. Which substances does the nurse explain are transported across the placenta by simple diffusion? Select all that apply. Water Illicit drugs Glucose Oxygen Sodium
Water Illicit drugs Oxygen Sodium
The nurse is educating a pregnant client who is of normal pre-pregnancy weight about weight gain during pregnancy. What information should the nurse include when educating this client? Weight gain needs to be up to 45 pounds. Weight gain is the same for all women who are pregnant. Weight gain should be between 25 and 35 pounds. Weight gain is the same for a normal-weight woman as for an overweight woman.
Weight gain should be between 25 and 35 pounds.
The critical care nurse is developing a clinical question that explores the etiology of adult respiratory distress syndrome (ARDS). Which clinical question is the most appropriate? Which medications lead to best outcomes for clients with ARDS? What are some potential complications of ARDS? How does ARDS affect arterial blood gas values? What are the causes of ARDS?
What are the causes of ARDS?
The nurse is designing a quantitative research study about the relationship between yoga and wellness. Which research question is the most appropriate for this study? How do health beliefs about hypertension influence an individual's choice to practice yoga? What is the relationship between engaging in yoga and the incidence of hypertension? What is the nature of the relationship between engaging in yoga and experiencing wellness? How do individuals who engage in yoga perceive the link between exercise and hypertension?
What is the relationship between engaging in yoga and the incidence of hypertension?
The forensic nurse is preparing a webinar about mandatory reporting requirements related to known or suspected abuse of vulnerable individuals. Which guideline is most appropriate for the forensic nurse to include in the webinar? To protect the client's privacy, the nurse should not document the reported information in the client's chart. When forming a good faith suspicion of abuse, the nurse may or may not include client reports. Prior to reporting suspected abuse, the nurse must conduct a preliminary investigation to confirm the suspected abuse. As a general rule, the nurse should immediately contact local law enforcement when possible abuse is suspected.
When forming a good faith suspicion of abuse, the nurse may or may not include client reports.
A healthcare organization implemented the STOP STICKS program on all client care areas. Which observations by the nurse manager indicate the need for additional education about the program? (Select all that apply.) Changing sharps containers when 3/4 full Witnessing a nurse recapping used needles Finding sharps containers at the head of every client's bed space Supplying nursing staff with blunt edged scissors Finding used syringes and needles on top of medication carts
Witnessing a nurse recapping used needles Finding used syringes and needles on top of medication carts
The nurse manager is establishing a team of nurses to explore ways to reduce sharps exposure among staff on the unit. Which is an example of using collaboration when coaching staff members on the unit? Following a stringent chain of command Designating a single team leader Working toward a common goal Delegating tasks to specific individuals
Working toward a common goal
The nurse is discussing care with an adult client. Which action by the nurse is the most appropriate for providing collaborative care? Working with the client to determine care objectives Sharing the physician's treatment goals with the client Asking the client's husband to wait outside Encouraging the client to request more aggressive treatment
Working with the client to determine care objectives
The staff nurse and the client are discussing patient rights as outlined by The Joint Commission. Which statements are appropriate for the nurses to include in the discussion? You have the right to know the names of the caregivers who treat you. You have the right to receive medication for pain management. You have the right to use an advocate who is employed by the hospital. You have the right to refuse care that you do not want. You have the right to receive information in your preferred language.
You have the right to know the names of the caregivers who treat you. You have the right to refuse care that you do not want. You have the right to receive information in your preferred language.
The client asks the nurse to describe the benefits and limitations of the U.S. Advisory Commission on Consumer Protection and Quality in the Health Care Industry's Bill of Rights. Which statement is most appropriate for the nurse to include in the description? You do not have the right to copy the information contained in your medical records. You have the right to read everything in your medical records. You do not have the right to receive treatment for severe pain without prior authorization. You have the right to change any item in your medical record.
You have the right to read everything in your medical records.
The nurse teaches principles of diet and nutrition at a community health center. When evaluating one client's comprehension of the content during the third teaching session, the client states, "My friend says I don't know anything about what foods are good for me. I feel like I've learned a lot about nutrition, though. I've started eating healthier, and I already lost two pounds." Which nursing response best reflects application of humanist learning theory? Perhaps we should explore how knowledge of diet and nutrition applies to you. Because of individual differences, your perception of the teaching material will be different from your friend's perception of the content. Perhaps we should try a different way of teaching this material to you to help you better understand. Your opinion of how much you've learned is more important than is your friend's opinion.
Your opinion of how much you've learned is more important than is your friend's opinion.
Sushila Patel is a 25-year-old woman who is at her first prenatal visit with her husband, Rajesh. She tells the nurse that anemia runs in her family and her uncle gets really sick and has to have blood transfusions. What is the nurse's best response to explain how this will affect the management of her pregnancy? "At this visit, we will do labs that will tell us if your blood is abnormal. We can have you see a genetic counselor and test your husband too. The genetic counselor can determine whether your baby is at risk." "There is no way for us to tell if your baby is at risk for that." "If your blood count is normal, the baby should be fine." "This will only affect your baby if it is a boy. We can talk about it again after your anatomy ultrasound."
"At this visit, we will do labs that will tell us if your blood is abnormal. We can have you see a genetic counselor and test your husband too. The genetic counselor can determine whether your baby is at risk."
During a medical-surgical clinical rotation, the nurse educator is teaching students how to develop client learning outcomes. Which statements should the educator include in the teaching? (Select all that apply.) "Be sure that each desired client action and response is measurable." "To motivate the client, learning outcomes should include goals that reflect the highest level of accomplishment." "Avoid using words such as 'believes,' 'knows,' 'appreciates,' and 'understands' in the client learning outcomes." "Client-specific characteristics, such as age, gender, and cultural background, should be incorporated in the client learning outcomes." "The nursing interventions, including the planned topics of teaching, should be clearly stated in the client learning outcomes."
"Be sure that each desired client action and response is measurable." "Avoid using words such as 'believes,' 'knows,' 'appreciates,' and 'understands' in the client learning outcomes." "Client-specific characteristics, such as age, gender, and cultural background, should be incorporated in the client learning outcomes."
The nursing student asks the nurse educator which elements are included in evaluation of a teaching plan's effectiveness. How should the educator respond? "Feedback questionnaires from the client are not useful in the evaluation process." "Teaching strategies are not evaluated." "Choice of content is included in the evaluation." "The degree to which the plan facilitated the nurse's achievement of the learning outcomes is part of the evaluation."
"Choice of content is included in the evaluation."
The nurse is preparing an in-service on conflict for newly hired nurses. Which responses by the newly hired nurses indicate understanding of the concepts of conflict management? (Select all that apply.) "Conflict weakens team relationships." "Conflict in the workplace is a negative occurrence." "Conflict in the workplace can be a positive event." "Conflict can foster improved communication." "Conflict can bring about healthy change."
"Conflict in the workplace can be a positive event." "Conflict can foster improved communication." "Conflict can bring about healthy change."
A client at 24 weeks gestation is in the clinic for a regular prenatal visit, along with her mother. The grandmother-to-be states that she is quite uncertain about how she can be a good grandmother to this baby, because she works full time. She states that her own grandmother was always available, and that this helped form a strong bond between them. What response by the nurse best addresses the grandmother's concern? "Grandmothers take on many roles. Have you thought about taking grandparent classes?" "As long as there is another grandmother available, you don't have to worry." "Don't worry. You'll be a wonderful grandmother. It will all work out fine." "Grandmothers are supposed to be available. You should retire from your job."
"Grandmothers take on many roles. Have you thought about taking grandparent classes?"
An elementary school nurse is participating in a quarterly fire drill for the school district. The nurse is aware of the responsibility of nurses during an emergency. What slogan captures this responsibility? "Scope of practice changes with circumstances" "Fastest triage for physical injuries" "Greatest good for the greatest number" "Most intense help for most severe injuries"
"Greatest good for the greatest number"
A client who is 8 weeks pregnant tells the nurse that she does not know what to expect regarding the father's ongoing feelings and reactions concerning the pregnancy. Which would be the nurse's most appropriate response? "He may need to know what his role will be once the baby is born." "He may view himself as being pregnant." "He will want to attend childbirth classes with you." "He may have a hard time understanding what you are going through."
"He may have a hard time understanding what you are going through."
A nurse is returning to work as an intensive care staff nurse after an absence of several years and is taking a continuing education course on just culture. What statement by the nurse shows the need for further education on this topic? "An atmosphere of punishment can impede error prevention activities." "Just culture employees consider themselves stakeholders." "Healthcare errors are the likely result of natural individual mistakes." "A just culture environment will not tolerate employee gross misconduct."
"Healthcare errors are the likely result of natural individual mistakes."
Natasha Martin is a 19-year-old young woman at her intake visit for prenatal care, having found out 2 weeks before that she is pregnant with her first child. She tells the nurse, "I'm scared to have a baby. I think I might want to have a C-section. If a baby weighs 8 pounds, doesn't it really damage the vaginal area?" What is the nurse's best response? "I know it seems scary, but your body is designed to give birth without damage." "Don't worry. Your health care provider knows how to fix that." "I will schedule your next visit with your health care provider, who can plan the surgery for you." "It is so early in your pregnancy. You have plenty of time to get used to the idea of having a baby."
"I know it seems scary, but your body is designed to give birth without damage."
The nurse is developing a teaching plan for clients with hypertension. Which statement by the nurse indicates correct understanding of the principles of effective teaching? "I should choose one method of teaching and use that throughout this class." "To help keep the clients from feeling intimidated, I should avoid setting goals for them." "I need to find out the ages of the clients who will be attending this class." "To avoid distractions, I should ask the clients to hold their questions until I'm finished teaching, then have a question-and-answer session."
"I need to find out the ages of the clients who will be attending this class."
The nurse manager is providing training on collaboration to a group of nurses. Which comment by a group member indicates that teaching was effective? "The physician keeps ordering physical therapy for my client, who ambulates in the hall every day." "I've done my job the same way for 20 years, and it works well for me." "The charge nurse asked me to be on the infection control committee, but I don't have time." "I need to teach my client how important it is to adhere to her treatment regimen."
"I need to teach my client how important it is to adhere to her treatment regimen."
As the newly hired nurse in the fertility clinic, you feel your own success with in vitro fertilization (IVF) makes you a unique resource for clients. This morning, Helena and Chad Smythe, both 39-year-old accountants, have a scheduled appointment. They have been to the fertility clinic for several years. Each time Helena and her husband find out that the IVF was not successful, her mood spirals downward. Helena and Chad tell you that they have decided to adopt a child, rather than have Helena continue to suffer from increasing depression. "My wife's mental health is so important to me," Chad relates. Helena nods in agreement. Which response would show that you understand the ethical value of advocacy? "I would suggest that you try IVF one more time before you give up." "I understand why you don't want to continue with IVF and support you in that choice." "I would like to tell you about my experience with IVF." "I kept trying and waited for new developments in IVF."
"I understand why you don't want to continue with IVF and support you in that choice."
The nurse is caring for an adolescent client who is seen in the clinic for a pelvic examination. Which client statement indicates to the nurse that there is a risk for pregnancy? "I will be tired after my volleyball game today." "I joined the Students Against Drunk Driving club today." "I want to run away from home sometimes." "I get my birth control pills from the free teen clinic."
"I want to run away from home sometimes."
Grace, a staff nurse, is developing a research study to explore the emotional experiences of individuals whose children are diagnosed with autism spectrum disorder (ASD). When describing her research plan to her mentor, which statement reflects Grace's intent to protect the participants' dignity? "The primary purpose of this study is to provide the greatest possible benefit to clients." "I'll take steps to ensure that participants are in no way coerced into taking part in this study." "Participants will not be exploited in any way during the course of this study nor at any point afterward." "Protection of the participants' anonymity will be guaranteed."
"I'll take steps to ensure that participants are in no way coerced into taking part in this study."
The nurse at a college health center is discharging a 19-year-old female client following her annual sports physical and gynecological exam. As the nurse is completing the client's discharge teaching, the client states, "I read online that you can't get pregnant while you're on your period." Which information should the nurse include in her response? (Select all that apply.) "Don't believe what you read on the Internet. Almost all online information is incorrect." "I'm glad you brought this up. A lot of people believe that you can't get pregnant while you're on your period, but you can." "That's foolishness. Of course you can get pregnant while you're on your period." "Most of what you'll find on the Internet is accurate, but that is not. Where did you read that you couldn't get pregnant while you were on your period?" "Tell me more about your understanding of the times when a woman is most likely to get pregnant."
"I'm glad you brought this up. A lot of people believe that you can't get pregnant while you're on your period, but you can." "Tell me more about your understanding of the times when a woman is most likely to get pregnant."
A novice nurse is introduced to the features of an Incident Command System (ICS) during a full-day training session. After the completion of the session, what statement by the nurse would show the need for further education? "ICS relies on a standardized organizational structure." "ICS has teams dedicated to major functional areas." "ICS is an all-hazards incident management approach." "ICS is used by the public sector, rather than the private sector."
"ICS is used by the public sector, rather than the private sector."
A novice nurse is questioning the clinical nurse specialist (CNS) about the rationale for reverse triage in a disaster. Which statement by the novice nurse shows an understanding of the CNS's explanation? "Triage and reverse triage are interchangeable concepts." "Reverse triage gives priority to the very young and very old." "In reverse triage, the most severely injured clients are treated last." "Emergency personnel use reverse triage on a daily basis."
"In reverse triage, the most severely injured clients are treated last."
A client with type 2 diabetes mellitus requiring insulin has just learned she's pregnant. The nurse is teaching her about insulin requirements during pregnancy. Which guidelines should the nurse provide? Select all that apply. "Insulin requirements usually decrease during the first trimester." "Insulin requirements increase greatly during labor." "Insulin requirements usually increase greatly during the first trimester." "Insulin requirements usually increase during the last two trimesters." "Insulin requirements don't change during pregnancy. Continue your current regimen."
"Insulin requirements usually decrease during the first trimester." "Insulin requirements usually increase during the last two trimesters."
When discussing the process of developing a client teaching plan, the nursing student asks, "What's the purpose of the client learning outcomes?" How should the nurse educator respond? "Learning outcomes help the nurse to evaluate the client's developmental level and select appropriate teaching strategies." "Learning outcomes guide the teaching plan and help the nurse evaluate the effectiveness of the plan." "Learning outcomes help the client set goals and help to evaluate the client's degree of satisfaction with the teaching plan." "Learning outcomes identify the nursing interventions and help the client evaluate the effectiveness of the plan."
"Learning outcomes guide the teaching plan and help the nurse evaluate the effectiveness of the plan."
The nursing student asks the nurse preceptor to describe the nurse's role when caring for clients who request genetic testing. Which statement should the nurse preceptor include in the description? "Nurses who serve clients who may undergo testing for inherited illnesses should examine the clients' personal beliefs about genetic testing." "Parental consent is needed before a minor can choose to undergo genetic testing or to obtain related counseling services." "Limited media coverage about genetics has minimized client awareness with regard to the potential for inheriting medical conditions." "The nursing Code of Ethics does not address clients' rights to receive information about making genetic testing decisions."
"Nurses who serve clients who may undergo testing for inherited illnesses should examine the clients' personal beliefs about genetic testing."
The nurse is explaining fetal circulation to a pregnant client. Which statement by the nurse correctly describes fetal gas exchange? "Oxygen is exchanged through the placenta, whereas other gases go to the lungs." "Oxygen is vital to the fetus and is exchanged through amniotic fluid." "Oxygen and carbon dioxide gas exchange occurs through the placenta." "Gas exchange occurs through the lungs in the fetus."
"Oxygen and carbon dioxide gas exchange occurs through the placenta."
Ashlee Demaris, a certified nurse midwife, is reviewing the AHA's patient responsibilities with Lara Kingston, a 19-year-old client who is 34 weeks gestation. As Ashlee is speaking, Ms. Kingston interrupts and says, "I get it. You're in charge, and I have to do what you tell me." Which response by the nurse midwife is the most appropriate? "Patient responsibilities are intended to help keep you and members of your healthcare team safe and comfortable." "Patient responsibilities are meant to help you understand that you are entitled to respectful, courteous care." "Patient responsibilities are established to make sure you know you can refuse care without suffering any consequences." "Patient responsibilities are designed to help you and your care providers work together as a team."
"Patient responsibilities are designed to help you and your care providers work together as a team."
The nurse researcher is presenting a webinar about the application of the primary risk model for managing ethical dilemmas in nursing. When describing peer support, which statement is most accurate? "Peer support should be combined with didactic training for maximum effect." "Peer support involves developing secondary risk management skills." "Peer support involves acquiring the necessary coping skills prior to experiencing the stressor." "Peer support should be combined with consultation to prevent ethical challenges from arising."
"Peer support should be combined with consultation to prevent ethical challenges from arising."
The clinical nurse educator is teaching nursing students about methods of evaluating the client's degree of learning. Which statement should the educator include in the teaching? "Self-reports are acceptable forms of client evaluation. " "Direct observation of behavior is the only acceptable form of client evaluation." "Oral questioning is not an objective means of evaluation." "Written tests are acceptable, but online tests should be avoided."
"Self-reports are acceptable forms of client evaluation. "
Matthias McPherson is a nursing student at a local university. During a seminar about ethics and nursing, the nurse educator asks Matthias to describe an issue that may lead to ethical conflict in the workplace. Which response indicates an issue that may lead to an ethical conflict? "Because of more stringent cost containment methods, allocating resources is becoming a less urgent ethical issue." "Focusing on palliative treatment and emphasizing the nurse's role leads to ethical conflicts in nursing." "Staffing shortages are a critical ethical concern because research shows a link between staffing and safe client care." "Personnel issues are not a valid source of ethical conflict because they are usually rooted in personality clashes."
"Staffing shortages are a critical ethical concern because research shows a link between staffing and safe client care."
The nurse educator is teaching a group of students about learning environments. Which statement should the educator include? "Teaching may take place in any setting that offers an opportunity for effective communication between the teacher and the learner." "Private residences do not qualify as teaching environments because the client is away from the clinical setting." "Managed care facilities do not recognize the nurse's role as teacher; therefore, client education is not required in these facilities." "Community health organizations are not legally considered to be teaching environments."
"Teaching may take place in any setting that offers an opportunity for effective communication between the teacher and the learner."
During a seminar, the nurse educator is asked how the Internet affects the selection of content and teaching methods used in client education. Which is the best response? "Because the Internet is infrequently used to access health-related information, it does not have much effect on selecting content and teaching methods." "The Internet offers content that is both accurate and inaccurate. When choosing client education materials, we take this into consideration." "Almost all of the information presented on the Internet is inaccurate, but it still affects the selection of content used in client education." "Health-related information on the Internet is accurate, and it does not affect the selection of content and teaching methods."
"The Internet offers content that is both accurate and inaccurate. When choosing client education materials, we take this into consideration."
A nurse is teaching a prenatal group about amniotic fluid. Which statement by a participant indicates an understanding of factors associated with amniotic fluid? "The fluid helps to prevent movement of the fetus, decreasing the chance of injury." "There will be about 30 mL of amniotic fluid present when the baby is born." "The amniotic fluid acts as a cushion to protect the fetus from trauma." "Oligohydramnios means there is too much amniotic fluid for the baby."
"The amniotic fluid acts as a cushion to protect the fetus from trauma."
Urgent care center staff nurse Olivia DeSantos is caring for 39-year-old David Keebler, a Native American male client who has just been diagnosed with tuberculosis. David is allergic to penicillin and has a history of diabetes. For the past 2 years, David has been homeless, although he sometimes sleeps at a local shelter. He is uninsured and rarely seeks medical care. When notifying the county health department about David's tuberculosis, which statement is most appropriate to include in the report? "The client has a history of diabetes." "The client has no medical insurance." "The client is allergic to penicillin." "The client is of Native American descent."
"The client is of Native American descent."
A team comprised of nurses and healthcare providers is collaborating to create a policy related to organ transplantation. Which team member's statement best represents an ethical concern? "Clients who undergo organ transplantation must give informed consent." "The client's ability to pay for treatment should influence the plan of care." "Client teaching for potential organ transplantation candidates should include the client's family members." "Potential candidates for organ transplantation should undergo blood tests."
"The client's ability to pay for treatment should influence the plan of care."
A pregnant client asks when her baby will have a heartbeat. Which response by the nurse is correct? "The heartbeat of the embryo is present by week 4 of pregnancy." "The heart forms when you are almost 16 weeks pregnant." "The baby's heart will begin to form when you are about 12 weeks pregnant." "The heartbeat usually occurs around week 8 of pregnancy."
"The heartbeat of the embryo is present by week 4 of pregnancy."
Which statements best reflect the nurse's correct understanding of principles related to evidence-based practice (EBP)? (Select all that apply.) "Evidence-based practice requires application of all research evidence about a given topic." "The nurse's level of expertise influences evidence-based practice." "Evidence-based practice promotes individualization of client care." "Client choices do not affect evidence-based practice." "Client-centered care is an outcome of evidence-based practice."
"The nurse's level of expertise influences evidence-based practice." "Evidence-based practice promotes individualization of client care." "Client-centered care is an outcome of evidence-based practice."
The nurse is critically appraising a research study. Which statement is reflective of an appraisal of the study's reliability? "The study's results are applicable to clinical practice." "The original study was repeated three times, but it did not produce consistent results." "The study's results are not applicable to clinical practice." "Although the study was supposed to measure the client's wound healing, it really measured the client's satisfaction with care."
"The original study was repeated three times, but it did not produce consistent results."
Ashley Estevez is 28 weeks pregnant and has been diagnosed with gestational diabetes. She tells the nurse that she is afraid her baby will not be healthy. What is the nurse's best response to reassure the client? "You should make an appointment in a few days to talk to the midwife about that." "It is not necessary to be concerned. The test is mostly to determine your risk of diabetes later in life. Diabetes does not have much effect on pregnancy." "We will help you to modify your diet to keep your blood sugar at normal levels. If you are careful to follow the diet and your blood sugars stay in the normal range, your baby will be healthy." "Your pregnancy will be considered high risk from now on and you should be prepared to have a child with serious complications."
"We will help you to modify your diet to keep your blood sugar at normal levels. If you are careful to follow the diet and your blood sugars stay in the normal range, your baby will be healthy."
The home health nurse is helping a client with congestive heart failure to plan for the future. The client is having difficulty making some final decisions. What question could the nurse ask to help clarify the client's values? "What alternative courses of action have you been thinking about? "Are you feeling healthy enough to be making decisions?" "Do you want to postpone talking about this difficult matter?" "What do you think your children would like you to do?"
"What alternative courses of action have you been thinking about?
During a teaching session about early recognition of the signs and symptoms of colon cancer, the client states, "I think ''feces' means 'poop.' Is that right?" How should the nurse respond? "Yes, that's right." "No, the correct term is 'feces.'" "'Feces' is also called 'stool.'" "Let's move on with the teaching."
"Yes, that's right."
A client who is at 32 weeks gestation with her second child asks the nurse how she should prepare her preschooler for the new baby. Which response by the nurse is most appropriate? "Take your preschooler to a friend's house that has a baby." "You can enroll your preschooler in sibling classes." "No preparation is needed; your child will eventually accept the new baby." "Just introduce the child when you bring the baby home."
"You can enroll your preschooler in sibling classes."
While reviewing the health histories for a group of clients, the case manager becomes concerned that several clients are at risk for falls. Which clients would benefit from fall prevention interventions? (Select all that apply.) 55-year-old female who lives alone and walks with two canes 47-year-old male recovering from a fractured arm 84-year-old male with chronic renal failure and macular degeneration 55-year-old female recovering from breast cancer surgery 70-year-old female prescribed three blood pressure medications
55-year-old female who lives alone and walks with two canes 84-year-old male with chronic renal failure and macular degeneration 70-year-old female prescribed three blood pressure medications
Which item is used by the nurse case manager when organizing a client's care? Cost containment Diagnosis-related groups (DRGs) Health promotion Use of resources
Diagnosis-related groups (DRGs)
Patricia, a nurse manager at a busy inner city hospital in New York City, is reviewing insurance coverage accepted by the agency during an educational training session. Which types of insurance is she likely to cover? -Socialized insurance -Socialized medicine -Sickness funds -Employer-based health insurance
Employer-based health insurance
When teaching about the female reproductive cycle, the nurse explains that the anterior pituitary gland produces which hormone? Select all that apply. Follicle-stimulating hormone (FSH) Luteinizing hormone (LH) Gonadotropin-releasing hormone (GnRH) Estrogen Prolactin
Follicle-stimulating hormone (FSH) Luteinizing hormone (LH) Prolactin
The nurse is planning a teaching session at the local high school regarding teenage pregnancy. Which major risk factor will the nurse include in the presentation? Access to pornography Tobacco use High-risk sexual behavior Oral sex
High-risk sexual behavior
Mikel Nikkelson, a 60-year-old long-time unemployed plumber, has asthma attacks that flare up on a regular basis in the fall. He cannot afford some of the medications that have been prescribed for him. The last time he went to the Emergency Department, the nurse recommended that he explore getting his care at a local community health center (CHC). What characteristic would likely qualify him for that care? Asthma attacks with a recurring pattern Dislike of long waits at the emergency department Long-time unemployment Referral from an emergency department nurse
Long-time unemployment
The health care provider enters the room to perform an ultrasound. As she moves the ultrasound transducer over Mrs. Moores abdomen, she takes the time to explain to Mrs. Moore what she is seeing.Which description would give you the greatest cause for concern? Monochorionic-monoamniotic Monoamniotic-dichorionic Dichorionic-diamniotic Monochorionic-diamniotic
Monochorionic-monoamniotic
Which strategy may assist in identifying or quantifying costs associated with providing nursing care? -Quality and Safety Education for Nurses (QSEN) knowledge, skills, and attitudes -Socialized medicine -Diagnosis-related groups (DRGs) -NANDA-International nursing diagnoses
NANDA-International nursing diagnoses
Before planning care, the nurse asks the client to identify goals and any cultural aspects that should be taken into consideration when providing nursing care. Which competency is this nurse demonstrating? Evidence-based practice Quality improvement Teamwork and collaboration Patient-centered care
Patient-centered care
The nurse manager is preparing the care area in anticipation of a scheduled OSHA inspection. Which particular areas should the nurse manager focus on in order to prepare for this visit? (Select all that apply.) Schedule for staff to view the DVD on safety issues is posted. Safety information is posted in the staff lounge. Puncture-resistant containers for used sharps are appropriately mounted. Glove boxes are filled and placed at each point of client access. Water, soap and hand hygiene disinfectant is available at all client bedsides.
Puncture-resistant containers for used sharps are appropriately mounted. Glove boxes are filled and placed at each point of client access. Water, soap and hand hygiene disinfectant is available at all client bedsides.
Which statement best describes a principle of humanist learning theory? By altering the stimulus or the type of reinforcement that is delivered, the learner's response can be modified. The learner is motivated to acquire new knowledge by understanding how and why the knowledge is directly applicable to his specific situation. Self-evaluation and self-criticism are more important than others' evaluation of the learner. The learner's personal characteristics affect his perception of a given cue.
Self-evaluation and self-criticism are more important than others' evaluation of the learner.