Exam 3
A nursing student is listing the different aspects of obtaining informed consent from clients. Which point mentioned by the nursing student needs correction? "Informed consent should be obtained in all situations except during extraordinary circumstances." Correct! "Informed consent is an important part of the nurse-client relationship; it is a vital part of the nursing duty." "Informed consent is provided by clients based on the full disclosure of risks, benefits, alternatives, and consequences of refusal." "The primary healthcare provider legally has to disclose facts in terms that the client is able to understand to make an informed choice."
"Informed consent is an important part of the nurse-client relationship; it is a vital part of the nursing duty."
As a new nurse, you want your communication in top form to start your new career. So, you ask your preceptor which communication skill you should focus on first. Which of her responses below would make you very confident in her knowledge of the importance of communication? "Make sure to listen to your patients, doctors, everyone. Actively listening will show your compassion and so that you can get a deeper understanding of everything going on." "Make sure that you clarify what you do not understand. Ask lots of questions." "Just fake it til you make it. Your confidence and posture will go a long way, trust me." "You are never going to remember everything, so just write down what you can and we will go back through it."
"Make sure to listen to your patients, doctors, everyone. Actively listening will show your compassion and so that you can get a deeper understanding of everything going on."
A registered nurse is educating a nursing student about nursing malpractice. What information should the nurse provide? Select all that apply. "Nursing malpractice includes willful acts that violate a client's rights." "Nursing malpractice takes place when nursing care falls below the standards of care." "Nursing malpractice may be prevented by developing a caring rapport with the client." "Nursing malpractice may occur even when the nurses do not intend to harm the clients." "Nursing malpractice refers to the publication of false statements to damage a person's reputation."
"Nursing malpractice takes place when nursing care falls below the standards of care." "Nursing malpractice may be prevented by developing a caring rapport with the client." "Nursing malpractice may occur even when the nurses do not intend to harm the clients."
You are talking with your friend, also a nurse, who is the leader of her departments Unit Council. What comments by your friend would lead you to believe that their team is in the "performing" stage of team development? "I'm starting to feel a little frustrated with Unit Council at work. If feels like Linda keeps pushing back about these changes and doesn't see how these changes will really help our unit." "Everyone seems really excited, but we are not getting a whole lot accomplished." "We are really starting to jive in this Unit Council group. I have to remember to remind Bill put email out those minutes from the last meeting though...don't let me forget!" "Sally and Kevin really took the lead on this bedside reporting thing and did so great! They just made the decision, ran with it, and it worked!"
"Sally and Kevin really took the lead on this bedside reporting thing and did so great! They just made the decision, ran with it, and it worked!"
Certain questions are applicable in determining nursing negligence. Select all that apply. "Was reasonable care provided?" "Was there a breach of nursing duty?" "Was there an act of omission that resulted in harm?" "Except for the nurse's action, would the injury have occurred?" "Did the nurse fully understand the actions would result in harm?"
"Was reasonable care provided?" "Was there a breach of nursing duty?" "Was there an act of omission that resulted in harm?" "Except for the nurse's action, would the injury have occurred?"
You have just received report for your upcoming shift and are looking to prioritize your first hours of the day. Which of the following patients would be your first priority? Confused, dementia patient whose family is at the desk with questions re: LTC placement COPD patient whose O2 sat is 94% and due for their morning inhalers Appendectomy patient with a pain of 6/10 and due for pain medication 2-hour post-op with saturated abdominal dressing
2-hour post-op with saturated abdominal dressing
Which patient would be the most appropriate to assign to a new graduate nurse who has just completed their unit orientation? A patient who is second day post-op and needs pain medication one hour prior to wound dressing changes A patient who is being discharged with a newly surgically implanted venous access catheter An anxious patient with chronic, uncontrolled pain who frequently uses the call light for 'more meds' A patient with HIV who reports headaches, abdominal and sharp, pleuritic chest pain that is rated at 7/10
A patient who is second day post-op and needs pain medication one hour prior to wound dressing changes
Which of the following legal defenses are the most important for a nurse to develop? Dedication Certification Assertiveness Accountability
Accountability
What type of law does the State Board of Nursing implement when granting authority for licensing and nursing practice? Statuatory Constitutional Criminal Administrative
Administrative
Nurses are held responsible for the commission of a tort. What is the definition of a tort? The application of force to the body of another by a reasonable individual An illegality committed by one person against the property or person of another Doing something that a reasonable person under ordinary circumstances would not do An illegality committed against the public and punishable by the law through the courts
An illegality committed by one person against the property or person of another
During a meeting aimed to discuss upcoming staffing changes, the leader opens up the conversation to allow for members to verbalize their ideas on how to go about implementing the necessary changes. Many of the nurses start to avoid eye contact and withdraw from the discussion. What conflict resolution strategy are the nurses using? Avoidance Competition Compromise Collaboration
Avoidance
Two nurses have a disagreement at the end of their shift on Friday. When they see each other again on Monday they choose to talk about the weather. Which conflict management strategy are they using? Compromising (no lose-no win) Competition (win-lose) Collaboration (win-win) Avoidance (lose-lose)
Avoidance (lose-lose)
A nurse caring for a client post-surgery takes necessary steps to achieve quality client care. Which nursing actions satisfy the Quality and Safety Education for Nurses (QSEN) competency called informatics? Select all that apply. Washing the hands before handling the client's incision site Implementing a new method of monitoring the client's incision site for infections Documenting in the electronic health record (EHR) after performing wound debridement Locking the electronic health record (EHR) after every entrance of necessary information Using computer-assisted instruction (CAI) program to provide better quality of care to the client
Documenting in the electronic health record (EHR) after performing wound debridement Locking the electronic health record (EHR) after every entrance of necessary information Using computer-assisted instruction (CAI) program to provide better quality of care to the client
What does the 'forces of Magnetism' identify as an outcome as a designated Magnet Hospital? Effective incentives to remain in current RN position Impact on the bottom line with an increase in expenses for nurses High turn over rates with low vacancy rates for nurses Excellence in nursing practice
Excellence in nursing practice
The American Nursing Regulatory Agency worked on the foundation to establish the Magnet Recognition program. True False
False
Your references can include former managers, former co-workers, family and friends. True False
False
When being interviewed for a position as a registered professional nurse, the applicant is asked to identify an example of an intentional tort. What is the appropriate response? Negligence Malpractice Breach of Duty False Imprisonment
False imprisonment
You are an RN working at a clinic when a pregnant patient tells you that she wants an abortion. She does not want to discuss any other options; she just wants an abortion. You are strongly pro-life. What is your best action at this point? Refuse to take care of this patient Ask the patient if she has other children Have another nurse take over care of this patient Tell the patient she should really consider adoption. There are a lot of families waiting for a baby.
Have another nurse take over care of this patient
You have been selected to lead a team that will be responsible for implementing a new evidence-based practice technique within a unit of 70 employees at your local hospital. When you overhear members during a meeting giving constructive feedback to each other and working well as a team after you discuss everyone's roles within the group you know that your group is in which stage of team building? Forming Storming Norming Performing
Norming
The conflict management strategy of Accommodation suppresses and smooths over differences. Which best describes this type of conflict management strategy? Lose-Win Win-lose Win-win Lose-Lose
Lose-Win
Which of the following describes compromise as a conflict management strategy? Modified win-lose Win-lose Lose-lose Win-win
Modified win-lose
Laura, a LPN on the unit, has just received her patient care assignment and will be responsible for the following four patients. Patient J: a one-day post-op knee surgery patient who will need a dressing change. Patient K: a patient with pneumonia receiving IV antibiotics who needs reinforcement of teaching on their incentive spirometer. Patient L: a chronic CHF patient receiving oral Lasix. Patient M: an incoming observation admission from the ER for an acute asthma exacerbation who is now stable. Which of the patients above would require Laura to "reverse back" the assignment as the patient required RN care? Patient K Patient L Patient M Patient J
Patient M
The nurse has just received SBAR shift report. Which patient should the nurse assess first as being the highest priority? Patient diagnosed with gallbladder disease who refuses to eat the food sent on the meal tray Patient diagnosed with osteoarthritis who is complaining of extreme pain in both knees Patient diagnosed with a deep vein thrombosis who is complaining of dyspnea and coughing Patient diagnosed with pancreatitis who wants the naso-gastric (NG) tube removed now and is becoming more irritable
Patient diagnosed with a deep vein thrombosis who is complaining of dyspnea and coughing
One of your patients today is a 75 year-old male patient with a history of post-op day 2 knee replacement. When you discuss with him that the goal for the day is to walk briefly many times today with the use of a walker, the patient says "I don't want to be in too much pain today. I think I'm doing pretty well. Don't you think we can wait on the walking until tomorrow"? What is the type of conflict? Patient vs. Nurse Nurse vs. Nurse Nurse vs. Doctor
Patient vs Nurse
An RN is employed at a memory-care facility where staff provide care for 40 residents elderly residents. Bedside cares are performed by CNAs within the unit; however, the RN is responsible for 24-hours a day. What nursing delivery model does this nurse practice within? Primary Nursing Functional Nursing Team Nursing Total Patient Care Nursing
Primary Nursing
You are caring for a team of 4 patients with an UAP on your med-surg unit. After receiving report, you start to plan out your day. Which of the following patient needs would you not want to delegate to the CNA? Ambulating a 78 year-old who is 2 days post-op hip replacement Providing discharge teaching to a 85 year-old with pneumonia Collecting a urine specimen to rule out UTI Calculating I & O for a CHF patient who is on Lasix
Providing discharge teaching to a 85 year-old with pneumonia
A nurse-lead committee is given the task of addressing low patient satisfaction scores within a busy Med-Surg unit. Their plan is in place and everyone knows what to expect. What phase of Lewin's Change Theory is this group currently in? Unfreezing Moving Refreezing
Refreezing
You are the RN working with a UAP and LPN today to care for a team of 6 patients. You are working very hard at delegating and perfecting this skill in order to make the most out of everyone's time and scope of practice. Which of the following tasks would be appropriate for you to delegate to either the UAP or LPN? Reinforce teaching on urinary catheter care Repositioning a patient every 2 hours to decrease skin breakdown Caring for a diabetic patient with blood sugars ranging from 110-135 Administering oral pain medications after you have assessed new onset pain
Repositioning a patient every 2 hours to decrease skin breakdown
A nurse manager is looking at the possibility of changing the nursing care model in the small unit that they manage. A total patient care model is the primary option being considered at this point because of a number of factors. What are all of the key components applicable to this type of model? Select all that apply. Responsibilities and assignments are clear Cost-effective way to provide care May be difficult due to RN shortages Seamless patient care
Responsibilities and assignments are clear May be difficult due to RN shortages Seamless patient care
An experienced nurse on your unit is a great team player, happy, and liked by pretty much everyone on their unit. While she is a leader among the staff, often helping with disputes and difficult situations or patients, she has not branched into management. What type of power does this nurse likely not hold within the unit? Reward power Leadership power Expert power Referent power
Reward Power
The RN is preparing to admit a patient with a seizure disorder. Which of the following actions should the RN delegate to the LPN so they can focus on RN responsibilities? Setting up oxygen and suction equipment per protocol Completing the initial seizure risk assessment tool until the RN has time to finish it Placing a padded tongue blade at the bedside Completing the admission assessment
Setting up oxygen and suction equipment per protocol
A motorist receives a ticket for speeding because the State of Wisconsin has determined that the speed limit in an area is 55mph. What type of law is involved in this case? Constitutional Criminal Case/Common Statutory
Statutory
A patient with migraine headaches has a seizure. After the seizure, which task can the RN delegate to the certified nursing assistant to do first? Documenting the characteristics of the seizure on the neuro flow sheet Placing restrains on the patient, for protection, from additional seizures Correct! Taking the patient's vital signs per policy post-seizure Performing neuro checks q 4 hours and PRN based on the patient's condition
Taking the patient's vital signs per post-seizure
Which organization has regulations and mandates over a registered nurse's scope of nursing practice? The Board of Nursing with the State Nurse Practice Act The National League of Nursing with the "Guidelines for Nursing Practice" the organization where the nurse is employed State and Federal healthcare laws for registered nurses
The Board of Nursing with the State Nurse Practice Act
James is a CCU RN where he patient load consists of 2-3 very ill patients and is responsible for planning, organizing, and performing all cares for his patients. He is a CVTC graduate so, of course, he provides excellent, quality care to both his patients and their families, and is the "go-to" RN for Mary, who had heart surgery yesterday. James practices what nursing care delivery model? Functional Nursing Total Patient Care Nursing Team Nursing Primary Nursing
Total Patient Care Nursing
When creating a resume and when interviewing you should try to connect to an organizations mission, vision and values of the organization. True False
True
A nurse in a med-surg unit is brainstorming all of the challenges and barriers that they may need to be addressed when they incorporate a new fall-risk protocol next month. Which of the Lewin's Change Theory phases is this nurse in? Unfreezing, Refreezing Moving
Unfreezing
What should the nurse consider when obtaining an informed consent from a 17-year-old adolescent? Whether the client is allowed to give consent That the client cannot make informed decisions about healthcare Whether the client is permitted to give voluntary consent when parents are not available That the client probably will be unable to choose between alternatives when asked to consent
Whether the client is allowed to give consent
The conflict management strategy of Collaboration objectively evaluates differing views, often leads to creativity and new ideas. Which best describes this type of conflict management strategy? Win-Win Lose-Lose Win-lose Lose-Win
Win-Win
The first 5 minutes of an interview are critical. When is the decision to hire a person made during that first 5 minutes of the interview? Within the first 2 minutes Within the first 4 minutes Within the first 3 minutes Within the first 60 seconds
Within the first 60 seconds
What is the formal document that outlines a person's wishes in terms of health care when they are not able to communicate these wishes that would help families and healthcare providers to determine appropriate treatment while easing the decision-making process with withholding treatment or deciding on options? an advance directive a power of attorney a treatment proxy with specific directives for healthcare a health care proxy
an advance directive
Which ethical principle applies to the patient regarding their rights with decision making by being knowledgeable when signing an informed consent for a medical procedure? autonomy veracity privacy and confidentiality justice
autonomy
What is the key concern with with bioethics? values of what is right or wrong what is good and desirable life the study of morality
life
The nurse is admitting a patient with a spinal cord injury at the C3-4 level. What is the priority assessment, by the RN, for this patient? Hint: keep in the mind the location of this injury and its effect on the body's functioning. monitoring respiratory effort and oxygen saturation levels determining the level at which the patient has intact neurological sensation assessing the level at which the patient has retained mobility monitoring blood pressure and pulse for beginning signs of spinal shock
monitoring respiratory effort and oxygen saturation levels
A graduate nurse is observed by a registered nurse breaking sterile technique with the insertion of an indwelling catheter for a patient who has dementia. The registered nurse needs to address this issue based on which of the following ethical principles? justice non-maleficence autonomy role fidelity
non-maleficence
What would be an ethical justification for withholding treatment for a patient? nurse's own personal values, beliefs and wishes as a means of advocating for the patient to make the 'best choice' in their treatment family wanting treatment withheld with 'justification" for their decision as it had been discussed earlier with the patient patient's verbalization of wishes, beliefs or values concerning their own treatment an extremely high deductibles for insurance that would cause a hardship for the patient
patient's verbalization of wishes, beliefs or values concerning their own treatment
What is the best course of action, for a registered nurse to take, if another nurse asks him/her to document their nursing care for them? check with the nursing supervisor to review the documentation/charting policy in the agency refuse to chart the documentation as the nurse "asking you" can make a 'late' entry in the medical record check the Nurse Practice Act to see if this is advisable, as it is under certain emergency situations complete the documentation by having the Information Technology department scan the nurse's hand-written personal notes into the medical record as you have been given 'permission' to do so for a 'complete timeline' of the patient's care
refuse to chart the documentation as the nurse "asking you" can make a 'late' entry in the medical record
A LPN is providing nursing care, under the supervision of the RN, who has completed an initial assessment for a patient with Guillain-Barre syndrome. What data by the LPN should the RN instruct the LPN to report back immediately? facial weakness with difficulty speaking shallow respirations with decreased breath sounds rapid heart rate of 105 or > and core temperature of < 37.6 complaints of numbness and tingling in the lower extremities
shallow respirations with decreased breath sounds
The medical-surgical unit is desperately short-staffed for the pm shift. A registered nurse agrees to continue working for an extra shift. During the 14th hour while on duty, this nurse makes a medication error while giving an IVP medication that caused harm to the patient. Who 'holds' the liability as the nurse was filling a 'desperate' staffing need and was fatigued? there is no problem if the patient will be 'ok' later, so no legal action was brought forth by the family the hospital and nursing supervisor must accept the responsibility for the negligent act the nurse will be held to the same 'standard of care' as any nurse with a similar education and nursing experience the nurse would meet any legal responsibilities if an incident report, med variance report was filled out explaining the staffing situation
the nurse will be held to the same 'standard of care' as any nurse with a similar education and nursing experience
What is the ethical principle where the nurse must disclose factual information to the patient/family as it relates to be truthful? role fidelity veracity autonomy beneficence
veracity
