FNP Exam #1 Ch. 1-7, 24, 31

When looking at a model for evidence-based practice, what is the final step of the process?

Evaluating practice change

*Before developing a procedure, a nurse reviews all current research-based literature on insertion of a nasogastric tube. What type of nursing will be practiced based on this review?

Evidence-based Practice (EBP)

*A nurse is preparing a presentation about ethical and legal issues for nurses. As part of the presentation, the nurse is planning to review the different types of laws. Which example would the nurse include as an intentional tort? (Select all that apply)

Intentional torts include: - Assault - False imprisonment - Libel/lie

*Altruism

Is a concern for the welfare and well-being of others. Ex: - A nurse becoming a mentor to a student nurse working on the floor - A nurse shows an understanding of the culture of the client - A nurse respects the right of a Native American to call in a shaman for a consultation.

The nurse is receiving a confused client with a draining wound onto the medical-surgical unit. Which room assignment will the nurse make?

into a private room

A nurse who works in a pediatric practice assesses the developmental level of children of various ages to determine their psychosocial development. These assessments are based on the work of:

Erikson

Which is not appropriate regarding the use of gowns as PPE?

use of one gown per person per shift

A nurse is working with a client who has undergone a lower leg amputation. While conducting an assessment, the nurse notes the client has a downcast mood. Which statement by the nurse conveys empathy to the client?

"I notice you might be experiencing some feelings of sadness. Would you like to share how you are feeling with me?"

A nurse is assessing the client's ability to perform ear care. Which statement by the client requires further education by the nurse?

"I use cotton-tipped applicators daily to remove cerumen."

The nurse has completed teaching regarding pediculosis. Which client statement requires further nursing teaching?

"I will use conditioner so that the lice eggs will slide off my hair."

Fahrenheit to Celsius Formula

*C = *F - 32 / 1.8

A veteran nurse is working with a new graduate nurse. The graduate nurse states that she was exposed to a client's blood and that she was not wearing any PPE. Which would be considered significant blood exposures by occupational health? Select all that apply.

- Hepatitis B - Hepatitis C - HIV

320 g = ________ kg. Enter the number only in the blank.

0.32 Conversion from a lower to higher unit of measurement, move decimal to the left 3 places OR Divide by 1000 320 g = 0.32 kg

*A medication label indicates 460 mcg. What would be the equivalent in milligrams? (Enter the number leave a space and the unit of measurement, round to tenths place)

0.5 mg

Convert the following measures to the equivalent units indicated.28 in = ________ cm. Enter the number only in the blank. Round to the tenths place.

1 inch = 2.54 cm 28x2.54 = 71.12 = 71.1

1 milligram = 1 mg =

1,000 micrograms 1,000 mcg

10.4 kg = ________ g. Enter the number only in the blank.

10,400 1 kg = 1000 g Conversion from a higher to lower unit of measurement, move decimal to the right 3 places OR Multiply by 1000 10.4 kg = 10,400 g

*Convert the following temperature as indicated (Enter the number only, round to hundredths place) 102* F = ________ *C

102 - 32 / 1.8 = 38.89

Convert the following traditional time to military time. 5:45 PM

1745

Which nursing activity reflects care given on the tertiary level of healthcare delivery?

Assisting with transplant surgery

Which behavior by the nurse is stereotyping?

Avoiding older adult clients because their care is time consuming

The new nursing graduate is concerned about some of the critical changes that will be occurring in nursing. What changes does the nurse anticipate will impact nursing care?

Difficulty for nurses to remain current in a rapidly changing medical and technology

*Which best exemplifies the role of the nurse as educator?

Discussing the side effects of a medication with a client

What is the best nursing intervention to promote health in a client at risk for heart disease?

Emphasizing a client's strengths to encourage weight loss

Which action should the nurse implement when working with a medically homeless client?

Encourage client to utilize the free health care clinic

The nurse is disposing of an old dressing that is saturated with a client's blood. How should the nurse dispose of the dressing?

In a bag marked "biohazards"

A nurse talks with family members about an AIDS client from the clinic where the nurse works. Which tort has the nurse committed?

Invasion of privacy

*What is the ultimate goal of expanding nursing knowledge through nursing research?

Learn improved ways to promote and maintain health

For the nurse become a nurse practitioner, what is the minimal degree the nurse will need to acquire?

Master's

A client has been recently admitted to the hospital unit following a suspected stroke, and a family member states that the client's soft contact lenses are still in place. Which solution should the nurse use for the storage of the client's lenses after removal?

Normal saline

What is the best explanation for the way evidence-based practice (EBP) has changed the way nursing care is delivered?

Nursing care now uses EBP as a means of ensuring quality care

Which explanation accurately differentiates the role of the registered nurse (RN) from that of the licensed practical/vocational nurse (LPN/LVN)?

The LPN/LVN should work under the supervision of an RN

A nursing student is changing the client's bed. Which action requires intervention from the nursing instructor?

tossing soiled linen on the floor

*Which nursing actions best describe the use of the professional value of altruism? (Select all that apply)

• A nurse demonstrates an understanding of the culture of his or her patient • A nurse becomes a mentor to a student nurse working on her floor • A nurse respects the right of a Native American to call in a shaman for a consultation.

*A nurse is being sued for malpractice in a court of law. What elements must be established to prove that malpractice or negligence has occurred? (Select all that apply)

- Causation - Duty - Breach of duty

*The nurse is caring for clients in a hospital setting. Which situations encountered by the nurse have a significant ethical component? (Select all that apply)

- Helping a client make end-of-life decisions - Addressing a suspected breach in confidentiality - Deciding how to reassign staff in light of budget cuts - Deciding when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest

*A nurse is asked to serve on an ethics committee. Which roles would the nurse be required to fill on the committee? (Select all that apply)

- Serving as a liaison between the family and the committee members - Presenting explanations about technical terminology - Advocating for the client's wishes

*A client takes a medication every 6 hours and takes the first dose at 6:30 AM. At what time will the client take the next dose? (Use Military time)

1230

*A nurse is caring for a young victim of an accident. During the rehabilitative process, the nurse assists the client in bathing and dressing. What role is the nurse engaged in?

Caregiver

The nurse has completed an intervention with a client. There is no visible soiling on the nurse's hands. Which technique is recommended by infection control practice standards for hand hygiene?

Decontaminate hands using an alcohol-based hand rub

A nurse is providing care to a client who is from a different culture. Which aspect about culture would be most important for the nurse to integrate into the client's care?

Not all members of the same culture act and think alike

1 Tsp =

5 mL

During the course of any given day of work in the acute care setting, the nurse may need to perform which roles? Select all that apply.

- Teacher - Communicator - Counselor

A client is admitted to the hospital with tuberculosis. Which statement by the nurse explains how to reduce the risk of transmission to others?

"All visitors who enter the room must wear special masks."

The parent of a pediatric client tells the nurse, "I do not believe in vaccinations." What is the appropriate nursing response?

"Help me understand your perspective about vaccinating."

The nurse is preparing a sterile field for a procedure in the client's presence. Which is the most appropriate instruction to give the client in this situation?

"I have set up this sterile field for your procedure, so please do not touch anything around the tray."

Libel/Lie

A published false statement that is damaging to a person's reputation; a written defamation

The nurse is educating a client with human immunodeficiency virus (HIV) about ways the virus can be transmitted. Which statements made by the client demonstrates the education provided was effective? Select all that apply.

- "I may transmit the virus to my child during pregnancy and childbirth." - "I may transmit the virus if I share needles with another person." - "If someone is exposed to my blood, I may transmit the virus to him or her."

The nurse is preparing to perform handwashing. Place the following steps in the correct order. Use all options.

- Turn on the faucet and adjust force and temperature of the water. - Wet the hand and wrists. - Apply soap. - Wash the palms and backs of the hands for at least 20 seconds. - Pat the hands dry with a paper towel. - Turn the faucet off with a paper towel.

A nurse has implemented numerous practices with the goal of reducing the number and transfer of pathogens. Which actions are consistent with this goal? Select all that apply.

- Use personal grooming habits, such as shampooing hair often, to prevent spreading microorganisms. - Clean the least soiled areas first and then move to the more soiled ones.

The nurse instructor has completed a session detailing major factors differentiating exacerbations from remissions. The instructor determines the session is successful when the students point out which factor(s) can contribute to exacerbations? Select all that apply.

- client is facing a potential eviction - sleep has been disrupted due to family issues - immune system is functioning poorly

Tort

A wrongful act or an infringement of a right (other than under contract) leading to civil legal liability.

*A client comes to the emergency room complaining of abdominal pain, fever, chills, and nausea. Upon further examination the client is diagnosed with appendicitis. What type of illness does the nurse identify the client to have?

Acute Illness

A nurse is caring for a client newly diagnosed with diabetes mellitus and developing a holistic plan of care. For this plan of care to be successful, it must what?

Address the disease but also incorporate the mind, body, and spirit

The nurse is caring for an older adult with pulmonary tuberculosis. Which precautions will the nurse begin?

Airborne

After meeting with the family to give an update on the surgical client, the nurse shakes their hands before leaving. Which method of hand hygiene is most appropriate following this encounter?

Alcohol-based hand rub

The nurse is considering medical-surgical certification after working in a medical-surgical floor for the past five years. Nursing specialty certification is given by which group?

American Nurses Credentialing Center (ANCC)

When preparing to take a client's blood pressure, the nurse notes that the sphygmomanometer is visibly soiled. What is the correct action by the nurse?

Cleanse and disinfect the sphygmomanometer.

The nurse is inserting an indwelling catheter. What steps will the nurse distinguish as priorityin preventing an infection?

Create an area for sterile field and opening packages

A nurse who is caring for a new mother realizes that the woman is not prepared to go home with her newborn after a hospital stay of only 24 hours. However, hospital policy dictates that the mother be discharged. This nurse may be faced with which moral problem?

Ethical distress

A hospice nurse is caring for a client with terminal cancer. The family would like the client to continue aggressive therapy to treat the cancer, but the client has voiced to the nurse that no further pursuit of treatment is desired. The nurse speaks to the family about the client's wishes, condition, and terminal state. This action is most likely derived from which nursing obligation?

Ethical principles

A nurse is shampooing a client's hair while the client is in bed. Which intervention should the nurse make to reduce back strain while performing the procedure?

Raise the bed to elbow height.

Nurses working in bed management are assigning clients from the emergency room to semiprivate rooms. Clients with which two diagnoses are appropriate to room together, based on safety and infection control standards?

Reactive airway disease and exacerbation of chronic obstructive pulmonary disorder (COPD)

A 13-year-old client with cystic fibrosis who is being discharged confides in the nurse that her parents argue a lot. Sometimes, her mother has too much to drink and starts throwing things at people. At times she gets scared her mom will hurt someone. She feels as if she is causing her parents to fight and her mom to drink because she is always in the hospital. She also worries about getting a bad grade in school due to her many absences and not getting into a good college. According to Maslow's hierarchy of human needs, which issue should take priority when caring for this client?

The client feels scared that her mother will hurt someone

In addressing health promotion for a client who is a member of another culture, the nurse should be guided by which principle?

The client may have a very different understanding of health promotion

A nurse is applying the principles of Standard and Contact Precautions in the care of a hospital client. Which action violates these principles?

The nurse removes her gown and then removes her gloves.

The nurse is caring for a client after a stroke rendered the client's right side weaker than the left. The nurse coordinates the plan of care with the physical therapist. The nurse's interventions reflect which one of nursing's four broad goals?

To restore health

The nurse is working in a clinic in a rural setting that has a diverse population of clients. Which client will the nurse refer to the case manager to determine eligibility for Medicaid?

a client with four children who works part-time in a fast food restaurant making minimum wage

The nurse is caring for a 27-year-old client who presents with possible signs of an infected abdominal wound. Which action should the nurse prioritize and initiate after receiving the results of the laboratory test indicating the client has methicillin-resistant Staphylococcus aureus (MRSA) infection?

contact

The nurse is caring for a client with a draining abscess. Which precautions will the nurse begin?

contact

The nurse is caring for an older adult with a recurrent wound infection. Which precautions will the nurse begin?

contact

When an American client states, "I only want an American doctor," the client is expressing:

ethnocentrism

Which nursing action is a component of medical asepsis?

handwashing after removing gloves

A lead nurse is removing personal protective equipment after dressing the infected wounds of a client. Which is the priority nursing action?

handwashing before leaving the client's room

When administering immunizations, the nurse is engaged in:

illness prevention

Which care intervention should the nurse anticipate when providing care to a client admitted with a possible diagnosis of tuberculosis (TB)?

wearing a particulate respirator for all care and interaction with this client

When analyzing an ethical dilemma according to the ethical framework, what is most important for the nurse to take into consideration?

Standards of conduct

The nurse is teaching a client about hearing aid care. Which teaching is appropriate?

Store the hearing aid in a cool environment.

Convert the following traditional time to military time. 11:58 PM

2358

Convert the following military time to traditional time. 0207

2:07 AM

Convert from military time to standard/traditional time: 0257 = _____.

2:57 AM

*A client is instructed to take 2 tsp of a cough suppressant every 8 hours for 5 days. How many milliliters of medication will the client take in 1 day? (Enter the number leave a space and the unit of measurement)

30 mL

*Convert the following temperature as indicated. (Enter the number only) 36* C = ________ *F

36 x 1.8 + 32 = 96.8

38.5 cm = _____ mm Place the number only in the blank

385 1 cm = 0.01 m = 10 mm 38.5x10 = 385

Convert the following military time to traditional time. 1620

4:20 PM

The client being admitted to the oncology unit conveys wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in the client's best interest to obtain which document?

A living will

A community health nurse has been visiting a diabetic client whose morning fasting glucose levels are constantly elevated. Upon further assessment, the nurse determines that the client's spouse does not understand how to prepare meals following the prescribed diabetic diet. Using Dorothea Orem's Self-Care Theory, how can the nurse help meet the needs of this client?

Arrange an evaluation appointment with a dietitian

Who is considered to be the first nursing theorist who conceptualized nursing in terms of manipulating the environment?

Florence Nightingale

A client refuses to allow any healthcare worker of Asian descent to provide care. This client is demonstrating what practice?

Racism

Which nursing intervention would be most appropriate for a new mother that calls the nursery for help with breastfeeding?

Refer the mother for a home care visit

*Human Dignity

Respecting others

A nurse is implementing interventions that focus on protecting a client from physical and emotional harm. Which category of needs is the nurse addressing?

Safety and security

The nurse provided teaching to a client newly diagnosed with gout. Which behavior observed by the nurse indicates the client understood the teaching?

Selects foods low in purine from the dinner menu

A nurse is working at a community clinic that serves mostly families with young children. What would be a priority intervention for clients in this developmental stage?

Setting up parenting classes

A nurse is caring for a client with a decreased level of consciousness (LOC). When performing mouth care, what action by the nurse will decrease complications of oral care?

The client should be placed in a side-lying position to prevent aspiration.

Evidence-based Practice

The conscientious, explicit, and judicious use of research-based information in making decisions about the delivery of care

The nurse is conducting a family assessment of a traditional family. Which assessment data cue describes the socioeconomic status of the family?

The father is an engineer and the mother is an elementary school teacher

*The nurse is caring for a group of clients. Which client should the nurse assess first?

The highest priority is the basic physiologic need, such as air. Of these clients, the person who needs to breathe should be assessed first.

A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the physician is late for another visit, the physician requests that the nurse write down the order for the physician. What should be the appropriate nursing action in this situation?

The nurse should ask the physician to come back and write the order

A registered nurse wishes to work as a nurse researcher. Which is true regarding nurse researchers?

They are responsible for the continued development and advancement of nursing

The registered nurse (RN) working with a licensed practical nurse (LPN) understands which about LPNs?

They must take a licensure exam

The nurse is preparing to don a gown to care for a client requiring contact precautions. When should the nurse don the gown?

Before entering the client's room

*Integrity

Being honest and having strong moral principles. Ex: - Providing honest information to a client about the client's illness - Reporting an error

The nurse is attempting to provide anticipatory guidance for the parents of an 18-month-old child. Which statement would be best for the nurse to make?

"Keep all medications in a locked cabinet."

The nurse has been educating a young adult client about living with type 1 diabetes and the importance of adhering to a strict dietary regimen. The client is repeatedly admitted and is not following the prescribed plan. What statement made by the nurse may facilitate values clarification for the client?

"Rank the three most important things in your life."

Celsius to Fahrenheit Formula

*F = *C x 1.8 + 32

There are various levels of preparation for nursing practice. Which degree program will best prepare a nurse to work as a nurse researcher?

Doctoral

*Human Dignity

Human dignity is the respect for the inherent worth and uniqueness of individuals and populations. Ex: - A nurse refusing to discuss a client with a curious friend (confidentiality) - Planning individualized nursing care for assigned clients - Including the client in the client's own care - Providing privacy for an older adult client

A nurse is caring for a client following endotracheal intubation. Before applying soft wrist restraints to prevent the client from pulling out the endotracheal tube, what is the mostappropriate action of the nurse?

Obtain a medical order

A client is undergoing chemotherapy for ovarian cancer which has metastasized. She has been experiencing increased nausea and vomiting associated with treatment. Which is an internal resource that the client has to help her attain her self-care goals?

She has motivation to participate in self-care

When an adult client from Indonesia refuses a complete bath on the day after abdominal surgery, the nurse should:

understand that his culture may influence his hygiene and ask him his preference.

A client being discharged from the hospital asks the nurse, "When I go visit my family out of state, should I take my living will with me, or do I need a new one for that state?" Which is the mostappropriate response by the nurse?

"Take it with you. It is recognized universally in the United States."

***A client had a physical a year ago and weighed 340 lbs. The client tells you he lost 15 lb. What is the client's current weight in kg? (Enter the number leave a space and the unit of measurement, round to the tenths place)

***147.70 kg

The nurse is preparing to complete the admission assessment on a new client. Which factor(s) should the nurse include when assessing the client's cultural needs? Select all that apply.

- Is the client comfortable with accepting help from strangers? - Does the client wear special clothing? - What method does the client prefer to use to make decisions?

Which actions by the nurse demonstrate the ethical principle of fidelity? Select all that apply.

- Maintaining current nursing registration and meeting continuing education requirements - Taking an extra client assignment so that the client will be cared for - Performing an intervention for a client at the time that was promised

The community health nurse creates a program to promote the health of the community using health promotion principles. Which intervention would the nurse include in this program?

Activities focused on maintaining wellness