HESI Issues in Nursing

How would the student nurse describe a quasi-intentional tort occurring during the practice of nursing? 1 It is a willful act violating a client's rights. 2 It is a civil wrong made against a person or property. 3 It is an act that lacks intent but involves volitional action. 4 It is an unintentional act that includes negligence and malpractice.

3 A quasi-intentional tort lacks intent but involves volitional actions such as invasion of privacy and defamation of character. An intentional tort is a willful act that violates another's rights. This includes assault, battery, and false imprisonment. A tort is a civil wrong made against a person or property. An unintentional tort involves negligence and malpractice.

Which nursing action is not likely to cause legal issues? 1 Using restraints on a non-cooperative client 2 Refraining from reporting suspected child abuse 3 Refraining from leaving the client during a staffing shortage 4 Allowing nursing assistive personnel (NAP) to administer medications

3 The nurse should not abandon clients if there is a staffing shortage. This action helps to avoid legal complications. Using restraints without the order of the primary healthcare provider may lead to battery and false imprisonment charges. The nurse should always report cases of suspected child abuse. A nurse should never allow nursing assistive personnel (NAP) to administer medications because this action may lead to malpractice charges.

What does the nurse understand by the word felony? 1 A felony is a less serious crime that has a penalty of a fine or imprisonment for less than one year. 2 A felony is the publication of false statements that occurs when one speaks falsely about another. 3 A felony is the publication of false statements that occurs when false entries are made in a medical record. 4 A felony is a crime of a serious nature that has a penalty of imprisonment for longer than one year or even death.

4 A felony is a crime of a serious nature that has a penalty of imprisonment for longer than 1 year or even death. A misdemeanor is a less serious crime that has a penalty of a fine or imprisonment for less than 1 year. Slander is the publication of false statements that occurs when one speaks falsely about another. Libel is the publication of false statements that occurs when false entries are made in the medical record.

A registered nurse is explaining the term "just culture" to the student nurse. Which explanation provided by the registered nurse is accurate? 1 "It refers to the agreement to keep promises." 2 "It refers to taking positive actions to help others." 3 "It refers to the ability to answer for one's actions." 4 "It refers to promoting open discussion whenever error occurs without fear of recrimination."

4 The term "just culture" refers to the promotion of open discussion whenever errors occur without fear of recrimination. Fidelity refers to the agreement to keep promises. Beneficence refers to taking positive actions to help others. Accountability refers to the ability to answer for one's actions.

In what order should a nurse follow steps of risk management to identify potential hazards and to eliminate them before harm occurs? 1. Identifying possible risks 2. Analyzing the possible risks 3. Acting to reduce the risks 4. Evaluating the steps taken

To eliminate potential hazards before harm occurs, the nurse should first identify the possible risks. After this, the nurse should analyze the possible risks. Then the nurse should act to reduce risks. Finally, the nurse should evaluate the steps that have been taken.

A nursing student is listing the professional responsibilities and roles of the nurse. Who is the most independently functioning nurse? 1 Nurse educator 2 Nurse researcher 3 Nurse administrator 4 Advanced practice registered nurse

4 The advanced practice registered nurse is the most independently functioning nurse. The nurse educator, nurse researcher, and nurse administrator all must be associated with an organization to pursue their professional prospects.

A nursing student is listing the different levels of the health care services pyramid. Under which type of health care services should the nursing student include subacute care? 1 Tertiary care 2 Continuing care 3 Restorative care 4 Secondary acute care

1 The nursing student should include subacute care under tertiary care. Subacute care is not a part of continuing care, restorative care, or secondary acute care health care services.

A pharmacy technician arrives on the nursing unit to deliver opioids and, following hospital protocol, asks the nurse to receive the medications. The nurse is assisting a confused and unsteady client back to the client's room. How should the nurse respond to the technician? 1 "I can't receive them right now. Please wait a few minutes or come back." 2 "Please leave the medications and sign-out sheet in a location where I can see them." 3 "Please bring them to me and I will be sure to put them away in a couple of minutes." 4 "I can't receive them right now. Please give them to the unlicensed healthcare worker."

1 The transfer of controlled substances from one authorized person to another must occur according to protocol. In this situation the controlled substance must be returned to the pharmacy and delivered at a later time. The controlled substances cannot be left unattended. The nurse cannot delay the securing of controlled substances; if time is not available when the medications are delivered, they must be returned to the pharmacy. The unlicensed healthcare worker does not have the authority to receive controlled substances.

The nurse should understand the effects of internal and external variables to plan and deliver individualized care. Which variable is an internal variable? 1 Family practices 2 Emotional factors 3 Cultural background 4 Socioeconomic factors

2 Emotional factors are internal variables. Family practices, cultural background and socioeconomic factors are external variables.

The nurse should understand the effects of internal and external variables to plan and deliver individualized care. Which variable is an example of an external variable? 1 Spiritual factors 2 Developmental issues 3 Socioeconomic factors 4 Perception of functioning

3 Socioeconomic factors are considered to be external variables. Spiritual factors, developmental issues, and the perception of functioning are internal variables.

A nurse is teaching staff members about the legal terminology used in child abuse. What definition of battery should the nurse include in the teaching? 1 Maligning a person's character while threatening to do bodily harm 2 A legal wrong committed by one person against property of another 3 The application of force to another person without lawful justification 4 Behaving in a way that a reasonable person with the same education would not

3 Battery means touching in an offensive manner or actually injuring another person. Battery refers to actual bodily harm rather than threats of physical or psychological harm. Battery refers to harm against persons, not property. Behaving in a way that a reasonable person with the same education would not is the definition of negligence.

A registered nurse is teaching an economically challenged client about different healthcare plans. Which healthcare plan is the most expensive? 1 Medicaid 2 Medicare 3 Long-term care insurance (LTC) 4 Managed care organization (MCO)

3 The long-term care insurance (LTC) plan is the most expensive insurance plan.

A client is placed on a stretcher and restrained with straps while being transported to the x-ray department. A strap breaks, and the client falls to the floor, sustaining a fractured arm. Later the client shows the strap to the nurse manager, stating, "See, the strap is worn just at the spot where it snapped." What is the nurse's accountability regarding this incident? 1 Exempt from any lawsuit because of the doctrine of respondeat superior 2 Totally responsible for the obvious negligence because of failure to report defective equipment 3 Liable, along with the employer, for misapplication of equipment or use of defective equipment that harms the client 4 Exonerated, because only the hospital, as principal employer, is responsible for the quality and maintenance of equipment

3 Using a stretcher with worn straps is negligent; this oversight does not reflect the actions of a reasonably prudent nurse. The nurse is responsible and must ascertain the adequate functioning of equipment. The hospital shares responsibility for safe, functioning equipment.

What legal complications might a nurse face for using a restraint without a legal warrant on a client? 1 The nurse may be charged with libel. 2 The nurse may be charged with negligence. 3 The nurse may be charged with malpractice. 4 The nurse may be charged with false imprisonment.

4 If a nurse uses restraints without a legal warrant on a client, he/she may be charged with false imprisonment. Libel is the written defamation of character. Negligence is any conduct that falls below the standard of care. Malpractice is a type of negligence that is regarded as professional negligence.

When should a medical examiner decide whether a postmortem examination should be conducted? 1 When a client dies under normal circumstances 2 When a client dies after 48 hours of admission to the hospital 3 When a client dies within 24 hours of admission to the hospital 4 When the client gives a written consent to perform autopsy before death

3 If a client dies within 24 hours of admission to the hospital, the medical examiner is required to decide whether a postmortem examination should be conducted. If a client dies under suspicious circumstances, the medical examiner decides whether a postmortem examination is necessary. The medical examiner does not make the decision regarding postmortem examination if the client dies after 48 hours of being admitted to the hospital. A client may give a written consent before death to perform an autopsy. Such instances are not subject to the review of the medical examiner.

A 3-year-old child with eczema of the face and arms has disregarded the nurse's warnings to "stop scratching, or else!" The nurse finds the toddler scratching so intensely that the arms are bleeding. The nurse then ties the toddler's arms to the crib sides, saying, "I'm going to teach you one way or another." How should the nurse's behavior be interpreted? 1 These actions can be construed as assault and battery. 2 The problem was resolved with forethought and accountability. 3 Skin must be protected, and the actions taken were by a reasonably prudent nurse. 4 The nurse had tried to reason with the toddler and expected understanding and cooperation.

1 Assault is a threat or an attempt to do violence to another, and battery means touching an individual in an offensive manner or actually injuring another person. The nurse's behavior demonstrates anger and does not take into account the growth and developmental needs of children in this age group. Although the behavior (scratching) needs to be decreased, this can be done with mittens, not immobilization. A 3-year-old child does not have the capacity to understand cause (scratching) and effect (bleeding).

What purpose does block and parish nursing serve in preventive and primary care services? 1 Block and parish nursing provides services to older clients or those who are unable to leave their homes. 2 Block and parish nursing provides primary care to a specific client population that lives in a specific community. 3 Block and parish nursing provides nursing services with a focus on health promotion and education as well as on chronic disease. 4 Block and parish nursing provides services aimed at increasing worker productivity, decreasing absenteeism, and reducing the use of expensive medical care.

1 Block and parish nursing provides services to older clients or those who are unable to leave their homes. Community health centers provide primary care to a specific client population living in a specific community. Nurse-managed clinics provide nursing services with a focus on health promotion and education as well as on chronic disease. Occupational health services provide services that aim to increase worker productivity, decrease absenteeism, and reduce the use of expensive medical care.

What purpose does a community health center serve in preventive and primary care services? 1 Community health centers are outpatient clinics that provide primary care to a specific population. 2 Community health centers aim to increase worker productivity, decrease absenteeism, and reduce the use of costly medical care. 3 Community health centers emphasize program management, interdisciplinary collaboration, and community health principles. 4 Community health centers include a complete program designed for health promotion and accident or illness prevention in the workplace.

1 Community health centers are outpatient clinics that provide primary care to a specific population, such as clients with young children or clients with diabetes. Occupational health services aim to increase worker productivity, decrease absenteeism, and reduce the use of costly medical care. School health services emphasize program management, interdisciplinary collaboration, and community health principles. Occupational health services include a complete program designed for health promotion and accident or illness prevention in the workplace.

A registered nurse is educating a nursing student about the process of resolving an ethical dilemma. What information should the nurse provide regarding negotiation of outcomes? 1 "A nurse should provide a personal point of view." 2 "Negotiations should be held in formal settings only." 3 "Negotiation takes place immediately after gathering information." 4 "The group agrees to a statement of the problem during the negotiation process."

1 During the process of negotiating outcomes, the nurse is required to provide a personal point of view. Negotiations may take place informally at the client's bedside or in a formal setting. After gathering relevant information regarding an ethical dilemma, the nurse is required to examine his or her own values and formulate an opinion regarding the matter. When verbalizing the problem, the group agrees to a statement of the problem to begin discussions. This step is performed before negotiating outcomes. Negotiations take place after determining all possible courses of action.

A registered nurse is teaching a nursing student about the components of the magnet model. What information should the registered nurse provide about exemplary professional practice according to the revised magnet model? 1 "Strong professional practice is established, and accomplishments of the practice are demonstrated." 2 "A vision for the future and the systems and resources to achieve the vision are created by nursing leaders." 3 "Focus is on structure and processes and demonstration of positive clinical, work force, and client and organizational outcomes." 4 "Structures and processes provide an innovative environment in which staff are developed and empowered and professional practice flourishes."

1 Exemplary professional practice is evident when a strong professional practice is established, and accomplishments of the practice are demonstrated. The characteristic of transformational leadership is a vision for the future and the systems and resources to achieve the vision are created by nursing leaders. The characteristic of empirical quality outcomes is that the focus is on structure and processes and demonstration of positive clinical, work force, and client and organizational outcomes. The characteristic of structural empowerment includes structures and processes to provide an innovative environment in which staff are developed and empowered and professional practice flourishes.

While visiting the hospital, the spouse of a client slips and falls on a recently washed floor in the hallway leading to the client's room. To meet the criteria of ethical practice, what action should the nurse who witnessed the occurrence take? 1 Initiate an agency incident report. 2 Report the fall to the state (provincial) health department. 3 Write a brief description of the incident to be kept by the nurse manager. 4 Determine that no documentation is needed because the visitor is not a client in the hospital.

1 Health care agencies document the occurrence of any event out of the ordinary that results in or has the potential to harm a client, employee, or visitor. Falls by visitors are not required to be reported to state (provincial) health departments. However, incident reports are required to be presented to accrediting agencies for review when an agency is in the process of being accredited. Writing a brief description of the incident to be kept by the nurse manager is not a requirement of ethical practice. However, a nurse who is involved in an incident or is a witness to an incident should write an accurate description of the event, along with the names of individuals involved. This documentation should be kept by the nurse at home. Lawsuits may take several years before they come to trial, and personal notes may help the nurse recall the event. The documentation must accurately contain the same elements included in the formal incident report. Taking no action is irresponsible. All events out of the ordinary that result in or have the potential to harm a visitor should be documented in an agency incident report.

A registered nurse is educating a nursing student about the stages of changes in a client's health behavior. Which statement describes the stage of contemplation? 1 "The client considers a change within the next 6 months." 2 "The client does not intend to make changes within the next 6 months." 3 "The client is actively engaged in strategies to change behavior; this lasts up to 6 months." 4 "The client displays sustained change over time; this begins 6 months after action has started and continues indefinitely."

1 In the contemplation stage, the client considers a change within the next 6 months. In the precontemplation stage, the client does not intend to make changes within the next 6 months. In the action stage, the client is actively engaged in strategies to change behavior. This stage lasts up to 6 months. When sustained change is noticed over time and begins 6 months after action has started and continues indefinitely, the client has reached the maintenance stage.

What does the nurse understand the term in-service education to mean? 1 It helps achieve an organization's required competencies. 2 It helps the nurse gain knowledge about traditional health care practices. 3 It is a one-way education program to promote and maintain current nursing skills. 4 It is focused on techniques and technologies that have been used successfully in the past.

1 In-service education helps achieve an organization's required competencies. Continuing education and in-service education help the nurse gain knowledge about the latest research and practice developments. Continuing education is a one-way education program to promote and maintain current nursing skills. In-service education is focused on new technologies.

An octogenarian client asks the nurse about the United States' government-funded national health insurance program. About which healthcare plan should the nurse inform the client? 1 Medicare 2 Long-term care insurance 3 Private insurance 4 Preferred provider organization

1 Medicare is a government-funded national health insurance program for people 65 years and older in the United States. The nurse should inform the client about this plan. Long-term care insurance is a supplemental insurance for the coverage of long-term care services. Private insurance is a traditional fee-for-service plan in which the payment is computed on basis of the number of services used after the client is treated. A preferred provider organization is a type of managed care plan that limits an enrollee's choice to a list of preferred hospitals, physicians, and providers.

Which nurse participates in the development of nursing policies and procedures? 1 Nurse educator 2 Clinical nurse specialist 3 Certified nurse-midwife 4 Certified registered nurse anesthetist

1 Nurse educators participate in the development of nursing policies and procedures. The clinical nurse specialist (CNS) is an advanced practice registered nurse (APRN) who is an expert clinician in a specialized area of practice. The CNS is not known for participating in the development of nursing policies and procedures. The certified nurse-midwife (CNM) is an APRN who is also educated in midwifery and certified by the American College of Nurse-Midwives. The CNM is not known for participating in the development of nursing policies and procedures. The certified registered nurse anesthetist (CRNA) is an APRN with advanced education in a nurse anesthesia accredited program. The CRNA is not known for participating in the development of nursing policies and procedures.

A nurse is recalling the various levels of preventive care to promote health, wellness, and to prevent illness. Which scenario is a perfect example of primary prevention? 1 An infant receives rotavirus vaccination in the hospital setting. 2 An adult in the early stages of Parkinson's disease is advised to perform adequate exercise. 3 An older adult permanently paralyzed due to brain hemorrhage is transferred to a long-term care facility. 4 An older adult with Parkinson's disease is administered carbidopa-levodopa to slow the progression of the disease.

1 Primary prevention consists of all health promotion efforts and wellness education activities. An infant receiving the rotavirus vaccination is an example of primary prevention. An adult in the early stages of Parkinson's disease is advised to perform adequate exercises; this is an example of secondary prevention. An older adult permanently paralyzed due to brain hemorrhage is transferred to a long-term care facility. This is an example of tertiary prevention. An older adult with Parkinson's disease is administered carbidopa-levodopa to slow the progression of the disease. This is an example of secondary prevention.

According to Quality and Safety Education (QSEN), what is patient-centered care? 1 Understanding that the client is the source of control when providing care 2 Functioning effectively within nursing and interprofessional teams to deliver quality care 3 Using data to evaluate outcomes of care processes and designing methods to improve health care 4 Minimizing the risk of harm to clients and health care workers through improved professional performance

1 The Quality and Safety Education (QSEN) competency called patient-centered care requires the nurse to understand that the client is the source of control. The nurse should therefore respect the values, beliefs, and preferences of the client to provide quality care. The QSEN competency called teamwork and collaboration states that a nurse should function effectively within nursing and interprofessional teams in order to provide quality care. Quality improvement involves using data to evaluate the outcomes of care processes and design methods to improve the health care delivery system. Safety focuses on minimizing the risk of harm to clients and health care workers through improved professional performance.

A client tells the nurse, "I keep reverting to my old habit of drinking soda, although I have stopped drinking as much." What stage of health behavior change has the client reached? 1 Action stage 2 Preparation stage 3 Maintenance stage 4 Contemplation stage

1 The client in this situation has reached the action stage of health behavior change. In this stage, old habits may get in the way of new behaviors. In the preparation stage, the client understands that the advantages of the health behavior change outweigh its disadvantages. In this situation, the client has already made changes in health behavior. In the maintenance stage, the client continues the health behavior change indefinitely. In the contemplation stage, the client may be ambivalent but is more ready to accept information regarding health behavior change.

A nursing student is listing the different aspects of the healthcare services pyramid. Under which type of healthcare services should the nursing student include family planning? 1 Primary care 2 Continuing care 3 Restorative care 4 Secondary Acute care

1 The nursing student should include family planning under primary care. Family planning is not a part of continuing care, restorative care or secondary acute care healthcare services.

A nursing student lists examples of health promotion activities that can help patients maintain or enhance their present levels of health. Which examples are accurate? Select all that apply. 1 Good nutrition 2 Regular exercise 3 Physical awareness 4 Immunization against measles 5 Education about stress management

12 Health promotion activities enable clients to enhance or maintain their current health levels. Good nutrition and regular exercise are examples of such activities. Immunization against measles is an example of an illness prevention activity. Education about stress management and physical awareness are examples of a wellness education activity.

What are the elements of discovery of a lawsuit? Select all that apply. 1 Experts 2 Medical records 3 Proof of negligence 4 The depositions of witnesses 5 Petition-elements of the claim

124 Experts, medical records, and the depositions of witnesses are elements of discovery of a lawsuit. Proof of negligence is a part of a trial. Petition and elements of the claim are a part of the pleadings phase.

A nursing student is listing risk factors that affect the health and wellness of a client. Which risk factors listed by the nursing student are accurate? Select all that apply. 1 Lifestyle 2 Environment 3 Spiritual factors 4 Emotional factors 5 Genetic and physiological factors

125 Lifestyle, environmental and genetic and physiological factors affect the health and wellness of the client. Spiritual and emotional factors are internal variables that influence health, health beliefs, and practices.

What are the instances when an adult can give consent for medical treatment? Select all that apply. 1 Any guardian for the adult's ward 2 Any parent for the adult's emancipated minor 3 Any parent for the adult's unemancipated minor 4 Any adult for the treatment of his or her minor brother or sister (if an emergency and parents are not present) 5 As a grandparent for a minor grandchild under normal circumstances

134 An adult can give consent for medical treatment as a guardian for his or her ward. An adult can give consent for medical treatment as a parent for his or her unemancipated minor. An adult can give consent for the medical treatment of his or her brother or sister in case of an emergency if the client's parents are not present. An adult cannot give consent for his or her emancipated minor. An adult can only give consent as a grandparent for a minor grandchild in emergency cases when the parents are not present.

What does the Medicaid healthcare plan provide? Select all that apply. 1 Health coverage for uninsured children 2 Health insurance for low-income families 3 Skilled nursing care, hospice, and home health care 4 Health assistance to low-income people with disabilities requiring long-term care (LTC) 5 Supplemental coverage and long-term care assistance to older adults and Medicare beneficiaries in nursing homes

145 The Medicaid healthcare plan provides health insurance to low-income families and to low-income people with long-term care disabilities. This plan also provides supplemental coverage and long-term care assistance to older adults and Medicare beneficiaries in nursing homes. The State Children's Health Insurance Program (SCHIP) provides health coverage for uninsured children. Part A of the Medicare healthcare plan provides limited skilled nursing facility care, hospice, and home health care.

What is the role of a nurse administrator in a healthcare setting? 1 Providing surgical anesthesia under the guidance and supervision of an anesthesiologist 2 Preparing the budget, staffing, strategic planning of programs and services, employee evaluations, and employee development 3 Providing comprehensive care by directly managing the medical care of clients who are healthy or who have chronic conditions 4 Providing knowledge about current nursing practices, trends, theories, and necessary skills in laboratories and clinical settings

2 A nurse administrator's function is to prepare the budget, staffing, strategic planning of programs and services, employee evaluations, and employee development. A certified registered nurse anesthetist provides surgical anesthesia under the guidance and supervision of an anesthesiologist. The nurse practitioner provides comprehensive care and directly manages the medical care of clients who are healthy or have chronic conditions. Nurse educators provide knowledge about current nursing practices, trends, theories, and necessary skills in laboratories and clinical settings.

According to the Institute of Medicine (IOM) competencies for the 21st century, what task should the nurse perform when working in interdisciplinary teams? 1 Advocate for disease prevention and health promotion. 2 Integrate care to ensure that care is continuous and reliable. 3 Measure quality in relation to structure, process, and outcomes. 4 Use information technology to communicate, manage knowledge, reduce error, and support decision-making.

2 According to IOM competencies for the 21st century, when working in interdisciplinary teams, the nurse should integrate care to ensure that care is continuous and reliable. When providing client-centered care, the nurse should advocate for disease prevention and health promotion. When applying quality improvement, the nurse should measure quality in relation to structure, process, and outcomes. When using informatics, the nurse should use information technology to communicate, manage knowledge, reduce errors, and support decision-making.

What necessary information should the nurse remember regarding assisted suicide, according to American Nurses Association (ANA) (2008)? 1 Nurses may have an open attitude toward the client's end of life. 2 Nurses' participation in assisted suicide may violate the code of ethics. 3 Nurses may listen to the client's expressions of fear and to attempt to control the client's pain. 4 Nurses can participate in assisted suicide only if the individual could make an oral and written request.

2 According to the ANA, a nurse's participation in assisted suicide will violate their code of ethics. According to the American Association of Colleges of Nursing (AACN) and the International Council of Nurses', the nurse may have an open attitude toward the client's end of life. According to the American Association of Colleges of Nursing (AACN) and the International Council of Nurses', nurses may listen to the client's expressions of fear and to attempt to control the client's pain. According to the Oregon Death with Dignity Act (1994) the primary health care provider in the state of Oregon can participate in assisted suicide only if an individual with terminal disease makes an oral and written request to end his or her life in a humane and dignified manner.

What does the Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986 state? 1 The act states that employees can change jobs without losing health insurance coverage. 2 The act states that the hospital should not discharge or transfer a client if an emergency condition exists. 3 The act states that the hospital protects a person who is HIV positive but does not have acquired immunodeficiency syndrome (AIDS). 4 The act states that health care institutions should provide written information to clients concerning their rights under state law to make decisions.

2 According to the Emergency Medical Treatment and Active Labor Act (EMTALA) act, the hospital should not discharge or transfer a client if an emergency condition exists. According to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), employees can change jobs without losing health insurance coverage. According to the Americans with Disabilities Act (ADA) of 1990, the hospital protects a person who is HIV positive but does not have acquired immunodeficiency syndrome (AIDS). According to the Patient Self-Determination Act (PSDA) of 1991, healthcare institutions should provide written information to clients about their rights under state law to make decisions.

A nursing student is evaluating statements regarding the five levels of proficiency set forth by Benner. Which statement indicates that a nurse is in the advanced beginner stage? 1 The nurse is learning about the profession through a specific set of rules and procedures. 2 The nurse is able to identify the basic principles of nursing care through careful observation. 3 The nurse is able to understand the organization and specific care required by certain clients. 4 The nurse is able to assess the entire situation and transfer knowledge gained from multiple previous experiences.

2 According to the levels of proficiency set forth by Benner, a nurse in the advanced beginner stage is able to identify basic principles of nursing care through careful observation. A nurse in the novice stage learns about the profession through a specific set of rules and procedures. After reaching the competent stage, a nurse will be able to understand the organization and specific care required by certain clients. A nurse who has reached the proficient stage is able to assess an entire situation and transfer knowledge gained from multiple previous experiences.

A primary healthcare provider notes that all conventional treatment procedures have proved to be ineffective in managing a client's disorder. The primary healthcare provider decides to try an experimental treatment. The nurse ensures that the client has understood the implications of the new treatment plan thoroughly and then signs the client's consent form as a witness. Which basic healthcare ethic does the nurse follow in this situation? 1 Justice 2 Autonomy 3 Beneficence 4 Nonmaleficence

2 Autonomy refers to the commitment to include clients in decisions about all aspects of care as a way of acknowledging and protecting their independence. In the given situation, the nurse ensures that the client has thoroughly understood the new treatment plan before gaining written consent. This ensures that the client is involved in the decision-making process appropriately. Justice refers to fairness. The given situation does not deal with fairness. Beneficence refers to taking positive actions to help others. This involves keeping the interests of the client before self-interest. Nonmaleficence is the avoidance of harm or hurt. Weighing the pros and cons of the new treatment plan would involve nonmaleficence.

A nurse is recalling common terms that are used in health ethics. What does beneficence in health ethics refer to? 1 Beneficence refers to the agreement to keep promises. 2 Beneficence refers to taking positive actions to help others. 3 Beneficence refers to the ability to answer for one's actions. 4 Beneficence refers to avoiding harming or hurting an individual.

2 Beneficence refers to taking positive actions to help others. Fidelity refers to the agreement to keep promises. Accountability refers to the ability to answer for one's actions. Nonmaleficence refers to avoiding harming an individual.

An unemancipated pediatric client is to undergo a medical procedure. Who is the appropriate authority to provide consent? 1 The court 2 Either of the child's parents 3 One of the child's grandparents 4 The parent who holds legal custody

2 For unemancipated pediatric clients, the parents are required to provide consent. Either parent may do so. The court intervenes in situations where the parents refuse to allow a child to undergo treatment. A grandparent may provide consent only if the situation is an emergency and the parents are not present. If the parents are divorced, a parent with legal custody of the child may provide consent.

What is the professional nurse's legal responsibility regarding child abuse? 1 Honor the request of the parents not to report the suspected abuse. 2 Report any suspected abuse to local law enforcement authorities. 3 Return the child to the legal parent even if he or she is suspected of abuse. 4 Provide the parents with a copy of the child's medical record.

2 Nurses and primary healthcare providers are legally responsible for reporting suspected or actual abuse. Child protective services may obtain a court order to grant temporary guardianship if it is found that the child is in immediate danger. The other answer options do not fulfil the nurse's duty to report suspected child abuse.

Which act protects a person who is HIV positive? 1 The National Organ Transplant Act 2 The Americans with Disabilities Act (ADA) 3 The Patient Self-Determination Act (PSDA) 4 The Health Insurance Portability and Accountability Act of 1996 (HIPAA)

2 The Americans with Disabilities Act (ADA) protects a person who is HIV positive. The National Organ Transplant Act protects the donor's estate from liability for injury or damage that results from the use of the organ. The Patient Self-Determination Act (PSDA) requires healthcare associations to provide written information to clients about their rights under state law to make decisions, including the right to refuse treatment and formulate advance directives. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects individuals from losing their health insurance when changing jobs by providing portability.

A nurse who promotes freedom of choice for clients in decision-making best supports which principle? 1 Justice 2 Autonomy 3 Beneficence 4 Paternalism

2 The principle of autonomy relates to the freedom of a person to form his or her own judgments and actions. The nurse promotes autonomy nonjudgmentally so as not to infringe on the decisions or actions of others. Justice means to be righteous, equitable, and to act or treat fairly. Beneficence relates to the state or act of doing good and being kind and charitable. It also includes promotion of well-being and abstaining from injuring others. Paternalism encompasses the practice of governing people in a fatherly manner, especially by providing for their needs without infringing on their rights or responsibilities.

What is a living will? 1 It is a legal document that allows registered nurses to offer special skills to the public. 2 It is an order that directs primary healthcare providers to refrain from reviving clients. 3 It is a written document that directs treatment according to the client's wishes, in case of a terminal illness or condition. 4 It is a legal document that designates a person or persons chosen by a client to make health care decisions on his/her behalf.

3 A living will is a written document that directs treatment on the basis of the client's wishes if he/she has a terminal illness or condition. A license allows registered nurses to offer the special skills to the public. A 'do not resuscitate' (DNR) order prevents primary healthcare providers from reviving clients or performing cardiopulmonary resuscitation (CPR). A durable power of attorney is a legal document that designates a person or persons chosen by a client to healthcare decisions on his/her behalf when the client is unable to do so.

What should a nurse understand regarding the Uniform Anatomical Gift Act? 1 The Uniform Anatomical Gift Act prohibits the purchase or sale of organs. 2 The Uniform Anatomical Gift Act protects the rights of people with physical or mental disabilities. 3 The Uniform Anatomical Gift Act gives individuals who have reached 18 years of age the right to make an organ donation. 4 The Uniform Anatomical Gift Act provides civil and criminal immunity to hospitals and healthcare providers who adhere to the act.

3 According to the Uniform Anatomical Gift Act, individuals who are at least 18 years of age have the right to make organ donations. The National Organ Transplant Act of 1984 prohibits the purchase or sale of organs. The Americans with Disabilities Act (1990) protects the rights of people with physical or mental disabilities. The National Organ Transplant Act of 1984 provides civil and criminal immunity to hospitals and healthcare providers.

A nurse is helping a client to maintain and regain health, manage his or her disease and symptoms, and attain a maximal level of function and independence through the healing process. What role is the nurse playing? 1 Manager 2 Advocate 3 Caregiver 4 Communicator

3 As a caregiver, a nurse helps clients maintain and regain health, manage diseases and symptoms, and attain a maximal level of function and independence through the healing process. As a manager, the nurse coordinates the activities of members of the nursing staff in delivering nursing care and has personnel, policy, and budgetary responsibility for a specific nursing unit or agency. As a client's advocate, the nurse protects the client's human and legal rights and provides assistance in asserting these rights if the need arises. As a communicator, the nurse learns about a client's strengths and weaknesses and his or her needs through effective communication.

A nursing student lists the preventive and primary care services available in schools, primary healthcare provider's offices, occupational health clinics, community health centers, and nursing centers. Which service provided by these centers is most expensive? 1 Running errands 2 Health education 3 Disease management 4 Routine physical examinations

3 Disease management is the most expensive service provided by community health centers. Running errands is inexpensive, and if the person walks or rides a bike, can be used as a health promotion activity. Health education and routine physical examinations are inexpensive and can usually stop complications of diseases, which prevents from having to "manage" diseases, leading to costly and expensive treatment.

A client dies in the hospital 2 hours after being admitted. Who has the authority to decide if a post-mortem should be conducted? 1 Surviving spouse 2 Nursing manager 3 Medical examiner 4 Primary healthcare provider

3 If a client dies within 24 hours of being admitted to the hospital, the medical examiner has the right to decide whether a post-mortem should be conducted. If the client's death does not need to be reviewed by the medical examiner and the client has not requested an autopsy in writing, the surviving spouse may request a post-mortem. The nursing manager and the primary healthcare provider are not authorized to make decisions regarding a post-mortem.

What information should the nurse provide when explaining the benefits of illness prevention activities to a client? 1 "These activities aim to teach people how to care for their own health." 2 "These activities enable people to maintain or enhance their health levels." 3 "These activities help protect clients from actual or potential health threats." 4 "These activities encourage people to reach an optimal state of physical, mental, and social well-being."

3 Illness prevention activities help protect clients from actual or potential health risks and threats. Nurses impart wellness education to people to teach them to care for themselves in a healthy way. Health promotion activities enable clients to maintain or enhance their health levels. These activities also help people to reach an optimal state of physical, mental, and social well-being. Routine exercise and good nutrition are examples of health promotion activities.

What does a nurse understand by the term regulatory law as applied to nursing practice? 1 Regulatory law provides fair and equitable treatment when civil wrongs or violations occur. 2 Regulatory law describes and defines the legal boundaries of the nursing practice within each state. 3 Regulatory law reflects the decisions made by administrative bodies such as the State Boards of Nursing. 4 Regulatory law results from judicial decisions made in courts based on the judgments of individual legal cases.

3 Regulatory law, also known as administrative law, reflects the decisions made by administrative bodies such as the State Boards of Nursing when they set down the rules and regulations. Civil laws protect the rights of individuals within society and provide for fair treatment in case civil wrongs or violations take place. Nurse Practice Acts are responsible for describing and defining the legal boundaries of the nursing practice within each state. Common law is based on judicial decisions made in courts when individual legal cases are decided.

A nurse is hired to work in a healthcare facility that has a completely computer-based client information system. The nurse in charge knows that the newly hired nurse is knowledgeable about this system when the nurse says what? 1 "More medication errors are made when this system is used." 2 "It is disappointing that nurses are not allowed to use this system." 3 "Client information is immediately available when this system is used." 4 "I will have less time to provide direct care to my clients with this system."

3 The intent of these systems is to streamline documentation and recordkeeping for all appropriate health team members, including nurses. There is a reduction in medication errors with this type of system. Data are immediately available to appropriate health team members without the need to depend on record or chart availability. By streamlining documentation and recordkeeping, these systems increase opportunities for more direct client care by nurses.

A nurse speaking in support of the best interest of a vulnerable client reflects which nursing duty? 1 Caring 2 Veracity 3 Advocacy 4 Confidentiality

3 The nurse has a professional duty to advocate for a client by promoting what is best for the client. This is accomplished by ensuring that the client's needs are met and by protecting the client's rights. Caring is a behavioral characteristic of the nurse. Veracity relates to the habitual observance of truth, fact, and accuracy. Confidentiality is an ethical principle and legal right that the nurse will hold secret all information relating to the client unless the client gives consent to permit disclosure.

A client with cancer is undergoing treatment in a hospital. The nurse finds the orders from the primary healthcare provider inappropriate. Clarification from the healthcare provider does not resolve the nurse's doubts. Who should the nurse contact and inform next? 1 Risk manager 2 Nursing student 3 Supervising nurse 4 Nurse administrator

3 The nurse should go to the supervising nurse or follow the established chain of command if he or she finds any discrepancies in the primary healthcare provider's orders. All nurses must act as risk managers, depending upon the situation. The nurse in question should follow the established chain of command to address his or her doubts. A nursing student is still a novice and is too inexperienced to handle such matters. A nurse administrator manages client care and the delivery of specific nursing services within a healthcare agency; a nurse administrator is not the appropriate person to ask for help in solving the problem at hand.

A visitor from a room adjacent to a client asks the nurse what disease the client has. The nurse responds, "I will not discuss any client's illness with you. Are you concerned about it?" This response is based on the nurse's knowledge that to discuss a client's condition with someone not directly involved with that client is an example of what? 1 Libel 2 Negligence 3 Breach of confidentiality 4 Defamation of character

3 The release of information to an unauthorized person or gossiping about a client's activities constitutes a breach of confidentiality and an invasion of privacy. Libel occurs when a person writes false statements about another that may injure the individual's reputation. Negligence is a careless act of omission or commission that results in injury to another. Defamation of character is the publication of false statements that injure a person's reputation.

A registered nurse is explaining the Quality and Safety Education for Nurses (QSEN) competencies to a nursing student. What information should the nurse provide about the competency teamwork and collaboration? 1 "A nurse should be able to use information and technology to communicate, manage knowledge, mitigate errors, and support decision-making." 2 "A nurse should be able to understand that the client is the source of control and full partner when providing compassionate and coordinated care." 3 "A nurse should be able to implement improvement methods to design and test changes in order to improve the quality and safety of the healthcare system." 4 "A nurse should be able to work effectively within nursing and interprofessional teams by promoting open communication and shared decision-making to provide client care."

4 According to the QSEN competency called teamwork and collaboration, a nurse should be able to work effectively within nursing and interprofessional teams, promoting open communication and shared decision-making to provide quality client care. According to the QSEN competency called informatics, a nurse should be able to use information and technology to communicate, manage knowledge, mitigate errors, and support decision-making. This helps to deliver optimal healthcare. As per the QSEN competency called patient-centered care, a nurse should be able to understand that the client is the source of control and full partner when the healthcare team provides compassionate and coordinated care. According to the QSEN competency called quality improvement, a nurse should be able to implement improvement methods to design and test changes in order to improve the quality and safety of the healthcare system

A nursing student is recalling information about hospice care. What is hospice care? 1 Hospice care is a resident's temporary or permanent home, where the surroundings have been made as homelike as possible. 2 Hospice care offers an attractive long-term care setting with an environment akin to the client's home, which offers the client greater autonomy. 3 Hospice care is a service that provides short-term relief for people providing home care to an ill, disabled, or frail older adult. 4 Hospice care is a system of family-centered care that allows clients to remain at home in comfort while easing the pains of terminal illness.

4 Hospice care is a system of family-centered care that allows clients to remain at home in comfort while easing the pain of terminal illness. A nursing center is a resident's temporary or permanent home, where the surroundings are made as homelike as possible. Assisted living offers an attractive long-term care setting with an environment that is like the client's home and offers the client greater autonomy. Respite care is a service that provides short-term relief for people providing home care to an ill, disabled, or frail older adult.

A nursing student is listing examples of active and passive health promotion strategies. Which strategy is an example of a passive health promotion strategy? 1 Weight-reduction program 2 Smoking-cessation program 3 Drug abuse prevention strategy 4 Fluoridation of municipal drinking water

4 Passive strategies of health promotion help people benefit from the activities of others without direct involvement. The fluoridation of municipal drinking water is an example of a passive health promotion strategy. Active strategies of health promotion require clients to adopt specific programs for improving health. Weight-reduction programs, smoking-cessation programs, and drug abuse prevention strategies are examples of active health promotion activities.

Litigation resulting from improper restraint use is a common nursing legal issue. A nursing student is listing points related to the use of restraints. Which factor needs correction? 1 Restraints can be used when less restrictive interventions are not successful. 2 Restraints can be used when all other alternatives have been tried and exhausted. 3 Restraints can be used only to ensure the physical safety of the resident or other residents. 4 Restraints can be used anytime without a written order from the healthcare provider.

4 Restraints can be used only on the written order of a healthcare provider. Restraints can be used when less restrictive interventions are not successful. Restraints may be used after all available alternatives have been tried and exhausted. Restraints can be used only to ensure the physical safety of the resident or other residents.

A nursing student notes that a nurse is required to integrate best current research with clinical expertise and client preferences and values in order to provide quality healthcare. Which Quality and Safety Education for Nurses (QSEN) competency does this comply with? 1 Safety 2 Quality improvement 3 Patient-centered care 4 Evidence-based practice

4 The QSEN competency evidence-based practice states that a nurse should integrate best current research with clinical expertise and client's preferences and values in order to provide quality healthcare. Safety involves nursing actions aimed at minimizing the risk of harm to clients and healthcare workers by ensuring system effectiveness and improving individual performance. Quality improvement involves the use of data to monitor outcomes of processes and implementation of methods to improve the healthcare delivery system. Patient-centered care states that the client is the source of control in providing healthcare.

Which of the following legal defenses are the most important for a nurse to develop? 1 Dedication 2 Certification 3 Assertiveness 4 Accountability

4 The concept of accountability is of high priority in nursing practice. As a licensed professional, the nurse is always accountable, which means liable and answerable for his or her actions. Dedication means to be committed, and assertiveness means to be confident. These are desired characteristics in a nurse but not legal defenses. Certification relates to achieving a higher level of knowledge or proficiency in one's area of specialization and is also not a legal defense.

A nurse is caring for a client with renal failure. The client wants to go back home but the family members want the client to undergo a kidney transplant. The nurse gives details about the possible threats and benefits of the surgery to the family and informs them that the client wants to stay home. What role does the nurse play here? 1 Educator 2 Manager 3 Caregiver 4 Advocate

4 The nurse in the given scenario plays the role of an advocate by protecting the client's human and legal rights and by providing assistance in asserting these rights. As an educator, the nurse explains concepts and facts about health and the reason for routine care activities, demonstrates procedures, and evaluates the client's progress in learning. As a caregiver, the nurse helps clients to maintain and regain health, manages diseases and symptoms, and attains a maximal level function and independence through the healing process. As a manager, the nurse coordinates the activities of members of the nursing staff in delivering nursing care and has responsibility for personnel, policy, and budgetary issues for a specific nursing unit or agency.

A student nurse is listing the different aspects of the healthcare services pyramid. Under which type of healthcare services should the student nurse include sports medicine? 1 Primary care 2 Tertiary care 3 Preventive care 4 Restorative care

4 The student nurse should include sports medicine under restorative care. It is not categorized as primary, tertiary, or preventive healthcare services.

A nursing student is examining the health services pyramid. Keeping in mind that care services begin at the bottom of this pyramid, in which order should care services be arranged? 1. Primary health care 2. Tertiary health care 3. Secondary health care 4. Clinical preventive services 5. Population-based health care services

According to the health services pyramid, population-based health care services come first. Clinical preventive services form the next level of the pyramid. A nurse should then address the primary health care needs of clients; these needs include prenatal and baby care and nutrition counseling. The next level of health care is secondary health care services, which include emergency care and acute medical-surgical care. Tertiary health care forms the highest level of health care; these needs include intensive care and subacute care.