Issues in nursing
A registered nurse is educating a nursing student about the utilitarian system of ethics. What information should the nurse provide? Select all that apply. "The value of something is decided by its usefulness." "The main emphasis is on the outcome or consequence of the action." "The system examines a situation for the presence of essential right or wrong." "The greatest good for the greatest number of people determines the right action." "The actions can be determined whether right or wrong based on their 'right-making characteristics.'"
The value of something is decided by its usefulness." "The main emphasis is on the outcome or consequence of the action." The greatest good for the greatest number of people determines the right action."
A nursing student is listing examples of unintentional torts. Which examples mentioned by the student are correct? Select all that apply. Assault Negligence Malpractice Invasion of privacy Defamation of character
Negligence Malpractice
A client who underwent open heart surgery died 2 days after the surgery due to septicemia. Which tool will the nurse use to determine the cause of the client's death? Plan-do-study-act (PDSA) Root cause analysis (RCA) Failure mode effective analysis (FMEA) Computerized physician order entry (CPOE)
Root cause analysis (RCA)
A registered nurse is educating a client about the three levels of prevention through different scenarios. Which scenario mentioned by the nurse is an example of secondary prevention? "A nurse educates a young couple regarding sex and sexually transmitted infections." "A nurse collaborates with a dietician to help prepare a healthy nutritional plan for a client." "A nurse arranges for a client's rehabilitation to help in gaining maximum limb function after amputation." "A nurse takes charge of screening every client upon suspecting a chicken pox outbreak in the healthcare facility."
"A nurse takes charge of screening every client upon suspecting a chicken pox outbreak in the healthcare facility."
A nursing student is examining different scenarios to understand Quality and Safety Education for Nurses (QSEN) competencies. Which scenarios are examples of the QSEN competency called quality improvement? Select all that apply. A nurse studies old medical cases about clients with Alzheimer's disease before formulating the care plan for a client. A nurse prepares a graph to compare the effectiveness of regular nursing practice with traditional healthcare practices. A nurse demonstrates the method of using electronic health records to assure a client about confidentiality of the records. A nurse designs a new method for ensuring surgical asepsis on the basis of information obtained from facility administrators. A nurse prepares a flow chart to show the decline in client injuries after implementing a weekly client education program on the use of nurse call lights.
A nurse designs a new method for ensuring surgical asepsis on the basis of information obtained from facility administrators. A nurse prepares a flow chart to show the decline in client injuries after implementing a weekly client education program on the use of nurse call lights. A nurse prepares a graph to compare the effectiveness of regular nursing practice with traditional healthcare practices.
The Quality and Safety Education for Nurses (QSEN) initiative addresses the challenge to prepare nurses with the competencies that are required to improve the quality of client care. Which scenario is representative of the teamwork and collaboration competency? A nurse uses the intake and output (I & O) form to ensure that the client has accurate fluid intake. A nurse discusses the development of a special diet chart with a dietician for a diabetic client. A nurse educates the caregiver on the basic steps for caring for a client with a central venous access device (CVAD) at home. A nurse ensures that clients and other healthcare team members are shifted to a safe place in case of a fire in the hospital setting.
A nurse discusses the development of a special diet chart with a dietician for a diabetic client.
A registered nurse is educating a nursing student about the different levels of prevention with different scenarios. Which scenario is an example of tertiary prevention? A nurse educates a community about the proper use of environmental sanitation. A nurse educates a family about how to protect themselves from carcinogens. A nurse provides education to a family regarding the need to pay attention to personality development. A nurse educates a community about the need to integrate individuals' limb amputations into the professional sphere.
A nurse educates a community about the need to integrate individuals' limb amputations into the professional sphere.
The advanced practice registered nurse is the most independently functioning nurse. What are the specific functions of the nurse practitioner as an advanced practice registered nurse in a healthcare setting? Select all that apply. A nurse practitioner focuses on teaching clients and family members to self-manage illnesses or disabilities. A nurse practitioner is usually a certified diabetes educator or an ostomy care nurse and sees only a specific population of clients. A nurse practitioner has the knowledge and skills necessary to detect and manage self-limiting acute and chronic stable medical conditions. A nurse practitioner provides comprehensive care by directly managing the medical care of clients who are healthy or who have chronic conditions. A nurse practitioner may establish a collaborative provider-client relationship, working with a specific group of clients or with clients of all ages and healthcare needs.
A nurse practitioner has the knowledge and skills necessary to detect and manage self-limiting acute and chronic stable medical conditions. A nurse practitioner provides comprehensive care by directly managing the medical care of clients who are healthy or who have chronic conditions. A nurse practitioner may establish a collaborative provider-client relationship, working with a specific group of clients or with clients of all ages and healthcare needs.
A nursing student is listing examples of quasi-intentional torts. Which examples mentioned by the nursing student need correction? Select all that apply. Assault Battery Malpractice Invasion of privacy Defamation of character
Assault Battery Malpractice
A nurse is discussing various scenarios involving healthcare settings and services with other team members. Which scenario mentioned by the nurse is an example of continuing care? Caring for a client with Parkinson's disease who requires day care service Explaining to the family member the risks and benefits of screening for cancer Teaching a couple about the proper use of contraceptives and promotion of sexual health Teaching a teenager about the importance of eating nutritious foods to prevent health issues
Caring for a client with Parkinson's disease who requires day care service
A nursing student is giving examples of healthcare settings and services. Which scenario is a perfect example of tertiary care? Preparing a client for an X-ray who has sustained a leg fracture in an accident Teaching community members about the importance of using seat belts in cars Caring for a postoperative client in the intensive care unit who is suffering from respiratory distress Advising a client with stage 1 Parkinson's disease to include exercise in his or her daily routine
Caring for a postoperative client in the intensive care unit who is suffering from respiratory distress
What problems may a nurse come across when dealing with ethical issues related to end-of-life care? Select all that apply. Clients are unable to communicate effectively. All interventions for helping the clients seem futile. Clients are often unfamiliar with the concept of autonomy. Multiple medications affect the cognitive ability of the clients. Predictions regarding health outcomes are not always accurate.
Clients are unable to communicate effectively. All interventions for helping the clients seem futile. Predictions regarding health outcomes are not always accurate.
What activities would the nurse participate in while providing a primary level of preventive care? Select all that apply. Providing individual and mass screening activities Providing education about adequate housing and recreation Providing education about attention to personality development Providing instructions about good standard of nutrition adjusted to developmental phases of life Providing hospital and community facilities for retraining and education to maximize use of remaining capacities
Providing education about adequate housing and recreation Providing education about attention to personality development Providing instructions about good standard of nutrition adjusted to developmental phases of lif
What points should a nurse keep in mind when caring for a client who belongs to a different culture? Select all that apply. The nurse should be aware of his or her own cultural values and behavior patterns. The nurse should focus on understanding the client's traditions, values, and beliefs. The nurse should understand that unique cultural perceptions exist regarding health practices. The nurse should know that every client strictly adheres to his or her cultural beliefs and traditions. The nurse should know that a client's cultural background does not influence the nurse-client relationship.
The nurse should be aware of his or her own cultural values and behavior patterns. The nurse should focus on understanding the client's traditions, values, and beliefs. The nurse should understand that unique cultural perceptions exist regarding health practices.
What would be the consequences if a health care organization follows the guidelines of transparency and allows the free flow of information? The potential for errors would be increased. The number of malpractice suits would not be affected. The patients would be able to make informed decisions. The number of patients visiting the hospital would increase.
The patients would be able to make informed decisions
A student nurse requests the registered nurse explain the characteristics of the primary nursing care delivery model. What explanation should the registered nurse provide? "There is lateral communication from nurse to nurse and caregiver to caregiver." "Team members provide direct client care under the supervision of the registered nurse (RN). "The team leader develops client care plans, coordinates care among team members, and provides care requiring complex nursing skills." "There is hierarchical communication from charge nurse to charge nurse, charge nurse to team leader, and team leader to team members."
There is lateral communication from nurse to nurse and caregiver to caregiver."
An adult client with mobility problems wishes to become an organ donor. Which act allows the client to donate his or her organs? Mental Health Parity Act Uniform Anatomical Gift Act National Organ Transplant Act Americans with Disabilities Act
Uniform Anatomical Gift Act
The nurse is teaching the benefits of electronic health records (EHRs) to clients in a community health care center. What would be appropriate for the nurse to include in the education? Select all that apply. The EHR helps obtain Medicare and Medicaid payments. The EHR helps to order medications online at a reduced price. The EHR helps to learn about food interactions with various medications. The EHR helps to share personal health information with selected family members. The EHR helps provide more accurate diagnoses and treatment in emergency conditions.
he EHR helps obtain Medicare and Medicaid payments. The EHR helps to share personal health information with selected family members. The EHR helps provide more accurate diagnoses and treatment in emergency conditions.
A registered nurse is teaching the appropriate manner of acting in a professional environment to a student nurse. Which statements mentioned by the student nurse post-training are accurate? Select all that apply. "I should provide care that is consistent with my level of expertise." "I should remember and follow the policies and procedures of the institution." "I should never protest if I am assigned to care for more clients than reasonable." "I should use restraints on a client only after obtaining a written order from a primary healthcare provider." "I should never disclose the client's confidential medical information without the primary healthcare provider's consent."
should provide care that is consistent with my level of expertise." "I should remember and follow the policies and procedures of the institution." "I should use restraints on a client only after obtaining a written order from a primary healthcare provider."
The nursing supervisor assigns a nurse to care for five clients in the intensive care unit (ICU). The nurse notes that all the clients in the ICU are at a risk of developing serious complications at any time. What course of action should the nurse take to handle the situation? Refuse to accept the assignment Leave the ICU as a sign of protest Notify the primary healthcare provider Submit a written protest to the nursing administrator
Submit a written protest to the nursing administrator
A hospitalized client experiences a fall after climbing over the bed's side rails. Upon reviewing the client's medical record, the nurse discovers that restraints had been prescribed but were not in place at the time of the fall. What information should the nurse include in the follow-up incident report? A statement that the nursing staff was not at fault because the client initiated the accident A listing of facts related to the incident as witnessed by the nurse The name of the nurse who was responsible for implementing the restraints The potential reasons why the restraints were not in place at the time of the fall
A listing of facts related to the incident as witnessed by the nurse
A client with a bleeding disorder is taking intravenous coagulant medications. The client suddenly develops an embolic stroke as a result of drug overdose. Which actions by the hospital management does the Leapfrog Group suggest? Select all that apply. Apologize to the client and family Waive all costs directly related to the adverse effect Report the adverse event to The Joint Commission Include the details of the medical error in the client's case sheet Share the client's details and condition with other health care facilities
Apologize to the client and family Waive all costs directly related to the adverse effect Report the adverse event to The Joint Commission
The nurse is caring for a client with breast cancer who is receiving chemotherapy. Which action performed by the nurse is in accordance with the rules of the Centers for Medicare & Medicaid Services (CMS)? Checks the prescription before administering medications to the client Refers the client to support systems and provides financial assistance Teaches safety measures to the client in order to prevent the risk of infection Enters symptoms and treatment provided to the client in the electronic health record (EHR)
Enters symptoms and treatment provided to the client in the electronic health record (EHR)
wo clients in the same medical facility receive differing levels of care due to the lack of financial resources of the family of one of the clients. The nurse in charge tries to resolve the ethical dilemma at hand. The nurse collects all relevant information regarding the problem from multiple sources. What should be the nurse's next course of action? Verbalize the issue by agreeing to a clear statement of the problem at hand. Analyze the situation at hand to determine whether it is an ethical dilemma. Examine own values regarding the issue at hand based on the information obtained. Negotiate the outcome of the possible course of action through proper group discussions.
Examine own values regarding the issue at hand based on the information obtained.
A nursing student is listing the instructions that clients require before leaving a healthcare facility. Which instruction listed by the nursing student indicates a need for more education? rovide instruction about accessing available and appropriate community resources. Provide instruction about the safe and effective use of medications and medical equipment. Provide instructions about all the legislation and guidelines that protect the interests of a client. Provide instructions about notifying the primary healthcare provider of any changes in function or new symptoms.
Provide instructions about all the legislation and guidelines that protect the interests of a client.
A nurse is working in a hospital that receives most of its payment from Medicare and Medicaid services. In the annual assessment of The Joint Commission, the hospital had not met all the standards set forth in the Centers of Medicare and Medicaid Services. Which action does the nurse expect to be taken? The Centers of Medicare and Medicaid Services will stop paying the hospital. The hospital will lose its accreditation given by The Joint Commission. The Joint Commission would conduct an unannounced follow-up survey in the hospital. The Centers of Medicare and Medicaid Services will conduct a follow-up survey in the hospital.
The Joint Commission would conduct an unannounced follow-up survey in the hospital
What is the role of cognitive science in health informatics? To use computer application for creating, describing, and transforming health information To understand how culture and social changes in an organization affect information technology To provide a structure for analysis of complex human performance in technology-based settings To use statistics and mathematical applications for storing and retrieving health care information
To provide a structure for analysis of complex human performance in technology-based settings
A nursing student is listing examples of healthcare services. Which scenario is an example of restorative care? Performing radiological procedures on a client who has sustained a heart attack Monitoring the blood pressure of an older adult with insomnia and hypertension Advising a pregnant woman to eat a nutrition-rich diet to avoid any deficiencies in the baby Visiting a private residence to perform maggot-aided debridement therapy of a client's wound
Visiting a private residence to perform maggot-aided debridement therapy of a client's wound
A nurse is caring for a client who has lost both feet in an accident. What course of action should the nurse take to adhere to the Quality and Safety Education for Nurses (QSEN) competency called evidence-based practice? Check whether the client prefers artificial limbs or crutches. Work with the physical therapist to enhance the client's remaining limb function. Refer to medical textbooks to understand the psychological effects of loss of limbs. Use data gathered from previous cases to determine the best approach for delivering care.
efer to medical textbooks to understand the psychological effects of loss of limbs.
Which statements accurately explain the deontology system of ethics? Select all that apply. Deontology examines a situation for the presence of essential right or wrong. Deontology emphasizes the commitment to respect the "rightness" of autonomy. Deontology deals specifically with the consequences of an action to determine right and wrong. Deontology determines that actions are right or wrong based on their "right-making characteristics." Deontology believes in the concept of using the greatest good for the greatest number of people principle to decide the right action.
eontology examines a situation for the presence of essential right or wrong. Deontology emphasizes the commitment to respect the "rightness" of autonomy. Deontology determines that actions are right or wrong based on their "right-making characteristics."
A nurse is educating an older adult for the purpose of promoting wellness. What instruction should the nurse give to reduce the risk of disability? "Engage in physical activities to stay fit." "Don't exhaust yourself by engaging in physical activities." "Pay no heed to your financial problems if you want to stay healthy." "Stay away from people so as to prevent anxiety and stress disorders.
"Engage in physical activities to stay fit."
Which components of a hospital service represent the process factor in the Avedis Donabedian model? Select all that apply. Promotion of continuity of care Adequacy of patient education Quality of interpersonal relations Adequacy of equipment and supplies Provider's knowledge and supervision
Promotion of continuity of care Adequacy of patient education Quality of interpersonal relations
While performing the discharge assessment of a client who has undergone abdominal surgery, the nurse finds that the client exhibits good health and is able to perform activities without assistance. Which nursing action during the discharge indicates failure to promote appropriate continuity of care? The nurse asks the client to get a chest X-ray in one week. The nurse asks the client to schedule a follow-up visit once in two weeks. The nurse asks the client to perform breathing exercises on a regular basis. The nurse asks the client to follow the dietary recommendations made by the dietitian.
The nurse asks the client to get a chest X-ray in one week.
A nursing student is listing the guidelines to be followed to make the referral process successful. Which step listed by the nursing student needs correction? Making the referral as soon as possible Including the referral discipline in the client's treatment plan Involving the client and family members in the referral process Refraining from giving the referral care provider information about the client in advance
Refraining from giving the referral care provider information about the client in advance
A client is admitted with a diagnosis of premature labor. The nurse discovers that the client has been using heroin throughout her pregnancy. What is the most appropriate action for the nurse to take? Notify the nurse manager of the unit. Inform no one because all client information is confidential. Inform the client's primary healthcare provider. Alert the hospital security department, because heroin is an illegal substance.
Inform the client's primary healthcare provider.
The nurse is caring for a client who is terminally ill with cancer. The health care team meets and agrees to provide the client with information to help the client make decisions regarding treatment. Which ethical principles are applied in this situation? Select all that apply. Justice Fidelity Veracity Autonomy Beneficence
Justice Fidelity Veracity Autonomy
uring an initial survey in a health care facility, members of The Joint Commission (TJC) find that the facility does not follow regulations for seclusion set by TJC. What will be the possible consequence of this negligence by the health care facility? The organization has to pay a large-dollar-amount to TJC. The organization cannot provide treatment to psychiatric patients. The organization will receive a condition-level deficiency certificate. The organization will not receive funding from Medicaid and Medicare
The organization will receive a condition-level deficiency certificate.
A group of nurses are assessing the quality of health care provided in a women's health hospital. What should the nurses consider when performing this assessment? Select all that apply. The number of employees working in the hospital The number of patients admitted in the hospital per day The satisfaction of the patient with regard to the treatment provided The safety measures taken while using the equipment in the hospital The implementation of recent evidence-based treatment approaches in the hospital
The satisfaction of the patient with regard to the treatment provided The safety measures taken while using the equipment in the hospital The implementation of recent evidence-based treatment approaches in the hospital
A nursing student is noting the characteristics of the secondary level of prevention. What points should the nursing student note? Select all that apply. Secondary prevention activities are aimed at health promotion. Secondary prevention focuses on individuals with health problems and illnesses. Secondary prevention activities are directed at diagnosis and prompt interventions. Secondary prevention helps in minimizing the effects of long-term disease and disability. Secondary prevention includes screening techniques and treating diseases at early stages.
Secondary prevention includes screening techniques and treating diseases at early stages. Secondary prevention focuses on individuals with health problems and illnesses. Secondary prevention activities are directed at diagnosis and prompt interventions.
A child with hip dysplasia has undergone a closed reduction surgery. The nurse assesses the child 2 days after the surgery and feels that the treatment and care provided for the child were not effective. The nurse made this conclusion based on what findings? The child has a staggering gait. The child is unable to walk independently. The child has impaired muscle tone and flexibility. The child's femoral head did not return to the hip socket
The child's femoral head did not return to the hip socket.
A client with multiple fractures is admitted to the hospital. What is a nurse in the proficient stage expected to do in this situation? Assess the client carefully for potential complications related to multiple fractures Ensure that the client is transferred to the orthopedic unit to undergo appropriate treatment Coordinate with all the appropriate members of the healthcare team when providing client care Identify the basic principles of providing orthopedic care and let a higher-level nurse perform client care
Coordinate with all the appropriate members of the healthcare team when providing client care
The nurse needs to collect health care data for all employees at a multi-specialty hospital for research purposes. Which type of health information technology would the nurse access to obtain the needed information? Electronic health record (EHR) Electronic medical record (EMR) Clinical information systems (CIS) Regional Health Information Organization health record (RHIO)
Electronic health record (EHR)
An ostomy specialist nurse is required to 'float' to the obstetric department. The nurse realizes that he or she lacks the required level of expertise to care for the clients in the unit. What course of action should the nurse take to deal with the situation? Notify the nursing supervisor. Refrain from taking the assignment. Learn the policies of the institution regarding floating. Perform necessary interventions using self-knowledge
Notify the nursing supervisor.
A geriatric client with hypertension and diabetes mellitus is taking propranolol (Inderal) and insulin (Humulin N) therapy. Which interventions by health care professionals help prevent client medication errors according to the Leapfrog Group? Scheduling regular follow-up visits Prescribing low dosage of medication Using computer physician order entry Closely monitoring the client for 24 hours
Using computer physician order entry
A registered nurse is educating a student nurse on the eight dimensions of patient-centered care provided by the Picker Institute. What information should the nurse provide regarding the dimension of "transition and continuity"? Select all that apply. "Clients look to care providers to share their fears and concerns." "Clients expect privacy and to have their cultural values respected." "Clients and caregivers expect access to necessary healthcare resources on a continuing basis." "Clients expect to have their continuing healthcare needs met after discharge with well-coordinated services." "Clients require information about medications, physical limitations, follow-up plans regarding diet and treatment, and danger signals to look for after treatment."
"Clients and caregivers expect access to necessary healthcare resources on a continuing basis." "Clients expect to have their continuing healthcare needs met after discharge with well-coordinated services." "Clients require information about medications, physical limitations, follow-up plans regarding diet and treatment, and danger signals to look for after treatment."
A client with a right-sided brain tumor had a surgery performed on the left side of the brain. The client is presently in a coma. Which actions should the hospital take according to the Leapfrog Group's policy? Select all that apply. Refer the client to another hospital. Report the event to The Joint Commission. Perform a failure mode effective analysis (FMEA). Apologize to the family and caregivers of the client. Agree to pay all costs related to the condition of the client.
Apologize to the family and caregivers of the client. Agree to pay all costs related to the condition of the client. Report the event to The Joint Commission.
A nursing instructor states that hospitals should operate like high-reliability organizations (HROs). What should the nursing student infer from this statement? HROs allow transparency of information. HROs operate in a conducive environment. HROs have a low incidence of adverse events. HROs help create effective organizational policies.
HROs have a low incidence of adverse events.
An emancipated minor admitted to the healthcare setting states "I have not had proper meals since last week." Which needs should the nurse address using Maslow's hierarchy of needs? Physiological Self-actualization Safety and security Love and belonging needs
Physiological
A nurse is caring for a community-dwelling older adult with hypertension. What interventions should the nurse take to ensure the client's well-being? Select all that apply. Suggest that the client have annual Papanicolaou (Pap) smears and mammograms Promote dietary modifications by using varied techniques Assess the client's current lifestyle and promote lifestyle changes Monitor the client's blood pressure and weight and establish blood pressure screening programs Teach the client about correct body mechanics and the availability of mechanical appliances
Promote dietary modifications by using varied techniques Assess the client's current lifestyle and promote lifestyle changes Monitor the client's blood pressure and weight and establish blood pressure screening programs
