leadership mod 2

A nursing student is listing the different aspects of obtaining informed consent from clients. Which point mentioned by the nursing student needs correction? A. "Informed consent is an important part of the nurse-client relationship; it is a vital part of the nursing duty." B. "Informed consent should be obtained in all situations except during extraordinary circumstances." C. "Informed consent is provided by clients based on the full disclosure of risks, benefits, alternatives, and consequences of refusal." D. "The primary healthcare provider legally has to disclose facts in terms that the client is able to understand to make an informed choice."

A. "Informed consent is an important part of the nurse-client relationship; it is a vital part of the nursing duty."

Which situations illustrates the failure of the RN to meet one or more of the Standards of Nursing Practice? Select all that apply. A. A RN responds to a telemetry unit report that a patient's heart rate has increased to 150 by sending the UAP to check the patient's pulse B. A RN places a new patient with a history of MRSA and foul smelling wound drainage on contact isolation before recieving an order from the provider C. A RN charge nurse assigns a RN from a travel service the care of a patient with gastrostomy tube feedings and sterile wound care D. A RN working the weekend shift uses a new suction device for wound care without attending the training session on how to use the device E. A RN, regularly employed on the cardiac unit, asks the director of cardiac care services to check out a new telemetry monitor on the market

A. A RN responds to a telemetry unit report that a patient's heart rate has increased to 150 by sending the UAP to check the patient's pulse D. A RN working the weekend shift uses a new suction device for wound care without attending the training session on how to use the device

A registered nurse is confronted with the following patient situations simultaneously. Which patient has the highest priority? A. A disoriented patient yelling "help"and trying to get out of bed B. A patient who is NPO and has a fasting glucose of 64 C. A patient with cirrhosis who has a platelet count of 99,780 D. A patient with pancreatitis who has a pain level of 10

A. A disoriented patient yelling "help"and trying to get out of bed

Which patients are appropriate for the charge nurse on the medical unit to assign to the LVN? Select all that apply. A. A hemodialysis patient with chronic renal failure B. A patient who is one-day postoperative cholecystectomy C. A patient to be discharged with a new central line D. A patient transferred from the ICU with a fresh tracheostomy C. A patient with a newly-diagnosed epileptic disorder D. A patient with COPD and a Bilevel Positive Airway Pressure machine

A. A hemodialysis patient with chronic renal failure B. A patient who is one-day postoperative cholecystectomy

Which action by a nurse creates the greatest risk for the nurse to be charged with malpractice? A. A nurse restarts a peripheral IV in the same arm as an arteriovenous fistula B. A nurse applies a nonsterile dressing to a closed abdominal wound with surgical staples C. A nurse fails to document the administration of Tylenol gr X PO at shift change D. A nurse transcribes an order for Lasix 40 mg IV now as Lasix 40 mg PO now

A. A nurse restarts a peripheral IV in the same arm as an arteriovenous fistula

A RN preceptor is working with a graduate nurse (GN) who is starting the second week of orientation. Which patient should the RN assign the GN? A. A patient with a tracheostomy who needs tracheostomy care every shift B. A patient with moderate persistent asthma awaiting discharge C. A patient with lung cancer who has just undergone left lower lobectomy D. A patient who was just admitted with a new diagnosis of esophageal cancer

A. A patient with a tracheostomy who needs tracheostomy care every shift

A nurse is caring for a patient with COPD and is 2 days post-op after a cholecystectomy. Which intervention for airway management should the nurse delegate to the UAP? A. Assisting the patient to sit up on the edge of the bed B. Instructing the patient to cough effectively C. Teaching the patient to use IS D. Auscultating breath sounds every 4 hours

A. Assisting the patient to sit up on the edge of the bed

An experienced LVN is working under the supervision of an RN. The LVN is providing nursing care for a patient who has a respiratory problem. Which activities should the RN delegate to the LVN? A. Auscultate breath sounds B. Administer medications via MDI C. Complete in-depth admission assessment D. Initiate the nursing care plan E. Evaluate the patients technique for using MDIs

A. Auscultate breath sounds B. Administer medications via MDI The LVN is capable of gathering date and making observations. LVNs can also administer meds as long as they are not given IV

Which hospital performance measures affect a health care facility's Medicare reimbursement? Select all that apply. A. DVT after total knee replacement B. UTI after Foley placement C. IV catheter infection D. Stage 3 pressure ulcer E. Misplaced dentures F. Incompatible blood transfusion

A. DVT after total knee replacement B. UTI after Foley placement C. IV catheter infection D. Stage 3 pressure ulcer F. Incompatible blood transfusion

A patient tells the nurse that he has an advanced directive from 6 years ago. The nurse looks at the medical record for the advanced directive. What content should the nurse expect to find in the advanced directive? A. Decisions regarding treatments B. When to take the patient to the hospital C. DNR orders D. Who should be notified in the case of illness, injury, or death E. Durable power of attorney for health care F. HIPAA protocol

A. Decisions regarding treatment B. When to take the patient to the hospital C. DNR orders E. Durable power of attorney for health care

Which common practice puts the nurse at liability for invasion of privacy? A. During care, the nurse reveals information about the patient to those in the room B. The nurse releases information about the patient to nursing students who will be caring for the patient. C. The nurse conducts a patient care session about a patient whose care if difficult and challenging D. Confidential information regarding an admitted patient is related to third-party payers.

A. During care, the nurse reveals information about the patient to those in the room.

Staff on an oncology unit suggested they charge for the individual items for a port-a-cath dressing change instead of using a prepackaged kit. The kit is expensive and they do not use everything in it. What will the decision management makes most likely be based on? A. Ease of gathering and charging the individual items B. Patient satisfaction about their dressing changes C. Physician preference and recommendation D. Other staff members acceptance of the individual charges

A. Ease of gathering and charging the individual items

What key points should the nurse keep in mind about the legal implications of nursing practice? Select all that apply. A. Ensure that the nurse knows all the laws and that these laws are applied in the nursing practice, whenever required. B. Ensure that the primary healthcare providers' orders are followed unless they appear to be incorrect or inappropriate. C. Ensure that all incident and occurrence reports are filed only for errors that have caused injury to the client. D. Ensure that the client has given consent to any surgery or therapy voluntarily or involuntarily. E. Ensure that the nurse can makes a formal protest to the nursing administrator if he or she is asked to take care of more clients than is reasonable.

A. Ensure that the nurse knows all the laws and that these laws are applied in the nursing practice, whenever required. B. Ensure that the primary healthcare provider's orders are followed unless they appear to be incorrect or inappropriate E. Ensure that the nurse can make a formal protest to the nursing administrator if he or she is asked to take care of more clients than is reasonable

A nurse notes that a medication dosage ordered for a patient greatly exceeds the usual dose. When contacted, the prescribing physician refuses to change the order. The nurse should take which action next? A. Inform the physician that he/she must refuse to give the drug B. Call the immediate nursing supervisor to give the medication C. Report the situation to the chief of the hospital medical staff D. Ask the hospital pharmacist to talk to the physician about the dosage

A. Inform the physician that he/she must refuse to give the drug

A new graduate takes and passes the NCLEX-RN Exam on June 22 , 2022. This new graduate was born on July 15, 1988. By what date must this newly-licensed RN renew his first license? A. July 31, 2024 B. June 30, 2024 C. June 22, 2024 D. July 15, 2024

A. July 31, 2024

A patient is transported to the ER by rescue after being involved in a MVC. The patient is alert and oriented but keeps saying he is having trouble breathing. Oxygen is started but the patient is still showing signs of dyspnea. The patient suddenly develops respiratory arrest and dies. During the resuscitation process, is it discovered that the nurse failed to open the correct oxygen valve. The family sues the hospital and the nurse for: A. Malpractice B. Negligence C. Nonmaleficence D. Equipment failure

A. Malpractice The patient become injured, therefore malpractice occurred

Which is true of malpractice? A. Malpractice is a negligent act by an individual whose duties require specialized education B. Malpractice occurs when a professional shares information about a patient that could damage that patient's reputation C. Malpractice is a minor criminal offense D. Malpractice is a serious criminal offense

A. Malpractice is a negligent act by an individual whose duties require specialized education

A patient was involuntarily admitted to the mental health unit because of episodes of extremely violent behavior. The patient is demanding to be discharged and the nurse does not allow the patient to leave. What are the legal ramifications associated with the nurse's behavior? A. No charge will be made against the nurse B. The nurse will be charged with assault C. The nurse will be charged with false imprisonment D. The nurse will be charged with battery

A. No charge will be made against the nurse

A patient tells the nurse that he wants to change his do not resuscitate (DNR) order. What action should the nurse take first? A. Notify the attending physician B. Provide literature about end-of-life care C. Confirm this with the patient's next-of-kin D. Consult with the nursing supervisor

A. Notify the attending physician

A patient with COPD is having difficulty breathing. Which action is best delegated to the experienced LPN? A. Observe how well the patient performs pursed-lip breathing B. Plan a nursing care regimen that gradually increases activity intolerance C. Assist the patient with basic activities of daily living D. Consult with the physical therapy department about reconditioning exercises

A. Observe how well the patient performs pursed-lip breathing

The patient with COPD has a nursing diagnosis of ineffective breathing pattern. Which is an appropriate action to delegate to the experienced LVN under your supervision? A. Observe how well the patient performs pursed-lip breathing B. Plan a nursing care regimen that gradually increases activity intolerance C. Assist the patient with basic ADLs D. Consult with the physical therapy department about reconditioning exercises

A. Observe how well the patient performs pursed-lip breathing LVNs can use observation of patients to gather data regarding how well patients perform interventions that have already been taught

Results of the Texas BON investigatory process indicate a nurse violated the nurse practice act. What sanctions/requirements can the BON place on this nurse for the nurse to retain his/her license to practice? Select all that apply. A. Practice restriction B. Probation C. Remedial education D. Monetary fine

A. Practice restriction B. Probation C. Remedial education D. Monetary fine

Which statement accurately represents the Texas Board of Nursing agency mission? A. Protect Texas citizens by ensuring nurses are competent to practice B. Participate in the annual review of the national licensure examination process C. Collaborate with interprofessional team members to improve nursing practice D. Record the names and license numbers of nurses who practice in Texas

A. Protect Texas citizens by ensuring nurses are competent to practice

A patient develops compartment syndrome as a result of the failure of a nurse to recognize the signs and symptoms of this condition and notify the physician. This situation best illustrates which of the elements of malpractice on the part of the nurse? A. Proximate cause B. Diagnosis error C. Intentional tort D. Moral duty

A. Proximate cause

A nursing team for 12 patients on the medical unit consists of a RN team leader, a LVN, and an UAP. One of the patients assigned to the LVN becomes physiologically unstable. Which initial action should the charge nurse take in this situation? A. Reassign the unstable patient to the RN Team Leader B. Ask the physician to transfer the patient to intensive care C. Ask the UAP to monitor the patients while he/she helps the LVN D. Request additional licensed nursing assistance

A. Reassign the unstable patient to the RN Team Leader

What important points should the nurse keep in mind regarding orders from a primary healthcare provider to prevent any legal complications? Select all that apply. A. Registered nurses should follow the primary healthcare provider's order unless the order seems to be harmful or is incorrect. B. Registered nurses should ensure that nursing students verify verbal orders by reading them out to the primary healthcare provider. C. Registered nurses should be aware that following an inappropriate order does not make them legally responsible for any harm to the client. D. Registered nurses should inform the nursing supervisor if the order looks inappropriate but the primary healthcare provider is required to confirm the order. E. Registered nurses should document that the primary healthcare provider was notified about an incorrect order, along with his or her response, follow-up, and the client's response.

A. Registered nurses should follow the primary healthcare provider's order unless the order seems to be harmful or is incorrect D. Registered nurses should inform the nursing supervisor if the order looks inappropriate but the primary healthcare provider is requires to confirm the order E. Registered nurses should document that the primary healthcare provider was notified about an incorrect order, along with his or her response, follow-up, and the client's response.

The nursing assistant tells the nurse that a patient who is receiving oxygen at 6L/min by nasal cannula is complaining of nasal passage discomfort. What intervention should the nurse suggest to help improve the patients comfort for this problem? A. Suggest that the patients oxygen be humidified B. Suggest that a simple face mask be used instead of a nasal cannula C. Suggest that the patient be provided with an extra pillow D. Suggest that the patient sit up in a chair at the bedside

A. Suggest that the patients oxygen be humidified

A RN whose primary residence is in Texas accepts a travel position in Oklahoma. This Nurse will also be working in Kansas, New Mexico, and Louisiana. What RN license(s) will this nurse need to obtain and maintain? Select all that apply. A. Texas B. Kansas C. New Mexico D. Lousianna E. Oklahoma

A. Texas The nurse will only need a Texas License because his/her primary residence is in Texas, and New Mexico, Kansas, Louisiana, and Oklahoma are all members of the enhanced nursing licensure compact.

A RN enters a patient's room to place an indwelling urinary catheter, as ordered by the health-care professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which action by the RN could be considered false imprisonment? A. The RN tells the client he is not allowed to leave until the physician has released him B. The RN asks the client to explain why he wishes to leave C. The RN asks the client to explain what he understands about his medical diagnosis D. The RN asks the client to sign an against medical advice discharge form

A. The RN tells the client he is not allowed to leave until the physician has released him

The nurse is helping a UAP provide a bed bath to a comatose patient who is incontinent. Which of the following actions requires the nurse to intervene? A. The UAP answers the phone while wearing gloves B. The UAP log-rolls the patient to provide back care C. The UAP places an incontinent diaper under the patient D. The UAP positions the patient on their left side, head elevated

A. The UAP answers the phone while wearing gloves

Which should be included in a discussion of advance directives with new nurse graduates? A. The advance directive designates a health-care surrogate who will make known the client's wishes regarding medical treatment if the client is unable to do so B. A living will designates who will make health-care decisions for an individual in the event the individual is unable or incompetent to make his or her own decisions C. The advance directive designates an individual who will make financial decisions for the client if he or she is unable to do so D. According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive

A. The advance directive designates a health-care surrogate who will make known the client's wishes regarding medical treatment if the client is unable to do so

A patient received a wrong medication but suffered no adverse reaction. The patient is threatening an lawsuit against the nurse that made the error. Why would a lawsuit against the nurse most likely be unsuccessful? A. The client did not suffer any physical harm B. Respondent superior would apply to this incident C. A breach of duty to the patient could not be proven D. It is considered a minor incident by BON definition

A. The client did not suffer any physical harm

A patient with metastatic pancreatic cancer is admitted to the medical unit. The patient has no orders for pain management. Who is the best person to advocate for the patient in this situation? A. The nurse assigned to the patient B. The case manager for the patient C. The pharmacist on duty D. The director of the unit

A. The nurse assigned to the patient

Which action by the nurse indicates an understanding of the hospital acquired condition reduction program? A. The nurse assures that a patient who is post knee replacement wears SCDs B. The nurse calls a health care provider to verify a home medication order C. A nurse advances a patient's diet who is post appendectomy to full liquids D. A nurse arranges transportation to the community shelter for a homeless patient who is discharged

A. The nurse assures that a patient who is post knee replacement wears SCDs

The nurse is caring for a patient who has a PE. The patient is receiving anticoagulation with IV heparin. What instructions should the nurse give the UAP who will help the patient with ADLs? A. Use a lift sheet when moving and positioning the patient in bed B. Use an electric razor when shaving the patient C. Use a soft-bristled toothbrush or tooth sponge for oral care D. Use a rectal thermometer to obtain a more accurate body temperature E. Be sure the patients footwear has a non-slip sole

A. Use a lift sheet when moving and positioning the patient in bed B. Use an electric razor when shaving the patient C. Use a soft-bristled toothbrush or tooth sponge for oral care E. Be sure the patients footwear has a non-slip sole

In which situation would the total patient care model of nursing service delivery be most appropriate? A. A skilled care facility staffed with one RN and two LVNs on each shift B. A coronary care unit (CCU) with an all-RN nursing staff C. A medical-surgical unit with a staff mix of RNs, LVNs, and UAPs D. A rehabilitation unit staffed with RNs, LVNs, and physical therapists

B. A coronary care unit (CCU) with an all-RN nursing staff

A RN comes upon a serious motor vehicle accident that has just occurred and no first responders are on the scene. One car has been flipped upside down and she can see the driver still in the car. The RN decides to stop and help. She knows she is protected from civil liability as long as she does which of the following? A. Does not make any verbal comments that could lead to economic harm B. Acts in an ordinary, reasonable, and prudent professional manner C. Fails to meet the established standards of practice D. Assures that information obtained is not communicated to anyone else

B. Acts in an ordinary, reasonable, and prudent professional manner

A medical-surgical nurse is assigned by her nurse manager to work the pediatric unit for the shift. This nurse has no recent pediatric experience. What would be the medical-surgical nurse's most prudent response to this assignment? A. Report the nurse manager to the med-surg unit's Director B. Ask to be assigned with an experienced pediatric nurse C. Go to the pediatric unit and do the best job possible D. Refuse to accept the assignment to the pediatric unit

B. Ask to be assigned with an experienced pediatric nurse

A patient and his wife arrive at the ED in a small rural hospital with severe chest pain. The physician on call instructs the RN to send the patient to a larger, urban hospital 30 miles away. What is the most appropriate action for the RN to take? A. Advise the patient's wife to drive him quickly to the larger hospital B. Assess the patient's condition and find other medical attention for him C. Supply portable oxygen to the patient to use on way to larger hospital D. Transfer the patient to an observation room in the Critical Care Unit

B. Assess the patient's condition and find other medical attention for him

A RN staff nurse reports to duty on the medical unit. The charge nurse notes during change-of-shift report that the staff nurse is drowsy and has slurred speech. When confronted after report by the charge nurse, the staff nurse admits to having taken two Lortab an hour prior to report. Which of the following actions by the RN charge nurse has highest priority? A. Call the TPAPN hot line to get an advocate for the staff nurse B. Do not permit the nurse to assume a patient assignment C. Report this staff nurse to a BON investigator in the Enforcement department D. Notify the risk manager that a nurse has reported to work impaired

B. Do not permit the nurse to assume a patient assignment

The nurse is managing the care of a patient who is continually threatening to file a lawsuit against the healthcare organization and its employees. Which intervention by this nurse has the highest priority to reduce the personal risk of being named in legal action by the patient? A. Promptly report any complaints by the patient to the immediate nursing supervisor B. Endeavor to establish a caring relationship with the patient as quickly as possible C. Seek the advice of the risk manager at the first signs of conflict with the patient D. Avoid discussing the patient's complaints directly with the patient without a witness

B. Endeavor to establish a caring relationship with the patient as quickly as possible

What free service is available to Texas nurses for license verification and renewal reminders? A. Compact data B. Nursys C. BON verifier D. LicenseVerify.com

B. Nurses

A RN completes the following CE activities during his/her second renewal period. The second renewal period is from 11/30/2020 to 11/30/2022. Which continuing education hour(s) are appropriate and applicable for the second renewal period? Select all that apply A. Postoperative Complications: A home-study program by the American Nurses Association—3/15/2020 B. Nursing Theory in a RN to BSN university program - Spring 2022 C. In-service of Hohn catheters by company representatives--04/1/2021 D. Principles of IV Therapy offered by Amarillo College Center for Continuing Healthcare Education--08/12/22 E. Sociology at Texas Tech University — spring semester 2022 F. BLS for Healthcare Providers--10/10/2021

B. Nursing Theory in a RN to BSN university program - Spring 2022 D. Principles of IV Therapy offered by Amarillo College Center for Continuing Healthcare Education--08/12/22 BLS for Healthcare Providers--no, BLS is not approved Principles of IV Therapy offered by Amarillo College Center for Continuing Healthcare Education--yes, completed during renewal period and through the college In-service of Hohn catheters by company representatives--no, in-services on how to use equip,emt are not approved Sociology at Texas Tech University—no, it is not a nursing course so it's not apporved Postoperative Complications: A home-study program by the ANA—no, it was not completed during the renewal period Nursing Theory in a RN to BSN university program - yes, it is a nursing course completed during the renewal period

The RN delegates several tasks to the UAP. Which task should the nurse direct the UAP to complete first? A. Take a urine specimen of a patient with sepsis to the lab for culture and sensitivity B. Obtain vital signs on a patient returning from the cardiac catheterization lab C. Ambulate a postoperative patient complaining of severe "gas" pains and "bloating" D. Transport the patient with suspected pneumonia to radiology for a chest x-ray

B. Obtain vital signs on a patient returning from the cardiac catheterization lab

A nurse suspects that the RN, assigned to a patient who expired, had not assessed the patient during the shift even though assessment data was recorded by the RN in the medical record. How should this nurse proceed with this information? A. Complete a variance report for the agency Risk Manager B. Report these suspicions to the nurse manager of the unit where the patient died C. Contact the Enforcement Department of the BON with this information D. Ask the chair of the Peer Review Committee to review the situation

B. Report these suspicions to the nurse manager of the unit where the patient died

The charge nurse must make a decision about which patient would be best suited for discharge home, so that another patient being held in the Emergency Department can be admitted to the unit. Which patient should the charge nurse ask the physician to discharge? A. The patient with diabetes mellitus who has abdominal pain and a glucose of 258 B. The patient with Crohn's Disease who has a rectal fistula and is on oral Flagyl C. The post-operative ruptured appendectomy patient with hypoactive bowel sounds D. The patient with heart failure and atrial fibrillation on telemetry monitoring

B. The patient with Crohn's Disease who has a rectal fistula and is on oral Flagyl

A patient who belongs to a HMO went to see a dermatologist without a primary care physician referral. The office visit costs $200. How much of the cost is the patient responsible for? A. Half of the total bill B. The total bill C. A small deductible D. Out-of-pocket expenses

B. The total bill

A nurse is assigned to care for four patients. When planning patient rounds at the beginning of the shift, which patient should the nurse see first? A. A pneumonia patient who is on oxygen at 3 liters and has a 94% oxygen saturation B. A new patient who is scheduled for a knee surgery and has a pre-operative antibiotic order C. A patient who had morphine one hour earlier and is reporting a pain level of 9 D. A patient admitted with left shoulder pain who has new orders for a MRI

C. A patient who had morphine one hour earlier and is reporting a pain level of 9

Which patient is considered the most "stable and predictable"? A. A patient who is 1 day post pneumonectomy B. A patient who is difficult to arouse C. A patient who is in hospice D. A patient in the recovery room

C. A patient who is in hospice

The hospital is expecting multiple admissions and the charge nurse must identify patients who can be discharged to home. Which patient would be most suitable for discharge? A. A patient who has a deep vein thrombosis and an INR of 1.9 B. A patient who was admitted with a kidney stone and has a creatinine of 2.1 C. A patient who is one day post appendectomy and has a temperature of 99.4 D. A patient whose abdomen is distended and firm two hours after a colonoscopy

C. A patient who is one day post appendectomy and has a temperature of 99.4

Which situation should the nurse plan to address as the highest priority need? A. A patient admitted with atrial fibrillation who has right sided weakness and slurred speech B. A patient who is post heart catheterization saying that her groin hurts and feels likes a "goose egg" C. A postoperative patient with sudden breathing difficulties and decreasing oxygen saturations D. A post thoracotomy patient who tells the LVN that his chest tube came out while walking to the bathroom

C. A postoperative patient with sudden breathing difficulties and decreasing oxygen saturations

A patient's physician informs him that he must have chemotherapy now or he will die within 2 months. The patient confides in the nurse that he does not want treatment. How can the nurse best advocate for this patient? A. Identifying potential benefits of further treatment for both him and his family B. Encouraging the patient to discuss the issue with a close family member C. Assuring the patient that he has the right to accept or refuse treatment D. Supporting the physician's treatment plan for the patient

C. Assuring the patient that he has the right to accept or refuse treatment

A RN reports to duty to find he/she is reassigned from the medical-surgical unit to the critical care unit (CCU). This RN has only six months experience and no electrocardiography or hemodynamic monitoring training since nursing school. After discussing these concerns with the supervisor, the RN is still required to go to the CCU. The RN decides to invoke Safe Harbor Peer Review. What should this RN do next? A. Request Peer Review of the situation B. Refuse to go to the CCU C. Complete the Safe Harbor Quick Request form D. Report the situation to the DSHS

C. Complete the Safe Harbor Quick Request form

An RN new to the ED documented that "the patient was intoxicated and acted in a crazy manner". The team leader told the RN that this type of documentation can lead to: A. Assault B. Wrongful publication C. Defamation of character D. Slander

C. Defamation of character

An RN sees an olde woman fall in the mall. The RN helps the woman. The woman later complains that she twisted and sprained her ankle. The RN is protected from litigation under: A. Hospital malpractice insurance B. Good faith agreement C. Good Samaritan law D. Personal Professional insurance

C. Good Samaritan law

A RN employed in a Texas hospital believes that nurse staffing levels on the unit where he is assigned are inadequate. How should the RN proceed in this situation? A. Contact a TNA attorney to initiate a formal review of staffing levels on this unit B. Gather evidence of inadequate staffing and present this to the organizational CEO C. Request that the Nurse Staffing Advisory Committee investigate staffing levels on this unit. D. Advise the Joint Commission that patient lives are being endangered by unsafe nurse staffing.

C. Request that the Nurse Staffing Advisory Committee investigate staffing levels on this unit.

A patient who is member of a preferred provider organization (PPO) goes to see a specialist without a primary care physicians' referral. How will this affect the patient's total bill? A. The patient will have to pay the total bill B. The patient will pay the primary care physician a referral fee C. The patient will pay less if the specialist is 'in network" D. The patient might pay up to 20% of the total bill

C. The patient will pay less if the specialist is 'in network"

An UAP has floated to another unit. A nurse on the unit has observed the UAP perform glucometer checks in a satisfactory manner in the past. Which statement illustrates the best way for the nurse to delegate glucometer checks to this UAP A. "I want you to do glucometer checks on the patients in room 406 and 409 before meals. Let me know if you need any help." B. "Here is a list of our scheduled routine glucometer checks that you will need to do this morning before breakfast." C. "Do glucometer checks on patient A and patient B, and please let me know right away if they are abnormal. Thank you!" D. "You'll need to do glucometer checks on patient A and patient B at 0730 and 1130 and report the results to me immediately."

D. "You'll need to do glucometer checks on patient A and patient B at 0730 and 1130 and report the results to me immediately."

The nurse is assigned to care for the following patients. Which patient should the nurse assess first? A. 60 year old patient on a ventilator for whom a sterile sputum specimen must be sent to the lab B. 55 year old with COPD and pulse ox reading from the previous shift of 90% C. 70 year old with pneumonia who needs to be started on IV antibiotics D. 50 year old with asthma who complains of shortness of breath after using a bronchodilator

D. 50 year old with asthma who complains of shortness of breath after using a bronchodilator

A spring 2022 ADN graduate received a graduate nurse (GN) temporary permit to practice from the Texas BON. What is the maximum length of time that the GN can practice nursing before the permit expires? A. 75 days B. 2 months C. 120 days D. 6 months

D. 6 months

An assistant nurse manager is making assignments for the next shift. Which patient should the assistance nurse manager assign to a nurse with 6 months experience and who has been floated from the surgical unit to the medical unit? A. 58 year old on airborne precautions for TB B. 68 year old who just returned from bronchoscopy and biopsy C. 69 year old with COPD and who is ventilator dependent D. 72 year old who needs teaching about use of IS

D. 72 year old who needs teaching about IS Many surgical patients are taught about TCDB and use of IS

A client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which statement should be included in the RN's teaching to the client? A. Physicians must wait 24 hours before writing a do not resuscitate (DNR) order B. A DNR requires a court decision C. When a heart ceases to beat, the client is pronounced clinically dead D. A DNR order can be written after the health-care provider has discussed it with the client and family

D. A DNR order can be written after the health-care provider has discussed it with the client and family

Which patients are the most appropriate for the RN to assign to the LVN on her team? A. A patient with pulmonary edema and a patient post CVA with right hemiparesis and new discharge orders B. A patient transferred from the ICU with a fresh tracheostomy and patient to be discharged with a new central line C. A patient with COPD and respiratory compromise and a patient with a newly-diagnosed epileptic disorder D. A patient who is one-day postoperative cholecystectomy and a hemodialysis patient with chronic renal failure

D. A patient who is one-day postoperative cholecystectomy and a hemodialysis patient with chronic renal failure

What calculation reflects the number of days that patients usually stay on a nursing unit? A. Length of stay B. Current in-house numbers C. Average daily census D. Average length of stay

D. Average Length of Stay

A postop nurse who is caring for a client after a knee replacement discovers that the consent was not signed before the surgery. Which charge could be filed? A. Malpractice B. Libel C. False imprisonment D. Battery

D. Battery

A new graduate with a GN permit reports to duty on the medical unit. This GN has been working under the supervision of one particular RN on the unit since obtaining his/her GN permit. However, the GN has been re-assigned by the charge nurse to work on the neurology unit for the shift. What would be the most important action for this GN to take upon learning of his re-assignment? A. Only perform tasks as an unlicensed assistant while on the neurology unit B. Report the charge nurse's assignment to the nursing director on the medical unit C. Remind the charge nurse that GNs cannot be reassigned to different units D. Make sure there is a RN available to supervise him/her on the neurology unit

D. Make sure there is a RN available to supervise him/her on the neurology unit

An RN has asked the UAP to trim the toenails of a diabetic patient. The UAP trims the nails too short which results in the a toe amputation from infection. The patient files a lawsuit against the hospital, RN, and the UAP. What might all three be found guilty of? A. Unintentional tort B. Intentional tort C. Negligence D. Malpractice

D. Malpractice Malpractice occurs when an unintentional tort causes injury to a patient

A RN administered a patient's morning insulin as the breakfast tray arrived at 0800. After 0800, the RN got busy with other patients and did not check on the patient again until 1400. At that time, she found the patient unresponsive with a blood glucose of 23. Both the breakfast and lunch tray were at the bedside untouched. What offense could the RN be charged with? A. Misdemeanor B. Juvenile offense C. Quasi-intentional tort D. Negligence

D. Negligence

A patient is scheduled to have a cardiac catheterization. When asked to sign the permit for the procedure, the patient tells the nurse that the doctor has not explained the potential risks associated with cardiac catheterization. What is the nurse's best response? A. Ask the patient sign the permit and arrange for the doctor to speak with the patient in the cath lab B. Explain the cardiac catheterization procedure in detail before having the patient sign the permit C. Give the patient information to read about the potential risks associated with cardiac catheterization D. Notify the doctor that the procedure needs to be explained to the patient before the permit is signed

D. Notify the doctor that the procedure needs to be explained to the patient before the permit is signed

A patient admitted to the hospital for treatment of a severe anxiety disorder is demanding immediate release from the hospital. The nurse reviewing the patient's record notes that the patient's admission was voluntary. What is the nurse's best response? A. Persuade the patient to stay B. Call the patient's family C. Tell the patient discharge is impossible D. Notify the physician

D. Notify the physician

A Graduate Nurse (GN) permit is issued to a new graduate with an effective date of May 31, 2022. When will the GN permit for this individual expire? A. July 1, 2022 B. June 16, 2022 C. July 31, 2021 D. November 31, 2022

D. November 31, 2022

A new patient who has asthma and respiratory insufficiency is arriving from the emergency department. The charge nurse should assign this patient which staff member? A. New Graduate Nurse B. Experienced LVN C. Resource pool RN D. RN Team leader

D. RN Team leader

A RN standing in line for the cafeteria cashier overhears staff talking about a client the RN took care of earlier in the week. The client's room number is mentioned along with the diagnosis and prognosis. Which of the following actions should the RN take? A. Join in the conversation in case the RN is assigned to care for the client in the future B. Do not listen to the conversation C. Correct an inaccurate statement made by one of the staff members D. Remind the staff members that they are in a public location and sharing this information is a breach of the Health Insurance Portability and Accountability Act (HIPAA)

D. Remind the staff members that they are in a public location and sharing this information is a breach of the Health Insurance Portability and Accountability Act (HIPAA)

A RN receives a written notification from the BON that a complaint has been received by a former patient about her practice. What action should this RN take first? A. Contact a personal liability attorney for representation B. Consult her immediate supervisor for assistance C. Call the BON licensure department for advice D. Review the BON investigatory process for direction

D. Review the BON investigatory process for direction

A UAP tells nursing staff that the unit secretary has acquired immunodeficiency syndrome (AIDS) from her husband who is a drug addict. What legal tort may the UAP be charged with? A. Assault B. non-veracity C. Libel D. Slander

D. Slander

The family of a confused, older adult patient has filed a lawsuit because the patient was injured trying to get out of bed unassisted. What will the plaintiff's attorney most likely use to prove the legal liability of the nurse who was assigned to the patient at the time of the patient's injury? A. Federal regulations about the safety of hospitalized older adult patients B. Joint Commission documentation standards for fall precautions C. Statutory laws in the state pertaining to care of older adult patients in healthcare facilities D. Standards of nursing practice that are relevant to ensuring patient safety

D. Standards of nursing practice that are relevant to ensuring patient safety

Which patient has the greatest need for advocacy? A. The pediatric patient who lives with her single mother B. The teenager with a wound infected with MRSA C. The older adult patient who is returning to the nursing home D. The homeless patient with newly-diagnosed diabetes mellitus

D. The homeless patient with newly-diagnosed diabetes mellitus

All nursing errors categorized as minor incidents must be reported to the Texas BON. True or False

False

A patient who had a cesarean section a day ago is being treated prophylactically for endometritis. She reports abdominal cramping at a level of 7 and fears having her first bowel movement. Based on priority, indicate the order the medications should be administered. Ampicillin sodium Prenatal vitamin Docusate Sodium Ketorolac

Ketorolac Ampicillin sodium Docusate sodium Prenatal vitamin

A RN team leader is working with a LPN and UAP. Which patient situation should be addressed by the RN? A. A patient with obstructive pulmonary disease who has become confused B. A patient on an insulin drip who needs a peripheral blood glucose check C. A patient who is back from radiology and requesting a bedtime snack D. A terminally ill patient who is requesting medication for severe abdominal pain

A. A patient with obstructive pulmonary disease who has become confused

Which statement best illustrates appropriate communication by the RN when delegating morning vital signs to the UAP? A. "Do the 0800 vital signs on Mr. X in room 12, Ms. Y in room10, and Ms. Z in room 11 . Bring me the results when you are done." B. "I want you to do the vital signs on the patients in rooms 10, 11, and 12. Let me know if you need any help." C. "Here is the list of morning vital signs that have to be done before bath time. Thank you for getting them for me." D. "Please get the morning vital signs on the patients in rooms 10, 11, and 12 while I pass their morning medications

A. "Do the 0800 vital signs on Mr. X in room 12, Ms. Y in room10, and Ms. Z in room 11 . Bring me the results when you are done."

An experienced nurse is using all continuing nursing education (CNE) hours for license renewal. How many total hours must the nurse earn for license renewal? A. 20 B. 30 C. 10 D. 50

A. 20

Which intervention can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN) working on a medical-surgical unit? A. Administer 10mg of diazepam IM for muscle spasms B. Administer an IV insulin bolus to a patient on an insulin drip C. Teach a patient how to perform blood glucose testing D. Develop the plan of care for a patient with a broken wrist

A. Administer 10mg of diazepam IM for muscle spasms

A physician prescribes tube feedings for a patient if that patient does not eat at least 50% of each meal. The nurse carrying for the patient notes the patient only ate a few bites of breakfast and states "If you don't eat more than that I will put a tube down your throat to get a feeding in that way'". The patient begins to cry and tries to eat more. What legal action might this nurse be charged with? A. Assault B. Slander C. Battery D. Maleficence

A. Assault

An RN is obtaining a signature on a surgical informed consent document. Before obtaining the signature., the RN must ensure which of following? SATA A. The patient is not sedated B. The doctor is present C. A family member is a witness D. The signature is in ink E. The patient understands the procedure

A. The patient is not sedated E. The patient understands the procedure While a paper copy must be signed in ink, some consents may be electronic.

What types of complaints about nursing practice are investigated by the Texas BON? Select all that apply. A. Unprofessional conduct B. Impaired practice related to chemical dependency C. Impaired practice related to mental illness D. Failure to follow minimum standards of practice

A. Unprofessional conduct B. Impaired practice related to chemical dependency C. Impaired practice related to mental illness D. Failure to follow minimum standards of practice

A registered nurse is educating a nursing student about licensure. What information should the nurse provide? Select all that apply. A. "The hearing for suspension or revocation of a license occurs in a formal courtroom setting." B. "The hearing for suspension or revocation of a license is conducted by a panel of professionals." C. "The state board of nursing may revoke a license in case of a violation without informing the nurse." D. "The nurse must be notified of any charges against him or her and given an opportunity to defend him or herself." E. "The state board of nursing may revoke or suspend a license if a nurse's conduct violates provisions in the licensing statutes."

B. "The hearing for suspension or revocation of a license is conducted by a panel of professionals" D. "The nurse must be notified of any charges against him or her and given an opportunity to defend him or herself" E. "The state board of nursing may revoke or suspend a license is a nurse's conduct violates provisions in the licensing statutes"

In which situation would the Primary method for nursing care delivery be the most effective approach ? A. An older adult is admitted to the day surgery unit for a colonoscopy and discharged to home the same day B. A teenager with a severe brain injury is transferred from the ICU to the neurology unit and discharged to a rehab unit three weeks later C. A young adult is admitted to the surgical unit for a laparoscopic appendectomy and discharged home the day after surgery D. A child is admitted from an external outpatient clinic to the pediatric unit with RSV and discharged to home two days later

B. A teenager with a severe brain injury is transferred from the ICU to the neurology unit and discharged to a rehab unit three weeks later

Which patient care need has the highest immediate priority for the nurse? A. Administering a scheduled 0800 IV antibiotic medication B. Assessing a patient's complaint of severe lower back pain C. Reporting an AM potassium level of 3.6 mEq/L to the provider D. Teaching a patient how to obtain an sputum specimen for AFB

B. Assessing a patient's complaint of severe lower back pain

Only one UAP is available to work on the surgical unit. The nurse in charge determines that this UAP can best be utilized for which patient situation? A. Monitor a newly-admitted patient with esophageal varices for bloody stools B. Obtain vital signs on a patient receiving a blood transfusion after the first 15 minutes C. Accompany a cardiac patient with intermittent chest pain on telemetry to the cardiac cath lab D. Provide wound care to a patient with a surgical site infection in an abdominal wound

B. Obtain vital signs on a patient receiving a blood transfusion after the first 15 minutes

A charge nurse reports to the unit and finds that the other nurse scheduled to work has called in sick. The two UAPs scheduled to work have already arrived. There are 14 patients on the unit with two admissions scheduled. The nurse should take which action first? A. Send the UAPs out to the unit to start vital signs and personal care B. Request the night shift charge nurse to review the staffing situation C. Notify the immediate nursing supervisor of the specific staffing needs of the unit D. Refuse to accept change-of-shift report until additional licensed help has arrived

C. Notify the immediate nursing supervisor of the specific staffing needs of the unit

A nurse is caring for a patient diagnosed with CAD and sleep apnea. Which action should the nurse delegate to the UAP? A. Discuss weight-loss strategies such as diet and exercise with the patient B. Teach the patient how to set up the CPAP machine C. Remind the patient to sleep on their side instead of their back D. Administer modafinil (Provigil) to promote daytime wakefullness

C. Remind the patient to sleep on their side instead of their back

Which statement by the nurse manager to the new graduate is most consistent with the American Nurses Association's position on safe nurse staffing? A. Organizational charts should be used to identify and establish nurse staffing needs B. Mandated nurse to patient ratios are essential to safe nurse staffing on any unit C. Nurse staffing must be determined by use of a patient classification system. D. Nurse staffing must be adjusted as necessary to meet the needs of each unit

D. Nurse staffing must be adjusted as necessary to meet the needs of each unit

A new patient is recovering from a spinal cord injury. The RN assigned to the patient asks a UAP to turn the patient and the UAP replies "I've never had a patient with a spinal cord injury before." Based on this information, which response by the nurse would be most prudent? A. Turn the patient while the UAP watches B. Ask a LVN to help the UAP turn the patient C. Explain the procedure before allowing the UAP to turn the patient D. Provide direct supervision while turning the patient with the UAP

D. Provide direct supervision while turning the patient with the UAP

A nurse who request safe harbor must never accept the questionable assignment. True or false

False

Medicare and other insurance companies base hospital reimbursement amounts on diagnosis related groups (DRGs). True/False

True

New nursing student graduates will not receive an authorization to test or GN permit until after they pass the Nursing Jurisprudence Exam (NJE) True or False

True