MODULE 1 EXAM

A nurse is part of a multidisciplinary team working with groups of depressed patients. Half the patients receive supportive interventions and antidepressant medication. The other half receives only medication. The team measures outcomes for each group. Which type of study is evident?

Clinical epidemiology

What is the nurse's first action when beginning patient education?

Determine the patient's interest in learning prior to initiation of teaching sessions.

The nurse is admitting a patient who speaks very little English. What is the most appropriate method to use to ensure the patient understands the instructions?

Obtain a hospital interpreter.

A nurse is teaching a patient about his condition. The nurse is demonstrating which core competency for health professionals?

Providing patient-centered care

The cardiac nurse wants to know about the best practices to prevent pneumonia after open-heart surgery. What does the nurse do first?

Search for evidence to answer the question.

A middle-aged woman is referred for a mammogram. What level of illness prevention is being practiced in this situation?

Secondary prevention

The health care facility is implementing a new evidence-based nursing protocol. What is necessary to ensure successful implementation?

Support from the nurses implementing the protocol is present.

After leaving work, a nurse realizes documentation of administration of a PRN medication was omitted. This off-duty nurse phones the unit and tells the nurse, "Please document administration of the medication for me; I forgot to do it. My password is alpha1." The nurse receiving the call should:

refer the matter to the charge nurse to resolve.

A patient who has been diagnosed with breast cancer has many questions related to surgery, radiation therapy, and chemotherapy. The nurse provides education about the disease and treatments but perceives that the patient has further questions about coping with day-to-day situations. The action of greatest benefit to the patient would be:

referring her to a support group for persons with breast cancer.

A nurse uses Maslow's hierarchy of needs to plan care for a patient with mental illness. Which problem will receive priority? The patient:

refuses to eat or bathe

Clinical pathways are used in managed care settings to:

streamline the care process and reduce costs.

A charge nurse overhears an unlicensed assistive personnel (UAP) speaking harshly to a patient who has an expressive aphasia and a left hemiparesis from a stroke. When the UAP leaves the room, the charge nurse decides to speak with her. How should the nurse respond to the situation?

"I am concerned because it sounded to me as though you might be losing patience with Mr. Hernandez."

Matthew is completing his first year of employment as an RN on a medical-surgical unit. A new graduate has just started her orientation on his unit. He found her crying in the patient lounge saying, "I can't do this. This is just not like we learned in school." What response from Matthew demonstrates his leadership skills?

"I remember those feelings. Come on, let's talk about it."

A patient is hospitalized for depression and suicidal ideation after their spouse asks for a divorce. Select the nurse's most caring comment.

"Let's discuss some means of coping other than suicide when you have these feelings."

Which nursing statement illustrates the concept of client advocacy for a female client who was admitted after a suicide attempt?

"The client has stated to me that she does not want to take the prescribed medication because she had adverse effects when it was prescribed previously."

The nurse is developing a clinical question in a PICOT format. What components are included in the question? (Select all that apply.)

-Population -Comparison -Intervention

A sentinel event has occurred that requires review by the Joint Commission (JC). Which of the following events would be included? (Select all that apply.)

-Suicide with around-the-clock care -Infant abduction -Hemolytic blood transfusion reaction

A nurse is assessing a patient who is taking methotrexate (Rheumatrex) for rheumatoid arthritis. The nurse notices that the patient's hemoglobin and hematocrit are 9.2 and 27, respectively. Using the ISBARR method, what should the nurse include in the communication with the health-care provider? (Select all that apply.)

-The nurse's name -The hemoglobin and hematocrit values -The medication -the patients birthday

Which statement best describes the process of nursing case management?

A collaborative process to promote quality and cost-effective care.

Which nursing intervention demonstrates false imprisonment?

A patient has been irritating and attention seeking much of the day. Now a nurse escorts the patient down the hall saying, "Stay in your room or you'll be put in seclusion."

A nurse surveys medical records. Which finding signals a violation of patients' rights?

A patient was not allowed to have visitors.

A nurse has just received the shift handoff report. Which patient should the nurse assess first?

A patient who has asthma and is continuing to have difficulty breathing

A nurse is part of a CQI program that is evaluating the structure within which the care is being given. Which of the following would be evaluated?

Accessibility of support services

You are examining several published articles related to examining evidence for a clinical question you are addressing as part of a process improvement effort at your facility. You are looking for a study that is rated as a Level III or Level IV on the pyramid of evidence which provides a Level of Evidence (LOE) ranking. The appropriate choice would be:

An article which discusses a non-experimental study.

What two legal responsibilities should the RN take into consideration when delegating to others?

Assessing how much supervisory time is necessary and assessing the competence of each staff member

Behaviors of an effective leader include:

Developing oneself and others.

A nurse wants to find a description of diagnostic criteria for anxiety disorders. Which resource would have the most complete information?

Diagnostic and Statistical Manual of Mental Disorders

What QSEN competency is the nurse employing when basing care on respect for the client's preference, values, and needs?

Evidence-based practice

An RN arrives at work and the nurse manager tells her that the ICU needs more help. The RN is the most experienced nurse on this unit. The RN tells the nurse manager she has never worked in the ICU and shares her concerns regarding the lack of familiarity with the technical equipment and protocols of the ICU. The nurse manager states that she understands the RN's concern but is to go to the ICU. How should the RN respond to the situation?

Go to the ICU and inform the charge nurse of the tasks she is able to perform and those tasks with which she feels she needs assistance

Which response by the patient following discharge teaching would require further teaching?

I need to check my blood glucose after eating.

A patient who was involved in a motor vehicle accident is admitted through the emergency department. He has an IV of 0.9% NS @ 100 mL/hr, BP 92/58, and complains of weakness, fatigue, and abdominal pain. On assessment, the nurse discovers that Mr. Reynolds is nauseated and just vomited 560 milliliters of green emesis with flecks of "coffee grounds." The nurse delegates patient care activities to the unlicensed assistive personnel (UAP). Which activity should the nurse keep?

Increasing the IV rate to 250 mL/hr if the blood pressure drops to 85/50

A person says, "I was the only survivor in a small plane crash. Three business associates died. I got depressed and saw a counselor twice a week for 4 weeks. We talked about my feelings related to being a survivor and I'm OK now." Which type of therapy was used?

Interpersonal therapy

Nancy is supervising a patient care assistant and a licensed practical nurse. When giving them assignments she says, "You two decide how you want to divide up the patients." This is an example of what type of leadership?

Laissez-faire

Communication has the best chance of being interpreted accurately when:

More than one mode is used.

The nurse is initiating a series of teaching sessions with an older patient. What is nurse's highest priority action prior to beginning the session?

Make certain the patient is wearing glasses required to see distance and close up.

An RN who has been a nurse for 10 years is precepting a novice RN. The novice is having difficulty prioritizing patient care. What should the RN tell the novice about the principles of prioritizing care?

Maslow's hierarchy of needs

A nurse started a new position in a health-care institution that has implemented interprofessional collaboration. The nurse asks the nurse manager how this differs from what has been done in the past. How should the nurse manager explain interprofessional collaboration?

Members should demonstrate a respect for one another's skills and contributions.

What is an expected outcome for the patient who is scheduled to undergo a surgical procedure if the nurse successfully implements patient-centered care?

Questions about the procedure answered and a signed informed consent.

Delegation is defined as:

Reassigning the responsibility of performing a job from one person to another.

Which action shows an understanding of the principle of self-determination?

The nurse allows a postoperative patient to decide to take medication with fruit juice rather than water.

Which action demonstrates the nurse understands the purpose of the Rapid Response Team (RRT)?

The nurse notifies the physician of the patient's change in systolic blood pressure from 140 to 102 mm Hg.

Several nurses are concerned that agency policies related to restraint and seclusion practices are inadequate. Which understanding about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice?

The policies do not absolve an individual nurse of the responsibility to practice according to professional standards of nursing care.

The nurse is looking for the best interventions for postoperative pain control. When are the facility's policies and procedures an appropriate source of evidence?

When policies are based on high-quality clinical practice guidelines.

Which statement is not involved in the definition of mental health? The individual:

conforms to the culture's view of normal.

In the majority culture of the United States, which individual has the greatest risk to be labeled mentally ill? One who:

describes hearing God's voice speaking.

A nurse influenced by Peplau's interpersonal theory works with an anxious, withdrawn patient. Interventions should focus on

enhancing the patient's interactions with others.

Which intervention by a psychiatric nurse best applies the ethical principle of autonomy? The nurse:

explores alternative solutions with a patient, who then makes a choice.

A 4-year-old grabs toys from siblings and says, "I want that now!" Using Freudian theory, the nurse can interpret this behavior as a product of impulses originating in the:

id

The goal for a patient is to increase resiliency. Which outcome should a nurse add to the plan of care? Within 3 days, the patient will:

identify healthy coping behaviors in response to stressful events.