NUR 166 Chap 18, 19, 20, 27 Exam #3 NCLEX Style Questions

Accurately documenting patient care on the patient record.

A patient accuses a nurse of negligence when he trips when ambulating for the first time since hip replacement surgery. Which action is the best defense against allegations of negligence?

As needed

A patient has an order for an analgesic pain medication to be given PRN. When would the nurse administer this medication?

"Sorry, but I am unable to give information about patients to the public. Even when my best friend or a family member asks."

A friend of a nurse calls and tells the nurse that his girlfriend's father was just admitted to the hospital as a patient, and he wants the nurse to provide him with information about the man's condition. The friend states, "Sue seems unusually worried about her dad, but she won't talk to me and I want to be able to help her." What is the best initial response by the nurse?

Design

A home health nurse is using the steps of the SDLC, to design a new system for home health care documentation. The nurse analyzes the old system and develops plans for the new system. What is the next step of the nurse in this process?

Monitoring patient status q1h; turning a patient on bed rest q2h; administering pain medication ordered by the physician

A new nurse who is being oriented to a subacute care unit is expected to follow existing standards when providing patient care. Which nursing actions are examples of these standards?

Confront the nurse and explain how this could be dangerous for the patient

A nurse caring for an older adult patient who has dementia observes another nursing putting restraints on a patient without a health care provider's order. The patient is agitated and not cooperating. What would be the BEST initial action of the first nurse in this situation?

Charting by exception

A nurse documents hypertension in a woman who is 5 months pregnant and then writes a narrative describing the situation. This type of abnormal status can be seen immediately with narrative easily retrieved in what documentation format?

Problem-oriented method

A nurse documents the following patient data in the patient record according to the SOAP format: Patient complains of relieved pain; patient is seen clutching his side and grimacing; patient pain medication does not appear to be effective; call in to primary care provider to increase dosage of pain medication or change prescription. This is an example of what charting method?

The nurse evaluates the patient's goal/outcome achievement

A nurse evaluates patients prior to discharge from a hospital setting. Which action is the MOST important act of evaluation performed by the nurse?

The nurse makes health care decisions for a patient who is uncooperative

A nurse follows the universal patient compact principles for partnership when providing care for patients. Which nursing action does not reflect this philosophy?

Telemedicine and mobile technology

A nurse has a two-way video communication with the specialist involved in the care of a patient in a long-term care facility. This is an example of what type of technology?

"You can link your record to a specific health care organization's electronic health record system."

A nurse helps a patient who has CF prepare a standalone personal health record. Which statement by the nurse best explains this type of information?

A patient who is homebound and needs skilled nursing care.

A nurse is arranging for home care for patients and reviews the Medicare reimbursement requirements. Which patient meets one of these requirements?

Skeletal muscle paralysis that progresses symmetrically and in a descending manner

A nurse is assessing a patient who was exposed to botulism from contaminated food supplies. Which symptom would the nurse expect to find in this patient?

A toddler playing with his 9-year-old brother's construction set

A nurse is assessing children. Which child would the nurse identify as having the greatest risk for choking?

Basing patient care on continuous healing relationships; using evidence-based decision making; using safety as a system priority

A nurse is attempting to improve care on the pediatric ward of a hospital. Which nursing improvements might the nurse employ when following the recommendations of the Institute of Medicine's Committee on Quality of Health Care in America?

The nurse collects data to measure outcome achievement

A nurse is collecting evaluative data for a patient who is finished receiving chemotherapy for an osteosarcoma. Which nursing action represents this step of the nursing process?

"I can make a copy of your record for you right now."

A nurse is discharging a patient from the hospital following a heart stent procedure. The patient asks to see and copy his medical health record. What is the nurse's best response?

6/12/20 0945 30 minutes following administration of morphine 10 mg IV, patient reports pain as 2 on a scale of 1 to 10. M. Patrick, RN; 6/12/20 0945 Patient reports severe pain in right lower quadrant. M. Patrick, RN; 6/12/20 0945 Patient states she does not want pain medication despite return of pain. After discussing situation, patient agrees to medication administration. M. Patrick, RN

A nurse is documenting patient data in the medical record of a patient admitted to the hospital with appendicitis. The health care provider has ordered 10 mg morphine q4h. Which examples of documentation of care for this patient follow recommended guidelines?

Mark the entry "mistaken entry"; add correct information; date and initial

A nurse is documenting the care given to a patient diagnosed with an osteosarcoma, whose right leg was amputated. The nurse accidentally documents that a dressing changed was performed on the left leg. What would be the best action of the nurse to correct this documentation?

Mr. Gray reports that on a scale of 1 to 10, the pain he is experiencing is a 3.

A nurse is documenting the effectiveness of a patient's pain management on the patient record. Which documentation is written correctly?

The nurse devises a post-discharge questionnaire to evaluate patient satisfaction.

A nurse is evaluating nursing care and patient outcomes by using a retrospective evaluation. Which action would the nurse perform in this approach?

The nurse details the patient's response and the examination and treatment of the patient after the incident.

A nurse is filing a safety event report for an older adult patient who tripped and fell when getting out of bed. Which action exemplifies an accurate step of this process?

Graphic record

A nurse is looking for trends in a postoperative patient's vitals. Which documents would the nurse consult first?

Data visualization

A nurse is reviewing data from EHRs that is transformed into pie charts. What is the term for this presentation of analytics?

Performance

A nurse is testing a new computer program designed to store patient data. In what phase of testing would the nurse determine if the system can handle high volumes of end-users or care providers using the system at the same time?

A patient problem list

A nurse is using SOAP format to document care of a patient who is diagnosed with type 2 diabetes. Which source of information would be the nurse's focus when completing this documentation?

Predictive analysis

A nurse is using informatics technology to decide which patients may be at risk for readmission. What is the term for this type of analytic?

Knowledge

A nurse is using information from informatics tech that is synthesized so that relationships between lung cancer diagnoses and smoking are identified. What part of "DIKW" does this represent?

"1/20/20- Outcome not met. Patient reports no change in diet or activity level"

A nurse is writing an evaluative statement for a patient who is trying to lower cholesterol through diet and exercise. Which evaluative statement is correctly written?

Graphic sheets

A nurse takes a patient's pulse, respiratory rate, blood pressure, and body temp. On which form would the nurse most likely document these results?

Identifying evaluative criteria and standards; collecting data to determine whether evaluative criteria and standards are met; interpreting and summarizing findings; documenting your judgement; terminating, continuing, or modifying the plan

A nurse uses the classic elements of evaluation when caring for patients. What is their correct sequence?

Involve family members in the patient's care

A nurse working in a long-term care facility institutes interventions to prevent falls in the older adult population. Which intervention would be an appropriate alternative to the use of restraints for ensuring patient safety and preventing falls?

Cognitive

A nurse writes the following outcome for a patient who is trying to lose weight: "The patient can explain the relationship between weight loss, increased exercise, and decreased calorie intake." This is an example of what type of outcome?

Affective

A nurse writes the following outcome for a patient who is trying to stop smoking: "The patient values a healthy body sufficiently to stop smoking." This is an example of what type of outcome?

Quality by inspection

A quality-assurance program reveals higher incidence of falls and other safety violations on a particular unit. A nurse manager states, "We'd better find the people responsible for these errors and see if we can replace them." This is an example of:

State: "I am sorry, but VOs can only be given in an emergency situation that prevents us from writing them out. I'll bring the chart and we can do this quickly."

A resident who is called to see a patient in the middle of the night is leaving the unit but then remembers that he forgot to write a new order for a pain medication a nurse had requested for another patient. Tired and already being paged to another unit, he verbally tells the nurse the order and asks the nurse to document it on the health care provider's order sheet. What is the nurse's best response?

Providing drug, alcohol, and sexuality education

A school nurse is preparing a teaching session on safety for parents of school-aged children. What would be an appropriate topic for this age group?

Modify the care plan after discussing possible reasons for the student's partial success

A student health nurse is counseling a college student who wants to lose 20 lbs. The nurse develops a plan to increase the student's activity level and decrease her consumption of the wrong types of foods and excess calories. The nurse plans to evaluate the student's weight loss monthly. When the student arrives for her monthly "weigh-in," the nurse discovers that instead of a projected weight loss of 5 lb, the student has lost only 1 lb. Which is the best nursing response?

Quality Improvement

After one nursing unit with an excellent safety record meets to review the findings of an audit, the nurse manager states, "We're doing well, but we can do better! Who's got an idea to foster increased patient well-being and satisfaction?" This is an example of leadership that values:

As soon as possible

For a client with self-care deficit, the long-term goal is that the client will be able to dress himself by the end of the 6-week therapy. For best results, when should the nurse evaluate the client's progress toward this goal?

By 8/18/20, patient will demonstrate improved motion in left arm

Nurses formulate different types of goals for patients when planning patient care. What is considered a psychomotor patient goal?

User acceptance

Nurses test new tech in phases. In which phase would the nurse "test drive" the new system?

The transition from fee-for-service models to value based payment models

Population health addresses the health status and health issues of aggregate populations and addresses way in which resources may be allocated to address these concerns. What is the driving force behind the use by health corporations of analytics and big data to support population health?

Interoperability

The nurse is able to share patient data stored on an EHR with a specialist in another country. What is the term for this advantage of informatics use?

Take the restraints off, stay with her, and talk gently to her

The nurse is caring for an 80 yo patient who was admitted to the hospital in a confused and dehydrated state. After the patient got out of bed and fell, restraints were applied. She began to fight and was rapidly becoming exhausted. She has black-and-blue marks on her wrists from the restraints. What would be the most appropriate nursing intervention for this patient?

The nurse meets with nurses or other health care professionals to discuss some aspect of patient care.

The nurse is finding it difficult to plan and implement care for a patient and decides to have a nursing care conference. What action would the nurse take to facilitate this process?

The seat belt stays low on the hips and is not resting on the soft part of the stomach.

The nurse is performing a safety belt fit test for a young patient at a well-child checkup. What criteria confirm that the child may sit in the back seat of a vehicle with a lap and shoulder belt in place?

Design

The nurse is using the SDLC to implement the placement of new computers in the workplace. In what stage of this process would the nurse most likely consult with coworkers for their input in creating new work stations?

Optimization

The nurse meets with coworkers to discuss and make improvements to a new EHR reporting system being used in their office. What is the technical term for this core concept?

The effect of genetic makeup on the drug prescribed.

The nurse reviews the list of drugs that have been prescribed for a patient based on pharmacogenomics. What is the basis for this emerging practice?

Consider using multifactor authentication

The nurse using EHRs for patients decides upon a password to keep the patient information safe. Which password guideline is recommended?

Outcome

The quality assurance model of the ANA identifies three essential components of quality care. Which one of these components does the nurse use when determining whether a patient has met the goals stated on the care plan?

Continue the care plan if more time is needed to achieve the goals/outcomes

Which action is appropriate when evaluating a patient's response to a care plan?

Review each preceding step of the nursing process

Which action should the nurse take when client data indicate that the stated goals have not been achieved?

A nurse allows a patient to see and copy her own health record.

Which nursing action is an example of properly handling the patient record?