Nursing 138 - Exam 1 Part 2

Health promotion plans need to be developed according to the needs, desires, and priorities of the client. What is the first step in developing a joint promotion/prevention plan?

1. Reinforce strengths and competencies of client 2. Review and summarize data from assessment 3. Determine a time frame for implementation 4. Identify behavioral or health outcomes

Family members are seeking an institution, which involves stimulation and socializing, where their grandmother could periodically attend since she can no longer be home alone. The nurse would suggest which of the following health care agency?

1. Retirement center 2. Assisted living center 3. Skilled nursing facility 4. Day care center

A client is receiving a full knee replacement. Before surgery the client shares with the attending nurse that s/he dreams of climbing Half Dome with his/her son after rehabilitation. Which of Kalish's hierarchy of needs does the nurse recognize in the client? Rank each answer in order of importance.

A) Self-actualization B) Stimulation C) Love and belonging D) Physiologic

A nurse is performing a health assessment of a 25 year old patient who has been smoking for five years. The patient states that she has tried to quit smoking for the past year, but finds it difficult to do so in the midst of her demanding graduate program. What should the nurse say?

"Health is wealth. You should prioritize your quitting over your schooling." " Have you tried exercising to alleviate your stress instead of smoking?" "What would be the pros and cons of quitting smoking right now?" "Here is a flyer for a support group that could help you quit smoking."

A patient with asthmatic symptoms has expressed to their nurse that they are considering quitting smoking. The nurse recognizes that this patient is in the contemplation stage of health behavior change. What is the nurse's best response to help move the patient to the next stage?

"I've been waiting for the day when you when you would say that." "Great. I will help you create a plan you can follow to accomplish this change." "Wonderful. I will prescribe you a nicotine patch so you won't be tempted with cravings." "Good for you. I hope you're ready for this difficult challenge ahead of you."

An elderly client informs a nurse of an inability to fill a prescription due to cost, stating "I just don't understand, I have Medicare but they told me I don't have prescription coverage". How should the nurse respond?

"That's too bad. Perhaps you can pay out of pocket or get by without the medication." "Medicare Plan D covers prescription medication, perhaps you should enroll." "Medicare Plan B covers prescription medication, perhaps you should enroll." "Medicare does not cover prescription medication; you will have to enroll in coinsurance to have medication coverage."

A nurse is discussing a discharge plan with a patient in order to promote healthy choices and prevent further illness after the patient's procedure. The patient appears nervous about the upcoming changes. What advice could the nurse offer this patient to establish healthy self-care techniques?

"Try having a glass of wine at dinner to help unwind and relax from a stressful day" "Go to a quiet place to concentrate on breathing and meditation to reduce stress" "Check the internet when any symptoms arise to be sure of any possible illnesses" "Try various activities or mind-body therapies to find a self-care system that works"

A 65 year-old patient gets admitted to the hospital for chronic heart failure (CHF) and declares to the nurse that s/he is an alcoholic and is considering changing his/her behavior. What should the nurse say to the patient?

"You shouldn't wait a year to stop drinking, you should stop immediately." "My dad was an alcoholic for 30 year and he died from CHF at 60." "I will gather some information for you about alcohol addiction programs." "Drinking alcohol is fun, you don't necessarily need to stop any time soon."

A client tells the nurse that he is aware that his chemotherapy is no longer effective, he will most likely live two more months, and that he wants to die at home. The nurse should respond:

1) "Would you like to learn about in-home hospice services?" 2) "Would you like to discuss this with your family first?" 3) "Would you like to reconsider? Nothing is certain in medicine." 4) "Would you like to fill out an advance care directive?"

A caring nurse:

1) Approaches each patient equally 2) Lobbies for more time with each patient 3) Continues learning through online classes 4) Reflects on events to learn from experiences

A patient is admitted to a cardiac rehabilitation center following an acute myocardial infarction. The care plan consists of physical therapy, psychological rehabilitation and regular exercising. These are examples of:

1) Illness prevention 2) Primary prevention 3) Secondary prevention 4) Tertiary prevention

According to "Failure to Rescue" by Clarke and Aiken, which of the following is least associated with failure-to-rescue rates?

1) Patient's clinical characteristics 2) Patient-nurse ratio 3) Portion of RNs relative to other nursing personnel 4) Technology and services available

The nurse is educating a patient who uses indoor tanning regularly about the risk of skin cancers associated to indoor tanning. The patient refuses to quit using indoor tanning saying that "No worries, I know indoor tanning is much safer than direct sun tanning. Let's not talk about this." The nurse recognizes that the patient is in which stage of the health behavior change process?

1) Precontemplation stage 2) Contemplation stage 3) Preparation stage 4) Action stage

The nurse should do which of the following in providing patient-centered care? Select all that apply.

1) Recognize the patient as the source of control 2) View the patient as a full partner in care 3) Respect patient's preferences, values, and needs 4) Implement all necessary physician care orders

A patient gives the nurse a long list of barriers to losing excess weight. The nurse perceives which one of the following?

1) The patient does not want to lose the excess weight. 2) The patient may have decreased commitment to lose weight. 3) The patient cannot be convinced to lose excess weight. 4) The patient will have extreme difficulties in losing excess weight.

Which behavior would demonstrate that a person is self-actualized, according to Maslow?

1) The person desires to change the world, is optimistic. 2) The person desires to see the best in people, is trusting. 3) The person desires privacy, is remote and detached. 4) The person desires the good opinion of others, is hopeful.

An expert nurse with knowledge on the "Failure to rescue" concept would ask all of the following questions except

1. "How many patients am I caring for this shift?" 2. "How many nurses am I working with this shift?" 3. "How many deaths have occurred in this hospital?" 4. "How quickly am I able to utilize my resources?"

A nurse is approached by the daughter of an elderly man who is being treated for pneumonia. The daughter states that her mother recently passed away and the father is lonely and would be comforted if the nurse would sit with him for a few minutes during his meals. How would the nurse respond?

1. "I am sorry but I am so busy and don't have time to sit with him." 2. "I will arrange for someone to sit with your father." 3. "I would be happy to sit with him as much as I am able to." 4."I'm sorry but that is not part of my duties as a nurse."

A patient has just received a diagnosis of cancer that requires immediate chemotherapy. The nurse caring for this patient wishes to go over their medication options, including an opportunity to participate in a new drug trial. Although the nurse believes the latter option is the best choice, what should the nurse say to the patient in order to clarify their values?

1. "I have looked into it, and you should consider the drug trial. It may be the best option for you. What do you think?" 2. "If I were you, I would weigh both options before making my final decision." 3. "Have you had time to consider both options? Have you thought about any other course of action that you would like to discuss?" 4. "I'm sorry, but we are running out of time and you need to pick one option now."

A 70 year-old woman who has been a life-long smoker is in the hospital with severe COPD. If in the precontemplation stage, how would she respond when her nurse explains to her the importance of quitting smoking?

1. "I have tried before. It is hopeless." 2. "I am going to buy Nicorette gum on my way home." 3. "I haven't smoked in 2 weeks and my husband promised to not buy them for me." 4. "I stopped a awhile ago. I'm not touching another cigarette."

A nurse is dissatisfied in their relationship with the nurse manager on shift. The nurse says "I think that if we talk through our problems, we can have a much stronger working relationship." According to the Thomas-Kilmann Conflict Mode Instrument, what is likely the nurse's dominant conflict management style?

1. Accommodating 2. Collaborating 3. Competing 4. Avoiding

A patient would like to know why a diagnostic test is being run and the nurse responds with "I'm not aware of the reason but will go and find out for you". When the nurse returns to the patient with the answer the nurse is acting under which principle?

1. Beneficence 2. Nonmaleficence 3. Fidelity 4. Justice

A nurse arrives at work and is told to float to the critical care unit (CCU) for the shift because it is short staffed. The nurse has never worked in the CCU. What is the appropriate action?

1. Call the hospital lawyer. 2. Refuse to float to the ICU. 3. Call the nursing supervisor. 4. Identify tasks that can be performed safely in the CCU.

A patient is diagnosed with cancer, and after he/she received all the required information he/she decides not to follow any treatment. The nurse reaction is to:

1. Call the specialist to talk to the patient 2. Respect the patient's decision to choose 3. Advise patient is best to have a treatment 4. Organize a meeting with patient's family

An elderly patient has been admitted to a facility that offers nursing care (limited), transportation and social activities. She will have a private room, and will likely stay here long-term because she is unable to live alone. What type of health-care facility will she live in?

1. Extended (long-term) care facility 2. Assisted living center 3. Rehabilitation center 4. Home health care agency

A patient postoperative gallbladder removal was transferred to the surgical floor. The nurse did not properly monitor and review trends in the patients vital signs. The patient went into shock and died. What could the hospital have done to prevent this outcome?

1. Have more doctors on staff to attend to postoperative patients. 2. Have only the charge nurse provide care for postoperative patients. 3. Have nurses prepared and supported to handle possible complications that can occur with postoperative patients. 4. Have a case manager assigned to all postoperative patients.

An elderly client, alert and oriented, with a terminal cancer and multiple comorbid conditions refuses to receive anti-cancer treatment. His family insists on continuing the treatment. What should the role of the nurse be in family disagreement?

1. Help the client to understand the concerns of the family 2. Continue the anti-cancer therapy in client's best interest. 3. Say, "I can't be involve in the family disagreement". 4. Be an advocate for the client.

What could help to improve learning strategy in order to improve the quality and safety of healthcare system? Check all that apply.

1. Increase number of years students spend in a Nursing school. 2. Require all nurses to be CNA. 3. Require nursing students to practice all nursing skills on each other. 4. Promote critical thinking in majority of nursing classes.

According to Maslow's needs theory, a Self-Actualized person would not possess the following characteristics:

1. Is realistic and objective 2. Is highly dependent 3. Is open to new ideas 4. Is friendly and loving

A novice nurse is assigned a Native-American patient. The patient does not look at the nurses' eyes; thus the nurse determines:

1. Patient is simply being disrespectful 2. Needs to report his/her patient behavior 3. It is a cultural behavior in native-Americans 4. Ask the patient to look at his/her eyes

A nurse on a Medical-Surgical nursing unit is preparing to discharge his patient who has been recovering from surgery for several days and is very frail and without a good support system. Discharge planning should include all of the following EXCEPT:

1. Preparing for the patient's discharge as soon as they are admitted. 2. Gather as much information as possible to give to a home health agency about the patient and the hospitalization. 3. Be familiar with the resources available in the community to make a referral. 4. Provide instruction on all necessary further treatment and insure the home health agency implements them safely.

A nurse is assessing a 20 year old patient who has anxiety about the recent passing of her mother to breast cancer and a history of cancer on her maternal side. Which level of prevention would be most appropriate for the nurse to implement with this patient?

1. Primary Prevention: The nurse should refer the patient to a breast-cancer specialist for further assessment. 2. Primary Prevention: The nurse should refer the patient to a support group for loved ones lost to cancer. 3. Secondary Prevention: The nurse should teach the patient how to perform regular breast exams. 4. Tertiary Prevention: The nurse should urge the patient not to worry but recommend a mammogram at 22.

A nurse is speaking with a seventeen year old woman who is pregnant. In their assessment, the patient discusses her failed relationship with the baby's father who was verbally abusive.The patient then states that she is excited to have a baby so she can experience "real love". According to Maslow's Hierarchy of Needs, which basic need is the patient seeking to fulfill?

1. Safety & Security 2. Success & Self-Esteem 3. Love & Belonging 4. Nurturing & Dependence

A nurse in a community clinic is informing pregnant women that breastfeeding is more beneficial for their newborns' health than formula feeding. The nurse is applying:

1. Secondary prevention 2. Primary prevention 3. Tertiary prevention 4. Experience prevention

A charge nurse is attempting to integrate better teamwork and collaboration within her staff of nurses. According to Cronenwett et al in an article entitled, "Quality and Safety Education for Nurses", which action demonstrates that she understands the teamwork and collaboration principles in QSEN and making sure patients receive the best possible care? Select all that apply.

1. She requests that nurses treat the patient and their family as the center of the healthcare team. 2. She requests that nurses treat the patient only as the center of the healthcare team. 3. She requests that nurses analyze and consider differences in communication styles within the team. 4. She requests that nurses urge the family to communicate in a way that is sensitive to the patient's emotions.

Because of cultural and linguistic differences, a client has failed to follow a health promotion plan developed by a nurse. What should the nurse do ?

1. Speak to the clients physician about noncompliance. 2. Not treat the client due to noncompliance 3. Persuade the client to comply with the plan. 4. Not force the client to comply and give up the plan.

Which of the following patient problems is considered of the highest priority on Maslow's hierarchy of human needs?

1. Spiritual distress 2. Homelessness 3. Decreased skin turgor indicating dehydration 4. Impaired interpersonal relations

According to Prochaska, Norcross, and DiClemente, which stage in health behavior change would include when the client no longer experiences temptation to return to previous unhealthy behaviors:

1. Termination Stage 2. Action Stage 3. Maintenance Stage 4. Contemplation Stage

A nurse observes an anesthesia resident placing an arterial line in a client. During the procedure, the nurse notices that the anesthesia resident is not adhering to sterile technique as outlined by hospital policy. What action should the nurse take?

1. The nurse contacts the attending anesthesia provider to inform the provider of break in sterile technique. 2. The nurse refrains from interfering, recognizing the anesthesia resident's level of professional expertise. 3. The nurse informs the anesthesia resident that the nurse will complete the procedure in order to maintain adherence to hospital policy. 4. The nurse reminds the anesthesia resident that sterile technique is important to prevent hospital acquired infections and offers assistance.

An expert nurse is expanding their sex-education program to teens in a Latino community center. The center director has advertised the program and brought condoms to give out. According to Berman, which of the following variables represent barriers to the success of the program? Select all that apply

1. The nurse's perceived self-efficacy 2. The teens' perceived benefits of action 3. Interpersonal influences 4. The director's perceived benefits of action

A nursing student exercised 20 minutes, ate a balanced breakfast, and meditated for 5 minutes before going to clinical. Which one of the following is a consequence of these actions?

1. The nursing student lost 25 minutes of valuable study time. 2. The nursing student increased ability to care for others. 3. The nursing student modeled beneficial healthy behaviors. 4. The nursing student was selfish by performing these actions.

A hospital volunteer asks a nurse on shift what jobs they recommend in healthcare. The volunteer is interested in direct interaction with patients and a lot of autonomy, but believes their hands are not steady enough for surgery. Which of the following members of the health care team are appropriate? Select all that apply.

1. Unlicensed assistive personnel 2. Case manager 3. Podiatrist 4. Social worker 5. Massage therapist

What type of unit is a nurse working on, if it has it's own admitting, pharmacy, lab, and radiology departments ?

1. case managed unit 2. patient focused unit 3. hospice unit 4. oncology unit

A 35 year-old male has been diagnosed, and is being treated for Diabetes mellitus type 2. He knows the importance of changing his lifestyle and now exercises daily and eats healthy nutritious meals. This demonstrates which kind of prevention(s)?

1. primary prevention and secondary prevention 2. secondary prevention and tertiary prevention 3. tertiary prevention 4. secondary prevention

A client with COPD returns to the clinic for a follow up appointment and tells the nurse, "I've been doing everything the doctor has recommended. I have learned to chew gum instead of smoking and it seems to really be helping." Based on the stages of health behavior change, the nurse understands that this is an example of:

1.) Action 2.) Termination 3.) Maintenance 4.) Change

The nurse notices that the client is crying because she just lost her mother. By sitting with the client, the nurse is exhibiting which of the following caring encounters:

1.) Empowering the Client 2.) Nursing Presence 3.) Compassion 4.) Availability

A nursing school graduate is interested in working in primary health care and asks her/his mentor for advice. To what type of setting should the mentor direct the graduate?

A health clinic on a college campus An urgent care clinic in a hospital A skilled nursing facility in a suburban area. A family practice in an urban area.

Select from these options, those that would be considered Health Insurance Portability and Accountability Act (HIPPAA) violations

A nurse not minimizing the charting software before leaving the computer station, leaving the screen visible to others Having a friend in the lab look up old lab results for a family member Discussing an interesting case with another nurse without identifying the individual patient A hospitalist calling an oncologist to discuss a cancer patient who has just been admitted to the hospital

Which of the following is NOT ethical practice regarding end-of-life issues? Select all that apply:

A nurse withholds food because it is more harmful to administer it to the patient than to withhold it. A nurse withholds life-sustaining treatment at the request of the patient, although the family has requested life-sustaining treatment be continued. A nurse administers life-sustaining treatment to the patient at the request of the family, although the patient requested withdraw of life-sustaining treatment. A nurse administers a lethal dose of medication to the patient at the patient's request.

An RN is on shift with 12 patients; 4 critically ill. He has one other RN on shift with him and one CNA due to illness among staff. One of the critically ill patients has a 102° temp and another started to vomit blood. What should the RN do?

A. Call the charge nurse for help. B. Keep doing his job. Two RNs are perfectly adequate for this situation. C. Have the CNA take charge of the patients that are not critically ill. D. Discuss the situation with his RN colleague so that the patients are appropriately divided among them.

A patient undergoing life-saving surgery suffers a ischemic attack in the brain and is rendered vegetative. The family has decided to allow natural death. The nurse monitoring the patient has become increasingly uncomfortable and brings the situation to the charge nurse. Which response is most likely to reduce or alleviate the discomfort of the nurse?

A) "Have you discussed your concerns with a therapist?" B) "Have you taken advantage of hospital resources to reduce stress?" C) "Have you followed Thompson and Thompson's decision making models?" D) "Have you used the 4A process?"

A nurse who is relatively new to the Critical Care Unit at Clooney General has noticed that the repeated actions of a renowned physician have put his/her patient at risk for further injury. The physician has threatened to have the nurse fired if he/she discloses information on the questionable practice. Knowing this to be a fact, what should the nurse do?

A) Discuss the questionable practice with the charge nurse in hopes of support. B) Report the questionable practice to the regulatory agency which evaluates standards of practice. C) Discuss the questionable practice with a lawyer in lieu of the upcoming legal battle. D) Report the questionable practice to the Chief Physician of Clooney General.

A 3 year old boy is brought into the community clinic for a check up by his overweight parents. He weighs 26 lbs. and is considered obese. It is important for the health care provider to discuss with the parent: (select all that apply)

A) Healthy eating habits B) Eating the same diet as adult C) Encourage family exercise D) Call CPS for child endangerment

A nurse is interviewing a male patient of Asian descent who averts his gaze. The patient is accompanied by his child, but the child has no trouble looking at the nurse during the interview and translating as needed. This shedding of cultural characteristics in favor of those in a new country demonstrates the principle of:

A) Indoctrination B) Acculturation C) Adaptation D) Assimilation

A patient is receiving dialysis 5 times a week for end-stage renal failure and was recently diagnosed with prostate cancer. They determine that they would like to stop receiving treatment, and return home to die. Which principal supports the patients right to choose death?

A) Justice B) Autonomy C) Nonmaleficence D) Beneficence

Which example of best illustrates the principle of empowering the client?

A) Listening to the life story of the client. B) Displaying vast amount of knowledge about the diagnosis of the client. C) Maintaining a warm and friendly demeanor. D) Educating the client and his/her family about health promotion.

A female patient who uses intravenous drugs is being screened for sexually transmitted diseases. The patient expresses remorse for use of drugs and states being ready to change. What stage of the Transtheoretical model proposed by Prochaska, Redding, and Evers is the patient in?

A) Preparation stage B) Precontemplation stage C) Contemplation stage D) Action stage

The physician has ordered an MRI for a patient exhibiting confusing and disorientation following a car accident. The nurse explains to the patient the procedure, its benefits, possible complications, alternatives, and the risks of doing nothing. The patient makes no coherent response to this explanation. Which statement best describes ethical treatment by the nurse?

A) The nurse notes a failure to agree to the procedure in the chart and does not wheel the patient to imaging. B) The nurse notes patient is not mentally competent and does not wheel the patient to imaging. C) The nurse recognizes symptoms which justify implied consent to the procedure and takes patient to imaging. D) The nurse brings a friend of the patient to the room, explains the procedure again, and uses consent of the friend to justify taking the patient to imaging.

A nurse notices that her patient hasn't touched any of the food on their dinner tray. After politely questioning the patient, the nurse learns the patient is Jewish and will only eat Kosher food. The nurse should then:

A) call the patients family and ask them to provide the kosher meals B) ask the patient to eat now, a kosher meal can be arranged for tomorrow C) scold the patient for not mentioning it sooner D) call the dietary department to request a kosher meal

A nurse living and working at a hospital in North Carolina is looking to pick up shifts at a hospital across state lines in Virginia. A colleague tells her...

A. "In order to work there, you will have to get an additional state license in Virginia." B. "You can only work in one state at a time." C. "You can work there under your North Carolina license if they have an interstate arrangement in place." D. "You can work in any state under the same license."

A client with chronic back pain asks a nurse about mind-body therapies. The nurse's best response is:

A. "Yoga is a mind-body therapy that could help with your back pain." B. "I can provide you with a list of recommended chiropractors." C. "Complimentary therapies are unfounded and will likely provide little or no relief." D. "I know of a great acupuncturist, let me get the phone number for you."

A mother is concerned that her child is not exhibiting appropriate behavior for his/her age. Using developmental stage theories, how should the nurse respond? Check all that apply.

A. "You should speak with a child psychologist" B. "Choose your battles; safety should be a priority" C. "You can expect your child to begin speaking in sentences" D. "You should not worry, no two children are exactly alike" E. "Having imaginary friends is typical for a 3 year old"

What is the best example of Tertiary Prevention?

A. A nurse refers a client with Chronic Obstructive Pulmonary Disease to a support group. B. A health care provider performs a risk assessment for any genetic or acquired diseases. C. A nurse teaches a client how to perform regular breast and skin self-examinations. D. A nurse implements a care plan in response to a nursing diagnosis of acute pain.

Which of the following scenarios is an example of perceived self-efficacy in a patient?

A. A patient has trouble eating healthy because of the lack of restaurants in her community that offer healthful menu items. B. A patient stays motivated to keep exercising because it makes her feel energized and decreases her stress levels. C. A patient has difficulty following a diet and exercise program because he has little support from family and friends. D. A patient feels confident in his ability to follow a new exercise and diet regimen in order to lose 100 pounds.

A patient with pancreatic cancer is in the hospital. The lucid patient claims that they are "ready to go" and refuses to eat or drink any longer. The spouse of the partner gets angry and tells the nurse that they must provide nutrition and liquids to the patient to keep them alive. What does the nurse do?

A. Attempts to convince the patient to eat but, when that fails, obtains orders for a feeding tube. B. Spoon feeds the patient applesauce against their will. C. Advise the spouse to respect the patient's wishes and direct them to a counseling support group. D. Respects the patients wishes but checks with them regularly to see if they have changed their mind.

Jennie and Jayson are nursing students who have just finished their first day of clinical rotations. They decide to meet up with some friends afterwards to discuss the details of their first day. Jennie notices that Jayson has taken photos of his patients from earlier that day and is showing them to his friends. He is also saying their full names and revealing their conditions. Jennie decides to bring this to the attention of the clinical instructor, as well as reminding Jayson of the HIPAA regulations. In this situation, which of the following "C's of Caring" is Jennie most appropriately utilizing?

A. Caring B. Competence C. Conscience D. Comportment

An obese patient decides to lose weight. He purchases a gym membership to start exercising. According to the Transtheoretical model, which stage of health behavior change is the patient in?

A. Contemplation Stage B. Maintenance Stage C. Action Stage D. Preparation Stage

Which of the key terms do the following principles apply to? Care across the life span, discharge planning, preparing clients to go home, home health care teaching, and referrals.

A. Continuity of care B. Community-based nursing C. Primary health care D. Integrated health care system

A school nurse is looking to implement health prevention measures on campus. Which of the following is an example of a secondary prevention?

A. Coordinating influenza vaccinations during flu season. B. Installing alcohol based sanitizers in public areas. C. Bringing in a group of student nurses for lice removal during an outbreak. D. Referring a student diagnosed with dyslexia to campus tutoring services.

A local hospital has noticed a drastic increase in deaths associated with nursing errors. What process should the hospital implement first in order to address and further prevent such errors?

A. Design and implement Checklists B. Color coded labels on medications C. Increase pharmaceutical staff D. Only allow doctors to administer medications

Two nurses work on the same floor, but on different shifts and they each cover the same patients. One of the patients notices that each nurse responds to complaints and requests in different, but effective ways. This is due to:

A. Ethical Knowing: The Moral Component B. Personal Knowing: The Therapeutic Use of Self C. Aesthetic Knowing: The Art of Nursing D. Empirical Knowing: The Science of Nursing

A patient is admitted to the emergency room at the hospital with alcohol poisoning. He has been seen at the hospital many times and is often referred to a rehabilitation house upon discharge. Many of the nurses feel that he should not be treated as their prior efforts to care for him have " been in vain". Which of the following describes this ethical conflict?

A. Fidelity versus autonomy B. Justice vs. benefience/nonmalefience C. Veracity vs. benefience D. Autonomy vs. benefience

There are three levels of prevention in health care. Select all that apply:

A. Health promotion B. Initial assessment C. Diagnosis / treatment D. Health restoration

An expert nurse is assisting a novice nurse on how to access patient information via electronic health records. This is an example of which Quality and Safety in Education (QSEN) competency?

A. Informatics B. Safety C. Patient-Center Care D. Evidence Based-Practice

A patient has been in the hospital for one week and will need to be transferred to a skilled nursing facility. What would be the nurse's best next step to ensure continuity of care?

A. Initiate discharge planning for the patient. B. Involve the patient's family in the planning process C. Mail patient's health records to the new facility. D. Arrange for appropriate mode of transportation.

Which of these are stages in Maslow's hierarchy of needs. Select all that apply:

A. Love and belonging needs B, Stimulation needs C. Physiological needs D. Safety and security needs E. All of these are levels in Maslow's hierarchy of needs

A nurse is caring for 85-year-old man who lives alone and is taking multiple medications for chronic illnesses. During the assessment, the patient reports that he does not have a good understanding of medications and sometimes he even forgets to take medications. The nurse explains about his medications and gives him a pillbox to enhance medication adherence. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency?

A. Patient-centered care B. Evidence-based Practice C. Safety D. Informatics

A nurse is consulting with a patient that has just been diagnosed with liver disease due to alcoholism. The patient asks for resources and support to help him "cut back" on his drinking. Which stage of health behavior change is this patient in?

A. Precontemplation Stage B. Preparation Stage C. Contemplation Stage D. Planning Stage

A nurse and his/her patient identify well with each other. The nurse maintains professional objectivity and simultaneously engages in an interpersonal relationship that generates a self-healing process. Which of the nursing theories on caring does this scenario depict?

A. Ray's theory of bureaucratic caring B. Boykin and Schoenhofer's theory of nursing as caring C. Watson's theory of human care D. Swanson's theory of caring

Which of the following is an example of secondary prevention?

A. Referring a patient who had coronary artery bypass surgery to a cardiac rehabilitation program. B. The local hospital offering cholesterol screenings to the public. C. Providing an annual influenza immunization. D. Teaching high school students the dangers of Tobacco use.

As a physician prepares to insert a central line, a nurse observes that the patient's legs are not fully draped as specified on the procedure checklist. The nurse should:

A. Remain quiet because draping the patient's legs is irrelevant to central line insertion. B. Remain quiet because you do not want to second guess the physician or alarm the patient. C. Ensure the doctor is safe when inserting the line, but remind the doctor after of the standard procedure D. Immediately inform the physician of your concern for patient safety regardless of the consequences

Which assessment tool would the nurse be using when asking the patient the following questions: What do you think is wrong? What do you think caused your problem? What have you done to make your condition better? What are your concerns regarding the condition and treatment?

A. The LEARN model B. The 4 C's of culture model C. Assement and diagnose model D. The ABCE model

Which of the following examples best illustrates the principle of competence?

A. The nurse asks the client several health history questions and listens carefully to learn more about the client's health. B. The nurse takes time out of her busy day to massage one of his/her client's that is complaining of neck pain. C. The nurse understands how diabetes affects the body so she is able to provide the proper care to his/her client. D. The nurse spends some time sitting with the mother and father of his/her patient who is critically injured.

Which of the following is an example of the provisions within the ANA Code of Ethics?

A. The nurse must think of others before themselves in all cases. B. The nurse's primary commitment is to the patient, whether an individual, family, group or community. C. The nurse participates in the advancement of the profession before all else. D. The doctor promotes, advocates for, and strives to protect the health, safety, and rights of the patient.

A nurse comes on to a PM home health care shift with orders to make sure that the patient with dementia "eats today." The nurse becomes frustrated after checking on the patient and finding their plate of food untouched. What would be the best first course of action?

A. The nurse should report her findings to her colleague who wrote the initial request. B. The nurse should ask the patient if there is a reason they are not eating. C. The nurse should inform the patients family that if the patient doesn't eat, their condition may worsen. D.The nurse should bring out more food, hoping that the patient will eat it.

A nurse feels an economically constrained healthcare environment is compromising his/her ethical integrity. What should she/he do?

A. Understand that in an economically constrained healthcare environment conditions will never be ideal. B. Tell the charge nurse she/he refuses to work that shift with out more support. C. Email the hospital President and file an official complaint. D. Seek an integrity-preserving compromise not jeopardizing dignity or well being of self or others.

1. A public health nurse wants to provide better access to health care in a neighborhood community that is severely poverty stricken. What type of care would be most appropriate for this area?

A.Primary Care (PC) B. Community-Based Health Care (CBHC) C. Community-Centered Health Care (CCHC) D. Primary Health Care (PHC)

A nurse is discussing a home health case with the nursing assistant that will be staying with the patient on a daily basis to help with health management and daily activities. While discussing the care plan with the nursing assistant, she decides to take a picture of the patient's chart with his or her camera phone and text it to the nursing assistant so that he or she has it on hand in case he or she needs to refer back to it. Is this a safe way for the nurse and the nursing assistant to access patient healthcare information?

Accessing patient health care information through unrestricted email and text is safe as long as it is only shared with the people involved in the case. Accessing patient medical records through unrestricted email and text is safe as long as the nurses have attended Heath Insurance Portability and Accountabilty Act training. Accessing patient medical records through a restricted access system is safe because it protects patient information from being accessed from those not authorized. Accessing patient health care information through unrestricted email and text is safe as long as the physician in charge oversees who is sharing the patient's information.

A teen discovers that she is pregnant and after a long thought out and difficult decision process, she has decided she is going to abort her baby. She goes to the school nurse to discuss her options. This particular nurse is very against abortions for personal reasons. As a client advocate, the nurse should:

Advise the teen that she should consult with her parents before proceeding with her decision. Inform the teen of resources where she can safely and privately follow through with the procedure. Explain why he or she does not believe an abortion is appropriate for the teen. Explain other alternatives, for example putting the baby up for adoption.

A nurse who is attempting to clarify health values of a patient should do the following (select all that apply):

Assist the patient by offering an opinion when asked for one Assist the patent by imposing their personal values Assist the patient by listing alternatives actions Assist the patient by examining possible consequences

A nurse has been assigned their first patient from Afghanistan. The patient is not eating the pork chop that was provided for their dinner on the second night's hospital stay. The night before however, the nurse observed the patient eating the salad that was served. The nurse would best address the uneaten pork chop dinner by:

Bringing other types of food to the patient as they are most likely Muslim Call a dietician to consult with the patient in case they cannot eat pork Consult with the patient and ask if they are not able to eat pork due to their religion Consult with the patient to discover the meaning of their non-eating Bringing the patient a salad for dinner, as they ate that the night before

A patient comes onto the surgical floor after just going through surgery to correct a hemopneumothorax. A newly hired nurse is put in charge of the patient and notices that the patient's vital signs are slowly rising, but still within normal range. The charge nurse just went on break and is nowhere to be found. What should he/she do?

Call a code blue immediately. Wait to see if the patient's vital signs go outside of normal range. Call the attending physician for help. Wait for the charge nurse to come back.

Culturally responsive care is characterized by?

Care that is centered on the client's cultural perspectives and beliefs Care that integrates the client's values and beliefs into the plan of care The nurse develops self-awareness of her own culture All of the above

A nurse turning and moving an immobile patient at risk for pressure ulcers is an example of what kind of caring?

Competence Compassion Comportment Conscience

When considering a patient's preferences regarding their medical indications, a healthcare provider should not do which of the following?

Discuss in detail the burdens of each treatment with the patient. Explain all pathophysiologic considerations before posing treatment options with the patient. Communicate to a patient, what treatment goals are realistic and the likelihood of achieving them. Ask noncontextual open-ended questions like, ''What do you want us to do?''

Richard is an 85 year old patient that has come to the hospital with a kidney infection. Richard lives with his son's family and is in the beginning stages of dementia. His son has accompanied Richard to the emergency department. The nurse is concerned because this is the third time in the last 6 months that Richard has had problems with his kidney. Richard's son wants to discuss alternative treatments for his father. What is the correct action for the nurse to take?

Discuss the medical condition with Richard's son since it's obvious that Richard would not understand? Discuss the medical condition with Richard only and ask his son leave to give them privacy. Just send Richard home with another round of antibiotics Ask Richard to give permission for his son to discuss the medical condition with both Richard and his son explaining the risks and benefits of the different available options for treatment

Of the following list; which 2 of the 4 are types of knowledge, as identified by Carper, that are integrated to guide the nursing practice?

Embedded Personal Ethical Caring

During lecture the nursing students learn the importance of Maslow's hierarchy of needs. What type of knowledge are they learning?

Ethical Knowing: The Moral Component Personal Knowing: The Therapeutic Use of Self Aesthetic Knowing: The Art of Nursing Empirical Knowing: The Science of Nursing

Nurse Michael notices a sharp rise in the number of catheter associated urinary tract infections. Upon further investigation, he identifies the problem and brings it to his nurse manager. He says, "I have noticed that some nurses are putting newly unwrapped catheters onto the abdomens of patients before insertion, I think I have identified the reason we have seen a spike in catheter associated urinary tract infections." According to Quality and Safety Education for Nurses (QSEN), Michael is utilizing which area of skill?

Evidence-based Practice Patient-centered Care Teamwork and Collaboration Quality Improvement

A 65-year-old patient is having cataracts surgery in an outpatient surgery center and is sent home the same day. Years ago, the patient's older sibling had cataracts surgery in a hospital and remained in the hospital under observation for ten days. The difference in experience between the two patients can be attributed to which factor affecting health care delivery?

Specialization Increasing number of elderly Advances in technology Patient preference Uneven distribution of services

Which of the following best describe a nurse who employs the principal of Autonomy?

Expresses and defends the cause of another. Respects patient's choice when not in the patient's best interest. Is faithful to promises and agreements made to the patient Spends extra time with the patient during a home visit.

A nurse is caring for the driver from an alleged drunk driving accident that involved two fatalities. What should guide the decision making for this patient?

Follow the facility protocol for treatment of etoh positive patients Follow local laws regarding treatment of an alleged criminal The decisions made must be in the best interests of the patient As an advocate for the family members of the deceased

A nurse checks vitals on a patient and notes his blood pressure was 140/95 and heart rate 77 beats per minute an hour ago. Upon recheck, the heart rate has decreased to 64 beats per minute and blood pressure is 124/81. This is an example of:

Homeostasis Equilibrium Positive Feedback Negative Feedback

Some examples of nursing surveillance can include: (Select all that apply)

Identifying patient complications Screening patient rooms with cameras Evaluating patients on a frequent basis Assessing for patient distress signals

A nurse gives her/his patient the wrong dose of morphine. S/he immediately tells her charge nurse and states that s/he had trouble reading the numbers on the medication. The charge nurse notices that over the past three weeks, many nurses have complained of their inability to read the small numbers on the medication bottles. What should the charge nurse do?

Immediately fire the nurses that are having trouble seeing the labels. Recommend to the nurses that they get their eyes checked and report back. Develop a comprehensive checklist for administering medication. Participate in a root cause analysis of the ongoing and dangerous problem.

A local hospital recently found out their incidence of deaths from nosocomial infections and medication errors was high. Based on the article "Failure to Rescue", which of the following is the best plan of action for hospital administrators to lower these rates if the hospital keeps the same number of patients?

Isolating patients who have been diagnosed with a nosocomial infections. Hiring more Registered Nurses. Hiring more Family Medicine doctors. Changing the shifts for nurses from eight to twelve hours.

A nurse is responsible for ten patients and doing their best with managing the patient's needs. Patient A asks for more pain medication and the nurse replies, "I will go get your pain medication and bring it to you within the next couple minutes". While the nurse is getting the pain medication, they get wrapped up in attending to Patient B for 20 minutes and forgets about bringing the medicine to Patient A. Which moral principle has the nurse violated?

Justice Veracity Nonmaleficience Fidelity

A patient is 65 years old, healthy, and middle class. He/she is doing research on Medicare. Which of the following Medicare options are available to him/her?

Medicare Part B Medicare Part A Medicare Part C Medicare Part D

A twenty year old male comes in for a physical assessment for his new job. During the interview he says that he smokes a pack of cigarettes a day. He knows they are bad for him, but says that since he is young he has plenty of time to quit and not suffer any consequences. What is the best way to take him from the precontemplation stage to the contemplation stage about quitting smoking?

Mention that he should quit every time he comes in. Teach him about the dangers of smoking, focusing on his age. Give him pamphlets about the dangers of smoking. Show him what a smoker's lung looks like compared to a health lung.

When practicing self-care it is important to maintain a healthy lifestyle. What lifestyle practices can help anybody maintain a healthy lifestyle? Choose all that apply.

Nutrition Meditation Recreation Rock-climbing

An example of a secondary prevention health promotion is:

Physical therapy for a nurse with chronic back problems Low salt diet for a 30 year-old man who is pre-hypertensive A needle exchange truck in a community with high rates of HIV contraction due to intravenous drug use Varicella immunizations for children who have not had chicken pox Sex education for junior high school students

Which of the following exemplifies a nurse empowering a client who just found out she is HIV positive?

Providing the client with tools, resources, and support on managing her condition Showing empathy and genuine concern Assessing the client's condition, creating a plan, and implementing it Trying to share the client's joys, sorrows, pain, and accomplishments

A hospital has just had a large hiring of nurses, they all have their Bachelor of Science in Nursing. Which part of the American Nurses Association's Health System Reform Agenda does this change address?

Quality Workforce Access Cost

A 25 year-old woman with a family history of breast cancer in her mother, maternal aunt, maternal grandmother and older sister reports to her nurse that although she knows how to complete a breast exam she does not perform self-breast exams because her fear of finding a lump causes her to suffer anxiety attacks. The woman does not experience anxiety when being examined by a physician. How should the nurse intervene?

Schedule the patient once a month to ensure she is getting frequent breast examinations. Do nothing. The patient is too young to get breast cancer. Tell the patient she has to get over her anxiety because it is a matter of "life or death." Suggest the patient teach her partner how to perform a breast exam on her.

Which of the following activities is an example of tertiary prevention?

Teaching middle aged adults about the importance of weight control and exercise to prevent illness and maintain health. Doing a home hazard appraisal in the home of an aging client whose family has a history of neurological disorders. Referring a new amputee to a rehabilitation center to receive training on how to do daily activities. Referring a new mother to a breast feeding consultant for the best way for a baby to latch on.

A patient tells the nurse that she is a smoker and thinks that smoking is a major reason for her reoccurring respiratory illness. She tells the nurse she has cut back to 8-10 cigarettes per day and asks the nurse for a prescription for a nicotine patch to aid her in quitting completely. What stage of health behavior change is the patient in?

Termination Stage Contemplation Stage Maintenance Stage Preparation Stage

Checklists can be a valuable tool for reducing illness and mortality in a hospital. Which of the following is the most important factor in implementing checklist procedures in a hospital?

That doctors have full respect for supporting staff, like nurses That the checklist is appropriate for the procedure That there is a laminated copy of the checklist at the bedside during the procedure The support of hospital administration who oversee the processes and enforce compliance

A nurse is discussing health promotion with a seven year-old patient's mother. Which of the following topics is most appropriate for this patient based on lifespan considerations?

a) Dental checkups b) Play group influences c) Exercise d) Vision screening e) Weight Control

A client recently diagnosed as prehypertensive with a Body Mass Index of 40 states to the nurse "I am worried about my health. I'm thinking about trying to lose some weight." This client is demonstrating which stage of change?

The client is in the action stage. The client is in the preparation stage. The client is in the contemplation stage. The client is in the precontemplation stage.

A 78 year old pt is transferred to the ICU from an assisted living facility for a respiratory infection. He has end stage pancreatic cancer and a Do Not Resuscitate order. The night of his admission, he becomes bradycardic and apneic. His family demand he be resuscitated and life saving measures be implemented. What is the appropriate response of his nurse?

The nurse administers IV antibiotics to treat the infection. The nurse informs the family that resuscitation is against the patient's wishes. The nurse contacts the attending physician and case manager to explain the DNR. The nurse calls a code team to stabilize the patient.

A patient checks into a wellness center to follow up on lab results. The nurse sees from the patient's chart that the patient has a diagnosis of Diabetes Type I. Which of the following is an example of nursing advocacy for the protection of the patient's rights?

The nurse teaches the patient how to safely administer insulin. The nurse considers the socioeconomic status of the patient in planning care. The nurse presents the patient with medication information in language that is easily understood. The nurse requests a private room to discuss the patient's test results.

Which of the following activities would be considered healthy lifestyle self care behavior by the nursing student?

The nursing student practices yoga three times per week for 30 minutes to increase balance, flexibility and mental alertness. The nursing student practices yoga five times per week for 30 minutes to increase balance, flexibility and mental alertness. The nursing student bikes to school five days per week, for 40 minutes per day round-trip to incorporate vigorous-intensity aerobic physical activity into his/her schedule. The nursing student walks to school five days per week, for 10 minutes per day round-trip to incorporate moderate-intensity aerobic physical activity into his/her schedule.

hospital is instituting mandatory checklists. Several nurses complain, "We already know what we are doing." What reasons should the charge nurse give for implementing the change? Select all that apply.

a) "Due to the complexities of our work, experience is not enough to prevent error." b) "Checklists will empower you to correct doctors when they fail to follow procedure." c) "Health care is trending toward outpatient care, check list's are a teaching tool for patients." d) "Checklists clarify the minimum necessary steps in caring out complex processes."

A nurse overhears a colleague complaining that there is a revolving door for their clients struggling with addiction. What should the nurse say?

a) "Relapse is preventable, the problem is insufficient social support and treatment." b) "Relapse can be fatal, the severity of an addiction is often worse after a relapse." c) "Relapse is common and periods of sobriety predict better success in the future" d) "Relapse is hard on everyone your feelings are understandable, but your client is suffering more."

A nurse is receiving training on becoming more culturally competent in their practice. Which of the following things said to clients demonstrates this practice the best?

a) "Your people use sweat huts, so I can get you access to a sauna." b) "Which type of Asian are you?" c) "Let me know if I do anything that is not acceptable in your culture." d) "Have you considered having your children not just speak Spanish?"

After promising a young patient a cold drink right away, the nurse is distracted by a personal phone call from his/her own child. The nurse chooses to follow-through with delivery of the drink before taking the call. This is an example of which of the Six Cs of Caring:

a) Comportment b) Conscience c) Compassion d) Commitment e) Competence

A patient comes to the emergency department with an apparent broken leg. Although they appear to be in great pain, they refuse any pain medications citing religious beliefs. The nurse believes that they should administer drugs anyway due to the clear pain the patient is in, but still obeys the patient's request. Which moral principle provides the basis for the nurse's actions?

a) Nonmaleficience b) Autonomy c) Fidelity d) Veracity

The nurse is teaching a client who is set to receive dialysis for the first time about arteriovenous fistula development and maintenance after discharge. This teaching most clearly reflects which caring activity?

a) Nursing Presence b) Compassion for the client c) Empowering the client d) Influencing the client

Which of the following attitudes best describe teamwork and collaboration?

a) Only acknowledging one's own potential within team b) Appreciate the risks associated with handoffs among providers and across transitions in care c) Seek learning opportunities with patients who represent all aspects of human diversity d) Value the need for continuous improvement in clinical practice based on new knowledge

A teenager comes in the ER with a broken bone injury. In the interview, the patient states that they just wanted to prove that they could do the same tricks as their older brothers. Which would best describe this teenager's highest priority of human needs?

a) Self esteem b) Safety and security needs c) Physiological needs d) Love and belonging needs

There's a patient who is has had a stroke and smells profusely but also refuses a bath every time asked. Which one of the following would be the best example of Aesthetic Knowing?

a) The nurse states that the patient has bad odor so she gives a bed bath to the patient by force. b) The nurse gives options to patient to figure out a way to work it in with the morning schedule. c) The nurse secretly gives the patient a bath at night while he/she is sleeping. d) The nurse gently explains why baths are important and how they promote health, promising to make the bath quick yet thorough.

In preparation for discharge of a homeless patient, which of the following parameters should the nurse consider? Select all that apply.

a) The patient's cultural beliefs. b) The patient's ability to prepare meals. c) The patient's mental stability. d) The patient's financial ability to obtain prescribed medications. e) The patient's mental health.

The nurse is developing a care plan for a diabetic patient. The patient practices Buddhism and regularly fasts for days at a time. How should the nurse respond?

a. "I'm sorry, but you can't fast with diabetes." b. "I will develop a care plan that respects your lifestyle but fasting will be seriously harmful to your health. Can you tell me more about your fasting habits?" c. "I'll go get the doctor who can explain everything to you." d. "Fasting isn't smart when you have diabetes."

Upon entering the patient's room, the nurse notices that his/her terminally-ill patient has been crying, the urine stains on the linens, and the unkept appearance of the patient. How should the nurse first respond to this situation?

a. Comb the patient's hair b. Get the patient out of bed and change the linens c. Direct the patient to go take a shower d. Ask if there is anything he/she can do to make the patient feel more comfortable

The nurse that is currently caring for a patient with an UTI due to complication of care gets the blame for providing low-quality care to that patient. What impact can this have on the nurse? Select all that apply:

a. Divert resources and attention away from issues of quality b. Damages morale and satisfaction c. Provides constructive criticism d. Contributes to aggressive behavior

When planning for a client's discharge, a nurse should be careful to:

a. Include the client's entire chart/file when being transferred to another level of care or facility b. Include the client and the client's family or support persons in the planning process c. Prioritize the client's physical needs above psychosocial, cultural and spiritual needs d. Not start planning for discharge until necessary, because conditions and medical orders change

Early detection of disease by screening individuals at increased risk of developing certain conditions is an example of what?

a. Primary Illness Prevention b. Secondary Illness Prevention c. Tertiary Illness Prevention d. Quaternary Illness Prevention

The nurse notices an extensive amount of blood loss from a caesarean incision site on the patient. The nurse documents the findings and walks out. An hour later, the patient is found dead due to blood loss. What should the nurse have done to help prevent the patient's death?

a. Recognized possible complications and acted accordingly b. Contacted the charge nurse to respond to the situation c. Called the nurse assistant to take her vitals d. Given her medications to stop the bleeding

The nurse is using an interpreter to communicate with a non-English speaking patient. How should the nurse communicate with the patient despite the language barrier?

a. Speak slowly, loudly, and clearly and maintain eye contact. b. Speak primarily to the interpreter and sometimes point towards the patient. c. When the patient is speaking, listen and maintain appropriate eye contact to show understanding and attentiveness. d. Allow the interpreter to ask all of the questions and take notes.

The nurse has requested the presence of a physician in an intensive care patient's room where contact precautions requiring gown and gloves upon entry are in place. As the physician enters the room in her lab coat, she requests an alcohol prep pad to clean her stethoscope and begins washing her hands. The nurse should first:

a. Support the physician by retrieving a prep pad as requested b. Remind the physician that she is not following contact precaution procedure c. Inform the charge nurse that there is a problem after the physician leaves d. Ask the physician to leave the room

1. While giving an initial assessment, the young patient tells the nurse that she has started to become sexually active. The nurse recommends regular gynecology check ups, and locates several free clinics for the girl to get free condoms and birth control to encourage safe sex. This is an example of which level of prevention?

a. Tertiary prevention b. Secondary prevention c. Early prevention d. Primary prevention