Problem Questions For Theory

Health care reform will bring changes in the emphasis of care. Which of these models is expected from health care reform? 1. Moving from an acute illness to a health promotion, illness prevention model 2. Moving from an illness prevention to a health promotion model 3. Moving from hospital-based to community-based care 4. Moving from an acute illness to a disease management model

1

Which message would a nurse keeping arms and legs uncrossed during a conversation convey to the patient? 1. is open to what the patient says 2. is feeling uncomfortable with the patient 3. is involved an interested in the conversation 4. is becoming defensive about what the patient is saying

1 (not 3 bc that is leaning forward)

Which of the following are common barriers to effective discharge planning? (Select all that apply.) 1. Ineffective communication among providers 2. Lack of role clarity among health care team members 3. Sufficient number of hospital beds to manage patient volume 4. Patients' long-term disabilities 5. The patient's cultural background

1,2

9. Which of the following statements indicate that the new nursing graduate understands ways to remain involved professionally? (Select all that apply.) 1. "I am thinking about joining the health committee at my church." 2. "I need to read newspapers, watch news broadcasts, and search the Internet for information related to health." 3. "I will join nursing committees at the hospital after I have completed orientation and better understand the issues affecting nursing." 4. "Nurses do not have very much voice in legislation in Washington, DC, because of the nursing shortage." 5. "I will go back to school as soon as I finish orientation."

1,2,3

Which measure would the nurse take when communicating with a visually impaired patient? 1. use at least 14 point print 2. check if the patient wears glasses 3. use indirect lighting and avoid glare 4. enter the room without addressing the patient 5. follow the patient's gestures and non verbal communication

1,2,3

Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities.Which of the following are examples of these roles and responsibilities? (Select all that apply.) 1. Caregiver 2. Autonomy 3. Patient advocate 4. Health promotion 5. Genetic counselor

1,2,3,4

Based on the eight principles of patient-centered care, which action would the nurse take while providing emotional support to the patient? 1. talk to the patient about fears and concerns 2. inform the patient and family how to manage care independently 3. help the patient understand the effect of the illness on the patient and the fmaily 4. explain the procedures and tests in a language the patient can understand 5. identify staff that can alleviate the patient's anxiety about paying for medical care needs

1,3,5

Which statements properly apply an ethical principle to justify access to health care? (Select all that apply.) 1. Access to health care reflects the commitment of society to principles of beneficence and justice. 2. If low income compromises access to care, respect for autonomy is compromised. 3. Access to health care is a privilege in the United States, not a right. 4. Poor access to affordable health care causes harm that is ethically troubling because nonmaleficence is a basic principle of health care ethics. 5. If a new drug is discovered that cures a disease but at great cost per patient, the principle of justice suggests that the drug should be made available to those who can afford it.

1,2,4

Which statements reflect the difficulty that can occur for agreement on a common definition of the word quality when it comes to quality of life? (Select all that apply.) 1. Community values influence definitions of quality, and they are subject to change over time. 2. Individual experiences influence perceptions of quality in different ways, making consensus difficult. 3. The value of elements such as cognitive skills, ability to perform meaningful work, and relationship to family is difficult to quantify using objective measures. 4. Statistical analysis is difficult to apply when the outcome cannot be quantified. 5. Whether a person has a job is an objective measure, but it does not play a role in understanding quality of life.

1,2,4

A 40 yr old patient has poorly controlled hypertension. The dietitian recommended server dietary modifications to the patient. Which technique would the nurse use during the orientation phase of this helping relationship? 1. closely observe the patients behavior 2. prioritize the patient's problems and identify goals 3. review the patients medical history 4. begin the conversation with warmth and empathy 5. work to understand the patients behavior 6. choose a private and quit location for the interaction

1,2,4,5

Which element is necessary for the resolution of conflicting opinions? 1. strict adherence to patient confidentiality 2. patient centered decision making 3. identification of possible outcomes 4. presumption of good will on the part of all participates 5. participation of families and primary caregivers

1,2,4,5

Which of the following are examples of a nurse participating in primary care activities? (Select all that apply.) 1. Providing prenatal teaching on nutrition to a pregnant woman during the first trimester 2. Assessing the nutritional status of older adults who come to the community center for lunch 3. Working with patients in a cardiac rehabilitation program 4. Providing home wound care to a patient 5. Teaching a class to parents at the local grade school about the importance of immunizations

1,2,5

Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which duty is the responsibility of a nurse as a patient educator? 1. explain concepts and facts about health to a patient 2. protect the patients human and legal rights 3. teach the patient to self administer insulin injections 4. provide adequate information to the patient to help make treatment decisions 5. prescribe appropriate medications

1,3

The patient states, "I don't have confidence in my doctor. She looks so young." The nurse therapeutically responds: (Select all that apply.) 1. Tell me more about your concern. 2. You have nothing to worry about. Your doctor is perfectly competent. 3. You are worried about your care? 4. You can go online and see how others have rated your doctor. I do that. 5. You should ask your doctor to tell you her background.

1,3

Which statement by the newly hired about interacting with a patient in the orientation phase indicates the charge nurse needs to intervene? 1. I should encourage and help the patient accomplish goals 2. I will begin to make inferences and judgments about the patient's messages 3. I should achieve a smooth transition for the patient to other caregivers as needed 4. I will set the tone for the relationship by adopting a warm, empathetic, and caring manner 5. I should closely observe the patient and expect to be closely observed by the patent

1,3

Which strategies should a nurse use to facilitate a safe transition of care during a patient's transfer from the hospital to a skilled nursing facility? (Select all that apply.) 1. Collaboration between staff members from sending and receiving departments 2. Requiring that the patient visit the facility before a transfer is arranged 3. Using a standardized transfer policy and transfer tool 4. Arranging all patient transfers during the same time each day 5. Relying on family members to share information with the new facility

1,3

The ethics of care suggests that ethical dilemmas can best be solved by attention to relationships. How does this differ from other approaches to ethical problems? (Select all that apply.) 1. Ethics of care pays attention to the context in which caring occurs. 2. Ethics of care is used only by nurses because it is part of the Nursing Code of Ethics. 3. Ethics of care requires understanding the relationships between involved parties. 4. Ethics of care considers the decision maker's relationships with other involved parties. 5. Ethics of care is an approach that suggests a greater commitment to patient care.

1,3,4

The nurse is learning about negligence in unintentional torts. Which action would the nurse consider as a common act of negligence? 1. failure to follow prescriptions 2. failure to preform malpractice 3. failure to document monitoring 4. failure to follow policies and deadlines 5. failure to explain the risks of surgery to a patient

1,3,4

When working with an older adult who is hearing-impaired, the use of which techniques would improve communication? (Select all that apply.) 1. Check for needed adaptive equipment. 2. Exaggerate lip movements to help the patient lip-read. 3. Give the patient time to respond to questions. 4. Keep communication short and to the point. 5. Communicate only through written information.

1,3,4

Which action is an example of the nurse showing respect for a patient's autonomy? 1. ensuring the patient understands the risks of a medical procedure 2. keeping promises by following through on any interventions 3. including the patient in all care decisions 4. ensuring the patient has read and signed an informed consent before surgery 5. receiving permission from the patient before performing a physical examination

1,3,4,5

Motivational interviewing (MI) is a technique that applies understanding a patient's values and goals in helping the patient make behavioral changes. When using motivational interviewing, what outcomes does the nurse expect? (Select all that apply.) 1. Gaining an understanding of the patient's motivations 2. Directing the patient to avoid poor health choices 3. Recognizing the patient's strengths and supporting his or her efforts 4. Providing assessment data that can be shared with families to promote change 5. Identifying differences in patient's health goals and current behaviors

1,3,5

Which of the following describe characteristics of an integrated health care system? (Select all that apply.) 1. The focus is holistic. 2. Participating hospitals follow the same model of health care delivery. 3. The system coordinates a continuum of services. 4. The focus of health care providers is finding a cure for patients. 5. Members of the health care team link electronically to use the EMR to share the patient's health care record.

1,3,5

Which action by a registered nurse would result in both criminal and administrative sanctions against the nurse? 1. taking or selling controlled substances 2. refusing to provide health care information to a parent's child 3. reporting suspected abuse and neglect of children 4. applying physical restraints without a written physician's prescription 5. administering the wrong medication to a patient

1,4

Which of the following actions, if performed by a registered nurse, could result in both criminal and administrative law sanctions against the nurse? (Select all that apply.) 1. Reviewing the electronic health record of a family member who is a patient in the same hospital on a different unit 2. Refusing to provide health care information to a patient's child 3. Reporting suspected abuse and neglect of children 4. Applying physical restraints without a written order 5. Completing an occurrence report on the unit

1,4

1. social distance 2. personal distance 3. public distance

1. 4-12ft 2. 18-40in 3. 12ft or more

The nurse therapeutically responds to an adult patient who is anxious by: (Select all that apply.) 1. Matching the rate of speech to be the same as that of the patient 2. Providing good eye contact 3. Demonstrating a calm presence 4. Spending time attentively with the patient 5. Assuring the patient that all will be well

2,3,4

Which nursing intervention helps the nurse establish a therapeutic relationship while working with a patient to solve a problem and accomplish goals? 1. assessing the patient's health status 2. encouraging and helping the patient set goals 3. taking action to met goals set with the patient 4. providing the information needed to understand and change behavior 5. talking to other caregivers who have information about the patient

2,3,4

A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with them. The nurse is acting as the patient's: 1. Educator. 2. Advocate. 3. Caregiver. 4. Communicator.

2

When caring for a patient, the nurse identifies factors that affect the outcomes of the treatment. To which phase of the nurse process does this belong? 1. planning 2. evaluation 3. assessment 4. implementation

2

Which statement about advanced directives is accurate? 1. a living will allows an appointed person to make health care decisions when the patient is in an incapacitated state 2. a living will is evoked only when the patient has a terminal condition or is in a persistent vegetative state 3. the patient cannot make change in the advance directive once admitted into the hospital 4. a durable power of attorney for health care is invoked only when the patient has a terminal condition or is in a persistent negative state

2

A nurse sends a text message to the oncoming nurse to report that a patient refuses to take medication as ordered. What should the oncoming nurse do? (Select all that apply). 1. Add this information to the board hanging at the patient's bedside. 2. Tell the nurse who sent the text that the text is a HIPAA violation. 3. Inform the nursing supervisor. 4. Forward the text to the charge nurse. 5. Thank the nurse for sending the information.

2,3

The nurse uses silence as a therapeutic communication technique. What are the purposes of the nurse's silence? (Select all that apply.) 1. Allows the nurse time to focus and avoid saying the wrong thing 2. Prompts the patient to talk when he or she is ready 3. Allows the patient time to think and gain insight 4. Allows time for the patient to drift off to sleep 5. Determines whether the patient would prefer to talk with another staff member

2,3

Nurses must communicate effectively with the health care team for which of the following reasons? (Select all that apply.) 1. To improve the nurse's status with the health team members 2. To reduce the risk of errors to the patient 3. To provide an optimum level of patient care 4. To improve patient outcomes

2,3,4

The nurse is practicing according to the professional nursing code of ethics. Which action is in accordance with the standards of responsibility? 1. protecting the patients right to privacy 2. trying to remain competent to practice 3. being responsible for delegated tasks 4. being willing to respect professional obligations 5. supporting the health, safety, and rights of the patients

2,3,4

The school nurse has been following a 9-year-old student who has shown behavioral problems in class. The student acts out and does not follow teacher instructions. The nurse plans to meet with the student's family to learn more about social determinants of health that might be affecting the student. Which of the following factors would be appropriate for this type of assessment? (Select all that apply.) 1. The student's seating placement in the classroom 2. The level of support parents offer when the student completes homework 3. The level of violence in the family's neighborhood 4. The age at which the child first began having behavioral problems 5. The cultural values about education held by family

2,3,5

A nurse works with a patient using therapeutic communication and the phases of the therapeutic relationship. Place the nurse's statements in order according to these phases. 1. The nurse states, "Let's work on learning injection techniques." 2. The nurse is mindful of his/her own biases and knowledge in working with the patient with B12 deficiency. 3. The nurse summarizes progress made during the nursing relationship. 4. After providing introductions, the nurse defines the scope and purpose of the nurse-patient relationship.

2,4,1,3

The nurse is learning about standards of nursing practice. Which activity is part of the practice of implementation? 1. developing strategies for patient care 2. educating patients for health awareness 3. analyzing assessment data for diagnosis 4. using therapeutic procedures for patient care 5. providing consultation for patient care

2,4,5

Which of the following accurately describes the Magnet Recognition Program? 1. transactional leadership is one of the main components 2. nurses practice self empowerment and autonomy in the organization 3. all health care professionals collect data on specific nursing sensitive quality outcomes 4. the hospitals that maintain Magnet status have an organizational culture focused on a clear strategic direction 5. health care organizations achieve magnet status by presenting evidence indicating achievement of the model and forces of magnetism

2,4,5

The application of deontology does not always resolve an ethical problem. Which of the following statements best explains one of the limitations of deontology? 1. The emphasis on relationships feels uncomfortable to decision makers who want more structure in deciding the best action. 2. The single focus on power imbalances does not apply to all situations in which ethical problems occur. 3. In a diverse community it can be difficult to find agreement on which principles or rules are most important. 4. The focus on consequences rather than on the "goodness" of an action makes decision makers uncomfortable.

3

Which of the following nursing activities is provided in a secondary health care environment? 1. Conducting blood pressure screenings for older adults at the Senior Center 2. Teaching a patient with chronic obstructive pulmonary disease purse-lipped breathing techniques at an outpatient clinic 3. Changing the postoperative dressing for a patient on a medical-surgical unit 4. Doing endotracheal suctioning for a patient on a ventilator in the medical intensive care unit

3

In what situation is the nurse allowed to use psychical restraints? 1. the patient is extremely irritated 2. the patient has suicidal intentions 3. the health care provider has given a written prescription 4. the patient is potentially dangerous to other patients 5. the patient's family members have asked to restrain the patient

3,4

Which parameter is addressed in the physical comfort dimension in patient centered care? 1. patients need to know at all times whom to call for help 2. patients look to care providers to share their fears and concerns 3. patients often need help completing actives of daily living 4. patients expect safe, pleasant surroundings and environment 5. patients want to be informed and share in decisions about their care

3,4

Which situational context factor influences communication? 1. privacy levels 2. emotional status 3. expression of feeling 4. information exchange 5. balance of power and control

3,4

Which zone of personal space is involved when a nurse is instructing victors in the hallway to avoid talking loudly? 1. public 2. intimate 3. personal 4. social

4

A nurse prepares to contact a patient's physician about a change in the patient's condition. Put the following statements in the correct order using SBAR (Situation, Background, Assessment, and Recommendation) communication. 1. "She is a 53-year-old female who was admitted 2 days ago with pneumonia and was started on levofloxacin at 5 PM yesterday. She states she has a poor appetite; her weight has remained stable over the past 2 days." 2. "The patient reported feeling very nauseated after her dose of levofloxacin an hour ago." 3. "Is it possible to make a change in antibiotics, or could we give her a nutritional supplement before her medication?" 4. "The patient started to complain of nausea yesterday evening and has vomited several times during the night."

4,1,2,3

The nurse applying effective communication skills throughout the nursing process should: (Place the following interventions in the correct order.) 1. Validate health care needs through verbal discussion with the patient. 2. Compare actual and expected patient care outcomes with the patient. 3. Provide support through therapeutic communication techniques. 4. Complete a nursing history using verbal communication techniques.

4,1,3,2

The following are steps in the process to help resolve an ethical problem. What is the best order of these steps to achieve resolution? 1. List all the possible actions that could be taken to resolve the problem. 2. Articulate a statement of the problem or dilemma that you are trying to resolve. 3. Develop and implement a plan to address the problem. 4. Gather all relevant information regarding the clinical, social, and spiritual aspects of the problem. 5. Take time to clarify values and identify the ethical elements, such as principles and key relationships involved. 6. Recognize that the problem requires ethics.

6,4,5,2,1,3