Prof Role 1 Midterm
A nurse is caring for a toddler who appears frightened by the nurse. To make the child more at ease, the nurse gives the toddler a disposable tape measure to play with. Which critical thinking concept is the nurse using? 1. Independence 2. Creativity 3. Concreteness 4. Confidence
2
A nurse working on a telemetry unit is caring for a client with sick sinus syndrome. The client tells the nurse, open double quote"I felt dizzy earlier this morning.close double quote" The nurse responds by asking the client, open double quote"Did this occur after breakfast?close double quote" Which method of therapeutic communication is the nurse using with this client? 1. Acknowledging 2. Clarifying time 3. Giving information 4. Focusing
2
During a staff meeting, the manager asks staff members to identify any and all ways to reduce unnecessary waste of supplies when providing client care. Which type of decision-making technique is the manager using with the staff? 1. Monopolizing 2. Brainstorming 3. Groupthink 4. Delphi technique
2
Prior to performing an assessment, a nurse states to the client, open double quote"This weather we are having is crazy, isn't it?close double quote" Which phase of the therapeutic relationship is the nurse displaying? 1. Working 2. Introductory 3. Termination 4. Preinteraction
2
The manager appoints a staff nurse to serve as a member of a semi-formal group. What should the nurse expect as a group member? 1. The leader will be replaced if she makes a mistake. 2. Structured activities will take up a large part of the group's meeting time. 3. Interactions with group members will be limited. 4. Members function under a strict code of ethics.
2
The novice nurse asks the nurse preceptor to explain the relationship between the business of health care and the provision of client care. Which response by the nurse preceptor is the most appropriate? 1. "The business of health care is the same thing as the provision of client care." 2. "The Institute of Medicine compels nurses to preserve a caring model within health care's business model." 3. "Nurses are morally responsible for recognizing the business of health care as the main priority." 4. "When nursing standards conflict with organizational standards, the nurse must maintain commitment to the organization's standards.
2
The nurse educator asks the nursing students to describe the stage of commitment development during which the student discovers negative aspects of a chosen profession. Which student's response is accurate? 1. The passionate stage. 2. The testing stage. 3. The integrated stage. 4. The quiet-and-bored stage.
2
The nurse is caring for a client with schizophrenia. The client is at risk for disturbed thought processes. What is the priority focus for interventions when caring for this client? 1. Discussing expectations 2. Providing reality testing 3. Being an active listener 4. Providing anxiety medication
2
The nurse is caring for a neonate, Sally, who requires nasogastric tube feedings due to prematurity. Sally's nasogastric tube frequently slips out of position and the nurse tries different approaches to prevent this from happening. Which critical thinking skill is the nurse demonstrating? 1. Reflection 2. Inquiry 3. Intellect 4. Reasoning
2
The nurse is evaluating the current plan of care for a client who is receiving care in a long-term healthcare facility. The evaluation indicates that the client is not meeting goals related to mobility. What is the appropriate nursing action at this time? 1. Asking the client to try harder 2. Revising the plan of care 3. Determining the client does not have any risk factors 4. Concluding that the problem is resolved
2
The nurse manager is interviewing a candidate for a staff nurse position. During the interview, the nurse manager evaluates the candidate's professional commitment to nursing. Which statement by the staff nurse best reflects commitment to the nursing profession? 1. "Whenever possible, the nurse should try to abide by the professional code of ethics for nurses." 2. "I'm a member of two national nursing organizations, and I belong to one specialty nursing group." 3. "I believe the nurse's choices outside of the workplace are unrelated to the nurse's professional role." 4. "The values and goals of nursing are honorable, but they are unrealistic and difficult to achieve."
2
The nurse manager is preparing an annual performance appraisal for Alisha, a staff nurse who has worked on a medical-surgical care area for two years. The manager determines that Alisha's level of proficiency is competent. What did the manager observe Alisha perform to make this decision? 1. Referred to the procedure manual to change an intravenous site dressing 2. Focused on a specific client problem when planning care 3. Determined how a new medication would impact a client's other health problems 4. Waited for direction from charge nurse before providing care
2
The primary nurse is caring for a client with chronic obstructive pulmonary disease (COPD). The nurse arrives at the client's room to complete the morning assessment and finds the client is upset. The client states, open double quote"My nurse overnight referred to me to the assistant as the COPDer.close double quote" The primary nurse tells the client that she will address the issue with the nurse. Which basis of the therapeutic relationship is the nurse displaying by addressing this client issue with the other nurse? 1. Reflecting 2. Respecting 3. Assuming 4. Identifying
2
The staff development trainer provides a program on assertive communication for the staff of a care area. At the end of the program, the trainer states, "I can't believe I had to waste my time on this." Which response made by a nurse who attended the training indicates effective teaching has occurred? 1. "I'm sorry you had to spend so much time with us today." 2. "I needed this training, and it wasn't a waste of time for me." 3. "Maybe you should read your own notes." 4. "It's your job. You want to do mine instead?"
2
What is the purpose of reflecting within Tanner's clinical decision making model? 1. Sense what is happening in a situation 2. Learn from actions to make adjustments 3. Gain understanding about a situation 4. Analyze a situation to choose action
2
When does a nurse make a scheduling decision? 1. When deciding what can be completed by a nursing assistant 2. When deciding what needs to be done before a client attends therapy 3. When deciding when to change a dressing 4. When deciding what information to share with other healthcare providers
2
Which attribute of critical thinking is explained as making neutral judgments without bias? 1. Open-mindedness 2. Fair-mindedness 3. Perseverance 4. Integrity
2
Which clinical situation best exemplifies a nurse who is choosing between alternatives when making a clinical decision? 1. The nurse has a "gut reaction" to the client's pain and calls the client's physician. 2. The nurse administers an IV narcotic instead of an oral narcotic. 3. The nurse determines the client's nursing diagnosis is acute pain. 4. The nurse changes the client's position numerous times until the client appears in less pain.
2
Which short-term goal does the nurse view as appropriate for a client newly diagnosed with diabetes mellitus? 1. The client will learn the correct way to inject IV insulin. 2. The client will demonstrate how to self-inject insulin by end of hospital stay. 3. The client will demonstrate how to wrap left leg wound. 4. The client will be able to identify and prepare meals approved by the ADA within 3 weeks.
2
The nursing student is participating in revising the plan of care for a client diagnosed with myasthenia gravis who did not meet care goals. Which will the nurse consider when revising the plan of care? (Select all that apply.) 1. What nurses were assigned to the client? 2. Were the interventions that were selected appropriate? 3. Did the client have access to planned interventions? 4. Were the goals realistic and attainable? 5. Were interventions implemented as planned?
2, 3, 4, 5
The nursing student is writing a care plan for a client who was recently cared for during a clinical rotation. What should the student nurse do when planning nursing interventions for the client? (Select all that apply.) 1. Be general and brief 2. Ensure relevancy to situation 3. Be specific and concise 4. Be realistic 5. Include priorities of care
2, 3, 4, 5
A client tells the nurse, "My blood sugars have been all over the place lately." The nurse responds, "It sounds like your blood sugar has been difficult to manage. Can I please see your blood sugar log?" Which therapeutic communication skills is the nurse displaying during this interaction with the client? (Select all that apply.) 1. Genuineness 2. Confronting 3. Concreteness 4. Clarifying 5. Paraphrasing
2, 5
The nurse is a member of a nursing journal club. What interpersonal perspectives would be demonstrated by the group members? (Select all that apply.) 1. Provides source of collegiality and support 2. Promotes a feeling of goodwill among members 3. Provides a context for setting priorities 4. Empowers group members to promote change 5. Provides socialization toward growth and development
2,3,5
Which behavior indicates a nurse is an aggressive communicator? (Select all that apply.) 1. Denying feelings of anger 2. Blaming others for errors 3. Expressing feelings using "I" language 4. Telling a staff member to move out of the way 5. Stating that a nursing assistant is "worthless"
2,4,5
A nurse is participating in a group in which all members are voicing ideas to address an issue. Their ideas will be analyzed later. Which kind of decision-making method is the group using? 1. Consensus 2. Brainstorming 3. Quantitative analysis 4. Nominal group
2.
Jasmine Riddle is a novice nurse in the telemetry unit of a large hospital. While assessing her client, 72-year-old Albert Griswald, Jasmine notes that his pulse feels irregular. When she calls the telemetry monitoring station, the monitoring technician, Miguel, tells Jasmine that Mr. Griswald just developed atrial fibrillation. The technician praises Jasmine for catching the change in Mr. Griswald's cardiac rhythm so quicklylong dash—even before the telemetry technician recognized it. In her response, which action would reflect Jasmine's nursing integrity? 1. Advising the telemetry technician to focus on his job and monitor clients' heart rhythms more closely 2. Thanking the telemetry technician for praising her and for being part of the client's care team 3. Notifying the telemetry technician's supervisor of his failure to recognize the change in cardiac rhythm 4. Telling the telemetry technician that noticing the client's change in cardiac rhythm was "pure luck"
2.
Mitchell Asplund, a clinical nursing instructor, is assigned to serve as a student faculty advisor. Mitchell's responsibilities include determining which stage of commitment to nursing his students are experiencing. He is evaluating nursing student Don Rowlands, who is a junior in nursing school. During his evaluation, Don states, "I want to join the National Student Nurses Association. I'm also volunteering to participate in the student health fair. I know I'm really busy, but my schedule will be crazy when I'm working as a nurse, too. It's worth it to me." Mitchell recognizes that Don is in which stage of making a professional commitment to nursing? 1. Exploratory 2. Passionate 3. Integrated 4. Testing
2.
The nursing instructor assigns Carol, a senior nursing student, to create a concept map for a client recently assigned during clinical. The concept map is going to be showcased during the School of Nursing's scheduled open house for nursing student candidates in a week. What should be a priority for Carol when preparing this concept map? 1. Include the rationales for each nursing intervention 2. Follow the sequence of the nursing process 3. Highlight medical treatments provided by other providers 4. Individualize the care by using checklists and blank lines
2.
What would be an appropriate goal when caring for a client with impaired communication? 1. The client will review discharge instructions at home. 2. The client will effectively communicate needs. 3. The client will call for help before getting out of bed. 4. The client will state ways to reduce communication deficits.
2.
A novice nurse is working independently on a maternal-newborn unit after 12 weeks of orientation with a preceptor. The nurse is assigned several newborns to care for during the shift. Based on the clinical pathway for a mother and baby of a vaginal birth, which intervention by the nurse is appropriate? 1. Administering vitamin K to the mother within 24 hours of delivery 2. Ensuring the newborn is breastfed 6 times per day at 48 hours of life 3. Scheduling bottle feedings for the newborn of 15 to 30 mL every 4 hours at 24 hours of life 4. Administering erythromycin ointment to the newborn's eyes at 48 hours of life
3
A nurse is caring for a client who is scheduled to have a chest x-ray at 0900 and will be off the unit. The client is also due to have medication at 0900. Which action by the nurse is most appropriate? 1. Administer the medication after the client returns from x-ray 2. Administer the client's medication at the start of shift 3. Administer the client's medication at 0845 4. Wait to administer the medication at the next dosage time
3
A nurse is caring for a pediatric client who is recovering from a recent open appendectomy surgery. The nurse states to the client, open double quote"I saw that you walked up and down the hallway twice today already. Good job!close double quote" Which therapeutic communication technique is the nurse using to establish rapport with the client? 1. Listening actively 2. Validating perceptions 3. Giving recognition 4. Offering self
3
A nurse is interviewing for a staff position on a medical-surgical unit. Which portion of the hiring process best represents the hospital's efforts to evaluate the nurse's commitment to the profession? 1. Offering the candidate the option of completing a four-week unit orientation and preceptorship 2. Requiring the candidate to provide official copies of college transcripts 3. Exploring the candidate's desire to maintain membership in the profession 4. Inviting current staff nurses to serve as members of the candidate's interview committee
3
A nurse working in the ICU has decided to attend a professional critical care conference. What critical thinking attitude is exemplified by this nurse's actions? 1. Independence 2. Integrity 3. Awareness of self-limits 4. Confidence
3
An adolescent client is sitting in a chair waiting for the nurse to complete a health history. After entering the room, where should the nurse sit to conduct the history with the client? 1. Against the wall near the door 2. About 4 to 12 feet from the client 3. Between 1 ½ to 4 feet from the client 4. One foot away from the client
3
TThe nurse is providing care to several clients in the emergency department: A client who arrived by ambulance with stroke symptoms; a client with a fractured femur; a client complaining of sharp, continuous pain radiating from the kidney area; and a young child with a possible fractured arm whose mother is with him. Using the urgency factor, which client will the nurse prioritize for care? 1. The young child with the possible arm fracture 2. The client with sharp, continuous pain radiating from the kidney area 3. The client with stroke symptoms 4. The client with a fractured femur
3
The charge nurse is reviewing e-mails and sees a message from the laboratory containing results for a client's blood work. What is the priority action by the nurse regarding this information? 1. Delete the message 2. Forward the message to the client 3. Print the message and place it in the client's medical record 4. Phone the healthcare provider and verbally provide the results
3
The clinical nursing instructor is evaluating the student's developmental stage of professional commitment. The student has settled into the nursing program's routine and reports experiencing decreased performance anxiety. Which stage of professional commitment is most appropriate for the clinical nursing instructor to use when describing the student's current level of development? 1. The testing stage 2. The integrated stage 3. The quiet-and-bored stage 4. The exploratory stage
3
The nurse is formulating a plan of care for a client who is pregnant. Which goal is appropriate for the nursing diagnosis dealing with a knowledge deficit related to pregnancy? 1. Client will attend medication management classes within four weeks. 2. Nurse will facilitate learning readiness. 3. Client will attend prenatal classes through the course of the pregnancy. 4. Nurse will teach client about prescribed exercise regimen for pregnancy at next appointment.
3
The nurse is providing care to a 1-year-old pediatric client who is admitted to the emergency department with SaO2% of 93% on room air, respiratory rate of 50 breaths per minute, with moderate wheezing. Based on the pediatric clinical pathway for asthma, what intervention does the nurse anticipate for this client? 1. Systemic magnesium sulfate 2. Continuous anticholinergic medication administration 3. Nebulizer treatment of albuterol 4. IV corticosteroids
3
The nurse unit manager is giving an in-service about sexual harassment in the workplace. When discussing what constitutes sexual harassment, which statement is most appropriate for the nurse unit manager to include in the in-service? 1. Behaviors must include unwelcome advances of a sexual nature that are demonstrated through the perpetrator's physical conduct. 2. Submitting to requests for sexual behaviors must be explicitly considered a condition of an individual's employment. 3. Sexual harassment must be considered both a form of discrimination and a violation of an individual's rights.. 4. The sexual behaviors must interfere with the victim's work performance and prevent fulfillment of work functions.
3
The nursing student is experiencing the integrated stage of commitment development. When developing professional commitment, which behavior would the nursing student be most likely to demonstrate during the integrated stage? 1. Considering switching to a major other than nursing 2. Learning about positive aspects of the nursing profession 3. Being eager to take the NCLEX-RN® examination 4. Becoming involved in a student nursing association
3
While transferring a client back into bed after a procedure, the client says that it wasn't very nice for the nurse to say that the "cow" was coming down the hall. Which response by the nurse is most appropriate in this situation? 1. "You must have misunderstood what I said." 2. "I didn't mean to call someone a cow!" 3. "The term 'cow' is used for computer on wheels." 4. "I was just joking with that person!"
3
The manager schedules a nursing assistant to attend a basic communication program after observing the assistant provide client care. Which actions would result in this type of referral? (Select all that apply.) 1. Talking with a newly admitted client about his grandchildren 2. Referring to a 75-year-old male client as "Mr. Dan" 3. Asking a 65-year-old client, "Are we ready to get out of bed?" 4. Calling an 80-year-old client "Sweetie" 5. Referring to a 70-year-old client's abdominal wound as a "boo-boo"
3, 4, 5
A healthcare provider yells at a novice nurse for not knowing a client's latest laboratory values. Which responses by the novice nurse would demonstrate assertive communication? (Select all that apply.) 1. "You can look them up on the computer." 2. "I'm sorry. I'll see where those results are." 3. "I will locate the values and get them to you." 4. "I can't do anything right for you." 5. "The lab has not phoned in the results yet."
3, 5
A healthcare organization is adopting the use of a three-column nursing care plan. What information will be documented in these columns? (Select all that apply.) 1. Assessment 2. Evaluation 3. Goals/desired outcomes 4. Nursing interventions 5. Nursing diagnoses
3,4,5
Which are characteristics of a primary group? (Select all that apply.) 1. Impersonal communication 2. Task oriented 3. Spontaneity 4. Face-to-face communication 5. Unity
3,4,5
Esther Wulfman, an 83-year-old client with a hearing deficit, is admitted for exacerbation of heart failure. What should Marta, the nurse, do to support Esther's communication needs during the assessment process? 1. Shout into the client's good ear when talking 2. Ask if a family member is available to complete the assessment 3. Close the door to the room when conducting the assessment 4. Sit beside the client during the assessment
3.
Gordon Sullivan, a 58-year-old client with acute pain and bleeding from prostate cancer, rates his pelvic pain as an 8 on a pain rating scale from 1 to 10. He is considering surgery to remove the prostate before beginning chemotherapy and radiation. When writing a three-part nursing diagnosis for Gordon, what should the nurse use as the etiology? 1. Surgery 2. Acute Pain 3. Prostate cancer 4. Bleeding
3.
The leader of a group of staff nurses is encouraging all members to work towards achievement of a common goal. Which behavior is the leader demonstrating? 1. Monopolizing 2. Commitment 3. Power 4. Brainstorming
3.
The nurse is providing care to several clients on a medical-surgical unit. The nurse needs to prioritize care for the assigned clients. Which action is a common pitfall when prioritizing client care? 1. Being cognizant of time when completing tasks 2. Involving the client during the care plan process 3. Administering medications based on vital signs at admission 4. Completing tasks based on level of difficulty
3.
A nurse educator chooses to implement scenario-based simulations for educating a group of student nurses regarding clinical judgment. Which approach is the educator using? 1. Benner's skill acquisition model 2. Tanner's clinical judgment model 3. Maslow's hierarchy of needs 4. Lasater's assessment rubric
4
A nurse is caring for a client who has been diagnosed with liver cancer but has not shared this diagnosis with family members. The client tells the nurse, open double quote"I can't tell my family that I have cancer.close double quote" The nurse replies, open double quote"What do you think would be best?close double quote" Which method of therapeutic communication is the nurse using with this client? 1. Presenting reality 2. Focusing 3. Acknowledging 4. Reflecting
4
A nurse is caring for a client who will undergo a cholecystectomy surgery in two hours. To assess that the client has informed consent, the nurse asks the client, open double quote"Can you tell me what your surgery will involve?close double quote" Which method of therapeutic communication is the nurse using with this client? 1. Giving information 2. Seeking clarification 3. Paraphrasing 4. Open-ended questioning
4
A nurse is caring for a client with a history of a heart dysrhythmia. The nurse notifies the client's healthcare provider after noticing a decreasing trend in the client's serum potassium level, client muscle spasms, and changes in ECG pattern. Which critical thinking concept is the nurse using? 1. Seeking new knowledge 2. Approaching situations objectively 3. Differentiating fact from fiction 4. Recognizing salient cues
4
A nurse is caring for a pediatric client with possible pneumonia who is about to go for an X-ray. The nurse states, open double quote"The doctor needs to X-ray your chest so she can get a picture of what's happening in your lungs. Let me tell you what's going to happen.close double quote" Which therapeutic communication technique is the nurse using to develop a therapeutic relationship with the client? 1. Clarifying time 2. Acknowledging 3. Focusing 4. Giving information
4
A nurse is caring for a client, with a right femur fracture, who complains of pain in the right leg. The nurse asks the client, open double quote"Please tell me how you would rate your pain on a scale of zero to ten.close double quote" Which method of therapeutic communication is the nurse using with this client? 1. Seeking clarification 2. Giving information 3. Providing general leads 4. Being specific
4
A nursing assistant is overheard telling a client, open double quote"I don't have all day. Let me put those shoes on you.close double quote" What type of communication style is the assistant demonstrating? 1. Assertive 2. Passive 3. Passive-aggressive 4. Aggressive
4
A staff nurse is overhead counseling a newly hired nurse about limiting suggestions to improve the functioning of the unit because the manager open double quote"does not like suggestionsclose double quote" and will open double quote"put you down.close double quote" Which characteristic of an ineffective group is the manager influencing? 1. Goal setting 2. Cohesion 3. Problem solving 4. Creativity
4
During a health history interview, the client denies having any health problems but then crosses her arms and looks away. What does this behavior indicate to the nurse? 1. The nurse is taking too long, and the client is uncomfortable sitting in a chair. 2. The client is bored with the nurse asking too many questions. 3. The nurse is rushing the client to complete the health history. 4. The client's verbal communication and nonverbal communication are not congruent.
4
During a meeting to discuss the implementation of a new computerized documentation system, one staff nurse asks about the ease of use, preloaded templates, and online nursing resources. What behavior is the staff nurse demonstrating? 1. Opinion giver 2. Information giver 3. Opinion seeker 4. Information seeker
4
In an annual evaluation, the nurse unit leader describes the staff nurse as "skilled at analyzing a complex situation and able to pick out the most important aspects of a clinical scenario." According to Patricia Benner's model of nursing development, which developmental stage best matches the nurse unit leader's evaluation of the staff nurse? 1. Expert 2. Novice 3. Competent 4. Proficient
4
Several nurse managers are having lunch after attending a shared governance committee meeting. Which manager statement indicates that the committee is ineffective? 1. "Who knew we had such a nice conference room!" 2. "I think the goals are tough but appropriate in the circumstances." 3. "I could have prepared better before today's meeting." 4. "I am not sure why the chairperson made all of the decisions."
4
The manager is concerned that a novice nurse is being made a scapegoat for an event that occurred on the care area. Which observation supports this manager's concern? 1. The novice nurse volunteers to work with other staff on a quality improvement study. 2. The charge nurse meets with the oncoming shift to review clients who could be discharged later in the day. 3. Nursing assistants are discussing work assignments and suggesting ways to help each other. 4. Staff nurses suggest that the novice nurse is responsible for missing narcotics during a shift when the nurse was not at work.
4
The nurse educator is explaining the significance of punctuality and attendance in the nursing profession to a class of nursing students. Which statement is most appropriate for the nurse educator to include in the discussion? 1. "Nurses must be flexible about helping colleagues who routinely need to miss work." 2. "During a nursing shortage, hospital attendance requirements usually are less strict." 3. "The most severe consequence of excessive tardiness for the professional nurse is suspension." 4. "Chronic tardiness and frequent absenteeism among nurses can compromise client care."
4
The nurse educator is teaching a class about professional development in nursing. When describing an area of nursing competence, which component is most appropriate for the nurse educator to include in the teaching? 1. Recognizing the nurse's responsibility to remain strictly in a client-centered role 2. Understanding that client populations tend to demonstrate the same personal needs 3. Knowing and demonstrating adherence to the ethics of primary care providers 4. Understanding the culture of the client population and the healthcare institution
4
The nurse has been determining a method of communicating with a client recovering from a stroke. Which client observation indicates that an effective communication method has been established? 1. Slapping the nurse's hand to refuse an action 2. Groaning to get the nurse's attention 3. Holding a pen to write on paper 4. Spelling words on a bedside table using tiled letters
4
The nurse is a member of a work group in which the members like and trust each other and provide each other with support. Which characteristic is this group demonstrating? 1. Atmosphere 2. Creativity 3. Power 4. Cohesion
4
The nurse is assessing Julia McMichael, an 82-year-old client with pneumonia. Mrs. McMichael is experiencing dyspnea, has a pulse oximeter reading of 90, and lung assessment reveals rales. Which nursing intervention is the most appropriate for Mrs. McMichael at this time? 1. Keep the head of Mrs. McMichael's bed flat 2. Use a face mask for oxygen even though a request for nasal cannula was made 3. Empty fluid from the oxygen humidifier 4. Explain that the oxygen will help Mrs. McMichael breath better
4
The nurse is assessing an 8-year-old client whose parent brought him to the walk-in clinic. The parent reports that the child is tired and has been coughing for 2 days. Which assessment findings may be clustered as significant cues suggesting that the child has influenza? 1. The child's oxygen saturation is 98%. 2. The child's lungs are clear on auscultation. 3. The child's vital signs are BP 95/62 mmHg, RR 23, P 90, T 98.8degrees°F 4. The child's vital signs are BP 90/60 mmHg, RR 22, P 80, T 101.5degrees°F.
4
The nurse is caring for a client who is recovering from abdominal surgery. During the morning assessment, the client complains of pain and rates the pain at 7 out of 10. The nurse tells the client that she will prepare pain medication and return in 10 minutes to administer it. Which characteristic of verbal communication is the nurse using? 1. Pace 2. Humor 3. Intonation 4. Credibility
4
The nurse is caring for an adolescent client who is alert but intubated following a C7-T1 spinal cord injury. Which communication strategy is the most developmentally appropriate for the nurse to use with this intubated client? 1. Hand signals 2. Grease pencil and white board 3. Flash cards 4. Text messages
4
The nurse is preparing to discharge a client after a hospital stay. What should the nurse take into consideration when evaluating the client's health status at discharge? 1. Modification of implemented interventions 2. Impact of the evaluation 3. Opportunities to correct intervention deficiencies 4. Identification of the client's self-care abilities
4
The nurse is preparing to explain the insertion of an intravenous catheter into the arm of a client who has never been hospitalized. Which explanation by the nurse is the most appropriate for this procedure? 1. "An angiocath is inserted in a vein and fluids are administered." 2. "An intracath is placed in a vein, and the IV is set to administer 100 ccs an hour." 3. "A needle is inserted in a vein so that this bag of fluid is pushed into your body." 4. "A small tube is put in a blood vessel, and liquid is dripped into your body."
4
The nurse leader is evaluating the charge nurse's type of commitment to the nursing profession. Which behavior by the charge nurse is most reflective of affective commitment to nursing? 1. Expressing a sense of obligation to remain in the nursing profession 2. Choosing to stay in nursing due to personal experiences with illness 3. Remaining in the nursing profession to avoid loss of income 4. Joining professional nursing organizations and engaging in nursing service activities
4
The nurse leader is preparing a webinar about how to prevent burnout in nursing. To accurately describe strategies for preventing burnout, which activity should the nurse educator include in the webinar? 1. Develop acceptance and recognize that the limitations of any situation can be changed 2. Study assertiveness and learn to take on added responsibilities even when feeling overwhelmed 3. Learn to depend on oneself and to avoid expressions of emotions toward colleagues 4. Actively engage in efforts to produce constructive change if organizational policies create stress
4
The nurse prioritizing care for a client with diabetes mellitus utilizes Maslow's hierarchy of needs. Which need is priority for this client? 1. The nurse teaches the client proper home safety techniques to prevent diabetic wounds. 2. The client attends classes to deal with body image after amputation of right leg. 3. The client joins the local American Diabetes Association support group. 4. The nurse teaches the client how to properly change dressings on right leg amputation site.
4
The nurses on a care area are uncharacteristically quiet. There is no friendly chatter, and nurses are staying in clients' rooms to document until the end of the shift. Which incident might cause the nurses to demonstrate this behavior? 1. The director is identifying staff for promotion. 2. The nurse manager is working on the annual budget. 3. The medical director is making client rounds. 4. The charge nurse called everyone incompetent during report.
4
The nursing student is designing a poster that describes how to recognize burnout among nurses. Which recommendation for identifying manifestations of burnout should be included on the poster? 1. Understand that emotional depletion is a natural response to the demands of employment 2. Recognize that outbursts of anger are normal signs of professional frustration 3. Acknowledge feelings of helplessness as signs of inexperience or professional inadequacy 4. Interpret that smoking and an increase in coffee consumption may be potential warning signs
4
Which evaluation statement by the nurse is appropriate and indicates a goal has been met for a client diagnosed with a stroke? 1. 04/03/2015, 1830: Goal partially met: Client demonstrates use of home oxygen machine. 2. 1750: Goal met: Client voices understanding of treatment therapy. 3. 04/03/2015: Goal not met: Client does not demonstrate use of incentive spirometer. 4. 04/03/2015, 1800: Goal met: Client demonstrates self-injection of Lovenox prior to discharge.
4
Dena, the nurse at a local clinic, is determining the best way to communicate test results to a client who has requested all communication go to his e-mail address. The test results showed some abnormalities. Which is the best option for Dena in this situation? 1. E-mail the test results directly to the client 2. Ask the healthcare provider to e-mail the test results to the client 3. Send the test results by regular mail 4. E-mail the client with a request to call the office
4
A nurse educator asks the student nurse to describe chronic obstructive pulmonary disease (COPD) and nursing interventions used to treat the condition. The student nurse states, "COPD is a chronic pulmonary disease, and the nurse should place the client in high Fowler position." Which clinical reasoning concepts is the student nurse using in this statement (Select all that apply.) 1. Judgment 2. Inference 3. Inquiry 4. Fact 5. Opinion
4, 5
A nurse working in the emergency department uses a clinical decision tree to determine the best course of action for a client who presents with signs and symptoms of a myocardial infarction (MI). Which statements are true regarding this clinical decision tool? (Select all that apply.) 1. It cannot be implemented by all nurses. 2. It requires higher-level decision making. 3. It requires no decision making. 4. It can assist in decision making. 5. It requires standardization of care.
4, 5
When communicating discharge instructions to a client, the nurse states exactly what needs to be done using the fewest number of words. Which characteristics of verbal communication is the nurse using? (Select all that apply.) 1. Intonation 2. Pace 3. Simplicity 4. Brevity 5. Clarity
4,5
During hospital orientation, the human resources specialist is defining and explaining sexual harassment. Which statement should be included in the human resource specialist's discussion of sexual harassment? 1. "Physical contact is required for a behavior to be considered sexual harassment." 2. "Discrimination is one type of sexual harassment." 3. "Sexual harassment requires the victim and violator to be of different genders." 4. "Sexual harassment interferes with performance in the workplace."
4.
Linda is a member of a nursing journal club that meets every 2 weeks. Linda does not agree with most of the group members' opinions about proposed changes that would expand the membership of the group, but she does not speak up. Which behavior is Linda demonstrating at this time? 1. Monopolizing 2. Scapegoating 3. Apathy 4. Groupthink
4.
William is a nurse working on the pediatric cancer unit at a large urban hospital. One of his clients, Angela, is a 16-year-old who is recovering from surgery. Her mother, Carlotta, has been by her side almost constantly, but Angela's father has not been to visit since she was transferred to the unit. Angela is frequently rude to William, and it often takes him several attempts to get her to participate in interventions when William is on duty. The nurse from the night shift, who is female, shared that she does not have any difficulty with Angela. William recognizes that Angela's hostility toward him is most likely due to which factor? 1. Apathy 2. Countertransference 3. Scapegoating 4. Transference
4.
Rosario, the manager of a 20-bed unit, is evaluating the success of assertiveness training classes that staff nurses attended to improve communicating with physicians. Which behavior by Yvonne, a staff nurse, indicates she needs more training? 1. Focusing on the situation before speaking and requesting help 2. Using a neutral voice when discussing a client's abnormal laboratory values 3. Stating "I would like some help" when planning care with other team members 4. Apologizing to the neurosurgeon for "bothering him" with a question 5. Identifying an area where both the nurse and client agree
4.
A nurse auscultates a client's breath sounds after the client receives an albuterol nebulizer treatment secondary to wheezing. The nurse finds that the client is still wheezing despite the therapy. Which aspect of the Tanner clinical judgment model is the nurse displaying? 1. Noticing 2. Responding 3. Reflecting 4. Interpreting
1
A nurse caring for clients across the life span must consider the age, development level, and functional status of clients when helping them in clinical decision making. Which action by the nurse indicates support for a preschooler's decision making ability? 1. Asking the client if she would like to have her snack before or after going for an x-ray 2. Showing the client the materials that will be used to stich up the wound in her knee 3. Inviting the client to the interdisciplinary meeting 4. Soothing the client by rocking her until she calms down
1
A nurse is caring for a client with a history of diabetes mellitus. The nurse notices an upward trend to the client's daily fasting serum blood glucose and notifies the client's healthcare provider. Which level best describes this nurse according to Benner's skill acquisition model? 1. Proficient 2. Novice 3. Competent 4. Advanced beginner
1
A nurse is caring for a pediatric client who requires IV antibiotic therapy. Prior to inserting the IV catheter, the client asks the nurse, open double quote"Is this going to hurt me?close double quote" Which response by the nurse best promotes rapport and trust with the client? 1. "It is going to hurt, but once I am done it shouldn't hurt anymore." 2. "It might hurt, but I am not sure." 3. "Yes, it is going to hurt. Hold really still or it will hurt much worse." 4. "No. As long as you hold still it shouldn't hurt."
1
As part of hospital orientation for a group of nurses, the human resources representative is discussing intimidation. Which information is most appropriate for the human resources representative to include in the discussion? 1. Intimidation may include unintentional nursing behaviors and statements made to clients. 2. Overt forms of intimidation may include standing too close to someone. 3. Intimidation may include repeatedly asking another individual for favors. 4. Covert forms of intimidation may include making verbal threats.
1
During a home visit, the nurse observes a client perform wound care that is different from the verbal instructions. The written instructions are crumpled and located at the bottom of a stack of papers. Which action by the nurse is the most appropriate? 1. Verbally review the wound care process with the client again 2. Place the instructions on the top of the stack for the client to use 3. Tell the client that a new set of instructions will be brought at the next visit 4. Explain that the client is at risk for a wound infection
1
Mike Kellerton is a 64-year-old client admitted for dehydration. During morning care, Mr. Kellerton became irate when the breakfast tray featured items that he does not eat. Later in the day, Mr. Kellerton told a family member that he is not important and everyone is "trying to kill him." What should the nurse do to improve the care that Mr. Kellerton is receiving? 1. Plan to talk with the client about his care needs, priorities, and preferences 2. Explain to the client that his care issues are not life threatening and can be delayed 3. Identify the easiest task to complete for the client and do this first 4. Discuss the importance of other clients' treatments being of greater priority
1
Prior to meeting a client, the mental health nurse reviews the client's demographics, including the client's name, address, age, medical history, and social history. Which phase of the therapeutic relationship is reflected by this action? 1. Preinteraction 2. Working 3. Introductory 4. Termination
1
The nurse is caring for a client diagnosed with pulmonary hypertension. Which intervention can be considered a direct, dependent intervention? 1. Assisting with the prescribed cardiac catheterization 2. Monitoring pulse oximetry for a client receiving oxygen by nasal cannula 3. Teaching the client about a prescribed medication 4. Calling the primary care provider and suggesting a physical therapy evaluation
1
The nurse is caring for several clients during a shift. Which observation made during a nursing assessment would be priority? 1. The client who complains of shortness of breath when walking from room to room 2. A client with a BP of 96/54 mmHg, HR of 70 bpm, RR of 20 breaths per minute, and T 97.6°F 3. A client who begins coughing after 6 minutes of walking 4. A client with an oxygen saturation of 94%
1
The nurse is implementing care for clients in an acute care facility. Which guidelines should the nurse use when choosing interventions for goal achievement? 1. They are consistent with clients' values, beliefs, and culture. 2. They are identified with specific laws and regulations. 3. They can be performed with limited resources. 4. They are interchangeable among clients for optimal applicability.
1
The nurse is providing care to a client recently diagnosed with chronic obstructive pulmonary disease (COPD). Which nursing action supports collaboration, which is essential to planning care? 1. Discussing appropriate smoking cessation programs with the client, upon request 2. Facilitating a home health consult when the client is discharged 3. Adjusting the head of the client's bed to ease breathing effort 4. Administering a breathing treatment to the client, as ordered
1
The nurse is working with an adult client who has a diagnosis of posttraumatic stress disorder (PTSD). The client shares that he has begun exercising daily at a local gym, and states that this lowers his daily stress level. Which type of nursing diagnosis would best capture the client's exercise behavior? 1. Wellness diagnosis 2. Health promotion diagnosis 3. Syndrome diagnosis 4. Risk diagnosis
1
The nurse leader is planning an in-service about integrity in nursing practice. Which statement regarding integrity in nursing is most appropriate for the nurse leader to include in the in-service? 1. "Nurses with integrity adhere to a strict moral or ethical code." 2. "Integrity means internalizing professional practices that the nurse prefers to follow." 3. "Integrity means understanding that negative feedback from peers has little value." 4. "Nurses with integrity provide excellent care and do not make errors."
1
The nurse preceptor is designing a nursing orientation program that addresses abuse of power in the workplace. Which information should the nurse preceptor include in the program? 1. Bullying behaviors and incivility are among the leading causes of sentinel client events. 2. The Joint Commission has not taken an official stand on addressing workplace intimidation. 3. Nursing research finds limited evidence of bullying and lateral violence among nursing professionals. 4. Improper use of authority in the workplace is a form of sexual harassment.
1
The psychiatric nurse practitioner is giving a webinar about prevention of burnout in nursing. Which items should the psychiatric nurse practitioner include when describing tips related to having compassion? (Select all that apply.) 1. Acknowledging that most individuals do the best they can do 2. Perceiving errors and failures as opportunities for constructive learning 3. Recognizing the limitations associated with any given situation 4. Joining nursing associations that promote constructive discussion of work issues 5. Learning to ask for help from colleagues or confidantes when needed
1
The staff nurse is caring for a client who has recently undergone surgical repair of an inguinal hernia. Despite administration of pain medications as ordered, the client continues to complain of excruciating pain. When the staff nurse offers to reposition the client, the client states, "You don't have any idea what you're doing. I need more medication. I need a nurse who can help me!" Which behavior best illustrates demonstration of compassion by the staff nurse? 1. Notifying the primary care provider about the client's complaints of pain despite receiving medication 2. Seeking out a nursing colleague to privately vent about the client's rudeness and inconsideration 3. Explaining that inguinal hernia repairs usually require significantly less medication for adequate pain relief 4. Collaborating with the charge nurse and requesting that another nurse assume the client's care
1
What is the first action that should be made when prioritizing care? 1. Assess client situations 2. Assign staff to clients 3. Ascertain interventions 4. Analyze collected data
1
What is used as the framework for identifying nursing interventions? 1. Etiology of the problem 2. Signs and symptoms 3. Healthcare provider's orders 4. Previous health history
1
While providing care in the emergency department, the nurse asks the victim of a pedestrian accident "why did you cross the street in the middle of the block?" Which communication barrier is this nurse demonstrating? 1. Probing 2. Being defensive 3. Challenging 4. Testing
1
While talking with a nursing colleague, the staff nurse states, "I don't drink alcohol, but I smoke marijuana." Which response by the nursing colleague best reflects correct understanding of professional behaviors? 1. "Even in your personal life, the same rules of professionalism still apply to your behavior." 2. "Even though you're a nurse, what you do in your personal life is your business." 3. "If your client care is negatively affected, then you should stop smoking marijuana." 4. "If you're arrested for smoking marijuana, your professional credibility will be negatively affected."
1
Following the collection of assessment data, what does the nurse do next? (Select all that apply.) 1. Clusters cues to generate tentative hypotheses 2. Measures the data against standards to identify significant cues 3. Analyzes the data for gaps and inconsistencies 4. Compares the data with suspected medical problems 5. Identifies strengths and resources
1, 2, 3
Which skills are used when implementing client care? (Select all that apply.) 1. Interpersonal 2. Psychomotor 3. Cognitive 4. Assessment 5. Physical examination
1, 2, 3
Which statements are true of nursing diagnoses? (Select all that apply.) 1. Nursing diagnoses describe responses to a health problem. 2. Nursing diagnoses are flexible and change based upon client responses. 3. A nursing diagnosis is a judgment statement. 4. Nursing diagnoses are uniform between clients. 5. A nursing diagnosis is a condition that nurses are licensed to treat.
1, 2, 3 ,5
During post-clinical conference, a student nurse expresses a desire to work on the same unit where clinical is being held because of the nursing staff. What did the student likely observe to form this opinion? (Select all that apply.) 1. Staff members laugh with each other. 2. Staff members help each other complete assignments. 3. Staff nurses compliment each other for a job well done. 4. Staff members focus on their individual assignments. 5. Staff nurses ask about each other's families.
1, 2, 3, 5
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is having difficulty breathing. Which will the nurse include in formulating nursing diagnoses? (Select all that apply.) 1. Evidence of cyanosis in the client's mouth and nail beds 2. The client's pulse oximetry reading of 92% 3. The client's expressed desire to quit smoking 4. The client's twice daily meditation practice 5. The client's report of having difficulty walking in from the parking lot
1, 2, 3, 5
The nurse is preparing to assess an older client with a hearing deficit who has just been admitted to the care unit. Which actions should the nurse take to communicate with this client? (Select all that apply.) 1. Turn down the volume on the television set 2. Close the door to the room 3. Face the client when speaking 4. Ask the family to wait in the hall 5. Ask about the client's meal preferences
1, 2, 3, 5
The nurse leader is presenting an in-service about competence in nursing. Which examples should the nurse leader include in the in-service as examples of nursing competence? (Select all that apply.) 1. Completion of documentation in an accurate, timely manner 2. Acknowledgement of the client's need for individualized care 3. Awareness of factors that positively affect client care 4. Elimination of factors that negatively influence client care 5. Knowledge about the culture of the healthcare institution
1, 2, 3, 5
When formulating a nursing diagnosis for a client diagnosed with diabetes mellitus, which information should be taken into consideration to mobilize health and the recovery process for this diagnosis? (Select all that apply.) 1. The client joins the ADA support group. 2. The client demonstrates the ability to monitor blood glucose. 3. The client independently administers insulin. 4. The client requests information on how to control blood pressure. 5. The client tells the nurse that he adheres to his 1800 calorie ADA diet.
1, 2, 3, 5
What are the components of a nursing diagnosis? (Select all that apply.) 1. Defining characteristics 2. Etiology 3. Data clusters 4. Variations 5. Diagnostic label
1, 2, 5
A nurse educator is teaching a group of student nurses about the development of professional decision making and the types of approaches related to clinical judgment. Which statements made by the student nurse reflect understanding of Benner's skill acquisition model? (Select all that apply). 1. New graduates are typically considered advanced beginners. 2. An advanced beginner is intentional in planning care. 3. A competent nurse usually has 2-3 years of experience. 4. Proficient nurses can see the whole picture. 5. A novice acts by following rules.
1, 3, 4, 5
The nurse preceptor is discussing integrity with the novice nurse. Which examples should the nurse preceptor use to illustrate integrity in nursing? (Select all that apply.) 1. Maintaining accountability for personal actions 2. Delivering error-free nursing care 3. Accepting negative feedback from clients 4. Accepting positive feedback from peers 5. Working within the scope of practice
1, 3, 4, 5
How does intellect help nurses with critical thinking? (Select all that apply.) 1. Differentiate fact from opinion 2. Evaluate performance 3. Approach situations objectively 4. Clarify concepts 5. Think outside the box
1, 3, 5
The director of nursing is reviewing a status report provided by the policy and procedure committee. Which information indicates to the director that the committee has been effective? (Select all that apply.) 1. Committee members have attended all scheduled meetings. 2. Committee member vacancies for two areas remain unfilled. 3. Committee members reviewed all policies prior to the scheduled accreditation survey. 4. The committee chair resigned due to the volume of work. 5. Subcommittee members provided recommendations as expected.
1, 3, 5
A pediatric client is alone in the room after the client's mother leaves to make a phone call. The client is crying and tells the nurse, "I want my mommy to come back." The nurse responds by stating, "It's okay to cry when you miss your mommy. I will sit with you until she comes back if you want." Which therapeutic communication techniques is the nurse using to establish rapport with the client? (Select all that apply.) 1. Accepting 2. Exploring 3. Broad openings 4. Offering self 5. Clarifying
1, 4
The nurse is caring for a client diagnosed with cancer. When formulating the plan of care for this client, what should the nurse consider related to client goals? (Select all that apply.) 1. Goals should be attainable. 2. Goals may address multiple actions. 3. Goals should indicate whether treatment is successful. 4. Goals should be measurable. 5. Goals should center on the client.
1, 4, 5
Which are characteristics of an advanced beginner within Benner's Skill Acquisition Model of clinical judgment? (Select all that apply.) 1. Begins to recognize cues 2. Is able to intentionally plan care 3. Follows rules when acting 4. Can see the whole picture 5. Is a new graduate
1, 5
What techniques are associated with assertive communication? (Select all that apply.) 1. Fogging 2. Negative assertion 3. Avoidance 4. Name calling 5. Submission
1,2
Which actions can the nurse use to establish rapport with a pediatric client? (Select all that apply.) 1. Listening to the child talk about a favorite teacher 2. Sitting on the bed with the child 3. Telling the child that she has pretty hair 4. Asking the child to choose between milk or juice to drink 5. Coming into the room to hang an IV medication and leaving
1,2,3,4
The nurse is planning to assess a client's communication approach. What client characteristics should the nurse consider when conducting this assessment? (Select all that apply.) 1. Developmental level 2. Primary health problem 3. Culture 4. Age 5. Employment status
1,3,4
Which actions are appropriate when the nurse is communicating with a client whose primarily language is not English? (Select all that apply.) 1. Avoid using slang 2. Speak slowly 3. Avoid using medical jargon 4. Use an interpreter 5. Emphasize words with gestures
1,3,4
During a classroom discussion, the nurse educator asks the nursing students to describe intimidation. Which students' statements most accurately describe intimidation? (Select all that apply.) 1. "Intimidation can include threatening someone with consequences for disobedience." 2. "Nurses always realize when their behaviors toward clients are forms of intimidation." 3. "Intimidation includes experienced nurses who bully new nurses." 4. "Intimidation includes having negative thoughts about nursing peers or colleagues." 5. "Covert and overt behaviors may qualify as being intimidation."
1,3,5
What behaviors will the nurse demonstrate as a member of a group that is highly committed? (Select all that apply.) 1. Members value each other's opinions. 2. Members strive to place blame on one person. 3. Members give priority to the opinions of the leader. 4. Members enjoy working with each other. 5. Members support each other with difficulties.
1,4,5
Jiao Liu, a 64-year-old client, is receiving chemotherapy for breast cancer. After morning report, the nurse finds Ms. Liu nauseated, vomiting light green emesis, and crying because her hair is falling out in clumps. Her pulse is 110 beats per minute and thready, and her blood pressure is 96/50 mmHg. Which intervention should the nurse make a priority for Ms. Liu? 1. Begin intravenous fluids at 100 mL/hr 2. Premedicate for nausea before next chemotherapy dose 3. Teach Ms. Liu some deep breathing exercises to help her calm down 4. Cleanse skin and apply a clean hospital gown
1.
Planning is underway to transfer Agnes Watson, a 76-year-old client, to a long-term care facility. Agnes wants to live near her family; however, the facility that would best meet her needs is a few miles further away. What should the nurse do when helping Agnes make the choice of facility? 1. Discuss with Agnes the advantages of the facility that is a bit further away 2. Tell Agnes that the facility that is closer to family is not accepting admissions 3. List other facilities so that Agnes can make a better decision 4. Tell Agnes that being near family is not always a good idea
1.
Scott Nitroskey, a home health nurse, is caring for 67-year-old Martha Miriste, a female client who is diagnosed with diabetes. Scott is completing Mrs. Mireste's client teaching. During the teaching session, which statement might Mrs. Mireste interpret as being Scott's attempt to intimidate her? 1. "If you don't stop eating so much candy, your diabetes is going to get much worse." 2. "Regular exercise can help with the management of your diabetes." 3. "If you cut back on your sugar intake, you might see some improvement in your diabetes." 4. "Increased sugar in your diet can cause your blood sugar to go up and impact your diabetes."
1.
When discussing a painful procedure with a child, how will the nurse answer the child's questions? 1. With honesty, while being sure to end the conversation on a positive note 2. By explaining the procedure to the parents first and having the parents tell the child 3. By giving handouts with more information about the procedure 4. By redirecting the child's attention to something else
1.
What should be done first before implementing a nursing intervention? 1. Ensure the client's privacy 2. Reassess the client 3. Find someone to help 4. Review nursing diagnoses
2
Colleen is assessing Janie, a 6-year-old girl who was hit by a car while riding her bicycle. When Colleen sits down to look in Janie's eyes, she says, "Promise you won't do anything that hurts." Janie's mother looks at Colleen with pleading eyes. Which response by Colleen is the most appropriate? 1. "Nothing can feel worse than how you hurt right now." 2. "There's no way that I can make that promise to you." 3. "I promise that I won't let anyone hurt you." 4. "Sometimes things hurt just for a second so that you can get better faster."
4.