Professional Development
Nurse Practice Act
Defines the title and regulations governing the practice of nursing.
When asked to perform a procedure that the nurse has never done before, what should the nurse do to legally protect himself or herself?
Discuss it with the charge nurse, asking for direction.
Which of the following IS NOT a component of a client's plan of care, when the nurse is organizing for the day and utilizing the principles of time management?
Documenting task completion at the end of the day.
A new policy is in place that a nurse is not following. Which steps does the nurse manager take?
Encourage the nurse to verbalized the reasons for resistance to change.
A nurse may practice in another state if he or she has passed the NCLEX-PN examination in the nurse's own state and meets the other state's educational requirements. What is the process of transferring licensure from one state to another called?
Endorsement.
Breach of Contract
Failure on the part of the nurse or the employer to perform the obligations of the contract.
True or False. The NCLEX bases competency on the number of questions answered correctly.
False.
True or false: An employer is always seeking the employee with the highest level of education for the job.
False.
True or false: Oral contracts are not considered binding when made between the nurse and the employer.
False.
Lassiez-Faire
Free run style of management, permissive leadership.
Which of the following could cause a nurse to be cited for malpractice?
Giving prochlorperazine (Compazine) to a patient allergic to phenothiazines.
Signs and symptoms of burnout are:
Physical,
Which employment setting would likely involve a daytime schedule with weekends off, and would focus on prevention and patient teaching?
Physician's office.
In what employment setting does the nurse give total care to one patient; is totally independent; provides care in the home, hospital, or other facility; is paid directly by the patient; and is legally responsible for his or her own actions?
Private duty nursing.
The VN is totally dependent and the job stays the same even thought the patient may change.
Private duty nursing.
What is the best way for a nurse to avoid a lawsuit?
Provide compassionate, competent care.
A nurse has been working at an acute care facility for a year and is due for her performance. The head nurse notes that this nurse has some deficiencies in her performance. Which of the following would be most appropriate for the head nurse to do at this time?
Provide the nurse with an oral reprimand and then create a plan of assistance for the nurse.
The school nurse has been assigned to assist the food service in a poor school setting. The goal is to avoid nutritional deficiencies and implement intervention by level of prevention to improve the dietary menu. Which of the following would be a primary prevention intervention that the nurse could suggest?
Providing educational programs, literature and posters to promote awareness of healthy eating.
Which of the following is an example of team nursing approach?
RN supervises nursing personnel in providing care to a group of clients.
The LVN is correct when identifying that his or her license permits primarily which action?
Rendering safe nursing service to the public.
What is a function of the state board of nursing in every state?
Renewing and issuing licenses and suspending or revoking a license.
A nurse pockets a controlled substance but records it as given. What should you do?
Report it to the supervisor.
An older adult is admitted to the hospital with numerous bodily bruises, and the nurse suspects elder abuse. What is the best nursing action?
Report the bruises to the charge nurse.
Ticket of admission
Required for entrance to the NCLEX exam.
What fundamental principle must the nurse first observe when confronted with an ethical decision?
Respect for people
What is the correct term for a concise, one- or two-page summary of educational and work experience, activities and honors, and concrete skills and interests?
Resume.
A charge nurse in a LTC facility follows up on a delegated task.
Right supervision
The style of leadership that takes into account the style of the leader, the maturity of the groups, and the circumstances at hand is which type of leadership?
Situational.
What type of leadership uses four different styles—directing, coaching, supporting, and delegating?
Situational.
Concerns with assisted living. Who to refer to?
Social Worker
Role
Socially expected behavior pattern associated with your function in social groups.
Which statement best reflects the autocratic style of leadership?
"I'll consider each of your requests and then give you the guidelines for establishing new acuity ratings for our patients."
The nurse is seeking advice regarding professional liability insurance. Which of the following statements by the preceptor are appropriate?
"Personal liability coverage is not mandatory, but should consider purchasing your own coverage."
A nurse is unable to sleep because the previous day they participated in an unsuccessful CPR event. Which statement should the nurse manager make?
"Tell me what your concerns are."
When a resume reflects too many job changes, the employer may question it. How long should an employee remain at the first place of employment?
1 year.
Placing a new order
1. Write down and repeat info back. 2. Have someone double check the order.
Which of the following leadership styles is the least structured and allows for creativity and independent thought and actions?
Laissez-Faire leadership.
A new graduate who has achieved the goal of getting others to do something that is believed necessary has demonstrated what skill?
Leadership.
Which is a nursing care error that violates the Health Insurance Portability and Accountability Act (HIPAA)?
Leaving a copy of the patient's history and physical in the photocopier.
Endorsement
Licensure from another state.
In what setting can the LPN/LVN's management and leadership skills be developed best?
Long-term care facility.
A nurse fails to irrigate a feeding tube as ordered, resulting in harm to the patient. This nurse could be found guilty of:
Malpractice *The nurse can be held liable for malpractice for acts of omission. Failure to meet a legal duty, thus causing harm to another, is malpractice. The nurse practice act has general guidelines that can support the charge of malpractice.
A physician instructs the nurse to bladder train a patient. The nurse clamps the patient's indwelling urinary catheter but forgets to unclamp it. The patient develops a urinary tract infection. What do the nurse's actions exemplify?
Malpractice.
The experienced nurse who assists a novice to learn the skills of the profession is called a(n) ________________.
Mentor.
Which organizations are totally committed to practical and vocational nursing and its continuing education?
NAPNES and NFLPN.
Which organization specifically supports and meets the needs of the LVN/LPN?
NAPNES. National Association for Practical Nurse Education and Service.
An organization founded in 1949 to promote the LVN that informs members of current issues, lobbies on state and national levels for issues and concerns of it's members, and whose official publication is the Licensed Practical Nurse is:
NFLPN
Which of the following organizations provide professional testing services, and surveys, and accredits education programs?
National League for Nursing.
What is the term for the commission of an act that a prudent nurse should not have done, or the omission of an act a prudent nurse should have done, that results in injury or harm to another person?
Negligence.
What is the name of the licensing law that defines the title and regulations governing the practice of nursing and states the requirements for licensure?
Nurse Practice Act.
An LPN/LVN is asked by the RN to administer an IV chemotherapeutic agent to a patient in the acute care setting. What law should this nurse refer to before initiating this intervention?
Nurse practice act *It is the nurse's responsibility to know the nurse practice act in his or her state. Standards of care, regulation of practice, and the American Nurses' code are not laws that the nurse should refer to before initiating this treatment.
The nurse caring for a patient in the acute care setting assumes responsibility for a patient's care. What is this legally binding situation?
Nurse-patient relationship
A patient has difficulty with physical aspects of feeding herself due to arthritis. The nurse should initiate referral to which department?
OT.
A nurse is considering purchasing malpractice insurance. What should the nurse be aware of regarding malpractice insurance provided by the hospital?
Only offers protection while on duty.
Altruistic Egoism
Paying as much attention to your own needs as you do to the needs of others.
Personal beliefs about the worth of an object, idea, custom, or attitude that influence a person's behavior in a given situation are referred to as ___________.
Values.
The nurse is assisting a patient to clarify values by encouraging the expression of feelings and thoughts related to the situation. What is the most appropriate action for the nurse?
Withhold an opinion.
A nursing instructor is preparing her class for the NCLEX-PN examination. Which statements by the students indicate understanding of the testing process? Select all that apply.
a. "It will be a computerized adaptive test." c. "The maximum time allowed for testing is 5 hours." e. "My state board of nursing must approve my application to test."
A nurse failed to monitor a patient's respiratory status after medicating the patient with a narcotic analgesic. The patient's respiratory status worsened, requiring intubation. The patient's family claimed the nurse committed malpractice. What must be present for the nurse to be held liable? (Select all that apply.)
a. A nurse-patient relationship exists. b. The nurse failed to perform in a reasonable manner. c. There was harm to the patient.
What data are necessary to compile an effective end-of-shift report? (Select all that apply.)
a. Patient's mental status. b. Status of lung sounds. c. All pertinent nursing care.
Why is it important for new graduates to purchase their own malpractice insurance rather than depend on an institutional policy?
A private policy will carry personal liability coverage.
Career
A profession for which one trains and which is undertaken as a permanent calling.
Contract
A promise or a set of promises between 2 or more persons that create a legal relationship.
Advancement
A rise in rank or advancement, promotion, progress or improvement.
Democratic
A style of leadership that works best with mature employees.
Resume
A summary of educational and professional experiences during activities and honors.
The LVN is planning the assignments for the 3-11 shift. Which of the following assignments is the least appropriate to be assigned to the CNA?
Assisting a Down Syndrome, 6 year old child, who is severely developmentally disabled to eat lunch.
List the 3 styles of leadership
Autocratic, Democratic, and Laissez-Faire.
What type of leadership involves a leader who displays little trust or confidence in employees and therefore makes all the decisions?
Autocratic.
A recent report indicates that the decision to hire a candidate is often made within the first __________ of the interview.
30 seconds.
Which of the following clients would the LVN assign to the CNA in a long term care facility?
A client requiring frequent ambulation.
What is required at a higher level for a home health nurse?
Autonomy.
List 4 strategies for Burnout
Awareness. Balance. Choice. Detachment
What is another name for promotion?
Advancement.
Which of the following is a quality of an effective leader?
Advocacy.
What role is the nurse who diligently works for the protection of patients' interests playing?
Advocate
Patients have expectations regarding the health care services they receive. To protect these expectations, which of the following has become law?
American Hospital Association's Patient's Bill of Rights. *Patients have expectations regarding the health care services they receive. In 1972, the American Hospital Association (AHA) developed the Patient's Bill of Rights. The Self-determination act, American Hospital Association's Standards of Care, and The Joint Commission's rights and responsibilities do not address patients' expectations regarding health care.
Which actions demonstrate effective time management skills for the nurse?
Anticipating possible interruptions in the plan of care for the day. Planning care based on prioritizing the needs of the patient.
The nurse has strong moral convictions that abortions are wrong. When assigned to assist with an abortion, what is the most appropriate action for the nurse to take?
Ask for another assignment.
A nurse is giving a bed bath, when she is informed by the CNA that another client is in pain and needs pain medication, Which of the following is the most appropriate action?
Ask the nursing assistant to inform the charge nurse of the client in pain.
What is the physical, emotional, and spiritual exhaustion that can occur among caregivers?
Burnout.
the nurse is reinforcing teaching to CNA. Which of the following should the nurse include in the teaching.
B. Delegation permits a designated person to meet a goal on your behalf.
The objectives of a letter of application should include all of the following EXCEPT:
Be a one to two page written document.
First step in preventing burnout is?
Becoming aware that there is a problem
An employee failed to perform the duties listed in the employment contract. What is the term for this failure?
Breach of contract,
What leadership style is used by a charge nurse who relies on established policies and protocols?
Bureaucratic Leadership.
When reviewing critical paths of the clients on the nursing unit, after analyzing the information which on indicates further action?
Canceling physical therapy sessions on the week-end*.
What is the definition of case management?
Case management represents a primary health prevention focus managed by a single case manager.
After transcribing each order in a list of orders, the nurse should ___________ __________ the order.
Check off.
What is the best way to resolve most disagreements?
Communication.
When a nurse becomes involved in a legal action, the first step to occur is that a document is filed in an appropriate court. What is this document called?
Complaint *A document called a complaint is filed in an appropriate court as the first step in litigation. A deposition is when witnesses are required to undergo questioning by the attorneys. An appeal is a request for a review of a decision by a higher court. A summons is a court order that notifies the defendant of the legal action.
When a nurse protects the information in a patient's record what ethical responsibility is the nurse fulfilling?
Confidentiality. *The nurse has an ethical and legal duty to protect information about a patient and preserve confidentiality. Some disclosures are legal and anticipated, and may not be subject to the rules of confidentiality. None of the information in a chart is considered secret.
Which setting provides greater nurse autonomy and continuity of care and is less costly for insurance companies?
Home health.
To settle a conflict between two staff members, the nurse manager should focus on which strategy?
Identifying the real issues and assisting in solving them.
The nurse is preparing the patient for a thoracentesis. What must be completed before the procedure may be performed?
Informed consent *The doctrine of informed consent refers to full disclosure of the facts the patient needs to make an intelligent (informed) decision before any invasive treatment or procedure is performed. A physical assessment, interview, and surgical checklist are not required before this procedure.
Technical and scientific changes have resulted in a multiplicity and complexity of functions placed on nurses, and sometimes job descriptions have not been rewritten. What is true of the role of the LPN/LVN?
It is constantly changing.
Whats true about delegation?
It requires compliance and follow up to ensure this.
What are the universal guidelines that define appropriate measures for all nursing interventions?
Standard of Care. *Standards of care define actions that are permitted or prohibited in most nursing interventions. These standards are accepted as legal guidelines for appropriateness of performance. The laws that formally define and limit the scope of nursing practice are called nurse practice acts. An advocate is one who defends or pleads a cause or issue on behalf of another. Prudent is a term that refers to careful and/or wise practice.
Acts whose performance is required, permitted, or prohibited are defined by:
Standards of care.
The new LPN/LVN is concerned regarding what should or should not be done for patients. What resource will best provide this information?
Standards of care.
Which of the following has authority to revoke a nurse's license?
State Board of Nursing.
Autocratic
Style of management where the leader retains all authority and responsibility.
Patient has a hip fracture. Who is responsible for obtaining informed consent?
Surgeon.
For an LVN to become certified in long-term care, the nurse must do which of the following?
Take and pass a national certification examination.
List the 3 types of MD orders
Telephone, Verbal, and Written.
Which health care employment setting would provide the nurse a very good salary, the opportunity to refuse to take an assignment, and more flexibility in the personal schedule but with an uncertainty of work availability?
Temporary Agency.
Which act of the state legislature delineates the legal scope of the practice of nursing within the geographic boundaries of the jurisdiction?
The Nurse Practice Act.
Leadership.
The art of getting others to do something you are convinced should be done.
Why is it beneficial to become certified in other areas after becoming an LVN?
The certifications are designed to increase nursing knowledge and skill.
What is true about nurse practice acts?
The nurse must know the nurse practice act within his or her state.
In the change-of-shift report, which information should the outgoing nurse pass on to the receiving nurse?
The patient's blood glucose levels for the shift. The patient's total intake and output for the shift.
State Board of Nursing
Their purpose is to protect the public by administering the Nurse Practice Act.
The nurse is caring for a patient with a do-not-resuscitate (DNR) order. Although the nurse may disagree with this order, what is his or her legal obligation?
To follow the order.
What is the main purpose of state requirements that nurses be licensed to practice nursing?
To provide legal guidelines to protect the public.
True or false: A resume should use only short, bulleted sentences, no more than 4 words in length if possible.
True
True or False. A minimum of 60 scored questions must be answered on the NCLEX exam to ensure coverage of the test plan.
True.
True or False. It is usually desirable to have a written contract for employment.
True.
True or False. It is always best to remain at a position for one year prior to leaving for another.
True.
True or false: In a personal job interview, first impressions have a lasting effect.
True.
A nurse working on an acute care medical surgical unit is aware that his or her first duty is to the patient's health, safety, and well-being. Given this knowledge, which of the following is most necessary for the nurse to report?
Unethical behavior of other staff members.
A manager is concerned that one of the nurses on the unit is experiencing burnout. Which symptoms would support the concerns? (Select all that apply.)
a. Fatigue. b. Forgetfulness. d. Negative outlook. e. Changes in eating habits.
During a lunch break, an emergency department (ED) nurse truthfully tells another nurse about the condition of a patient who came to the ED last night. What is the ED nurse guilty of? (Select all that apply.)
a. HIPAA violation. d. Invasion of privacy.
Which questions should the nurse consider before delegating care to another team member? (Select all that apply.)
a. Is it the right task? c. Is this the right person? d. Is this the right supervision? e. Is this the right circumstance?
When writing a letter of application you should be sure that you:
a. Make it direct and to the point. b. Neatly type it. c. Customize it.
How can the medical record be used in litigation? (Select all that apply.)
a. Public record. b. Proof of adherence to standards. c. Evidence of omission of care. d. Documentation of time lapses.
What are considered duties of a team leader? (Select all that apply.)
a. Receiving reports on assigned patients. b. Making patient assignments for team members. c. Assessing all assigned patients. e. Conferring with team members.
The nurse is assigned to care for 3 patients. In planning care and prioritizing, which patient would the nurse care for first?
a. The patient receiving oxygen via nasal cannula who has difficulty breathing during the previous shift.
A nursing license may be suspended or revoked by the State Board of Nursing as a result of all the following except:
a. a breach of contract between a nurse and an employer.
As a newly graduated LVN, you might use the following to obtain a job interview:
a. an interview. b. a resume. c. a letter of application.
Characteristics of the Laissez-Faire style of leadership include:
a. chooses to avoid responsibility by delegating all decision making. b. often results in no sense of direction. c. seldom works in health care. d. relinquishes control completely.
A code of ethics: which demonstrates the best nursing practice?
a. deliver competent patient care.
The most appropriate clothing for a male to wear during a job interview would be:
a. dress pants, shirt, and a tie.
The following is true about the NCLEX exam:
a. each test is assembled interactively. b. each test is based on the same test plan. c. each exam continues to question until a pass or fail decision is made.
In caring for a hospitalized patient, an act of negligence might include:
a. endangering a patient's life. b. failing to comply with the standards and requirements of the Nurse Practice Act.
A resume could be expected to consist of the following:
a. information about you, your education and your experience. b. be well organized, neat, and accurate. c. be a brief statement of your qualifications. d. contains the most recent information regarding your qualifications.
Which of the following would be considered a breach of contract between a nurse and the hospital where she's employed?
a. leaving work prior to the arrival of the staff coming in to replace them. b. performing tasks that are not within the scope of their license. c. failure of the hospital o provide a safe working environment and safe equipment.
An advancement in your position is usually based on: a. performance and preparation. b. seniority. c. A&D. d. qualifications.
a. performance and preparation. d. qualifications.
As a newly hired employee of the hospital, you might expect your written contract to include:
a. salary. b. educational benefits. c. a guarantee of schedule and hours to work.
A recommendation to the Board of Nursing for the candidate to take the NCLEX exam must be made by:
a. the director of the nursing program.
When taking the NCLEX exam, the computer stops asking questions when the candidate reaches clearly above or clearly below passing standards or:
a. when the maximum 205 questions are reached. b. when out of time.
Continuing Education (CEUS) required to renew professional nursing licenses can be obtained by which of the following?
a. workshops. b. in-services. c. orientation.
Charge nurse overhears a provider speaking to a nurse. Which demonstrates conflict resolution.
address the situation as soon as possible.
Which actions would best aid the new nurse in coping with working the night shift? (Select all that apply.)
b. Use dark shades to block out light when sleeping. d. Wear sunglasses on the drive home from work.
Characteristics of a good manager include all of the following EXCEPT:
b. the ability to criticize and find fault with your coworkers.
A letter of resignation should include all of the following EXCEPT:
c. a list of issues that need resolved with the position you're resigning from.
The LVN
can help pay for extra out of pocket expenses that are not covered by hospital.
A lumbar puncture was performed on a patient without a signed informed consent form. This patient might sue for:
civil battery.
A nurse is having difficulty reading a providers handwriting
contact the provider to clarify prescription.
When transcribing orders, the LVN knows that which health care provider order takes priority? a. prn orders b. one-time-only orders. c. routine orders. d. stat orders.
d. stat orders.
Role of a nurse manager?
determine employee schedule
The maximum time allowed to complete the Computerized Adaptive Exam (NCLEX) is:
five hours
Which action indicates good time management?
gathers appropriate suppplies for a upcoming procedure.
A chemically impaired nurse uses drugs alcohol to:
self medicate for anger.
Delegation of wound care to a cna is not following which rights of delegation?
task, person, and direction.
the nurse manager is man a client is waiting to transfer back from PACU. Which should be assigned to this client?
the RN. They require assessment, and this is the RN's role.