Review Questions

A community center is presenting a nurse-leg program on the Patient Protection and Affordable Care Act. Which statement made by a participant indicates a need for further teaching? - "My small company will now have to offer the 75 employees health insurance or pay a penalty." - "As long as my son is a full-time student in college, I will be able to keep him on my health insurance until he is 26 years old." - "I signed up for the state health insurance exchange before the designated deadline to make sure I had health insurance." - "Since I have now been diagnosed with diabetes, my health insurance plan cannot charge me higher premiums."

- "As long as my son is a full-time student in college, I will be able to keep him on my health insurance until he is 26 years old."

Which of the following statements is trye regarding Magnet status recognition for a hospital? - nursing is run by a magnet manager who makes decisions for the nursing units - nurses in Magnet hospitals make all of the decisions on the clinical units - Magnet is a term that is used to describe hospitals that are able to hire the nurses they need - Magnet is a special designation for hospitals that achieve excellence in nursing practice

- Magnet is a special designation for hospitals that achieve excellence in nursing practice

A group of staff nurses notice an increased incidence of medication errors on their unit. After further investigation it is determined that the nurses are not consistently identifying the patient correctly. A change is needed quickly. What type of quality improvement method would be most appropriate? - PDSA - Six Sigma - Rapid-improvement event (RIE) - a randomized controlled trial

- Rapid-improvement event (RIE)

Which activity performed by a nurse is related to maintaining competency in nursing practice? - asking another nurse about how to change the settings on a medication pump - regularly attending unit staff meetings - participating as a member of the professional nursing council - attending a review course in preparation for a certification examination

- attending a review course in preparation for a certification examination

The nurses on a medical unit have seen an increase in the number of pressure ulcers that develop in their patients. They decide to initiate a quality improvement project using the PDSA model. Which of the following is an example of "Do" from that model? - implementing the new skin care protocol on all medicine units - reviewing the data collected on patient cared for using the protocol - reviewing the quality improvement reports on the six patients who developed ulcers over the last three months - based on findings from patients who developed ulcers, implementing an evidence-based skin care protocol

- based on findings from patients who developed ulcers, implementing an evidence-based skin care protocol

Which of the following nursing activities is provided in a secondary health care environment? - conducting blood pressure screenings for older adults at the senior center - teaching a clinic patient with COPD purse-lipped breathing techniques - changing the postoperative dressing for a patient on a medical-surgical unit - doing endotracheal suctioning for a patient on a ventilator in the medical intensive care unit

- changing the postoperative dressing for a patient on a medical-surgical unit - doing endotracheal suctioning for a patient on a ventilator in the medical intensive care unit

Nurses on a nursing unit are discussing the processes that led up to a near-miss error on the clinical unit. They are outlining strategies that will prevent this in the future. This is an example of nurses working on what issue in the health care system? - patient safety - evidence-based practice - patient satisfaction - maintenance of competency

- patient safety

A nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is an appropriate goal for restorative care? - patient will be able to walk 200 feet without SOB - wound will heal without signs of infection - patient will express concerns related to return to home - patient will identify strategies to improve sleep habits

- patient will be able to walk 200 feet without SOB

A nurse is presenting information to a management class of nursing students on the topic of financial reimbursement for achievement of established, measurable patient outcomes. The nurse is presenting information to the class on which topic? - prospective payment system - pay for performance - capitation payment system - manages care systems

- pay for performance

Which of the following are characteristics of managed care systems? Select all that apply - provider receives a predetermined payment for each patient in the program - payment is based on a set fee for each service provided - systems includes a voluntary prescription drug program for an additional cost - system tries to reduce costs while keeping patients healthy - focus of care is on prevention and early intervention

- provider receives a predetermined payment for each patient in the program - system tries to reduce costs while keeping patients healthy - focus of care is on prevention and early intervention

Which of the following are examples of a nurse participating in primary care activities? Select all that apply. - providing prenatal teaching on nutrition to a pregnant woman during the first trimester - assessing the nutritional status of older adults who come to the community center for lunch - working with patients in a cardiac rehabilitation program - providing home wound care to a patient - teaching a class to parents at the local grade school about the importance of immunizations

- providing prenatal teaching on nutrition to a pregnant woman during the first trimester - assessing the nutritional status of older adults who come to the community center for lunch - teaching a class to parents at the local grade school about the importance of immunizations

A nurse is using data collected from the unit to monitor the incidence of falls after the unit implemented a new fall protocol. The nurse is working in which area? - quality improvement (QI) - health care patient system - nursing informatics - computerized nursing network

- quality improvement (QI)

A patient tells a nurse that she is enrolled in a preferred provider organization (PPO) but does not understand what this is. What is the nurse's best explanation of a PPO? - this health plan is for people who cannot afford their own health insurance - this health plan is operated by the government to provide health care to older adults - this health plan gives you a list of physicians and hospitals from which you can choose - this is a fee-for-service plan in which you can choose any physician or hospital setting

- this health plan gives you a list of physicians and hospitals from which you can choose

The nursing staff is developing a quality program. Which of the following are nursing-sensitive indicators from the National Database of Nursing Quality Indicators (NDNQI) that the nurses can use to measure patient safety and quality for the unit? Select all that apply - use of physical restraints - pain assessment, intervention, and reassessment - patient satisfaction with food preparation - RN education and certification - number of outpatient surgical cases per year

- use of physical restraints - pain assessment, intervention, and reassessment - RN education and certification

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. "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."

The staff on the nursing unit are discussing implementing interprofessional rounding. Which of the following statements correctly describe interprofessional rounding? Select all that apply. 1. allows team members to share information about patients to improve care 2. provides an opportunity for early patient discharge planning 3. improves communication among health care team members 4. allows each of the health care team members to identify separate patient goals 5. allows each health care provider an opportunity to delegate a task

1. allows team members to share information about patients to improve care 2. provides an opportunity for early patient discharge planning 3. improves communication among health care team members

You are floated to work on a nursing unit where you are given an assignment that is beyond your capability. Which is the best nursing action to take first? 1. call the nursing supervisor to discuss the situation 2. discuss the problem with a colleague 3. leave the nursing unit and go home 4. say nothing and begin your work

1. call the nursing supervisor to discuss the situation

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. check for needed adaptive equipment 3. give the patient time to respond to questions 4. keep communication short and to the point

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. collaboration between staff members from sending and receiving departments 3. using a standardized transfer policy and transfer tool

the nurse calls the primary health care provider regarding a new medication prescription, because the dosage prescribed is higher than the recommended dosage. the nurse is unable to locate the PHCP, and the medication is due to be administered. which action should the nurse take? 1. contact the nursing supervisor 2. administer the dose prescribed 3. hold the medication until the PHCP can be contacted 4. administer the recommended dose until the PHCP can be located

1. contact the nursing supervisor

A patient gas a fractured femur that is placed in skeletal traction with a fresh plaster cast applied. The patient experiences decreased sensation and a cold feeling in the toes of the affected leg. The nurse observes that the patient's toes have become pale and cold but forgets to document this because one of the nurse's other patients experienced cardiac arrest at the same time. Two days later the patient in skeletal traction has an elevated temperature, and he is prepared for surgery to amputate the leg below the knee. Which of the following statements regarding a breach of duty apply to this situation? Select all that apply. 1. failure to document a change is assessment data 2. failure to provide discharge instructions 3. failure to follow the six rights of medication administration 4. failure to use proper medical equipment ordered for patient monitoring 5. failure to notify a health care provider about a change in the patient's condition

1. failure to document a change is assessment data 5. failure to notify a health care provider about a change in the patient's condition

Motivational interviewing (MI) is a technique that applies understanding a patient's values and goals in helping the patient make behavior changes. What are other benefits of using MI techniques? Select all that apply 1. gaining an understanding of patient motivations 2. focusing on opportunities to avoid poor health choices 3. recognizing patients' strengths and supporting their 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. gaining an understanding of patient motivations 3. recognizing patients' strengths and supporting their efforts 5. identifying differences in patient's health goals and current behaviors

A RN is providing care to a patient who had abdominal surgery 2 days ago. Which tasks is appropriate to delegate to the nursing assistant? 1. helping the patient ambulate in the hall 2. changing surgical wound dressing 3. irrigating the NG tube 4. providing brochures to the patient on health diet

1. helping the patient ambulate in the hall

A new nurse complains to her preceptor that she has no time for therapeutic communication with her patients. Which of the following is the best strategy to help the nurse find more time for this communication? 1. include communication while performing tasks such as changing dressings and checking vital signs 2. ask the patient if you can talk during the last few minutes of visiting hours 3. ask Pastoral care to come back a little later in the day 4. remind the nurse to complete all her tasks and then set up remaining time for communication

1. include communication while performing tasks such as changing dressings and checking vital signs

the nurse has just assisted a client back to bed after a fall. the nurse and primary health care provider have assessed the client and have determined that the client is not injured. after completing the occurrence report, the nurse should implement which action next? 1. reassess the client 2. conduct a staff meeting to describe the fall 3. contact the nursing supervisor to update information regarding the fall 4. document in the nurse's notes that an occurrence report was completed

1. reassess the client

a nurse asks a nursing assistive personnel to help the patient in room 418 walk to the bathroom right now. The nurse tells the CNA that the patient needs the assistance of one person and the use of a walker. The nurse also tells the CNA that the patients' oxygen can be removed while he goes to the bathroom but to make sure that it is put back on at 2 L. the nurse also instructs the CNA to make sure the side rails are up and the bed alarm is reset after the patient gets back in bed. Which of the following components of the "Five Rights of Delegation" were used by the nurse? Select all that apply 1. right task 2. right circumstances 3. right person 4. right direction/communication 5. right supervision/evaluation

1. right task 2. right circumstances 3. right person 4. right direction/communication

Which of the following actions, if performed by a RN, would result in both criminal and administrative law sanctions against the nurse? Select all that apply 1. taking or selling controlled substances 2. refusing to provide health care information to a patient's child 3. reporting suspected abuse and neglect of children 4. completing an occurrence report on the unit

1. taking or selling controlled substances 4. completing an occurrence report on the unit

the charge nurse is planning the assignment for the day. which factors should the nurse remain mindful of when planning the assignment? select all that apply. 1. the acuity level of the clients 2. specific requests from the staff 3. the clustering of the rooms on the unit 4. the number of anticipated client discharges 5. client needs and workers' needs and abilities

1. the acuity level of the clients 5. client needs and workers' needs and abilities

which identifies accurate nursing documentation notation(s)? select all that apply. 1. the client slept through the night 2. abdominal wound dressing is dry and intact without drainage 3. the client seemed angry when awakened for vital sign measurement 4. the client appears to become anxious when it is time for respiratory treatments 5. the client's left lower medial leg wound is 3 cm in length without redness, drainage, or edema

1. the client slept through the night 2. abdominal wound dressing is dry and intact without drainage 5. the client's left lower medial leg wound is 3 cm in length without redness, drainage, or edema

The nurse manager from the surgical unit was awarded the nursing leadership award for practice of transformational leadership. Which of the following are characteristics or traits of transformation leadership displayed by award winner? Select all that apply 1. the nurse manager regularly rounds on staff to gather input on unit decisions 2. the nurse manager sends thank-you notes to staff in recognition of a job well done 3. the nurse manager sends memos to staff about decisions that the manager has made regarding unit policies 4. the nurse manager has an "innovation idea box" to which staff are encouraged to submit ideas for unit improvements 5. the nurse develops a philosophy of care for the staff

1. the nurse manager regularly rounds on staff to gather input on unit decisions 2. the nurse manager sends thank-you notes to staff in recognition of a job well done 4. the nurse manager has an "innovation idea box" to which staff are encouraged to submit ideas for unit improvements

A nurse has been gathering physical assessment data on a patient and is now listening to the patient's concerns. The nurse sets a goal of care that incorporates the patient's desire to make treatment decisions. This is an example of the nurse engaged in which phase of the nurse-patient relationship? 1. working phase 2. pre-interaction phase 3. termination phase 4. orientation phase

1. working phase

A patient asks a nurse what the patient-centered care model for the hospital means. What is the nurse's best answer? 1. "This model ensures that all patents have private rooms when they are admitted to the hospital." 2. "In this model you and the health care team are full partners in decisions related to you health care." 3. "This model focuses on making the patient experience a good one by providing amenities such as restaurant-style food service." 4. "Patients and families sign as document providing them full access to their medical charts."

2. "In this model you and the health care team are full partners in decisions related to you health care."

A nurse notes that an advance directive is on a patient's medical record. Which statement represents the best description of an advance directive guideline that the nurse will follow? 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 invoked only when the patient has terminal condition or is in a persistent vegetative state 3. the patient cannot make changes in the advance directive once admitted to 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 vegetative state

2. a living will is invoked only when the patient has terminal condition or is in a persistent vegetative state

As a nurse, you are assigned to four patients. Which patient do you need to see first? 1. the patient who had abdominal surgery 2 days ago who is requesting pain medication 2. a patient admitted yesterday with atrial fibrillation with decreased level on consciousness 3. a patient with a wound drain who needs teaching before discharge in the early afternoon 4. a patient going to surgery for a mastectomy in 3 hours who has a question about the surgery

2. a patient admitted yesterday with atrial fibrillation with decreased level on consciousness

the nurse arrives at work and is told to report (float) to the ICU for the day because the ICU is understaffed and needs additional nurses to care for the clients. the nurse has never worked in the ICU. the nurse should take which best action? 1. refuse to float to the ICU based on lack of unit orientation 2. clarify the ICU assignment with the team leader to ensure that it is a safe assignment 3. ask the nursing supervisor to review the hospital policy on floating 4. submit a written protest to nursing administration, and then call the hospital lawyer

2. clarify the ICU assignment with the team leader to ensure that it is a safe assignment

At 1200 the RN says to the nursing assistive personnel, "You did a good job walking Mrs. Taylor by 0930. I saw that you recorded her pulse before and after the walk. I saw that Mrs. Taylor walked in the hallway barefoot. For safety, the next time you walk a patient, you need to make sure that the patient wears slippers or shoes. Please walk Mrs. Taylor again by 1500." Which characteristics of positive feedback did the RN use when talking to the nursing assistant? Select all that apply. 1. feedback is given immediately 2. feedback focuses on one issue 3. feedback offers concrete details 4. feedback identifies ways to improve 5. feedback focuses on changeable things 6. feedback is specific about what is done incorrectly only

2. feedback focuses on one issue 3. feedback offers concrete details 4. feedback identifies ways to improve 5. feedback focuses on changeable things

the nurse manager is discussing the facility protocol in the event of a tornado with the staff. which instructions should the nurse manager include in the discussion? select all that apply. 1. open doors to client rooms 2. move beds away from windows 3. close window shades and curtains 4. place blankets over clients who are confined to bed 5. relocate ambulatory clients from the hallways back into their rooms

2. move beds away from windows 3. close window shades and curtains 4. place blankets over clients who are confined to bed

Which of the following are components of interprofessional collaboration? Select all that apply 1. interprofessional education does not impact the collaboration among interprofessional team members 2. nurses are often viewed as the team leader because of their coordination of patient care 3. effective interprofessional collaboration requires mutual respect and trust from all team members 4. open communication improves the collaboration among the interprofessional team members 5. the goal of interprofessional collaboration is to improve the quality of patient care

2. nurses are often viewed as the team leader because of their coordination of patient care 3. effective interprofessional collaboration requires mutual respect and trust from all team members 4. open communication improves the collaboration among the interprofessional team members 5. the goal of interprofessional collaboration is to improve the quality of patient care

A nurse is talking with a young-adult patient about the purpose of a new medication. The nurse says, "I want to be clear. Can you tell me in your words the purpose of this medicine?" this exchange is an example of which element of the transactional communication process? 1. message 2. obtaining feedback 3. channel 4. referent

2. obtaining feedback

A nurse is caring for a patient who recently had coronary bypass surgery and now is on the postoperative unit. Which are legal sources of standards of care that the nurse uses to deliver safe health care? Select all that apply 1. information provided by the head nurse 2. policies and procedures of the employing hospital 3. State Nurse Practice Act 4. regulations identified in The Joint Commission manual 5. the American Nurses Association standards of nursing practice

2. policies and procedures of the employing hospital 3. State Nurse Practice Act 4. regulations identified in The Joint Commission manual 5. the American Nurses Association standards of nursing practice

The nurse uses silence as a therapeutic communication technique. What is the purpose of the nurse's silence? Select all that apply. 1. precent the nurse from saying the wrong thing 2. prompt the patient to talk when he or she is ready 3. allow the patient time to thing and gain insight 4. allow time for the patient to drift off to sleep 5. determine if the patient would prefer to talk with another staff member

2. prompt the patient to talk when he or she is ready 3. allow the patient time to thing and gain insight

Nurses must communicate effectively with the health care team for which of the following reasons? Select all that apply 1. improve the nurse's status with the health team members 2. reduce the risk of errors to the patient 3. provide optimum level of patient care 4. improve patient outcomes 5. prevent issues that need to be reported to outside agencies

2. reduce the risk of errors to the patient 3. provide optimum level of patient care 4. improve patient outcomes

the nurse has made an error in documentation of the dose administered of an opioid pain medication in the client's record. the nurse draws 1 mg from the vial and another RN witnesses wasting of the remaining 1 mg. when scanning the medication, the nurse entered into the MAR that 2 mg of hydromorphone was administered instead of the actual dose administered, which was 1 mg. the nurse should take which action(s) to correct the error in the MAR? select all that apply. 1. complete and file an occurrence report 2. right-click on the entry and modify it to reflect the correct information 3. document the correct information and end with the nurse's signature and title 4. obtain a co-signature from the RN who witnessed the waste of the remaining 1 mg 5. document in a nurse's note in the client's record detailing the corrected information

2. right-click on the entry and modify it to reflect the correct information 3. document the correct information and end with the nurse's signature and title 4. obtain a co-signature from the RN who witnessed the waste of the remaining 1 mg 5. document in a nurse's note in the client's record detailing the corrected information

nursing staff members are sitting in the lounge taking their morning break. an assistive personnel tells the group that she thinks that the unit secretary has AIDS and proceeds to tell the nursing staff that the secretary probably contracted the disease from her husband, who is supposedly a drug addict. the RN should inform the assistive personnel that making this accusation has violated which legal tort? 1. libel 2. slander 3. assault 4. negligence

2. slander

A nurse is planning care for a patient going to surgery. Who is responsible for information the patient about the surgery along with possible risks, complications, and benefits? 1. family member 2. surgeon 3. nurse 4. nurse manager

2. surgeon

A nurse is sued for negligence due to failure to monitor a patient appropriately after a procedure. Which of the following statements are correct about this lawsuit? Select all that apply 1. the nurse does not need any representation 2. the patient much prove injury, damage, or loss occurred 3. the person filing the lawsuit has to show a compensable damage, such as lost wages, has occurred 4. the patient must prove that a breach in the prevailing standard of care caused an injury 5. the burden of proof is always the responsibility of the nurse

2. the patient much prove injury, damage, or loss occurred 3. the person filing the lawsuit has to show a compensable damage, such as lost wages, has occurred 4. the patient must prove that a breach in the prevailing standard of care caused an injury

A new nurse is experiencing lateral violence at work. Which steps could the nurse take to address this problem? 1. challenge the nurses in a public forum to embarrass them and change their behavior 2. talk with the department secretary and ask if this has been a problem for other nurses 3. talk with the preceptor or manager and ask for assistance in handling this issue 4. say nothing and hope things get better

3. talk with the preceptor or manager and ask for assistance in handling this issue

A nurse stops to helping an emergency at the scene of an accident. The injured party files a suit, and the nurse's employing institution insurance does not cover the nurse. What would probably cover the nurse in this situation? 1. the nurse's automobile insurance 2. the nurse's homeowner's insurance 3. the Good Samaritan law, which grants immunity from suit if there is no gross negligence 4. the Patient Care Partnership, which may grant immunity from suit if the injured party consents

3. the Good Samaritan law, which grants immunity from suit if there is no gross negligence

A patient is evaluated in the ED after causing an automobile accident while being under the influence of alcohol. While assessing the patient, which statement would be the most therapeutic? 1. "Why did you drive after you had been drinking?" 2. "We have multiple patients to see tonight as a result of this accident." 3. "Tell me what happened before, during, and after the accident tonight." 4. "It will be okay. No one was seriously hurt in the accident."

3. "Tell me what happened before, during, and after the accident tonight."

A nurse notes that the health care unit keeps a listing of the patient names at the front desk in easy view for health care providers to more efficiently locate the patient. The nurse talks with he nurse manager because this action is a violation of which act? 1. Patient Protection and Affordable Care Act (PPACA) 2. Patient Self-Determination Act (PSDA) 3. Health Insurance Portability and Accountability Act (HIPAA) 4. Emergency Medical Treatment and Active Labor Act

3. Health Insurance Portability and Accountability Act (HIPAA)

The nurse hears a client calling out for help, hurries down the hallway to the client's room, and finds the client lying on the floor. The nurse performs an assessment, assists the client back to bed, notifies the health care provider of the incident, and completes an incident report. Which statement should the nurse document on the incident report? 1. The client fell out of bed. 2. The client climbed over the side rails. 3. The client was found lying on the floor. 4. The client became restless and tried to get out of bed.

3. the client was found lying on the floor

the RN is planning the client assignments for the day. which is the most appropriate assignment for an assistive personnel? 1. a client requiring a colostomy irrigation 2. a client receiving continuous tube feedings 3. a client who requires urine specimen collections 4. a client with difficulty swallowing food and fluids

3. a client who requires urine specimen collections

While administering medications, a nurse realizes that a prescribed dose of a medication was not given. The nurse acts by completing an incident report and notifying the patient's health care provider. The nurse is exercising: 1. authority 2. responsibility 3. accountability 4. decision making

3. accountability

Which example demonstrates a sures performing the skill of evaluation? 1. the nurse explains the side effects of the new blood pressure medication ordered for the patient 2. the nurse asks a patient to rate pain on a scale of 0 to 10 before administering the pain medication 3. after completing the teaching, the nurse observes a patient dray up and administer an insulin injection 4. the nurse changes a patient's leg ulcer dressing using aseptic technique

3. after completing the teaching, the nurse observes a patient dray up and administer an insulin injection

the nurse who works on the night shift enters the medication room and finds a coworker with a tourniquet wrapped around the upper arm. the coworker is about to insert a needle, attached to a syringe containing a clear liquid, into the antecubital area. which is the most appropriate action by the nurse? 1. call security 2. call the police 3. call the nursing supervisor 4. lock the coworker in the medication room until help is obtained

3. call the nursing supervisor

the nurse employed in a hospital is waiting to receive a report from the laboratory via fax. the fax machine activates and the nurse expects the report, but instead receives a sexually oriented photograph. which is the most appropriate initial nursing action? 1. call the police 2. cut up the photograph and throw it away 3. call the nursing supervisor and report the occurrence 4. call the laboratory and ask for the mane of the individual who sent the photograph

3. call the nursing supervisor and report the occurrence

A home health nurse notices significant cruising on a 2-year-old patient's head, arms, abdomen, and legs. The patient's mother describes the patient's frequent falls. What is the best nursing action for the home health nurse to take? 1. document her findings and treat the patient 2. instruct the mother on safe handling of a 2-year-old child 3. contact a child abuse hotline 4. discuss this story with a colleague

3. contact a child abuse hotline

A RN performs the following four steps in delegating a task to a nursing assistant. Place the steps in the order of appropriate delegation. 1. do you have any questions about walking Mr. Malone? 2. before you take him for his walk to the end of the hallway and back, please take and record his pulse rate 3. in the next 30 minutes please assist Mr. Malone in room 418 with her afternoon walk 4. I will make sure that I check with you in about 40 minutes to see how the patient did

3. in the next 30 minutes please assist Mr. Malone in room 418 with her afternoon walk 2. before you take him for his walk to the end of the hallway and back, please take and record his pulse rate 4. I will make sure that I check with you in about 40 minutes to see how the patient did 1. do you have any questions about walking Mr. Malone?

A nurse is teaching a patient about wound care that will need to be done daily at home after the patient is discharged. This is which priority nursing need for this patient? 1. low priority 2. high priority 3. intermediate priority 4. nonemergency priority

3. intermediate priority

Then nurse received a hand-off report at the change of shift in the conference room from the night shift nurse. The nursing student assigned to the nurse asks to review the medical records of the patients assigned to them. The nurse begins assessing the assigned patients and lists the nursing care information for each patient on each individual patient's message board in the patient rooms. The nurse also lists the patients' medical diagnoses on the message board. Alter in the day the nurse discusses the plan of care for a patient who is dying with the patient's family. Which of these actions describes a violation of HIPAA? 1. discussing patient conditions in the nursing report room at the change of shift 2. allowing nursing students to review patient charts before caring for patients to whom they are assigned 3. posting medical information about the patient on a message board in the patient's room 4. releasing patient information regarding terminal illness to family when the patient has given permission for information to be shared

3. posting medical information about the patient on a message board in the patient's room

A nurse is using the Plan-Do-Study-Act (PDSA) strategy to do a quality improvement project to decrease patient falls on a nursing unit. Place the steps in the correct sequence for PDSA. 1. bedside change of shift report is piloted on two medical-surgical units 2. patient satisfaction levels after implementation of the bedside report are compared to patient satisfaction levels before the change 3. the nursing council develops a strategy for bedside change of shift report 4. after modifications are made in the shift report elements, bedside shift report is implemented on all nursing units

3. the nursing council develops a strategy for bedside change of shift report 1. bedside change of shift report is piloted on two medical-surgical units 2. patient satisfaction levels after implementation of the bedside report are compared to patient satisfaction levels before the change 4. after modifications are made in the shift report elements, bedside shift report is implemented on all nursing units

After a nurse receives a change-of-shift report on his assigned patients, he prioritizes the tasks that need to be completed. This is an example of a nurse displaying which practice? 1. organizational skills 2. use of resources 3. time management 4. evaluation

3. time management

a client is brought to the ED by EMS after being hit by a car. the name of the client is unknown, and the client has sustained a severe head injury and multiple fractures and is unconscious. an emergency craniotomy is required. regarding informed consent for the surgical procedure, which is the best action? 1. obtain a court order for the surgical procedure 2. ask the EMS team to sign the informed consent 3. transport the victim to the operating room for surgery 4. call the police to identify the client and locate the family

3. transport the victim to the operating room for surgery

A patient who is a Spanish-speaking does not appear to understand the nurse's information on wound care. Which action should the nurse take? 1. arrange for a Spanish-speaking social worker to explain the procedure 2. ask a fellow Spanish-speaking patient to help explain the procedure 3. use a professional interpreter to provide wound care education in Spanish 4. ask the patient to write down questions that he or she has for the nurse

3. use a professional interpreter to provide wound care education in Spanish

an older woman is brought to the ED for treatment of a fractured arm. on physical assessment, the nurse notes old and new ecchymotic areas on the client's chest and legs and asks the client how the bruises were sustained. the client, although reluctant, tells the nurse in confidence that her son frequently hits her if supper is not prepared on time when he arrives from work. which is the most appropriate nursing response? 1. "Oh, really? I will discuss this situation with your son." 2. "Let's talk about the ways you can manage your time to prevent this from happening." 3. "Do you have any friends who can help you out until you resolve these important issues with your son?" 4. "As a nurse, I am legally bound to report abuse. I will stay with you while you give the report and help find a safe place for you to stay."

4. "As a nurse, I am legally bound to report abuse. I will stay with you while you give the report and help find a safe place for you to stay."

a hospitalized client tells the nurse that an instructional directive is being prepared and that the lawyer will be bringing the document to the hospital today for witness signatures. the client asks the nurse for assistance in obtaining a witness to the will. which is the most appropriate response to the client? 1. "I will sign as a witness to your signature." 2. "You will need to find a witness on your own." 3. "Whoever is available at the time will sign as a witness for you." 4. "I will call the nursing supervisor to seek assistance regarding your request."

4. "I will call the nursing supervisor to seek assistance regarding your request."

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 communication. 1. "She is a 53-year-old female who was admitted 2 days ago with pneumonia and was started on Levaquin at 5 pm yesterday. She complains of a poor appetite." 2. "The patient reported feeling very nauseated after her dose of Levaquin an hour ago." 3. "Would you like to make a change in antibiotics, or could we give her a nutritional supplement before her medication?" 4. "The patient started complaining of nausea yesterday evening and has vomited several times during the night."

4. "The patient started complaining of nausea yesterday evening and has vomited several times during the night." 1. "She is a 53-year-old female who was admitted 2 days ago with pneumonia and was started on Levaquin at 5 pm yesterday. She complains of a poor appetite." 2. "The patient reported feeling very nauseated after her dose of Levaquin an hour ago." 3. "Would you like to make a change in antibiotics, or could we give her a nutritional supplement before her medication?"

A homeless man enters the ED seeking health care. The health care provider indicated that the patient needs to be transferred to the City Hospital for care. This action is most likely a violation of which of the following laws? 1. HIPAA 2. Americans with Diabetes Act (ADA) 3. Patient Self-Determination Act (PSDA) 4. Emergency Medical Treatment and Active Labor Act (EMTALA) without triage completed

4. Emergency Medical Treatment and Active Labor Act (EMTALA) without triage completed

the nurse employed in a LTC facility is planning assignments for the clients on a nursing unit. the nurse needs to assign four clients and has a LPN and 3 CNAs on a nursing team. which client would the nurse most appropriately assign to the LPN? 1.a client who requires a bed bath 2. an older client requiring frequent ambulation 3. a client who requires hourly vital sign measurements 4. a client requiring abdominal wound irrigations and dressing changes every 3 hours

4. a client requiring abdominal wound irrigations and dressing changes every 3 hours

the nurse has received the assignment for the day shift. after making initial rounds and checking all of the assigned clients, which client should the nurse plan to care for first? 1. a client who is ambulatory demonstrating steady gait 2. a postoperative client who has just received an opioid pain medication 3. a client scheduled for physical therapy for the first crutch-walking session 4. a client with a WBC count of 14,000mm^3 and a temperature of 38.4*C

4. a client with a WBC count of 14,000mm^3 and a temperature of 38.4*C

the nurse is assigned to care for four clients. in planning client rounds, which client should the nurse assess first? 1. a postoperative client preparing for discharge with a new medication 2. a client requiring daily dressing changes of a recent surgical incision 3. a client scheduled for a chest x-ray after insertion of a nasogastric tube 4. a client with asthma who requested a breathing treatment during the previous shift

4. a client with asthma who requested a breathing treatment during the previous shift

the nurse employed in an ED is assigned to triage clients coming to the ED for treatment on the evening shift. the nurse should assign priority to which client? 1. a client complaining of muscle aches, a headache, and history of seizures 2. a client who twisted her ankle when rollerblading and is requesting medication for pain 3. a client with a minor laceration on the index finger sustained while cutting an eggplant 4. a client with chest pain who states that he just ate pizza that was made with a very spicy sauce

4. a client with chest pain who states that he just ate pizza that was made with a very spicy sauce

a nursing graduate is attending an agency orientation regarding the nursing model of practice implemented in the health care facility. the nurse is told that the nursing model is a team nursing approach. the nurse determines that which scenario is characteristic of the team-based model of nursing practice? 1. each staff member is assigned a specific task for a group of clients 2. a staff member is assigned to determine the client's needs at home and begin discharge planning 3. a single RN is responsible for providing care to a group of 6 clients with the aid of an assistive personnel 4. an RN leads 2 LPNs and 3 CNAs in providing care to a group of 12 clients

4. an RN leads 2 LPNs and 3 CNAs in providing care to a group of 12 clients

A nurse assesses patients and uses assessment findings to identify patient problems and develop an individualize plan of care. The nurse is displaying. 1. organizational skills 2. use of resources 3. priority setting 4. clinical decision making

4. clinical decision making

the nurse manager has implemented a change in the method of the nursing delivery system from functional to team nursing. an assistive personnel is resistant to the change and is not taking an active part in facilitating the process of change. which is the best approach in dealing with the AP? 1. ignore the resistance 2. exert coercion on the AP 3. provide a positive reward system for the AP 4. confront the AP to encourage verbalization of feelings regarding the change

4. confront the AP to encourage verbalization of feelings regarding the change

the nurse is giving a bed bath to an assigned client when an assistive personnel enters the client's room and tells the nurse that another assigned client is in pain and needs pain medication. which is the most appropriate nursing action? 1. finish the bed bath and then administer the pain medication to the other client 2. ask the AP to find out when the last pain medication was given to the client 3. ask the AP to tell the client in pain that medication will be administered as soon as the bed bath is complete 4. cover the client, raise the side rails, tell the client that you will return shortly, and administer the pain medication to the other client.

4. cover the client, raise the side rails, tell the client that you will return shortly, and administer the pain medication to the other client.

You are the night shift nurse caring for a newly admitted patient who appears to be confused. The family asks to see the patient's medical record. What is the priority nursing action? 1. give the family the record 2. discuss the issues that concern the family with them 3. call the nursing supervisor 4. determine from the medical record if the family has been granted permission by the patient to access his or her medical information

4. determine from the medical record if the family has been granted permission by the patient to access his or her medical information

A nursing student is reviewing a process recording with the instructor. The student engaged the patient in a discussion about availability of faily members to provide support at home once the patient is discharged. The student reviews with the instructor whether the comments used encouraged openness and allowed the patient to "tell his story." This is an example of which step of the nursing process? 1. planning 2. assessment 3. intervention 4. evaluation

4. evaluation

Which task is appropriate for a RN to delegate to a nursing assistant? 1. explaining to the patient the preoperative preparation before the surgery in the morning 2. administering the ordered antibiotic to the patient before surgery 3. obtaining the patient's signature on the surgical informed consent 4. helping the patient to the bathroom before leaving for the operating room

4. helping the patient to the bathroom before leaving for the operating room

A nurse is assigned to care for a patient for the first time and states, "I don't know a lot about your culture and want to learn how to better meet your health care needs." Which therapeutic communication technique did the nurse use in this situation? 1. validation 2. empathy 3. sarcasm 4. humility

4. humility

A woman has severe life-threatening injuries and is hemorrhaging following a care accident. The health care provider ordered 2 units of packed red blood cells to treat the woman's anemia. The woman's husband refuses to allow the nurse to give his wife the blood for religious reasons. What is the nurse's responsibility? 1. obtain a court order to give the blood 2. coerce the husband into giving the blood 3. call security and have the husband removed from the hospital 4. more information is needed about the wife's preference and if the husband has her medical POA

4. more information is needed about the wife's preference and if the husband has her medical POA

a nursing instructor delivers a lecture to nursing students regarding the issue of clients' rights and asks a nursing student to identify a situation that represents an example of invasion of client privacy. which situation, if identified by the student, indicates an understanding of a violation of this client right? 1. performing a procedure without consent 2. threatening to give a client a medication 3. telling the client that he or she cannot leave the hospital 4. observing care provided to the client without the client's permission

4. observing care provided to the client without the client's permission

Which of the following statements are true regarding a culture of safety? (Select all that apply.) a) Acknowledges the influence complex systems and human factors have on safety b) Discourages nurses from reporting mistakes they make related to medication administration c) Requires support from those in leadership roles d) Focuses on teamwork and communication e) Does not consider individual member's attitudes and perceptions regarding safety; only group attitudes and perceptions are deemed valuable

a) Acknowledges the influence complex systems and human factors have on safety c) Requires support from those in leadership roles d) Focuses on teamwork and communication

The nurse administers a medication to which the patient is allergic. The allergy was noted in the patient's chart and on the patient's identification band. Which type of error did this nurse commit? a) An error of commission b) An error of omission c) An error of execution d) An error of documentation

a) An error of commission

The Quality and Safety Education for Nurses (QSEN) project recommends that nursing students are taught that nurses should rely less on memory when performing nursing actions. a) True b) False

a) True

The nurse is administrating medications to a pediatric patient. The nurse notes that one of the medications for the child, which was sent to the floor from the pharmacy, consisted of an adult dosage. The nurse recognizes this error and does not administer the medication. Which of the following best describes this situation? a) An adverse event b) A near-miss event c) A sentinel event d) A latent event

b) A near-miss event

According to the Institute of Medicine (IOM), it is acceptable for health care facilities to have lower standards of care on night shifts because fewer treatments are prescribed during those hours and patients are typically sleeping. a) True b) False

b) False

Which statement best describes an active error? a) Occurs at the organizational level b) Made by a physician, nurse, or technician who is providing direct patient care c) An event that results in unintended harm to a patient d) An event that could have been prevented if effective communication processes were in place

b) Made by a physician, nurse, or technician who is providing direct patient care

Which type of event is described as an unexpected occurrence of death or serious injury that warrants an immediate investigation and response? a) An adverse event b) A near-miss event c) A sentinel event d) A latent event

c) A sentinel event

A patient had orthopedic surgery. The surgeon failed to prescribe a blood thinner following surgery and the patient developed a deep vein thrombosis as a result. Which of the following best describes this scenario? a) Diagnostic error b) Treatment error c) Preventive error d) Communication error

c) Preventive error

Which of the following is true regarding a just culture? a) Professionals are not held responsible for their errors if it is found that the error happened due to a systems problem b) Discourages disclosure of errors among stakeholders c) Does not pertain to personal injuries and near-miss events d) People can report mistakes or errors without reprisal or personal risk

d) People can report mistakes or errors without reprisal or personal risk