Transitions Final
A nurse is reviewing treatment protocols for clients exposed to bioterrorism agents. For which of the following agents should the nurse plan to administer a vaccine following exposure? A. Plague B. Anthrax C. Botulism D. Smallpox
D
A community health nurse is reviewing the levels of disease prevention. Which of the following activities is an example of tertiary prevention? A. Providing treatment for clients who have chronic obstructive pulmonary disease B. Performing screening for sexually transmitted infections C. Administering influenza immunizations at a local health fair D. Testing new nurses for exposure to tuberculosis.
A
A nurse in a community health center is assessing the results of a tuberculin skin test she performed for a client. Which of the following results indicates exposure to and a possible infection with tuberculosis (TB)? A. 15 mm induration B. 10 mm wheal C. 5 mm induration D. 4 mm erythema
A
A nurse is teaching a class about preventive care to clients who are at risk for acquiring viral hepatitis. Which of the following information should the nurse include in the presentation? A. Avoid foods prepared with tap water. B. Avoid eating meat. C. Avoid handwashing after eating. D. Avoid covering sores with bandages.
A
A nurse is triaging clients injured during a tornado. The nurse assesses a client who has an open fracture of his arm. Which of the following tags would the nurse place on the client? A. Place a yellow tag on the client's upper body. B. Place a red tag on the client's upper body. C. Perform a rapid head-to-toe assessment. D. Have the client's wife drive him to the hospital.
A
A nurse is working with an interdisciplinary disaster committee to develop a community-wide emergency response plan in the event of a non biological or chemical incident. The nurse should include which of the following agencies to be notified immediately after calling 911? A. Office of Emergency Management (OEM) B. U.S. Department of Homeland Security (DHS) C. Federal Emergency Management Agency (FEMA) D. American Red Cross (ARC)
A
After a nursing student has graduated from their program, what is the timeframe the applicant has to take and pass the NCLEX-RN? (According to the Utah Nurse Practice Act Rule) A. 5 years B. 1 year C. 90 days D. Indefinite
A
An occupational health nurse in the clinic of an industrial plant is developing a guidebook for clinic workers. Which of the following actions should the nurse include as a secondary prevention strategy? A. Help plant workers identify signs of carpal tunnel syndrome. B. Collaborate with physical therapists to develop programs for injured employees to return to work. C. Set up an influenza immunization campaign. D. Teach plant workers about proper lifting techniques.
A
How does the Utah Nurse Practice Act Rule define a Comprehensive nursing assessment? A. conducting extensive initial and ongoing data collection B. assessing the patient's care plan C. appraisal of a patient's status and the situation at hand D. verification and evaluation of prescribed orders
A
The new graduate nurse would like to pursue a career in the Intensive Care Unit (ICU). What goal might be appropriate for this career? A. Credentialing as a Certified Critical Care Nurse (CCRN) B. Obtain employment at only Magnet status facilities. C. Become a Family Nurse Practitioner (FNP) D. Complain to the Clinical Placement Team regarding their capstone assignment in a M/S unit
A
The student nurse is preparing a resume. Which elements would he/she include? A. Experience and education B. Hobbies and interests C. Marital status D. Nursing class grade point average
A
After receiving report on 4 patients, the RN may delegate which client's needs to an assistive personnel? A. Reapplying a condom catheter for a client who has urinary incontinence B. Reinforcing teaching with a client who is learning to walk using a quad cane C. Applying a sterile dressing to a pressure ulcer D. Feeding a client who was admitted 24 hours ago with aspiration pneumonia
A RATIONALE: All of the tasks require an RN except the condom catheter. Assistive personnel can feed clients, however this client has feeding problems and has aspirated previously. Assistive personnel cannot reinforce teaching - LPNs can. Assistive personnel are not trained in sterile technique.
A nurse is being sued for assault and battery. What does this mean? A. The nurse, without consent, touched the patient in an offensive, insulting, or injurious way. B. The nurse threatened to put the patient in restraints if he did not stay in bed. C. The nurse told the patient he could not leave until his bill was paid. D. The nurse failed to perform an act expected of a reasonable nurse.
A RATIONALE: Assault and battery are the legal terms applied to non-consensual threat of touch (assault) or the actual touching (battery).
What does the "scope of nursing practice" refer to? A. The activities legally permissible for a nurse to perform in a particular state B. Acts that permit some overlap between nursing and medicine C. The specific duty the nurse owes to a patient D. Those activities for which a nurse can be held liable for malpractice
A RATIONALE: Defining the scope of nursing practice is part of the responsibility of the state board of nursing. This involves determining the specific activities for each level of nursing and who can perform what functions.
A nurse is respected by peers for clinical skills and effective interpersonal relationships. The nurse has studied diabetic patient educational needs and consults with several units. What type of power does this nurse possess? A. Expert B. Legitimate C. Reward D. Informational
A RATIONALE: Expert power is based on specialized knowledge, skills, or abilities that are recognized and respected by others. Those who have information that others need to perform their duties have informational power. Legitimate power is based on the person's position within an organization. Reward power occurs when an individual has the power to give or withhold rewards.
The nurse is reviewing I-SBAR-R with a coworker at the end of the shift. Which statement indicates that they are discussing the Situation component? A. The nurse states that the patient was hospitalized for a broken tibia and that surgery is scheduled for later today. B. The nurse states an opinion on what is happening with the patient. C. The nurse states the patient's name using two identifiers. D. The oncoming nurse acknowledges the info that has been received.
A RATIONALE: In the Situation component of I-SBAR-R, the nurse states what is going on with the patient. In this situation, the patient was hospitalized with a broken tibia, and surgery is planned for later today. The Identification component involves stating the patient's name, the Assessment component involves the nurse discussing what the nurse thinks is happening with the patient, and the Read-Back or Response component involves that the oncoming nurse repeating what the nurse has heard from the nurse who is reporting at the end of the shift.
During a job interview, the interviewee is asked, "What do you believe your weaknesses to be?" What is the best reply? A. "I'm looking forward to strengthening my ability to plan care for a group of patients." B. "I've never thought about having any weaknesses." C. "My biggest problem is getting to work on time." D. "My instructors told me I was disorganized."
A RATIONALE: It is important to develop responses to probable interview questions. This is not an uncommon question, and the graduate nurse should prepare a positive response, such as "strengthening ability to plan for a group of patients." Telling the interviewer that you never thought about your weaknesses or that you need help with planning and implementing discharge teaching does not indicate that you are prepared for the interview. The other option about admitting disorganization is not a positive response.
What is the legal source of rules of conduct for nurses? A. Nurse Practice Acts B. agency policies and protocols C. constitution of the United States D. American Nurses Association
A RATIONALE: Nurse Practice Acts are examples of statutory law, enacted by a legislative body in keeping with both the federal constitution and the applicable state constitution. They are the primary source of rules of conduct for nurses. Standards of practice, which differ from rules of conduct, are made by agency policies and protocols and by the American Nurses Association.
The nurse has several tasks to complete. Which task would the nurse NOT delegate to a certified nursing assistant? A. Discussing the importance of deep breathing to a pre-operative patient B. Accompanying a patient being discharged by wheelchair to the front door C. Bathing an unconscious patient D. Sitting at the bedside of a confused patient to keep them from wandering
A RATIONALE: Pre-Operative teaching cannot be delegated to the nursing assistant. The RN must determine what needs to be done and then identify whether this is a task that can be delegated to someone else. The role of the RN involves the coordination and planning of care, with the primary focus on identifying with the patient and the physician the desired outcomes for the patients. Bathing a patient is within the role and responsibilities of the CNA.
What is a correct statement regarding a nurse who acts beyond the scope of practice? A. May be disciplined by the board of nursing B. May make other nurses angry because of the increased expectations created C. Demonstrates what a good nurse she or he can be D. Provides enriched services to patients who would not otherwise receive them
A RATIONALE: States may regulate nursing practice by controlling the scope of practice and determining the specific activities for each level of nursing. In most states, the Nurse Practice Act provides definitions and scope of practice for each level of nursing practice. The power of the board to discipline can have an adverse affect on the nurse's ability to practice.
The nurse understands that delegation and supervision are two concepts that go hand-in-hand. Which is the best example of the concept of supervision? A. Following up with a CNA on the assigned task of ambulation and feeding of two patients B. Assigning a urinary catheterization and collection of sterile culture to an LPN C. Assigning nursing care for a group of five patients to an RN D. Scheduling the LPN to administer medications on the unit for the afternoon
A RATIONALE: Supervision is the provision of guidance, direction, and follow-up for the accomplishment of an assigned task. The nurse would follow up with the CNA to determine whether the tasks were completed and whether any problems occurred.
What is the purpose of the nurse's Code of Ethics? A. To guide the behavior of the professional nurse B. To assist in clarifying the individual nurse's personal values and goals C. To identify acts that are legal for the nurse to perform D. To differentiate between moral and immoral acts
A RATIONALE: The American Nurses Association (ANA) Code of Ethics (2001) is a statement to society that outlines the values, concerns, and goals of the profession. It should be compatible with the values and goals of each nurse.
What is the primary role of The Joint Commission (TJC)? A. ensuring medical facilities meet patient safety guidelines. B. granting magnet status to excellent hospitals. C. inspecting hospitals for compliance of infection control standards. D. lobbying Congress on behalf of Medicare/Medicaid patients.
A RATIONALE: The Joint Commission (TJC) is the primary accrediting body for health care institutions. Its standards directly address patient safety issues. Magnet status is approved by the American Nurses Association. TJC does not lobby Medicare/Medicaid issues. The CDC is the agency that maintains standards regarding infection control for hospital compliance.
What is the purpose of the Robert Wood Johnson Institute of Medicine report? A. To make recommendations for the nursing profession to transform healthcare. B. To give physicians an opportunity to have input in the nursing profession. C. To force all nurses to obtain a Baccalaureate in Nursing. D. To help congress Pass laws and make changes in healthcare.
A RATIONALE: The RWJ IOM report purpose is to transform health care and make recommendations for nursing, since nursing represents the largest profession in health care.
Which of the following actions by the nurse manager would indicate an autocratic management style? A. Makes most of the decisions without input from the staff members B. Allows staff members to make most of the decisions C. Exerts little control over staff D. Emphasizes effective group functioning
A RATIONALE: The autocratic manager uses an authoritarian approach to direct the activities of others. This manager would make most of the decisions without input from the staff members. Allowing staff members to make most of the decisions and exerting little control over staff is a laissez-faire management style. Emphasizing effective group functioning is common for a democratic management style.
Which situation could lead to performance inadequacy? A. The person to whom the task was assigned did not understand what the task involved. B. The person to whom the task was assigned had appropriate educational qualifications to complete the task. C. The person who delegated the task confirmed the recipient's ability to perform the task. D. The task was assigned to a person capable of carrying out the assignment.
A RATIONALE: The person who delegates a task must ensure clear direction and communication.The person to whom the task is assigned should verify that he or she understands and can perform the task.
A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first? A. Review the events leading up to each medication administration error. B. Provide an inservice on medication administration to all the nurses. C. Require staff nurses to demonstrate competency by passing a medication administration examination. D. Develop a quality improvement program for nurses involved in medication administration errors.
A RATIONALE: After a sentinel event, the first step the committee should plan to take is to use root cause analysis to identify the underlying cause or causes that led to the medication errors.
A nurse tells a patient, "If you don't stop getting out of that chair, I'm going to put some restraints on you." What may this nurse be accused of? A. Assault B. Defamation C. Invasion of privacy D. Malpractice
A RATIONALE: Assault and battery are the legal terms applied to non-consensual threat of touch (assault) or the actual touching (battery). Use of restraints may also be interpreted as false imprisonment.
What is the best legal safeguard for a nurse? A. Competent practice B. A legal contract C. A valid license D. Following management policies
A RATIONALE: Practicing within the parameters of the state's Nurse Practice Act, performing care based on established policies and procedures, and performing as a reasonable nurse are the best ways for a nurse to safeguard against legal action.
Following an earthquake, patients are triaged by emergency medical personnel and are transported to the hospital. Which of these patients will the nurse need to assess first? A. A patient with a red tag B. A patient with a yellow tag C. A patient with a green tag D. A patient with a blue tag
A RATIONALE: The red tag indicates a patient with a life-threatening injury requiring rapid treatment. The other tags indicate patients with less urgent injuries or those who are likely to die.
A nurse is developing an education program for a community group about dietary intake of vitamins and minerals in the diet. The nurse should include which of the following foods as sources of vitamin C? (Select all that apply.) A. Green pepper B. Orange C. Cabbage D. Strawberries E. Milk
A, B, C, D
Which action would help the graduate nurse when seeking out employment? (Select all that apply.) A. Determine the length of orientation. B. Find out what type of nursing care is delivered. C. Ask to speak to nurses who work on the unit. D. Plan out interviews. E. Wait until the interview day to gather all of the information.
A, B, C, D RATIONALE: It is important for the graduate nurse to be prepared when seeking out employment. Planning out interviews, speaking to nurses who work on the units, finding out what type of nursing care is provided, and determining the length of orientation are all actions the graduate nurse can take to prepare for employment. Waiting to gather information at the interview can leave the graduate nurse feeling frazzled and disorganized.
What is expected of the new graduate across healthcare agencies? Select all that apply A. To work effectively with assistive personnel, delegating and supervising nursing care tasks in an appropriate manner. B. Use communication skills effectively with clients and coworkers. C. Possess theoretic background for safe client care and for decision making. D. Recognize own abilities and limitations E. Use the nursing process in a systematic way. F. Possess all knowledge regarding pathophysiology of all disease processes.
A, B, C, D, E
The nurse is implementing fall prevention protocol. What would be included in the protocol? (Select all that apply) A. assessment of medication side effects B. thorough and sound assessment of clients abilities and limitations C. bed and chair alarms D. placing the client bed is a high position E. toileting every 2 hours and visual hourly checks
A, B, C, E
The nurse is considering strategies to increase nurses' time at the bedside. Which strategies should be included? Select all that apply A. Standardized documentation tools B. Hourly rounding by staff members C. Supplies in a central location near the nurses station D. Effectiveness in medication administration E. Bedside change of shift report
A, B, D, E
What are the key messages that structure the discussion and recommendations presented in the Robert Wood Johnson Institute of Medicine Report? Select all that apply A. Nurses should practice to the full extent of their education and training B. Effective workforce planning and policy making require better data collection and an improved information infrastructure C. Nurses should work to become transformational leaders through continuing educations courses. D. Nurses should achieve higher levels of education and training through and improved education system that promotes seamless academic progression. E. Nurses should be full partners, with physicians and other health professionals, in redesigning health care i the U.S.
A, B, D, E
A nurse is caring for a client following exposure to inhalational anthrax due to bioterrorism. Which of the following medications should the nurse expect as a common medication to treat anthrax? (Select all that apply.) A. Doxycycline B. Amoxicillin C. Cefotaxime D. Penicillin G E. Ciprofloxacin
A, B, E
The nursing student is preparing an application for employment. Who would be the best reference for the student to include? Select all that apply A. A recent clinical instructor B. Their preceptor C. A student mentor D. The schools student support team member E. A previous employer
A, B, E
The nurse is reviewing categories for improving client safety. Which categories should the nurse review? Select all that apply A. Facilitating information transfer and clear communication B. Surgery on wrong body part C. Prevention of hospital-related infections D. Medication management E. Tubing misconnections
A, C, D
What are the factors that contribute to medication errors? Select all that apply A. inadequate staffing B. computerized drug monitoring and electronic dispensing systems C. overly tired nurses D. high nurse-client ratios E. the use of Computerized Physician/ Provider Entry CPOE
A, C, D
What aspects define nursing as a profession? select all that apply A. Nurses have developed a Code of Ethics. B. Nurses work around the clock. C. Nurses serve the public. D. Nurses are trusted by the public. E. Nurse's possess a specialized body of knowledge.
A, C, E
A nurse is among the first responders to a mass-casualty incident and does not know what type of personal protective equipment (PPE) is needed. Which of the following actions should the nurse take? A. Use a dosimeter to measure the level of radiation in the area before intervening. B. Choose the highest level of protection equipment available. C. Wait until the type of equipment needed is known. D. Decontaminate victims before intervening.
B
A nurse is caring for a client involved in a suspected bioterrorism event involving exposure to cutaneous anthrax. Which of the following manifestations should the nurse anticipate? A. Flu-like symptoms B. Skin lesions with pruritus C. Respiratory distress D. Bloody diarrhea
B
A nurse is teaching a group of newly hired nurses about the requirements for disaster planning. Which of the following statements by one of the newly hired nurses indicates an understanding of the teaching? A. "A staff nurse can function as the incident commander." B. "Disaster drills should be held on a regular basis." C. "An actual disaster cannot take the place of a disaster drill." D. "A physician must triage victims of a disaster in the emergency department
B
A nurse is performing triage for a group of clients following a mass casualty incident (MCI). Which of the following clients should the nurse plan to care for first? A. A client who has full-thickness burns over 80% of his body B. A client who has agonal respirations C. A client experiencing a tension pneumothorax D. A client who has a closed upper extremity fracture
C
George the construction worker fell off a crane while working on the Ameritech roof. The students rushed to his aid, and decided not to move him in case he had sustained a neck injury. What ethical principle were the students following? A. Fidelity B. Non-maleficence C. Justice D. Autonomy
B
The nursing student is studying about root cause analysis (RCA) Which of the following is a critical element in error reporting? A. Errors are documented as person focused. B. Non-punitive action when errors are reported. C. Individuals are encouraged to report near misses. D. Communication is linked to increased errors.
B
Where does the definition of nursing "one that would put the client in the best condition for nature to act upon him" come from? A. NCSBN B. Florence Nightingale C. Google D. American Nursing Association
B
Where should a nurse go if they are facing a dilemma in patient care with no absolute right or wrong answer? A. The nurse's religious leader B. The hospital Ethics Committee C. The hospital legal department D. The client's insurance company review board
B
A nurse manager needs to purchase new thermometers for the nursing unit. What technique would demonstrate a laissez-faire style of leadership? A. Having the nurses on the unit try several types and vote on their favorite B. Having the nurses on the day shift order any thermometer that they want C. Purchasing the brand that the nurse manager thinks is the best thermometer D. Asking the nurses during staff meeting what they prefer in a thermometer
B RATIONALE: A laissez faire manager maintains a permissive climate with little direction or control. They allow staff members to make and implement decisions independently and relinquishes most of their power and responsibility to them.
Which of the following actions best reflects maintaining accountability for the nursing process? A. Asking a client's daughter to bring her father's non-skid slippers to the hospital B. Reassessing a client's BP when the reported value is higher than usual C. Asking the CNA to take vital signs on a patient who just received pain medication D. Assisting a team member in providing a client with a complete bed bath
B RATIONALE: Accountability refers to individuals being responsible for their actions. It means that a nurse accepts the commitment to provide excellent client care and the responsibility for the outcomes of the actions in providing that care. Reassessing an abnormally high BP is the best example of nursing accountability because it shows the nurse being responsible for the accuracy of the assessment. The remaining options better reflect nursing responsibility.
A nurse is interested in moving into a management position. Which action would assist with accomplishing this? A. Use of legitimate power B. Use of expert power C. Use of reward power D. Use of coercive power
B RATIONALE: An expert refers to someone who is knowledgeable, experienced, and respected in his or her area of nursing. This type of expert power would assist the nurse to advance to higher positions in nursing. Reward power is closely linked with legitimate power in that it comes about because the individual has the power to provide or withhold rewards. Legitimate power is power connected to a position of authority. Coercive power is power derived from fear of consequences.
What does the "scope of nursing practice" refer to? A. Acts that permit some overlap between nursing and medicine B. The activities legally permissible for a nurse to perform in a particular state C. The specific duty the nurse owes to a patient D. Those activities for which a nurse can be held liable for malpractice
B RATIONALE: Defining the scope of nursing practice is part of the responsibility of the state board of nursing. This involves determining the specific activities for each level of nursing and who can perform what functions.
The nurse manager is updating unit staff on findings by The Joint Commission. Which of the following statements shows an understanding of the primary cause of untoward events in the hospital setting? A. "unclear chain of communication for reporting." B. "unclear, ineffective communication." C. "ineffective reporting of the untoward event." D. "lack of consistent supervision of nursing staff."
B RATIONALE: Ineffective communication was identified as the root cause for nearly 70% of all sentinel events reported. The majority of those untoward events involved communication failure. The other options were not identified as the majority of all sentinel events.
When caring for a patient who is Native American, the best initial action by the nurse is to A. avoid all eye contact with the patient. B. observe the patient's use of eye contact. C. look directly at the patient when interacting. D. ask the family about the patient's cultural beliefs.
B RATIONALE: Observation of the patient's use of eye contact will be most useful in determining the best way to communicate effectively with the patient.
A nurse who commits an infraction of the Nurse Practice Act may be subject to discipline by what group? A. A court of law B. The state board of nursing C. The local chapter of the state nurses association D. The National League for Nursing
B RATIONALE: State Nurse Practice Acts regulate nursing by controlling the scope of practice and determining the specific activities for each level of nursing. Some states control who may use the titles registered nurse (RN) and licensed practical nurse (LPN) or licensed vocational nurse (LVN). The Nurse Practice Act is regulated and enforced by the state board of nursing.
Which of the following actions by the graduate nurse would be advised during an interview campaign? A. For more exposure post your resume on the public internet. B. Research the prospective employer and evaluate their mission statement. C. Plan 3-4 interviews in a day to save time. D. Make note cards with details to take with you to use during the interview.
B RATIONALE: The graduate nurse should identify a desirable date to begin employment, ask questions about the interview process, research the prospective employer, and plan no more than 2 interviews in one day.
According to the American Hospital Association, what is a basic right of patients? A. Choice of diet to be eaten during hospitalization B. Considerate and respectful care from all care providers C. Information from nurses about diagnosis and prognosis D. Medical care regardless of ability to pay
B RATIONALE: When you are a patient in the hospital, you have the right to receive considerate and respectful care.
A nurse is preparing to care for a client who has suspected exposure to plague as a result of bioterrorism. Which of the following actions should the nurse plan to take first? A. Prepare for drainage of lesions. B. Notify the Centers for Disease Control and Prevention (CDC). C. Initiate contact precautions. D. Decontaminate the client
C
Which statement by the nursing student indicates an understanding of the purpose in setting a career goal? A. "To keep you focused on your current job" B. "To help you define the direction of your career" C. "To guarantee you will achieve your goal" D. "To impress those part of the interview process"
B RATIONALE: A career goal defines who or what you wish to be professionally. In addition, it will help tie together the elements of your job search—the resume writing, research, employer contacts, and interview process—by giving you direction. Setting a career goal does not guarantee achievement of that goal. It does not help focus on the job search or impress those participating in the interview process.
A nurse is educating community members about how to prepare for a disaster. Which of the following supplies should the nurse instruct the clients to include in a disaster preparedness kit? (Select all that apply.) A. 3 boxes of vodka B. Three quarts of water per person C. Personal identification D. Clean clothing E. Prescription medications F. Antibiotics
B, C, D, E
The new graduate nurse is working to create culture of safety on the unit. What actions will exemplify a culture of safety? Select all that apply A. Over riding the smart IV pump to save time. B. Using Universal Protocol 3 steps prior to surgery and procedures. C. Refusing to be interrupted during medication administration. D. Using the I-SBARR when collaborating with a provider. E. Adopt a work around when the system is not functioning to save time. F. look at systems and processes to identify areas that need to be changed
B, C, D, F
Which of the following describes reward power used by the nurse manager? (Select all that apply.) A. A nurse manager who is perceived as an expert due to specialized knowledge B. A nurse manager who uses fear of consequences to motivate staff C. A nurse manager who is well liked by the majority of staff D.A nurse manager who uses salary increases to motivate staff E. A nurse manager who has information that others need to perform their jobs
B, D RATIONALE: Reward power occurs when nurse managers provide or withhold rewards. A nurse manager who is perceived as an expert has expert power. A nurse manager who is well liked the majority of staff has referent power. A nurse manager who has information needed by others to perform their jobs has informative power.
A nurse is caring for a client who suspects recent exposure to inhalation anthrax. Which of the following findings indicate possible exposure? A. Sloughing of skin B. Vesicles on the skin C. Flu-like symptoms D. Respiratory failure
C
According to the Utah Nurse Practice Act Rule, how many hours must a licensed nurse practice without an additional requirement of contact hours to renew their license? A. 1,000 B. 40/week C. 400 D. 200
C
An experienced nurse overhears a new graduate giving instructions to an unlicensed nursing assistant. What statement by the new graduate would cause the experienced nurse to be concerned? A. "Do not take the patient's blood pressure on the same arm as her IV line" B. "Thank you for helping me turn my unconscious patient" C. "Let me know if any of my patients has a fever" D. "Please document the amount of urine emptied from the Foley"
C
George and his fellow construction workers were listening to the Trends class study for a quiz on ethics. What is NOT an ethical dilemma that the students are discussing? A. Passive euthanasia B. Quality of life C. Parking D. Abortion
C
George the construction worker decided to leave the emergency room against medical advice. His nurse is an incredibly ethical AmeriTech graduate. What did the nurse do in this situation? A. Hid George's clothes so he couldn't get dressed and walk away B. Tied George to the bed so he wouldn't leave C. Informed George that he could return to the hospital if he changes his mind D. Called George's girlfriend to come and talk some sense into him
C
George was taken to the emergency room after falling off a crane in the Ameritech construction site. George's buddies came to the emergency room to visit. A doctor told George's buddies that George is HIV-positive. What ethical principle did the doctor violate? A. Justice B. Beneficence C. Veracity D. Fidelity
C
The soon to graduate nurse would like information about what to expect on the NCLEX-RN exam and how to apply to take the exam. Where would the student find information? A. State Board of Nursing B. A nursing unit manager C. NCSBN website D. RWJ IOM report
C
The student nurse is reviewing sentinel events in healthcare. According to the Joint Commission which of the following is considered the main reason for Sentinel Events? A. Medication errors B. Conflict among staff C. Communication errors D. Ambiguity in responsibilities
C
Which does not reflect one of the "five rights" of delegation? A. Right Person B. Right Communication C. Right Route D. Right Task
C
Which organization developed the most definitive statement on the competencies needed by the newly licensed RN? A. Magnet Council for Nurses (MCN) B. American Association of Colleges of Nursing (ACEN) C. National Council of State Boards of Nursing (NCSBN) D. Intermountain Health care (IHC)
C
Which of the following is the most frequent reason for revocation or suspension of a nurse's license? A. mental impairment B. criminal acts C. alcohol or drug abuse D. fraud
C RATIONALE: A nurse's license may be suspended or revoked for fraud, deceptive practices, criminal acts, previous disciplinary action by other state boards, negligence, physical or mental impairments, or alcohol or drug abuse. The most frequent reason is alcohol or drug abuse.
When performing a cultural assessment with a patient of a different culture, the nurse's first action should be to A. wait until a cultural healer is available to help with the assessment. B. obtain a list of any cultural remedies that the patient currently uses. C. ask the patient about any affiliation with a particular cultural group. D. tell the patient what the nurse already knows about the patient's culture.
C RATIONALE: An early step in performing a cultural assessment is to determine whether the patient feels an affiliation with any cultural group. The other actions may be appropriate if the patient does identify with a particular culture.
A student in the last semester of nursing school has established a goal of making a successful role transition to graduate nurse. Which statement by the student indicates his/her understanding of how to achieve this goal during the capstone experience? A. "I will observe staff nurses as they perform nursing procedures to refine technique." B. "I will evaluate my progress every 6 months to allow time for growth." C. "I should care for increased numbers of patients to enhance work organization skills." D. "I should seek increasingly close guidance from the nursing instructor to reduce errors."
C RATIONALE: It is important for the student to start taking care of increased numbers of patients to help with time management and work organization. The student should also be able to function without close guidance from the nursing instructor. Waiting 7 weeks to evaluate progress would not be helpful to the student.
As the interview is drawing to a close, the interviewer asks the applicant, "What questions could I answer for you?" Which of the following questions would it be most advisable to ask to create a favorable impression? A. "After completing orientation, how much and when will the first pay raise be given?" B. "Will you provide full tuition reimbursement for all courses to obtain my terminal degree?" C. "What is the orientation process and what is the length of orientation?" D. "What will happen if I am unable to meet the outcomes for the competency-based orientation?"
C RATIONALE: Prepare a few questions!. This will be the applicant's opportunity to gather important details and possibly impress the interviewer by showing interest in the position. Keep questions on the positive side and inquire about responsibilities of the position. It would be inappropriate to inquire about pay raises at this time. Inquiries about pay and tuition reimbursement would be appropriate after the job offer has been provided.
An older adult woman of Chinese ancestry refuses to eat at the nursing home, stating, "I'm just not hungry." What factors should the staff assess for this problem? A. The woman does not like to eat with other residents of the home. B. The woman is using this as a means of going home. C. The food served may not be culturally appropriate. D. The food served may violate religious beliefs.
C RATIONALE: Residents in long-term care settings often do not have much choice of foods. As a result, they may not be able to select cultural food preferences. When assessing the cause of decreased appetite in patients, the nurse should determine whether the problem may be related to culture.
In a malpractice suit, how may a breach of duty be established? A. Liability testimony of physician B. Testimony from state board of nurses C. Expert testimony D. Testimony of coworkers
C RATIONALE: The duty of a nurse is to act as a reasonable nurse would under the same or similar circumstances. An expert witness may testify as to what a reasonable nurse in the same or similar circumstances would be expected to do.
A nurse manager is giving a presentation at a local community college. The nurse manager understands the job expectations of a new graduate when making which of the following statements? A. "A graduate nurse should be able to function in the role that was described in the curriculum for the school of nursing." B. "A graduate nurse should be able to function independently with ability to make clinical nursing judgments and set priorities and handle all emergencies during all shifts." C. "A graduate nurse should be able to function competently as an advanced beginner as a registered nurse at the entry level." D. "A graduate nurse should be able to perform as independently as was demonstrated the beginning of the last semester of nursing."
C RATIONALE: The job expectations of a new graduate nurse are those of an entry-level new employee. This frequently includes an extended orientation to assist the new graduate to transition into the independent role of the nurse. The new graduate nurse is not expected to function independently with the ability to make clinical nursing judgments. School curriculum and how one functioned the last semester of school are usually not considered in the job expectations of a new graduate.
Which task could a staff nurse delegate to a certified nursing assistant (CNA)? A. Reporting on the color of nasogastric (NG) drainage B. Checking a patient's response to pain medication C. Collecting a routine urine sample D. Making rounds with a physician
C RATIONALE: The majority of state boards have addressed the issue of delegation and have developed rules that offer specific guidelines regarding who can do what. The scope of practice for each level-of-care provider usually includes a description of the tasks that may be performed at that level. Collecting a urine sample
The health care team responsible for deciding whether to move a critically ill patient out of the ICU so that a new patient may be admitted to the unit is faced with what principle of an ethical dilemma? A. Deontology B. Veracity C. Justice D. Autonomy
C RATIONALE: The principle of justice is involved in the allocation of scarce and/or expensive health care resources.
In a legal suit, what element is necessary to prove a tort has been committed? A. Intent B. Assault C. Injury D. Malpractice
C RATIONALE: There are four elements that need to be present in a malpractice case, one of which is patient injury. The patient will have to prove that the specific nursing action caused injury or harm. The nurse, as a defendant, does not have a "burden of proof."
A charge nurse explains to a student: "I tend to act differently depending on which nurses are working that particular shift. Some nurses need more direction from me than others." What type of leadership style best describes this charge nurse's approach? A. Transformational B. Transactional C. Situational D. Interactional
C RATIONALE: This is an example of situational leadership in which different styles of leadership for different employees.
Which of the following statement by the nurse reflect transformational leaders? (Select all that apply.) A. Hesitant to follow B. Slow to change C. Value-driven visionaries D. Lifelong learners E. Courageous change agents.
C, D, E RATIONALE: Transformational leaders are lifelong learners, courageous change agents, and value driven visionaries. They are not slow to change or hesitant to follow
A charge nurse is discussing staff nurses' responsibilities in preplanning for response to a disaster. Which of the following responsibilities should the nurse include in the discussion? A. Assess survivors of a disaster for levels of psychological stress. B. Evaluate the impact of a disaster on the community. C. Link victims with support agencies to help with food, clothing, shelter, and counseling needs. D. Identify potential community disasters.
D
A nurse is discussing emergency response with a newly licensed nurse. The nurse should identify which of the following as a triage officer during the time of a disaster? A. Responding law enforcement officers B. Members of the Federal Emergency Management Agency (FEMA) C. Representatives from the American Red Cross D. Nurses and other emergency medical personnel
D
George the construction worker tells the Ameritech students preparing for a quiz on ethics: "I find it easy to make the right decision. All life is sacred, and all decisions must be made with the intent to continue life." What do we call the framework from which George approaches ethical reasoning? A. Situational B. Confusional C. Teleological D. Deontological
D
Which of the following actions is consistent with a nurse leader? A. A nurse who gives pain medication to an assigned patient B. A nurse who writes yearly staff evaluations C. A nurse who performs chart audits on her staff D. A nurse who encourages staff to give excellent patient care
D RATIONALE: A nurse leader is someone who influences others, such as a nurse who encourages staff to give excellent patient care. A nurse who performs chart audits and writes staff evaluations is functioning as a nurse manager. Giving pain medications is a function of the staff or bedside nurse.
How is assertive behavior described? A. Coercive B. Apologetic C. Self-denying D. Direct
D RATIONALE: A person exhibiting assertive behavior would express his or her true feelings in an honest, direct manner.
The nurse on the unit is determining which activities may be delegated to assistive personnel. Assuming that the nurse assistant is competent, which one of the following activities may be safely delegated by the registered nurse? A. Administration of medications prepared by the nurse B. Initial transfer of a postoperative client C. An admission history on a new client D. Vital signs on a stable client
D RATIONALE: An institution's policies and procedures and job description for assistive personnel provide specific guidelines in regard to which tasks or activities can be delegated. The nurse should match tasks to the delegate's skills, such as delegating vital signs to a nurse assistant.
The nurse manager is giving a presentation on the disadvantages of democratic leadership in group functioning. Which statement shows an understanding of this type of leadership? A. "Increases the possibility of "scapegoating" or argumentative behavior" B. "Discourages participation from quieter members of the group" C. "It is frustrating to the leader because they cannot control all the decisions of the group" D. "Requires more time and effort to make decisions and accomplish goals"
D RATIONALE: Because of the encouragement of participation in decision making and the democratic leadership's emphasis on group function, decision making becomes more involved with consensus and is less timely. Democratic leadership encourages group participation and works to reduce any type of scapegoating behavior among members because everyone has equal voice. The group democratically makes decisions and determines outcomes that are not controlled by management.
The nurse manager needs to let a nurse know that he will be put on probation if he continues to be tardy to work. Which type of power is the nurse manager using? A. Legitimate power B. Reward power C. Referent power D. Coercive power
D RATIONALE: Coercive power is power derived from fear of consequences.
Which of the following represents appropriate feedback for an assignment to an LPN? A. "Have you completed the urinary catheterization and care of the new patient?" B. "I know you are busy; however, you need to get caught up with your pain medications." C. "Did you understand the assignment that you received in the staff report?" D. "The patient in Room 430 looks much better, and you did a good job of making her comfortable."
D RATIONALE: Feedback is a process of informing someone of how well or how poorly a delegated task was performed. In option D the pain medications may have been delegated; however, if this task was delegated, the feedback does not tell the LPN what he or she is doing right or wrong.
What is the best definition of malpractice? A. A criminal act committed against society B. Doing something a reasonable person or nurse would not do C. An intentional professional act of negligence D. A professional act or failure to act that leads to injury of a patient
D RATIONALE: Malpractice may be defined as doing something outside your scope of practice or something that is unsafe for the patient and could cause injury.
A nurse is caring for a patient from Taiwan who constantly requests pain medication. What should the nurse consider when assessing the patient's pain? A. Most people react to pain in the same way. B. Pain in adults in less intense than pain in children. C. The patient is a constant complainer. D. Pain is what the patient says it is.
D RATIONALE: Pain is what the patient says it is, and nursing care should always be individualized. The nurse respects the patient's right to respond to pain in whatever manner is culturally and individually appropriate and never stereotypes a patient's perceptions or responses to pain.
The nurse is receiving a phone order from a health care provider. How will the nurse make sure that the provider's order is received without error? A. Write the order without using any unclear or unapproved abbreviations. B. Ask the nurse in charge to come to the phone to take the order. C. Advise the health care provider that the order must be written on the chart within the next 24 hours. D. Repeat the order, write the order verbatim, and read it back to the provider.
D RATIONALE: Repeat the order, write the order verbatim, and read it back to the provider are the steps recommended to confirm that the order was understood correctly, as well as communicated correctly. The question is in regard to the receiving of the order, not specifically how it is written. The nurse will write the phone order on the chart, and later the health care provider will co-sign the order. The charge nurse does not have to take the phone order; any licensed nurse can take the phone order.
What is a correct statement regarding a nurse who acts beyond the scope of practice? A. Demonstrates what a good nurse she or he can be B. Provides enriched services to patients who would not otherwise receive them C. May make other nurses angry because of the increased expectations created D. May be disciplined by the board of nursing
D RATIONALE: States may regulate nursing practice by controlling the scope of practice and determining the specific activities for each level of nursing. In most states, the Nurse Practice Act provides definitions and scope of practice for each level of nursing practice. The power of the board to discipline can have an adverse affect on the nurse's ability to practice.
A nurse is gathering data on a patient of a different culture. Which action can the nurse take to enhance communication while gathering cultural data? A. Ignore the patient's culture and focus on the reason for hospital admission. B. Use hand gestures to get points across to a patient with poor English. C. Use close-ended questions to gather information. D. Determine the patient's level of fluency in English.
D RATIONALE: The nurse should determine the patient's level of fluency in English to enhance communication. The nurse should not avoid the patient's culture during the assessment. Hand gestures should not be used because they could be offensive to the patient. The nurse should use open-ended questions or questions phrased in different ways as a method to gather data.
The ethical principle of autonomy is not applicable in which patient situation? A. The patient has values that conflict with the caregiver's values. B. The patient has been in a long-term care facility for 10 years. C. The patient does not speak or understand the English language. D. The patient is unaware of who he is and where he is.
D RATIONALE: This principle assumes rational thinking on the part of the individual.
Which statement by the graduate nurse indicates understanding of the importance of a cover letter? A. "It is optional." B. "It is necessary only if your resume needs further explanation." C. "It should recapitulate all of the important points of your resume." D. "It should introduce you to the reader."
D RATIONALE: Along with your resume, the nurse should enclose a cover letter that gives a brief introduction. The cover letter should summarize important strengths or give information regarding change of specialty (after you graduate and have experience). Remember that this letter should not be longer than one page.
What would be the most effective way for a nurse to validate "informed consent?" A. Check the chart for a completed and signed consent form. B. Determine from the physician what was discussed with the patient. C. Ask the family whether the patient understands the procedure. D. Ask the patient what he understands regarding the procedure.
D RATIONALE: Informed consent in the health care setting is a process whereby a patient is informed of the risks, benefits, and alternatives of a certain procedure and then gives consent for the procedure to be done.
