114 Questions
*A hospital's quality improvement committee is adapting the hospital's policies and procedures to align with the Joint Commission 2015 Hospital National Patient Safety Goals. Which of the following is an explicit focus of the 2015 goals?* - Screen every new client for intimate partner violence. - Use two unique client identifiers before giving medications. - Eliminate the use of shared client rooms to prevent healthcare-acquired infections (HAIs) - Identify clients at high risk of developing postoperative complications.
Use two unique client identifiers before giving medications.
Which term is most closely associated with quantitative research? - Concept - Process - Variable - Ethnography
Variable
The nursing process is: - a critical thinking method used by nurses to provide nursing care that is individualized and holistic. - a mechanism for increasing the knowledge and skill of the nurse through programs of education. - the promotion of health, prevention of illness, and care of ill, disabled, and dying individuals. - an approach for identifying and analyzing the best available scientific evidence for nursing care.
a critical thinking method used by nurses to provide nursing care that is individualized and holistic.
A client has been recovering in the hospital following bowel resection surgery. The care team has identified that the client is at a high risk for developing venous thromboembolism during the immediate postoperative period. The nurse can best promote this client's safety by: - using informatics in an appropriate and individualized way. - establishing a therapeutic relationship with the client. - assigning the client to a room that is as close to the nurses' station as possible. - closely monitoring the client for changes in health status.
closely monitoring the client for changes in health status.
*A hospital client's urine output is 35 mL over the past 5 hours, so the nurse has chosen to inform the client's primary care provider by telephone. The nurse will use the SBAR tool to communicate, so will begin the dialogue by:* - introducing the client and listing the client's current medications. - explaining the client's symptoms and suggesting a preliminary plan. - describing the major objective signs that the client is exhibiting. - giving an overview of the client's circumstances and the exact reason for the call.
giving an overview of the client's circumstances and the exact reason for the call.
New intravenous (IV) access ports are being introduced in a hospital that are described as being "mistake-proof." The nurse should understand that these new ports may: - have a design that makes it difficult to attach incorrect tubing to the ports. - make it easy for nurses to follow the six rights of safe medication administration. - reduce nurses' risks of being exposed to bloodborne pathogens. - prevent adverse reactions associated with IV medications.
have a design that makes it difficult to attach incorrect tubing to the ports.
A health care institution's most recent strategic plan includes a commitment to creating a culture of safety. The organization can best meet this commitment by: - ensuring that the care clients receive is based on the latest research evidence. - publicizing events that threatened client safety, while still maintaining confidentiality. - having every employee focus on safety, not only direct care providers. - rotating staff members through various sites in order to reduce complacency.
having every employee focus on safety, not only direct care providers.
Which of the following is a current trend affecting nursing education and practice? - overabundance of graduating nurses - office-based care delivery systems - increase in length of hospital stay - increase in chronic health conditions
increase in chronic health conditions
*Though evidence is not readily available, a rural hospital has a local reputation of having a high rate of healthcare-associated infections (HAIs). Which strategy is most likely to improve the institution's infection control practices?* - measuring and disseminating the hospital's HAI rate - adopting care bundles for clients with intravenous access - providing interdisciplinary education around medication safety - arranging for an Occupational Safety and Health Administration (OSHA) audit
measuring and disseminating the hospital's HAI rate
Teaching a woman about breast self-examination is an example of what broad aim of nursing? - treating illness - preventing illness - restoring health - facilitating coping
preventing illness
A licensed practice nurse (LPN) is working as a staff nurse. What role do the LPNs working as staff nurses play? - work only in long-term care facilities and at client's homes - provide direct nursing care to the clients in the health care facility - work only as care providers, team members, and communicators - supervise the work of charge nurses working in different units
provide direct nursing care to the clients in the health care facility
The nurse is administering an antibiotic to a client with community-acquired pneumonia. This activity encompasses which aim of nursing? - restoring health - promoting health - preventing illness - facilitating coping
restoring health
Which is the best example of a nurse demonstrating the role of caregiver? - starting an intravenous line in the client's arm - referring the client to a mental health clinic - assigning a room for a new hospital client - reporting lab values to a client's physician
starting an intravenous line in the client's arm
Which is a focus of medical research rather than nursing research? - Promotion of recovery - Drug metabolism - Health appraisal - Prevention of trauma
Drug metabolism
*When looking at a model for evidence-based practice, what is the final step of the process?* - Searching the literature - Formulating a clinical question - Evaluating practice change - Appraising evidence
Evaluating practice change
A new graduate is working with a registered nurse. The registered nurse demonstrates the use of intuition to focus on a client's problem. The registered nurse is functioning at which level of proficiency? - Competent - Expert - Novice - Proficient
Expert
*A client undergoing chemotherapy for a brain tumor believes that having a good attitude will help in the healing process. This is an example of what type of knowledge?* - Process - Philosophy - Science - Virtue
Philosophy
A group of nurses is planning to investigate the effectiveness of turning immobilized stroke clients more frequently in order to prevent skin breakdown. The team has begun by formulating a PICO question. Which element will the "O" in the team's PICO question refer to? - Turning clients more frequently - The currently used turning schedule - Clients who have experienced a stroke - Preventing skin breakdown
Preventing skin breakdown
A nurse researcher is studying perceptions of vocational rehabilitation for clients after a spinal cord injury. What type of research method will be used to study the perceptions of this group of individuals? - Qualitative research - Applied research - Basic research - Quantitative research
Qualitative research
A nurse researcher must decide on the method for conducting the research. The researcher that plans to emphasize collection of numerical data and analysis would select which method of research? - Applied research - Quantitative research - Basic research - Qualitative research
Quantitative research
Which source of knowledge is based on objective data? - Applied - Scientific - Authoritative - Traditional
Scientific
Two nurses are discussing a well-known adverse event in the hospital in which a wrong site surgery was performed. One of the nurses states, "Someone had better lose their job over this. How that could happen is beyond me." What is the other nurse's most appropriate response? - "I understand what you're saying, but a focus on punishment doesn't really make things safer in the future." - "That's not really possible, because disciplining a particular staff member would be a violation of confidentiality." - "The hospital really won't have much influence on the decision because it's up to OSHA to discipline." - "We have to accept that there are always going to be some errors like this from time to time, and that's unavoidable."
"I understand what you're saying, but a focus on punishment doesn't really make things safer in the future."
*A nurse mistakenly documented a client's vital signs and assessment findings in the health record of a client who has since been discharged. The nurse tells a colleague, "I'm wary of filing an incident report because I don't know what the consequences will be." What should the colleague tell the nurse?* - "It sounds like it was an honest mistake, and maybe a report will lead to improvements." - "There's nothing you could possibly have done to prevent this, so you've got nothing to fear." - "Now that you've told me about this, it's best if I actually fill out the incident report." - "You're very likely to lose your license if you don't report this."
"It sounds like it was an honest mistake, and maybe a report will lead to improvements."
The nurse is performing care for a client in the end stage of cancer. How can the nurse best facilitate the client and family's ability to cope? Select all that apply. - Assist the client with activities of daily living (ADLs). - Inform the family that there is nothing they can do for their loved one. - Encourage the family to leave and let the nurse take over care. - Assist the client and family with the preparation for end-of-life. - Refer the client and family to hospice services.
- Assist the client with activities of daily living (ADLs). - Assist the client and family with the preparation for end-of-life. - Refer the client and family to hospice services.
The nurse is caring for a client who has been placed in physical restraints. Which nursing action is appropriate? Select all that apply. - Check circulation and skin condition frequently and regularly. - Obtain a physician order 2 hours after restraints are applied. - Continue using the restraints until discharge. - Communicate with the family regarding the need for restraints. - Offer opportunities for toileting frequently and regularly.
- Check circulation and skin condition frequently and regularly. - Communicate with the family regarding the need for restraints. - Offer opportunities for toileting frequently and regularly.
*A nurse is using quantitative research for a question related to nursing practice. When conducting the research, which aspect would the nurse need to keep in mind? Select all that apply.* - Statistical processes are used to interpret the data. - Data are collected in real-world settings. - An existing body of literature is available. - Concepts are fairly well-developed. - The focus needs to be holistic.
- Concepts are fairly well-developed. - An existing body of literature is available. - Statistical processes are used to interpret the data.
When planning the care of a client, which nurse-prescribed interventions would be appropriate to implement? Select all that apply. - administering narcotic pain medications as needed - monitoring IV site access every 2 hours for clients with IV fluid infusion -initiating contact precaution for a client with Methicillin-resistant Staphylococcus aureus (MRSA) - monitoring the day's Input and Output to determine fluid retention -turning clients every 2 hours to prevent skin breakdown
- monitoring IV site access every 2 hours for clients with IV fluid infusion -initiating contact precaution for a client with Methicillin-resistant Staphylococcus aureus (MRSA) - monitoring the day's Input and Output to determine fluid retention -turning clients every 2 hours to prevent skin breakdown
Which healthcare trends should the nurse include when speaking about the efficiency of today's healthcare system at a community health fair? (Select all that apply.) -Provide information on nationally linked computerized medical record systems. -Emphasize the need to focus on health promotion and prevention. -Discuss the expansion of genetic research. -Explain how physicians are controlling healthcare decision making. -Encourage the increase use of outpatient and ambulatory services.
-Emphasize the need to focus on health promotion and prevention. -Encourage the increase use of outpatient and ambulatory services.
The community health nurse is talking with four clients. Who does the nurse identify that would most benefit from teaching about alcohol and drug use? - 40-year-old female who is working two jobs - 25-year-old female who just accepted her first job - 34-year-old male who does not use a seat belt - 19-year-old male college student majoring in physics
19-year-old male college student majoring in physics
Which nursing action would be considered an ethical/legal skill? - A nurse helps a client prepare a living will. - A nurse obtains a urine sample for a urinalysis. - A nurse explains the rationale for a client's plan of care. - A nurse holds the hand of a woman whose baby died at birth.
A nurse helps a client prepare a living will.
A nurse is reading a research article from a nursing journal. The nurse is aware that the opening paragraph summarizing the article and the research findings is a good place to start. What part of the article is the nurse reading? - Conclusions - Review of the literature - Abstract - Results
Abstract
Which organization has established standards that help the nurse determine which clinical actions fall under the scope of nursing practice? - American Nurses Association - National League for Nursing - International Council of Nurses - National Council of State Boards of Nursing
American Nurses Association
A community health nurse has been visiting a diabetic client whose morning fasting glucose levels are constantly elevated. Upon further assessment, the nurse determines that the client's spouse does not understand how to prepare meals following the prescribed diabetic diet. Using Dorothea Orem's Self-Care Theory, how can the nurse help meet the needs of this client? - Authorize an unlicensed nursing personnel to cook for the client. - Assist the spouse with online grocery shopping. - Set up diabetic home meal delivery for the client. - Arrange an evaluation appointment with a dietitian.
Arrange an evaluation appointment with a dietitian.
What phrase best describes the science of nursing? - Art of individualized nursing - Body of nursing knowledge - Application of clinical skills - Holistic client care
Body of nursing knowledge
A nurse develops the following foreground question using the PICOT format in preparation for a research study: "In overweight clients, how do chromium supplements compared to no supplements help with weight loss?" Which part of the question reflects the intervention? - No supplements - Overweight clients - Chromium supplements - Weight loss
Chromium supplements
Which statement is most applicable to evidence-based practice? - It emphasizes personal experience over science. - The purpose is to learn about a specific problem. - It involves gaining solutions to problems. - Clinical expertise is integrated with external evidence.
Clinical expertise is integrated with external evidence.
Which contributor to the nursing profession established two missions: sick nursing and health nursing? - Clara Barton - Lillian Wald - Dorothea Dix - Florence Nightingale
Florence Nightingale
A student is conducting a literature review to identify a problem area for a research paper. Which should the student remember when conducting a literature review? - Indexes are rarely found on the Internet. - Books are a primary source for up-to-date information. - Abstracts provide detailed information about a topic. - Journal reference lists provide sources for original articles.
Journal reference lists provide sources for original articles.
The client's plan of care is created by the nurse using which guideline for nursing practice? - Nursing process - Nursing's Social Policy Statement - Nurse practice act - ANA Standards of Nursing Practice
Nursing process
What might a nurse need to do to ensure the continuation of his or her nursing license? - Obtain a baccalaureate degree. - Obtain a master's degree. - Attend hospital in-services. - Obtain continuing education credits.
Obtain continuing education credits.
A nurse is developing a foreground question for nursing research using the PICO model. Which component would be represented by the statement, "a 45-year-old male with coronary heart disease and atrial fibrillation"? - O - C - I - P
P
The nurse is reading another nurse's notes that were recorded in the electronic health record (EHR) during the previous shift. What is the appropriate nursing action when numerous unapproved abbreviations are noticed in the previous nurse's notes? - Contact the facility's information technology department to delete abbreviations. - Suggest to the nurse manager that an in-service on abbreviation use would be helpful. - Ask another nurse to fix the abbreviations. - Correct the abbreviations in the EHR.
Suggest to the nurse manager that an in-service on abbreviation use would be helpful.
The nurse conducts a home safety assessment for a client. Which statement best explains the standard of care being implemented? - The RN promotes a safe environment. - The RN identifies client outcomes. - The RN educates about preventing falls. - The RN develops a plan of care.
The RN promotes a safe environment.
The manager of a geriatric medicine unit is reviewing some of the incident reports that have been filed over the past several months. One report describes an event where a nurse raised all four side rails of a confused client's bed, causing the client to fall when he tried to climb over them to go to the restroom. Which of the following statements about this incident is most accurate? - The location of the restroom relative to the client's bed was a latent error. - The root cause of the incident was the client's decreased cognition. - The client's nurse committed an active error by raising all four of the side rails. - The root cause of the incident was the nurse's flawed decision-making.
The client's nurse committed an active error by raising all four of the side rails.
A confused client entered the dirty supply room on the unit and was found rummaging through trash that contained blood and body fluids. An incident report has been completed about this event by the nurse who discovered the client. Which statement about the incident report is most accurate? - The incident report becomes an attachment to the client's health record. - The nurse's priority in completing the report is justifying and explaining her initial response to the incident. - The incident report is completed anonymously, allowing the nurse to be frank with suggestions. - The incident report will be used to inform changes so that the dirty supply room becomes less accessible to clients.
The incident report will be used to inform changes so that the dirty supply room becomes less accessible to clients.
*A nurse has approached the unit manager and admitted to giving a client an incorrect dose of insulin. Which aspect of this event would suggest that it constitutes at-risk behavior rather than a human error?* - The unit was exceptionally busy during the shift when the nurse made the error. - The nurse manager suspects that the nurse is not telling the truth about the timing of the error. - The nurse made a similar insulin error 4 months ago and has also made an oral medication error. - The nurse is a recent graduate and began working on the unit only 5 months ago.
The nurse made a similar insulin error 4 months ago and has also made an oral medication error.
A hospital is being evaluated by the Centers for Medicare & Medicaid Services. Which of these findings from the evaluation may result in a reduction in the hospital's reimbursement under the value-based purchasing (VBP) program? - The hospital is not using the latest version of its electronic health records software. - The hospital has a policy of using generic drugs rather than brand-name drugs whenever possible. - The rate of postoperative complications is significantly higher than national averages. - The ratio of registered nurses to licensed practical nurses is significantly lower than in other similar-sized hospitals.
The rate of postoperative complications is significantly higher than national averages.
A nurse researcher is conducting a scientific literature review. Which statement would be most important for the nurse researcher to keep in mind? - Literature review should be done with a favorable mind. - Using a systematic approach for this step is most effective. - The review needs to be limited to 25 resources. - Untested theories provide little basis for research topics.
Using a systematic approach for this step is most effective.
A hospital has mandated screening for alcohol abuse for all newly-admitted clients. However, a chart audit reveals that this is rarely being done. Root cause analysis of this situation should begin with what question? - What is the difference between the nurses who screen their clients and those who don't? - Why aren't nurses screening their clients for alcohol abuse? - What proportion of our clients actually has risk factors for alcohol abuse? - Have other health care institutions faced similar challenges?
Why aren't nurses screening their clients for alcohol abuse?
A client has been admitted with a gastrointestinal bleed. Two nurses should perform checks before which intervention is performed? - drawing a blood sample for analysis of hemoglobin levels - inserting a peripheral intravenous catheter in the client's forearm - placing the client on "NPO." (nothing by mouth) status - administering a unit of packed red blood cells
administering a unit of packed red blood cells
A nurse must possess several characteristics to be successful in this profession. Secondary to critical thinking skills, which is of great value? - educational attainment such as Master's of Nursing - delegation of responsibilities - advocating for the client at all times - good teamwork and team-building skills
advocating for the client at all times
The nurse is caring for a client who cannot meet health needs independently. Which action made by the nurse depicts concern and attachment? - telling the client, "I will be back in 15 minutes to change your dressing." - asking the client, "How are you today? I am really worried about you." - talking about diabetes and teaching the client how to do foot care - organizing the work for the day and evaluating how the day went
asking the client, "How are you today? I am really worried about you."
A series of medication errors have prompted a reevaluation of the drug administration practices on a unit. Which of the following strategies is most likely to prevent errors and enhance safety? - ensuring that no nurse is responsible for more than four clients - banning the practice of nurses' delegating medication administration to other nurses - eliminating interruptions to nurses while they are preparing medications - working with the pharmacy to avoid the use of medications that have similar names
eliminating interruptions to nurses while they are preparing medications
A theory of nursing will primarily inform which aspect of a nursing student's activities and interactions at the bedside? - choosing interventions based on evidence - prioritizing nursing activities according to an established criteria - assessing and addressing clients' illnesses - framing and giving meaning to student-client interactions
framing and giving meaning to student-client interactions
The nurse is studying nursing models for a Baccalaureate course. Which action made by the nurse exemplifies proper application of the Adaptation model? - alleviating the client's pain with medication - letting the client perform activities of daily living independently - helping the client adjust to blood sugar testing each morning - teaching the client about the risks of asbestos
helping the client adjust to blood sugar testing each morning
A nurse who is preparing to integrate evidence-based practice into nursing care is using the PICO model. What would the nurse do first? - evaluate the decision - identify the clinical question - critique the evidence - identify relevant evidence
identify the clinical question
A sentinel event involving a client's suicide attempt on a hospital unit is being analyzed by the hospital's quality and safety committee. The committee should prioritize what consideration when performing this analysis? - identifying the hospital's and staff members' liability in the case - apportioning blame fairly and providing supplementary education - identifying strategies for preventing a repeat of this event - mapping the chain of command that existed immediately before the event
identifying strategies for preventing a repeat of this event
*A nurse who is a recent graduate has been formally reprimanded after administering a medication to the wrong client. This reprimand would be considered to be consistent with a just culture if:* - the reprimand has been deemed appropriate and relevant to the nurse's actions. - the reprimand was legally documented. - the needs of the client were prioritized over the needs of the nurse. - the nurse received ample support from colleagues during the discipline process.
the reprimand has been deemed appropriate and relevant to the nurse's actions.
Although all of the following are nursing responsibilities, which one would be expected of a nurse with a baccalaureate degree? - providing direct physical care - using research findings to improve practice - administering medications as prescribed - collaborating with other health care providers
using research findings to improve practice
