ati leadership focused review
Which are the best ways for the nurse to avoid malpractice? Select all that apply
Bring gifts to each client. 2. Perform interventions in a timely manner. (CORRECT) 3. Provide the same care to each and every client. 4. Document assessments and procedures completed. (CORRECT) 5. Know current nursing literature in their area of practice. (CORRECT) Rationale: The nurse can avoid malpractice by developing a caring rapport (not bringing gifts) with the client and documenting assessments, interventions, and evaluations completely and in a timely manner. Nurses should also know current nursing literature in their area of practice.
The nurse is caring for a client who just returned from surgery for repair of a fractured arm. The client complains of severe pain in the arm and also that his hand is feeling numb. The nurse notes that the client's fingers are pale and that the pulse in his arm is very weak. The nurse attempts to contact the surgeon numerous times, but the surgeon does not return the call. Who should the nurse notify at this time? Select all that apply.
Charge nurse (correct) 2. Hospital supervisor (correct) 3. Hospital administrator 4. Surgeon's supervisor (correct) 5. Local media representative Rationale: The nurse has a duty to find assistance for this client even if the client's health care provider does not respond. The nurse would immediately notify the charge nurse, the hospital supervisor, and the surgeon's supervisor or another surgeon that the charge nurse directed the nurse to call. It would not be necessary to notify the hospital administrator at this time and the nurse would never notify local media about the client's condition.
A hospitalized client with type 1 diabetes mellitus received NPH and regular insulin 2 hours ago at 7:30 am. The client calls the nurse and reports that he is feeling hungry, shaky, and weak. The client ate breakfast at 8:00 and is due to eat lunch at noon. List in order of priority the actions that the nurse should take. Arrange the actions in the order that they should be performed. All options must be used.
Correct Answers: Your Answers: Check the client's blood glucose level. 1 Check the client's blood glucose level. Give the client half a cup of fruit juice to drink. 2 Give the client half a cup of fruit juice to drink. Take the client's vital signs. 3 Take the client's vital signs. Retest the client's blood glucose level. 4 Retest the client's blood glucose level. Give the client a small snack of carbohydrate and protein. 5 Give the client a small snack of carbohydrate and protein. Document the client's complaints, the actions taken, and the outcome. 6 Document the client's complaints, the actions taken, and the outcome. Rationale: The client is experiencing symptoms of mild hypoglycemia. If symptoms such as hunger, irritability, shakiness, or weakness occur, the nurse first would check the client's blood glucose level to verify that the client is experiencing hypoglycemia. After this is verified, the nurse would give the client 10 to 15 g of carbohydrates and then retest the blood glucose level in 15 minutes. In the meantime, the nurse would check the client's vital signs. The nurse would give the client another food item containing 10 to 15 g of carbohydrate if the client's symptoms do not resolve. Otherwise, the nurse would provide a small snack of carbohydrates and protein if the client's next scheduled meal is more than an hour away from the time of the occurrence. After treatment and the resolution of the hypoglycemic event, the nurse would document the occurrence, the actions taken, and the outcome.
The nurse on the day shift is assigned to care for the following six clients. List in order of priority how the nurse should plan to check the assigned clients. Arrange the actions in the order that they should be performed. All options must be used.
Correct Answers: Your Answers: Client who has a tracheostomy and is on a mechanical ventilator 1 Client who has a tracheostomy and is on a mechanical ventilator Client who requires before-breakfast insulin 2 Client who requires before-breakfast insulin Client who is scheduled for a cardiac catheterization at 9:00 am 3 Client who is scheduled for a cardiac catheterization at 9:00 am Client who requires medications at 10:00 am 4 Client who requires medications at 10:00 am Client who has been diagnosed with diabetes mellitus and who is scheduled for discharge to home 5 Client who has been diagnosed with diabetes mellitus and who is scheduled for discharge to home Client who is scheduled for physical therapy in the afternoon 6 Client who is scheduled for physical therapy in the afternoon Rationale: The airway is always a high priority, and the nurse first assesses the client who has a tracheostomy and is on a mechanical ventilator. The remaining order of priority is guided by time guidelines. Therefore, the nurse next administers before-breakfast insulin, assesses the client who is scheduled for a cardiac catheterization at 9:00 am, and then administers medications scheduled for 10:00 am. Finally, the nurse checks the client who is scheduled for discharge, and this is followed by checking the client who is scheduled for physical therapy in the afternoon.
The nurse was assigned to care for five clients and spent most of the day caring for one of these clients who had just returned from surgery. The nurse did not ask for assistance and did not regularly check on the other clients. During the day, one of the nurse's other clients got out of bed without calling for assistance and fell, breaking his arm. Which possible charges could this nurse face with this situation? Select all that apply.
Libel 2. Battery 3. Negligence (correct) 4. Malpractice (correct) 5. Abandonment of care (correct) Rationale: The nurse could be charged with malpractice, which is failure to meet a legal duty that resulted in harm to another. The nurse could also be charged with negligence, which is the commission of an act or the omission of an act that a reasonably prudent person would have performed in a similar situation, thus causing harm to another person. It is also possible that the nurse could be charged with abandonment of care, which is the wrongful termination of providing client care.
The nurse posted a comment on a social media site that was unflattering to another nurse. Which accusations can the second nurse bring against the first nurse? Select all that apply.
Libel (CORRECT) 2. Assault 3. Slander 4. Defamation (CORRECT) 5. Malpractice Rationale: The first nurse could be accused of defamation, which is spoken or written statements made maliciously and intentionally that may injure the subject's reputation, and libel, which is malicious or untrue writing about another person that is brought to the attention of others. Assault is an intentional threat to cause bodily harm to another, malpractice is the failure to meet a legal duty that causes harm to another, and slander is malicious untrue spoken words about another person that are brought to the attention of others.
The licensed practical nurse knows that which items are examples of common law? Select all that apply.
Malpractice (CORRECT) 2. Informed consent (CORRECT) 3. Nurse practice act 4. American's with Disabilities Act 5. Client's right to refuse treatment (CORRECT) Rationale: Common law results from judicial decisions made in courts when individual legal cases are decided. Malpractice, informed consent, and a client's right to refuse treatment all came from legal decisions. Statutory laws are created by elected legislative bodies. The nurse practice act arises from each state's statutory law and the American's with Disabilities Act arises from Federal statutory law.
The nurse has just been licensed and has begun to practice in an acute health care facility. The nurse knows that which nursing specialties will require more specific defined standards of care and skills? Select all that apply.
Nurse-midwives (CORRECT) 2. Nurse-anesthetists (CORRECT) 3. Intensive care unit (ICU) nurses (CORRECT) 4. Postsurgical care unit nurses 5. Respiratory disease unit nurses Rationale: Nurses are responsible for meeting the same standards as other nurses practicing in similar settings. Specialized nurses such as nurse anesthetists, ICU nurses, and certified nurse-midwives have specially defined standards of care and skills. Nurses who care for clients on medical surgical units do not usually require these specially defined standards of care and skills.
Which is a recommended guideline for safe computerized charting?
Passwords to the computer system should only be changed if lost. 2. Computer terminals may be left unattended during client-care activities. 3. Accidental deletions from the computerized file need to be reported to the nursing manager or supervisor. (correct) 4. Copies of printouts from computerized files should be kept on a clipboard at the nurses' station for other nurses to access. rationale: After any inadvertent deletions of permanent computerized records, the nurse should type an explanation into the computer file with the date, time, and his or her initials. The nurse should also contact the nursing manager or supervisor with a written explanation of the situation. Options 1, 2, and 4 represent unsafe charting actions. Only option 3 follows the guidelines for safe computer charting.
a nurse manager is providing information about the audit process to members of the nursing team. which of the following information should the nurse manager include?
a. a structure audit evaluates the setting and resources available to provide care (correct): a structure audit evaluates the setting in which care is provided and includes resources such as equipment and staffing levels b. an outcome audit evaluates the results of the nursing care provided (correct): an outcome audit evaluates the effectiveness of nursing care. it should include the observable data, such as infection rates among client c. a root cause analysis is indicated when a sentinel event occurs (correct): a root cause analysis is indicated when a sentinel even occurs. a sentinel even is a serious problem such as injury to or death of a client. immediate investigation of the problem is indicated. the health care team can use root cause analysis to study the problem and take measures to prevent reoccurrence. d. retrospective audits are conducted while the client is receiving care e. after data collection is completed, it is compared to a benchmark (correct): the benchmark is set at the beginning of the process and then it is compared to the data after collection is completed
a nurse is hired to replace a staff member who has resigned. after working on the unit for several weeks, the nurse noticed that the unit manager does not intervene when there is conflict between team members, even when it escalates. which of the following conflict resolution strategies is the unit manager demonstration?
a. avoidance (correct) b. smoothing c. cooperating d. negotiating RATIONALE: the goal in resolving conflict is a win-win situation. the unit manager is using an ineffective strategy, avoidance, to deal with the conflict. she is aware of the conflict but is not attempting to resolve it.
a nurse enters the room of a client who is on contact precautions and finds the client lying on the floor. which of the actions should the nurse take first?
a. call the provider b. ask a staff member for assistance getting the client back in bed c. inspect the client for injuries (correct) d. instruct the client to ask for help if he needs to get out of bed RATIONALE: the first action the nurse should take using the nursing process is to assess the client
a PN ending her shift reports to the RN that a newly hired AP has not calculated the I&O for several clients. which of the following actions should the RN take?
a. complete an incident report b. delegate this task to the pn c. ask the AP if she needs assistance (correct) d. notify the nurse manager rationale: the nurse should find out what the AP knows about performing the task and provide education for the AP if indicated
a nurse manager is working with a committee of nurses to update policies for new employee orientation. the nurse manager directs the team to collect as much data as possible and recommend several options. which of the following decision-making styles is the nurse manager demonstrating?
a. decisive b. flexible c. hierarchical d. integrative (correct) rationale: when the integrative decision-making style is used, the team uses a large amount of data and generates several options
a nurse is participating in a quality improvement study of a procedure frequently preformed on the unit. which of the following information will provide data regarding the efficacy?
a. frequency with which procedure is performed? b. client satisfaction with performance of the procedure c. incidence of complications related to procedures (correct) d. accurate documentation of how procedure was performed rationale: the incidence of complications related to the procedure is an outcome measure directly related to the efficacy of the procedure.
a nurse on a telemetry unit is caring for a client who was admitted 2 hours ago and has chest pain. the client becomes angry and tells the nurse that there is nothing wrong with him and that he is going home immediately. which of the following actions should the nurse take?
a. notify the client's family of his intent to leave the facility b. document that the client left the facility against AMA (correct): when documenting a discharge, the nurse should document the type of discharge, including an AMA discharge. c. explain to the client the risks involved if the chooses to leave (correct): the nurse is legally responsible to warn the client of the risks involved in leaving the hospital AMA d. ask the client to sign a form relinquishing responsibility of the facility (correct) clients who leave the hospital prior to discharge are asked to sign a form to provide legal protection for the hospital e. prevent the client from leaving the facility until the provider arrives
an RN on a med-surg unit is making assignments at the beginning of the shift. which of the following tasks should the nurse delegate to the PN?
a. obtain vital signs for a client who is 2 hrs post op following a cardiac catheterization (correct) b. administer a unit of packed rbcs to a client who has cancer c. instruct a client who is scheduled for discharge in the performance of wound care d. develop a plan of care for a newly admitted client who has pneumonia rationale: it is within the scope of practice of the PN to monitor a client who is 2hr post-op for a cardiac catheterization
a nurse is participating in an inter professional conference for a a client who has a recent C6 spinal cord injury. the client worked as a construction worker prior to his injury. which of the following members of the inter-professional team should participate in planning care for the client?
a. physical therapist (correct): the client will need the assistance of a [physical therapist to assist with mobility skills and maintain muscle strength b. speech therapist c. occupational therapist (correct): the client will need the assistance of an occupational therapist to learn how to perform activities of daily living d. psychologist (correct): the client will need the assistance of a psychologist to adapt to the psychosocial impact of the injury e. vocational counselor (correct): the client will need the assistance of a vocational counselor to explore options for re-employment
a nurse manager is developing an orientation plan for newly licensed nurses. which of the following information should the manager include in the plan?
a. skill proficiency (correct) :the purpose of orientation is to assist the newly licensed nurse to transition from the role of student to the role of employee and licensed nurse. the nurse manager should include evaluation of skill proficiency and provide additional instruction as needed. b. assignment to a preceptor (correct): the purpose of orientation is to assist the newly licensed nurse to transition from the role of student to the role of employee and licensed nurse. the nurse manager should include assignment of a preceptor to ease the transition of the newly licensed nurse c. budgetary principles d. computerized charting (correct): the purpose of orientation is to assist the new nurse from the role of student to the role of employee and licensed nurse. the nurse manager should include computerized charting, which is a vital skill for the newly licensed nurse. e. socialization into unit crime (correct): the purpose of orientation is to assist the new nurse to transition from the role of student to the role of nurse/employee. the nurse manager should include socialization to the unit as a way to ease the transition of the newly licensed nurse. f. facility policies and procedures (correct): the purpose of orientation is to assist the newly licensed nurse. the nurse manager should include information about facility policies and procedures, which is essential information for the newly licensed nurse.
a nurse is preparing to transfer an older adult who is 72 hr post-op to a long-term care facility. which of the following info should the nurse include in the transfer report?
a. type of anesthesia used b. advanced directive status (correct): the receiving nurse and facility need to know advance directive status in order to provide care and address the client's current needs c. vital signs on the day of admission d. medical dx (correct): the receiving nurse and facility need to know the client's medical dx in order to provide care and address the client's current needs e. need for specific equipment (correct): the receiving nurse and facility need to know the client's need for specific equipment in order to provide care and address the client's current needs.
a nurse who has just assumed the role of unit manager is examining her skills in inter professional collaboration. which of the following actions support the nurse's inter professional collaboration?
a. use aggressive communication when addressing the team b. recognize the knowledge and skills of each member of the team (correct): the nurse should recognize that each member of the team haas specific skills to contribute to the collaboration process c. ensure that a nurse is assigned to serve was the group facilitator for all interprofessional meetings (correct): the nurse is legally responsible to warn the client of the d. encourage the client and family to participate in the team meeting (correction): collaboration should occur among the client, family, and interprofessional team e. support team member requests for referral (correct) the nurse should support suggestions for referrals to link clients to appropriate resources
The nurse is aware that the American's with Disabilities Act provides which rights to individuals who are disabled? Select all that apply.
abels asymptomatic HIV as a disability (CORRECT) 2. Protects the privacy of individuals with HIV (CORRECT) 3. Provides employment to persons with disabilities 4. Prohibits discrimination in employment and public services (CORRECT) 5. Allows health care workers to refuse to care for a client with HIV
A licensed practical nurse has decided to purchase disciplinary defense insurance and is aware that this type of insurance would provide which type of benefits? Select all that apply.
epresentation by a qualified attorney (correct) 2. Payment to an individual for negligent care 3. Reimbursement for travel to the state board of nursing (correct) 4. Payment of all legal fees for defense of negligent care 5. Payment of all legal fees for defense of a nursing license (correct) Rationale: Disciplinary defense insurance provides benefits if the individual has had action brought against a nursing license by a state board of nursing. The benefits of this insurance are to provide a qualified nurse attorney or attorney to represent the nurse and to pay for or reimburse the nurse for this attorney. It will reimburse for loss of wages and also for travel, food, and lodging to a hearing at the state board of nursing. It does not pay legal fees or any monetary benefit to an individual if the nurse is involved in a lawsuit related to negligent care.
The nurse shares with a client that violation of a civil law usually results in which type of penalty? Select all that apply.
onetary fine (CORRECT) 2. Public service (CORRECT) 3. Replacement of property (CORRECT) 4. Imprisonment for more than 1 year 5. Monetary fine and imprisonment for less than 1 year Rationale: Civil laws protect the rights of individuals within our society, and the consequences of civil law violations are damages in the forms of fines or specific performance of good works such as public service. A monetary fine, public service, and replacement of damaged property would be examples of this. Criminal law protects society as a whole and provides punishment of crimes. A felony (serious crime) is punishable by imprisonment for more than 1 year. A misdemeanor (less serious crime) is punishable by payment of a fine and imprisonment for less than 1 year.