Exam 6

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? Overweight clients No supplements Chromium supplements Weight loss

Chromium supplements

Professional Values

altruism, autonomy, human dignity, integrity, social justice

principle based approach

an approach to bioethics that offers specific action guides

Human Flourishing

an effort to achieve self-actualization and fullfillment with the context of a larger community of individuals, each with the right to pursue his or her own efforts

defamation of character

an intentional tort in which one party makes derogatory remarks about another that diminishes the other party's reputation; slander is oral defamation of character; libel is written defamation of character

allow natural death (AND) order

an order that no attempts are to be made to resuscitate a patient who stops breathing or whose heart stops beating

comfort-measures-only order

an order written to indicate that the goal of treatment is a comfortable, dignified death and that further life-sustaining measures are no longer indicated

Health insurance marketplace

federal and state system designed to help people more easily find health insurance that fits their budget and needs with a plan offering comprehensive coverage, from doctors to medications to hospital visits; insurance options can be compared based on price, benefits, quality, and other features described in plain language

A nurse observes another nurse place an unused dose of an opioid in the nurse's pocket. If caught, the nurse could be charged with which type of crime?

felony

Virtues

human excellence; cultivate dispositions of character and conduct that motivate and enable us to be good humans.

Tertiary Health Care

involves the provision of specialized highly technical care. examples include oncology centers and burn centers

value system

organization of values ranked along a continuum of importance

pallitative care

prevention.relief,reduction,or soothing of symptoms of disease or disorders throughout the entire course of an illness, including care of the dying and bereavement follow-up for the family

Advocacy

protection and support of another's rights

deductive reasoning

reasoning in which a conclusion is reached by stating a general principle and then applying that principle to a specific case (The sun rises every morning; therefore, the sun will rise on Tuesday morning.)

basic research

research designed to generate and refine theory; the findings are often not directly useful in practice

autonomy

self-determination; being independent and self-governing

values

set of beliefs that are meaningful in life that influence relationships with others

conceptual framework or model

set of concepts, along with the statements that arrange the concepts into an understandable pattern

value-based pricing

setting the price at a level that seems to the customer to be a good price compared to the prices of other options

Charting by exception (CBE)

shorthand method for documenting patient data that is based on well-defined standards of practice; only exceptions to these standards are documented in narrative notes

ethical dilemma

situation that arises when attempted adherence to basic ethical principles results in two conflicting courses of action

bedside report

standardized, streamlined shift report system at the bedside; helps ensure the safe handoff of care between nurses by involving the patient and family

QSEN

stands for Quality and Safety Education for Nurses, a project for preparing future nurses with the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the health care systems within which they work

bereavement

state of grieving from loss of a loved one

scientific problem solving

systematic problem-solving process that involves (1) problem identification, (2) data collection, (3) hypothesis formulation, (4) plan of action, (5) hypothesis testing, (6) interpretation of results, and (7) evaluation resulting in conclusion or revision of the study

Defendant

the one being accused of a crime or tort

medication reconciliation

the process of creating the most accurate list possible of all medications a patient is taking — including drug name, dosage, frequency, and route — and comparing that list against the physician's admission, transfer, and/or discharge orders, with the goal of providing correct medications to the patient at all transition points within the hospital.

therapeutic relationship

the relationship between the carer and the cared for is used for promoting or restoring the health and well-being of people within the relationship

The nurse is working to enhance time management skills and has to administer pain medications to several patients, obtain vital signs, and assist clients with bathing. What should the nurse do next? Administer pain medications. Obtain vital signs. Bathe clients. Delegate bathing and vital signs tasks.

Delegate bathing and vital signs tasks.

Which explanation accurately differentiates the role of the registered nurse (RN) from that of the licensed practical/vocational nurse (LPN/LVN)? The RN directs the workload of an LPN/LVN. The LPN/LVN should work under the supervision of an RN. The LPN/LVN can only work in a long-term care facility. The RN is permitted to prescribe medications.

The LPN/LVN should work under the supervision of an RN.

multipayer system

a health care system in which care is paid for by both private insurance companies and the government

An HIV-positive client discovers that the client's name is published in a research report on HIV care prepared by the client's nurse. The client is hurt and files a lawsuit against the nurse. Which offense has the nurse committed? Defamation of character Unintentional tort Invasion of privacy Negligence of duty

Invasion of privacy

A nurse is conducting a presentation for a local community group about health care services available in the community. When describing voluntary agencies, which agency would the nurse include? Select all that apply. American Lung Association Meals on Wheels American Heart Association Centers for Disease Control and Prevention

Meals on Wheels American Heart Association American Lung Association

A nurse knows that the expression "Do not cause harm" refers to which ethical principle? Justice Beneficence Nonmaleficence Fidelity

Nonmaleficence

A nurse identifies a client's health care needs and devises a plan of care to meet those needs. Which guideline is being followed in this case? Nursing standards Nursing orders Nursing process Nurse practice acts

Nursing process

As a nurse which patient are you going to care for FIRST A) 25 year old female complaining of a sore throat & cough B) 52 year old male complaining of chest pain and SOB C) 78 year old female with a broken wrist D) 33 year old male with a head laceration with no obvious CNS changes or s/s hemorrhage

52 year old male complaining of chest pain and SOB

Which of the following assignments would you question? A. The UAP assigned to take pre-op VS B. The LPN assigned to give nebulized medications to patient with asthma C. The UAP assigned to get urine specimens from an 18 year old female D. The LPN assigned to count narcotics

A

The nurse is caring for several clients with chronic conditions that need to be evaluated for long-term care. After evaluating each client, the nurse determines which client is most appropriate to receive long-term care? A client with severe back injury as a result of a car accident needing ongoing physical therapy. A client who suffered a stroke who has mobility issues and problems completing activities of daily living (ADLs). A client diagnosed with pneumonia requiring mechanical ventilation. A client newly diagnosed with rheumatoid arthritis requiring medication monitoring.

A client who suffered a stroke who has mobility issues and problems completing activities of daily living (ADLs).

The nurse is evaluating client health. Which client should the nurse determine to be exhibiting the most signs of health? A client in acute emotional distress due to spouse's death A client with a leg amputation who performs activities of daily living with a prosthesis A client with diabetes who is in denial of the diabetes and refuses to take insulin A client with depression who refuses to get out of bed

A client with a leg amputation who performs activities of daily living with a prosthesis

The client being admitted to the oncology unit conveys wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in the client's best interest to obtain which document? A living will A proxy directive A will Proof of health care power of attorney

A living will

Which scenario is the best example of a nurse in the role of counselor? A nurse providing the physician a client's test results A nurse allowing a crying client to verbalize fears of death A nurse ensuring that a client has follow-up care at a free clinic A nurse telling a client the side effects of a medication

A nurse allowing a crying client to verbalize fears of death

Which nursing actions describe the use of the professional value of altruism? Select all that apply. A nurse respects the right of a Native American/First Nations client to call in a shaman for a consultation. A longtime nurse becomes a mentor to a student nurse working on the floor. A nurse demonstrates an understanding of the culture of his or her client. A nurse protects the privacy of a client with AIDS. A nurse lobbies for universal access to health care. A nurse is accountable for the care provided to a mentally challenged client.

A nurse demonstrates an understanding of the culture of his or her client. A longtime nurse becomes a mentor to a student nurse working on the floor. A nurse respects the right of a Native American/First Nations client to call in a shaman for a

A 32-year-old construction worker is admitted to the emergency department after suffering a heat stroke. Which of the following IV solutions would the nurse expect the physician would order? A solution of normal saline Blood products A solution of dextrose Total parenteral nutrition

A solution of normal saline

Which of the following statements made by the nursing student will the nurse preceptor clarify? SATA. A. I will ask the UAP to take VS on the patient who has a leg fracture and is experiencing sudden shortness of breath and pleuritic pain B. The LPN can take the patient who needs to be taught how to use crutches C. The LPN can remove peripheral IVs D. The RN needs to take the patient who is going to be discharged home on new medications

A,B

Which patient assignment would you question? SATA A. The LPN receiving a newly admitted patient for DKA B. The LPN giving 02 C. The UAP assigned to feed a patient at risk for aspiration D. The UAP assigned to transfer a patient to the chair 2 days after surgery

A,C

You are a charge nurse making assignments for LPNs, RNs, and UAPs. Which assignments could you give? SATA A. Assign the UAP to feed a patient who had carpal tunnel surgery B. Assign the LPN to give IVP (IV push) medications C. Assign the RN to the patient who needs a sterile dressing change D. Assign the LPN to the patient who is on an insulin drip

A,C

You are making patient assignments for the upcoming shift. You have 2 LPNs, 2 RNs, and 1 UAP. Which patient assignments should be given to the RNs? SATA. A. The patient who will be discharged home with a new NG tube B. The patient with Alzheimer's who has a colostomy C. The patient who is newly admitted with sharp abdominal pains D. The patient who needs to ambulate in the hall

A,C

You are an LPN and are receiving assignments for the day. Which assignments will you question? SATA A. The patient with a central line dressing change B. The patient due for NG tube medications C. The patient due to come back from PACU after a knee replacement D. The patient with a new ostomy E. The patient with TPN due

A,C,D,E

Which is an appropriately stated nursing intervention? Ambulate with the assistance of a walker. Stand at bedside with assistance. Ambulate 30 ft (9 m) twice a day with the assistance of a walker. Ambulate in the hall.

Ambulate 30 ft (9 m) twice a day with the assistance of a walker.

Walk in clinics & hospitals are examples of ___________ ________ centers

Ambulatory Care

Which scenario is using a prospective payment plan to reimburse for services? An older adult client is admitted to the hospital and treated for pneumonia. The hospital is reimbursed based on a predetermined fixed price. A client with chronic heart failure is offered health care teaching and preventative services for free. A child is hospitalized and treated for a fractured femur. The hospital receives a preset fee for each member regardless of whether the member required services. A client is hospitalized for an emergency appendectomy. Since the hospital is a preferred provider the fee for service was discounted.

An older adult client is admitted to the hospital and treated for pneumonia. The hospital is reimbursed based on a predetermined fixed price.

A nurse volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee? Present options about the type of care. Decide the care for a client who is unable to voice an opinion. Convince the family to choose a specific course of action. Assist in decision making based on the client's best interests.

Assist in decision making based on the client's best interests.

Which statement regarding perceptions of death by children is accurate? Toddlers perceive death as irreversible and unnatural. At about age 9, the child perceives death as irreversible. Preschool-age children view death as a spiritual release. Adolescents tend to respond better than adults with death.

At about age 9, the child perceives death as irreversible.

A client aged 83 years who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. The nurse communicates the client's wish to the family and health care team. This is an example of what ethical principle? Justice Autonomy Nonmaleficence Veracity

Autonomy

Which ethical principle is related to the idea of self-determination? Confidentiality Beneficence Nonmaleficence Autonomy

Autonomy

Which of the following tasks is the best assignment for the UAP? A. Vital signs for a patient returning from PACU (post anesthesia care unit) B. Draw blood in a stable patient who is needing lab work C. Transfer a patient from the bed to a chair after leg amputation 2 days ago D. Teach a patient how to do a finger stick blood sugar

C

Which of the following tasks can the UAP safely do? SATA. A. Insert a foley B. Assess a patient's pain level 30 min after the RN administered morphine C. Obtain a urine specimen on a patient who was admitted to have their gall bladder removed D. Help shower a patient admitted for pancreatitis

C&D

Which are appropriate assignments for the LPN? SATA A. The newly diagnosed type 1 diabetic who is stable and ready to be discharged home today B. The patient who will require a blood transfusion C. The patient who has a g-tube with several feedings throughout the day D. The patient with COPD whose 02 sat is 89% E. The patient who need a foley insertion

C,D,E

Nurses in various health care settings provide services to prevent the fragmentation of care that is occurring as a health care trend in today's society. What role of the nurse is most important in preventing this effect? Coordinator of care Educator Care provider Counselor

Coordinator of care

During the course of any given day of work in the acute care setting, the nurse may need to perform which roles? Select all that apply. Counselor Teacher Statistician Financier Communicator

Counselor Teacher Communicator

Which are ethical issues that need to be considered as health care reform continues? Select all that apply. Should hospitals and providers receive payment from health insurance entities based in part on patient satisfaction scores? Do smokers and the obese who do not make necessary lifestyle changes deserve the same health care as people who lead healthier lives? Should undocumented peoples in the U.S. have the same access to health care as its citizens? Is someone who can afford to advertise for an organ donation more deserving than someone who has been waiting months for a transplant? Should citizens pay higher insurance premiums and/or taxes so that someone who overdoses on heroin can have intensive care?

Do smokers and the obese who do not make necessary lifestyle changes deserve the same health care as people who lead healthier lives? Is someone who can afford to advertise for an organ donation more deserving than someone who has been waiting months for a transplant? Should citizens pay higher insurance premiums and/or taxes so that someone who overdoses on heroin can have intensive care? Should undocumented peoples in the U.S. have the same access to health care as its citizens?

Which of the following actions should the nurse implement when working with a medically homeless client? Assist the client in finding housing. Encourage client to utilize the free healthcare clinic. Encourage the client to utilize the emergency room when ill. Assist the client in finding a job.

Encourage client to utilize the free healthcare clinic.

A nurse who works in a pediatric practice assesses the developmental level of children of various ages to determine their psychosocial development. These assessments are based on the work of: Erikson. Rogers. Maslow. Watson.

Erikson

What nursing activity forms the bridge between theory and practice? Case management Client-focused care Evidence-based research Theoretical writing

Evidence-based research

Which activity best helps the nurse apply theory to practice? Case management Client-focused care Evidence-based research Theory development

Evidence-based research

A terminally ill client told her family, "I am ready to die." Her family is very upset that she has given up and wants the nurse to intervene. Which nursing intervention is most appropriate? Explain to the family that acceptance is part of the grieving process. Explain to the family that giving up is expected with terminal illness. Encourage the client to think about living instead of dying. Explain to the client that she cannot give up because her family needs her.

Explain to the family that acceptance is part of the grieving process.

A female client is brought to the emergency room with matted hair, bruising, and malnutrition. The nurse suspects physical abuse and neglect. The nurse states, "This happens to many women." Which type of ethical approach is the nurse exhibiting? Feminist Moralizing Values clarification Paternalism

Feminist

A client rings the call bell to request pain medication. On performing the pain assessment, the nurse informs the client that the nurse will return with the pain medication. After a few moments, the nurse returns with the pain medication. The nurse's returning with the pain medication is an example of which principle of bioethics? Nonmaleficence Justice Autonomy Fidelity

Fidelity

A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which statement demonstrates the principle of accountability? Documenting in the chart a narrative note about the occurrence Filling out an occurrence report and notifying the healthcare provider Telling the client that the medication will be given the following morning Administering the medication with the other evening medications

Filling out an occurrence report and notifying the healthcare provider

Who is considered to be the first nursing theorist who conceptualized nursing in terms of manipulating the environment? Florence Nightingale Sister Callista Roy Dorothea Orem Lydia Hall

Florence Nightingale

Nurses have an important role in healthcare reform. The goals of healthcare reform include which of the following? Decreasing healthcare services to provide all citizens with some access to care but control escalating costs. Controlling healthcare costs through limited services for more consumers of healthcare. Improving quality of care, while limiting access for the uninsured to control rising costs. Focus on cost containment with improved access and quality of services for everyone.

Focus on cost containment with improved access and quality of services for everyone.

A dying client expresses to the nurse a desire to not see family to avoid causing them more sadness. Which action by the nurse is most appropriate? Arrange a meeting between the family and the client. Allow the client time for quiet reflection. Educate the client on the concepts of death and dying. Help the client clarify personal values.

Help the client clarify personal values.

A nurse is providing supportive care to a client diagnosed with a terminal illness who is not expected to live past the next 3 months or so. The nurse is likely working in which setting? Hospice care Palliative care Respite care Parish nursing

Hospice care

A nurse is researching health care in rural areas. Based on a 2013 U.S. Subcommittee on Primary Health and Aging, which statement regarding access to primary health care is correct? Over 100,000 people die each year because they do not have health insurance and do not get to a doctor on time. One in five Americans lives in an area without adequate access to primary health care due to a shortage of primary care providers. Fewer than one in five physicians specializes in primary care. Although over half of client visits are for primary care, only 17% of the nation's medical school graduates now choose a primary care career.

One in five Americans lives in an area without adequate access to primary health care due to a shortage of primary care providers.

You are given your patient assignments, which patient do you assess FIRST? A) Patient that is post op day 1 from CABG that is complaining of new onset chest pain, RR 34, and HR 120 B) Patient that is waiting to be discharged today C) Patient that is post op day 2 from lobectomy that is stable and has orders for ambulating D) Patient that is resting with orders for pain medications q 4 hours and received their last dose 6 hours ago

Patient that is post op day 1 from CABG that is complaining of new onset chest pain, RR 34, and HR 120

What type of research study would a hospital conduct to explore clients' and families' perceptions of receiving care? Nonscientific Ordinal Qualitative Quantitative

Qualitative

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? Quantitative research Qualitative research Applied research Basic research

Quantitative research

The nurse is providing care for a client who has a tracheostomy and whose pulse oximeter has recently alarmed, showing the client's oxygen saturation to be 77%. The nurse has repositioned the client and applied supplementary oxygen, interventions that have raised the client's oxygen levels to 80% and have somewhat decreased his work of breathing. The client is not in immediate distress, and his level of consciousness remains high. The nurse should page which practitioner? Respiratory therapist Physical therapist Occupational therapist Physician

Respiratory therapist

Name the IOM's 6 outcomes for a new health system in the 21st century

Safe, effective, efficient, patient-centered, timely, equitable

The nurse is assessing the IV infusion of a patient. The nurse notes the IV is positional and only runs well if the patient's arm is straightened. What is the priority action by the nurse in order to complete the infusion? Remind the patient to keep the arm straight. Ask the family member at the bedside to hold the patient's arm straight. Notify the health care provider Remove the IV and restart the infusion from another, more stable site. Secure the arm to an arm board.

Secure the arm to an arm board.

A nurse is caring for an older adult who has cancer and is experiencing complications requiring a revision of the plan of care. The nurse sits down with the client and the family and discusses their preferences while sharing the nurse's own judgments based on the nurse's expertise. Which type of healthcare decision making does this represent? Ethical decision making Shared decision making Paternalistic model Client sovereignty model

Shared decision making

A client severely injured in a motor vehicle accident is rushed to the health care facility with severe head injuries and profuse loss of blood. Which sign indicates approaching death? The client is calm and peaceful. The arms and legs are warm to touch. The client's breathing becomes noisy. The frequency of urination decreases.

The client's breathing becomes noisy.

A parent teaches a child not to drink and drive; however, the parent does drink and drive. This action results in: insecurity and a lack of safety. a disruption in consistency. a failure to model one's own values. conflict with society.

a failure to model one's own values.

To practice ethically, the nurse should avoid: reviewing past cases before making decisions about practice. allowing the nurse's own personal judgment to guide practice. asking the client's family about their views on caring. allowing an ethics committee to guide the nurse's practice.

allowing the nurse's own personal judgment to guide practice.

A terminally ill client is being cared for at home and receiving hospice care. The hospice nurse is helping the family cope with the client's deteriorating condition, educating them on the signs of approaching death. Which sign would the nurse include in this education plan? decreased pain difficulty swallowing increased sensory stimulation increased urinary output

difficulty swallowing

Primary health care focuses on ____________ & __________

health promotion and illness prevention

A hospital owned by a Catholic order of nuns will not allow tubal ligations to be performed. This is considered to be institutional policy. legal obligation. personal morality. personal values.

institutional policy.

The experience of parting with an object, person, belief, or relationship that one values is defined as:

loss

A nurse is of the Catholic faith and votes pro-life. This nurse is considered to have: personal values. ethics. moral agency. legal obligations.

personal values.

Identify at least one health care service for the seriously ill and/or dying?

respite care, hospice services, palliative care

fraud

willful and purposeful misrepresentation that could cause, or has caused, loss or harm to people or property

Diagnosis-related groups (DRGs)

System that categorizes into payment groups patients who are medically related with respect to diagnosis and treatment and statistically similar with regard to length of stay

Patient Record

a compilation of a patient's health information; the patient record is the only permanent legal document that details the nurse's interactions with the patient

Felony

a crime, typically one involving violence, regarded as more serious than a misdemeanor, and usually punishable by imprisonment for more than one year or by death.

nursing judgement

critical thinking, clinical judgement, and integration of best evidence into practice

In what time period did nursing care as we now know it begin? 18th to 19th century pre-civilization 16th to 17th century early civilization to 16th century

18th to 19th century

Patient Protection and Affordable Care Act (PPACA)

2010 federal legislation designed for comprehensive health reform, with an intent to expand coverage, control health care costs, and improve the health care delivery system

A nurse researcher keeps current on the trends to watch in health care delivery. What trends are likely included? Select all that apply. a. Globalization of the economy and society b. Slowdown in technology development c. Decreasing diversity d. Increasing complexity of patient care e. Changing demographics f. Shortages of key health care professionals and educators

A,D,E,F

Which of the following delegated tasks will the LPN question? A. Assigning a UAP to feed a patient post stroke with dysphagia B. Assigning a UAP to ambulate a post op patient after the RN has already done it once C. Assign the UAP to measure the amount of urine in the foley of a patient who is NPO D. Perform ROM (range of motion) exercises on a patient who is 2 days post op

A.

A nurse researcher is reviewing the Privacy Rule under the Health Insurance Portability and Accountability Act (HIPAA) and finds information about handling protected health information (PHI). The nurse researcher would most likely find rules for which aspects of PHI? Select all that apply. Sharing Access Documentation Revisions Usage

Access Usage Sharing

Big Pictures In Healthcare

Access to Health Care Quality and Safety Affordability

The nurse is developing a plan of care for a client with a fractured femur who is in traction and will be restricted to bed for some time. Which domain should the nurse consider when developing a nursing diagnosis based on this client's musculoskeletal health problems? Activity and rest Health promotion Nutrition Self-perception

Activity and rest

Which government policy addresses penalizing hospitals for readmissions of clients with certain diagnoses within 30 days after discharge? American Nurses Association Bylaws Affordable Care Act Americans with Disabilities Act National Commission for Minorities

Affordable Care Act

When prioritizing care ABCs stands for what?

Airway Breathing Circulation

You are a nurse and you are about to go change a patients brief when the PCA tells you a patient is requesting their pain medicine, what do you do? A) Tell the PCA to give the patient norco as ordered B) Change the patient's brief and then give the other Pt. pain medicine C) Assess the Pt. and give pain meds as ordered and then change the brief D) Quit and go home

Assess the Pt. and give pain meds as ordered and then change the brief

The nurse is performing an assessment on a client who reports having a rash on the back that is red and raised. What would be the most appropriate nursing action? Document the rash in the client's chart. Report it to the health care provider. Assess the client's back visually. Establish a nursing diagnosis of Altered Skin Integrity.

Assess the client's back visually.

A nurse is conducting focused data collection and recognizes the existence of cues. The nurse is most likely involved in which phase of the nursing process? Planning Implementation Assessment Diagnosis

Assessment

Trends to watch in healthcare delivery

Changing demographics increasing diversity technology explosion globalization of economy and society educated and engaged consumers increasing complexity of patient care cost of healthcare

A state attorney decides to charge a nurse with manslaughter for allegedly administering a lethal medication. This is an example of what type of law? Public law Private law Civil law Criminal law

Criminal Law

A hospital nurse is admitting a patient who sustained a head injury in a motor vehicle accident. Which activity could the nurse delegate to licensed assistive personnel? Collecting information for a health history Performing a physical assessment Contacting the health care provider for medical orders Preparing the bed and collecting needed supplies

D

A nurse ensures that a hospital room prepared by an aide is ready for a new ambulatory patient. Which condition would the nurse ask the aide to correct? The bed linens are folded back. A hospital gown is on the bed. Equipment for taking vital signs is in the room. The bed is in the highest position.

D

A nurse is practicing as a nurse-midwife in a busy OB-GYN office. Which degree in nursing is necessary to practice at this level? a. LPN b. ADN c. BSN d.MSN

D

True or False: An incident report goes in a patient chart

FALSE

Capitiation

In a capitated plan the fixed amount paid to a provider on a regular basis.

Statutory Law

Laws enacted by legislative bodies at any level of government

POLST

Physicians orders for life sustaining treatment. May include order for DO NOT RESUSCITATE

The nurse is using the nursing process to care for a client and is in the process of making a nursing diagnosis. Which condition best reflects a nursing diagnosis? Pneumonia Risk for falls Hypertension Congestive heart failure

Risk for falls

SBAR

Situation Background Assessment Recommendation

care-based approach

approach to bioethics that directs attention to the specific situations of individual patients viewed within the context of their life narrative

battery

assault that is carried out

A student is choosing an educational path and desires a nursing degree with a track for community nursing and leadership and that allows for classes in liberal arts. The student would best be suited in which type of program? diploma nursing program baccalaureate program certification in a nursing specialty licensed practical nursing program

baccalaureate program

A client who experienced a cesarean birth rates pain as a 9 on a 10-point scale. The nurse medicates the client for pain. This is an example of the nurse practicing which ethical principle?

beneficence

A nurse is conducting quantitative research to examine the effects of following nursing protocols in the emergency department (ED) on patient outcomes. This is also known as what type of research? a. Descriptive b. Correlational c. Quasi-experimental d. Experimental

c

When conducting quantitative research, the researcher collects information to support a hypothesis. This information would be identified as: The subject Variables Data The instrument

data

Which therapist is most likely to focus on teaching a client to hold a toothbrush with an adaptive device and brush the teeth? A speech therapist An occupational therapist A physical therapist A respiratory therapist

An occupational therapist

A client has been receiving dialysis for years and now states, "I have been thinking about this for a long time. I no longer wish to continue dialysis. I just want to die." What is the most appropriate statement by the nurse? "Can you tell me about why you've made this decision?" "Does your family agree with this decision?" "Have you discussed this with your health care provider?" "Once you've started treatment, it's important to continue."

"Can you tell me about why you've made this decision?"

Which nurse-to-provider interaction correctly utilizes the SBAR format for improved communication? "I am calling about the patient in room 212. He has new onset diabetes mellitus, and I wondered if you would like to adjust the sliding scale of insulin." "I am calling about Mr. Jones. He has new onset diabetes mellitus. His blood glucose is 250 mg/dL (13.875 mmol/L), and I wondered if you would like to adjust the sliding scale insulin." "I am calling about Mr. Jones, who has diabetes mellitus. His blood sugar seems high, and I think he needs more insulin." "I am calling about Mr. Jones in room 212. His blood glucose is 250 mg/dL (13.875 mmol/L), and I think that is high."

"I am calling about Mr. Jones. He has new onset diabetes mellitus. His blood glucose is 250 mg/dL (13.875 mmol/L), and I wondered if you would like to adjust the sliding scale insulin."

Which statement made by the nurse providing care to a group of clients indicates that the nurse requires further education regarding negligence? "I am going to auscultate breath sounds every 8 hours on a client receiving enteral feedings." "Please avoid bringing fresh fruit to a client with neutropenia." "I am going to assess for collateral circulation before preforming an arterial blood gas (ABG)." "I don't need to assess distal pulses on a client after a femoral arteriography."

"I don't need to assess distal pulses on a client after a femoral arteriography."

A client admitted with Hodgkin lymphoma has a handwritten prescription for vinblastine 3.7 mg intravenously (IV) weekly. The nurse interprets the prescription as vincristine 3.7 mg and administers the wrong medication. The client becomes neurovascularly compromised and has a fatal reaction to the medication. The client's family begins a lawsuit against the facility and the nurse's license is suspended by the board of nursing. In preparation for the lawsuit, the nurse meets with the nurse attorney to review the events. Which appropriate statement given by the nurse indicates he has an understanding of the lawsuit? "I had a duty and it was my responsibility to double check the medication, which I did, yet this still happened." "I checked the medication before giving it and literature states it is for Hodgkin lymphoma." "I had a duty and it was my responsibility to get clarification before administering the medication, which I did not." "I could not read the health care provider's handwriting, so I am not at fault."

"I had a duty and it was my responsibility to get clarification before administering the medication, which I did not."

An attorney is representing a patient's family who is suing a nurse for wrongful death. The attorney calls the nurse and asks to talk about the case to obtain a better understanding of the nurse's actions. How should the nurse respond? "I'm sorry, but I can't talk with you; you will have to contact my attorney." "I will answer your questions so you'll understand how the situation occurred. "I hope I won't be blamed for the death because it was so busy that day." "First tell me why you are doing this to me. This could ruin my career!"

"I'm sorry, but I can't talk with you; you will have to contact my attorney."

MOLST form

"Medical Orders for Life-Sustaining Treatment"; MOLST is intended for patients with serious health conditions who: Want to avoid or receive any or all life-sustaining treatment; Reside in a long-term care facility or require long-term care services; and/or Might die within the next year.

The nurse is assessing a 1-year-old baby. The mother states, "I'm not sure if he has a fever. I have such a hard time with my glass thermometer. It's so hard to read." The nurse's best response would be: "Yes, they are hard to read, but with practice, it gets easier." "Why would you use that for your baby?" "There is some danger in using a glass thermometer and the mercury it contains. You might consider buying a new type of device." "Bring it with you next time and I will teach you the proper way to use your thermometer."

"There is some danger in using a glass thermometer and the mercury it contains. You might consider buying a new type of device."

A home care nurse has just completed a dressing change on her client. Which statement best describes the termination phase? "You need to eat more protein to assist you with wound healing." "Have you had any problems since our last visit? Is your wife doing well with your dressing changes?" "Your wound is healing nicely. It is draining less and it is smaller by a half centimeter." "On a scale of 0 to 10 with 0 being no pain and 10 being the worst, where would you rate your pain?"

"Your wound is healing nicely. It is draining less and it is smaller by a half centimeter."

Misdemeanor

(n.) a crime or offense that is less serious than a felony; any minor misbehavior or misconduct

confer

(v.) to consult, talk over, exchange opinions; to present as a gift, favor, or honor

CCNE (Commission on Collegiate Nursing Education)

- national accreditation for collegiate programs is provided through the AACN by this organization - not an arm of the AACN - autonomous accrediting agency for baccalaureate and graduate education programs - ensures quality and integrity of baccalaureate/graduate programs

ISBARQ

- revised approach adding introduction and question and answer components to SBAR

As the RN, you are making patient assignments for the next shift. Which patient would you assign to the LPN?: -A 68 year old male patient experiencing atrial fibrillation and is receiving a diltiazem drip. -A 25 year old female patient newly admitted with diabetic ketoacidosis. -An 85 year old female patient with Alzheimer's disease who has a colostomy and scheduled tube feedings. -A 45 year old male patient who is ordered to receive 2 units of pack red blood cells.

-An 85 year old female patient with Alzheimer's disease who has a colostomy and scheduled tube feedings.

NLNAC

-branch of NLN responsible for accreditation of nursing schools and programs: clinical doctorate, master's, baccalaureate, associates, practical

A 70-year-old patient who has had a number of strokes refuses further life-sustaining interventions, including artificial nutrition and hydration. She is competent, understands the consequences of her actions, is not depressed, and persists in refusing treatment. Her health care provider is adamant that she cannot be allowed to die this way, and her daughter agrees. An ethics consult has been initiated. Who would be the appropriate decision maker? The patient The patient's daughter The patient's health care provider The ethics consult team

A

A caregiver asks a nurse to explain respite care. How would the nurse respond? a. "Respite care is a service that allows time away for caregivers." b. "Respite care is a special service for the terminally ill and their family." c. "Respite care is direct care provided to people in a long-term care facility." d."Respite care provides living units for people without regular shelter."

A

A home health care nurse has been visiting a patient with AIDS who says, "I'm no longer afraid of dying. I think I've made my peace with everyone, and I'm actually ready to move on." This reflects the patient's progress to which stage of death and dying? Acceptance Anger Bargaining Denial

A

A hospice nurse is caring for a patient who is terminally ill and who is on a ventilator. After a restless night, the patient hands the nurse a note with the request: "Please help me end my suffering." Which response by a nurse would best reflect adherence to the position of the American Nurses Association (ANA) regarding assisted suicide? The nurse promises the patient that he or she will do everything possible to keep the patient comfortable but cannot administer an injection or overdose to cause the patient's death. The nurse tells the patient that under no condition can he be removed from the ventilator because this is active euthanasia and is expressly forbidden by the Code for Nurses. After exhausting every intervention to keep a dying patient comfortable, the nurse says, "I think you are now at a point where I'm prepared to do what you've been asking me. Let's talk about when and how you want to die." The nurse responds: "I'm personally opposed to assisted suicide, but I'll find you a colleague who can help you."

A

A hospice nurse is caring for a patient with end-stage cancer. What action demonstrates this nurse's commitment to the principle of autonomy? The nurse helps the patient prepare a durable power of attorney document. The nurse gives the patient undivided attention when listening to concerns. The nurse keeps a promise to provide a counselor for the patient. The nurse competently administers pain medication to the patient.

A

A nurse caring for patients in a primary care setting submits paperwork for reimbursement from managed care plans for services performed. Which purpose best describes managed care as a framework for health care? a. A design to control the cost of care while maintaining the quality of care b. Care coordination to maximize positive outcomes to contain costs c. The delivery of services from initial contact through ongoing care d.Based on a philosophy of ensuring death in comfort and dignity

A

A nurse is providing postmortem care. Which nursing action violates the standards of caring for the body after a patient has been pronounced dead and is not scheduled for an autopsy? The nurse leaves the patient in a sitting position while the family visits. The nurse places identification tags on both the shroud and the ankle. The nurse removes soiled dressings and tubes. The nurse makes sure a death certificate is issued and signed.

A

A nurse manager schedules a clinic for the staff to address common nursing interventions used in the facility and to explore how they can be performed more efficiently and effectively. The nurse manager's actions to change clinical practice are an example of a situation described by which nursing theory? a. Prescriptive theory b. Descriptive theory c. Developmental theory e. General systems theory

A

A nurse working in a primary care facility prepares insurance forms in which the provider is given a fixed amount per enrollee of the health plan. What is the term for this type of reimbursement? a. Capitation b. Prospective payment system c. Bundled payment d.Rate setting

A

A patient diagnosed with breast cancer who is in the end stages of her illness has been in the medical intensive care unit for 3 weeks. Her husband tells the nurse that he and his wife often talked about the end of her life and that she was very clear about not wanting aggressive treatment that would merely prolong her dying. The nurse could suggest that the husband speak to his wife's health care provider about which type of order? Comfort Measures Only Do Not Hospitalize Do Not Resuscitate Slow Code Only

A

A patient is being transferred from the ICU to a regular hospital room. What must the ICU nurse be prepared to do as part of this transfer? Provide a verbal report to the nurse on the new unit. Provide a detailed written report to the unit secretary. Delegate the responsibility for providing information. Make a copy of the patient's medical record.

A

An older nurse asks a younger coworker why the new generation of nurses just aren't ethical anymore. Which reply reflects the BEST understanding of moral development? "Behaving ethically develops gradually from childhood; maybe my generation doesn't value this enough to develop an ethical code." "I don't agree that nurses were more ethical in the past. It's a new age and the ethics are new!" "Ethics is genetically determined...it's like having blue or brown eyes. Maybe we're evolving out of the ethical sense your generation had." "I agree! It's impossible to be ethical when working in a practice setting like this!"

A

Nurses today work in a wide variety of health care settings. What trend occurred during World War II that had a tremendous effect on this development in the nursing profession? a. There was a shortage of nurses and an increased emphasis on education. b. Emphasis on the war slowed development of knowledge in medicine and technology c. The role of the nurse focused on acute technical skills used in hospital settings. d.Nursing was dependent on the medical profession to define its priorities.

A

Nursing in the United States is regulated by the state nurse practice act. What is a common element of each state's nurse practice act? a. Defining the legal scope of nursing practice b. Providing continuing education programs c. Determining the content covered in the NCLEX examination d.Creating institutional policies for health care practices

A

On your unit there are two RNs: one is new, other is experienced. Also 3 LPNs and 2 nursing assistants. Which tasks delegated to one of the nursing assistants by new RN needs to be re-evaluated. A. Apply hydrocortisone cream to eczema on skin after bath B. Assist patient with administering Fleets Enema C. Emptying ostomy bag D. Collecting vital signs E. Weighing and recording patients' weight.

A & B

Medicaid

A federal and state assistance program that pays for health care services for people who cannot afford them.

Medicare

A federal program of health insurance for persons 65 years of age and older or qualifying diagnosis

managed care

A health care system whose goals are to provide cost effective quality care.

Theory

A hypothesis that has been tested with a significant amount of data

The joint Commision

a not-for-profit organization that evaluates and accredits different types of healthcare facilities with a mission to improve safety, and quality of care

active euthanasia

A situation in which someone takes action to bring about another person's death, with the intention of ending that person's suffering.

ethics

A system of moral principles.

inductive reasoning

A type of logic in which generalizations are based on a large number of specific observations.

A nurse is preparing a family for a terminal weaning of a loved one. Which nursing actions would facilitate this process? Select all that apply. Participate in the decision-making process by offering the family information about the advantages and disadvantages of continued ventilatory support. Explain to the family what will happen at each phase of the weaning and offer support. Check the orders for sedation and analgesia, making sure that the anticipated death is comfortable and dignified. Tell the family that death will occur almost immediately after the patient is removed from the ventilator. Tell the family that the decision for terminal weaning of a patient must be made by the primary care provider. Set up mandatory counseling sessions for the patient and family to assist them in making this end-of-life decision.

A,B,C

A nurse midwife is assisting a patient who is firmly committed to natural childbirth to deliver a full-term baby. A cesarean delivery becomes necessary when the fetus displays signs of distress. Inconsolable, the patient cries and calls herself a failure as a mother. The nurse notes that the patient is experiencing what type of loss? Select all that apply. Actual Perceived Psychological Anticipatory Physical Maturational

A,B,C

A nurse working in a rehabilitation facility focuses on the goal of restoring health for patients. Which examples of nursing interventions reflect this goal? Select all that apply. a. A nurse counsels adolescents in a drug rehabilitation program b. A nurse performs range-of-motion exercises for a patient on bedrest c. A nurse shows a diabetic patient how to inject insulin d. A nurse recommends a yoga class for a busy executive e. A nurse provides hospice care for a patient with end-stage cancer f.A nurse teaches a nutrition class at a local high school

A,B,C

A discharge nurse is evaluating patients and their families to determine the need for a formal discharge plan or referrals to another facility. Which patients would most likely be a candidate for these services? Select all that apply. An older adult who is diagnosed with dementia in the hospital A 45-year-old man who is diagnosed with Parkinson's disease A 35-year-old woman who is receiving chemotherapy for breast cancer A 16-year-old boy who is being discharged with a cast on his leg A new mother who delivered a healthy infant via a cesarean birth A 59-year-old man who is diagnosed with end-stage bladder cancer

A,B,F

A nurse who cared for a dying patient and his family documents that the family is experiencing a period of mourning. Which behaviors would the nurse expect to see at this stage? Select all that apply. The family arranges for a funeral for their loved one. The family arranges for a memorial scholarship for their loved one. The coroner pronounces the patient's death. The family arranges for hospice for their loved one. The patient is diagnosed with terminal cancer. The patient's daughter writes a poem expressing her sorrow.

A,B,F

A nurse is using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model PET as a clinical decision-making tool when delivering care to patients. Which steps reflect the intended use of this tool? Select all that apply. A. A nurse recruits an interprofessional team to develop and refine an EBP question. B. A nurse draws from personal experiences of being a patient to establish a therapeutic relationship with a patient. C. A nurse searches the Internet to find the latest treatments for type 2 diabetes. D. A nurse uses spiritual training to draw strength when counseling a patient who is in hospice for an inoperable brain tumor. E. A nurse questions the protocol for assessing postoperative patients in the ICU. F. A nursing student studies anatomy and physiology of the body systems to understand the disease states of assigned patients.

A,C,E

A nurse decides to become a home health care nurse. Which personal qualities are key to being successful as a community-based nurse? Select all that apply. Making accurate assessments Researching new treatments for chronic diseases Communicating effectively Delegating tasks appropriately Performing clinical skills effectively Making independent decisions

A,C,E,F

A student nurse begins a clinical rotation in a long-term care facility and quickly realizes that certain residents have unmet needs. The student wants to advocate for these residents. Which statements accurately describe this concept? Select all that apply. Advocacy is the protection and support of another's rights. Patient advocacy is primarily performed by nurses. Patients with special advocacy needs include the very young and the older adult, those who are seriously ill, and those with disabilities. Nurse advocates make good health care decisions for patients and residents. Nurse advocates do whatever patients and residents want. Effective advocacy may entail becoming politically active

A,C,F

Nurses provide care to patients as collaborative members of the health care team. Which roles may be performed by the advanced practice registered nurse? Select all that apply. a. Primary care provider b. Hospitalist c. Physical therapist d. Anesthetist e. Midwife f. Pharmacist

ADE

A nurse is completing a family assessment on a routine home health visit. The parents have a child with a severe peanut allergy. The mother states that she does not purchase any foods with peanut or peanut oil for her family. The other children are allowed to have foods containing peanuts while they are at school and visiting with friends and family. The nurse would conclude that which of the following theories would most like be the basis for this family's functioning? General Systems Theory Maslow's Theory Developmental Theory Adaptation Theory

Adaptation Theory

Assisted suicide is expressly prohibited under statutory or common law in the overwhelming majority of states. Yet public support for physician-assisted suicide has resulted in a number of state ballot initiatives. The issue of assisted suicide is opposed by nursing and medical organizations as a violation of the ethical traditions of nursing and medicine. Which scenario would be an example of assisted suicide? Administering a morphine infusion Neglecting to resuscitate a client with a "do not resuscitate" status Administering a lethal dose of medication Granting a client's request not to initiate enteral feeding when the client is unable to eat

Administering a lethal dose of medication

Which scenario is an example of the laissez-faire approach to value transmission? Allowing a child to decide not to have an intravenous line inserted Modeling healthy behaviors for teenagers, such as not smoking electronic cigarettes Telling a child an injection will feel like a pinch before the nurse gives the injection Teaching children right from wrong and telling them the reason behind a bad action

Allowing a child to decide not to have an intravenous line inserted

Health Maintenance Organization (HMO)

Alternative means of health care in which people or their employers are charged a set amount and the HMO provides health care and covers hospital costs.

Spirit of Inquiry

An ongoing curiosity about the best evidence to guide clinical decision making

Accountable Care Organization (ACO)

An organization of healthcare providers accountable for the quality, cost, and overall care of Medicare beneficiaries who are assigned and enrolled in the traditional fee-for-service program

A nurse manager informs the staff members during a meeting that unlicensed assistive personnel will no longer be allowed to check clients' blood glucose levels. The nurse manager informs the group that this is a new policy on the unit and that discussions will not change the enforcement of this policy. What type of leadership style is the nurse manager demonstrating? Democratic Laissez-faire Transformational Autocratic

Autocratic

A nurse is caring for a patient in the ICU who is being monitored for a possible cerebral aneurysm following a loss of consciousness in the emergency department (ED). The nurse anticipates preparing the patient for ordered diagnostic tests. What aspect of nursing does this nurse's knowledge of the diagnostic procedures reflect? a. The art of nursing b. The science of nursing c. The caring aspect of nursing d.The holistic approach to nursing

B

A nurse is caring for a terminally ill patient during the 11 PM to 7 AM shift. The patient says, "I just can't sleep. I keep thinking about what my family will do when I am gone." What response by the nurse would be most appropriate? "Oh, don't worry about that now. You need to sleep." "What seems to be concerning you the most?" "I have talked to your wife and she told me she will be fine." "I'm not qualified to advise you, I suggest you discuss this with your wife."

B

A nurse is caring for patients in a primary care center. What is the most likely role of this nurse based on the setting? a. Assisting with major surgery b. Performing a health assessment c. Maintaining patients' function and independence d.Keeping student immunization records up to date

B

A nurse is caring for terminally ill patients in a hospital setting. Which nursing action describes appropriate end-of-life care? To eliminate confusion, the nurse takes care not to speak too much when caring for a comatose patient. The nurse sits on the side of the bed of a dying patient, holding the patient's hand, and crying with the patient. The nurse refers to a counselor the daughter of a dying patient who is complaining about the care associated with artificially feeding her father. The nurse tells a dying patient to sit back and relax and performs patient hygiene for the patient because it is easier than having the patient help.

B

A nurse is visiting a patient with pancreatic cancer who is dying at home. During the visit, he breaks down and cries, and tells the nurse that it is unfair that he should have to die now when he's finally made peace with his family. Which response by the nurse would be most appropriate? "You can't be feeling this way. You know you are going to die." "It does seem unfair. Tell me more about how you are feeling." "You'll be all right; who knows how much time any of us has." "Tell me about your pain. Did it keep you awake last night?"

B

A nurse working in a pediatric clinic provides codes for a patient's services to a third-party payer who pays all or most of the care. This is an example of what mode of health care payment? a. Out-of-pocket payment b. Individual private insurance c. Employer-based group private insurance d.Government financing

B

A nursing student asks the charge nurse about legal liability when performing clinical practice. Which statement regarding liability is true? Students are not responsible for their acts of negligence resulting in patient injury. Student nurses are held to the same standard of care that would be used to evaluate the actions of a registered nurse. Hospitals are exempt from liability for student negligence if the student nurse is properly supervised by an instructor. Most nursing programs carry group professional liability making student personal professional liability insurance unnecessary.

B

A patient tells a nurse that he would like to appoint his daughter to make decisions for him should he become incapacitated. What should the nurse suggest he prepare? POLST form Durable power of attorney for health care Living will Allow Natural Death (AND) form

B

According to the National Advisory Council on Nurse Education and Practice, what is a current healthcare trend contributing to 21st century challenges to nursing practice? a. Decreased numbers of hospitalized patients b. Older and more acutely ill patients c. Decreasing health care costs owing to managed care d.Slowed advances in medical knowledge and technology

B

Review of a patient's record revealed that no one obtained informed consent for the heart surgery that was performed on the patient. Which intentional tort has been committed? Assault Battery Invasion of privacy False imprisonment

B

Which statement or question MOST exemplifies the role of the nurse in establishing a discharge plan for a patient who has had major abdominal surgery? "I'll bet you will be so glad to be home in your own bed." "What are your expectations for recovery from your surgery?" "Be sure to take your pain medications and change your dressing." "You will just be fine! Please stop worrying."

B

As the RN, which tasks below can you delegate to the experienced LPN? A. Performing an assessment on a new admission B. Collecting a urine sample from an indwelling Foley catheter C. Developing a plan of care for a patient who is admitted with Guillain-Barre Syndrome D. Educating patient about how to monitor for side effects associated with Warfarin E. Auscultating lung and bowel sounds F. Evaluating a patient's understanding on how to administer SUB-Q injections of Exonaparin Sodium (Lovenox)

B & E

A nurse answers a patient's call light and finds the patient on the floor by the bathroom door. After calling for assistance and examining the patient for injury, the nurse helps the patient back to bed and then fills out an incident report. Which statements accurately describe steps of this procedure and why it is performed? Select all that apply. A. An incident report is used as disciplinary action against staff members. B. An incident report is used as a means of identifying risks. C. An incident report is used for quality control. D.The facility manager completes the incident report. E. An incident report makes facts available in case litigation occurs. F. Filing of an incident report should be documented in the patient record.

B,C,E

A nurse is using general systems theory to describe the role of nursing to provide health promotion and patient teaching. Which statements reflect key points of this theory? Select all that apply. A. A system is a set of individual elements that rarely interact with each other. B. The whole system is always greater than the sum of its parts. C. Boundaries separate systems from each other and their environments. D. A change in one subsystem will not affect other subsystems. E. To survive, open systems maintain balance through feedback. F. A closed system allows input from or output to the environment.

B,C,E

A nurse is providing health care to patients in a health care facility. Which of these patients are receiving secondary health care? Select all that apply. a. A patient enters a community clinic with signs of strep throat. b. A patient is admitted to the hospital following a myocardial infarction. c. A mother brings her son to the emergency department following a seizure. d. A patient with osteogenesis imperfecta is being treated in a medical center. e. A mother brings her son to a specialist to correct a congenital heart defect. f.A woman has a hernia repair in an ambulatory care center.

B,C,F

A nurse who is a discharge planner in a large metropolitan hospital is preparing a discharge plan for a patient after a kidney transplant. Which actions would this nurse typically perform to ensure continuity of care as the patient moves from acute care to home care? Select all that apply. Performing an admission health assessment Evaluating the nursing plan for effectiveness of care Participating in the transfer of the patient to the postoperative care unit Making referrals to appropriate facilities Maintaining records of patient satisfaction with services Assessing the strengths and limitations of the patient and family

B,D,F

A nurse caring for patients in the intensive care unit develops values from experience to form a personal code of ethics. Which statements best describe this process? Select all that apply. People are born with values. Values act as standards to guide behavior. Values are ranked on a continuum of importance. Values influence beliefs about health and illness. Value systems are not related to personal codes of conduct. Nurses should not let their values influence patient care.

B,c,d

The registered nurse on a busy telemetry floor is delegating tasks to an unlicensed assistive person (UAP). Which task is appropriate for the UAP to complete? Assessing a client's wound Bathing a combative client Inserting an indwelling urinary catheter Taking an order over the telephone from a physician

Bathing a combative client

A nurse administers the wrong medication to a patient and the patient is harmed. The health care provider who ordered the medication did not read the documentation that the patient was allergic to the drug. Which statement is true regarding liability for the administration of the wrong medication? The nurse is not responsible, because the nurse was following the doctor's orders. Only the nurse is responsible, because the nurse actually administered the medication. Only the health care provider is responsible, because the health care provider actually ordered the drug. Both the nurse and the health care provider are responsible for their respective actions.

Both the nurse and the health care provider are responsible for their respective actions.

The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports that the pain is unrelieved. The nurse takes no further action regarding assessment and intervention for the client's pain. The nurse does not notify the surgeon regarding the client's pain. The nurse's failure to take further action represents which element of liability in this case? Causation Damages Duty Breach of duty

Breach of duty

A nurse cares for dying patients by providing physical, psychological, social, and spiritual care for the patients, their families, and other loved ones. What type of care is the nurse providing? a. Respite care b. Palliative care c. Hospice care d.Extended care

C

A nurse in a NICU fails to monitor a premature newborn according to the protocols in place, and is charged with malpractice. What is the term for those bringing the charges against the nurse? Appellates Defendants Plaintiffs Attorneys

C

A nurse interviews an 82-year-old resident of a long-term care facility who says that she has never gotten over the death of her son 20 years ago. She reports that her life fell apart after that and she never again felt like herself or was able to enjoy life. What type of grief is this woman experiencing? Somatic grief Anticipatory grief Unresolved grief Inhibited grief

C

A nurse is preparing an infant and his family for a hernia repair to be performed in an ambulatory care facility. What is the primary role of the nurse during the admission process? To assist with screening tests To provide patient teaching To assess what has been done and what still needs to be done To assist with hernia repair

C

A nurse pleads guilty to a misdemeanor negligence charge for failing to monitor a patient's vital signs during routine eye surgery, leading to the death of the patient. The nurse's attorney explained in court that the nurse was granted recognition in a specialty area of nursing. What is the term for this type of credential? Accreditation Licensure Certification Board approval

C

A premature infant with serious respiratory problems has been in the neonatal intensive care unit for the last 3 months. The infant's parents also have a 22-month-old son at home. The nurse's assessment data for the parents include chronic fatigue and decreased energy, guilt about neglecting the son at home, shortness of temper with one another, and apprehension about their continued ability to go on this way. What human response would be appropriate for the nurse to document? Grieving Ineffective Coping Caregiver Role Strain Powerlessness

C

A home health care nurse is scheduled to visit a 38-year-old woman who has been discharged from the hospital with a new colostomy. Which duties would the nurse perform for this patient in the entry phase of the home visit? Select all that apply. Collect information about the patient's diagnosis, surgery, and treatments. Call the patient to make initial contact and schedule a visit. Develop rapport with the patient and her family. Assess the patient to identify her needs. Assess the physical environment of the home. Evaluate safety issues including the neighborhood in which she lives.

C,D,E

A nurse practicing in a primary care center uses the ANA's Nursing's Social Policy Statement as a guideline for practice. Which purposes of nursing are outlined in this document? Select all that apply. a. A description of the nurse as a dependent caregiver b. The provision of standards for nursing educational programs c. A definition of the scope of nursing practice d. The establishment of a knowledge base for nursing practice e. A description of nursing's social responsibility f.The regulation of nursing research

C,D,E

A nurse instructor outlines the criteria establishing nursing as a profession. What teaching point correctly describes this criteria? Select all that apply. a. Nursing is composed of a well-defined body of general knowledge b. Nursing interventions are dependent upon medical practice c. Nursing is a recognized authority by a professional group d. Nursing is regulated by the medical industry e. Nursing has a code of ethics f.Nursing is influenced by ongoing research

C,E,F

Nursing students are reviewing information about health care delivery systems in preparation for a quiz the next day. Which statements describe current U.S. health care delivery practices? Select all that apply. a. Access to care depends only on the ability to pay, not the availability of services. b. The Patient Protection and Affordable Care Act provides private health care insurance to underserved populations. c. Every health insurance plan in the Health Insurance Marketplace offers comprehensive coverage, from doctors to medications to hospital visits. d. The uninsured pay for more than one third of their care out of pocket and are usually charged lower amounts for their care than the insured pay. e. Fifty years ago, half of the doctors in the United States practiced primary care, but today fewer than one in three do. f. Quality of care can be defined as the right care for the right person at the right time.

C,E,F

A nurse has identified a nursing diagnosis of "Imbalanced nutrition: less than body requirements related to continued weight loss despite adequate intake." During the implementation phase of the nursing process, which activities would be appropriate for the nurse to perform in care of this client? Select all that apply. Gather subjective and objective data. Contact a dietician to perform a calorie count. Administer 100 mL of nutritional supplement as ordered at bedtime. Ask the family to bring in a home-cooked meal. Change the outcome to denote an increase in body weight.

Contact a dietician to perform a calorie count. Ask the family to bring in a home-cooked meal. Administer 100 mL of nutritional supplement as ordered at bedtime.

A nurse is counseling an older woman who has been hospitalized for dehydration secondary to a urinary tract infection. The patient tells the nurse: "I don't like being in the hospital. There are too many bad bugs in here. I'll probably go home sicker than I came in." She also insists that she is going to get dressed and go home. She has the capacity to make these decisions. What is the legal responsibility of the nurse in this situation? To inform the patient that only the primary health care provider can authorize discharge from a hospital To collect the patient's belongings and prepare the paperwork for the patient's discharge To request a psychiatric consult for the patient and inform her PCP of the results To explain that the choice carries a risk for increased complications and make sure that the patient has signed a release form

D

A nurse is formulating a clinical question in PICOT format. What does the letter P represent? a. Comparison to another similar protocol b. Clearly defined, focused literature review of procedures c. Specific identification of the purpose of the study d. Explicit descriptions of the population of interest

D

A student nurse asks an experienced nurse why it is necessary to change the patient's bed every day. The nurse answers: "I guess we have just always done it that way." This answer is an example of what type of knowledge? A.Instinctive knowledge B. Scientific knowledge C. Authoritative knowledge E. Traditional knowledge

D

Nurses today complete a nursing education program, and practice nursing that identifies the personal needs of the patient and the role of the nurse in meeting those needs. Which nursing pioneer is MOST instrumental in this birth of modern nursing? a. Clara Barton b. Lilian Wald c. Lavinia Dock d.Florence Nightingale

D

The family of a patient who has just died asks to be alone with the body and asks for supplies to wash the body. The nurse providing care knows that the mortician usually washes the body. Which response would be most appropriate? Inform the family that there is no need for them to wash the body since the mortician typically does this. Explain that hospital policy forbids their being alone with the deceased patient and that hospital supplies are to be used only by hospital personnel. Give the supplies to the family but maintain a watchful eye to make sure that nothing unusual happens. Provide the requested supplies, checking if this request is linked to their religious or cultural customs and asking if there is anything else you can do to help.

D

The role of nurses in today's society was influenced by the nurse's role in early civilization. Which statement best portrays this earlier role? a. Women who committed crimes were recruited into nursing the sick in lieu of serving jail sentences. b. Nurses identified the personal needs of the patient and their role in meeting those needs. c. Women called deaconesses made the first visits to the sick, and male religious orders cared for the sick and buried the dead. d.The nurse was the mother who cared for her family during sickness by using herbal remedies.

D

The nurse has noted that a dying client is increasingly withdrawn and is often teary at various times during the day. The nurse recognizes that the client may be experiencing which of Kübler-Ross's stages of grief? Bargaining Denial Anger Depression

Depression

A parent has brought a 6-year-old child into the clinic. The parent is concerned that the child does not seem to skip as well as the other children in the child's class. In planning assessments and care for this child, the nurse would be best served by choosing which theory as a foundation for decision making? Maslow's theory Developmental theory Adaptation theory General systems theory

Developmental theory

Beneficence

Doing good or causing good to be done; kindly action

Identify the FOUR elements of liability

Duty, Breach of Duty, Causation, and Damages

A home health nurse performs a careful safety assessment of the home of a frail older adult to prevent harm to the patient. The nurse's action reflects which principle of bioethics? Autonomy Beneficence Justice Fidelity Nonmaleficence

E

The growth in home health care is largely attributed to which factor? The inability of hospitals to care for an increasing number of clients Nurses' desire to work in the community The nursing shortage in hospitals Early discharge of clients from the hospital setting

Early discharge of clients from the hospital setting

A nurse wants to call an ethics consult to clarify treatment goals for a patient no longer able to speak for himself. The nurse believes his dying is being prolonged painfully. The patient's doctor threatens the nurse with firing if the nurse raises questions about the patient's care or calls the consult. What ethical conflict is this nurse experiencing? Ethical uncertainty Ethical distress Ethical dilemma Ethical residue

Ethical Distress

A nurse studies the culture of Native Alaskans to determine how their diet affects their overall state of health. Which method of qualitative research is the nurse using? Historical Ethnography Grounded theory Phenomenology

Ethnography

Research has demonstrated that a common source of hospital-acquired infections in clients with intravenous (IV) infusions is the hub on the IV tubing. Which nursing practice competency is displayed when health care institutions recommend that health care providers always wash hands and wear gloves when accessing the hubs of IV tubing? Evidence-based practice Informatics Person-centered care Teamwork and collaboration

Evidence-based practice

Malpractice

Failure by a health professional to meet accepted standards

single-payer system

Government run healthcare system. Healthcare system is made up of a) cost, b) access and c) quality.

The designated charge nurse on the telemetry unit organizes and facilitates the unit meetings; however, during most of the meetings, another registered nurse runs the show and influences staff decisions just by her charisma and personality. Her power to lead is defined by which of the following terms? Implied Democratic Situational Explicit

Implied

The nurse is documenting a variance that has occurred during the shift. This report will be used for quality improvement to identify high-risk patterns and, potentially, to initiate in-service programs. This is an example of which type of report? Nurse's shift report Transfer report Incident report Telemedicine report

Incident report

A nurse incorporates the "five values that epitomize the caring professional nurse" (identified by the American Association of Colleges of Nursing) into a home health care nursing practice. Which attribute is best described as acting in accordance with an appropriate code of ethics and accepted standards of practice? Altruism Autonomy Human dignity Integrity

Integrity

A home care nurse has completed a home assessment. Of the following findings, which should be reported to service providers immediately? Smell of natural gas Unclean environment Diminished food sources Infestation with roaches

Smell of natural gas

Preferred Provider Organization (PPO)

group of healthcare providers that provide services to a specific group, often at a reduced rate

A nurse educator is discussing the role of nursing based on the American Nurses Association (ANA). Which statement best describes this role? It is the role of the physician, not the nurse, to assist clients in understanding their health problems. It is the role of nursing to provide a caring relationship that facilitates health and healing. Nursing is a profession dependent upon the medical community as a whole. The essential components of professional nursing care are strength, endurance, and cure.

It is the role of nursing to provide a caring relationship that facilitates health and healing.

A charge nurse meets with staff to outline a plan to provide transcultural nursing care for patients in their health care facility. Which theorist promoted this type of caring as the central theme of nursing care, knowledge, and practice? Madeline Leininger Jean Watson Dorothy E. Johnson Betty Newman

Madeline Leininger

A nurse provides a patient with a heating pad and gets busy and forgets to monitor the patient and the patient ends up sustaining a burn as a result of the heating pad. Is this an example of negligence or malpractice?

Malpractice

This provides health coverage to those 65+ or those with qualifying health conditions

Medicare

A nurse is reading a journal article about providing individualized care. Which aspect would the nurse most likely read about as the almost universally accepted method for providing nursing care? Clinical reasoning Reflection Experience Nursing process

Nursing process

advanced care planning

process of planning for future care in the event a person becomes unable to make his or her own decisions

Patient is admitted with respiratory distress with the following orders: start a PIV & initiate IV fluids, administer albuterol via nebulizer, administer solu-medrol IV, give O2 via nasal cannula at 4L/min. Which order do you initiate FIRST?

Oxygen

A student nurse interacting with patients on a cardiac unit recognizes the four concepts in nursing theory that determine nursing practice. Of these four, which is most important? Person Environment Health Nursing

Person

When doing discharge planning for an older adult client who had a stroke, what is the nursing priority? Realize that goals may not be met after discharge. Plan reachable goals with the client and family. Help the client after discharge to establish goals. Involve the family in discussing when the client will go home.

Plan reachable goals with the client and family.

collective bargaining

Process by which a union representing a group of workers negotiates with management for a contract

The nurse is caring for an obese client who needs to be turned every 2 hours. Which action by this nurse is an example of reflection-for-action? During the first attempt to turn the client, the nurse realizes the need for assistance and calls the front desk for help. Reflecting on prior experience and best practice, the nurse includes assistance with turning in the client's plan of care. After turning the client alone, the nurse realizes that the nurse should have insisted on having help. The nurse decides to turn the client every 4 hours because everyone is too busy to help.

Reflecting on prior experience and best practice, the nurse includes assistance with turning in the client's plan of care.

A pediatric nurse is assessing a 5-year-old boy who has dietary modifications related to his diabetes. His parents tell the nurse that they want him to value good nutritional habits, so they decide to deprive him of a favorite TV program when he becomes angry after they deny him foods not on his diet. This is an example of what mode of value transmission? Modeling Moralizing Laissez-faire Rewarding and punishing

Reward and punishing

justice

process that distributes benefits, risks, and costs fairly

The charge nurse is reviewing SOAP format documentation with a newly hired nurse. What information should the charge nurse discuss? Objective data are what the client states about the problem. The plan includes interventions, evaluation, and response. Abnormal laboratory values are common items that are documented. Subjective data should be included when documenting.

Subjective data should be included when documenting.

A charge nurse on a medical-surgical unit is asked by the nurse manager to serve as a mentor to another staff nurse who is less experienced. Which of these would best describe this role? The staff nurse is learning about all the hospital policies from the charge nurse. The staff nurse is orienting to the unit as a newly hired nurse. The charge nurse is being paid to supervise the staff nurse. The charge nurse is providing support for the staff nurse in new responsibilities.

The charge nurse is providing support for the staff nurse in new responsibilities.

A family brings the client to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure? The nurse informs the family about advance directives. The nurse confirms that the client has signed the consent form. The nurse informs the family about the living will. The nurse confirms that the client's family has signed the consent form.

The nurse confirms that the client's family has signed the consent form.

Which finding from a nursing audit reflects high standards for client safety and institutional health care? The nurse fails to adequately complete data on clients' health histories and discharge planning. The nurse documents clients' responses to nursing interventions. The nurse records inappropriate nursing interventions. The nurse fails to identify the nursing diagnoses or clients' needs.

The nurse documents clients' responses to nursing interventions.

A veteran nurse, pleaded guilty to a misdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into a coma during routine outpatient hernia surgery. The nurse admitted failing to monitor the woman's vital signs during the procedure. The surgeon who performed the procedure called the nurse's action pure negligence, stating that the patient could have been saved. The patient was a vibrant grandmother of 10 who had walked three quarters of a mile the morning of her surgery and had sung in her church choir the day before. What criteria must be established to prove that the nurse is guilty of malpractice or negligence in this case? The surgeon who performed the procedure called the nurse's action pure negligence, saying that the patient could have been saved. The fact that this patient should not have died since she was a healthy grandmother of 10, who was physically active and involved in her community. The nurse intended to harm the patient and was willfully negligent, as evidenced by the tragic outcome of routine hernia surgery. The nurse had a duty to monitor the patient's vital signs, and due to the nurse's failure to perform this duty in this circumstance, the patient died.

The nurse had a duty to monitor the patient's vital signs, and due to the nurse's failure to perform this duty in this circumstance, the patient died.

A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the physician is late for another visit, the physician requests that the nurse write down the order for the physician. What should be the appropriate nursing action in this situation? The nurse should remind the physician later to write the work order. The nurse should inform the client of the change in medication. The nurse should ask the physician to come back and write the order. The nurse should write the order and implement it.

The nurse should ask the physician to come back and write the order.

Which of the following is the central theme in theoretical frameworks of nursing? The person receiving the care The health care environment The nursing plan The person providing the care

The person receiving the care

Mindfulness

The state of being alert and mentally present for one's everyday activities.

The nursing process is based upon the process of problem solving. The nurse attempts to obtain a blood pressure on the client's right arm, then on the left arm, then on the left leg, and finally on the right leg, where the blood pressure is obtained. What type of problem solving did the nurse use? Critical thinking Intuitive thinking Trial-and-error problem solving Scientific problem solving

Trial-and-error problem solving

True or False: Traditional and authoritative knowledge are practical to implement, but are often based on subjective data, limiting their usefulness in a wide variety of settings

True

Newly hired nurses in a busy suburban hospital are required to read the state nurse practice act as part of their training. Which topics are covered by this act? Select all that apply. Violations that may result in disciplinary action Clinical procedures Medication administration Scope of practice Delegation policies Medicare reimbursement

Violations that may result in disciplinary action, Scope of Practice

When would it be appropriate for the nurse to initiate discharge planning with a client who will be discharged the next morning? When the client is being triaged During chest radiography When the client is signing consent forms When providing preoperative education related to a scheduled cataract extraction

When providing preoperative education related to a scheduled cataract extraction

concept

a mental grouping of similar objects, events, ideas, or people

incident report

a report of any event that is not consistent with the routine operation of the healthcare facility that results in or has the potential to result in harm to a patient, employee, or visitor

Professional Identity

a sense of oneself that is influenced by characteristics, norms, and values of the nursing discipline, resulting in an individual thinking, acting, and feeling like a nurse.

ethical dilemma

a situation in which you have to decide whether to pursue a course of action that may benefit you or your organization but that is unethical or even illegal

clinical reasoning

a specific term usually referring to ways of thinking about patient care issues (determining, preventing, and managing patient problems); for reasoning about other clinical issues (e.g., teamwork, collaboration, and streamlining work flow); nurses usually use critical thinking

nursing ethics

a subset of bioethics; formal study of ethical issues that arise in the practice of nursing and of the analysis used by nurses to make ethical judgments

respite care

a type of care provided for caregivers of homebound ill, disabled, or elderly patients

tort

a wrong committed against a person or the person's property

moral agency

ability to behave in an ethical way, to do the ethically right thing because it is the right thing to do

dysfunctional grief

abnormal or distorted grief that may be either unresolved or inhibited

utilitarian

action-guiding theory of ethics that states that the rightness or wrongness of an action depends on the consequences of the action

Outcome and Assessment Information Set (OASIS)

assessment instrument representing core items of a comprehensive assessment for adult nonmaternity home care patients and forms the basis for measuring patient outcomes for the purpose of improving the quality of care that is provided

A nurse caring for patients in an institutional setting expresses a commitment to social justice. What action best exemplifies this attribute? Providing honest information to patients and the public Promoting universal access to health care Planning care in partnership with patients Documenting care accurately and honestly

b

A nurse who is working in a hospital setting uses value clarification to help understand the values that motivate patient behavior. Which examples denote "prizing" in the process of values clarification? Select all that apply. A patient decides to quit smoking following a diagnosis of lung cancer. A patient shows off a new outfit that she is wearing after losing 20 pounds. A patient chooses to work fewer hours following a stress-related myocardial infarction. A patient incorporates a new low-cholesterol diet into his daily routine. A patient joins a gym and schedules classes throughout the year. A patient proudly displays his certificate for completing a marathon.

b & f

actual loss

can be recognized by others

private law

civil law; regulates relationships among people

standards for critical thinking

clear, precise, specific, accurate, relevant, plausible, consistent, logical, deep, broad, complete, significant, adequate (for the purpose), and fair

entitlement reform

proposed legislation making changes in entitlement benefits, such as Medicare and Medicaid, paid by the government to citizens, with the goal of improving the nation's budget

Change of shift report

communication method used by nurses who are completing care for a patient to transmit patient information to nurses who are about to assume responsibility for continuing care; may be exchanged verbally in a meeting or audiotaped

criminal law

concerns state and federal criminal statues

anticipatory loss

condition in which a person displays loss and grief behaviors for a loss that has yet to take place

care coordination

coordination of services provided to patients before they enter a health care setting, during the time they are in the setting, and after they leave the setting

continuity of care

coordination of services provided to patients before they enter a health care setting, during the time they are in the setting, and after they leave the setting

competency

delivering safe, quality nursing care based on professional standards

moral resilience

developed capacity to respond well to morally distressing experiences and to emerge strong

nursing theory

differentiates nursing from other disciplines and activities by serving the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices

Nonmaleficence

do no harm

variance charting

documentation method in case management that records unexpected events, the cause for the event, actions taken in response to the event, and discharge planning when appropriate

source oriented record

documentation system in which each health care group records data on its own separate form

primary health care

emphasizes health promotion, and includes prenatal and well-baby care, nutrition counseling, and disease control. is based on a sustained partnership between client and provider. examples include office or clinic visits and scheduled school/work centered screenings (vision, hearing, obesity)

deontologic

ethical system in which actions are right or wrong independent of the consequences they produce

nursing process

five-step systematic method for giving patient care; involves assessing, diagnosing, planning, implementing, and evaluating

credentialing

general term that refers to ways in which professional competence is maintained

public law

government is directly involved; regulates relationships between individuals and government

evidence based practice guideline

guidelines written by a panel of experts that synthesize information from multiple studies and recommend best practices to treat patients with a disease, a symptom, or a disability

According to the Health Insurance Portability and Accountability Act (HIPAA) passed in 1996, clients: need to obtain legal representation to update their health records. have the right to copy their health records. are required to obtain health record information through their insurance company. can be punished for violating guidelines.

have the right to copy their health records.

ambulatory care

health care settings located in areas that are convenient for people to walk into and receive care; may be provided in hospitals, clinics, or centers

Secondary health care

includes the diagnosis and treatment of emergency, acute illness, or injury. examples include care given in hospital settings (inpatient and EDs), diagnostic centers, or emergent care centers

whistle-blowing

informing the press or government officials about unethical practices within one's organization

fidelity

keep promises

Nurse Practice Act

law established to regulate nursing practice

common law

law resulting from court decisions that is then followed when other cases involving similar circumstances and facts arise; common law is as binding as civil law

litigation

lawsuit

liability

legal responsibility

morals

like ethics, concerned with what constitutes right action; more informal and personal than the term ethics

physical loss

loss of life, limb, an object, person, pet, or job

perceived loss

loss of youth, of financial independence, and of a valued environment experienced by a person, but intangible to others

psychological loss

loss that affects a person's self-image

SOAP format

method of charting narrative progress notes; organizes data according to subjective information (S), objective information (O), assessment (A), and plan (P)

expert witness

nurse who explains to the judge and jury what happened based on the patient's record and who offers an opinion as to whether the nursing care met acceptable standards of practice

fact witness

nurse who has knowledge of the actual incident prompting a legal case; bases testimony on firsthand knowledge of the incident, not on assumptions

ethical distress

occurrence when the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action

Reflective Practice

occurs when the caregiver has a profound awareness of self, and one's own biases, prejudgments, prejudices, and assumptions, and understands how these may affect the therapeutic relationship

Negligence

performing an act that a reasonably prudent person under similar circumstances would not do, or failing to perform an act that a reasonably prudent person under similar circumstances would do

plantiff

person or government bringing a lawsuit against another

patient navigator

person without a clinical background, who assist the patient with scheduling, financial assistance, psychosocial support, and community support

code of ethics

principles that reflect the primary goals, values, and obligations of the profession

Reciprocity

process allowing a nurse to apply for and be endorsed as a registered nurse by another state

Accredidation

process by which an educational program is evaluated and then recognized as having met certain predetermined standards of education

values clarification

process by which people come to understand their own values and value system

Public health nursing is the branch of nursing that: provides health care for the community. provides primary care to individuals. assesses individuals for community care. administers care for a defined geographic community.

provides health care for the community.

clinical judgement

refers to the result (outcome) of critical thinking or clinical reasoning; the conclusion, decision, or opinion a nurse makes

conscientious objection

refusal to participate in certain types of treatment and care based on the fact that these activates violate the nurses personal and professional ethical beliefs and standards

Community Health Centers

regionalized services for vulnerable geographic populations with an emphasis on primary care and education

quantitative research

research that collects and reports data primarily in numerical form

qualitative research

research that relies on what is seen in field or naturalistic settings more than on statistical data

applied research

scientific study that aims to solve practical problems

systematic review

summarized findings from multiple studies of a specific clinical practice question or topic that recommend practice changes and future directions for research; one of the strongest sources of evidence for evidence-based practice

discharge planning

systematic process of preparing the patient to leave the health care facility and for maintaining continuity of care

euthanasia

the act of painlessly killing a suffering person or animal; mercy killing

blended competencies

the set of intellectual, interpersonal, technical, and ethical/legal capacities needed to practice professional nursing

critical thinking

thought that is disciplined, comprehensive, based on intellectual standards, and, as a result, well-reasoned; a systematic way to form and shape one's thinking that functions purposefully and exactingly

assault

threat or attempt to make bodily contact with another person without that person's permission

Licensure

to be given a license to practice nursing in a state or province after successfully meeting requirements

patient handoff

transferring responsibility for a patient from one caregiver to another with the goal of providing timely, accurate information about a patients plan of care, treatment, current condition, and anticipated changes

secondary traumatic stress

trauma that health care providers experience when witnessing and caring for others suffering trauma

occurrence charting

use in case management model When a patient fails to meet an expected outcome or a planned intervention is not implemented,

Evidence-based care emphasizes decision making based on the best available evidence and: evaluation by experts to direct care in specialty areas. care based on pathophysiologic factors. use of outcome studies to guide decisions. cost efficiency of treatment models.

use of outcome studies to guide decisions.

Select the best description of how the nurse applies the nursing process in caring for clients. The nurse: applies intuition and routine care for clients. employs communication to meet the client's needs. uses critical thinking to direct care for the individual client. uses scientific problem solving to meet client problems.

uses critical thinking to direct care for the individual client.

Collaborative practice

what happens when multiple health workers from different professional backgrounds work together with patients, families, careers, and communities to deliver the highest quality of care

The nursing student is learning how to care for clients whose death is expected within a limited period of time. Which statement makes the faculty member believe the student has mastered this topic? "Many clients know they have a terminal illness by picking up on nonverbal communication." "Health care personnel should not discuss the client's condition with the client's grieving family members." "Competent clients do not have the right to refuse life-sustaining treatment." "Clients and their families should be told their diagnosis and prognosis without regard to cultural influences."

"Many clients know they have a terminal illness by picking up on nonverbal communication."

A nurse is conducting a class about health care trends for a group of newly graduated registered nurses at the community hospital. Which of the following six trends stated by the nurse reflects the Institute of Medicine's (IOM) focus? "The system should be safe, efficient, centralized, wellness promoting, government driven, and patient centered." "The system should be safe, effective, efficient, patient centered, timely, and equitable." "The system should be flexible, patient centered, bureaucratic, timely, safe, and efficient." "The system should be static, reliable, timely, equitable, efficient, and illness focused."

"The system should be safe, effective, efficient, patient centered, timely, and equitable."

The daughter of an older client is concerned that her mother is depressed because she is reading the obituaries every day. What is the most appropriate nursing response? "This indicates that your mother is entering into the bargaining stage of grief." "This is a sign of impending death and we need to notify the provider." "This is a clear indicator that your mother is depressed." "This is common in older adults and doesn't necessarily indicate depression."

"This is common in older adults and doesn't necessarily indicate depression."

After reporting to work for a night shift, the nurse learns that the unit is understaffed because two RNs called out sick. As a result, each nurse on the unit must provide care for four acute clients in addition to the nurse's regular clients. Which statement is true for this nurse when working in understaffed circumstances? The nurse is legally held to the same standards of care as when staffing levels are normal. Understaffing constitutes an extenuating circumstance that creates a temporarily lower expectation for care for the nurse. The nurse must document that float staff, nurses on overtime, and part-time staff were contacted in an effort to fill the gaps in care. The nurse is legally obliged to refuse to provide care when understaffing creates the potential for unsafe conditions.

The nurse is legally held to the same standards of care as when staffing levels are normal.

Which statement is true when comparing home care with acute care? The client directs the education of all caregivers. The nurse directs all aspects of the home. The nurse and the client work independently of each other. The nurse is the guest in the client's home.

The nurse is the guest in the client's home.

Which action would cause a charge nurse to have concerns about a nurse's moral agency? The nurse often must stay after shift change to complete documentation. A family member complained that the nurse was slow answering call lights. The nurse was unable to pass a required dosage calculation examination. The nurse was seen at a grocery store after calling in sick.

The nurse was seen at a grocery store after calling in sick.

How can a nurse best protect themselves from legal litigation?

Thorough, accurate, & timely DOCUMENTATION

A nurse working in a long-established hospital learned a specific approach to administering intravenous injections from the previous generation of nurses at the hospital. This is an example of which type of knowledge? Scientific knowledge Traditional knowledge Authoritative knowledge Philosophy knowledge

Traditional knowledge

Which aspect of the nursing research process addresses a client's understanding of the potential risks and benefits of the study? Meeting with the hospital's institutional review board (IRB) Undergoing the informed consent process with the client Giving the client the opportunity to ask questions about the study Obtaining the client's signature on a permission document

Undergoing the informed consent process with the client

The husband of a client who has died cannot express his feelings of loss and at times denies them. His bereavement has extended over a lengthy period. What type of grief is the husband experiencing? Normal grief Unresolved grief Inhibited grief Anticipatory grief

Unresolved grief

The differences between the pro-life and abortion rights movement are an example of:

Values inquiry

A patient asks the nurse to keep their cancer diagnosis a secret from the patient's family. When the family asks the nurse about the patient's diagnosis the nurse tells them to talk with the patient and refuses to discuss the patient's health status. What moral principle is this an example of?

Veracity

What is the primary purpose of standards of nursing practice? to ensure knowledgeable, safe, comprehensive nursing care to enable nurses to have a voice in health care policy to provide a method by which nurses perform skills safely to establish nursing as a profession and a discipline

to ensure knowledgeable, safe, comprehensive nursing care

Evidence-based care emphasizes decision making based on the best available evidence and: evaluation by experts to direct care in specialty areas. use of outcome studies to guide decisions. cost efficiency of treatment models. care based on pathophysiologic factors.

use of outcome studies to guide decisions.