Med Surg I - Midterm 1 - Units 1-3
Secondary prevention
-focuses on early identification of individuals or communities experiencing illness, providing treatment, and conducting activities that are geared to prevent worsening health status
What are the five elements required to prove negligence?
1. duty to provide care as defined by a standard 2. breach of duty by failure to meet standard 3. forseeability of harm 4. breach of duty has potential to cause harm (combines elements 2 and 3) 5. harm occurs
A nurse is instructing a group of newly licensed nurses about how to know and what to expect when ethical dilemmas arise. Which of the following situations should the newly licensed nurses identify as an ethical dilemma?
A family has conflicting feelings about the initiation of enteral tube feedings for their father, who is terminally ill
It would be appropriate to delegate the taking of vital signs of which client to a UAP?
A patient being prepared for elective facial surgery with a history of stable hypertension
A nurse is acquainting a group of newly licensednurses with the roles of the various members of the health care team they will encounter on a medical-surgical unit. When providing examples of the types of tasks CNAs can perform, which of the following client activities should the nurse include? (select all that apply) A) Bathing B) Ambulating C) Toileting D) Determining pain level E) Measuring Vital signs
A, B, C, E
A client who is postoperative following knee arthroplasty is concerned about the adverse effects of the medication prescribed for pain management. Which of the following members of the interprofessional care team can assist the client in understanding the medication's effects? (Select all that apply) A) Provider B) CNA C) Pharmacist D) RN E) RT
A, C, D
A nurse is caring for a group of clients on a medical-surgical unit. For which of the following client care needs should the nurse initiate a referral for a social worker? (Select all that apply) A) A client who has terminal cancer requests hospice care in the home B) A client asks about community resources available for older adults C) A client states, "I would like to have my child baptized before surgery D) A client requests and electric wheelchair for use after discharge E) A client states, "I do not know how to use a nebulizer."
A, C, D
A patient has been admitted for acute dehydration, secondary to nausea and diarrhea. When is the best time for the nurse to conduct this client's interview and complete admission navigator?
After patient has been settled into bed and nausea symptoms minimized
A patient reports feeling hungry, but does not eat when food is served. Using clinical reasoning skills the nurse should perform which of the following?
Assess why the patient is not ingesting the food provided
A nurse is caring for a client who decides not to have surgery despite significant blockages of the coronary arteries. The nurse understands that this client's choice is an example of which of the following ethical principles?
Autonomy
Although the patient refused the procedure, the nurse insisted and inserted a nasogastric tube in the right nostril. The administrator of the hospital decides to settle the lawsuit because the nurse is most likely to be found guilty of which of the following?
Battery
A nurse offers pain medication to a client who is postoperative prior to ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principles?
Beneficence
Quasi-intentional torts include...
Breach of confidentiality and defamation of character
A client is admitted for heart failure. The nurse assesses that the client's blood pressure is below the normal range and the apical pulse is 110 bpm. The nurse knows that the increase in the client's pulse illustrates which aspect of the client's homeostatic mechanism?
Compensation
A goal for a client who has difficulty with self-feeding due to rheumatoid arthritis is to use adaptive devices. The nurse caring for the client should initiate a referral to which of the following members of the interprofessional care team? A. Social worker B. Certified nursing assistant C. Registered dietitian D. Occupational therapist
D. Occupational Therapist
In the clinical reasoning process, the nurse sets and weighs the criteria, examines alternatives, and performs which of the following before implementing a plan?
Determines the logical course of action should intervening problems arise
Breach of confidentiality is...
Disclosure of information without proper authorization.
Malpractice is...
Failure by a health professional to meet accepted standards
Quaternary Care
Highly specialized healthcare services offered at large hospitals; quaternary care may involve experimental treatments and procedures
A nurse is teaching a group of nurses and asks which of the NLN integrating competencies is defined as having respect for diversity, holistic care, client-centered approach, and client advocacy. Which of the following competencies does this describe?
Human flourishing
A nursing student is employed and working as an unlicensed assistive personnel (UAP) on a busy surgical unit. The nurses know that the UAP is enrolled in a nursing program and will be graduating soon. A nurse asks the UAP if he has performed a urinary catheterization on patients while in the nursing program. When the UAP says "Yes," the nurse asks him to help her out by doing a urinary catheterization on a postsurgical patient. What is the best response by the UAP?
I can't do it. Is there something else I can help you with?
When making rounds, the nurse finds a patient on the floor in the hall. What should be the nurse's first response?
Inspect the patient for injury
Batter occurs when...
Intentional and wrongful physical contact with a person that involves injury or offensive contact
A nurse is instructing a group of newly licensed nurses about the responsibilities organ donation and procurement involve. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the newly licensed nurses should understand that this aspect of care delivery is an example of which of the following ethical principles?
Justice
Types of Advanced directives include...
Living will, DPA for h
The patient has a high priority nursing diagnosis of "risk for impaired skin integrity" related to the need for several weeks of imposed bed rest. The nurse evaluates the patient after 1 week and finds the skin integrity is not impaired. When the care plan is reviewed, the nurse should perform which of the following?
Modify the nursing diagnosis to impaired mobility
A nurse questions a medication prescription as too extreme in light of the client's advanced age and unstable status. The nurse understands that this action is an example of which of the following ethical principles?
Nonmaleficence
A nurse is explaining to a newly licensed nurse that caring for clients involves lifelong learning by the nurse. The nurse should include which of the following as examples of learning opportunities for nurses? (select all that apply) Nursing blogs/opinions Online continuing education journal articles Nursing skill refresher opportunities Continuing education presentations Participating in healthcare research
Online continuing education journal articles Nursing skill refresher opportunities Continuing education presentations Participating in healthcare research
During the first day a nurse is caring for a patient who has been in the hospital for two days, the nurse thinks that the patient's BP seems high. What is the next step?
Reassess on other arm and review the graphic record on the patient's record
A nurse at a clinic is providing free BP screenings for clients. Which of the following levels of health prevention is the nurse demonstrating?
Secondary Prevention
The nurse reports that the client has dyspnea when ambulating. The nurse is most likely to have assessed which of the following?
Shortness of breath
A client who had a CVA has persistent problems with dysphagia. The nurse caring for the client should initiate a referral with which one of the following members of the interprofessional care team?
Speech-language pathologist
A nurse is providing client care using the nursing process. The nurse should identify that which of the following standards or guidelines includes this criterion.
Standards of practice
A nurse is teaching a group of guardians about primary prevention techniques. Which of the following topics should the nurse include as an example of primary prevention?
Taking measures to decrease the risk of childhood injuries within home
A nurse is reviewing the Institute of Medicine (IOM) Future of Nursing report to better understand proposed educational requirements of nurses. Which of the following organizations is responsible for publishing this report?
The national academy of medicine
A nursing student expresses a desire to become more involved with the nursing profession on a national level. Which of the following organizations should the student join?
The national student nurses' association
During a shift assessment, the nurse notes that the patient's pedal pulses are not palpable. What would the next intervention be?
Use a doppler to assess pedal pulses
Defamation of character is...
Wrongfully hurting a person's good reputation. The law imposes a general duty on all persons to refrain from making false, defamatory statements about others.
A nurse is teaching about Medicaid to a client who is concerned about paying for health care. Which of the following statements should the nurse make?
Your income will determine if you are eligible for Medicaid
Nonmaleficence is...
a commitment to do no harm
Veracity is....
a commitment to tell the truth
False imprisonment occurs when...
a person is confined or restrained against their will
Beneficence is...
action that promotes good for others, without any self-interest
Intentional Torts include....
assault, battery, false imprisonment
Negligence is...
careless neglect, often resulting in injury
What does an advanced directive do?
communicates client's wishes regarding end-of-life care should the client become unable to do so
Critical Thinking
directed, purposeful, mental activity by which ideas are evaluated, plans are constructed, and desired outcomes are decided
Tertiary Prevention
effort to control a health issue that has already occurred by slowing the spread or lessening the effects of the health issue
Justice is...
fairness in care delivery and use of resources
Primary prevention
focuses on decreasing the risk for the development of medical conditions by changing behaviors or minimizing exposures
Fidelity is....
fulfillment of promises
A nurse is caring for a client who tells the nurse they want to quit smoking. The nurse provides the client with information about smoking cessation and other ways to improve their health. Which of the following nursing roles is the nurse demonstrating? (select all that apply) Advocate Collaborator Change Manager Health Promoter Nurse educator
health promoter and nurse educator
Unintentional torts include...
negligence and malpractice
What is informed consent?
permission granted in the knowledge of the possible consequences, typically that which is given by a patient to a doctor for treatment with full knowledge of the possible risks and benefits.
What are values?
personal beliefs about ideas that determine standards that shape behavior
What are morals?
personal values and beliefs about behavior and decision making
Assault occurs when...
the conduct of one person makes another person fearful and apprehensive
Patient Autonomy is...
the right to make one's own decisions, even when those decisions might not be in that person's own best interest
What is ethics?
the study of conduct and character