PNC Exam #3

The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is:

"As the disease progresses, you will most likely require renal replacement therapy."

A hospital uses the SOAP method of charting. Within this model, which of the nurse's statements would appear at the beginning of a charting entry?

"Client reporting abdominal pain rated at 8/10."

The nurse is giving discharge instructions to the client following a bladder ultrasound. Which statement by the client indicates the client understands the instructions?

"I can resume my usual activities without restriction."

After teaching a woman about breast self-examination, the nurse understands that the teaching was successful when the woman makes which statement?

"I'll do the check about a week after my period."

An informatics nurse specialist is conducting an in-service program for a group of staff nurses about this specialty. One of the nurses asks, "What exactly is nursing informatics?" Which response by the informatics nurse specialist would be most appropriate?

"It combines nursing science with information management and analytical sciences."

The nurse is talking with the mother of a 6-month-old who was born at 32 weeks' gestation about nutrition-related concerns. The mother questions the nurse about when additional foods may be added to the diet. She remarks that her older child was started on additional foods between 4 and 6 months of age. What response by the nurse is most appropriate?

"The addition of foods to your baby's diet may be slightly delayed because of his prematurity."

The mother of a Black newborn asks the nurse about the bluish-black areas she noticed around the infant's lower back and buttocks. What is the nurse's best response?

"These areas are normal and should disappear by early childhood."

A client has been given fecal occult blood test (FOBT) testing supplies. What teaching will the nurse provide about the purpose for this test?

"This test detects heme, a type of iron compound in blood in the stool."

The nursing student is discussing the benefits of electronic charting with a precepting nurse who is frustrated with computerized documentation. Which statement by the student requires intervention from the nursing instructor?

"You can make extra money with overtime pay with end-of-shift charting."

A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply.

- Ingestion of strong acids - Irritating foods - Overuse of aspirin

Which are appropriate actions for protecting clients' identities? Select all that apply.

-Documentation must be kept of personnel who have accessed a client's record. -Light boxes for examining X-rays with the client's name must be in private areas. -Conversations about clients must take place in private places where they cannot be overheard.

The nurse transcribes the physician's order onto the client's medication record: September 15, 20XX Administer 10 gtt of timolol maleate ophthalmic solution AU daily. John Bloom, MD Which components of the medication order should the nurse question? Select all that apply.

-Number of drops -Route

An informatics nurse specialist is involved in the testing of a new clinical information system that is being planned for use by the health network. The system is currently undergoing unit testing. Which information would be addressed during this phase? Select all that apply.

-The correct information appears on the screen. -All information is included. -There are no typographical errors. -Information is in its proper location on screen.

Which are examples of objective assessment information? Select all that apply.

-Vital signs, height, weight -Findings on palpation of abdomen

To be effective, percutaneous transluminal coronary angioplasty (PTCA) must be performed within what time frame, beginning with arrival at the emergency department after diagnosis of myocardial infarction (MI)?

60 minutes

Saline lavages to the nares

A client is experiencing acute viral rhinosinusitis. The nurse is providing instructions about self-care activities and includes information about

Which client may be the most appropriate candidate for telepsychiatry?

A client whose depression does not warrant inpatient or outpatient care but who is motivated to maintain the client's health

A nursing student is preparing for a debate with another student about e-mental health. Which would the nurse include to support its use?

Ability to provide services in a variety of locations

Which is the strongest predisposing factor for asthma?

Allergy

A client receives dialysis four times a week at a dialysis center. Which type of care is provided at a dialysis center?

Ambulatory care

An informatics nurse specialist has completed the evaluation of an update to a current clinical information system used by the staff at the local hospital and has documented the results. Documentation reveals the need for an improvement in the screen display. Which action would be next?

Analyze and Plan

An informatics nurse is assisting with the development of a new clinical information system that will be implemented in the facility. As part of the process, the team is evaluating the purpose of the system and the technological options available. The team is in which phase of the system development lifecycle?

Analyze and plan

The nurse is caring for a client with coronary artery disease (CAD). What is an appropriate nursing action when evaluating a client with CAD?

Assess the characteristics of chest pain.

A client has lung cancer and underwent chemotherapy and radiation treatment. The tumors continue to grow and have metastasized. The nurse assesses the client is in the dying phase of the Trajectory Model of Chronic Illness. The nurse

Assists with arranging hospice care for the client

A client's diagnosis of pneumonia requires treatment with antibiotics. The corresponding order in the client's chart should be written as

Avelox (moxifloxacin) 400 mg daily

The nurse is providing education to an English-speaking client who immigrated to the United States 2 years ago. The nurse determines that further education may be needed when the client does which action?

Changes the subject

Glulisine insulin is prescribed to be administered to a client before each meal. To assist the day-shift nurse who is receiving the report, the night-shift nurse gives the morning dose of glulisine. When the day-shift nurse goes to the room of the client who requires glulisine, the nurse finds that the client is not in the room. The client's roommate tells the nurse that the client "went for a test." What should the nurse do next?

Check the computerized care plan to determine what test was scheduled.

Why are health promotion and illness prevention a key responsibility of nurses?

Chronic illnesses are the leading health problem in the world

A nurse administers morphine sulfate as ordered for pain. The client experiences nausea and vomiting and a decrease in respiratory rate. When documenting this event in the health record, which data would be considered subjective data?

Client seems very nauseated.

A client has an elevated temperature. The nurse is applying a cool compress to his forehead. This is an example of which of the following types of heat loss?

Conduction

The hospital nurse is using barcode medication administration software when preparing to administer medication to a client. When the scanning system cannot identify the client's identity, what is the appropriate nursing action?

Contact the pharmacy and information technology department for assistance.

A nurse is documenting a client's vital signs, height, and weight in the electronic health record. Applying the framework for informatics practice, the nurse would identify these values as which component of the framework?

Data

An informatics nurse is applying the informatics framework to a clinical situation. Which component of the framework would the nurse apply first?

Data

An informatics nurse specialist is describing the framework underlying informatics practice. Which component of the framework would the nurse specialist describe as discrete entities without interpretation?

Data

An informatics nurse specialist is collecting data from the clinical information system about the demographics of individuals diagnosed with heart failure admitted to the facility over the past five years. The nurse specialist is preparing a presentation to the facility's executive board. To promote understanding of this complex information, the nurse specialist prepares the data results using a pie chart and a bar graph. The nurse specialist is using which area of analytics?

Data visualization

An informatics nurse specialist is working on a team that is considering a new technological system for the facility. Which aspect would be most important for the team to do as the firststep?

Determine the need or problem to be solved

The growth in home health care is largely attributed to which factor?

Early discharge of clients from the hospital setting

When developing a program for STI prevention, which action would need to be done first?

Educating on how to promote sexual health

An informatics nurse is evaluating a new clinical information system for usability. The nurse notes that the system requires the user to complete a maximum of 3 steps to complete a task. The system also provides shortcuts to frequent users of the system. The nurse would determine that which concept of usability is being addressed?

Efficient interactions

Which general nursing measure is used for a client with a fracture reduction?

Encourage participation in ADLs

When maintaining medical records for a client, the nurse knows that a medical record also serves as legally admissible evidence. What should the nurse do to ensure legally defensible charting?

Ensure that the client's name appears on all pages.

An informatics nurse is participating in an online continuing education course about nursing informatics. The nurse demonstrates successful comprehension of the course by identifying which individual as being considered the first informatics nurse?

Florence Nightingale

Which term refers most precisely to a localized skin infection of a single hair follicle?

Furuncle

After reading about an international effort organized to develop a map to link genetic variations and complex diseases, a client asks the nurse what this effort is called. What is the nurse's best response?

HapMap

The primary aim of the Healthy People 2030 initiative is:

Health promotion

Development of malignant melanoma is associated with which risk factor?

History of severe sunburn

An informatics nurse specialist is gathering data from electronic health records at the facility about clients who have had central venous catheters inserted for more than the recommended time as specified by the facility's protocol. The nurse specialist is collecting this data most likely for which purpose?

Identify clients at risk for infection

Which is a true statement regarding Medicaid?

It covers individuals and families with low incomes.

A nurse manager of the pediatric unit is responsible for making sure that each staff member reviews the unit policies annually. What policy should the nurse manager emphasize with the clerical support staff?

Logging off a computer containing client information

Which is the largest single source of reimbursement for home health care services?

Medicare

The nurse is preparing a presentation for a men's community group about health promotion. Which of the following would the nurse include as a current recommendation for screening?

Monthly testicular self-examination (TSE)

An informatics nurse specialist is interviewing several nurses who have participated in testing a new electronic assessment tool. The nurses report that the tool "feels so familiar, like we know exactly what it is that we're supposed to do." The nurse specialist interprets this as indicating which concept?

Naturalness

ischemia of the left ventricle

One of the most common causes of mitral valve regurgitation in people living in developed countries is

An informatics nurse specialist is involved with implementing strategies to improve the performance of the clinical information system being used. As part of this process, the nurse specialist is working on updating the plans of care in the system to reflect changes to a procedure based on new evidence. The nurse is also working to streamline the display screens to reduce the need to document the same information in three different areas. The nurse specialist is addressing which aspect of the system?

Optimization

The nurse is caring for a client with congestive heart failure. The nurse manager informs the nurse that the client was enrolled in a clinical trial to assess whether a 10-minute walk, 3 times per day, leads to expedited discharge. Which type of evaluation best describes what the researchers are examining?

Outcome

A nursing student observes the home care nurse provide education to a client with congestive heart failure (CHF). The nurse teaches the client how to read food labels and calculate sodium content. The nursing student recognizes that the home care nurse is aware of which basic principle of patient education?

Patient instruction related to self-care activities promotes patient independence.

An informatics nurse specialist is preparing a presentation for a local community group about advances in technology in health care. Part of the presentation will focus on technological advances to promote greater client participation in managing health. Which component would the nurse likely describe as playing a major role?

Patient portal

Which intervention is helpful for the neonate experiencing drug withdrawal?

Place the Isolette in a quiet area of the nursery.

Prior to the discharge of a client who is recovering from a stroke from an acute care facility, the nursing case manager has the nursing staff, client, client's family, physical therapist, and home health nurse meet. The most likely purpose of this meeting is to:

Prepare the client for home care.

The nurse is teaching a group of high school students about risk-taking behaviors. Which topic would be considered an example of healthy behaviors?

Preventative vaccinations

A nurse is immunizing children against measles. This is an example of what level of preventive care?

Primary

An employer establishes a physical exercise area in the workplace and encourages all employees to use it. This is an example of which level of health promotion?

Primary prevention

The nurse is working in an ambulatory health clinic. What is the focus of community-based nursing practice?

Promoting and maintaining population health and preventing and minimizing disease progress

The nurse is preparing to teach a client about a newly prescribed medication. The client lacks insurance. The medication costs approximately $100 per month. The client states, "I can't afford it." The nurse assesses a variable to successful education and health promotion for this client based on the Health Belief Model is

Resources

To ensure ethical nursing care when dealing with genetic and genomic information, which principle would the nurse integrate as the foundation for all nursing care?

Respect for people

A nurse is preparing to administer cardiac medications to two clients with the same last name. The nurse checks the medication three times before entering the room to administer medications to the first client. While leaving the room, the nurse realizes they didn't check the client's identification before administering the medication. Which action should the nurse take first?

Return to the room, check the client's identification against the medication administration record, and complete a variance report if needed.

Which symptom occurs in the client diagnosed with mitral regurgitation when pulmonary congestion occurs?

Shortness of breath

The nursing student is having difficulty obtaining a mobile computer for the purpose of administering medications using the electronic medical record. The student has been reprimanded for delivering medications late in the past and wants to ensure timely administration. What action should the student take?

Speak to the instructor about the unavailability of mobile computers for medication administration, and request assistance in obtaining one.

A nurse cares for a client who is post op from bariatric surgery. Once able, the nurse encourages oral intake for what primary purpose?

Stimulate GI peristalsis

You are the nurse employed in an acute care hospital. The head nurse states that you will be caring for 12 clients with the help of two nurse assistants. This is considered to be what type of nursing care delivery?

Team nursing

A client is scheduled for a diagnostic test to measure blood hormone levels. The nurse expects that this test will determine which of the following?

The functioning of endocrine glands

Parents of a preschool-age child ask the nurse about nutrition. Which statement about a preschooler's nutritional requirements is accurate?

The quality of food that a preschooler consumes is more important than the quantity.

A young client is being seen by a pediatric ophthalmologist due to a recent skateboarding accident that resulted in trauma to the right cornea, and is now at risk of developing an infection. Which nursing intervention would be contraindicated for a client at risk for infection?

To ensure correct application of antibiotic ointment, gently drag tip of tube along lower lid while squeezing ointment on to lid.

Which drug is a topical corticosteroid used to treat psoriasis?

Triamcinolone

Several nurses are discussing their impressions of the newly implemented electronic health record with an informatics nurse specialist. They say, "There is so much information on one screen, it hard to tell what we should do first. It's not really clear." The informatics nurse specialist interprets the comments as reflecting an issue with which area?

Usability

An informatics nurse specialist is conducting an in-service education program for a group of staff nurses. The topic is ensuring electronic client data is secure and private. The specialist determines that the teaching was successful when the group identifies which aspect as essential to ensuring the security of electronic data when using clinical systems?

Use of strong passwords

Which strategy would provide the most effective form of change of shift report?

Utilizing a reporting form and allowing time for any questions.

The nurse is working with a group of caregivers of children in a community setting. The topic of hospitalization and the effects of hospitalization on the child are being discussed. Which statement made by the caregivers supports the most effective way for children to be educated about hospitals?

We are going to take our child to an open house at the hospital so she can see the pediatric unit.

A client with newly diagnosed type 2 diabetes is admitted to the metabolic unit. The primary goal for this admission is education. Which goal should the nurse incorporate into her teaching plan?

Weight reduction through diet and exercise

A nurse takes specific elements from the electronic health record and then interprets and organizes them to identify relationships. The nurse applies understanding of the relationships to client care situations to enhance client care delivery. The nurse's action reflects which component of the informatics framework?

Wisdom

The most common symptom of esophageal disease is

dysphagia

A physician enters a computer order for a nurse to irrigate a client's nephrostomy tube every 4 hours to maintain patency. The nurse irrigates the tube using sterile technique. After irrigating the tube, the nurse decides that she can safely use the same irrigation set for her 8-hour shift if she covers the set with a paper, sterile drape. This action by the nurse is

inappropriate because irrigation requires strict sterile technique.

Which measurements were most likely obtained from a normal newborn born at 38 weeks to a healthy mother with no maternal complications?

weight = 3500 g, length = 20 inches (51 cm), head circumference = 34 cm, and chest circumference = 32 cm