THEORY Exam 2

List the three attributes of safety

-Knowledge -Skills -Attitudes

list the 4 interrelated concepts of safety

-health care quality ** this overlaps with safety -communication -Collaboration -care coordination

A study by the Institute of Medicine (IOM) reported that medication errors harmed _______________ people every year. The additional medical cost of treating drug-related injuries in the hospital was at least ____________ per year.

1.5 million $ 3.5 billion (Zerwick text)

________ human development is organized, progressive, and follows a predicated sequenced A) Expected B) Delayed D) Advanced

A) Expected

NCLEX question: A 17-year old girl and her mother are both in the exam room for the girl's school physical. Before asking the girl about her sexual history, which statement should the nurse make? A. "mother, I am going to ask you to step out, so I can complete health history B. "Mother, do you think your daughter is sexually active" C. "The two of you seem close, so I will ask a question about sexual history now" D. "Do you think your mother should leave the room now"

A. "mother, I am going to ask you to step out, so I can complete health history Confidentiality and privacy are critical developmental needs for the adolescent. The nurse should respect these needs in order to establish a relationship of trust with the client. A sexual history should be conducted privately with a teen. Therefore, the nurse should ask the mother to leave for a few minutes. The nurse should also avoid putting the daughter in an uncomfortable position of having to ask her mother to step out. Before starting the sexual history, tell the teen that this information is confidential, and will not be shared with parents. Also, inform the client that issues of abuse or life-threatening matters are required by law to be disclosed to the authorities.

Formal patient education courses or classes would be the most appropriate strategy to A. Address needs common to a group. B. Explain self-directed learning. C. Describe nursing interventions. D. Respond to questions of a patient's family.

A. Address needs common to a group.

Interrelated concepts regarding patient attributes and preferences that a nurse would consider when addressing patient education include A. Adherence. B. Health promotion. C. Quality. D. Technology.

A. Adherence. Adherence, culture, developmental level, family dynamics, and motivation are considered interrelated concepts regarding patient attributes and preferences. Interrelated concepts regarding the professional role of a nurse include health promotion, leadership, technology and informatics, quality, collaboration, and communication

The nurse accidentally administers the wrong dose of blood pressure medication to a patient. The patient becomes moderately hypotensive and the Physician and nurse must intervene right away to correct this. This is an example of? A. Adverse event B. Near miss C. Sentinel event D. Latent event

A. Adverse event Adverse event refers to unintended harm by an act of commission or omission of rather than a result of a disease process Near miss is an error of commission or omission that could have harmed a patient but harm did not occur as a result of chance Sentinel event is an unexpected occurrence involving death or serious injury

When planning the evaluation of a teaching activity that has the goal of educating a patient and family about the long-term effects of diabetes, it would be most appropriate for the nurse to include an opportunity for the patient to A. Ask questions. B. Inject insulin. C. Meet exercise goals. D. Prepare a menu.

A. Ask questions.

Mentally competent patient who has been warned to use a call light but instead crawls out of bed and thus injures herself....this is an example of? A. Assumption of the risk B. statute of limitations C. Contributory negligence

A. Assumption of the risk (Zerwirk Text)

In what ways can a nurse prevent medication errors? Select all that apply. A. Avoid using abbreviations and acronyms B. Minimize the use of verbal and telephone orders C. Try to guess what the client is saying if the language is not understood D. Document each dose of the drug using trailing zeros when recording the dose E. Check three times before giving a drug by comparing the drug order and medication profile

A. Avoid using abbreviations and acronyms B. Minimize the use of verbal and telephone orders E. Check three times before giving a drug by comparing the drug order and medication profile

Who regulates the types and routes of medications that can be administered by various levels of nurses A. Board of Nursing B. Hospital CEO C. American Medicine Institute D. The joint commission

A. Board of Nursing (LPN cannot administer IV medications in some states.....so you always need to refer to the Nurse Practice Act to define ones scope of practice)

The nurse is assessing a patient's ability to perform basic activities of daily living (BADLs). Which of the following activities are considered in the BADLs assessment? Select all that apply. A. Brushing teeth or dentures B. Dressing oneself in the mornings C. Washing, drying, and folding laundry D. Counting own pulse and taking heart pill E. Taking the bus to the park F. Calling family members

A. Brushing teeth or dentures B. Dressing oneself in the mornings

To promote safety, the nurse manager sensitive to point-of-care (sharp-end) and systems-level (blunt-end) exemplars works closely with administrators to address organizational system exemplars, such as A. Care coordination. B. Communication. C. Diagnostic workup. D. Fall prevention.

A. Care coordination.

Label each with the correct domain of learning...cognitive, psychomotor, affective A. Explaining the effects of sun exposure on the skin and hand out educational pamphlets B. Show pictures of sun damaged skin and have patient with serious skin CA share their story C. Have patient apply proper SPF product to skin and lips

A. Cognitive B. Affective C. Psychomotor

Which is the best description of the scope of the concept of functional ability? A. Continuum from complete independence to complete dependence B. Ability to perform the normal range of basic and advanced activities of daily living C. Capacity to perform specific self-care behaviors D. Levels of function within the family and the community

A. Continuum from complete independence to complete dependence

Refers to a set of congruent behaviors, attitudes, and policies that enables nurses and other health care professionals to work effectively in cross-cultural situations A. Cultural competence B. Care Coordination C. Adherence D. Family dynamics

A. Cultural competence

_______________ is one of the best ways to protect your patient, yourself, and your license. A. Documentation B. Informing another nurse about an incident C. Telling a family member about an incident at work D. All of the above

A. Documentation Failure to document jeopardizes patient safety and puts you at risk should there be an adverse outcome (Zerwick text)

*Health promotion guidelines are based on ? A. Evidence B. Culture C. Health Care economic D. Health policy

A. Evidence

A baby crawling is an example of ? A. Gross motor B. Fine Motor

A. Gross motor

A state of complete physical, mental, and social well being and not merely the absence of disease and infirmity A. Health B. Wellness C. Disease D. Illness

A. Health

Identifying the gap that occurs between ideal care and actual care given A.Health care quality B. Quality improvement C. Care coordination D. Safety

A. Health care quality

A nurse needs to teach a young woman newly diagnosed with asthma how to manage her disease. Which of the following topics does the nurse teach first? A. How to use an inhaler during an asthma attack B. The need to avoid people who smoke to prevent asthma attacks C. Where to purchase a medical alert bracelet that says she has asthma D. The importance of maintaining a healthy diet and exercising regularly

A. How to use an inhaler during an asthma attack

Who defines safety as "freedom from accidental injuries" A. IOM B. The joint commission C. QSEN D. NPSF

A. IOM

Which of the following interventions will assist in creating and maintaining a therapeutic environment on an acute care mental health unit? Select all that apply. A. Reorienting clients to the rules of the unit whenever necessary B. Providing a posted schedule of unit activities C. Monitoring each client for the potential of aggressive behavior D. Assuring the clients that they will have unlimited access to the telephone E. Encouraging the clients to take an active role in planning the unit's activities

A. Reorienting clients to the rules of the unit whenever necessary B. Providing a posted schedule of unit activities C. Monitoring each client for the potential of aggressive behavior E. Encouraging the clients to take an active role in planning the unit's activities

Jeopardy question: What are the top factors that places a client at risk for falls ( Select all that apply) A. confusion B. Medication C. Age D. Depression E. environment F. Hx of falls

A. confusion B. Medication C. Age E. environment F. Hx of falls

errors of commission A. doing the wrong thing B. not doing the right thing C. doing the right thing incorrectly

A. errors of commission: doing the wrong thing errors of omission: not doing the right thing errors of execution: doing the right thing incorrectly (on powerpoint)

When an older patient is admitted to the hospital what should be done? select all that apply A. perform risk assessment B. focus history questionnaire C. Perform physical exam D. Re-assess your patient ever 12 hours

A. perform risk assessment B. focus history questionnaire C. Perform physical exam (power point) * Pt at risk for falls should be re assessed ever 8 hours and the frequency may need to be increased

**In a culture of safety, the focus is on ________________ to accomplish the goal of safe, high quality care A. teamwork B. error reporting c. fall prevention d. leadership

A. teamwork

If someone scores a 24 on the Morse Scale that means: A. they are at low risk of fall B. they are at moderate risk for fall c. they are at high risk for fall

A. they are at low risk of fall 0-24 low risk 24-45 moderate 46+ high risk

Which older adult populations should have a comprehensive assessment of functional ability? Select all that apply. A. those with multiple consistent health problems B. those with a change mental status C. Those with a demonstrated loss of ability to perform one or more instrumental activities of daily living

A. those with multiple consistent health problems B. those with a change mental status C. Those with a demonstrated loss of ability to perform one or more instrumental activities of daily living

**Which concept is so closely related to safety that they practically over lap A.Health care quality B. Quality improvement C. Care coordination D. Collaboration

A.Health care quality

On which basis is an alteration in functional ability categorized as a primary problem? A. Age at onset B. Sudden versus gradual onset C. Duration of the problem D. Absence as opposed to loss of function

Absence as opposed to loss of function

Measures to prevent falls (select all that apply) A. place bed in lowest position B. call alarm near patient C. urinal is near male patient D. use non skid socks E. move patient near nurse station F. remove clutter G. ensure proper lighting

All are preventive measures Note:: additional prevention measures in the home --> rugs with backing and leveled pavements/stairs

Failure to meet expected development A) Expected B) Delayed D) Advanced

B) Delayed

Which one of the following processes does NOT contribute to human development ? A) growth B) transparency C) differentiation D) maturation

B) transparency

When a nurse is teaching a patient about how to administer an epinephrine injection in case of a severe allergic reaction, he or she tells the patient to hold the injection like a dart. Which of the following instructional methods did the nurse use? A. Telling B. Analogy C. Demonstration D. Simulation

B. Analogy

A nurse gathers data about the success of keeping the side rails of clients' beds up at nighttime to reduce the risk of falls. Which competency does the nurse display according to the Institute of Medicine (IOM) competencies of the 21st century? A. using informatics B. Applying quality improvement C. Using evidence-based practice D. Working in interdisciplinary teams

B. Applying quality improvement According to the Institute of Medicine (IOM) competencies of the twenty-first century, nurses are required to incorporate quality improvement into their work. A nurse performs this task by identifying potential hazards, designing interventions to improve quality, and evaluating the success of the strategies. In the given situation, the nurse is evaluating the success of a strategy to minimize clients' risks of falls. Using informatics involves the use of information technology for the purposes of communication, management of knowledge, and reduction of errors. Using evidence-based practice involves participating in research activities and integrating results of research with client care. A nurse is required to work with interdisciplinary teams to provide better care to clients. This action is done by cooperating and collaborating with the client, caregivers, and other health care workers.

The three elements of nursing competency described in the Quality and Safety for Nurses (QSEN) initiative are knowledge, skill, and A. Accountability. B. Attitude. C. Education. D. Value.

B. Attitude.

Which of the following concepts would a nurse think has the strongest link to safety? (Select all that apply): A. Cognition. B. Communication. C. Quality. D. Regulation. E. Teamwork.

B. Communication. C. Quality. D. Regulation. E. Teamwork.

Involves respect for clients identify and needs regardless of who they are, where they are from, how they speak, what reglion they practice, how old they are, how much wealth or poverty they have experienced, how socially popular they are, how much they weight, or any other aspect that may lead to unfair treatment. A. Enculturation B. Culture sensitivity C. Just Culture D. Acculturation

B. Culture sensitivity

Which type of assessment involves a rapid history and exam of a pt while maintaining vital functions A.Comprehensive B. Emergency C.Focused

B. Emergency Comprehensive - includes a detailed health history and PE of all body systems Typically done upon admission to hospital Focused - used to evaluate the status of previously identified problems and monitor for s/sx of new problems.

Designing and implementing health promotion require cultural competence and sensitivity to difference among cultures A. Just culture B. Enculturation C. Culture Competency D. Self-Awareness

B. Enculturation

A preschooler using a crayon is an example of ? A. Gross motor B. Fine Motor

B. Fine Motor

**What is the foundation for establishing a health promotion plan? A. Just culture B. Health assessment C. Health promotion D. Developmental milestones

B. Health assessment Health assessment is the foundation for establishing a health promotion plan and the basis for application of health promotion into practice. *assessment can target individual, family, or community

The nurse is preparing to conduct a scheduled health maintenance visit for a 15-month-old toddler-age client. Which information should the nurse include in the teaching session with the toddler's parents related to socialization and cognition? A. Engages in parallel play B. Imitation of parental activities C. An elevated fear of strangers D. Tolerates long periods of parental separation

B. Imitation of parental activities The 15-month-old toddler will imitate parental activities such as cleaning house or sweeping the floors; therefore, this is an appropriate topic for the nurse to include in the teaching session. Engagement in parallel play does not occur until approximately 24 months of age. The 15-month-old toddler will have a decreased, not elevated, fear of strangers. The 15-month-old toddler tolerates some, but not long, periods of parental separation.

A tool that is most appropriate to asses the functional status as a measurement of the clients ability to perform daily activities independently A. St. Thomas Risk Assessment B. Katz Index of Independence in Activities of Daily Living (ADL) C. Morse Fall Risk Assessment

B. Katz Index of Independence in Activities of Daily Living (ADL)

Which is NOT a level of error A. adverse event B. Latent C. Near miss D. Sentinel

B. Latent Latent is part of the scope of errors Scope: latent to active

On admission the nurse gets the patients list of medication. The Provider reviews the list and tells the nurse which medications the patient needs to be taking while in the hospital. The nurse passes this information along to patient and/or facility . This is know as A. Maintaining good communication B. Medication reconciliation C. Functional performance D. Developmental milestones

B. Medication reconciliation

Patient X needs a blood transfusion. Pt is AB+ (can receive from all blood types ) 1 unit of AB+ ordered. The nurse accidentally administers B+ by mistake. This is an example of? A. Adverse event B. Near miss C. Sentinel event D. Latent event

B. Near miss AB+ can receive any blood type so no adverse reaction occurred. If the patient was O- ( can only receive O- and O+) and received B+ this would have been and adverse event Adverse event refers to unintended harm by an act of commission or omission of rather than a result of a disease process Near miss is an error that could have harmed a patient but harm did not occur as a result of chance Sentinel event is an unexpected occurrence involving death or serious injury

The nurse is assessing a patient's ability to perform instrumental activities of daily living (IADLs). Which of the following activities are considered in the IADLs assessment? Select all that apply. A. Feeding oneself B. Preparing a meal C. Balancing a checkbook D. Walking E. Toileting F. Grocery shopping

B. Preparing a meal C. Balancing a checkbook F. Grocery shopping

Professor Pryzby taught the nursing students proper hand washing in todays skill class. This is an example of which domain of learning A.cognitive B. Psychomotor C. Affective

B. Psychomotor -- developing or improving a skill cognitive-increases knowledge affective --changing or influencing attitudes

Approach to practice that measures the variance and ideal in actual care and implements strategies to close the gap A.Health care quality B. Quality improvement C. Care coordination D. Collaboration

B. Quality improvement

A regulatory government body that its primary agency use for hospital accreditation A. IOM B. The joint commission C. Centers for medicare and medicaid services

B. The joint commission

On the show Greys Anatomy, Dr. Burk left a towel inside a patient during surgery. Which category of error is this? A. Diagnostic error B. Treatment error C. Preventive error D. Communication error

B. Treatment error

Incorporates physical, intellectual, sociocultural, psychological, and spiritual dimensions A. Health B. Wellness C. Disease D. Illness

B. Wellness

WHO defines health as: A. Absence of disease B. a state of complete physical mental, and social, wellbeing C. the state of being free from illness or injury D. the state of being in good health, especially as an actively pursued goal

B. a state of complete physical mental, and social, wellbeing

Set of functional skills or age specific tasks that most children can complete at a certain age rage. A. developmental level B. developmental milestones C. developmental tasks D. developmental arrest

B. developmental milestones -->Major markers in tracking development developmental level: position of an individual in the sequence of development development tasks--> skills and competencies to master at each level developmental arrest--> does not reach normal completion

Selet all that apply to a sentinel event A. results in moderate harm B. results in death or serious injury C. harm did not occur due to chance D. an investigation needs to be followed afterward

B. results in death or serious injury D. an investigation needs to be followed afterward (powerpoints)

Refers to the prevention of health care errors and the elimination or mitigation of patient injury caused by health care errors A. Health care quality B. Safety C. Quality management D. Health care error

B. safety

NCLEX QUESTION: When caring for an elderly client who has visual and hearing impairments, which of the following should the nurse assess? A. confusion and anger B. social isolation C. sensory overload D. Cognitive decline

B. social isolation Sensory impairments can lead to social isolation for older adults. Confusion and anger can be part of cognitive decline, which is a separate concern, unrelated to diminished vision or hearing. Sensory overload very unlikely.

A nurse is educating the mother of a seven-month-old child about an adequate diet plan for the child. Which statement made by the nurse should be included? A. "You should provide up to 4 to 6 cups of milk per day." B. "You should refrain from serving finger food and feed the child." C. "You should supplement milk with solid food items like vegetables and fruits." D. "It is preferably to provide low-fat or skimmed milk until the baby is 2 years old."

C. "You should supplement milk with solid food items like vegetables and fruits." When the child is 6 months old, the mother should start supplementing the child's intake of milk with solid food items to ensure a balanced diet for adequate growth. The intake of milk should be limited to 2 to 3 cups per day because the consumption of more than a quart of milk per day tends to decrease the child's appetite for essential solid foods and results in inadequate iron intake. Serving finger foods to toddlers allows them to eat by themselves and to satisfy their need for independence and control. Small, reasonable servings allow toddlers to eat all of their meals. Children below 2 years of age should not be given low-fat or skimmed milk because the fat is important for the physical and intellectual growth of the child.

Which pregnancy safety category shows a proven risk of fetal harm, but potential benefits of use during pregnancy may be acceptable despite its risks? A. Category A B. Category C C. Category D D. Category X

C. Category D Category D drugs show a proven risk of fetal harm; however, potential benefits of its use during pregnancy are acceptable in case there is a life-threatening disease. Category A drugs pose little to no risk of fetal harm. Category X drugs have been proven to harm the fetus; the risks outweigh the possible benefits of using this drug. Category C drugs have harmed animal fetuses, but there is no conclusive evidence that the drug may harm human fetuses.

An expected component of nursing education and professional nursing practice. A. Just culture B. Enculturation C. Culture Competency D. Self-Awareness

C. Culture Competency

Functional or structural disturbance that results when a persons adaptive mechanisms to counteract stress A. Health B. Wellness C. Disease D. Illness

C. Disease

Which gross-motor skills would the nurse explain are developed in children between 5 and 6 years of age? Select all that apply. A. Jumping rope B. Walking stairs C. Drawing diamonds D. Stacking blocks E. Drawing triangles

C. Drawing diamonds E. Drawing triangles

NCLEX Question (and discussed in lecture) **According to Erikson's stages of psychosocial development, which intervention is most appropriate for a hospitalized 16-year old? A. Ask parents to assist with missed homework. B. Request the hospital chaplain to stop by. C. Encourage friends to visit at the hospital. D. Restrict visitors to the teen's best friend.

C. Encourage friends to visit at the hospital. In Erikson's Identity vs. Role Confusion stage, about 12-18 years old, adolescents learn a sense of self and independence. Their most significant social relationships are their peers. Parents and adults have influence, but friends, social groups, and societal trends help shape identity.

Which is NOT a type of error A. Error of commission B. Error of omission C. Error of prevention D. Error of execution

C. Error of prevention Prevention is a category of error along with diagnostic, treatment, and communication

Doing the right thing but doing it incorreclty A. Commission B. Omission C. Execution

C. Execution does something that should not have been done --> Commission failure to do something that should have been done --> Omission

Select the BADLs (basic activities of daily living) A. Managing money B. Food shopping C. Grooming D. Transferring E. Taking medications

C. Grooming D. Transferring More examples of BADLs: -eating -bathing -toileting -Walking, wheelchair, stairs

Which is not part of the 5 most common medication errors? A. incomplete patient information B. Unavailable drug information C. Lack of access to a translator D. miscommunication of drug orders E. Lack of appropriate drug labeling F. Environmental distractions

C. Lack of access to a translator 5 most common medication error (* I Use My Lipgloss Everyday) Incomplete patient information Unavailable drug information Miscommunication of drug orders Lack of appropriate drug labeling Environmental distractions

In an agency with a culture of safety, when an error or patient safety issue is identified, the individual who reports the problem knows which information? A. Is disciplined according to established protocols. B. Must communicate the problem to the patient. C. Near misses in healthcare are used to improve care. D. Shares details to locate the individual at fault.

C. Near misses in healthcare are used to improve care. in an agency with a culture of safety, a nurse knows that near misses are used to improve care. Individual people are not punished for flawed systems, and there are no protocols for discipline. Consequences are individualized to improve the system and minimize the opportunity for future problems. Telling the patient is part of the transparency and the sharing and disclosure among stakeholders but is generally the responsibility of the risk management staff, not the staff nurse. Through a strategy such as root cause analysis, the reasons for errors in medication administration can be identified and strategies developed to minimize future occurrences, not to point a finger at a certain person.

Which group of the pediatric population is at a higher risk of developing respiratory complications upon administration of general anesthesia? A. Infants B. Children C. Neonates D. Adolescents

C. Neonates The physical characteristics of the larynx and small airway diameter, the structure of the respiratory system, and the high metabolic rate of neonates place them at a higher risk than infants, children, or adolescents of developing respiratory complications from anesthesia. Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

A client who has a hemoglobin of 6 gm/dL (60 mmol/L) is refusing blood because of religious reasons. What is the most appropriate action by the nurse? A. Call the chaplain to convince the client to receive the blood transfusion. B. Discuss the case with coworkers. C. Notify the primary healthcare provider of the client's refusal of blood products. D. Explain to the client that they will die without the blood transfusion.

C. Notify the primary healthcare provider of the client's refusal of blood products.

Is a process of helping people learn health-related behaviors so that they can incorporate these behaviors into everyday life A. Development B. Care coordination C. Patient education D. Self management

C. Patient education

Failure to provide prophylactic treatment is which category of error A. Diagnostic error B. Treatment error C. Preventive error D. Communication error

C. Preventive error Diagnostic error--> delay in diagnosis Treatment error--> occur in the performance of an operation or treatment Communication error--> group of errors that occur from failure of communication

Pt has not been taking his insulin. After further investigation you realize the patient did not understand the medication instructions clearly. This is an example of A. Secondary prevention, individual assessment B. Primary prevention, family assessment C. Primary prevention, individual assessment D. Secondary prevention, community assessment

C. Primary prevention, individual assessment

Defines safety as "minimizing risk of harm to patients and provides through both system effectiveness and individual performance" A. IOM B. The joint commission C. QSEN D. NPSF

C. QSEN

Mr. Jones passes away during surgery due to a rare allergic reaction to the anesthesia which was unforeseeable which level of error is this A. Adverse event B. Near miss C. Sentinel event D. Latent event

C. Sentinel event Adverse event refers to unintended harm by an act of commission or omission of rather than a result of a disease process Near miss is an error of commission or omission that could have harmed a patient but harm did not occur as a result of chance Sentinel event is an unexpected occurrence involving death or serious injury

NCLEX question: The most appropriate toys to give to a 5-month old infant are: A. Stuffed animals B. Plastic toy cars C. Teething objects D. Wooden puzzles

C. Teething objects Washable teething toys are appropriate for infants, who put everything in their mouths. Babies at this age enjoy biting on objects that relieve the discomfort of teething. These toys are not harmful and should be encouraged. Plastic toys may not be safe due to small parts. Games and puzzles are too advanced; pieces can be swallowed. Stuffed animals have eyes that can be swallowed or aspirated.

the aim is to optimize management of a disease and minimize complications so the individual can achieve the highest level of health A. Primary prevention B. Secondary prevention C. Tertiary prevention

C. Tertiary prevention (note...dont focus too much on tertiary examples...noted in class only needed to know examples of primary and secondary)

The nurse is evaluating the effectiveness of diet teaching for a patient who was diagnosed with diabetes. Which finding indicates a need for further teaching? A. The patient does not perform capillary blood glucose tests as directed. B. The patient occasionally forgets to take the prescribed medication daily. C. The patient states that dietary changes have not made any difference at all. D. The patient cannot identify signs or symptoms of high and low blood glucose.

C. The patient states that dietary changes have not made any difference at all.

NECLEX question: During a home assessment of a 2-year old, which behavior indicates normal development? A. Pours milk into cereal bowl B. Knows how to eat with a fork C. Uses a cup to drink D. Tries to cut food with a knife

C. Uses a cup to drink By the time toddlers are 2-years old, they should be able to use a spoon and a cup, with some spilling. Forks are used by 3-4 years old. By age 5, normal development includes using a knife and pouring.

A school nurse is performing annual scoliosis screenings. This is an example of what type of assessment? A. individual B. family C. community

C. community ...other examples: assessments lice, flu, or chickenpox outbreak Individual: age health status presence of risk factors health preference and values social realtionsship Family: risk factors family strength relationship among family genetics Community: structure of the community morbidity and mortality resources

Errors of execution A. doing the wrong thing B. not doing the right thing C. doing the right thing incorrectly

C. doing the right thing incorrectly

QSEN, developed to meet the challenge of preparing future nurses who will have the knowledge, skills, and attitudes necessary to continuously improve quality and safety stands for what? A) Quality & Security for Every Nurse B) Qualtiy & Standards Evaluating Nurses C) Quality & Satisfactory Education Nursing D) Quality and Safety Education for Nurses: developed

D) Quality and Safety Education for Nurses: developed

Which is a acceptable abbreviation per the Joint Commission? A. 100u of insulin B. 2.0mg of MA C. 1cc of Testosterone D. 200 micrograms of levothroxine

D. 200 microgram of levothroxine -"units" must be written out -"international unit" needs to be written out -NO trailing zeros -Morphine Sulfate must be written out for MA -Don't use less than or greater than symbols -dont use cc for mL -dont use ug- write out micrograms

Are unintended health care outcomes caused by a defect in the delivery of care to a patient A. Health care quality B. Safety C. Quality management D. Health care error

D. Health care error

A nurse is teaching a group of young college-age women the importance of using sunscreen when going out in the sun. What type of content is the nurse providing? A. Simulation B. Restoring health C. Coping with impaired function D. Health promotion and illness prevention

D. Health promotion and illness prevention

Seen as the physical signs and symptoms and the individual's subjective experience which can be presence in the absence of disease A. Health B. Wellness C. Disease D. Illness

D. Illness

Any preventable event that may cause or lead to inappropriate medication use or harm to a patient A. Adverse event B. Near miss C. Sentinel event D. Medication error

D. Medication error

Defines safety as "the prevention of health care errors, and elimination or mitigation of patient injury caused by healthcare errors" Aterm-120. IOM B. The joint commission C. QSEN D. NPSF

D. NPSF

The nurse at a community healthcare center focuses on providing primary preventive care. What is the focus of primary preventive care? A. Rehabilitating the client B. Treating early stages of disease C. Preventing complications from illness D. Promoting health in healthy individuals

D. Promoting health in healthy individuals Primary prevention precedes disease or dysfunction and is applied to patients considered physically and emotionally healthy. Health education programs, immunizations, and physical and nutritional fitness activities are primary prevention activities. Tertiary preventive care occurs when an individual has a permanent or irreversible disability. The client undergoing rehabilitation is receiving tertiary preventive care. Secondary preventive care focuses on individuals who are experiencing health problems. Secondary preventive care involves treating clients in the early stages of disease. It also focuses on preventing complications from illness.

To address administrative concerns about the effectiveness of staff nurses related to patient education, the nurse manager would first A. Assign one nurse to teach patients. B. Organize patient teaching resources. C. Post a teaching outline in the lounge. D. Survey nurses about patient teaching.

D. Survey nurses about patient teaching.

The nurse at a health fair has taken a client's blood pressure twice, 10 minutes apart, in the same arm while the client is seated. The nurse records the two blood pressures of 172/104 mm Hg and 164/98 mm Hg. What is the appropriate nursing action in response to these readings? A. refer the client to a nutritionist after providing health teaching about a low-sodium diet. B. Place the client in a recumbent position and call the paramedics for transport to the hospital. C. Talk with the client to assess whether there is stress in the client's life and refer to a counseling service. D. Take the client's blood pressure in the other arm and then schedule a healthcare practitioner's appointment for as soon as possible.

D. Take the client's blood pressure in the other arm and then schedule a healthcare practitioner's appointment for as soon as possible.

When a patient tells the nurse about plans to do research about the patient's diagnosis and potential treatment on the Internet, the nurse's most appropriate initial response is to A. Discount the reliability of the Internet. B. Evaluate the patient's computer competency. C. Provide a list of recommended sources. D. Teach about evaluation of Internet resources.

D. Teach about evaluation of Internet resources.

NCLEX question: When making a checklist for an older adult who is learning to do self-catherization, which action is most helpful? A. Include charts and graphs. B. Write at a high school reading level. C. Print material in a fun and colorful font. D. Use short words and sentences

D. Use short words and sentences When planning education or writing instructions for an elderly client, information should be as simple as possible. Use short words, sentences, and paragraphs. Write at a fifth-grade level, and avoid medical jargon. Formatting should include a large font that is easy to read. Charts or graphs are not necessary, and can lead to confusion

What can cause medication error? A. lack of knowledge B. Incorrect dosage C. lack of information about patients labs, medical hx, and/or allergies D. all of the above

D. all of the above (powerpoint)

7 rights of medication

Drug Dose Time Route Patient Education Documentation

Which is NOT a method to prevent medication errors? A. make sure the lighting is adequate B. make sure the nurse is not fatigued, distracted, or interrupted C. alway remember to document D. Use of barcoding medications E. Substitute technology for the nurses knowledge

E. Substitute technology for the nurses knowledge

All of the following are assessed on the Morse Fall scale EXCEPT: A. Secondary dx B. Hx of falls C. Ambulatory aids D. IV/Heparin lock E. lighting in home F. Gait/transferring G. Mental status

E. lighting in home ensuring proper lighting is a prevention measure, however, it is not used on the Morse fall Scale

TRUE or FALSE: "students practice under their instructor's license"

FALSE Nursing students have responsibility for their own actions and can be held liable. Student nurses at all times will be held to the standard of care for the tasks they perform. It is therefore important that students never accept assignments beyond their preparation and that they communicate frequently with their instructors to obtain assistance and guidance. Instructors and preceptors are responsible for reasonable and prudent clinical supervision. An instructor could be held liable for inadequate supervision in erroneously determining that a student was competent to perform a skill, when he or she was not competent. (Zerwirk Text)

True or False When asking the patient about allergies it is not important to ask what type of reaction they have as long as you are documenting the allergy

FALSE: It is important to ask the patient their allergies AND what type of reaction they have. Sometimes the patient is not truly allergic to a medication or may only have a mild reaction Ex: patient reaction to a Z-pack is mild itching. The Doc may prescribe Benadryl as well as Z-pack since reaction is mild

The most common factors contributing to falls with injury are all the follow EXCEPT: A. inadequate assessment B. failure to communicate C. failure to adhere to facility protocols and safety practices D. inadequate staff supervision or staffing E. lack of leadership F. physical environment deficiencies G. Lack of proper spill clean up in hospital settings

G. Lack of proper spill clean up in hospital settings (Zerwick text)

TRUE or FALSE If a nurse administers a medication without an order the board of nursing can revoke his/hers license

TRUE

TRUE or FALSE: The order of skill development is more important than the chronologic age at which each skill is manifested

TRUE

A student nurse receives an order for diazepam to be given intravenously. Diazepam tablets are available. The student nurse crushes a tablet and mixes it with sterile water for injection. The instructor notes that the solution is cloudy and asks to see the medication vial. When the student produces the vial of sterile water for injection and the instructor stops the medication from being given, what type of error is prevented? A. Communication error B. Diagnostic error C. Preventive error D. Treatment error

Treatment error

IOM (Institute of Medicine) Definition of safety: a. "freedom from accidental injury; ensuring patient safety involves the establishment of operational systems and processes that minimize the likelihood of errors and maximizes the likelihood of intercepting them when they occur." B. "prevention of health care errors, and the elimination or mitigation of patient injury caused by healthcare errors." C. a state of complete physical mental, and social, wellbeing

a. "freedom from accidental injury; ensuring patient safety involves the establishment of operational systems and processes that minimize the likelihood of errors and maximizes the likelihood of intercepting them when they occur." "prevention of health care errors, and the elimination or mitigation of patient injury caused by healthcare errors."--> NPSF

Interrelated concepts regarding patient attributes that a nurse manager would consider when addressing concerns about the quality of health promotion include which type of attribute? a. Culture b. Evidence c. Health policy d. Nutrition

a. Culture Culture, development, adherence, and motivation are patient attribute concepts. Interrelated concepts regarding professional nursing include evidence, health care economics, health policy, and patient education. Nutrition is a health and illness concept.

NCLEX question: The nurse on the surgical unit receives a call from the operating room to administer a preoperative medication to a client scheduled for surgery. After giving the ordered medication, the nurse discovers the consent form for the surgery has not been signed. Which of the following actions should the nurse take NEXT? a. Inform the nursing supervisor. b. Call the physician. c. Transfer the client to the operating room. d. Call the operating room and inform them that the surgery must be canceled.

a. Inform the nursing supervisor. Always go up the chain of command to your superior- nursing supervisor

Which phrase indicates that reporting of errors is valued and is free of reprisal or personal risk? a.Just culture b.High reliability c.Benign vigilance d.Blunt end surveillance

a. Just culture

The nurse is teaching a patient about the importance of maintaining an ideal body weight. This is an example of which type of prevention? a. Primary b. Secondary c. Tertiary

a. Primary

The school nurse incorporates seatbelt and helmet use in a high school class on health promotion as examples of which strategies? a. Primary prevention b. Rehabilitation c. Secondary prevention d. Tertiary prevention

a. Primary prevention

The home health nurse is visiting a patient who was diagnosed with hyperlipidemia. The patient was prescribed a low-fat, low-carbohydrate diet. The patient is refusing instruction and states he will not follow the diet. How should the nurse proceed? a. Emphasize to the patient how important it is to follow the provider's advice. b. Determine whether any cultural, socioeconomic, or religious values conflict, and thus interfere, with the patient's compliance. c. Explain that without diet and medication the condition will worsen and serious problems will develop. d. Inform the provider that the patient is unable to understand the instructions.

b. Determine whether any cultural, socioeconomic, or religious values conflict, and thus interfere, with the patient's compliance.

Primary health prevention in adults (select all that apply) a. hearing screening b. Fall prevention mesures c. blood lipid screening d. Shingle vaccination e. Cancer screening f. wearing seatbelt

b. Fall prevention mesures d. Shingle vaccination f. wearing seatbelt

What is the process of enabling people to increase control over and improve their health? a. Community care b. Health promotion c. High-level wellness d. Primary prevention

b. Health promotion Health promotion is the process of enabling people to increase control over, and improve, their health, according to the World Health Organization. Community care refers to interventions directed at a community rather than a process. High-level wellness refers to a positive state of health for an individual, a family, or a community; it is not a process. Primary prevention refers to strategies aimed at optimizing health and disease prevention rather than a process.

A defining characteristic of high reliability organizations (HROs) is sensitivity to operations. Which of the following is a manifestation of this characteristic? a.Near misses are treated as opportunities for improvement. b.Process anomalies and outliers are quickly identified. c. Ongoing efforts are to simplify solutions to problems. d.Decision making is strongly hierarchical.

b. Process anomalies and outliers are quickly identified. HROs exhibit sensitivity to operations, which means that they maintain a "situational awareness" in which process anomalies and outliers are quickly identified. This sensitivity to operations both reduces the number of errors and facilitates prompt recognition to avoid larger consequences from errors. HROs are preoccupied with failure and focused on predicting and eliminating errors instead of reacting to them. This is a second defining characteristic of HROs which involves near misses being treated as opportunities for improvement. HROs recognize the complexity of their work and have a reluctance to simplify. They also deemphasize hierarchy and defer to the person with the most knowledge.

A patient is diagnosed with heart failure after being admitted to the hospital for shortness of breath and fatigue. Which teaching strategy, if implemented by the nurse, is most likely to be effective? a. Assure the patient that the nurse is an expert on management of heart failure. b. Teach the patient at each meal about the amounts of sodium in various foods. c. Discuss the importance of medication control in maintenance of long-term health. d. Refer the patient to a home health nurse for instructions on diet and fluid restrictions.

b. Teach the patient at each meal about the amounts of sodium in various foods. Principles of adult learning indicate that if this patient is motivated to learn and is focused on the problem, this would be a good time to start teaching about diet. The nurse should act as a facilitator for learning, rather than as the expert. Adults learn best when the topic is of immediate usefulness. Long-term goals may not be very motivating.

Secondary health prevention in adolescents (select all that apply) a. vaccination b. hearing screening c. physical activity d. avoidance of smoking e. safe sex and drug education f. BMI

b. hearing screening f. BMI (vaccination and education are always primary.....anything screening is secondary)

Primary prevention in the prenatal group (select all that apply) a. Rh factor screening b. prenatal care c. folic acid supplement d. vaccination e. Ultrasound screening f. absence from smoking g. nutrition h. genetic consuling i. STD screening

b. prenatal care c. folic acid supplement d. vaccination f. absence from smoking g. nutrition h. genetic consuling Secondary prevention: Rh factor Screening Ultrasound screening STD screening

The nurse understands that which of the following health promotion activities are associated with increased adherence? a. Increasing physiological well-being. b. Increasing security, by providing psychological comfort c. Increasing self-esteem, by promoting independence and learning d. Providing comfort and support

c. Increasing self-esteem, by promoting independence and learning Empowering the patient through education promotes self-esteem and increasing adherence. Teaching patient activities that are to be used after discharge enhances independence and promotes self-esteem. Physiological well-being is important for healing. Psychological comfort is important for healing as well; however, this is not the best option. Providing comfort and support are important for good nursing care; however, this is not the best option for promoting adherence.

NCLEX question: During report, the previous nurse emphasized that one of the newly admitted patients is on seizure precautions. The incoming nurse is correct when she performs which of the following actions to the client? a. Serve the client's food in paper and plastic containers b. Move the client to a room closer to the nurses' station. c. Maintain the client's bed in the lowest position. d. Ensure that soft limb restraints are applied to upper extremities.

c. Maintain the client's bed in the lowest position. To protect a client with a known or suspected seizure disorder, the bed should be kept in the lowest position, decreasing the chance of injury from falling to the floor during seizure activity.

A primary health care provider has recommended a mammogram and a Papanicolaou (pap) smear for a 50-year-old female patient. In response to questions, the nurse teaches the patient about health promotion activities, describing the mammogram and pap smear as which forms of prevention? a. Illness prevention b. Primary prevention c. Secondary prevention d. Tertiary prevention

c. Secondary prevention

What is the primary benefit to classifying errors as either active or latent? a.Decreased variability as to how health care agencies manage error b.Increased focus on the importance of individual vigilance c.More accurate identification of the part of the system needing improvement d.Enhanced attention to the need for transparency

c.More accurate identification of the part of the system needing improvement

NCLEX question: When evaluating the growth and development of a 6 month-old infant, a nurse expects the infant to be able to perform which of the following actions? a. Display pincer grasp, sit alone, and wave. b. Release a toy by choice, pull self to a standing position, and play peek-a-boo. c. Transfer a toy from one hand to the other, crawl, and display fear of strangers d. Sit for a moment without support, turn over completely, and reach to be picked up.

d. Sit for a moment without support, turn over completely, and reach to be picked up. These abilities are age appropriate for a 6 month-old infant. The other items are abilities that should be developed by a 10 month-old infant.

While admitting a patient to the medical unit, the nurse determines that the patient is hard of hearing. How should the nurse use this information to plan teaching and learning strategies? a. Motivation and readiness to learn will be affected. b. The family must be included in the teaching process. c. The patient will have problems understanding information. d. Written materials should be provided with verbal instructions.

d. Written materials should be provided with verbal instructions.

The nurse is caring for an 85-year-old woman 6 weeks following a hysterectomy secondary to ovarian cancer. The patient will need chemotherapy and irradiation on an outpatient basis. The nurse should identify and address which barriers to healing? (Select all that apply.) A.Can feed herself and prepare meals but cannot drive to the store B.Lives on a fixed income and can balance her checkbook C.Experiences stress incontinence D. Cannot participate in activities at the senior center E.Lives alone and has no nearby relatives F. Has no transportation to the oncology clinic

experience stress incontinence lives alone and has no nearby relatives has no transportation to the oncology clinic

What are the four major techniques used when performing PE

inspection palpation percussion auscultation

List the 7 aspects of the concept that contributes to culture of safety

leadership teamwork evidence base communication learning just culture patient centered care

Testing a pregnant women's sugar is an example of ____________ prevention, while hand washing is and example of __________________ prevention

secondary (it is a screening tool to r/o gestational DM) primary

"Crossing the Quality Chasm: A New Health System for the 21st Century" defined six aims to improve health care quality, including care that is (IOM, 2001)...what are the six aims :

▪ Safe ▪ Effective ▪ Patient centered ▪ Timely ▪ Efficient ▪ Equitable (Zerwick text)