Transitions Final
The health care team responsible for deciding whether to move a critically ill patient out of the ICU so that a new patient may be admitted to the unit is faced with what principle of an ethical dilemma?
Justice principle of justice is involved in the allocation of scarce and/or expensive health care resources
An experienced nurse overhears a new graduate giving instructions to an unlicensed nursing assistant. Which statement by the new graduate would cause the experienced nurse to be concerned?
Let me know if any of my patients has a fever
Which of the following actions by the nurse manager would indicate an autocratic management style?
Makes most of the decisions without input from the staff members Autocratic manager uses an authoritarian approach to direct activities.
A nurse is reviewing treatment protocols for clients exposed to bioterrorism agents. For which of the following agents should the nurse plan to administer a vaccine following exposure?
Smallpox
What does the "scope of nursing practice" refer to?
The activities legally permissible for a nurse to perform in a particular state
An older adult woman of Chinese ancestry refuses to eat at the nursing home, stating, "I'm just not hungry." What factors should the staff assess for this problem?
The food served may not be culturally appropriate When assessing the cause of decreased appetite in patients, the nurse should determine whether the problem may be related to culture
Where should a nurse go if they are facing a dilemma in patient care with no absolute right or wrong answer?
The hospital Ethics Committee
The nurse is describing the "failure to rescue" to a new graduate nurse. Which statement by the new graduate would indicate an understanding of the definition?
The inability to prevent death after the development of a complication
During a job interview, the interviewee is asked, "What do you believe your weaknesses to be?" What is the best reply?
"I'm looking forward to strengthening my ability to plan care for a group of patients"
A nurse is caring for a client following exposure to inhalational anthrax due to bioterrorism. Which of the following medications should the nurse expect as a common medication to treat anthrax?
Doxycycline Ciprofloxacin Amoxicillin
The student nurse is preparing a resume. Which elements would he/she include?
Experience and education
Which situation could lead to performance inadequacy?
the person to whom the task was assigned did not understand what the task involved. The person that delegates a task must ensure clear direction and communication. The person to whom the task is assigned should verify that he or she understands and can perform the task.
What is the purpose of the Robert Wood Johnson Institute of Medicine Report?
To make recommendations for the nursing profession to transform healthcare
The nurse manager is updating unit staff on findings by The Joint Commission. Which of the following statements shows an understanding of the primary cause of untoward events in the hospital setting?
"Unclear, ineffective communication" Ineffective communication was identified as the root cause for nearly 70% of all sentinel events reported.
A nurse in a community health center is assessing the results of a tuberculin skin test she performed for a client. Which of the following results indicates exposure to and a possible infection with tuberculosis (TB)?
15 mm induration
According to the Utah Nurse practice Act Rule, how many hours must a licensed nurse practice without an additional requirement of contact hours to renew their license?
400 hrs
After a nursing student has graduated from their program, what is the timeframe the application has to take and pass the NCLEX-RN?
5 years
A nurse is performing triage for a group of clients following a mass casualty incident (MCI). Which of the following clients should the nurse plan to care for first?
A client experiencing a tension pneumothorax
A nurse manager is giving a presentation at a local community college. The nurse manager understands the job expectations of a new graduate when making which of the following statements?
A graduate nurse should be able to function competently as an advanced beginner as a registered nurse at the entry level.
Which of the following actions is consistent with a nurse leader?
A nurse who encourages staff to give excellent patient care
Following an earthquake, patients are triaged by emergency medical personnel and are transported to the hospital. Which of these patients will the nurse need to assess first?
A patient with a red tag Red tag indicates a patient with a life-threatening injury requiring rapid treatment.
What is the best definition of malpractice?
A professional act or failure to act that leads to injury of a patient. Malpractice may be defined as doing something outside your scope of practice or something that is unsafe for the patient and could cause injury
The nursing student is preparing an application for employment. Who would be the best reference for the student to include?
A recent clinical instructor Their preceptor A previous employer
What are the key messages that structure the discussion and recommendations presented in the Robert Wood Johnson Institute of Medicine Report?
A: Nurses should practice to full extent of their education and training B: Effective workforce planning and policy making require better data collection and an improved information infrastructure C: Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression E: Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the US
Which of the following statement by the nurse reflect transformational leaders?
A: Value-driven visionaries C: Lifelong learners E: Courageous change agents
Which is the most frequent reason for revocation or suspension of a nurse's license?
Alcohol or drug abuse License can be suspended for fraud, deceptive practices, criminal acts, negligence, physical or mental impairment, or alcohol or drug use
When performing a cultural assessment with a patient of a different culture, the nurse's first action should be to?
Ask the patient about any affiliation with a particular cultural group An early step in performing a cultural assessment is to determine whether the patient feels an affiliation with any cultural group.
What would be the most effective way for a nurse to validate "informed consent"?
Ask the patient what he understands regarding the procedure
A nurse tells a patient, "If you don't stop getting out of that chair, I'm going to put some restraints on you." What may this nurse be accused of?
Assault
A nurse is teaching a class about preventive care to clients who are at risk for acquiring viral hepatitis. Which of the following information should the nurse include in the presentation?
Avoid foods prepared with tap water.
What aspects define nursing as a profession?
B: Nurses have developed a Code of Ethics C: Nurse's possess a specialized body of knowledge E: Nurses serve the public
Which of the following describes reward power used by the nurse manager?
C: A nurse manager who uses fear of consequences to motivate staff E: A nurse manager who uses salary increases to motivate staff Reward power occurs when nurse managers provide or withhold rewards
What is a correct statement regarding a nurse who acts beyond the scope of practice?
C: May be disciplined by the board of nursing States can regulate nursing practice by controlling scope of practice and determining the specific activities for each level of nursing. Have the power to disciple.
What does the "scope of nursing practice" refer to?
C: The activities legally permissible for a nurse to perform in a particular state. Defining scope of nursing practice is part of the responsibility of the state board. Involves determining the specific activities for each level of nursing.
A nurse is among the first responders to a mass-casualty incident and does not know what type of personal protective equipment (PPE) is needed. Which of the following actions should the nurse take?
Choose the highest level of protection equipment available
The nurse manager needs to let a nurse know that he will be put on probation if he continues to be tardy to work. Which type of power is the nurse manager using?
Coercive power Power derived from fear of consequences
Which task could a staff nurse delegate to a certified nursing assistant (CNA)?
Collecting a routine urine sample.
The student nurse is reviewing sentinel events in healthcare. According to the Joint Commission which of the following is considered the main reason for sentinel events?
Communication errors
What is the best legal safeguard for a nurse?
Competent practice Practicing within the parameters of the state's Nurse Practice Act, performing care based on establishing policies and procedures, and performing as a reasonable nurse are the best ways.
How does the Utah Nurse Practice Act Rule define a Comprehensive nursing assessment?
Conducting extensive initial and ongoing data collection
The new graduate nurse would like to pursue a career in the ICU. What goal might be appropriate for this career?
Credentialing as a Certified Critical Care Nurse (CCRN)
The soon to graduate nurse would like information about what to expect on the NCLEX-RN exam and how to apply to take the exam. Where would the student find information?
D: NCSBN website
George the construction worker tells the Ameritech students preparing for a quiz on ethics: "I find it easy to make the right decision. All life is sacred, and all decisions must be made with the intent to continue life." What do we call the framework from which George approaches ethical reasoning?
Deontological
Which action would help the graduate nurse when seeking out employment?
Determine the length of orientation Find out what type of nursing care is delivered Ask to speak to nurses who work on the unit Plan out interviews
A nurse is gathering data on a patient of a different culture. Which action can the nurse take to enhance communication while gathering cultural data?
Determine the patient's level of fluency in English Nurse should determine patient's level of fluency in English to enhance communication. Nurse should not avoid patient's culture during the assessment.
How is assertive behavior described?
Direct A person exhibiting assertive behavior would express his or her true feelings in an honest, and direct manner
A nurse is teaching a group of newly hired nurses about the requirements for disaster planning. Which of the following statements by one of the newly hired nurses indicates an understanding of the teaching?
Disaster drills should be held on a regular basis
The nurse has several tasks to complete. Which task would the nurse NOT delegate to a CNA?
Discussing the important of deep breathing to a pre-operative patient
The nurse is considering strategies to increase nurses' time at the bedside. Which strategies should be included?
Effectiveness in medication administration Bedside change of shift report Hourly rounding by staff members Standardized documentation tools
What is the primary role of The Joint Commission?
Ensuring medical facilities meet patient safety guidelines TJC is primary accrediting body for health care institutions. Standards directly address patient safety issues.
A nurse is respected by peers for clinical skills and effective interpersonal relationships. The nurse has studied diabetic patient educational needs and consults with several units. What type of power does this nurse possess?
Expert Expert power is based on specialized knowledge, skills, or abilities that are recognized by others.
In a malpractice suit, how may a breach of duty be established?
Expert testimony The duty of nurse is to act as a reasonable nurse would under the same or similar circumstances. An expert witness may testify as to what a reasonable nurse would be expected to do.
George was taken to the emergency room after falling off a crane in the Ameritech construction site. George's buddies came to the emergency room to visit. A doctor told George's buddies that George is HIV-positive. What ethical principle did the doctor violate?
Fidelity
A nurse is caring for a client who suspects recent exposure to inhalation anthrax. Which of the following findings indicate possible exposure?
Flu-like symptoms
The nurse understands that delegation and supervision are two concepts that go hand-in-hand. Which is the best example of the concept of supervision?
Following a CNA on the assigned task of ambulation and feeding of two patients Supervision is the provision of guidance, direction, and follow-up for the accomplishment of an assigned task
A nurse is developing an education program for a community group about dietary intake of vitamins and minerals in the diet. The nurse should include which of the following foods as sources of Vit. C?
Green pepper Orange Cabbage Strawberries
When caring for a patient who is Native American, the best initial action by the nurse is to?
Observe the patient's use of eye contact.
A nurse manager needs to purchase new thermometers for the nursing unit. What technique would demonstrate a laissez-faire style of leadership?
Having the nurses on the day shift order any thermometer that they want Laissez faire manager maintains a permissive climate with little direction or control. Allow staff members to make and implement decisions independently and relinquishes most of their power and responsibility
An occupational health nurse in the clinic of an industrial plant is developing a guidebook for clinic workers. Which of the following actions should the nurse include as a secondary prevention strategy?
Help plant workers identify signs of carpal tunnel syndrome
A student in the last semester of nursing school has established a goal of making a successful role transition to graduate nurse. Which statement by the student indicates his/her understanding of how to achieve this goal during the capstone experience?
I should care for increased numbers of patients to enhance work organization skills
A charge nurse is discussing staff nurses' responsibilities in preplanning for response to a disaster. Which of the following responsibilities should the nurse include in the discussion?
Identify potential community disasters
What are the factors that contribute to medication errors?
Inadequate staffing Overly tired nurses High nurse-client ratios
A nurse is preparing to care for a client who has suspected exposure to plague as a result of bioterrorism. Which of the following actions should the nurse plan to take first?
Initiate contact precautions
In a legal suit, what element is necessary to prove a tort has been committed?
Injury
Which statement by the graduate nurse indicates understanding of the importance of a cover letter?
It should introduce you to the reader. A cover letter gives a brief introduction, should summarize important strengths or give information regarding change of specialty.
What is the correct statement regarding a nurse who acts beyond the scope of practice?
May be disciplined by the board of nursing
What organization developed the most definitive statement on the competencies needed by the newly licensed RN?
National Council of State Boards of Nursing (NCSBN)
George the construction worker fell off a crane while working on the Ameritech roof. The students rushed to his aid, and decided not to move him in case he had sustained a neck injury. What ethical principle were the students following?
Non-maleficence
The nursing student is studying about root cause analysis (RCA). Which of the following is a critical element in error reporting?
Non-punitive action when errors are reported
A nurse is discussing emergency response with a newly licensed nurse. The nurse should identify which of the following as a triage officer during the time of a disaster?
Nurses and other emergency medical personnel
A nurse is working with an interdisciplinary disaster committee to develop a community-wide emergency response plan in the event of a nonbiological or chemical incident. The nurse should include which of the following agencies to be notified immediately after calling 911?
Office of Emergency Management (OEM)
A nurse is caring for a patient from Taiwan who constantly requests pain medication. What should the nurse consider when assessing the patient's pain?
Pain is what the patient says it is. nursing care should always be individualized. Nurse respects the patient's right to respond to pain in whatever manner is culturally and individually appropriate.
George and his fellow construction workers were listening to the Trends class study for a quiz on ethics. What is NOT an ethical dilemma that the students are discussing?
Parking
A nurse is triaging clients injured during a tornado. The nurse assesses a client who has an open fracture of his arm. Which of the following tags would the nurse place on the client?
Place a yellow tag on the client's upper body
A nurse is educating community members about how to prepare for a disaster. Which of the following supplies should the nurse instruct the clients to include in a disaster preparedness kit?
Prescription medications three quarts of water per person Clean clothing Personal identification
A community health nurse is reviewing the levels of disease prevention. Which of the following activities is an example of tertiary prevention?
Providing treatment for clients who have chronic obstructive pulmonary disease
After receiving report on 4 patients, the RN may delegate which client's needs to be an assistive personnel?
Reapplying a condom catheter for a client who has urinary incontinence.
Which of the following actions best reflects maintaining accountability for the nursing process?
Reassessing a client's BP when the reported value is higher than usual Accountability refers to individuals being responsible for their actions.
The nurse is receiving a phone order from a health care provider. How will the nurse make sure that the provider's order is received without error?
Repeat the order, write the order verbatim, and read it back to the provider.
The nurse manager is giving a presentation on the disadvantages of democratic leadership in group functioning. Which statement shows an understanding of this type of leadership?
Requires more time and effort to make decisions and accomplish goals Democratic leadership encourages group participation and works to reduce any type of scapegoating behavior among members because everyone has equal voice.
Which of the following actions by the graduate nurse would be advised during an interview campaign?
Research the prospective employer and evaluate their mission statement Nurse should: identify desirable date to begin employment, ask questions about the interview process, research the prospective employer, and plan no more than 2 interviews in one day
A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?
Review the events leading up to each medication administration error
Which does not reflect one of the five rights of delegation
Right route
A charge nurse explains to a student: "I tend to act differently depending on which nurses are working that particular shift.. Some nurses need more direction from me than others." What type of leadership style best describes this charge nurse's approach?
Situational
A nurse is caring for a client involved in a suspected bioterrorism event involving exposure to cutaneous anthrax. Which of the following manifestations should the nurse anticipate?
Skin lesions with pruritus
The nurse is reviewing I-SBAR-R with a coworker at the end of the shift. Which statement indicates that they are discussing the Situation component?
The nurse states that the patient was hospitalized for a broken tibia and that surgery is scheduled for later today. The situation component, the nurse states what is going on with the patient. The identification component involves stating the patient's name. The assessment involves the nurse discussing what the nurse thinks is happening. The read-back or response involves that the oncoming nurse repeating what the nurse has heard from the nurse who is reporting at the end of the shift.
A nurse is being sued for assault and battery. What does this mean?
The nurse, without consent, touched the patient in an offensive, insulting, or injurious way Assault: nonconsensual threat of touch Battery: actual touching
Which of the following represents appropriate feedback for an assignment to an LPN?
The patient in Room 430 looks much better, and you did a good job of making her comfortable. Feedback is a process of informing someone of how well or how poorly a delegated task was performed.
Which ethical principle of autonomy is not applicable in which patient situation?
The patient is unaware of who he is and where he is
A nurse who commits an infraction of the Nurse Practice Act may be subject to discipline by what group?
The state board of nursing State nurse practice acts regulate nursing by controlling the scope of practice and determining the specific activities for each level of nursing
The nurse is implementing fall prevention protocol. What would be included in the protocol?
Thorough and sound assessment of clients abilities and limitations Toileting every 2 hrs and visual hourly checks Assessment of medication side effects Bed and chair alarms
What is the purpose of the nurse's Code of Ethics?
To guide the behavior of the professional nurse ANA code of ethics is a statement to society that outlines the values, concerns, and goals of the profession. Should be compatible with the values and goals of each nurse
Which statement by the nursing student indicates an understanding of the purpose in setting a career goal?
To help you define the direction of your career. A career goal defines who or what you wish to be professionally, it will help tie together the elements of your job search.
What is expected of the new graduate across healthcare agencies?
To work effectively with assistive personnel, delegating and supervising nursing care tasks in an appropriate manner. Use communication skills effectively with clients and coworkers. Recognize own abilities and limitations
A nurse is interested in moving into a management position. Which action would assist with accomplishing this?
Use of expert power Expert power would assist the nurse to advance to higher positions in nursing
The new graduate nurse is working to create culture of safety on the unit. What actions will exemplify a culture of safety?
Using the ISBARR when collaborating with a provider Look at systems and processes to identify areas that need to be changed Refusing to be interrupted during medication administration Using Universal Protocol 3 steps prior to surgery and procedures
The nurse on the unit is determining which activities may be delegated to assistive personnel. Assuming that the nurse assistant is competent, which one of the following activities may be safely delegated by the registered nurse?
Vital signs on a stable client The nurse should match tasks to the delegate's skill.
As the interview is drawing to a close, the interviewer asks the applicant, "What questions could I answer for you?" Which of the following questions would it be most advisable to ask to create a favorable impression?
What is the orientation process and what is the length of orientation? prepare a few questions to gather important details, keep questions on the positive side and inquire about responsibilities of the position.
George the construction worker decided to leave the emergency room against medical advice. His nurse is an incredibly ethical AmeriTech graduate. What did the nurse do in this situation?
informed George that he could return to the hospital if he changes his mind
