trends midterms
A nurse demonstrates assertive behavior by doing which of the following?
A patient complains of pain when ambulating and asks not to walk. The nurse respects the patient's feelings and medicates the patient as ordered for pain while supporting the need to carry out the physician's order.
Which of the following is true regarding informed consent?
A patient is informed that he or she has the right to revoke consent at any time
The LPN/LVN charge nurse at the long-term care facility has assigned a newly licensed LPN/LVN to care for a resident needing a colostomy irrigation. The new LPN/LVN voices concern, because he has never performed a colostomy irrigation. What would be the best course of action for the LPN/LVN charge nurse?
Arrange to supervise the new LPN/LVN as he performs the irrigation.
A nursing assistant states, "I have never learned how to transfer a resident with end-stage Parkinson's disease from the bed to the chair." The nursing assistant refuses to transfer the resident at this time. Select the appropriate approach for the LPN/LVN charge nurse to take.
Arrange to teach the nursing assistant how to transfer the resident.
Which quality is rarely found in democratic leaders?
Arrogance
When a resident's family complains that their mother is receiving inferior care in the extended care facility, which action should the LPN/LVN charge nurse initially take?
Ask the family to be specific and give examples of "inferior care" the mother has received.
During an emergency, the charge nurse tells the LPN/LVN, "I need you to place the patient on a nonrebreather mask now." The charge nurse has little regard for the LPN/LVNs input at this time. The charge nurse is displaying what leadership style?
Autocratic
When the Nurse Practice Act of the state permits delegation as part of the LPN/LVN charge nurse duties, which task could be delegated to experienced, unlicensed assistive personnel who have been trained to perform the task?
Taking the vital signs of a resident whose condition is not critical
The LPN/LVN tells the charge nurse, "You can be glad I'm on duty today to pick up the slack for the staff member who called in sick. It's lucky that I came in early. Oh, and by the way, I can stay late, if necessary. You know how the next shift is. They expect everything to be caught up, even if they aren't that efficient themselves." These remarks suggest that the LPN/LVN may be
co-dependent.
The nurse providing care for patients or residents must act on the knowledge that a basic right of a patient or a resident is to receive
considerate and respectful care from all care providers
During a staff meeting, the charge nurse encourages feedback from staff nurses about improving patient safety. The charge nurse is displaying what leadership style?
democratic
The LPN/LVN nursing home charge nurse encourages nursing assistants to make suggestions regarding improvement of nursing care and shows concern for the staff. This leadership style is called
democratic
A leadership style that focuses on both the task and the employee is the
democratic style.
The LPN/LVN notices that the nursing assistants are taking longer breaks than agency policy permits and wishes to change this behavior as quickly as possible. The LPN/LVN's initial actions should be to
determine the reason staff members are taking longer breaks.
An example of a criminal action committed by a nurse is
discontinuing a ventilator without a physician's order.
A way of practicing fidelity to a patient would be to
document the patient's expression of feelings and wishes.
The patient tells the nurse, "I want to make sure that my daughter can make health care decisions for me in the event I'm unable to make decisions for myself. What do I need to do?" The nurse should advise the patient that he or she needs to execute a/an
durable medical power of attorney
The action the LPN/LVN charge nurse takes independently that would most likely require conflict resolution at the unit level is
eliminating morning breaks and adding 10 minutes to the lunch hour.
A patient tells the LPN/LVN, "I want you to bring my medical record so I can read it. I know HIPAA gives me the right to see it." The LPN/LVN should
explain that the request will be made to the RN, who will follow agency policy.
A nursing assistant (NA) did an exceptionally good job by encouraging a resident to leave his room and go to an activity. Select the response by the LPN/LVN charge nurse that would best encourage the employee to continue this effort.
Tell the NA that the charge nurse knows how hard she worked to get the resident out of his room and how pleased the nurse is that the NA is concerned with the resident's need for socialization.
The 3 to 11 shift LPN/LVN charge nurse on a 20-bed nursing home unit is asked by the only other staff member on duty, a nursing assistant, "Will it be all right if I go home tonight while you are giving report to the night shift? My husband needs the car so he can go to work." The best response by the charge nurse is
That won't be possible. You must be here to answer lights while I give report to the night staff."
The LPN/LVN charge nurse has assigned tasks to the nursing assistant staff and the LPN/LVN orienting to the unit. On which statement about responsibility for outcomes should the LPN/LVN charge nurse base her or his actions?
The LPN/LVN charge nurse is legally responsible for checking the outcomes of all assignments made.
Which of the following is an example of breach of duty?
The LPN/LVN does not perform duties according to the standard of care.
The instructor tells an SP/VN, "You have functioned at a substandard level of clinical performance recently. Now you have a chance to redeem yourself. I'm assigning you to a complex nursing situation. I expect you to function without asking for assistance." What is the most accurate assessment of the instructor's action?
The instructor is accountable for making an unsafe patient care assignment.
What is the nurse's responsibility regarding an improper medical order that, if carried out, may harm a patient?
The nurse must go directly to the physician and, if necessary, refuse to carry out the order.
A new LPN/LVN passes the NCLEX-PN examination and obtains licensure in state X. The LPN/LVN wishes to work in a state other than state X but is unsure of how to proceed. Which statement provides sound advice in this situation?
The nurse should contact the state board of nursing of the state in which she wishes to work to determine whether they have multistate licensure with state X
A nurse is found liable for battery. What does this mean?
The nurse, without consent, touched the patient in a way that caused harm.
Which behavior should the LPN/LVN charge nurse identify as dysfunctional behavior that violates OBRA regulations by threatening resident quality of life, health, or safety?
The nursing assistant uses a sharp tone of voice and body posture, suggesting impatience when feeding a resident.
When the LPN/LVN charge nurse makes rounds with the physician, which information should be called to the physician's attention?
The resident demonstrates a reduced level of consciousness.
Which statement is true regarding durable medical power of attorney and living wills?
They allow patients a voice about medical interventions after they are incapable of acting
How can nurses avoid burnout?
Understand their own needs and maintain balance between work and personal life.
The LPN/LVN nursing home charge nurse usually tells nursing assistants what to do and offers little opportunity for input or suggestions for how to improve care. This leadership style is called
autocratic
A purely task-centered leadership style that thrives on power and involves telling someone what to do, with little regard for the employee as a person, is the
autocratic style.
Encouraging a patient to be involved in planning and carrying out his or her own care is a nursing action that supports the ethical principle of
autonomy
Leaving an unconscious patient exposed during a treatment or procedure is a violation of the ethical principle of
autonomy.
With regard to HIPAA implementation, the LPN/LVN who is newly employed at a health care agency should
be aware that each agency may interpret HIPAA provisions somewhat differently
When a treatment team decides to go to court to obtain permission to provide chemotherapy for a child whose parents refuse to give consent for the treatment based on religious grounds, the ethical principles that are in conflict are
beneficence and autonomy
The patient asks the nurse what he should do about continuing cancer treatment. The nurse responds, "You should stop before you get so weak you can't enjoy a few good weeks with your family." This is an example of
beneficent paternalism.
A new LPN/LVN asks the LPN/LVN charge nurse what continuous quality improvement (CQI) is all about. The charge nurse should explain that the focus of CQI in a health care agency is
better patient care outcomes.
The nurse discusses the patient's condition on the phone with the patient's brother. On learning this, the patient is upset, saying he has not spoken with his brother for years and does not want his brother to know anything about his condition. The nurse has
breached confidentiality.
A nursing assistant tells the nurse, "I'm feeling negative about my job and just about everything else these days. Like today, I found myself feeling angry with Mrs. X. because she's overweight. I felt like telling her if she didn't eat so much, she'd make my life a lot easier. I need a vacation or a new job." The nurse can correctly determine that the nursing assistant is experiencing feelings associated with
burnout
The nurse is assigned to park in a newly created parking lot that is far from the hospital building. Some of the lights in the new parking lot have not been installed. As the nurse is about to leave, she notices several young men loitering near the walkway she must take. The nurse should
call for a security guard to serve as an escort to the car
A resident asks an LPN/LVN, "What is meant by the practical/vocational nurse's standard of care in a long-term care agency?" The LPN/LVN should respond, "The practical/vocational nurse who provides care for residents in a long-term care agency must implement care that is consistent with
care that an ordinary, prudent LPN/LVN with the same education and experience would perform in similar circumstances."
The priority step the LPN/LVN charge nurse should take before delegating one of the charges to another LPN/LVN on staff is to
check the Nurse Practice Act of the state to learn whether an LPN/LVN charge nurse is allowed to delegate duties.
During report, the LPN/LVN relates that although her assigned patient was ambulatory, she provided a bed bath, special foot care, and nail care; she justified the care by saying that the patient seemed very tired. The nurse also mentioned that the patient had a number of personal problems for which she provided counseling. The charge nurse recognizes these behaviors as suggesting
co-dependence
A nurse is overheard telling a patient, "No, you do not need to bathe yourself. It doesn't make any difference if that's what the other nurses have you do. I will do that for you. I enjoy doing things for others, and I know you'll appreciate my taking this time with you." The most accurate assessment of this nurse's behavior is that she's
co-dependent
Patient A, who has Alzheimer's disease, wanders and is often noisy and intrusive. The patient has a prn order for haloperidol (Haldol) IM for assaultive behavior. At report, the LPN/LVN charge nurse explains that staffing is poor and she is unable to provide the supervision the patient needs. She directs the medication nurse to administer the patient's prn haloperidol q4h during the shift. This action constitutes
false imprisonment.
A major change in medical ethics that affected nursing occurred when the Western secular belief system shifted emphasis from duties to
individual autonomy rights
The term used to describe a competent patient's agreement to have a surgical procedure after the physician explains the procedure, the desired outcome, possible complications, and possible alternative treatment is
informed consent.
Civil law is concerned with
intentional and unintentional torts
A people-oriented leadership style that focuses on people's feelings but ignores the task at hand and allows people to act without any direction is the
laissez-faire style.
A student nurse is assigned to care for a patient who is known to be angry. During the caregiving process, the patient hits the student nurse. The action the student nurse should initially take is to
leave the patient in a safe situation and immediately report the event to the instructor
A nurse damages a physician's reputation through false written communication without the physician's permission. This is an example of
libel
The student nurse caring for a patient with a large decubitus ulcer photographs the ulcer without obtaining permission from the patient. The patient developed the ulcer while being cared for at home by her physician husband. The student plans to give the patient's history and use the photograph in a paper she is writing. The instructor explains to the student that this action is unacceptable and could result in a court action for
libel.
The most fundamental requirement for assuming the practice role of LPN/LVN charge nurse is
licensure in the state of practice.
A risk management strategy a nurse can use to prevent being named in malpractice lawsuits is
maintaining good relationships with patients and families
The LPN/LVN reads this statement, "Stress is the body's reaction to the mind's analysis of a situation." The LPN/LVN concludes that the critical factor to teach nursing assistants to help them control their stress levels is to
manage how they think about a situation.
A patient tells a student nurse, "I unwind by going to a quiet place, sitting in a comfortable chair, closing my eyes, and concentrating on my breathing." The patient is describing use of
meditation
The LPN/LVN charge nurse notices that a new nursing assistant has offensive body odor. The LPN/LVN charge nurse should a.
meet with the person to inform her of the problem and reinforce agency expectations.
When a student nurse prepares diligently for a clinical assignment, the ethical principle being observed is
nonmaleficence.
Evaluate the following documentation found in the medical record of a resident. It was provided by an LPN/LVN charge nurse relative to an incident that occurred while resident care was being provided by a nursing assistant. July 1, 2009, 8:10 AM While administering meds on Wing 1, I heard someone sobbing in the shower room on that wing. On entering the shower stall, I found Mrs. Garrity crying and shivering. She was sitting naked on the shower chair and was alone in the room. She stated that Becky, her nursing assistant, told her she had to leave for a phone call. I covered Mrs. Garrity with a bath blanket that was on the shelf in the bathroom. At that point Becky returned and confirmed that she had received a phone call. I think the in-service director needs to review the procedure for showering a resident with Becky and the policy about personal phone calls. Becky and I discussed the discomfort caused to Mrs. Garrity by her actions. She listened to my comments without defensiveness. The documentation should be evaluated as
not meeting criteria for good documentation.
The new nursing assistant arrived 1 hour late for duty on the second day of employment, giving the excuse of car trouble. The LPN/LVN charge nurse should
note the incident of tardiness in the charge nurse's personal file.
Health promotion for patients is facilitated when the nurse encourages changes based on information that diabetes, heart disease, and breast and colon cancer are causally linked to
obesity
To discover the expanded role of the practical nurse, the LPN/LVN should investigate
the state's Nurse Practice Act.
To provide justice to patients on the unit, the nurse must
treat all patients with equal dignity and respect.
For an LPN/LVN to motivate staff members to meet the goals of the organization, it is helpful if the nurse
understands work motivators.
A nurse injects himself or herself with a narcotic prescribed for a patient. This is an example of
unethical and illegal behavior.
The nurse states, "I like being part of the health care team caring for the traditional two-parent family during the postpartum period as they bond with their newborn." This statement reveals the nurse's
values
A telltale sign of a chemically impaired nurse is
an increasing number of practice errors.
How can the LPN/LVN charge nurse meet needs for affiliation among staff on their shift?
Arrange a social gathering for the staff on the shift.
A nurse who angrily tells a patient, "If you don't go to sleep, I'm going to give you an injection," can be accused of
assault
A nurse damages a patient's reputation by verbalizing private information about the patient to a third party. This is an example of
slander.
. How should an LPN/LVN explain the term accountability to a student nurse?
"Accountability is assuming personal responsibility for one's nursing actions."
A student nurse asks, "What's the difference between laws and ethics?" Which response best explains the difference between nursing laws and ethics?
"Ethics refer to expected behavior of nurses, but laws require mandatory observance by nurses."
When a patient inquires about the 2010 MyPlate recommendations the nurse responds
"Half of the plate should be fruits and vegetables."
When a nurse is the target for unwanted behavior that she perceives as sexually harassing, she should first
assertively tell the person that the behavior is unwanted.
LPN/LVNs functioning in an expanded role are most often employed in
Long-term care.
The instructor tells a student nurse, "You have functioned at a substandard level of clinical performance recently. Now you have a chance to redeem yourself. I'm assigning you to a complex nursing situation. I expect you to function without asking for assistance." The most appropriate response from the student nurse would be
"I cannot accept the assignment. Complex nursing situations are beyond my abilities."
When a nurse tells a peer, "You have to watch out for the charge nurse. Sometimes she's OK, but sometimes she's just plain unreasonable. The best thing to do is to tell her off the first time she gets on your back about something. Keep me posted and I'll try to help you." An assertive reply would be
"I think it would be best for me to work on my relationship independently."
Which of the following is an example of objective, rational thinking rather than subjective, irrational thinking about nursing assistants whom the LPN/LVN charge nurse supervises?
"I want nursing assistants to be on time for report."
Which statement shows a personal commitment to work on the goal of devoting more time to coursework for the LPN/LVN program?
"I will say 'no' when people ask me to do things that take time away from my studies."
nursing instructor has instructed a student nurse to document objectively. The student nurse demonstrates understanding when documenting
"Odor of alcohol on breath; refuses to stay in assigned room."
A student nurse asks a peer, "What's the difference between recreation and relaxation?" The best response would be
"Relaxation usually lowers stress, but recreation can create stress."
A resident has not voided in 6 hours. Which instruction to a nursing assistant would likely ensure getting the information needed by the LPN/LVN charge nurse?
"Report to me immediately if the resident voids between now and 10 AM, and tell me the amount he voids. If he has not voided by 10 AM, please report this to me."
The student nurse states, "I don't have time for the bending and stretching routines the textbook advises." A peer student nurse could be most helpful by saying
"The idea of warm-ups preventing injury seems valid."
Which statements would the nurse evaluate as suggesting that the patient's decision has not been autonomous? (Select all that apply.)
-"I wish I knew for sure that I had all the facts about the treatment." -"My son told me emphatically what he thought would be best for the family."
Which statements are accurate with regard to a living will? (Select all that apply.) a.
-A living will does not let the person select someone to make decisions for them. -Living wills are recognized as legal documents in 47 states in the United States, the District of Columbia, and Guam. -A living will is a legal document that describes the kind of medical or life-sustaining treatments the person would want if seriously or terminally ill.
Examples of tasks the LPN/LVN charge nurse of the extended care unit might assign to a nursing assistant (NA) include which of the following? (Select all that apply.)
-Bathing a resident who is in stable condition -Assisting a resident with Parkinson disease to ambulate -Transferring a resident from bed to chair with the assistance of another NA
Which principles of delegation should the LPN/LVN charge nurse follow when delegating a duty to a nursing assistant? (Select all that apply.)
-Choose a nursing assistant who is competent to perform the delegated duty. -Determine the nursing assistant's willingness to accept the delegated duty.
Telltale signs of chemical dependency in nurses include which of the following behaviors? (Select all that apply.)
-Complaints by staff, students, and patients -a greater number of injuries caused while moving patients -arriving early or staying late to assist in the narcotic count -Frequent absenteeism after days off and for personal emergencies -Increased visits to the employee health department or emergency room -Work performance that consistently exceeds the expectations of the supervisor
Which of the following measures are most helpful to the nurse who makes a personal commitment to practice violence prevention in the workplace? (Select all that apply.)
-Get to know co-workers and look out for them. -Treat patients and co-workers with courtesy and respect. -Become familiar with policies relating to violence and harassment -Set clear, firm limits on unacceptable behavior.
A nurse experiences potential danger from a patient who is highly suspicious and fears being harmed. Which behaviors by the nurse will help alleviate the threat of violence? (Select all that apply)
-Maintain an open position with the hands in view. -Speak in a quiet, controlled voice
Which statements about manipulation would be useful to the nurse who interacts with both patients and peers? (Select all that apply.)
-Manipulation usually disregards the feelings and needs of others. -Manipulation exploits the weaknesses of others. -A divide-and-conquer strategy is often used by those who manipulate. -Manipulation often results in individuals being treated as objects.
What actions should be taken by the nurse to increase the possibility of doing no harm while caring for a patient? (Select all that apply.)
-Never participate in any action that will deliberately harm the patient. -Question how to do the least amount of harm when doing something that is expected to result in good. -Make sure the patient has agreed to the procedure verbally or in writing. -Become aware of side effects of commonly administered medications.
Select the examples of LPN/LVN charge nurse directions that meet the criteria for Right Direction/Communication. (Select all that apply.)
-Please bathe Mrs. Duffy today, cut her nails, and shampoo her hair. The beautician will set her hair at 11 AM." -Mrs. Neidert needs to walk from her room to the nurses' station with the assistance of two this morning and again after lunch. Please report whether she does this easily or with difficulty." -Offer Mr. Jones the urinal before breakfast and before his shower. Report to me immediately if he voids and the amount he voids. If he does not void by 10 AM, notify me, as I will need to catheterize him." -"Mrs. Snyder must be showered, dressed in street clothes, and groomed by 10 AM. Have her hat, coat, and mittens ready. The Medi-van is picking her up at 10:30 for a doctor's appointment.
Which nursing actions are examples of use of the ethical principle of beneficence? (Select all that apply)
-The LPN/LVN provides emotional support when the patient cries. -The LPN/LVN places the bed in a low position before leaving the room. -The LPN/LVN places medication the patient brought from home at the nurses' station.
In the following list, identify the instances of possible malpractice. (Select all that apply.)
-The nurse accidentally administers an excessively large dose of a prescribed medication, and the patient becomes comatose. -The nurse notes the patient's poor capillary return distal to a cast, becomes busy and does not report it, and the patient later loses limb function.
Individual A has worked as an LPN/LVN for a year. The agency where she works discovers that the registration document she presented at the time she was hired was altered to remove the name of the rightful registrant and show her name instead. What are the possible outcomes of this situation? (Select all that apply.)
-The state board of nursing, when notified, will charge the nurse with fraud and deceit -The agency will terminate the employment of the individual.
A nurse is appointed to a workplace committee to plan changes in the emergency department. The committee's task is to make recommendations that will provide an environment that deters violence. Which recommendations are consistent with this goal? (Select all that apply.)
-install bullet-resistant glass in the nurses' station. -Install security alarm devices in examining rooms. -Develop a minimum safe staffing policy. -Change security officers' uniforms to shirt, tie, blazer, slacks.
The introduction of the nursing process and critical thinking into nursing practice has resulted in increased ethical and legal responsibilities for nurses in the areas of (select all that apply):
-peer reporting. -accountability -patient advocacy.
The nurse is to present a mini-class on burnout prevention strategies at a nursing team meeting. Which topics would be appropriate to include? (Select all that apply.)
-practice time management skills -use humor to reduce tension -keep nursing skills current -maintain perspective about work
The nurse is asked to explain the meaning of ethics to a patient. The nurse should correctly state, "Ethics is a system of standards that refer to ideas and actions in terms of being
-right and wrong -moral and immoral -good and bad -ought and ought no -rights and duties
which statement are relevant to the problem that use proper body mechanics does not wholly protect nurses from back injuries?(SATA)
-small workplaces may contribute to injuries -there is increased obesity among nurses and patients -some musculosketal injuries are the result of cumulative stress. -body mechanics studies were performed on men, providing results that may not be true for women -Some nursing tasks require unnatural positions, such as bending from the torso, twisting, and so on.
Nurse A is assigned to care for a patient with diabetes who is being regulated on new types of insulin. The patient performs most of her own care and rarely uses the call bell to summon the nurse. The nurse knows this and leaves the patient unobserved most of the shift. Just before change of shift report, the aide reports that she cannot rouse the patient. The patient enters a vegetative state as the result of brain damage related to severe hypoglycemia. Which, if any, of the four elements needed to prove malpractice are present? (Select all that apply.)
Duty Breach of duty Damages Proximate cause
What LPN/LVN charge nurse behavior will best accomplish the goal of promoting team building?
Encouraging politeness, cooperation, respect, and trust
Which nonverbal behavior is most congruent with a nurse's assertive verbal statement?
Firm voice, erect posture, direct eye contact
Which situation can be identified as abandonment of patients by the nurse?
Going off duty without giving report rather than care for patients on an unfamiliar unit
The LPN/LVN charge nurse notices that a nursing assistant has not weighed her assigned residents. The best statement by the nurse is
I need to have you weigh your assigned residents and report to me by 10 AM."
A nursing student's mother states, "I need you to watch your younger siblings while I play bingo." The nursing student had planned to prepare for a unit examination. An assertive approach would be to say
I'm sorry, but I won't be able to babysit. I have an exam tomorrow. I need the time tonight to study."
The instructor tells a nursing student to hurry with the assignment in order to help a classmate who is behind with work. The student has promised a patient she'd return in 15 minutes to polish the patient's nails. Which response would be considered assertive?
I've promised one of my patients that I'll come back to polish her nails. I'd like to be able to keep that promise. Can you possibly ask someone else?"
Which duty would exceed the LPN/LVN scope of practice if included in the job description for an LPN/LVN charge nurse?
Independently developing written treatment protocols
How does co-dependence relate to nursing?
It is potentially destructive, because the nurse's co-dependency may prevent meeting the patient's needs.
fa student about accountability. What does the word 'accountability' really mean?" The best response by the nurse would be
It is taking personal responsibility for one's nursing actions."
What are the expected outcomes of using assertive communication in the nursing workplace? (Select all that apply.)
It promotes positive relationships. It is clear and unequivocal. It respects the rights of oneself and others.
In the following scenario, who owns the problem? Before the shift starts, the nursing assistants sympathetically tell the LPN/LVN charge nurse about nursing assistant Jenny's latest child care and car problems, which make it difficult for Jenny to get to work on time. The problem is owned by
Jenny
What ethical principle underlies the statement in the National Federation of Licensed Practical Nurses (NFLPN) Code for Licensed Practical/Vocational Nurses, "The practical nurse provides health care to all patients regardless of race, creed, cultural background, disease, or lifestyle"?
Justice
Legally, student practical/vocational nurses are held to the level of performance
LPN/LVN
Assuming all the following are staff members on the unit, to whom should the LPN/LVN charge nurse assign a newly admitted 65-year-old resident with left hemiplegia and a large sacral decubitus requiring a sterile dressing change?
LPN/LVN with 2 years of experience
Which behavior should be considered an early sign that a co-worker may have the potential for violence?
Lack of cooperation with supervisors
Which understanding about leadership would help the LPN/LVN become a more skillful leader?
Leaders see change as challenging and providing opportunities for improving quality of care.
In which situation would the LPN/LVN charge nurse be in violation of OBRA provisions?
Letting the unit secretary, who has completed 30 hours of instruction in a CNA program, bathe and ambulate a resident
The LPN/LVN charge nurse asks the nurse manager, "How can I motivate the nursing assistants on my shift?" The best answer would be
Motivation is an inner force. You can't motivate someone else, but understanding the things that are important to workers can be helpful."
The Nurse Practice Act of state X expressly states that blood products may be administered only by physicians, registered nurses, and physician assistants. Under what conditions can an LPN/LVN administer a unit of packed red cells?
Never; LPN/LVNs cannot administer packed cells
An example of statutory law is
Nurse Practice Act
To function within the scope of the law, the nurse must know that the legal duties and functions of the nurse in a given state are determined by the
Nurse Practice Act of the state
The LPN/LVN day shift charge nurse in a nursing home usually reports to the
RN manager of the unit.
A nurse demonstrates assertive behavior by doing which of the following?
Requesting to speak with the physician privately when she feels that the physician has ordered an inappropriate treatment
To which goal should the LPN/LVN give priority?
Resident X who has been experiencing a medication reaction will have no rash and uncompromised respirations.
The plan of care for a resident in the rehabilitation unit requires the resident to receive teaching about how to monitor blood glucose as part of discharge teaching. The RN is working with a resident whose condition is deteriorating. The LPN/LVN charge nurse has performed blood glucose monitoring many times but is new and has not received facility certification. The nursing assistant assigned to the patient is a diabetic and monitors blood glucose several times a day. Who should perform the teaching?
Rn
Which information can be omitted when the LPN/LVN charge nurse gives the change-of-shift report?
Routine care for each resident
The nurse in the workplace has little opportunity to receive positive feedback from peers or supervisors. What can be substituted?
Self-evaluation
An LPN/LVN is working in a health care facility that allows delegation of nursing duties to nursing assistants by the LPN/LVN. Which of the following duties could be delegated to the nursing assistant?
Weighing a patient
A nurse demonstrates nonassertive behavior by doing which of the following?
When a patient asks about the nurse's personal life, the nurse responds to the patient's questions out of fear of not being liked by the patient.
A nurse demonstrates assertive behavior by doing which of the following?
When asked about something unfamiliar, admitting to not knowing but agreeing to find out
The long-term care agency has recently announced that it will soon lay off six LPN/LVNs and hire eight nursing assistants. Today, the RN charge nurse presents the LPN/LVN charge nurse with a certificate recognizing her ability to manage effectively despite short staffing. The LPN/LVN responds somewhat politely but seems more angry than pleased. In terms of the Howlett hierarchy of needs, which of the following is the best explanation for the employee's reaction?
When job security is threatened, recognition needs assume lesser importance.
A nurse demonstrates assertive behavior by doing which of the following?
When unexpected visitors arrive to visit the patient during breakfast, the nurse asks whether the patient would prefer to eat now or visit.
A nurse demonstrates assertive behavior by doing which of the following?
When working with a patient who is critical of the nurse, the nurse sits down with the patient and listens attentively to the patient's concerns.
A staff nurse enters the room in which you're giving care to a patient in traction. She calls you aside and states, "I've watched you all morning. You don't seem to know how to do anything right. Look at you now! You're bathing the patient and it's almost time for lunch." An assertive approach would be to say
You're right. I am still bathing the patient. She was in pain earlier. I waited until her narcotic made her more comfortable."
How should the following scenario be evaluated with respect to the goal of encouraging the nursing assistant to be accountable for learning skills? Nursing assistant: "I do not know how to use the new lifting device to get Mrs. Jackson out of bed. I missed the demonstration the other day." LPN/LVN charge nurse: "I will ask Kay if she has time to get Mrs. Jackson out of bed with the new device while you assist. How can you prepare yourself to use the new device?" Nursing assistant: "I could watch closely when I assist Kay and ask questions. Then, I guess I could watch the videotape that came from the company and practice with a couple of the aides when they have time." LPN/LVN charge nurse: "Good plan. I will plan to observe and evaluate your competency tomorrow afternoon." The scenario should be evaluated as
a good example of encouraging the nursing assistant to be accountable for learning.
An example of battery is
a patient who refuses to be suctioned and is suctioned anyway after refusal
A newly graduated LPN/LVN who is orienting to the unit tells a peer, "You should have seen that new associate degree RN trying to take care of three patients! She was so disorganized that it made me glad I'm an LPN/LVN." The LPN/LVN is demonstrating
projection
The key to modifying co-dependent behavior is
recognition
When documenting patient behavior, the LPN/LVN should
record all interventions performed and patient instruction given.
The LPN/LVN notices that another nurse has made errors in practice and judgment over the past few weeks. In addition, the nurse's personality has undergone changes, such as irritability and unpredictability when responding to others. A patient mentioned to the LPN/LVN that when the nurse administered medication for pain relief, it didn't work as well as it had earlier in the day. Based on this information the LPN/LVN should
report these findings to the nurse in charge.
Which cycle is associated with being a co-dependent individual?
rescue someone, view the rescued individual disrespectfully, experience the feeling of victimization.
The nurse who works in the ICU leaves the room of a patient and bursts into tears. She tells a co-worker, "I have to touch the patient to provide care, but when I was turning her, a big piece of skin just sloughed off her back. How can I justify giving care when it seems to do more harm than good?" The nurse is most likely experiencing
secondary traumatic experiences
A student nurse is assigned to care for a patient with complex nursing care needs. The student was busy and did not prepare in advance for the assignment. In preconference, the student is unable to describe the care to be given and admits not knowing how to execute one of the treatments. The instructor would be ethically justified in
sending the student home and turning the patient care over to staff.
A nursing student is assigned to care for a patient who requires several technical procedures. The student was busy and did not prepare in advance for the assignment. In preconference, the student is unable to describe the care to be given. The instructor would be justified in
sending the student off duty and turning the patient's care over to staff.
13. A male nurse has been assigned to mentor a newly hired female nurse. Several times during the day, the new nurse perceives her mentor as touching her inappropriately. In the afternoon the mentor tells the new nurse, "I think we should meet after work for a drink. I could give you the lowdown on other staff, and we could get our relationship off to a good start. With my help, you'll be able to get raises and promotions regularly." The new nurse thinks, "I don't want this man's help." The new nurse can correctly determine that these behaviors suggest
sexual harassment.
A student nurse tells a peer, "I find myself constantly thinking about patient X and the problems she's experiencing. Sometimes, it makes me want to cry. If only I had a magic wand and could make things better for her!" The peer to whom this is revealed can correctly determine that the student nurse is experiencing
sympathy for the patient
The student nurse has a goal to become a more assertive person. To achieve this, the student nurse must be willing to
take a positive stand
The intervention that is most effective at reducing patient violence against nurses is
teaching nurses to communicate respect for patients and confidence in themselves
The LPN/LVN spends time exploring the agency mission statement with the nursing assistants who work that shift. They create a list of ways they can contribute to achieving the agency goals. This process is called
team building.
When conducting an employee performance evaluation conference, the LPN/LVN charge nurse should understand that
the employee should be encouraged to identify strengths and ask questions for clarification.