Unit 1
Which of the following describes a standard of care?
A standard of care is defined as a level of care a nurse provides that is the same for all nurses who have comparable education, competency, and experiences.
In same-day surgery clinics, screening tests and teaching take place upon admission to the clinic. A. True B. False
False
A school nurse who works in a low-income school district is assisting with planning a community program to improve healthy eating habits of school-age students in the district. Which of the following organizations should the school nurse contact to provide funding?
Administration for Children and Families (ACF)
collab with one more providers to deliver care to maternal - newborn clients and their families
CNM
Types of advance directives include
DNR, living will, power of attorney
Centralized Management
Senior managers make decisions with little input from the group
health care quality
access quality and safety affordability
An attorney is representing a patient's family who is suing a nurse for wrongful death. The attorney calls the nurse and asks to talk about the case to obtain a better understanding of the nurse's actions. How should the nurse respond? "I'm sorry, but I can't talk with you; you will have to contact my attorney." "I will answer your questions so you'll understand how the situation occurred. "I hope I won't be blamed for the death because it was so busy that day." "First tell me why you are doing this to me. This could ruin my career!"
"I'm sorry, but I can't talk with you; you will have to contact my attorney."
nursing's roles in ethical decision making
- an agent for clients facing an ethical decision - a decision maker for health care delivery
By the second postoperative day, a client has not achieved satisfactory pain relief. Based on this evaluation, which of the following actions should the nurse take, according to the nursing process? A. Reassess the client to determine the reasons for inadequate pain relief. B. Wait to see whether the pain lessens during the next 24 hr. C. Change the plan of care to provide different pain relief interventions. D. Teach the client about the plan of care for managing his pain.
A
A nurse is planning care for a client who has residual effects from an ischemic stroke. Which of the following interprofessional consults should the nurse request first? A. Speech-language pathologist B. Occupational therapist C. Physical therapist Dd. Social worker
A. Speech-language pathologist
A nurse is asked to act as a mentor to a new nurse. Which nursing action is related to this process? A. The nurse mentor accepts payment to introduce the new nurse to his or her responsibilities B. The nurse mentor hires the new nurse and assigns duties related to the position C. The nurse mentor makes it possible for the new nurse to participate in professional organizations D. The nurse mentor advises and assists the new nurse to adjust to the work environment of a busy emergency department
D
Title XIX (Social Security Act, 1965) to make health care available to those people with less than the minimum income who do not qualify for Medicare
Medicaid
A new nurse manager at a small hospital is interested in achieving Magnet status. Which action would help the hospital to achieve this goal? a. Centralizing the decision-making process b. Promoting self-governance at the unit level c. Deterring professional autonomy to promote teamwork d. Promoting evidence-based practice over innovative nursing practice
b
relates to loyalty and faithfulness to the patient and to one's duty
fidelity
process of lawsuit
litigation
A nurse working in an acute care facility is caring for a client who has a total brain injury and is receiving mechanical ventilation. Which of the following facilities should the nurse anticipate the client to be transferred for further treatment?
long term care hospital
collab with one or more providers to deliver nonemergency primary health care in a variety of settings
nurse practitioner
conducts research primarily to improve the quality of client care
nurse researcher
a subset of bioethics; formal study of ethical issues that arise in the practice of nursing and of the analysis used by nurses to make ethical judgments
nursing ethics
evaluate the patient's functional level and teaching activities to promote self-care in activities of daily living
occupational therapist
prepared at the doctoral level, is licensed to formulate and dispense medications.
pharmacist
situation that arises when attempted adherence to basic ethical principles results in two conflicting courses of action
ethical dilemma
: the use of health information technology to improve the quality, efficiency, or delivery of health care
health informatics
organization that operates in a complex, high-hazard domain for an extended period without serious accidents or catastrophic failures
high reliability org
Types of quasi-intentional torts
-Breach of confidentiality -Defamation of character
A nurse is completing the Minimum Data Set assessment for a resident in a skilled nursing facility. Which of the following information should the nurse include in the assessment?
Input from members of the interdisciplinary team. Client's cognitive status. Each physical therapy visit. Clients need for assistance with ADLs.
A nurse is preparing a poster describing leadership styles for a unit in-service. Which of the following terms should the nurse use to describe a nurse manager who exerts little control over the decisions made by the charge nurse?
Laissez-faire Under a laissez-faire style of leadership, nurses are given the freedom to work independently to accomplish goals with little control asserted by the nurse manager.
a type of end-of-life care for persons who are terminally ill, characterized by the following: (1) patients are kept as free of pain as possible so that they may die comfortably and with dignity; (2) patients receive continuity of care, are not abandoned, and do not lose personal identity; (3) patients retain as much control as possible over decisions regarding their care and are allowed to refuse further life-prolonging technologic interventions; and (4) patients are viewed as individuals with personal fears, thoughts, feelings, values, and hopes
hospice
-type of involuntary commitment in which the patient in in need of observation, a diagnosis, and a treatment plan-time for this type of commitment is controlled by state statue and varies greatly between states-this may be imposed by a family member, legal guardian, PCP, or mental health provider
observational or temporary involuntary commitment
summarized findings from multiple studies of a specific clinical practice question or topic that recommend practice changes and future directions for research; one of the strongest sources of evidence for evidence-based practice
systematic review
the use of technology to deliver health care, health information, or health education at a distance
telehealth
A nurse decides to become a home health care nurse. Which personal qualities are key to being successful as a community-based nurse? Select all that apply. a/Making accurate assessments b/Researching new treatments for chronic diseases c/Communicating effectively d/Delegating tasks appropriately e/Performing clinical skills effectively f/Making independent decisions
a c e f
A nurse is participating in a high school career day and is teaching about accreditation of nursing programs. Which of the following statements should the nurse make?
"Nurses who graduate from accredited nursing programs will have more employment opportunities."
A caregiver asks a nurse to explain respite care. How would the nurse respond? "Respite care is a service that allows time away for caregivers." "Respite care is a special service for the terminally ill and their family." "Respite care is direct care provided to people in a long-term care facility." "Respite care provides living units for people without regular shelter."
"Respite care is a service that allows time away for caregivers."
types of assessments
- initial - focused - emergency - time-lapsed
RN is responsible for
- provide initial teachings to clients - Performing assessments of clients - Administering blood transfusions
Types of unintentional torts
-Negligence -Malpractice (professional negligence)
Federal laws affecting nursing practice
-The Health Insurance Portability and Accountability Act (HIPAA) -The Americans with Disabilities Act (ADA) -The Mental Health Parity Act (MHPA) -The Patient Self-Determination Act (PSDA)
Who can an RN delegate to?
1)Unlicensed Assistive Personnel 2)LPN 3)Another RN
Consent must have the following present or it is not valid:
1. Disclosure 2. Comprehension 3. Competence 4. Voluntariness
A nurse who has a multi-state license receives a request from a facility in a neighboring state about providing care in their facility during an emergency disaster. Which of the following actions should the nurse take prior to responding to the request?
Contact the state board of nursing in the neighboring state.
A nurse is teaching about the Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS). What should she include?
HCAHPS measures the client satisfaction with health care services.
ISBARQ Method of Patient Hand-off
I - Introduction S - Situation B - Background A - Assessment R - Recommendation Q - Question and answer
Title XVIII (Social Security Act, 1965) to provide a measure of health coverage to all Social Security recipients
Medicare
A nurse is discussing hospice care. What is the goal of hospice care?
Provide care for a client who has less than 6 months to live
A nurse is teaching a newly licensed nurse about the purpose of peer review in scholarly publications. Which of the following statements should the nurse make?
This process ensures scientific quality and rigor.
There are numerous reasons for resistance to change, which include:
Threat of self Lack of understanding Limited tolerance for change Disagreements about the change Fear of Increased Responsibility
a nurse is discussing restorative health care with a newly licensed nurse. Which of the following examples should the nurse include in the teaching? a. home health care b. rehabilitation facilities c. diagnostic centers d. skilled nursing facillities e. oncology centers
a b d
Nurses provide care to patients as collaborative members of the health care team. Which roles may be performed by the advanced practice registered nurse? Select all that apply. a.Primary care provider b.Hospitalist c.Physical therapist d.Anesthetist e.Midwife f.Pharmacist
a, d, e
A nurse researcher keeps current on the trends to watch in health care delivery. What trends are likely included? Select all that apply. a. Globalization of the economy and society b. Slowdown in technology development c. Decreasing diversity d. Increasing complexity of patient care e. Changing demographics f. Shortages of key health care professionals and educators
a, d, e, f
group of health care entities (e.g., hospitals, primary care settings, and specialty care practices) organized via incentives to deliver the most efficient and high-quality care for the population served
accountable care organization (ACO)
3 processes used for credentialing in nursing
accreditation, licensure, certification
this refers to the patients right to make her own decisions. but the patient must accept the consequences of those decisions. the patient must also respect the decisions of others.
autonomy
A nursing student asks the charge nurse about legal liability when performing clinical practice. Which statement regarding liability is true? a. Students are not responsible for their acts of negligence resulting in patient injury. b. Student nurses are held to the same standard of care that would be used to evaluate the actions of a registered nurse. c. Hospitals are exempt from liability for student negligence if the student nurse is properly supervised by an instructor. d. Most nursing programs carry group professional liability making student personal professional liability insurance unnecessary.
b
relates to the quality of doing good and can be described as charity
beneficence
emergency seclusion/restraints
charge nurse can use seclusion/restraints without doctors order; but must obtain within a specified period of time (usually 15-30 minutes)
Decentralized management
decision making occurs at the level of the staff
the transfer of responsibility for the performance of an activity to another individual while retaining accountability for the outcome
delegation
Assualt
making a threat to a patient
ability to behave in an ethical way; to do the ethically right thing because it is the right thing to do
moral agency
specific beliefs or actions whose outcomes are often examined utilizing the principles of autonomy, beneficence, nonmaleficence, double effect, and distributive justice
morality
a nurse questions a medication prescription as too extreme in light of the client's advanced age and status. the nurse understands this action is part of what ethical principle?
nonmaleficence
supervise and coordinate direct care to patients and families.
nurse
A nurse in a NICU fails to monitor a premature newborn according to the protocols in place, and is charged with malpractice. What is the term for those bringing the charges against the nurse? Appellates Defendants Plaintiffs Attorneys
plaintiffs
a systematic, problem-solving approach for meeting people's health care and nursing needs; components involve assessment, diagnosis, planning, implementation, and evaluation
precision medicine
Types of Nursing Diagnoses
problem-focused risk health promotion
Types of Torts
quasi-intentional, intentional and unintentional
is trained in techniques that improve pulmonary function and oxygenation.
respiratory therapist
A home health nurse is caring for a client who is receiving hospice care. The clients partner reports feeling overwhelmed from care for the client. What facility should the nurse recommend?
respite care
a type of care provided for caregivers of homebound ill, disabled, or older adult patients
respite care
False Imprisonment
restraining an individual or restricting an individual's freedom
a charge nurse is reviewing client acuities to make the nursing staff's daily assignments. using the 5 rights of delegation, which ensures client safety?
right task
5 rights of delegation
right: task circumstance person direction and communication supervision and evaluation
A nurse is admitting a client who has heart failure. Which of the following tools should the nurse use to implement nursing interventions for the client?
standard of care
A nurse should consult a social worker if:
the client requires special resources
this refers to being honest when dealing with a patient
veracity
term generally used to refer to employees who report their employers' violation of the law to appropriate law enforcement agencies outside the employers' facilities
whistle blowing
refusal to participate in certain types of treatment and care based on the fact that these activities violate the nurse's personal and professional ethical beliefs and standards
conscientious objection:
Levels of critical thinking
-basic critical thinking -complex critical thinking -commitment
a nurse in a surgeons office is providing preop teaching for a client who is scheduled surgery the following week. the client tells the nurse that "I plan to prepare my advance directives before I come". Which of the following statements made by the client should indicate to the nurse an understanding of ads? "I'd rather have my brother make decisions, but it has to be my wife" "I know I can't have surgery unless I have these forms" "I plan to write I don't want to be put on a breathing machine" "I will get my regular doc to approve my plan before I hand it in"
"I plan to write I don't want to be put on a breathing machine"
A nurse is teaching about hospice care to a client. What statement shows that the client understands?
"I understand that services provided will include just what is needed to keep me comfortable."
A nurse is caring for a client who has a new diagnosis of cancer. The client states, "I don't understand what my treatment options are." Which of the following statements by the nurse demonstrates advocacy?
"I will contact your provider to review your treatment options."The nurse is demonstrating advocacy by contacting the provider to communicate the client's concerns so that the client can make an informed decision regarding their health care.
A nurse is discussing the nursing process with new nurse. What statement identifies as appropriate for planning steps of nursing process?
"I will determine the most important client problems that we should address"
A nurse is teaching about the Affordable Care Act. What should she include?
A focus of the ACA is disease prevention.
A nurse is providing an in-service about research methods for a group of nurses. Which of the following methods provides the most credible evidence to support practice changes?
A systemic review summarizing findings of studies.
A nurse is a servant leader working in an economically depressed community to set up a free mobile health clinic for the residents. Which actions by the leader BEST exemplify a key practice of servant leaders? Select all that apply A. The nurse motivates coworkers to solicit funding to set up the clinic. B. The nurse sets only realistic goals that are present oriented and easily achieved. C. The nurse forms an autocratic governing body to keep the project on track. D. The nurse spends time with supporters to help them grow in their roles. E. The nurse first ensures that other's lowest priority needs are served. F. The nurse prizes leadership because of the need to serve others.
A, D, F
supports the interests of nursing education, nursing practice, and the public by the functions of accreditation. Accreditation is a voluntary, peer-review, self-regulatory process by which non-governmental associations recognize educational institutions or programs that have been found to meet or exceed standards and criteria for educational quality.
ACEN
identify and respond to the spiritual needs of patients, families, and other members of the interdisciplinary team. They may be members of the clergy, pastoral care workers with graduate degrees, or lay volunteers.
Chaplain/Spiritual Care Provider
A charge nurse is overseeing an assistive personnel (AP) who has been assigned care for a group of clients. Which of the following actions by the charge nurse demonstrates accountability?
Files an incident report when the AP performs a task that is outside their scope of practice
A nurse is discussing responsibility with a newly licensed nurse. Which of the following actions should the nurse include as an example of responsibility?
Checks a client to determine how well a pain medication worked This action by the nurse represents responsibility because the nurse identified a client need, intervened, and is now determining the outcome of the intervention.
A school nurse notifies the guardian of a school-age child who has failed the vision screening and recommends the child see an optometrist. The guardian reports that they cannot afford private health insurance. Which of the following programs should the nurse recommend the guardian contact?
Children's Health Insurance Program (CHIP)
A nurse is discussing the Model of Professionalism with another nurse. Which of the following concepts should the nurse include as an outer process?
Clear communication Clear communication is an outer process because it is a behavior or action that the nurse performs.
trained to help hearing-impaired patients speak more clearly, to assist patients who have had a stroke to relearn how to speak, and to correct or modify a variety of speech disturbances in children and adults.
speech therapist
A nurse is planning care for four clients. Which of the following tasks should the nurse delegate to a licensed practical nurse (LPN)? A. Assess a client's postoperative abdominal incision. B. Provide discharge teaching for a client who had a laparoscopic cholecystectomy. C. Perform a wet-to-dry dressing change for a client who has a pressure ulcer. D. Initiate a blood transfusion for a client who has a low hemoglobin.
C. Perform a wet-to-dry dressing change for a client who has a pressure ulcer.
A nurse is managing the care for a client who has recent unexplained weight loss and a low serum albumin level. Which of the following members of the interprofessional care team should the nurse consult? A. Occupational therapist B. Case manager C. Registered dietitian D. Social worker
C. Registered dietitian
admin anesthesia and provides care during procedures under the supervision of an anesthesiologist
CRNA
Conflict Resolution Strategies
Avoiding Collaborating Competing Compromising Cooperating/accommodating Smoothing
A nurse manager who is attempting to institute the SBAR process to communicate with health care providers and transfer patient information to other nurses is meeting staff resistance to the change. Which action would be most effective in approaching this resistance? A. Containing the anxiety in a small group and moving forward with the initiative B. Explaining the change and listing the advantages to the person and the organization C. Reprimanding those who oppose the new initiative and praising those who willingly accept the change D. Introducing the change quickly and involving the staff in the implementation of the change
B
The role of the nurse in hospitals includes managing other members of the health care team. T of F
B
A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to a UAP. Which of the following info should the nurse share with the UAP? A. the roommate ambulates independently B. the client amb. wearing slippers over antiembolic stockings C. the client uses a front wheeled walker when amb. D. client had meds 30 min ago E. client allergic to codeine F. client ate 50% of breakfast
B C D
A nurse is a member of the facility's quality improvement committee. The committee is concerned with the increase in the number of catheter-associated urinary tract infections (CAUTI) at the facility. Which of the following agencies should the nurse use to find best-practice guidelines for the care of clients with indwelling urinary catheters?
Centers for Disease Control (CDC)
A charge nurse uses a transformational leadership style when working with other staff on the unit. Which of the following actions by the charge nurse demonstrates transformational leadership?
Challenges a nurse to investigate evidence-based approaches to reduce the client fall rate on the unitA transformational leader focuses on a person's willingness to change and stimulates them to review current structures and come up with fresh new ways to improve them, such as finding a way to decrease client falls.
Trends to Watch in Health Care Delivery
Changing demographics Increasing diversity Technology explosion Globalization of economy and society Educated and engaged consumers Increasing complexity of patient care Costs of health care Effect of health policy and regulation Shortages of key health care professionals and educators
A nurse on a med surge unit has recieved change of shift report and will care for 4 clients. Which of the following clients needs will the nurse assign to an AP? A. updating the plan of care for a client who is postop B. Reinforcing teaching with a client who is learning to walk using a quad cane C. Reapplying a condom catheter for a client who has urinary incontinence D. Applying a sterile dressing to a pressure injury
C, (noninvasive, routine)
a client who had cerebrovascular accident has persistent problems with dysphagia. the nurse caring for the client should initiate a referral with which of the following members of the interprofessional team?
speech-language pathologist
A nurse manager of a busy cardiac unit observes disagreements between the RNs and the LPNs related to schedules and nursing responsibilities. At a staff meeting, the manager compliments all the nurses on a job well done and points out that expected goals and outcomes for the month have been met. The nurse concludes the meeting without addressing the disagreements between the two groups of nurses. Which conflict resolution strategy is being employed by this manager? A. Collaborating B. Competing C. Compromising D. Smoothing
D
A veteran nurse, pleaded guilty to a misdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into a coma during routine outpatient hernia surgery. The nurse admitted failing to monitor the woman's vital signs during the procedure. The surgeon who performed the procedure called the nurse's action pure negligence, stating that the patient could have been saved. The patient was a vibrant grandmother of 10 who had walked three quarters of a mile the morning of her surgery and had sung in her church choir the day before. What criteria must be established to prove that the nurse is guilty of malpractice or negligence in this case? a.The surgeon who performed the procedure called the nurse's action pure negligence, saying that the patient could have been saved. b. The fact that this patient should not have died since she was a healthy grandmother of 10, who was physically active and involved in her community. c. The nurse intended to harm the patient and was willfully negligent, as evidenced by the tragic outcome of routine hernia surgery. d. The nurse had a duty to monitor the patient's vital signs, and due to the nurse's failure to perform this duty in this circumstance, the patient died.
D
Which statement accurately describes part of the process involved when a patient leaves AMA? A. The patient is not legally free to leave without being discharged. B. The patient leaving AMA must sign a form releasing the nurse from legal responsibility for health status. C. After signing the form, the patient should be informed of any possible risks involved with leaving AMA. D. The patient's signature must be witnessed, and the form becomes part of the patient's record.
D
Which of the following is designed to provide palliative and supportive care services for dying persons? A. Respite care B. Parish nursing C. Voluntary agencies D. Hospice services
D. Hospice services
A nurse is receiving change-of-shift report for a group of clients. Which of the following should the nurse attend to first? A client who: A. is scheduled for discharge and requires teaching for wound care B. is postoperative and requests pain medication before ambulation C. is to receive an antibiotic in 1 hr and has a prescription for a peak and trough level D. has received nitroglycerin sublingual for chest pain and requires a 12-lead EKG
D. has received nitroglycerin sublingual for chest pain and requires a 12-lead EKG
A nurse is discussing leadership styles with a newly licensed nurse. Which of the following characteristics should the nurse identify as describing a bureaucratic leader? (Select all that apply.)
Decisions are controlled by policies is correct. A bureaucratic leader bases their decisions on policies and strictly follows the rules. Enforces the rules is correct. A bureaucratic leader strictly follows and enforces the rules. Inflexible to creative suggestions is correct. Bureaucratic leaders abide by the specific policy and procedures and are not open to creativity, suggestions, or ideas.
Gibb's Model of Reflection
Description, feelings, evaluation, analysis, conclusion, action plan
A nurse is teaching a class about citing references to use for evidence-based changes. Which of the following requires citing a reference to avoid plagiarism? (Select all that apply.)
Direct quotations from a journal article. A photograph depicting equipment. Ideas published in a theoretical paper. Paraphrased sentence from an article.
Checklist to ensure informed consent
Disclosure Comprehension Competence Voluntariness
IOM''s Six Outcomes for a New Health
SafeEffectiveEfficientPatient-centeredTimelyEquitable
law enacted by a legislative body
statutory law
leadership style based on maintaining control by rewarding good behavior and punishing negative or detrimental behavior
transactional
type of leadership in which the person creates revolutionary change and commits to the personal and professional growth of self and others
transformational
A nurse is preparing for a presentation on professional identity in nursing. Which of the following statements should the nurse use to describe professional identity?
"Professional identity is how one describes themselves as a professional."Professional identity is a personal interpretation of how one sees themselves within a professional role. It is often described as the self-image, self-concept, or personal view an individual has of themselves in their professional role.
A nurse in a provider's office is completing an admission history for a client. Which of the following statements should the nurse make?
"The Affordable Care Act requires all insurance plans to offer preventive services such as mammogram screenings.
A nurse is teaching about Medicaid to a client who is concerned about paying for health care. Which of the following statements should the nurse make?
"Your income will determine if you are eligible for Medicaid."
Maslow's Hierarchy of Needs
(level 1) Physiological Needs, (level 2) Safety and Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self Actualization
ethical principles for client care
-autonomy -beneficence -fidelity -justice -nonmaleficence -veracity
A nurse who is newly hired to manage a busy pediatric office is encouraged to use a transactional leadership style when dealing with subordinates. Which activities best exemplify the use of this type of leadership? Select all that apply. A. The manager institutes a reward program for employees who meet goals and work deadlines. B. The manager encourages the other nurses to participate in health care reform by joining nursing organizations. C. The manager promotes compliance by reminding subordinates that they have a good salary and working conditions. D. The manager makes sure all the employees are kept abreast of new developments in pediatric nursing. E. The manager works with subordinates to accomplish all the nursing tasks and goals for the day. F. The manager allows the other nurses to set their own schedules and perform nursing care as they see fit.
A, C
Which of the following statements should the nurse use to define licensure?
Licensure protects the health and welfare of the public
a beginning list of suggested terms for health problems that might be identified and treated by nurses
NANDA-I
A national computer-adapted standardized, graded, pass/fail test used to determine if a graduate nurse is ready to become licensed as an entry-level nurse
NCLEX
For more than 100 years this has been premier organization for nurse faculty, schools of nursing, and leaders in nursing education.
NLN
A nurse is teaching a newly licensed nurse about an OSHA standard that is engineer controlled to minimize needlestick injuries. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?
Needless IV tubing for IV infusions is an example of an OSHA standard that is engineer controlled
An agreement that allows nurses to practice in other NLC states without having to obtain additional licenses
Nurse Licensure Compact
completed a specific course of study and a licensing examination in preparation for providing support to the physician.
PA
a project whose aim is to develop curricula that prepare future nurses with the knowledge, skills, and attitudes (KSA) required to continuously improve the quality and safety of the health care system through demonstrating competency in patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics
QSEN
A nurse is teaching a newly licensed nurse about Medicare reimbursement. What should she include?
Reimbursement amounts will be adjusted for clients who contract HACs.
A newly licensed nurse is assigned to care for a client who has a newly inserted chest tube. The nurse has not previously cared for a client who has a chest tube. Which of the following actions should the nurse take?
Review the facility's policy and procedure (P&P) manual.
Which of the following information should the nurse identify as a passing criteris for the NCLEX computerized test (CAT)
The computer will stop giving items using the 95% confidence interval rule.
help nurses provide direct care to patients.
UAP
Change Theory
Unfreezing: The need for change is recognized. Moving: Change is initiated after a careful process of planning. Refreezing: Change becomes operational.
A nurse is teaching a class about searching the internet for research articles to use for evidence-based changes. Which of the following information should the nurse include?
Use Quackwatch to verify credible websites.
an approach to bioethics that offers specific action guides
principle-based approach
A nurse is exploring leadership styles of nurse managers as a part of a quality improvement project. Which of the following statements by a nurse manager should the nurse identify as an example of transactional leadership?
"The staff members who complete their online learning courses before the deadline will receive a gift card." Transactional leaders use rewards or punishments to encourage compliance for an established goal. They communicate specific expectations, focusing on tasks and completion of short-term goals.
restraints shouldn't be used for
-convenience of the staff-punishment of the patient-patients who are extremely physically or mentally unstable-patients who can't tolerate the decreased stimulation of a seclusion room
components of critical thinking
-knowledge -experience -competence -attitudes -standards
A nurse is educating a group of nurses about the Nurse Practice Act (NPA). Which of the following statement should the nurse include? SATA
1. The NPA contains current laws and regulations for nursing practice 2. The NPA contains standards and scope of practice 3. The Nurse is responsible to know the current roles and responsibilities as defined by the NPA
What information should the graduate nurse identify as a requirement during the initial licensure process? SATA
1. Verification of graduation 2. Criminal background check in certain states 3. Passing score on the NCLEX examination 4. Self-disclosure of any substance use in the past 5 years
A nurse is caring for a group of clients. Which of the following actions by the nurse demonstrates professionalism?
Asks a client for their name, date of birth, and scans their medical identification bracelet before administering medicationsThe nurse demonstrates professionalism by practicing the rights of medication administration to promote client safety.
A nurse is discussing nursing roles with a newly licensed nurse. The nurse should include that which of the following is a role of the nurse? (Select all that apply.)
Caregiver is correct. The role of the nurse includes providing care to clients with respect and empathy, engaging in therapeutic communication, and providing physical, mental and emotional support. Advocate is correct. The role of the nurse includes advocating for client needs and assisting clients to make informed decisions regarding their care. Change agent is correct. The role of the nurse includes guiding a client to recognize the need for change, engage in the plan, and take a proactive role in their health status.
Planning for discharge begins when the patient receives discharge orders from the physician in charge of care. A. True B. False
False
A nurse has completed administering a controlled substance to a client. There is 1 mL of the medication left in the syringe. Which of the following actions should the nurse take to dispose of the unused medication?
Have a second nurse witness the disposal of the client's unused medication.
Gordon functional health patterns
Health Perception/Health Management Nutritional/Metabolic Elimination Activity/Exercise Cognitive/Perceptual Sleep/Rest Self-Perception/Self-concept Role/Relationship Sexuality and Reproductive Coping/Stress Tolerance Value-Belief
A nurse at a community health center is providing an in-service for a group of residents about the Healthy People program. Which of the following information should she include?
Initiatives to reduce health care disparities. Activities to improve social determinants of health. Improving access to health care.
The governing body for nurses in the state of MS. Responsible for issuing nursing licensure for the state. They handle any issues that may interfere with licensure, as well as taking actions to revoke licensure of those who have violated any statutes within the state.
MSBON
Public Federally Funded Programs
Medicare Medicaid Patient Protection & Affordable Care Act State Children's Health Insurance Program
Current laws and regualtins governing nursing practice in every state and territory of the United States
Nurse Practice Act
Paying for Health Care
Out-of-pocket payment Individual private insurance Employer-based private insurance Government financing
2010 federal legislation designed for comprehensive health reform, with an intent to expand coverage, control health care costs, and improve the health care delivery system
Patient Protection and Affordable Care Act (PPACA)
Strategies to Promote Quality of Care
Pay per performance/value-based purchasing Penalties for excess readmissions
A newly licensed nurse is considering strategies to improve critical thinking. Which action should the nurse take? a. find a mentor b. use journal to write about outcomes of clinical judgements c. review articles about evidence based practice d. limit consultations w/ other professionals involved in a client's care e. make quick decisions when unsure about clients needs
a b c
A pediatric nurse is assessing a 5-year-old boy who has dietary modifications related to his diabetes. His parents tell the nurse that they want him to value good nutritional habits, so they decide to deprive him of a favorite TV program when he becomes angry after they deny him foods not on his diet. This is an example of what mode of value transmission? a.Modeling b.Moralizing c. Laissez-faire d. Rewarding and punishing
d
a nurse uses a head-to-toe approach to conduct a physical assess. of a client who will undergo surgery the following week. Which critical thinking attitudes did the nurse demonstrate?
d
an intentional tort in which one party makes derogatory remarks about another that diminishes the other party's reputation; slander is oral defamation of character; libel is written defamation of character
deflammation of character
a nurse is caring for a competent adult client who tells the nurse, "I am leaving the hospital this morning whether the doc discharges me or not". The nurse believes that this is not in the clients best interest, and prepares to administer PRN sedative medication the client has not requested along with morning meds. What type of tort?
false imprisonment
willful and purposeful misrepresentation that could cause, or has caused, loss or harm to people or property
fraud
A nurse cares for dying patients by providing physical, psychological, social, and spiritual care for the patients, their families, and other loved ones. What type of care is the nurse providing? Respite care Palliative care Hospice care Extended care
hospice care
power obtained by force of a person's personality that might enable that person to have more power to influence others than designated leaders
implied power
report of any event that is not consistent with the routine operation of the health care facility that results in or has the potential to result in harm to a patient, employee, or visitor
incident report
person who enters a health care setting for a stay ranging from 24 hours to many years
inpatient
Obtains specimens of body fluids and performs diagnostic tests
laboratory tech
leadership style in which the leader relinquishes all power to the group
laissez-faire leadership
-type of commitment that is similar to temporary commitment but must be imposed by the courts-time of commitment varies, but it is usually 60-180 days; sometimes no release date
long-term or formal involuntary commitment
Examples of task a nurse might delegate to a LPN
monitoring findings reinforcing client teaching from a standard care plan performing tracheostomy care suctioning checking NG tube patency administering enteral feedings inserting urinary catheter administering medication
primarily responsible for the diagnosis of illness and the medical or surgical treatment of that illness.
physician
A community health nurse is teaching about social determinants of health. What should she identify as a physical determinant or health?
poor air quality
responsibilities of informed consent
provider: obtains informed consent client: gives informed consent nurse: witnesses informed consent
Ex of Primary Sources
subjective: what the client tells the nurse objective: data the nurse obtains through observation and examination
Management of rare and complex disorders such as pituitary tumors and congenital malformations
tertiary health care
Which statement or question MOST exemplifies the role of the nurse in establishing a discharge plan for a patient who has had major abdominal surgery? "I'll bet you will be so glad to be home in your own bed." "What are your expectations for recovery from your surgery?" "Be sure to take your pain medications and change your dressing." "You will just be fine! Please stop worrying."
"What are your expectations for recovery from your surgery?"
mandatory reporting
-abuse: child or elder abuse, domestic violence -communicable diseases (according to CDC) such as hepatitis and TB
nurses responsibility during seclusion/restraints
-assessment -offered food and toilet -monitored for vital signs
resources for solving ethical patient issues
-code of ethics for nurses-patient care partnership-nurse practice act of a specific state-legal advice from attorneys-facility policies-other members of the health care team-members of the clergy and other spiritual or ethical counselors
various specific rights
-informed consent and the right to refuse treatment -confidentiality -written plan of care/treatment that includes discharge follow-up, as well as participation in the care plan and review of that plan -communication with people outside the mental health facility; family, attorneys and other health care professionals -provision of adequate interpretive services if needed -care provided with respect, dignity, and without discrimination -freedom from harm related to physical and pharmacological restraint, seclusion, and any physical or mental abuse or neglect -provision of care with the least restrictive interventions necessary to meet the patients need's without allowing him to be a threat
The IHI triple aim
-population health -experience of care -per capita cost
complete documentation includes
-precipitating events and behavior of the patient prior to seclusion or restraint -alternative actions taken to avoid seclusion/restraints -time treatment began -patients current behavior, what foods/fluids were offered and taken, needs provided for, and vital signs -medication administration -nurse must document patients behavior in a clear and objective manner and the staff response to disruptive, violent, or potentially harmful behavior
A nurse caring for patients in a primary care setting submits paperwork for reimbursement from managed care plans for services performed. Which purpose best describes managed care as a framework for health care? A design to control the cost of care while maintaining the quality of care Care coordination to maximize positive outcomes to contain costs The delivery of services from initial contact through ongoing care Based on a philosophy of ensuring death in comfort and dignity
A design to control the cost of care while maintaining the quality of care
A nurse is planning a presentation about shared governance. Which of the following examples should the nurse plan to include?
A group of staff nurses in a clinic work together to recommend new equipment purchases for the unit.
A nurse is discussing leadership styles with a newly licensed nurse. The nurse should include that which of the following is a characteristic of situational leadership?
Adjusts quickly to different circumstances A situational leader looks at each situation quickly and adjusts strategies based on the circumstances. The situational leader aligns their style to assist in the development and growth of others and the overall effectiveness of the organization. This leader communicates, problem-solves, organizes, and prepares with their employees to accomplish tasks and improve overall efficiencies.
develops positions relevant to nursing practice, health policy, and social concerns impacting the health of patients and families. Position statements guide the profession, amplify the views of nursing, and educate consumers and decision makers.
American Nurses Association
A nurse is reviewing a report by the Institute of Medicine. Which of the following competencies should the nurse identify health care professionals need in order to reduce errors?
Cooperation Communication Coordination
A nurse is hired to be a case manager in a facility. Which of the following services should the nurse expect to perform?
Facilitate transfer of clients to meet the required level of care.
A nurse is discussing shared governance with a newly licensed nurse. Which of the following components should the nurse include in the discussion? (Select all that apply.)
Guides decisions toward accountability is correct. Guiding decisions toward accountability is a function of shared governance. Improves client outcomes is correct. Improving client outcomes is a function of shared governance. Promotes professional development is correct. Promoting professional development is a function of shared governance.
Which of the NLN integrating competencies is defined as having respect for diversity, holistic care, client centered approach, and client advocacy.
Human Flourishing Defined as the nurse providing client care that demonstartes respect for diversity approaches clients in a holistic and client-centered manner, and uses advocacy to enhance a clients' health
A nurse is caring for a young adult client who is deceased and has a valid organ donation card. The client's parents have expressed a desire against having the client's organs donated. Which of the following actions should the nurse take?
Inform the parents about the law that prohibits their ability to revoke the client's wishes to donate.
A nurse is preparing a poster about professional accountability for an in-service. Which of the following examples should the nurse include? (Select all that apply.)
Lowers a client's bed to the lowest position after assisting the client to lie down is correct. A nurse is accountable to the client as well as the facility to take actions to ensure a client's safety. This includes lowering the client's bed to reduce the risk of falls if the client tries to get out of bed. Administers pain medication to a client 30 min before the client is scheduled for physical therapy is correct. Planning actions, such as providing pain medication to a client prior to physical therapy, demonstrates planning and accountability for ensuring the client receives quality care. This action allows the medication time to take effect prior to the client having to perform physical activities, allowing for a more effective physical therapy session and decreasing the risk of client injury and discomfort. Provides instructions to assistive personnel (AP) on how to provide culturally competent care to a client is correct. Professional accountability involves not only ensuring the safety and quality of nursing care, but also delivering it in a culturally competent manner.
Types of Home Health Care Facilities
Official or public facilities: These facilities are operated by state or local governments and primarily financed by tax funds. Most offer home care and disease-prevention programs in the community. Voluntary or private not-for-profit facilities: These facilities are supported by donations, endowments, charities (such as the United Way), and insurance reimbursements. They are governed by a board of directors, usually representing the community they serve. Private, proprietary facilities: Most private, proprietary facilities are for-profit organizations governed by individual owners or national corporations. Their services are paid for through health care insurance or individual self-pay. Institution-based facilities: These facilities operate under a parent organization, such as a hospital. The home care facility is governed by the institution, and most referrals for care come from within the institution.
components of PICOT format
P = Patient, population, or problem of interest I = Intervention of interest C = Comparison of interest O = Outcome of interest T = Time
A nurse is caring for a Parkinson's patient and needs assistance for their ADLs. Which of the following referrals should the nurse anticipate the provider to prescribe?
Physical therapist Occupation therapist Dietician
The Human Dimensions
Physical, Emotional, Intellectual, Environmental, Sociocultural, Spiritual
Defines those duties that a nurse is considered competent to carry out and authorized to perform as defined by state law. In other words, the scope of practice stipulates those activities nurses can and cannot perform legally.
Scope of Practice
Ex of Secondary Sources
Subjective: what others tell the nurse what the client has told them Objective: data the nurse collects from other sources (ex; family)
A nurse ensures that a hospital room prepared by an aide is ready for a new ambulatory patient. Which condition would the nurse ask the aide to correct? The bed linens are folded back. A hospital gown is on the bed. Equipment for taking vital signs is in the room. The bed is in the highest position.
The bed is in the highest position.
A nurse is discussing chain of command with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the discussion?
The chain of command clarifies the steps I need to take when I have a concern about a client's care."
A nurse is caring for a client who is postoperative and has sanguineous drainage on their dressing. The nurse is unable to reach the client's provider. Which of the following members of the chain of command should the nurse contact next?
The charge nurse. According to evidence-based practice, the first person in the chain of command that the nurse should contact is the charge nurse. The nurse should initiate the chain of command to make the charge nurse aware of the situation and to ensure the client receives safe and effective care.
A nurse is using evidence-based practice to develop a PICOT question. Which of the following describes the "O" in PICOT?
The desired result of the intervention to the problem.
A graduate nurse notes that a hospital with Pathway to Excellence recognition is hiring staff. What should the nurse expect from this facility?
The facility has practices in place that lead to a health workplace environment. The facility emphasizes shared governance. The facility emphasizes practices that positively affect the nurse well being
A nurse is preparing an infant and his family for a hernia repair to be performed in an ambulatory care facility. What is the primary role of the nurse during the admission process? To assist with screening tests To provide patient teaching To assess what has been done and what still needs to be done To assist with hernia repair
To assess what has been done and what still needs to be done
A nurse is counseling an older woman who has been hospitalized for dehydration secondary to a urinary tract infection. The patient tells the nurse: "I don't like being in the hospital. There are too many bad bugs in here. I'll probably go home sicker than I came in." She also insists that she is going to get dressed and go home. She has the capacity to make these decisions. What is the legal responsibility of the nurse in this situation? To inform the patient that only the primary health care provider can authorize discharge from a hospital To collect the patient's belongings and prepare the paperwork for the patient's discharge To request a psychiatric consult for the patient and inform her PCP of the results To explain that the choice carries a risk for increased complications and make sure that the patient has signed a release form
To explain that the choice carries a risk for increased complications and make sure that the patient has signed a release form
A nurse receives a license renewal notification from the board of nursing. The nurse should identify that a license renewal requires the disclosure of which of the following?
When renewing a nursing license, the applicant is required to disclose any history of criminal record, substance use within the past 5 years, and any action taken against a professional license, registration, or certification
A hospice nurse is caring for a patient with end-stage cancer. What action demonstrates this nurse's commitment to the principle of autonomy? a. The nurse helps the patient prepare a durable power of attorney document. b. The nurse gives the patient undivided attention when listening to concerns. c. The nurse keeps a promise to provide a counselor for the patient. d. The nurse competently administers pain medication to the patient.
a
A nurse is using time management techniques when planning activities for patients. Which nursing action reflects effective time management? a. The nurse asks patients to prioritize what they want to accomplish each day b. The nurse includes a "nice to do" for every "need to do" task on the list c. The nurse "front loads" the schedule with "must do" priorities d. The nurse avoids helping other nurses if scheduling does not permit it
a
Examples of task a nurse might delegate to a UAP
activities of daily livings (bathing, dressing, etc) routine task (bed making, specimen collection, vital signs FOR STABLE)
A nurse is caring for a client who is going to require 7 days of IV antibiotics and dressing changes for cellulitis. Where is this client going to be admitted to?
acute care hospital
principles of ethics
advocacy, responsibility, accountability, confidentiality
health care settings located in areas that are convenient for people to walk into and receive care; may be provided in hospitals, clinics, or centers
ambulatory care
a nurse observes a UAP reprimanding a client for not using the urinal properly. the uap tells the client that diapers will be used next time the urinal is used improperly. which tort is the uap committing?
assault
Types of intentional torts
assault, battery, false imprisonment
A charge nurse is observing a newly licensed nurse care for a client who reports pain. The nurse checked the client's MAR and noted the last dose of pain meds was 6 hrs ago. The prescription reads every 4 hr PRN for pain. The nurse administered the meds and checked with the client 40 min later, when the client reported improvement. The newly licensed nurse left out which nursing process step?
assessment (pain scale?)
A nurse answers a patient's call light and finds the patient on the floor by the bathroom door. After calling for assistance and examining the patient for injury, the nurse helps the patient back to bed and then fills out an incident report. Which statements accurately describe steps of this procedure and why it is performed? Select all that apply. a. An incident report is used as disciplinary action against staff members. b. An incident report is used as a means of identifying risks. c. An incident report is used for quality control. d. The facility manager completes the incident report. e. An incident report makes facts available in case litigation occurs. f. Filing of an incident report should be documented in the patient record.
b, c, e
Review of a patient's record revealed that no one obtained informed consent for the heart surgery that was performed on the patient. Which intentional tort has been committed? Assault Battery Invasion of privacy False imprisonment
battery
a nurse offers pain medication to a client who is postoperative prior to ambulation. the nurse understands that this aspect of care delivery is an ex of which ethical principle?
beneficence
ethics that encompass all those perspectives that seek to understand human nature and behavior, the domain of social science, and the natural world
bioethics
A home health care nurse is scheduled to visit a 38-year-old woman who has been discharged from the hospital with a new colostomy. Which duties would the nurse perform for this patient in the entry phase of the home visit? Select all that apply. a/Collect information about the patient's diagnosis, surgery, and treatments. b/Call the patient to make initial contact and schedule a visit. c/Develop rapport with the patient and her family. d/Assess the patient to identify her needs. e/Assess the physical environment of the home. f/Evaluate safety issues including the neighborhood in which she lives.
c d e
Nursing students are reviewing information about health care delivery systems in preparation for a quiz the next day. Which statements describe current U.S. health care delivery practices? Select all that apply. a. Access to care depends only on the ability to pay, not the availability of services. b. The Patient Protection and Affordable Care Act provides private health care insurance to underserved populations. c. Every health insurance plan in the Health Insurance Marketplace offers comprehensive coverage, from doctors to medications to hospital visits. d. The uninsured pay for more than one third of their care out of pocket and are usually charged lower amounts for their care than the insured pay. e. Fifty years ago, half of the doctors in the United States practiced primary care, but today fewer than one in three do. f. Quality of care can be defined as the right care for the right person at the right time.
c, e, f
a nurse is instructing a group of newly licensed nurses about how to know and what to expect when ethical dilemmas arise. Which of the following situations can be an ethical dilemma? a. nurse on med surge unit demonstrates chemical impairment b. nurse overhears another nurse telling older adult that if he doesn't stay in bed, she will apply restraints. c. family has conflicting feelings about initiation of eternal tube feedings for their father, who is terminally ill d. client who is terminally ill hesitates to name their partner on power of attorney form.
c.
A nurse pleads guilty to a misdemeanor negligence charge for failing to monitor a patient's vital signs during routine eye surgery, leading to the death of the patient. The nurse's attorney explained in court that the nurse was granted recognition in a specialty area of nursing. What is the term for this type of credential? Accreditation Licensure Certification Board approval
certification
typically specializes in a practice setting or a clinical field
clinical nurse specialist
A state attorney decides to charge a nurse with manslaughter for allegedly administering a lethal medication. This is an example of what type of law? Public law Private law Civil law Criminal law
criminal
A nurse is collaborating with an interdisciplinary team to develop a plan of care for a client. Which of the following tools should the nurse use to guide the delivery of care?
critical pathway
A goal for a client who has difficulty with self-feeding due to rheumatoid arthritis is to use adaptive devices. The nurse caring for the client should initiate a referral to which of the following members of the interprofessional care team? a. Social worker b. Certified nursing assistant c. Registered dietitian d. Occupational therapist
d
A nurse administers the wrong medication to a patient and the patient is harmed. The health care provider who ordered the medication did not read the documentation that the patient was allergic to the drug. Which statement is true regarding liability for the administration of the wrong medication? a. The nurse is not responsible, because the nurse was following the doctor's orders. b. Only the nurse is responsible, because the nurse actually administered the medication. c. Only the health care provider is responsible, because the health care provider actually ordered the drug. d. Both the nurse and the health care provider are responsible for their respective actions.
d
A nurse incorporates the "five values that epitomize the caring professional nurse" (identified by the American Association of Colleges of Nursing) into a home health care nursing practice. Which attribute is best described as acting in accordance with an appropriate code of ethics and accepted standards of practice? a.Altruism b. Autonomy c. Human dignity d. Integrity
d
leadership style characterized by a sense of equality between the leader and followers
democratic leadership
classification of patients by major medical diagnosis for the purpose of standardizing health care costs
diagnosis-related group (DRG)
manages and plans for the dietary needs of patients, based on knowledge about all aspects of nutrition.
dietian
A home health nurse performs a careful safety assessment of the home of a frail older adult to prevent harm to the patient. The nurse's action reflects which principle of bioethics? a. Autonomy b. Beneficence c. Justice d. Fidelity e. Nonmaleficence
e
A nurse is caring for a client who reports that they have lost their job and do not have insurance. Which of the following social determinants of health is challenging for this client?
economic stability
Which of the following ways is the Press Ganey survey conducted?
-type of involuntary commitment in which the patient is hospitalized to prevent harm to self/others-emergency commitment is usually temporary (may be up to 10 days)-usually imposed by PCP's, mental health providers and police officers
emergency involuntary commitment
generally address unusual or complex ethical issues
ethics committees
a best practice derived from valid and reliable research studies that also considers the health care setting, patient preferences and values, and clinical judgment
evidence based practice
merg of science and art (not cut and dry) results in highest qual. of health care and patient outcomes prov solv approach to clinical decisions ** effects quality based outcomes
evidence based practice
defined as fair and equal treatment for all
justice
situation in which two or more ethically plausible principles are in opposition to each other and only one may be chosen
moral dilemma
internal response that occurs when a health care provider believes they inherently know the correct ethical action that is needed but cannot act on that knowledge
moral distress
virtue composed of veracity, fidelity, benevolence, wisdom, and moral courage
moral integrity
competing moral claim or principle; one principle is clearly dominant
moral problem
developed capacity to respond well to morally distressing experiences and to emerge strong
moral resilence
internal conflict that arises when the person cannot define what the moral situation is or what moral principles apply but has a strong feeling that something is not right
moral uncertainty
provides leadership to nursing departments within a health care facility
nurse admin
Teaches in schools of nursing, staff development departments in health care facilities, or client education departments
nurse educator
a systematic, problem-solving approach for meeting people's health care and nursing needs; components involve assessment, diagnosis, planning, implementation, and evaluation
nursing process
method of research conducted to gain insight by discovering meanings
qualitive research
A nurse has created a table of evidence to organize findings from a literature search. Which of the following components of the table provides information for implementing a change in practice?
recommendations
a nurse has noticed several occassions in the past week when another nurse on the unit seemed drowsy and unable to focus. today, the nurse was found asleep in a chair in the break room not during break time. what should she do?
report observations to nurse manager on unit
deep investigation into a sentinel event to determine why the event occurred, and exploring the circumstances that led to it to determine where improvements can be made
root cause analysis
Problems that require more specialized clinical expertise, such as hospital care for a patient with a myocardial infarction or stroke
secondary health care
an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof
sentinel event
philosophy and set of practices that begins with the natural feeling of wanting to serve; its aim is to enrich the lives of individuals, build better organizations, and ultimately creates a more just and caring world
servant
assist patients and families in dealing with the social, emotional, and environmental factors that affect their well-being. They make referrals to appropriate community resources and provide assistance with securing equipment and supplies, as well as with health care finances.
social worker
a nurse is giving a change of shift report to an oncoming nurse using SBAR reporting. What demonstrates SBAR?
the client in room 1 has been experiencing breakthrough pain following a surgery yesterday. vital signs are stable. recommend calling the provider for breakthrough dose if pain continues.
Health care financing involves two streams of money:
the collection of money for health care (money going in), and reimbursement of health care providers for health care (money going out)
a nonprofit organization that accredits hospitals and health care organizations
the joint commission
-special civil category in which legal issues regarding health care may be decided upon-wrongful act or injury committed by an entity or person against another person's property-can be used to decide liability issues, as well as intentional issues that may involve criminal penalties, such as abuse of patient
tort
legal rights in the mental health setting
-right to humane treatment and care, such as medical and dental care -right to vote -right to due process of law, including the right to press legal charges against another person
after all less restraints have been used
-treatment must be ordered by the PCP in writing -order must specify the duration of treatment -provider must rewrite the order every 24 hours or the frequency of time
The seven basic tenets of the Bill of Rights for Registered Nurses are:
1) Nurses have the right to practice in a manner that fulfills their obligations to society and to those who receive nursing care. 2) Nurses have the right to practice in environments that allow them to act in accordance with professional standards and legally authorized scopes of practice. 3) Nurses have the right to a work environment that supports and facilitates ethical practice, in accordance with the Code of Ethics for Nurses and its interpretive statements. 4) Nurses have the right to freely and openly advocate for themselves and their patients, without fear of retribution. 5) Nurses have the right to fair compensation for their work, consistent with their knowledge, experience, and professional responsibilities. 6) Nurses have the right to a work environment that is safe for themselves and their patients. 7) Nurses have the right to negotiate the conditions of their employment, either as individuals or collectively, in all practice settings
QSEN competencies
1. Patient-centered care 2. Teamwork and collaboration 3. Evidence-based practice/ Safety 4. Informatics
A Nurse holds a single state nursing license and is preparing to move to another state. For the nurse to apply for a reciprocity, which of the following actions should the nurse take SATA
1. Present a current and valid nursing license 2. Submit and application 3. Pay the fees for the new license
5 key practices for servant leaders
1. develop your vision 2. listen and learn before speaking and acting 3. envision and invest in others' greatness 4. give away your power 5. build community by developing strategic relationships
5 elements to prove negligence
1. duty to provide care as defined by a standard (care that should be given) 2. Breach of duty by failure to meet standard (failure to give care that should have been given) 3. Forseeability of harm (knowing that failing to give the proper standard of care may cause harm to the client) 4. Breach of duty has potential to cause harm (failing to meet standard had potential to cause harm-relationship must be provable) 5. harm occurs
a nurse is aquainting new nurses with the roles of the various members of the health care team they will encounter on a med-surge unit. When providing ex of the types of tasks CNAs can perform, which of the following client activites should the nurse include? a. bathing b. ambulating c. toileting d. determine pain level e. measure vital signs
a b c e
a nurse is caring for a group of clients on a med surg unit. for which of the following client care needs should the nurse initiate a referral for a social worker. a. client has term. cancer requests hospice b. client asks about community resources avail for older adults c. states, "I would like to have child baptized before surgery" d. client request electric chair for use upon discharge \ e. states, "I do not know how to use a nebulizer"
a b d
Nursing Process Framework
assessment/data collection, analysis/data collection, planning, implementation, evaluation
a nurse is caring for a client who decides not to have surgery despite significant blockages of the coronary arteries. the nurse understands that this client's choice is an ex of what ethical principle?
autonomy
A nurse who is working in a hospital setting uses value clarification to help understand the values that motivate patient behavior. Which examples denote "prizing" in the process of values clarification? Select all that apply. a. A patient decides to quit smoking following a diagnosis of lung cancer. b. A patient shows off a new outfit that she is wearing after losing 20 pounds. c. A patient chooses to work fewer hours following a stress-related myocardial infarction. d. A patient incorporates a new low-cholesterol diet into his daily routine. e. A patient joins a gym and schedules classes throughout the year. f. A patient proudly displays his certificate for completing a marathon.
b, f
An RN on a surgical unit is behind schedule administering medications. Which of the RN's other tasks can be safely delegated to a UAP? a. The assessment of a patient who has just arrived on the unit b. Teaching a patient with newly diagnosed diabetes about foot care c. Documentation of a patient's I & O on the flow chart d. Helping a patient who has recently undergone surgery out of bed for the first time
c
regionalized service for vulnerable geographic populations with an emphasis on primary care and education, established to ensure that everyone who needs care has access regardless of ability to pay
community health center
Four concepts essential to nursing care of patients within and across health care settings are
community-based nursing care, continuity of care, collaborative practice, and care coordination.
a prepaid group practice that allows a third-party payer (such as an insurance company) to contract with a group of health care providers to administer services at a lower fee in return for prompt payment and a guaranteed volume of patients and services
preferred provider organization (PPO)
Common health problems (sore throats, diabetes, arthritis, depression, or hypertension) and preventive measures (vaccinations, mammograms) that account for 80-90% of visits to clinicians
primary health care
A nurse is using evidence-based practice to reduce pain during venipunctures for adolescent clients by asking a PICOT question: "Does providing music to adolescent clients during venipunctures decrease their discomfort compared to those clients who do not listen to music?" Which of the following is a component of the "I" in this PICOT question?
providing music
research involving the concepts of basic and applied research
quantitative research
An older nurse asks a younger coworker why the new generation of nurses just aren't ethical anymore. Which reply reflects the BEST understanding of moral development? a. "Behaving ethically develops gradually from childhood; maybe my generation doesn't value this enough to develop an ethical code." b. "I don't agree that nurses were more ethical in the past. It's a new age and the ethics are new!" c. "Ethics is genetically determined...it's like having blue or brown eyes. Maybe we're evolving out of the ethical sense your generation had." d. "I agree! It's impossible to be ethical when working in a practice setting like this!"
a
a nurse is caring for a client who has a new prescription for antihypertensive medication. Prior to administering the meds the nurse uses an electronic database to gather info about the med and the effects it might have on this client. which of the components of critical thinking is the nurse using when he reviews the med info?
a
a nurse is caring for a client who is 24 hrs postop following sn inguinal hernia repair. The client is tolerating clear liquids well, has active bowel sounds, and is expressing desire for food. The nurse tells the client "I will call the surgeon and ask for a change in diet". The surgeon hears the nurses report and prescribes a full liquid diet. What level of critical thinking was nurse using?
a
a nurse manager is developing strategies to care for the increasing number of clients who have obesity. which of the following actions should the nurse include as as primary health care strategy a. collab w/ providers to perform obesity screenings during routine office visits b. ensure the avail. of specialized beds in rehab centers for obese clients c. providing specialized intraoperative training in surgical treatments for obesity d. educating acute care nurses about postop complications related to obesity
a
a nurse is explaining the various levels of health care services to a group of newly licensed nurses. which of the following ex of health care settings should be classified as tertiary care? a. ICU b. Oncology treatment center c. burn center d. cardiac rehab e. home health care
a b c
A discharge nurse is evaluating patients and their families to determine the need for a formal discharge plan or referrals to another facility. Which patients would most likely be a candidate for these services? Select all that apply. a.An older adult who is diagnosed with dementia in the hospital b.A 45-year-old man who is diagnosed with Parkinson's disease c.A 35-year-old woman who is receiving chemotherapy for breast cancer d.A 16-year-old boy who is being discharged with a cast on his leg e.A new mother who delivered a healthy infant via a cesarean birth f.A 59-year-old man who is diagnosed with end-stage bladder cancer
a b f
A client who is postop following knee arthroplasty is concerned about the adverse affects of the med prescribed for pain. Which of the following members can assist the client in understanding the med side effects? a. provider b. CNA c. pharmacist d. RN e. respiratory therapist
a c d
a charge nurse is reviewing the steps of the nursing process with a group of nurses. Which of the following data should the charge nurse identify as objective data? a. respiratory rate is 22/min with even, unlabored respirations b. client's partner states, "They said they hurt after a 10 min walk" c. client pain rating is a 3 on scale of 1-10 d. client's skin us pink, warm, and dry e. UAP reports client walked with a limp
a d e
A nurse is caring for a client who is about to undergo an elective surgical procedure. the nurse should take which of the following actions regarding informed consent? a. make sure surgeon obtain client consent b. witness client signature on consent form c. explain risks and benefits of procedure d. describe consqeuences of choosing no surgery e. tell of alternatives
a, b
A nurse caring for patients in an institutional setting expresses a commitment to social justice. What action best exemplifies this attribute? a. Providing honest information to patients and the public b. Promoting universal access to health care c. Planning care in partnership with patients d. Documenting care accurately and honestly
b
a nurse is discussing the purpose of regulatory agencies during a staff meeting. which of the following tasks should the nurse identify as the responsibility of state licensing boards? a. monitoring ebp for clients have specific diagnosis b. ensuring health care providers comply with regulations c. setting quality standards for accreditation of health care facilities d. determining whether meds are safe to administer
b
a nurse is explaining the various types of health care coverage clients might have to a group of nurses. which of the following health care financing mechanisms should the nurse include as federally founded a. preferred provider org b. medicare c. long-term care insurance d. exclusive provider org e. medicaid
b e
A nurse is providing health care to patients in a health care facility. Which of these patients are receiving secondary health care? Select all that apply. a. A patient enters a community clinic with signs of strep throat. b. A patient is admitted to the hospital following a myocardial infarction. c. A mother brings her son to the emergency department following a seizure. d. A patient with osteogenesis imperfecta is being treated in a medical center. e. A mother brings her son to a specialist to correct a congenital heart defect. f. A woman has a hernia repair in an ambulatory care center.
b, c, f
A nurse is using evidence-based research to care for a client who has diabetes mellitus. Which of the following resources should the nurse use to manage the delivery of care?
clinical practice guidlines
law resulting from court decisions that is then followed when other cases involving similar circumstances and facts arise; common law is as binding as civil law
common law
-patients privacy protected by Health Insurance Portability and Accountability Act (HIPAA) of 2003-gain understanding of federal laws and state laws as they relate-information about the patient, verbal and in writing, must be shared only with those who are involved in care of the patient-can be shared with others with patients approval
confidentiality
: method by which nurses can comfortably and respectfully address conflict in the workplace (rather than avoiding conflict) by creating connections with others to build trust
conflict engagement
process used to work through conflicts in a way that minimizes negative effects and promotes positive consequences
conflict management
proposed legislation making changes in entitlement benefits, such as Medicare and Medicaid, paid by the government to citizens, with the goal of improving the nation's budget
entitlement reform
patient enters the mental health facility against her will for an indefinite period of time. commitment is based on the patients need for psychiatric treatment, the risk of harm to self/others, or inability to provide self-care. the need for commitment could be determined by a judge of the court or by another agency. number of physicians required to certify that the patients condition required commitment varies from state to state (usually two)
involuntary (civil) commitment
a nurse is instructing a group of newly licensed nurses about the responsibilities of organ donation and procurement involve. when the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the newly licensed nurses should understand this aspect of care delivery is an ex of which ethical principle?
justice
hospice care; taking care of the whole person—body, mind, spirit, heart, and soul—with the goal of giving patients with life-threatening illnesses t
pallative care
-use of seclusion rooms and/or restraints may be warranted and authorized for patients in some cases-should be ordered for shortest duration necessary, and only if less restrictive measures are not sufficient. they are for physical protection of the patient/staff-patient may voluntarily request temporary seclusion in cases in which the environment is disturbing or seems too stimulating-restraints can be physical or chemical
patients rights regarding seclusion and restraint
A nurse is teaching a newly licensed nurse about using credible databases for research studies. Which of the following sources should the nurse include?
peer reviewed journal
seeks to restore function or to prevent further disability in a patient after an injury or illness.
physical therapist
A nurse in a provider's office is calling a client's insurance company to obtain permission prior to scheduling a magnetic resonance imaging (MRI) test. Which of the following is the nurse obtaining?
precertification
Prior to delegating care, nurses should consider:
predictability of the outcome potential for harm complexity of the care need for problem solving and innovation level of interaction with the clients
A nurse is collecting data from a group of clients regarding their feelings and experiences of living with congestive heart failure. In which of the following types of research studies is the nurse participating?
qualitative
leadership that moves beyond the traditional modes previously experienced by all levels of workers; spawned by the impact of the information age on work and the worker
quantum
Positions clients and performs x-rays and other imaging procedures for providers to review for diagnosis of disorders of various body parts.
radiologic technologist
Battery
touching a patient in a harmful or offensive way is considered battery
action-guiding theory of ethics that states that the rightness or wrongness of an action depends on the consequences of the action
ulitarian
process by which people come to understand their own values and value system
value clarification
organization of values ranked along a continuum of importance
value system
Newly hired nurses in a busy suburban hospital are required to read the state nurse practice act as part of their training. Which topics are covered by this act? Select all that apply. Violations that may result in disciplinary action Clinical procedures Medication administration Scope of practice Delegation policies Medicare reimbursement
violations , scope of practice
patient or guardian chooses commitment to a mental health facility in order to obtain treatment. a voluntarily committed patient has the right to apply for release at any time. this patient is considered competent, and so has the right to refuse medication and treatment
voluntary commitment
A nurse follows the six rights of medication administration when caring for a client. Which of the following concepts is the nurse demonstrating?
Accountability The nurse is demonstrating accountability because they are administering medications in a way that reduces errors and harm to the client.
a charge nurse is assigning client care for 4 clients. Which of the following tasks should the nurse assign to a UAP? A. creating a plan of care for a client who is recovering following a stroke B. assessing a pressure injury on a client on bed rest C. providing nasopharyngeal suctioning to pneumonia client D. teaching client who has asthma to use inhaler
C
A nurse is discussing social determinants of health with a newly licensed nurse. The nurse should include that which of the following factors contribute to the neighborhood and built environment determinant category?
Access to foods that support healthy eating patterns. Crime and violence. Environment conditions.
is a registered nurse educated at the master's or post-master's level in a specific role and for a specific population.
APRN
A nurse in a provider's office is speaking with a client who needs a refill for a prescription that has expired. The nurse should identify that which of the following team members can assist the client with the refill?
Advanced practice registered nurse (APRN)Physician Assistant (PA)Physician
A nurse manager is assigning care of a client who is being admitted from the PACU following thoracic surgery. The nurse manager should assign the client to which of the following staff members? A. charge nurse B. RN C. LPN D. UAP
B
A charge nurse in a busy hospital manages a skilled nursing unit using an autocratic style of leadership. Which leadership tasks BEST represent this style of leadership? Select all that apply. A. The charge nurse polls the other nurses for input on nursing protocols. B. The charge nurse dictates break schedules for the other nurses. C. The charge nurse schedules a mandatory in-service training on new equipment. D.The charge nurse allows the other nurses to divide up nursing tasks. E. The charge nurse delegates nursing responsibilities to the staff. F. The charge nurse encourages the nurses to work independently.
B, C, E
A nurse is handing off a patient to a nurse in an extended- care facility using the ISBARQ framework of communication. Which step is performed correctly? A. The nurse introduces the patient to the new nurse. B. The nurse discusses the patient's background. C. The nurse assesses the patient's vital signs. D. The nurse questions the patient about comfort level.
B. The nurse discusses the patient's background.
A nurse in a rehabilitation facility is performing the role of a case manager for a group of clients. Which of the following actions should the nurse take? A. Offer alternative therapies that differ from traditional Western medicine. B. Manage the day-to-day operation of a specific health care unit. C. Ensure clients receive optimal care in a cost-effective manner. D. Provide continuing education of nursing staff
C. Ensure clients receive optimal care in a cost-effective manner.
4 Concepts Essential to Nursing Care of Patients Across SettingsPatients Across Setting
Community-based nursing care Continuity of care Collaborative practice Care coordination
A patient is being transferred from the ICU to a regular hospital room. What must the ICU nurse be prepared to do as part of this transfer? Provide a verbal report to the nurse on the new unit. Provide a detailed written report to the unit secretary. Delegate the responsibility for providing information. Make a copy of the patient's medical record.
Provide a verbal report to the nurse on the new unit.
A nurse is preparing a presentation on the regulation of nursing practice. Place the hierarchy of the regulation of practice in the correct order beginning with the highest level (step one) and proceeding to the lowest level (step four). (Move the steps into the box on the right, placing them in the order of hierarchy. Use all the steps.)
Nursing regulatory board is the highest level in the hierarchy of regulation (step one). Each state has a board of nursing that reports to the National Council of State Board who oversees the standards for educational programs, license requirements, scope of practice, and grounds for disciplinary action, remediation, or violations. Nurse practice act is the second highest level in the hierarchy of regulation (step two). Each board of nursing determines the laws of practice or the Nurse Practice Act (NPA) for licensed nurses within that state. The NPA defines the nursing activities and ensures nurses practice within the defined laws, rules, and regulations. Nurses are responsible for knowing the details and abiding by the NPA. Nurses can be held liable when they, even in error, violate the standards of the NPA. Organization policies and procedures is the third highest level in the hierarchy of regulation (step three). Organizations establish policies and procedures that regulate and guide nursing practice within their establishments. These policies define the standards of care and responsibilities of individual nurses from assistive personal, nursing students, graduate nurses, the newly licensed, and the experienced nurse. Individual self-regulation is the lowest level in the hierarchy of regulation (step four). Each nurse is in control of their individual competence, decisions, and actions while providing client care. This is the duty to self-regulate. Nurses must use their knowledge and expertise to be prepared for all eventualities.
A hospital nurse is admitting a patient who sustained a head injury in a motor vehicle accident. Which activity could the nurse delegate to licensed assistive personnel? Collecting information for a health history Performing a physical assessment Contacting the health care provider for medical orders Preparing the bed and collecting needed supplies
Preparing the bed and collecting needed supplies
A nurse is teaching a newly licensed nurse about professional competence. Which of the following examples should the nurse include in the teaching?
Presenting a summary of an evidence-based journal
IOM 6 outcomes for a new health system
Safe Effective Efficient Patient-centered Timely Equitable
A nurse is reviewing the scope of nursing practice. Which of the following is the purpose of the nursing scope of practice?
Specifies the actions a nurse can perform.
Define competent behavior of all registered nurses and licensed practical nurses where care is provided in an ethical manner with respect for cultural diversity
Standards of Professional Performance
A nurse is providing client care using the nursing process. The nurse should identify that which of the following standards or guideline includes this criterion
Standards of practice Standards of practice are explanatory statements that describe a compentent level of care for all nurses using the critical thinking model known as the nursing process. Nursing has general standards of practive to which every nurse is held accountable.
A nurse is responsible for their actions with whom they interact professionally, including client, colleagues, and society as a whole. Which of the following components of nursing addresses this as expected behavior?
Standards of professional performance Specifies the competent level of behavior expected in the professional role.
Five-Step Process for Resolving Ethical Conflict
Step 1: Assess the Situation (Gather Data) Step 2: Diagnose (Identify) the Ethical Problem Step 3: Plan Steps 4-5: Implement and Evaluate Your Decision
A nurse is teaching a newly licensed nurse about The Joint Commission (TJC). Which of the following information should the nurse include?
TJC ensures organizations remain up-to-date with state guidelines.
Transition to practice programs (TTP). Which of the following factors should the nurse expect?
TPP programs increase job retention
Multidisciplinary members of the health care team. This is an example of which of the following QSEN competencies?
Teamwork and collaboration
A nurse is caring for a client whose neighbor works on another unit. The neighbor calls the unit and asks the client's nurse, "What happened to the client?" Which of the following actions should the nurse take?
Tell the neighbor they cannot give them that information.
A nurse is teaching a class about the Hospital-Acquired Condition Reduction Program (HACRP). Which of the following information should the nurse include?
The HACRP links Medicare payments to health care quality.
A nurse resides in a state that recently enacted the Nursing Licensure Compact (NLC). Which of the following information should the nurse identify as part of the NLC?
The NLC allows a nurse to practice across state lines with one license
The goal of collaborative practice is to
The goal of collaborative practice is to deliberatively work together to build a safer and better patient-centered and community/population oriented U.S. health care system
A nurse is preparing to perform a procedure on a client. Which of the following resources should the nurse use to meet the standard of care? (Select all that apply.)
The health care organization policy and procedure manual. Info from a government website. Article published by a perr-reviewed journal.
A charge nurse is supervising a nurse providing care to several clients. For which of the following actions by the nurse should the charge nurse intervene?
The nurse alters the steps in a procedure established in the clinical practice guidelines.
A nurse is discussing professional commitment with their supervisor during an annual performance review. Which of the following actions by the nurse demonstrates professional commitment?
The nurse attends an educational course to learn about the treatment and prevention of pressure ulcers. Professional commitment includes a motivation to improve oneself in the domain of their profession. Attending a course that expands current knowledge contributes to promoting one's professional commitment.
a nurse is speaking to a client who is noncompliant with in performing daily blood glucose testing regimen. what response should the nurse make?
What is preventing your consistency with your daily blood glucose checks?
A nurse working in a primary care facility prepares insurance forms in which the provider is given a fixed amount per enrollee of the health plan. What is the term for this type of reimbursement? a. Capitation b. Prospective payment system c. Bundled payment d. Rate setting
a
A student nurse begins a clinical rotation in a long-term care facility and quickly realizes that certain residents have unmet needs. The student wants to advocate for these residents. Which statements accurately describe this concept? Select all that apply. a. Advocacy is the protection and support of another's rights. b. Patient advocacy is primarily performed by nurses. c. Patients with special advocacy needs include the very young and the older adult, those who are seriously ill, and those with disabilities. d. Nurse advocates make good health care decisions for patients and residents. e. Nurse advocates do whatever patients and residents want. f. Effective advocacy may entail becoming politically active.
a, c, f
leadership style in which the leader assumes complete control over the decisions and activities of the group
autocratic leadership
A nurse is caring for patients in a primary care center. What is the most likely role of this nurse based on the setting? a. Assisting with major surgery b. Performing a health assessment c. Maintaining patients' function and independence d. Keeping student immunization records up to date
b
A nurse recieves a prescription for an antibiotic for a client who has cellulitis. The nurse checks the client's medical record, discovers that the client is allergic to the antibiotic, and calls the provider to request a prescription for a different antibiotic. Which critical thinking attitudes did the nurse demonstrate?
b
A nurse wants to call an ethics consult to clarify treatment goals for a patient no longer able to speak for himself. The nurse believes his dying is being prolonged painfully. The patient's doctor threatens the nurse with firing if the nurse raises questions about the patient's care or calls the consult. What ethical conflict is this nurse experiencing? a. Ethical uncertainty b. Ethical distress c. Ethical dilemma d. Ethical residue
b
A nurse working in a pediatric clinic provides codes for a patient's services to a third-party payer who pays all or most of the care. This is an example of what mode of health care payment? a. Out-of-pocket payment b. Individual private insurance c. Employer-based group private insurance d. Government financing
b
A nurse who is a discharge planner in a large metropolitan hospital is preparing a discharge plan for a patient after a kidney transplant. Which actions would this nurse typically perform to ensure continuity of care as the patient moves from acute care to home care? Select all that apply. a.Performing an admission health assessment b.Evaluating the nursing plan for effectiveness of care c.Participating in the transfer of the patient to the postoperative care unit d.Making referrals to appropriate facilities e.Maintaining records of patient satisfaction with services f.Assessing the strengths and limitations of the patient and family
b d f
A nurse manager is attempting to update a health care provider's office from paper to electronic health records (EHR) by using the eight-step process for planned change. Place the following actions in the order in which they should be initiated: A. The nurse devises a plan to switch to EHR. B. The nurse records the time spent on written records versus EHR. C. The nurse attains approval from management for new computers. D. The nurse analyzes all options for converting to EHR. E.The nurse installs new computers and provides an in-service for the staff. F. The nurse explores possible barriers to changing to EHR. G. The nurse follows up with the staff to check compliance with the new system. H. The nurse evaluates the effects of changing to EHR.
b, f, d, c, a, e, h, g
A nurse caring for patients in the intensive care unit develops values from experience to form a personal code of ethics. Which statements best describe this process? Select all that apply. a.People are born with values. b. Values act as standards to guide behavior. c. Values are ranked on a continuum of importance. d. Values influence beliefs about health and illness. e. Value systems are not related to personal codes of conduct. f. Nurses should not let their values influence patient care.
b,c,d
a charge nurse is talking with a newly licensed nurse and is reviewing nursing interventions that do not require a providers prescription. which interventions should she include? a. writing prescription for morphine as needed for pain b. inserting a nasogastric tube to relieve gastric distention c. showing client how to use progressive muscle relaxation d. performing daily bath after evening meal e. repositioning a client every 2 hrs to reduce pressure injury
c d e
fixed amount per patient for a specified time period paid to a health care service provider for the delivery of health care services
captitation
deliberate organization of patient care activities between two or more participants (including the patient) to facilitate the appropriate delivery of quality health care services in an efficient person-centered manner; mechanism to make sure that patients get the right care at the right time in the most efficient and cost-effective manner, by the right person in the right setting
care coordination
ethics that encompass all those perspectives that seek to understand human nature and behavior, the domain of social science, and the natural world
care-based approach
autonomous, accountable professional nursing practice; a characteristic of a democratic leadership style and the heart of a self-governance model of unit organization
decentralized decision-making process
ethical system in which actions are right or wrong independent of the consequences they produce
deontologic
unitary person human response patterns
exchanging communicating relating valuing choosing moving perceiving knowing feeling
hiearchy of evidence for intervention questions
expert opinion case studies uncontrolled cohort studies controlled cohort studies randomized controlled trials systematic reviews
nurse who explains to the judge and jury what happened based on the patient's record and who offers an opinion as to whether the nursing care met acceptable standards of practice
expert witness
power obtained by virtue of a person's position
explicit power
organizations, family members, and other caregivers that provide medical and nonmedical care for people with chronic illnesses or disabilities who are physically or mentally unable to care for themselves independently
extended care services
nurse who has knowledge of the actual incident prompting a legal case; bases testimony on firsthand knowledge of the incident, not on assumptions
fact witness
prepaid, group-managed care plan that allows subscribers to receive all the medical services they require through a group of affiliated providers; there may be no additional out-of-pocket costs, or subscribers may pay only a small fee, called a copayment
health maintenance organization (HMO):
focuses on the potential for wellness and targets appropriate alterations in personal habits, lifestyle, and environment in ways that reduce risks and enhance health and well-being
health promotion
employing multiple health professionals to work together with patients, families, and communities to deliver best practices, thus ensuring best patient outcomes
interprofessional collaborative practice
refers to an organization's commitment to accountability and a focus supporting universal safety in health care
just culture
