310 11-20

1. Physical examinations 2. PAP smears 4. Family planning counseling 5. One-on-one management of high-risk pregnancies

A student nurse is contemplating seeking independent practice as a certified nurse midwife. If the nurse reaches this goal, which components of practice should the she expect to fulfill? Select all that apply. 1. Physical examinations 2. PAP smears 3. Management of postpartum complications 4. Family planning counseling 5. One-on-one management of high-risk pregnancies

3. Unless both parties agreed in advance that the decision is not binding 5. If the dispute involves collective bargaining the decision is binding.

A work dispute has gone to arbitration. The nurses involved in the dispute are unhappy with the decision made by the arbitrator. Is the arbitrator's decision binding? Select all that apply. 1. The decision is binding. 2. Only if the other party also does not agree with the decision 3. Unless both parties agreed in advance that the decision is not binding 4. These decisions are only suggestions meant to guide further discussion. 5. If the dispute involves collective bargaining the decision is binding.

1. The accommodation would be very difficult to implement. 5. The requested accommodation will require very expensive equipment and renovation.

An employee has requested special accommodations secondary to a disability. The hospital refuses, citing undue hardship. What must be present for that refusal to be upheld? Select all that apply. 1. The accommodation would be very difficult to implement. 2. The accommodation would require physical changes to the work environment. 3. The accommodation would not be necessary if the employee changed positions. 4. The accommodation has never been made before this case. 5. The requested accommodation will require very expensive equipment and renovation.

2. Eliminate the hazard before anyone else is harmed.

The hospital's risk management team has identified a hazard to patient safety through review of incident reports. What should be the team's next action?

2. The nurse is easily contactable by pager but is not present in the care environment.

In which scenario is the nurse providing indirect supervision of a nursing assistant? 1. The nursing assistant and nurse work on the same team, jointly providing care to inpatients. 2. The nurse is easily contactable by pager but is not present in the care environment. 3. The nurse makes rounds on the patient care units, observing the nursing assistant's work, at least every two hours. 4. The nursing assistant receives constant instruction regarding patient care from the nurse.

3. The facility does not renew a contract that has ended. 5. The hospital releases a nurse from the contract so that the family can relocate.

In which situations has legal termination of a contract occurred? Select all that apply. 1. The nurse contracts with another nurse to work out the contract. 2. The hospital refuses to pay the nurse for shifts worked. 3. The facility does not renew a contract that has ended. 4. The nurse repeatedly violates hospital policy and procedure outlined in the contract. 5. The hospital releases a nurse from the contract so that the family can relocate.

2. The nurse fails to report a co-worker who is working outside his scope of practice. 4. The nurse made a false statement on the licensure application.

In which situations would the state board of nursing have probable grounds for disciplining a nurse?Select all that apply. 1. The nurse can no longer lift 30 pounds. 2. The nurse fails to report a co-worker who is working outside his scope of practice. 3. The nurse questioned a direct physician order. 4. The nurse made a false statement on the licensure application. 5. The nurse told a co-worker that she is taking antidepressant medications.

4. Yes, if this practice makes other patients wait past their own appointment times.

The advanced nurse practitioner believes that he should spend as much time with each patient as the patient desires. Does this practice raise ethical challenges? 1. No, patients should expect to wait in any health care provider's office. 2. Yes, this practice reflects poorly on the nurse's physician colleagues. 3. No, this is the way all nursing should be practiced. 4. Yes, if this practice makes other patients wait past their own appointment times.

3. The nurse manager did not tell a potential employer that a former employee was asked to resign for incompetence.

The court found a nurse manager liable for failure to warn. Which option reflects a failure to warn scenario? 1. The nurse manager did not advise a newly hired nurse that continuing education was an annual requirement for promotion. 2. The nurse manager did not notify the physician regarding worsening of a patient's respiratory status. 3. The nurse manager did not tell a potential employer that a former employee was asked to resign for incompetence. 4. The nurse manager did not adequately supervise a newly hired nurse who had not practiced nursing in five years.

2. Corporate liability

The hospital acts to revoke the clinical privileges of a physician who has repeatedly refused to respond to emergency calls from nursing staff. Under which doctrine is this action advisable? 1. Respondeat superior 2. Corporate liability 3. Borrowed servant 4. Dual servant

2. Yes, the preceptor is responsible for delegating appropriately and supervising completion of tasks.

The preceptor nurse delegates a complex nursing procedure to a newly licensed nurse. The new nurse makes an error, which results in the patient's death. Does the preceptor hold any liability in this case? 1. Yes, but only because the event resulted in patient demise. 2. Yes, the preceptor is responsible for delegating appropriately and supervising completion of tasks. 3. No, since the new nurse has a license, all liability is retained by the new nurse. 4. No, since the new nurse is employed by the medical facility, all liability is corporate.

1. The aides understand the importance of walking with the patient.

The registered nurse has delegated the task of ambulating a patient to two nursing assistants. The patient appears to ambulate without assistance, but must be ambulated with two assistants due to a history of unexpected fall. What is the most important aspect of delegating this task? 1. The aides understand the importance of walking with the patient. 2. The patient is comfortable walking with the aides. 3. The aides understand the patient is to be ambulated twice daily. 4. The patient understands the need for assistance.

1. A supervisor offers to give a nurse a promotion if she will consent to going to dinner with him. 2. A nurse is fired after breaking off a romantic relationship with the unit nurse manager.

Which scenarios meet the Civil Rights Act of 1991 definition of quid pro quo sexual harassment? Select all that apply. 1. A supervisor offers to give a nurse a promotion if she will consent to going to dinner with him. 2. A nurse is fired after breaking off a romantic relationship with the unit nurse manager. 3. The nurse is offended by the jokes told during morning report. 4. The nurse no longer feels comfortable eating lunch in the break room because the other staff members in the room often discuss their sexual encounters. 5. A nurse becomes uncomfortable because one of the unit physicians often hugs or touches her.

2. The individual hospital

The advanced nurse practitioner wishes to obtain admitting privileges at an area hospital. To whom should this nurse apply for these privileges? 1. The state board of medicine 2. The individual hospital 3. The Joint Commission 4. The state board of health

4. Respondeat superior

Which legal doctrine cannot apply to a nurse's practice as a private duty nurse? 1. Res ipsa loquitur 2. Negligent cause of action 3. Personal liability 4. Respondeat superior

3. Currently, the entry level for this certification is a master's degree. 5. In the future, nurses wishing to become CRNAs must have a doctoral degree.

A certified registered nurse anesthetist (CRNA) is addressing a group of high school students that have expressed interest in this profession. Which information should the nurse provide? Select all that apply. 1. The fastest way to gain certification as a CRNA is through a physician's assistant program. 2. Nurse anesthetists are a newly developing field. 3. Currently, the entry level for this certification is a master's degree. 4. Nurse anesthetists practice outside the scope of nursing by virtue of a grandfather clause in anesthesia. 5. In the future, nurses wishing to become CRNAs must have a doctoral degree.

1. Continue to respond and attempt to reorient the patient.

A confused patient frequently calls out for "help" throughout the shift. When nursing staff respond to the call, the patient is unable to explain what is needed. What action should be taken by the nurse? 1. Continue to respond and attempt to reorient the patient. 2. Restrain the patient in soft wrist restraints. 3. Move the call bell out of the patient's reach. 4. Chemically restrain the patient with a mild sedative.

1. Mandatory

A medical technician working in a physician's office routinely refers to herself as a nurse. Which type of licensure protects that title as well as the professional actions associated with nursing? 1. Mandatory 2. Institutional 3. Transitional 4. Permissive

2. The handbook must be written clearly. 4. The employee must continue to work after the manual takes effect.

Changes have been made to the employee handbook. What must occur in order for these changes to constitute a contract? Select all that apply. 1. The handbook must have been distributed to all employees of the facility. 2. The handbook must be written clearly. 3. The employee must attend an inservice session about the new handbook. 4. The employee must continue to work after the manual takes effect. 5. The employee must sign a document indicating the handbook has been received.

1. Clinical nurse leader

Hospital management has identified quality of care issues that center around coordination of multidisciplinary services. Which classification of advanced practice nurse would be the best choice to help address these issues? 1. Clinical nurse leader 2. Advanced nurse practitioner 3. Nurse with a doctorate of nursing practice 4. Clinical nurse specialist

2. Spend additional time with the patient, showing that he or she is important.

Hostile or angry patients present unique nursing challenges from a legal perspective. Which basic interventions can a nurse take when caring for a hostile or angry patient? Select all that apply. 1. Allow the patient to be alone and have long periods of quiet time. 2. Spend additional time with the patient, showing that he or she is important. 3. Ensure that family members are always present to calm the patient. 4. Sedate the patient to diffuse further encounters with the patient. 5. Include the patient in discussions of treatment plans.

1. Borrowed servant

In an effort to attract clinic physicians, the hospital has agreed to provide a nurse to work in the physician's office. The nurse will work under the direction and supervision of the physician whose clinic is housed with the hospital building. Which doctrine most closely describes the conditions in which this nurse is working? 1. Borrowed servant 2. Dual servant 3. Agent of the principal 4. Independent contractor

3. Be certain patients are aware that the nurse is not a physician. 5. Wear a nametag that clearly lists the nurse's credentials as an ANP.

The advanced nurse practitioner is routinely addressed as "doctor" by clinic patients. What is the best way for the nurse to handle this mistake? Select all that apply. 1. Only allow this practice if the ANP has an earned doctorate. 2. Accept the mistake with good humor and ignore it. 3. Be certain patients are aware that the nurse is not a physician. 4. Ask the patients to address the ANP by first name. 5. Wear a nametag that clearly lists the nurse's credentials as an ANP.

1. There is no problem as the practice requirements are the same.

The advanced practice nurse would like to move to a large metropolitan area. How will this move impact the advanced practice nurse's practice? 1. There is no problem as the practice requirements are the same. 2. There would be no problem as the move is to an area that is primarily minority. 3. This would be an unwise move for the nurse, as advanced practice is limited to rural areas. 4. There would be no problem if the move is to a medically underserved area.

4. Equality

The aim of the Americans with Disabilities Act was to eliminate discrimination against individuals with disabilities. In order to achieve this goal, Congress combines disability with which other legal concept? 1. Autonomy 2. Right to work 3. Fairness 4. Equality

3. The charge nurse retains the accountability.

The charge nurse has delegated a task to another staff member. Who assumes accountability for the task? 1. It is held jointly by the charge nurse and the person performing the task. 2. It can be imputed to either the charge nurse or the person performing the task. 3. The charge nurse retains the accountability. 4. Accountability is transferred to the person performing the task.

1. Correct, common dosage for this patient 2. Action of the medication 4. Signs of untoward reaction to the medication

Which options reflect what the nurse should consider prior to administering medication to a hospitalized patient? Select all that apply. 1. Correct, common dosage for this patient 2. Action of the medication 3. Cost of the medication 4. Signs of untoward reaction to the medication 5. Whether the patient's insurance covers the medication

4. A staff nurse as compared to his or her supervisor

Which person best meets the criteria as a "member of a protected class" in a quid pro quo sexual harassment lawsuit? 1. A female nurse as compared to a male staff nurse 2. A male housekeeper as compared to a male laboratory technician 3. A female physician as compared to a male physician 4. A staff nurse as compared to his or her supervisor

2. A consultant from outside the hospital

Which person would be the best choice for a mediator in a contract dispute between a nurse and a hospital? 1. A nurse who works on a similar unit in the hospital 2. A consultant from outside the hospital 3. A retired nurse who worked at the hospital five years ago 4. A hospital administrator from an area different from nursing

2. The nurse continually finds cartoons of a sexual nature posted on the unit bulletin board.

Which scenario meets the Civil Rights Act of 1991 definition of hostile environment sexual harassment? 1. A nurse manager suggests that a nurse's performance evaluation be discussed over dinner and drinks. 2. The nurse continually finds cartoons of a sexual nature posted on the unit bulletin board. 3. The nurse has a continuing argument with a co-worker that makes the workplace uncomfortable. 4. A nurse working on the unit is homosexual.

4. Support the patient in her wishes but continue education about end-of-life care.

A frail 90-year-old resident of a long-term care facility refuses to sign an advanced directive and tells the nurse she "wants everything done" to save her life if she should go into cardiopulmonary arrest. What action by the nurse is ethically and legally indicated? 1. Discuss the situation with the resident's family and plan to follow their wishes. 2. Tell the resident that end of life interventions are generally up to the physician. 3. Tell the resident that everything will be done, but make a do not resuscitation note on the medical record. 4. Support the patient in her wishes but continue education about end-of-life care.

1. There is no Medicare regulation mandating medical staff membership of APNs. 3. State laws concerning ANP admitting privileges are confusing and contradictory. 4. Some state laws limit the scope of ANP practice. 5. Some hospitals do not allow non-physicians to admit patients.

A group is working to increase the number of advanced nurse practitioners (ANPs) who have hospital admitting privileges. Which barriers should these nurses address? Select all that apply. 1. There is no Medicare regulation mandating medical staff membership of APNs. 2. The fees associated with obtaining admitting privileges are prohibitive for ANPs. 3. State laws concerning ANP admitting privileges are confusing and contradictory. 4. Some state laws limit the scope of ANP practice. 5. Some hospitals do not allow non-physicians to admit patients.

3. Lobby for legislation supporting safe staffing measures.

A group of nurses are concerned about the chronic understaffing and mandatory overtime requirements of their state's hospitals. How could this group best help solve this issue? 1. Advise nurses to go home after their assigned shift instead of working overtime. 2. Talk to state legislatures about establishing staffing ratios. 3. Lobby for legislation supporting safe staffing measures. 4. Develop policies whereby nurse managers are the only ones required to work overtime.

2. Workplace modifications to allow the applicant to be a successful employee 4. Schedule modifications if acceptable to all involved. 5. Workplace modifications that are realistic

A job applicant with a disability has requested that the employer provide a reasonable accommodation. What does this request entail? Select all that apply. 1. Employment opportunities not given to persons without disabilities 2. Workplace modifications to allow the applicant to be a successful employee 3. Selection of this applicant over other qualified applicants 4. Schedule modifications if acceptable to all involved. 5. Workplace modifications that are realistic

3. Nursing notes reveal that the patient is repositioned frequently, but somehow manages to return to the back-lying position.

A long-term care resident has limited use of the right side of his body, but is coherent at intervals. If this patient develops decubiti, which factor might the facility plead to prevent liability? 1. The resident is unable to obtain proper nutrition because of his refusal to eat. 2. The resident must be confined to bed for prolonged periods of time because of his condition. 3. Nursing notes reveal that the patient is repositioned frequently, but somehow manages to return to the back-lying position. 4. Understaffing prevents the nurses from performing necessary passive range of motion exercises to the patient's affected side.

2. Take breaks to rest when needed. 4. Maintain certifications that will support care provided during emergencies. 5. Be honest about one's capabilities.

A nurse responds to help provide care at the scene of a disaster. Which nursing action will help to reduce the chance of lawsuit? Select all that apply. 1. Do not perform any actions outside of the scope of nursing care. 2. Take breaks to rest when needed. 3. Keep detailed notes on every action taken. 4. Maintain certifications that will support care provided during emergencies. 5. Be honest about one's capabilities.

3. The individual's adult child

A nurse suspects that an elderly person has been physically abused. According to research, which person would be the most likely abuser? 1. The person's paid caregiver 2. Someone previously unknown to the person 3. The individual's adult child 4. The person's neighbor

2. The responsibilities are equally as technical and demanding as those of acute care nursing.

A nurse who has a history of difficulty meeting the professional responsibilities of acute care nursing is considering a move to ambulatory nursing. What should this nurse consider about the professional responsibilities of ambulatory nursing prior to making this decision? 1. Ambulatory nursing is totally different from acute care nursing. 2. The responsibilities are equally as technical and demanding as those of acute care nursing. 3. The duty to communicate is lessened in ambulatory care nursing. 4. Ambulatory nursing is less physically demanding on the nurse.

2. Yes, older patients are members of a vulnerable population and there is a duty for anyone to report suspected abuse.

A nursing assistant suspects that another staff member is abusing residents in a nursing home. Is there a duty for this nursing assistant to report this suspicion? 1. Yes, but not until the nursing assistant has proof of the abuse. 2. Yes, older patients are members of a vulnerable population and there is a duty for anyone to report suspected abuse. 3. Only if another nursing assistant has the same suspicions and is also willing to report the suspicion of abuse 4. No, since the nursing assistant does not have a state license, there is not a duty to report.

1. Grandfather clause

A nursing student reports that her grandmother served as a nurse in World War II. At the end of the war, her grandmother was licensed as a nurse, even though she never graduated from nursing school. Which type of exemption from licensure does this reflect? 1. Grandfather clause 2. Reciprocity 3. Endorsement 4. Licensure by waiver

1. Documentation that the receiving hospital has available space 2. Physician certification that the medical benefits of transferring the patient outweigh the risks of transfer 4. An agreement with the receiving hospital stating willingness to provide care

A patient presents at a small rural medical clinic after falling from a ladder. The physician suspects that the patient may have intracranial injuries but no diagnostic equipment to determine the severity of injury is available. What is necessary for the physician to legally transfer this unstable patient? Select all that apply. 1. Documentation that the receiving hospital has available space 2. Physician certification that the medical benefits of transferring the patient outweigh the risks of transfer 3. Documentation that the transferring hospital is a qualified Medicare provider 4. An agreement with the receiving hospital stating willingness to provide care 5. Confirmation that the incident causing the injuries was accidental

3. Use a buddy system when providing care. 5. Assign the most experienced nurse to work with this patient.

A patient who is well known to be violent arrives by ambulance at the emergency department for care of a laceration. What actions should be taken? Select all that apply. 1. Sedate the patient prior to repairing the laceration. 2. Send the patient to another hospital. 3. Use a buddy system when providing care. 4. Restrain the patient prior to repairing the laceration. 5. Assign the most experienced nurse to work with this patient.

2. The registered nurse who has worked on this unit for 8 months

A patient who requires vasoactive intravenous medications was just admitted. Which person should the charge nurse ask to measure this patient's vital signs? 1. The licensed practical nurse who has worked on this unit for 5 years 2. The registered nurse who has worked on this unit for 8 months 3. The unlicensed assistive personnel (UAP) who was recently transferred to the unit from an acute care environment 4. The nursing assistant who has worked in this unit for 7 years

3. A nursing home

A person requires assistance with bathing, feeding, ambulation, and skin care. Which inpatient care setting is most appropriate for this person? 1. An elder day care center 2. A hospice care center 3. A nursing home 4. An assisted living center

1. The complaint will be screened and an investigation initiated if appropriate.

A physician reported a case of possible nursing negligence to the state board of nursing. What action will be taken by the board? 1. The complaint will be screened and an investigation initiated if appropriate. 2. Nothing will be done as only another professional nurse is qualified to report nursing negligence. 3. The nurse or nurses will be placed on probation pending investigation of the complaint. 4. The incident will be recorded as a "first strike" against the nurse or nurses involved.

4. The reasonably prudent school nurse

A school nurse negligently administered an overdose of medication to a student, causing the student to suffer a severe reaction that necessitated hospitalization. Should a lawsuit result from this case, the nurse would be held to what standard? 1. The reasonably prudent advanced nurse practitioner 2. The reasonably prudent general duty hospital nurse 3. The reasonably prudent pediatric nurse 4. The reasonably prudent school nurse

2. If there is a signed, standing order for the change

After analyzing assessment data, the home health care nurse determines that a change is necessary in the medical care of a patient. The nurse makes the change without consulting the physician. Under which circumstance is this a legal action by this nurse? 1. If the nurse is experienced and sure the change will not harm the patient 2. If there is a signed, standing order for the change 3. If the nurse is certain the physician will agree with the change 4. If the patient's family agrees that the action is necessary

4. Adult day health care

An elderly person, who lives with adult children, requires therapeutic and social services and cannot stay alone in the daytime. The person is alert and oriented, but needs a more structured setting during the day. Which care setting is likely the most appropriate for this person? 1. Adult day social care 2. Assisted living 3. Alzheimer's specific adult day care 4. Adult day health care

3. Report the error and complete an incident report.

At 2:00 a.m. the night nurse gives a patient 600 mg of ibuprofen according to the standard dosage she has given other patients. When charting the medication the nurse discovers that this patient's PRN order for ibuprofen calls for administering 400 mg of the drug. What nursing action is indicated? 1. Just monitor the patient as the dose given is within normal limits. 2. Notify the physician immediately. 3. Report the error and complete an incident report. 4. Chart that 400 mg of ibuprofen was given for pain.

4. No, contracts must fulfill a lawful purpose.

The news reports that a nurse "contracted over the telephone" to distribute narcotics. Under contract law is that a correct statement? 1. Yes, the contract agreement can be verbal or written. 2. Only if something of value, like money, is offered as compensation 3. If both parties understand the terms and meaning of the contract 4. No, contracts must fulfill a lawful purpose.

4. The nurse can be dismissed at any time, without cause.

The nurse and immediate supervisor have a personal conflict. The supervisor warns the nurse that the hospital is an employment-at-will institution. What does that indicate? 1. The nurse must work a given number of hours each week. 2. The nurse can only be dismissed for just cause. 3. The nurse has the choice of working in any hospital unit. 4. The nurse can be dismissed at any time, without cause.

1. Police power within the state

Changes to nursing licensure are being considered. The nurse identifies which source of the state's power to license nurses? 1. Police power within the state 2. State and federal case laws 3. Constitution of the United States 4. Nurse practice act

3. In all health care settings, including home health care settings, if federal funds are received

Nurses in which health care settings are required to comply with the Patient Self-Determination Act of 1991? 1. In home health care settings only if they have a validly executed advanced directive when care is first rendered 2. Solely in formal institutional settings, such as hospitals 3. In all health care settings, including home health care settings, if federal funds are received 4. In all health care settings except home health care settings

3. Resident falls

Nurses providing care in a long term care settings should be very aware of the potential for which patient incident that is one of the primary causes of action in lawsuits against these facilities? 1. Medication errors 2. Abuse of residents 3. Resident falls 4. Inadequate resident nutrition

2. That of a prudent layperson

Health plan administrators are designing methods to assure that consumers have appropriate access to emergency services. Which standard should guide the development of these methods? 1. That of a reasonable physician 2. That of a prudent layperson 3. That of an ethical insurance provider 4. That of a prudent and reasonable nurse

1. The wife restrains the patient in bed while she goes to the grocery store. 3. The wife tries to "stretch" the patient's medications by giving one half doses twice a week. 4. The wife reports being afraid to intervene when the home health nursing assistant strikes the patient for soiling the bed.

In which scenarios could the elderly wife of a homebound patient likely be guilty of elder abuse? Select all that apply. 1. The wife restrains the patient in bed while she goes to the grocery store. 2. The wife only bathes the patient three times a week. 3. The wife tries to "stretch" the patient's medications by giving one half doses twice a week. 4. The wife reports being afraid to intervene when the home health nursing assistant strikes the patient for soiling the bed. 5. The wife cries while telling the nurse that her husband often "yells and screams" when he doesn't feel well

2. The home health nurse no longer provides care for the patient when reimbursement amounts change. 3. The nurse stops making home visits without giving the patient notice that this would occur.

In which situations would the home health nurse likely be considered to have abandoned a client? Select all that apply. 1. The nurse and patient decided together that home health care was no longer needed. 2. The home health nurse no longer provides care for the patient when reimbursement amounts change. 3. The nurse stops making home visits without giving the patient notice that this would occur. 4. The nurse fails to assess the patient on a daily basis. 5. The nurse left the patient's home when a grandchild threatened the nurse.

4. It requires nurse managers to be vigilant concerning safety.

Mandatory overtime raises ethical issues about patient and nurse safety. How does voluntary overtime affect these issues? 1. It is also outlawed in states controlling mandatory overtime. 2. Nurses working overtime shifts are given smaller patient loads to protect safety. 3. There is no effect since the nurse has chosen to work overtime. 4. It requires nurse managers to be vigilant concerning safety.

1. Report the concerns to the state board of nursing.

The hospital nurse supervisor has concerns that a staff nurse is no longer capable of competent patient care because of alcohol use. Repeated counseling sessions with the nurse have not changed the behaviors that are of concern. What action should be taken by the supervisor? 1. Report the concerns to the state board of nursing. 2. Terminate the nurse's hospital employment. 3. Transfer the nurse to a non-patient care position. 4. Nothing as the nurse might sue the supervisor.

1. States have allowed patients who receive substandard care to successfully bring suit against HMOs.

State legislatures are gradually changing the care that patients potentially receive from health maintenance organizations (HMOs). What is one means by which this improvement has occurred? 1. States have allowed patients who receive substandard care to successfully bring suit against HMOs. 2. States have mandated that all citizens be covered by HMOs if that is the desire of the citizen. 3. States have set the premiums that enrollees pay for HMO coverage. 4. States have mandated how many HMOs will operate within the state.

2. Ask specific questions about the patient's presenting situation.

Telenursing presents numerous ethical concerns. What is one way the nurse can help to control for the ethical issues surrounding this technology? 1. Use telenursing to give only general, not specific, advice. 2. Ask specific questions about the patient's presenting situation. 3. Restrict telenursing to patients who have been seen in person within the last two days. 4. Refuse to give advice to patients over the telephone.

3. Staff model

The advanced nurse practitioner is an employee of a health maintenance organization, along with several other ANPs and physicians. All the providers receive a set salary from the organization regardless of how many or few patient contacts are made monthly. Which type of HMO does this describe? 1. Network model 2. Group model 3. Staff model 4. Independent practice association model

1. The expanding role of the advanced nurse practitioner has increased the number of lawsuits filed. 5. The severity of malpractice claims against some ANP roles has increased in the last few years.

The advanced nurse practitioner is considering changing malpractice insurance carriers. What should the nurse consider prior to making this change? Select all that apply. 1. The expanding role of the advanced nurse practitioner has increased the number of lawsuits filed. 2. The advanced nurse practitioner should carry medical malpractice, just as the physician does. 3. Advanced nurse practitioners are less likely to be sued than nurses holding a doctorate of nursing practice. 4. The advanced nurse practitioner is more likely to be sued than a physician. 5. The severity of malpractice claims against some ANP roles has increased in the last few years.

2. Implied provisions

The contract between a nurse and a hospital delineates the nurse's salary, benefits package, and when the job will begin. The contract does not state that the nurse must provide quality care. How would the hospital attorney describe this expectation if the nurse brings suit for wrongful discharge? 1. Expressed terms 2. Implied provisions 3. Silent terms 4. Inherent provisions

1. No, the blood can be used only for the determination of medical diagnosis.

The correctional nurse has drawn blood from an inmate who has experienced gastrointestinal bleeding. While performing the venipuncture, the nurse told the inmate the blood was being drawn for the purposes of evaluating the inmate's hemoglobin and hematocrit. Can the blood also be used to screen the inmate for drug usage? 1. No, the blood can be used only for the determination of medical diagnosis. 2. Yes, the inmate signs away all rights to privacy when incarcerated. 3. Yes, as long as the nurse suspects the inmate of drug use. 4. No, the laboratory will not accept this blood drawn and will insist that the blood be drawn again by a laboratory technician.

3. Remember to respect the person, not the actions of the person.

The emergency room nurse is often faced with the responsibility of providing care for people who were responsible for motor vehicle accidents. In some cases, the nurse is caring for that person along with victims of the accident. This situation causes the nurse moral distress. How could the nurse best help to alleviate this distress? 1. Refuse to care for these patients in the future. 2. Be frank with the patients about how uncomfortable the nurse is. 3. Remember to respect the person, not the actions of the person. 4. Ask a co-worker to care for the patients.

1. The male nurse's yearly evaluations are better than the female nurse's. 5. The male nurse has worked in the facility 3 years more than the female nurse.

The female nurse works in a nursing home where many of the patients are military service veterans. She discovers that a male nurse with whom she works makes $2.80 per hour more than she makes. In which situations could this be legal under affirmative action? Select all that apply. 1. The male nurse's yearly evaluations are better than the female nurse's. 2. The male nurse is friendlier and gets along better with the male patients. 3. The male nurse is also a veteran. 4. The male nurse is physically stronger than the female nurse. 5. The male nurse has worked in the facility 3 years more than the female nurse.

2. A nursing assistant who completed a training and competency evaluation program

The home health care agency that receives federal funds desires to hire a new home health care aide. This aide will provide direct and hands-on care to patients. Which person would meet federal requirements for that position? 1. A nursing assistant who has on-the-job training at a nursing home 2. A nursing assistant who completed a training and competency evaluation program 3. A nursing assistant who has on-the-job training at a hospital 4. A second-semester student enrolled in a registered nursing program

4. Social work counseling if requested 5. Written notice

The long-term care facility is considering the involuntary discharge of a resident. What should the facility provide the resident prior to making this decision? Select all that apply. 1. A referral to a different long-term care facility 2. Return of the last month's fees 3. Access to a psychiatric evaluation 4. Social work counseling if requested 5. Written notice

3. Fall rates have increased, but the incidence of long-term injuries has remained unchanged.

The nurse executive wishes to change the culture of the long-term care facility to one in which restraints are seldom used. Which information would the nurse provide when discussing this change with the facility's ownership? 1. In facilities where restraints are seldom used the rate of falls has decreased. 2. Reducing restraint use increases fall rate and injury rate, but results in better patient satisfaction ratings. 3. Fall rates have increased, but the incidence of long-term injuries has remained unchanged. 4. Chemical restraints can be substituted for most physical restraints.

3. They promote competition and efficiency in health care.

The nurse has been involved in work to support antitrust laws in health care. Why are these laws important to health care consumers? 1. They encourage activities to promote health. 2. They promote the use of registered nurses rather than unlicensed assistive personnel. 3. They promote competition and efficiency in health care. 4. They prevent physicians from ordering unnecessary tests.

2. Communicating with others regarding patient care. 3. Adequately and efficiently assessing the patient. 4. Monitoring the patient throughout the care encounter.

The nurse has many responsibilities in the care of patients. What are the most important components of this care? Select all that apply. 1. Following physician orders exactly as written. 2. Communicating with others regarding patient care. 3. Adequately and efficiently assessing the patient. 4. Monitoring the patient throughout the care encounter. 5. Selecting correct staff to provide patient care.

4. Talk with the patient about the reason for secrecy.

The nurse is caring for a 45-year-old patient who reveals that recent injuries are a result of domestic violence. The patient begs the nurse not to "tell." What action, taken by the nurse, is correct? 1. Report the revelation to the charge nurse. 2. Tell the patient that the law requires reporting this incident. 3. Promise the patient not to tell anyone. 4. Talk with the patient about the reason for secrecy.

3. An agreed-upon set of basic and supplemental health maintenance and treatment services 4. An organized system of providing health care in a geographic region 5. Persons who voluntarily enroll in the plan for services

The nurse is considering taking a job with a health maintenance organization. To be federally qualified as an HMO, the nurse's possible job site must have which of these aspects in place? Select all that apply. 1. A list of health care providers from which patients may choose 2. The capacity to provide care by telehealth 3. An agreed-upon set of basic and supplemental health maintenance and treatment services 4. An organized system of providing health care in a geographic region 5. Persons who voluntarily enroll in the plan for services

1. The nurse may unintentionally neglect to educate patients on services available.

The nurse is frustrated by the number of single mothers who receive medical services at no cost. What is the greatest danger of this frustration? 1. The nurse may unintentionally neglect to educate patients on services available. 2. The nurse may be rude to these mothers. 3. This frustration may increase the likelihood that the nurse elects to leave this job position. 4. The frustration may increase the nurse's job stress.

1. The workflow of the organization is focused on the patient as an informed partner in creating plans for care. 2. An interdisciplinary team of care providers will provide prevention and wellness care for these patients. 4. The medical home will establish a system of email communication with members for rapid access to providers. 5. The medical home will rely heavily on evidence-based decision making.

The nurse is involved in establishing a patient-centered medical home to care for a growing population of older adults. The nurse would support which components of this plan? Select all that apply. 1. The workflow of the organization is focused on the patient as an informed partner in creating plans for care. 2. An interdisciplinary team of care providers will provide prevention and wellness care for these patients. 3. The medical home will serve as a long term care facility for the patients as they age. 4. The medical home will establish a system of email communication with members for rapid access to providers. 5. The medical home will rely heavily on evidence-based decision making.

2. There is a need for greater assessment skills in long-term care because of the lack of direct physician contact with residents.

The nurse manager of a long-term care facility is planning to hire additional nursing staff. What should this manager consider about how the need to assess resident/patient changes and potential problems differ between the long-term care facility and an acute care facility? 1. There is a need for greater assessment skills in acute care because patients are so sick. 2. There is a need for greater assessment skills in long-term care because of the lack of direct physician contact with residents. 3. There is a lesser need for good assessment in long-term care because the residents are generally stable. 4. They are the same.

1. Medication history 3. Living arrangements 4. Demographic information

The nurse preparing to complete an Outcome and Assessment Information Set (OASIS) would expect to collect which information? Select all that apply. 1. Medication history 2. Insurance information 3. Living arrangements 4. Demographic information 5. Financial information

1. Social Security Act of 1935 5. Public Health Service Act of 1994

The nurse presenting a community education session about community health would include information about which foundational federal laws? Select all that apply. 1. Social Security Act of 1935 2. 1947 Taft Hartley Amendment 3. Civil Rights Act of 1991 4. Americans with Disabilities Act of 1990 5. Public Health Service Act of 1994

3. The nurse should practice as a reasonably prudent nurse when providing these services. 4. The nurse should assure that a system of record keeping is initiated and maintained.

The nurse volunteers services at a free medical clinic. What is true of these donated services? Select all that apply. 1. They fall under the auspices of the state nurse practice act. 2. Since the nurse is serving as a volunteer an exemption from possible lawsuit exists. 3. The nurse should practice as a reasonably prudent nurse when providing these services. 4. The nurse should assure that a system of record keeping is initiated and maintained. 5. The nurse's actions will be protected by Good Samaritan laws.

3. Be certain that any advice given reflects both nursing and community standards.

The nurse's neighbor routinely calls and asks for advice regarding health issues. What should the nurse do about these calls? 1. Tell the neighbor that the nurse is not legally able to give health advice outside the work environment. 2. Charge the neighbor a flat fee of $25 for each call. 3. Be certain that any advice given reflects both nursing and community standards. 4. Tell the neighbor that nurses are not educationally prepared to give health advice.

4. The nurse may hold liability depending upon circumstances.

The occupational nurse has sponsored and taught first aid classes to workers throughout the factory. If a person, taught by the nurse, makes an error in providing first aid that causes further injury, does the nurse hold any liability? 1. No, the liability is on the person who caused the original accident causing the need for first aid. 2. No, all liability is on the person who made the error. 3. The nurse holds all the liability. 4. The nurse may hold liability depending upon circumstances.

3. It does not alter the nurse's personal accountability at all.

The physician, in telling the nurse to follow an order, states, "If anything happens, I'll take full responsibility." What effect would the physician's statement have in a subsequent lawsuit for malpractice? 1. It alters the rule of professional accountability, because the physician is also a professional. 2. It alters the rule of personal accountability, because accountability is now substituted to the physician. 3. It does not alter the nurse's personal accountability at all. 4. It provides a valid defense for the nurse in the lawsuit.

4. The reasonably prudent nurse in an emergency situation

The school nurse is leaving campus after work when an accident occurs on the playground. The nurse responds and treats the injured students. Which standard of care would most likely determine liability? 1. The reasonably prudent pediatric nurse 2. The reasonably prudent general duty hospital nurse 3. The reasonably prudent school nurse 4. The reasonably prudent nurse in an emergency situation

2. "Please bring him back immediately while I get a treatment room prepared."

The triage nurse in a busy emergency department calls the charge nurse and says, "We have a patient who attempted suicide in the waiting room. I think we should just let him wait awhile so he has time to think about what he has done." Which response by the charge nurse is indicated? 1. "Is he in any danger of dying right now?" 2. "Please bring him back immediately while I get a treatment room prepared." 3. "Okay if that is what you think we should do." 4. "Is anyone with the patient?"

1. The nurse's ability to exercise independent judgment in emergency situations

What is the most significant professional qualification necessary for a nurse who practices as a school nurse? 1. The nurse's ability to exercise independent judgment in emergency situations 2. The nurse's ability to properly counsel students about medical concerns 3. The nurse's ability to work closely with school officials 4. The nurse's ability to effectively teach students about their health

1. The least restrictive restraint possible should be used. 4. Use of restraints increases the need to monitor the resident.

What is true of the use of restraints in long-term care facilities today? Select all that apply. 1. The least restrictive restraint possible should be used. 2. Restraints should be used for all residents at risk for falls. 3. They are expressly forbidden by federal laws. 4. Use of restraints increases the need to monitor the resident. 5. Chemical restraints are preferable to physical restraints.

3. The local newspaper publishes pictures of residents enjoying a holiday presentation by children. 5. The nursing home provides a list of names and clothing sizes to a local group who wishes to purchase birthday gifts for residents.

Which actions could meet the definition of a quasi-intentional tort in a long-term care facility? Select all that apply. 1. A resident wanders away from the facility and is found 2 miles away. 2. The resident is restrained to a chair in the day room to prevent wandering. 3. The local newspaper publishes pictures of residents enjoying a holiday presentation by children. 4. The nursing assistant slaps a resident's hand when the resident pinches another resident. 5. The nursing home provides a list of names and clothing sizes to a local group who wishes to purchase birthday gifts for residents.

4. The occupational health nurse

Which nurse is exposed to the greatest risk of liability for malpractice because of the nature of the employment relationship? 1. The hospital-based staff nurse 2. The home health care nurse 3. The federally employed nurse 4. The occupational health nurse

1. "Do you feel safe in your home?"

Which option is an example of a question and statement regarding violence a nurse should use in the assessment of all patients? 1. "Do you feel safe in your home?" 2. "Most violence involves physical abuse." 3. "Violence is rare in upper middle class families." 4. "Don't take your safe home environment for granted."

4. The caregiver has the patient sign power of attorney papers by saying they are required by the government.

Which option reflects financial exploitation? 1. The caregiver allows the patient to pay for incidentals necessary for care. 2. The caregiver encourages the elder person who wishes to continue to work in the family business. 3. The caregiver takes the patient's Social Security check to the bank for deposit. 4. The caregiver has the patient sign power of attorney papers by saying they are required by the government.

1. If a resident attempts to get out of bed, a soft vest restraint is applied. 2. The nursing staff routinely leave doors open when getting residents up to bedside commodes. 3. The patient is not consulted prior to a change in medical treatment. 4. The nursing assistant is overheard telling a resident, "If you don't eat, I won't take you down to play dominoes this afternoon."

Which options reflect a scenario that violates the Nursing Home Reform Act of 1987? Select all that apply. 1. If a resident attempts to get out of bed, a soft vest restraint is applied. 2. The nursing staff routinely leave doors open when getting residents up to bedside commodes. 3. The patient is not consulted prior to a change in medical treatment. 4. The nursing assistant is overheard telling a resident, "If you don't eat, I won't take you down to play dominoes this afternoon." 5. The resident falls during a physical therapy session, despite being attended by two staff members.

1. A hospital-provided interpreter

Which person would be the best choice as an interpreter for a non-English-speaking patient? 1. A hospital-provided interpreter 2. The patient's daughter who is bilingual 3. The patient's neighbor who is bilingual 4. A hospital housekeeper who is bilingual

1. A 16-year-old whose father died in a motor vehicle accident 2. A 70-year-old man who is retired from a job he held for 30 years 4. A 34-year-old person who files for unemployment after losing her job 5. A 30-year-old woman who has become blind secondary to diabetic retinopathy

Which person would likely be provided for under the Social Security Act of 1935? Select all that apply. 1. A 16-year-old whose father died in a motor vehicle accident 2. A 70-year-old man who is retired from a job he held for 30 years 3. A 45-year-old woman who suffered a myocardial infarction 4. A 34-year-old person who files for unemployment after losing her job 5. A 30-year-old woman who has become blind secondary to diabetic retinopathy

2. The promotion the nurse was seeking was given to the supervisor's girlfriend.

Which situation would the nurse manager evaluate as sexual favoritism or preferential treatment? 1. The female nurse agrees to meet a male nurse for coffee after work. 2. The promotion the nurse was seeking was given to the supervisor's girlfriend. 3. A nurse reports another nurse who makes a disparaging remark about a lesbian co-worker. 4. Co-workers offer support for a co-worker who decides to divulge his homosexuality to his family.

2. An oral agreement to purchase a new car by making payments over the next 48 months. 3. A "handshake" agreement to sell a one-acre parcel of land 4. An agreement that the hospital will continue to provide oncology services if the current oncology specialty group breaks their contract. 5. A verbal agreement for a nurse to work in a physician's office indefinitely

Which situations are exceptions to the statute of frauds principle? Select all that apply. 1. A verbal contract for a teenager to receive $25 to mow a neighbor's lawn 2. An oral agreement to purchase a new car by making payments over the next 48 months. 3. A "handshake" agreement to sell a one-acre parcel of land 4. An agreement that the hospital will continue to provide oncology services if the current oncology specialty group breaks their contract. 5. A verbal agreement for a nurse to work in a physician's office indefinitely

1. Standards of care in one state's hospitals are different from those in hospitals in another state. 3. The use of telenursing equipment is new in the hospital and requires the presence of a non-medical technician. 5. The nurse who is licensed in one state is caring for a patient who is in a different state.

Which situations reflect legal issues associated with telenursing? Select all that apply. 1. Standards of care in one state's hospitals are different from those in hospitals in another state. 2. A telehealth nurse in one state holds an associate degree while a nurse in a similar position in a neighboring state holds a baccalaureate degree in nursing. 3. The use of telenursing equipment is new in the hospital and requires the presence of a non-medical technician. 4. The nurse using telemedicine is paid by the patient "visit," while the hospital staff nurse is paid by the shift. 5. The nurse who is licensed in one state is caring for a patient who is in a different state.

4. "Since the hospital is liable for my actions, I am liable to my employer to provide competent care."

Which statement indicates that a nurse understands how the doctrine of respondeat superior alters his liability for negligent conduct? 1. "If I can prove that this doctrine applies, all of the liability is shifted to the hospital." 2. "Respondeat superior will not alter my liability in any way." 3. "My liability to the patient is reduced by this doctrine." 4. "Since the hospital is liable for my actions, I am liable to my employer to provide competent care."

1. Establishing a means of protecting the public at large

A nurse appointed to the state board of nursing would expect work focused on which basic purpose of that body? 1. Establishing a means of protecting the public at large 2. Ensuring that all schools of nursing seek national accreditation 3. Ensuring that all practicing nurses are competent 4. Restricting nursing practice through regulations

3. The nurse and the nursing assistant work together to provide care to a team of six patients.

A newly hired nursing assistant can work only when under direct supervision by a registered nurse. In which way can this assistant provide care? 1. The nursing assistant charts care in the patient's medical record and the nurse reviews that charting on a regular basis. 2. The nursing assistant provides hygienic care according to protocols approved by the nurse. 3. The nurse and the nursing assistant work together to provide care to a team of six patients. 4. The nurse is available on the unit while the nursing assistant provides care.

4. No, the allegations should have been made to the appropriate authorities.

A nurse calls the newspaper and reports that circumstances surrounding several deaths in the local hospital are suspicious and that a cover-up is in action. The subsequent article identifies the nurse by name and the nurse is fired. Is the nurse protected under the whistleblower law? 1. No, the report should have been made in person, not by telephone. 2. Yes, since a death occurred, any action to expose the situation is appropriate. 3. Yes, the nurse's action is one that any reasonable and prudent citizen would take. 4. No, the allegations should have been made to the appropriate authorities.

1. The physician shortage of the late 1960s

A nurse discussing the establishment of today's advanced nurse practitioner role would discuss which factor as the primary driving force? 1. The physician shortage of the late 1960s 2. The need for providers to work in primary care settings 3. The need for more rural health care by qualified providers 4. The refusal of physicians to see rural patients

2. "Nurse specialty certification has been shown to lower patient mortality." 4. Higher failure-to-rescue rates 5. "Education at the BSN level, when coupled with specialty certification, has been shown to reduce adverse patient outcomes."

A nurse executive has requested that additional budgetary funds be allocated to support staff seeking a baccalaureate degree in nursing or specialty certification. Which information should this executive provide during discussions of this funding? Select all that apply. 1. "Research shows no correlation between an increased number of BSN prepared nurses and increased nursing salaries." 2. "Nurse specialty certification has been shown to lower patient mortality." 3. "If our nursing staff is educated at a higher level and are certified we will see fewer lawsuits for negligence and malpractice." 4. Higher failure-to-rescue rates 5. "Education at the BSN level, when coupled with specialty certification, has been shown to reduce adverse patient outcomes."

2. Determine why only one person is ambulating the patient. 4. Assist the aide in completion of the ambulation.

A nurse has delegated the task of ambulating a patient to two nursing assistants. Despite the patient's appearance, assistance of two people is needed for safe ambulation. The nurse discovers the patient being ambulated by only one aide. What nursing actions are indicated? Select all that apply. 1. Scold the second aide for not carrying through with the delegated task. 2. Determine why only one person is ambulating the patient. 3. Assume that something important must have taken the second assistant away from this task. 4. Assist the aide in completion of the ambulation. 5. Notify the patient's physician of the incident.

1. Misuse of delegation is an ethical issue.

A nurse has the reputation of delegating tasks that are time-consuming or distasteful. What should the nurse manager consider before addressing this situation? 1. Misuse of delegation is an ethical issue. 2. One of the privileges of loyalty to the hospital is being able to delegate distasteful tasks to others. 3. Doing distasteful tasks is part of the learning process for new nurses. 4. The nurse reserves the right to delegate any task he or she wishes.

3. People living with HIV/AIDS began to identify loopholes in the existing state and federal non-discrimination laws.

A nurse manager has been asked to present information about the Americans with Disabilities Act to newly employed nurses. What information about the evolution of this act should be included? 1. This act was written to protect a growing population of older Americans. 2. Increased numbers of children with disabilities resulting from advances in technologies to save premature infants made this legislation essential. 3. People living with HIV/AIDS began to identify loopholes in the existing state and federal non-discrimination laws. 4. There was a big increase in the number of soldiers returning from war with orthopedic injuries.

4. Would a reasonable person's work be affected by this behavior?

A nurse manager is concerned that actions by a female nurse may constitute sexual harassment. What element should the manager consider? 1. The number of male employees working on the unit 2. The females nurse's age 3. Does the nurse mean to be offensive? 4. Would a reasonable person's work be affected by this behavior?

1. "The shortage of nurses has been the major reason that there are so many rules to follow when delegating."

A nurse returning to practice remarks that delegation is much more regulated and complicated than when she last practiced 20 years ago. What rationale would the nurse manager provide for this change? 1. "The shortage of nurses has been the major reason that there are so many rules to follow when delegating." 2. "Since nursing is trying to move back to the team approach to care delegation has become more important." 3. "The introduction of multiple levels of professional staff members increases need for delegation rules and regulations." 4. "The widespread return to primary nursing makes delegation more risky."

4. If the son is a member of the National Guard

A nurse was granted 12 weeks' leave under the Family and Medical Leave Act for care of an adult son. At the conclusion of the 12 weeks the nurse does not want to return to work. Under which situation might the leave be extended? 1. If the son is under treatment for substance abuse 2. If the son is still too sick to work 3. If the son is a firefighter, police officer, or other public servant 4. If the son is a member of the National Guard

2. "Are you able to fulfill the requirements of this job?"

A nurse who has an obvious physical disability applies for a staff nurse position. Which question, asked by the nurse recruiter, is legal? 1. "How long have you been disabled?" 2. "Are you able to fulfill the requirements of this job?" 3. "How does your disability affect your life?" 4. "Has your condition stabilized, or do you foresee it getting worse with time?"

3. "I assume greater legal liability because of my specialty credentials."

A nurse working as a clinical nurse specialist (CNS) in a hospital is aware of a greater risk for being sued for malpractice than that of the staff nurses' co-workers. What rationale would the CNS give for this difference? 1. "I have greater autonomy in my work." 2. "Since I make more money, I am a better litigation target." 3. "I assume greater legal liability because of my specialty credentials." 4. "The patients I work with are sicker and more likely to develop treatment related complications."

1. The nurse assesses for common causes of confusion and agitation. 3. The nurse contacts the patient's primary care provider regarding the confusion. 4. The nurse documents findings and actions in the medical record. 5. Ask for assistance from the nurse manager if necessary.

A nurse working in the intensive care unit (ICU) notes that a patient is more confused and agitated than yesterday. Which nursing actions are evidence of patient advocacy? Select all that apply. 1. The nurse assesses for common causes of confusion and agitation. 2. Tell the family that confusion and agitation frequently occur after ICU admission. 3. The nurse contacts the patient's primary care provider regarding the confusion. 4. The nurse documents findings and actions in the medical record. 5. Ask for assistance from the nurse manager if necessary.

3. Prior to 1938, most medications were over-the-counter and nurses were instrumental in their choice.

A nursing student's grandmother relates a time in the 1920s when medications were selected based upon the recommendation of a nurse who lived in the neighborhood. How is this possible? 1. Prescriptive authority was not removed from nurse practice acts until the 1950s. 2. The grandmother must be mistaken because medications have always been selected based upon physician prescription. 3. Prior to 1938, most medications were over-the-counter and nurses were instrumental in their choice. 4. This student's grandmother must have lived on a military base or facility where nurses were granted this privilege.

3. Additional assessment of the meaning of this statement is necessary.

The nurse says, "I don't want to take care of these patients anymore. I spend my whole day getting patients up to the bathroom or to the bedside chair. My back hurts so badly by the end of my shift." How should the nurse manager interpret this statement? 1. This nurse is likely burned out and needs a few days off work. 2. The nurse should be transferred to a different unit. 3. Additional assessment of the meaning of this statement is necessary. 4. The nurse should be educated about use of lift equipment.

2. The nurse must notify hospital risk management.

The nurse suspects that a patient's death was related to faulty monitoring equipment. What is the nurse's duty to report? 1. The nurse must notify the patient's survivors. 2. The nurse must notify hospital risk management. 3. The nurse must notify local law enforcement. 4. The nurse must notify the Food and Drug Administration.

4. Perhaps, secondary to the doctrine of ostensible authority

The hospital has outsourced housekeeping services to an independent contractor. A patient who was injured in a fall on wet flooring brings suit against the company. Does the hospital also hold liability? 1. Yes, secondary to the doctrine of borrowed servant 2. No, secondary to the doctrine of respondeat superior 3. Maybe, secondary to the doctrine of dual servant 4. Perhaps, secondary to the doctrine of ostensible authority

2. A person who takes medication for schizophrenia 4. A person who used a wheelchair for 1 year as a child 5. A person who has cancer

The nurse manager, making hiring decisions, would consider which applicants as protected from discrimination by the Americans with Disabilities Act and amendments? Select all that apply. 1. A person required to wear a hand brace for 3 weeks 2. A person who takes medication for schizophrenia 3. A person who wears glasses 4. A person who used a wheelchair for 1 year as a child 5. A person who has cancer

3. Possession of marijuana is illegal under federal law. 4. Some states have current legislative guidelines for legal possession of medical marijuana.

The home health nurse discovers that a homebound cancer patient is using marijuana to control nausea from chemotherapy. What advice should the nurse give this patient? Select all that apply. 1. The effect of marijuana on decreasing nausea is fleeting and not worth the health problems caused by using it. 2. Since the patient is homebound, it is likely the use of marijuana will not be discovered by anyone else. 3. Possession of marijuana is illegal under federal law. 4. Some states have current legislative guidelines for legal possession of medical marijuana. 5. As long as it is documented that an illness exists that can be treated with marijuana, no risk of prosecution is present.

1. Yes, if the plaintiff can prove the nurse was incompetent and that the hospital was aware of the incompetence.

The hospital has been sued for the actions of a nurse employee. The hospital proves that the nurse was not providing care within the scope of employment as a nurse. Can the hospital still hold liability in this case? 1. Yes, if the plaintiff can prove the nurse was incompetent and that the hospital was aware of the incompetence. 2. No, the doctrine of ostensible authority relieves the hospital of liability related to a rogue employee. 3. Yes, the hospital is automatically liable for the action of any employee. 4. No, at this point the nurse is considered a "lone ranger" and the hospital is not liable for the nurse's actions.

1. No, employers may offer preference to individuals of the same religion.

The nurse applies to a faith-based hospital. Another applicant who is of the same faith supported by the hospital is hired instead. Is this seen as discrimination under ADA? 1. No, employers may offer preference to individuals of the same religion. 2. Yes, the hiring decision must be made solely on ability. 3. Only if both nurses have similar experience and skill sets 4. Only if other cases of preference by the facility can be demonstrated

4. The employer deliberately created the work condition to force the nurse to resign. 5. Other nurses working on the unit describe the working conditions as intolerable.

The nurse cited "intolerable working conditions" as the reason for resignation. In order to claim constructive discharge, what must the nurse prove? Select all that apply. 1. The nurse's performance evaluation was not as good as other nurses on the unit. 2. The workplace stress had increased since hire. 3. The nurse was tired of waiting for a transfer to the day shift that had been promised for 6 months. 4. The employer deliberately created the work condition to force the nurse to resign. 5. Other nurses working on the unit describe the working conditions as intolerable.

2. Be up front and discuss the issue during the employment interview.

The nurse has a strong religious conviction against elective sterilization procedures. When seeking employment, how should the nurse handle this belief? 1. Request placement on a unit where care of these patients is unlikely. 2. Be up front and discuss the issue during the employment interview. 3. Say nothing about this belief as it is personal, private information. 4. Be certain that this information is documented in the employment contract.

2. Firmly enforce the standards of care guiding the facility. 4. Establish a discipline system that is progressive. 5. Encourage supervisors to be consistent in applying discipline.

The nurse has recently assumed the position of chief nurse in a long-term care facility with a record of poor patient care. How should this nurse approach the issue of effective discipline regarding patient care activities? Select all that apply. 1. Fire any nurse who does not meet established standards of care. 2. Firmly enforce the standards of care guiding the facility. 3. Set variable standards of care depending upon the nurse's previous experience. 4. Establish a discipline system that is progressive. 5. Encourage supervisors to be consistent in applying discipline.

3. Only the state in which the nurse holds licensure can act to suspend or revoke that license. 5. The remote state can limit or stop the nurse from practicing in that state.

The nurse holds original licensure in a compact state and has practice privileges in two remote states. Should practice concerns arise with this nurse in a remote state, what is the status of the nurse's license? Select all that apply. 1. Only the state in which the nurse demonstrated poor practice can act to suspend or revoke the nurse's license. 2. License suspension or revocation can only occur if all three states agree to the action. 3. Only the state in which the nurse holds licensure can act to suspend or revoke that license. 4. The remote state can place the nurse's license on probation. 5. The remote state can limit or stop the nurse from practicing in that state.

1. State nurse practice acts 2. ANA Code of Ethics for Nurses 4. ANA Nursing Scope and Standards of Practice 5. Nursing rules and regulations as promulgated by the state

The nurse is searching for information about nurses' responsibility and accountability for appropriate delegation of tasks. Where should this nurse look for this information? Select all that apply. 1. State nurse practice acts 2. ANA Code of Ethics for Nurses 3. State medical association bylaws 4. ANA Nursing Scope and Standards of Practice 5. Nursing rules and regulations as promulgated by the state

2. State Nurse Practice Act

The nurse is searching for the legal guide to the practice of registered nurse. Which document should the nurse review? 1. ANA Code of Ethics 2. State Nurse Practice Act 3. Nurse's Bill of Rights 4. Nightingale Pledge

2. Only if all other applicants for similar positions are subjected to the same examination

The nurse manager requests that a job applicant who has a physical disability receive a medical examination prior to assignment to a work station. Is this examination legal? 1. No, this requirement violates ADA. 2. Only if all other applicants for similar positions are subjected to the same examination 3. Only if the examination takes place before the job offer is extended 4. Only if the applicant agrees to have medical information released to those on the committee screening applicants.

1. "I can't believe our state board authorized this plan." 2. "I don't want to have these UAPs working under my license."

The nurse manager walks in on a conversation in the break room concerning the hospital's plan to employ unlicensed assistant personnel (UAPs) to help relieve a nursing shortage. Which statements would the manager correct? Select all that apply. 1. "I can't believe our state board authorized this plan." 2. "I don't want to have these UAPs working under my license." 3. "The hospital will have to assure that the UAPs they hire are competent." 4. "It will be important that the UAPs hired have adequate orientation to our nursing units." 5. "It will be even more important that we follow delegation policy and procedure."

3. The contract was accepted when the nurse showed up for work.

The nurse takes a position working in a clinic and receives a sign-on bonus. After having worked for one month the nurse charges that she never signed a contract with the clinic and therefore can leave for a different, higher-paying job without returning the bonus. What is true about this situation? 1. Since there was no signed paper, the contract does not exist. 2. Cashing the bonus check indicates acceptance of the contract. 3. The contract was accepted when the nurse showed up for work. 4. Acceptance of the terms of a contract must be in writing.

3. No, but the nurse's seniority should be considered in salary negotiations.

The nurse who has worked at a hospital for twenty five years suffers a disability secondary to a work-related accident and requests accommodation. The nurse is offered a position for which she is qualified, but in an area which she has no experience. Ethically, does the nurse's new position have to provide the same high salary as the old position? 1. No, the nurse's salary may be cut to the entry-level salary of the new position. 2. Yes, the new position must match or exceed the old position's salary. 3. No, but the nurse's seniority should be considered in salary negotiations. 4. Only if the nurse is equally as "productive" in the new position

1. The hospital is only liable in the suit because of the employee's actions. 3. The hospital incurred monetary damages because of the employee's actions.

The nurse who was found to be negligent in a lawsuit was just told by her attorney that the hospital will attempt to recover damages from the nurse pursuant to the principle of indemnification. What will the hospital have to prove for this to occur? Select all that apply. 1. The hospital is only liable in the suit because of the employee's actions. 2. The nurse has been employed at the hospital for less than 6 months. 3. The hospital incurred monetary damages because of the employee's actions. 4. The employee has personal professional liability insurance. 5. The money owed by the hospital is in excess of one million dollars.

3. The charge nurse divides the patient load into one team for each staff nurse who works the shift.

The nurse would correctly state that an assignment had been made in which situation? 1. The nurse says to the charge nurse, "Please watch my patients while I run down and pick up some lunch from the hospital cafeteria." 2. The nurse says to the UAP, "Please take all of the vital signs before you begin to deliver breakfast trays." 3. The charge nurse divides the patient load into one team for each staff nurse who works the shift. 4. The nurse asks a housekeeper to clean a bed quickly for a new admission.

2. Typically physicians are reimbursed at a higher rate than ANPs.

The office director of a medical practice has recommended that the advanced practice nurses bill for service under the name of one of the group's physicians. What is the probable rationale for this suggestion? 1. Patients are more likely to pay physician bills than nurse bills. 2. Typically physicians are reimbursed at a higher rate than ANPs. 3. Having a smaller number of names under which billing is submitted is more efficient. 4. Nurses are not permitted to bill government payers.

2. "We need to talk about how medications work to control diabetes mellitus." 3. "Tell me more about why you decided to make this change."

The patient decides to discontinue standard medical treatment for diabetes mellitus and to rely on diet and herbal medications for blood sugar control. Which statements, made by the nurse, are appropriate? Select all that apply. 1. "You are an adult and can do anything you want to do." 2. "We need to talk about how medications work to control diabetes mellitus." 3. "Tell me more about why you decided to make this change." 4. "Don't you know that you are gambling with your health?" 5. "I think that would be a mistake."

1. Some states allow advanced nurse practitioners to prescribe controlled substances.

The patient requires a controlled substance for the treatment of pain. What is true of the advanced nurse practitioner's role in independently prescribing this medication? 1. Some states allow advanced nurse practitioners to prescribe controlled substances. 2. There are no states in which any advanced nurse practitioner can prescribe controlled substances. 3. Prescriptive authority allows all advanced practice nurses to prescribe any medication necessary for the treatment of their patients. 4. Prescriptive authority is limited to nurse anesthetists.

4. This nurse may be guilty of practicing massage without a license.

The patient tells the nurse that the physician mentioned deep tissue massage as treatment for rheumatoid arthritis. As a part of the subsequent conversation, the nurse demonstrates techniques and encourages the patient to begin a regimen immediately. What is true regarding this situation? 1. Since back massage is a standard skill taught in nursing school, the nurse has no liability for these actions. 2. The nurse's liability centers on the recommendation to begin a massage regime. 3. Since the physician initiated the discussion, the nurse has no liability. 4. This nurse may be guilty of practicing massage without a license.

1. The physician 2. The pharmacist 3. The nurse

The physician made a calculation error that lead to the patient receiving a serious medication error. This error was overlooked by the pharmacist and the nurse who administered the dose as ordered. The patient questioned the medication saying, "This doesn't look like I was taking at home," but took the medication anyway when the nurse said it was a generic form of the drug. Who holds liability in this situation? Select all that apply. 1. The physician 2. The pharmacist 3. The nurse 4. The patient 5. The drug manufacturer

1. The charge nurse should assist the new nurse with the procedure.

The unit is extremely busy when the physician orders that a urinary catheter be inserted in a patient. The patient's assigned nurse is new, has seen the procedure done, but has never done it independently. How should the charge nurse handle this situation? 1. The charge nurse should assist the new nurse with the procedure. 2. The charge nurse should ask the new nurse to try the procedure alone. 3. The charge nurse should assign the task to a different nurse. 4. The charge nurse should do the procedure to save time.

3. No, generally the most capable and efficient person should be floated.

The unit policy is that the nurse with the least seniority is required to float to understaffed units. Is this the best policy? 1. Yes, the most senior people should be required to manage their home unit. 2. No, this policy is against most corporate philosophy. 3. No, generally the most capable and efficient person should be floated. 4. Yes, having choice in these matters is a benefit of longevity in the facility.

2. The nurse should follow the order unless the nurse has reason to believe that the patient could come to harm if the order is followed.

What is the nurse's legal duty with regard to implementing a physician's order? 1. The nurse should follow the order unless the nurse believes some other course of action would be better. 2. The nurse should follow the order unless the nurse has reason to believe that the patient could come to harm if the order is followed. 3. The nurse should discuss each order with the physician, since physicians are only human. 4. The nurse should follow all orders as written.

3. Mentally ill persons cannot fully appreciate their exposure to potential harm.

What is the principal reason that a higher standard of care may be required for safeguarding mentally ill persons? 1. Mentally ill persons bring more lawsuits than those with no mental illness. 2. The standards of care for mentally ill patients are higher than those for physically ill patients. 3. Mentally ill persons cannot fully appreciate their exposure to potential harm. 4. These patients require more care than do those who are physically ill.

2. A person who has just revealed he is homosexual 3. A person diagnosed with a gender identity disorder 4. A person who is a compulsive gambler

Which employee would likely be unsuccessful in claiming job protection under the Americans with Disabilities act? Select all that apply. 1. A person who has progressive hearing loss 2. A person who has just revealed he is homosexual 3. A person diagnosed with a gender identity disorder 4. A person who is a compulsive gambler 5. A person with a femur fracture who will require a wheelchair for three months.

1. Advancing technologies, especially telehealth and telephone triage makes single state licensure problematic.

Which information would the nurse provide as rationale for supporting the nurse licensure and mutual recognition movements? 1. Advancing technologies, especially telehealth and telephone triage makes single state licensure problematic. 2. Some areas have an oversupply of nurses while others are still experiencing a nursing shortage. 3. Multistate licensure will protect the safety of consumers who use call-in phone lines for health advice. 4. The number of practicing nurses holding more than one state license is increasing.

1. A 40-year-old nurse with excellent work history whose replacement is 35 years old 5. A competent 60-year-old nurse who discovers the nurse hired for his position is 50 years old

Which nurses would be most likely to be protected under the Age Discrimination Employment Act of 1967 if fired? Select all that apply. 1. A 40-year-old nurse with excellent work history whose replacement is 35 years old 2. A 49-year-old male nurse who held a position in obstetrics 3. A 23-year-old nurse who was told that she was "too young" for the job 4. A 72-year-old nurse who was fired from an OR scheduling position 5. A competent 60-year-old nurse who discovers the nurse hired for his position is 50 years old

2. Development of a new category to include clinical nurse specialists and advanced nurse practitioners

Which option reflects a change that may occur in the roles of advanced practice nurses? 1. Movement to decrease the educational requirements for advanced practice nursing to the baccalaureate level 2. Development of a new category to include clinical nurse specialists and advanced nurse practitioners 3. Change of the doctor of nursing practice to eliminate the practice emphasis 4. Elimination of nurse midwifery

4. The nurse is required to select the proper equipment and to use it correctly.

Which option reflects the nurse's duty regarding use of equipment? 1. Nurses are responsible for cleaning and repairing equipment so that it can be used readily. 2. Nurses should modify equipment so that it meets the particular patient's requirements. 3. Nurses have no responsibility for use or maintenance of equipment. 4. The nurse is required to select the proper equipment and to use it correctly.

1. The nurse has a duty to assess the patient for risk for falls.

Which option reflects the nurse's duty to prevent patient falls? 1. The nurse has a duty to assess the patient for risk for falls. 2. The nurse has a duty to provide minimal assistance. 3. The nurse has a duty to provide continual observation of patients. 4. The nurse has a duty to see that siderails on all beds are raised at all times.

3. The patient's immediate ability to harm self 5. The patient's threat to harm another patient

Which options reflect a general criterion for restraining a patient? Select all that apply. 1. The patient's inability to care for himself or herself 2. The patient's verbally abusive but nonthreatening behavior toward others 3. The patient's immediate ability to harm self 4. The patient's refusal to take psychotropic medications as prescribed 5. The patient's threat to harm another patient

1. The nurse agrees to work for specific wages.

Which situation reflects consideration in contract law? 1. The nurse agrees to work for specific wages. 2. Assertion that the nurse is legally able to enter into a contract 3. The description of the type of work expected by the facility wishing to employ the nurse 4. The nurse agrees to work at an immunization clinic from October through December.

1. Consider the patient care delivery systems on each unit. 3. Float nurses to areas with similar patient care requirements if possible. 4. Cross-train staff to various units.

Which strategies should the nurse manager employ when asked to float staff from one area to another? Select all that apply. 1. Consider the patient care delivery systems on each unit. 2. Float staff in alphabetical order of their last name. 3. Float nurses to areas with similar patient care requirements if possible. 4. Cross-train staff to various units.