CAUSE NO HAM

A dying patient is crying. She says, "I can't pray. I can't forgive myself." What would be an appropriate nursing diagnosis based on this data? A. Noncompliance B. Knowledge deficit C. Low Self Esteem D. Spiritual Distress

D

A grade school is preparing a series of classes on the dangers of smoking. Who would be most likely to teach the classes? A) A community health nurse B) An outside consultant C) A teacher D) The school nurse

D

A man is scheduled for hospital outpatient surgery. He tells the nurse, "I don't know what that word,outpatient, means." How would the nurse respond? A) "It means you will have surgery in the hospital and stay for 2 days." B) "It means the surgeon will come to your home to do the surgery." C) "Why would you ask such a question? Don't worry about it." D) "You will have surgery and go home that same day."

D

A middle-aged man is having increasing difficulty breathing. He never exercises, eats fast food regularly, and smokes two packs of cigarettes a day. He tells the nurse practitioner that he wants to change the way he lives. What is one means of helping him change behaviors? A) Ethical change strategy B) Values neutrality choices C) Values transmission D) Values clarification

D

A nurse does not assist with ambulation for a postoperative client on the first day after surgery. The client falls and fractures a hip. What charge might be brought against the nurse? A) Assault B) Battery C) Fraud D) Negligence

D

A nurse has been named as a defendant in a lawsuit. With whom should the nurse discuss the case? A) Colleagues B) Reporters C) Plaintiff D) Attorney

D

A nurse moves from Ohio to Missouri. Where can a copy of the Nurse Practice Act in Missouri be obtained? A) Ohio State Board of Nursing B) Missouri State Board of Nursing C) Federal government nursing guidelines D) National League for Nursing

B

A nurse is caring for a woman 28 years of age who has delivered a baby by Cesarean section. She describes her pain as a 9. The nurse medicates her for pain. This is an example of which of the following ethical frameworks? a) Beneficence b) Justice c) Nonmaleficence d) Fidelity

A

A nurse is providing client care in a hospital setting. Who has full legal responsibility and accountability for the nurse's actions? A) The nurse B) The head nurse C) The physician D) The hospital

A

A nurse provides client care within a philosophy of ethical decision making and professional expectations. What is the nurse using as a framework for practice? A) Code of Ethics B) Standards of Care C) Definition of Nursing D) Values Clarification

A

A nurse using the principle-based approach to client care seeks to avoid causing harm to clients in all situations. What is this principle known as? A) Nonmaleficence B) Justice C) Fidelity D) Autonomy

A

The nurse recognizes that the goals established for a client's discharge are more likely to be accomplished when ... A) the client assists in developing the goals. B) the physician develops the goals. C) the nurse develops the goals. D) the multidisciplinary team develops the goals.

A

What is a systematic way to form and shape one's thinking? A) Critical thinking B) Intuitive thinking C) Trial-and-error D) Interpersonal values

A

What is one negative aspect for children of learning values through the moralizing mode of transmission A. Not much opportunity to weigh values B. Can lead to confusion and conflict C. Unacceptable behaviors are punished D. Little likelihood of developing acceptable behaviors

A

What are the 4 key principles of Principle - Based Approach?

1. Autonomy 2. Non-maleficence 3. Beneficence 4. Justice

A client has a private insurance policy that pays for most health care costs and services. Why is this plan called a third-party payer? A) The insurance company pays all or most of the costs. B) The family of the client is required to pay costs. C) The client gets the bill and pays out-of-pocket costs. D) Medicare and Medicaid will pay most of the costs.

A

A client is suing a nurse for malpractice. What is the term for the person bringing suit? A) Plaintiff B) Defendant C) Litigator D) Witness

A

A client refuses to have a pain medication administered by injection. A nurse says, "If you don't let me give you the shot, I will get help to hold you down and give it." With what crime might the nurse be charged? A) Assault B) Battery C) Negligence D) Defamation

A

What type of law regulate the practice of nursing A. Civil law B. Common law C. Public law D. Criminal law

A

A client with a diagnosis of colorectal cancer has been presented with her treatment options, but wishes to defer any decisions to her uncle, who acts in the role of a family patriarch within the client's culture. By which of the following is the client's right to self-determination best protected? A) Respecting the client's desire to have the uncle make choices on her behalf B) Revisiting the decision when the uncle is not present at the bedside C) Teaching the client about her right to autonomy D) Holding a family meeting and encouraging the client to speak on her own behalf Ans: A Feedback: The right to self-determination (autonomy) means that it should never be forced on anyone. The client has the autonomous right to defer her decision-making to another individual if she freely chooses to do so.

A

A client, scheduled for open-heart surgery, tells the nurse he does not want to be "saved" if he dies during surgery. What should the nurse do next? A) Discuss with and document the wishes of the client and family B) Administer the ordered oral and intravenous preoperative medications C) Notify the physician after completion of the surgical procedure D) Verbally report the client's wishes to the operating room supervisor A) Discuss with and document the wishes of the client and family

A

A competent adult patient is scheduled for surgery. Who signs the informed consent to allow the surgery A. The patient B. A relative C. A nurse D. The physician

A

A home health care agency providing care in a local community is supported by the United Way and local donations. What type of agency is this? A) Voluntary B) Public C) Proprietary D) Institution-based

A

A lawsuit has been brought against a nurse for malpractice. The client fell and suffered a skull fracture, resulting in a longer hospital stay and need for rehabilitation. What does the description of the client and his injuries represent as proof of malpractice? A) Damages B) Causation C) Duty D) Breach of duty

A

A male client age 56 years is experiencing withdrawal from alcohol and is placing himself at risk for falls by repeatedly attempting to scale his bedrails. Benzodiazepines have failed to alleviate his agitation and the nurse is considering obtaining an order for physical restraints to ensure his safety. The nurse should recognize that this measure may constitute what? A) Paternalism B) Deception C) Harm D) Advocacy

A

A mother always thanks clerks at the grocery store. Her daughter age 6 years echoes her thank you. The child is demonstrating what mode of value transmission? A) Modeling B) Moralizing C) Reward and punishment D) Responsible choice

A

A patient is suing a nurse for malpractice. What is the term for the person bringing the suit A. Plaintiff B. Defendant C. Litigator D. Witness

A

A student nurse is working in the library on her plan of care for a clinical assignment. The client's name is written at the top of her plan. What ethical responsibility is the student violating? A) Confidentiality B) Accountability C) Trust D) Informed consent

A

After many years of advanced practice nursing, a nurse has recently enrolled in a nurse practitioner program. This nurse has been attracted to the program by the potential to provide primary care for clients after graduation, an opportunity that is most likely to exist in which of the following settings? A) A rural health center B) A long-term care facility C) A university hospital D) A community hospital

A

At what point during hospital-based care does planning for discharge begin? A) Upon admission to the hospital B) After the patient is settled in a room C) Immediately before discharge D) After leaving the hospital

A

Which of the following best describes voluntary standards? A) Voluntary standards are guidelines for peer review, guided by the public's expectation of nursing. B) Voluntary standards set requirements for licensure and nursing education. C) Voluntary standards meet criteria for recognition, specified area of practice. D) Voluntary standards determine violations for discipline and who may practice.

A

Which of the following illustrates the activity of acting in values clarification? A) respecting the human dignity of all patients B) seeking public affirmation for actions C) disregarding several alternatives when choosing D) considering consequences of actions

A

Who provides physicians with the authority to admit and provide care to clients requiring hospitalization? A) The health care institution itself B) Board of Healing Arts C) American Medical Association D) State Board of Nursing

A

The nurse is preparing to send a client to the operating room for an exploratory laparoscopy. The nurse recognizes that there is no informed consent for the procedure on the client's chart. The nurse informs the physician who is performing the procedure. The physician asks the nurse to obtain the informed consent signature from the client. What is the nurse's best action to the physician's request? A) Inform the physician that it is his or her responsibility to obtain the signature. B) Obtain the signature and ask another nurse to cosign the signature. C) Inform the physician that the nurse manager will need to obtain the signature. D) Call the house officer to obtain the signature.

A) Inform the physician that it is his or her responsibility to obtain the signature.

Which of the following are examples of a nurse demonstrating the professional value of altruism? Select all that apply. A. The nurse arranges for an interpreter for a patient whose primary language is Spanish B. The nurse provides information for a patient so he is capable of participating in planning his care C. The nurse calls the physician of a patient whose pain medication is not strong enough D. The nurse reviews a patient chart to determine who may be informed of the patients condition E. The nurse documents patient care accurately and honestly and reviews the entry to ensure there are no errors

A,B

Which of the following statements describe a characteristic of ethics? Select all that apply. A. Ethics usually refers to personal or communal standards of right and wrong B. Ethics is a systematic inquiry into principles or right and wrong conduct C. Ethics cannot be defined as a code of professional conduct D. Values are intimately related to, and direct, ethical conduct E. The ability to be ethical begins in young adulthood F. It is important to distinguish ethics from region, law, custom, and institutional practices.

A,B,D,E,F

During a clinical placement on a subacute, geriatric medicine unit, a student nurse fed a stroke client some beef broth, despite the fact that the client's diet was restricted to thickened fluids. As a result, the client aspirated and developed pneumonia. Which of the following statements underlies the student's potential liability in this situation? A) The same standards of care that apply to a registered nurse apply to the student. B) The student and the nursing instructor share liability for this lapse in care. C) The patient's primary nurse is liable for failing to ensure that delegated care was appropriate. D) The student's potential liability is likely negated by the insurance carried by the school of nursing.

Ans: A Feedback: Despite the fact that their knowledge and skills are still under development, nursing students are held to the same standards of care as registered nurses. Consequently, primary liability does not lie with the student's instructor or the patient's primary nurse. Insurance may be carried by the school of nursing, but this does not negate the student's legal responsibility to provide care at a high standard.

Which of the following aspects of nursing would be most likely defined by legislation at a state level? A) The differences in the scope of practice between registered nurses (RNs) and licensed practical nurses (LPNs). B) The criteria that a nurse must consider when delegating tasks to unlicensed care providers. C) The criteria that clients must meet in order to qualify for Medicare or Medicaid. D) The process that nurses must follow when handling and administering medications.

Ans: A Feedback: The scope of practice defines the parameters within which nurses provide care, and is established by state legislation, most commonly in the form of a Nurse Practice Act. The criteria and due process for delegation in the clinical setting is addressed by a state board of nursing. Qualification criteria for programs such as Medicare and Medicaid are established by federal legislation, while the process for safe and appropriate medication administration is defined and monitored by a state board of nursing.

A nurse is examining a child two years of age. Based on her findings, she initiates a care plan for a potential problem with normal growth and development. Which step of the nursing process identifies actual and potential problems? A) Assessing B) Diagnosing C) Planning D) Implementing

B

A nurse is arrested for possession of illegal drugs. What kind of law is involved with this type of activity? A) Civil B) Private C) Public D) Criminal

Ans: D

A nurse has been asked to ensure informed consent for a surgical procedure. What might be a role of the nurse? A) Securing informed consent from the client B) Signing the consent form as a witness C) Ensuring the client does not refuse treatment D) Refusing to participate based on legal guidelines

B

A client rings the call bell to request pain medication. Upon performing the pain assessment, the nurse informs the cliient that she will return with the pain medication. The nurse's promise to return with the pain medication is an example of which principle of bioethics? a) Nonmaleficence b) Fidelity c) Justice d) Autonomy

B

A nurse states to the client that she will keep her free of pain. However, her family wishes to try a treatment to prolong her life that may necessitate withholding pain medication. This factor will cause an ethical dilemma for the nurse in relation to which ethical principle? a) Autonomy b) Fidelity c) Justice d) Veracity

B

A nurse working in a long-term care facility has an elderly male client who is very confused. What ethical dilemma is posed when using restraints in a long-term care setting? a) It prevents self-directed care. b) It threatens autonomy. c) It increases confusion. d) It limits personal safety.

B

A patient tells the nurse that he does not want to have a painful procedure. By respecting and supporting the patient's right to make decisions, what is the nurse demonstrating? A) confidentiality B) advocacy C) altruism D) justice

B

After a stroke, a client is having difficulty swallowing. The nurse may make a referral to what member of the health care team? A) Physical therapist B) Speech therapist C) Social worker D) Respiratory therapist

B

Two nurses are discussing a client's condition in an elevator full of visitors. With what crime might the nurses be charged? A) Defamation of character B) Invasion of privacy C) Unintentional negligence D) Intentional negligence

B

Two nurses are discussing a patients condition in an elevator full of visitors. With what crime might the nurses be charged? A. Intentional negligence B. Invasion of privacy C. Defamation of character D. Unintentional negligence

B

What nursing organization first legitimized the use of the nursing process? A) National League for Nursing B) American Nurses Association C) International Council of Nursing D) State Board of Nursing

B

Which of the following is the major goal of ambulatory care facilities? A) To save money by not paying hospital rates B) To provide care to clients capable of self-care at home C) To perform major surgery in a community setting D) To perform tests prior to being admitted to the hospital

B

Which of the following is the nurses best legal safeguard. A. Patient education B. Component practice C. Written or implied contracts D. Collective bargaining

B

Which of the following phrases best describes hospitals today? A) Focus on chronic illnesses B) Focus on acute care needs C) Primary care centers D) Voluntary agencies

B

While at lunch, a nurse heard other nurses at a nearby table talking about a client they did not like. When they asked him what he thought, he politely refused to join in the conversation. What value was the nurse demonstrating? A) The importance of food in meeting a basic human need B) Basic respect for human dignity C) Men do not gossip with women D) A low value on collegiality and friendship

B

Which of the following are ANA standards of clinical nursing practice? Select all that apply A. The nurse delivers care in a manner that preserves or protects patient dependency, dignity, and rights. B. The nurse maintains patient confidentiality within legal and regulatory parameters C. The nurse seeks available resources to help formulate ethical decisions and use them in practice D. The nurses practice andantinos are guided by hospital policy and regulations E. The nurse is the patient advocates and discourages patients to advocate for themselves F. The nurse delivers care in a nonjudgemental manner that is sensitives to patient diversity. Answers: B,C,F Rationale: The nurses practice is guided by the Code for Nurses and the nurse maintains patient confidentially within legal and regulatory parameters. The nurse acts a patient advocate and assists patients in developing skills so they can advocate for themselves. The nurse delivers care in a nonjudgemental and nondiscriminatory manner that is sensitive to patient diversity. The nurse also delivers care in a manner that preserves or protects patient autonomy, dignity, and rights.

BCF

A lawyer quotes a precedent for punishment of a crime committed by the defendant in a trail. What is the court-made law is known as? A. Administrative law B. Public law C. Common law D. Statutory law

C

A nurse in a walk-in health care setting provides technical services (e.g., administering medications), determines the priority of care needs, and provides client teaching on all aspects of care. Which of the following terms best describes this type of health care setting? A) Hospital B) Physician's office C) Ambulatory center D) Long-term care

C

A nurse in a women's health clinic values abstinence as the best method of birth control. However, she offers compassionate care to unmarried pregnant adolescents. What is the nurse demonstrating? A) modeling of value transmission B) conflict in values acceptance C) nonjudgmental "value neutral" care D) values conflict that may lead to stress

C

Legally speaking, how would the nurse ensure that care was not negligent? A) Verbally reporting assessments to the client's physician B) Keeping private notes about the care given to each assigned client C) Documenting the nursing actions in the client's record D) Tape recording complete information for each oncoming shift

C

Medicare uses a prospective payment plan based on diagnosis-related groups (DRGs). What are DRGs? A) Locally supported health care financing, usually by donations B) A public assistance program for low-income individuals C) Predetermined payment for services based on medical diagnoses D) A private insurance plan for subscribers who pay a copayment

C

What population do hospice nurses provide with care? A) Those requiring care to improve health B) Children with chronic illnesses C) Dying persons and their loved ones D) Older adults requiring long-term care

C

What type of law regulates the practice of nursing? A) Common law B) Public law C) Civil law D) Criminal law

C

Which of the following accreditations is a legal requirement for a school of nursing to exist? A) National League for Nursing Accrediting Commission B) American Association of Colleges of Nursing accreditation C) State Board of Nursing accreditation D) Educational institution accreditation

C

Which of the following best describes the utilitarian theory of ethics? A. If an action is useful, it is ethically correct B. There is no way to determine whether an action is ethical or not C. The consequences of an action determine if it is right or wrong D. All actions are either right or wrong, regardless of consequences

C

Which of the following is the most frequent reason for revocation or suspension of a nurse's license? A) Fraud B) Mental impairment C) Alcohol or drug abuse D) Criminal acts

C

Which of the following is true of long-term care facilities? A) They provide care only to older adults. B) They provide care for homeless adults. C) They provide care to people of any age. D) They provide care only for people with dementia.

C

Which of the following modes of value transmission is most likely to lead to confusion and conflict? A) Modeling B) Moralizing C) Laissez-faire D) Responsible choice

C

Which of the following phrases best describes continuity of care? A) Focusing on acute care in the hospital B) Serving the needs of children C) Facilitating transition between settings D) Providing single-episode care services

C

Which of the following nursing actions would be considered a violation of HIPAA regulations? Select all that apply. A. A nurse shoves a confused bedridden patient into bed after he made several attempts to get up B. A nurse misrepresents herself to obtain a license to practice nursing C. A nurse reports the condition of a patient to the patients employer D. A nurse inadvertently administers the wrong does of morphine to a patient in the ICU E. A nurse uses a patients chart as a simple teaching case without changing the patients name F. A nurse ambulates a patient though the hospital hallway in a hospital gown that is open in the back.

CF

A nurse is conducting an interview for a health history. In addition to asking the client about medications being taken, what else should be asked to assess the risk for drug interactions? A) The effects of prescribed medications B) Type and amount of foods eaten C) Daily amount of intake and output D) Use of herbal supplements

D

According to established standards, which health care provider should conduct a holistic assessment for all clients admitted to the hospital? A) Physician B) Admission clerk C) Licensed practical nurse D) Registered nurse Ans: D Feedback: The Joint Commission has established standards for hospital admission. These standards include assessment of each client's need for nursing care by a registered nurse and biophysical, psychosocial, environmental, self-care, educational, and discharge planning factors. The admission health assessment is not the responsibility of the physician, licensed practical nurse, or admission clerk.

D

An elderly woman has total care of her husband, who suffers from debilitative rheumatoid arthritis. The couple voices concern over the pain and stress associated with the condition. What type of care might the nurse suggest to help the couple? A) Primary care B) Respite care C) Bereavement care D) Palliative care

D

In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that she has made. The nurse is most clearly demonstrating which of the following professional values? a) Human dignity b) Altruism c) Social justice d) Integrity

D

Nurses who are employed in home care have a variety of responsibilities. Which of the following is one of those responsibilities? A) Provide all care and services B) Maintain a clean home environment C) Advise clients on financial matters D) Collaborate with other care providers

D

Two children need a kidney transplant. One is the child of a famous sports figure, whereas the other child comes from a low-income family. What ethically relevant consideration is important to the nurse as an advocate for these clients? A) Balance between benefits and harms in patient care B) Norms of family life C) Considerations of power D) Cost-effectiveness and allocation

D

What is required of a client who leaves the hospital against medical advice (AMA)? A) Nothing. The hospital has no legal concerns. B) Full reimbursement of any medical expenses C) Providing contact phone numbers if needed D) Signing a form releasing legal responsibility

D

What is the legal source of rules of conduct for nurses? A) Agency policies and protocols B) Constitution of the United States C) American Nurses Association D) Nurse Practice Acts

D

Which of the folioing illustrates the activity of acting in values clarification? A. Disregarding several alternatives when choosing B. Considering the consequences of actions C. Seeking public affirmation for actions D. Respecting the human dignity of all patients

D

A client who is scheduled to have surgery for a hernia the next day is anxious about the whole procedure. The nurse assures the client that surgery for hernias is very common and that the prognosis is very good. What skills of the nurse are reflected here? A) Imaginal skills B) Interpersonal skills C) Instrumental skills D) Systems skill

b

A nurse asks a multidisciplinary team to collaborate in developing the most appropriate plan of care to meet the needs of an adolescent with a severe head injury. Which of the blended skills essential to nursing practice is the nurse using? A) Cognitive skills B) Interpersonal skills C) Technical skills D) Ethical/legal skills

b

Nursing students in an ethics class have been asked to define "ethics". What would be the best definition of ethics? a) The adherence to formal personal values. b) The formal, systematic study of moral beliefs. c) The informal, systematic study of moral beliefs. d) The adherence to informal personal values.

b

A nurse explains the informed consent form to a patient who is scheduled for heart bypass surgery. Which of the following are elements of this consent form? Select all that apply. A. DNR orders B. Disclosures C. Voluntariness D. Organ donation E. Competence F. Comprehension

bcef

A client nearing the end of life requests that he be given no food or fluids. The physician orders the insertion of a nasogastric tube to feed the client. What situation does this create for the nurse providing care? A) Nurse must follow the physician's orders B) An inability to provide care for the patient C) An ethical dilemma about inconsistent courses of action D) A barrier to establishing an effective nurse-patient relationship

c

A client, unsure of the need for surgery, asks the nurse, "What should I do?" What answer by the nurse is based on advocacy? A) "If I were you, I sure would not have this surgical procedure." B) "Gosh, I don't know what I would do if I were you." C) "Tell me more about what makes you think you don't want surgery." D) "Let me talk to your doctor and I will get back to you as soon as I can."

c

A lawyer quotes a precedent for punishment of a crime committed by the defendant in a trial. What is court-made law known as? A) Public law B) Statutory law C) Common law D) Administrative law

c

A nurse in a women's health clinic values abstinence as the best method of birth control. However, she offers compassionate care to unmarried pregnant adolescents. What is the nurse demonstrating? A) modeling of value transmission B) conflict in values acceptance C) nonjudgmental "value neutral" care D) values conflict that may lead to stress

c

A nurse is admitting an older woman (Grace Staples) to a long-term care facility. How should the nurse address the woman? A) "We will just call you Grace while you live here. Okay?" B) "I know you have lots of grandchildren, Grandma." C) "What name do you want us to use for you?" D) "I think you will enjoy living here, Sweetie."

c

Nurses who assist clients to deal holistically with their health care needs at the end of their lives work primarily in which health care delivery system? A) Acute care B) Primary care C) Hospice D) Rehabilitation

c

What is the primary focus of health care today? A) Care of acute illnesses B) Care of chronic illnesses C) Health promotion D) Health restoration

c

What phrases best describes a value? A. Questions about how one should act and live B. The process by which one decides what is important in life C. A belief about the worth of something to guide behavior D. Dispositions of character that motivate goodness

c

Which of the following is the nurse's best legal safeguard? A) Collective bargaining B) Written or implied contracts C) Competent practice D) Patient education

c

A client gets out of bed following hip surgery, falls, and re-injures her hip. The nurse caring for her knows that it is her duty to make sure an incident report is filed. Which of the following statements accurately describes the correct procedure for filing an incident report? A) The physician in charge should fill out the report. B) The names of the staff involved should not be included. C) The reports are used for disciplinary action against the staff. D) The report should contain all the variables related to the incident.

d

A nurse is concerned about the practice of routinely ordering a battery of laboratory tests for clients who are admitted to the hospital from a long-term care facility. An appropriate source in handling this ethical dilemma would be which of the following? A) The client's family B) The admitting physician C) The nurse in charge of the unit D) The institutional ethics committee

d