Chapter 7 Course Points, Chapter 11 Course Points, Chapter 6 Course Points

A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS due to exposure to sex workers at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist. With what legal action could the nurse be charged? a. Libel b. Slander c. Negligence d. Malpractice

b. Slander

When talking with family over dinner, the nurse shares about a client with infertility at the hospital, identifying the person by name. Which tort has the nurse committed? a. Slander b. Assault c. Invasion of privacy d. Fraud

c. Invasion of privacy

Which scenario is an example of certification? a. A nurse who demonstrates advanced expertise in a content area of nursing through special testing b. A hospital that meets the standards of the Joint Commission c. An education program that meets the standards of the National League for Nursing d. A graduate of a nursing education program who passes the NCLEX-RN

a. A nurse who demonstrates advanced expertise in a content area of nursing through special testing

Which statement regarding health care reform trends is most accurate? a. "Systems are in place to pay for performance and penalize hospitals for excessive readmissions." b. "Distinctive to the United States is the dominance of the public element over the private one." c. "The United States is second in the world in total health care dollars spent annually." d. "Spending on medical services will rise to almost 32% of the U.S. gross domestic product by 2021."

a. "Systems are in place to pay for performance and penalize hospitals for excessive readmissions."

Which statement is true when comparing home care with acute care? a. The nurse is the guest in the client's home. b. The nurse directs all aspects of the home. c. The client directs the education of all caregivers. d. The nurse and the client work independently of each other.

a. The nurse is the guest in the client's home.

While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects: a. invasion of privacy. b. defamation of character. c. professional negligence. d. false imprisonment.

a. invasion of privacy.

An HIV-positive client discovers that the client's name is published in a research report on HIV care prepared by the client's nurse. The client is hurt and files a lawsuit against the nurse. Which offense has the nurse committed? a. Unintentional tort b. Invasion of privacy c. Defamation of character d. Negligence of duty

b. Invasion of privacy

What governing body has the authority to revoke or suspend a nurse's license? a. The State Board of Nurse Examiners b. The employing health care institution c. The National League for Nursing d. The Supreme Court

a. The State Board of Nurse Examiners

The Nursing Agenda for Health Care Reform (American Nurses Association [ANA]) identifies the recipients of health care. This reform's main focus is on: a. accurate assessment in the acute health care setting. b. health promotion. c. better connectivity through the use of technology. d. high-quality disease management.

b. health promotion.

Professional regulations and laws that govern nursing practice are in place for which reason? a. To limit the number of nurses in practice b. To ensure that practicing nurses are of good moral standing c. To protect the safety of the public d. To ensure that enough new nurses are always available

c. To protect the safety of the public

A student nurse is assisting an older adult client to ambulate following hip replacement surgery when the client falls and reinjures the hip. Who is potentially responsible for the injury to this client? a. The student nurse b. The nurse instructor c. The hospital d. The student nurse, the nurse instructor, and the hospital

d. The student nurse, the nurse instructor, and the hospital

The client being admitted to the oncology unit conveys wishes regarding the use of tube feedings if the client becomes unable to feed by mouth. The nurse advises the client that it would be in the client's best interest to obtain which document? a. A feeding plan b. A living will c. Proof of health care power of attorney d. A proxy directive

b. A living will

Nurses complete incident reports as dictated by the agency protocol. What is the primary reason nurses fill out an incident report? a. To document everyday occurrences b. To document the need for disciplinary action c. To improve quality of care d. To initiate litigation

c. To improve quality of care

Which scenario is an example of certification? a. A nurse who demonstrates advanced expertise in a content area of nursing through special testing b. A graduate of a nursing education program who passes NCLEX-RN c. An education program that meets standards of the National League for Nursing d. A hospital that meets the standards of the Joint Commission

a. A nurse who demonstrates advanced expertise in a content area of nursing through special testing

The nurse is caring for several clients with chronic conditions that need to be evaluated for long-term care. After evaluating each client, the nurse determines which client is most appropriate to receive long-term care? a. Aclient who suffered a stroke who has mobility issues and problems completing activities of daily living (ADLs). b. A client newly diagnosed with rheumatoid arthritis requiring medication monitoring. c. A client with severe back injury as a result of a car accident needing ongoing physical therapy. d. A client diagnosed with pneumonia requiring mechanical ventilation.

a. A client who suffered a stroke who has mobility issues and problems completing activities of daily living (ADLs).

Nurses are occasionally asked to witness a testator's (person who makes the will) signing of a will. Which guideline is true regarding a nurse's role in witnessing a testator's signature? a. Witnesses to a signature do not need to read the will. b. Witnesses do not need to observe the signing of the will and can sign it at a later time. c. A beneficiary to a will is allowed to act as a witness. d. A single witness is sufficient for a will.

a. Witnesses to a signature do not need to read the will.

Which scenario is using a prospective payment plan to reimburse for services? a. An older adult client is admitted to the hospital and treated for pneumonia. The hospital is reimbursed based on a predetermined fixed price. b. A client is hospitalized for an emergency appendectomy. Since the hospital is a preferred provider the fee for service was discounted. c. A client with chronic heart failure is offered health care teaching and preventative services for free. d. A child is hospitalized and treated for a fractured femur. The hospital receives a preset fee for each member regardless of whether the member required services.

a. An older adult client is admitted to the hospital and treated for pneumonia. The hospital is reimbursed based on a predetermined fixed price.

Which action constitutes battery? a. An older adult client refuses an intramuscular injection, but the nurse administers it. b. The nurse threatens to restrain a client if the client does not take a medication. c. While bathing a client behind pulled curtains, two nurses discuss a different client. d. The nurse tells a client that the client cannot leave the hospital because the client is seriously ill.

a. An older adult client refuses an intramuscular injection, but the nurse administers it.

An RN is working on a medical-surgical unit with a licensed practical/vocational nurse (LPN/LVN). Which action by the RN is considered negligent if injury results from this action? a. Asking the LPN/LVN to teach a new diabetic client how to administer insulin b. Calling the health care provider about abnormal lab results c. Obtaining vital signs on a newly admitted client d. Delegating oral medication administration to the LPN/LVN

a. Asking the LPN/LVN to teach a new diabetic client how to administer insulin

An RN enters a client's room and observes the unlicensed assistive personnel (UAP) forcefully pushing a client down on the bed. The client starts crying and informs the UAP of the need to go to the bathroom. What action is the RN witnessing that should be immediately reported to the supervisor? a. Battery b. Assault c. Fraud d. Defamation of character

a. Battery

A client is admitted to the facility after fracturing a hip. The client has undergone surgery to repair the fracture and is receiving services to promote healing of the surgical site and regain mobility. Which discussion should the nurse have with a member of the interdisciplinary team member to promote the goal of regaining mobility? a. Speak with the physical therapist about exercises to strengthen muscles. b. Discuss oxygen administration with the respiratory therapist. c. Talk with the occupational therapist about providing assistance with activities of daily living. d. Discuss transfer to a rehabilitation facility with the social worker.

a. Speak with the physical therapist about exercises to strengthen muscles.

Injuries related to lifting or transferring clients occur in the health care setting and may be considered a work-related injury. Which law was intended to reduce work-related injuries and illnesses? a. The Occupational Safety and Health Act of 1970 b. The Health Care Quality Improvement Act of 1986 c. Title VII of the Civil Rights Act of 1964 d. Americans with Disabilities Act of 1990

a. The Occupational Safety and Health Act of 1970

A nurse demonstrates understanding of Healthy People 2030 by supporting which statement? a. Establish a set of nursing skills that focuses on quick resolution to clients' needs. b. A client's health is affected by social, economic, and political factors. c. Clinical care supports wellness in the environment. d. Physical therapy supports client safety at home.

b. A client's health is affected by social, economic, and political factors.

When conducting an education program for a group preparing for retirement, the nurse would include information about applying for Social Security benefits and Medicare insurance. The nurse would include in the education that Medicare is a federally funded insurance program which bases the fee for payment on what? a. A retrospective payment plan, after the service is rendered b. A payment to health care provider groups willing to take Medicare clients c. A prospective payment plan based on a predetermined fixed cost d. The need to cut health care costs for indigent older adults

c. A prospective payment plan based on a predetermined fixed cost

Which client would a nurse correctly refer to Medicare services? a. A client with cancer b. A low-income family with infants needing immunizations c. A client with a disability d. A 66-year-old client with diabetes

d. A 66-year-old client with diabetes

Which is the acute care setting for people who are too ill to care for themselves at home, are severely injured, or require surgery? a. Hospitals b. Primary care centers c. Ambulatory care centers d. Day care centers

a. Hospitals

Which is the primary criterion for admission to a long-term care facility? a. Inability to provide self-care b. Advanced age c. Absence of family members locally d. Coexistence of multiple chronic health problems

a. Inability to provide self-care

A client rings the call bell to request pain medication. On performing the pain assessment, the nurse informs the client that the nurse will return with the pain medication. After a few moments, the nurse returns with the pain medication. The nurse's returning with the pain medication is an example of which principle of bioethics? a.Fidelity b. Autonomy c. Nonmaleficence d. Justice

Fidelity Fidelity is keeping one's promises and never abandoning a client entrusted to one's care without first providing for the client's needs. Autonomy respects the rights of clients or their surrogates to make healthcare decisions. Nonmaleficence is preventing harm from being done to a client. Justice involves meeting the needs of each client equitably and acting fairly.

A charge nurse has implemented staff education on nursing values. The nurse would determine that further education is required when which statement(s) are overheard? Select all that apply. a. "I can't believe the client is giving that precious infant up for adoption." b. "The gonorrhea test was positive. That's what the client gets for sleeping around." c. "If that was my mother, I sure wouldn't agree to a no-code." d. "If you are going to have extramarital sex, please protect yourself by using a condom." e. "Smoking has been shown to be a risk for many illnesses, including heart disease and cancer."

a. "I can't believe the client is giving that precious infant up for adoption." b. "The gonorrhea test was positive. That's what the client gets for sleeping around." c. "If that was my mother, I sure wouldn't agree to a no-code." Being judgmental, as in the options about adoption, gonorrhea, and code-status, does not reflect the values desired in a nurse. Professional nurses do not assume that their personal values are more correct than those of their clients. Nurses are obligated, however, to provide health information such as recommending condom use and smoking cessation.

Which word is best described as protection and support of another's rights? a. Advocacy b. Paternalism c. Autonomy d. Ethics

a. Advocacy

An undocumented immigrant with no health insurance sustained life-threatening injuries in an automobile accident. Which action in this case demonstrates the ethical principle of justice? a. Airlifting the client to a local trauma center for emergency surgery b. Avoiding treating the client so as to not do any additional harm c. Filing the paperwork for the client to receive retroactive health insurance d. Telling the client honest information about the client's medical condition and prognosis

a. Airlifting the client to a local trauma center for emergency surgery

A nurse has completed 4 hours of an 8-hour shift on a medical-surgical unit when the nursing supervisor calls. The nursing supervisor directs the nurse to give a report to the other two nurses on the medical-surgical unit and immediately report to the telemetry unit to assist with staff needs on that unit. The nurse informs the supervisor that the nurse has been busy with client assignments and feels this will overwhelm the nurses on the medical-surgical unit. The supervisor informs the nurse that the need is greater on the telemetry unit. This is an example of which type of ethical problem? a. Allocation of scarce nursing resources b. Advocacy in a market-driven environment c. Conflicts concerning new technology d. Deception

a. Allocation of scarce nursing resources This is a clear example of ethical issues surrounding the allocation of scarce nursing resources and involves distributing nursing care. Advocacy in a market-driven environment and conflicts concerning new technology are not related to the presented situation. Deception is the action of deceiving someone, and the nursing supervisor is not deceiving the nurse.

A nurse volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee? a. Assist in decision making based on the client's best interests. b. Decide the care for a client who is unable to voice an opinion. c. Convince the family to choose a specific course of action. d. Present options about the type of care.

a. Assist in decision making based on the client's best interests. One reason an ethics committee convenes is when a client is unable to make an end-of-life decision and the family cannot come to a consensus. In this case, the committee members are there to advocate for the best interest of the client and to promote shared decision making between the client (or surrogates, if the client is legally incapacitated) and the clinicians. The committee would not convince, decide, or present options about the type of care. This is not the role of an ethics committee.

Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing? a. Care-based ethics b. Deontology c. Utilitarianism d. Principle-based ethics

a. Care-based ethics Central to the care-based approach to ethics is the nurse's relationships with clients and the nurse's "being," or character and identity. Deontology is the study of the nature of duty and obligation. Utilitarianism is the doctrine that actions are right if they are useful or for the benefit of a majority. Principle-based ethics prioritizes goals and principles that exist beyond the particularities of the nurse-client relationship.

A nurse is most likely to experience ethical distress in which client situation? a. Continuing intravenous fluids for a client who wants to die b. Administering pain medication as ordered c. Turning and positioning a client every hour d. Ambulating a client who is postoperative from a hip replacement

a. Continuing intravenous fluids for a client who wants to die Nurses sometimes have to legally continue orders despite what they feel is right or wrong. This can result in ethical distress, as in this scenario of continuing intravenous fluids. Administering pain medication is promoting comfort and not an ethical issue. Turning and positioning a client as well as ambulating a client will increase comfort, mobility, and healing of the client. Initially, these interventions may be difficult for a new nurse, but eventually the interventions will aid in healing of the client.

Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when reflecting on the decision-making process and the role it will play in making future decisions? a. Evaluating b. Diagnosing c. Planning d. Implementing

a. Evaluating Evaluating an ethical decision involves reflecting on the process and evaluating those elements that will be helpful in the future. The nurse may also question how this experience can improve reasoning and decision making in the future. Diagnosing the ethical problem involves stating the problem clearly. Planning includes identifying the options and exploring the probable short-term and long-term consequences. Implementing includes the implementation of the decision and comparing the outcomes of the action with what was considered and hoped for in advance.

Which nursing action demonstrates the principle of fidelity? a. Filing an incident report after making a medication error b. Administering a vaccination c. Treating an uninsured client in the emergency department d. Witnessing a client signature on an informed consent

a. Filing an incident report after making a medication error Fidelity means being faithful to work-related commitments and obligations. The ethical principle is best demonstrated by the nurse following the employer's policies by completing the incident report following a medication error. Administering vaccines is an example of beneficence; treating an uninsured client in the emergency department is an example of justice; witnessing a client signature on an informed consent is autonomy.

The nurse beginning practice would like to access the standards for ethical practice. Which organization should the nurse research for these standards? a. International Council of Nurses b. Canadian Hospital Association c. Department of Health Professions d. World Health Organization

a. International Council of Nurses The American Nurses Association Code of Ethics for Nurses is the main source of the ethical principles that nurses must follow, and this is developed by the International Council of Nurses. The Canadian Hospital Association has not developed standards of ethical practice. Individual state boards of nursing through the department of health professions have laws and regulations that guide practice but not ethical and moral principles. The World Health Organization is a large organization that does not determine ethical practice for nurses.

A parent of a 17-year-old high school student is allowing the child to decide which college the child will attend. When the child requests direction from the parent in making this decision, the parent responds by stating, "You will need to make this decision on your own." What type of value transmission is the parent displaying? a. Laissez-faire b. Modeling c. Moralizing d. Responsible choice

a. Laissez-faire This situation demonstrates laissez-faire value transmission, which is characterized by allowing the adolescent to explore values independently and the development of a personal value system. The laissez-faire approach involves little or no guidance and can lead to confusion and conflict. Through modeling, children learn that which is of high or low value by observing parents, peers, and significant others. The moralizing mode of value transmission teaches a complete value system and allows little opportunity for the weighing of different values. Responsible choice encourages children to explore competing values and to weigh their consequences while support and guidance are offered.

The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy? a. Limiting visitors due to the client reporting pain b. Administering pain medication when the pain level reaches 9 on a pain scale of 0 to 10 c. Changing the channel on the television while providing care d. Turning and positioning the client every 4 hours

a. Limiting visitors due to the client reporting pain Advocating for clients is a nursing responsibility and is performed with the best interest and welfare of the client in providing safe, competent, and comforting care. Limiting visitors is an example of advocacy. The nurse recognizes that the client is in pain; therefore, limiting the visitors allows for the nurse to advocate for additional measures to allow the client to rest and recover. Administering pain medication and turning and the client every 4 hours are important and necessary interventions for a postoperative client, but this is not advocacy. Changing the channel on the television while providing care also does not promote advocacy.

Which action most clearly demonstrates a nurse's commitment to social justice? a. Lobbying for an expansion of healthcare resources and benefits to those in poverty b. Ensuring that a hospital client's diet is culturally acceptable c. Answering a client's questions about care clearly and accurately d. Documenting client care in a timely, honest, and thorough manner

a. Lobbying for an expansion of healthcare resources and benefits to those in poverty Social justice is a professional value that encompasses efforts to promote universal access to health care, such as the expansion of publicly funded programs like Medicare. Culturally competent care is a reflection of human dignity. Answering clients' questions and documenting care accurately are expressions of the value of integrity.

The nurse understands that a diagnostic-related group is one of the reimbursement strategies in a prospective payment system. The diagnostic-related group is a part of which health care system? a. Medicare b. Medicaid c. Capitation d. AmeriCare

a. Medicare

A nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle? a. Paternalism b. Deception c. Confidentiality d. Conflict

a. Paternalism Making a decision for a client who is confused to prevent an injury is an example of paternalism. Deception occurs when the true nature or reason is concealed and the client is deprived of basic human rights. Confidentiality requires a health care provider to keep a client's personal health information private unless consent to release the information is provided by the client. Conflict is a disagreement or argument and does not represent the example in this question.

The nurse strives to uphold human dignity when providing care to clients. Which behaviors by the nurse would best exemplify this value? Select all that apply. a. Protects the privacy of the client b. Maintains confidentiality c. Promotes universal health care d. Provides culturally competent care e. Demonstrates accountability

a. Protects the privacy of the client b. Maintains confidentiality d. Provides culturally competent care Human dignity is defined by the right of a person to be valued and respected for one's own sake, and to be treated ethically. The nurse is exemplifying this by protecting privacy, maintaining confidentiality, and providing culturally competent care. Promoting universal health care would better exemplify the value of social justice and, in any case, would not be appropriate an appropriate action when providing care to clients. Demonstrating accountability is not a human dignity issue but is a core concept in the overall nursing care of a client.

x Which traits are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply. a. Trustworthiness b. Humility c. Deception d. Conflict e. Compassion

a. Trustworthiness b. Humility e. Compassion Trustworthiness, humility, and compassion are all examples of professional virtues, as well as cultivated dispositions of character and conduct, that motivate and enable us to be good human beings. Deception and conflict are negative traits that do not exemplify professional virtues.

Which ethical principle is related to the idea of self-determination? a. autonomy b. beneficence c. confidentiality d. nonmaleficence

a. autonomy Autonomy refers to self-rule, or self-determination; it respects the rights of clients or their surrogates to make healthcare decisions. Beneficence is the duty to do good and the active promotion of benevolent acts. Confidentiality is related to the concept of privacy. Nonmaleficence is the duty not to inflict harm, as well as to prevent and remove harm.

A nurse is caring for an older adult who has cancer and is experiencing complications requiring a revision of the plan of care. The nurse sits down with the client and the family and discusses their preferences while sharing the nurse's own judgments based on the nurse's expertise. Which type of healthcare decision making does this represent? a. shared decision making b. the paternalistic model c. client sovereignty d. ethical decision making

a. shared decision making Shared decision making is recommended by most ethicists and involves considering both the client's preferences and the nurse's expertise to make the best decision. The paternalistic model involves the clinician making the decisions. The client sovereignty model involves the client making all the decisions without input from the clinician. Ethical decision making is that based on a personal or organizational code of ethics.

Which scenario is an example of the laissez-faire approach to value transmission? a. Teaching children right from wrong and telling them the reason behind a bad action b. Allowing a child to decide not to have an intravenous line inserted c. Modeling healthy behaviors for adolescents, such as not smoking electronic cigarettes d. Telling a child an injection will feel like a pinch before the nurse gives the injection

b. Allowing a child to decide not to have an intravenous line inserted A laissez-faire approach to value transmission is one that allows others, especially children, to make decisions without guidance, resulting in a decision that may not be a sound one. Teaching a child about right and wrong behavior is a more active learning strategy, and reflects the moralizing approach to value transmission. Modeling or role modeling is leading (and transmitting values) by example—in this case, not smoking electronic cigarettes to show the adolescents good behavior. Telling the child about the injection feeling like a pinch is not an approach to value transmission.

Which ethical principle refers to the obligation to do good? a. Fidelity b. Beneficence c. Veracity d. Nonmaleficence

b. Beneficence Beneficence is the duty to do good and the active promotion of benevolent acts. Fidelity refers to the duty to be faithful to one's commitments. Veracity is the obligation to tell the truth. Nonmaleficence is the duty not to inflict, as well as to prevent and remove, harm; however, there will be times when the action may cause "harm" to promote the "good" such as chemotherapy being used to treat and eliminate cancer, but it causes various adverse effects while trying to reach the ultimate goal..

A nurse pulls the curtains closed before changing the dressing of the surgical wound on the abdomen of a postsurgical client. What value is served? a. Accountability b. Dignity c. Freedom d. Altruism

b. Dignity The nurse values the dignity of the client and provides the client with privacy before changing the wound dressing. This incident does not serve the values of accountability, freedom, or altruism. A nurse values accountability when documenting nursing care accurately and honestly. The nurse values freedom when the client's right to refuse treatment is honored. The nurse shows value for altruism when showing concern for the client's welfare.

The focus of the unit where a nurse works is changing. The nurse has deeply held moral and religious objections to procedures that will be commonly performed on clients on this new unit. Which action(s) should the nurse take? Select all that apply. a. Resign before the new unit focus is implemented. b. Discuss the situation with the unit nurse manager. c. Be careful not to share objections with anyone. d. Plan to care only for clients who will not have these procedures. e. Do not compromise the nurse's own personal moral standards.

b. Discuss the situation with the unit nurse manager. e. Do not compromise the nurse's own personal moral standards. The nurse should discuss this situation with the nurse manager and should not compromise personal moral standards. The nurse can express conscientious objection to participating in activities that violate personal ethical beliefs. The nurse should not plan to care only for clients who will not have these procedures as all nurses on a unit are responsible for care in emergencies. Resigning before the new unit focus is implemented is unnecessary if the nurse can be transferred to a different unit.

A nurse who is caring for a new mother realizes that the woman is not prepared to go home with her newborn after a hospital stay of only 24 hours. However, hospital policy dictates that the mother be discharged. This nurse may be faced with which moral problem? a. Ethical uncertainty b. Ethical distress c. Ethical dilemma d. Ethical dissatisfaction

b. Ethical distress

A female client is brought to the emergency room with matted hair, bruising, and malnutrition. The nurse suspects physical abuse and neglect. The nurse states, "This happens to many women." Which type of ethical approach is the nurse exhibiting? a. Paternalism b. Feminist c. Values clarification d. Moralizing

b. Feminist A feminist approach is one in which the focus is on specific problems and concerns faced by women. The statement that "this happens to many women" is an example of a feminist approach. Paternalism is action limiting a person's or group's liberty or autonomy that is intended to promote their own good (e.g., if the nurse stated that "I must make all decisions about this client's care for her, as she's not in any shape to do so herself"). Values clarification is a self-assessment process that enables a person to discover the content and strength of the person's own system of values. An example of this would be if the nurse stated, "I feel bad for the client, as no one deserves this." Moralizing is to comment on issues of right and wrong, typically with an unfounded air of superiority. An example of this would be if the nurse stated, "If she was a good girl, this would have never happened to her."

Which statement by the nurse is an example of deception? a. "I will administer your pain medication as soon as it is due." b. "It is important to get out of bed to prevent pneumonia." c. "This injection of procaine will feel like a little pinch." d. "I am going to teach you how to give yourself insulin."

c. "This injection of procaine will feel like a little pinch." Telling a client that an injection of procaine will feel like a little pinch is not being truthful, and is defined as a deception. Telling a client that pain medicine will be administered when it is time is being truthful. Telling a client to get out of bed also supports a nursing intervention. Teaching a client how to give an injection is important for the client to take care of himself or herself.

Nurses who value client advocacy follow what guideline? a. They value their loyalty to an employing institution or to a colleague over their commitment to their clients. b. They give priority to the good of the individual client rather than to the good of society in general. c. They choose the claims of the client's well-being over the claims of the client's autonomy. d. They make decisions for clients who are uninformed concerning their rights and opportunities.

b. They give priority to the good of the individual client rather than to the good of society in general. Advocacy is the protection and support of another's rights. If the nurse values client advocacy, the nurse would give priority to the good of the individual client rather than to the good of society in general. The nurse would not be demonstrating advocacy if the nurse values the loyalty to an employing institution or to a colleague over the commitment to the client. The nurse demonstrating client advocacy would not choose the claims of the client's well-being over the claims of the client's autonomy. The nurse would not make decisions for clients who are uninformed concerning the client's rights and opportunities.

What is the term for the beliefs held by the individual about what matters? a.. Ethics b. Values c. Morals d. Bioethics

b. Values Values are ideals and beliefs held by an individual or group about what matters; values act as a standard to guide one's behavior. Ethics are moral principles and values that guide the behavior of honorable people. A moral is a standard for right and wrong. Bioethics is related to ethical questions surrounding life and death, as well as questions and concerns regarding quality of life as it relates to advanced technology.

A parent teaches a child not to drink and drive; however, the parent does drink and drive. This action results in: a. conflict with society. b. a failure to model one's own values. c. insecurity and a lack of safety. d. a disruption in consistency.

b. a failure to model one's own values. Many role models fail to model their own values and, as a result, cause conflict with and confusion in those who look up to them, such as children (not society, in general). The primary result of this action, which is saying one thing and doing another, is not so much insecurity and a lack of safety or a disruption in consistency as it is a failure to reflect one's own values.

A client tells the nurse that the client does not want to have a painful procedure. By respecting and supporting the client's right to make decisions, the nurse is demonstrating: a. confidentiality. b. advocacy. c. altruism. d. justice.

b. advocacy. Advocacy is the protection and support of another person's rights. Nurses have always been strong client advocates, carefully evaluating the competing claims of the client's autonomy (self-determination) and well-being. Altruism is the principle and moral practice of concern for happiness of other human beings, resulting in a quality of life both material and spiritual. Justice is concerned with moral rightness and fairness. Confidentiality is keeping or one's personal information secret or private.

A client is brought to the emergency department by an adult child, who states, "I am unable to care for my parent anymore. Although I would like to, financially and physically I cannot do it anymore." What ethical problem is the adult child experiencing? a. ethical dilemma b. moral distress c. ethical uncertainty d. dissatisfaction

b. moral distress

A client is brought to the emergency department by an adult child, who states, "I am unable to care for my parent anymore. Although I would like to, financially and physically I cannot do it anymore." What ethical problem is the adult child experiencing? a. ethical dilemma b. moral distress c. ethical uncertainty d. dissatisfaction

b. moral distress Moral distress is when someone wants to do the right thing but is not able. The adult child brings the parent to the emergency department to maintain the parent's safety, although the child needs to take care of the parent. Dilemma is a situation in which a difficult choice has to be made between two or more alternatives, especially equally undesirable ones. The client is not experiencing a dilemma. Uncertainty means a feeling of not knowing what will happen. The adult child is certain that he or she cannot care for the parent. Dissatisfaction implies a sense of dislike for, or unhappiness in, one's surroundings. Although the adult child is unhappy, this is not the primary ethical problem.

A nurse is of the Catholic faith and votes pro-life. This nurse is considered to have: a. moral agency. b. personal values. c. ethics. d. legal obligations.

b. personal values. The only information given here tells us that this nurse has personal values on a particular issues. Personal values are ideas or beliefs a person considers important and feels strongly about. Moral agency is the ability to do the ethically right thing because one knows it is the right thing to do. Ethics is a systematic study of principles of right and wrong conduct, virtue and vice, and good and evil as they relate to conduct and human flourishing. Legal obligations are behaviors and actions required by law.

It is time for a nurse to renew licensure. The nurse says, "I need some really easy and quick continuing education hours. I don't understand why we have to do these every year." What is the nurse's coworker's best response? a. "There is lots of free continuing education online." b. "See if any of the classes we have to take at the hospital each year will count." c. "Life-long learning is part of the code for nurses." d. "It is hard to get enough hours since we work full time and have families."

c. "Life-long learning is part of the code for nurses." While all of these answers have some merit, the best is to remind the nurse that life-long learning is an expectation of nursing and is part of the American Nurses Association Code for Nurses.

A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which statement demonstrates the principle of accountability? a. Administering the medication with the other evening medications b. Telling the client that the medication will be given the following morning c. Filling out an occurrence report and notifying the healthcare provider d. Documenting in the chart a narrative note about the occurrence

c. Filling out an occurrence report and notifying the healthcare provider Accountability means that when an error occurs, the nurse takes the proper actions to address it. In this instance, the nurse should fill out an occurrence form for follow-up and notify the provider, as the error may change outcomes in the client's condition. Administering the missed medications with the other evening medications may double up the dose or cause unexpected adverse effects with the other medications. Telling the client that the medication will be administered the following day is not acceptable, as the nurse is suggesting next actions without the provider's knowledge. Documenting in the chart in a narrative about the occurrence does not allow for the health care provider to be notified and aware of a change in the client's condition.

A nurse reports to the charge nurse that a client medication due at 9 am was omitted. Which principle is the nurse demonstrating? a. Altruism b. Social justice c. Integrity d. Autonomy

c. Integrity The principle of integrity is based on the honesty of a nurse according to professional standards. In this instance, the nurse reported the occurrence of the missed medication to the charge nurse. The definition of altruism is concern for others; it can best be explained by a nurse concerned about how a client will care for self after discharge. Social justice is a concept of fair and just relations between the individual and society and is related to wealth and distribution of goods in a society. Autonomy is the right to self-determination or acting independently and making decisions.

Ethical distress is: a. being aware of the principles of right and wrong. b. supporting the rights of a client during hospitalization. c. knowing the correct action but being unable to perform it due to constraints. d. having trouble deciding which of two conflicting ethical principles to follow.

c. knowing the correct action but being unable to perform it due to constraints. Knowing the correct action but being unable to perform it due to constraints is the definition of moral or ethical distress. Being aware of knowing what is right and wrong is the first step of having an ethical conscience. Supporting a client during a hospitalization is an ethical principle of doing what is right (beneficence) and the focus of client-centered care. An ethical dilemma is a situation in which a person has difficulty deciding which of two or more conflicting ethical principles to follow.

Which example best describes feminist ethics? a. A combination of elements of utilitarian and deontologic theories that offer specific action guidelines for practice b. Attention directed to the specific situation of individual clients viewed within the context of their life narratives c. The formal study of ethical issues that arise in the practice of nursing d. An approach critiquing existing patterns of oppression and domination in society

d. An approach critiquing existing patterns of oppression and domination in society Feminist ethics offer an approach critiquing existing patterns of oppression and domination in society, especially as they affect women and the poor. The principle-based approach to ethics combines elements of utilitarian and deontologic theories and offers specific action guidelines for practice. The care-based approach directs attention to the specific situation of individual clients viewed within the context of their life narratives. The formal study of ethical issues that arise in the practice of nursing describes nursing ethics.

The nurse is attempting to clarify the values of an adolescent client. The nurse should identify what factor as having the greatest influence on an adolescent's value formation during this developmental stage? a. Educational institutions b. Organized religion c. Awareness of other cultures d. Peers

d. Peers In adolescence, peer groups have a major influence on value formation. The attitudes, beliefs, and behaviors that grow out of peer group relationships are powerful. It is generally accepted that the influence of peers exceeds that of school, religion, or the awareness of other cultures during this developmental stage.

Which action would cause a charge nurse to have concerns about a nurse's moral agency? a. The nurse often must stay after shift change to complete documentation. b. A family member complained that the nurse was slow answering call lights. c. The nurse was unable to pass a required dosage calculation examination. d. The nurse was seen at a grocery store after calling in sick.

d. The nurse was seen at a grocery store after calling in sick. The only option with an ethical component possibility is the nurse being seen at the grocery store after calling in sick. It may be that the nurse had no other choice but to go to the grocery store, even if sick, but it would cause the charge nurse to be suspicious. The other options do not reflect an ethical issue because they did not lead to other unethical behaviors, just job performance issues.

At the last hospital unit meeting, the policy for the insertion of Foley catheters was revised based on current evidence. The new nurse on the unit just learned "the old way" and is frustrated to now have to learn a new methodology. Several other nurses comment that the change is "all about money." The charge nurse must educate the staff about the importance of this new policy. Which explanation by the charge nurse is most appropriate? a. "Incorporating evidenced-based practice into our care routines links our interventions to valued outcomes, thereby increasing quality care. When we provide quality care, we can decrease cost." b. "Cost is not a driver in quality health care delivery." c. "Using evidence-based practice is the trend in providing quality care and may expose the client to better care implementation. None of our care methods are associated with cost." d. "Because our clients are considered

a. "Incorporating evidenced-based practice into our care routines links our interventions to valued outcomes, thereby increasing quality care. When we provide quality care, we can decrease cost."

Action has been taken against a nurse's license based on a claim that the nurse acted outside of nursing's scope of practice. The nurse's attorney determines that the nurse needs more education about the purpose of the board of nursing when the nurse makes which statement? a. "The rules made by the board of nursing don't reflect my practice." b. "The board of nursing exists to protect the safety of the public." c. "The board of nursing is established by state legislation." d. "Board of nursing rules keep unlicensed people from practicing nursing."

a. "The rules made by the board of nursing don't reflect my practice."

The nurse is providing care to several clients. For which client should the nurse include secondary care in the nursing plan of care? a. A middle-aged client who presents with new-onset angina b. A pediatric client who tests positive for strep c. An older adult client who requires a medication refill d. An adolescent client who requires a sports physical

a. A middle-aged client who presents with new-onset angina

A client is in a persistent vegetative state following a severe motor vehicle accident. The client has no immediate family. Whom should the nurse consult when seeking direction for care? a. A surrogate decision maker b. The interdisciplinary care team c. The primary care provider d. An impartial lawyer with experience in healthcare

a. A surrogate decision maker

A client is in a persistent vegetative state following a severe motor vehicle accident. The client has no immediate family. Whom should the nurse consult when seeking direction for care? a. A surrogate decision maker b. The interdisciplinary care team c. The primary care provider d. An impartial lawyer with experience in healthcare

a. A surrogate decision maker Infants, young children, people with severe cognitive impairment or who are incapacitated, and people in a persistent vegetative state or coma do not have the capacity to participate in decision-making about their health care. For such people, a surrogate decision maker must be legally designated to act on their behalf. This individual's authority would supersede that of the care team, the primary care provider or an outside legal representative.

Which process evaluates and recognizes educational programs as having met certain standards? a. Accreditation b. Credentialing c. Licensure d. Certification

a. Accreditation

Which is an emerging trend in health care delivery? a. Active involvement of consumers b. Resolution of the nursing shortage c. Simplification of client care d. Reduction in the use of technology at the bedside

a. Active involvement of consumers

The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports that the pain is unrelieved. The nurse takes no further action regarding assessment and intervention for the client's pain. The nurse does not notify the surgeon regarding the client's pain. The nurse's failure to take further action represents which element of liability in this case? a. Breach of duty b. Causation c. Damages d. Duty

a. Breach of duty

The nurse recognizes that liability requires specific elements that must be established to prove that malpractice or negligence has occurred. Identify the specific elements. Select all that apply. a. Causation b. Damages c. Duty d. Breach of confidentiality e. Breach of duty

a. Causation b. Damages c. Duty e. Breach of duty

Having recently completed a specialty nursing program in neonatal care, a nurse is now preparing to leave the medical unit and begin providing care in the hospital's neonatal intensive care unit (NICU). The nurse has completed which process of credentialing? a. Certification b. Licensure c. Accreditation d. Validation

a. Certification

A client states that the client's recent fall was caused by his scheduled antihypertensive medications being mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritize when anticipating that legal action may follow? a. Document the client's claims and the events surrounding the alleged incident. b. Consult with the hospital's legal department as soon as possible. c. Consult with practice advisors from the state board of nursing. d. Enlist support from nursing and non-nursing colleagues from the unit.

a. Document the client's claims and the events surrounding the alleged incident.

The nurse is providing care to a client whose condition has progressively declined. The nurse assesses and makes appropriate interventions as well as notifies the health care provider. Despite the nurse's efforts, the client expires. What element of liability has the nurse demonstrated? a. Duty b. Breach of duty c. Causation d. Damages

a. Duty

The growth in home health care is largely attributed to which factor? a. Early discharge of clients from the hospital setting b. Nurses' desire to work in the community c. The nursing shortage in hospitals d. The inability of hospitals to care for an increasing number of clients

a. Early discharge of clients from the hospital setting

During the orientation to the hospital, the staff development educator discusses unit and institutional-based policies. What is the source of the practice rules that result in unit and institutional-based policies? a. Health care institution b. Federal legislation c. State legislation d. Board of nursing

a. Health care institution

A nurse talks with family members about an AIDS client from the clinic where the nurse works. Which tort has the nurse committed? a. Invasion of privacy b. Fraud c. Assault d. Slander

a. Invasion of privacy Invasion of privacy involves a breach of keeping client information confidential. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Slander is oral defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent.

A nurse is reading a journal article about paying for health care. The nurse demonstrates understanding of the article by identifying which method as being federally funded? Select all that apply. a. Medicare b. Medicaid c. Veterans Health Administration d. Children's Health Insurance Program e. Third party payers

a. Medicare b. Medicaid c. Veterans Health Administration d. Children's Health Insurance Program

The implementation of diagnosis-related groups (DRGs) by Medicare in 1983 affected hospitals in which way? a. Medicare pays only the amount of money preassigned to a treatment for a diagnosis. b. Benefits and reimbursement cannot be changed annually. c. Part B of Medicare covers most inpatient and outpatient costs. d. Part A of Medicare is voluntary and is paid for by a monthly premium.

a. Medicare pays only the amount of money preassigned to a treatment for a diagnosis.

A client is being prepared for discharge from the hospital after an exacerbation of heart failure. The client needs assessment of cardiac status, instruction in medications and diet therapy as well as exercises to increase endurance and stamina. The client also needs assistance with self-care, both in performing it now and learning how to adapt to the limitations to maintain independence. The client also lives alone with an older adult, frail spouse. In addition to the client's health care provider, which members of the interdisciplinary team would need to be involved? Select all that apply. a. Nurse b. Physical therapist c. Occupational therapist d. Unlicensed assistive personnel e. Social worker f. Respiratory therapist

a. Nurse b. Physical therapist c. Occupational therapist d. Unlicensed assistive personnel e. Social worker

A nurse has very strong client education skills. In which health care setting would the nurse make best use of these skills? a. Primary care center b. Emergency department c. Same-day surgery unit d. Tertiary care medical center

a. Primary care center

A client who does not have a budget limit and places a high priority on maintaining freedom to choose which health care providers and health care services the client uses would most likely be best served by which group plan? a. Private insurance b. Long-term care (LTC) insurance c. A preferred provider organization (PPO) d. A health maintenance organization (HMO)

a. Private insurance Private insurance is normally more expensive than alternative group plans such as PPOs, HMOs, and LTC insurance. However, it typically allows the policyholder to have significantly more autonomy related to which practitioners and services to use. Long-term care insurance is an insurance product that helps pay for the costs associated with long-term care. PPO plans allow the client to visit whatever in-network health care provider or health care provider desired without first requiring a referral from a primary care health care provider. An HMO gives the client access to certain doctors and hospitals within its network. A network is made up of providers who have agreed to lower their rates for plan members and also meet quality standards. But unlike PPO plans, care under an HMO plan is covered only if the client sees a provider within that HMO's network.

The nurse is providing care for a client who has a tracheostomy and whose pulse oximeter has recently alarmed, showing the client's oxygen saturation to be 77%. The nurse has repositioned the client and applied supplementary oxygen, interventions that have raised the client's oxygen levels to 80% and have somewhat decreased his work of breathing. The client is not in immediate distress, and his level of consciousness remains high. The nurse should page which practitioner? a. Respiratory therapist b. Physical therapist c. Health care provider d. Occupational therapist

a. Respiratory therapist

A nurse is providing care to a client recently admitted to the health care facility for treatment of an infection. The client experienced a traumatic brain injury several months ago that resulted in paralysis of both lower extremities and difficulty swallowing and speaking. The client's spouse is the primary caregiver. The client's spouse says to the nurse, "It's been really tough this last month caring for my spouse. Even though I have an aide who comes in to help for a couple of hours a week, I'm just spent, physically and emotionally." A referral for which service would be appropriate? a. Respite care b. Parish nursing services c. Palliative care d. Hospice care

a. Respite care

Nurse practice acts are examples of which type of laws? a. Statutory laws b. Constitutional laws c. Administrative laws d. Common laws

a. Statutory laws Nurse practice acts are statutory laws. Statutory laws must be in keeping with both the federal constitution and the state constitution. Constitutional law refers to rights carved out in the federal and state constitutions. The majority of this body of law has developed from state and federal supreme court rulings, which interpret their respective constitutions and ensure that the laws passed by the legislature do not violate constitutional limits. Administrative law is the body of law that governs the activities of administrative agencies of government. Common law is the body of English law as adopted and modified separately by the different states of the U.S. and by the federal government and is in contrast with statutory law.

A nurse witnesses a traffic accident and dresses the open wounds sustained by a child. Later, in the hospital, the child develops complications from an infection in the wound. The family holds the nurse responsible for the complications and attempts to file a lawsuit. Which statement is true regarding how the Good Samaritan law applies to this case? a. The Good Samaritan law will provide legal immunity to the nurse. b. The Good Samaritan law will not protect the nurse because the nurse did not accept compensation. c. The Good Samaritan law is not applicable to health care workers. d. The Good Samaritan law will provide absolute exemption from prosecution.

a. The Good Samaritan law will provide legal immunity to the nurse.

A client is being prepared for an elective surgical procedure and the consent form has not been signed. Who should the nurse have obtain consent for the procedure? a. The health care provider performing the surgical procedure b. The client's family or significant other c. The perioperative nurse d. The nursing supervisor

a. The health care provider performing the surgical procedure The nurse should inform the surgeon the consent has not been signed. Obtaining informed consent is the responsibility of the person who will be performing the diagnostic or treatment procedure or the research study. In this particular case, the surgeon, the client, and a witness, all need to sign the consent form. The nurse's roles are to confirm that a signed consent form is present in the client's chart and to answer any client questions about the consent.

Legal safeguards are in place in the nursing practice to protect the nurse from exposure to legal risks as well as to protect the client from harm. What is an example(s) of legal safeguards for the nurse? Select all that apply. a. The nurse confirms informed consent was give by the client to perform a procedure. b. The health care provider is responsible for administration of a wrongly prescribed medication. c. The nurse educates the client about what to expect during the hospital stay. d. The nurse executes the health care provider's prescriptions without questioning them. e. . The nurse documents all client care in a timely manner. f. The nurse claims management is responsible for inadequate staffing leading to negligence.

a. The nurse confirms informed consent was give by the client to perform a procedure. c. The nurse educates the client about what to expect during the hospital stay e. . The nurse documents all client care in a timely manner.

After reporting to work for a night shift, the nurse learns that the unit is understaffed because two RNs called out sick. As a result, each nurse on the unit must provide care for four acute clients in addition to the nurse's regular clients. Which statement is true for this nurse when working in understaffed circumstances? a. The nurse is legally held to the same standards of care as when staffing levels are normal. b. Understaffing constitutes an extenuating circumstance that creates a temporarily lower expectation for care for the nurse. c. The nurse must document that float staff, nurses on overtime, and part-time staff were contacted in an effort to fill the gaps in care. d. The nurse is legally obliged to refuse to provide care when understaffing creates the potential for unsafe conditions.

a. The nurse is legally held to the same standards of care as when staffing levels are normal.

A health care provider is called to see a client with angina. During the visit the health care provider advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the health care provider is late for another visit, the health care provider requests that the nurse write down the order for the health care provider. What should be the appropriate nursing action in this situation? a. The nurse should ask the health care provider to come back and write the order. b. The nurse should write the order and implement it. c. The nurse should inform the client of the change in medication. d. The nurse should remind the health care provider later to write the work order.

a. The nurse should ask the health care provider to come back and write the order.

A nurse says, "We have so many drills and safety checks for everything. It is almost like we are preoccupied with the possibility of failure." How should the charge nurse respond to this statement? a. "Which drills and safety checks do you think we could eliminate?" b. "Highly reliable organizations think about the possibility of failure and what to do to avoid it." c. "I agree with you. We need to focus more on the positive things we do instead of what could go wrong." d. "I am afraid that there may be an issue when our next accreditation visit occurs."

b. "Highly reliable organizations think about the possibility of failure and what to do to avoid it."

The nurse is assigned to various clients on a medical unit. Which statement(s) made to a client by the nurse constitutes assault? Select all that apply. a. "I will withhold your cell phone until you pay full attention to these discharge instructions." b. "I am going to insert a catheter in you if you do not get up to go to the bathroom." c. "Give me your hand to hold, I can see you are upset by the bad news." d. "Hold still for these stitches; otherwise, I am going to have to hold you down." e. "Let me help you get your shirt off, so I can listen to your lungs."

b. "I am going to insert a catheter in you if you do not get up to go to the bathroom." d. "Hold still for these stitches; otherwise, I am going to have to hold you down."

A client being discharged from the hospital asks the nurse, "When I go visit my family out of state, should I take my living will with me, or do I need a new one for that state?" Which is the most appropriate response by the nurse? a. "A living will can only be used in the state in which it was created." b. "Take it with you. It is recognized universally in the United States." c. "As long as your family knows your medical wishes, you will not need it." d. "We have it on file here, so any hospital can call and get a copy."

b. "Take it with you. It is recognized universally in the United States."

Which refers to a person's ability to find and to receive care from a health care provider? a. Access to clinics b. Access to health care c. Access to doctors d. Access to nurses

b. Access to health care

Which government policy addresses penalizing hospitals for readmissions of clients with certain diagnoses within 30 days after discharge? a. Americans with Disabilities Act b. Affordable Care Act c. American Nurses Association Bylaws d. National Commission for Minorities

b. Affordable Care Act

A nurse working in a coronary care unit resuscitates a client who had expressed wishes not to be resuscitated. Which tort has the nurse committed? a. Assault b. Battery c. Libel d. Slander

b. Battery

Based on the Patient Protection and Affordable Care Act (ACA), nurses are to assume an important new role in health care. Which is an example of this new role? a. Identifying individuals who are at risk of developing diabetes mellitus b. Collaborating with all agencies to provide for the client's home health needs c. Verifying that all documentation is updated prior to surgery d. Providing client education related to colostomy care

b. Collaborating with all agencies to provide for the client's home health needs

A nurse is caring for a client who has a PPO health care plan. What is the greatest advantage of this type of plan? a. Ease of referrals b. Cost effectiveness c. Care coordination d. Improved health outcomes

b. Cost effectiveness

A clinical nurse specialist is preparing a presentation for a group of colleagues about the current state of the health care delivery system. As part of the presentation, the nurse is planning to address trends that may play a role in shaping health care delivery in the near future. Which information would the nurse most likely include? Select all that apply. a. Increased focus on the treatment of disease b. Greater numbers of informed persons using health care services c. Rise in accessible health information due to technology d. Reduction in the numbers of diverse individuals seeking care e. Abundance of key health care professionals available

b. Greater numbers of informed persons using health care services c. Rise in accessible health information due to technology

A client has a prescription for amoxicillin 500 mg P.O. every 8 hours. The nurse administers the medication via the intravenous route. Based on the nurse's action, the client develops complications and has an increased length of stay. The client files a lawsuit against the facility and the nurse. Which legal action has the nurse's attorney identified that meets the criteria for the client's lawsuit? a. Negligence b. Malpractice c. Assault d. Battery

b. Malpractice

While caring for an infant, the nurse hears another child screaming in the next room and rushes there, forgetting to put the side rails up on the infant's crib. The nurse returns to the room to find that the infant has fallen out of the crib and sustained a head injury. Based on the nurse's action, which tort is the nurse liable for? a. Defamation b. Malpractice c. Assault d. Battery

b. Malpractice

What nursing function would be most commonly found in an ambulatory care facility? a. Serving as an administrator or manager b. Providing direct client care c. Educating individuals or groups d. Assessing the home environment

b. Providing direct client care

During a hospice visit, the client's spouse suddenly begins to cry and says, "I am so tired. I just can't do this anymore. I am not getting to sleep and I just eat sandwiches when I can." What is the nurse's best intervention? a. Request a mental health evaluation for the spouse. b. Send the spouse to the emergency department. c. Arrange for short-term inpatient care for the client. d. Have the chaplain visit with the spouse and client.

c. Arrange for short-term inpatient care for the client.

A client admitted to a mental health unit has exhibited physical behaviors that put the client and others at risk. The nurse applies four-point restraints on the client without obtaining a health care provider's order or the client's consent. The nurse is at risk of being accused of which action? a. Slander b. Negligence c. Battery d. Malpractice

c. Battery

A nurse working for a home health agency is scheduled to evaluate a client with worsening heart failure to determine whether the client is a candidate for the new "Hospital at Home" program. Which statement accurately reflects an outcome for this program? a. Disease-specific quality standards have been found to be slightly worse than when clients are treated in the hospital. b. Clients and their family members have been found to be happier with stays in the hospital in which they have 24/7 access to the healthcare team. c. Clients in the "Hospital at Home" program have been found to require shorter lengths of stay than when admitted to the acute care setting. d. Clients in the acute care setting require fewer chemical and physical restraints.

c. Clients in the "Hospital at Home" program have been found to require shorter lengths of stay than when admitted to the acute care setting.

A hospitalized client with advanced metastatic lung cancer states, "I want to go home. I don't have much time left. I want to be with my family." Which type of care referral by the nurse is most appropriate? a. Respite b. Extended c. Hospice d. Palliative

c. Hospice

A nurse recommends palliative care for a client who is being discharged following a diagnosis of cancer. What is the chief focus of this type of care? a. Provision of a dignified death experience b. Physical rehabilitation c. Relief from physical, mental, and spiritual distress d. Occupational therapy

c. Relief from physical, mental, and spiritual distress

The nurse is a member of the multidisciplinary team in a large primary healthcare setting. The nurse understands that which healthcare team member is responsible for a client's swallow evaluation following a cerebral vascular accident? a. Physical therapist b. Occupational therapist c. Speech pathologist/therapist d. Physician assistant

c. Speech pathologist/therapist

A nurse is a member of an interdisciplinary team providing home health care to a client who was discharged home after experiencing a stroke. The client has been receiving services to assist with swallowing. The nurse would collaborate with which member of the team to discuss the client's progress? a. Physical therapist b. Occupational therapist c. Speech therapist d. Social worker

c. Speech therapist

A family brings the client to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure? a. The nurse informs the family about advance directives. b. The nurse informs the family about the living will. c. The nurse confirms that the client has signed the consent form. d. The nurse confirms that the client's family has signed the consent form.

c. The nurse confirms that the client has signed the consent form.

A family brings the client to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure? a. The nurse informs the family about advance directives. b. The nurse informs the family about the living will. c. The nurse confirms that the client has signed the consent form. d. The nurse confirms that the client's family has signed the consent form.

c. The nurse confirms that the client has signed the consent form. The nurse should confirm that the client's family has signed the consent form. However, the health care provider is responsible for having the client, or in this case, the client's family sign consent. This client cannot sign the consent form because the client is not in an alert state and is unable to communicate. If the client is not in a condition to sign the consent form, a family member may sign the consent form on the client's behalf. Advance directives are written statements identifying a competent person's wishes concerning terminal care and are not applicable here. A living will is an instructive form of advance directive; that is, it is a written document that identifies a person's preferences regarding medical interventions to use in a terminal condition, irreversible coma, or persistent vegetative state with no hope of recovery.

A client is unhappy with the health care provided and informs the nurse that the client is leaving the facility. The client has not been discharged by the health care provider. The nurse finds that the client has dressed and is ready to go. What should the nurse's action be in this situation? a. The nurse should have the client restrained and call the health care provider. b. The nurse should let the client go because the nurse cannot do anything. c. The nurse should call and inform the nursing supervisor of the situation. d. The nurse should warn the client that the client cannot come to the hospital again.

c. The nurse should call and inform the nursing supervisor of the situation.

Which statement made by the nurse providing care to a group of clients indicates that the nurse requires further education regarding negligence? a. "Please avoid bringing fresh fruit to a client with neutropenia." b. "I am going to assess for collateral circulation before preforming an arterial blood gas (ABG)." c. "I am going to auscultate breath sounds every 8 hours on a client receiving enteral feedings." d. "I don't need to assess distal pulses on a client after a femoral arteriography."

d. "I don't need to assess distal pulses on a client after a femoral arteriography."

An older adult client has expressed to the nurse a desire to specify and document the care they want to receive and do not want to receive if they become incapacitated. The nurse should encourage the client to explore what option? a. A will b. A do-not-resuscitate (DNR) order c. Assignment of a surrogate decision-maker d. A living will

d. A living will A living will is an advance directive that specifies the types of medical treatment patients do and do not want to receive should they become unable to speak for themselves in a terminal or permanently unconscious condition. A will is a legal document where one communicates wishes of how to dispose of personal effects and belongings upon one's death. The scope of a DNR order is limited to CPR and other heroic life-saving interventions. A surrogate decision-maker can makes choices on the client's behalf but does not necessarily record or convey the client's specific wishes.

Which is an example of an unintentional tort? a. Nurses discuss a client's laboratory values in the elevator. b. A nurse tells a client that the client cannot leave the hospital until the client pays the bill. c. A nurse threatens to restrain a client if the client does not stop talking. d. A nurse gives the client a medication, and the client has an adverse reaction to it.

d. A nurse gives the client a medication, and the client has an adverse reaction to it.

The nurse is providing care to several clients on a medical-surgical unit. For which client's plan of care should the nurse include information regarding extended care? a. A middle-aged client who had a knee replacement b. A client who developed sepsis after a ruptured polyp c. A client who had a cholecystectomy d. An older adult client who fell at home and required a hip replacement

d. An older adult client who fell at home and required a hip replacement

Unlicensed assistive personnel (UAP) include which workers? a. Admission clerks, technicians, and orderlies b. Housekeepers, orderlies, and certified nursing assistants c. Volunteers, telemetry technicians, and hospital transporters d. Certified nursing assistants, orderlies, attendants, and technicians

d. Certified nursing assistants, orderlies, attendants, and technicians

A new nurse is considering getting a job in either an acute care setting or a home care setting. Which statement about these care settings is most accurate? a. Nurses work more as team members in the home care setting. b. Good communication skills are unnecessary in the home care setting. c. Clients are encouraged to help each other in the acute care setting. d. Clients play a large role in helping themselves in the home care setting.

d. Clients play a large role in helping themselves in the home care setting.

A client who is scheduled for hernioplasty needs clarification regarding the procedure. The nurse calls the health care provider at the client's insistence. The health care provider, who is in a bad mood, is overheard telling the client that the nurse does not know anything. Which legal tort has the health care provider committed? a. Libel b. Battery c. Assault d. Slander

d. Slander