DeWits Ch1 & Ch 3
A characteristic of an advance directive is that: a. advance directives do not expire. b. only some states recognize advance directives. c. advance directives can be nonverbal. d. advance directives from one state are recognized by another.
A
A nurse remarks to several people that "Dr. X must be getting senile because she makes so many mistakes." If that remark results in some of Dr. X's patients changing to another doctor, Dr. X would have grounds to sue the nurse for: a. slander. b. libel. c. invasion of privacy. d. negligence.
A
A patient has signed a do-not-resuscitate (DNR) order. If a nurse performs cardiopulmonary resuscitation (CPR) when the patient stops breathing and then successfully revives the patient, the: a. nurse could be found guilty of battery. b. patient would have no grounds for legal action. c. patient could charge the nurse with false imprisonment. d. nurse could be found guilty of assault.
A
A person who has been brought to the emergency room after being struck by a car insists on leaving, although the doctor has advised him to be hospitalized overnight. The nurse caring for this patient should: a. have him sign a Leave Against Medical Advice (AMA) form. b. tell him that he cannot leave until the doctor releases him. c. immediately begin the process of involuntary committal. d. contact the person's health care proxy to assist in the decision-making process.
A
After passing the National Council Licensure Examination for Practical Nurses (NCLEX PN), the nurse is qualified to take an additional certification in the field of: a. pharmacology. b. care of infants and children. c. operating room technology. d. community health.
A
An advantage of preferred provider organizations (PPOs) is that: a. they make insurance coverage of employees less expensive to employers. b. there are fewer physicians to choose from than in an HMO. c. long-term relationships with physicians are more likely. d. patients may go directly to a specialist for care.
A
An example of a violation of criminal law by a nurse is: a. taking a controlled substance from agency supply for personal use. b. accidentally administering a drug to the wrong patient, who then has a serious reaction. c. advising a patient to sue the doctor for a supposed mistake the doctor made. d. writing a letter to the newspaper outlining questionable or unsafe hospital practices.
A
An example of tertiary health care is: a. hospice care. b. restorative care. c. emergency care. d. home health care.
A
In order to fulfill the common goals defined by nursing theorists (promote wellness, prevent illness, facilitate coping, and restore health), the LPN must take on the roles of: a. caregiver, educator, and collaborator. b. nursing assistant, delegator, and environmental specialist. c. medication dispenser, collaborator, and transporter. d. dietitian, manager, and housekeeper.
A
Nursing interventions are best defined as activities that: a. are taken to improve the patient's health. b. involve researching methods to maintain asepsis. c. include the family in nursing care. d. review guidelines for handling infectious wastes.
A
The advent of diagnosis-related groups (DRGs) required that nurses working in health care agencies: a. record supportive documentation to confirm a patient's need for care in order to qualify for reimbursement. b. use the DRG rather than their own observations for patient assessment. c. be aware of the specific drugs related to the diagnosis. d. acquire cross-training to make staffing more flexible.
A
Which nursing care delivery systems have some nursing schools adopted as the foundation of their education programs? a. Relationship-based care b. Team nursing c. Patient-centered care d. Total patient care
A
The most frequently cited cause of a sentinel event by the Joint Commission is a problem in: a. applying physical restraints. b. methods of patient transportation. c. medication errors. d. inadequate communication.
D
The nurse explains that a sentinel event is a situation in which a patient: a. refuses care. b. is accidentally exposed. c. leaves the hospital against medical advice. d. comes to harm.
D
The nursing theory presented by Sister Calista Roy is based on: a. reduction of stress. b. achievement of maximum level of wellness. c. relief of self-care deficit. d. adaptation modes.
D
The patient who cannot legally sign his or her own surgical consent is: a. a 17-year-old who is serving in the armed forces. b. a 16-year-old who is legally married. c. a 17-year-old emancipated minor. d. an 18-year-old who received a narcotic 30 minutes ago.
D
The commonalities of The Codes of Ethics of the National Association for Practical Education and Service (NAPNES) and The National Federation of Licensed Practical Nurses (NFLPN) include: (Select all that apply.) a. commitment to continuing education. b. respect for human dignity. c. maintenance of competence. d. requirement for membership in a national organization. e. preserving the confidentiality of the nurse-patient relationship.
A, B, C, E
The Ethics Committee of a facility has the responsibility to: (Select all that apply.) a. develop policies. b. address issues in their facility. c. modify the established codes of ethics as suits the situation. d. create a master plan for decision making to be followed in ethical dilemmas. e. help to find a better understanding of ethical dilemmas from different standpoints.
A, B, E
During the Civil War, nursing schools offered education to women both in England and in the United States. The schools in the United States differed from those in Europe because in US schools: (Select all that apply.) a. students worked without pay. b. the core curriculum was the same. c. instruction was presented by physicians at the bedside. d. the educational focus was on nursing care. e. classes were held separately from the clinical experience.
A, C
Professional accountability includes: (Select all that apply.) a. understanding theory. b. adhering to the dress code of the facility. c. asking for assistance when unsure of a procedure or primary care provider order. d. participating in continuing education classes. e. meeting the health care needs of the patient. f. reporting patient health status changes to all family members.
A, C, D, E
Characteristics of primary nursing include: (Select all that apply.) a. elimination of fragmentation of care between shifts. b. evolved in the mid-1950s. c. planning and direction performed by one nurse. d. ancillary workers used to increase productivity. e. the care plan covering the entire day. f. associate nurses taking over care and planning when the primary nurse is off duty.
A, C, D, E, F
In 1991, the American Nurses Association (ANA) published the Standards of Nursing Practice. These standards are designed to: (Select all that apply.) a. set standards for safe nursing care delivery. b. define the legal scope of practice. c. state legal requirements for clinical practice. d. protect the nurse, patient, and health care agency. e. regulate the nursing profession. f. define activities in which nurses may engage.
A, D, F
A 48-year-old man refuses to take a medication ordered for the control of his blood pressure. The nurse's most effective response would be: a. "Your doctor expects you to be compliant." b. "You have the right to refuse. This medication keeps your blood pressure under control." c. "Fine. I will document that you are refusing this drug." d. "Are you aware that you could have a stroke?"
B
A patient refuses to take his medications or to eat his breakfast. He is alert, mentally competent, and fairly comfortable. The nurse should: a. give the medications by injection if the patient will not take them orally. b. respect the patient's right to refuse medications or food, because he is competent. c. tell the patient that he must cooperate with his care. d. contact the doctor to insert a feeding tube to supply both medicine and food.
B
An elderly, slightly confused patient sustains an injury from a heating pad that was wrongly applied by the nurse. The nurse should: a. pretend to be unaware of the injury to the patient. b. report the incident to the risk management team via an incident report. c. document in the patient's medical record that an incident report was filled out. d. not document anything about the injury in the patient's medical record.
B
Early nursing education and care in the United States: a. were directed at community health. b. provided independence for women through education and employment. c. were an educational model based in institutions of higher learning. d. have continued to be entirely focused on hospital nursing.
B
Ethics and law are different from each other in that ethics: a. bear a penalty if violated. b. are voluntary. c. rarely change. d. can always direct all decisions.
B
If a nurse receives unwelcome sexual advances from a nursing supervisor, the first step the nurse should take is to: a. send an anonymous letter to the nursing administration to alert them to the situation. b. tell the nursing supervisor that she is uncomfortable with the sexual advances and ask the supervisor to refrain from this behavior. c. report the nursing supervisor to the state board for nursing. d. resign and seek employment in a more comfortable environment.
B
It is appropriate for practical nurses to provide direct patient care to persons in a hospital under the supervision of a: a. medical assistant. b. registered nurse on the unit. c. supervising nurse who is responsible for care on several units. d. more experienced LPN on the unit.
B
The Health Insurance Portability and Accountability Act's (HIPAA) main focus is in keeping: a. patients safe from harm. b. patient information in a secure office area. c. medications in a locked area. d. hospital infections under control.
B
The LPN demonstrates an evidence-based practice by: a. using a drug manual to check compatibility of drugs. b. using scientific information to guide decision making. c. using medical history of a patient to direct nursing interventions. d. basing nursing care on advice from an experienced nurse.
B
When a student nurse performs a nursing skill, it is expected that the student: a. performs the skill as quickly as the licensed nurse. b. achieves the same result as the licensed nurse. c. not be held to the same standard as the licensed nurse. d. always be directly supervised by an instructor.
B
When diagnosis-related groups (DRGs) were established by Medicare in 1983, the purpose was to: a. put patients with the same diagnosis on the same unit. b. attempt to contain the costs of health care. c. increase the availability of medical care to older adults. d. identify a patient's condition more quickly.
B
Which of the following could place the nurse in a serious legal situation? a. A nurse posts a poem about the qualities of a compassionate nurse on his or her social media page. b. A nurse's mother shares a "selfie" of her daughter (a nurse) and a celebrity patient she is caring for on her social media page. c. A nurse posts a request for prayer for strength after a difficult day at work. d. A nurse posts a video of fellow nurse's lip syncing and dancing to a popular song, "We are Strong."
B
Women volunteers were organized to give nursing care to the wounded soldiers during the Civil War by: a. Florence Nightingale. b. Dorothea Dix. c. Clara Barton. d. Lillian Wald.
B
In the United States, the Young Women's Christian Association (YMCA) in New York opened The ____________ School, the first practical nursing school.
Ballard
A licensed nurse is liable for charges of malpractice when she: a. does not show up for work and fails to call to notify the agency. b. clocks in for another nurse to prevent that nurse from having pay docked. c. falsifies data, causing the patient to suffer problems resulting in death. d. assists in performing CPR that is unsuccessful, and the patient dies.
C
A nurse co-worker arrives at work 30 minutes late, smelling strongly of alcohol. The fellow nurses' legal course of action is to: a. have the nurse lie down in the nurses' lounge and sleep while others do the work. b. state that, if this happens again, it will be reported. c. report the condition of the nurse to the nursing supervisor. d. offer a breath mint and instruct the nurse co-worker to work.
C
A patient has advance directives spelled out in a durable power of attorney, with the appointment of his daughter as his health care agent. The daughter will be responsible for: a. paying all the medical bills associated with the father's illness. b. making all informed consent decisions for her father. c. making all choices about her father's health care if the father is unable. d. paying only for those health care decisions based on the advance directives.
C
A patient who is refusing to take his medication is threatened that he will be held down and forced to take the dose. This is an example of: a. battery. b. defamation. c. assault. d. invasion of privacy.
C
A postoperative patient in the intensive care unit (ICU) is so confused and agitated that staff have not been able to safely care for him. He has pulled out his central line once, and he slides to the bottom of the bed, where he attempts to climb out, pulling and disrupting the various tubes and monitors. The nurse's best course of action is to: a. place him in a protective vest device. b. use a sheet to tie him in a chair at the nurses' station. c. request that the doctor write an order for a protective device and/or medication. d. call a family member to stay with the patient.
C
A state's Nurse Practice Act is designed to protect the: a. physician. b. nurse. c. public. d. hospital.
C
A student nurse who is not yet licensed: a. may not perform nursing actions until he or she has passed the licensing examination. b. is not responsible for his or her actions as a student under the state licensing law. c. are held to the same standards as a licensed nurse. d. must apply for a temporary student nurse permit to practice as a student.
C
A written statement expressing the wishes of a patient regarding future consent for or refusal of treatment in case the patient is incapable of participating in decision making is an example of: a. a privileged relationship. b. a health care agent. c. an advance directive. d. witnessed will.
C
An educational pathway for an LPN/LVN refers to an LPN/LVN: a. learning on the job and being promoted to a higher level of responsibility. b. moving from a maternity unit to a more complicated surgical unit. c. obtaining additional education to move from one level of nursing to another. d. learning that advancement requires consistent work and commitment.
C
Criteria that justify becoming an emancipated minor and able to sign a medical consent include all of the following except: a. independence established through a court order. b. service in the armed forces. c. a 14-year-old whose parents are dead. d. a 17-year-old pregnant female.
C
Florence Nightingale's contributions to nursing practice and education: a. are historically important but have no validity for nursing today. b. were neither recognized nor appreciated in her own time. c. were a major factor in reducing the death rate in the Crimean War. d. were limited only to the care of severe traumatic wounds.
C
Lillian Wald and Mary Brewster established the Henry Street Settlement Service in New York in 1893 in order to: a. offer a shelter to injured war veterans. b. found a nursing apprenticeship. c. provide health care to poor persons living in tenements. d. offer better housing to low-income families.
C
Nurse Practice Acts define the legal scope of an LPN's practice, which are written and enforced by: a. American Nurses Association. b. National Council Licensure Examiners. c. each state. d. each health care agency.
C
Nursing liability insurance is a policy purchased and put into effect by the nurse for the purpose of: a. providing protection against being sued. b. reducing the chance of litigation. c. paying attorney fees and any award won by the plaintiff. d. providing the hospital with added protection.
C
The LPN (LVN) assigns part of the care for her patients to a nursing assistant. The LPN is legally required to perform which of the following for the residents assigned to the assistant? a. Toilet the residents every 2 hours and as needed. b. Feed breakfast to one of the residents who needs assistance. c. Give medications to the residents at the prescribed times. d. Transport the residents to the physical therapy department.
C
The Occupational Safety and Health Act includes all of the following, except: a. regulations for handling infectious materials. b. radiation and electrical equipment safeguards. c. staffing ratios and delegation criteria. d. regulations for handling toxic materials.
C
The Standards of Nursing Practice are designed to direct LPNs to: a. advance their nursing career. b. seek a scientific basis for their interventions. c. deliver safe, knowledgeable care. d. a leadership role.
C
The acronym SBAR is a method to communicate with a primary care provider that clarifies a situation that may result in litigation. The acronym stands for: a. situation, background, alterations, results. b. subjective, believable, actual, recommendation. c. situation, background, assessment, recommendation. d. situation, basis, assessment, recommendation.
C
The information in a patient's medical record may legally be: a. copied by students for use in school reports or case studies. b. provided to lawyers or insurers without the patient's permission. c. shared with other health care providers at the patient's request. d. withheld from the patient, because it is the property of the doctor or agency.
C
The nurse who may be liable for invasion of privacy would be the nurse who is: a. refusing to give patient information to a relative over the phone. b. firmly closing the door prior to bathing the patient. c. discussing her patients with a fellow nurse. d. reporting the patient as a possible victim of elder abuse.
C
The nursing theorist whose practice framework is based on 14 fundamental needs is: a. Dorothy Johnson. b. Jean Watson. c. Virginia Henderson. d. Martha Rogers.
C
The nursing theory that uses seven behavioral subsystems in an adaptation model is: a. Betty Neumann. b. Sister Calista Roy. c. Dorothy Johnson. d. Patricia Benner.
C
To best protect himself or herself from being sued, the nurse should: a. continue to do procedures as taught in school. b. purchase malpractice insurance. c. maintain competency. d. use evidence-based practice.
C
When a patient asks a nurse to witness the signing of a will, the nurse should refer the request to the: a. nurse supervisor. b. hospital legal department. c. notary public for the hospital. d. nurse's attorney.
C
Which nursing care delivery system has been fully embraced by the nursing community and is identified as one of the seven QSEN competencies? a. Relationship-based care b. Team nursing c. Patient-centered care d. Total patient care
C
An example of the role of an LPN as a delegator is: (Select all that apply.) a. changing a patient's wound dressing. b. assisting a patient to complete his or her bath. c. assigning patient care tasks to certified nursing assistants. d. requesting the housecleaning staff to mop the floor of a patient's room. e. instructing the unit secretary to page a physician to the floor.
C, D, E
CAPTA, passed in 1973, is a law regarding the safety of minors. It is the ________ _________ and _______.
Child Abuse Prevention; Treatment Act
A 16-year-old boy is admitted to the emergency room after fracturing his arm from falling off his bike while visiting with his stepfather who is not the custodial parent. The nurse is preparing him to go to the operating room but must obtain a valid informed consent by: a. having the patient sign the consent for surgery. b. obtaining the signature of his stepfather for the surgery. c. declaring the patient to be an emancipated minor. d. obtaining permission of the custodial parent for the surgery.
D
A nurse arrives at the scene of a motor vehicle accident. A person in the vehicle mumbles incoherently when asked his name. Which actions are not covered by the Good Samaritan Law? (Select all that apply.) a. Using two magazines and a bandana to splint a broken arm b. Applying a tourniquet to a lacerated leg while awaiting emergency personnel c. Pulling the individual from the surface of the highway d. Initiating an emergency tracheotomy when the individual goes into respiratory arrest e. Compressing a bleeding wound with a soiled shirt
D
A nurse is caring for an unmarried 16-year-old patient who has just given birth to a baby boy. The nurse will get the consent to perform a circumcision on the patient's son from the: a. patient's father. b. patient's primary care provider. c. patient's mother. d. 16-year-old patient.
D
Although nursing theories differ in their attempts to define nursing, all of them base their beliefs on common concepts concerning: a. self-actualization, fundamental needs, and belonging. b. stress reduction, self-care, and a systems model. c. curative care, restorative care, and terminal care. d. human relationships, the environment, and health.
D
During an employment interview, the interviewer asks the nurse applicant about HIV status. The nurse applicant can legally respond: a. "No," even though he or she has a positive HIV test. b. "I don't know, but I would be willing to be tested." c. "I don't know, and I refuse to be tested." d. "You do not have a right to ask me that question."
D
If a member of a health maintenance organization (HMO) is having respiratory problems such as fever, cough, and fatigue for several days and wants to see a specialist, the person is required to go: a. directly to an emergency room for treatment. b. to any general practitioner of choice. c. directly to a respiratory specialist. d. to a primary care provider for a referral.
D
If a nurse is reported to a state board of nursing for repeatedly making medication errors, it is most likely that: a. the nurse will immediately have his or her license revoked. b. the nurse will have to take the licensing examination again. c. a course in legal aspects of nursing care will be required. d. there will be a hearing to determine whether the charges are true.
D
If a patient indicates that he is unsure if he needs the surgery he is scheduled for later that morning, the nurse would best reply: a. "Your doctor explained all of that yesterday when you signed the consent." b. "Your doctor is in the operating room; she can't talk to you now." c. "You should have the surgery; your doctor recommended that you have it." d. "I will call the doctor to speak with you before you go to the operating room."
D
Standards of care for the nursing practice of the LPN are established by the: a. Boards of Nursing Examiners in each state. b. National Council of States Boards of Nursing (NCSBN). c. American Nurses Association (ANA). d. National Federation of Licensed Practical Nurses.
D
The founding of the Red Cross is attributed to: a. Lillian Wald. b. Dorothea Dix. c. Florence Nightingale. d. Clara Barton.
D
Which of the following is considered a positive aspect of the Affordable Care Act? a. A 38-year-old mother is penalized on her taxes for not purchasing health insurance. b. A 42-year-old laborer who has chronic kidney disease is denied insurance coverage. c. Jamie, age 24, cannot continue insurance coverage on his parent's insurance since he has graduated from college. d. Maria, age 60, is able to obtain health insurance at a rate that is manageable on her income.
D
In 2003, the Patients' Bill of Rights was revised to become the _________: Understanding Expectations, Rights, and Responsibilities.
Patient Care Partnership
Preferred provider organizations (PPOs) use ____________ to finance their services and pay the physical cost of the service.
capitated cost
Such health services as surgical procedures, restorative care, and home health care would be classified as ________ care.
secondary