FINAL PREP U & NCLEX

The nurse is preparing to assess a client's oral temperature. The nurse should plan to place the thermometer probe in which area of the client's mouth? a. deep in the posterior sublingual pocket b. superior to the tongue, with the tip touching the hard palate c. in the inferior buccal space on either side of the tongue d.along either upper gum line, adjacent to an incisor

a.

Which is the best definition of ethics? a. The formal, systematic study of moral beliefs b.The informal, systematic study of moral beliefs c. The adherence to formal personal values d.The adherence to informal personal values

a.

Which of the following statements accurately describes an aspect of the credentialing process used in nursing practice? Select all that apply. A) Credentialing refers to the way in which professional competence is ensured and maintained. B) Accreditation is the process by which the state determines that a person meets minimum requirements to practice nursing. C) Certification grants recognition in a specified practice area to people who meet certain criteria. D) Legal accreditation of a school preparing nursing personnel by the state Board of Nursing is voluntary. E) Once earned, a license to practice is a property right and may not be revoked without due process.

A,C,E

Which of the following nursing actions would be considered a violation of HIPPA regulations? Select all that apply. A) A nurse ambulates a client through a hospital hallway in a hospital gown that is open in the back. B) A nurse shoves a confused, bedridden client into bed after he made several attempts to get up. C) A nurse inadvertently administers the wrong dose of morphine to a client in the ICU. D) A nurse uses a client's chart as a sample teaching case without changing the client's name. E) A nurse reports the condition of a client to the client's employer.

A,D,E

Which nursing actions best describe the use of the professional value of human dignity? Select all that apply. a. The nurse includes the client in developing the plan of care. b. A nurse provides honest information to a client about the client's illness. c. A nurse provides privacy for an older adult client. d.A nurse reports an error made by an incompetent coworker. e.A nurse plans individualized nursing care for clients. f. A nurse refuses to discuss a client with a curious friend.

ACEF a. The nurse includes the client in developing the plan of care. c. A nurse provides privacy for an older adult client. e. A nurse plans individualized nursing care for clients. f. A nurse refuses to discuss a client with a curious friend.

Which word is best described as protection and support of another's rights?

Advocacy is the protection and support of another's rights. Nurses who value client advocacy make sure their loyalty to an employing institution or colleague does not compromise their primary commitment to the client;

______________is a concern for the welfare and being of others

Altruism

Standards of practice, which differ from rules of conduct, are made by agency policies and protocols and by the _________

American Nurses Association.

The nurse advocates for the client's decision based on the understanding that the client has the right to self-determination, interpreting the client's decision as reflecting which ethical principle?

Autonomy

A client diagnosed with cancer has met with the oncologist and is now weighing whether to undergo chemotherapy or radiation for treatment. This client is demonstrating which ethical principle in making this decision?

Autonomy entails the ability to make a choice free from external constraints.

Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing?

Care-based ethics

_______________ is an intentional tort in which one party makes derogatory remarks about another that diminish the other party's reputation

Defamation

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

D Nurse Practice Acts are examples of statutory law, enacted by a legislative body in keeping with both the federal constitution and the applicable state constitution. They are the primary source of rules of conduct for nurses. Standards of practice, which differ from rules of conduct, are made by agency policies and protocols and by the American Nurses Association.

The family of a terminally ill client asks the nurse about respite care. What does the nurse educate the family about regarding respite care?

It is primarily nursing assistants and volunteers who provide the care either in the client's home or an adult daycare center

in the 1980s, the nursing care delivery model shifted from a team nursing model to a

Primary nursing model

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

a

A nurse has had, on several occasions, the opportunity to share personal prescriptions with family members when they were in need of pain medication or antibiotics. Which set of rules should govern this moral decision? A) Ethics B) Administrative law C) Common law D) Civil law

a

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

a Fidelity means being faithful to one's commitments and promises

Ethical decision making is that based on

a personal or organizational code of ethics.

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

a,

The nurse is assessing a client's brachial artery blood pressure. Which nursing actions are performed correctly? Select all that apply. a. The nurse centers the bladder of the cuff over the brachial artery about midway on the arm. b. The nurse places the cuff over the client's bulky clothing and fastens it snugly. c. The nurse notes the point on the gauge at which the first faint but clear sound appears, and increases in intensity as the diastolic pressure. d. The nurse repeats any suspicious reading before 1 minute has passed since the last reading. e.The nurse has the client lying or sitting down with the forearm supported at the level of the heart and the palm of the hand upward. f.The nurse wraps the cuff around the arm smoothly and snugly and fastens it.

a, e, f

The nurse reports a nursing colleague on the unit who is lethargic and verbally responding in a slow manner. What is this an example of? A) Whistle-blowing B) Collective bargaining C) Delegating nursing care D) Ensuring adequate staffing

a. Whistle-blowing is when the nurse reports unsafe practice environments. Impaired nurses threaten the safety of clients in the clinical setting, as does inadequate staffing.

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

a. Assault is a threat or attempt to make bodily contact with another person without that person's consent. Threatening to forcibly administer an injection after the patient has refused it is assault.

What is the best nursing intervention to promote health in a client at risk for heart disease? a. Emphasizing a client's strengths to encourage weight loss b. Informing the client that the client must lose weight c. Instructing the client to adhere to a high-sodium diet d.Taking the client's pulse rate daily

a. Emphasizing the client's strengths to encourage

What is the function of the American Nurses Association's Code of Ethics for Nurses? A) Serves to establish personal ethics for nurses B) Delineates nurses' conduct and responsibilities C) Serves as a guideline for all health care practice D) Plays an important role in legal proceedings

b

While at a clinic visit, a client asks the nurse, "I'm going to be eligible for Medicare soon. Can you help explain what this involves?" Which information would the nurse likely include in the explanation? Select all that apply. a. "You won't have to pay for anything anymore. All your care will be covered." b. "Part A pays for inpatient hospital costs; Part B covers most outpatient costs." c. "If you want coverage for inpatient costs, you'll have to pay a monthly fee." d. "It's good to have an extra policy to supplement what might not be covered." e."The benefits you receive when you start will stay the same forever."

b. d. People who receive Medicare pay both a deductible cost and a monthly premium for full insurance coverage. Part A of Medicare, which pays most inpatient hospital costs, is paid by the federal government. Part B of Medicare, which is voluntary, is paid by a monthly premium; it covers most outpatient costs for physician visits, medications, and home health services. Because the full cost of some services is not covered by Medicare, a supplemental insurance policy offered by a private insurance company is recommended. Also, because Medicare is federally funded, benefits may change annually according to Congressional decisions related to the federal budget.

Which ethical principle refers to the obligation to do good? Fidelity Beneficence Veracity Nonmaleficence

beneficence

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

c

Which is a characteristic of the care-based approach to bioethics? a.The need to emphasize the relevance of clinical experience b. The rightness or wrongness of an action independent of its consequences c. The promotion of the dignity and respect of clients as people d.The need for an orientation toward service

c. The care-based approach to bioethics focuses on the specific situations of individual clients, and characteristics of this approach include promoting the dignity and respect of clients as people.

What result is the most appropriate outcome for the nursing diagnosis of Impaired Urinary Elimination? The client will: a. feel the urge to urinate. b. have clear yellow urine. c. maintain urine output of 30 mL/hr. d. urinate three times per day

c. Maintaining urine output of 30 mL/hr is a the most appropriate single, observable, and measurable outcome.

When examining values, a nurse notes that one country allows physician-assisted suicide and another outlaws it, making it punishable by imprisonment. Which factors best explain the differences in values between these two countries?

cultural

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? Evaluating Diagnosing Planning Implementing

evaluating Evaluating an ethical decision involves reflecting on the process and evaluating those elements that will be helpful in the future

A person's core body temperature is highest in the early morning and lowest in the late afternoon. True False

false lowest in the AM

A nurse is providing care for a client with cancer. The client's wife indicates that she does not want her husband to be told he is terminal. This is a breach of which ethical principle? Autonomy Fidelity Beneficence Nonmaleficence

fidelity The principle of fidelity involves the nurse being faithful to the client, who has the right to the truth. By not telling the client, the nurse is not being faithful to the client.

In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that the nurse has made. The nurse is most clearly demonstrating which professional value?

integrity which is defined as acting in accordance with an appropriate code of ethics and accepted standards of practice

The nurse notes the point on the gauge at which the first faint but clear sound appears, and increases in intensity as the ____________pressure.

systolic

The client sovereignty model involves

the client making all the decisions without input from the clinician.

The paternalistic model involves

the clinician making the decisions.

what is the term for the beliefs held by the individual about what matters?

values

The nurse is caring for a client who has been experiencing prolonged wound healing from a surgical procedure. A deficiency in which nutrient would be associated with this condition?

vit c

_______________ is upholding moral, legal, and humanistic principles.____________________ is respect for the inherent worth and uniqueness of individuals and populations.

1. Social justice 2. Human dignity

1. _______________are human excellences, or cultivated dispositions of character and conduct that motivate and enable us to be good human beings. 2.__________ are beliefs about the worth of something, about what matters, that act as a standard to guide one's behavior. 3.__________ are personal or communal standards of right and wrong. 4. ________________ are general guides to action, including autonomy, nonmaleficence, beneficence, justice, and fidelity.

1. Virtues 2.Values 3.Morals 4. ethical principles

Shared decision making model

1. making is recommended by most ethicists and involves considering both the client's preferences and the nurse's expertise to make the best decision.

An 1._____________question is often used when the nurse is obtaining a nursing history and allows the client to reply with a wide range of possible responses, thus encouraging free verbalization. A 2._________ question is answered by one or two words, often "yes" or "no." A 3.___________question is used to place events in a chronological order and to investigate a possible cause-and-effect relationship. A 4.____________question involves repeating what the person has said or describing the person's feelings.

1. open-ended 2.closed 3.sequencing 4.reflective

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

a Paternalism involves the violation of a client's autonomy in order to maximize good or minimize harm, a situation that requires careful consideration in light of ethical principles.

An illegal 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.

The growth in home health care is largely attributed to which of the following? 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 numbers of clients

a.

Which best defines value clarification? a. A process by which people come to understand their own values and value systems b.A belief about the worth of something, about what matters, that acts as a standard to guide one's behavior c. An organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct d.A systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct

a. Value clarification is a process by which people come to understand their own values and value systems.

When a nurse refuses to compromise a client's right to privacy, even when the nurse is threatened, the nurse is expressing an ethical framework termed what? A) Utilitarian B) Deontologic C) Justice D) Nonmaleficence Ans: B

b Deontologic frameworks emphasize roles or responsibilities that one is morally obligated to fulfill

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

c

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

c

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

c Medicare, based on DRGs, pays a hospital a fixed amount that is predetermined by the medical diagnosis or specific treatment rather than by the actual cost of hospitalization and care

A home care nurse visits a client who is confined to bed and is cared for by her daughter. The daughter is known to suffer from chemical dependence. The home is cluttered and unclean. During the assessment the nurse notes that the client is wet with urine and has dried feces on her buttocks, and demonstrates signs of dehydration. After caring for the client, the nurse contacts the physician and reports the incident to Adult Protective Services. This is an example of which ethical framework? A) Justice B) Autonomy C) Nonmaleficence D) Fidelity

c.

A nurse must possess several characteristics to be successful in this profession. Secondary to critical thinking skills, which is of great value? a. educational attainment such as Master's of Nursing b.delegation of responsibilities c. advocating for the client at all times d. good teamwork and team-building skills

c.

Virtues are: a. beliefs about the worth of something, about what matters, that act as a standard to guide one's behavior. b. personal or communal standards of right and wrong. c. cultivated dispositions of character and conduct that motivate and enable us to be good human beings. d.general guides to action, including autonomy, nonmaleficence, beneficence, justice, and fidelity.

c.

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

c. aka private law

Nurses have an important role in health care reform. The goals of health care reform include which of the following? a. Controlling health care costs through limited services for more consumers of health care. b.Decreasing health care services to provide all citizens with some access to care, but control escalating costs. c.Improving quality of care, while limiting access for the uninsured, to control rising costs. d.Focus on cost containment with improved access and quality of services for everyone.

d

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. Ethical decision making b.Paternalistic model c. Client sovereignty model d. Shared decision making

d.

Which is an important element of implementation? a. client database b. critical thinking c.nursing orders d.documentation

d.

____________the ethical problem involves stating the problem clearly. ___________includes identifying the options and exploring the probable short-term and long-term consequences. ____________ includes using the decision and comparing the outcomes of the action with what was considered and hoped for in advance.

diagnosing Planning Implementing

Which nursing action(s) best demonstrate the ethical principle of autonomy? Select all that apply. a. The nurse reviews best practice standards for procedures commonly performed on the unit. b. The nurse calls the prescriber when a medication dosage seems too high for the intended client. c. The nurse checks to ensure an informed consent document is signed prior to transferring the client for a surgical procedure. d. The nurse completes yearly continuing education requirements. e. The nurse documents that a client refused a new medication.

e, c Autonomy is respect for the client's right to make health care decisions. Informed consent and right to refuse medications are a part of autonomy.

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

international council of nurses

A client is admitted to the hospital with an abscess on the leg that will not heal after multiple treatment options as an outpatient. The nurse knows from past experiences that the appearance of this type of wound in clients heavily suggests a resistant bacterial infection and the need for contact isolation and IV antibiotics. The nurse begins to prepare for this admission. What type of problem solving does this exhibit? Experiential Intuitive Scientific Trial-and-Error

intuitive *nurse knows from past experiences