issues in nurs
Which nursing action is legally required?
Reporting incidents of suspected child abuse to the appropriate authorities
A nurse understands that the effects of different variables on client's health beliefs and practices can help healthcare providers to plan and deliver individualized care. Which statement made by the client is a socioeconomic influence on the client's health beliefs?
"I cannot afford expensive medications because I have to take care of my family."
A nurse is caring for an adult client who drinks large amounts of coffee every day. The nurse advises the client to avoid coffee because caffeine can have adverse effects on health. Arrange the proper of responses that the client might demonstrate while passing through the stages of health behavior change.
"I've been drinking coffee for the last 10 years and haven't had any health problems." "I know that too much coffee can cause problems, but it helps me stay alert and focused on my work."
A registered nurse is teaching a nursing student about the importance of values in nursing practice. Which information provided by the registered nurse is appropriate? Select all that apply.
"Values vary among clients and develop and change over time." "The values that an individual holds reflect cultural and social influences." "To discuss differences in opinions and values, the nurse should be clear about his or her own values.
A nursing student is recalling the importance of the Magnet Recognition Program. Which statements about the program are accurate?
1. The MRP empowers the nursing team to make changes and be innovative 3. The MRP recognizes health care organizations that achieve excellence in nursing practice. 4. The MRP has clinical promotion systems and research and evidence-based practice programs
a nurse is educating a client about the Uniform Determination of Death Act. What information should the nurse provide?
2. nurses have a specific legal obligation to treat a deceased person's remains with dignity 4. Different definitions regarding death are in place to facilitate recovery of organs for transplantation 5. The cardiopulmonary standard of determining death sets an irreversible cessation of circulatory and respiratory functions as the criterion
A registered nurse is educating a nursing student about the different levels of prevention with different scenarios. Which scenario is an example of tertiary prevention?
A nurse educates a community about the need to integrate individuals' limb amputations into the professional sphere.
A nursing student is listing the characteristics of an ethical issue. Which point listed by the nursing student requires correction?
An ethical issue occurs if the problem aims at the greatest good for the greatest number of people.
Nurses are held responsible for the commission of a tort. What is the definition of a tort?
An illegality committed by one person against the property or person of another
A nursing student is listing examples of quasi-intentional torts. Which examples mentioned by the nursing student need correction? Select all that apply.
Assault Battery Malpractice
Which statement captures the essence of feminist ethics accurately?
Feminist ethicists propose that the natural human urge to be influenced by relationships is a positive value.
What services do community health centers provide in preventive and primary care services? Select all that apply.
Health screenings Physical assessments Disease management
In what order should a nurse follow steps of risk management to identify potential hazards and to eliminate them before harm occurs?
Identifying possible risks Analyzing the possible risks Acting to reduce the risks Evaluating the steps taken
A client dies in the hospital 2 hours after being admitted. Who has the authority to decide if a post-mortem should be conducted?
Medical examiner
What should the nurse consider to be limitations of assisted living? Select all that apply.
Most residents need to pay privately. Only home care nurses can visit the clients. Average monthly fee is $3,022 for a private unit
A nursing student is recalling the definitin of Nurse Practice Acts. What do the Nurse Practice Acts do?
Nurse Practice Acts describe and define the legal boundaries of nursing practice within each state.
A child admitted to the hospital is in need of a life-saving heart transplant surgery. However, the parents refuse to allow the surgery stating that such surgeries are against their belief system. The nurse in charge of the client recognizes the situation as an ethical dilemma. What first step should the nurse take in order to resolve the dilemma?
Obtain information from the child, the parents, health care workers, and other sources.
What activities would the nurse state are involved in providing a secondary level of preventive care? Select all that apply.
Preventing the spread of communicable disease Providing facilities to limit disability and prevent death Providing adequate treatment to arrest the disease process
A client admitted to the hospital is diagnosed with leukemia. The client's family members inform the nurse that no blood should be transfused to the client under any circumstances because it is against their belief system. The client however, requests the nurse to carry out all necessary procedures without informing family members. What should the nurse do to comply with the principle of confidentiality according to the American Nurses Association (ANA) code of ethics?
Refrain from repeating the client's instructions to the family members.
Which nursing action is not likely to cause legal issues?
Refraining from leaving the client during a staffing shortage
A nursing student is listing the steps that need to be considered when preparing discharge planning for a client. Which steps listed by the nursing student are accurate? Select all that apply.
Teach the client the safe and effective use of medications and medical equipment." "Remember that discharge planning is a centralized, coordinated, interdisciplinary process." "Develop a care plan that moves the client from the hospital to another level of healthcare.
An emaciated older adult with dementia develops a large pressure ulcer after refusing to change position for extended periods of time. The family blames the nurses and threatens to sue. What is considered when determining the source of blame for the pressure ulcer?
The client should have been turned regularly.
A nurse complies to the American Nurses Association (ANA) standards of nursing practice. Which scenario is an example of assessment according to the ANA standards?
The nurse checks the client's ability to swallow before administering oral medication.
A registered nurse is educating a nursing student about the utilitarian system of ethics. What information should the nurse provide? Select all that apply.
The value of something is decided by its usefulness." "The main emphasis is on the outcome or consequence of the action. "The greatest good for the greatest number of people determines the right action."
According to Quality and Safety Education (QSEN), what is patient-centered care?
Understanding that the client is the source of control when providing care
A graduate nurse is preparing to apply to the State Board of Nursing for licensure to practice as a registered professional nurse. What group primarily is protected under the regulations of the practice of nursing?
the public
A nursing student is evaluating different scenarios that are examples of following the basic health care principles. Which scenario is an example of following the principle of justice?
A nurse manager encourages the nurses to discuss their mistakes in order to improve the quality of care.
What is the rationale for performing sponge, needle, and instrument counts in the operating room?
A nurse is responsible for performing sponge and instrument counts as a part of routine surgical standards.
Which statement accurately demonstrates an act of nursing negligence?
A nurse instructs the nursing assistive personnel to administer medication through an intravenous line
A nurse speaking in support of the best interest of a vulnerable client reflects which nursing duty?
Advocacy
A nursing student is listing points that make nursing a profession and not just a job. Which points have been correctly stated? Select all that apply.
"Nursing provides a specific service." "Nursing requires a basic liberal foundation and an advanced education." "Nursing has a theoretical body of knowledge leading to defined skills, abilities, and norms.
A registered nurse is educating the nursing student regarding the importance of consensus building in the resolution of bioethical dilemmas. Which statements by the student nurse indicate effective learning? Select all that apply.
Consensus building is an act of discovery. Consensus building promotes respect and agreement. Consensus building inspires respect for unusual points of view.
A nurse notices that a client is in spiritual distress. Which nursing action establishes the nurse as a caregiver?
The nurse provides therapeutic treatment to the client.
What information should the registered nurse provide when teaching a nursing student about defamation of character? Select all that apply.
Speaking falsely about another person is slander. Written defamation of character is also called libel. It is the publication of false statements that may damage a person's reputation.
A nursing student is noting the characteristics of the secondary level of prevention. What points should the nursing student note?
2. Secondary prevention focuses on individuals with health problems and illnesses 3. Secondary prevention activities are directed at diagnosis and prompt intervention 5. Secondary prevention includes screening techniques and treating diseases at early stages.
What does the basic principle of advocacy provide to the nurse according to the American Nurses Association (ANA) code of ethics?
The basic principle of advocacy helps the nurse make a unique contribution to the understanding of the client's point of view.
A nursing student is listing the characteristics of the maintenance stage of health behavior change. Which points mentioned by the nursing student are accurate? Select all that apply.
The client can sustain health behavior changes over time." "The client feels the need to integrate the changes into his or her lifestyle. "The client reaches this stage 6 months after engaging in action and continues with the changes indefinitely."
A registered nurse is educating a student nurse about the concept of "floating." What information should the nurse provide? Select all that apply.
The nurse needs to request and receive an orientation to the unit. The nurse needs to learn about the policies of the institution regarding floating before accepting employment. The nurse must inform supervisors about any lack of experience in caring for the type of clients in the assigned nursing unit.
A nurse caring for a client who presents with herpes zoster conducts extensive research on the disease to formulate the care plan. In addition, the nurse adds photos of the client's infected area to the electronic health record (EHR) to evaluate progress toward recovery. The nurse also educates the client on maintaining proper hygiene to prevent the spread of the infection. Which competencies does the nurse display according to the Institute of Medicine (IOM) competencies of the 21st century? Select all that apply.
Using informatics Using evidence-based practice Providing patient-centered care
The unlicensed healthcare worker assigned to the 7:00 am shift has not been coming to work until 8:00 am. Nursing care is delayed, and assignments are started late. What is the most appropriate action by the charge nurse/team leader?
Document the information before discussing it with the unlicensed healthcare worker.
A nurse is caring for an obese client with diabetes mellitus. Which nursing actions satisfy the Quality and Safety Education for Nurses (QSEN) competency called teamwork and collaboration? Select all that apply.
Engaging the physical therapist in managing the client's condition Explaining the client's medication routine to the next shift nurse Consulting with the dietician to help manage the client's condition
In order to prolong a hospitalization stay, the nurse documents in a client's electronic health record (EHR) that there are no signs of recovery. However, in reality, the client appears to be cured of the illness. What legal implication does the nurse's action have?
The nurse may be charged with libel.
A registered nurse is educating a nursing student about assault. What information should the registered nurse provide?
"Assault refers to any action that places a client in apprehension of harmful contact without consent."
A nurse who is working on a medical-surgical unit receives a phone call requesting information about a client who has undergone surgery. What is the best response by the nurse?
"It is against the hospital's policy to provide you with any information."
A nurse instructs a client who leads a sedentary lifestyle to take up regular physical activity. What are the client's responses in the order reflecting the stages of health behavior change?
1. "I'm fit and completely healthy, and I have no time for physical activity." 2. "I know that exercise is good for my health, but so far my lifestyle hasn't caused me any problems." 3. "I don't even know how to begin exercising. Could you refer me to a personal trainer?" 4. "I go to the gym every day, but I feel like giving up." 5. "I need help fitting my exercise routine into my daily schedule
Common negligent acts of nurses found in the hospital setting?
1. Failure to notify the healthcare provider of problems 2. Failure to follow the six rights of medication administration 3. Failure to ensure the safety of a client with disequilibrium problems
A nurse withholds a prescribed opioid medication from a client with intractable pain because the nurse fears the client will become addicted. In this situation the nurse is adhering to which ethical principle?
Beneficence
What does "access to care" include according to the Picker Institute's eight dimensions of patient-centered care? Select all that apply.
Clients want to be able to see a specialist when a referral is made." "Clients want to schedule appointments at convenient times without trouble." "Clients need to be able to find conveyance when travelling to different healthcare settings
What purpose does a community health center serve in preventive and primary care services?
Community health centers are outpatient clinics that provide primary care to a specific population.
What important points should the nurse keep in mind when witnessing consent forms? Select all that apply.
Confirm that the client's signature is authentic. Ensure that the client has given the consent voluntarily. Refrain from asking the student nurse to witness consent forms.
A client in need of a lung transplant tells the nurse, "I will not take the organ of any person belonging to a different religion." The nurse initiates the process for resolving the ethical dilemma by collaborating with other healthcare team members. What should the team do after agreeing to a statement of the problem?
The team should determine all the possible courses of action based on available information.
A nurse is obtaining consent from an unemancipated minor to perform an abortion. When would the nurse consider the consent-giving process to be appropriately completed? Select all that apply.
When consent has been given specifically by a court When self-consent has been granted by a court order When consent has been obtained from at least one parent of the minor
Which nurse participates in the development of nursing policies and procedures?
nurse educator
A nurse caring for a client tries to prioritize nursing actions on the basis of Maslow's hierarchy of needs. Which statement of the client would the nurse pay attention to last?
"My aim is to be a famous writer, and I will do anything to achieve my dream."
A registered nurse is educating a nursing student about issues related to short staffing. What information should the nurse provide? Select all that apply.
"Nurses should refrain from walking out when faced with a short staffing problem." "Nurses should inform their supervisors when they are assigned to care for more clients than is reasonable." "Written protests should be submitted to nursing administrators if unreasonable assignments are given to nurses."
A nursing student is listing the points that need to be remembered regarding the United Network for Organ Sharing (UNOS) program. Which point listed by the nursing student is accurate?
"The United Network for Organ Sharing (UNOS) has a contract with the federal government."
A cognitively impaired client's family member requests that the nurse list the benefits of using a respite care service. What information should the nurse provide about respite care services? Select all that apply.
"They are offered at home, in a day care setting, or in a health care institution that provides overnight care." "Medicare health care plans do not cover this service, and Medicaid has strict requirements for services and eligibility." "It is a service that provides short-term relief or "time off" for people providing home care to an ill, disabled, or frail older adult."
The nurse follows a step-by-step approach to obtain the strongest available evidence to apply in client care. What is the order in which the nurse should perform evidence-based practice (EBP)?
1. Ask a clinical question. 2. Collect the most relevant and best evidence. 3. Critically appraise the gathered evidence. 4. Integrate all evidence with one's clinical expertise and client preferences and values in making a practice decision or change. 5. Evaluate the practice decision or change. 6. Share the outcomes of EBP changes with others
What are the advantages of The Health Insurance Portability and Accountability Act of 1996 (HIPPA)?
1. HIPPA provides rights to clients and protects employees 3. HIPPA protects an individual from losing health insurance when changing jobs. 4. HIPPA provides the basis for privacy and confidentiality concerns in the healthcare setting.
A registered nurse is informing a nursing student that nurses play an important role in helping hospitals to meet requirements for quality, efficiency, and client satisfaction. Which points mentioned by the registered nurse are accurate
1. Pay for performance programs promote quality, effectiveness, and safe client care. 2. Six Sigma is used to analyze the collected data and to identify unnecessary steps in the processes. 3. Balanced scorecards are used to report data on the key performance indicators and are published pubicly
A registered nurse is educating a nursing student about licensure. What information should the nurse provide?
2. The hearing for suspension or revocation of a license is conducted by a panel of professionals 4. The nurse must be notified of any charges against hum or her and given an opportunity to defend him or herself 5. The state board of nursing may revoke or suspend a license if a nurse's conduct violates provisions in the licensing statutes.
A nursing student is reviewing different statements as they fulfill Maslow's hierarchy of needs, from the highest level of needs to the lowest level of needs. In which order should the nursing student arrange the scenarios, from the highest the lowest level of needs?
A client says to the nurse, "I want to maintain good health as I intend to be the best soccer player on my team." A client says to the nurse, "I do not have any skills that will help me be an achiever in life." A client says to the nurse, "I have been feeling depressed ever since my sibling stopped speaking to me." A client says to the nurse, "My father threatens to commit me to an asylum if I dare disobey him."
A nurse is evaluating various scenarios related to the basic codes of ethics set forth by the American Nurses Association. Which situation is an example of following the principle of accountability?
A nurse ensures that all nursing actions performed during care can be explained to the client and the hospital.
A nurse is examining different scenarios related to defamation of character. Which scenarios are examples of slander? Select all that apply.
A nurse informs the primary healthcare provider falsely that a client shows signs of drug abuse A nurse informs the client's caregivers that the client is aggressive, even though there is no evidence. A nurse warns a colleague that a client displays inappropriate sexual behavior when no such event happened.
A nurse is caring for a client with pain after surgery. The nurse takes the blood pressure and pulse rate of the client and asks the client to rate the level of pain on the pain scale. The nurse then notifies the primary healthcare provider. Which standard of practice does the nurse perform?
Assessment
A nurse is caring for a client who believes that surgery contaminates the soul unless proper cleansing rituals are performed. Which nursing activity adheres to the Quality and Safety Education for Nurses (QSEN) competency patient-centered care?
Coordinating with appropriate spiritual practitioners to help perform the cleansing ritual before the client's surgery
A registered nurse is educating a nursing student about the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Which points mentioned by the nursing student post-teaching are correct? Select all that apply.
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a standardized survey developed to measure client perceptions of their hospital experience. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is administered to a randomly selected sample of adults who were discharged from a hospital between 48 hours and 6 weeks ago. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys have 27 questions that ask clients to rate their communication with nurses and physicians, discuss other details about treatment, and share their willingness to recommend the hospital.
According to the Institute of Medicine (IOM) competencies for the 21st century, what tasks should the nurse perform when applying quality improvement? Select all that apply.
Identify errors and hazards in care. Design and test interventions to change processes. Measure quality in relation to structure, process, and outcomes.
A nursing student is listing the key points that need to be remembered to maintain health and wellness of the client. Which key points listed by the nursing student are accurately stated? Select all that apply
Internal and external variables are considered when planning care for the client." "The health belief model considers the relationship between a person's health beliefs and health behaviors." "The health promotion model highlights factors that increase individual well-being and self-actualization.
A nursing student is listing the instructions that clients require before leaving a healthcare facility. Which instruction listed by the nursing student indicates a need for more education?
Provide instructions about all the legislation and guidelines that protect the interests of a client.
A student nurse lists the 10 rules of performance designed by the Institute of Medicine (IOM) that should be followed to provide appropriate care for clients. Which rules listed by the student nurse are accurate? Select all that apply.
knowledge is shared and information flows freely. Care is individualized based on client needs and values. Correct 4 The client is the source of control participating in shared decision making.
