Issues in Nursing

What services do community health centers provide in preventive and primary care services? Select all that apply. 1. Day care 2. Health screenings 3. Physical assessments 4. Disease management 5. Acute and chronic care management

2. Health screenings 3. Physical assessments 4. Disease management Health screenings, physical assessments, and disease management services are provided by community health centers in preventive and primary care services. Day care and acute and chronic care management services are provided by nurse-managed clinics.

What are the elements of discovery of a lawsuit? Select all that apply. 1. Experts 2. Medical records 3. Proof of negligence 4. The depositions of witnesses 5. Petition-elements of the claim

1. Experts 2. Medical records 4. The depositions of witnesses Experts, medical records, and the depositions of witnesses are elements of discovery of a lawsuit. Proof of negligence is a part of a trial. Petition and elements of the claim are a part of the pleadings phase.

A terminally ill client has died in the hospital and it is time to inform the client's family members. The nurse is unsure how to console the family members. Which member of the interprofessional team is appropriate for the nurse to ask for support in informing and consoling the family? 1. Primary Health Care Provider 2. Pharmacist 3. Social Worker 4. Occupational Therapist

3. Social worker The social worker on the interprofessional team helps the family members prepare for the client's death and also during the grief and bereavement process. Therefore, the nurse involves the social worker in consoling the family members in this situation. The primary health care provider and pharmacist may not be involved in consoling the family members after the client's death, nor may the occupational therapist be involved at this stage.

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? 1. A nurse educates a community about the proper use of environmental sanitation. 2. A nurse educates a family about how to protect themselves from carcinogens. 3. A nurse provides education to a family regarding the need to pay attention to personality development. 4. A nurse educates a community about the need to integrate individuals' limb amputations into the professional sphere.

4. A nurse educates a community about the need to integrate individuals' limb amputations into the professional sphere. Educating the public about the use of rehabilitated individuals to their fullest extent is a tertiary prevention. Educating a community about the proper use of environmental sanitation is an example of primary prevention. Educating a family about methods of protecting themselves from carcinogens is an example of primary prevention. Providing education about the need to pay attention to personality development is also an example of primary prevention.

Which factors may help in providing excellent health care services to the client? Select all that apply. 1. Cultural sensitivity 2. High client literacy 3. Competent health care 4. One-way communication 5. Interprofessional teamwork

1. Cultural sensitivity 3. Competent health care 5. Interprofessional teamwork Excellent health care services can be provided through competent health care that helps in reaching the client's goals. Interprofessional teamwork helps provide comprehensive care to the client. Cultural sensitivity helps provide health care while keeping in mind the client's cultural background and attitude. Communication should not be one-way; rather, it should be comprehensive to include all the team members and the client. Literacy level of the client is unrelated to quality health care.

A client with congestive heart failure is receiving intravenous digoxin (Cardoxin) therapy. The registered nurse identifies that which items on the client's care plan are appropriate for a licensed practical nurse (LPN) to perform? Select all that apply. 1. Help the client ambulate when required. 2. Monitor the client's vitals every 30 minutes. 3. Administer adequate oral fluids to the client. 4. Prepare the nursing diagnosis after assessing the client. 5. Administer the digoxin (Cardoxin) if the client has chest pain.

1. Help the client ambulate when required. 2. Monitor the client's vitals every 30 minutes. 3. Administer adequate oral fluids to the client. To provide safe care, the nurse should act within the scope of practice and certification. The licensed practice nurse (LPN) can monitor the vitals, ambulate the client, and administer oral fluids to prevent dehydration. The LPN cannot administer medications intravenously and cannot formulate nursing diagnosis; therefore, these two actions do not fall within the scope of the LPN's practice.

The nurse is entering a client's data in the electronic health record. What action should the nurse take to minimize ambiguity and confusion? 1. Use consistent, codified terminology. 2. Record the data in the client's presence. 3. Enter the data in the client's native language. 4. Upload scanned copies of the client's records.

1. Use consistent, codified terminology. An electronic health record is a client's official digital health record, and is shared among multiple facilities and agencies. Therefore the nurse must use consistent, codified terminology to eliminate ambiguity and confusion. Recording the data in the presence of the client will not help another health care professional understand the data. Healthcare providers review electronic health record for continuing a client's treatment. Therefore the nurse should enter client data by using a clear codified scheme, not in the client's native language. The nurse should not upload scanned copies of client records because others may not understand the nurse's handwriting and may get confused.

A nurse educates a client about the role played by an individual in taking responsibility for health and wellness and its impact. What instructions should the nurse give? Select all that apply. 1. "An individual should use passive strategies for health promotion." 2. "An individual should know that lifestyle choices affect his or her quality of life and well-being." 3. "An individual should take responsibility of health and wellness by making proper lifestyle choices." 4. "An individual should realize that illness prevention has a positive economic impact on his or her life." 5. "An individual should understand that it is enough to make positive lifestyle choices in order to prevent illness."

2. "An individual should know that lifestyle choices affect his or her quality of life and well-being." 3. "An individual should take responsibility of health and wellness by making proper lifestyle choices." 4. "An individual should realize that illness prevention has a positive economic impact on his or her life." A client should understand that making appropriate lifestyle choices can affect his or her quality of life and well-being. An individual should take responsibility for his or her health and wellness by making proper lifestyle choices. The client should also realize that illness prevention has a positive economic impact by decreasing health care costs. Passive health promotion strategies enable people to benefit from the activities of others. These strategies do not require the involvement of the clients. The client should understand that making positive lifestyle choices and discarding negative lifestyle choices contribute to illness prevention.

A nurse is recalling common terms that are used in health ethics. What does beneficence in health ethics refer to? 1. Beneficence refers to the agreement to keep promises. 2. Beneficence refers to taking positive actions to help others. 3. Beneficence refers to the ability to answer for one's actions. 4. Beneficence refers to avoiding harming or hurting an individual.

2. Beneficence refers to taking positive actions to help others. Beneficence refers to taking positive actions to help others. Fidelity refers to the agreement to keep promises. Accountability refers to the ability to answer for one's actions. Nonmaleficence refers to avoiding harming an individual.

Identify factors associated with an increased incidence of abuse within a family. Select all that apply. 1. Acute illness 2. Pregnancy 3. Drug abuse 4. Chronic illness 5. Sexual orientation

2. Pregnancy 3. Drug abuse 5. Sexual orientation Pregnancy, drug abuse, and sexual orientation are associated with an increased incidence of abuse within a family. Acute and chronic illness may place stress on the family, but these factors are not specifically linked to a higher incidence of violence.

A nursing student is giving examples of healthcare settings and services. Which scenario is a perfect example of tertiary care? 1. Preparing a client for an X-ray who has sustained a leg fracture in an accident 2. Teaching community members about the importance of using seat belts in cars 3. Caring for a postoperative client in the intensive care unit who is suffering from respiratory distress 4. Advising a client with stage 1 Parkinson's disease to include exercise in his or her daily routine

3. Caring for a postoperative client in the intensive care unit who is suffering from respiratory distress Tertiary care consists of intensive care and subacute care. Caring for a postoperative client in an intensive care unit who is suffering from respiratory distress is a perfect example of tertiary care. Preparing a client with a leg fracture for an X-ray is an example of secondary acute care. Teaching community members about the importance of using seat belts in cars is an example of secondary acute care. Advising a client in stage 1 of Parkinson's disease about the importance of exercise in his or her daily routine is an example of primary care.

A nurse is teaching staff members about the legal terminology used in child abuse. What definition of battery should the nurse include in the teaching? 1. Maligning a person's character while threatening to do bodily harm 2. A legal wrong committed by one person against property of another 3. The application of force to another person without lawful justification 4. Behaving in a way that a reasonable person with the same education would not

3. The application of force to another person without lawful justification Battery means touching in an offensive manner or actually injuring another person. Battery refers to actual bodily harm rather than threats of physical or psychological harm. Battery refers to harm against persons, not property. Behaving in a way that a reasonable person with the same education would not is the definition of negligence.

A client is injured from falling from a hospital bed on which the side rails were not raised appropriately. The client's family files a malpractice suit against the nurse responsible for taking care of the client. Which statements regarding the lawsuit are accurate? Select all that apply. 1. The nurse is the plaintiff and the client is the defendant. 2. The plaintiff selects experts to establish the appropriateness of nursing care. 3. The defendant obtains all of the plaintiff's medical records in the discovery phase. 4. The jury uses certain standards of care to determine whether the nurse acted properly. 5. The plaintiff outlines what the defendant did wrong and how it resulted in injury in the pleadings phase.

3. The defendant obtains all of the plaintiff's medical records in the discovery phase. 4. The jury uses certain standards of care to determine whether the nurse acted properly. 5. The plaintiff outlines what the defendant did wrong and how it resulted in injury in the pleadings phase. In this lawsuit, the client is the plaintiff and the nurse is the defendant. The nurse selects experts to establish that appropriate care was provided to the client. In the discovery phase (which occurs before the trial), the defendant obtains all of the client's relevant medical records from before and after the treatment. The jury uses standards of care to determine whether the nurse acted appropriately or committed malpractice. In the pleadings phase, the petition is put forward in the court. The plaintiff (client) outlines what the defendant (nurse) did wrong and how his or her actions resulted in injury.

A nursing student is listing the professional responsibilities and roles of the nurse. Who is the most independently functioning nurse? 1. Nurse educator 2. Nurse researcher 3. Nurse administrator 4. Advanced practice registered nurse

4. Advanced practice registered nurse The advanced practice registered nurse is the most independently functioning nurse. The nurse educator, nurse researcher, and nurse administrator all must be associated with an organization to pursue their professional prospects.

A nurse working in an emergency department is concerned about a recent increase in malpractice claims against nurses. What is the best way for the nurse to prevent being named in a lawsuit? 1. Carry malpractice insurance. 2. Write vague incident reports. 3. Transfer to another department. 4. Attend professional development programs.

4. Attend professional development programs. The best way to prevent professional negligence (malpractice) is to attend continuing education programs and improve practice; additional education is advisable when one is working in specialty areas, such as emergency departments or intensive care areas. Insurance is helpful after an incident, but it will not prevent malpractice claims. Writing vague incident reports is not professional; incident reports should be detailed. Preventing the issue by transferring to another department will not solve the problem. Each area of nursing practice requires expertise.

A nurse is educating an older adult for the purpose of promoting wellness. What instruction should the nurse give to reduce the risk of disability? 1. "Engage in physical activities to stay fit." 2. "Don't exhaust yourself by engaging in physical activities." 3. "Pay no heed to your financial problems if you want to stay healthy." 4. "Stay away from people so as to prevent anxiety and stress disorders."

1. "Engage in physical activities to stay fit." The nurse should instruct the older adult to engage in physical activities as a means of extending the years of active independent life and reducing the risk of disability. To promote a healthy lifestyle, the nurse should encourage the older adult to engage in physical activities. The nurse should understand that the willingness of the older adult to participate in health promotion activities depends in part on socioeconomic factors; moreover, the nurse should not provide financial advice to the client. The nurse should ensure that the older adult has social support to promote health and provide access to resources.

A registered nurse is educating a nursing student about the stages of changes in a client's health behavior. Which statement describes the stage of contemplation? 1. "The client considers a change within the next 6 months." 2. "The client does not intend to make changes within the next 6 months." 3. "The client is actively engaged in strategies to change behavior; this lasts up to 6 months." 4. "The client displays sustained change over time; this begins 6 months after action has started and continues indefinitely."

1. "The client considers a change within the next 6 months." In the contemplation stage, the client considers a change within the next 6 months. In the precontemplation stage, the client does not intend to make changes within the next 6 months. In the action stage, the client is actively engaged in strategies to change behavior. This stage lasts up to 6 months. When sustained change is noticed over time and begins 6 months after action has started and continues indefinitely, the client has reached the maintenance stage.

A nursing student is listing the nursing manager's role in the hospital setting. Which roles listed by the nursing student are accurate? Select all that apply. 1. "The nursing manager coordinates the activities of the nursing staff in delivering nursing care." 2. "The nursing manager uses appropriate leadership styles to create a nursing environment for clients and staff." 3. "The nursing manager investigates ways to improve nursing care and further define and expand the scope of the nursing practice." 4. "The nursing manager provides independent care to women during a normal pregnancy, labor, and delivery, and also provides care for the newborn." 5. "The nursing manager establishes an environment for collaborative client-centered care to provide safe and quality care with positive client outcomes."

1. "The nursing manager coordinates the activities of the nursing staff in delivering nursing care." 2. "The nursing manager uses appropriate leadership styles to create a nursing environment for clients and staff." 5. "The nursing manager establishes an environment for collaborative client-centered care to provide safe and quality care with positive client outcomes." As a manager, the nurse should coordinate the activities of the nursing staff in delivering nursing care. As a manager, the nurse uses appropriate leadership styles to create a nursing environment for the clients and staff. As a manager, the nurse establishes an environment for collaborative client-centered care to provide safe, quality care with positive client outcomes. As a researcher, the nurse investigates problems to improve nursing care and further define and expand the scope of the nursing practice. A certified nurse-midwife is an advanced practice registered nurse who provides independent care for women during normal pregnancy, labor and delivery, and care for the newborn.

A client tells the nurse, "I keep reverting to my old habit of drinking soda, although I have stopped drinking as much." What stage of health behavior change has the client reached? 1. Action stage 2. Preparation stage 3. Maintenance stage 4. Contemplation stage

1. Action stage The client in this situation has reached the action stage of health behavior change. In this stage, old habits may get in the way of new behaviors. In the preparation stage, the client understands that the advantages of the health behavior change outweigh its disadvantages. In this situation, the client has already made changes in health behavior. In the maintenance stage, the client continues the health behavior change indefinitely. In the contemplation stage, the client may be ambivalent but is more ready to accept information regarding health behavior change.

A nurse is recalling the various levels of preventive care to promote health, wellness, and to prevent illness. Which scenario is a perfect example of primary prevention? 1. An infant receives rotavirus vaccination in the hospital setting. 2. An adult in the early stages of Parkinson's disease is advised to perform adequate exercise. 3. An older adult permanently paralyzed due to brain hemorrhage is transferred to a long-term care facility. 4. An older adult with Parkinson's disease is administered carbidopa-levodopa to slow the progression of the disease.

1. An infant receives rotavirus vaccination in the hospital setting. Primary prevention consists of all health promotion efforts and wellness education activities. An infant receiving the rotavirus vaccination is an example of primary prevention. An adult in the early stages of Parkinson's disease is advised to perform adequate exercises; this is an example of secondary prevention. An older adult permanently paralyzed due to brain hemorrhage is transferred to a long-term care facility. This is an example of tertiary prevention. An older adult with Parkinson's disease is administered carbidopa-levodopa to slow the progression of the disease. This is an example of secondary prevention.

Which antipyretic medication may cause Reye syndrome in children? 1. Aspirin (Anacin) 2. Naproxen (Aleve) 3. Ibuprofen (Advil) 4. Dantrolene (Dantrium)

1. Aspirin Aspirin (Anacin) increases the risk of swelling in the brain and liver, which are the main symptoms of Reye syndrome in children. Therefore aspirin is not recommended in children. Drugs such as naproxen (Aleve) and ibuprofen (Advil) do not induce swelling in the brain and liver; therefore, these drugs may not cause Reye syndrome. Dantrolene (Dantrium) does not induce swelling in the brain and liver; instead, it decreases calcium levels during malignant hyperthermia conditions.

A victim of an automobile crash is brought to the hospital. The nurse notes that the client is in need of cardiopulmonary resuscitation (CPR). What factors should the nurse remember before performing CPR? Select all that apply. 1. Cardiopulmonary resuscitation is an emergency treatment that is provided without a client's consent. 2. Cardiopulmonary resuscitation is not performed on adult clients who have already consented to a do not resuscitate order either verbally or in writing. 3. Cardiopulmonary resuscitation is not to be performed by a primary healthcare provider in violation of a do not resuscitate order under any circumstances. 4. Cardiopulmonary resuscitation is performed on appropriate clients unless a do not resuscitate order has been signed and made part of the client's record. 5. Cardiopulmonary resuscitation is generally performed on any client who requires resuscitation in an emergency, but the client's consent is required.

1. Cardiopulmonary resuscitation is an emergency treatment that is provided without a client's consent. 2. Cardiopulmonary resuscitation is not performed on adult clients who have already consented to a do not resuscitate order either verbally or in writing. 4. Cardiopulmonary resuscitation is performed on appropriate clients unless a do not resuscitate order has been signed and made part of the client's record. Cardiopulmonary resuscitation (CPR) is an emergency treatment provided to clients without a formal consent. CPR should not be performed on an adult client who has already consented to a do not resuscitate order, either verbally or in writing. CPR is performed on appropriate clients unless a do not resuscitate order has been placed in the client's list. The primary healthcare provider is required to review clients' DNR orders in case there is a need for change because of the client's condition.

What does the nurse understand the term in-service education to mean? 1. It helps achieve an organization's required competencies. 2. It helps the nurse gain knowledge about traditional health care practices. 3. It is a one-way education program to promote and maintain current nursing skills. 4. It is focused on techniques and technologies that have been used successfully in the past.

1. It helps achieve an organization's required competencies. In-service education helps achieve an organization's required competencies. Continuing education and in-service education help the nurse gain knowledge about the latest research and practice developments. Continuing education is a one-way education program to promote and maintain current nursing skills. In-service education is focused on new technologies.

Which nurse participates in the development of nursing policies and procedures? 1. Nurse educator 2. Clinical nurse specialist 3. Certified nurse-midwife 4. Certified registered nurse anesthetist

1. Nurse educator Nurse educators participate in the development of nursing policies and procedures. The clinical nurse specialist (CNS) is an advanced practice registered nurse (APRN) who is an expert clinician in a specialized area of practice. The CNS is not known for participating in the development of nursing policies and procedures. The certified nurse-midwife (CNM) is an APRN who is also educated in midwifery and certified by the American College of Nurse-Midwives. The CNM is not known for participating in the development of nursing policies and procedures. The certified registered nurse anesthetist (CRNA) is an APRN with advanced education in a nurse anesthesia accredited program. The CRNA is not known for participating in the development of nursing policies and procedures.

A nursing student is examining the health services pyramid. Keeping in mind that care services begin at the bottom of this pyramid, in which order should care services be arranged? 1. Primary health care 2. Secondary health care 3. Clinical preventive services 4. Tertiary health care 5. Population-based health care services

1. Population-based health care services 2. Clinical preventive services 3. Primary health care 4. Secondary health care 5. Tertiary health care According to the health services pyramid, population-based health care services come first. Clinical preventive services form the next level of the pyramid. A nurse should then address the primary health care needs of clients; these needs include prenatal and baby care and nutrition counseling. The next level of health care is secondary health care services, which include emergency care and acute medical-surgical care. Tertiary health care forms the highest level of health care; these needs include intensive care and subacute care.

According to the most recent Diagnostic and Statistical Manual of Mental Disorders, which statement is correct? 1. Prevalence of gender dysphoria ranges from five to 14 in 1,000 natal males. 2. Prevalence of gender dysphoria ranges from three to five in 1,000 natal females. 3. Prevalence of transgender people is between one in 11,900 and one in 200,000 people. 4. Prevalence of invasive cancer of the cervix is the third most common cancer of the female genital system found in transwomen.

1. Prevalence of gender dysphoria ranges from five to 14 in 1,000 natal males. According to the Diagnostic and Statistical Manual of Mental Disorders ( DSM) prevalence of gender dysphoria ranges from five to 14 in 1,000 natal males. Prevalence of gender dysphoria in 1,000 natal females ranges from two to three as per the DSM. Prevalence of transgender people is between one in 11,900 and one in 200,000 people, but this data is not present in the DSM. According to the Centers for Disease Control and Prevention, not DSM, invasive cancer of the cervix is the third most common cancer of the female genital system after ovarian and uterine cancers. It is not specific to one transwomen population.

A nursing student is listing the different levels of the health care services pyramid. Under which type of health care services should the nursing student include subacute care? 1. Tertiary care 2. Continuing care 3. Restorative care 4. Secondary acute care

1. Tertiary care The nursing student should include subacute care under tertiary care. Subacute care is not a part of continuing care, restorative care, or secondary acute care health care services.

The nurse manager working at a rehabilitation center for older adults notices an increase in the incidence of client falls. The nurse manager reprimands the nurses and staff responsible for the falls and places them on probation. Which statement best describes the nurse manger's leadership style? 1. The nurse manager exhibits autocratic leadership. 2. The nurse manager demonstrates shared leadership. 3. The nurse manger exhibits good clinical leadership skills. 4. The nurse manger demonstrates effective interprofessional leadership.

1. The nurse manager exhibits autocratic leadership. The nurse manager in this scenario exhibits autocratic leadership. In an autocratic leadership style, all decisions are solely made by the leader. Autocratic leaders are more concerned about the task and may use the threat of punishment to accomplish it. The nurse manager is not involved in direct client care and so is not demonstrating clinical leadership. The nurse manger is not involving the staff in the decision-making process and thus is not demonstrating shared leadership. The nurse manger is not involving members of the health care team across disciplines in the decision-making process and thus is not exhibiting interprofessional leadership.

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? 1. The nurse may be charged with libel. 2. The nurse may be charged with slander. 3. The nurse may be charged with malpractice. 4. The nurse may be charged with invasion of privacy.

1. The nurse may be charged with libel. Written defamation of character is known as libel. The nurse may be charged with libel because he or she makes false entries in the client's medical records. Speaking falsely about another individual amounts to slander. Malpractice occurs if nursing care falls below the professional standards of care. If the nurse divulges a client's medical information to unauthorized personnel, this action is an invasion of privacy.

A 3-year-old child with eczema of the face and arms has disregarded the nurse's warnings to "stop scratching, or else!" The nurse finds the toddler scratching so intensely that the arms are bleeding. The nurse then ties the toddler's arms to the crib sides, saying, "I'm going to teach you one way or another." How should the nurse's behavior be interpreted? 1. These actions can be construed as assault and battery. 2. The problem was resolved with forethought and accountability. 3. Skin must be protected, and the actions taken were by a reasonably prudent nurse. 4. The nurse had tried to reason with the toddler and expected understanding and cooperation.

1. These actions can be construed as assault and battery. Assault is a threat or an attempt to do violence to another, and battery means touching an individual in an offensive manner or actually injuring another person. The nurse's behavior demonstrates anger and does not take into account the growth and developmental needs of children in this age group. Although the behavior (scratching) needs to be decreased, this can be done with mittens, not immobilization. A 3-year-old child does not have the capacity to understand cause (scratching) and effect (bleeding).

Which organization's 2010 publication did not include a call to improve health care for lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) clients? 1. U.S. Department of Health and Human Services 2. Institute of Medicine (IOM) 3. The Joint Commission 4. World Professional Association for Transgender Health

1. U.S. Department of Health and Human Services The U.S. Department of Health and Human Services published Healthy People 2010, which did not include any information related to the need to improve the health care for LGBTQ people. The Institute of Medicine's (IOM) report on LGBT health, The Joint Commission field guide for care of LGBT clients, and the World Professional Association for Transgender Health standards of care all included an emphasis on the need to improve health care for LGBTQ clients.

According to Quality and Safety Education (QSEN), what is patient-centered care? 1. Understanding that the client is the source of control when providing care 2. Functioning effectively within nursing and interprofessional teams to deliver quality care 3. Using data to evaluate outcomes of care processes and designing methods to improve health care 4. Minimizing the risk of harm to clients and health care workers through improved professional performance

1. Understanding that the client is the source of control when providing care The Quality and Safety Education (QSEN) competency called patient-centered care requires the nurse to understand that the client is the source of control. The nurse should therefore respect the values, beliefs, and preferences of the client to provide quality care. The QSEN competency called teamwork and collaboration states that a nurse should function effectively within nursing and interprofessional teams in order to provide quality care. Quality improvement involves using data to evaluate the outcomes of care processes and design methods to improve the health care delivery system. Safety focuses on minimizing the risk of harm to clients and health care workers through improved professional performance.

Which role does a nurse play when helping clients to identify and clarify health problems and to choose appropriate courses of action to solve those problems? 1. Educator 2. Counselor 3. Change agent 4. Case manager

2. Counselor As a counselor, the nurse helps clients identify and clarify health problems and choose appropriate courses of action to solve those problems. As an educator, the nurse teaches clients and their families to assume responsibility for their own health care. A nurse acts as a change agent within a family system or as a mediator for problems within a client's community; this involves identifying and implementing new and more effective approaches to problems. As a case manager, the nurse establishes an appropriate plan of care on the basis of assessment findings and coordinates needed resources and services for the client's well-being along a continuum of care.

An unemancipated pediatric client is to undergo a routine medical procedure. Who is the appropriate authority to provide consent? 1. The court 2. Either of the child's parents 3. One of the child's grandparents 4. The pediatric client

2. Either of the child's parents For unemancipated pediatric clients, the parents are required to provide consent. Either parent may do so. The court intervenes in situations where the parents refuse to allow a child to undergo treatment. A grandparent may provide consent only if the situation is an emergency and the parents are not present. The client is underage and unemancipated; therefore if at all possible, consent must be obtained from one of the child's parents in a non life-threatening situation.

What important points should the nurse keep in mind when caring for an older adult to promote health? Select all that apply. 1. Focus on achieving the highest level of health and absence of disease 2. Encourage regular physical activity and the use of stress-management strategies 3. Encourage the client to accept help for carrying out activities of daily living (ADLs) 4. Consider the client's social environment and strengthen social support to promote health 5. Assess the client for fear of falling and provide support by making environmental changes

2. Encourage regular physical activity and the use of stress-management strategies 4. Consider the client's social environment and strengthen social support to promote health 5. Assess the client for fear of falling and provide support by making environmental changes The nurse should encourage the client to include physical activity regularly and to use stress-management strategies to promote a healthy lifestyle. The nurse should consider the client's social environment and strengthen social support to promote health. Because a fear of falling is a significant risk related to older adults, the nurse should assess the client for fear and provide support by making environmental changes. The nurse should not focus on the absence of a disease, but on achieving the highest level of health in the presence of disease. The nurse should encourage older adults to perform activities of daily living on their own to promote health.

What is the professional nurse's legal responsibility regarding child abuse? 1. Honor the request of the parents not to report the suspected abuse. 2. Report any suspected abuse to local law enforcement authorities. 3. Return the child to the legal parent even if he or she is suspected of abuse. 4. Provide the parents with a copy of the child's medical record.

2. Report any suspected abuse to local law enforcement authorities. Nurses and primary healthcare providers are legally responsible for reporting suspected or actual abuse. Child protective services may obtain a court order to grant temporary guardianship if it is found that the child is in immediate danger. The other answer options do not fulfil the nurse's duty to report suspected child abuse.

A client with a right-sided brain tumor had a surgery performed on the left side of the brain. The client is presently in a coma. Which actions should the hospital take according to the Leapfrog Group's policy? Select all that apply. 1. Refer the client to another hospital. 2. Report the event to The Joint Commission. 3. Perform a failure mode effective analysis (FMEA). 4. Apologize to the family and caregivers of the client. 5. Agree to pay all costs related to the condition of the client.

2. Report the event to The Joint Commission. 4. Apologize to the family and caregivers of the client. 5. Agree to pay all costs related to the condition of the client. The client had undergone a surgery at the wrong site. This falls under the "never events" category. According to the Leapfrog Group's never event policy, the health care organization should report the event to The Joint Commission, state-reporting program for medical errors, or a client safety organization. The organization should apologize for its mistake to the caregiver of the family and waive the entire amount required for the compensation of this never event. The hospital does not need to refer the client to another hospital for the treatment. The facility should perform a root cause analysis for analyzing the cause of this never event.

A nursing student is evaluating statements regarding the five levels of proficiency set forth by Benner. Which statement indicates that a nurse is in the advanced beginner stage? 1. The nurse is learning about the profession through a specific set of rules and procedures. 2. The nurse is able to identify the basic principles of nursing care through careful observation. 3. The nurse is able to understand the organization and specific care required by certain clients. 4. The nurse is able to assess the entire situation and transfer knowledge gained from multiple previous experiences.

2. The nurse is able to identify the basic principles of nursing care through careful observation. According to the levels of proficiency set forth by Benner, a nurse in the advanced beginner stage is able to identify basic principles of nursing care through careful observation. A nurse in the novice stage learns about the profession through a specific set of rules and procedures. After reaching the competent stage, a nurse will be able to understand the organization and specific care required by certain clients. A nurse who has reached the proficient stage is able to assess an entire situation and transfer knowledge gained from multiple previous experiences.

The nurse working in a cardiac center is preparing to enter client data using health information technology. The nurse needs to refer to this data during subsequent follow-up client visits. Which type of record should the nurse use to enter client's data? 1. Personal health record (PHR) 2. Electronic health record (EHR) 3. Electronic medical record (EMR) 4. Regional Health Information Organization health record (RHIO)

3. Electronic medical record (EMR) The EMR is a client's health record within a healthcare provider's facility. These records are not intended to be shared between multiple facilities and agencies. The PHR is self-recorded and maintained by the client. An EHR is an individual's official, digital health record; it is shared among multiple facilities and agencies. RHIO health records are client records that can be exchanged among providers and across geographic areas.

A nurse is educating the caregivers of an elderly adult with advanced Parkinson's disease about continuing care. What information should the nurse provide? Select all that apply. 1. "Home care is a type of continuing care in which the primary objectives are health promotion and education." 2. "Continuing care is necessary for clients who are recovering from an acute or chronic illness or disability." 3. "Adult day care centers are ideal for clients whose caregivers have to be away from home during the day." 4. "Hospice care is a continuing care system that allows clients to live at home with comfort, independence, and dignity." 5. "Nursing centers provide 24-hour custodial care in order to help residents achieve and maintain their highest level of functioning."

3. "Adult day care centers are ideal for clients whose caregivers have to be away from home during the day." 4. "Hospice care is a continuing care system that allows clients to live at home with comfort, independence, and dignity." 5. "Nursing centers provide 24-hour custodial care in order to help residents achieve and maintain their highest level of functioning." Adult day care centers are ideal for providing continuing care to clients whose caregivers have to be away from home during the day. Hospice care is a type of continuing care that provides palliative care to clients within the comfort, dignity, and independence of their homes. Clients also go to nursing centers to receive continuing care. Nursing centers provide 24-hour custodial care. They help clients achieve and maintain their highest level of functioning. The primary objectives of providing restorative home care are health promotion and education. Clients recovering from chronic or acute illnesses or disabilities require restorative care. Continuing care is necessary for clients who are suffering from a terminal disease, who are disabled, or who were never functionally independent.

A nurse is hired to work in a healthcare facility that has a completely computer-based client information system. The nurse in charge knows that the newly hired nurse is knowledgeable about this system when the nurse says what? 1." More medication errors are made when this system is used." 2. "It is disappointing that nurses are not allowed to use this system." 3. "Client information is immediately available when this system is used." 4. "I will have less time to provide direct care to my clients with this system."

3. "Client information is immediately available when this system is used." The intent of these systems is to streamline documentation and recordkeeping for all appropriate health team members, including nurses. There is a reduction in medication errors with this type of system. Data are immediately available to appropriate health team members without the need to depend on record or chart availability. By streamlining documentation and recordkeeping, these systems increase opportunities for more direct client care by nurses.

What information should the nurse provide when explaining the benefits of illness prevention activities to a client? 1. "These activities aim to teach people how to care for their own health." 2. "These activities enable people to maintain or enhance their health levels." 3. "These activities help protect clients from actual or potential health threats." 4. "These activities encourage people to reach an optimal state of physical, mental, and social well-being."

3. "These activities help protect clients from actual or potential health threats." Illness prevention activities help protect clients from actual or potential health risks and threats. Nurses impart wellness education to people to teach them to care for themselves in a healthy way. Health promotion activities enable clients to maintain or enhance their health levels. These activities also help people to reach an optimal state of physical, mental, and social well-being. Routine exercise and good nutrition are examples of health promotion activities.

A nursing student is listing the characteristics of an ethical issue. Which point listed by the nursing student requires correction? 1. An ethical issue occurs if it is perplexing and if it is not easy to think logically or make a decision. 2. An ethical issue occurs if it is not possible to resolve solely through a review of scientific data. 3. An ethical issue occurs if the problem aims at the greatest good for the greatest number of people. 4. An ethical issue occurs if the answer to the problem has a profound relevance for areas of human concern.

3. An ethical issue occurs if the problem aims at the greatest good for the greatest number of people. The utilitarianism system of ethics decides on the right action based on the greatest good for the greatest number of people. This is not a characteristic feature of an ethical dilemma. A situation can be called an ethical dilemma if it fulfills one of three conditions. An ethical issue is challenging and generally cannot be solved through logical decision-making. An ethical issue cannot be solved solely through a review of scientific data. If the answer to a specific problem has a profound relevance for areas of human concern, then it is an ethical issue.

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. Which standard of practice does the nurse perform? 1. Planning 2. Diagnosis 3. Assessment 4. Implementation

3. Assessment When a nurse collects comprehensive data relevant to the client's health or the situation, it is considered assessment. In the given scenario, the nurse is assessing the client to minimize pain. Planning refers to instances when a nurse develops a plan to attain expected outcomes. Diagnosis refers to instances when the nurse analyzes the assessment data to determine the diagnoses or issues. Implementation refers to instances when the nurse implements the identified plan.

A visitor from a room adjacent to a client asks the nurse what disease the client has. The nurse responds, "I will not discuss any client's illness with you. Are you concerned about it?" This response is based on the nurse's knowledge that to discuss a client's condition with someone not directly involved with that client is an example of what? 1. Libel 2. Negligence 3. Breach of confidentiality 4. Defamation of character

3. Breach of confidentiality The release of information to an unauthorized person or gossiping about a client's activities constitutes a breach of confidentiality and an invasion of privacy. Libel occurs when a person writes false statements about another that may injure the individual's reputation. Negligence is a careless act of omission or commission that results in injury to another. Defamation of character is the publication of false statements that injure a person's reputation.

Which ethical principles govern a nurse's behavior when making difficult decisions about a client's care at the point of care? 1. Bioethics 2. Metaethics 3. Clinical ethics 4. Research ethics

3. Clinical ethics Clinical ethics help in decision-making in issues that involve bedside client care and other client-related issues. The principles of bioethics govern ethical issues in biological sciences and technology. Metaethics is a branch of philosophy that deals with fundamental questions about concepts. Research ethics are applicable toward research subjects, whether human or animal.

The nurse is preparing to insert an intravenous catheter in a thin, emaciated client who is scheduled to begin intravenous fluid therapy. Which interventions should the nurse follow to provide high-quality care? Select all that apply. 1. Insert an 18 gauge IV catheter 2. Change the intravenous line every 7 days 3. Flush the intravenous line with normal saline 4. Insert the intravenous catheter in the client's femur 5. Stop the insertion procedure when there is a break in technique

3. Flush the intravenous line with normal saline 5. Stop the insertion procedure when there is a break in technique The nurse should flush the IV line with normal saline to maintain patency. The nurse should stop the insertion procedure when there is a break in technique. This intervention helps prevent catheter-related bloodstream infections and provides high-quality care to the client. An 18-gauge needle is not an appropriate size needle to insert in a thin, emaciated client; it would cause unnecessary trauma and a high risk of phlebitis. The nurse should change the intravenous line every 72 to 96 hours to prevent the risk of infection. The nurse should avoid inserting the catheter in the client's femur because it increases the risk of bloodborne infections.

The family of a client infected with human immunodeficiency virus (HIV) wants to see the results of the client's blood tests, unaware that the client is infected. A nurse obliges the family's request without waiting for the client's consent. What legal charge may be brought against the nurse? 1. Slander 2. Negligence 3. Invasion of privacy 4. Defamation of character

3. Invasion of privacy Invasion of privacy is unwanted intrusion into the private affairs of a client. In this situation, the nurse has divulged the client's confidential medical information to family members without consent. Slander is when one person speaks falsely about another. In this situation, the nurse has not given false information about the client. Negligence is conduct that falls below the established standard of care. The nurse in this situation has not engaged in any negligent acts. Defamation of character is the publication of false statements that could damage a person's reputation. The nurse has not damaged the reputation of the client with false statements.

How does the International Classification of Nursing Practice (ICNP) help nurses deliver effective care to clients? 1. It gives information about medications and their side effects. 2. It provides information about various cultural practices and beliefs. 3. It provides vocabulary to include nursing data in computerized information systems. 4. It helps the nurse to conduct biosurveillance and gives information on various diseases.

3. It provides vocabulary to include nursing data in computerized information systems. The American Nurses Association recognizes the International Classification of Nursing Practice (ICNP) as standardized terminology for nursing. It provides vocabulary to include nursing data in computerized information systems, such as the electronic health record. ICNP is not a drug guide, so it does not provide information about medications and their side effects. ICNP does not give information on cultural practices and beliefs. Unlike public health informatics, ICNP does not help to develop new tools and methodologies for conducting biosurveillance.

A client is placed on a stretcher and restrained with straps while being transported to the x-ray department. A strap breaks, and the client falls to the floor, sustaining a fractured arm. Later the client shows the strap to the nurse manager, stating, "See, the strap is worn just at the spot where it snapped." What is the nurse's accountability regarding this incident? 1. Exempt from any lawsuit because of the doctrine of respondeat superior 2. Totally responsible for the obvious negligence because of failure to report defective equipment 3. Liable, along with the employer, for misapplication of equipment or use of defective equipment that harms the client 4. Exonerated, because only the hospital, as principal employer, is responsible for the quality and maintenance of equipment

3. Liable, along with the employer, for misapplication of equipment or use of defective equipment that harms the client Using a stretcher with worn straps is negligent; this oversight does not reflect the actions of a reasonably prudent nurse. The nurse is responsible and must ascertain the adequate functioning of equipment. The hospital shares responsibility for safe, functioning equipment.

A client dies in the hospital 2 hours after being admitted. Who has the authority to decide if a post-mortem should be conducted? 1. Surviving spouse 2. Nursing manager 3. Medical examiner 4. Primary healthcare provider

3. Medical examiner If a client dies within 24 hours of being admitted to the hospital, the medical examiner has the right to decide whether a post-mortem should be conducted. If the client's death does not need to be reviewed by the medical examiner and the client has not requested an autopsy in writing, the surviving spouse may request a post-mortem. The nursing manager and the primary healthcare provider are not authorized to make decisions regarding a post-mortem.

Which nursing action is not likely to cause legal issues? 1. Using restraints on a non-cooperative client 2. Refraining from reporting suspected child abuse 3. Refraining from leaving the client during a staffing shortage 4. Allowing nursing assistive personnel (NAP) to administer medications

3. Refraining from leaving the client during a staffing shortage The nurse should not abandon clients if there is a staffing shortage. This action helps to avoid legal complications. Using restraints without the order of the primary healthcare provider may lead to battery and false imprisonment charges. The nurse should always report cases of suspected child abuse. A nurse should never allow nursing assistive personnel (NAP) to administer medications because this action may lead to malpractice charges.

When should a medical examiner decide whether a postmortem examination should be conducted? 1. When a client dies under normal circumstances 2. When a client dies after 48 hours of admission to the hospital 3. When a client dies within 24 hours of admission to the hospital 4. When the client gives a written consent to perform autopsy before death

3. When a client dies within 24 hours of admission to the hospital If a client dies within 24 hours of admission to the hospital, the medical examiner is required to decide whether a postmortem examination should be conducted. If a client dies under suspicious circumstances, the medical examiner decides whether a postmortem examination is necessary. The medical examiner does not make the decision regarding postmortem examination if the client dies after 48 hours of being admitted to the hospital. A client may give a written consent before death to perform an autopsy. Such instances are not subject to the review of the medical examiner.

A nursing student is listing examples of active and passive health promotion strategies. Which strategy is an example of a passive health promotion strategy? 1. Weight-reduction program 2. Smoking-cessation program 3. Drug abuse prevention strategy 4. Fluoridation of municipal drinking water

4. Fluoridation of municipal drinking water Passive strategies of health promotion help people benefit from the activities of others without direct involvement. The fluoridation of municipal drinking water is an example of a passive health promotion strategy. Active strategies of health promotion require clients to adopt specific programs for improving health. Weight-reduction programs, smoking-cessation programs, and drug abuse prevention strategies are examples of active health promotion activities.

A student nurse is listing the different aspects of the healthcare services pyramid. Under which type of healthcare services should the student nurse include sports medicine? 1. Primary care 2. Tertiary care 3. Preventive care 4. Restorative care

4. Restorative care The student nurse should include sports medicine under restorative care. It is not categorized as primary, tertiary, or preventive healthcare services.

The student nurse is reviewing the electronic health record for clients in a health care facility. Which action by the student nurse may inhibit clients from disclosing personal information? 1. Use of clients' data for nursing research 2. Use of client data for Medicaid payment 3. Discussing a client's illness with the client 4. Sharing clients' data with family members

4. Sharing clients' data with family members Clients may not want their health information shared with others and may want to maintain their privacy. If the nurse retrieves client data from the electronic health records and shares it with family members, it may lead to clients not sharing information. The nurse can use client data for research without mentioning a client's personal details. The nurse can use client data for filing insurance to receive Medicaid payments. The nurse can discuss the client's illness with the client; doing so helps to understand the client's perspective and to provide effective care.

The nurse is assessing a client 24 hours after the client underwent permanent tracheotomy. The nurse concludes that the client has complications as a result of a medical error. Which finding led the nurse to this conclusion? 1. The client is unable to talk. 2. The client is unable to swallow fluids. 3. The client has a hole in front of the neck. 4. The client has a hole in the thyroid gland.

4. The client has a hole in the thyroid gland. The adverse effects or complications caused by variation from the standard care or procedure are known as medical errors. Tracheotomy is a surgical procedure in which the surgeon makes an opening through the neck into the trachea. During this procedure, if the surgeon is not careful, the organs located near the trachea such as the thyroid glands may be ruptured and may lead to complications. Therefore the presence of hole in the thyroid gland indicates medical error. Due to the insertion of tracheotomy tube, clients may feel uncomfortable for a few days. They may have difficulty in talking and swallowing fluids until they adapt to breathing through the tube. A hole is made in front of the neck for the insertion of the tube. Thus these findings are not indicative of medical errors.

A nursing student is recalling the order of priority for giving consent to perform an autopsy in cases where a medical examiner review is not needed. Which person receives the highest priority for giving consent? 1. Surviving child 2. Surviving parent 3. Surviving spouse 4. The client in writing before death

4. The client in writing before death If a medical examiner's review is not necessary, the highest priority is given to the client. The client may provide the consent in writing before death. If the client or the surviving spouse is unable to give consent for the autopsy, a surviving child may be requested to give consent. The surviving parent may give consent for an autopsy if the client, the surviving spouse, and the surviving child are unable to do so. In case the client has not provided written consent before death, the nurse may obtain consent from the surviving spouse.

According to Avedis Donabedian, which is the most important validator of quality and effectiveness of health care in a hospital? 1. The number of clients admitted in a hospital 2. The values and goals presented by the hospital 3. The number of health care workers in the hospital 4. The client outcomes achieved by the care provided

4. The client outcomes achieved by the care provided Avedis Donabedian was a physician and founder of the Donabedian model of care. According to him, the client outcomes obtained by health care delivery determines the quality and effectiveness of the health care. The number of clients admitted to a hospital does not indicate the quality of the health care delivered in the hospital. The values and goals presented by the hospital define the quality of the medical system. Similarly, the number of health care workers in the hospital does not determine the quality or effectiveness of the health care system.

The waiting area of a health care facility displays a pink triangle. What does this signify? 1. The waiting area is for females. 2. The waiting area is for pediatric clients. 3. The health care facility welcomes transwomen. 4. The health care facility welcomes lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) clients.

4. The health care facility welcomes lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) clients. A waiting room in a health care facility marked with a pink triangle indicates that the health care facility is in a safe place for LGBTQ clients, and they can expect respectful and knowledgeable quality care. Other symbols might be used to represent areas that are meant for female and pediatric clients. There are no widely used symbols to designate transwomen-specific health care facilities.

What legal complications might a nurse face for using a restraint without a legal warrant on a client? 1. The nurse may be charged with libel. 2. The nurse may be charged with negligence. 3. The nurse may be charged with malpractice. 4. The nurse may be charged with false imprisonment.

4. The nurse may be charged with false imprisonment. If a nurse uses restraints without a legal warrant on a client, he/she may be charged with false imprisonment. Libel is the written defamation of character. Negligence is any conduct that falls below the standard of care. Malpractice is a type of negligence that is regarded as professional negligence.

What does a nurse understand by the quality improvement competency, according to Quality and Safety Education (QSEN)? 1. Using information and technology to communicate, manage knowledge, mitigate errors, and support decision-making 2. Integrating best current evidence with clinical expertise along with client and family preferences and values for the delivery of quality healthcare 3. Functioning effectively within nursing and interprofessional teams by fostering open communication, mutual respect, and shared decision making to achieve quality client care 4. Using data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems

4. Using data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems The quality improvement competency states that a nurse should use data to monitor the outcomes of healthcare processes and use improvement methods to design and test changes to continuously improve the quality and safety of healthcare systems. According to the competency called informatics, a nurse should use information and technology to communicate, manage knowledge, mitigate errors, and support decision-making. As per the competency called evidence-based practice, a nurse should integrate best current evidence with clinical expertise and client and family preferences and values for the delivery of quality healthcare. According to the competency called teamwork and collaboration, a nurse should function effectively within nursing and interprofessional teams by fostering open communication, mutual respect, and shared decision making to achieve quality client care.