Med Surg Test questions
The student nurse asks the nursing instructor what advocacy means in terms of patient care. What is the instructor's best response?
"Advocacy means the nurse acknowledges and protects the rights of patients." Rationale The nurse educator best describes advocacy as acknowledging and protecting patient rights. Keeping patients happy is a superficial task that does not ensure patient rights are protected. Assuring all patient information is kept confidential is part of the Health Insurance Portability and Protection Act (HIPAA). Assuring HIPAA is followed may be considered part of patient advocacy, but it is not the best definition. Competency means the nurse has the knowledge to carry out tasks safely. p. 2
What is the primary goal of the Patient Protection and Affordable Care Act (ACA)?
Increase access to healthcare Rationale The ACA's primary goal is to increase access to healthcare. Medicare covers some of the financial aspects of healthcare to specific individuals. The ACA encouraged the creation of ACOs, but this was not the primary goal. HMOs are part of a managed healthcare system that offers cost-effective healthcare delivery. p. 4
Which term is used to describe a biopsychosocial spiritual being in constant interaction with a changing environment?
Individual Rationale The individual is considered a biopsychosocial spiritual being in constant interaction with a changing environment composed of dimensions that are interrelated and not separate entities. Family are those related or close to the individual. Community is the surrounding area in which the individual lives or spends time. The health care team is made up of people caring for the individual. p. 3
What minimum qualification is needed by an aspiring nurse to become an advanced practice nurse (APN)?
Master's degree in nursing Rationale An advanced practice nurse (APN) is a nurse with at least a master's degree in nursing. This is the minimum qualification for an APN. A nurse with a PhD can work as faculty in nursing institutes and/or work as an APN. A high school diploma does not fulfill the eligibility criteria for an APN. A medical degree is required for the health care practitioner, but not for the nurse. p. 3
A patient with a diagnosis of aggression secondary to psychosis has been admitted to the critical care unit. The nurse consults with the mental health team to provide a set of planned interventions to meet certain goals regarding the aggression. This is an example of what type of care plan?
Patient care protocols Rationale Patient care protocols are developed to provide a consistent application of nursing to ensure outcomes are met. Nursing diagnosis, evaluation, and SMART goals should be developed for each patient to individualize patient care. p. 10
Which part of the PICOT format that is used in step 1 of the evidence-based practice (EBP) process covers teaching a postoperative patient who has had abdominal surgery to splint with a binder?
"I" Rationale Teaching a postoperative patient who has had abdominal surgery to splint with a binder falls under "I" in the PICOT formula that is used in step 1 of the EBP process. The "I" represent intervention. "P" represents patient/population, "O" represents outcome, and "T" represents time period. p. 15
At the end of a very long day involving the death of a patient, the nurse uses her social media account to share her experience and find some support. According to the Health Insurance Portability and Accountability Act (HIPAA), which posting would be acceptable?
"It was a very difficult day for me due to the death of one of my favorite patients." Rationale The Health Insurance Portability and Accountability Act (HIPAA) prohibits the sharing of any health information which could potentially identify a patient. Stating that the nurse had a difficult day due to the death of a favorite patient does not contain any personally identifying information and generally would not be considered a violation. Sharing any information pertaining to location (Affinity Hospital), age (27), or diagnosis (cancer) could aid in identification of the individual and is thus prohibited by HIPAA standards. p. 14
The nurse is giving a report using situation-background-assessment-recommendation (SBAR). Which statement is an appropriate example of "B - Background"?
"The patient's current medications are..." Rationale "The patient's current medications are..." refers to pertinent background or circumstances leading up to the situation. "The patient needs to be seen now" is a recommendation or request. "I am concerned about..." is the situation to be discussed. "The patient's condition is worsening..." is an assessment. p. 11
After performing assessments on patients, a nurse refers them for appropriate care. Which patient would require long-term care?
A ventilator-dependent patient Rationale Long-term care is appropriate for patients that require care for more than 30 days. It is required for individuals who are severely developmentally disabled, are mentally impaired, or have physical deficits requiring continuous medical or nursing management. A patient who is ventilator-dependent requires long-term care. Flu, fever, and diarrhea do not require long-term care because the patients' recovery period is less than 30 days. In these conditions the patient is not severely disabled and does not require long-term care. p. 9
What does the National Quality Forum's (NQF) list of safe practices address?
Adverse events that are preventable Rationale The NQF provides a list of safe practices in order to address adverse events that are preventable. These events are termed serious reportable events (SREs) or "never" events. The Joint Commission issues the NPSGs. The state boards of nursing and agency policies regulate safe delegation by a registered nurse. Patient satisfaction is a quality outcome initiative. p. 12
"Protecting and maintaining patient privacy and confidentiality are basic obligations." Which of the following organizations has defined this code of ethics for nurses?
American Nurses Association (ANA) Rationale The ANA has defined the code of ethics for nurses that states that protecting and maintaining confidentiality is a basic obligation. The NDNQI provides data on nursing-sensitive measures to evaluate the impact of nursing care on patient outcomes. The NPSGs address patient safety concerns that have been initiated by The Joint Commission. The SBON protects the public's health and welfare through the licensing and monitoring of registered nurses. p. 14
Which professional organization states that the authority for the practice of nursing is based on a contract with society?
American Nurses Association (ANA) Rationale The ANA states that the authority for the practice of nursing is based on a contract with society. TJC evaluates and accredits healthcare facilities. QSEN addresses the preparation of nurses to work in the healthcare field. The State Board of Nursing protects the public's health and welfare through the licensing and monitoring of registered nurses. p. 2
One model of care is a collaborative process of assessment, planning and facilitating services, and evaluating outcomes. It involves working with multiple disciplines on health care teams to meet the needs of patients and their families. Which model is being described?
Case management Rationale Case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes. Primary care is a holistic approach involving one nurse caring for a patient or family. Team care is the distribution of aspects of patient care among a team of health care professionals, often composed of a registered nurse, licensed practical nurse, and unlicensed assistive personnel. The interprofessional team is composed of providers from various health care disciplines, working together and sharing ideas to meet the needs of individual patients. pp. 9-10
A nurse can specialize in nursing education. What is the name of the formal process to obtain recognition for expertise in this specialty area?
Certification Rationale Certification is the process used in nursing to recognize expertise in a specialty area. Accreditation is a process used to ensure that educational programs (such as for nursing) meet minimum guidelines and criteria. Licensure is monitored by state and national entities to ensure minimum competency for individuals in a profession. Authorization is approval, such as authorization to test. p. 3
When planning care for a patient, the nurse may use a visual diagram of patient problems and interventions to illustrate the relationships among pertinent clinical data. What is this format called?
Concept map Rationale A concept map is another method of recording a nursing care plan. In a concept map, the nursing process is recorded in a visual diagram of client problems and interventions. A clinical (critical) pathway is a prewritten plan that directs the entire health care team in the daily care goals for select health care problems. A nursing care plan is a documented plan of care for a patient.Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses. p. 8
A nurse is dispensing medications to patients. What precaution should the nurse take to ensure the safe use of medications?
Discard all unlabeled medicines. Rationale The nurse should discard all unlabeled medicines to ensure the safety of medications. Unlabeled medicines are difficult to identify. The nurse should avoid placing medicines that are scheduled for a later time at the bedside; the patient may accidentally consume them and this may result in an overdose. Relabeling medicines that are already labeled should be avoided because it can lead to inaccurate administration. Soap, water, and hand sanitizer should be used before and after contact with the patient to reduce the risk of infections. p. 13
A patient has visited a hospital twice. A computerized record of the patient's protected health information is generated for both visits. What is this record called?
Electronic health record (EHR) Rationale The electronic health record (EHR) is a computerized record of protected health information (PHI). It is generated when the patient visits any care delivery setting. A discharge summary is the document made when a patient is about to be discharged. It contains the information about medications and interventions that a patient needs to follow after discharge. A personal health record is maintained by an individual to track and maintain personal health. Evidence-based practice is a problem solving approach that helps with clinical decision making. p. 14
A nurse understands that a patient's medical information should be kept confidential. Which regulation protects the privacy of the patient and promotes confidentiality?
Health Insurance Portability and Accountability Act (HIPAA) Rationale The Health Insurance Portability and Accountability Act (HIPAA) protects the personal information of the patient. QSEN stands for Quality and Safety Education for Nurses. It has six components aimed at improving the nursing practice through the development of specific competencies. CPOE stands for computerized provider order. It is used to eliminate errors due to misread handwritten orders. NANDA is concerned with nursing diagnoses, definitions, and classification. p. 14
The Quality and Safety Education for Nurses (QSEN) was project established to address the educational link between professional nursing practice and what?
Healthcare delivery Rationale The QSEN project was instituted to address the educational link between professional nursing practice and healthcare delivery. QSEN competencies do not measure patient satisfaction, eliminate disparities, or address access to healthcare. p. 5
What is the U.S. government initiative that establishes ten-year goals and objectives for improving the health of the nation by empowering people to adhere to healthy lifestyles?
Healthy People 2020 Rationale Healthy People 2020 is a government initiative establishing 10-year goals and objectives for improving the nation's health by empowering people to adhere to healthy lifestyles. WIC is a federal grant program that provides nutritious foods to low-income breastfeeding mothers, nonbreastfeeding postpartum mothers and infants, and children up to their fifth birthdays. Patient-centered care is a strategy to improve the quality of care and patient care outcomes. QSEN is a project that provides resources that promote safe and effective care for nursing students and nurse educators.Test-Taking Tip: The most reliable way to ensure that you select the correct response to a multiple choice question is to recall it. Depend on your learning and memory to furnish the answer to the question. To do this, read the stem, and then stop! Do not look at the response options yet. Try to recall what you know and, based on this, what you would give as the answer. After you have taken a few seconds to do this, then look at all of the choices and select the one that most nearly matches the answer you recalled. It is important that you consider all the choices and not just choose the first option that seems to fit the answer you recall. Remember the distractors. The second choice may look okay, but the fourth choice may be worded in a way that makes it a slightly better choice. If you do not weigh all the choices, you are not maximizing your chances of correctly answering each question. pp. 4-5
What did the United States government initiate to improve health?
Healthy People Initiative Rationale The U.S. government is active in establishing goals and objectives for improving health through the Healthy People Initiative. PPOs are part of a managed healthcare system that offers cost-effective healthcare delivery. ACOs are groups of physicians, hospitals, and other healthcare providers who unite to provide care for patients who receive Medicare. Medicaid is a healthcare payment system for patients that meet certain criteria. The eligibility for Medicaid varies for each state. p. 4
The Health Insurance Portability and Accountability Act (HIPAA) is part of federal legislation that addresses what?
How protected healthcare information (PHI) is used Rationale HIPAA is part of federal legislation that addresses how protected healthcare information is used. The Joint Commission monitors sentinel events. Medicaid fraud is monitored by several agencies, including the State Medicaid Agencies and the Medicaid Fraud Control Units. CPOE was initiated to assist in preventing errors, increasing patient safety, and streamlining workflow. p. 14
According to the American Nurses Association (ANA), to which of these should nursing diagnosis and treatment be directed?
Human response to actual or potential health problems Rationale The American Nurses Association (ANA) defines nursing as dealing with the human response to health issues, not specifically medical diagnoses, signs and symptoms, or patient complaints and concerns. Although these may be related to or contribute to the human response, by this definition nurses deal with the human response.Test-Taking Tip: Many times the correct answer is the longest alternative given, but do not count on it. NCLEX item writers (those who write the questions) are also aware of this and attempt to avoid offering you such "helpful hints." p. 5
The nurse is writing a plan of care for a patient admitted with chronic obstructive pulmonary disease (COPD). Which planning method is likely to increase patient compliance with the plan of care?
Include the patient in the development of the goals and interventions in the plan of care Rationale The patient is more likely to be compliant with the plan of care when he or she is actively involved in the development of goals and interventions. It is not the responsibility of the health care provider to assign nursing goals and desired outcomes. The nurse is responsible for identifying patient diagnoses, goals of care, evidence-based interventions, and desired patient outcomes founded on the nursing process. As such, asking other health care team members to write at least one intervention is not appropriate. Prewritten plans of care may be used; the nurse should review any plan and individualize it to the patient's unique needs before placing it on the medical record for use by others caring for the patient. However, these do not contribute to increased patient compliance. pp. 6-7
Leaders in nursing often provide information to help patients better understand complex healthcare topics. An elderly patient in the clinic asks the nurse to explain the Affordable Care Act (ACA). The nurse correctly explains what as the main goal of the ACA?
Increase access to health care services for all people Rationale The main goal of the ACA is to increase access to health care services for all people. With that goal in mind, the ACA offers health promotion services for all people at affordable prices, delivers holistic and efficient care to the elderly population, and promotes quality and consistency in the health care setting. ACA is not limited to those 65 years and older; it covers any person in need of health care. p. 4
The nurse is caring for a patient using a clinical pathway of care. What is a benefit of a clinical pathway?
It directs the health care team in daily care goals and improves outcomes. Rationale Directing the health care team in daily care goals and improving outcomes is correct because the clinical pathway describes the patient care required at a specific time and day during the hospital stay. The interventions are initiated by the nurse and health care provider and designed to achieve patient outcomes. Increasing the length of stay is incorrect because clinical pathways are designed to move the patient toward desired outcomes within an estimated length of stay and not designed to increase the length of stay. A plan of care includes more than just therapies. A plan of care used by health care providers to prescribe medications is incorrect because the clinical pathway is an interdisciplinary approach that includes interventions from multiple disciplines caring for the patient.Test-Taking Tip: Many times the correct answer is the longest alternative given, but do not count on it. NCLEX item writers (those who write the questions) are also aware of this and attempt to avoid offering you such "helpful hints." p. 10
What type of prospective payment system do current health care organizations utilize as a means of offering cost-effective health care delivery?
Managed care Rationale Current health care organizations utilize managed care systems as a means of offering cost-effective health care delivery. Medicaid, Medicare, and private health insurance are other designated payers for health care. p. 4
A patient with coronary artery disease is admitted to the hospital. An electronic health record (EHR) is generated for the patient. Which information will be present in the EHR?
Medications Laboratory data Medical and surgical history Rationale The electronic health record (EHR) is a computerized record of protected health information (PHI). It includes information such as patient demographics, progress notes, problems and medications, vital signs, medical history, immunizations, and laboratory and radiology reports. The educational qualifications of the patient are not included in EHR. Similarly, the financial background of the patient is not mentioned in the EHR. p. 14
Which of the following provides nursing interventions that are selected to achieve patient outcomes for which nursing is accountable?
Nursing diagnosis Rationale The nursing diagnosis provides nursing interventions that are selected to achieve patient outcomes for which nursing is accountable. NANDA-I is the organization that develops and maintains the standard classification system for nursing diagnosis. The nursing assessment is part of the nursing process. The NOC is a list of patient outcomes developed to evaluate the effects of interventions provided by nurses. p. 7
What is an individual, family, or community state, behavior, or perception that is measured along a continuum in response to a nursing intervention?
Nursing-sensitive patient outcome Rationale An individual, family, or community state, behavior, or perception that is measured along a continuum in response to a nursing intervention is a nursing-sensitive patient outcome. The nursing process is a problem-solving approach to the identification and treatment of patient problems that is the foundation of nursing. NANDA-NOC-NIC linkage shows how three distinct nursing terminologies can be connected and used together when planning care for patients. NANDA-I develops and maintains the standard classification system for nursing diagnoses.Test-Taking Tip: Start by reading each of the answer options carefully. Usually at least one of them will be clearly wrong. Eliminate this one from consideration. Now you have reduced the number of response choices by one and improved the odds. Continue to analyze the options. If you can eliminate one more choice in a four-option question, you have reduced the odds to 50/50. While you are eliminating the wrong choices, recall often occurs. One of the options may serve as a trigger that causes you to remember what a few seconds ago had seemed completely forgotten. p. 7
A nurse is helping a patient share his or her feelings about a recent diagnosis of mental illness contributing to psychosis. What method best helps the patient explore his or her feelings?
Open-ended questions Rationale Therapeutic communication is a method to help the patient explore their feelings using open-ended questions. Yes-or-no questions do not promote an easy flow of communication. Past patient experiences are not appropriate to with the patient. Leaving the patient alone does not promote sharing feelings. p. 10
A nurse asks a clinical question using the PICOT format. What does PICOT stand for?
P - Patient, I - Intervention, C - Comparison, O - Outcome, T - Time Rationale The PICOT system is used for asking clinical questions correctly. In the PICOT system, P stands for patient, I stands for intervention, C stands for comparison, O stands for outcome, and T stands for time. A clinical question does not necessarily need all the components. p. 15
A patient is recovering from a stroke and needs help with improving muscle strength, gait training, and transfer training. The nurse should refer the patient to what health care professional?
Physical therapist Rationale A physical therapist helps the patient improve strength and endurance and provides gait training and transfer training. Pastoral care offers spiritual support to the patient and family. A speech therapist focuses on the management of speech disorders. An occupational therapist helps the patient improve motor-sensory coordination, cognitive-perceptual skills, and the ability to perform activities of daily living. p. 10
In the Medicare program, the payment for hospital services is based on flat fees. These are determined by the diseases and problems treated during the hospital admission. For example, the hospital will receive a fixed amount of $45,000 for the care of a patient who had a total knee replacement. What is the term for this type of payment?
Prospective payment system Rationale A prospective payment system was established in the Medicare program to reimburse hospitals using a flat fee based on the disease and problems treated during the admission. Value-based purchasing programs base reimbursement to health care providers on their performance on certain quality measures. Preferred provider organizations and health maintenance organizations are programs through which charges are negotiated in advance of the delivery of care using predetermined reimbursement rates or capitation fees.Test-Taking Tip: After you have eliminated one or more choices, you may discover that two of the options are very similar. This can be helpful, because it may mean that one of these look-alike answers is the best choice and the other is a very good distractor. Test both of these options against the stem. Ask yourself which one completes the incomplete statement grammatically and which one answers the question more fully and completely. The option that best completes or answers the stem is the one you should choose. Here, too, pause for a few seconds, give your brain time to reflect, and recall may occur. p. 4
The nurse has identified that the patient is having an adverse reaction to a medication prescribed for schizophrenia. What is the best method for the nurse to use to share this finding with the primary health care provider?
Provide the doctor with the situation, background, assessment, and recommendations. Rationale The doctor should be provided information in the "SBAR" format to ensure effective communication; this includes the situation, background, assessment, and recommendations. Texting about patients is inefficient and a breach of confidentiality. The doctor does not need the full history in this specific scenario. The nurse should not have the family call the doctor to ask for a different drug to be prescribed; it is the nurse's responsibility to share his or her findings with the doctor.Test-Taking Tip: Look for answers that focus on the patient or are directed toward feelings. p. 11
A patient diagnosed with psychosis is complaining of being anxious on a newly prescribed medication. Which action by the nurse promotes the patient's psychosocial integrity?
Provide time for the patient to verbalize his or her complaint. Rationale The nurse should first provide time for the patient to verbalize his or her complaint to help the patient better understand his or her feelings; this promotes psychosocial integrity. Yelling at other patients is not acceptable and should be discouraged. A letter may help the patient express him or herself, but this is not an example of patient advocacy. If the nurse or patient feels the medication may be causing anxiety, the doctor should be notified but this is less about promoting psychosocial integrity. p. 3
The student nurse knows leadership includes Quality and Safety Education for Nurses (QSEN) competencies. Which are QSEN competencies?
Quality improvement Evidence-based practice Patient-centered care Rationale QSEN competencies include quality improvement, evidence based-practice, patient-centered care, teamwork and collaboration, safety, and informatics. Nursing diagnosis is a phase in the nursing process. Nursing outcomes classification is a list of patient outcomes developed to evaluate the effects of interventions provided by nurses. p. 6
The registered nurse (RN) is delegating tasks to the licensed practical nurse (LPN) and unlicensed assistive personnel (UAP). Which statement reflects inappropriate delegation?
RN delegates to LPN: Complete admission assessment and documentation on a new patient. Rationale The RN cannot delegate an admission assessment to an LPN, as this is not within the LPN's scope of practice. LPNs can gather data but cannot assess a patient. All admission assessments must be done by the RN. Obtaining and recording vital signs is within the scope of practice for the UAP. The LPN is legally permitted to administer oral medications, intramuscular medications, subcutaneous medications, simple intravenous (IV) fluids, and IV antibiotics. The UAP can assist a patient in ambulating to the bathroom.Test-Taking Tip: Start by reading each of the answer options carefully. Usually at least one of them will be clearly wrong. Eliminate this one from consideration. Now you have reduced the number of response choices by one and improved the odds. Continue to analyze the options. If you can eliminate one more choice in a four-option question, you have reduced the odds to 50/50. While you are eliminating the wrong choices, recall often occurs. One of the options may serve as a trigger that causes you to remember what a few seconds ago had seemed completely forgotten. p. 15
In any clinical setting, which health care team member is responsible for developing an individualized plan of care that includes nursing diagnoses, interventions, and outcomes including the patient's self-management care plan?
Registered nurse Rationale The registered nurse (RN) is responsible for developing individualized plans of care for patients. The nursing plan of care includes identification of nursing diagnosis based on assessment data, patient goals or outcomes, provision of interventions, and continued evaluation of the plan's effectiveness. The primary health care provider determines the medical diagnosis based on testing and physical examination, prescribes medications, and orders testing as needed. It is the nurse's responsibility to carry out primary health care provider prescriptions. The NAP works under the supervision of an RN. The nursing supervisor is a manager or administrator responsible for overseeing and directing multiple healthcare team members. pp. 5-6
A patient with chronic obstructive pulmonary disease (COPD) is being discharged to home. The patient is advised to take oxygen therapy. The nurse should collaborate with which health care professional to assist the patient with oxygen therapy in the home?
Respiratory therapist Rationale A respiratory therapist is a health care professional who helps patients with oxygen therapy in the home. The respiratory therapist provides specialized respiratory treatments and educates the patient and family about various respiratory techniques. A social worker assists the patient with identifying caregivers, appropriate settings for care following discharge, and identifying resources for the patient. A home health aide assists patients in their personal needs such as bathing, dressing, and feeding. An occupational therapist helps patients improve motor-sensory coordination, cognitive-perceptual skills, and the ability to perform activities of daily living. p. 10
In health care, value-based purchasing programs base reimbursement to hospitals on their performance and quality measures. When an adverse event that is considered preventable happens to a patient, the insurance company can withhold payment. What is this type of event called by the National Quality Forum (NQF)?
Serious reportable event Rationale A serious reportable event is an event that happens to a patient that is considered preventable and can affect reimbursement to the health care organization from insurance companies. Health care error event, adverse health care event, and serious preventable event are not terms that refer to an event that happens to a patient and is considered preventable. p. 4
What communication tool will the nurse utilize to provide safe, effective care when reporting a change in a patient's condition?
Situation-Background-Assessment-Recommendation (SBAR) tool Rationale The SBAR tool is a structured technique that provides a way for members of the healthcare team to talk about a patient's condition. A nursing diagnosis provides a basis for selecting nursing interventions to achieve patient outcomes for which a nurse is accountable. A nursing care plan is a guide for routine nursing care. A clinical pathway is an interprofessional nursing care plan that specifies care and desired outcomes during a specific time period for patients with particular diagnoses or health conditions. p. 10
On what do the nursing terminologies, Nursing Interventions Classification (NIC), NANDA International (NANDA-I), and Nursing Outcomes Classification (NOC) specifically focus?
Specific phases of the nursing process Rationale The nursing terminologies, Nursing Interventions Classification (NIC), NANDA International (NANDA-I), and Nursing Outcomes Classification (NOC) focus on the specific phases of the nursing process. Quality patient care relates to high-quality healthcare. A nursing care plan provides an individualized plan of care for a patient. Classifications of outcomes are in the Nursing Outcomes Classification (NOC), which is a list of patient outcomes developed to evaluate the effects of interventions provided by nurses.Test-Taking Tip: Do not worry if you select the same numbered answer repeatedly, because there usually is no pattern to the answers. p. 7
A nurse is caring for a patient on the cardiac care unit. A cardiologist who lives in another city consults with the health care team through videoconferencing. What is this process known as?
Telehealth Rationale Telehealth is the use of technology such as videoconferencing to provide care when patients and their health care providers are geographically separated. Electronic health records are health records maintained by clinics or hospitals in an electronic format. Evidence-based practice is a problem-solving approach used to answer clinical questions. Online health management is the use of the Internet and technology for managing health. pp. 9, 14, 15
Which branch of nursing is defined as a care delivery model that utilizes the nursing process to provide nursing care to patients through telecommunication technologies and increase access to care for those who may not be able to afford travel to the nearest health care facility?
Telehealth nursing Rationale Telehealth nursing is using the nursing process to provide nursing care to patients through telecommunication technologies. Team care involves a group of providers who work together to deliver care. Parish nursing does not involve telecommunication technologies. Case management involves managing a patient's care with interprofessional team members across multiple care settings and levels of care.Test-Taking Tip: Start by reading each of the answer options carefully. Usually at least one of them will be clearly wrong. Eliminate this one from consideration. Now you have reduced the number of response choices by one and improved the odds. Continue to analyze the options. If you can eliminate one more choice in a four-option question, you have reduced the odds to 50/50. While you are eliminating the wrong choices, recall often occurs. One of the options may serve as a trigger that causes you to remember what a few seconds ago had seemed completely forgotten. p. 9
Which organization promotes safety by providing evidence-based solutions to common safety problems?
The Joint Commission Rationale The Joint Commission issues National Patient Safety Goals which promote safety by providing evidence-based solutions to common safety problems. The NDNQI provides data on nursing-sensitive measures to evaluate the impact of nursing care on patient outcomes. The National Quality Forum (NQF) is dedicated to improving quality in healthcare. The NQF provides a list of safe practices in order to address adverse events that are preventable. HIPAA is part of federal legislation that addresses actions for how protected health information (PHI) is used and disclosed. p. 12
The nurse must use critical thinking while providing nursing care. How is critical thinking defined?
The ability to focus thinking to get the desired results in various situations, which has been described as knowing how to learn, be creative, generate ideas, make decisions, and solve problems Rationale Critical thinking is defined as the ability to focus your thinking to get the desired results in various situations, which has been described as knowing how to learn, be creative, generate ideas, make decisions, and solve problems. Understanding the medical and nursing implications of a patient's situation when making decisions involves knowledge. Using the nursing process to provide nursing care to patients using technology involves technology and informatics. The collaborative nursing process is part of teamwork and collaboration for care coordination.Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer. p. 9
The nurse is reviewing the use of linkages among NANDA-I nursing diagnoses, Nursing Outcomes Classification (NOC) patient outcomes, and Nursing Interventions Classification (NIC) nursing interventions. Which statement best describes the use of these linkages?
They provide guidance and are the basis for planning care. Rationale NANDA, Nursing Outcomes Classification (NOC), and Nursing Interventions Classification (NIC) (NNN) linkages show how the three distinct nursing terminologies can be connected and used together when planning care for patients. Linkages may assist in planning nursing care by determination of a nursing diagnosis, projection of a desired outcome, or selection of interventions to achieve the desired outcome. The linkages are not used to evaluate data, to predict the results of nursing care, or to reduce the length of written care plans. Test-Taking Tip: When using this program, be sure to note if you guess at an answer. This will permit you to identify areas that need further review. Also it will help you to see how correct your guessing can be. p. 7
Delegation is a common leadership role in professional nursing practice. How is delegation defined?
Transferring authority to a competent individual to complete a selected task Rationale Delegation is defined as transferring authority to a competent individual to complete a selected task in a selected situation. When done appropriately, delegation can result in safe, effective, and efficient patient care. Assigning nursing tasks to the UAP is part of the work each staff member is to accomplish during a given shift; this is an example of delegation. Responsibility for completing a task falls on the registered nurse (RN) even when the task is delegated. RNs are responsible for monitoring patient outcomes. Distributing workload among subordinates to create a fair working environment is referred to as patient care assignments. p. 11
A nurse understands that it is very important to identify the patient accurately before any patient-related activity is performed. What method should the nurse take to improve the accuracy of patient identification?
Use at least two ways of identifying the patient, including full name and date of birth. Rationale The best way to improve the accuracy of patient identification is to use at least two ways to identify patients. The nurse can use information such as the patient's full name and date of birth or full name and birth city. Asking the patient to repeat his or her name is not practical and will not serve the purpose. Similarly, giving only numbers to patients may create confusion. Asking the other nurse to keep a backup will only increase workload and is not practical. p. 13
Telehealth nursing is using the nursing process to provide nursing care to patients and increase access to care to those who may not be able to afford transportation to the nearest health care facility. What methods are considered telehealth nursing?
Wireless Satellite High-speed internet Video communications Rationale Telehealth nursing provides nursing care to patients through telecommunication technologies, such as satellite, wireless, video communications, and high-speed Internet. Telephone conversation is not a method for telehealth nursing. p. 9
