NUR TEST 8

A nurse who has worked on a unit for 8 years is conflicted about asking to meet with the charge nurse about staffing ratios. Which question(s) reflect the professional value of altruism in this decision? Select all that apply. "Can I discuss this matter without violating my client's privacy?" "Are my clients receiving equal treatment?" "Am I able to provide safe and efficient care to my clients?" "Am I willing to take this risk to help protect my fellow nurses?" "Will less experienced nurses on the unit learn from my actions?"

"Am I able to provide safe and efficient care to my clients?" "Am I willing to take this risk to help protect my fellow nurses?" "Will less experienced nurses on the unit learn from my actions?" *Altruism is a concern for the welfare and well-being of others. Being concerned about quality of care, mentoring other professionals, and taking risks to benefit others are examples of altruism. Privacy rights reflect the professional value of human dignity. Fairness and equality reflect the professional value of social justice.

A nurse educator understands that his teaching was effective regarding the Code of Ethics for Nurses when students state which of the following? "The code critiques existing patterns of oppression and domination in society." "The code enables nurses to provide good care to clients." "The code is an expression of nursing?s own understanding of its commitment to society." "The code provides nurses with specific action guides for practice."

"The code is an expression of nursing's own understanding of its commitment to society."

Magnet Status

-empowers organizations to attract and retain top talent -improve client care, safety, and satisfaction -collaborative culture -advance nursing standards and practice -grow business and financial success. -decentralized decision-making process -self-governance at the unit level -respect for and acknowledgment of professional autonomy

clinical reasoning cycle

1. Consider the patient situation 2. Collect cues/information 3. Process information 4. Identify problems/issues 5. Establish goals 6. Take action 7. Evaluate outcomes 8. Reflect on process and new learning

The nurse is having difficulty managing time while caring for a group of clients with complex needs. Medications are several hours behind schedule and several nursing procedures have not be performed. How should the nurse resolve the time management issue? Place the following steps in order. 1Identify which nursing interventions are priority. 2Evaluate the potential to successfully complete the nursing interventions. 3Identify which nursing interventions can be delegated to other members of the health care team. 4Establish a timeline to get the nursing interventions completed.

1. Identify which nursing interventions are priority. 2.Evaluate the potential to successfully complete the nursing interventions. 3. Identify which nursing interventions can be delegated to other members of the health care team. 4.Establish a timeline to get the nursing interventions completed.

Steps for Improving Time Management

1. establish goals and priorities 2. evaluate the ability to complete the goals 3.decide which goals can be delegated to other personnel 4.establish a timeline to complete goals that cannot be delegated, and, finally, evaluate the success of completing the goals.

Put the steps of the clinical reasoning cycle in the correct order.

1.Review current information. 2.Analyze data to come to an understanding of signs or symptoms. 3.Match current clients to past clients. 4.Describe what the nurse wants to happen, a desired outcome, a time frame. 5.Select a course of action between different alternatives available. 6.Evaluate the effectiveness of actions.

The nurse is caring for a client during the postsurgical period after having a right femoral-popliteal bypass graft. The nurse enters the room to conduct a nursing assessment and care. Order the nurse's actions according to priority. All options must be used. 1Assess peripheral pulses. 2Assess incision site. 3Assess lung fields. 4Assess pain/obtain medication. 5Instruct on client positioning. 6Offer clear fluids.

1Assess peripheral pulses. 2Assess incision site. 3Assess lung fields. 4Assess pain/obtain medication. 5Instruct on client positioning. 6Offer clear fluids.

The nurse is caring for a client who just returned from the postanesthesia care unit following surgery to repair a fractured arm. Place the following interventions in order of highest priority to lowest priority. 1Place the client in a position that facilitates breathing. 2Measure pulse, blood pressure, respirations, and temperature. 3Measure oxygen saturation. 4Assess neurovascular status to the affected arm. 5Assess dressing for bleeding or other drainage. 6Assess for pain and administer prescribed analgesics, if indicated.

1Place the client in a position that facilitates breathing. 2Measure pulse, blood pressure, respirations, and temperature. 3Measure oxygen saturation. 4Assess neurovascular status to the affected arm. 5Assess dressing for bleeding or other drainage. 6Assess for pain and administer prescribed analgesics, if indicated.

Nursing Process Clinical Reasoning Phases

Assessment: Detect/notice cues -S/S, risks Diagnose: Analyze Data; differential dx, list suspected problems -weighing the probability of each Plan: Responding - predicting complications, anticipate consequences, consider actions, set priorities, Decision-making Implement: Responding - taking actions, monitoring responses, reflecting, making adjustments Evaluate: Reflect. Repeat ADPIE as indicated.

A school nurse is teaching about adolescent safety with students entering high school. What will the nurse include in the discussion about the major causes of death in this group? Select all that apply. Choking Diving accidents Car accidents Suicide Intimate partner violence Cigarette smoking

Car accidents Suicide Car accidents and suicide are common causes of death in adolescents. Choking is more typical in children younger than age 3 years. While diving accidents can occur in adolescents due to poor judgment, this is not as common. Intimate partner violence is more common in adults. Smoking, while ill advised, takes many years or decades to become a cause of death.

A short time after administering pain medication to a client, the nurse returns to the client's room and finds the client difficult to arouse. The nurse realizes that 25 ml of the liquid medication was administered instead of the ordered 25 mg, which is contained in 5 ml. How could the nurse have prevented this error? Have another nurse double check the medications before administration. Attempt non-pharmacological pain control methods, and administer PRN pain medications as a last resort. Carefully review the order and medication label, then calculate the ordered dose. Highlight dosage instructions on the medication bottles.

Carefully review the order and medication label, then calculate the ordered dose.

The nurse is getting accustomed to the role of nurse manager. What are requirements for this nursing role? Select all that apply. Creating schedules for the unit Setting goals for individual clients Managing the unit's operational budget Introducing methods to improve staff efficiency Evaluating the success of the unit policies Regulating the amount of teamwork used by staff

Creating schedules for the unit Managing the unit's operational budget Introducing methods to improve staff efficiency Evaluating the success of the unit policies

A class of fundamentals nursing students is learning about ethical issues and ethical dilemmas in nursing and healthcare. Which of the following are ethical issues that will need to be considered as healthcare reform continues? Select all that apply. Do smokers and the obese who do not make necessary lifestyle changes deserve the same healthcare as people who lead healthier lives? Should hospitals and providers receive payment from health insurance entities based in part on patient satisfaction scores? Is someone who can afford to advertise for an organ donation more deserving than someone who has been waiting months for a transplant? Should citizens pay higher insurance premiums and/or taxes so that someone who overdoses on heroin can have intensive care? Should undocumented peoples in the U.S. have the same access to healthcare as its citizens?

Do smokers and the obese who do not make necessary lifestyle changes deserve the same healthcare as people who lead healthier lives? Is someone who can afford to advertise for an organ donation more deserving than someone who has been waiting months for a transplant? Should citizens pay higher insurance premiums and/or taxes so that someone who overdoses on heroin can have intensive care? Should undocumented peoples in the U.S. have the same access to healthcare as its citizens?

A nurse who is caring for a new mother realizes that the woman is not prepared to go home with her newborn after a hospital stay of only 24 hours, but hospital policy dictates that the mother be discharged. This nurse may be faced with which moral problem? Ethical uncertainty Ethical distress Ethical dilemma Ethical dissatisfaction

Ethical distress Ethical distress occurs when the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action. Ethical dilemmas arise when attempted adherence to basic ethical principles results in two conflicting courses of action.

A nurse manager is planning to introduce to the staff a new procedure for documenting supplies used for clients on a medical-surgical unit. Several of the staff members say to the nurse manager, "Why do we have to change the procedure? The one we're using is working just fine." Which action would be important for the nurse manager to take first? Explain the change using simple, concise language. Inform them that the change will occur in steps. Emphasize the advantages of the change. Involve all affected by the change in planning.

Explain the change using simple, concise language.

Which action by the nurse manager demonstrates the function of directing? Identifying a goal for the nurse-client ratio on the clinical unit Hiring an adequate number of nurses to staff the unit on all shifts Using a weekly system for keeping the workforce budget balanced Helping manage unit flow with client care if there is a staff call-out

Helping manage unit flow with client care if there is a staff call-out

A registered nurse checks the American Nurses Association (ANA) regulations prior to delegating tasks to unlicensed assistive personnel (UAP) on a burn unit. Which principle(s) regarding the regulation, education, and use of UAP is recommended by the ANA? Select all that apply. It is the health care institution that determines the scope of nursing practice. It is the LPN/LVN who supervises any UAP involved in providing direct client care. It is the purpose of the UAP to work in a supportive role to the registered nurse. It is the role of the UAP to carry out tasks to enable the professional nurse to concentrate on nursing care for the client. It is the role of the LPN/LVN to assign nursing duties to the UAP. It is the registered nurse who is responsible and accountable for nursing practice.

It is the purpose of the UAP to work in a supportive role to the registered nurse. It is the role of the UAP to carry out tasks to enable the professional nurse to concentrate on nursing care for the client. It is the registered nurse who is responsible and accountable for nursing practice.

A client involved in a motor vehicle collision has awakened from a coma and asks for his wife, who was killed in the same accident. The family does not want the client to know at this time that his wife was killed. The family wants all nursing staff to tell the client that the wife was air lifted to another hospital, has a severe head injury, and is in the ICU. Because the American Nurses Association Code of Ethics requires the nurse to preserve integrity, but the nurse wants to follow the family's instructions, the nurse faces an ethical dilemma. The steps of ethical analysis can assist the nurse with decision making. Select from the list below all the steps that are correct. Recognize the ethical, legal, and professional dimensions involved. Collect information. List the alternatives. Coordinate an ethics committee. Decide and evaluate the decision.

Recognize the ethical, legal, and professional dimensions involved. Collect information. List the alternatives. Decide and evaluate the decision.

A staff member says she is really busy and asks the charge nurse to double-check a dose of insulin which she has drawn up. The nurse holds up a bottle of Lente insulin, but the charge nurse notices a bottle of Lantus insulin on the medication cart. This nurse has made multiple medication errors and the charge nurse is concerned that she isn't safe. What should the charge nurse do? State that she can't check the dose unless she sees the nurse draw it up. Ask the nurse which bottle of insulin she used to draw up the client's dose. Ask to see the original order, then determine if the dose is correct. Tell the nurse that she'd like to start at the beginning to be on the safe side.

Tell the nurse that she'd like to start at the beginning to be on the safe side. The charge nurse should observe the process from the beginning and determine whether the nurse is following the five rights of drug administration. Only then should she cosign that the dose is correct. Saying that she can't check the dose unless she sees the nurse draw it up, asking the nurse which bottle of insulin she used, and asking to see the original order provide too much opportunity for error.

Ethical practice is evaluated as a portion of the nurse's annual review. Which practice(s) would cause the evaluator to reduce the nurse's score on this section of the review? Select all that apply. The nurse is frequently late to work. The nurse made two medication errors in the last year. The nurse often speaks harshly to cleaning staff and transport workers. The nurse requested that a specific client not be assigned his or her to care. The nurse suggested that a client be moved to palliative care status.

The nurse is frequently late to work. The nurse often speaks harshly to cleaning staff and transport workers.

A nurse manager of a health care provider's office uses the laissez-faire style of leadership with the staff. Which nursing actions reflect this management style? Select all that apply. The nurse manager is the authority on all issues. The nurse manager allows self-scheduling. The nurse manager allows dominant staff members to direct the group activities. Manager and staff work independently, making task accomplishment difficult. The manager does not request input from staff. The nurse manager inspires and motivates staff to provide excellent client care.

The nurse manager allows self-scheduling. The nurse manager allows dominant staff members to direct the group activities. Manager and staff work independently, making task accomplishment difficult.

A nurse has been offered a position on an obstetric unit and has learned that the unit offers therapeutic abortions, a procedure which contradicts the nurse's personal beliefs. What is the nurse's ethical obligation to these patients? The nurse should adhere to professional standards of practice and offer service to these patients. The nurse should make the choice to decline this position and pursue a different nursing role. The nurse should decline to care for the patients considering abortion. The nurse should express alternatives to women considering terminating their pregnancy.

The nurse should decline to care for the patients considering abortion. To avoid facing ethical dilemmas, nurses can follow certain strategies. For example, when applying for a job, a nurse should ask questions regarding the patient population. If a nurse is uncomfortable with a particular situation, then not accepting the position would be the best option. The nurse is only required by law (and practice standards) to provide care to the patients the clinic accepts; the nurse may not discriminate between patients and the nurse expressing his or her own opinion and providing another option is inappropriate.

Two new nurses are requesting the same preceptor for unit orientation and say they will be unhappy if they do not receive their choice of preceptor. Which illustrates the nurses using an accommodating approach to conflict resolution? The nurses ignore each other's request for the preceptor. The nurses allow the preceptor to decide which nurse to precept. The nurses agree for one nurse to obtain the preceptor for orientation in exchange for that nurse working each weekend. The nurses discuss the situation with the preceptor to come to an agreement mutually beneficial for both parties.

The nurses agree for one nurse to obtain the preceptor for orientation in exchange for that nurse working each weekend.

A nurse is working as part of a group on developing strategies to meet the health care needs of the children being served by the facility. The nurse identifies the need for expanded play therapy programs. The nurse works to motivate others in the group and promote a common vision. The nurse and the group communicate openly and honestly with the others involved, focusing on the process as well as the outcomes. The nurse is exhibiting which style of leadership? Transactional Transformational Laissez-faire Democratic

Transformational -

A nurse is obtaining consent for a bone marrow aspiration. Which action(s) should the nurse take? Select all that apply. Witness the client signing the consent form. Evaluate that the client understands the procedure. Explain the risks of the procedure to the client. Verify that the client is signing the consent form of their own free will. Determine that the client understands postprocedure care.

Witness the client signing the consent form. Evaluate that the client understands the procedure. Verify that the client is signing the consent form of their own free will. Determine that the client understands post procedure care.

The nursing care of a patient receiving drug therapy should include measures to decrease the anticipated adverse effects of the drug. Which of the following measures would a nurse consider? a. A positive approach b. Environmental temperature control c. Safety measures d. Skin care e. Refrigeration of the drug f. Involvement of the family

a. A positive approach b. Environmental temperature control c. Safety measures d. Skin care f. Involvement of the family

A nurse is preparing to administer a drug to a patient for the first time. What questions should the nurse consider before actually administering the drug? a. Is this the right patient? b. Is this the right drug? c. Is there a generic drug available? d. Is this the right route for this patient? e. Is this the right dose, as ordered? f. Did I record this properly?

a. Is this the right patient? b. Is this the right drug? d. Is this the right route for this patient? e. Is this the right dose, as ordered?

The nurse obtains a medical history from a patient before beginning drug therapy based on an understanding of which of the following? a. Medical conditions can alter a drug's pharmacokinetics and pharmacodynamics. b. A medical history is a key component of any nursing protocol. c. A baseline of information is necessary to evaluate a drug's effects. d. The medical history is the first step in the nursing process.

a. Medical conditions can alter a drug's pharmacokinetics and pharmacodynamics.

A community health nurse is providing education on child safety. Who does the nurse identify as at highest risk for choking and suffocation? a. A toddler playing with his older brother's wooden blocks b. A 4-year-old eating yogurt and strawberries for lunch c. An infant sleeping in the prone position d. A 3-year-old drinking a glass of juice

c. An infant sleeping in the prone position Infants should be placed on their backs to sleep. A young child may place small or loose parts in the mouth. Anything that will fit through the average toilet paper roll is not safe for a toddler. A 3-year-old and a 4-year-old drinking juice and eating yogurt are developmentally appropriate.

A school nurse is teaching parents about home and fire safety. What information will be included in the teaching plan? Select all that apply. a. Sixty percent of U.S. fire deaths occur in the home. b. Most fatal fires occur when people are cooking. c. Most people who die in fires die of smoke inhalation. d. Fire-related injury and death have declined due to the availability and e. use of smoke alarms. f. Fires are more likely to occur in homes without electricity or gas. g. Fires are less likely to spread if bedroom doors are kept open when sleeping.

c. Most people who die in fires die of smoke inhalation. d. Fire-related injury and death have declined due to the availability and e. use of smoke alarms. Eighty percent of fire deaths in the United States occur in the home. Most fatal home fires occur while people are sleeping, and most deaths result from smoke inhalation rather than burns. The widespread availability and use of home smoke alarms is considered the primary reason for the decline in fire-related injury and death. People with limited financial resources may use space or kerosene heaters, wood stoves, or a fireplace as the sole source of heat if utilities are turned off. Bedroom doors should be kept closed when sleeping and monitors used to listen for children.

A nurse believes in listening to patients and coworkers more than talking to them, allowing more personal control for all involved. This is a quality of which of the following managerial mind-sets? reflective analytical worldly collaborative

collaborative

Nursing students are invited to participate in the clinical agency's annual disaster drill, simulating the release of an airborne infectious agent and ensuing panic. Which assignment is most appropriate for the students? a. Cleansing and dressing wounds sustained during the panic b. Triaging patients with respiratory symptoms and traumatic injuries c. Providing information to families of missing loved ones d. Ensuring everyone entering and working has an N95 mask

d. Ensuring everyone entering and working has an N95 mask Rapid assessment and triage are essential during a disaster. Delegating tasks appropriate to students are based on skill level and ability to complete skills independently. Ensuring masks are worn and the education for this, if needed, are within the educational and clinical skills of nursing students.

Autocratic leadership

directive leadership or authoritarian leadership -involves the leader assuming control over the decisions and activities of the group. -The manager makes decisions without seeking input from staff. -Staff have limited opportunities to express creativity in care delivery.

laissez-faire leadership

nondirective leadership -the leader relinquishes power to the group, such that an outsider could not identify the leader in the group.

A group of nursing students are reviewing current nursing codes of ethics. Such a code is important in the nursing profession because: nurses are highly vulnerable to criminal and civil prosecution in the course of their work nurses interact with clients and families from diverse cultural and religious backgrounds nursing practice involves numerous interactions between laws and individual values nurses are responsible for carrying out actions that have been ordered by other individuals

nursing practice involves numerous interactions between laws and individual values

Democratic leadership

participative leadership -characterized by a sense of equality among the leader and other participants

Transformational leadership

positive and compelling vision --fosters a new culture for nursing practice and client care. -key component of organizations that achieve Magnet® status.

Transactional leadership style

task-and-reward orientation

Altruism

unselfish regard for the welfare of others