Nursing 130 - Practice Test 1
a
A day-care center would be best for which of the following clients? a. A slightly confused woman with a daughter who works during the day b. An older man who has begun to have episodes of breathing difficulty that require intervention. c. A baby with frequent seizure activity. d. A severely psychotic and belligerent young man.
a
A group of nurses is discussing the advantages of using computerized provider order entry (CPOE). Which of the following statements indicates that the nurses understand the major advantage of using CPOE? a. "CPOE reduces transcription errors." b. "CPOE reduces the time necessary for health care providers to write orders." c. "Health care providers can write orders from any computer that has Internet access." d. "CPOE reduces the time nurses use to communicate with health care providers."
b
A new graduate nurse is providing a telephone report ot a patient's health care provider and accepting telephone orders from the provider. Which of the following actions requires the new nurse's preceptor to intervene? The new nurse: a. Uses SBAR (Situation-Background-Assessment-Recommendation) as a format when providing the report b. Gives a newly ordered medication before entering the order in the patient's medical record c. Reads the orders back to the health care provider after receiving them and verifies their accuracy d. Asks the preceptor to listen in on the phone conversation
b
A patient asks for a copy of her medical record. The best response by the nurse is to: a. State that only her family may read the record. b. Indicate that she has the right to read her record. c. Tell her that she is not allowed to read her record. d. Explain that only health care workers have access to her record.
b
A theory is a set of concepts, definitions, relationships, and assumptions that: a. formulate legislation b. explain phenomenon c. measure nursing functions d. reflect the domain of nursing practice
a
All of the following are benefits of using a flow sheet for documentation except: a. Recording the specifics of significant changes in the client's condition is easier b. Time spent on writing a narrative note is decreased c. Team members can quickly see changes over time d. Errors resulting from transfer of information are decreased
c
An 18-yr old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, auscultates her lung sounds, listens to her heart sounds, determines her level of comfort, and collects blood and sputum samples analysis. Which standard of practice performed? a. Diagnosis b. Evaluation c. Assessment d. Implementation
d
As you enter the patient's room, you notice that he is anxious to say something. He quickly states, "I don't know what's going on; I can't get an explanation from my doctor about my test results. I want something done about this." Which of the following is the most appropriate documentation of the patient's emotional status? a. The patient has a defiant attitude and is demanding his test results. b. The patient appears to be upset with his nurse because he wants his test results immediately. c. The patient is demanding and complains frequently about his doctor. d. The patient state that he felt frustrated by the lack of information he received regarding his tests.
a, b, c, d
Contemporary nursing requires that the nurse had knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply) a. Caregiver b. Autonomy and accountability c. Patient Advocate d. Health promotion e. Lobbyist
c
Failure to act as a reasonably prudent person would have acted in a specific situation is known as: a. An intentional tort b. Malpractice c. Negligence d. Liability
b
In which of the following situations may a nurse be charged with negligence? a. Slapping a client for using inappropriate language. b. Not putting the siderails up on the bed of a confused patient. c. Using restraints on a client without a physician's written order. d. Telling the local newspaper about the client's diagnosis.
1=C; 2=A; 3=D; 4=B
Match the following components of systems theory with the definition of that component. 1. Feedback 2. Input 3. Content 4. Output A. Data entering the system B. End Product C. Data related to system functioning D. Product and information obtained from the system
a
Nurses are best prepared to work in a variety of situations when they have learned: a. The reasons for their actions when they give care. b. How to complete various health agency forms accurately. c. How to operate the technology used in health care. d. The basic nursing procedures used in all health agencies.
b
On the nursing unit you are able to access a patient's medical record and review the education that other nurses provided to the patient during the initial hospitalization and three subsequent clinic visits. This type of feature is most common in what type of record system? a. Information Technology b. Electronic health record c. Personal health information d. Administrative information system
c
The client delayed having surgery longer than her physician had wished. Which one of the following statements has the least amount of scientific support as a reason why some people neglect obtaining proper health care? a. Fear of having disease often leads to ignoring its symptoms. b. An attitude often influences behavior more than a fact. c. Neglecting to have health care often appears to be an inherited trait. d. Lack of knowledge of a disease often results in neglecting to seek proper health care.
c
The nurse caring for a patient on a ventilator electronically documents the head of bed elevated at 20 degrees. Suddenly an alert warning appears on the screen warning the nurse that this patient is at a high risk for aspiration because the head of the bed is not elevated high enough. This warning is known as what type of system? a. Electronic health record b. Clinical documentation c. Clinical decision support system d. Computerized physician order entry
a
The nurse observes a patient going into another patient's room without permission, which upsets the other patient. When responding to the wandering patient's behavior, the nurse should initially: a. Help the patient to the correct room. b. Place the patient in restraints temporarily c. Determine the motivation for the patient's behavior. d. Share the observation about the patient with the health care team.
c
The nurse recognizes that the rights and values of clients and their families takes precedence even when they conflict with the health care provider's or delivery system's rights and values. The nurse is practicing the role of: a. Decision maker b. Care giver c. Advocate d. Manager
b
The primary purpose of nurse practice acts is to: a. Upgrade the profession b. Protect the public welfare c. Correct educational programs in nursing d. Provide good environments for nursing practice
d
The process whereby qualified agents certify that individuals nurses, or the institutions and programs that prepare them for entry or advanced practice, meet minimum standards at specified times is called: a. Certification b. Accreditation c. Licensure d. Credentialling
d
Vulnerable populations of patients are those who are more likely to develop health problems as a result of: a. Chronic diseases and homelessness b. Poverty and acute illness c. Lack of transportation, ability to perform self-care but are homeless d. Excess health risks, limits in access to health care services and dependency on others for care
c
What is an appropriate way for a nurse to dispose of printed patient information? a. Rip several times and place in a standard trash can. b. Place in the patient's paper-based chart. c. Place in a secure canister marked for shredding. d. Burn the documents.
d
When the nurse writes in the chart and discovers that an error has been made, which is the best approach? a. Erase the erroneous information b. Carefully ink-out the erroneous information c. Place an asterisk before the information and footnote an explanation of the error d. Draw one line through the error and initial above it
c
Which of the following activities by the nurse is an example of primary preventative care? a. Teaching the client to ambulate with the walker. b. Calculating the correct insulin dosage for the client. c. Informing the client where immunizations are available for an infant. d. Arranging for a hospice to visit with the family of a client with cancer.
d
Which of the following charting entries is most accurate? a. Patient walked up and down hallway with assistance, tolerated well. b. Patient up, out of bed, walked down hallways and back to room, tolerated well. c. Patient up, walked 50 feet and back down hallway with assistance from nurse. Spouse also accompanied patient during the walk d. Patient walked 50 feet and back down hallway with assistance from nurse; HR 88 and regular before exercise, 94 and regular following exercise.
a
Which of the following circumstances may result in the client seeking an alternative health care system? a. A client believes that no one in the conventional agency cares about his as an individual. b. No one in the conventional agency can provide a cure. c. The client was informed of treatments and potential side effects. d. The family was asked to participate in care.
c
Which of the following responses to a request for recommendation would be ethnically and legally appropriate? a. "Dr. James is a sweet guy." b. "Dr. Madison is a terror. I wouldn't let him take care of me." c. "Dr. Johnson does not usually encourage parent participation in care while a child is hospitalized." d. "No Doctor is as good as Dr. Wilson."
c
Which of the following situations could result in the nurse being liable? a. Not keeping the care plan updated b. Notifying the physician that a wound was red and draining. c. Not charting that a client's fingers were cold to touch and cyanotic. d. Not charting that the client disliked the diet.
b
While reviewing the pulmonary section of a patient's electronic chart, the physician notices blank spaces since the initial assessment the previous day when the nurse documented that the lung assessment was within normal limits. There also are no progress notes about the patient's respiratory status in the nurse's notes. The most likely reason for this is because: a. The nurses forgot to document on the pulmonary system b. The nurses were charting by exception. c. The computer is not working correctly. d. The physician does not have authorization to view the nursing assessment.
a, b, e
You are giving a hand-off report to another nurse who will be caring for your patient at the end of your shift. Which of the following pieces of information do you include in the report? (Select all that apply) a. The patient's name, age, and admitting diagnosis b. Allergies to food and medications c. Your evaluation that the patient is "needy" d. How much the patient ate for breakfast e. That the patient's pain rating went from 8 to 2 on a scare of 1 to 10 after receiving 650mg of Tylenol
b
You are helping to design a new patient discharge reaching sheet that will go home with patients who are discharged to home from your unit. Which of the following do you need to remember when designing the teaching sheet? a. The new federal laws require that teaching sheets be e-mailed to patients after they are discharged. b. You need to use words the patients can understand when writing the directions. c. The form needs to be given to patients in a sealed envelope to protect their health information. d. The names of everyone who cared for the patient in the hospital need to be included on the form in case the patient had questions at home.
c
You are reviewing Health Insurance Portability and Accountability Act (HIPAA) regulations with your patient during the admission process. The patient states, "I've heard a lot about these HIPAA regulations in the news lately. How will they affect my care?" Which of the following is the best response? a. HIPAA allows all hospital staff to access your medical record b. HIPAA limits the information that is documented in your medical record c. HIPAA provides you with greater control over your personal health care information d. HIPAA enables health care institutions to release all your personal information to improve continuity of care
a
You are supervising a beginning nursing student who is documenting patient care. Which of the following actions requires you to intervene? The nursing student: a. Documented medication given by another nursing student. b. Included the date and time of all entries in the chart. c. Stood with his back against the wall while documenting on a the computer d. Signed all documentation electronically.
d
Nurses on a pediatric nursing unit are discussing ways to improve patient care. One nurse asks a colleague, "I wonder how best to measure pain in a child who has sickle cell disease?" This question is an example of a/an: a. Hypothesis b. PICOT question c. Problem-focused trigger d. Knowledge-focused trigger
b
A child's immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation? a. Fidelity b. Beneficence c. Nonmaleficence d. Respect for autonomy
d
A critical nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? a. Patient-centered care b. Safety c. Teamwork and collaboration d. Informatics
b
A group of nurses have implemented an evidence-based practice (EBP) change and have evaluated the effectiveness of the change. Their next step is to: a. Conduct a literature review b. Share the findings with others c. Conduct a statistical analysis d. Create a well-defined PICOT question
c
A group of nurses on the research council of a local hospital are measuring nursing-sensitive outcomes. Which of the following is a nursing-sensitive outcome that the nurses need to consider measuring? a. Incidence of asthma among children of parents who smoke b. Frequency of low blood sugar episodes in children at a local school c. Number of patients who fall and experience subsequent injury on the evening shift d. Number of sexually active adolescent girls who attend the community-based clinic for birth control
b
A group of staff educators are reading a research study together at a journal club meeting. While reviewing the study, one of the nurses states that it evaluates if newly graduated nurses progress through orientation more effectively when they participate in patient simulation exercises. Which part of the research process is reflected in this nurse's statement? a. Introduction b. Purpose statement c. Methods d. Results
c
A group of staff nurses notice an increased incidence of medication errors on their unit. After further investigation it is determined that the nurses are not consistently identifying the patient correctly. A change is needed quickly. What type of quality improvement method would be most appropriate? a. PDSA b. Six Sigma c. Rapid-improvement event d. A randomized controlled trial
c
A home health nurse notices significant bruising on a 2-year-old patient's head, arms, abdomen, and legs. The patient's mother describes the patient's frequent falls. What is the best nursing action for the home health nurse to take? a. Document her findings and treat the patient b. Instruct the mother on safe handling of a 2-year-old child c. Contact a child abuse hotline d. Discuss this story with a colleague
d
A homeless man enters the emergency department seeking health care. The health care provider indicates that the patient needs to be transferred to the City Hospital for care. This action is most likely a violation of which of the following laws? a. Health Insurance Portability and Accountability Act (HIPAA) b. American with Disabilities Act (ADA) c. Patient Self-Determination Act (PSDA) d. Emergency Medical Treatment and Active Labor Act (EMTALA)
a, c
A male patient has been laid off from his construction job and has many unpaid bills. He is going through a divorce from his marriage of 15 years and has been seeing his pastor to help him through this difficult time. He does not have a primary health care provider because he has never really been sick and his parents never took him to the physician when he was a child. Which external variables influence the patient's health practices? (Select all that apply) a. Difficulty paying his bills b. Seeing his pastor as a means of support c. Family practice of not routinely seeing a health care provider d. Stress from the divorce and the loss of a job
d
A manager who is reviewing the nurse's notes in a patient's medical record finds the following entry, "Patient is difficult to care for, refuses suggestion for improving appetite." Which of the following directions does the manger give to the staff nurse who entered the note? a. Avoid rushing when charting an entry b. Use correction fluid to remove the entry c. Draw a single line through the statement and initial it d. Enter only objective and factual information about the patient
b, c, d, e
A nurse is caring for a patient who recently had coronary bypass surgery. Which are legal sources of standards of care the nurse uses to deliver safe health care? (Select all that apply) a. Information provided by the head nurse b. Policies and procedures of the employing hospital c. State Nurse Practice Act d. Regulations identified in the Joint Commission's manual e. The American Nurses Association standards of nursing practice
b
A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with the family. The nurse is acting as the patient's: a. Educator b. Advocate c. Caregiver d. Case Manager
b
A nurse is caring for an older-adult couple in a community-based assisted living facility. During the family assessment, he notes that the couple has many expired medications and multiple medications for their respective chronic illnesses. They note that they go to two different health care providers. The nurse begins to work with the couple to determine what they know about their medications and helps them decide on one care provider rather than two. This is an example of which QSEN competency? a. Patient-centered care b. Safety c. Teamwork and collaboration d. Informatics
d
A nurse is presenting information to a management class of nursing students on the topic of groups of inpatient hospital services that have a fixed reimbursement amount, with adjustments made on the basis of case severity and regional costs. The nurse is presenting information to the class on which topic? a. Utilization review committee b. Resource utilization group c. Capitation payment system d. Diagnosis-related groups
d
A nurse is providing care to a patient who is experiencing major abdominal trauma following a car accident. The patient is losing blood quickly and needs a blood transfusion. The nurse finds out that the patient is a Jehovah's Witness and cannot have blood transfusions because of religious beliefs. He or she notifies the patient's health care provider and receives an order to give the patient an alternative to blood products. This is an example of: a. A quality improvement study b. An evidence-based practice change c. A time when calling the hospital's ethics committee is essential d. Considering the patient's preferences and values while providing care
c, d
A nurse is sued for failure to monitor a patient appropriately after a procedure. Which of the following statements are correct about this lawsuit? (Select all that apply) a. The nurse represents the plaintiff b. The defendant must prove injury, damage, or loss c. The person filing the lawsuit has the burden of proof d. The plaintiff must prove that a breach in the prevailing standard of care caused an injury
c
A nurse notes that the health care unit keeps a listing of the patient names at the front desk in easy view for health care providers to more efficiently locate the patient. The nurse talks with the nursing manager because this action is a violation of which act? a. Mental Health Parity Act b. Patient Self-Determination Act (PSDA) c. Health Insurance Portability and Accountability Act (HIPAA) d. Emergency Medical Treatment and Active Labor Act
d
A nurse researcher conducts a study that randomly assigns 100 patients who smoke and attend a wellness clinic into two groups. One group receives the standard smoking cessation handouts; the other group takes part in a new educational program that includes a smoking cessation support group. The nurse plans to compare the effectiveness of the standard treatment with the educational program. What type of a research study is this? a. Qualitative b. Descriptive c. Correlational d. Randomized controlled trial
a
A nurse researcher decides to complete a study to evaluate how Florence Nightingale improved patient outcomes in the Crimean War. This is an example of what type of research? a. Historical b. Evaluation c. Exploratory d. Experimental
b
A nurse researcher interviews parents of children who have diabetes and asks them to describe how they deal with their child's illness. The analysis of the interviews yields common themes and stories describing the parent's coping strategies. This is an example of which type of study? a. Historical b. Qualitative c. Correlational d. Experimental
b
A nurse researcher is developing a research proposal and is in the process of selecting an instrument to measure anxiety. In which part of the research process is this nurse? a. Analyzing the data b. Designing the study c. Conducting the study d. Identifying the problem
c
A nurse stops to help in an emergency at the scene of an accident. The injured party files a suit, and the nurse's employing institution insurance does not cover the nurse. What would probably cover the nurse in the situation? a. The nurse's automobile in this situation b. The nurse's homeowner's insurance c. The Good Samaritan laws, which grant immunity from suit if there is no gross negligence d. The Patient Care Partnership, which may grant immunity from suit if the injured party consents
c
A nurse who works in a newborn nursery asks, "I wonder if the moms who breastfeed their babies would be able to breastfeed more successfully if we played peaceful music while they were breastfeeding." In this example of a PICOT question, the I is: a. Breastfeeding moms b. Infants c. Peaceful music d. The nursery
d
A nurse works in a special care unit for children with severe immunology problems and is caring for a 3-year old boy from Greece. The boy's father is with him while his mother and sister are back in Greece. The nurse is having difficulty communication with the father. What action does the nurse take? a. Care for the boy as she would any other patient b. Ask the manager to talk with the father and keep him out of the unit c. Have another nurse care for the boy because maybe that nurse will do better with the father d. Search for help with interpretation and understanding of the cultural differences by contacting someone from the local Greek community
d
A patient at the community clinic asks the nurse about health promotion activities that she can do because she is concerned about getting diabetes mellitus since her grandfather and father both have the disease. This statement reflects that the patient is in what stage of the health belief model? a. Perceived threat of disease b. Likelihood of taking preventive health action c. Analysis of perceived benefits of preventive action d. Perceived susceptibility to the disease
b
A patient comes to the local health clinic and states: "I've noticed how many people are out walking in my neighborhood. Is walking good for you?" What is the best response to help the patient through the stages of change for exercise? a. "Walking is OK. I really think running is better." b. "Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" c. "Yes, I want you to being walking. Walk for 30 minutes every day and start to eat more fruits and vegetables." d. "They probably aren't walking fast enough or far enough. You need to spend at least 45 minutes if you are going to do any good."
c
A patient experienced a myocardial infarction 4 weeks ago and is currently participating in the daily cardiac rehabilitation session at the local fitness center. In what level of prevention is the patient participating? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Quaternary prevention
d
A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed a. Planning b. Evaluation c. Assessment d. Implementation
b
A patient is admitted to an acute care area. The patient is an active business man who is worried about getting back to work. He has had severe diarrhea and vomiting for the last week. He is weak, and his breathing is labored. Using Maslow's hierarchy of needs, identify this patient's immediate priority. a. Self-actualization b. Air, water, and nutrition c. Safety d. Esteem and self-esteem needs
D
A patient with a 20-year history of diabetes mellitus had a lower leg amputation. Which statement made by the patient indicates that he is experiencing a problem with body image? a. "I just don't have any energy to get out of bed in the morning." b. "I've been attending church regularly with my wife since I got out of the hospital." c. "My wife has taken over paying the bills since I've been in the hospital." d. "I don't go out very much because everyone stares at me."
b
A patient with diabetes is controlling the disease with insulin and diet. The nursing health care provider is focusing efforts to teach the patient self-management. Which of the following nursing theories is useful in promoting self management? a. Neuman b. Orem c. Roy d. Peplau
c
A research study is investigating the following research question: What is the effect of the diagnosis of breast cancer on the roles of the family? In this study "the diagnosis of breast cancer" and "family roles" are examples of? a. Surveys b. The sample c. Variables d. Data collection points
d
A woman who is a Jehovah's Witness has severe life-threatening injuries and is hemorrhaging following a car accident. The health care provider ordered 2 units of packed red blood cells to treat the woman's anemia The woman's husband refuses to allow the nurse to give his wife the blood. What is the nurse's responsibility? a. Obtain a court order to give the blood b. Coerce the husband into giving the blood c. Call security and have the husband removed from the hospital d. Abide by the husband's wishes and inform the health care provider
a
Advanced practice registered nurses generally: a. Function independently b. Function as unit directors c. Work in acute care settings d. Work in the university setting
2, 6, 5, 1, 3, 4
Arrange the following steps of evidence-based practice (EBP) in the appropriate order: 1. Integrate the evidence 2. Ask the burning clinical question 3. Evaluate the practice decision or change 4. Share the results with others 5. Critically appraise the evidence you gather 6. Collect the most relevant and best evidence
a, b, c
As an art, nursing relies on knowledge gained from practice and reflection on past experiences. As a science, nursing relies on (select all that apply): a. Experimental research b. Nonexperimental research c. Research from other disciplines d. Professional opinions.
a
The nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is an appropriate goal for restorative care? a. Patient will be able to walk 200 feet without shortness of breath b. Would will heal without signs of infection c. Patient will express concerns related to return to home d. Patient will identify strategies to improve sleep habits
c
Based on the transtheoretical model of change, what is the most appropriate response to a patient who states: "Me, exercise? I haven't done that since junior high gym class, and I hated it then!" a. "That's fine. Exercise is bad for you anyway." b. "OK. I want you to walk 3 miles 4 times a week, and I'll see you in 1 month" c. "I understand. Can you think of one reason why being more active would be helpful for you?" d. "I'd like you to ride your bike 3 times this week and eat at least four fruits and vegetables every day"
b
Ethical dilemmas often arise over a conflict of opinion. What is the critical first step in negotiating the difference of opinion? a. Consult a professional ethicist to ensure that the steps of the process occur in full b. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma c. Ensure that the attending physician or health care provider has written an order for an ethics consultation to support the ethics process d. List the ethical principles that inform the dilemma so negotiations agree on the language of the discussion
c
Evidence-based practice is defined as: a. Nursing care based on tradition b. Scholarly inquiry of nursing and biomedical current literature c. A problem-solving approach that integrates best current evidence with clinical practice d. Quality nursing care provided in an efficient and economically sound manner
a
Health care reform will bring changes in the emphasis of care. Which of the following models in expected from health care reform? a. Moving from an acute illness to a health promotion, illness prevention model b. Moving from illness prevention to a health promotion model c. Moving from an acute illness to a disease management model d. Moving from a chronic care to an illness prevention model
c
If you as a nurse participate in a public online social network such as Facebook, could you post images of a patient's x-ray fil if you deleted all patient identifiers? a. Yes, because patient privacy would no be violated as long as the patient identifiers were removed b. Yes because respect for autonomy implies that you have the autonomy to decide what constitutes privacy c. No because, even though patient identifiers are removed, someone could identify the patient based on other comments that you make online about his or her condition and your place of work d. No because the principal of justice requires you to allocate resources fairly
b
In an occupational health setting, the nurse determines that a large number of employees smoke and designs an employee assistance program for smoking cessation. This is an example of which nursing role: a. Educator b. Counselor c. Collaborator d. Case Manager
c
In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable? a. Nurses understand the principle of autonomy to guide respect for patient's self -worth b. Nurses have a scope of practice that encourages their presence during ethical discussions c. Nurses develop a relationship to the patient that is unique among all professional health care providers d. The nurse's code of ethics recommends that a nurse be present an any ethical discussion about patient care
c
Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? a. Continuing education b. Graduate education c. In-service education d. Professional Registered Nurse Education
a
Nurses on a nursing unit are discussing the processes that led up to a near-miss error on the clinical unit. They are outlining strategies that will prevent this in the future. This is an example of nurses working on what issue in the health care system? a. Patient safety b. Evidence-based practice c. Patient satisfaction d. Maintenance of competency
a
Which of the following is closely aligned with Leininger's theory? a. Caring for patients from unique cultures b. Understanding the humanistic aspect of life c. Variables affecting a patient's response to a stressor d. Caring for patients who cannot adapt to internal and external environmental demands
b
The nurse is conducting a home visit with an older adult couple. She assesses that the lighting in the home is poor and there are throw rugs throughout the home and a low footstool in the living room. She discusses removing the rugs and footstool and improving the lighting with the couple. The nurse is addressing which level of need to according to Maslow? a. Physiological b. Safety & Security c. Love & Belonging d. Self-actualization
a
Resolution of an ethical dilemma involves discussion with the patient, the patient's family, and the participants from all health care disciplines. Which of the following describes the role of the nurse in the resolution of the ethical dilemmas? a. To articulate his or her unique point of view, including knowledge based on clinical and psychosocial observations b. To await new clinical orders from the physician c. To limit discussions about ethical principals d. To allow the patient and the physician to resolve the dilemma without regard to personally held values or opinions regarding the ethical issues
b
The nurse is developing a health promotion program on healthy eating and exercise for high school students using the health belief model as a framework. Which statement made by a nursing student is related to the individual's perception of susceptibility to an illness? a. "I don't have time to exercise because I have to work after school every night." b. "I'm worried about becoming overweight and getting diabetes because my father has diabetes." c. "The statistics of how many teenagers are overweight is scary." d. "I've decided to start a walking club at school for interested students."
a
The nurse is participating at a health fair at the local mall giving influenza vaccines to senior citizens. What level of prevention is the nurse practicing? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Quaternary prevention
b
The nurse is planning care for a patient going to surgery. Who is responsible for informing the patient about the surgery along with possible risks, complications, and benefits? a. Family member b. Surgeon c. Nurse d. Nurse Manager
d
The examination for registered nurse licensure is exactly the same in every state in the United States. This examination: a. Guarantees safe nursing care for all patients b. Ensures standard nursing care for all patients c. Ensures that honest and ethical care is provided d. Provides a minimal standard of knowledge for a registered nurse in practice
b
The nurse notes that an advance directive is on a patient's medical record. Which statement represents the best description of an advance directive guideline the nurse will follow? a. A living will allows an appointed person to make health care decisions when the patient is in an incapacitated state. b. A living will in invoked only when the patient has a terminal condition or is in a persistent vegetative state. c. The patient cannot make changes in the advance directive once admitted to the hospital. d. A durable power of attorney for health care is invoked only when the patient has a terminal condition or is in a persistent vegetative state.
d
The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patents. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? a. Clinical Nurse Specialist b. Nurse Administrator c. Nurse Educator d. Nurse Researcher
b, c, e
The nursing staff is developing a quality program for the floor. Which of the following are nursing-sensitive indicators from the National Database of Nursing Quality Indicators that the nurses can use to measure patient safety and quality for the unit? (Select all that apply) a. Number of medication errors committed by registered nurses b. Turnover rate of nurses on the unit c. Incidence of patient falls d. Number of certified RNs e. Number of emergency department admissions per year
d
The patient for whom you are caring needs a liver transplant to survive. This patient has been out of work for several months and doesn't have health insurance or enough cash. What principles would be priority in a discussion about ethics? a. Accountability because you as the nurse are accountable for the well-being of this patient b. Respect for autonomy because this patient's autonomy will be violated if he does not receive the liver transplant c. Ethics of care because the caring thing that a nurse could provide this patient is resources for a liver transplant d. Justice because the first and greatest question in this situation is how to determine the just distribution of resources
a, e
The patient has a fractured femur that is placed in skeletal traction with a fresh plaster cast applied. The patient experiences decreased sensation and a cold feeling in the toes of the affected leg. The nurse observes that the patient's toes have become pale and cold but forgets to document this because one of the nurse's other patients experienced cardiac arrest at the same time. Two days later the patient in skeletal traction has an elevated temperature, and he is prepared for surgery to amputate the leg below the knew. Which of the following statements regarding a breach of duty apply to this situation? (Select all that apply) a. Failure to document a change in assessment data b. Failure to provide discharge instructions c. Failure to follow the six rights of medication administration d. Failure to use proper medical equipment ordered for patient monitoring e. Failure to notify a health care provider about a change in the patient's condition
d
The patient states she joined a fitness club and attends the aerobics class three nights a week. The patient is in what stage of behavioral change? a. Precontemplation b. Contemplation c. Preparation d. Action
c
The patient tells the nurse that she is enrolled in a preferred provider organization (PPO) but does not understand what this is. What is the nurse's best explanation of a PPO? a. This health plan is for people who cannot afford their own health insurance b. This health plan is operated by the government to provide health care to older adults c. This health plan provides you with a preferred list of physicians, hospitals, and providers from which you can choose d. This is a fee-for-service plan in which you can choose any physician or hospital
b
The philosophy sometimes called the ethics of care suggests that ethical dilemmas can best be solved by attention to which of the following? a. Patients b. Relationships c. Ethical principles d. Code of ethics for nurses
c
The point of the ethical principal to "do no harm" is an agreement to reassure the public that in all ways the health care team not only works to heal patients but agree to do this in the least painful and harmful way possible. Which principle describes this agreement? a. Beneficence b. Accountability c. Nonmeleficence d. Respect for autonomy
a
The principals of utilitarianism proposes which of the following? a. The value of something is determined by its usefulness to society b. People's value are determined by religious leaders c. The decision to perform a liver transplant depends on a measure of the moral life that the patient has led so far d. The best way to determine the solution to an ethical dilemma is to refer the case to the attending physician or health care provider
d
Theory-based nursing practice uses a theoretical approach for nursing care. This approach moves nursing forward as a science. This suggests that: a. One theory will guide nursing practice. b. Scientists will decide nursing decisions. c. Nursing will only base patient care on the practice of other sciences. d. Theories will be tested to describe or predict patient outcomes.
c
To practice in today's health care environment, nurses need a strong scientific knowledge base from nursing and other disciplines such as the physical, social, and behavioral sciences. This statement identifies the need for which of the following? a. Systems theories b. Developmental theories c. Interdisciplinary theories d. Health and wellness models
d
What is the best example of the nurse practicing patient advocacy? a. Seek out the nursing supervisor in conflicting procedural situations b. Document all clinical changes in the medical record in a timely manner c. Work to understand the law as it appli9es to an error in following standards of care d. Assess the patient's point of view and prepare to articulate it
a
When a nurse assesses a patient for pain and offers a plan to manage the pain, which principal is used to encourage the nurse to monitor the patient's response to the pain? a. Fidelity b. Beneficence c. Nonmaleficence d. Respect for autonomy
c
When a nurse uses information and technology to communicate, locate and use knowledge, reduce and eliminate errors, and help make decisions, the nurse is working in which area? a Integrated delivery system b Health care patient system c. Nursing informatics d. Computerized nursing network
b
When an ethical dilemma occurs on your unit, can you resolve the dilemma by taking a vote? a. Yes because ethics is essentially a democratic process, with all participants sharing an equal voice b. No because an ethical dilemma involves the resolution of conflicting values and principals rather than simply the identification of what people want to do c. Yes because ethical dilemmas otherwise take up time and energy that is better spent at the bedside performing direct patient care d. No because most ethical dilemmas are resolved by deferring to the medical director of the ethics department
b
When illness occurs, different attitudes about it cause people to react in different ways. What do medical sociologist call this reaction to illness? a. Health belief b. Illness behavior c. Health promotion d. Illness prevention
d
When recruiting subjects to participate in a study about the effects of an exercise program on balance, the researcher provides full and complete information about the purpose of the study and gives the subjects the choice to participate or not participate in the study. This is an example of: a. Bias b. Anonymity c. Confidentiality d. Informed consent
a
When taking care of patients, the nurse routinely asks them if they take any vitamins or herbal medications, encourages family members to bring in music that the patient likes to help the patient relax, and frequently prays with her patients if that is important to them. The nurse is practicing which model? a. Holistic b. Health belief c. Transtheoretical d. Health promotion
d
Which activity performed by the nurse is related to maintaining competency in the nursing practice? a. Asking another nurse about how to change the settings on a medication pump b. Regularly attending unit staff meetings c. Participating as a member of the professional nursing council d. Attending a review course in preparation for the certification examination
a
Which activity represents secondary prevention? a. A home health care curse visits a patient's home to change a wound dressing. b. A 50-yr-old woman with no history of disease attends the local health fair and has her blood pressure checked. c. The school health nurse provides a program to the first year students on healthy eating. d. The patient attends cardiac rehabilitation sessions weekly.
c
Which is the best method of negotiating or processing difficult ethical decisions? a. Ethical issues arise between dissenting providers and can be best resolved by deference to an independent arbitrator such as a chaplain b. Since ethical issues usually affect policy and procedure, a legal expert is the best consultant to help resolve disputes. c. Institutional ethics committees help to ensure that all participants involved in the ethical dilemma get a fair hearing and an opportunity to express values, feelings, and opinions as a way to find cons+ensus d. Medical experts are best able to resolve conflicts about outcome predictions
a, d
Which of the following actions, if performed by a registered nurse, would result in both criminal and administrative law sanctions against the nurse? (Select all that apply) a. Taking or selling controlled substances b. Refusing to provide health care information to a patient's child c. Reporting suspected abuse and neglect of children d. Applying physical restraints without a written physician's order
a, b, c, f
Which of the following activities performed by the nurse is/are focused on the patient-centered care principle of physical comfort? (Select all that apply) a. Asking the patient what a tolerable level of pain is for him or her following surgery b. Providing a back rub at bedtime c. Offering the patient a warm washcloth for his or her hands before eating d. Teaching the patient about the new antihypertensive medication ordered e. Scheduling for patient's follow-up appointments on discharge f. Changing the bed linens for a patient who is experiencing diaphoresis
a, b, c
Which of the following apply to Peplau's theory when establishing the nurse-patient relationship? (Select all that apply) a. An interaction between the nurse and patient must develop. b. The patient's needs must be clarified and described. c. The nurse-patient relationship is influenced by patient and nurse preconceptions. d. The nurse-patient relationship is influenced only by the nurse's preconceptions.
d
Which of the following are components of paradigm of nursing? a. The person, health, environment, and theory b. Health, theory, concepts, and environment c. Nurses, physicians, health, and patient needs d. The person, health, environment/situation, and nursing
b, c, e
Which of the following are examples of the principle of patient-centered care that is focused on respect, values, preferences, and expressed needs? (Select all that apply) a. Administer antihypertensive medications to patient daily b. Pulling the curtain around the patient bed before changing the wound dressing on the patient's leg c. Allowing the patient to ask questions and express his or her concern about surgery d. Explaining a colonoscopy procedure to the patient e. Working with the family to bring the ethnic foods that the patient prefers
b
Which of the following in an example of the principle of patient-centered care focused on continuity and transition? a. The nurse asks the patient who in the family should have access to patient information b. The nurse is teaching the patient how to change the wound dressing at home c. The nurse responds promptly to the patient's request for pain medication d. The nurse schedules the patient's diagnostic scan following the physical therapy session
a
Which of the following is an example of the nurse participating in primary care activities? a. Providing prenatal teaching on nutrition to a pregnant woman during the first trimester b. Working with patients in a cardiac rehabilitation program c. Assessing a patient at an emergent care facility d. Providing home would care to a patient
a, d, e
Which of the following is/are characteristics of managed care systems? (Select all that apply) a. Provider receives a predetermined payment for each patient in the program. b. Payment is based on a set fee for each service provided. c. System includes a voluntary prescription drug program for an additional cost d. System tries to reduce costs while keeping patients healthy. e. Focus of care is on prevention and early intervention.
c
Which of the following nursing activities is found in a tertiary health care environment? a. Administering influenza immunizations at the senior independent living facility b. Providing well-baby care in the clinic run by the local community health department c. Admitting a patient following open heart surgery to the cardiovascular intensive care unit d. Working the triage desk in the emergency department
b, c
Which of the following nursing roles may have prescriptive authority in their practice? (Select all that apply) a. Critical Care Nurse b. Nurse Practitioner c. Certified Clinical Nurse Specialist d. Charge Nurse
c
Which of the following statements about theory-based nursing practice is incorrect? a. Contributes to evidence-based practice b. Provides a systematic process for designing nursing interventions c. Is not linked to nursing outcomes d. Guides the nurse's assessment
d
Which of the following statements is true regarding Magnet status recognition for a hospital? a. Nursing is run by a Magnet manager who makes decisions for the nursing units b. Nurses in Magnet hospitals make all of the decisions on the clinical units c. Magnet is a term that is used to describe the hospitals that are able to hire the nurses they need d. Magnet is a special designation for hospitals that achieve excellence in nursing practice
b
Which of the following theories describe the life processes of and older adult facing chronic illness? a. System theories b. Developmental theories c. Interdisciplinary theories d. Health and wellness models
c
Which of these actions describes a violation of the Health Insurance Portability and Accountability Act (HIPAA)? a. Discussing patient conditions in the nursing report room at the change of shift b. Allowing nursing students to review patient charts before caring for patients wo whom they are assigned c. Posting medical information about the patient on a message board in the patient's room d. Releasing patient information regarding terminal illness to family when the patient has given permission for information to be shared
d
Which of these is an over goal of Healthy People 2020: a. Assess the health care needs of individuals, families, or communities b. Develop and implement public health policies and improve access to care c. Gather information on incident rates of certain diseases and social problems d. Increase life expectancy and quality of life and eliminate health disparities
a
Which statement made by the nurse is an example of applying the principle of patient-centered care while focusing on alleviation of a patient's fear and anxiety? a. "Let's talk about the concerns that you have about going home." b. "I'll get the medication prescriptions for you before discharge." c. "I'll be back in 30 minutes to help you get cleaned up." d. "I'll make a referral to the home health nurse for you"
a
You are floated to work on a nursing unit where you are given an assignment that is beyond your capability. What is the best nursing action to take first? a. Call the nursing supervisor to discuss the situation b. Discuss the problem with a colleague c. Leave the nursing unit and go home d. Say nothing and begin your work
d
You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A nonnursing colleague asks about this code. Which of the following statements best describes this code? a. Improves self-health care b. protects the patient's confidentiality c. ensures identical care to all patients d. defines the principles of right and wrong to provide patient care
c
You are the night shift nurse and are caring for a newly admitted patient who appears to be confused. The family asks to see the patient's medical record. What is the first nursing action to take? a. Give the family a record b. Give the patient the record c. Discuss the issues that concern the family with them d. Call the nursing supervisor
