Prep u UNIT 1 and 2

The nurse moves a confused, disruptive patient to a private room at the end of the hall so that other patients can rest, even though the confused patient becomes more agitated. The nurse's intervention is consistent with what moral theory? "Consequentialism," by which good consequences for the greatest number are maximized "Duty of obligation," by which an action, regardless of its results, is justified if the decision making was based on moral principles "Paternalism," in which the action limits the patient's autonomy "Veracity," in which the nurse has an obligation to tell the truth

"Consequentialism," by which good consequences for the greatest number are maximized

A home care nurse is preparing a presentation for a group of nursing students about the area of practice. Which statement would the nurse most likely include when describing this practice area? "Home care requires that the nurse has an advanced degree in nursing." "The major emphasis of care involves accessing community resources." "Home care nurses need to have high-level assessment skills." "Decision-making is shared among the other health care professionals."

"Home care nurses need to have high-level assessment skills."

The nurse is preparing to serve on the hospital's ethics committee. What are ethical dilemmas in the nurse's clinical practice that can show direct conflict with the principle of veracity? Select all that apply. administering placebos for pain relief keeping a client's medical diagnosis from the client discussing a client's health information with the health care provider on call teaching a client how to perform self-care measures revealing a diagnosis to people other than the client with the diagnosis

-administering placebos for pain relief -keeping a client's medical diagnosis from the client -revealing a diagnosis to people other than the client with the diagnosis

A nurse is collecting data from a client who has major depressive disorder the nurse should identify which of the following client statements as an overt comment about suicide A my family will be better off if I'm dead B The stress in my life is too much to handle C I wish my life was over D I don't feel like I could ever be happy again E if I kill myself and my problems will go away

A my family will be better off if I'm dead C I wish my life was over E if I kill myself and my problems will go away

What is the primary focus of the nurse advocacy role in managing a clinical pathway? Continuity of care Cost-containment practices Effective utilization of services A patient's progress toward desired outcomes

A patient's progress toward desired outcomes

Which of the following best describes the health-illness continuum? A person with chronic illness is at the far end of the continuum reflecting illness. A person may be considered neither completely healthy or completely ill. A person with high-level wellness is free of any disease or infirmity. A person on the continuum remains at the point based on his or her initial state of health.

A person may be considered neither completely healthy or completely ill.

In the past several years, the number of malpractice suits against nurses has increased. Many reasons contribute to the increase in litigation. Which measures can limit or reduce a nurse's liability? All of the responses are correct. risk management documentation liability insurance

All of the responses are correct.

x Which professional values apply to the nursing profession? All of the responses are correct. autonomy beneficence fidelity

All of the responses are correct.

An unresponsive client with a terminal illness in the hospital has no advanced directive. What are the steps the nurse will follow to practice ethical decision making? Select all that apply. Assess the ethical/moral situations of the problem. Gather a team of nurses for decision making Convene an ethics panel. List the alternatives. Decide and evaluate the decision.

Assess the ethical/moral situations of the problem. Convene an ethics panel. List the alternatives. Decide and evaluate the decision.

A nurse warns a client that he may fall off his bed during a seizure attack if he does not put on the side rails of the bed. Before leaving the client's room, the nurse puts on the side rails, but after the nurse has left, the client lowers them again. Later, the client has a fall from the bed during seizures and holds the nurse responsible for it. Which of the following legal provisions protects the nurse in this case? Good Samaritan law Statute of limitations Common law Assumption of risk

Assumption of risk

A nurse is caring for a 28-year-old woman who has delivered a baby by Cesarean section. She describes her pain as a nine. The nurse medicates her for pain. This is an example of which of the following ethical frameworks? Justice Fidelity Beneficence Nonmaleficence

Beneficence

A nurse is assisting with the development of protocols to address the increasing number of suicide attempts in the community which of the following intervention should the nurse include as a primary intervention A Conducting a suicide risk screening on all new clients B creating a support group for family members of clients who died by suicide C informing high school teams about suicide prevention D initiating one on one observation for a client who has current suicide ideation E reinforce teaching middle school educators about warning indicators of suicide

C informing high school teams about suicide prevention E reinforce teaching middle school educators about warning indicators of suicide

A nurse is assisting in conducting a class for a group of newly licensed nurses on caring for clients who are at risk for suicide which of the following information should the nurse include in the teaching A A clients verbal threat to oneself is attention seeking behavior B interventions are infected for clients who really want to commit suicide C usually the term suicide increases the clients for us for suicide attempt D A no suicide contact decreases the clients route for suicide

D A no suicide contact decreases the clients route for suicide

A nurse is caring for a client who states I plan to commit suicide which of the following findings should the nurse identifies the priority A clients educational and economic background B Quality of the clients social support C clients insight into the reasons for the decision D Lethality of the method and availability of means

D Lethality of the method and availability of means

A nurse is caring for a client who is on suicide precautions which of the following intervention should the nurse contribute to plan of care A assign the client to a private room B document the clients behavior every hour CAllow the client to keep perfume in the room D ensure that the client swallows medication

D ensure that the client swallows medication

After teaching a group of students about health, wellness and illness, a nursing instructor determines that additional instruction is necessary when the students identify which of the following as a component of wellness? Performing to the best of one's ability Reporting a feeling of well-being Adjusting to varying situations Feeling together about one part of life

Feeling together about one part of life

A nurse states to the client she will keep her pain free. However, her family wishes to try a treatment to prolong her life which may necessitate withholding pain medication. This factor will cause an ethical dilemma for the nurse in relation to which ethical principle? Fidelity Veracity Justice Autonomy

Fidelity

A patient with a "Do Not Resuscitate" (DNR) order requires large doses of a narcotic for pain that rates a 10 on a 0-10 scale. After the patient requests pain medication, the nurse assesses a respiratory rate of 12 breaths per minute. What intervention by the nurse would be considered ethical? Ask the patient to wait 20 minutes and reassess. Give half of the prescribed dose. Give the pain medication without fear of respiratory depression. Withhold the pain medication and contact the physician.

Give the pain medication without fear of respiratory depression.

A nurse who provides care in a postsurgical care unit of a hospital is aware that reimbursement to the hospital for Medicare patients is based on diagnosis-related groups (DRGs). How are DRGs used to determine reimbursement for Medicare patients? Hospitals receive payment at a fixed rate for patients with diagnoses that fall into a specific DRG. Medicare patients match the hospital's reimbursement from Medicare at a dollar-for-dollar rate. A Medicare patient's minimum levels of care are established by the DRG that best relates to the patient's care needs. Hospitals do not receive reimbursement if it can be demonstrated that a patient falls within a DRG.

Hospitals receive payment at a fixed rate for patients with diagnoses that fall into a specific DRG.

Health care in the United States continues to be impacted by larger social trends and by factors in a variety of domains. Among these trends in the recent past and the foreseeable future are increases in: The birth rate and the incidence of acute illness The number of Americans who reside in rural settings Illiteracy levels and international funding for health care Immigration and life expectancy

Immigration and life expectancy

The foundation for decisions about resource allocation throughout a society or group is based on the ethical principle of Veracity Autonomy Justice Confidentiality

Justice

A physician is being sued for malpractice in a case involving a birth accident. What circumstance determines whether the suit is a negligence or malpractice suit? None of the options is correct. legal standing of the medical practice size of the medical practice physician income

None of the options is correct.

A home care nurse is at her elderly client's home. The client is confined to bed and is cared for by her daughter. The daughter is known to suffer from chemical dependence. The home is cluttered and infested with roaches. The nurse notices the client is wet with urine and has dried feces on her buttocks. She appears dehydrated. The nurse cleans her, changes the sheets, and calls to have her transported to the hospital. The nurse also reports the incident to the Division of Aging. This is an example of which ethical framework? Justice Beneficence Nonmaleficence Fidelity

Nonmaleficence

A hospice nurse is caring for a client who is dying of lymphoma. According to Maslow hierarchy of needs, what dimension of care should the nurse consider primary in importance when caring for a dying client? Spiritual Social Physiologic Emotional

Physiologic

Nursing students are attending a seminar about laws. Which of the following characteristics would they correctly identify as characteristics of laws? Select all that apply. Serve as rules of conduct Guide actions and interactions within a society Are regulated by authorized organizations and law officers Deal with right and wrong Consider beliefs about morals and values

Serve as rules of conduct Guide actions and interactions within a society Are regulated by authorized organizations and law officers

Nurse Practice Acts are examples of which type of laws? Statutory law Constitutional law Administrative law Common law

Statutory law

Which of the following best describes the utilitarian theory of ethics? If an action is useful, it is ethically correct. The consequences of an action determine if it is right or wrong. All actions are either right or wrong, regardless of consequences. There is no way to determine whether an action is ethical or not.

The consequences of an action determine if it is right or wrong.

A client who has undergone resection of the intestine is on a liquid diet with a nasogastric tube in place. He refuses the food tray with regular food that comes to his room and insists that a physician be called. The nurse insists that it is the right food and makes the client take it. The client develops complications and has to be re-operated upon. How is negligence determined in this situation? The nurse did not call the physician when the client asked. The nurse did not realize the importance of the tube. The dietary department sent the wrong diet for the client. The nurse insisted the patient have the solid food.

The nurse did not realize the importance of the tube.

A client is brought to the Emergency Department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure? The nurse informs the family about advance directives. The nurse informs the family about the living will. The nurse ensures that the client signs the consent form. The nurse ensures that the client's family signs the consent form.

The nurse ensures that the client's family signs the consent form.

A nurse on a medical-surgical unit has asked to represent the unit on the hospital's quality committee. When describing quality improvement programs to nursing colleagues and members of other health disciplines, what characteristic should the nurse cite? These programs establish consequences for health care professionals' actions. These programs emphasize the need for evidence-based practice. These programs identify specific incidents related to quality. These programs seek to justify health care costs and systems.

These programs emphasize the need for evidence-based practice.

A client is confused about advance directives and asks the nurse to explain them. What information will the nurse include in client teaching about advance directives? Select all that apply. They provide information about client wishes for health care situations. They list the client's belongings and who should get what after the client dies. They may contain a living will. They address financial information that may assist health care providers in decision making. They explain the client's philosophy of life.

They provide information about client wishes for health care situations. They may contain a living will.

Nurses in acute care settings must work with other health care team members to maintain quality care while facing pressures to care for clients who are hospitalized for shorter periods of time than in the past. To ensure positive health outcomes when clients return to their homes, what action should the nurse prioritize? Promotion of health literacy during hospitalization Close communication with primary providers Thorough and evidence-based discharge planning Participation in continuing education initiatives

Thorough and evidence-based discharge planning

When the nurse voices preference for the funding of services that assist many clients in his community over services that assist a small group of in the community is noted as a(an) Deontologic framework Beneficence framework Nonmaleficence framework Utilitarian framework

Utilitarian framework

When an ethical decision is made based on the reasoning of the "greatest good for the greatest number," what theory is the nurse following? Deontological theory Formalist theory Moral-justification theory Utilitarian theory

Utilitarian theory

A client has just been told she has cancer. The client tells the nurse that she is not sure if she wants her family to know. The nurse encourages the client to consider sharing this information with her family members so they can support her through future treatment-related decisions. What ethical principle is the nurse demonstrating? Confidentiality Veracity Fidelity Justice

Veracity

When a nurse answers questions posed by a cancer client in a thorough and accurate manner, the nurse is demonstrating the ethical principle of Veracity Fidelity Justice Autonomy

Veracity

Which of the following phrases best describes a value? questions about how one should act and live the process by which one decides what is important in life a belief about the worth of something to guide behavior dispositions of character that motivate goodness

a belief about the worth of something to guide behavior

The nurse understands that the sharing of personal prescriptions, especially narcotic pain medication, violates a number of local, state, and federal regulations. Specifically referring to nursing licensure, which area of law would be violated? administrative law common law civil law criminal law

administrative law

Which area of law is violated by a nurse sharing personal prescriptions, especially narcotic pain medication? administrative law criminal law common law None of the options is correct.

administrative law

A nurse who has been working a lot of overtime didn't shovel the sidewalk after a recent snow. A person walking down the street fell on the snow-covered sidewalk and brought suit against the nurse for negligence. Negligence is categorized as: an unintentional tort. an intentional tort. a criminal tort. a civil tort.

an unintentional tort.

A nurse has been subpoenaed to testify in a malpractice suit brought against an LV/PN coworker. The jury will determine if there was malpractice by: comparing the actions of the nurse with those of the nurse's peers. identifying the costs of anticipated losses. reviewing all the problems that occur at the workplace. identifying the nature of the incident and witnesses.

comparing the actions of the nurse with those of the nurse's peers.

Several days this week, a nurse takes time after work to read to a visually impaired client who has no family close by. This behavior demonstrates that ethical values: concern the treatment of others. are consistent. take priority over other values. are well thought out.

concern the treatment of others.

Ethical theories provide a means to determine if a particular action is good or bad. Which theory of ethics holds that a person's duties are as important as the outcome or consequences of one's actions? deontology utilitarianism teleologic theory contractualism

deontology

In which type of managed care plan do physicians have an incentive to keep costs low because fees paid are based on the number of members, not on the number of services provided? health maintenance organization (HMO) preferred provider organization (PPO) point-of-service (POS) plan physician hospital organization (PHO)

health maintenance organization (HMO)

The financial stability of Health Maintenance Organizations (HMOs) is based on: keeping clients healthy and out of the hospital through periodic screening, health education, and preventive services. maintaining the statistics and records of all the clients admitted in hospitals on a regular basis. keeping clients satisfied by providing them with regular financial assistance and looking after their medical requirements. providing entertainment programs for clients in order to distract clients from their illness.

keeping clients healthy and out of the hospital through periodic screening, health education, and preventive services.

A nurse administers a dose of the wrong antibiotic to a client who has a severe allergic reaction within an hour. Which term describes the nurse's legal responsibility for the harm that resulted from this action? liability duty tort standards of practice

liability

A nurse using the principle-based approach to patient care seeks to avoid causing harm to patients in all situations. This principle is known as: nonmaleficence justice fidelity autonomy

nonmaleficence

A hospital has reaffirmed its commitment to meeting National Patient Safety Goals (NPSGs). The hospital is most likely to meet these goals by: reducing the incidence of hospital-acquired infections. decreasing the use of unlicensed care providers. encouraging researchers to conduct evidence-based studies within the hospital. involving clients and families in their care planning

reducing the incidence of hospital-acquired infections

An Emergency Department had a chaotic shift with multiple MVAs, a couple of suicide attempts, and three MIs. The clients underwent many tests, labs, radiographs, etc. and it was important for nursing staff keep client information and treatments organized. Of what benefit is an anecdotal record? refreshes the nurse's memory becomes official record of care performed aligns treatment given with facility policy helps clients prepare advance directives

refreshes the nurse's memory

The nursing staff provided care 10 years ago to a client who had just been diagnosed with prostate cancer. Last week, the hospital received notification that the client's family had filed suit against the hospital, the oncologist, and nurses who provided care. The suit claims that the diagnosis was not made quickly enough to prevent the client's death (9 years later). After checking with the hospital's attorney, which measure to limit professional liability could offer the nurses some peace of mind? statute of limitations good Samaritan laws missing documentation assumption of risk

statute of limitations

A medical-surgical nurse is aware of the scope of practice as defined in the jurisdiction where the nurse provides care. When exploring the legal basis for the scope of practice, the nurse should consult: codes of ethics. a code of nursing conduct. the nurse practice act in the nurse's jurisdiction. client preferences and norms within the profession.

the nurse practice act in the nurse's jurisdiction.

A nurse saw a coworker steal drugs from a locked cabinet. The supervisor notices the missing drugs and has a good idea who is responsible for the theft. The supervisor asks if the nurse saw anything out of the ordinary. Which professional value reflects a nurse's duty to tell the truth? veracity autonomy beneficence nonmaleficence

veracity

The nurse has organized a care team meeting for a client in rehabilitation. The client, the client's spouse, the physical therapy assistant, and the social worker are present. Many decisions are made during this meeting. Which type of feedback determines if the decisions made are understood by the client? · verbal feedback from the client · verbal feedback from the client's spouse · nonverbal feedback from the client · Decisions do not have to be understood by the client if they are in his or her best interest.

verbal feedback from the client

Which cranial nerve is tested by listening to a ticking watch? · Acoustic · Facial · Vagus · Trigeminal

· Acoustic

Nursing students are reviewing the various weapons of mass destruction, specifically biologic agents. The students demonstrate understanding of the information when they identify which of the following as the most likely weaponized agent? · Anthrax · Tularemia · Botulism · Plague

· Anthrax

A nurse plans to have an education session with a client who has cardiomyopathy and the client's spouse about ways to decrease the sense of powerlessness. What action by the nurse will provide this information? · Assist the client in identifying life areas over which the client still has control. · Encourage the client to try to forget about things in life that have been lost. · Change the subject quickly if the client brings up the things in life that have been lost. · Encourage the client to occasionally have foods not on a low-sodium diet.

· Assist the client in identifying life areas over which the client still has control.

A client has just been told she needs to have an incisional biopsy of a right breast mass. During preoperative teaching, how could the nurse best assess this client for specific educational, physical, or psychosocial needs she might have? · By encouraging her to verbalize her questions and concerns · By discussing the possible findings of the biopsy · By discussing possible treatment options if the diagnosis is cancer · By reviewing her medical history

· By encouraging her to verbalize her questions and concerns

Which management function involves a team effort to achieve patient care outcomes? · Time management · Advocacy · Supervision · Collaboration

· Collaboration

While the nurse is recording the health history of a client who is scheduled for a thyroid test, the client informs the nurse about an allergy to seafood. What is the nurse's most appropriate response? · Document the allergy and inform the physician · Inquire about frequent urination · Palpate the thyroid gland · Consult the institution's procedure manual

· Document the allergy and inform the physician

The ED nurse is caring for a client who has gone into cardiac arrest. During external defibrillation, what action should the nurse perform? · Place gel pads over the apex and posterior chest for better conduction. · Ensure no one is touching the client at the time shock is delivered. · Continue to ventilate the client via endotracheal tube during the procedure. · Allow at least 3 minutes between shocks.

· Ensure no one is touching the client at the time shock is delivered.

A client recovering from thoracic surgery is on long-term mechanical ventilation and becomes very frustrated when he tries to communicate. What intervention should the nurse perform to assist the client? · Assure the client that everything will be all right and that remaining calm is the best strategy. · Ask a family member to interpret what the client is trying to communicate. · Ask the physician to wean the client off the mechanical ventilator to allow the patient to speak freely. · Express empathy and then encourage the client to write, use a picture board, or spell words with an alphabet board.

· Express empathy and then encourage the client to write, use a picture board, or spell words with an alphabet board.

The nurse is making a referral to physical therapy for a client who has had a hip replacement and is going to be discharged in 2 days. The nurse understands that physical therapy as part of the client's plan of care includes the client in what discipline? · Inclusion in the collaborative healthcare team · A discipline unto themselves · Inclusion in the administrative team · Inclusion in the supervisory team

· Inclusion in the collaborative healthcare team

The nurse documents in the EHR (electronic health record) while performing a physical assessment on a client. What does the nurse recognize is a benefit of the EHR? · It is universally more accepted by clients. · It decreases the cost of care provided. · It improves collaboration among health care providers. · It improves communication with the client.

· It improves collaboration among health care providers.

The nurse is caring for clients in the emergency department who have been admitted from the area surrounding a nuclear power plant. There had been a small explosion at the plant and a small amount of radiation had escaped. The nurse knows that this is what type of a disaster? · Natural · Explosive · Chemical · Radiologic

· Radiologic

A nurse refers a patient with a new colostomy to a support group. This nurse is practicing which of the following aims of nursing? · promoting health · preventing illness · restoring health · facilitating coping

· facilitating coping

A pipe bomb detonated on a city bus, causing numerous casualties. This would be an example of which type of disaster? · intentional human · natural · unintentional human · biologic

· intentional human