Prof Role 1 Midterm professional nursing behaviors

A nurse auscultates a client​'s breath sounds after the client receives an albuterol nebulizer treatment secondary to wheezing. The nurse finds that the client is still wheezing despite the therapy. Which aspect of the Tanner clinical judgment model is the nurse​ displaying? 1. Noticing 2. Responding 3. Reflecting 4. Interpreting

1 According to the Tanner clinical judgment​ model, the nurse is displaying noticing by recognizing the presence or absence of expected significant cues from the​ client's response to an illness or medical condition. Interpreting involves using logical reasoning to determine appropriate action after noticing a clinical finding. Responding occurs when the nurse acts based on what is found and interpreted. When the nurse reviews the clinical​ action, the nurse is reflecting.

The nurse is caring for a client diagnosed with pulmonary hypertension. Which intervention can be considered a​ direct, dependent​ intervention? 1. Assisting with the prescribed cardiac catheterization 2. Monitoring pulse oximetry for a client receiving oxygen by nasal cannula 3. Teaching the client about a prescribed medication 4. Calling the primary care provider and suggesting a physical therapy evaluation

1 Assisting with catheterization is an example of a​ direct, dependent intervention. It is direct in that the nurse is providing direct care to the​ client, and dependent in that a prescription is​ required; the nurse cannot initiate the care without a prescription. Monitoring pulse oximetry for a client on oxygen is an independent intervention as it is an ongoing assessment. Client teaching is an indirect intervention. Suggesting a referral for physical therapy is both indirect and dependent.

The nurse is providing care to a client recently diagnosed with chronic obstructive pulmonary disease​ (COPD). Which nursing action supports​ collaboration, which is essential to planning​ care? 1. Discussing appropriate smoking cessation programs with the​ client, upon request 2. Facilitating a home health consult when the client is discharged 3. Adjusting the head of the client​'s bed to ease breathing effort 4. Administering a breathing treatment to the​ client, as ordered

1 Each step of the nursing process is​ ongoing, including the planning phase. The nurse who discusses smoking cessation with the client at the​ client's request is allowing the client to collaborate on the care that is received. Collaboration is essential for the plan of care to be effective. The other actions indicate the nurse is providing care to the​ client, but not collaborating with the client.

Prior to meeting a​ client, the mental health nurse reviews the client​'s ​demographics, including the client​'s ​name, address,​ age, medical​ history, and social history. Which phase of the therapeutic relationship is reflected by this​ action? 1. Preinteraction 2. Working 3. Introductory 4. Termination

1 In the preinteraction​ phase, the nurse reviews information about the client before the first​ face-to-face meeting. The introductory phase is the initial​ face-to-face meeting and sets the tone for the interaction. In the working​ phase, the nurse helps the client to discover​ thoughts, feelings, and actions and to plan an action to meet goals. Termination occurs at the end of the therapeutic relationship.

The nurse leader is planning an​ in-service about integrity in nursing practice. Which statement regarding integrity in nursing is most appropriate for the nurse leader to include in the​ in-service? 1. "Nurses with integrity adhere to a strict moral or ethical code." 2. "Integrity means internalizing professional practices that the nurse prefers to follow." 3. "Integrity means understanding that negative feedback from peers has little value." 4. "Nurses with integrity provide excellent care and do not make errors."

1 Integrity requires adherence to a strict ethical or moral​ code, such as the ANA Code of Ethics for Nurses. Integrity involves practicing consistent behaviors based on the internalization of the​ ethics, values, and best practices of the nursing profession. Integrity in nursing includes accepting positive or negative feedback as a tool for improving the delivery of client care. Nurses with integrity are not​ perfect; however, they admit to their mistakes.

As part of hospital orientation for a group of​ nurses, the human resources representative is discussing intimidation. Which information is most appropriate for the human resources representative to include in the​ discussion? 1. Intimidation may include unintentional nursing behaviors and statements made to clients. 2. Overt forms of intimidation may include standing too close to someone. 3. Intimidation may include repeatedly asking another individual for favors. 4. Covert forms of intimidation may include making verbal threats.

1 Intimidation includes​ threatening, bullying, or forcing someone who is emotionally or physically weaker to do something in order to avoid retribution or negative consequences. Asking an individual for favors without any associated retribution or negative consequences is not reflective of intimidation.​ Subtle, or​ covert, forms of intimidation include standing close to someone while maintaining a hostile facial expression. Intimidation may also be​ overt, such as threatening an individual with consequences for not obeying an order. On the​ nurse's part, intimidation may be​ unintentional; for​ example, making statements such​ as, "If you do not take your medicine​ (or go to physical​ therapy, or follow the treatment​ plan), you're going to get​ worse."

A nurse caring for clients across the life span must consider the​ age, development​ level, and functional status of clients when helping them in clinical decision making. Which action by the nurse indicates support for a ​preschooler's decision making​ ability? 1. Asking the client if she would like to have her snack before or after going for an​ x-ray 2. Showing the client the materials that will be used to stich up the wound in her knee 3. Inviting the client to the interdisciplinary meeting 4. Soothing the client by rocking her until she calms down

1 Preschoolers are able to make some decisions related to preference when information is provided to them in a way that makes sense to them. Asking the preschooler if she would like snack before or after a procedure is an example of assisting a preschool child in decision making. Because adolescents are capable of participating in making decisions on their own​ behalf, it would be appropriate to invite an adolescent client to come to an interdisciplinary meeting.​ School-age children benefit from direct explanations and would likely be interested in seeing and handling materials that will be used in their own care. Although infants cannot make​ decisions, they need to feel secure during​ care; soothing and rocking the infant client is appropriate.

While providing care in the emergency​ department, the nurse asks the victim of a pedestrian accident "why did you cross the street in the middle of the ​block?" Which communication barrier is this nurse​ demonstrating? 1. Probing 2. Being defensive 3. Challenging 4. Testing

1 Probing is asking for information chiefly out of curiosity rather than with the intent to assist the client. This approach is considered prying and violates the​ client's privacy. Asking open double quote"whyclose double quote" is often probing and places the client in a defensive position. Challenging is giving a response that makes a client prove his or her statement or point of view. Being defensive is attempting to protect an individual or healthcare service from negative comments. Testing is asking questions that make the client admit to something. These responses permit the client only limited answers and often meet the​ nurse's need rather than the​ client's.

The staff nurse is caring for a client who has recently undergone surgical repair of an inguinal hernia. Despite administration of pain medications as​ ordered, the client continues to complain of excruciating pain. When the staff nurse offers to reposition the​ client, the client​ states, "You don​'t have any idea what you​'re doing. I need more medication. I need a nurse who can help ​me!" Which behavior best illustrates demonstration of compassion by the staff​ nurse? 1. Notifying the primary care provider about the client​'s complaints of pain despite receiving medication 2. Seeking out a nursing colleague to privately vent about the client​'s rudeness and inconsideration 3. Explaining that inguinal hernia repairs usually require significantly less medication for adequate pain relief 4. Collaborating with the charge nurse and requesting that another nurse assume the client​'s care

1 Professionalism in nursing requires demonstrating a positive attitude while working with​ clients, their family​ members, and other healthcare professionals. Venting to a nursing colleague is not reflective of a positive attitude. Professionalism in nursing also requires​ compassion, which is an awareness of and concern about other​ individuals' suffering. Requesting that the​ client's care be reassigned to another staff nurse is not reflective of compassion. Demonstrations of compassion in nursing include recognizing and meeting​ clients' needs and treating each client as a unique and special individual and not as a diagnosis​ (for example,​ "an inguinal hernia​ repair") or number. Notifying the primary care provider about the​ client's complaints of pain despite receiving pain medication best reflects recognizing and meeting the​ client's needs.

The nurse is implementing care for clients in an acute care facility. Which guidelines should the nurse use when choosing interventions for goal​ achievement? 1. They are consistent with clients​'​ values, beliefs, and culture. 2. They are identified with specific laws and regulations. 3. They can be performed with limited resources. 4. They are interchangeable among clients for optimal applicability.

1 The challenge is for the nurse to identify the best interventions to ensure goal achievement. The best interventions are those that are safe and appropriate for the​ client; performed with available​ resources, consistent with client​ values, beliefs, and​ culture; consistent with other prescribed treatments and​ therapies; evidence-based; and provided within established standards of care and applicable laws and regulations.

The nurse is working with an adult client who has a diagnosis of posttraumatic stress disorder​ (PTSD). The client shares that he has begun exercising daily at a local​ gym, and states that this lowers his daily stress level. Which type of nursing diagnosis would best capture the client​'s exercise​ behavior? 1. Wellness diagnosis 2. Health promotion diagnosis 3. Syndrome diagnosis 4. Risk diagnosis

1 The client has already modified his behavior to improve his health​ status; a wellness diagnosis would be appropriate. A health promotion diagnosis may be made when clients express a desire to improve their health. A risk diagnosis is used to capture client risk factors for illness or alterations in health. A syndrome diagnosis is a type of nursing diagnosis that may be used when a cluster of nursing diagnoses will help improve client outcomes if addressed at the same time.

The nurse is caring for several clients during a shift. Which observation made during a nursing assessment would be​ priority? 1. The client who complains of shortness of breath when walking from room to room 2. A client with a BP of​ 96/54 mmHg, HR of 70​ bpm, RR of 20 breaths per​ minute, and T 97.6​°F 3. A client who begins coughing after 6 minutes of walking 4. A client with an oxygen saturation of​ 94%

1 The first step when prioritizing care is assessment. Assessment is the process of gathering information to make decisions. At all​ times, the nurse needs to be aware that​ airway, breathing, and circulation are vital for life. The client who is complaining of shortness of breath when walking from room to room may have airway​ issues: This is the priority. The other clients may require​ interventions, but the client with shortness of breath takes priority.

What is the first action that should be made when prioritizing​ care? 1. Assess client situations 2. Assign staff to clients 3. Ascertain interventions 4. Analyze collected data

1 The first step when prioritizing care is assessment. Assessment is the process of gathering information to make decisions. This assessment includes knowing individual​ clients' health statuses in order to prepare for anticipated or unanticipated changes. Ascertaining interventions would occur after the assessment. Analyzing collected data would occur after an assessment. Assigning staff to clients would occur after knowing the number and level of care givers available to provide care.

What is used as the framework for identifying nursing​ interventions? 1. Etiology of the problem 2. Signs and symptoms 3. Healthcare provider​'s orders 4. Previous health history

1 The framework for selecting nursing interventions is created when the correct problem etiology is identified during the assessment and nursing diagnosis phases. Healthcare​ provider's orders are not used as the framework for identifying nursing interventions. Signs and symptoms help explain how a problem is affecting a client. A​ client's previous health history is not used as the framework for identifying nursing interventions.

During a home​ visit, the nurse observes a client perform wound care that is different from the verbal instructions. The written instructions are crumpled and located at the bottom of a stack of papers. Which action by the nurse is the most​ appropriate? 1. Verbally review the wound care process with the client again 2. Place the instructions on the top of the stack for the client to use 3. Tell the client that a new set of instructions will be brought at the next visit 4. Explain that the client is at risk for a wound infection

1 The issue is the client is not performing wound care correctly. Verbal and written instructions were​ provided; however, the written instructions are not being used. This could indicate two​ things: the client cannot​ read, or the client does not understand the terminology in the instructions. The nurse should use the communication method that the client is most comfortable using. In this​ case, providing the client with verbal instructions is likely to be the most​ helpful, as it provides the client with an opportunity to ask questions. The client may not read another set of written instructions. Placing the instructions on the top of the stack of papers does not mean that the client will read them. Explaining that the client is at risk for a wound infection is using a threat to motivate the​ client; this does not strengthen the nursedash-client relationship.

A nurse is caring for a client with a history of diabetes mellitus. The nurse notices an upward trend to the client​'s daily fasting serum blood glucose and notifies the client​'s healthcare provider. Which level best describes this nurse according to Benner​'s skill acquisition​ model? 1. Proficient 2. Novice 3. Competent 4. Advanced beginner

1 The nurse is proficient according to​ Benner's skill acquisition model. In this level of the​ model, the nurse develops her own rules for actions by analyzing significant cues and sees open double quote"the big picture.close double quote" The novice level includes those without any nursing experience who act only by​ rules, not cognition. The advanced beginner is typically a new graduate who begins to recognize significant cues using​ cognition, but is unable to piece all clinical cues into a whole picture. The competent​ nurse, according to​ Benner, has 2dash-3 years of nursing experience.​ However, the competent nurse is still unable to see the open double quote"big picture.close double quote

A nurse is caring for a pediatric client who requires IV antibiotic therapy. Prior to inserting the IV​ catheter, the client asks the​ nurse, open double quote"Is this going to hurt ​me?close double quote" Which response by the nurse best promotes rapport and trust with the​ client? 1. "It is going to​ hurt, but once I am done it shouldn​'t hurt​ anymore." 2. "It might​ hurt, but I am not​ sure." 3. "​Yes, it is going to hurt. Hold really still or it will hurt much​ worse." 4. "No. As long as you hold still it shouldn​'t ​hurt."

1 To establish rapport and trust with a pediatric client and​ family, the nurse must be honest. The nurse should tell the client that the procedure will​ hurt, but follow the statement with a positive one. The other statements are not appropriate or therapeutic.

While talking with a nursing​ colleague, the staff nurse​ states, "I don​'t drink​ alcohol, but I smoke marijuana." Which response by the nursing colleague best reflects correct understanding of professional​ behaviors? 1. "Even in your personal​ life, the same rules of professionalism still apply to your behavior." 2. "Even though you​'re a​ nurse, what you do in your personal life is your business." 3. "If your client care is negatively​ affected, then you should stop smoking marijuana." 4. "If you​'re arrested for smoking​ marijuana, your professional credibility will be negatively affected."

1 Unprofessional behaviors include substance abuse. The rules of professionalism and the dangers of unprofessional behavior extend to social situations. The effects of unprofessional behavior may include adversely affecting client​ outcomes, but unprofessional behavior is inappropriate with or without consequences. Engaging in unprofessional​ behavior, regardless of whether it leads to an​ arrest, can negatively impact the​ nurse's credibility.

The nurse preceptor is designing a nursing orientation program that addresses abuse of power in the workplace. Which information should the nurse preceptor include in the​ program? 1. Bullying behaviors and incivility are among the leading causes of sentinel client events. 2. The Joint Commission has not taken an official stand on addressing workplace intimidation. 3. Nursing research finds limited evidence of bullying and lateral violence among nursing professionals. 4. Improper use of authority in the workplace is a form of sexual harassment.

1 ​Intimidation, sexual​ harassment, bullying, and lateral violence are forms of abuse of power. In the healthcare​ setting, evidence of​ bullying, lateral​ violence, and incivility has been well documented in nursing research for more than three decades. The Joint Commission has identified bullying behaviors and incivility in health care as being among the leading causes of sentinel client events. The Joint Commission calls for zero tolerance of workplace bullying and intimidation and recommends that healthcare facilities implement policies to stop such behaviors.

Following the collection of assessment​ data, what does the nurse do​ next? ​(Select all that​ apply.) 1. Clusters cues to generate tentative hypotheses 2. Measures the data against standards to identify significant cues 3. Analyzes the data for gaps and inconsistencies 4. Compares the data with suspected medical problems 5. Identifies strengths and resources

1, 2, 3 Once assessment data are​ collected, the nurse begins the process of data analysis. This process includes three​ steps: comparing data against standards to identify significant​ cues, clustering cues to generate tentative​ hypotheses, and identifying gaps and inconsistencies. Listing client strengths and resources occurs later in the process of writing a nursing diagnosis. Comparing data with medical problems is not done when analyzing collected data.

Which skills are used when implementing client​ care? ​(Select all that​ apply.) 1. Interpersonal 2. Psychomotor 3. Cognitive 4. Assessment 5. Physical examination

1, 2, 3 The nurse uses three sets of skills when implementing client care. These skills are​ cognitive, interpersonal, and​ technical/psychomotor. Assessment is a type of cognitive or technical skill. Physical examination is a type of knowledge or technical skill.

Which statements are true of nursing​ diagnoses? ​(Select all that​ apply.) 1. Nursing diagnoses describe responses to a health problem. 2. Nursing diagnoses are flexible and change based upon client responses. 3. A nursing diagnosis is a judgment statement. 4. Nursing diagnoses are uniform between clients. 5. A nursing diagnosis is a condition that nurses are licensed to treat.

1, 2, 3 ,5 A nursing diagnosis is a statement of nursing​ judgment; a condition that​ nurses, by virtue of their​ education, experience, and​ expertise, are licensed to​ treat; and a description of the​ physical, sociocultural,​ psychological, and spiritual responses to an illness or health problem. Nursing diagnoses are flexible because they change as the client

The nurse is caring for a client with chronic obstructive pulmonary disease​ (COPD) who is having difficulty breathing. Which will the nurse include in formulating nursing​ diagnoses? ​(Select all that​ apply.) 1. Evidence of cyanosis in the client​'s mouth and nail beds 2. The client​'s pulse oximetry reading of​ 92% 3. The client​'s expressed desire to quit smoking 4. The client​'s twice daily meditation practice 5. The client​'s report of having difficulty walking in from the parking lot

1, 2, 3, 5 A nursing diagnosis is a statement of nursing judgment that describes a​ client's physical,​ sociocultural, psychological, and spiritual response to an illness or health​ problem, and is flexible in that it will change as the​ client's responses change. The nurse will consider the​ client's activity​ intolerance, low oxygen level and cyanosis when determining actual nursing diagnoses. The nurse will also take into consideration the​ client's desire to quit​ smoking, which may be captured in a health promotion diagnosis.

The nurse is preparing to assess an older client with a hearing deficit who has just been admitted to the care unit. Which actions should the nurse take to communicate with this​ client? ​(Select all that​ apply.) 1. Turn down the volume on the television set 2. Close the door to the room 3. Face the client when speaking 4. Ask the family to wait in the hall 5. Ask about the client​'s meal preferences

1, 2, 3, 5 Closing the door and turning down the volume of the television helps minimize distractions while conversing with the client. Facing the client may assist in​ communication, especially if the client lip reads. Asking about the​ client's meal preferences gives an opportunity to allow choices and establish if there are any religious or spiritual practices related to meals. The family does not necessarily need to wait in the hall until the assessment is complete.

During​ post-clinical conference, a student nurse expresses a desire to work on the same unit where clinical is being held because of the nursing staff. What did the student likely observe to form this​ opinion? ​(Select all that​ apply.) 1. Staff members laugh with each other. 2. Staff members help each other complete assignments. 3. Staff nurses compliment each other for a job well done. 4. Staff members focus on their individual assignments. 5. Staff nurses ask about each other​'s families.

1, 2, 3, 5 Commitment to the group is an essential aspect of group dynamics and is exhibited among members when they enjoy each​ other, support each other in​ difficulty, seek each other for​ counsel, value the contributions of each​ member, and are motivated by the group and want to do their tasks well. Staff members who focus on their own assignment are placing individual goals over the goals of the group

When formulating a nursing diagnosis for a client diagnosed with diabetes​ mellitus, which information should be taken into consideration to mobilize health and the recovery process for this​ diagnosis? ​(Select all that​ apply.) 1. The client joins the ADA support group. 2. The client demonstrates the ability to monitor blood glucose. 3. The client independently administers insulin. 4. The client requests information on how to control blood pressure. 5. The client tells the nurse that he adheres to his 1800 calorie ADA diet.

1, 2, 3, 5 When formulating a nursing​ diagnosis, it is important for the nurse to considered the​ client's diagnosis of diabetes.

What are the components of a nursing​ diagnosis? ​(Select all that​ apply.) 1. Defining characteristics 2. Etiology 3. Data clusters 4. Variations 5. Diagnostic label

1, 2, 5 There are three components to a nursing​ diagnosis: diagnostic​ label, etiology, defining characteristics. Variations are used when additional information is needed to make the diagnoses more clear and​ client-specific. Data clusters are created when analyzing assessment information prior to beginning to write a nursing diagnosis.

A nurse educator is teaching a group of student nurses about the development of professional decision making and the types of approaches related to clinical judgment. Which statements made by the student nurse reflect understanding of Benner​'s skill acquisition​ model? ​(Select all that​ apply). 1. New graduates are typically considered advanced beginners. 2. An advanced beginner is intentional in planning care. 3. A competent nurse usually has​ 2-3 years of experience. 4. Proficient nurses can see the whole picture. 5. A novice acts by following rules.

1, 3, 4, 5 According to​ Benner's model, a competent​ nurse, not an advanced​ beginner, is intentional in planning care. This statement would reflect the need for further education. All other statements are correct and reflect understanding of this model by the student nurse.

The director of nursing is reviewing a status report provided by the policy and procedure committee. Which information indicates to the director that the committee has been​ effective? ​(Select all that​ apply.) 1. Committee members have attended all scheduled meetings. 2. Committee member vacancies for two areas remain unfilled. 3. Committee members reviewed all policies prior to the scheduled accreditation survey. 4. The committee chair resigned due to the volume of work. 5. Subcommittee members provided recommendations as expected.

1, 3, 5 For a group to be​ effective, three main functions have to occur. The group has to accomplish​ goals, maintain​ cohesion, and develop and modify the structure to improve effectiveness. Reviewing all policies prior to the scheduled accreditation survey indicates that the goals have been accomplished. Regular attendance by members at scheduled meetings indicates that the group is cohesive. Subcommittees providing recommendations as expected indicates that the structure of the group was modified to improve effectiveness. The resignation of the committee chair indicates a lack of cohesion. Committee member vacancies indicate a lack of cohesion and unstable group structure.

How does intellect help nurses with critical​ thinking? ​(Select all that​ apply.) 1. Differentiate fact from opinion 2. Evaluate performance 3. Approach situations objectively 4. Clarify concepts 5. Think outside the box

1, 3, 5 The critical thinking skill of intellect helps nurses differentiate facts from​ opinions, approach situations​ objectively, and clarify concepts. The critical thinking skill of creativity helps nurses think outside of the box. The critical thinking skill of inquiry helps nurses evaluate performance.

A pediatric client is alone in the room after the​ client's mother leaves to make a phone call. The client is crying and tells the​ nurse, "I want my mommy to come​ back." The nurse responds by​ stating, "It's okay to cry when you miss your mommy. I will sit with you until she comes back if you​ want." Which therapeutic communication techniques is the nurse using to establish rapport with the​ client? ​(Select all that​ apply.) 1. Accepting 2. Exploring 3. Broad openings 4. Offering self 5. Clarifying

1, 4 The nurse is using accepting and offering self to establish rapport with the child. By conveying​ acceptance, the nurse respects the​ child's emotions and lets the child know that crying is okay. Offering self indicates that the nurse is accessible and wants to listen to the child. Clarifying is when the nurse asks the child to elaborate in order for the nurse to understand. Broad openings include​ open-ended questions, which allow the child to provide answers that are longer than one or two words. Exploring encourages the child to discuss the issue in more detail.

The nurse is caring for a client diagnosed with cancer. When formulating the plan of care for this​ client, what should the nurse consider related to client​ goals? ​(Select all that​ apply.) 1. Goals should be attainable. 2. Goals may address multiple actions. 3. Goals should indicate whether treatment is successful. 4. Goals should be measurable. 5. Goals should center on the client.

1, 4, 5 The client is always the subject of the goal and requires a​ specific, single action to ensure all nurses understand what the client needs to do to achieve a goal. Goals should be​ measurable, attainable,​ relevant, and time limited. An​ evaluation, not a goal​ statement, will indicate whether interventions were successful.

Which are characteristics of an advanced beginner within Benner​'s Skill Acquisition Model of clinical​ judgment? ​(Select all that​ apply.) 1. Begins to recognize cues 2. Is able to intentionally plan care 3. Follows rules when acting 4. Can see the whole picture 5. Is a new graduate

1, 5 Characteristics of an advanced beginner nurse are being a new graduate and beginning to recognize significant cues from internal cognitive processing. A characteristic of a competent nurse is being able to intentionally plan care. A characteristic of a novice nurse is following rules when providing care. Being able to see the whole picture when providing client care is characteristic of the proficient nurse.

During a classroom​ discussion, the nurse educator asks the nursing students to describe intimidation. Which​ students' statements most accurately describe​ intimidation? ​(Select all that​ apply.) 1. "Intimidation can include threatening someone with consequences for disobedience." 2. "Nurses always realize when their behaviors toward clients are forms of intimidation." 3. "Intimidation includes experienced nurses who bully new nurses." 4. "Intimidation includes having negative thoughts about nursing peers or colleagues." 5. "Covert and overt behaviors may qualify as being intimidation."

1. "Intimidation can include threatening someone with consequences for disobedience." 3. "Intimidation includes experienced nurses who bully new nurses." 5. "Covert and overt behaviors may qualify as being intimidation."

The psychiatric nurse practitioner is giving a webinar about prevention of burnout in nursing. Which items should the psychiatric nurse practitioner include when describing tips related to having​ compassion? ​(Select all that​ apply.) 1. Acknowledging that most individuals do the best they can do 2. Perceiving errors and failures as opportunities for constructive learning 3. Recognizing the limitations associated with any given situation 4. Joining nursing associations that promote constructive discussion of work issues 5. Learning to ask for help from colleagues or confidantes when needed

1. Acknowledging that most individuals do the best they can do 2. Perceiving errors and failures as opportunities for constructive learning 5. Learning to ask for help from colleagues or confidantes when needed

Which actions are appropriate when the nurse is communicating with a client whose primarily language is not​ English? ​(Select all that​ apply.) 1. Avoid using slang 2. Speak slowly 3. Avoid using medical jargon 4. Use an interpreter 5. Emphasize words with gestures

1. Avoid using slang 3. Avoid using medical jargon 4. Use an interpreter

Jiao​ Liu, a​ 64-year-old client, is receiving chemotherapy for breast cancer. After morning​ report, the nurse finds Ms. Liu​ nauseated, vomiting light green​ emesis, and crying because her hair is falling out in clumps. Her pulse is 110 beats per minute and​ thready, and her blood pressure is​ 96/50 mmHg. Which intervention should the nurse make a priority for Ms.​ Liu? 1. Begin intravenous fluids at 100​ mL/hr 2. Premedicate for nausea before next chemotherapy dose 3. Teach Ms. Liu some deep breathing exercises to help her calm down 4. Cleanse skin and apply a clean hospital gown

1. Begin intravenous fluids at 100​ mL/hr

The nurse leader is presenting an​ in-service about competence in nursing. Which examples should the nurse leader include in the​ in-service as examples of nursing​ competence? ​(Select all that​ apply.) 1. Completion of documentation in an​ accurate, timely manner 2. Acknowledgement of the client​'s need for individualized care 3. Awareness of factors that positively affect client care 4. Elimination of factors that negatively influence client care 5. Knowledge about the culture of the healthcare institution

1. Completion of documentation in an​ accurate, timely manner 2. Acknowledgement of the client​'s need for individualized care 3. Awareness of factors that positively affect client care 5. Knowledge about the culture of the healthcare institution

The nurse is planning to assess a​ client's communication approach. What client characteristics should the nurse consider when conducting this​ assessment? ​(Select all that​ apply.) 1. Developmental level 2. Primary health problem 3. Culture 4. Age 5. Employment status

1. Developmental level 3. Culture 4. Age

Planning is underway to transfer Agnes​ Watson, a​ 76-year-old client, to a​ long-term care facility. Agnes wants to live near her​ family; however, the facility that would best meet her needs is a few miles further away. What should the nurse do when helping Agnes make the choice of​ facility? 1. Discuss with Agnes the advantages of the facility that is a bit further away 2. Tell Agnes that the facility that is closer to family is not accepting admissions 3. List other facilities so that Agnes can make a better decision 4. Tell Agnes that being near family is not always a good idea

1. Discuss with Agnes the advantages of the facility that is a bit further away

What techniques are associated with assertive​ communication? ​(Select all that​ apply.) 1. Fogging 2. Negative assertion 3. Avoidance 4. Name calling 5. Submission

1. Fogging 2. Negative assertion

Which actions can the nurse use to establish rapport with a pediatric​ client? ​(Select all that​ apply.) 1. Listening to the child talk about a favorite teacher 2. Sitting on the bed with the child 3. Telling the child that she has pretty hair 4. Asking the child to choose between milk or juice to drink 5. Coming into the room to hang an IV medication and leaving

1. Listening to the child talk about a favorite teacher 2. Sitting on the bed with the child 3. Telling the child that she has pretty hair 4. Asking the child to choose between milk or juice to drink

The nurse preceptor is discussing integrity with the novice nurse. Which examples should the nurse preceptor use to illustrate integrity in​ nursing? ​(Select all that​ apply.) 1. Maintaining accountability for personal actions 2. Delivering​ error-free nursing care 3. Accepting negative feedback from clients 4. Accepting positive feedback from peers 5. Working within the scope of practice

1. Maintaining accountability for personal actions 3. Accepting negative feedback from clients 4. Accepting positive feedback from peers 5. Working within the scope of practice

What behaviors will the nurse demonstrate as a member of a group that is highly​ committed? ​(Select all that​ apply.) 1. Members value each other​'s opinions. 2. Members strive to place blame on one person. 3. Members give priority to the opinions of the leader. 4. Members enjoy working with each other. 5. Members support each other with difficulties.

1. Members value each other​'s opinions. 4. Members enjoy working with each other. 5. Members support each other with difficulties.

Mike Kellerton is a​ 64-year-old client admitted for dehydration. During morning​ care, Mr. Kellerton became irate when the breakfast tray featured items that he does not eat. Later in the​ day, Mr. Kellerton told a family member that he is not important and everyone is​ "trying to kill​ him." What should the nurse do to improve the care that Mr. Kellerton is​ receiving? 1. Plan to talk with the client about his care​ needs, priorities, and preferences 2. Explain to the client that his care issues are not life threatening and can be delayed 3. Identify the easiest task to complete for the client and do this first 4. Discuss the importance of other​ clients' treatments being of greater priority

1. Plan to talk with the client about his care​ needs, priorities, and preferences

When discussing a painful procedure with a​ child, how will the nurse answer the child​'s ​questions? 1. With​ honesty, while being sure to end the conversation on a positive note 2. By explaining the procedure to the parents first and having the parents tell the child 3. By giving handouts with more information about the procedure 4. By redirecting the child​'s attention to something else

1. With​ honesty, while being sure to end the conversation on a positive note

Scott​ Nitroskey, a home health​ nurse, is caring for​ 67-year-old Martha​ Miriste, a female client who is diagnosed with diabetes. Scott is completing Mrs.​ Mireste's client teaching. During the teaching​ session, which statement might Mrs. Mireste interpret as being​ Scott's attempt to intimidate​ her? 1. ​"If you​ don't stop eating so much​ candy, your diabetes is going to get much​ worse." ​2. "Regular exercise can help with the management of your​ diabetes." ​3. "If you cut back on your sugar​ intake, you might see some improvement in your​ diabetes." ​4. "Increased sugar in your diet can cause your blood sugar to go up and impact your​ diabetes."

1. ​"If you​ don't stop eating so much​ candy, your diabetes is going to get much​ worse."

What is the purpose of reflecting within Tanner​'s clinical decision making​ model? 1. Sense what is happening in a situation 2. Learn from actions to make adjustments 3. Gain understanding about a situation 4. Analyze a situation to choose action

2 According to​ Tanner's model, reflecting helps the nurse learn from actions to make adjustments. Interpreting involves using logical reasoning to gain understanding about a situation and determine appropriate actions. Noticing requires a sense about what is happening in the client situation. Responding is analyzing a situation to choose the best course of action.

The staff development trainer provides a program on assertive communication for the staff of a care area. At the end of the​ program, the trainer​ states, "I​ can't believe I had to waste my time on​ this." Which response made by a nurse who attended the training indicates effective teaching has​ occurred? 1. ​"I'm sorry you had to spend so much time with us​ today." ​2. "I needed this​ training, and it​ wasn't a waste of time for​ me." ​3. "Maybe you should read your own​ notes." ​4. "It's your job. You want to do mine​ instead?"

2 Assertive statements use the word​ "I" to voice feelings and wishes without placing blame on someone else. The statement​ "I needed this training and it​ wasn't a waste of time for​ me" also includes a negative assertion in that the nurse repeats the​ trainer's phrase about the training being a waste of time. The statement beginning with​ "I'm sorry" is a passive response. The statements​ "It's your​ job?" and​ "maybe you should read your own​ notes" are both aggressive responses.

The novice nurse asks the nurse preceptor to explain the relationship between the business of health care and the provision of client care. Which response by the nurse preceptor is the most​ appropriate? 1. "The business of health care is the same thing as the provision of client care." 2. "The Institute of Medicine compels nurses to preserve a caring model within health care​'s business model." 3. "Nurses are morally responsible for recognizing the business of health care as the main priority." 4. "When nursing standards conflict with organizational​ standards, the nurse must maintain commitment to the organization​'s standards.

2 Because the business of health care and the provision of client care are two distinct​ issues, corporate goals can collide with nursing ethics. Nurses have the moral responsibility to address client needs and to advocate for safe care within the business of health care. The Institute of Medicine​ (IOM) compels nurses to lead the healthcare transformation and to preserve a caring model within the business model of health care. The nurse must maintain commitment to the nursing profession even when doing so conflicts with organizational commitment.

The nurse manager is interviewing a candidate for a staff nurse position. During the​ interview, the nurse manager evaluates the candidate​'s professional commitment to nursing. Which statement by the staff nurse best reflects commitment to the nursing​ profession? 1. "Whenever ​possible, the nurse should try to abide by the professional code of ethics for nurses." 2. "I​'m a member of two national nursing​ organizations, and I belong to one specialty nursing group." 3. "I believe the nurse​'s choices outside of the workplace are unrelated to the nurse​'s professional role." 4. "The values and goals of nursing are​ honorable, but they are unrealistic and difficult to achieve."

2 Factors associated with professional commitment include desire to maintain membership in the​ profession; strong acceptance of and belief in a​ profession's role,​ code, values,​ goals, standards; willingness to exert considerable personal effort on behalf of the​ profession; and a pattern of behaviors that is consistent with the​ nurses' professional code of ethics. The rules of professionalism in nursing extend to behaviors outside the workplace.

Which​ short-term goal does the nurse view as appropriate for a client newly diagnosed with diabetes​ mellitus? 1. The client will learn the correct way to inject IV insulin. 2. The client will demonstrate how to​ self-inject insulin by end of hospital stay. 3. The client will demonstrate how to wrap left leg wound. 4. The client will be able to identify and prepare meals approved by the ADA within 3 weeks.

2 Goal statements include a time frame for completion.​ Short-term goals are useful for clients needing a limited amount of nursing care. These goals can be achieved in a few hours to a few days. The statement that the client will demonstrate​ self-injection of insulin by the end of hospital stay is an example of a properly written​ short-term goal.​ Long-term goals are generally those that can be achieved by the client in 1 week to several months. Stating that the client will be able to prepare meals approved by the ADA within 3 weeks is a reasonable​ long-term goal. The remaining goal statements are insufficient in that they do not give a time frame.

Prior to performing an​ assessment, a nurse states to the​ client, open double quote"This weather we are having is​ crazy, isn​'t ​it?close double quote" Which phase of the therapeutic relationship is the nurse​ displaying? 1. Working 2. Introductory 3. Termination 4. Preinteraction

2 In the introductory​ phase, the nurse may discuss the weather or another general topic to put the client at ease. The preinteraction phase occurs prior to any​ face-to-face contact. During the working​ phase, the nurse helps the client identify feelings in order to help the client make decisions. The termination phase occurs at the end of the therapeutic relationship.

The manager appoints a staff nurse to serve as a member of a​ semi-formal group. What should the nurse expect as a group​ member? 1. The leader will be replaced if she makes a mistake. 2. Structured activities will take up a large part of the group​'s meeting time. 3. Interactions with group members will be limited. 4. Members function under a strict code of ethics.

2 In​ semi-formal groups, the activities are structured and take up a large part of the meeting times. Interactions within formal groups are limited. Informal groups typically replace leaders who make mistakes quickly. Members function under a strict code of ethics in informal groups.

When does a nurse make a scheduling​ decision? 1. When deciding what can be completed by a nursing assistant 2. When deciding what needs to be done before a client attends therapy 3. When deciding when to change a dressing 4. When deciding what information to share with other healthcare providers

2 Nurses make four types of decisions. A scheduling decision is made when the nurse decides what a client needs before attending a therapy session. A value decision occurs when deciding what information to share with other healthcare providers. A time management decision is made when deciding when to change a dressing. A priority decision is deciding what can be assigned to a nursing assistant to complete.

The nurse is caring for a client with schizophrenia. The client is at risk for disturbed thought processes. What is the priority focus for interventions when caring for this​ client? 1. Discussing expectations 2. Providing reality testing 3. Being an active listener 4. Providing anxiety medication

2 Nursing interventions are​ actions, tasks, and documentation taken to help a client achieve identified goals. Interventions for risk nursing diagnoses focus on measures to reduce the client

The nurse is evaluating the current plan of care for a client who is receiving care in a​ long-term healthcare facility. The evaluation indicates that the client is not meeting goals related to mobility. What is the appropriate nursing action at this​ time? 1. Asking the client to try harder 2. Revising the plan of care 3. Determining the client does not have any risk factors 4. Concluding that the problem is resolved

2 The client is not meeting goals related to​ mobility, therefore the care plan must be revised. The nurse will work with the client to determine how the plan might be revised. Perhaps assessment data were not fully considered or goals were not within reasonable expectations for what the client is able to accomplish. Asking the client to try harder is not appropriate. Concluding the problem is resolved would be inaccurate. The nurse would be wise to reassess risk factors as part of reassessment before revising the plan of care.

Which attribute of critical thinking is explained as making neutral judgments without​ bias? 1. Open-mindedness 2. Fair-mindedness 3. Perseverance 4. Integrity

2 The critical thinking attribute that makes neutral judgments without bias is​ fair-mindedness. Open-mindedness refers to being open to different ideas or different methods to reach the same goal and is similar to independence. Challenging ideas and methods of doing nursing care explains integrity. Being motivated to find the best solution for quality client outcomes is perseverance.

A nurse working on a telemetry unit is caring for a client with sick sinus syndrome. The client tells the​ nurse, open double quote"I felt dizzy earlier this morning.close double quote" The nurse responds by asking the​ client, open double quote"Did this occur after ​breakfast?close double quote" Which method of therapeutic communication is the nurse using with this​ client? 1. Acknowledging 2. Clarifying time 3. Giving information 4. Focusing

2 The nurse is using the technique of clarifying time by helping the client clarify an event in relationship to time. Focusing is used when the nurse helps the client expand on and develop a topic of​ importance, which is often an emotion disguised behind words. Giving information occurs when the nurse provides the client specific factual information. Acknowledging is used when the nurse gives nonjudgmental recognition to the client for a client effort or change in behavior.

A nurse is caring for a toddler who appears frightened by the nurse. To make the child more at​ ease, the nurse gives the toddler a disposable tape measure to play with. Which critical thinking concept is the nurse​ using? 1. Independence 2. Creativity 3. Concreteness 4. Confidence

2 The nurse is using​ creativity, or finding a solution by using a method that is unconventional. In this​ case, the nurse is​ "thinking outside the​ box" to let the toddler play and put the child at ease. Concreteness is a concept of therapeutic​ communication, which is when the nurse is specific rather than general. Confidence is an attitude that nurses convey by acting on information and experience they know are correct. Nurses exhibit Independence by looking at facts and not being easily influenced by opinion.

What should be done first before implementing a nursing​ intervention? 1. Ensure the client​'s privacy 2. Reassess the client 3. Find someone to help 4. Review nursing diagnoses

2 The nurse reassesses the client immediately before implementing an intervention to make sure that the action is still appropriate since the​ client's condition might have changed. Newly assessed data may indicate a need to change the priorities of care or the nursing activities. Reviewing nursing diagnoses is done while identifying nursing interventions. Finding someone to help may or may not be​ necessary, based on the results of the reassessment. Ensuring for the​ client's privacy is done immediately before implementing the intervention.

Which clinical situation best exemplifies a nurse who is choosing between alternatives when making a clinical​ decision? 1. The nurse has a​ "gut reaction" to the​ client's pain and calls the​ client's physician. 2. The nurse administers an IV narcotic instead of an oral narcotic. 3. The nurse determines the​ client's nursing diagnosis is acute pain. 4. The nurse changes the​ client's position numerous times until the client appears in less pain.

2 The nurse who administers an IV narcotic instead of an oral narcotic is choosing between alternatives. The nurse who helps the client change position numerous times is using trial and error. The nurse acting on a​ "gut reaction" is using intuition. The nurse determining the nursing diagnosis is utilizing the nursing process.

The primary nurse is caring for a client with chronic obstructive pulmonary disease​ (COPD). The nurse arrives at the client​'s room to complete the morning assessment and finds the client is upset. The client​ states, open double quote"My nurse overnight referred to me to the assistant as the COPDer.close double quote" The primary nurse tells the client that she will address the issue with the nurse. Which basis of the therapeutic relationship is the nurse displaying by addressing this client issue with the other​ nurse? 1. Reflecting 2. Respecting 3. Assuming 4. Identifying

2 The therapeutic relationship is based on mutual​ trust, respect, and acceptance. The nurse is respecting the client as an individual and not as a diagnosis by addressing the issue with the other nurse.​ Reflecting, assuming, and identifying are all therapeutic communication​ techniques, but are not the basis of the therapeutic relationship.

During a staff​ meeting, the manager asks staff members to identify any and all ways to reduce unnecessary waste of supplies when providing client care. Which type of​ decision-making technique is the manager using with the​ staff? 1. Monopolizing 2. Brainstorming 3. Groupthink 4. Delphi technique

2 When​ brainstorming, group members meet and generate ideas as a solution to a problem. The atmosphere supports the free flow of ideas. Group members are expected to generate as many ideas as​ possible, and all ideas are initially approved.​ Later, ideas are examined for viability. Monopolizing is the domination of a discussion by one member of a group and is not a​ decision-making technique. The Delphi technique is used for decisions that require more time or responses from people in different locations. Groupthink is not a​ decision-making approach but rather occurs when the group fails to examine its own processes and practices or when group members fail to recognize and respond to change

The nursing student is writing a care plan for a client who was recently cared for during a clinical rotation. What should the student nurse do when planning nursing interventions for the​ client? ​(Select all that​ apply.) 1. Be general and brief 2. Ensure relevancy to situation 3. Be specific and concise 4. Be realistic 5. Include priorities of care

2, 3, 4, 5 Nursing interventions are dated and regularly reviewed for applicability towards goal achievement. Nursing interventions should be client​ centered; detailed,​ specific, and​ concise; realistic,​ relevant, and limited to the top 3dash-5 priority interventions for each nursing diagnosis.

The nursing student is participating in revising the plan of care for a client diagnosed with myasthenia gravis who did not meet care goals. Which will the nurse consider when revising the plan of​ care? ​(Select all that​ apply.) 1. What nurses were assigned to the​ client? 2. Were the interventions that were selected​ appropriate? 3. Did the client have access to planned​ interventions? 4. Were the goals realistic and​ attainable? 5. Were interventions implemented as​ planned?

2, 3, 4, 5 When it is necessary to revise a plan of care because the client did not achieve one or more care​ goals, the nurse examines the reasons that the goals were unmet. These include whether or not the goals were realistic and​ attainable, whether the interventions that were selected were​ appropriate, if the interventions were implemented as planned. The nurse also examines if there were any faulty assessment data. If a client did not have access to planned​ interventions, that would explain why interventions were not​ implemented, as well as suggest that assessment of the client was​ insufficient; a thorough assessment would have determined any limitations the client had to access interventions. Which staff members were assigned to the client is not a consideration.

A client tells the​ nurse, "My blood sugars have been all over the place​ lately." The nurse​ responds, "It sounds like your blood sugar has been difficult to manage. Can I please see your blood sugar​ log?" Which therapeutic communication skills is the nurse displaying during this interaction with the​ client? ​(Select all that​ apply.) 1. Genuineness 2. Confronting 3. Concreteness 4. Clarifying 5. Paraphrasing

2, 5 The nurse paraphrased the​ client's statement by​ re-stating what the client said using the​ client's words. The nurse also used concreteness by encouraging the client to be specific rather than vague. Confronting and clarifying help the client to recognize inconsistencies that inhibit the​ client's self-understanding or exploration of specific areas and ideas.

Which behavior indicates a nurse is an aggressive​ communicator? ​(Select all that​ apply.) 1. Denying feelings of anger 2. Blaming others for errors 3. Expressing feelings using​ "I" language 4. Telling a staff member to move out of the way 5. Stating that a nursing assistant is​ "worthless"

2. Blaming others for errors 4. Telling a staff member to move out of the way 5. Stating that a nursing assistant is​ "worthless"

A nurse is participating in a group in which all members are voicing ideas to address an issue. Their ideas will be analyzed later. Which kind of​ decision-making method is the group​ using? 1. Consensus 2. Brainstorming 3. Quantitative analysis 4. Nominal group

2. Brainstorming

The nurse manager is preparing an annual performance appraisal for​ Alisha, a staff nurse who has worked on a​ medical-surgical care area for two years. The manager determines that​ Alisha's level of proficiency is competent. What did the manager observe Alisha perform to make this​ decision? 1. Referred to the procedure manual to change an intravenous site dressing 2. Focused on a specific client problem when planning care 3. Determined how a new medication would impact a​ client's other health problems 4. Waited for direction from charge nurse before providing care

2. Focused on a specific client problem when planning care

The nursing instructor assigns​ Carol, a senior nursing​ student, to create a concept map for a client recently assigned during clinical. The concept map is going to be showcased during the School of​ Nursing's scheduled open house for nursing student candidates in a week. What should be a priority for Carol when preparing this concept​ map? 1. Include the rationales for each nursing intervention 2. Follow the sequence of the nursing process 3. Highlight medical treatments provided by other providers 4. Individualize the care by using checklists and blank lines

2. Follow the sequence of the nursing process

The nurse is caring for a​ neonate, Sally, who requires nasogastric tube feedings due to prematurity.​ Sally's nasogastric tube frequently slips out of position and the nurse tries different approaches to prevent this from happening. Which critical thinking skill is the nurse​ demonstrating? 1. Reflection 2. Inquiry 3. Intellect 4. Reasoning

2. Inquiry

Mitchell​ Asplund, a clinical nursing​ instructor, is assigned to serve as a student faculty advisor.​ Mitchell's responsibilities include determining which stage of commitment to nursing his students are experiencing. He is evaluating nursing student Don​ Rowlands, who is a junior in nursing school. During his​ evaluation, Don​ states, "I want to join the National Student Nurses Association.​ I'm also volunteering to participate in the student health fair. I know​ I'm really​ busy, but my schedule will be crazy when​ I'm working as a​ nurse, too.​ It's worth it to​ me." Mitchell recognizes that Don is in which stage of making a professional commitment to​ nursing? 1. Exploratory 2. Passionate 3. Integrated 4. Testing

2. Passionate

The nurse is a member of a nursing journal club. What interpersonal perspectives would be demonstrated by the group​ members? ​(Select all that​ apply.) 1. Provides source of collegiality and support 2. Promotes a feeling of goodwill among members 3. Provides a context for setting priorities 4. Empowers group members to promote change 5. Provides socialization toward growth and development

2. Promotes a feeling of goodwill among members 3. Provides a context for setting priorities 5. Provides socialization toward growth and development

Jasmine Riddle is a novice nurse in the telemetry unit of a large hospital. While assessing her​ client, 72-year-old Albert​ Griswald, Jasmine notes that his pulse feels irregular. When she calls the telemetry monitoring​ station, the monitoring​ technician, Miguel, tells Jasmine that Mr. Griswald just developed atrial fibrillation. The technician praises Jasmine for catching the change in Mr.​ Griswald's cardiac rhythm so quicklylong dash—even before the telemetry technician recognized it. In her​ response, which action would reflect​ Jasmine's nursing​ integrity? 1. Advising the telemetry technician to focus on his job and monitor​ clients' heart rhythms more closely 2. Thanking the telemetry technician for praising her and for being part of the​ client's care team 3. Notifying the telemetry​ technician's supervisor of his failure to recognize the change in cardiac rhythm 4. Telling the telemetry technician that noticing the​ client's change in cardiac rhythm was​ "pure luck"

2. Thanking the telemetry technician for praising her and for being part of the​ client's care team

What would be an appropriate goal when caring for a client with impaired​ communication? 1. The client will review discharge instructions at home. 2. The client will effectively communicate needs. 3. The client will call for help before getting out of bed. 4. The client will state ways to reduce communication deficits.

2. The client will effectively communicate needs.

The nurse educator asks the nursing students to describe the stage of commitment development during which the student discovers negative aspects of a chosen profession. Which student​'s response is​ accurate? 1. The passionate stage. 2. The testing stage. 3. The integrated stage. 4. The ​quiet-and-bored stage.

2. The testing stage.

The nurse is providing care to several clients on a​ medical-surgical unit. The nurse needs to prioritize care for the assigned clients. Which action is a common pitfall when prioritizing client​ care? 1. Being cognizant of time when completing tasks 2. Involving the client during the care plan process 3. Administering medications based on vital signs at admission 4. Completing tasks based on level of difficulty

3 A common pitfall when prioritizing care is prioritizing care without completing an assessment. Administering medications based vital signs obtained at admission is failing to assess the​ client, as the​ client's condition may have changed since admission. Involving the client during the care plan​ process, completing tasks based on level of​ difficulty, and being cognizant of time when completing tasks are not pitfalls related to prioritizing care.

A novice nurse is working independently on a​ maternal-newborn unit after 12 weeks of orientation with a preceptor. The nurse is assigned several newborns to care for during the shift. Based on the clinical pathway for a mother and baby of a vaginal​ birth, which intervention by the nurse is​ appropriate? 1. Administering vitamin K to the mother within 24 hours of delivery 2. Ensuring the newborn is breastfed 6 times per day at 48 hours of life 3. Scheduling bottle feedings for the newborn of 15 to 30 mL every 4 hours at 24 hours of life 4. Administering erythromycin ointment to the newborn​'s eyes at 48 hours of life

3 Based on the clinical pathway for the mother and newborn after a vaginal​ delivery, the most appropriate intervention is to schedule bottle feedings for the infant every 4 hours​ (6 times per​ day) at 24 hours of life. These feedings should consist of 15 to 30 mL of infant formula. Vitamin K is administered to the​ newborn, not the​ mother, within 24 hours of delivery. Erythromycin ointment is administered to the​ newborn's eyes within 24 hours of delivery. Newborns who are breastfed should be offered the breast 8 times per day at 48 hours of​ life, not 6 times per day.

A nurse is caring for a client who is scheduled to have a chest​ x-ray at 0900 and will be off the unit. The client is also due to have medication at 0900. Which action by the nurse is most​ appropriate? 1. Administer the medication after the client returns from​ x-ray 2. Administer the client​'s medication at the start of shift 3. Administer the client​'s medication at 0845 4. Wait to administer the medication at the next dosage time

3 By administering the scheduled medication 15 minutes​ early, the nurse is using clinical decision making to ensure the client receives all necessary care despite the apparent scheduling conflict. Because there is no way to tell how long the client might be at​ x-ray, it might jeopardize the​ client's dosing schedule to wait to administer the​ client's medication. Administering medication at the start of shift may be inappropriate depending on the dosing schedule. Waiting until it is time for the next dose will result in the client missing a​ dose, which is not an option.

An adolescent client is sitting in a chair waiting for the nurse to complete a health history. After entering the​ room, where should the nurse sit to conduct the history with the​ client? 1. Against the wall near the door 2. About 4 to 12 feet from the client 3. Between 1​ ½ to 4 feet from the client 4. One foot away from the client

3 Communication is influenced by personal space. Personal distance is​ 1½ to 4​ feet, and much of the communication between nurses and clients takes place at personal distance. Social distance is 4​ - 12​ feet, which is too far for most communication between nurses and clients. One foot away is within intimate distance. Intimate distance is used by nurses when treating​ clients, but not for taking a health history. Against the wall near the door would be described as public​ distance, which would not be useful for taking a health history.

The clinical nursing instructor is evaluating the student​'s developmental stage of professional commitment. The student has settled into the nursing program​'s routine and reports experiencing decreased performance anxiety. Which stage of professional commitment is most appropriate for the clinical nursing instructor to use when describing the student​'s current level of​ development? 1. The testing stage 2. The integrated stage 3. The​ quiet-and-bored stage 4. The exploratory stage

3 Development begins with the exploratory​ stage, which begins when individuals explore the positive aspects of their profession. Examples include the excitement nursing students experience when first wearing their new uniforms or when purchasing their first stethoscope. The second stage is the testing​ stage, during which students discover the positive and negative aspects of the nursing profession. During the third​ stage, which is the passionate​ stage, students are willing to commit to their profession and to contribute to its​ well-being. Examples of student behaviors that are reflective of this stage include serving as a class officer and becoming involved in student nursing associations. During the fourth​ stage, which is the​ quiet-and-bored stage, students settle into the nursing​ program's routines, grow more comfortable in their​ role, and experience decreased performance anxiety. The integrated​ stage, which is the fifth​ stage, manifests through the​ student's demonstration of commitment as a matter of habit. This stage usually begins in the final phases of the nursing​ program, with students beginning to see themselves as​ nurses, and growing eager to take the​ NCLEX-RN® and to begin working.

The nurse is formulating a plan of care for a client who is pregnant. Which goal is appropriate for the nursing diagnosis dealing with a knowledge deficit related to​ pregnancy? 1. Client will attend medication management classes within four weeks. 2. Nurse will facilitate learning readiness. 3. Client will attend prenatal classes through the course of the pregnancy. 4. Nurse will teach client about prescribed exercise regimen for pregnancy at next appointment.

3 Goals are created from the​ client's nursing​ diagnoses, specifically from the diagnostic label. Each nursing diagnosis has one goal. An appropriate goal statement to address the​ client's insufficient knowledge about pregnancy is that the client will attend prenatal classes. Medication management classes will not be sufficient to assist the client with learning about other aspects of pregnancy. Client goal statements are always written to capture actions or changes of the​ client, not the nurse.

The charge nurse is reviewing​ e-mails and sees a message from the laboratory containing results for a client​'s blood work. What is the priority action by the nurse regarding this​ information? 1. Delete the message 2. Forward the message to the client 3. Print the message and place it in the client​'s medical record 4. Phone the healthcare provider and verbally provide the results

3 Information sent through​ e-mail is considered a part of the​ client's medical record. A copy of each​ e-mail message is to be placed in the​ client's chart. Deleting the message may alter the​ client's medical record. Sending laboratory results by​ e-mail is inappropriate as it denies the client the opportunity to ask questions. The nurse can phone the healthcare provider and verbally provide the​ results; however, the nurse still needs to print the message and place it in the​ client's medical record. The healthcare provider can see the results when reviewing the chart.

TThe nurse is providing care to several clients in the emergency​ department: A client who arrived by ambulance with stroke​ symptoms; a client with a fractured​ femur; a client complaining of​ sharp, continuous pain radiating from the kidney​ area; and a young child with a possible fractured arm whose mother is with him. Using the urgency​ factor, which client will the nurse prioritize for​ care? 1. The young child with the possible arm fracture 2. The client with​ sharp, continuous pain radiating from the kidney area 3. The client with stroke symptoms 4. The client with a fractured femur

3 Prioritizing client care can be approached by various methods. Criteria that impact the urgency factor include changes in the​ client's condition, deterioration of client​ status, or complexity of the​ client's condition. Imminent death is the highest urgency factor where interventions need to be addressed immediately in order to save a​ client's life. The client with stroke symptoms is at risk of imminent death or substantive impairment and must be seen immediately. The client experiencing kidney pain is considered​ medium-high urgency because the condition may become life threatening if not assessed and addressed quickly. Sprains and fractures are less urgent.

The nurse unit manager is giving an​ in-service about sexual harassment in the workplace. When discussing what constitutes sexual​ harassment, which statement is most appropriate for the nurse unit manager to include in the​ in-service? 1. Behaviors must include unwelcome advances of a sexual nature that are demonstrated through the perpetrator​'s physical conduct. 2. Submitting to requests for sexual behaviors must be explicitly considered a condition of an individual​'s employment. 3. Sexual harassment must be considered both a form of discrimination and a violation of an individual​'s rights.. 4. The sexual behaviors must interfere with the victim​'s work performance and prevent fulfillment of work functions.

3 Sexual harassment is a form of​ discrimination, as well as a violation of an​ individual's rights. The Equal Employment Opportunity Commission​ (EEOC) defines sexual harassment as open double quote"unwelcome sexual​ advances, requests for sexual​ favors, and other verbal or physical conduct of a sexual natureclose double quote" occurring when submitting to such requests or behavior is​ considered, either explicitly or​ implicitly, a condition of an​ individual's employment; when submission to or rejection of such requests or behavior is used as the basis for employment decisions affecting the individual​ (e.g., promotion); or when such conduct interferes with an​ individual's work performance or creates an​ "intimidating, hostile, offensive working environment.close double quote

A nurse working in the ICU has decided to attend a professional critical care conference. What critical thinking attitude is exemplified by this nurse​'s ​actions? 1. Independence 2. Integrity 3. Awareness of​ self-limits 4. Confidence

3 The nurse is demonstrating awareness of​ self-limits by seeking new knowledge or skills. Nurses exhibit independence when they think on their own. Confidence is exemplified by​ self-assurance. Integrity is displayed when the nurse chooses the right​ option, even if it is not the popular option.

A nurse is caring for a pediatric client who is recovering from a recent open appendectomy surgery. The nurse states to the​ client, open double quote"I saw that you walked up and down the hallway twice today already. Good ​job!close double quote" Which therapeutic communication technique is the nurse using to establish rapport with the​ client? 1. Listening actively 2. Validating perceptions 3. Giving recognition 4. Offering self

3 The nurse is giving recognition by observing the​ client's behavior and showing an interest in the child. Offering​ self, which the nurse might do by sitting with the child or walking with the child down the​ hall, shows that the nurse is accessible and willing to listen to the child. Validating perceptions provides an opportunity for the client to reflect on the explanations that the nurse has made. Active listening involves being present with the client in a discussion and encouraging the client to share thoughts and feelings.

While transferring a client back into bed after a​ procedure, the client says that it​ wasn't very nice for the nurse to say that the​ "cow" was coming down the hall. Which response by the nurse is most appropriate in this​ situation? 1. ​"You must have misunderstood what I​ said." ​2. "I didn't mean to call someone a​ cow!" ​3. "The term​ 'cow' is used for computer on​ wheels." ​4. "I was just joking with that​ person!"

3 The nurse should avoid using jargon when communicating with clients. The client did not understand the acronym​ "C.O.W." as meaning a computer on wheels. The nurse needs to explain the term in language the client understands. The nurse should not become argumentative and deny using the term. The client did not misunderstand the nurse. Saying that the nurse was joking with another person supports the​ client's claim that the nurse called someone a​ "cow."

The nurse is providing care to a​ 1-year-old pediatric client who is admitted to the emergency department with​ SaO2% of​ 93% on room​ air, respiratory rate of 50 breaths per​ minute, with moderate wheezing. Based on the pediatric clinical pathway for​ asthma, what intervention does the nurse anticipate for this​ client? 1. Systemic magnesium sulfate 2. Continuous anticholinergic medication administration 3. Nebulizer treatment of albuterol 4. IV corticosteroids

3 The pediatric client is experiencing a mild asthma attack. Based on the clinical​ pathway, the nurse anticipates the client will be given a nebulizer treatment of a beta adrenergic​ medication, such as albuterol. Systemic magnesium​ sulfate, IV​ corticosteroids, and continuous administration of anticholinergic medications are not appropriate for a pediatric client experiencing a mild asthma​ attack, per the clinical pathway.

A nurse is interviewing for a staff position on a​ medical-surgical unit. Which portion of the hiring process best represents the hospital​'s efforts to evaluate the nurse​'s commitment to the​ profession? 1. Offering the candidate the option of completing a​ four-week unit orientation and preceptorship 2. Requiring the candidate to provide official copies of college transcripts 3. Exploring the candidate​'s desire to maintain membership in the profession 4. Inviting current staff nurses to serve as members of the candidate​'s interview committee

3 The​ candidate's desire to maintain membership in the nursing profession is reflective of professional commitment. The requirement to provide official college transcripts is not directly related to the​ candidate's commitment to the nursing profession. Inviting current staff nurses to serve as interview committee members and offering a unit orientation and preceptorship are not direct methods of evaluating the​ candidate's professional commitment to nursing.

The manager schedules a nursing assistant to attend a basic communication program after observing the assistant provide client care. Which actions would result in this type of​ referral? ​(Select all that​ apply.) 1. Talking with a newly admitted client about his grandchildren 2. Referring to a​ 75-year-old male client as​ "Mr. Dan" 3. Asking a​ 65-year-old client,​ "Are we ready to get out of​ bed?" 4. Calling an​ 80-year-old client​ "Sweetie" 5. Referring to a​ 70-year-old client's abdominal wound as a​ "boo-boo"

3, 4, 5 Elderspeak is a demeaning way of speaking with an older adult client. Use of inappropriate terms of​ endearment, such as​ sweetie, inappropriate use of the first person plural​ ?we? when referring to getting out of​ bed, and using baby talk by referring to a wound as a​ boo-boo are all examples of elderspeak. Using a formal title as Mr. and following it with the​ client's first name is appropriate if the client has asked to be called in this manner. Discussing grandchildren with the client does not demonstrate elderspeak.

A healthcare provider yells at a novice nurse for not knowing a​ client's latest laboratory values. Which responses by the novice nurse would demonstrate assertive​ communication? ​(Select all that​ apply.) 1. ​"You can look them up on the​ computer." ​2. "I'm sorry.​ I'll see where those results​ are." ​3. "I will locate the values and get them to​ you." ​4. "I can't do anything right for​ you." ​5. "The lab has not phoned in the results​ yet."

3, 5 Assertive communication is demonstrated by using​ "I" statements such as​ "I will locate those values and get them to​ you." Fogging is another technique that causes both parties to focus on something that is agreed. In this​ case, the statement​ "the lab has not phoned in the results​ yet" takes the focus off of the healthcare​ provider's anger towards the nurse and places it on the issue that the values are not yet available. Saying​ "I can't do anything right for​ you" and​ "I'm sorry" are both passive responses. Saying​ "you can look them up on the​ computer" is an aggressive response.

The nursing student is experiencing the integrated stage of commitment development. When developing professional​ commitment, which behavior would the nursing student be most likely to demonstrate during the integrated​ stage? 1. Considering switching to a major other than nursing 2. Learning about positive aspects of the nursing profession 3. Being eager to take the ​NCLEX-RN​® examination 4. Becoming involved in a student nursing association

3. Being eager to take the ​NCLEX-RN​® examination

Esther​ Wulfman, an​ 83-year-old client with a hearing​ deficit, is admitted for exacerbation of heart failure. What should​ Marta, the​ nurse, do to support​ Esther's communication needs during the assessment​ process? 1. Shout into the​ client's good ear when talking 2. Ask if a family member is available to complete the assessment 3. Close the door to the room when conducting the assessment 4. Sit beside the client during the assessment

3. Close the door to the room when conducting the assessment

The leader of a group of staff nurses is encouraging all members to work towards achievement of a common goal. Which behavior is the leader​ demonstrating? 1. Monopolizing 2. Commitment 3. Power 4. Brainstorming

3. Power

Gordon​ Sullivan, a​ 58-year-old client with acute pain and bleeding from prostate​ cancer, rates his pelvic pain as an 8 on a pain rating scale from 1 to 10. He is considering surgery to remove the prostate before beginning chemotherapy and radiation. When writing a​ three-part nursing diagnosis for​ Gordon, what should the nurse use as the​ etiology? 1. Surgery 2. Acute Pain 3. Prostate cancer 4. Bleeding

3. Prostate cancer

Which are characteristics of a primary​ group? ​(Select all that​ apply.) 1. Impersonal communication 2. Task oriented 3. Spontaneity ​4. Face-to-face communication 5. Unity

3. Spontaneity ​4. Face-to-face communication 5. Unity

In an annual​ evaluation, the nurse unit leader describes the staff nurse as "skilled at analyzing a complex situation and able to pick out the most important aspects of a clinical scenario." According to Patricia Benner​'s model of nursing​ development, which developmental stage best matches the nurse unit leader​'s evaluation of the staff​ nurse? 1. Expert 2. Novice 3. Competent 4. Proficient

4 According to​ Benner's model, the novice nurse has no experience and relies only on​ guidelines, policies, and theories. The advanced beginner is starting to gain​ experience, with a focus on tasks and guidelines as the nurse at this stage does not have the experience to consider complexities. The competent nurse has begun to master some​ tasks, but does not yet possess the speed and flexibility of the proficient nurse. The proficient nurse is able to view the complexities of a​ situation, looking at the whole and determining which are the most important aspects. The expert nurse possesses an intuitive understanding of most situations and is able to quickly determine a course of action without much problem solving.

The nurse leader is evaluating the charge nurse​'s type of commitment to the nursing profession. Which behavior by the charge nurse is most reflective of affective commitment to​ nursing? 1. Expressing a sense of obligation to remain in the nursing profession 2. Choosing to stay in nursing due to personal experiences with illness 3. Remaining in the nursing profession to avoid loss of income 4. Joining professional nursing organizations and engaging in nursing service activities

4 Affective commitment develops when professional involvement produces a satisfying experience. Manifestations of affective commitment include engaging in​ profession-specific organizations and service activities. Normative commitment manifests as a feeling of obligation to continue in​ one's profession and it develops in response to benefits or positive experiences gained by way of engagement in​ one's profession. For​ example, the nurse whose desire to enter nursing stems from personal or family experiences with illness is reflective of normative commitment. Continuance commitment develops when negative consequences of​ leaving, such as loss of​ income, are viewed as reasons to stay.

The nurse is assessing an​ 8-year-old client whose parent brought him to the​ walk-in clinic. The parent reports that the child is tired and has been coughing for 2 days. Which assessment findings may be clustered as significant cues suggesting that the child has​ influenza? 1. The​ child's oxygen saturation is​ 98%. 2. The​ child's lungs are clear on auscultation. 3. The​ child's vital signs are BP​ 95/62 mmHg, RR​ 23, P​ 90, T 98.8degrees°F 4. The​ child's vital signs are BP​ 90/60 mmHg, RR​ 22, P​ 80, T 101.5degrees°F.

4 After collecting​ data, the nurse attempts to identify significant cues that form a pattern to generate a tentative hypothesis as to what is occurring with the client. In this​ scenario, significant cues suggesting influenza include the​ cough, malaise, and vital signs that show an elevated temperature of 101.5degrees°F. A normal temperature does not indicate the flu. Clear lungs and an oxygen saturation of​ 98% do not indicate influenza.

The nurse educator is teaching a class about professional development in nursing. When describing an area of nursing​ competence, which component is most appropriate for the nurse educator to include in the​ teaching? 1. Recognizing the nurse​'s responsibility to remain strictly in a​ client-centered role 2. Understanding that client populations tend to demonstrate the same personal needs 3. Knowing and demonstrating adherence to the ethics of primary care providers 4. Understanding the culture of the client population and the healthcare institution

4 Areas of nursing competence include understanding the culture of the client and the​ institution; knowing and demonstrating adherence to the ethics of the nursing​ profession; acknowledging the​ client's need for individualized​ care; and assuming multiple nursing​ responsibilities, including​ legal, professional,​ ethical, and​ client-centered roles.

The nurse is caring for a client who is recovering from abdominal surgery. During the morning​ assessment, the client complains of pain and rates the pain at 7 out of 10. The nurse tells the client that she will prepare pain medication and return in 10 minutes to administer it. Which characteristic of verbal communication is the nurse​ using? 1. Pace 2. Humor 3. Intonation 4. Credibility

4 By assessing the​ client's pain and stating a return time to administer needed pain​ medication, the nurse is relaying credibility. She is being trustworthy and reliable in responding to the​ client's report of postoperative pain. Pace and intonation are often used when communicating with a client who is​ anxious, but this scenario does not indicate that the client has anxiety. There is no indication that the nurse is using humor while communicating with this client.

The nurses on a care area are uncharacteristically quiet. There is no friendly​ chatter, and nurses are staying in clients​' rooms to document until the end of the shift. Which incident might cause the nurses to demonstrate this​ behavior? 1. The director is identifying staff for promotion. 2. The nurse manager is working on the annual budget. 3. The medical director is making client rounds. 4. The charge nurse called everyone incompetent during report.

4 By calling the nursing staff​ incompetent, the charge​ nurse's aggressive behavior influenced all of the staff during the shift as they tried to avoid another similar encounter. The behavior of the nurse​ manager, director, and medical director did not cause the nurses to be afraid to leave​ clients' rooms.

During a meeting to discuss the implementation of a new computerized documentation​ system, one staff nurse asks about the ease of​ use, preloaded​ templates, and online nursing resources. What behavior is the staff nurse​ demonstrating? 1. Opinion giver 2. Information giver 3. Opinion seeker 4. Information seeker

4 Each member of the group is responsible for individual behavior and participation. Roles that members assume include information​ giver, information​ seeker, and opinion giver. The nurse asking questions is seeking information. Providing information to another is functioning in the role of information giver. Explaining personal views about an issue would be characteristic of an opinion giver. Opinion seeker is not an identified role behavior when working in groups.

A staff nurse is overhead counseling a newly hired nurse about limiting suggestions to improve the functioning of the unit because the manager open double quote"does not like suggestionsclose double quote" and will open double quote"put you down.close double quote" Which characteristic of an ineffective group is the manager​ influencing? 1. Goal setting 2. Cohesion 3. Problem solving 4. Creativity

4 In an ineffective​ group, creativity is discouraged and members fear appearing foolish if they put forth a creative thought. In an ineffective​ group, problem solving is low and criticism may be​ destructive, taking the form of either overt or covert personal attacks. In an ineffective group cohesion is either ignored or used as a means of controlling members and promoting rigid conformity. In an ineffective​ group, goal setting is​ unclear, misunderstood, or imposed goals may be accepted by members. The goals are competitively structured.

Several nurse managers are having lunch after attending a shared governance committee meeting. Which manager statement indicates that the committee is​ ineffective? 1. "Who knew we had such a nice conference ​room!" 2. "I think the goals are tough but appropriate in the circumstances." 3. "I could have prepared better before today​'s meeting." 4. "I am not sure why the chairperson made all of the decisions."

4 In an ineffective​ group, decision making is made by the individual with the most authority in the​ group, with minimal involvement by members. In an effective​ group, goals are clarified so that all group members commit to completing them. In an effective​ group, self-evaluation of group members occurs often. The atmosphere in an effective group is comfortable and relaxed. The comment about the nice conference room indicates the group members feel comfortable commenting on the accommodations.

The nurse educator is explaining the significance of punctuality and attendance in the nursing profession to a class of nursing students. Which statement is most appropriate for the nurse educator to include in the​ discussion? 1. "Nurses must be flexible about helping colleagues who routinely need to miss work." 2. "During a nursing​ shortage, hospital attendance requirements usually are less strict." 3. "The most severe consequence of excessive tardiness for the professional nurse is suspension." 4. "Chronic tardiness and frequent absenteeism among nurses can compromise client care."

4 In nursing​ practice, chronic tardiness and frequent absenteeism place a greater burden on​ colleagues, compromise client​ care, and can cause conflict among staff. Just as excessive tardiness to clinicals can lead to severe​ repercussions, even during a nursing​ shortage, professional nurses who demonstrate excessive tardiness or absences may face disciplinary actions including suspension and termination.

The nursing student is designing a poster that describes how to recognize burnout among nurses. Which recommendation for identifying manifestations of burnout should be included on the​ poster? 1. Understand that emotional depletion is a natural response to the demands of employment 2. Recognize that outbursts of anger are normal signs of professional frustration 3. Acknowledge feelings of helplessness as signs of inexperience or professional inadequacy 4. Interpret that smoking and an increase in coffee consumption may be potential warning signs

4 Manifestations of burnout include physical and emotional​ depletion, negative attitude and​ self-concept, and feelings of helplessness and hopelessness. Danger signs that may precede the development of burnout include increased coffee consumption and smoking.

Which evaluation statement by the nurse is appropriate and indicates a goal has been met for a client diagnosed with a​ stroke? 1. 04/03/2015, 1830: Goal partially​ met: Client demonstrates use of home oxygen machine. ​2. 1750: Goal​ met: Client voices understanding of treatment therapy. ​3. 04/03/2015: Goal not​ met: Client does not demonstrate use of incentive spirometer. ​4. 04/03/2015, 1800: Goal​ met: Client demonstrates​ self-injection of Lovenox prior to discharge.

4 Once the nurse determines if a goal has been​ met, the nurse writes an evaluation statement on the care plan. Evaluation statements must contain the date and time of​ evaluation, and they must state whether the goal was​ met, partially​ met, or not met.

The nurse is preparing to discharge a client after a hospital stay. What should the nurse take into consideration when evaluating the client​'s health status at​ discharge? 1. Modification of implemented interventions 2. Impact of the evaluation 3. Opportunities to correct intervention deficiencies 4. Identification of the client​'s ​self-care abilities

4 Outcomes are evaluated to determine if the​ client's goals have been met and for the effectiveness of the care plan. Based on the​ evaluation, the plan of care is​ continued, modified, or terminated. Three situations in which nursing care should be evaluated are during or immediately after an intervention in order to continue or​ modify; at​ time-specific intervals in order to measure progress and correct or modify deficiencies as​ necessary; and at discharge to identify the​ client's self-care abilities and determine the need for​ follow-up care.

The manager is concerned that a novice nurse is being made a scapegoat for an event that occurred on the care area. Which observation supports this manager​'s ​concern? 1. The novice nurse volunteers to work with other staff on a quality improvement study. 2. The charge nurse meets with the oncoming shift to review clients who could be discharged later in the day. 3. Nursing assistants are discussing work assignments and suggesting ways to help each other. 4. Staff nurses suggest that the novice nurse is responsible for missing narcotics during a shift when the nurse was not at work.

4 Scapegoating occurs when an individual or group forces blame on an individual who is not at fault. People and groups who use this approach focus on​ others' weaknesses. Volunteering to work with other​ staff, discussing work​ assignments, and meeting to discuss possible discharges are all positive actions that do not indicate scapegoating.

The nurse leader is preparing a webinar about how to prevent burnout in nursing. To accurately describe strategies for preventing​ burnout, which activity should the nurse educator include in the​ webinar? 1. Develop acceptance and recognize that the limitations of any situation can be changed 2. Study assertiveness and learn to take on added responsibilities even when feeling overwhelmed 3. Learn to depend on oneself and to avoid expressions of emotions toward colleagues 4. Actively engage in efforts to produce constructive change if organizational policies create stress

4 Strategies for preventing burnout in nursing include​ involvement, studying assertiveness​ techniques, expressing​ compassion, and developing acceptance. Involvement includes being active in efforts to produce constructive change if organizational policies cause stress. Studying assertiveness​ techniques, which can help with overcoming feelings of powerlessness in​ relationships, includes learning to say no. Compassion includes learning to ask for help and expressing emotions toward colleagues. Acceptance includes recognizing the limitations associated with each situation and accepting what cannot be changed.

A nurse educator chooses to implement​ scenario-based simulations for educating a group of student nurses regarding clinical judgment. Which approach is the educator​ using? 1. Benner​'s skill acquisition model 2. Tanner​'s clinical judgment model 3. Maslow​'s hierarchy of needs 4. Lasater​'s assessment rubric

4 The Lasater clinical judgment rubric is designed to allow for student reflection on the level of observed development of decision making and clinical judgment skills. This is exemplified with the use of simulation in a nursing lab.​ Tanner's clinical judgment model emphasizes the importance of elements the nurse uses in cognitive​ processing, including book​ knowledge, past​ experiences, and previous knowledge.​ Benner's skill acquisition model is based on the idea that the ability to make clinical judgments progresses as nurses gain experience and build their skills.​ Maslow's hierarchy of needs is a model nurses can use to inform how they prioritize care for a client.

The nurse is caring for an adolescent client who is alert but intubated following a​ C7-T1 spinal cord injury. Which communication strategy is the most developmentally appropriate for the nurse to use with this intubated​ client? 1. Hand signals 2. Grease pencil and white board 3. Flash cards 4. Text messages

4 The client is an adolescent and has a spinal cord injury that most likely has kept his arm and hand function intact. Text​ messaging, popular among​ adolescents, would be the best communication method for this client. Flash​ cards, hand​ signals, and grease pencil with a white board might work as a method of communication to some​ extent; however, these may or may not support the​ client's physical and developmental needs. With text messaging the client will be able to communicate needs to healthcare staff as well as communicate with friends and family.

The nurse has been determining a method of communicating with a client recovering from a stroke. Which client observation indicates that an effective communication method has been​ established? 1. Slapping the nurse​'s hand to refuse an action 2. Groaning to get the nurse​'s attention 3. Holding a pen to write on paper 4. Spelling words on a bedside table using tiled letters

4 The client using letters to spell words on a bedside table demonstrates that an effective communication method has been established. Groaning and slapping hands are not effective communication methods. Trying to use a paper and pen to write might be premature for this client and does not indicate that an effective communication method has been established.

A nurse is caring for a client with a history of a heart dysrhythmia. The nurse notifies the client​'s healthcare provider after noticing a decreasing trend in the client​'s serum potassium​ level, client muscle​ spasms, and changes in ECG pattern. Which critical thinking concept is the nurse​ using? 1. Seeking new knowledge 2. Approaching situations objectively 3. Differentiating fact from fiction 4. Recognizing salient cues

4 The nurse has recognized salient​ cues, pieces of clinical information that provide the nurse with a larger overall clinical picture of the client. Differentiating fact from fiction and approaching situations objectively are aspects of​ intellect, not critical thinking as used by the nurse in this scenario. The nurse is not seeking new​ knowledge, but rather is recognizing a trend in the client

During a health history​ interview, the client denies having any health problems but then crosses her arms and looks away. What does this behavior indicate to the​ nurse? 1. The nurse is taking too​ long, and the client is uncomfortable sitting in a chair. 2. The client is bored with the nurse asking too many questions. 3. The nurse is rushing the client to complete the health history. 4. The client​'s verbal communication and nonverbal communication are not congruent.

4 The nurse is interpreting both verbal and nonverbal messages from the client. A client who denies having any problems while crossing her arms and looking the other way is sending incongruent messages. There is no way to confirm that the client is​ bored, that the nurse is rushing the​ client, or that the nurse is taking too long. Crossing the arms and looking away does not usually indicate an uncomfortable body position.

A nurse is caring for a​ client, with a right femur​ fracture, who complains of pain in the right leg. The nurse asks the​ client, open double quote"Please tell me how you would rate your pain on a scale of zero to ten.close double quote" Which method of therapeutic communication is the nurse using with this​ client? 1. Seeking clarification 2. Giving information 3. Providing general leads 4. Being specific

4 The nurse is using the therapeutic communication technique of being specific when the nurse makes statements that are specific rather than general. Providing general leads is using statements or questions that encourage the client to verbalize feelings and encourages further conversation. Seeking clarification occurs when the nurse restates the​ client's message to make it more understandable. Giving information is when the nurse provides the client specific factual information.

A nurse is caring for a client who will undergo a cholecystectomy surgery in two hours. To assess that the client has informed​ consent, the nurse asks the​ client, open double quote"Can you tell me what your surgery will ​involve?close double quote" Which method of therapeutic communication is the nurse using with this​ client? 1. Giving information 2. Seeking clarification 3. Paraphrasing ​4. Open-ended questioning

4 The nurse is using​ open-ended questioning. With this​ technique, the nurse invites the client to elaborate and use answers that are longer than one or two words. Paraphrasing is when the nurse repeats the​ client's basic message using the​ nurse's own words. Seeking clarification occurs when the nurse restates the​ client's message to make it more understandable. Giving information occurs when the nurse provides the client specific factual information.

A nurse is caring for a client who has been diagnosed with liver cancer but has not shared this diagnosis with family members. The client tells the​ nurse, open double quote"I can​'t tell my family that I have cancer.close double quote" The nurse​ replies, open double quote"What do you think would be ​best?close double quote" Which method of therapeutic communication is the nurse using with this​ client? 1. Presenting reality 2. Focusing 3. Acknowledging 4. Reflecting

4 The nurse is using​ reflecting, a technique that leads the​ client's feelings back to the client to assist the client in discovering his or her own ideas. Focusing is used when the nurse helps the client expand on and develop a topic of​ importance, which is often an emotion disguised behind words. Presenting reality helps the client distinguish the real from the unreal. Acknowledging is used when the nurse gives nonjudgmental recognition to the client for a client effort or change in behavior.

A nurse is caring for a pediatric client with possible pneumonia who is about to go for an​ X-ray. The nurse​ states, open double quote"The doctor needs to​ X-ray your chest so she can get a picture of what​'s happening in your lungs. Let me tell you what​'s going to happen.close double quote" Which therapeutic communication technique is the nurse using to develop a therapeutic relationship with the​ client? 1. Clarifying time 2. Acknowledging 3. Focusing 4. Giving information

4 The nurse is utilizing the technique of giving information to provide the client with​ specific, accurate information. The technique of clarifying time is used to clarify an event in relationship to time. Focusing is used when the nurse supports the client to expand on and advance a topic of​ importance, which is often an emotion disguised behind words. Acknowledging is used when the nurse gives broadminded recognition to the client for a client effort or change in behavior.

A nursing assistant is overheard telling a​ client, open double quote"I don​'t have all day. Let me put those shoes on you.close double quote" What type of communication style is the assistant​ demonstrating? 1. Assertive 2. Passive ​3. Passive-aggressive 4. Aggressive

4 The nursing assistant is displaying aggressive​ communication; she is focusing on her needs and has become impatient with the client. Passive communication involves a person focused on the​ needs, demands, and requests of others without regard to his or her own feelings and needs. Assertive communication conveys concern for the needs of others.​ Passive-aggressive communication combines the attributes of focusing on the needs of others and then lashing out and being impatient when personal needs are not met.

The nurse is preparing to explain the insertion of an intravenous catheter into the arm of a client who has never been hospitalized. Which explanation by the nurse is the most appropriate for this​ procedure? 1. ​"An angiocath is inserted in a vein and fluids are​ administered." ​2. "An intracath is placed in a​ vein, and the IV is set to administer 100 ccs an​ hour." ​3. "A needle is inserted in a vein so that this bag of fluid is pushed into your​ body." ​4. "A small tube is put in a blood​ vessel, and liquid is dripped into your​ body."

4 When communicating with a client regarding a​ procedure, the nurse should avoid the use of​ slang, buzz​ words, or medical jargon to prevent any potential misunderstanding. The statement​ "a small tube is put in a blood vessel and liquid is dripped into your​ body" is the simplest way to describe an IV​ infusion, using words with few syllables and no medical jargon. The phrases with​ "angiocath" and​ "intracath" use medical jargon. Saying​ "a needle is inserted in a​ vein" so​ "fluid is​ pushed" can be frightening to a client who has never been hospitalized.

The nurse prioritizing care for a client with diabetes mellitus utilizes Maslow​'s hierarchy of needs. Which need is priority for this​ client? 1. The nurse teaches the client proper home safety techniques to prevent diabetic wounds. 2. The client attends classes to deal with body image after amputation of right leg. 3. The client joins the local American Diabetes Association support group. 4. The nurse teaches the client how to properly change dressings on right leg amputation site.

4 When prioritizing care based on​ Maslow's hierarchy of​ needs, physiological needs will come before​ safety, social, and esteem needs. Caring for an amputation site is meeting a physiological need. Attending a class to deal with body image issues addresses an esteem need. Teaching the client about safety techniques to prevent diabetic wounds addresses a safety need. Joining a support group meets an esteem need.

A nurse working in the emergency department uses a clinical decision tree to determine the best course of action for a client who presents with signs and symptoms of a myocardial infarction​ (MI). Which statements are true regarding this clinical decision​ tool? ​(Select all that​ apply.) 1. It cannot be implemented by all nurses. 2. It requires​ higher-level decision making. 3. It requires no decision making. 4. It can assist in decision making. 5. It requires standardization of care.

4, 5 Clinical decision trees and protocols can assist in decision​ making, especially for nurses who do not have enough nursing​ experience, or nursing​ knowledge, to make decisions. This tool can assist in standardizing care because the tool can be used for all clients who present with similar symptoms. Because the tool has steps of decisions​ presented, it does not require​ higher-level decision making.​ However, the tool still requires some decision making by the nurse to ensure interventions are appropriate for the client.

A nurse educator asks the student nurse to describe chronic obstructive pulmonary disease​ (COPD) and nursing interventions used to treat the condition. The student nurse​ states, "COPD is a chronic pulmonary​ disease, and the nurse should place the client in high Fowler​ position." Which clinical reasoning concepts is the student nurse using in this statement ​(Select all that​ apply.) 1. Judgment 2. Inference 3. Inquiry 4. Fact 5. Opinion

4, 5 The nurse is using both fact and opinion in the statement. Facts can be confirmed by​ research-COPD is a chronic pulmonary disease. Opinions may be based on fact and are beliefs made over​ time, including nursing interventions such as placing the client with COPD in high Fowler position. Judgment is an evaluation of facts that reveal​ values; e.g., place the client with COPD in high Fowler when the sPO2 is​ <92%. Inference is going beyond the facts to make a statement about something not currently known. Inquiry is a search for knowledge.

During hospital​ orientation, the human resources specialist is defining and explaining sexual harassment. Which statement should be included in the human resource specialist​'s discussion of sexual​ harassment? 1. "Physical contact is required for a behavior to be considered sexual harassment." 2. "Discrimination is one type of sexual harassment." 3. "Sexual harassment requires the victim and violator to be of different genders." 4. "Sexual harassment interferes with performance in the workplace."

4. "Sexual harassment interferes with performance in the workplace."

​Rosario, the manager of a​ 20-bed unit, is evaluating the success of assertiveness training classes that staff nurses attended to improve communicating with physicians. Which behavior by​ Yvonne, a staff​ nurse, indicates she needs more​ training? 1. Focusing on the situation before speaking and requesting help 2. Using a neutral voice when discussing a​ client's abnormal laboratory values 3. Stating​ "I would like some​ help" when planning care with other team members 4. Apologizing to the neurosurgeon for​ "bothering him" with a question 5. Identifying an area where both the nurse and client agree

4. Apologizing to the neurosurgeon for​ "bothering him" with a question

When communicating discharge instructions to a​ client, the nurse states exactly what needs to be done using the fewest number of words. Which characteristics of verbal communication is the nurse​ using? ​(Select all that​ apply.) 1. Intonation 2. Pace 3. Simplicity 4. Brevity 5. Clarity

4. Brevity 5. Clarity

The nurse is a member of a work group in which the members like and trust each other and provide each other with support. Which characteristic is this group​ demonstrating? 1. Atmosphere 2. Creativity 3. Power 4. Cohesion

4. Cohesion

The nurse is assessing Julia​ McMichael, an​ 82-year-old client with pneumonia. Mrs. McMichael is experiencing​ dyspnea, has a pulse oximeter reading of​ 90, and lung assessment reveals rales. Which nursing intervention is the most appropriate for Mrs. McMichael at this​ time? 1. Keep the head of Mrs.​ McMichael's bed flat 2. Use a face mask for oxygen even though a request for nasal cannula was made 3. Empty fluid from the oxygen humidifier 4. Explain that the oxygen will help Mrs. McMichael breath better

4. Explain that the oxygen will help Mrs. McMichael breath better

Linda is a member of a nursing journal club that meets every 2 weeks. Linda does not agree with most of the group​ members' opinions about proposed changes that would expand the membership of the​ group, but she does not speak up. Which behavior is Linda demonstrating at this​ time? 1. Monopolizing 2. Scapegoating 3. Apathy 4. Groupthink

4. Groupthink

William is a nurse working on the pediatric cancer unit at a large urban hospital. One of his​ clients, Angela, is a​ 16-year-old who is recovering from surgery. Her​ mother, Carlotta, has been by her side almost​ constantly, but​ Angela's father has not been to visit since she was transferred to the unit. Angela is frequently rude to​ William, and it often takes him several attempts to get her to participate in interventions when William is on duty. The nurse from the night​ shift, who is​ female, shared that she does not have any difficulty with Angela. William recognizes that​ Angela's hostility toward him is most likely due to which​ factor? 1. Apathy 2. Countertransference 3. Scapegoating 4. Transference

4. Transference

​Dena, the nurse at a local​ clinic, is determining the best way to communicate test results to a client who has requested all communication go to his​ e-mail address. The test results showed some abnormalities. Which is the best option for Dena in this​ situation? 1. ​E-mail the test results directly to the client 2. Ask the healthcare provider to​ e-mail the test results to the client 3. Send the test results by regular mail 4. ​E-mail the client with a request to call the office

4. ​E-mail the client with a request to call the office

A healthcare organization is adopting the use of a​ three-column nursing care plan. What information will be documented in these​ columns? ​(Select all that​ apply.) 1. Assessment 2. Evaluation ​3. Goals/desired outcomes 4. Nursing interventions 5. Nursing diagnoses

​3. Goals/desired outcomes 4. Nursing interventions 5. Nursing diagnoses

Colleen is assessing​ Janie, a​ 6-year-old girl who was hit by a car while riding her bicycle. When Colleen sits down to look in​ Janie's eyes, she​ says, "Promise you​ won't do anything that​ hurts." Janie's mother looks at Colleen with pleading eyes. Which response by Colleen is the most​ appropriate? 1. "Nothing can feel worse than how you hurt right​ now." ​2. "There's no way that I can make that promise to​ you." 3. "I promise that I​ won't let anyone hurt​ you." ​4. "Sometimes things hurt just for a second so that you can get better​ faster."

​4. "Sometimes things hurt just for a second so that you can get better​ faster."