Foundations of Nursing Study Guide 4

Confidentiality

Issues are not to be discussed with nonmedical personnel or the client's family or friends without the client's permission. Protects private patient information once it have been disclosed in health care settings.

The point of the ethical principal to "do no harm" is an agreement to reassure the public that in all ways the health care team not only works to heal patients but agree to do this in the least painful and harmful way possible. Which principle describes this agreement? A. Beneficence B. Accountability C. Nonmaleficence D. Respect for autonomy

C. Nonmaleficence

A nurse notes that the health care unit keeps a listing of the patient names at the front desk in easy view for health care providers to more efficiently locate the patient. The nurse talks with the nursing manager because this action is a violation of which act? A. Mental Health Parity Act B. Patient Self-Determination Act (PSDA) C. Health Insurance Portability and Accountability Act (HIPAA) D. Emergency Medical Treatment and Active Labor Act

C. Health Insurance Portability and Accountability Act (HIPAA)

A student nurse employed as a nursing assistant may perform care A. As learned in school B. Expected of a nurse at that level C. Identified in the hospital's job description. D. Requiring technical rather than professional skills.

C. Identified in the hospital's job description.

A nurse reports a medication error and monitors the patient, who suffers no ill effects. Which element is lacking to prove nursing malpractice? A. Duty of care B. Breach of duty C. Injury D. Standard of care

C. Injury

A primary care provider prescribes on tablet, but the nurse accidentally administers two. After notifying the primary care provider, the nurse monitors the client carefully for untoward effects of which there are none. Is the client likely to be successful in suing the nurse for malpractice? 1. No, the client was not harmed 2.No, the nurse notified the primary care provider 3. Yes, a breach of duty exists 4. Yes, foreseeability is present

1. No, the client was not harmed

An individual has a seizure while walking down the street. During the seizure, a nurse from a physician's office is noticed driving past without stopping to assist. The individual sues the nurse for negligence but fails to win a judgement for which reason? 1. The nurse had no duty to the individual 2. The nurse did what most nurse's do in the same circumstance 3. the nurse did not cause the client's injuries 4. The nurse was off duty

1. The nurse had no duty to the individual

Following a motor vehicle crash, a nurse stops and offers assistance. Which of the following actions are most appropriate? Select all that apply 1. The nurse needs to know the Good Samaritan Act for the state. 2. The nurse is not held liable unless there is gross negligence 3. After assessing the situation, the nurse can leave to obtain help. 4. The nurse can expect compensation for helping. 5. The nurse offers to help but cannot insist on helping.

1. The nurse needs to know the Good Samaritan Act for the state. 3. After assessing the situation, the nurse can leave to obtain help. 4. The nurse can expect compensation for helping.

The HCP orders a med in a dose that is considered toxic. The nurse administers the med to the client, who later suffers a cardiac arrest and dies. What consequence can the nurse expect from this situation. Select all that apply. 1. the HCP can be chrgd w/ negligence, being the person who ordered the dose 2. as the employing agency, only the hospital can be charged w/ negligence 3. the nurse and the physician may be terminated from employment to prevent a charge of negligence to the hospital 4. negligence will not be charged, as this event could have happened to any reasonable person 5. The nurse can be charged with negligence for administering the toxic dose

1. the HCP can be chrgd w/ negligence, being the person who ordered the dose 5. The nurse can be charged with negligence for administering the toxic dose

Which nursing actions could result in malpractice? Select all that apply 1. Learns about a new piece of equipment 2. Forgets to complete the assessment of a client 3. Does not follow up on client's complaints. 4. Charts client's drug allergies 5. Questions primary care provider about an illegible order

2. Forgets to complete the assessment of a client 3. Does not follow up on client's complaints.

A nurse forgets to administer a client's diuretic and the client experiences an episode of pulmonary edema. The charge nurse would consider the medication error to constitute negligence b/c the situation contains which element? 1. purposeful failure to perform a healthcare procedure 2. unintentional failure to perform a healthcare procedure 3. Act of substituting a different med for the one ordered 4. failure to follow a direct order by a physician

2. unintentional failure to perform a healthcare procedure

A client with cancer has decided to discontinue further tx. Although the nurse would like the client to continue tx, the nurse recognizes the client is competent and supports the client's decision using which ethical principle? 1. Justice 2. Fidelity 3. Autonomy 4. Confidentiality

3. Autonomy

The primary care provider wrote a do-not-resuscitate (DNR) order. The nurse recognizes that which applies in the planning of nursing care for this client? 1. The client may no longer make decisions regarding his or her own health care. 2. The client and family know that the client will most likely die within the next 48 hours. 3. The nurses will continue to implement all treatments focused on comfort and symptom management. 4. A DNR order from a previous admission is valid for the current admission

3. The nurses will continue to implement all treatments focused on comfort and symptom management.

The nurse working in an acute care environment would utilize which strategies to reduce the risk of malpractice litigation? Select all that apply. 1. discuss any errors with the client and family in detail 2. keep incident reports on file 3. maintain expertise in practice 4. offer opinions to clients when the situation warrants 5. report unsafe staffing levels to supervisor

3. maintain expertise in practice 5. report unsafe staffing levels to supervisor

A nursing student is employed and working as an unlicensed assistive personnel (UAP) on a busy surgical unit. The nurses know that the UAP is enrolled in a nursing program and will be graduating soon. A nurse asks the UAP if he has performed a urinary catheterization on clients while in school. When the UAP says yes, the nurses asks him to help her by doing a urinary catheterization on a post surgical client. What is the best response by the UAP? 1. "Let me get permission from the client first." 2. "Sure, which client is it?" 3. "I can't do it unless you supervise me." 4. "I can't do it. is there something else I can help you with."

4. "I can't do it. is there something else I can help you with."

A home health nurse notices significant bruising on a 2-yearold patient's head, arms, abdomen, and legs. The patient's mother describes the patient's frequent falls. What is the best nursing action for the home health nurse to take? A. Document her findings and treat the patient B. Instruct the mother on safe handling of a 2-year-old child C. Contact a child abuse hotline D. Discuss this story with a colleague

C. Contact a child abuse hotline

DNR:

A DNR order only controls CPR and similar life-saving treatments.

A new graduate nurse is being mentored by a more experienced nurse. They are discussing the ways nurses need to remain active professionally. Which of the statements below indicates the new graduate understands ways to remain involved professionally? (Select all that apply.) A. "I am thinking about joining the health committee at my church." B. "I need to read newspapers, watch news broadcasts, and search the Internet for information related to health." C. "I will join nursing committees at the hospital after I have several years of experience and better understand the issues affecting nursing." D. "Nurses do not have very much voice in legislation in Washington, DC, because of the shortage of nurses

A. "I am thinking about joining the health committee at my church." B. "I need to read newspapers, watch news broadcasts, and search the Internet for information related to health."

The nurse questions a physician's order to administer a placebo to the patient. The nurse's action is based on which ethical principle? A. Autonomy B. Beneficence C. Justice D. Fidelity

A. Autonomy

Which philosophy of health care ethics would be particularly useful when making ethical decisions about vulnerable populations? A. Feminist ethics B. Deontology C. Bioethics D. Utilitarianism

A. Feminist ethics

When a nurse assesses a patient for pain and offers a plan to manage the pain, which principal is used to encourage the nurse to monitor the patient's response to the pain? A. Fidelity B. Beneficence C. Nonmaleficence D. Respect for autonomy

A. Fidelity

The nurse administers an intravenous (IV) hypertonic solution to a patient. In which direction will the fluid shift? A. From intracellular to extracellular b. From extracellular to intracellular c. From intravascular to intracellular d. From intravascular to interstitial

A. From intracellular to extracellular

-A patient has dehydration. While planning care, the nurse considers that the majority of the patient's total water volume exists in with compartment? A. Intracellular b. Extracellular c. Intravascular d. Transcellular

A. Intracellular

-Four patients in labor all request epidural analgesia to manage their pain at the same time. Which ethical principal is compromised when only one nurse anesthetist is on call? A. Justice B. Nonmaleficence C. Beneficence D. Fidelity

A. Justice

On a medical unit, several patients are being treated for Hepatitis B infection. One of the patients contracted Hepatitis B through using infected needles associated with heroin use. Another of the patients contracted Hepatitis B through a blood transfusion following a car accident. Several of the employees on the unit treat the patient who used heroin rudely and delay their attention to the patient's requests. The nurse intervenes and reminds the staff to use which ethical principle? A. Justice B. Nonmaleficence C. Beneficence D. Autonomy

A. Justice

The nurse is teaching about the process of passively moving water from an area of lower particle concentration to an area of higher particle concentration. Which process is the nurse describing? A. Osmosis b. Filtration c. Diffusion d. Active transport

A. Osmosis

Following a motor vehicle crash, the parents refuse to permit withdrawal of life support from the child with no apparent brain function. Although the nurse believes the child should be allowed to die and organ donation considered, the nurse supports their decision. Which moral principle provides the best basis for the nurse's actions? A. Respect for autonomy B. Nonmaleficence C. Beneficence D. Justice

A. Respect for autonomy

Successful ethical discussion depends on people who have a clear sense of personal values. When a group of people share many of the same values, it may be possible to refer for guidance to philosophical principals of utilitarianism. This philosophy proposes which of the following? A. The value of something is determined by its usefulness to society. B. People's values are determined by religious leaders. C. The decision to perform a liver transplant depends on a measure of the moral life that the patient has led so far. D. The best way to determine the solution to an ethical dilemma is to refer the case to the attending physician or health care provider.

A. The value of something is determined by its usefulness to society.

Resolution of an ethical dilemma involves discussion with the patient, the patient's family, and participants from all health care disciplines. Which of the following describes the role of the nurse in the resolution of ethical dilemmas? A. To articulate his or her unique point of view, including knowledge based on clinical and psychosocial observations B. To await new clinical orders from the physician C. To limit discussions about ethical principals D. To allow the patient and the physician to resolve the dilemma without regard to personally held values or opinions regarding the ethical issues

A. To articulate his or her unique point of view, including knowledge based on clinical and psychosocial observations

A nurse is on duty in the emergency room when the nurse is notified that a school bus has been struck by a train. Immediately the nurse reports to the triage area and begins the task of determining the severity of injuries, so that the most critical patients receive care first. Which ethical theory is the nurse putting into action? A. Utilitarianism B. Act deontology C. Rule deontology D. Virtue ethics

A. Utilitarianism

When caring for patients, the nurse knows that part of the ethical principles include all patients having the same right to nursing interventions. This principle is: A. Autonomy B. Nonmaleficence C. Justice D. Beneficence

C. Justice

A nurse forgets to put the call light within the client's reach and then leaves the room. The client reaches for it and falls out of bed. The nurse could be charged with which of the following? A. Assault B. Battery C. Negligence D. Criminal Intent

C. Negligence

If a nurse decides to withhold a medication because it might further lower the patient's blood -pressure, the nurse will be practicing the principle of? A. Responsibility B. Accountability C. Competency D. Moral Behavior

B. Accountability

The patient tells the nurse that she is afraid to speak up regarding her desire to end care for fear of upsetting her husband and children. Which principle in the nursing code of ethics ensures that the nurse will promote the patient's cause? A. Responsibility B. Advocacy C. Confidentiality D. Accountability

B. Advocacy

A child's immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation? A. Fidelity B. Beneficence C. Nonmaleficence D. Respect for autonomy

B. Beneficence

A client comes to the clinic and is found to have an STD (sexually transmitted disease). The client states to the nurse, "Promise you won't tell anyone about my condition." the nurse, according to the Health Insurance Portability and Accountability (HIPAA) of 1996, must do which of the following? A. Honor the client's wishes B. Communicate only necessary information C. Not disclose any information to anyone D. Respect the client's privacy and confidentiality

B. Communicate only necessary information

While the nurse is taking a patient history, the nurse discovers the patient has a type of diabetes that results from a head injury and does not require insulin. Which dietary change should the nurse share with the patient? A. Reduce the quantity of carbohydrates ingested to lower blood sugar. B. Include a serving of dairy in each meal to elevate calcium levels. C. Drink plenty of fluids throughout the day to stay hydrated. D. Avoid food high in acid to avoid metabolic acidosis.

C. Drink plenty of fluids throughout the day to stay hydrated.

Negligence:

Involves the actions of professionals that fall below standard of care for a specific professional group

A precise definition for the word quality is difficult to articulate when it comes to quality of life. Why? (Select all that apply.): A. Quality of life is measured by potential income, and average income varies in different regions of the country. B. Community values are subject to change, and communities influence definitions of "quality." C. Individual experiences influence perceptions of quality in potentially different ways, making consensus difficult. D. Placing measurable value on elusive elements such as cognitive skills, ability to perform meaningful work, and relationship to family is challenging.

B. Community values are subject to change, and communities influence definitions of "quality." C. Individual experiences influence perceptions of quality in potentially different ways, making consensus difficult. D. Placing measurable value on elusive elements such as cognitive skills, ability to perform meaningful work, and relationship to family is challenging.

Ethical dilemmas often arise over a conflict of opinion. What is the critical first step in negotiating the difference of opinion? A. Consult a professional ethicist to ensure that the steps of the process occur in full. B. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma. C. Ensure that the attending physician or health care provider has written an order for an ethics consultation to support the ethics process. D. List the ethical principles that inform the dilemma so negotiations agree on the language of the discussion.

B. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma.

When an ethical dilemma occurs on your unit, can you resolve the dilemma by taking a vote? A. Yes because ethics is essentially a democratic process, with all participants sharing an equal voice B. No because an ethical dilemma involves the resolution of conflicting values and principals rather than simply the identification of what people want to do C. Yes because ethical dilemmas otherwise take up time and energy that is better spent at the bedside performing direct patient care D. No because most ethical dilemmas are resolved by deferring to the medical director of the ethics department

B. No because an ethical dilemma involves the resolution of conflicting values and principals rather than simply the identification of what people want to do

A nurse is providing patient teaching for a patient undergoing chemotherapy. The nurse is explaining that the chemotherapy will cause some unpleasant side effects, such as nausea and hair loss. In this situation, the nurse is using which ethical principle? A. Beneficence B. Nonmaleficence C. Autonomy D. Justice

B. Nonmaleficence

The philosophy sometimes called the ethics of care suggests that ethical dilemmas can best be solved by attention to which of the following? A. Patients B. Relationships C. Ethical principles D. Code of ethics for nurses

B. Relationships

The nurse has become aware of missing narcotics in the patient care area. Which ethical principle obligates the nurse to report the missing medications? A. Advocacy B. Responsibility C. Confidentiality D. Accountability

B. Responsibility

The patient has a central venous line. The registered nurse (RN) delegates changing the sterile dressing over the line to a nursing assistant. The nursing assistant does not understand sterile technique and contaminates the dressing. An infection develops in the patient. The nurse manager discusses the action of the RN. Which statement is correct regarding the nurse's action? A. The nursing assistant is guilty of malpractice. B. The nurse is responsible for the acts delegated. C. The hospital cannot be held responsible for the act of its employees. D. No harm came to the patient, so a malpractice suit cannot be claimed

B. The nurse is responsible for the acts delegated.

During a severe respiratory epidemic, the local health care organizations decide to give health care providers priority access to ventilators over other members of the community who also need that resource. Which philosophy would give the strongest support for this decision? A. Feminist ethics B. Utilitarianism C. Deontology D.Ethics of care

B. Utilitarianism

Which issue has increased the attention paid to quality of life concerns in recent history? A. Health care disparities B.National movement regarding disabled persons C. Aging of the population D. Health care financial reform

B.National movement regarding disabled persons

Malpractice:

Is a type of negligence; When a nursing care falls below a standard of care.

The patient's son requests to view the documentation in his mother's medical record. What is the nurse's best response to this request? A. "I'll be happy to get that for you." B. "You will have to talk to the physician about that." C. "You will need your mother's permission." D."You are not allowed to see it."

C. "You will need your mother's permission."

Nurses agree to be advocates for their patients. Practice of advocacy calls for the nurse to: A. Seek out the nursing supervisor in conflicting situations B. Work to understand the law as it applies to the client's clinical condition. C. Assess the client's point of view and prepare to articulate this point of view. D. Document all clinical changes in the medical record in a timely manner.

C. Assess the client's point of view and prepare to articulate this point of view.

A nurse informs the patient's health care provider that the patient is refusing potentially life saving surgery. In this situation, which ethical principle is the nurse using? A. Beneficence B. Nonmaleficence C. Autonomy D. Justice

C. Autonomy

In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable? A. Nurses understand the principle of autonomy to guide respect for patient's self-worth. B. Nurses have a scope of practice that encourages their presence during ethical discussions. C. Nurses develop a relationship to the patient that is unique among all professional health care providers. D. The nurse's code of ethics recommends that a nurse be present at any ethical discussion about patient care.

C. Nurses develop a relationship to the patient that is unique among all professional health care providers.

Which of the following explain how health care reform is an ethical issue? (Select all that apply): A. Access to care is an issue of beneficence, a fundamental principal in health care ethics. B. Reforms promote the principle of beneficence, a hallmark of health care ethics. C. Purchasing health care insurance may become an obligation rather than a choice, a potential conflict between autonomy and beneficence. D. Lack of access to affordable health care causes harm, and nonmaleficence is a basic principal of health care ethics.

C. Purchasing health care insurance may become an obligation rather than a choice, a potential conflict between autonomy and beneficence. D. Lack of access to affordable health care causes harm, and nonmaleficence is a basic principal of health care ethics.

The nurse is assessing a patient and finds crackles in the lung bases and neck vein distention. Which action will the nurse take first? A. Offer calcium-rich foods. B. Administer diuretic. C. Raise head of bed. D. Increase fluids.

C. Raise head of bed.

The nurse finds it difficult to care for a patient whose advance directive states that no extraordinary resuscitation measures should be taken. Which step may help the nurse to find resolution in this assignment? A. Call for an ethical committee consult. B. Decline the assignment on religious grounds. C. Scrutinize her own personal values. D. Convince the family to challenge the directive.

C. Scrutinize her own personal values.

The health care provider asks the nurse to monitor the fluid volume status of a heart failure patient and a patient at risk for clinical dehydration. Which is the most effective nursing intervention for monitoring both of these patients? A. Assess the patients for edema in extremities. B. Ask the patients to record their intake and output. C. Weigh the patients every morning before breakfast. D. Measure the patients' blood pressures every 4 hours.

C. Weigh the patients every morning before breakfast.

Ethics in nursing

Confidentiality: HIPPA(Health Insurance Portability and Accountability Pact)/ Protection of Privacy. Responsibility; Specific accountability or liability or associated with performance of duties of a particular role. Accountability: Answerable to oneself and others for one's own actions. Advocacy; Accepting and respecting the client's right to decide, even if the nurse believes the decision to be wrong.

What is the best example of the nurse practicing patient advocacy? A. Seek out the nursing supervisor in conflicting procedural situations B. Document all clinical changes in the medical record in a timely manner C. Work to understand the law as it applies to an error in following standards of care D. Assess the patient's point of view and prepare to articulate it

D. Assess the patient's point of view and prepare to articulate it

Determinations regarding quality of life are: A. Based on a person's ability to act according to ethical principles. B. Based on a patient's self-determination. C. Value judgments that can vary from person to person. D. Consistent and stable over the course of one's lifetime.

D. Consistent and stable over the course of one's lifetime.

When people work together to solve ethical dilemmas, individuals must examine their own values. This step is crucial to ensure that A. The group identifies the one correct solution. B. Fact is separated from opinion. C. Judgmental attitudes are not provoked. D. Different perspectives are respected.

D. Different perspectives are respected.

The nurse values autonomy above all other principles. Which patient assignment will the nurse find most difficult to accept? A. Teenager in labor who requests epidural anesthesia B. Middle-aged father of three with an advance directive declining life support C. Elderly patient who requires dialysis D. Family elder who is making the decisions for a 30-year-old female member

D. Family elder who is making the decisions for a 30-year-old female member

A federal regulation that came into effect April 14, 2003 has impacted the health care field regarding privacy of a patient's health information. This regulation is the: A. Joint Commission on Accreditation of Healthcare Organizations B. Patient Self-Determination Act C. Patient's Bill of Rights D. Health Insurance Portability and Accountability Act

D. Health Insurance Portability and Accountability Act

After recovering from her hip replacement, an elderly client wants to go home. The family wants the client to go to a nursing home. If the nurse is acting as a client advocate, the nurse would perform which of the following actions? A. Informs the family that the client has a right to decide on her own. B. Ask the primary care provider to discharge the client to home. C. Suggest the client hire a lawyer to protect her rights. D. Help the client and family communicate their views to each other.

D. Help the client and family communicate their views to each other.

The patient for whom you are caring needs a liver transplant to survive. This patient has been out of work for several months and doesn't have health insurance or enough cash. What principles would be a priority in a discussion about ethics? A. Accountability because you as the nurse are accountable for the well-being of this patient B. Respect for autonomy because this patient's autonomy will be violated if he does not receive the liver transplant C. Ethics of care because the caring thing that a nurse could provide this patient is resources for a liver transplant D. Justice because the first and greatest question in this situation is how to determine the just distribution of resources

D. Justice because the first and greatest question in this situation is how to determine the just distribution of resources

A recent graduate of a nursing program has accepted a position in a longterm care unit. The nurse can use which strategy to reduce the risk of malpractice suits? A. Carry malpractice insurance B. Request supervision for all care C. Not sign his or her name in patient records D. Maintain good relationships with patients and families

D. Maintain good relationships with patients and families

The LPN/LVN knows that building the nurse-patient relationship is important in providing patient care, and a legal relationship is being formed. If there is a breach in this relationship and harm to the patient has occurred, which legal action can the nurse be charged with? A. Assault B. Negligence C. Slander D. Malpractice

D. Malpractice

A registered nurse arrives at work and is told to "float" to the ICU for the day because the ICU is understaffed and needs an additional nurse to care for the clients. The nurse has never worked in the ICU. Which of the following is the most appropriate nursing action? A. refuse to float in the ICU B. call the hospital lawyer C. call the nursing supervisor D. report to the ICU and identify tasks that can be safely performed

D. report to the ICU and identify tasks that can be safely performed

A nurse argues that we need to reform our health care system because we have a large number of people who are uninsured and end up needing expensive emergent care when low-cost measures could have prevented their illnesses. What ethical framework is she using to make this case? A. Deontology B.Ethics of care C.Feminist ethics D.Utilitarianism

D.Utilitarianism

Deontology

Defines actions as right or wrong on the basis of their "right-making characteristics" Focus on how the procedure ensures fidelity to the patient, truthfulness, justice, and beneficence. Looks to the presence of principles regardless of outcome.

Ethics in healthcare teams

Ethics in healthcare teams: Autonomy refers to the right to make one's own decisions, which is the principle supported in this situation. Justice refers to fairness. Fidelity refers to trust and loyalty. Confidentiality refers to privacy of personal health information. Nonmaleficence the obligation not to harm others (Hippocrates states, "First, do no harm." Beneficence positive actions to help others.

Feminist ethics:

Look to the nature of relationships to guide participants in making difficult decisions, especially relationships in which power is unequal.

A nurse is assessing a patient. Which assessment finding should cause a nurse to further assess for extracellular fluid volume deficit? A. Moist mucous membranes b. Postural hypotension c. Supple skin turgor d. Pitting edema

b. Postural hypotension

Privacy

Occurs with unreasonable intrusion into an individual's private affairs.

Ethics of care:

Promotes a philosophy that focuses on understanding relationships, especially personal narratives. Address issues beyond individual relationships

Utilitarianism

Relies on the application of a certain principle. Measures the effect that an act will have. ex: measures of "good" and "great"

Autopsy:

Requested by the family or by the patient. Or if there are belives that a patient died by violence, homicide, suicide, accident, or death.

The steps of working out an ethical problem:

Step 1: Is this an ethical dilemma? Step2; Gather information. Step 3: Examine and determine your values. Step 4 Verbalize the problem. Step 5: Consider possible courses of action.

Legal aspects of healthcare involving children:

The nurse must report situations related to child or elder abuse, gunshot wounds and other criminal acts, and certain infectious diseases.

A nurse is caring for an older patient with type II diabetes who is living in a long-term care facility. The nurse determines that the patient's fluid intake and output is approximately 1200 mL daily. What patient teaching would the nurse provide for this patient? Select all that apply. a. "Try to drink at least six to eight glasses of water each day." b. "Try to limit your fluid intake to one quart of water daily." c. "Limit sugar, salt, and alcohol in your diet." d. "Report side effects of medications you are taking, especially diarrhea." e. "Temporarily increase food containing caffeine for their diuretic effect." f. "Weigh yourself daily and report any changes in your weight."

a. "Try to drink at least six to eight glasses of water each day." c. "Limit sugar, salt, and alcohol in your diet." d. "Report side effects of medications you are taking, especially diarrhea." f. "Weigh yourself daily and report any changes in your weight."

A nurse is preparing an IV solution for a patient who has hypernatremia. Which solutions are the best choices for this condition? Select all that apply. a. 5% dextrose in water (D5W) b. 0.9% NaCl (normal saline) c. Lactated Ringer's solution d. 0.33% NaCl (1/3-strength normal saline) e. 0.45% NaCl (1/2-strength normal saline) f. 10% dextrose in water (D10W)

a. 5% dextrose in water (D5W) d. 0.33% NaCl (1/3-strength normal saline) e. 0.45% NaCl (1/2-strength normal saline)

Which client is at a greater risk for fluid volume deficit related to the loss of total body fluid and extracellular fluid? a. An infant age 4 months b. A man age 86 years c. A woman age 45 years d. An adolescent age 17 years

a. An infant age 4 months

The nurse calls the health care provider (HCP) regarding a new medication prescription because the dosage prescribed is higher than the recommended dosage. The nurse is unable to locate the HCP, and the medication is due to administered. Which action should the nurse take? a. Contact the nursing supervisor b. Administer the dose prescribed c. Hold the medication until the HCP can be contacted d. Administer the recommended dose until the HCP can be located

a. Contact the nursing supervisor

A client loses consciousness after strenuous exercise and needs to be admitted to a health care facility. The client is diagnosed with dehydration. The nurse knows that the client needs restoration of which of the following? a. Electrolytes b. Non-electrolytes c. Colloid solution d. Interstitial fluid

a. Electrolytes

A nurse is caring for a patient who has fluid imbalance related to the development of ascites. Which imbalances would the nurse monitor for in this patient? Select all that apply. a. Extracellular fluid volume deficit b. Protein deficit c. Metabolic alkalosis d. Sodium deficit e. Plasma-to-interstitial fluid shift f. Metabolic acidosis

a. Extracellular fluid volume deficit b. Protein deficit d. Sodium deficit e. Plasma-to-interstitial fluid shift

A nurse is working in a neonatal intensive care unit (NICU) where a premature baby (26 weeks gestation) is facing respiratory disorders, numerous infections, and a brain hemorrhage. The parents want every measure to be taken to keep their baby alive, but several members of the health care team are advocating removal of life support. The nurse believes there are several ethical issues involved in this case. What step should the nurse take first when facing an ethical dilemma? a. Gather as much information as possible about the situation b. Identify the options available in this situation c. Act in a fair and equitable manner for all involved d. Evaluate the actions taken using ethical principles

a. Gather as much information as possible about the situation

Endurance athletes who exercise for long periods of time and consume only water may experience a sodium deficit in their extracellular fluid. What is this electrolyte imbalance known as? a. Hyponatremia b. Hyperkalemia c. Hypernatremia d. Hypokalemia

a. Hyponatremia

A nurse monitoring a client's IV infusion auscultates the client's lung sounds and finds crackles in the bases of lungs that were previously clear. What would be the appropriate intervention in this situation? a. Notify the primary care provider immediately for possible fluid overload. b. Check all clamps on the tubing and check tubing for any kinking. c. No intervention is necessary as this is a normal finding with IV infusion. d. Notify the primary care provider immediately because these are signs of speed shock.

a. Notify the primary care provider immediately for possible fluid overload.

Ethical dilemmas are common occurrences when caring for patients. The nurse understands that dilemmas are a result of: a. Presence of conflicting values. b. Hierarchical systems. c. Judgmental perceptions of patients. d. Poor communication with the patient.

a. Presence of conflicting values.

A nurse is performing a physical assessment of a patient who is experiencing fluid volume excess. Upon examination of the patient's legs, the nurse documents: "Pitting edema; 6 mm pit; pit remains several seconds after pressing with obvious skin swelling." What grade of edema has this nurse documented? a. 1+ pitting edema b. 2+ pitting edema c. 3+ pitting edema d. 4+ pitting edema

c. 3+ pitting edema

A client who is NPO prior to surgery is complaining of thirst. What is the physiologic process that drives the thirst factor? a. Increased blood volume and extracellular overhydration. b. Increased blood volume and intracellular dehydration. c. Decreased blood volume and intracellular dehydration. d. Decreased blood volume and extracellular overhydration.

c. Decreased blood volume and intracellular dehydration.

A dialysis unit nurse caring for a client with renal failure will expect the client to exhibit which fluid and electrolyte imbalances? a. Fluid volume deficit and alkalosis. b. Fluid volume excess and alkalosis. c. Fluid volume excess and acidosis. d. Fluid volume deficit and acidosis.

c. Fluid volume excess and acidosis.

Which of the following statements most accurately describes the process of osmosis? a. Solutes pass through semipermeable membranes to areas of lower concentration. b. Water shifts from high-solute areas to areas of lower solute concentration. c. Water moves from an area of lower solute concentration to an area of higher solute concentration. d. Plasma proteins facilitate the reabsorption of fluids into the capillaries

c. Water moves from an area of lower solute concentration to an area of higher solute concentration.

An 87-year-old woman is brought to the emergency department for treatment of a fractured arm. On assessment, the nurse notes old and new ecchymotic areas on the client's chest and legs and asks the client how the bruises were sustained. The client, although reluctant, tells the nurse in confidence that her son frequently hits her if supper is not prepared on time when he arrives home from work. What is the most appropriate nursing response? a. "Oh really I will discuss this situation with your son" b. "Let's talk about the ways you can manage your time to prevent this from happening" c. "Do you have any friends that can help you out until you resolve these important issues with your son?" d. "As a nurse, I am legally bound to report abuse. I will stay with you while you give the report and help find a safe place for you to stay".

d. "As a nurse, I am legally bound to report abuse. I will stay with you while you give the report and help find a safe place for you to stay".

Which of the following commonly used intravenous solutions is hypotonic? a. 5% dextrose in 0.45% NaCl b. 0.9% NaCl c. Lactated Ringer's d. 0.45% NaCl

d. 0.45% NaCl

A nurse is monitoring a patient who is receiving an IV infusion of normal saline. The patient is apprehensive and present with a pounding headache, rapid pulse rate, chills, and dyspnea. What would be the nurse's priority intervention related to these symptoms? a. Discontinue the infusion immediately, monitor vital signs, and report findings to primary care provider immediately. b. Slow the rate of infusion, notify the primary care provider immediately and monitor vital signs. c. Pinch off the catheter or secure the system to prevent entry of air, place the patient in the Trendelenburg position, and call for assistance. d. Discontinue the infusion immediately, apply warm, moist compresses to the site, and restart the IV at another site.

d. Discontinue the infusion immediately, apply warm, moist compresses to the site, and restart the IV at another site.

A nurse is assessing infants in the NICU for fluid balance status. Which nursing action would the nurse depend on as the most reliable indicator of a patient's fluid balance status? a. Recording intake and output b. Testing skin turgor c. Reviewing the complete blood count (CBC) d. Measuring weight daily

d. Measuring weight daily

A nursing instructor delivers a lecture to nursing students regarding the issue of client's rights and asks a nursing student to identify a situation that represents an example of invasion of client privacy. Which situation, if identified by the student, indicates an understanding of a violation of this client right? a. Performing a procedure without consent b. Threatening to give a client a medication c. Telling the client that he or she cannot leave the hospital d. Observing care provided to the client without the client's permission

d. Observing care provided to the client without the client's permission

iso tonic solutions:

normal saline and Lactated Ringer's are isotonic.