Fundamentals Final (Missing Chapters 28-30)
The nurse assesses a terminal illness in a:
43 year old with Lou Gehrigs disease who is refusing food and fluid.
Sickle cell anemia is an example of a biological trait found primarily in _____ populations.
African
Criteria that justify becoming an emancipated minor and able to sign a medical consent include all of the following except
a 14-year-old whose parents are dead.
The nurse clarifies to a patient who now has an abscess following a ruptured appendix that the abscess is considered to be:
a secondary illness.
Homeostasis can be described as:
a tendency of biological systems toward stability of the internal environment by continuously adjusting to survive.
A written statement expressing the wishes of a patient regarding future consent for or refusal of treatment in case the patient is incapable of participating in decision making is an example of:
an advance directive.
According to Maslows hierarchy, physiological needs are those that:
are essential to human life.
Nursing interventions are best defined as activities that:
are taken to improve the patients health.
Ethics and law are different from each other in that ethics
are voluntary
In giving nursing care to persons of Asian origin, the nurse should:
ask permission before touching the patient.
An example of the role of an LPN as a delegator is: (Select all that apply.)
assigning patient care tasks to certified nursing assistants. requesting the housecleaning staff to mop the floor of a patients room. instructing the unit secretary to page a physician to the floor.
The nurse assesses that a person is in the acceptance stage of illness when the patient:
assumes the sick role.
When diagnosis-related groups (DRGs) were established by Medicare in 1983, the purpose was to:
attempt to contain the costs of health care.
The nurse describes behaviors of the transition stage of illness, which are: (Select all that apply.)
awareness of vague symptoms. denial of feeling ill. resorts to self medication.
The nurse assesses successful adaptation in a post stroke patient when the patient:
learns to walk and maintain balance with the aid of a walker.
Nursing liability insurance is a policy purchased and put into effect by the nurse for the purpose of:
paying attorney fees and any award won by the plaintiff.
After passing the National Council Licensure Examination for Practical Nurses (NCLEX-PN), the nurse is qualified to take an additional certification in the field of:
pharmacology
The nurse encourages a patient to participate in health maintenance by maintaining an ideal body weight as a method of _____ prevention.
primary
Lillian Wald and Mary Brewster established the Henry Street Settlement Service in New York in 1893 in order to:
provide health care to poor persons living in tenements.
Early nursing education and care in the United States:
provided independence for women through education and employment.
A states Nurse Practice Act is designed to protect the:
public
8. A nurse practicing a holistic approach to nursing care must:
recognize that a change in one aspect of the persons life can alter the whole of that persons life.
The advent of diagnosis-related groups (DRGs) required that nurses working in health care agencies:
record supportive documentation to confirm a patients need for care in order to qualify for reimbursement.
The nurse explains defense mechanisms as a patients attempt to:
reduce anxiety
It is appropriate for practical nurses to provide direct patient care to persons in a hospital under the supervision of a:
registered nurse
A nurse clarifies that methods of tertiary prevention are designed for:
rehabilitation
A nurse co-worker arrives at work 30 minutes late, smelling strongly of alcohol. The fellow nurses legal course of action is to:
report the condition of the nurse to the nursing supervisor.
An elderly, slightly confused patient sustains an injury from a heating pad that was wrongly applied by the nurse. The nurse should:
report the incident to the risk management team via an incident report.
When a new admission to an extended care facility wanders about listlessly, eats only a small amount of each meal, and keeps himself isolated, the nurse can intervene by:
supporting him to interact with an exercise group.
An example of a violation of criminal law by a nurse is:
taking a controlled substance from agency supply for personal use.
If a nurse receives unwelcome sexual advances from a nursing supervisor, the first step the nurse should take is to:
tell the nursing supervisor that she is uncomfortable with the sexual advances and ask the supervisor to refrain from this behavior.
A patient admitted for diagnostic tests is frightened of hospital procedures and is nervous about the possible outcome of the tests. She states that her mouth is dry and her heart is pounding. Her blood pressure is 168/78 mm Hg (her usual blood pressure is 140/80 mm Hg), pulse is 112 beats/min, and respirations are 22 breaths/min. The nurse will recognize that these signs and symptoms are:
the effects of the sympathetic nervous system that can negatively affect the patients health.
If a nurse is reported to a state board of nursing for repeatedly making medication errors, it is most likely that:
there will be a hearing to determine whether the charges are true.
An advantage of preferred provider organizations (PPOs) is that:
they make insurance coverage of employees less expensive to employers.
If a member of a health maintenance organization (HMO) is having respiratory problems such as fever, cough, and fatigue for several days and wants to see a specialist, the person is required to go:
to a primary care physician for a referral.
The LPN demonstrates an evidence-based practice by:
using scientific information to guide decision making.
Florence Nightingales contributions to nursing practice and education:
were a major factor in reducing the death rate in the Crimean War.
A patient states, I am not obese. My entire family is large. The nurse assesses that the patient is using the defense mechanism of:
denial
The nurse is aware that a stressor as experienced by an individual is usually perceived:
in different ways based on previous experience and personality traits.
A nurse is caring for an unmarried 16-year-old patient who has just given birth to a baby boy. The nurse will get the consent to perform a circumcision on the patients son from the:
16 year old patient
The patient who cannot legally sign his or her own surgical consent is a(n):
18-year-old who received a narcotic 30 minutes ago
The most frequently cited cause of a sentinel event by the Joint Commission is a problem in
inadequate communication
In the United States, the Young Womens Christian Association (YMCA) in New York opened The __________ School, the first practical nursing school.
Ballard
The founding of the Red Cross is attributed to:
Clara Barton
When the brain perceives a situation as threatening, the sympathetic nervous system reacts by stimulating which of the following physiological functions? (Select all that apply.)
Dilation of the bronchial tubes Dilation of the pupils
Women volunteers were organized to give nursing care to the wounded soldiers during the Civil War by:
Dorothea Dix
The nursing theory that uses seven behavioral subsystems in an adaptation model is:
Dorothy Johnson
Nurse Practice Acts define the legal scope of an LPNs practice, which are written and enforced by:
Each state
Characteristics of primary nursing include which of the following? (Select all that apply.)
Elimination of fragmentation of care between shifts Planning and direction performed by one nurse Ancillary workers used to increase productivity The care plan covering the entire day Associate nurses taking over care and planning when the primary nurse is off duty
The LPN (LVN) assigns part of the care for her patients to a nursing assistant. The LPN is legally required to perform which of the following for the residents assigned to the assistant?
Give medications to the residents at the prescribed times.
If a patient indicates that he is unsure if he needs the surgery he is scheduled for later that morning, the nurse would best reply:
I will call the doctor to speak with you before you go to the operating room.
During an employment interview, the interviewer asks the nurse applicant about HIV status. The nurse applicant can legally respond:
You do not have a right to ask me that question.
Standards of care for the nursing practice of the LPN are established by the:
National Federation of Licensed Practical Nurses.
A 48-year-old man refuses to take a medication ordered for the control of his blood pressure. The nurses most effective response would be
You have the right to refuse. This medication keeps your blood pressure under control
Which defines the holistic approach to caring for the sick and promoting wellness? (Select all that apply.)
The nurse realizes that each person has a responsibility for his or her own health. Health care providers are required to intervene on behalf of all persons to ensure that health goals are met. Providers combine traditional methods of health care with relaxation techniques for pain management. A change in one aspect of a persons life may or may not alter the person as a whole.
The nursing theorist whose practice framework is based on 14 fundamental needs is:
Virginia Henderson
When a student nurse performs a nursing skill, it is expected that the student:
achieve the same result as the licensed nurse.
When a young family man hospitalized after a breaking his leg confides to the nurse that he is concerned about the well being of his family and financial stress, the nurse can best support his sense of security by:
actively listening to his concerns.
The nursing theory presented by Sister Calista Roy is based on:
adaption modes
Preferred provider organizations (PPOs) use __________ to finance their services and pay the physical cost of the service.
capitated cost
In order to fulfill the common goals defined by nursing theorists (promote wellness, prevent illness, facilitate coping, and restore health), the LPN must take on the roles of:
caregiver, educator, and collaborator.
The nurse takes into consideration that in the stage of resistance in Selyes GAS, the patient:
continues to battle for equilibrium.
The nurse uses a diagram to demonstrate how Dunns theory of health and illness can be compared with a:
continuum, with peak wellness and death at opposite ends; the person moves back and forth in a dynamic state of change.
The nurse is aware that any description of health would include the concept that:
culture, education, and socioeconomic status influence ones definition of health or illness.
The Standards of Clinical Nursing Practice are designed to direct LPNs to:
deliver safe, knowledgeable care.
A patient has been advised by the physician to take medication for high cholesterol and to change eating habits after discharge home. The home health nurse discovered that the patient refused to follow the medical and nutritional directions. The nurses best initial response to this situation is to:
determine whether any cultural, socioeconomic, or religious values conflict, thus interfering with the patients compliance.
According to Hans Selyes general adaptation syndrome (GAS), a person who has experienced excessive and prolonged stress is likely to:
develop an illness or disease such as allergy, arthritis, or asthma.
The nurse who may be liable for invasion of privacy would be the nurse who is
discussing her patients with a fellow nurse.
A child who has just been scolded by her mother proceeds to hit her doll with a hairbrush. The nurse recognizes the childs actions are characteristic of:
displacement
Exercise can reduce stress and anxiety by the release of __________.
endorphins
The nurse instructs a patient that according to Selyes GAS theory, when stress is strong enough and occurs over a long enough period, the patient will enter the stage of:
exhaustion
A licensed nurse is liable for charges of malpractice when she
falsifies data, causing the patient to suffer problems resulting in death.
Adequate __________ is necessary in the communication between nurse and patient in order to meet the higher basic needs of security, love, belonging, and self esteem.
feedback
The nurse explains that an idiopathic disease is one that:
has an unknown cause
A person who has been brought to the emergency room after being struck by a car insists on leaving, although the doctor has advised him to be hospitalized overnight. The nurse caring for this patient should:
have him sign a Leave Against Medical Advice (AMA) form.
The nurse clarifies that a person who is self actualized would have the characteristics of: (Select all that apply.)
having met all other need levels. being certain of their beliefs and values.
An example of tertiary health care is _____ care.
hospice
Although nursing theories differ in their attempts to define nursing, all of them base their beliefs on common concepts concerning:
human relationships, the environment, and health.
To best protect himself or herself from being sued, the nurse should:
maintain competency
A patient has advance directives spelled out in a durable power of attorney, with the appointment of his daughter as his health care agent. The daughter will be responsible for:
making all choices about her fathers health care if the father is unable.
A student nurse who is not yet licensed:
may perform nursing actions only under the supervision of a licensed nurse.
The factors involved in assessing the importance the patient attaches to the relief of a particular deficit include:
needs that the nurse must assess to prioritize care, because they may be different from person to person.
When a patient asks a nurse to witness the signing of a will, the nurse should refer the request to the
notary public for the hospital
A patient has signed a do-not-resuscitate (DNR) order. If a nurse performs cardiopulmonary resuscitation (CPR) when the patient stops breathing and then successfully revives the patient, the:
nurse could be found guilty of battery.
An educational pathway for an LPN refers to an LPN:
obtaining additional education to move from one level of nursing to another.
A 16-year-old boy is admitted to the emergency room after fracturing his arm from falling off his bike while visiting with his stepfather who is not the custodial parent. The nurse is preparing him to go to the operating room but must obtain a valid informed consent by
obtaining permission of the custodial parent for the surgery.
The nurse takes into consideration that the patient with an admitting diagnosis of type 2 diabetes mellitus and influenza is described as having:
one chronic and one acute illness.
The Health Insurance Portability and Accountability Acts (HIPAA) main focus is in keeping
patient information in a secure office area.
A postoperative patient in the intensive care unit (ICU) is so confused and agitated that staff have not been able to safely care for him. He has pulled out his central line once, and he slides to the bottom of the bed, where he attempts to climb out, pulling and disrupting the various tubes and monitors. The nurses best course of action is to:
request that the doctor write an order for a protective device and/or medication
A patient refuses to take his medications or to eat his breakfast. He is alert, mentally competent, and fairly comfortable. The nurse should:
respect the patients right to refuse medications or food, because he is competent.
Such health services as surgical procedures, restorative care, and home health care would be classified as __________ care.
secondary
The nurse believes that teaching a patient how to give insulin and monitor blood glucose levels will improve the level of the patients:
self esteem, by promoting independence and learning.
In 1991, the American Nurses Association (ANA) published the Standards of Clinical Nursing Practice. These standards are designed to: (Select all that apply.)
set standards for safe nursing care delivery. protect the nurse, patient, and health care agency. define activities in which nurses may engage.
The information in a patients chart may legally be:
shared with other health care providers at the patients request.
The acronym SBAR is a method to communicate with a physician that clarifies a situation that may result in litigation. The acronym stands for
situation, background, assessment, recommendation
A nurse remarks to several people that Dr. X must be getting senile because she makes so many mistakes. If that remark results in some of Dr. Xs patients changing to another doctor, Dr. X would have grounds to sue the nurse for:
slander
The responses during the alarm stage of the general adaptation syndrome as defined by Hans Selye include: (Select all that apply.)
slight increase in body temperature. decreased appetite. hormones released for mobilization for defense.
The Occupational Safety and Health Act includes all of the following except
staffing ratios and delegation criteria.
In 1946, the World Health Organization redefined health as the:
state of complete physical, mental, and social well being.
During the Civil War, nursing schools offered education to women both in England and in the United States. The schools in the United States differed from those in Europe because in U.S. schools: (Select all that apply.)
students worked without pay. instruction was presented by physicians at the bedside.
