Integrated EXAM 1 Review

Autonomy

Respecting the rights of others to make their own decisions.

A client tells the nurse about deciding to refuse external cardiac massage. Which would be the most appropriate initial nursing action?

Notify the primary health care provider of the client's request.

Veracity

One's duty to communicate truthfully.

The nurse wants to ensure that the emergency department is prepared for a disaster and is creating an action plan for educating the staff. Which actions would the nurse plan in order to adequately prepare the staff? Select all that apply.

-Identify specific nursing roles during a disaster. -Test the disaster plans before a disaster occurs. -Encourage each nurse to create a personal emergency preparedness plan. -Begin educating staff on role responsibilities that will occur at the time of a disaster.

Situational leadership

Is a comprehensive approach that incorporates the leader's style, the maturity of the work group, and the situation at hand.

The nurse collecting data on a child suspects physical abuse. The nurse understands that which is a primary and legal nursing responsibility?

Report the case in which the abuse is suspected.

The nurse is newly employed in a health agency. The nurse is told that the decision-making process of the organization is based on a centralized structure. The nurse determines that this means that the authority to make decisions is vested in whom?

A few individuals such as the board of directors

A client asks the nurse to describe the preferred provider organization model of care because the client is unsure of the procedure involved in this form of health care. Which statement by the nurse indicates an inaccurate description of this form of organization?

"Beneficiaries are limited to those providers that are participating primary health care providers for any required health care services."

The nurse asks a nursing student to describe case management. Which student response indicates a lack of understanding about this concept?

"It represents a primary health prevention focus managed by a single case manager."

The licensed practical nurse knows that which items are examples of common law? Select all that apply.

-Malpractice -Informed consent -Client's right to refuse treatment

Acknowledging the client's right to refuse medication promotes______________.

Autonomy

When caring for clients, the nurse knows that which ethical philosophies focus on understanding relationships and the use of personal narratives?

Ethics of care

After pleading for information, a visitor learns from the nurse that his friend (the client) has died from human immunodeficiency virus (HIV). Inadvertently, the visitor informs the client's family about the client's HIV diagnosis. Which is the most serious potential consequence of possible damages caused by these events?

The state convicts the nurse for invasion of privacy.

The nurse is assisting in working with disaster relief following a tornado. The nurse's goal with the overall community is to prevent as much injury and death as possible from the uncontrollable event. Finding safe housing for survivors, providing support to families, organizing counseling sessions, and securing physical care when needed are examples of which type of prevention?

The tertiary level of prevention

The nurse is completing a medication reconciliation form for a client. Which is a primary purpose of this process?

To compare a client's medication prescriptions to all of the medications the client is taking at home

Describing the purpose and side effects of psychotropic medications in a truthful and non-misleading way

Veracity

A client with a headache arrives in the emergency department and is staggering, confused, smells of alcohol, and is verbally abusive. The nurse explains to the client that the primary health care provider will need to perform an assessment before the administration of medication. When the client becomes verbally abusive, the nurse threatens to place the client in restraints. With what can the client legally charge the nurse as a result of this nursing action?

Assault

A client experiences cardiac arrest. The nurse leader quickly responds to the emergency and assigns clearly defined tasks to the work group. In this situation, the nurse is implementing which leadership style?

Autocratic

Spending extra time to help calm an extremely anxious client.

Beneficence

An assistive personnel (AP) who has been employed in a long-term care facility for 8 weeks is consistently 10 to 20 minutes late for work. The APs lateness has caused unrest with other staff members in the nursing unit. The AP is due to receive a 3-month probation evaluation in 1 month. Which is the most appropriate action by the nurse in charge of the nursing unit when dealing with this situation?

Confronting the AP to discuss the lateness and initiate problem-solving measures

The nurse is giving a bed bath to an assigned client. Assistive personnel (AP) enters the client's room and tells the nurse that another assigned client is in pain and needs pain medication. The nurse would do which?

Cover the client, raise the side rails, tell the client that you will return shortly, and administer the pain medication to the other client.

After weeks of witnessing a hospice client's deterioration and subsequent death from liver failure, his family disagrees about performing an autopsy. Which criterion does the nurse use to determine if the autopsy can proceed?

Determination by the client's son.

Following a group therapy session, a client approaches the nurse and verbalizes a need for seclusion because of uncontrollable feelings. The nurse reports the findings to the registered nurse (RN) and expects that the RN will take which action?

Get a written prescription from the primary health care provider (PHCP) and obtain an informed consent.

The nurse witnesses an automobile accident and provides care at the scene of the accident to an open wound on a young child. The family is extremely grateful and insists that the nurse accept monetary compensation for the care provided to the child. Because of the family's insistence, the nurse accepts the compensation to avoid offending the family. The child develops an infection and sepsis and is hospitalized. The family files suit against the nurse who provided care to the child at the scene of the accident. The nurse understands that which is accurate regarding immunity from this suit?

Good Samaritan laws will not provide immunity from suit if the nurse accepted compensation for the care provided.

Fidelity (nonmaleficence)

Maintaining loyalty and commitment to the client and doing no wrong to the client.

The nurse admitting a client to the hospital is reviewing the client's history and medications taken at home. Which condition in the client's history is being treated with tamoxifen citrate?

Metastatic breast cancer

The nurse asks the registered nurse to call the primary health care provider (PHCP) of a client scheduled for a cardiac catheterization because the client has numerous questions regarding the procedure and has requested to speak to the PHCP. The PHCP is very upset and arrives at the unit to visit the client after prompting by the nurse. The nurse is outside the client's room and hears the PHCP tell the client in a derogatory manner that the nurse "doesn't know anything." The nurse plans to address the PHCP's remark, understanding that the PHCP has violated which legal tort?

Slander

The nurse overhears a client ask the primary health care provider if the results of a biopsy indicated cancer. The primary health care provider tells the client that the results have not returned, when in fact, the primary health care provider is aware that the results of the biopsy indicated the presence of malignancy. The nurse is upset that the primary health care provider has not shared the results with the client and tells another nurse that the primary health care provider has lied to the client and that this primary health care provider probably lies to all of the clients. Which legal tort has the nurse violated by this statement?

Slander

The nurse witnesses an accident in which the victim was hit by a car. The nurse stops at the scene of the accident and administers safe care to a victim who sustained a compound fracture of the femur. The victim is hospitalized and later develops sepsis as a result of the fractured femur. The victim files suit against the nurse who provided care at the scene of the accident. Which accurately describes the nurse's immunity from this suit?

The Good Samaritan laws will protect the nurse if the care given at the scene was not willfully negligent.

Beneficence

The duty to act to benefit or promote the good of others.

Justice

The duty to distribute resources or care equally, regardless of personal attributes.

A nursing instructor asks a nursing student to identify situations that indicate a secondary level of prevention in health care. Which statement made by the student indicates a need for further study of the levels of prevention?

Teaching a stroke client how to use a walker

The nurse is caring for a client with severe cardiac disease. While the nurse is caring for the client, the client states, "If anything should happen to me, please make sure that the doctors do not try to push on my chest and revive me." Which is the appropriate nursing action?

Tell the client that it is necessary to notify the primary health care provider of the client's request.

A nursing instructor asks a nursing student to define a critical path. Which statement made by the student indicates a need for further teaching regarding critical paths?

"They are nursing care plans and use the steps of the nursing process."

A client with chronic obstructive pulmonary disease (COPD) asks the nurse for assistance with preparing a living will. The client tells the nurse that she has not discussed the living will with the family and wanted to make some decisions before discussing the will with the family. Which initial step in preparing this document should the nurse inform the client to do?

Discuss the request with the primary health care provider.

An ICU nurse devotes equal attention to someone who has attempted suicide as to someone who suffered a brain aneurysm.

Justice

The nurse is attending an agency orientation regarding the nursing model of practice implemented in the facility. The nurse is told that the nursing model is a team nursing approach. What does the nurse determine is a characteristic of this type of nursing model practice?

Nursing personnel are led by an RN leader in providing care to a group of clients.

The nurse shares with a client that violation of a civil law usually results in which types of penalty? Select all that apply.

-Monetary fine -Public service -Replacement of property

The nurse who works in a cardiac unit reports to work and is told that she needs to float to the neurological nursing unit because of a short-staffing problem on that unit. The nurse reports to the unit and receives a client assignment for the day from the nurse manager. The nurse is angry with the assignment because of a belief that the assignment is more difficult than the assignment delegated to other nurses on the unit. The nurse would carry out which action?

Ask the nurse manager of the neurological unit to discuss the assignment.

The nurse is assisting in caring for a client with a head injury who is restless and is pulling at the intravenous (IV) line. The client's primary health care provider does not want to sedate the client, and the family has requested that the client not be restrained. The nurse would implement which action?

Stay with the client and consult with the nurse manager about the situation.

A client is being evaluated as a potential kidney donor for a family member. The donor asks the nurse why a different team of people other than the team working with the potential recipient is doing the evaluation. Which response would the nurse give to the client?

A conflict of interest by the team evaluating the recipient and the team evaluating the donor is avoided.

A client had a colon resection. A Salem tube was in place when a regular diet was brought into the client's room. The client did not want to eat solid food and asked that the primary health care provider be called. The nurse persisted in the belief that the solid food was the correct diet. The client ate two meals and subsequently had additional surgery due to complications. The nurse understands that the determination of negligence in this situation is based on what?

A duty existed and it was breached

The nurse is assisting in reviewing the critical paths of the clients on the nursing unit. In performing a variance analysis, which indicates the need for further action and analysis?

A postoperative client who develops a cough and a fever

A client with a diagnosis of cystitis has an indwelling urinary catheter and is being cared for by an assistive personnel (AP). The nurse observes the AP care for the client and intervenes if the AP performs which action?

Allows the drainage tubing to rest under the leg

Autocratic leadership

Also called "directive leadership," involves the leader in assuming complete control over the decisions and activities of the group.

Democratic leadership

Also called "participative leadership," is characterized by a sense of equality among the leader and other participants.

The nurse sees another nurse administer an incorrect medication to a client. The nurse who administered the incorrect medication does not report the error. Which would be the initial action by the nurse who observed the error?

Ask the nurse if he or she intends to report the error.

The home care nurse observes that an older male client is confined to his room by his daughter-in-law. When the nurse suggests that he walk to the den and join the family, he says, "I'm in everyone's way, and my son needs me to stay here." Which is the best nursing intervention for this situation?

Suggest appropriate resources such as respite care and a senior citizens' center to the client and daughter-in-law.

A nursing instructor asks a nursing student to describe the standards of care formulated by the American Nurses Association. Which statement by the student indicates an inaccurate description of these statements?

"They are specific guidelines."

The nurse is documenting information regarding a client's care into the computerized medical record. Which actions by the nurse would be most effective in ensuring client confidentiality? Select all that apply.

-Change the password for entering computer files at least monthly. -Shred the printout of the nurse's flowchart at the end of the nurse's shift. -Use own user name and password when logging into the computer system.

The nurse is caring for a client who has refused to take an oral medication. The nurse tells the client that the nurse will hold the client down and give the medication by injection if the client doesn't take the oral medication. The nurse then takes the client's bathrobe so the client will have to remain in his room. Which intentional torts has this nurse committed? Select all that apply.

-False imprisonment -Assault

The nurse is working with a 21-year-old client who has a family history of Huntington's disease and asks for information about the advantages of genetic testing. Which responses by the nurse are best? Select all that apply.

-Genetic testing will help you make decisions about having children. -Retirement issues might be easier to plan if you know the results of the test. -Planning for the future might be affected if you know the results of the test."

The nurse in charge of a rehabilitation center is planning the client assignments for the day. Which client would the nurse assign to the assistive personnel (AP)?

A client on strict bed rest and a 24-hour urine collection

The nurse is aware that which criteria are necessary for a situation to be classified as malpractice? Select all that apply.

-The client sustained an injury. -The nurse owed a duty to the client. -The nurse did not carry out a duty to a client. -The client's injury was caused by the nurse's failure to carry out a duty.

The nurse is attending an agency orientation meeting about the nursing model of practice implemented in the facility. The nurse is told that the nursing model is a team nursing approach. The nurse determines that which describes the team-based model of nursing practice?

Nursing staff are led by the nurse when providing care to a group of clients.

The licensed practical nurse is considering leaving the nursing profession after caring for multiple clients who have been diagnosed with conditions that have poor outcomes. Which measures would most likely assist the nurse in relieving this distress? Select all that apply.

-Share the frustrations at unit multidisciplinary meetings. -Tell stories about the experiences with other professionals. -Engage in ethics discussions with both nurses and other health care practitioners.

The primary health care provider writes a prescription for the nurse to obtain a consent for a colonoscopy. Which are the nurse's responsibilities to obtain an informed consent? Select all that apply.

-To ensure the client is the age of consent -To ensure the client is signing voluntarily

The nurse is aware that the Americans with Disabilities Act provides which rights? Select all that apply.

-Labels asymptomatic HIV as a disability -Protects the privacy of individuals with HIV -Prohibits discrimination in employment and public services

An assistive personnel (AP) tells the nurse that she is becoming very frustrated trying to communicate with an older client who is severely hard of hearing and does not have his hearing aid. Which instructions would the nurse recommend to improve communication between the AP and the client? Select all that apply.

-Make sure the environment is well lit. -Face the client and speak slowly and clearly. -Ask the client to restate what has been said. -Turn the television volume down while communicating.

Maintaining expertise in nursing skill through nursing education.

Fidelity (nonmaleficence)

The nurse is caring for a client who is receiving intramuscular antibiotics. The nurse enters the client's room to administer the prescribed antibiotic, and the client tells the nurse that the medication burns and that he does not want the medication to be given. The nurse tells the client that the medication is necessary and administers the medication. With which crime can the client legally charge the nurse as a result of the nursing action?

Battery