Management of Care
Which activity best helps the nurse apply theory to practice?
Evidence-based research
A client has been admitted to the hospital for the treatment of diabetic ketoacidosis, with a random blood glucose reading of 575 mg/dL (31.91 mmol/L), vomiting, and shortness of breath. This client has experienced which phenomenon?
Exacerbation
During the nurse's admission interview the client says, "I don't get too much rest because I am in nursing school and work full time to support myself and my kids." The nurse classifies this statement as an issue at which level of Maslow's basic needs?
Physiologic
A nurse fails to communicate a change in the client's condition to the physician. Which element related to proving malpractice has been met? Duty Breach of duty Damages Proximate cause
Breach of duty
The nurse has just attended a seminar on concepts of cultural diversity. Which statement made by the nurse would require further education? "Culture helps to define identity within specific groups of people." "Language is the primary way that people share their culture." "Culture cannot be influenced, and you are born with your culture." "Culture can be seen in attitudes and institutions of certain populations."
"Culture cannot be influenced, and you are born with your culture."
A client admitted with Hodgkin lymphoma has a handwritten prescription for vinblastine 3.7 mg intravenously (IV) weekly. The nurse interprets the prescription as vincristine 3.7 mg and administers the wrong medication. The client becomes neurovascularly compromised and has a fatal reaction to the medication. The client's family begins a lawsuit against the facility and the nurse's license is suspended by the board of nursing. In preparation for the lawsuit, the nurse meets with the nurse attorney to review the events. Which appropriate statement given by the nurse indicates he has an understanding of the lawsuit? "I had a duty and it was my responsibility to double check the medication, which I did, yet this still happened." "I could not read the health care provider's handwriting, so I am not at fault." "I checked the medication before giving it and literature states it is for Hodgkin lymphoma." "I had a duty and it was my responsibility to get clarification before administering the medication, which I did not."
"I had a duty and it was my responsibility to get clarification before administering the medication, which I did not."
A 35-year-old client with Down syndrome is on the nurse's unit following heart surgery. The client is very weak and has had difficulty with activities of daily living. Which statement is the best example of the nurse using advocacy as a style of client communication? "You have to get out of bed; otherwise you may get a blood clot. Do you want to take a bath or shower?" "If you do not get up and move around you may develop a blood clot. Wouldn't your family be so stressed if you had to stay in the hospital longer? Do you want to walk in the hall or in the courtyard?" "I know that it has been difficult for you to walk to the bathroom to brush your teeth. How can we make this work for you?" "I realize that eating makes you tired, but you need to eat to get healthy. Would you like to pick out your dinner menu?"
"I know that it has been difficult for you to walk to the bathroom to brush your teeth. How can we make this work for you?"
A home health care nurse is explaining to an emergency room nurse how nursing care in the home setting differs from that in the hospital setting. Which statement by the home health care nurse would be most appropriate? "The client and family are in control of the setting, not the nurse." "You need a graduate degree to specialize in home health care." "It requires that you have high-level critical care skills." "Each team member works independently of other team members."
"The client and family are in control of the setting, not the nurse."
The nurse manager who asks staff members to give suggestions on how to improve collaboration between nurses and physicians is exhibiting what style of leadership? Transactional Autocratic Democratic Laissez-faire
Democratic
A nurse is conducting a class about health care trends for a group of newly graduated registered nurses at the community hospital. Which of the following six trends stated by the nurse reflects the Institute of Medicine's (IOM) focus? "The system should be flexible, patient centered, bureaucratic, timely, safe, and efficient." "The system should be safe, effective, efficient, patient centered, timely, and equitable." "The system should be safe, efficient, centralized, wellness promoting, government driven, and patient centered." "The system should be static, reliable, timely, equitable, efficient, and illness focused."
"The system should be safe, effective, efficient, patient centered, timely, and equitable."
When the preoperative client tells the nurse that the client cannot sleep because the client keeps thinking about the surgery, an appropriate reflection of the statement by the nurse is: "It sounds as if your surgery is a pretty scary procedure." "You shouldn't be nervous. We perform this procedure every day." "You have a great surgeon. You have nothing to worry about." "The thought of having surgery is keeping you awake."
"The thought of having surgery is keeping you awake."
A client from a minority culture has been hospitalized for 6 days for postoperative infection. The client's weight is decreasing each day, and the nutritional intake is declining. Which nutritional assessment question is most appropriate? "Don't you like what is on your food tray?" "Are you aware that you are losing weight?" "Why aren't you eating your food?" "What type of food do you eat at home?"
"What type of food do you eat at home?"
A parent brings a 2-year-old child for a well-baby visit. Which actions address primary prevention strategies for the nurse to discuss with the parent? Select all that apply.
-Discussing healthy meal choices for a 2-year-old child -Adhering to the immunization schedule -Reviewing appropriate discipline for a 2-year-old child -Using a child safety seat appropriately
Which client would be the best candidate for the nurse to engage in motivational interviewing? A 28-year-old client with elevated blood glucose for 8 months A 66-year-old client who is showing improvement in range of motion A 38-year-old client training to walk a half marathon A 44-year-old client who brought a food log to weight loss counseling
A 28-year-old client with elevated blood glucose for 8 months
A nurse demonstrates understanding of Healthy People 2030 by supporting which statement? Establish a set of nursing skills that focuses on quick resolution to clients' needs. Physical therapy supports client safety at home. A client's health is affected by social, economic, and political factors. Clinical care supports wellness in the environment.
A client's health is affected by social, economic, and political factors.
A 32-year-old construction worker is admitted to the emergency department after suffering a heat stroke. Which of the following IV solutions would the nurse expect the physician would order?
A solution of normal saline
A nurse is reading a research article from a nursing journal. The nurse is aware that the opening paragraph summarizing the article and the research findings is a good place to start. What part of the article is the nurse reading?
Abstract
The nurse is developing a plan of care for a client with a fractured femur who is in traction and will be restricted to bed for some time. Which domain should the nurse consider when developing a nursing diagnosis based on this client's musculoskeletal health problems? Self-perception Activity and rest Health promotion Nutrition
Activity and rest
Which is an appropriately stated nursing intervention?
Ambulate 30 ft (9 m) twice a day with the assistance of a walker.
Which example best describes feminist ethics? The formal study of ethical issues that arise in the practice of nursing A combination of elements of utilitarian and deontologic theories that offer specific action guidelines for practice An approach critiquing existing patterns of oppression and domination in society Attention directed to the specific situation of individual clients viewed within the context of their life narratives
An approach critiquing existing patterns of oppression and domination in society
The home health nurse is making a home visit for an older adult client recently discharged from the hospital after suffering a stroke. Which finding would most concern the nurse? Area rugs are present in multiple areas throughout the house. Medication bottles are on the counter without safety caps. The client's home has a basement with small staircase. The client is living with an adult child's family.
Area rugs are present in multiple areas throughout the house.
During a hospice visit, the client's spouse suddenly begins to cry and says, "I am so tired. I just can't do this anymore. I am not getting to sleep and I just eat sandwiches when I can." What is the nurse's best intervention? Arrange for short-term inpatient care for the client. Send the spouse to the emergency department. Have the chaplain visit with the spouse and client. Request a mental health evaluation for the spouse.
Arrange for short-term inpatient care for the client.
A client informs the nurse about leaving the health care facility because the client is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and further testing and evaluations are scheduled. Which action by the nurse would be most appropriate to prevent false imprisonment? Tell the client that the client will not be able to get access again. Call the health care provider to speed up the discharge process. Restrain the client to prevent from leaving. Ask the client to sign a release without medical approval.
Ask the client to sign a release without medical approval.
The nurse admits a client to the critical care unit to rule out a myocardial infarction. The client has several family members in the waiting room. Which nursing action is most appropriate? Explain to the family that too many visitors will tire the client. Allow all the visitors into the room. Assess the client's beliefs about family support during hospitalization. Insist that only one family member can be in the room at a time.
Assess the client's beliefs about family support during hospitalization.
A nurse technician is assigned to take clients' vital signs. When making rounds, the nurse notices that one client's vital signs are very different from what they were at the beginning of the shift. What is most appropriate for the nurse to do about these findings? Ask the nurse technician whether the vital signs are correct. Call the health care practitioner for new orders. Document the vital signs in the client's chart. Assess the client's vital signs again.
Assess the client's vital signs again.
A nurse is conducting focused data collection and recognizes the existence of cues. The nurse is most likely involved in which phase of the nursing process? Implementation Assessment Planning Diagnosis
Assessment
A nurse touches the client's hand while discussing the client's diagnosis. This action is: a translation. a communication channel. an auditory channel. a dynamic process.
a communication channel.
The home health care nurse is providing information to a client and family on medication changes. What role is the nurse performing? Client and family educator Client advocate Coordinator of services Caregiver
Client and family educator
A client reads the nutritional chart and follows it accurately. The nurse also notes that the client understands the need for a balanced diet and its relationship with a quick recovery. In which domain is the client demonstrating successful learning? Cognitive Interpersonal Psychomotor Affective
Cognitive
A community is defined as a social group that may or may not share common geographic boundaries yet interact because of
Common interests
A successful discharge includes effective planning. Identifying and meeting client needs beyond the acute care facility reduce readmissions. Which nursing role is of great importance to this success? Clinician Caregiver Nurse practitioner Coordinator
Coordinator
The emergency department nurse is caring for a client injured in a motor vehicle collision. The client recently immigrated to the country. The nurse should implement interventions aimed at addressing which issue? Culture shock Generalization Ageism Ethnocentrism
Culture shock
A client diagnosed with type 2 diabetes has been prescribed insulin therapy in conjunction with an oral agent because the client has been experiencing difficulty controlling blood sugar levels with an oral agent alone. The nurse is preparing a teaching plan for this client. Which intervention would the nurse include in the teaching plan to address the psychomotor domain? Explaining what to do if hypoglycemia occurs Demonstrating the technique for insulin self-injection Reviewing with the client appropriate foods to eat Describing the signs and symptoms of low blood sugar
Demonstrating the technique for insulin self-injection
A nurse administers intravenous fluids to a client diagnosed with dehydration. After the fluids are completed, the client's blood pressure is increased and pulse is decreased. During the final phase of the nursing process, what should the nurse do? Check the client's skin turgor. Determine whether the prescribed treatment was effective. Formulate a plan of care based on risk for dehydration. Administer an additional liter of intravenous fluids.
Determine whether the prescribed treatment was effective.
The new nursing graduate is concerned about some of the critical changes that will be occurring in nursing. What changes does the nurse anticipate will impact nursing care?
Difficulty for nurses to remain current in a rapidly changing medical and technology environment
A nurse informs the client that the client has no choice and must take a bath in the morning. What type of leadership does this exemplify? Shared governance Directive leadership Participative leadership Institutional governance
Directive leadership
The growth in home health care is largely attributed to which factor? The inability of hospitals to care for an increasing number of clients The nursing shortage in hospitals Nurses' desire to work in the community Early discharge of clients from the hospital setting
Early discharge of clients from the hospital setting
Which role is the home health nurse exhibiting when demonstrating how to suction the oropharynx of the client? Educator Care coordinator Advocate Caregiver
Educator
A nurse is developing a plan of care for a client to meet the client's self-actualization needs. The nurse would focus on which area as most important?
Emphasizing the client's strengths
A client is having an increasing amount of difficulty caring for oneself in the home alone. The client states to the nurse, "I need more help. What am I going to do?" Which action would be the most appropriate for the nurse to take? Have the home health aide increase visits for bathing the client. Have the social worker visit the client to discuss care options. Have the occupational therapist assess for the client's need for adaptive devices. Have the physical therapist help the client with rehabilitation.
Have the social worker visit the client to discuss care options.
Which is the acute care setting for people who are too ill to care for themselves at home, are severely injured, or require surgery? Day care centers Hospitals Primary care centers Ambulatory care centers
Hospitals
A nurse is preparing to teach a 6-year-old client with a broken arm and the client's mother about caring for the child's cast. Which statement reflects the best education plan for these clients? Focus mainly on the mother; ask the child a couple of simple questions. Separate the mother and the child; teach the mother and then let the mother teach the child. Provide the mother with written materials; teach the child about keeping the cast dry. Include the child in the education; ask questions of both the mother and the child.
Include the child in the education; ask questions of both the mother and the child.
In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that the nurse has made. The nurse is most clearly demonstrating which professional value? Human dignity Integrity Social justice Altruism
Integrity
Which developmental consideration is a nurse assessing when determining that an 8-year-old child is not equipped to understand the scientific explanation of the child's disease? Motor development Emotional maturity Intellectual development Psychosocial development
Intellectual development
Which is a characteristic of person-centered care? It is a framework for providing care. It involves general care for all clients. It is independent of other disciplines. It can be used in hospital settings.
It is a framework for providing care.
While caring for an infant, the nurse hears another child screaming in the next room and rushes there, forgetting to put the side rails up on the infant's crib. The nurse returns to the room to find that the infant has fallen out of the crib and sustained a head injury. Based on the nurse's action, which tort is the nurse liable for? Battery Assault Malpractice Defamation
Malpractice
A nurse knows that the expression "Do not cause harm" refers to which ethical principle? Fidelity Justice Nonmaleficence Beneficence
Nonmaleficence
A nurse is reading a journal article about providing individualized care. Which aspect would the nurse most likely read about as the almost universally accepted method for providing nursing care? Reflection Experience Nursing process Clinical reasoning
Nursing process
Which theory describes, explains, predicts, and controls outcomes in nursing practice?
Nursing theory
The nurse has measured from the tip of the client's nose to the earlobe and then down to the xiphoid process before inserting a nasogastric (NG) tube and attaching it to low suction. Which components of the nursing process has the nurse demonstrated? Assessing; diagnosing Diagnosing; implementing Planning; implementing Implementing; evaluation
Planning; implementing
A nurse is immunizing children against measles. This is an example of what level of preventive care?
Primary
A client with severe congestive heart failure (CHF) has been referred to a long-term care facility. The nurse is transferring care from the hospital setting to a long-term care facility. Which action is a priority to ensure continuity of care for this client? Providing accurate and complete communication to the new facility. Asking family members to meet with the social worker at the receiving facility prior to the client's arrival. Discussing the move with both client and the family. Notifying all departments of the room change.
Providing accurate and complete communication to the new facility.
What type of research study would a hospital conduct to explore clients' and families' perceptions of receiving care?
Qualitative
Which nursing intervention would be most appropriate for a new mother that calls the nursery for help with breastfeeding?
Refer the mother for a home care visit.
Which term refers to a purposeful activity that leads to action, improvement of practice, and better client outcomes? Memorization Evaluation Assessment Reflection
Reflection
The nurse assists a postoperative client with ambulation. The nurse recognizes that assisting the client when performing this skill meets which of Maslow's basic human needs?
Safety and security
The home health nurse is caring for a noncompliant client who has been diagnosed with type 2 diabetes. Which nursing interventions would be effective in helping the client change behaviors? Select all that apply. Provide information taken from textbooks regarding the consequences of diabetes. Request immediate changes to behaviors. Include the client in creating a list of benefits for exercising. Set short-term goals for modifying eating habits. Encourage participation in a diabetes support group.
Set short-term goals for modifying eating habits. Encourage participation in a diabetes support group. Include the client in creating a list of benefits for exercising.
A nurse manager best demonstrates effective leadership characteristic by which action? Being very structured and rigid with the unit flow Sharing a vision for the unit and enlisting support Knowing all information about the unit processes Indicating an interest in becoming a role model
Sharing a vision for the unit and enlisting support
Which are factors that impact how a client defines health? Select all that apply.
Society Community Family Culture
A client continues to complain of pain despite receiving medication. The family states, "In our culture it is acceptable to complain out loud." What would be the best response by the nurse? Tell me more about your cultural beliefs. Describe your home situation to me. It is fine to complain out loud. The pain medication should have worked by now.
Tell me more about your cultural beliefs.
A nurse refers an HIV-positive client to a local support group. This is an example of what level of preventive care?
Tertiary
A new client comes to the primary care clinic and asks for help treating head lice. The nurse assesses that the client lives in low-income housing, and nine other people live with her in a one-bedroom apartment. Which of the following is a primary nursing concern? The client has no hope for the future. The client does not have air-conditioning. The client does not have running water. The client receives government assistance.
The client does not have running water.
The nurse is providing instructions to a client about performance of breast self-examination. What learning outcome would be most appropriate regarding this education? The client will demonstrate improved coping skills. The client will demonstrate self-efficacy and improved body image. The client will be able to perform proper breast self-examination for breast cancer detection and prevention. The client will have restoration of breast function.
The client will be able to perform proper breast self-examination for breast cancer detection and prevention.
The case manager works in a facility that supports a participative leadership style. Which action should the nurse recognize as an example of democratic leadership style? The interdisciplinary health care team collectively developing plans of care for clients The dietitian completing a nutritional assessment for a registered nurse (RN) The unlicensed assistive personnel (UAP) taking vital signs for several nurses The nurse implementing the physician's written orders for client care
The interdisciplinary health care team collectively developing plans of care for clients
While applying dressings to a client's wound, the nurse teaches the client about wound care. To promote the most effective teaching-learning relationship with this client, what would be most important for the nurse to keep in mind? Nurses are experts who generously bestow knowledge upon clients. Nurses have control over the client because of their knowledge and expertise. Nurses barter knowledge of medication with the client for compliance. The nurse and client relationship is based on mutual sharing and negotiation.
The nurse and client relationship is based on mutual sharing and negotiation.
Which is the best example of a client-centered approach to care?
The nurse asks the client about health goals.
A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the physician is late for another visit, the physician requests that the nurse write down the order for the physician. What should be the appropriate nursing action in this situation? The nurse should inform the client of the change in medication. The nurse should remind the physician later to write the work order. The nurse should ask the physician to come back and write the order. The nurse should write the order and implement it.
The nurse should ask the physician to come back and write the order.
Which types of knowledge are subjective? (Select all that apply.)
Traditional knowledge Authoritative knowledge
Which traits are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply. Compassion Conflict Trustworthiness Deception Humility
Trustworthiness Humility Compassion
Which client would a nurse correctly refer to Medicare services? A low-income family with infants needing immunizations A 66-year-old client with diabetes A client with a disability A client with cancer
Which client would a nurse correctly refer to Medicare services?
Which of these statements reflects the expected functioning at a hospital that has achieved Magnet status? Staff nurses are developing innovative solutions to problems. Most client outcomes have improved but are not at target range. Nursing administration is in control of all decision-making. There is a decreased rate of retention among the nursing staff.
Which of these statements reflects the expected functioning at a hospital that has achieved Magnet status?
A nurse communicating with a client states, "I will be changing your dressing, but we have plenty of time to talk first." She is already wearing sterile gloves and a mask and is busy working with her back to the client. The nurse is conveying: a functional focus. a congruent relationship. a therapeutic relationship. an incongruent relationship.
an incongruent relationship.
After a nurse manager implements a solution to the problem of delays in obtaining supplies, the first task for the manager is to: make an appointment with the chief nursing officer. plan to monitor the supply cabinets. assess whether the desired results have occurred. ask the staff members for other solutions.
assess whether the desired results have occurred.
The client is admitted to the hospital with a ruptured ovarian cyst. The client has expressed that it is very important that the spouse be present to receive all medical information. Using the concepts of culturally competent care, which is the best response? a-Bring the client's spouse into the hallway to discuss surgical options for the client. b-Explain to the client that it is not a good idea to have the spouse in the room when discussing such a private matter. c-Document the client's request in the nursing care plan. d-Explain to the client that the client is required to make all decisions related to the client's own health care.
c
The exchange of information among the client, the caregivers, and those responsible for care while the client is in a care setting (and after the client returns home) is key to successful: discharge planning. guaranteed transfer. community service. proper referral.
discharge planning.
When educating clients in the community on health promotion and prevention of disease, it is important to stress: health promotion may not be possible for many of the older members of a community. the ideal location for education is in a health care institution. strenuous exercise is necessary for health. health education can benefit individuals and groups.
health education can benefit individuals and groups.
A nurse is caring for a client with diabetes mellitus. The client takes insulin 2 times per day. The nurse makes sure the client's meals arrive in coordination with the insulin's effect. The knowledge used by the nurse is: creative. lacking. integrated. evaluative.
integrated
Prior to the discharge of a client who is recovering from a stroke from an acute care facility, the nursing case manager has the nursing staff, client, client's family, physical therapist, and home health nurse meet. The most likely purpose of this meeting is to: evaluate the effectiveness of the hospitalization. prepare the client for home care. provide client education. determine hospital-based services needed by the client.
prepare the client for home care.
The nurse is caring for a group of inpatient clients. Which action by the nurse best demonstrates the use of universal precautions?
using universal precautions to protect the nurse from infection.
On admission to the hospital, each client is asked whether the client has a living will or a durable power of attorney. If not, the admitting staff person provides a sample form to the client if wanted. The purpose of this inquiry is to determine: how the client feels about being resuscitated and maintained on life support if this is necessary. whether the client has a document describing wishes for care when the client is no longer able to make decisions. what the client wants to have happen during the hospitalization. previous decisions made regarding whom to contact should the client die in the hospital.
whether the client has a document describing wishes for care when the client is no longer able to make decisions.
