NU271 EAQ Evolve Elsevier NU271 HESI Prep: Fundamentals - Issues in Nursing
Which of the following legal defenses is important for the nurse to develop? o Dedication o Certification o Assertiveness o Accountability
o Accountability · The concept of accountability is of high priority in nursing practice. As a licensed professional, the nurse is always accountable, which means liable and answerable for her or his actions. Dedication means to be committed, and assertiveness means to be confident. These are desired characteristics in a nurse but are not legal defenses. Certification relates to achieving a higher level of knowledge or proficiency in one's area of specialization and is also not a legal defense.
Which point listed by the nursing student is accurate regarding the loss of a client's medication records? o "Loss of medical records may lead to libel charges." o "The registered nurse would maintain accurate nursing records." o "There is an assumption that the care provided to the client was negligent." o "The health care facility needs to demonstrate why the medical records were lost.
o "There is an assumption that the care provided to the client was negligent." · In case a client's medical record is lost, there is an assumption that the care provided to the client was negligent. Loss of medical records may lead to a malpractice claim. The entire institution is responsible for maintaining medical records. Primary health care providers need to demonstrate why the medical records were lost.
Which type of health information technology would the nurse access to obtain health data for all employees at a multispecialty hospital for research purposes? o Electronic health record (EHR) o Electronic medical record (EMR) o Clinical information systems (CISs) o Regional Health Information Organization (RHIO) health record
o Electronic health record (EHR) · EHRs are the official health records of an individual that can be exchanged between facilities and health care agencies. EMRs are primarily prepared and maintained within a health care provider's facility; they are not shared between facilities. CISs consist of the information technology that provides the best tools for achieving quality outcomes for clients. The RHIO health record is an individual health record that can be exchanged among providers across geographic areas.
Which point listed about the United Network for Organ Sharing (UNOS) program is accurate? o The organization has a contract with the federal government. o The donor's estate is protected from liability for injury or damage. o Priority is given to international clients who need organs on an urgent basis. o Civil and criminal immunity is given to the hospital and the primary health care provider
o The organization has a contract with the federal government. · The United Network for Organ Sharing (UNOS) has a contract with the federal government. The National Organ Transplant Act of 1984 protects the donor's estate from liability for injury or damage. The United Network for Organ Sharing gives priority to clients in their geographical area who need organs on an urgent basis. The National Organ Transplant Act of 1984 provides civil and criminal immunity to the hospital and the health care provider.
Which organization has a publication that includes the objective, "Aiming to develop a system to identify clients who are lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ)"? o U.S. Department of Health and Human Services (USDHHS) o The Centers for Disease Control and Prevention (CDC) o The Joint Commission (TJC) o The World Professional Association for Transgender Health (WPATH)
o U.S. Department of Health and Human Services (USDHHS) · Developing a system to identify clients who are LGBTQ is a goal stated in the USDHHS's Healthy People 2020. The CDC's publications have goals that differ from this one. TJC's field guide lists recommendations for health care agencies for designing a safe environment for LGBT client care. WPATH summarizes core principles that nurses and other health care providers should follow when caring for transgender clients.
The nurse asks an unlicensed assistive personnel (UAP) to provide an ice pack to a client. Which nursing function does this represent? o Delegation o Implementation o Case management o Interprofessional teamwork
o Delegation · Delegation is the assignment of a nursing task to someone else who is able or qualified to perform the task. Implementation is a part of the nursing process where the nurse carries out the care plan for a client. Case management is the collaborative effort of care planning and advocacy to make sure that a client's and family's needs are met. The interprofessional team is made up of professionals from several different disciplines who work together in the provision of care to the client.
The registered nurse is educating a nursing student about the process of resolving an ethical dilemma. Which information would the nurse provide regarding negotiation of outcomes? o "The nurse would provide a personal point of view." o "Negotiations would be held in formal settings only." o "Negotiation takes place immediately after gathering information." o "The group agrees to a statement of the problem during the negotiation process.
o "The nurse would provide a personal point of view." · During the process of negotiating outcomes, the nurse is required to provide a personal point of view. Negotiations may take place informally at the client's bedside or in a formal setting. After gathering relevant information regarding an ethical dilemma, the nurse is required to examine his or her own values and formulate an opinion regarding the matter. When verbalizing the problem, the group agrees to a statement of the problem to begin discussions. This step is performed before negotiating outcomes. Negotiations take place after determining all possible courses of action.
A client with renal failure wants to go back home, but the family members want the client to undergo a kidney transplant. The nurse gives details about the possible threats and benefits of the surgery to the family and informs them that the client wants to stay home. Which role does the nurse play here? o Educator o Manager o Caregiver o Advocate
o Advocate · The nurse in the given scenario plays the role of an advocate by protecting the client's human and legal rights and by providing assistance in asserting these rights. As an educator, the nurse explains concepts and facts about health and the reason for routine care activities, demonstrates procedures, and evaluates the client's progress in learning. As a caregiver, the nurse helps clients maintain and regain health, manage diseases and symptoms, and attain a maximal level of function and independence through the healing process. As a manager, the nurse coordinates the activities of members of the nursing staff in delivering nursing care and has responsibility for personnel, policy, and budgetary issues for a specific nursing unit or agency.
Why would organizations promote transparency in health care? o Creates effective insurance policies o Helps determine whether medications are being diverted o Facilitates recruitment of competent team members o Allows continuous feedback for improving client outcomes
o Allows continuous feedback for improving client outcomes · Transparency means to be clear and unambiguous in the daily operations of a health care organization. Transparency allows continuous feedback for the consumers, which helps improve the clinical outcomes of the clients. Transparency is not related to the diversion of medications for a nontherapeutic purpose. Transparency may not contribute to better recruitment in the organization. Transparency in a health care organization is unrelated to insurance policies.
Which scenario is a perfect example of primary prevention? o An infant receives the rotavirus vaccination in the hospital setting. o An adult in the early stages of Parkinson disease is advised to perform adequate exercise. o An older adult permanently paralyzed due to brain hemorrhage is transferred to a long-term care facility. o An older adult with Parkinson disease is administered carbidopa-levodopa to slow the progression of the disease.
o An infant receives the rotavirus vaccination in the hospital setting. · Primary prevention consists of all health promotion efforts and wellness education activities. An infant receiving the rotavirus vaccination is an example of primary prevention. An adult in the early stages of Parkinson disease is advised to perform adequate exercises; this is an example of secondary prevention. An older adult permanently paralyzed due to brain hemorrhage is transferred to a long-term care facility. This is an example of tertiary prevention. An older adult with Parkinson disease is administered carbidopa-levodopa to slow the progression of the disease. This is an example of secondary prevention.
Which examples mentioned by the nursing student regarding quasi-intentional torts need correction? Select all that apply. One, some, or all responses may be correct. o Assault o Battery o Malpractice o Invasion of privacy o Defamation of character
o Assault o Battery o Malpractice · All willful acts that violate the rights of other people are called intentional torts. Assault and battery are intentional torts. Malpractice is an example of an unintentional tort. Invasion of privacy and defamation of character are example of quasi-intentional torts. These torts are characterized by acts of violation that directly cause harm to the clients.
The nurse takes the blood pressure and pulse rate of the client and asks the client to rate the level of pain on the pain scale. Which standard of practice would the nurse perform? o Planning o Diagnosis o Assessment o Implementation
o Assessment · When the nurse collects comprehensive data relevant to the client's health or the situation, it is considered assessment. In the given scenario, the nurse is assessing the client to minimize pain. Planning refers to instances when the nurse develops a plan to attain expected outcomes. Diagnosis refers to instances when the nurse analyzes the assessment data to determine the diagnoses or issues. Implementation refers to instances when the nurse implements the identified plan.
Which ethical principles govern the nurse's behavior when making difficult decisions about a client's care at the point of care? o Bioethics o Metaethics o Clinical ethics o Research ethics
o Clinical ethics · Clinical ethics help in decision-making in issues that involve bedside client care and other client-related issues. The principles of bioethics govern ethical issues in biological sciences and technology. Metaethics is a branch of philosophy that deals with fundamental questions about concepts. Research ethics are applicable toward research subjects, whether human or animal.
Which statement describes a client in the stage of contemplation in the stages of change? o Considers change within the next 6 months o No intention of making changes within the next 6 months o Actively engages in strategies to change behavior; this lasts up to 6 months o Displays sustained change over time; this begins 6 months after action has started and continues indefinitely
o Considers change within the next 6 months · In the contemplation stage, the client considers a change within the next 6 months. In the precontemplation stage, the client does not intend to make changes within the next 6 months. In the action stage, the client is actively engaged in strategies to change behavior. This stage lasts up to 6 months. When sustained change is noticed over time, beginning 6 months after action has started and continuing indefinitely, the client has reached the maintenance stage.
Which describes the purpose of a health care proxy or durable power of attorney for health care? o Prohibits the purchase or sale of organs o Ensures that the client has the right to refuse medical treatment o Designates a person or persons to make health care decisions on behalf of the client o Directs treatment in accordance with the client's wishes in case of a terminal illness or condition
o Designates a person or persons to make health care decisions on behalf of the client · Health care proxies enable another person or persons to make health care decisions on the client's behalf when the client is no longer able to make decisions on his or her own. The National Organ Transplant Act of 1984 prohibits the purchase or sale of organs. This act is not related to health care proxies. The ethical doctrine of autonomy ensures the client's right to refuse medical treatment. A living will is a written document that directs treatment in accordance with the client's wishes in case of a terminal illness or condition.
To meet the criteria of ethical practice, which action would the nurse who witnessed the spouse of a client fall take? o Initiate an agency incident report. o Report the fall to the state (provincial) health department. o Write a brief description of the incident to be kept by the nurse manager. o Determine that no documentation is needed because the visitor is not a client in the hospital
o Initiate an agency incident report. · Health care agencies document the occurrence of any event out of the ordinary that results in or has the potential to harm a client, employee, or visitor. Falls by visitors are not required to be reported to state (provincial) health departments. However, incident reports are required to be presented to accrediting agencies for review when an agency is in the process of being accredited. Writing a brief description of the incident to be kept by the nurse manager is not a requirement of ethical practice. However, the nurse who is involved in an incident or is a witness to an incident would write an accurate description of the event, along with the names of individuals involved. This documentation would be kept by the nurse at home. Lawsuits may take several years before they come to trial, and personal notes may help the nurse recall the event. The documentation must accurately contain the same elements included in the formal incident report. Taking no action is irresponsible. All events out of the ordinary that result in or have the potential to harm a visitor would be documented in an agency incident report.
Which is an appropriate action for the registered nurse regarding assisted suicide? o Nurses may have an open attitude toward the client's end of life. o Nurses' participation in assisted suicide violates the code of ethics. o Nurses may listen to the client's expressions of fear and attempt to control the client's pain. o Nurses can participate in assisted suicide only if the individual could make an oral and written request
o Nurses' participation in assisted suicide violates the code of ethics. · According to the American Nurses Association (ANA), the nurse's participation in assisted suicide would violate their code of ethics. According to the American Association of Colleges of Nursing (AACN) and the International Council of Nurses, the nurse may have an open attitude toward the client's end of life. According to the AACN and the International Council of Nurses, nurses may listen to the client's expressions of fear and to attempt to control the client's pain. According to the Oregon Death with Dignity Act (1994), the primary health care provider in the state of Oregon can participate in assisted suicide only if an individual with terminal disease makes an oral and written request to end his or her life in a humane and dignified manner.
Which is the subset of clinical health care informatics? o Clinical informatics o Nursing informatics (NI) o Public health informatics o Clinical research informatics
o Nursing informatics (NI) · NI is the subset of clinical health care informatics. This is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. Clinical health care informatics is a subdomain of clinical informatics. Public health informatics is one of the major domains of informatics that uses computer science and technology to improve public health. Clinical research informatics is a subdomain of clinical informatics.
The nurse working in a Catholic hospital discourages clients from using contraceptives per hospital policy. Which category of ethics is the nurse following? o Societal ethics o Research ethics o Professional ethics o Organizational ethics
o Organizational ethics · Organizational ethics help ensure smooth ethical operation of an organization. These ethical codes include sets of rules and regulations to guide the actions and behavior of the members of the organization. Societal ethics are norms that serve a large community and involve legal and regulatory mechanisms. Research ethics are applicable to those conducting research involving human and animal subjects. Professional ethics involve a set of ethical standards and expectations for members of that profession, but unlike organizational ethics, they may apply to many different companies.
Identify factors associated with an increased incidence of abuse within a family. Select all that apply. One, some, or all responses may be correct. o Acute illness o Pregnancy o Drug abuse o Chronic illness o Sexual Orientation
o Pregnancy o Drug abuse o Sexual Orientation · Pregnancy, drug abuse, and sexual orientation are associated with an increased incidence of abuse within a family. Acute and chronic illness may place stress on the family, but these factors are not specifically linked to a higher incidence of violence.
Which is the role of the nurse administrator in a health care setting? o Providing surgical anesthesia under the guidance and supervision of an anesthesiologist o Preparing the budget, staffing, strategic planning of programs and services, employee evaluations, and employee development o Providing comprehensive care by directly managing the medical care of clients who are healthy or who have chronic conditions o Educating staff about current nursing practices, trends, theories, and necessary skills in laboratories and clinical settings
o Preparing the budget, staffing, strategic planning of programs and services, employee evaluations, and employee development · The nurse administrator's function is to prepare the budget, staffing, strategic planning of programs and services, employee evaluations, and employee development. A certified registered nurse anesthetist provides surgical anesthesia under the guidance and supervision of an anesthesiologist. The nurse practitioner provides comprehensive care and directly manages the medical care of clients who are healthy or have chronic conditions. Nurse educators provide knowledge about current nursing practices, trends, theories, and necessary skills in laboratories and clinical settings.
Which is the purpose of the failure mode effective analysis? o Prevent medical errors in a hospital o Analyze the cause of sentinel events in a hospital o Analyze the efficacy of the care provided in the hospital o Evaluate the cause of client dissatisfaction with regard to care
o Prevent medical errors in a hospital · The failure mode effective analysis is a tool designed to prevent medical errors and system failures within a health care system. It analyzes the potential failure modes and the causes of system failures, finds solutions to the problem, and evaluates the effectiveness of those solutions. The root cause analysis tool is used to analyze the cause of sentinel errors in a hospital. The efficacy of the care provided and analysis of client satisfaction are not the components of client dissatisfaction.
Under which type of health care services would the student nurse include sports medicine? o Primary care o Tertiary care o Preventive care o Restorative care
o Restorative care · The student nurse would include sports medicine under restorative care. It is not categorized as primary, tertiary, or preventive health care services.
Which variable is an example of an external variable? o Spiritual factors o Developmental issues o Socioeconomic factors o Perception of functioning
o Socioeconomic factors · Socioeconomic factors are considered to be external variables. Spiritual factors, developmental issues, and the perception of functioning are internal variables.
