Professional practice end of chapters questions pt. 2

16.5 What does "be visible and vocal" mean? (SELECT ALL THAT APPLY) 1. Take a course on health-care policy. 2. Speak out on issues important to nursing. 3. Write letters to the editor, and e-mail your state and federal representatives. 4. Look for opportunities to appear on radio or television.

2. Speak out on issues important to nursing. 3. Write letters to the editor, and e-mail your state and federal representatives. 4. Look for opportunities to appear on radio or television.

5.7 George S. has just become a nurse manager in a long-term care facility. He knows he has a lot to learn-- What should he tell his staff? 1. Nothing, he should pretend he has experience 2. That he is still learning, too, and values their input 3. That the staff needs to manage themselves 4. How little he knows about management

2. That he is still learning, too, and values their input This is an accurate description of his situation and is likely to engage staff in supporting his growth an development as a nurse manager

3.4 An RN new to the emergency department documented that "the patient was intoxicated and acted in a crazy manner." The team leader told the RN that this type of documentation can lead to: 1. Assault. 2. Wrongful publication 3. Defamation of character 4. Slander

3. Defamation of character Charting or saying unsupported defamatory statements can lead to tort litigation.

3.5 An RN sees an older woman fall in the mall. The RN help the woman. The woman later complains that she twisted and sprained her ankle. The RN protected from litigation under: 1. Hospital malpractice insurance 2. Good faith agreement 3. Good Samaritan law 4. Personal professional insurance

3. Good Samaritan law

16.8 Janice Mendoza is settled in her nursing position and wants to devote some time to one of the issues facing the nursing profession. Which of the following activities would probably have the LEAST impact on advocating for the nursing profession? 1. Contribute to the ANA's PAC 2. Visit the representatives when the state legislature is in session 3. Talk with her friends, explaining her concerns 4. Speak on radio and television programs

3. Talk with her friends, explaining her concerns

13.6 New graduates usually experience a "honeymoon" period at their first job, which is characterized by: 1. Extreme criticism from colleagues 2. Long hours and low pay 3. Feeling undervalued 4. Excitement about the new position

4. Excitement about the new position

3.6 An RN has asked a licensed practical nurse (LPN) to trim the toenails of a diabetic patient. The LPN trims them too short, which results in a toe amputation from infection. The patient files a lawsuit against the hospital. the RN, and the LPN. What might all three be found guilty of: 1. Unintentional tort 2. Intentional tort 3. Negligence 4. Malpractice

4. Malpractice

3.10 An RN calls a health-care provider to report that a patient's condition is deteriorating. The physician gives orders on the telephone to draw arterial blood gases. What should the nurse do next when receiving telephone orders from a health-care provider? 1. Call the respiratory therapist to obtain the blood gases 2. Give the order to the unit secretary to ensure it is entered quickly 3. Enter the order directly into the system as it was given to the RN 4. Write the order down and read it back to the provider

4. Write the order down and read it back to the provider

16.10 Health-care reform encompasses many issues and concerns. Which of the following is probably the most controversial goal? A. Requiring everyone to have some form of health insurance B. Developing school-based health-care centers C. Eliminating preexisting condition rules in insurance coverage D. Eliminating lifetime limits to insurance coverage

A. Requiring everyone to have some form of health insurance

3.3 After 3 years of uneventful employment, the nurse made a medication error that resulted in patient injury. What hospital response to this event is ethical? A. The hospital was supportive and assistive as the nurse coped with this event B. The nurse was dismissed for incompetence C. The hospital quality department advised the nurse not to tell the patient about the error D. The nurse was reassigned to an area in which there is no direct patient care responsibility

A. The hospital was supportive and assistive as the nurse coped with this event Nurses must be held accountable for errors but should be treated in a professional and assistive manner.

3.2 The health-care facility has sponsored a continuing education offering an emergency management of pandemic influenza. At lunch, a nurse is overheard saying, "I'm not going to take care of anyone who might have that flu. I have kids to think about." What is true of this statement? (Select all that apply) A. The nurse has a greater obligation than a layperson to care for the sick or injured in an emergency B. This statement reflects defamation and may result in legal action against the nurse C. This statement is breach of the code of ethics for nurses D. The nurse has this right as no nurse-patient contract has been established.

A. The nurse has a greater obligation than a layperson to care for the sick or injured in an emergency C. This statement is breach of the code of ethics for nurses

6.2 A nurse is caring for a patient who has a pulmonary embolus, The patient is receiving anticoagulation with IV heparin. What instructions should the nurse give to the NAP who will help the patient with activities of daily living? (SATA) A. Use a lift sheet when moving and positioning the patient in bed B. Use an electric razor when shaving the patient each day C. Use a soft-bristled toothbrush or tooth sponge for oral care D. Use a rectal thermometer to obtain a more accurate body temperature E. Be sure the patient's footwear has a non-slip sole when the patient ambulates

A. Use a lift sheet when moving and positioning the patient in bed B. Use an electric razor when shaving the patient each day C. Use a soft-bristled toothbrush or tooth sponge for oral care E. Be sure the patient's footwear has a non-slip sole when the patient ambulates

2.5 Which best describes the difference between patient privacy and patient confidentiality? A. Confidentiality occurs between persons who are close, whereas privacy can affect anyone B. Privacy is the right to be free from intrusion into personal matters, whereas confidentiality is protection from sharing a herons's information C. Confidentiality involves the use of technology for protection, whereas privacy uses physical components of protection D. Privacy involves protection from being watched, whereas confidentiality involves protection from verbal exchanges.

B. Privacy is the right to be free from intrusion into personal matters, whereas confidentiality is protection from sharing a herons's information

16.2 In the U.S. health-care system, who is the real "customer"? That is, who actually pays most of the health-care bill? A. The U.S. government B. The head of the household C. Government entities and employers D. Employees and their families

C. Government entities and employers

16.3 In the United States, health-care insurance can best be described as.. A. Universal B. Available to all C. Free D. Expensive

D. Expensive

5.8 Mara Z. wants to become a nurse manager. She has been offered an opportunity to take a nursing management course. Which topic is most important for her to learn? a) Managing people b) Managing the unit's budget c) Planning for the future d) Redesigning the unit's workflow

a) Managing people Managing people is probably the most challenging task for nurse managers.

6.8 An assistant nurse manager is making assignments for the next shift. Which patient should the assistant nurse manager assign to a nurse with 6 months of experience and who has been floated from the surgical unit to the medical unit? a) A 58-year-old on airborne precautions for tuberculosis (TB) b) A 68-year-old who just returned from bronchoscopy and biopsy c) A 69-year-old with COPD who is ventilator dependent d) A 72-year-old who needs teaching about the use of incentive spirometry

d) A 72-year-old who needs teaching about the use of incentive spirometry Many surgical patients are taught about coughing, deep breathing, and use of incentive spirometry preoperatively.

6.10 The patient with COPD has a nursing diagnosis of Infective Breathing Pattern. Which is an appropriate action to delegate to the experienced LPN under your supervision? A. Observe how well the patient performs pursed-lip breathing B. Plan a nursing care regimen that gradually increases activity intolerance C. Assist the patient with basic activities of daily living D. Consult with the physical therapy department about reconditioning exercises.

A. Observe how well the patient performs pursed-lip breathing

13.7 An effective way to help a diverse staff work together is to: A. Provide equal opportunities for advancement B. Pretend there are no cultural differences C. Promote uniformity in communication styles D. Establish an English-only policy institution-wide

A. Provide equal opportunities for advancement Providing equal opportunities for raises and promotions is an excellent approach to managing a diverse team.

2.2 The ANA code of ethics with interpretive statements guides nurses in ethical behaviors. Provision 3 of the ANA code of ethics says: "The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient." Which of the following best describes an example of this provision? A. Respecting the patient's privacy and confidentiality when caring for him B. Serving on a committee that will improve the environment of patient care C. Maintaining professional boundaries when working with a patient D. Caring for oneself before trying to care for another person

A. Respecting the patient's privacy and confidentiality when caring for him The ANA code of ethics is designed to guide nurses toward quality, ethical care of patients. There may be times when it is difficult to discern the most ethical action, particularly when the lines are blurred as to the correct decision.

6.9 The nursing assistant tells a nurse that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula is complaining of nasal passage discomfort. What intervention should the nurse suggest to improve the patient's comfort for this problem? A. Suggest that the patient's oxygen be humidified B. Suggest that a simple face mask be used instead of a nasal cannula C. Suggest that the patient be provided with an extra pillow D. Suggest that the patient sit up in the chair at the bedside

A. Suggest that the patient's oxygen be humidified When the oxygen flow rate is higher than 4 L/min, the mucous membranes can be dried out. The best treatment is to add humidification to the oxygen delivery system. Application of a water-soluble jelly to the nares can also help decrease mucosal irritation.

6.1 A nurse is helping an NAP provide a bed bath to a comatose patient who is incontinent. Which of the following actions requires the nurse to intervene? A. The nursing assistant answers the phone while wearing gloves B. The nursing assistant log-rolls the client to provide back care C. The nursing assistant places an incontinence diaper under the client D. The nursing assistant positions the client on the left side, head elevated.

A. The nursing assistant answers the phone while wearing gloves The gloves are contaminated and should be removed before answering the phone.

16.7 Which of the following are the primary current problems with U.S. health-care system? (Select all that apply) A. Increased use of EHRs B. Less-than-optimum outcomes (quality issues) C. Number of people who are uninsured D. High cost of care

B. Less-than-optimum outcomes (quality issues) C. Number of people who are uninsured D. High cost of care

5.1 What is the difference between management and leadership? A. Management focuses on budget B. Management is an assigned position C. Leadership is not concerned with getting work done D. Leadership is more focused on people

B. Management is an assigned position Everyone can exert leadership at various times, but manager is a designated position, assigned by upper-level administration

16.4 Which of the following best describes the nurse of today? A. Assistant to the physician B. Member of the largest health-care profession C. Member of the most powerful lobby group in health care D. Woman in white

B. Member of the largest health-care profession

16.6 Which of the following health and safety concerns is NOT one of our greatest concerns currently? A. "Escape" of health-care acquired infections into the community B. Spread of poliomyelitis and smallpox C. Increase in opioid-related deaths D. Health disparities

B. Spread of poliomyelitis and smallpox both are well controlled

2.6 A nurse is working on an ethics committee to determine the best course of action for a patient who is dying. The nurse considers the positive and negative outcomes of the decision to assist with choices. Which best describes the distinction of using a list when making an ethical decision? A. The nurse can back up her reasons for why she has decided to provide a certain type of care B. The nurse can compare the benefits of one choice over another C. The nurse can communicate the best choice of action to the interdisciplinary team D. The nurse can provide care based on developed policies and standards.

B. The nurse can compare the benefits of one choice over another

2.3 Health Insurance Portability and Accountability Act (HIPAA) regulations guard confidentiality. In several situations, confidentiality can be breaches and information can be reported to other entities. Which of the following meet these criteria? (select all that apply) A. The patient is from a correctional institution B. The situation involves child abuse C. An injury occurred from a firearm D. The patient is a physician E. The breach of information was unintentional

B. The situation involves child abuse C. An injury occurred from a firearm

13.8 Which of the following events should be reported? (Select all that apply) A. A patient is placed in a broken wheelchair that tips over B. A staff member tells a neighbor about the famous athlete who is a patient C. An employee reports to work under the influence of alcohol D. A patient spills her supplemental protein drink on the floor; the certified nursing assistant mops it up

A. A patient is placed in a broken wheelchair that tips over B. A staff member tells a neighbor about the famous athlete who is a patient C. An employee reports to work under the influence of alcohol

13.2 Factors found to increase nurses' joy at work include: (select all that apply) A. Ability to provide quality care B. Consistently high workload C. A pattern of continuous conflict and disagreement D. Civility and respect

A. Ability to provide quality care D. Civility and respect

16.9 Which of the following is a current concern related to the nursing profession? A. Aging of the nursing workforce B. Oversupply of nurses versus decreasing demand for nursing care C. Emphasis on evidence-based practices D. Expansion of EHR use into the community

A. Aging of the nursing workforce

6.3 A nurse is caring for a patient who has COPD and is 2 days post after a laparoscopic cholecystectomy. Which intervention for airway management should the nurse delegate to the NAP? A. Assisting the patient to sit up on the side of the bed B. Instructing the patient to cough effectively C. Teaching the patient to use incentive spirometry D. Auscultating breath sounds every 4 hours

A. Assisting the patient to sit up on the side of the bed Assisting the patients with positioning and activities of daily living is within the educational preparation and scope of practice of a nursing assistant.

6.7 An experienced LPN is working under the supervision of the RN. The LPN is providing nursing care for a patient who has a respiratory problem. Which activities should the RN delegate to the experienced LPN? (select all that apply) A. Auscultate breath sounds B. Administer medications via metered-dose inhaler C. Complete in-depth admission assessment D. Initiate the nursing care plan E. Evaluate the patient's technique for using MDIs

A. Auscultate breath sounds B. Administer medications via metered-dose inhaler

3.9 A patient tells a nurse that he has an advance directive from 6 years ago. The nurse looks at the medical record for the advance directive. What content should the nurse expect to find in the advance directive? (Select all that apply) A. Decisions regarding treatments B. When to take the patient to the hospital C. Do not resuscitate orders D. Who should be notified in the case of illness, injury, or death E. Durable power of attorney for health care F. HIPPA protocols

A. Decisions regarding treatments B. When to take the patient to the hospital C. Do not resuscitate orders E. Durable power of attorney for health care

3.1 Which common practice puts the nurse at liability for invasion of patient privacy? A. During care, the nurse reveals information about the patient to those in the room B. The nurse releases information about the patient to nursing students who will be caring for the patient and the next day C. The nurse conducts a patient care session about a patient whose care is difficult and challenging D. Confidential information regarding an admitted patient is released to third-party payers.

A. During care, the nurse reveals information about the patient to those in the room Giving out information about a patient without permission is an invasion of privacy.

13.3 Enhancing the quality of work life can be achieved by: A. Encouraging critical thinking and new ideas B. Discouraging a working relationship with one's peers C. Being negative D. Endangering a client's health or safety

A. Encouraging critical thinking and new ideas Opportunities to express ideas and make suggestions are empowering

13.5 Burnout at work can be identified best by: A. Expressions of frustration and powerlessness B. Fatigue and refusal to work double shifts C. Allergic reactions D. A preference for efficiency

A. Expressions of frustration and powerlessness Clear warning signs of burnout

5.2 Theory Y emphasizes: A. Guidance, development, and reward B. Leadership, not management C. Supervision, monitoring, and reprimands D. Evaluation, budgeting, and time studies

A. Guidance, development, and reward A Theory Y manager employs stuff guidance, staff development, and rework.

2.10 A nurse is providing care to a patient whose family has previously brought suit against another hospital and two physicians. Under which ethical principle should the nurse practice? A. Justice B. Veracity C. Autonomy D. Nonmaleficence

A. Justice

5.4 Effective nurse managers have: (select all that apply) A. Leadership capabilities B. Clinical expertise C. Business sense D. Budgeting savvy

A. Leadership capabilities B. Clinical expertise C. Business sense D. Budgeting savvy

3.8 A patient is transported to the emergency department by rescue after being involved in a motor vehicle accident. The patient is alert and oriented but keeps stating he is having trouble breathing. Oxygen is started, but the patient is still showing signs of dyspnea. The patient suddenly develops respiratory arrest and dies. During the resuscitation process, it is discovered that the nurse failed to open the correct oxygen valve. The family sues the hospital and the nurse for: A. Malpractice B. Negligence C. Nonmaleficence D. Equipment failure

A. Malpractice

6.5 A nurse is assigned to care for the following patients. Which patient should the nurse assess first? A. A 60 year-old patient on a ventilator for when a sterile sputum specimen must be sent to the laboratory B. A 55 year-old with COPD and a pulse oximetry reading from the previous shift of 90% saturation C. A 70 year-old with pneumonia who needs to be started on IV antibiotics D. A 50-year-old with asthma who complains of shortness of breath after using a bronchodilator

D. A 50-year-old with asthma who complains of shortness of breath after using a bronchodilator The patient with asthma did not achieve relief from shortness of breath after using the bronchodilator and is at risk for respiratory complications.

2.8 Which of the following demonstrates a nurse as advocating for a patient? The nurse... A. Calls a nursing supervisor in conflicting situations B. Reviews and understands the law as it applies to the client's clinical condition C. Documents all clinical changes in the medical record in a timely manner D. Assesses the client's point of view and prepares to articulate this point of view

D. Assesses the client's point of view and prepares to articulate this point of view

5.5 Informational aspects of a nurse manager's job include: A. Evaluation B. Resource allocation C. Being a coach D. Being a spokesperson

D. Being a spokesperson Being a spokesperson for staff, patients, and administration is an informational activity.

13.9 A new nurse manager has observed several instances of horizontal violence between staff members on her unit, primarily verbal abuse and malicious gossip. What should she do? A. Ignore it because it is not physical violence and will not hurt anyone B. Model this bullying behavior so that staff can see how it affects people. C. Keep a log of observed bullying behavior to discuss during the employees' annual evaluation D. Confront the bullying behavior and discuss strategies for responding to it

D. Confront the bullying behavior and discuss strategies for responding to it Direct but carefully worded confrontations will make it clear that bullying is not tolerated.

5.9 Scientific management focuses on: A. Interpersonal relations B. Servant leadership C. Staff development D. Efficiency

D. Efficiency

6.6 A respiratory therapist performed suctioning on a patient with a closed head injury who has a tracheostomy. Afterward, the NAP obtains vital signs. The nurse should communicate that the NAP needs to report which vital sign value or values immediately? (select all that apply) A. Heart rate of 96 beats/min B. Respiratory rate of 24 breaths/min C. Pulse oximetry of 95% D. Tympanic temperature of 101.4 F

D. Tympanic temperature of 101.4 F The patient has a tracheostomy and is at risk for infection. A tympanic temperature of 101.4 indicates an infection and needs to be reported immediately.

16.1 A good description of the present U.S. health-care system would be: A. The best in the world B. Efficient and effective C. Needs improvement D. Meets everyone's needs

C. Needs improvement

2.7 A nurse is caring for a patient who feels that life should not be prolonged when hope is gone. She has decided that she does not want extraordinary measures taken when her life is at its end. She has discussed her feelings with her family and health-care provider. The nurse realizes that this is an example of: A. Affirming a value B. Choosing a value C. Prizing a value D. Reflecting a value

C. Prizing a value

6.4 A nurse is caring for a patient who is diagnosed with coronary artery disease and sleep apnea. Which action should the nurse delegate to the NAP? A. Discuss weight-loss strategies such as diet and exercise with the patient B. Teach the patient how to set up the CPAP machine before sleeping C. Remind the patient to sleep on his side instead of the back D. Administer modafinil (Provigil) to promote daytime wakefulness.

C. Remind the patient to sleep on his side instead of the back The nursing assistant can remind patients about actions that have already been taught by the nurse and are part of the patient's plan of care.

5.10 Which of the following is a major reason why newly licensed nurses resign? A. Poor pay scales B. Needlestick injuries C. Unsupportive management D. Lack of advancement opportunities

C. Unsupportive management Newly licensed nurses, in particular, need supportive management and may resign if it is not present

2.1 Several studies have shown that although care planning and advance directives are available to clients, only a minority actually complete them. Which of the following has been shown to be related to completing an advance directive? (Select all that apply) A. African American race B. Younger age C. History of chronic illness D. Lower socioeconomic status E. Higher education

E. Higher education

13.1 An incident of sexual harassment as identified by the EEOC is: (SELECT ALL THAT APPLY) 1. Telling jokes about sexual identity issues 2. Separate restrooms 3. Providing coffee and doughnuts to the nursing staff 4. Demanding a daily kiss for writing a favorable evaluation

1. Telling jokes about sexual identity issues 4. Demanding a daily kiss for writing a favorable evaluation Many people would find this behavior offensive in a workplace environment.

3.7 An RN is obtaining a signature on a surgical informed consent document. Before obtaining the signature, the RN must ensure which of the following? Select all that apply. 1. The client is not sedated 2. The doctor is present 3. A family member is a witness 4. The signature is in ink 5. The patient understands the procedure

1. The client is not sedated 5. The patient understands the procedure

2.9 A nurse's significant other undergoes exploratory surgery at the hospital where the nurse is an employee. Which practice is most appropriate? A. The nurse is an employee; therefore, access to the chart is permissible B. Access to the chart requires a signed release form C. The relationship with the client provides the nurse special access to the chart D. The nurse can ask the surgeon to discuss the outcome of the surgery

B. Access to the chart requires a signed release form

5.6 When should a new graduate consider taking on management responsibilities? A. As soon as they are offered B. After developing clinical expertise C. After 15 years on the job D. Before developing leadership expertise

B. After developing clinical expertise Development of clinical expertise is an essential part of preparing to be a nurse manager.

2.4 A patient asks a nurse if he has to agree to the health provider's treatment plan. The nurse asks that patient about his concerns. Which ethical principle is the nurse applying in this situation? (select all that apply) A. Beneficence B. Autonomy C. Veracity D. Justice

B. Autonomy The principle of autonomy indicates that the client has independence to make decisions and take action for himself or herself.

13.10 A colleague tells you, "Im so burned out, I think it's time for me to resign." What can you tell your colleague? A. "You probably need a break from work. Why don't you ask for a 6 month leave of absence?" B. "Why don't you apply for a position at our rival hospital?" C. "Tell me how you take care of yourself and what you like about your work." D. "We're all burned out. Welcome to the club."

C. "Tell me how you take care of yourself and what you like about your work." These are good opening questions to lead into learning how to manage stress and burnout.

5.3 Servant leadership focuses on: A. Helping patients care for themselves B. Removing incompetent managers C. Creating a supportive work environment D. Resolving conflicts quickly

C. Creating a supportive work environment Servant leadership employs a "people first" approach to improving how employees are treated

13.4 The occurrence of sexual harassment may be reported to: A. IHI B. ANA C. EEOC D. CDC

C. EEOC EEOC is the government agency charged with investigating employment issues such as sexual assault.