Ch. 1) A nurse is discussing restorative health care with a newly licensed nurse. Which of the following examples should the nurse include in the
... [Show More] teaching? (Select all that apply.) A. Home health care B. Rehabilitation facilities C. Diagnostic centers D. Skilled nursing facilities E. Oncology centers - ✔✔A, B, D Rationale: A. Restorative health care involves immediate follow up care for restoring health and prolonged self-care home healthcare is a type of restorative healthcare B. Rehabilitation facilities are a type of restorative health care D. Skilled nursing facilities are a type of restorative healthcare Ch. 1) A nurse is explaining the various types of health clients might have to a group care coverage of nurses. Which of the following health care financing mechanisms should the nurse include as federally funded? (Select all that apply.) A. Preferred provider organization (PPO) B. Medicare C. Long-term care insurance D. Exclusive provider organization (EPO) E. Medicaid - ✔✔B, E Rationale: Medicare and Medicaid are federally funded. PPOs, Long-term care insurance and EPOs are privately funded Ch. 1) A nurse manager is developing strategies to care for the increasing number of clients who have obesity. Which of the following actions should the nurse include as a primary health care strategy? A. Collaborating with providers to perform obesity screenings during routine office visits B. Ensuring the availability of specialized beds in rehabilitation centers for clients who have obesity C. Providing specialized intraoperative training in surgical treatments for obesity D. Educating acute care nurses about postoperative complications related to obesity - ✔✔A Rationale: identify obesity screenings at office visit as an example of primary healthcare. primary healthcare emphasizes health promotion and disease control, is often delivered during office visit, and includes screenings. Ch. 1) A nurse is discussing the purpose of regulatory agencies during a staff meeting. Which of the following tasks should the nurse identify as the responsibility of state licensing boards? A. Monitoring evidence-based practice for clients who have a specific diagnosis B. Ensuring that health care providers comply with regulations C. Setting quality standards for accreditation of health care facilities D. Determining whether medications are safe for administration to clients - ✔✔B Rationale: identify that state licensing boards are responsible for ensuring that healthcare providers and agencies comply with state regulations. Ch. 1) A nurse is explaining the various levels of health care services to a group of newly licensed nurses. Which of the following examples of care or care settings should the nurse classify as tertiary care? (Select all that apply) A. Intensive care unit B. Oncology treatment center C. Burn center D. Cardiac rehabilitation E. Home health care - ✔✔A, B, C Rationale: tertiary healthcare involves the provision of specialized and highly technical care (icu, oncology treatment center, and burn centers) Ch. 2) A nurse is caring for a group of clients on a medical-surgical unit. For which of the following client care needs should the nurse initiate a referral for a social worker? (Select all that apply.) A. A client who has terminal cancer requests hospice care in the home. B. A client asks about community resources available for older adults. C. A client states, "I would like to have my child baptized before surgery." D. A client requests an electric wheelchair for use after discharge. E. A client states, "I do not understand how to use a nebulizer." - ✔✔A, B, D Rationale: A. initiate a referral for a social worker to provide information and assistance in coordinating hospice care for a patient B. Initiate a referral for a social worker to provide information and assistance in coordinating care for community resources available for clients D. Initiate a referral for a social worker to assist the client in obtaining medical equipment for use after discharge Ch. 2) A goal for a client who has difficulty with self-feeding due to rheumatoid arthritis is to use adaptive devices. The nurse caring for the client should initiate a referral to which of the following members of the interprofessional care team? A. Social worker B. Certified nursing assistant C. Registered dietitian D. Occupational therapist - ✔✔D Rationale: an occupational therapist can assist clients who have physical challenges to use adaptive devices and strategies to help with self-care activities Ch. 2) A client who is postoperative following knee arthroplasty is concerned about the adverse effects of the medication prescribed for pain management. Which of the following members of the interprofessional care team can assist the client in understanding the medication's effects? (Select all that apply.) A. Provider B. Certified nursing assistant C. Pharmacist D. Registered nurse E. Respiratory therapist - ✔✔A, C, D Rationale: A. The provider must be knowledgeable about any medication prescribed for the client including its actions, effects, and interactions C. A pharmacist must be knowledgeable about any medication dispensed for the client, including its actions, effects, and interactions. D. A registered nurse must be knowledgeable about any medication administered, including its actions, effects, and interactions. Ch. 2) A client who had a cerebrovascular accident has persistent problems with dysphagia. The nurse caring for the client should initiate a referral with which of the following members of the interprofessional care team? A. Social worker B. Certified nursing assistant C. Occupational therapist D. Speech-language pathologist - ✔✔D Rationale: A speech language pathologist can initiate specific therapy for clients who have difficulty with feeding due to swallowing difficulties Ch. 2) A nurse is acquainting a group of newly licensed nurses with the roles of the various members of the health care team they will encounter on a medical-surgical unit. When providing examples of the types of tasks certified nursing assistants (CNAS) can perform, which of the following client activities should the nurse include? (Select all that apply.) A. Bathing B. Ambulating C. Toileting D. Determining pain level E. Measuring vital signs - ✔✔A, B, C, E Rationale: it is within the range of function for a CNA to provide basic care to patients (bathing, assisting with ambulation, assisting with toileting, measuring and recording vital signs) Ch. 4) A nurse observes an assistive personnel (AP) reprimanding a client for not using the urinal properly. The AP tells the client that diapers will be used next time the urinal is used improperly. Which of the following torts is the AP committing? A. Assault B. Battery C. False imprisonment D. Invasion of privacy - ✔✔A Rationale: by threatening the client, the AP is committing a salt. The AP's threats could make the client become fearful and apprehensive. Ch. 4) A nurse is caring for a competent adult client who tells the nurse, "I am leaving the hospital this morning whether the doctor discharges me or not." The nurse believes that this is not in the client's best interest, and prepares to administer a PRN sedative medication the client has not requested along with the scheduled morning medication. Which of the following types of tort is the nurse about to commit? A. Assault B. False imprisonment C. Negligence D. Breach of confidentiality - ✔✔B Rationale: administering a medication as a chemical restraint to keep the client from leaving the facility against medical advice is false imprisonment, because the client neither requested nor consented to receiving the sedative. Ch. 4) A nurse in a surgeon's office is providing preoperative teaching for a client who is scheduled for surgery the following week. The client tells the nurse that "I plan to prepare my advance directives before I come to the hospital." Which of the following statements made by the client should indicate to the nurse an understanding of advance directives? A. "I'd rather have my brother make decisions for me, but I know it has to be my wife." B. "I know they won't go ahead with the surgery unless I prepare these forms." C. "I plan to write that I don't want them to keep me on a breathing machine." D. "I will get my regular doctor to approve my plan before I hand it in at the hospital." - ✔✔C Rationale: The patient has the right to decide and specify which medical procedures he wants when a life-threatening situation arises. Ch. 4) A nurse is caring for a client who is about to undergo an elective surgical procedure. The nurse should take which of the following actions regarding informed consent? (Select all that apply.) A. Make sure the surgeon obtained the client's consent. B. Witness the client's signature on the consent form. C. Explain the risks and benefits of the procedure. D. Describe the consequences of choosing not to have the surgery. E. Tell the client about alternatives to having the surgery. - ✔✔A, B Rationale: it is the nurses responsibility to verify that The surgeon obtained the clients consent and that the client understands the information the surgeon gave them AND witness the client signing of the consent form, and to verify that they are consenting voluntarily and appear to be competent to do so. The nurse should also verify that the client understands the information the surgeon has provided. Ch. 4) A nurse has noticed several occasions in the past week when another nurse on the unit seemed drowsy and unable to focus on the issue at hand. Today, the nurse was found asleep in a chair in the break room not during a break time. Which of the following actions should the nurse take? A. Alert the American Nurses Association. B. Fill out an incident report. C. Report the observations to the nurse manager on the unit. D. Leave the nurse alone to sleep. - ✔✔C Rationale: any nurse who notices behavior that could jeopardize client care or could indicate a substance use disorder has a duty to report the situation immediately to the nurse manager. Ch. 5) A nurse is preparing information for a change-of-shift report. Which of the following information should the nurse include in the report? A. Input and output for the shift B. Blood pressure from the previous day C. Bone scan scheduled for today D. Medication routine from the medication administration record - ✔✔C Rationale: The bone scan is important because the nurse might have to modify the clients care to accommodate leaving the unit Ch. 5) A nurse manager is discussing the HIPAA Privacy Rule with a group of newly hired nurses during orientation. Which of the following information should the nurse manager include? (Select all that apply.) A. A single electronic records password is provided for nurses on the same unit. B. Family members should provide a code prior to receiving client health information. C. Communication of client information can occur at the nurses' station. D. A client can request a copy of their medical record. E. A nurse can photocopy a client's medical record for transfer to another facility. - ✔✔B, C, D, E Rationale: B. The HIPAA privacy rule states that information should only be disclosed to authorized individuals to whom the client has provided consent. Many hospitals use a code system that identifies these individuals and should only provide information if the individual can give the code C. The HIPAA privacy rule states that communication about a client should only take place in a private setting we're on authorized individuals cannot overhear it. A unit nurses station is considered a private and secure location. D. The HIPAA privacy rule states that clients have a right to read and obtain a copy of their medical record E. The HIPAA privacy rule states that nurses can only photocopy a clients medical record if it is to be used for transfer to another facility or provider Ch. 5) A charge nurse is reviewing documentation with a group of newly licensed nurses. Which of the following legal guidelines should be followed when documenting in a client's record? (Select all that apply.) A. Cover errors with correction fluid, and write in the correct information. B. Put the date and time on all entries. C. Document objective data, leaving out opinions. D. Use as many abbreviations as possible. E. Wait until the end of the shift to document. - ✔✔B, C Rationale: B. The date and time confirm the recording of the correct sequence of events C. Documentation must be factual, descriptive, and objective, without opinions or criticism Ch. 3) A nurse is caring for a client who decides not to have surgery despite significant blockages of the coronary arteries. The nurse understands that this client's choice is an example of which of the following ethical principles? A. Fidelity B. Autonomy C. Justice D. Nonmaleficence - ✔✔B Rationale: in this situation the client is exercising their right to make their own personal decision about surgery, regardless of others opinions of what is best for them. This is an example of autonomy Ch. 3) A nurse offers pain medication to a client who is postoperative prior to ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principles? A. Fidelity B. Autonomy C. Justice D. Beneficence - ✔✔D Rationale: Beneficence is an action that promotes good for others without self interest. By administering pain medication before the client attempts a potentially painful exercise like ambulation, The nurse is taking a specific and positive action to help the client Ch. 3) A nurse is instructing a group of newly licensed nurses about the responsibilities organ donation and procurement involve. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the newly licensed nurses should understand that this aspect of cared delivery is an example of which of the following ethical principles? A. Fidelity B. Autonomy C. Justice D. Nonmaleficence - ✔✔C Rationale: justice is fairness in care delivery and in the use of resources. By applying the same qualifications to all potential kidney transplant recipients, organ procurement organizations demonstrate this ethical principle in determining the allocation of these scarce resources Ch. 3) A nurse questions a medication prescription as too extreme in light of the client's advanced age and unstable status. The nurse understands that this action is an example of which of the following ethical principles? A. Fidelity B. Autonomy C. Justice D. Nonmaleficence - ✔✔D Rationale: Non-malfeasance is a commitment to do no harm. In this situation, administering the medication could harm the patient. By questioning it, the nurse is demonstrating the ethical principle Ch. 3) A nurse is instructing a group of newly licensed nurses about how to know and what to expect when ethical dilemmas arise. Which of the following situations should the newly licensed nurses identify as an ethical dilemma? A. A nurse on a medical-surgical unit demonstrates signs of chemical impairment B. A nurse overhears another nurse telling an older adult client that if he does not stay in bed, she will have to apply restraints C. A family has conflicting feelings about the initiation of enteral tube feedings for their father who is terminally ill D. A client who is terminally ill hesitates to name their partner on their durable power of attorney form - ✔✔C Rationale: making the decision about initiating enteral tube feedings is an example of an ethical dilemma. A review of scientific data cannot resolve the issue, and it is not easy to resolve. The decision will have a profound effect on the situation and on the client. Ch. 5) A nurse is discussing occurrences that require completion of an incident report with a newly licensed nurse. Which of the following should the nurse include in the teaching (SATA) A. Medication error B. Needlesticks C. Conflict with provider and nursing staff D. Omission of prescription E. Missed specimen collection of a prescribed laboratory test - ✔✔A, B, D Rationale: complete an incident report regarding a medication error, a needlestick, and omission of a prescription Ch. 5) A nurse is receiving a provider's prescription by telephone for morphine for a client who is reporting moderate to severe pain. Which of the following nursing actions are appropriate? (SATA) A. Repeat the details of the prescription back to the provider B. Have another nurse listen to the telephone prescription C. Obtain the provider's signature on the prescription within 24 hours D. Decline the verbal prescription because this is not an emergency situation E. Tell the charge nurse that the provider has prescribed morphine by telephone - ✔✔A, B, C Rationale: A. The nurse should repeat the medications name, dosage, time or interval, route, and any other pertinent information back to the provider and receive and document confirmation B. Having another nurse listen to the telephone prescription is a safety precaution that helps prevent medication errors due to miscommunication. C. The provider must sign the prescription within the timeframe the facility specifies in its policies generally 24 hours Ch. 6) A nurse on a medical-surgical unit has received change-of-shift report and will care for four patients. Which of the following tasks should the nurse assign the assistive personnel (AP)? A. Updating the plan of care for a client who is postop? B. Reinforcing teaching with a client who is learning to walk using a quad cane C. Reapplying a condom catheter for a client who has urinary incontinence D. Applying a sterile dressing to a pressure injury - ✔✔C Rationale: The application of a condom catheter is a non-invasive, routine procedure that can be delegated to an AP Ch. 6) A nurse manager is assigning care of a client who is bring admitted from the PACU following thoracic surgery. The nurse manager should assign the client to which of the following staff members? A. Charge nurse B. Registered Nurse C. Practical Nurse D. Assistive Personnel - ✔✔B Rationale: A client who is post operative following thoracic surgery requires professional nursing knowledge, skills, and judgment of an RN to provide safe and effective client care Ch. 6) A nurse is delegating the ambulation of a client who had a knee arthroplasty 5 days ago to an AP. Which of the following information should the nurse share with the AP? (SATA) A. The roommate ambulates independently B. The client ambulates wearing slippers over anti embolic stockings C. The client uses a front-wheeled walker when ambulating D. The client had pain medication 30 min ago E. The client is allergic to codeine F. The client ate 50% of breakfast this morning - ✔✔B, C, D Rationale: to complete this assignment safely, the assistive personnel should make sure the client wear stockings and slippers, uses a front wheeled walker, and the client should be feeling the effects of pain medicine Ch. 6) A charge nurse is assigning client care for four clients. Which of the following tasks should the nurse assign to a PN? A. Creating a plan of care for a client who is recovering following a stroke B. Assessing a pressure injury on a client who is on bed rest C. Providing nasopharyngeal suctioning for a client who has pneumonia D. Teaching a client who has asthma to use a metered-dose inhaler - ✔✔C Rationale: providing nasopharyngeal suctioning is within the scope of a practical nurse Ch. 6) A nurse is preparing an in-service program about delegation. Which of the following are components of the five rights of delegation (SATA)? A. Right place B. Right supervision and evaluation C. Right direction and communication D. Right documentation E. Right circumstances - ✔✔B, C, E (rights not in question- person and task) Ch. 7) By the second postoperative day, a client has not achieved satisfactory pain relief. Based on this evaluation, which of the following actions should the nurse take, according to the nursing process? [Show Less]