Participants of health care systems - correct answer 1. consumers (clients)
2. licensed providers (RN, LPN, MD, PT, OT, etc.)
3. unlicensed providers
... [Show More] (assistive personnel)
Settings of the health care delivery system - correct answer hospitals, homes, assisted-living, schools, hospices, occupational health clinics, urgent care, etc.
Regulatory agencies of health care delivery systems - correct answer department of health and human services, FDA, state licensing boards, the Joint Commission (set quality standards for accreditation of health care facilities), etc.
Health care financing mechanisms - correct answer medicare (65 or older and those who have permanent disabilities), medicaid (low income), private plans
Levels of health care - correct answer preventative: focus on educating to reduce and control risk factors
primary: emphasizes health promotion
Secondary: includes the diagnosis and treatment of acute illness and injury
Tertiary: acute care; involves provision of specialized and highly technical care
Restorative: intermediate follow-up care for restoring health and promoting self-care
Continuing: addresses long-term or chronic health care needs over a period of time
Safety in health care delivery - correct answer minimization of risk factors that could cause injury or harm while promoting high-quality care and maintaining a secure environment for clients, self, and others
Patient-centered care - correct answer caring and compassionate, culturally sensitive care that addresses clients' physiological, psychological, sociological, spiritual and cultural needs, preferences, and values. the client is included in the decision making process
Evidence based practice - correct answer use of current knowledge from research and other credible sources on which to base clinical judgement and client care
Informatics - correct answer the use of information technology as a communication and information-gathering tool that supports clinical decision-making and scientifically-based nursing practice
Quality improvement - correct answer care-related and organizational processes that involve the development and implementation of a plan to improve health care services and better meet clients' needs
teamwork and collaboration - correct answer the delivery of client care in partnership with interprofessional members of the health care team to achieve continuity of care and positive client outcomes
A nurse is discussing restorative health care with a newly licensed nurse. Which of the following examples should the nurse include in the teaching? (select all)
a. Home health care
b. Rehabilitation facilities
c. Diagnostic centers
d. Skilled nursing facilities
e. oncology centers - correct answer a. Home health care
b. Rehabilitation facilities
d. Skilled nursing facilities
A nurse is explaining the various types of health care coverage clients might have to a group of nurses. Which of the following health care financing mechanisms should the nurse include as federally funded? (select all)
a. Preferred provider organization (PPO)
b. Medicare
c. Long-term care insurance
d. Exclusive provider organization (EPO)
e. Medicaid - correct answer b. Medicare
e. Medicaid
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 - correct answer a. Collaborating with providers to perform obesity screenings during routine office visits
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 - correct answer b. Ensuring that health care providers comply with regulations
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)
a. Intensive care unit
b. Oncology treatment center
c. Burn center
d. Cardiac rehabilitation
e. Home health care - correct answer a. Intensive care unit
b. Oncology treatment center
c. Burn center
interprofessional personnel (non-nursing) - correct answer spiritual support staff, registered dietitian, laboratory technician, occupational therapist, pharmacist, physical therapist, provider, radiologic technologist, respiratory therapist, social worker, speech-language pathologist
nursing personnel - correct answer 1. RN (registered nurse)
2. PN (practical nurse)
3. AP (assistive personnel)
4. APN (advanced practical nurse)
- CNS (clinical nurse specialist)
- NP (nurse practitioner)
- CRNA (certified registered nurse anesthetist)
- CNM (certified nurse-midwife)
5. Nurse educator
6. Nurse administrator
7. Nurse researcher
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)
a. A client who has terminal cancer requests hospice care for 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 to use after discharge
e. A client states, "I do no - correct answer a. A client who has terminal cancer requests hospice care for the home
b. A client asks about community resources available for older adults
d. A client requests an electric wheelchair to use after discharge
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 - correct answer d. Occupational therapist
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)
a. provider
b. certified nursing assistant
c. pharmacist
d. registered nurse
e. respiratory therapist - correct answer a. provider
c. pharmacist
d. registered nurse
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 - correct answer d. speech-language pathologist
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
she gives examples of the types
of tasks certified nursing assistants
(CNAs) may perform, which of the
following client activities should
she include? (Select all that apply.)
A. Bathing
B. Ambulating
C. Toileting
D. Determining pain level
E. Measuring vital signs - correct answer A. Bathing
B. Ambulating
C. Toileting
E. Measuring vital signs
basic principles of ethics - correct answer advocacy, responsibility, accountability, confidentiality
autonomy - correct answer the right to make one's own personal decisions, even when those decisions might not be in that person's best interests
beneficence - correct answer action that promotes good for others, without any self-interest
fidelity - correct answer fulfillment of promises
justice - correct answer fairness in care delivery and use of resources
nonmaleficence - correct answer a commitment to do no harm
veracity - correct answer a commitment to tell the truth
ethics committee - correct answer generally address unusual or complex ethical issues
moral distress - correct answer occurs when the nurse is placed in a difficult situation where the actions taken are different from what the nurse feels is ethically correct
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 - correct answer b. Autonomy
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 - correct answer d. Beneficence
A nurse is instructing a group of newly licensed nurses about the responsibilities organ donation and procurement involve. When the nurse explains that the clients waiting for a kidney transplant have to meet the same qualifications, the newly licensed nurses should understand that this aspect of care delivery is an example of which of the following ethical principles?
a. Fidelity
b. Autonomy
c. Justice
d. Nonmaleficence - correct answer c. Justice
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 - correct answer d. nonmaleficence
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 doesn't stay in the bed, she will have to apply restraints
c. A family has conflicting feelings about the initiation of e - correct answer c. A family has conflicting feelings about the initiation of enteral tube feedings for their father, who is terminally ill
Federal regulations - correct answer Health Insurance Portability and Accountability Act (HIPAA), Americans with Disabilities Act (ADA), Mental Health Part Act (MHPA), Patient Self-Determination Act (PSDA)
unintentional torts: negligence - correct answer a nurse fails to implement safety measures for a client at risk for falls
unintentional torts: malpractice - correct answer a nurse administers a large dose of medication due to a calculation error, the client has cardiac arrest and dies
quasi-intentional torts: breach of confidentiality - correct answer a nurse releases a client's medical diagnosis to a member of the press
quasi-intentional torts: defamation of character - correct answer a nurse tells a coworker that they believe the client has been unfaithful to their partner
intentional torts: - correct answer assault, battery, false imprisonment
5 elements to prove negligence - correct answer 1. duty to provide care as defined by a standard
2. breach of duty by failure to meet standard
3. foreseeability of harm
4. breach of duty has potential to cause harm
5. harm occurs
refusal of treatment - correct answer PSDA stipulates that staff must inform clients of their right to accept or refuse care, including the right to leave a facility without a discharge prescription from the provider
living will - correct answer legal document that expresses that client's wishes regarding medical treatment in the event the client becomes incapacitated and is facing end-of-life issues
power of attorney - correct answer client designates health care proxy to make health care decisions for them if they are unable to
provider's order regarding DNR and AND - correct answer unless a provider writes a "do not resuscitate" (DNR) or "allow natural death" (AND), then the nurse initiates CPR when the client has no pulse or respirations
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 - correct answer a. assault
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 - correct answer b. false imprisonment
A nurse in a surgeon's office is providing preperative 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 - correct answer c. "I plan to write that I don't want them to keep me on a breathing machine."
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)
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 - correct answer a. Make sure the surgeon obtained the client's consent
b. Witness the client's signature on the consent form
A nurse has noticed several occasions in the past week when another nurse on the unit seemed drowsy & unable to focus on the issue at hand. Today, she found the nurse asleep in a chair in the break room when she was not on break. Which of the following actions should the nurse take?
a. Alert the American Nurse 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 - correct answer c. report the observations to the nurse manager on the unit
The Joint Commision (TJC) - correct answer mandates the use of computerized databases to expedite the accreditation process
elements of documentation - correct answer factual, accurate and concise, complete and current, organized
flow charts - correct answer show trends in vital signs, blood glucose levels, pain level, and other frequent assessments
narrative documentation - correct answer records information as a sequence of events in a story-like manner
charting by exception - correct answer uses standardized forms that identify norms and allows selective documentation of deviations from those norms
problem-oriented medical records - correct answer are organized by problem or diagnosis and consist of a database, problem list, care plan, and progress notes. Examples include SOAP, PIE, and DAR.
electronic health record - correct answer replacing manual formats in many settings
change of shift report - correct answer nurse gives this report at the conclusion of each shift to the nurse assuming responsibility for the clients
telephone reports - correct answer useful when contacting the provider or other members of the interprofessional team. important to have all the data ready prior to contacting any member of the interprofessional team, use a professional demeanor, use exact, relevant, and accurate information, document the name of person, time, content of the message, and the instructions or information received during the report.
telephone or verbal prescriptions - correct answer best to avoid these, but they are sometimes necessary during emergencies and at unusual times. have a second nurse listen to a telephone prescription, repeat it back, making sure to include the medication's name (spell if necessary), dosage, time, and route. question any prescription that may seem inappropriate for the client. make sure the provider signs the prescription in person within the time frame the facility specifies typically 24 hrs.
transfer (hand-off) reports - correct answer include demographic information, medical diagnosis, providers, etc. most recent vitals, medications and last doses, allergies, diet, etc.
incident report - correct answer document facts without judgment or opinion, do not refer an incident report in a client's medical record
SOAP - correct answer subjective, objective, assessment, plan
PIE - correct answer problem, intervention, evaluation
DAR - correct answer data, action, response
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 - correct answer c. Bone scan scheduled for today
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)
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 - correct answer 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
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)
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 - correct answer b. Put the date and time on all entries
c. Document objective data, leaving out opinions
A nurse is discussing occurrences that require completion of an incident report with newly licensed nurses. Which of the following should the nurse include in the teaching? (select all)
a. medication error
b. needle-sticks
c. conflict with provider and nursing staff
d. omission of prescription
e. missed specimen collection of a prescribed laboratory test - correct answer a. medication error
b. needle-sticks
d. omission of prescription
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? (select all)
a. repeat the details of prescription back to provider
b. have another nurse listen to the phone call
c. obtain the provider's signature on the prescription within 24 hr
d. decline the verbal prescription because it is not an emergency
e. tell the charge nurse that the provider has prescribed morphi - correct answer a. repeat the details of prescription back to provider
b. have another nurse listen to the phone call
c. obtain the provider's signature on the prescription within 24 hr
RNs can delegate to - correct answer other RNs, PNs and AP
delegation factors - correct answer -predictability of outcome
-potential for harm
-complexity of care
-need for problem solving and innovation
-level of interaction with the client
five rights of delegation - correct answer right task, right circumstance, right person, right direction and communication, right supervision and evaluation
A nurse on a medical surgical unit has received change-of-shift report and will care for four clients. Which of the following tasks should the nurse assign to an assistive personnel (AP)?
a. updating the plan of care for a client who is postoperative
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 - correct answer c. reapplying a condom catheter for a client who has urinary incontinence
A nurse manager is assigning care of a client who is being 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. RN
c. practical nurse PN
d. assistive personnel AP - correct answer b. RN
A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following info should the nurse share with the AP? (select all)
a. the roommate ambulates independently
b. The client ambulates with his slippers on over his antiembolic stockings
c. The client uses a front wheeled walker when ambulating
d. The client had pain meds 30 minutes ago
e. The client is allergic to codeine
f. the client ate 50 % of his breakfast this morning - correct answer b. The client ambulates with his slippers on over his antiembolic stockings
c. The client uses a front wheeled walker when ambulating
d. The client had pain meds 30 minutes ago
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 - correct answer c. providing nasopharyngeal suctioning for a client who has pneumonia
A nurse is preparing an in-service program about delegation. Which of the following are components of the fiver rights of delegation? (select all)
a. right place
b. right supervision and evaluation
c. right direction and communication
d. right documentation
e. right circumstances - correct answer b. right supervision and evaluation
c. right direction and communication
e. right circumstances
nursing process - correct answer five-step systematic method for giving patient care; involves assessing, diagnosing, planning, implementing, and evaluating
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?
a. reassess the client to determine the reasons for inadequate pain relief
b. wait to see whether the pain lessens during the next 24 hr
c. change the plan of care to provide different pain relief interventions
d. teach the client about the plan of care for managing pain - correct answer a. reassess the client to determine the reasons for inadequate pain relief
A charge nurse is observing a newly licensed nurse care for a client who reports pain. The nurse checked the client's MAR and noted the last dose of pain medication was 6 hr ago. The prescription reads every 4 hr PRN for pain. The nurse administered the medication and checked with the client 40 min later, when the client reported improvement. The newly licensed nurse left out which of the following steps of the nursing process?
a. assessment
b. planning
c. intervention
d. evaluation - correct answer a. assessment
A charge nurse is reviewing the steps of the nursing process with a group of nurses. Which of the following data should the charge nurse identify as objective data? (select all)
a. respiratory rate is 22/min with even, unlabored respirations
b. the client's partner states, "they said they hurt after walking about 10 minutes"
c. the client's pain rating is 3 on a scale of 0 to 10
d. the client's skin is pink, warm and dry
e. the assistive personnel reports that the client walked with a limp - correct answer a. respiratory rate is 22/min with even, unlabored respirations
d. the client's skin is pink, warm and dry
e. the assistive personnel reports that the client walked with a limp
A charge nurse is talking with a newly licensed nurse and is reviewing nursing interventions that do not require a provider's prescription. Which of the following interventions should the charge nurse include? (select all)
a. writing a prescription for morphine sulfate as needed for pain
b. inserting a nasogastric (NG) tube to relieve gastic distention [Show Less]