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In the care of a client who has experienced sexual assault, which task is most appropriate for an LPN/LVN to perform?
A licensed practical nurse has decided to purchase disciplinary defense insurance and is aware that this type of insurance would provide which type of benefits? Select all that apply.
A nurse is caring for a patient who has developed MODS (multiorgan dysfunction syndrome) resulting from septic shock. The patient is ventilator dependent and on vasopressors to maintain a Doppler-measured blood pressure of 80 mm Hg. The family is resistant to permit terminal weaning. The best action by the nurse is to:
A nurse is caring for a client with malignant hypertension whose blood pressure has increased by 40 mm Hg during the past hour. The nurse goes to lunch and fails to report the change to the physician. The nurse is at risk for being charged with:
A nurse is caring for a client who just suffered a stroke and is medicated for pain. The nurse completes the following interventions: places the client on the examining table, completes a thorough history and physical, covers the client with a sheet, places the call button within reach, and goes out in the hall to speak with the client’s physician. The client tries to get up to speak with his family and falls, sustaining a hematoma on the head and a broken hip. The nurse’s actions reflect:
A nurse is caring for a client who just consented to an elective abortion. The nurse is unsure of his/her own values as they relate to this issue. The nurse must:
A nurse enters the operating room ( OR) with artificial nails in place. Which statement best describes the use of artificial nails in the operating room? Select all that apply.
A nurse decides to use the ethical principle of deontology to make clinical decisions. This principle is based on treating all people the same regardless of circumstances and on one’s duty to do the right thing regardless of circumstances. Which situation would most likely cause an ethical dilemma for this nurse?
A nurse assesses a patient reported to have normal vital signs throughout the night and finds the patient in acute respiratory distress. What is the nurse’s next best action?
A nurse accidentally administers a medication to the wrong patient and the patient experiences a serious untoward reaction. For which tort can the nurse be legally charged?
A night shift nurse receives shift report from the day shift nurse when the day nurse states, ” I have an appointment and I need to leave. Can you get the rest of the client’s information from the medical records?” Which client right is violated by the day nurse?
A new nurse is interested in working a “weekend option.” Which of the following describes this pattern of scheduling?
A new nurse is hired to work in an acute care hospital. He was advised by Human Resources that liability insurance is not necessary because the institution has coverage for all employees. Which of the following responses by the nurse is best?
A new nurse has an appointment for an interview with the nurse manager of a medical/surgical unit. What should be an essential part of her plan for the interview?
A new graduate requires a lengthy time commitment to orientation from the nurse manager. The socialization of the new nurse may take as long as 2 years. Which of the following would be expected as a time frame for developing confidence?
A new graduate nurse is asked to present a brief, concise client history and assessment at the unit’s daily multidisciplinary client care rounds. Participants in the daily client care rounds include the unit case manager, the charge nurse, the physician conducting rounds, a clinical pharmacist, the unit dietician, a physical therapist and occupational therapist, a respiratory therapist, and each client’s primary care nurse in turn. The daily client care rounds are an example of:
A new employee asks about reducing health care costs to the hospital. What would help to reduce health care costs in the clinical setting? Select all that apply.
A new client tells the admissions nurse at a rehabilitation facility,” No one asked me which rehabilitation facility I preferred. I feel as if this entire process took place without my involvement. I was not informed of alternative options.” Which client right is being violated?
A middle- aged client has a strong positive family history of type 2 diabetes mellitus. The best method to prevent or delay the development of this disease in this client is to:
A male nurse is working with female nurses on a unit. One of the female nurses is overheard talking about how cute the male nurse is. The nurse overhearing this comment should be expected to do which of the following?
According to The Joint Commission, hospitals are required to form emergency management committees to periodically exercise the disaster operations plan. Hospital administration has selected various health care providers (HCPs) to join the committee. Members from which other key departments should be included? Select all that apply.
The nurse is caring for a client who has experienced a cerebral aneurysm and is in grave condition. In determining the client’s health care wishes, what documentation is most helpful?
The licensed practical/vocational nurse (LPN/LVN) is working with a registered nurse (RN) and an unlicensed assistive personnel (UAP) utilizing the team nursing concept. When discussing client assignment, which client(s) should be assigned to the LPN/LVN? Select all that apply.
A client with right-sided weakness prepares for discharge home from the rehabilitation facility where the physical therapist works with the client on independent transfers and safe use of a walker and assistive devices. The client expresses concern about self-care during the first week at home. Which response by the physical therapist demonstrates collaboration with the multidisciplinary care team for the safest client outcome?
A client’s physician writes the order to ” obtain consent for bronchoscopy and possible lung biopsy.” When the nurse presents the consent form to the client, the client states, ” I don’t know what a bronchoscopy is.” Which is the best action by the nurse?
A client’s primary physician writes an order to prepare the client for discharge from the hospital the next day. The client expresses concern to the nurse about the ability to provide self- care and perform daily activities of living after arriving home from the hospital. Which member of the health care team should the nurse contact to provide information and assist the client with resources for an effective discharge plan?
A client’s surgeon discusses the option of surgery and related benefits and risks with the client and the client’s family. Which statement by the client demonstrates that the client understands the right to make decisions regarding treatment and the proposed plan of care?
What nursing assessment data places the client at the highest risk for suicide?
A community hospital has assessed the need for an automatic internal cardiac defibrillator for special procedures. Because of the reimbursement allowed from Medicare, which of the following best explains the decision made?
A confused client falls out of the bed. When the nurse arrives, the side-rails are up, the client has urinated on the floor, and abrasion is noted on the client’s forehead. Which information should be included in the incident report? Select all that apply.
A disoriented client is admitted to the med- surg unit with a diagnosis of acute renal failure. The physician orders a hemodialysis line to be placed to facilitate acute hemodialysis. The client’s spouse presents the nurse with an advance directive that gives instructions that no hemodialysis treatment be provided if the client becomes incapacitated and unable to make informed health care decisions. What is the appropriate immediate action for the nurse to take at this time?
A Durable Power of Attorney for Health Care is an example of ( select all that apply):
A family requests that no additional heroic measures be instituted for their terminally ill mother who has advance directives in place. The nurse respects this decision in keeping with the principle of:
A father is concerned about how long his preschool-age child will continue sucking his thumb. The nurse’s most helpful response would be:
A group of nurses is reinforcing instructions on health and safety management to survivors of a hurricane before they leave their temporary shelter and return home. Which instructions should the nurses include? Select all that apply.
A hospital client with abdominal cancer refuses surgical treatment and chemotherapy and asks about options for hospice home care. Later, the client’s daughter asks the case manager to talk the client into agreeing to surgery and chemotherapy treatment. The case manager explains to the daughter that this violates which client right?
A lethargic, pale child is brought to the health care provider’s office with symptoms of periorbital edema and reduced quantity of urine output. The urine is cloudy and smoky in color. The nurse asks the mother if the child has had any recent infections, to which the mother responds that the child had a very sore throat a few weeks ago. The health care provider suspects that the child might have acute poststreptococcal glomerulonephritis. Which laboratory test would rule out a past streptococcal infection in the child?
A nurse is caring for a patient with end-stage heart failure and understands the futility of care for this patient. The family is in denial and refuses to consent to a DNR (do not resuscitate). Their misperceptions regarding the DNR status may be based on which interpretation?
A nurse is charged with battery after helping an invalid patient back to bed and not calling for help due to a reduced staffing level. The patient sustained excessive bruising, sore joints, and extended stay. In this case, the:
A nurse is confronted by a visitor and is threatened to be hurt when she gets to her car. What action is best for the nurse to take to protect herself?
Accrediting agencies require that staff demonstrate competency in their jobs. The annual competency of mandatory skills evaluate. Which of the following skills should be shown annually in the ICU setting as mandated by accrediting agencies?
A client informs the nurse during the hospital admission assessment that he does not have an advance directive, but designates the daughter to make health care decisions in the event that he becomes incapacitated or unable to make informed decisions. Which nursing actions are appropriate for this client? Select all that apply
A client is scheduled for open heart surgery. The nurse enters the client’s room to perform preoperative teaching and finds the client crying. The client states, ” I really do not want to go through open heart surgery. I have told my children this, but they still want me to go through with the surgery. I don’t know what to do.” What is the best response for the nurse as client advocate?
After receiving the shift report, which of the following requires a priority action by the nurse?
After reporting a nurse with a substance abuse problem to the State Board of Nursing (SBON), the next step that will most likely occur is:
After reviewing the psychosocial implications following a disaster, the nurse is assigned to care for a client who has just witnessed a mass shooting. Upon obtaining subjective information from the client, which actions should the nurse take? Select all that apply.
All hospitals receiving Medicare and Medicaid funds must ask clients whether they have a living will or a durable power of attorney. This act is known as the:
Although a hospital reversed all charges when a client was the victim of wrong site surgery, the court awarded the client $1.5 million. The client was able to return to work in 6 weeks and had no permanent damages. This monetary compensation is termed:
An algorithm is a client care tool used by the multidisciplinary team designed to improve client outcomes. Algorithms are utilized by members of the multidisciplinary team as ( select all that apply):
An effective manager of people must possess qualities that inspire staff to work in an efficient manner, produce a quality work product, work as a team, and perform the work in a professional and ethical manner. Which qualities would describe an effective manager? Select all that apply.
An elderly client from a long- term care facility arrives in the emergency department by ambulance with altered level of consciousness. The physician instructs the respiratory therapist to prepare for intubation. The nurse discovers a Do Not Resuscitate ( DNR) bracelet on the client’s wrist during the initial assessment. Which immediate action should the nurse take to appropriately advocate for this client?
An intubated client admitted to the intensive care unit appears anxious and fearful of the equipment in the room. The nurse observes this and takes the time to explain each piece of equipment and its role in providing care to the client. This is an example of the nurse acting as a client advocate?
An older adult client is comatose and had one electroencephalogram that indicated no activity. The daughter is very distraught and notices her mother’s hand moves when she is talking to her. The daughter asks the nurse, “Is mother responding to my voice?” The nurse, attempting to console the daughter, knows the movement was involuntary but states, “It does appear she did.” The nurse is violating which principle of ethics?
Arrange in order of priority the nurse’s actions when a patient admitted with an elevated ST-segment myocardial infarction on droplet precautions and oxygen per nasal cannula for his diagnosed influenza is complaining of shortness of breath with an oxygen saturation of 88%.
1. Call the rapid response team (RRT).
2. Obtain a chest radiograph.
3. Obtain a 12-lead ECG.
4. Initiate a bronchodilator nebulizer treatment.
5. Increase the oxygen concentration 2 L.
6. Repeat the oxygen saturation in 10 minutes.
As a nurse working in a chronic obstructive pul-monary disease ( COPD) clinic, you advise clients daily about health care matters. The most impor-tant factor in prevention and treatment of COPD is:
As a result of the spiraling costs of health care delivery, patients admitted to the hospitals are much sicker than were patients even a decade ago. The nurse understands that patients with which conditions or disease would most likely be admitted to the hospital in today’s health care climate?
As a team leader, the charge nurse would incorporate which of the following into the meetings for greatest team input?
The nurse in a long-term care facility observes a nursing assistant caring for a resident who has a hearing aid and dentures. Which action by the nursing assistant should be corrected?
Family members who have access to hospitals may present risks to the staff when which of the following is most likely present?
First-level managers are responsible for the day-to-day activities of the unit. Which activity would the nurse expect to see only from a first-level manager?
FLAT charting is an acronym used to remember the rules for good charting. The letters remind the nurse to chart Factually, Legibly, Accurately, and Timely. Which of the following is the most appropriate use of the acronym in charting?
The nurse witnesses an accident on a highway and stops to assist the victim. The nurse notes that the client sustained a head injury and a compound fracture to the left leg, and she provides the appropriate care before transporting the victim to the hospital by ambulance.
The client develops a severe bone infection at the site of the fracture that requires amputation of the leg and files suit against the nurse who provided care at the scene of the accident. Which is accurate regarding the nurse’s immunity from this suit?
Health care facility departments with effective, supportive managers share common indicators of employee satisfaction. What are some of the indicators of a department with high employee job satisfaction? Select all that apply.
Nurses must obtain permission from the patient to release information, even to family members. What should the nurse say to a person on the telephone who is claiming to be a relative of the patient and is inquiring about his condition?
Horizontal conflict in the workplace is observed with which of the following situations?
Hospital performance improvement standards are primarily focused on the ability of the hospital to:
Human Resources is required to provide education on violence prevention and management, which is tracked by the state board of health and The Joint Commission. Which of the following would the nurse expect to find in an education program required by state and federal health care regulatory agencies about violence prevention in the workplace?
If a nurse is caught confiscating pain medication for personal use, which procedure must be followed?
If a patient does not have an advance directive or has not expressed his wishes regarding end of life care, what ethical principle may help the family to make the right decision?
In addition to evaluative feedback, the nurse manager is also involved in orientation in which areas?
In addition to the organ procurement coordinator, which other resource is the best resource for the nurse to use in helping the family make a decision when there is disagreement among family members regarding organ donation?
In what ways is the environment controlled by the hospital safety committee to prevent workplace violence? Select all that apply.
In which case does the nurse act as “whistle blower”?
Accrediting agencies require that staff demonstrate competency in their jobs. Annual competency of mandatory skills is evaluated. Which of the following skills should be demonstrated annually in the health care field as required by accrediting agencies?
You are the nursing supervisor on the 11 P.M. to 7 A.M. shift. When making rounds, the charge nurse on the unit reports that one of the patients is dyspneic. What action would be expected from a nurse in the expertise stage of clinical competence when assessing shortness of breath in a patient?