Final Assessment I. Management of Care and Legal Issues

The nurse is assigning tasks to the UAP. Which is an appropriate delegation to the UAP? Select all that apply.

The client referred to a surgeon by the healthcare provider. After meeting the surgeon, the client decides to consult with a different surgeon about treatment options. The nurse supports the client’s action, utilizing which ethical principle?

A nurse forgets to administer a dose of a client’s diuretic drug and the client experiences an episode of pulmonary edema. The nurse should consider that this error constitutes negligence because the situation contains which element?

A client asks why a diagnostic test has been prescribed and the nurse replies, “I’m unsure but will find out for you.” When the nurse later returns and provides an explanation, the nurse is acting under which principle?

The new graduate (GN) working on a medical unit night shift is concerned that the RN charge nurse is drinking alcohol on duty. On more than one occasion, the new graduate has smelled alcohol when the charge nurse returns from a break. Which action should the new graduate nurse implement first?

The charge nurse observes two unlicensed assistive personnel (UAPs) arguing in the hallway. Which action should the RN implement first in this situation?

A client presents to triage with fever, myalgia, severe headache, abdominal pain, vomiting, diarrhea, and unexplained bruising that started after returning from Africa. The triage nurse suspects, but is unsure, that the client may have Ebola. What should the nurse do first?

A client is referred to a surgeon by the healthcare provider. After meeting the surgeon, the client decides to consult with a different surgeon about treatment options. The nurse supports the client’s action, utilizing which ethical principle?

A nurse forgets to administer a dose of a client’s diuretic drug and the client experiences an episode of pulmonary edema. The nurse should consider that this error constitutes negligence because the situation contains which element?

A client asks why a diagnostic test has been prescribed and the nurse replies, “I’m unsure but will find out for you.” When the nurse later returns and provides an explanation, the nurse is acting under which principle?

An individual falls and fractures a hip while walking down the street. A companion notices a nurse drive past without stopping to assist. The individual sues the nurse for negligence but fails to win a judgment for which reason?

A client who takes warfarin is given aspirin for a headache while visiting a neighbor, a nurse. The client subsequently has a bleeding episode caused by the interaction of these drugs. Does the legal nurse consultant interpret which necessary elements of malpractice are missing from this case? Select all that apply.

A client with cancer has decided to discontinue further treatment. Although the nurse would like the client to continue treatment, the nurse recognizes the client is competent and supports the client’s decision using which ethical principle?

The healthcare provider prescribes a medication in a dose that is considered toxic. The nurse administers the medication to the client, who later suffers a cardiac arrest and dies. What consequence can the nurse expect from this situation? Select all that apply.

Which behavior indicates that an 18-month-old infant is developing a nonadaptive reaction to hospitalization?

A staff nurse concerned about maintaining client confidentiality would take which action while carrying out assigned duties?

The nurse working in an acute care environment would utilize which strategies to reduce the risk of malpractice litigation? Select all that apply.

Which task would not be appropriate for the registered nurse (RN) to delegate to a licensed practical/vocational nurse (LPN/LVN) or unlicensed assistant (UAP/UCP)?

The charge nurse on the night shift reports that the narcotic count is incorrect. The nurse has spoken to the responsible staff nurse and believes that substance abuse by the nurse is the cause. If substance abuse proves to be the cause of the incorrect count, what is the most appropriate next step?

A quarterly audit is now due to evaluate the implementation of an electronic medical record system on the nursing unit. As the unit representative who supervised the adaptation of this documentation system, how can the nurse best determine if nursing staff have accepted this change?

The nurse on the hospital quality improvement team has been asked to evaluate nursing care on the nurse’s assigned unit. After deciding to ask the nursing staff for assistance in this effort, what would be most appropriate for the nurse to initially ask the staff to do?

An RN is about to make the first rounds after receiving an inter shift report at 3:00 p.m. In what order should the RN see the following clients? Place the options in order. All options must be used.

1. A 54-year-old client 4 hours post-cardiac catheterization who has mild discomfort at the access site
2. A client newly diagnosed with diabetes mellitus who needs reinforcement of sick-day management guidelines.
3. A client who arrived 30 minutes ago from the postanesthesia care unit
4. A client who is ready for discharge but will not have available transportation home until 5:00 p.m.
5. A client with pneumonia who has received two doses of IV antibiotics and has an oxygen saturation of 93%

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A nurse is assisting a client in room 1 with lunch. The charge nurse calls the nurse and states the client in room 3 is reporting pain and requests pain medication. What is the nurse’s best and first action?

A registered nurse (RN) who is the charge nurse for the shift is making assignments for the day. Which client should be assigned to the licensed practical/vocational nurse (LPN/LVN)?

An obstetric nurse is floated to a medical unit to care for a group of acutely ill clients. The charge nurse should assign which group of clients to the float nurse?

A nurse is assessing a patient to determine educational needs. Which is most important for the nurse to consider?

A nurse is designing a teaching-learning program for a patient who is to be discharged from the hospital. After developing a nurse-patient relationship, which should the nurse do next?

A nurse is planning a weight-reduction program with an obese patient. Which should the nurse anticipate will be the most important component that will determine the success or failure of this program?

Every person who attended a smoking cessation educational program completed a questionnaire. Which is this type of evaluation called?

To be most effective, at which grade reading level should the nurse prepare written educational medical material?

You are the nurse manager who is preparing the annual reviews for the staff members. You are aware that the nurse in the competent stage of clinical performance development would be expected to do what when assigned a patient on beta-blockers scheduled for a stress test?

You are the nurse educator on a medical unit. What action would be expected from a nurse in the proficient stage of clinical competence when assessing shortness of breath in a patient?

You are the charge nurse on a busy medical-surgical unit. You are also the preceptor to a novice nurse. What response would be expected from a nurse in the novice stage of clinical competence development when assigned to perform a morning assessment on a patient?

Which types of abuse are the nurse required to report or be subject to fines and imprisonment for not reporting? (Select all that apply.)

An older adult who is a member of the Jewish community is hospitalized. Her son has been at the bedside daily. When the nurse tries to communicate with the client and the son, the son avoids eye contact with the nurse. What would be the best nursing measure?

The clinic nurse answers a phone call from an Asian American client who is experiencing a fever. The client wants to self-treat first before taking an antipyretic medication. What would the nurse suggest to the client?

Which patient should be considered the highest priority by the nurse manager?

A client is being admitted to a psychiatric unit for anxiety disorder. The nurse is conducting the admission interview and asks the client their religious preference. The client responds and states that they have not practiced their religion in many years and asks the nurse if religious practices would help decrease the symptoms of anxiety. What would be an appropriate therapeutic response?

Which of these is a measured outcome from a performance improvement process perspective?