Issues in Nursing

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What purpose does a community health center serve in preventive and primary care services?

Community health centers are outpatient clinics that provide primary care to a specific population.

A nurse administers intravenous (IV) therapy to the wrong client. What possible legal complications might the nurse face in such situation?

Malpractice

An octogenarian client asks the nurse about the United States’ government-funded national health insurance program. About which healthcare plan should the nurse inform the client?

Medicare

A nurse is hired to work in a healthcare facility that has a completely computer-based client information system. The nurse in charge knows that the newly hired nurse is knowledgeable about this system when the nurse says what?

"Client information is immediately available when this system is used."

Which act protects a person who is HIV positive?

The Americans with Disabilities Act (ADA)

A nurse is caring for a client with renal failure. The client wants to go back home but the family members want the client to undergo a kidney transplant. The nurse gives details about the possible threats and benefits of the surgery to the family and informs them that the client wants to stay home. What role does the nurse play here?

Advocate

What does the nurse understand the term in-service education to mean?

It helps achieve an organization’s required competencies.

A nursing student is listing the different aspects of the healthcare services pyramid. Under which type of healthcare services should the nursing student include family planning?

Primary care

A nursing student is recalling the order of priority for giving consent to perform an autopsy in cases where a medical examiner review is not needed. Which person receives the highest priority for giving consent?

The client in writing before death

A nurse is recalling the various levels of preventive care to promote health, wellness, and to prevent illness. Which scenario is a perfect example of primary prevention?

An infant receives rotavirus vaccination in the hospital setting.

A registered nurse is educating a nursing student on the various classifications of torts. What acts are classified as intentional torts in nursing practice? Select all that apply.

-Battery -Assault -False Imprisonment

A nursing student is evaluating statements regarding the five levels of proficiency set forth by Benner. Which statement indicates that a nurse is in the advanced beginner stage?

The nurse is able to identify the basic principles of nursing care through careful observation.

While visiting the hospital, the spouse of a client slips and falls on a recently washed floor in the hallway leading to the client’s room. To meet the criteria of ethical practice, what action should the nurse who witnessed the occurrence take?

Initiate an agency incident report.

A nursing student is recalling the definitions of acts that are classified as torts in nursing practice. Which tort involves intentional touching without the client’s consent?

Battery

A client dies in the hospital 2 hours after being admitted. Who has the authority to decide if a post-mortem should be conducted?

Medical examiner

What does a nurse understand by the term regulatory law as applied to nursing practice?

Regulatory law reflects the decisions made by administrative bodies such as the State Boards of Nursing.

A registered nurse is explaining the Quality and Safety Education for Nurses (QSEN) competencies to a nursing student. What information should the nurse provide about the competency teamwork and collaboration?

"A nurse should be able to work effectively within nursing and inter-professional teams by promoting open communication and shared decision-making to provide client care."

A registered nurse is explaining the term "just culture" to the student nurse. Which explanation provided by the registered nurse is accurate?

"It refers to promoting open discussion whenever error occurs without fear of recrimination."

What should a nurse understand regarding the Uniform Anatomical Gift Act?

The Uniform Anatomical Gift Act gives individuals who have reached 18 years of age the right to make an organ donation.

A nursing student is recalling the definition of Nurse Practice Acts. What do the Nurse Practice Acts do?

Nurse Practice Acts describe and define the legal boundaries of nursing practice within each state.

A client with end-stage renal disease needs a kidney transplant. Which statements regarding the National Organ Transplant Act are true? Select all that apply.

-The National Organ Transplant Act of 1984 prohibits the purchase or sale of organs. -The act provides civil and criminal immunity to the hospital and the healthcare provider. -The act protects the donor’s estate from liability for injuries or damage that results from the use of the gift.

A nurse is caring for a client with pain after surgery. The nurse takes the blood pressure and pulse rate of the client and asks the client to rate the level of pain on the pain scale. The nurse then notifies the primary healthcare provider. Which standard of practice does the nurse perform?

Assessment

A nursing student is listing the points that need to be remembered about the loss of a client’s medical records. Which point listed by the nursing student is accurate?

"There is an assumption that the care provided to the client was negligent."

A nurse is obtaining consent from an unemancipated minor to perform an abortion. When would the nurse consider the consent-giving process to be appropriately completed? Select all that apply.

-When consent has been given specifically by a court -When self-consent has been granted by a court order -When consent has been obtained from at least one parent of the minor

A nursing student is listing the different levels of the health care services pyramid. Under which type of health care services should the nursing student include subacute care?

Tertiary care

A nurse is explaining the Mental Health Parity Act of 1996 to a client’s family member. Which explanation provided by the nurse is accurate?

It prevents health plans from placing less generous lifetime or annual limits on mental health coverage.

A nursing student is listing the professional responsibilities and roles of the nurse. Who is the most independently functioning nurse?

Advanced practice registered nurse

A nursing student is examining the health services pyramid. Keeping in mind that care services begin at the bottom of this pyramid, in which order should care services be arranged?

1. Population-based health care services 2. Clinical preventive services 3. Primary health care 4. Secondary health care 5. Tertiary health care

A registered nurse is educating a nursing student about the stages of changes in a client’s health behavior. Which statement describes the stage of contemplation?

"The client considers a change within the next 6 months."

Which role does a nurse play when helping clients to identify and clarify health problems and to choose appropriate courses of action to solve those problems?

Counselor

What purpose does block and parish nursing serve in preventive and primary care services?

Block and parish nursing provides services to older clients or those who are unable to leave their homes.

A nursing student is listing the points that need to be remembered regarding the United Network for Organ Sharing (UNOS) program. Which point listed by the nursing student is accurate?

"The United Network for Organ Sharing (UNOS) has a contract with the federal government."

What are the elements of discovery of a lawsuit? Select all that apply.

– Experts – Medical records – The depositions of witnesses

What services do community health centers provide in preventive and primary care services? Select all that apply.

– Health screenings – Physical assessments – Disease management

Which nurse participates in the development of nursing policies and procedures?

Nurse educator

The professional obligation of a nurse to assume responsibility for actions is referred to as what?

Accountability

A registered nurse is teaching an economically challenged client about different healthcare plans. Which healthcare plan is the most expensive?

Long-term care insurance (LTC)

A nursing student is listing risk factors that affect the health and wellness of a client. Which risk factors listed by the nursing student are accurate? Select all that apply.

-Lifestyle -Environment -Genetic and physiological factors

According to the Institute of Medicine (IOM) competencies for the 21st century, what task should the nurse perform when working in interdisciplinary teams?

Integrate care to ensure that care is continuous and reliable.

A 3-year-old child with eczema of the face and arms has disregarded the nurse’s warnings to "stop scratching, or else!" The nurse finds the toddler scratching so intensely that the arms are bleeding. The nurse then ties the toddler’s arms to the crib sides, saying, "I’m going to teach you one way or another." How should the nurse’s behavior be interpreted?

These actions can be construed as assault and battery.

A nursing student is listing examples of active and passive health promotion strategies. Which strategy is an example of a passive health promotion strategy?

Fluoridation of municipal drinking water

In what order should a nurse follow steps of risk management to identify potential hazards and to eliminate them before harm occurs?

1. Identifying possible risks 2. Analyzing the possible risks 3. Acting to reduce the risks 4. Evaluating the steps taken

A nurse who promotes freedom of choice for clients in decision-making best supports which principle?

Autonomy

What are the important points to be considered when imparting practical knowledge to nursing students about preventing complications in the hospital? Select all that apply.

-Nursing students should never be assigned any tasks they are unprepared for. -Nursing students can work as nursing assistants or nurse’s aides when not attending classes. -Nursing students should notify the nursing supervisor in case they are delegated tasks they are not prepared for.

A nursing student lists examples of health promotion activities. Which examples are accurate? Select all that apply.

-Good nutrition -Regular exercise -Weight reduction

A client is placed on a stretcher and restrained with straps while being transported to the x-ray department. A strap breaks, and the client falls to the floor, sustaining a fractured arm. Later the client shows the strap to the nurse manager, stating, "See, the strap is worn just at the spot where it snapped." What is the nurse’s accountability regarding this incident?

Liable, along with the employer, for misapplication of equipment or use of defective equipment that harms the client

A nursing student is recalling the definitions of acts that are classified as torts in nursing practice. Which tort involves intentional touching without the client’s consent?

Battery

According to the Institute of Medicine (IOM) competencies for the 21st century, what task should the nurse perform when using evidence-based practice?

Participate in research activities when possible.

What legal complications might a nurse face for using a restraint without a legal warrant on a client?

The nurse may be charged with false imprisonment.

What is the role of a nurse administrator in a healthcare setting?

Preparing the budget, staffing, strategic planning of programs and services, employee evaluations, and employee development

What services do nurse-managed clinics provide in preventive and primary care services? Select all that apply.

-Wellness counseling -Health risk appraisal -Employment readiness

A registered nurse is educating a nursing student about the process of resolving an ethical dilemma. What information should the nurse provide regarding negotiation of outcomes?

"A nurse should provide a personal point of view."

A student nurse is listing the different aspects of the healthcare services pyramid. Under which type of healthcare services should the student nurse include sports medicine?

Restorative care

What necessary information should the nurse remember regarding assisted suicide, according to American Nurses Association (ANA) (2008)?

Nurses’ participation in assisted suicide may violate the code of ethics.

Which of the following legal defenses are the most important for a nurse to develop?

Accountability

A nursing student is recalling information about hospice care. What is hospice care?

Hospice care is a system of family-centered care that allows clients to remain at home in comfort while easing the pains of terminal illness.

A nurse educates a client about the role played by an individual in taking responsibility for health and wellness and its impact. What instructions should the nurse give? Select all that apply.

-"An individual should know that lifestyle choices affect his or her quality of life and well-being." -"An individual should take responsibility of health and wellness by making proper lifestyle choices." -"An individual should realize that illness prevention has a positive economic impact on his or her life."

A visitor from a room adjacent to a client asks the nurse what disease the client has. The nurse responds, "I will not discuss any client’s illness with you. Are you concerned about it?" This response is based on the nurse’s knowledge that to discuss a client’s condition with someone not directly involved with that client is an example of what?

Breach of confidentiality

When should a medical examiner decide whether a postmortem examination should be conducted?

When a client dies within 24 hours of admission to the hospital

A nurse is recalling common terms that are used in health ethics. What does beneficence in health ethics refer to?

Beneficence refers to taking positive actions to help others.

A registered nurse is teaching a nursing student about the components of the magnet model. What information should the registered nurse provide about exemplary professional practice according to the revised magnet model?

"Strong professional practice is established, and accomplishments of the practice are demonstrated."

What does the nurse understand by the word felony?

A felony is a crime of a serious nature that has a penalty of imprisonment for longer than one year or even death.

A nursing student lists the preventive and primary care services available in schools, primary healthcare provider’s offices, occupational health clinics, community health centers, and nursing centers. Which service provided by these centers is most expensive?

Disease management

A registered nurse is teaching a nursing student about the standards of nursing practice. How would the nursing student define assessment?

Assessment is the process of collecting comprehensive data pertinent to the client’s health and/or situation.

A nursing student notes that a nurse is required to integrate best current research with clinical expertise and client preferences and values in order to provide quality healthcare. Which Quality and Safety Education for Nurses (QSEN) competency does this comply with?

Evidence-based practice

A nurse is helping a client to maintain and regain health, manage his or her disease and symptoms, and attain a maximal level of function and independence through the healing process. What role is the nurse playing?

Caregiver

A nurse is caring for a community-dwelling older adult with hypertension. What interventions should the nurse take to ensure the client’s well-being? Select all that apply.

-Promote dietary modifications by using varied techniques -Assess the client’s current lifestyle and promote lifestyle changes -Monitor the client’s blood pressure and weight and establish blood pressure screening programs

The nurse follows the American Nurses Association (ANA) standards of nursing practice when caring for a client. Which scenario qualifies for the implementation level of care?

The nurse provides a back massage to a client who complains of restlessness due to back pain.

What important step should the community nurse take when dealing with older adults with a confusional states problem? Select all that apply.

-The nurse should provide a protective environment. -The nurse should recommend applicable community resources. -The nurse should demonstrate proper hygiene to the primary caretaker.

A registered nurse is teaching a nursing student about malpractice insurance. Which statement by the nursing student requires correction?

"Most private insurance policies for nurses are primary policies that begin covering the nurse even before all hospital insurance coverage has been exhausted."

A nurse is discussing various scenarios involving healthcare settings and services with other team members. Which scenario mentioned by the nurse is an example of continuing care?

Caring for a client with Parkinson’s disease who requires day care service

A nurse caring for a client with dementia notes that the primary healthcare provider has prescribed an experimental course of treatment. What important factor should the nurse keep in mind regarding the procurement of informed consent?

Clients with mental illness have the right to refuse treatment.

What important points should the nurse keep in mind when witnessing consent forms? Select all that apply.

-Confirm that the client’s signature is authentic. -Ensure that the client has given the consent voluntarily. -Refrain from asking the student nurse to witness consent forms.

A nurse working in an emergency department is concerned about a recent increase in malpractice claims against nurses. What is the best way for the nurse to prevent being named in a lawsuit?

Attend professional development programs.

A registered nurse is educating a nursing student about assault. What information should the registered nurse provide?

"Assault refers to any action that places a client in apprehension of harmful contact without consent."

A nurse notes that a client is in the precontemplation stage of wellness behavior change. What are the characteristics of this stage? Select all that apply.

-The client has no intention of making any changes in the next 6 months. -The client does not show interest in information related to health behavior changes. -The client becomes defensive when confronted with information regarding his or her current health behavior.

What should a nurse do in order to comply with the ethic of nonmaleficence in the healthcare setting?

The nurse should focus on doing no harm.

A nurse gathers data about the success of keeping the side rails of clients’ beds up at nighttime to reduce the risk of falls. Which competency does the nurse display according to the Institute of Medicine (IOM) competencies of the 21st century?

Applying quality improvement

A nursing student is giving examples of healthcare settings and services. Which scenario is a perfect example of tertiary care?

Caring for a postoperative client in the intensive care unit who is suffering from respiratory distress

A student nurse is listing the limitations of the total client care nursing model. Which limitation listed by the student nurse is accurately stated?

"It is not cost effective because of the high number of registered nurses required to provide care."

What does a nurse understand about the secondary level of prevention?

Secondary prevention is focused on individuals who are in the early stage of their illnesses.

What are 2 examples of quasi-intentional torts?

-Defamation of character -Invasion of privacy

An elderly adult with Parkinson’s disease falls while going to the bathroom and gets injured. The nurse taking care of the client informs the primary healthcare provider. What step should the nurse take to alert the risk management system?

The nurse should document the incident in the occurrence report tool.

A nurse withholds a prescribed opioid medication from a client with intractable pain because the nurse fears the client will become addicted. In this situation the nurse is adhering to which ethical principle?

Beneficence

What are the four core roles for the advanced practice registered nurse (RN)? Select all that apply.

1. Clinical nurse specialist 2. Certified nurse midwife 3. Certified RN anesthetist 4. Certified nurse practitioner

The nurse is having difficulty understanding a client’s decision to have hospice care rather than an extensive surgical procedure. Which ethical principle does the client’s behavior illustrate?

Autonomy

When assessing a client, the nurse notices that he or she has reached the action stage of health behavior change. What should the nurse expect to be the client’s reaction after providing suggestions for change?

The client’s previous habits may prevent taking action related to new behaviors.

What does "access to care" include according to the Picker Institute’s eight dimensions of patient-centered care? Select all that apply.

– "Clients want to be able to see a specialist when a referral is made." – "Clients want to schedule appointments at convenient times without trouble." – "Clients need to be able to find conveyance when traveling to different healthcare settings."

A visitor from a room adjacent to a client asks the nurse what disease the client has. The nurse responds, "I cannot discuss any client’s illness with you." What legal issue supports the nurse’s response?

Invasion of privacy

A nurse manager in charge of a unit overhears two nurses in a hall filled with visitors discussing a client on the unit who has AIDS. What should be the nurse manager’s initial action?

Have a conference with the nurses and talk about the need for confidentiality.

A registered nurse is educating a nursing student about licensure. What information should the nurse provide? Select all that apply.

-"The hearing for suspension or revocation of a license is conducted by a panel of professionals." -"The nurse must be notified of any charges against him or her and given an opportunity to defend him or herself." -"The state board of nursing may revoke or suspend a license if a nurse’s conduct violates provisions in the licensing statutes."

A nurse notices that a client is in spiritual distress. Which nursing action establishes the nurse as a caregiver?

The nurse provides therapeutic treatment to the client.

A registered nurse is educating a nursing student about abortion-related issues. Which statement provided by the nursing student post-teaching needs correction?

"If a woman is in her first trimester, she may end her pregnancy according to state regulations."

A nurse is teaching a client about false imprisonment. What information should the nurse provide? Select all that apply.

-"False imprisonment is an example of an intentional tort." -"False imprisonment involves restraining a person unjustly without any legal warrant." -"A falsely imprisoned client should be aware of his or her confinement."

Which nursing behavior is an intentional tort?

Divulging private information about a client’s health status to the media

What points should the nurse remember when caring for a client who has a history of suicide attempts? Select all that apply.

-The nurse should document the measures taken to prevent suicides. -If the client makes a suicide attempt in the hospital, this action may lead to a lawsuit. -The primary health care facility will be responsible for failing to provide adequate supervision.

A nurse is educating a client regarding a do-not-resuscitate (DNR) order. What information should the nurse provide? Select all that apply.

-"Do-not-resuscitate orders should be reviewed routinely by the primary healthcare provider." -"Legally competent adults may issue a do-not-resuscitate order verbally or in writing after receiving proper information about it." -"Primary healthcare providers should check for a DNR order before deciding to perform cardiopulmonary resuscitation."

A graduate nurse is preparing to apply to the State Board of Nursing for licensure to practice as a registered professional nurse. What group primarily is protected under the regulations of the practice of nursing?

The public

An elderly client states, "Disease occurs when supernatural elements enter the body." Which variable influences the client’s health beliefs in this scenario?

Spiritual factors

A victim of an automobile crash is brought to the hospital. The nurse notes that the client is in need of cardiopulmonary resuscitation (CPR). What factors should the nurse remember before performing CPR? Select all that apply.

-Cardiopulmonary resuscitation is an emergency treatment that is provided without a client’s consent. -Cardiopulmonary resuscitation is not performed on adult clients who have already consented to a do not resuscitate order either verbally or in writing. -Cardiopulmonary resuscitation is performed on appropriate clients unless a do not resuscitate order has been signed and made part of the client’s record.

A student nurse is listing the benefits of the Patient Self-Determination Act (PSDA) (1991). Which statements of the student nurse indicate effective learning? Select all that apply.

– "The PSDA regulations allow the client to refuse treatment and formulate advance directives." – "The PSDA regulations require healthcare institutions to provide written information to clients concerning their rights under state law to make decisions."

A nurse is educating a client about the Uniform Determination of Death Act. What information should the nurse provide? Select all that apply.

– "Nurses have a specific legal obligation to treat a deceased person’s remains with dignity." – "Different definitions regarding death are in place to facilitate recovery of organs for transplantation." – "The cardiopulmonary standard of determining death sets an irreversible cessation of circulatory and respiratory functions as the criterion."

A nurse caring for a client from another country asks about the client’s healthcare traditions. Which Quality and Safety Education for Nurses (QSEN) competency does the nurse comply with?

Patient-centered care

A registered nurse is educating a student nurse regarding the role of value clarification in the resolution of ethical dilemmas. What information should the nurse provide?

"Value clarification involves tolerating differences of opinions."

A nursing student is recalling information about the primary level of prevention. Which statement accurately describes primary prevention?

Primary prevention is applied to clients who are physically and emotionally healthy.

A registered nurse is instructing a trainee nurse on the various advantages of the team nursing care delivery model. Which statement provided by the trainee nurse post-training indicates a need for effective learning?

"This model is inflexible but uses a variety of staffing levels and mixes."

What services does block and parish nursing provide for preventive and primary care services? Select all that apply.

-Respite care -Running errands -Homemaker aides

In what instances can a minor give consent for himself or herself for medical treatment? Select all that apply.

-The minor can give consent for any venereal disease. -The minor can give consent if he or she is lawfully married. -The minor can give consent for a drug or substance abuse.

A registered nurse is educating a nursing student about nursing malpractice. What information should the nurse provide? Select all that apply.

-"Nursing malpractice takes place when nursing care falls below the standards of care." -"Nursing malpractice may be prevented by developing a caring rapport with the client." -"Nursing malpractice may occur even when the nurses do not intend to harm the clients."

A nurse notes that a famous client has received an incorrect dose of medication due to the malfunction of the intravenous (IV) device, but does not inform the primary healthcare provider. Instead the nurse tells a colleague that the medication could not be given due to the client’s inappropriate behavior. The nurse then updates media personnel about the client’s health status. What legal charges may be brought up against the nurse? Select all that apply.

-Slander -Malpractice -Invasion of privacy

What points should a nurse keep in mind when caring for a client who belongs to a different culture? Select all that apply.

-The nurse should be aware of his or her own cultural values and behavior patterns. -The nurse should focus on understanding the client’s traditions, values, and beliefs. -The nurse should understand that unique cultural perceptions exist regarding health practices.

What are common negligent acts of nurses found in the hospital setting? Select all that apply.

-Failure to notify the healthcare provider of problems -Failure to follow the six rights of medication administration -Failure to ensure the safety of a client with disequilibrium problems

A client says "Do not cut the thread on my wrist before sending me for surgery because the thread is a blessing from God." Which internal variable influences the client’s health belief in this scenario?

Spiritual factors

A nursing student notes information regarding restorative care. Which points noted by the nursing student are accurate? Select all that apply.

-Success depends on effective and early collaboration with clients and their families. -Clients and families follow treatment plans better when they are involved in restorative care. -Restorative care is provided through home healthcare, rehabilitation, or extended care facilities.

A registered nurse is explaining the importance of the American Nurses Association (ANA) in nursing practice. Which points mentioned by the registered nurse are accurate? Select all that apply.

-"ANA is a part of the International Council of Nurses." -"ANA promotes the professional development and general and economic welfare of nurses." -"ANA is active in political, professional, and financial issues affecting health care and the nursing profession."

A client is admitted with a diagnosis of premature labor. The nurse discovers that the client has been using heroin throughout her pregnancy. What is the most appropriate action for the nurse to take?

Inform the client’s primary healthcare provider.

A nurse needs to obtain consent for the medical treatment of a child whose parent is a minor. What appropriate step should the nurse take to obtain consent?

The nurse should ask the minor to give consent.

A nurse complies to the American Nurses Association (ANA) standards of nursing practice. Which scenario is an example of assessment according to the ANA standards?

The nurse checks the client’s ability to swallow before administering oral medication.

A nursing student is listing key points about ethics and values. Which point listed by the nurse indicates a need for more education?

"The American Nurses Association (ANA) code of ethics ensures that the code remains constant."

What important points should the nurse keep in mind regarding orders from a primary healthcare provider to prevent any legal complications? Select all that apply.

-Registered nurses should follow the primary healthcare provider’s order unless the order seems to be harmful or is incorrect. -Registered nurses should inform the nursing supervisor if the order looks inappropriate but the primary healthcare provider is required to confirm the order. -Registered nurses should document that the primary healthcare provider was notified about an incorrect order, along with his or her response, follow-up, and the client’s response.

A parent objects to the child’s getting vaccinated because she believes that vaccinations can cause autism. However, a nurse gives the child the vaccination injection against the wishes of the mother. What legal charge may be brought against the nurse?

Battery

A foreign language-speaking client needs to undergo chemotherapy; a signed consent form is required. What should the nurse do to explain the terms of the consent to the client?

Seek the help of an official interpreter.

A nursing student is listing the nursing manager’s role in the hospital setting. Which roles listed by the nursing student are accurate? Select all that apply.

-"The nursing manager coordinates the activities of the nursing staff in delivering nursing care." -"The nursing manager uses appropriate leadership styles to create a nursing environment for clients and staff." -"The nursing manager establishes an environment for collaborative client-centered care to provide safe and quality care with positive client outcomes."

What does a community-based nurse do as a change agent? Select all that apply.

-The nurse empowers clients and their families to creatively solve problems. -The nurse works with clients to solve problems and helps clients identify an alternative care facility. -The nurse empowers clients to become instrumental in creating change within a health care agency.

A pregnant woman is admitted with a tentative diagnosis of placenta previa. The nurse implements prescriptions to start an intravenous (IV) infusion, administer oxygen, and draw blood for laboratory tests. The client’s apprehension is increasing, and she asks the nurse what is happening. The nurse tells her not to worry, that she is going to be alright, and that everything is under control. What is the best interpretation of the nurse’s statement?

Questionable, because the client has the right to know what treatment is being given and why

In order to prolong a hospitalization stay, the nurse documents in a client’s electronic health record (EHR) that there are no signs of recovery. However, in reality, the client appears to be cured of the illness. What legal implication does the nurse’s action have?

The nurse may be charged with libel.

A nurse checks the patency of the IV catheter before each use as well as the client’s tolerance to intermittent intravenous therapy. Which American Nurses Association (ANA) standard of nursing practice has been described in the given scenario?

Evaluation

An emancipated minor admitted to the healthcare setting states "I have not had proper meals since last week." Which needs should the nurse address using Maslow’s hierarchy of needs?

Physiological

What points regarding the Good Samaritan Act of 1997 should the nurse remember? Select all that apply.

-The nurse should provide care that is consistent with his or her level of expertise. -Good Samaritan laws limit liability and offer legal immunity if a nurse helps at an accident scene. -Good Samaritan laws were enacted to encourage healthcare workers to provide assistance during emergencies.

A visitor says to the nurse, "Can I read my client’s progress record? I am the sponsor from an alcohol recovery program." How should the nurse respond?

Do not allow the sponsor to review the record

A nurse is teaching a group of parents about child abuse. What definition of assault should the nurse include in the teaching plan?

Assault is a threat to do bodily harm to another person.

A nurse notes that a client with dementia refuses to eat. Instead of informing the primary healthcare provider, the nurse threatens to force-feed the client, and proceeds to apply restraints in order to do so. What legal charges may be brought up against the nurse? Select all that apply.

-Assault -Malpractice -False imprisonment

A nursing student is listing the instructions that clients require before leaving a healthcare facility. Which instruction listed by the nursing student indicates a need for more education?

Provide instructions about all the legislation and guidelines that protect the interests of a client.

nurse fails to act in a reasonable, prudent manner. Which legal principle is most likely to be applied?

Malpractice

A nursing student is noting the characteristics of the secondary level of prevention. What points should the nursing student note? Select all that apply.

-Secondary prevention focuses on individuals with health problems and illnesses. -Secondary prevention activities are directed at diagnosis and prompt interventions. -Secondary prevention includes screening techniques and treating diseases at early stages.

A nurse signs as a witness to informed consent provided by the client. What does the signature of the nurse imply? Select all that apply.

-That the client’s signature is authentic -That the client has given consent voluntarily -That the client appears to be competent to give consent

What should the nurse do initially when obtaining consent for surgery?

Determine whether the client’s knowledge level is sufficient to give consent.

Which statement captures the essence of feminist ethics accurately?

Feminist ethicists propose that the natural human urge to be influenced by relationships is a positive value.

What important points should the nurse keep in mind when caring for an older adult to promote health? Select all that apply.

-Encourage regular physical activity and the use of stress-management strategies -Consider the client’s social environment and strengthen social support to promote health -Assess the client for fear of falling and provide support by making environmental changes

A nurse is reviewing the key responsibilities of a primary healthcare provider for obtaining consent from a client before performing a medical procedure. Which key responsibilities have been accurately stated? Select all that apply.

-"The client receives a brief, complete explanation of the procedure or treatment." -"The client receives an explanation of alternative therapies and the risks of doing nothing." -"The client receives a description of the risks, including death, which may occur due to the procedure and anticipated pain and/or discomfort."

Nurses are held responsible for the commission of a tort. What is the definition of a tort?

An illegality committed by one person against the property or person of another

A client in a health care facility in the state of Oregon requests that the nurse explain about primary health care provider-assisted suicide. What information should the nurse provide?

"A terminally ill client may make an oral or written request for primary health care provider-assisted suicide."

A nurse is educating a client about the tertiary level of prevention. What information should the nurse provide? Select all that apply.

-Tertiary prevention focuses on preventing complications of illness. -Tertiary prevention helps clients achieve as high a level of functioning as possible. -Tertiary prevention aims at minimizing the effects of long-term disease or disability.

A nursing student is listing the primary characteristics that establish nursing as a profession. Which statement made by the student needs correction?

"Nurses are simply required to perform specific tasks."

A nursing student is recalling the various stages of health behavior change. What are the characteristics of the preparation stage? Select all that apply.

-The client requires assistance to plan changes in health behavior. -The client understands that the advantages of health behavior change exceed the disadvantages. -The client makes small changes in health behavior in preparation for major changes in the next month.

A nursing student is listing points that make nursing a profession and not just a job. Which points have been correctly stated? Select all that apply.

-"Nursing provides a specific service." -"Nursing requires a basic liberal foundation and an advanced education." -"Nursing has a theoretical body of knowledge leading to defined skills, abilities, and norms."

Which action by a home care nurse would be considered an act of euthanasia?

Knowing that a dying client is overmedicating and not acting on this information.

A nursing student is listing examples of nursing activities that conform to the American Nurses Association (ANA) standards of nursing practice. Which example listed by the nursing student is an example of diagnosis?

The nurse documents that the client is on the verge of losing mental stability due to low self-esteem and loneliness.

A nurse is explaining about healthcare plans to a patient. Which healthcare plan finances a large portion of care for low-income children, their parents, pregnant women, and disabled very poor adults?

Medicaid

A nursing student is listing the steps that need to be considered when preparing discharge planning for a client. Which steps listed by the nursing student are accurate? Select all that apply.

-"Teach the client the safe and effective use of medications and medical equipment." -"Remember that discharge planning is a centralized, coordinated, interdisciplinary process." -"Develop a care plan that moves the client from the hospital to another level of healthcare."

A pregnant client states, "Abortion is banned in our community because it interferes with God’s creative work." According to the nurse, which variable influences the client’s health belief?

Cultural background

According to the Institute of Medicine (IOM) competencies for the 21st century, what tasks should the nurse perform when applying quality improvement? Select all that apply.

-Identify errors and hazards in care. -Design and test interventions to change processes. -Measure quality in relation to structure, process, and outcomes.

A registered nurse is explaining healthcare settings and services to a nursing student. Which scenario mentioned by the registered nurse is considered secondary acute care?

A nurse prepares a client who has suffered from repeated cerebral attacks for a CT scan.

Arrange the actions in the order a nurse should take to resolve an ethical dilemma

1. Collect relevant case-related information 2. Clarify values 3. Verbalize the problem 4. Determine possible courses of action 5. Negotiate a plan 6. Evaluate the plan over time

An octogenarian client tells the nurse, "Please do not give me dietary instructions post-surgery. I’ve had several surgeries in my lifetime and I know what to eat." Which variable influences the client’s health beliefs and practices?

Intellectual background

A nurse is caring for an older adult with dementia who has been admitted in the special ward for further treatment. Which situation should the nurse address to meet the safety and security needs of the client according to Maslow’s hierarchy of needs?

"I do not want to talk to any stranger as I fear that they might take away my things."

A registered nurse is educating a nursing student about the different levels of prevention with different scenarios. Which scenario is an example of tertiary prevention?

A nurse educates a community about the need to integrate individuals’ limb amputations into the professional sphere.

A nursing student is listing the different aspects of obtaining informed consent from clients. Which point mentioned by the nursing student needs correction?

"Informed consent is an important part of the nurse-client relationship; it is a vital part of the nursing duty."

When might a nurse be charged with client abandonment?

If a nurse walks out when staffing is inadequate

An ostomy specialist nurse is required to ‘float’ to the obstetric department. The nurse realizes that he or she lacks the required level of expertise to care for the clients in the unit. What course of action should the nurse take to deal with the situation?

Notify the nursing supervisor.

A registered nurse is teaching a student nurse about the characteristics of various healthcare plans. Which statements provided by the student nurse post-teaching regarding the characteristics of managed care organizations (MCOs) are appropriate? Select all that apply.

-"They focus on health maintenance and primary care."’ -"They require referrals for access to specialists and hospitalization." -"They may use capitated payments for the healthcare service providers."

What key points should the nurse keep in mind about the legal implications of nursing practice? Select all that apply.

-Ensure that the nurse knows all the laws and that these laws are applied in the nursing practice, whenever required. -Ensure that the primary healthcare providers’ orders are followed unless they appear to be incorrect or inappropriate. -Ensure that the nurse can makes a formal protest to the nursing administrator if he or she is asked to take care of more clients than is reasonable.

A nurse is caring for a community-dwelling older adult with dementia. What interventions should the nurse take to ensure the client’s well-being? Select all that apply.

-Foster human dignity and maintain the best possible functioning, protection, and safety -Show the caregiver techniques to dress, feed, and toilet the older adult -Protect the client’s rights and provide support to maintain the physical and mental health of family members

A nurse administers medication via the central venous access device (CVAD) and forgets to monitor the client at the required intervals. The client then develops phlebitis. What charges may the nurse face for this action?

Malpractice

A nursing student is discussing aspects of the American Nurses Association (ANA) code of ethics. Which ANA Code of Ethics statements discussed by the nursing student are accurately stated? Select all that apply.

-"The nurse coordinates with other healthcare providers to meet health needs." -"The nurse takes part in the advancement of the profession by contributing to the practice and education." -"The nurse’s primary commitment is to the client, whether it be an individual, family, group, or community."

A nursing student is listing the guidelines to be followed to make the referral process successful. Which step listed by the nursing student needs correction?

Refraining from giving the referral care provider information about the client in advance

A client does not consent to disclose his or her medical records and information regarding his or her health status. However, a nursing student unintentionally makes the information public. According to the Health Insurance Portability and Accountability Act, which section has been violated?

Privacy

A registered nurse is educating a student nurse on the eight dimensions of patient-centered care provided by the Picker Institute. What information should the nurse provide regarding the dimension of "transition and continuity"? Select all that apply.

-"Clients and caregivers expect access to necessary healthcare resources on a continuing basis." -"Clients expect to have their continuing healthcare needs met after discharge with well-coordinated services." -"Clients require information about medications, physical limitations, follow-up plans regarding diet and treatment, and danger signals to look for after treatment."

What steps should a nurse take when caring for a client to prevent nursing malpractice? Select all that apply.

-Be alert about common sources of client injuries. -Gain knowledge regarding current nursing practices. -Communicate with the client regarding tests and treatment plans.

A registered nurse is educating a nursing student about risk management methods to ensure that appropriate nursing care is provided to a client by identifying and eliminating potential hazards. What information should the registered nurse provide? Select all that apply.

-"Ensure that the three principles of The Joint Commission’s Universal Protocol are adhered to before starting a surgery on a client." -"Refrain from depending on the use of electronic monitoring devices completely because they are not always reliable." -"File an occurrence report in case of an error in technique when administering medication intravenously (IV)."

A nursing team leader identifies that a nurse is coming to work after drinking alcohol. What is the most appropriate way for the team leader to approach this ethical situation?

Notify the nurse manager about the problem

A registered nurse is explaining the importance of capitation to a nursing student. What information should the nurse provide? Select all that apply.

-Capitation influences the way healthcare providers deliver care in all types of settings -Capitation means that primary healthcare providers are paid a fixed amount per client of a health care plan. -Capitation aims to build a payment plan for select diagnoses or surgical procedures that consists of the best standards of care at the lowest cost.

What should the nurse consider to be limitations of assisted living? Select all that apply.

-Most residents need to pay privately. -Only home care nurses can visit the clients. -Average monthly fee is $3,022 for a private unit

A client with a mental illness in the emergency unit needs to undergo an emergency surgery. What would be the nurse’s first course of action to prevent any legal complications?

Obtain consent from a person legally authorized to give it on the client’s behalf, if available.

A registered nurse is educating a nursing student about the importance of nursing documentation for performing risk management. What information should the nurse give? Select all that apply.

-"A nurse’s documentation is the evidence of care that a client receives." -"The nurse should note down assessments and significant changes in the client’s health." -"Nurses should always document the primary healthcare providers’ responses whenever they are contacted."

A nurse uses flow charts to determine the usefulness of bed-monitoring devices for checking on dementia clients. Which Quality and Safety Education for Nurses (QSEN) competency does the nurse comply with?

Quality improvement

The Institute of Medicine (IOM) has identified five interrelated competencies that are essential for healthcare professionals in the 21st century. Which tasks performed by the nurse would satisfy the patient-centered care competency? Select all that apply.

-Relieving pain and suffering -Communicating with and educating clients effectively -Recognizing and respecting differences in clients’ values, preferences, and needs

What is the rationale for performing sponge, needle, and instrument counts in the operating room?

A nurse is responsible for performing sponge and instrument counts as a part of routine surgical standards.

What activities should the nurse consider to be a part of the tertiary level of preventive care? Select all that apply.

-Using a sheltered colony -Providing selective placement -Providing work therapy in hospitals

A nurse is preparing a lecture for a group of nursing students related to ethics and legal principles. Which statement would be appropriate to include?

Beneficence emphasizes the importance of preventing harm and ensuring the client’s well-being.

The family of a client infected with human immunodeficiency virus (HIV) wants to see the results of the client’s blood tests, unaware that the client is infected. A nurse obliges the family’s request without waiting for the client’s consent. What legal charge may be brought against the nurse?

Invasion of privacy

A client is injured from falling from a hospital bed on which the side rails were not raised appropriately. The client’s family files a malpractice suit against the nurse responsible for taking care of the client. Which statements regarding the lawsuit are accurate? Select all that apply.

-The defendant obtains all of the plaintiff’s medical records in the discovery phase -The jury uses certain standards of care to determine whether the nurse acted properly -The plaintiff outlines what the defendant did wrong and how it resulted in injury in the pleadings phase

A nursing student is listing examples of healthcare services. Which scenario is an example of restorative care?

Visiting a private residence to perform maggot-aided debridement therapy of a client’s wound

A nurse is evaluating various scenarios related to the basic codes of ethics set forth by the American Nurses Association. Which situation is an example of following the principle of accountability?

A nurse ensures that all nursing actions performed during care can be explained to the client and the hospital.

A registered nurse is educating a student nurse about the concept of "floating." What information should the nurse provide? Select all that apply.

-The nurse needs to request and receive an orientation to the unit -The nurse needs to learn about the policies of the institution regarding floating before accepting employment. -The nurse must inform supervisors about any lack of experience in caring for the type of clients in the assigned nursing unit.

A nurse is following the guidelines for high-quality documentation and reporting. Which guideline followed by the nurse while documenting factual records indicates a need for additional training?

"The client seems restless."

A registered nurse is informing a nursing student that nurses play an important role in helping hospitals to meet requirements for quality, efficiency, and client satisfaction. Which points mentioned by the registered nurse are accurate? Select all that apply.

-"Pay for performance programs promote quality, effectiveness, and safe client care." -"Six Sigma is used to analyze the collected data and to identify unnecessary steps in the processes." -"Balanced scorecards are used to report data on the key performance indicators and are published publicly."

What important step should the nurse take to evaluate lifestyle change in the client?

Encourage the client to maintain an exercise and eating calendar to track adherence and provide positive reinforcement.

A nurse uses therapeutic communication techniques in order to achieve desired client outcomes. Which communication technique is a part of therapeutic communication?

Providing relevant information to the client

A client is admitted into the mental health unit involuntarily. What course of action should the nurse take in order to prevent legal complications?

File with the court within 96 hours of the client’s initial detention

Which tasks should a nurse perform in order to comply with public health laws? Select all that apply.

-Report cases of communicable diseases -Report incidences of domestic violence -Ensure that clients in a community have received necessary immunizations

A client tells the nurse, "I need help planning an exercise regimen to help manage my weight." Which stage of health behavior change does this reflect?

Preparation

What professional responsibility does the nurse display as a client’s advocate?

The nurse protects the client’s human and legal rights and provides assistance in asserting said rights.

A child admitted to the hospital is in need of a life-saving heart transplant surgery. However, the parents refuse to allow the surgery stating that such surgeries are against their belief system. The nurse in charge of the client recognizes the situation as an ethical dilemma. What first step should the nurse take in order to resolve the dilemma?

Obtain information from the child, the parents, health care workers, and other sources.

A nurse is educating an older adult for the purpose of promoting wellness. What instruction should the nurse give to reduce the risk of disability?

"Engage in physical activities to stay fit."

A nursing student is listing the characteristics of an ethical issue. Which point listed by the nursing student requires correction?

An ethical issue occurs if the problem aims at the greatest good for the greatest number of people

What role is the nurse expected to have in a community-based nursing practice if there is a sudden spread of malaria?

Epidemiologist

A community nurse takes the initiative to vaccinate people against diseases. What kind of health care service is this?

Preventive care

The nurse provides back massage therapy to a client complaining of back pain. The nurse then monitors the client on an hourly basis to check if the client is feeling comfortable. Which standard of practice does the nurse perform?

Evaluation

A nursing student is evaluating different examples of variables that influence the health beliefs and practices of clients. Which scenario is an example of an external variable?

A client stops taking medications after the disappearance of symptoms to cut down on medical bills.

An adult client with mobility problems wishes to become an organ donor. Which act allows the client to donate his or her organs?

Uniform Anatomical Gift Act

A nursing student is evaluating different scenarios that are examples of following the basic health care principles. Which scenario is an example of following the principle of justice?

A nurse manager encourages the nurses to discuss their mistakes in order to improve the quality of care.

What are the purposes of public health laws? Select all that apply.

-Advocating for the rights of people -Regulating health care and healthcare financing -Ensuring professional accountability for the care provided

List 2 unintentional torts:

1. Malpractice 2. Negligence

An elderly adult suffered an injury after falling down in the washroom. The primary healthcare provider performed a surgical procedure on the client and orders a blood transfusion. A family member of the client mentions that blood transfusions are not permitted in their community. What should the nurse do in order to handle the situation?

The nurse should inform the primary healthcare provider and not give blood to the client.

A nurse advises a client to refrain from adding salt to food as a way to help ease high blood pressure. What kind of health care service is this?

Primary care

A nurse is assessing a client by using Maslow’s hierarchy of needs. In which order should the nurse prioritize care?

1. Physiological 2. Safety & Security 3. Love and belonging 4. Self-esteem 5. Self-actualization

A registered nurse is teaching a nursing student about the characteristics of various healthcare plans. Which statements about preferred provider organizations (PPOs) by the nursing student need correction? Select all that apply.

– Preferred provider organizations reimburse nursing home payments. – Preferred provider organizations cover children who are not poor enough for Medicaid – Preferred provider organizations have deductibles that clients must meet before the insurance pays

What activities would the nurse participate in while providing a primary level of preventive care? Select all that apply.

– Providing education about adequate housing and recreation – Providing education about attention to personality development – Providing instructions about good standard of nutrition adjusted to developmental phases of life

A nurse notes that the primary healthcare provider has scheduled a surgery for an unconscious client. An informed consent has not yet been obtained. What course of action does the nurse expect to be taken to deal with the situation?

The surrogate decision maker designated by the client will give consent.

A nursing student is recalling the importance of the Magnet Recognition Program. Which statements about the program are accurate? Select all that apply.

– The Magnet Recognition Program empowers the nursing team to make changes and be innovative. – The Magnet Recognition Program recognizes health care organizations that achieve excellence in nursing practice. – The Magnet Recognition Program has clinical promotion systems and research and evidence-based practice programs.

What information should the registered nurse provide when educating a nursing student about living wills? Select all that apply.

– Health care workers should always follow the directions of a client’s living will. – Clients use living wills to declare any medical procedures they want or do not want when terminally ill – Living wills are written documents that direct the client’s treatments in the event of a terminal illness or condition.

The nursing supervisor assigns a nurse to care for five clients in the intensive care unit (ICU). The nurse notes that all the clients in the ICU are at a risk of developing serious complications at any time. What course of action should the nurse take to handle the situation?

Submit a written protest to the nursing administrator

A nurse is educating the caregivers of an elderly adult with advanced Parkinson’s disease about continuing care. What information should the nurse provide? Select all that apply.

– "Adult day care centers are ideal for clients whose caregivers have to be away from home during the day." – "Hospice care is a continuing care system that allows clients to live at home with comfort, independence, and dignity." – "Nursing centers provide 24-hour custodial care in order to help residents achieve and maintain their highest level of functioning."

A nursing student is listing the steps that need to be followed to provide competent care for vulnerable populations. Which point listed by the nursing student is accurate?

"Understand the client’s cultural beliefs, values, and practices to determine their specific needs and interventions."

A registered nurse notices that the insertion site of a client receiving intravenous medication is swollen. The nurse takes appropriate measures to treat the area and takes a photo of the insertion site and saves it in the client’s electronic health record. Which Quality and Safety Education for Nurses (QSEN) competency is the nurse following?

Informatics

In today’s healthcare delivery system, a nurse as a teacher is confronted with multiple stressors. What is the major stressor that detracts from the effectiveness of the teaching effort?

Limited time to engage in teaching

What are the advantages of The Health Insurance Portability and Accountability Act of 1996 (HIPAA)? Select all that apply.

– The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides rights to clients and protects employees. – The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects an individual from losing health insurance when changing jobs. – The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides the basis for privacy and confidentiality concerns in the healthcare setting.

What does the resources aspect of the American Nurses Association (ANA) standards of professional performance describe?

When a nurse uses appropriate nursing services that are safe, effective, and financially responsible

A hospitalized client experiences a fall after climbing over the bed’s side rails. Upon reviewing the client’s medical record, the nurse discovers that restraints had been prescribed but were not in place at the time of the fall. What information should the nurse include in the follow-up incident report?

A listing of facts related to the incident as witnessed by the nurse

A nursing student is listing the steps to be followed when communicating with older adults with hearing problems. Which step listed by the nursing student indicates a need for additional training?

"Speak clearly by exaggerating his or her lip movements."

A nurse checks the patency of the IV catheter before each use as well as the client’s tolerance to intermittent intravenous therapy. Which American Nurses Association (ANA) standard of nursing practice has been described in the given scenario?

Evaluation

A client is injured from falling from a hospital bed on which the side rails were not raised appropriately. The client’s family files a malpractice suit against the nurse responsible for taking care of the client. Which statements regarding the lawsuit are accurate? Select all that apply.

– The defendant obtains all of the plaintiff’s medical records in the discovery phase – The jury uses certain standards of care to determine whether the nurse acted properly. – The plaintiff outlines what the defendant did wrong and how it resulted in injury in the pleadings phase.

A registered nurse is teaching a nursing student about Healthcare Effectiveness Data and Information Set (HEDIS). Which point mentioned by the student post-teaching needs correction?

"Healthcare Effectiveness Data and Information Set (HEDIS) conducts surveys via a randomly selected sample of adults who were discharged from a hospital between 48 hours and 6 weeks ago."

A nurse instructs a client who avoids bathing to take a bath or shower each day as a means of maintaining hygiene and preventing infection. Which of these reactions should the nurse expect if the client is in the action stage? Select all that apply.

-"I try to take a shower every day, but I skip it sometimes because of my tight work schedule." -"I understand that bathing regularly is a good habit, but my bathroom is very cold in the mornings." -"I want to take a bath regularly, but I don’t have time because I need to look after my kids and my parents."

Which nursing action is legally required?

Reporting incidents of suspected child abuse to the appropriate authorities

Which statements accurately explain the deontology system of ethics? Select all that apply.

-Deontology examines a situation for the presence of essential right or wrong. -Deontology emphasizes the commitment to respect the "rightness" of autonomy. -Deontology determines that actions are right or wrong based on their "right-making characteristics."

When being interviewed for a position as a registered professional nurse, the applicant is asked to identify an example of an intentional tort. What is the appropriate response?

False imprisonment

A registered nurse is teaching the appropriate manner of acting in a professional environment to a student nurse. Which statements mentioned by the student nurse post-training are accurate? Select all that apply.

-"I should provide care that is consistent with my level of expertise." -"I should remember and follow the policies and procedures of the institution." -"I should use restraints on a client only after obtaining a written order from a primary healthcare provider."

A nursing student is listing the characteristics of various health models that are used in the healthcare setting. Which characteristics of the holistic health model are accurately described? Select all that apply.

-"According to this model, clients are involved in their own healing process." -"According to this model, the natural healing abilities of the body are used." -"According to this model, therapy is used alone or in conjunction with conventional medicine."

A nurse notes that a client is in the habit of skipping breakfast and lunch and educates the client on the harmful effects of not getting enough nutrition. Which responses are signs that the client has reached the action stage of health behavior change? Select all that apply.

-"I still tend to skip breakfast when I’m in a hurry to get to work." -"I follow a proper eating schedule, but sometimes it gets in the way of my work."

The unlicensed healthcare worker assigned to the 7:00 am shift has not been coming to work until 8:00 am. Nursing care is delayed, and assignments are started late. What is the most appropriate action by the charge nurse/team leader?

Document the information before discussing it with the unlicensed healthcare worker.

A registered nurse is teaching a nursing student about the nurse’s professional roles and responsibilities. When does the nurse play the role of an educator?

"A client is being discharged from the hospital setting with an implanted port. The nurse describes the routine care activities to prevent any complications."

Twenty-four hours after a cesarean birth, a client elects to sign herself and her baby out of the hospital. Staff members are unable to contact her primary healthcare provider. The client arrives at the nursery and asks that her infant be given to her to take home. What is the most appropriate nursing action?

???

A nurse is caring for a client who has recently been sleeping for 12 to 14 hours on weekend nights. The nurse instructs the client to sleep for no longer than 9 hours because excessive sleeping can lead to health issues. What reaction might the nurse expect if the client is in the maintenance stage?

"I’ve been following a proper sleep pattern for more than a year."

A nurse notices that a diabetic client is consuming chocolate brought by a family member. Which nursing action should a nurse perform to adhere to the principle of autonomy?

The nurse collaborates with a dietician to obtain a special diet chart for the client

What activities would the nurse state are involved in providing a secondary level of preventive care? Select all that apply.

-Preventing the spread of communicable disease -Providing facilities to limit disability and prevent death -Providing adequate treatment to arrest the disease process

A nurse caring for a client prioritizes nursing actions on the basis of Maslow’s hierarchy of needs. Which statement of the client would meet the self-esteem need?

"I tend to get worried about every little thing because I cannot do anything successfully."

A registered nurse is teaching a nursing student about the importance of values in nursing practice. Which information provided by the registered nurse is appropriate? Select all that apply.

-"Values vary among clients and develop and change over time." -"The values that an individual holds reflect cultural and social influences." -"To discuss differences in opinions and values, the nurse should be clear about his or her own values."

A nursing student is examining different scenarios to understand Quality and Safety Education for Nurses (QSEN) competencies. Which scenarios are examples of the QSEN competency called quality improvement? Select all that apply.

-A nurse prepares a graph to compare the effectiveness of regular nursing practice with traditional healthcare practices. -A nurse designs a new method for ensuring surgical asepsis on the basis of information obtained from facility administrators. -A nurse prepares a flow chart to show the decline in client injuries after implementing a weekly client education program on the use of nurse call lights.

A nursing student is listing points to remember about wellness promotion in older adults. Which points mentioned by the nursing student need correction? Select all that apply.

-"It is essential to focus on curing diseases or other illnesses completely in older adults to promote wellness." -"It is essential to assess the level of fear of falling and provide support accordingly when caring for older adults." -"It is necessary to consider the older adult’s social environment and ensure that he or she lives in social isolation to prevent stress."

The advanced practice registered nurse is the most independently functioning nurse. What are the specific functions of the nurse practitioner as an advanced practice registered nurse in a healthcare setting? Select all that apply.

-A nurse practitioner has the knowledge and skills necessary to detect and manage self-limiting acute and chronic stable medical conditions. -A nurse practitioner provides comprehensive care by directly managing the medical care of clients who are healthy or who have chronic conditions. -A nurse practitioner may establish a collaborative provider-client relationship, working with a specific group of clients or with clients of all ages and healthcare needs.

A nurse is caring for a client who has been admitted to a healthcare facility for the treatment of sinus disorders. The nurse discovers that the client is a cocaine addict. What task followed by the nurse is the best way to deal with the situation?

Assess the client’s drug intake and ensure that the individual does not leave the healthcare facility.

What important teaching strategies should the nurse take into consideration to bring a change in the client’s lifestyle? Select all that apply.

-Use written resources at an appropriate reading level. -Practice active listening, and ask the client how he or she prefers to learn. -Start with identifying what information the client knows regarding health risks related to poor lifestyle choices

A client in need of a lung transplant tells the nurse, "I will not take the organ of any person belonging to a different religion." The nurse initiates the process for resolving the ethical dilemma by collaborating with other healthcare team members. What should the team do after agreeing to a statement of the problem?

The team should determine all the possible courses of action based on available information.

A nurse is caring for a client who has lost both feet in an accident. What course of action should the nurse take to adhere to the Quality and Safety Education for Nurses (QSEN) competency called evidence-based practice?

Refer to medical textbooks to understand the psychological effects of loss of limbs.

A registered nurse is educating a nursing student about community health nursing. Which point made by the student nurse needs correction?

Community health nursing does not provide direct or indirect care services to subpopulations in a community.

A nurse caring for a client who presents with herpes zoster conducts extensive research on the disease to formulate the care plan. In addition, the nurse adds photos of the client’s infected area to the electronic health record (EHR) to evaluate progress toward recovery. The nurse also educates the client on maintaining proper hygiene to prevent the spread of the infection. Which competencies does the nurse display according to the Institute of Medicine (IOM) competencies of the 21st century? Select all that apply.

-Using informatics -Using evidence-based practice -Providing patient-centered care

A nurse understands that the effects of different variables on a client’s health beliefs and practices can help healthcare providers to plan and deliver individualized care. Which statement made by the client should the nurse consider as an influence of the client’s intellectual background on his or her health beliefs?

"Don’t include eggs in my diet because eggs contribute to excess body heat."

A nurse caring for a client prioritizes nursing actions on the basis of Maslow’s hierarchy of needs. Which statement made by the client meets the self-actualization need?

"I want to live because I want to be a good parent to my kids."

A registered nurse is educating a client about the three levels of prevention through different scenarios. Which scenario mentioned by the nurse is an example of secondary prevention?

"A nurse takes charge of screening every client upon suspecting a chicken pox outbreak in the healthcare facility."

A nurse is evaluating different situations related to addressing different levels of client needs. According to Maslow’s hierarchy of needs, in which order should the nurse prioritize his or her actions?

1. Providing a warm bath to the client to promote a good night’s sleep 2. Encouraging the client to talk about his or her fears and feelings 3. Assisting the client in getting out of bed to join family members for meals 4. Praising the client for administering insulin accurately

A client who is to have brain surgery has a signed advance directive in the medical record. In what situation should this document be used?

Client cannot consent to his or her own surgery

A client admitted to the hospital is diagnosed with leukemia. The client’s family members inform the nurse that no blood should be transfused to the client under any circumstances because it is against their belief system. The client however, requests the nurse to carry out all necessary procedures without informing family members. What should the nurse do to comply with the principle of confidentiality according to the American Nurses Association (ANA) code of ethics?

Refrain from repeating the client’s instructions to the family members

The Quality and Safety Education for Nurses (QSEN) initiative addresses the challenge to prepare nurses with the competencies that are required to improve the quality of client care. Which scenario is representative of the teamwork and collaboration competency?

A nurse discusses the development of a special diet chart with a dietician for a diabetic client

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