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67 Cards in this Set

  • Front
  • Back
Mary is assigned to orient a new graduate nurse. She shows him the daily routine of the unit and how to use the charting system and the medication system. Mary is acting in the role of:

Leader
Mentor
Preceptor
Manager
Preceptor
Which of the following is an example of effective followership?
Looks for information to solve only specific problems
Stays in the role of follower no matter what happens to the leader
Collaborates with the social worker and pharmacist to facilitate a patient’s discharge
Always goes along with the leader’s ideas so that the unit runs smoothly
Collaborates with the social worker and pharmacist to facilitate a patient’s discharge
A telemetry unit has recently decided to change the way in which they keep track of the daily rhythm strips recorded each morning for each patient. Susan, the unit manager, has put a letter in each nurse's box regarding the change. In terms of effecting change, Susan is:
A. disseminating information.
B. providing for psychological safety.
C. integrating change.
D. resolving conflict.
Disseminating information
Ramona and Patty are experiencing conflict in their workplace. The unit manager overhears Ramona say to Patty, "Let's take a look at some other options here. Tell me what you think we should do about this issue, and I'll share my thoughts with you." What step of conflict resolution are they working through?
A. Evaluating the resolution of the problem
B. Generating possible solutions
C. Identifying the problem
D. Implementing the solution chosen
Generating possible solutions
An effective nurse manager does not need to concern herself with the unit's budget.
True
False
False
A nurse manager has the ability to use authority, reward, or his clinical expertise as a source of power over employees.
True
False
True
The nurse can delegate a complex wound dressing change to any UAP who is working on the unit for the day.
True
False
False
The nurse is caring for Peter, a 58-year-old man with COPD. Peter's pulse oxygen saturation has declined from 90 to 84% on 2 liters of oxygen. The patient's breath sounds are decreased, and he is now short of breath. The nurse decides that the patient needs a respiratory treatment. This is an example of which of the following?
A. Application of wisdom
B. Stating data
C. Formation of new knowledge
D. Informatics
C. Formation of new knowledge. The nurse has grouped her data and created a meaningful relationship to make a decision. It is more than simply stating data, and knowledge about patient care does not constitute informatics.
Once a week, Mrs. Jones sends data from her implanted cardiac defibrillator via a special computer to the healthcare center 50 miles away. On the basis of the data, the doctor there adjusts her cardiac medications. This is an example of which of the following?
A. Wisdom
B. Telehealth
C. POTS
D. Electronic mail
B. Telehealth
Susan works on a busy rehabilitation unit. She finds a research article containing evidence that putting food coloring in tube feeding solutions increases the incidence of diarrhea in that patient population. She brings the research article to the policy committee to investigate having the policy changed. Susan is doing which of the following?
A. Overstepping her bounds as a nurse
B. Using nursing informatics
C. Creating an electronic health record
D. Participating in evidence-based practice
D. Participating in evidence-based practice. Because Susan is attempting to change a practice routine based on current research. The other choices are incorrect because she is doing more than just using nursing informatics. In addition, there is nothing in the scenario to indicate that she used informatics at all. She is definitely not overstepping her bounds; and an electronic health record pertains to patient information.
The most important advantage of using computerized patient records is that:
A. they make accessing patient information much more convenient.
B. they decrease the number of errors in healthcare delivery.
C. they increase the amount of data available for research.
D. they make charting so much easier for nurses.
B. they decrease the number of errors in healthcare delivery. Although choices A, C, and D might also be true, decreasing the number of medical errors is most important.
_________________________ is a form of electronic communication that would allow participants to pick up on a person's nonverbal language.
Videoconferencing
_________________________ is a format used to store all the healthcare data for a particular patient in a computer database.
Electronic health records
Putting an NCLEX practice exam program on your home computer is an example of installing software.
True or False
True
A pulse rate of 54 bpm is an example of data.
True or False
True
It is good for nurses to all use different terms to describe the same data because this will increase diversity in nursing language.
True or False
False. It should be a professional goal to make our professional language uniform.
It is permissible for student nurses to photocopy patient information to use at home in preparing for a clinical assignment because students are exempt from HIPAA regulations.
False. Students are held to the same HIPAA standards as other members of the healthcare team
Winnona has made the decision to stop smoking; her father was just diagnosed with lung cancer, and she fears that she will also develop this disease. This is an example of which of the following?
A. Health maintenance
B. Health protection
C. Health promotion
D. Health variance
B. Health protection. Winnona is attempting to improve her health, not maintain it. She is motivated to stop smoking because she does not want to die of lung cancer; therefore, it is not health promotion
Which of the following statements would indicate that the patient is likely to comply with her new dietary restrictions?
A. "I am anxious to try the new diet, but I would like to see what my doctor says about it first."
B. "I'll be happy to try the new diet, but you know my disease is going to get the best of me eventually."
C. "Well, we'll see. If fate is on my side, the changes will work."
D. "I'll tell my daughter that we are going to have to buy some different foods now."
D. "I'll tell my daughter that we are going to have to buy some different foods now." The person who has an internal locus of control, according to theory, would be more likely to make positive changes in her behavior.
Which of the following health promotion programs would have the greatest overall effect on the intended participants?
A. A weight loss and management program in a large corporation
B. A diabetes education program held at a community center in a Hispanic neighborhood
C. Prenatal classes held at a local hospital
D. An exercise program begun in a county school system
D. An exercise program begun in a county school system. Health programs aimed at school-aged children are most effective because the children can be exposed to health teaching at many levels on a consistent basis. In addition, they will develop a healthful lifestyle, which will affect their life-long health.
A man builds a gym in his home. He uses the gym on a regular basis to improve his health. As his muscle strength improves, he adds more machines, which in turn, enable him to work on his cardiovascular health. This is an example of which of the following?
A. Pender's Health Promotion Model
B. Wheels of wellness model
C. The model of change
D. Environmental control program
A. Pender's Health Promotion Model. The man is interacting with his new environment, and because it positively affects changes in his health, he further changes his environment. In addition, he is actively regulating his own behavior.
Lifestyle refers to the physical actions we take every day in all our activities.
True or false.
False. Lifestyle also includes emotional, spiritual, and mental aspects.
A person who is getting married would not score many points on the Holmes-Rahe Social Readjustment Scale because a wedding is such a happy event.
True or false.
False. Marriage is a life-changing event that would produce some degree of stress.
It is important for student nurses to reflect on their own health behaviors when planning health promotion interventions.
True or false.
True. Nurses often serve as role models, and we must be aware of how our own unhealthful behaviors will affect our credibility with clients.
Families are of great support to patients who are trying to make lifestyle changes that will promote a high level of wellness.
True or false.
False. This is not always true. Sometimes, certain family members are threatened by or jealous of changes being made.
Which of the following is an example of a vulnerable population?
A. Persons with an annual salary of $50,000
B. Persons living in an apartment complex for single seniors
C. Persons who are members of a health club
D. Persons having Blue Cross health insurance
B. Persons living in an apartment complex for single seniors. Persons who are elderly with little family support are at risk for health problems.
There has been a sudden increase in the number of childhood measles cases in a particular area of a city. To protect the health of the community, which of the following actions should be taken?
A. An acute care nurse should be sent into the community.
B. Community-based care should be instituted.
C. A public health nurse should be sent into the community.
D. A pediatric nurse should be sent to that area of the community.
C. A public health nurse should be sent into the community. The other responses are incorrect. An acute care nurse may not have the knowledge base necessary to deal with community health issues. The same may be said for a pediatric nurse. Community-based care is a global term not specific to the issue presented.
Educating 6-year-olds about prevention of tooth decay is what type of intervention?
A. Primary intervention of a school nurse
B. Secondary intervention of a public health nurse
C. Primary intervention of an occupational health nurse
D. Tertiary intervention of a parish nurse
A. Primary intervention of a school nurse. Primary interventions promote health and prevent disease. For this population, a school nurse would facilitate this educational intervention.
Roger is a public health nurse, and he wants to complete an assessment of the community assigned to him. Which of the following would be the least accurate way to complete this task?
A. Use various public databases
B. Arrange to meet with community focus groups
C. Initiate a telephone survey
D. Complete a windshield survey
D. Complete a windshield survey. All other methods would elicit more actual and complete data than merely observing the community from an automobile.
Hospitals were originally established so that surgeons could perform surgeries in a more sterile environment.
True or false.
False. Hospitals were established to quarantine individuals with contagious diseases.
Student nurses that "meet" in an on-line chat room to discuss student issues could be considered a community.
True or false.
True. Student nurses share a common "language" and special customs, and they have a common purpose.
In a windshield survey, the nurse would place questionnaires on car windshields throughout the community.
True or false.
False. A windshield survey entails observing the community through a car window.
_________________________ may direct nursing care in a flood zone.
The American Red Cross
_________________________ involves coordination, advocacy, and referral between the client and the community resources.
Case management
An example of a/an _________________________ would be women who have survived breast cancer.
aggregate
Juanita is an RN with Fidelity Home Care. She is doing an initial visit with a new client and notes that the home environment is very dirty. There are unwashed dishes, opened food boxes, spilled and dried food, and overflowing trash containers. Which of the following would be an appropriate action?
A. Call in a cleaning service for the client.
B. Notify the home care manager that nurses cannot work in this type of environment.
C. Go to the local market and buy cleaning supplies, and begin cleaning the area.
D. Complete a further assessment of the patient/family situation to determine the cause of the problem.
D. Complete a further assessment of the patient/family situation to determine the cause of the problem.
Although a dirty environment is of concern because of its potential affect on the client's health, the home care nurse must remember that she is a guest in the client's home. The nurse's best approach would be to collaborate with the client in determining a solution.
Which of the following nursing actions facilitates the goal of home health care?
A. Ensuring that a patient is able to take over the care of his ostomy
B. Straight catheterizing a patient every 8 hours
C. Administering subcutaneous insulin twice a day
D. Changing a wound dressing once a day
A. Ensuring that a patient is able to take over the care of his ostomy. The goal of home care nursing is to promote self- care. The nurse may complete the other activities listed (B, C, and D) on a short-term basis, but should be teaching the client or family member these skills as the visits progress.
Medicare would most likely deny reimbursement for home care services for which of the following reasons? The client:
A. is unable to leave her home.
B. needs grief counseling after the loss of a spouse.
C. needs a wound dressing changed three times a day.
D. needs twice-a-day antibiotic therapy for severe osteomyelitis.
B. needs grief counseling after the loss of a spouse. Grief counseling may be done in a variety of settings. There needs to be evidence that the client is homebound for this to be considered as a home care service.
The nurse would recommend hospice care for which of the following patients? One who:
A. requires a variety of rehabilitation services after a cerebrovascular accident (stroke) and is expected to have residual deficits.
B. is a brittle diabetic and cannot get his blood sugars under control.
C. has an acute exacerbation of chronic obstructive pulmonary disease and will require short-term ventilatory support.
D. has been diagnosed with end-stage, irreversible liver failure and is not eligible for transplant.
D. has been diagnosed with end-stage, irreversible liver failure and is not eligible for transplant. A person whose condition is not expected to improve or has limited life expectancy would qualify for hospice care
Identify which professional role the nurse is fulfilling in each of these cases. Choices may be repeated
Calling the pharmacist on the patient's behalf to ask for a generic brand of the medication that is less expensive.
Advocate
Identify which professional role the nurse is fulfilling in each of these cases. Choices may be repeated
Checking the patient’s blood pressure and pulse once a day.
Care provider
Identify which professional role the nurse is fulfilling in each of these cases. Choices may be repeated
Showing a patient how to apply an ostomy appliance.
Educator
Identify which professional role the nurse is fulfilling in each of these cases. Choices may be repeated
Demonstrating the correct technique for intramuscular injection to a family member.
Educator
Identify which professional role the nurse is fulfilling in each of these cases. Choices may be repeated
Including a social worker and a nutritionist in the patient’s plan of care.
Coordinator
The nurse strongly believes in honoring a patient's desire to use herbs as complementary therapy while she is hospitalized. The physician refuses to order the herbs even though there are no obvious drug-drug interactions. The nurse may experience which of the following?
A. Moral dilemma
B. Moral outrage
C. Moral distress
D. Moral defeat
The answer depends on how the nurse sees the situation.
• If the nurse focuses on her own action so that she is unable to do what she believes is right, the answer would be moral distress (response C).
• If the nurse focuses on the physician's actions and judges that the physician is not doing the right thing and that she can do nothing to change it, the answer would be moral outrage (response B).
Which of the following is the best example of an issue reflecting nursing ethics?
A. The physician and the patient's family decide to stop tube feedings for the patient.
B. A patient with a history of drug abuse has not been receiving adequate pain relief because the lowest dose of the PRN narcotic is being given.
C. The physical therapist is refusing to work with a patient who is overweight because she (the physical therapist) believes she will be injured.
D. A patient with a history of alcohol abuse and drug abuse will receive a liver transplant.
B. A patient with a history of drug abuse has not been receiving adequate pain relief because the lowest dose of the PRN narcotic is being given. The nurse would be choosing from a range dose of pain medication, and the ethical decision would be to medicate the patient for pain without passing judgment on the patient's past behavior. The other responses are incorrect because the nurse is not a participant in the final decision to withhold feedings (response A) or to transplant the liver (response D) or in the physical therapist's decision (response C).
Suzie is instructed by the charge nurse of the unit to restrain her confused, older patient. Suzie believes she can control the patient's behavior by using alternative means, such as music therapy and calling in the patient's family. Suzie is honoring which of the following moral principles?
A. Nonmaleficence
B. Autonomy
C. Fidelity
D. Veracity
A. Nonmaleficence. The other responses are incorrect because a confused patient may not be competent enough to make his own decisions (autonomy), there was no promise made in this scenario (fidelity), and this is not an example of having to tell the truth (veracity).
Mike, who is a charge nurse, thinks that honesty is very important. His co-worker on the pediatric unit has come in late for the second day in a row, yet she is signing in as "on time." The co-worker begs Mike not to report her to the supervisor. Which of the following is Mike is being asked to compromise?
A. Integrity
B. Values
C. Beliefs
D. Attitude
B. Values
The law requiring children to be vaccinated against diphtheria can best be justified by using which of the following moral frameworks?
A. Feminine ethics
B. Autonomy
C. Deontology
D. Utilitarianism
D. Utilitarianism. Utilitarianism uses the principle of utility: that an act must result in the greatest good for the greatest number of people. Vaccinations will protect entire populations. This would be opposite of the deontological perspective in which a parent may not want a child vaccinated because of fears of autism.
Match the following terms and descriptions:
Terms Descriptions
1. Kohlberg
2. Whistleblowing
3. Veracity
4. Ethical dilemma
5. Formalism A. Identification of an unethical practice to authorities
B. A moral principle
C. Progressing levels of moral development
D. System of ethical decision making
E. Two equally undesirable actions
Answer:
1, C
2, A
3, B
4, E
5, D
Putting aside the value of monogamous relationships to care for a person who has multiple sex partners is an example of value _________________________.
Neutrality
A patient has the right to choose to stop dialysis. This illustrates the moral principle of _________________________.
Autonomy
_________________________ is used by the State Board of Nursing to evaluate a nurse's ethical behavior.
The Nursing Code of Ethics
Dr. Land has requested privileges to admit and monitor patients at the community hospital. A license check by the hospital administrator reveals that there have been four judgments against Dr. Land for unsafe medical practice. The hospital ethics committee will meet to discuss granting privileges to Dr. Land. Which of the following models will the ethics committee most likely follow as they review Dr. Land’s case?
The social justice model
The patient benefit model
The autonomy model
The privilege to practice model
The social justice model focuses more on broad social issues involving the entire institution rather than on a single patient issue.
Community health nurses assume which of the following roles?
Manager, leader and follower
Direct care provider, manager, and community leader
Client advocate, educator, and collaborator
Leader, counselor, and teacher
Client advocate, educator, and collaborator. Community health nurses function as client advocates, counselors, case managers, educators and collaborators.
The first step in conflict resolution is to :
Generate possible solutions
Evaluate the resolution to the problem
Evaluate suggested solutions
Identify the problem
Identify the problem. Once the problem is identified, the next step is to generate possible solutions. Possible solutions are then evaluated for success and feasibility. The optimum solution is selected, implemented, and then evaluated for success.
Which of the following predictions about home care is/are accurate? Select all that apply.
High tech care in the home will continue to grow
There will be less use of the home for hospice care
The use of home care services will decline as more nurses work in the hospital
Home care will continue to be a cost-effective way of delivering care
High tech care in the home will continue to grow.
Home care will continue to be a cost-effective way of delivering care.
Health care analysts predict that home care will continue to grow, hospice and technological services in the home will expand, and research on benefits of home care will continue.
A nurse is documenting her assessment in the patient’s electronic health record (EHR) while seated at a computer in the nursing station. Dr. Wayne approaches her and asks her to access the patient’s HER so that he can look at this patient’s laboratory report. What should the nurse do?
Access the laboratory report for Dr. Wayne
Log off the computer and then allow Dr. Wayne to log on
Inform Dr. Wayne that she must complete her documentation first
Allow Dr. Wayne to sit down and access the lab report without logging out
Log off the computer and then allow Dr. Wayne to log on.
Accessing information that is not relevant to the care the nurse is providing is a HIPAA violation. The nurse should never allow anyone to use her password to access information.
Miss Dennison has decided to quit smoking and is preparing to ensure she is successful in this endeavor. Which of the change stages, identified by Prochaska and DiClemente, is Miss Dennison in? The stage of:
Determination
Contemplation
Precontemplation
Action
The determination stage exists when a decision to change a behavior has been made and a plan is prepared.
Mrs. Sloane had surgical repair of a rotator cuff injury and is now participating in physical therapy. This is an example of:
Primary prevention
Secondary prevention
Tertiary prevention
Health promotion
Tertiary prevention focuses on stopping the progress of the disease and returning the individual to the pre-illness phase. Rehabilitation is the main intervention during this level.
Which of the following groups represent(s) a vulnerable population? Select all that apply.
Persons with HIV
Middle age adults
School-age children
Pregnant teens
Persons with HIV and pregnant teens.
Vulnerable populations include those with limited economic or social resources, the very young and the very old, those with chronic disease, and people who have experienced trauma or abuse.
A unique feature of home care is:
Only skilled services are reimbursed
The nurse has increased access to the health care team
The environment is more controlled
The nurse sees the patient in his personal environment
The nurse sees the patient in his personal environment.
Skilled needs are required in order for the client to be eligible for home care services; however, other services are available and reimbursable as long as the primary need for services is skilled care. In the home setting, the nurse has less access to other members of the health care team, and the environment is less controlled
The home health nurse is reviewing several cases referred from a local physician’s office. She is charged with assessing which services are eligible for home health coverage. Which one of the following will she select?
Care for a new wound that requires assessment and monitoring in a bed-bound patient
Assessment of a central venous access device in a mobile patient
Patient teaching on diabetes and its management for an employed person
Homemaker services for a healthy, frail, older woman
Care for a new wound that requires assessment and monitoring in a bed-bound patient.
Only skilled services are eligible for coverage and reimbursement by most insurance policies.
There has been an accident involving two busloads of school children. All of the accident victims have been transported to the local emergency department (ED). The ED is overwhelmed. As a result, the ED physician is triaging the children to determine who will receive treatment first. On which moral framework is the physician basing his decisions?
Teleology
Utilitarianism
Deontology
Categorical imperative
Utilitarianism states that the value of an action is determined by its usefulness. When using this framework, the action that results in the most benefits for the greatest number of people involved is preferred.
A community health nurse works in a sexually transmitted infection (STI) clinic. She sees clients who believe thy have contracted an STI. What type of nursing interventions does this nurse perform?
Primary intervention
Secondary intervention
Tertiary intervention
Primary and tertiary interventions
Secondary intervention aims to reduce the impact of the disease process by early detection and treatment.
A ________________ is someone with more experience who provides practical teaching, role modeling, and guidance for a student or new employee.
Preceptor
________________ is the systematic study of right and wrong conduct in situations where there are issues of values and morals
Ethics