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Q:
The nurse is engaged in a relationship with a client. Which action should the nurse take when in the continuation phase of this relationship?
1. Identify major problems
2. Anticipate issues once discharged
3. Teach how to self-administer insulin
4. Recognize barriers to communication
Q:
The nurse is caring for a client newly diagnosed with heart failure. Which nursing statement encourages the client to express thoughts and feelings?
1. "Please tell me how I can help you learn to manage this health problem."
2. "Oftentimes heart failure can be prevented with proper diet and exercise."
3. "Many of my clients have your same health problem and they are doing very well."
4. "Would you mind holding any questions until I review your healthcare provider's care orders?"
Q:
The nurse is preparing to meet a newly admitted client. What should the nurse do first?
1. Ask the client for feedback
2. Introduce herself to the client
3. Ask if the client has any questions
4. Check client ID with two forms of identification
Q:
The nurse is completing a spiritual assessment as part of a health history with a newly admitted client. Which question should the nurse use to learn more about this client's spirituality? Select all that apply.
1. "Do you like your religion?"
2. "How often do you attend religious services?"
3. "Do you follow any particular religious practices?"
4. "Isn"t it difficult to have to go to church every Sunday?"
5. "How can I ensure that your religious practices are followed in the event of a health crisis?
Q:
The nurse is preparing to assess a client who has lived in the United States for 6 months. What should the nurse include to ensure cultural sensitivity? Select all that apply.
1. Education
2. Nutrition practices
3. Family relationships
4. Cultural background
5. Access to a computer
Q:
The nurse asks to attend a seminar on cultural diversity. What was the primary reason for the nurse making this request?
1. Improve ability to care for pediatric clients
2. Decide if a home care position should be accepted
3. Recognize the special needs of an aging population
4. Understand care issues of non-English speaking clients
Q:
The nurse manager is observing a new graduate provide client care. Which statements should the manager identify as being barriers to communication? Select all that apply.
1. "What a beautiful day! I love bright sunshine!"
2. "If it were me I would take the new medication."
3. "You gave yourself the insulin injection very well."
4. "You shouldn"t worry so much about your surgery."
5. "I think it was right for you to delay having the surgery."
Q:
The nurse is reviewing data collected during a health history. Which statement should the nurse use to clarify information?
1. "I hear what you"re saying."
2. "When you say that, it makes me feel uncomfortable."
3. "I don"t understand. Can you say it in a different way?"
4. "You were telling me how hard it is to talk to your spouse."
Q:
During an assessment a client answers no questions and tells the nurse to talk with the spouse who is due to arrive later in the day. What can occur with this situation?
1. Noncompliance
2. Enhanced rapport
3. Situational awareness
4. Dysfunctional communication
Q:
A visitor asks the nurse questions about a client's health status. What should the nurse respond to this individual?
1. "I can tell you that the client is not doing very well."
2. "That information cannot be shared without the client's permission."
3. "Please keep this to yourself. The client needs to go on hospice soon."
4. "Since you are a visitor I can tell you that the client will be here for a few more days."
Q:
The nurse educator is preparing an inservice presentation about communication. What should the nurse emphasize during this training?
1. Communication is an optional task
2. Communication is a sense of self-pride
3. Communication is an essential part of nursing care
4. Communication ensures the provision of quality nursing care
Q:
The nurse is caring for a group of clients. Which nursing behaviors exemplify communication about these clients' care? Select all that apply.
1. Making a check mark on a care tracking sheet
2. Initialing and dating an entry in the medical record
3. Volunteering to participate in an upcoming seminar
4. Reading the results of laboratory and diagnostic tests
5. Discussing a client's response to pain medication with the care provider
Q:
The nurse is completing a tool to help coordinate care needed for several clients. What should the nurse identify as a task that must be completed at a specific time for a client?
1. Evaluating the amount of food a client ingested after lunch
2. Providing intravenous medication before a peak blood level is drawn
3. Measuring urine in a collection bag before attending afternoon report
4. Checking the results of laboratory tests before documenting end of shift care
Q:
The nursing student is using a data collection tool while researching a client assignment before clinical the next day. In which category should the student document the client's use of oxygen?
1. Medications
2. Biographical data
3. Nursing interventions
4. Physical assessment findings
Q:
After delegating an aspect of care to unlicensed assistive personnel (UAP) the nurse answers any questions and is available while the care is being provided. Which "right of delegation" is this nurse performing?
1. Person
2. Direction
3. Supervision
4. Circumstances
Q:
The nurse is preparing to electronically enter data in a client's medical record. For which reason could a legal issue occur?
1. Obtains password taped under keyboard
2. Logs out of the record before leaving the terminal
3. Shreds laboratory reports after using them during report
4. Turns off the monitor when approached by a family member
Q:
The nurse is preparing a consent form for a client's signature. For which reason is this form most likely needed?
1. Chest x-ray
2. Drawing a blood sample
3. Measuring blood pressure
4. Biopsy of an abdominal mass
Q:
The nurse manager notes that documentation in the medical record about a client's fall does not match the information identified on the occurrence report. What could be the potential outcome of this inconsistency?
1. A court case would not occur
2. Valuable information would be forgotten
3. Client's hospitalization could be prolonged
4. Termination of the nurse completing the occurrence form
Q:
During morning care a client states that pain medication has been ineffective and wants to talk with the healthcare provider. How should the nurse categorize this information?
1. A variance
2. A complaint
3. Adverse effect
4. Subjective data
Q:
The preceptor is reviewing the content of a new graduate's documentation of client care. What areas should the preceptor easily identify in this notation? Select all that apply.
1. Questions asked by the family
2. Changes in the client's condition
3. Teaching and the client's response
4. Reactions to non-routine medications
5. Assessment made at the beginning of the shift
Q:
An organization uses the SOAP documentation format. In which area should the nurse document the appearance of a client's abdominal wound?
1. Plan
2. Objective
3. Subjective
4. Assessment
Q:
The nurse is preparing to make an entry into a client's medical record after completing morning care and providing medications. What should the nurse ensure when completing this documentation? Select all that apply.
1. Time care was provided
2. Client's response to care provided
3. Time medications were administered
4. Estimated date for goals to be achieved
5. Client's reaction to medications provided
Q:
After providing medications and changing a dressing the nurse accesses the client's computerized medical record and enters the information about the care provided. Why is the nurse documenting at this time? Select all that apply.
1. Evaluates individual performance
2. Helps determine the staffing needs of the care area
3. Estimates the amount of time required to provide care
4. Communicates information to other members of the team
5. Provides a permanent record of the care provided to the client
Q:
The nurse is meeting with physical therapist and a dietitian to review care for a client recovering from a stroke. Which tool is the nurse most likely using to coordinate this client's care?
1. Critical pathway
2. Variance analysis
3. Standardized care plan
4. Individualized care plan
Q:
The nurse notes that a client intervention has a deadline occurring in 3 days. What should this information indicate to the nurse?
1. The action should be observed every 3 days
2. The action should be completed every 3 days
3. The action should be documented every 3 days
4. The action will no longer be necessary in 3 days
Q:
The nurse identifies problems for a specific client. What action should the nurse perform next when planning this client's care?
1. Identify outcomes for care
2. Determine resources needed for care
3. Translate the needs into nursing diagnoses
4. Select appropriate interventions to address the needs
Q:
The nurse is reviewing data collected during a client assessment. Which information should the nurse identify as a client need? Select all that apply.
1. Desires to walk without a cane
2. License to drive has been suspended
3. Attends religious services every Sunday
4. Spends time with family every winter in Florida
5. Experiences shortness of breath with ambulation
Q:
After report the nurse reviews a standardized care plan for an assigned client. Where should the nurse find the current active problems identified for the client?
1. Look at the problem list area on the Kardex
2. Read the notes written about specific problems
3. Ask the charge nurse where the problems are located
4. Identify the areas with check marks placed on the care plan
Q:
A newly admitted client says desires to have surgery to replace a knee and then return home as soon as possible to resume living. On which part of the care plan should the nurse document this information?
1. Client problems
2. Short-term goals
3. Assessment data
4. Nursing interventions
Q:
The nurse manager determines that a staff nurse uses critical thinking when planning the outcomes for a client's care. What did the manager observe to come to this conclusion?
1. Prioritized client problems
2. Critically analyzed all client outcomes
3. Clustered data to determine relationships
4. Used a systematic approach to collect data
Q:
The nurse is explaining evidence-based practice to a group of new nursing students. Which statement should the nurse use during this explanation?
1. "Evidence-based nursing practice generates new knowledge."
2. "Evidence-based nursing practice applies knowledge to practice."
3. "Evidence-based nursing practice is measurable, time specific, quantifiable, and realistic."
4. "Evidence-based nursing practice is based on the best evidence available from nursing research."
Q:
The manager is reviewing care plans created for newly admitted clients. Which nursing diagnostic statement should the manager review with the nurse as needing to be amended?
1. Risk for injury related to left sided paralysis
2. Fluid volume overload related to congestive heart failure
3. Impaired coping related to recent death of spouse and son
4. Imbalanced nutrition: Less than body requirements related to mouth and throat ulcers
Q:
The nurse is identifying nursing diagnoses appropriate for a client's health issues. Which information should the nurse include when creating a three-part diagnostic statement?
1. Interventions
2. Learning needs
3. Expected outcomes
4. Signs and symptoms
Q:
The nurse is researching nursing interventions appropriate for a particular nursing diagnosis. Which classification system should the nurse use when researching this information?
1. NIC
2. PES
3. NOC
4. NANDA
Q:
The nurse is explaining nursing diagnoses to a group of first-year nursing students. What should the nurse include in this explanation? Select all that apply.
1. Focuses on client responses
2. Focuses on injury, illness, or disease
3. Requires physician orders to address
4. Remains the same until client discharge
5. Changes according to the client's needs
Q:
A client is being prepared for discharge. What should the nurse perform when evaluating this client's care? Select all that apply.
1. Reassess care plan
2. Record client responses
3. Determine effects of nursing actions
4. Communicate to client and client's family
5. Examine appropriateness of nursing actions
Q:
The nurse is implementing a client's plan of care. Which action should the nurse perform at this time?
1. Record relevant information
2. Motivate and maintain optimum wellness
3. Coordinate care and community resources
4. Anticipate needs of client and family based on priorities
Q:
The nurse is completing the planning phase of the nursing process with a client. Which should the nurse perform during this phase? Select all that apply.
1. Identify short- and long-term goals
2. Strategize approaches for goal outcomes
3. List nursing measures when delivering care
4. Create outcomes that are measurable and realistic
5. Organize defining characteristics of data into meaningful patterns
Q:
The instructor is preparing a lecture on the nursing process. Which statement should the instructor use that best describes nursing diagnosis?
1. It is an educated judgment about a client's potential or actual health problems
2. It refers to the priority nursing actions or interventions performed to accomplish a specified goal
3. It involves the careful acquisition and interpretation and use of information to reach a conclusion
4. It is the action of thinking back about an earlier clinical situation, recalling actions that worked or didn"t work, and determining if this information is helpful in the current situation
Q:
After completing an assessment the nurse analyzes all data collected. What is the significance of the nurse performing this analysis?
1. Confirms observations
2. Identifies client outcomes
3. Establishes a foundation for the client's care
4. Prioritizes interventions according to client needs
Q:
The nurse is preparing to assess a client new to the out-patient care environment. Which actions should the nurse expect to complete during this phase of the nursing process? Select all that apply.
1. Complete a client interview
2. Conduct a physical examination
3. Analyze test results and findings
4. Categorize data into meaningful patterns
5. Identify pertinent family health history issues
Q:
The nurse collects data slowly and methodically from a new client. Why is the nurse using this approach during this phase of the nursing process?
1. Ensures accuracy of data
2. Identifies client outcomes
3. Establishes a rapport with the client
4. Highlights the importance of the therapeutic relationship
Q:
After receiving morning report the nurse categorizes an assigned client's care according to priority needs. How does this behavior support the nursing process?
1. Organizes and structures care
2. Emphasizes client preferences
3. Follows Maslow's hierarchy of needs
4. Considers time needs for each nursing action
Q:
The nurse is reviewing care provided to a client. Which behavior indicates that the nurse is using critical thinking?
1. Administers prescribed medications
2. Studies the results of diagnostic tests
3. Individually analyzes client problems
4. Documents responses to care provided
Q:
The nurse is assigned to care for a newly admitted client. Which approach should be used to address the client's responses to the illness?
1. Best practices
2. Nursing process
3. Critical thinking
4. Evidence-based practice
Q:
The nurse is planning care for a newly admitted client. Which behavior indicates that the nurse is using critical thinking?
1. Recalls a similar client situation
2. Asks the healthcare provider for suggestions
3. Looks at a care plan written for another client
4. Expects the oncoming nurse to complete the care plan
Q:
A client refuses to complete an advance directive because he is not "ready to die." What should the nurse respond to this statement?
1> "It's best to be safe than sorry."
2> "You are right " it is more appropriate for someone who has a terminal illness."
3> "That's fine. I"ll just document that you refuse to decide your medical treatment."
4> "It is a document that allows you to make legal decisions about how you wish to receive future medical treatment."
Q:
What should the nurse include when reviewing the Patient Care Partnership brochure with a newly admitted client?
1> Visiting hours
2> Times for meals
3> Help with billing claims
4> How to avoid paying for medications
Q:
A client asks for a copy of the medical record to take home upon discharge. What action should the nurse take regarding this request?
1> Prepare the requested documentation
2> Tell the client that the record belongs to the hospital
3> Explain to the client that the record cannot be provided
4> Ask the health care provider if the medical record can be provided
Q:
What action should the nurse take to ensure the safe administration of prescribed medications to a client? Select all that apply.
1> Validating the healthcare provider's order
2> Checking two forms of client identification
3> Leaving a client's medications at the bedside
4> Returning a mislabeled medication to the Pharmacy
5> Deciding to report a medication error later in the shift
Q:
The nurse manager is contacting the Board of Registered Nursing (BRN) to report a staff member. Which action did the manager most likely observe the staff member perform?1> Changing a client's abdominal wound dressing2> Instructed a client on self-administration of insulin3> Assisting a client with ambulation to the bathroom4> Informing a client to stop taking a prescribed medication
Q:
For which reasons should a registered nurse contact the Board of Registered Nursing (BRN)? Select all that apply?
1> Renewing nursing license
2> Determining nursing standards
3> Identifying the date for a disciplinary hearing
4> Checking the dates for continuing education programs
5> Ascertaining when a nurse applicant became licensed
Q:
The nurse is asked to perform a task that is beyond the scope of practice. What should the nurse use as a reason when refusing to complete the task?
1> "It is not a part of the National Patient Safety Goals."
2> "The Joint Commission does not identify it as a nursing task."
3> "It is not identified as permitted within the Nurse Practice Act."
4> "The task can be delegated to unlicensed assistive personnel (UAP)."
Q:
Which document should the nurse refer to ensure safe care is being provided to a client?
1> Core measure sets
2> Nurse practice act
3> Joint Commission standards
4> National patient safety goals (NPSGs)
Q:
What actions should the nurse take to assist a client adapt to being hospitalized? Select all that apply.
1> Ensuring for the client's comfort
2> Completing the admission assessment
3> Attempting to accommodate the client's wishes
4> Communicating with the client as an individual
5> Accepting the client's perception of the environment
Q:
Which behavior indicates that the nurse is practicing as a professional?
1> Documenting that a client needs pain medication
2> Visiting with family of a client on another part of the care area
3> Telling a client to ask the next nurse for help getting out of bed
4> Directing unlicensed assistive personnel (UAP) to measure urine output
Q:
The nurse is caring for several clients during the shift. Which action demonstrates appropriate hand hygiene?
1> Putting on gloves
2> Washing hands with soap and water
3> Wiping hands off when entering room
4> Using the client's soap on hands
Q:
For which situation should the nurse apply clean disposable gloves?
1> Providing denture care
2> Bathing a client
3> Applying antiemboli stockings
4> Assessing vital signs
Q:
The nurse is working in a day care center where there recently has been an outbreak of viral conjunctivitis. What should the nurse instruct the staff to stop the spread of this infection?
1> Require all children with conjunctivitis to stay home until there is a reduction in drainage.
2> Require all children with an infection to be on otic antibiotics for at least 24 hours prior to returning to school.
3> Isolate all children with conjunctivitis in the same room away from those who are not infected.
4> Perform hand hygiene after providing personal care for all children.
Q:
The nurse observing the unlicensed assistive personnel (UAP) using alcohol-based rubs for hand hygiene would recognize that further teaching is required when the UAP performs which act?
1> Rubs palm against palm when washing hands.
2> Applies a palmful of product into cupped hands.
3> Interlaces fingers palm to palm.
4> Dries hands with clean paper towel.
Q:
Which statement indicates that unlicensed assistive personnel (UAP) understand directions provided regarding client care?
Standard Text: Select all that apply.
1> "I will bathe the client in room 402."
2> "I am done with the assigned tasks for Mr. Wells."
3> "I can give the medication for you."
4> "I will note all orders."
5> "I understand my assignment is to take and document the vital signs."
Q:
Which procedure should the registered nurse delegate to unlicensed assistive personnel (UAP)?
1> Making a nursing diagnosis
2> Assisting a client to bedside commode
3> Performing assessments on client
4> Giving the client pain medication
Q:
Which tasks would be appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)?
Standard Text: Select all that apply.
1> Taking vital signs
2> Measuring and recording intake and output
3> Postmortem care
4> Providing telephone advice
5> Weighing the client
Q:
Discuss the effects that grieving can have on one's health. Identify what one can do to effectively cope with grief.
Q:
Identify reasons why the number of reported near-death experiences have increased, and discuss two types of these near-death experiences.
Q:
Outline the five stages of Kbler-Ross' emotional responses to death with a brief description of each stage.
Q:
List and describe the different categories of death.
Q:
Identify the "Five Wishes" that help people prepare for medical crises.
Q:
Match the items below with the most appropriate description.
a. dementia
b. anger
c. subdromal hot flash
d. death
e. autoscopy
f. senesce
g. osteoporosis
h. denial
i. intestate
j. autopsy
1) night sweats
2) without a will
3) when the heart stops
4) death of egg cells
5) "no, not me."
6) watching resuscitation attempts
7) loss of mental capabilities
8) loss in bone density
9) exam of a body after death
10) "why me?"
Q:
The active form of "mercy killing" known as ____________________ is generally viewed as illegal and unethical.
Q:
____________________ is the incineration of an individual's remains.
Q:
____________________ occurs when a health professional provides a patient with the means to end his or her life.
Q:
One of the main factors leading to suicide is ____________________.
Q:
Due to advances in emergency medical care, the number of reported ____________________ experiences has grown.
Q:
One positive aspect of ____________________ programs is the medical and emotional care offered to both patients and family members or caregivers.
Q:
The second stage of responding to death when a patient learns that death is coming is called ____________________.
Q:
The moment the soul leaves the body is considered ____________________ death.
Q:
A(n) ____________________ document helps the aged, the seriously ill, their loved ones, and caregivers prepare for medical crises.
Q:
A(n) ____________________ DNR specifies an individual's wish not to be resuscitated at home.
Q:
Women, who have smaller skeletons, are more susceptible to ____________________ than men.