final exam review Flashcards
a case management nurse is preparing to initiate referrals for a client as part of discharge planning. which action would the nurse take first?
A. monitor the clients satisfaction with the referral
B. provide the client information to referral agencies
C. review available resources with the client
D. identify referrals that the client needs
D. identify referrals that the client needs
a case manger is discussing critical pathways with a group of newly hired nurses. which statement by the new nurses indicates understanding ?
A. the time to fill out the pathways often increases the cost of care
B. the pathway shows an estimate of the number of days the client will be hospitalized
C. deviance from the pathway is sign of improved care quality
D. the pathway includes information about the clients history
B. the pathway shows an estimate of the number of days the client will be hospitalized
a community experiences an outbreak of meningitis and hospital beds are urgently needed which client would he nurse recommend for discharge ?
A. a client newly admitted with angina and a history of MI 1 year ago
B. a client who was pre-admitted for rotator cuff surgery and has T2DM.
C. a client admitted the dat before with pneumonia and dehydration
D. a client who has a fractured hip and is scheduled for total hip replacement the next day?
B. a client who was pre-admitted for rotator cuff surgery and has T2DM.
a community health nurse is implementing health programs with several populations in the local area. which situation is an example of the nurse using primary prevention?
A. performing a home safety check at a clients home
B. teaching healthy nutrition to clients who have HTN
C. providing influenza immunization to employees at a local preschool
D. Implementing a program to notify individuals exposed to a communicable disease
C. providing influenza immunization to employees at a local preschool
a community health nursing case manager is assigned the case of a 12 y.o boy diagnosed with Diabetes mellitus. he is unreceptive to learning and does not want to learn to read the glucometer or give his own insulin injections. he eats what he wants without regard for his blood sugar . which suggestion by the nurse would be the most appropriate to help keep this child form feeling alone in regards to his diabetes ?
A. encourage his parents to home school him
B. encourage the school nurse to discuss his diabetes with him
C. encourage him to attend a diabetic support group for all ages
D. encourage him to attend a diabetic camp for preteens.
D. encourage him to attend a diabetic camp for preteens.
a home health nurse has adjusted his schedule to visit the following 4 clients today. which client would the nurse see first ?
A. a client with schizophrenia who will need a risperidone injection
B. a client who has COPD and is experiencing increased SHOB
C. a client receiving chemotherapy who will need blood drawn
D. a client with a recent MI who will need an initial assessment.
B. a client who has COPD and is experiencing increased SHOB
a nurse at your facility has been observed diverting drugs. the supervisor has been notified. which would the healthcare facility do to assist the nurse who is diverting , receive the best help with this problem ?
A. insist the nurse seek the guidance from personal counselor or treatment program
B. refer the nurse to the employee assistance proGRM (EAP) provided by the hospital
C. suggest that the nurse obtain the council of a layer for a charge of stealing
D. notify the board of nursing for referral to an alternative program
D. notify the board of nursing for referral to an alternative program
a. nurse has just assisted a Client back to bed after a fall. the nurse and healthcare provider have assessed the client and have determined that the client does not appear to be injured. after completion the incident report which action would the nurse implement first ?
A. conduct a staff meeting to discuss the fall
B. contact the nursing supervisor
C. document in the electronic chart the incident report was completed
D. reassess the client
D. reassess the client
a nurse is accused of professional negligence. in determining if the nurse is guilty . which standard would a jury compare to the incident in question?
A. what a lawyer would have done in the same situation
B. what a health care provider would have done in the same situation
C. what a reasonable and prudent nurse would have done in the same situation
D. what well educated layperson would have done in the same situation
C. what a reasonable and prudent nurse would have done in the same situation
a nurse is caring for a client who is from a different cultural. when beginning the cultural assessment , which action would the nurse take first ?
A. determine the clients perception of their current health status
B. gather data about the clients cultural beliefs
C. determine how the clients culture can affect the effectiveness of nursing action
D. gather information about previous client interactions with the health care system
B. gather data about the clients cultural beliefs
a nurse is caring for an elderly client who has been in a healthcare facility for 3 weeks d/t hip replacement surgery and pulmonary complications. the nurse notes development of decubitus ulcer on the clients coccyx area. which nursing action would be most appropriate to obtain a collaborative plan of care?
A. notify the unit manager that staff may not be consistently or effective carrying out the skin care protocol for high risk clients
B. develop a nursing care plan “ risk for impaired skin integrity”
C. facilitate a consult with the wound care nurse
D. bring the problem to the attention of the surgeon during rounds
C. facilitate a consult with the wound care nurse
a nurse is conducting health screenings at a statewide health fair and identifies several client who require referral to a health care provider. which statement by a client indicates barrier to accessing healthcare ?
A. “ I have made a list of local doctors but I am having trouble narrowing it down to the one I believe that would be best for me”
B. “I can’t take off during the day , and local after hours clinic is no longer in operation
C. only one doctor in my town is designated provider by my health maintenance Organization
D. I would like to schedule an appointment with the local doctor in my town who speaks Spanish and English
B. “I can’t take off during the day , and local after hours clinic is no longer in operation
a nurse is developing a community health education program for a group of clients who have a new diagnosis of diabetes mellitus. which learning strategy would the nurse include for clients who are auditory learner?
A. show photograph of sites for injection
B. provide equipment to practice hands on skills.
C. supply outlines of note -taking
D. facilitate small group discussion
D. facilitate small group discussion
a nurse is planning safety interventions at a new clinic. which intervention would the nurse include ?
A. have staff who will be performing X-rays wear dosimeters
B. provide both latex and non-latex gloves for employees
C. place sharps containers outside clients rooms
D. provide electrical tape for staff to repair frayed cords
A. have staff who will be performing X-rays wear dosimeters
a nurse is serving on a continuous quality improvement committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. which strategy would the committee plan to initiate first ?
A. provide an inservice on medication administration to all the nurses
B. require staff nurses to demonstrate competency by passing a medication administration examination
C. review the events leading up to each medication administration error
D. develop a quality improvement program for nurses involved in medication administration errors
C. review the events leading up to each medication administration error
a nurse manager is reviewing the history of four adults who were admitted to the medical surgical unit during the shift . which client situation is the nurse required to disclose information to an outside agency
A. a dependent adult admitted for the treatment of a spiral fracture
B. a young adult client admitted for asthma who has track marks that may indicate IV drug abuse
C. a young adult client admitted for acute Glomerulonephritis following a viral infection
D. an emancipated minor who has active appendicitis and wants to leave the facility without treatment
A. a dependent adult admitted for the treatment of a spiral fracture
a nurse on a quality control committee is evaluating the results of recently implemented measures designed to reduce the client medication errors. which method would the nurse use to evaluate the success of the recently implemented measures ?
A. establish a benchmark to identify a standard of performance
B. compare the number of medication errors before and after the actions were implemented
C. provide staff with a questionnaire to quantify staff satisfaction with the changes
D. conduct a study about the time and money costs of implementing the changes
B. compare the number of medication errors before and after the actions were implemented
a nurse terminates employment without giving the facility the required two week notice one month later the nurse manager receives a call from the personnel director at a different hospital requesting a reference for this nurse. which would be the nurse managers best response to this request?
A. the nurse worked here for several months before leaving abruptly
B. the nurse was irresponsible and did not give a two week notice
C. the nurse worked here from November 1 1993- April 9 2012
D. you will be lucky to hire a nurse of his caliber”
C. the nurse worked here from November 1 1993- April 9 2012
a nurse who works the night shift enters the medication room and finds a coworker with a tourniquet wrapped around the upper arm. the co-worker is about to insert a syringe containing clear liquid , into the antecubital area. which would be the appropriate initial action by the nurse ?
A. call security
B. call the nursing supervisor
C. lock the co-worker in the medication room until help arrives
D. call police
B. call the nursing supervisor
a nurse witnesses and assertive personnel they are supervising reprimanding a client for not using the urinal properly. the AP threatens to put a diaper on the client if the urinal is not used more carefully next time. which tort is the AP committing ?
A. assault
B. battery
C. False imprisonment
D. invasion of privacy
A. assault
a nurse is working for a home health agency is assessing an older adult male client. which assessment data would be primary to address
A. dysphagia
B. swollen gums
C. urinary hesitancy
D. pruritus
A. dysphagia
a female client asked the nurse to explain her lab results. the nurse tells the client that he must first assist another client to the bathroom and then he will return to explain the results. the nurse proceeds to assist the other client to the bathroom and then returns to explain the results to the female clients . which moral principle has the nurse displayed
A. non-malifence
B. Confidentiality
C. Autonomy
D. fidelity
D. fidelity
a client has sustained a spinal cord injury and is no longer able to get in and out if the bathtub without assistance . which nursing diagnosis appropriately addresses this problem ?
A. feeding self care deficit
B. bathing self care deficit
C. dressing self care deficit
D. activity intolerance
B. bathing self care deficit
a client who has recently traveled to china comes to the emergency department with increasing shortness of breath and is strongly suspected of having severe acute respiratory syndrome. which prescribed action would the nurse take first
A. place the client on airborne and contact precautions
B. infuse normal saline at 75ml/hr
C. obtain blood , urine, and sputum cultures
D. give methylpredisone 1g IV
A. place the client on airborne and contact precautions
a proposed change in the management structure of the nursing unit is explained during a staff meeting and several nurses express antagonistic comments to the nurse manager. which would be the best response by the nurse manger ?
A. lets consider potential positives and negatives to the proposal
B. we need to look at all the aspects of the proposal even though some of you may not think it is wise
C. if you cannot hold your comments until the end of the presentation please leave now
D. I will not continue with the presentation until the room is quiet
A. lets consider potential positives and negatives to the proposal
a public health nurse is planning an in service on older adult health trends. which information would the nurse include ?
A. the percentage of older adults in the population is decreasing
B. the proportion of older adults who live alone is increasing
C. older adults take one-half of all prescription medication
D. older adults have a decreased recovery time following injury
B. the proportion of older adults who live alone is increasing
A public health nurse is planning several initiatives for a city. Which intervention would the nurse include as part of public health assurance ?
A. Meeting with city officials to propose changes to health laws
B. Partnering with laboratory company to provide free HIV screening for the public
C. Review data incidence of influenza over 25- year span
D. Providing medical facilities with information accidental injury rates.
B. Partnering with laboratory company to provide free HIV screening for the public
A student nurse ask the registered nurse staff how he knows if client teaching is effective. Which would be the best response by the rn?
A. Clients who do not have objectives will learn material poorly
B. Clients learning is evaluated based on achievement of learning outcomes
C. Client learning objectives help the nurse organize the teaching material
D. Client learning will occur when the nurse makes an educational diagnosis
B. Clients learning is evaluated based on achievement of learning outcomes
Student reports to the instructor that her grade has been recorded as a 98 but she really made an 88. Which is the student displaying?
A. Veracity
B. Nonmaleficence
C. Reparation
D. Fidelity
A. Veracity
A unit manager is preparing the time schedule for the summer holiday season. Approximately half of the staff has acquired 1-2 weeks vacation. Granting all the requested time will lead to serve staffing shortages. What is the nurse managers primary consideration in developing this schedule?
A. Granting requests by seniority
B. Nurses satisfaction and work performance
C. Establishing good communication with staff members to reduce resentment
D. Client safety needs
D. Client safety needs
After her first week working on a busy medical/surgical unit, a new nurse manager notes that the individual nurses are highly competent but unable to function as a team. Which action by the nurse manager would best facilitate team building among the staff?
A. Allow the staff more input into important policy decision making
B. Provide an opportunity for the nurses to express their feelings and emotions
C. Hire more staff members to reduce stress and fatigue from understaffing
D. Give the staff members more time to adjust to the charge in nurse manager
B. Provide an opportunity for the nurses to express their feelings and emotions
An 18 year old female who has a recent history of repeated ER visits for numerous fictitious disorders has appeared in the ED today w/small superficial cuts on both arms. She reports that she awakened this morning to find these cuts on her arms. She tells the nurse she is concerned about getting “ lock jaw” and needs to be hospitalized. Which medical diagnosis would the nurse anticipate for this client?
A. Narcissistic personality disorder
B. Munchausens syndrome
C. Family neglect and abuse
D. Munchausen’s by proxy
B. Munchausens syndrome
Which is an important principle that guides managers who use democratic leadership style ?
A. The members of the group must carry out decisions of the leader without question
B. The leader performs the same task as the rest of the members of the group.
C.each member of the group respects all the other members as unique and valuable
D. The leader must be methodical and able to sift through complicated information
C.each member of the group respects all the other members as unique and valuable
An older adult client who is on fall precautions is found lying on the floor of his hospital room. The client is assessed and no injuries are noted. Which would the nurse document in the clients medical record ?
A. Physician notified and no new orders received
B. Client found lying on the floor beside his bed
C. Client fell out of bed by crawling over side rail
D. occurrence / incident report completed
B. Client found lying on the floor beside his bed
