Kaplan '13 Flashcards
Overview of the NCLEX-RN
how many hours do you have to complete the exam?
6, this includes the beginning tutorial an optional 10 min break after the first 2 hrs of testing and an optional break after an additional 90 min of testing.
How many questions are there?
min of 75 and a max of 265
how many questions are experimental?
15, regardless of the number of questions you answer. Your answers do not count for or against you (they are indistinguishable though).
The test ends when…
you either have demonstrated min competency and answered the min number of questions (75), you have demonstrated a lack of min competency and answered the min amt of questions (75), you have answered the max number of quetsions or you have used the max time allowed
how is the test broken down?
- 20% is management of care (advance directives, advocacy, case management, client rights, collaboration with interdisciplinary team, concepts of management, confidentiality/information security, consultation, continuity of care, delegation, establishing priorities, ethical practice, info technology, informed consent, legal rights and responsibilities, performace improvement or quality improvement, referrals, supervision)
2, 12% is Safety and infection control
(accident/injury prevention, emergency response plan, ergonomic principles, error prevention, handling hazardous and infectious materials home safety, reporting of incident or event or irregular occurrence or variance, safe use of equipment, security plan, standard precautions or transmission-based or surgical asepsis, use of restraints or safety devices) - 9% Health Promotion and Maintenance
(aging process, ante/intra/postpartum and newborn care, developmental stages and transitions,health and wellness, health promotion or disease prevention, health screening, high-risk behaviors, lifestyle choices, principles of teaching/learning, self-care, techniques of physical assessment)
how is the test broken down? cont.
- psychological integrity
(abuse/neglect, behavioral interventions, chemical and other dependencies, coping mechanisms, crisis intervention, cultural diversity, end of life care, family dynamics, grief and loss, mental health concepts, religious and spiritual influences on health, sensory/perceptual alterations, stress management, support systems, therapeutic communication, therapeutic environment) - basic care and comfort 9%
(assistive devices, elimination, mobility/immobility, non-pharm comfort intervention, nutritiona nd oral hydration, personal hygiene, rest and sleep) - pharm and parental therapies (15%)
(adverse effects/contraindications/side effects/interactions, blood and blood products, central venous assess devices, dosage calculations, exprected action/outcomes, med administration, parenteral/IV therapies, pharm pain management, total parenteral nutrition)
how is the test broken down? cont.
- Reduction of risk potential 12%
(changes/abnormalities in vital signs, diagnositic tests, lab values, potential for alterations in body systems, potential for complications of diagnostic tests/treatments/procedures, potential for complications from surgical procedures and health alterations, system specific assessments, therapeutic procedures) - physiological adaptation 13%
(alterations in body systems, fluid and electrolyte imbalances, hemodynamics, illness management, medical emergencies, pathophysiology, unexpected response to therapies) - The nursing process
( assessment, analysis, planning, implementation, evaluation)
10, caring, communication and documentation, teaching and learning principles, questions that contain graphic images
……………p 62
….
levels of hematocrit
42 to 50% male
40 to 48% female
urine specific gravity
1.010 - 1.030
decline was dehydrated the specific gravity of the hematocrit become
increased
will arrange for PTT
20- 45 seconds
the therapeutic range for a client receiving heparin anticoagulant is 1.5 - 2 timeouts the control or normal level. To calculate the therapeutic range take the lower number written on a range for a PTT which is 20 and multiply it by 1.5 and the result is 30. Then multiply the high number which is 45 by 2 and the results is the so the therapeutic range is 30-90. If a PTT reading is between those points of medication is needed
in order to help you establish priorities, exam
know maslow strategy, nursing process strategy, and safety strategy
maslow strategy
five levels of human means such as physiological, safety or security, love and belonging, esteem, and self actualization
maslow
physiological needs
they are necessary for survival and have highest priority and must be met first. They include oxygen, fluid, nutrition, temperature, elimination, shelter, rest, and sex.
maslow
safety and security needs
Kanebo physical and psychosocial. Physical safety includes decreasing what is frightening to the client which may be an illness such as a myocardial infarction, an accident such as appearing transporting newborn in a car without a car seat, or an environmental threat such as a client with COPD who insists on walking outside and very cold temperatures
to attain psychological safety the client must have the knowledge and understanding about what to expect from others in their environment so it is important to teach the client and the only what to expect after a stroke or that you allow the one preparing for a mastectomy to verbalize her concerns about changes that might occur in her relationship with her partner
maslow
love and belonging
the claims to feel loved by family and accepted by others. When they feel self-confident and useful they will achieve the need of self-esteem as described by maslow
maslow
self-actualization
highest level of need. To achieve this level of the client must experience fulfillment and recognize his or her potential. In order for self-actualization to occur all of the lower-level needs must be met many people may never achieve this high level of functioning
when working with maslow you’ll notice that the physical and psychosocial interventions are included
try to apply the ABCs first
according to maslow, pain is
psychosocial and so is emotional support
with a ruptured ectopic pregnancy, respiratory therapy is
not needed. They need fluid replacement because the client has extensive bleeding into the abdominal cavity due to a ruptured fallopian tube
when working with maslow
psychological answer more important than psychosocial
nursing process strategy: assessment versus implementation
assessment is the first step of the nursing process and takes priority over all understand. It is essential that you complete the assessment phase of the nursing process before you implement nursing activities. For example when performing CPR, if you do not access the airway before performing mouth-to-mouth resuscitation your actions may be harmful
the nursing process strategy
dependent interventions are based on the breadth orders of a physician
on the exam, you should assume that you have in order for all dependent intervention that are included in the answer choices
interdependent interventions
are shared with other members of the healthcare team. For example, nutrition education may be shared with the dietitian and chest physiotherapy may be shared with a respiratory therapist
if the answer choices are a mix of assessment or validation and implementation
use the nursing process strategy
lookup the somogyi effect
because rebound hyperglycemia that occurs in response to a rapid decrease in blood glucose during. Treatment includes adjusting the evening diet, changing the Windows, and altering the amount of exercise to prevent nocturnal hypoglycemia
safety strategy
includes clients in healthcare facilities, in the home, at work, and in the community. Safety includes meeting basic needs such as oxygen, food, fluids, etc.; reducing observed that cause injury to clients such as accident, opticals in the home; and decreasing the transmission of pathogens such as immunization and sanitation
when answering questions about procedures
the safety strategy will help you to establish priorities. All answers must be implementation. Try to answer based on knowledge that if you can’t think about what will cause the client the least amount of harm
safety strategy
minimizing crying will help prevent bleeding
Postural drainage may cause bleeding
coughing and deep breathing because leaving
giving ice cream to a child with a tonsillectomy may cause the child to clear his throat which causes bleeding
the nurse must prevent postoperative hemorrhage which is a complication seen after a tonsillectomy. Crying with your tape a child’s throat and increase the chance of hemorrhage.
before selecting to contact the physician
the examiner wants to know what you were going to do in a situation not the physician!
breathlessness should only be checked in and unconscious client
when you know that someone is choking ask them are you choking because the inability to speak or cough indicates the airway is obstructed. This is assessment
rules of management
do not delegate assessment, teaching, evaluation, or nursing judgment. Delegate care for stable patients with expected outcomes. Delegate tasks that involve standard, unchanging procedures such as AV, feeding, dressing, and transferring clients. Remember priorities such as maslow, ABC’s, and stable versus unstable when determining which client enters should attend to first
remember, nursing them and businesses place providing care to clients according to hell nursing care is defined in textbooks and journals
nurses supposed to care for the child or. While delegating tasks to the nursing assistant
strategies for positioning questions
immobility occurs when a client is unable to move about freely and independently. To answer questions on positioning, you need to know the hazards of immobility, normal anatomy, physiology, and the terminology for positioning
questions to ask are; are you trying to prevent or promote? what are you trying to prevent or promote? shake anatomy and physiology
the most serious and important complication after the percutaneous liver biopsy is
hemorrhage. What you do to prevent hemorrhage? Who apply pressure. Where’d you apply pressure? On the liver. Where is the liver? On the right side of the abdomen under the ribs. How should the client be positioned to prevent hemorrhage from the liver which is on the right side of the body? Right sideline
by positioning the client after angiogram you are trying to promote something: adequate circulation of the right leg
what promotes adequate circulation of the right leg? Keeping the lag at or below the level of the heart the blood flow is not constricted. Supine with the leg extended is a good position because in this position the leg above the level of the heart and circulation will not be constricted because the leg is straight
when turning the client after a laminectomy you are trying to promote a straight back because the client can’t bend or twist the torso. A laminectomy is the removal of one or more vertebral laminae so the back should be kept straight.
If the pillow is placed between the legs of the body is rolled as a unit the client back will be Straight
flat or supine position
avoid hip flexion which can compress arterial flow
dorsal recoumbent position
supine with knees flexed; more comfortable
side of lateral position
allows drainage of oral secretions
side with legs bent or Sam’s position
allows drainage of oral secretions and is used for rectal exams
had elevated or Fowler’s position
increases venous return and allows maximal long expansion. I Fowler’s is 80-90 degrees
Fowlers is 45- 60
70 Fowlers is 30-45
low Fowlers is 15-30
feet and leg elevated position
increases blood return to heart
feet elevated and had lowered or Trendelenburg position
used to insert central venous pressure line or for treatment of umbilical cord compression
seed elevated 20°, these straight, trunk flat, and head slightly elevated or modified Trendelenburg position
increases venous return and is used for shock and may be used to prevent shock
elevation of extremity position
increases venous return and decreases blood volume to extremity
flat on back, thighs flexed, legs abducted or lithotomy position
increases vaginal opening for examination
prone position
promotes extension of hip joint; not well tolerated by persons with respiratory or cardiovascular difficulties
knee to chest position
provide maximal visualization of rectal area
strategies for communication questions
using silence allows the client time to think and reflect; conveys acceptance. Allows the client to take the lead in conversation
using general leave or broad opening encourages the client to talk. Indicate your interest in the client. Allows the client to choose the subject
clarification encourages recall and details of a particular experience. Encourages descriptions of feelings, seek explanation, and pinpoints specific
reflecting paraphrases what the client says. Reflects on what the client says, especially the feelings conveyed
when selecting the best communication answer
eliminate don’t worry, explore answers, why, authoritarian answers, focus on the nurse answers, and close ended questions. These should be avoided
you actually want to avoid explore answers such as let’s talk about why you didn’t take your medication or tell me why you really injured yourself
the client must be allowed to verbalize the fact that he or she is sad, angry, fearful, or overwhelmed. It isn’t the nurse’s role to delve into the reasons why the client is feeling a particular way
why questions imply disapproval of the client who may become defensive. Examples include what makes you think that and why do you feel this way
a white question can come in many forms and the response that puts the client on the defensive is not therapeutic and therefore incorrect
authoritarian answers has no regard for the client desires or feelings
examples include insisting that the client followed unit rules or insisting that the client do what you command immediately
nurse focused answers are answers in which the focus of the comment is on the nurse. Although they sound empathetic they are wrong. Focus of your communication should always be on the client
examples include that happened to me once or I know from experience this is hard for you
the correct response will usually contain one or both of the following elements
gives correct information and is empathetic and reflects the clients feelings
when getting correct information it encourages further communication with the client
examples are you experiencing acute alcohol withdrawal and you may see and feel things that aren’t real or there are many reasons for memory loss, tell me more about what you have noticed
empathy is the ability to perceive what another person experiences using the person’s frame of reference. Reflection communicates to the client that the nurse has heard and understands what the client is trying to communicate. When reflecting feelings the nurse focuses on the feelings and not the content of what is said
examples are I could see that you are frightened about being here or you seem very upset, tell me how you’re feeling
when dealing with the client with psychological problems
you don’t want to encourage the client to talk about hallucinations or delusions. Rather you want your discussion to focus on the feelings that accompany them
safe and effective care environment: management of care
Advance directives
an advance directive is a legal document that provides guidance to caregivers about the client wishes and are followed if the client decision-making powers become impaired. 1990 patient self-determination act requires that upon admission to hospital, long-term facilities, and of health agencies, patient should be informed that they have the right to accept or refuse medical care as well as to specify in advance through advanced directives with their wishes are.
Since the nurse, your role is to integrate advanced directives into the client care plan. So, evaluate client status regarding advance directives and help determine whether family members or significant others should be involved in conversation and decision-making. Provide the information as needed if they are not familiar with the details of the directives. Ensure that copies of advance directives are placed in the client’s medical record. This includes information on organ or tissue donation for clients over 18 years old. The uniform anatomical gift act governs organ donations for transplantation and how to donate one’s cadaver as an anatomical gift
safe and effective care environment: management of care
Advocacy
promoting your clients rights and interests. Discuss treatment options including what the options are and how they work and what side effects may be so the client understands all available choices. You must respect client decisions even if you do not agree with them. When necessary use an interpreter or translator for non-English-speaking clients. Know when it is appropriate to engage others such as social workers on your client’s behalf
safe and effective care environment: management of care
Case management
the individualized care plan you develop should be aimed at providing safe, cost-effective care for the client. The plan is based on your assessment of the client needs as well as goals such as providing self-care. You should also incorporate evidence-based research into the plan. You are expected to evaluate and revise the plan is needed. When the client leaves the hospital, provide the client with information on discharge procedures to home, hospice, or community living whatever is relevant to the client situation. This includes info about medications, follow-up visit, feature lab tests etc.
safe and effective care environment: management of care
Client rights
the health insurance portability and accountability act (HIPPA) protects personal identifying information such as the client’s name, Social Security number, date of birth, and info about diagnosis and treatment. Such information should only be shared with individuals directly involved in the client’s care, the payment of care, for the management of the clients care.
The patient’s Bill of Rights is a statement about the rights to which individuals are entitled as recipients of healthcare, and the responsibilities. It covers information disclosure, choice of providers and plans, access to emergency services, participation in treatment decisions, confidentiality of health information, complaints and appeals, and consumer responsibilities.
Informed consent
safe and effective care environment: management of care
collaboration with interdisciplinary teams
you should be ready to act as the point person to review the care plan and ensure continuity across disciplines and to collaborate with healthcare members in other disciplines to provide efficient and effective client care
safe and effective care environment: management of care
concepts of management
apply the principles of conflict resolution as needed. Know-how to supervise care provided by others and know which staff members can perform particular procedures related to client care
safe and effective care environment: management of care
confidentiality or information security
you may need to intervene when confidentiality is breached by other staff members. Will also be effective to assess staff members and your clients understanding of confidentiality requirements such as those covered by HIPAA
safe and effective care environment: management of care
consultation
involve communicating with another nurse or health care professional such as a dietitian or pharmacist about an aspect of client care. Determine when a consultation is appropriate and then initiate such consultations as needed. Be able to identify the expected outcome of consultations and revise the care plan if the client needs change
safe and effective care environment: management of care
continuity of care
the goal is to provide high-quality and cost-effective healthcare. Continuity of care is the process by which a client and healthcare providers are cooperatively involved in the ongoing healthcare management of the client. To help ensure continuity of care, know the proper procedures to admit, transfer, and discharge a client. You may need to follow up on unresolved issues regarding client care such as lab results and client request and provide report on assigned clients
safe and effective care environment: management of care
delegation
it is your responsibility to make sure the person to whom you are delegating a task has the authority to do the job.
Make sure you have the right task, right circumstance, right person, right direction or communication ( has the nurse communicated appropriate instructions for accomplishing the task?) and right supervision ( will the delegating nurse remain responsible for the task and outcomes?)
safe and effective care environment: management of care
establishing priorities
ABC's Maslow agency policies and procedures time client and family preferences care related to client activity priorities in medication therapy
The following problems indicate priority needs: postop clients just out of surgery, deteriorating status, signs of shock, allergic reactions, post diagnostic procedure clients that require temporary monitoring, clients complaining of unusual symptoms, client with malfunctioning equipment or tubing
safe and effective care environment: management of care
ethical practice
be familiar with the ANA code of ethics for nurses and make sure you note the following ethical principles:
autonomy: the right of individuals to make decisions for themselves.
Beneficence: the nurses duty to do what is in the best interest of the client.
Justice: a fair equitable and appropriate treatment
nonmaleficence: the nurses duty to do no harm
Fidelity: keeping faithful to ethical principles and the ANA code of ethics for nurses
Virtues: compassion, trustworthiness, integrity, and verocity or truthfulness
CONFIDENTIALITY: maintaining the client’s privacy by not disclosing personal information about the client.
Accountability: responsibility for one’s actions
safe and effective care environment: management of care
information technology
tele-health uses transitions the a telecommunications technology to transmit health information remotely. You should know how to use information technology to enhance the care provided to a client
safe and effective care environment: management of care
informed consent
the components of informed consent includes an explanation of the following: details of the procedure or treatment, risks and benefits including potential for serious injury or death, alternative procedures or treatments, potential consequences of refusing treatment
the nurse’s role in the process is to advocate for the client by ensuring your she has been provided the necessary information to make an informed decision. In cases where the client does not speak English provide written materials in the native language if possible. Ensure that a client has actually given informed consent for treatment before that treatment occurs. One way to do so is to act as a witness to the informed consent. As a witness who confirmed that the client gave his or her informed consent voluntarily, the client signature is authentic and the client is competent to give consent. If the client waived consent, ensure it is documented in the medical record if the client is deemed incompetent to give informed consent, a court-appointed guardian may do so on the client’s behalf. The requirement to obtain the client informed consent can be waived in an emergency situation in which the client is incapacitated and the situation requires immediate treatment
safe and effective care environment: management of care
legal rights and responsibilities
negligence involved the unintentional failure to act as a responsible person in a circumstance that resulted in injury to the client. Elements include a breach of a duty of care, with a resultant injury that has been proximately cause, and actual damages to the injured party. Malpractice involves the failure by medical professional to carry out perform his or her duties that results in injury to the client. She should be familiar with the following:
identifying legal issues affecting clients such as refusing treatment and knowing how to respond appropriately, recognizing tasks and assignments are not prepared to perform and seeking assistance, identifying and managing clients valuable’s according to facility or agency policy, educating clients and staff on legal and ethical issues, complying with state and/or federal regulations for porting client conditions such as abuse or neglect, communicable diseases, gunshot wound, or dogfight, reporting unsafe practices of health-care personnel to internal or external entities, and intervening appropriately when you observe unsafe practices by staff members
safe and effective care environment: management of care
Performance improvement for quality improvement
meeting or exceeding the expectations of customers and standards, and achieving planned outcomes.
safe and effective care environment: management of care
referrals
there are different types of referrals: authorization for care or service, recommendation of a specific provider, referral to specialists, in referral to a different facility for care. Assess the need to refer clients for assistance with actual or potential problems such as physical therapy and speech therapy, and match community resources to the clients needs such as respite care, social services, shelters. In all referral situations you need to know which documents to include when referring the client such as a medical record or referral form
safe and effective care environment: management of care
supervision
a good supervisor provides the following:
clear direction and communication, timely follow-up, active listening, complete technical knowledge of supervised work, feedback and resolution of problems and conflicts.
Quiz questions
a 50-year-old man with head and neck cancer is admitted to the hospital and tells the nurse he does not want parenteral nutritional therapy as his cancer progresses. The nurse explains he can specify his wishes like eating in advance or active. The nurse knows that the requirement to provide clients with this type of information can be found in which of the following?
1. The patient self-determination act
2. Nursing scope and standards of practice
3. The patient protection and affordable care act
4. The patient’s Bill of Rights
- this is correct. The 1990 patient self-determination act was passed by Congress to ensure that upon admission to hospitals, long-term care facilities, and home health agencies, patient’s are informed that they have the right to accept or refuse medical care as well as to specify in advance. Instructors what their wishes are
quiz questions
a 14-year-old girl newly diagnosed with diabetes is preparing for discharge which of the following best describes the nurse’s role as a client advocate?
1. Arranging for a visit with home health nurse
2. providing written medication instructions to the client’s parents
3. Instructing the client to follow-up with her provider and four weeks
4. Teaching the client how to administer insulin injections
- This is correct. Teaching the client had to administer her own medication is the best example of the nurse’s role as a client advocate because this action directly helps the client develop self advocacy skills.
The other choices are important in the overall management of the clients care but does not directly assist in teaching the client the necessary skills to manage her diabetes
quiz questions
a client is seen for an outpatient appointment and asks the nurse if he can obtain a copy of his medical record. The nurse knows that the client has the right to read and copy his medical records and that this is guaranteed by virtue of which of the following?
1. The code of ethics for nurses
2. The health insurance portability and accountability act (HIPAA)
3. the patient self-determination act
4. The Americans with disabilities act
- This is correct. HIPAA protects the patient’s right to review, and requests amendments to his medical records
quiz questions
after receiving report at the start of the evening shift which the following clients should the nurse attend to first?
1. A 34-year-old man undergoing treatment for non-Hodgkin’s lymphoma with the potassium level of 7.5
2. A 21-year-old woman with sickle cell anemia with pain of a six on a scale of 10
3. A 55-year-old woman with ovarian cancer waiting to be discharged
4. A 72-year-old man with chronic obstructive pulmonary disease and a pulse ox of 96% on room air
- This is correct. Hyperkalemia is a potentially serious condition that any client undergoing treatment for non-Hodgkin’s lymphoma could indicate tumor lysis syndrome
quiz questions
a 34-year-old woman who developed Steven Johnson syndrome while undergoing treatment with Tegretol is being transferred in stable condition from the intensive care unit to the medical unit. Therefore beds available. The nurse knows the best choice of roommates for this client is which of the following?
1.a 40-year-old man with MRSA
2. a 28-year-old woman with diarrhea
3. A 72-year-old man with fever of unknown origin
4. A 68-year-old woman with atrial fib
- This is correct. A client with Stevens Johnson syndrome is likely to have severe skin integrity issues including blistering and skin shredding which can place the client at high risk for infection. Atrial fibrillation is not an infectious process
quiz questions a 72-year-old man who had a stroke is being transferred from a medical unit to a rehab center. The nurse case manager is assisting in the process. The nurse knows that the goals of case management include which of the following? Select all that apply
- improving the coordination of care
- Increasing referrals to local organizations
- Reducing the fragmentation of care
- Discharging clients quickly
1, 3. This is correct. One of the primary goals of case management is to improve the coordination of care and to reduce the fragmentation of care.
The other two answers are not goals of case management
quiz questions an 18-year-old client with acute lymphocytic leukemia is admitted to the bone marrow transplantation unit. His family is having trouble dealing with the emotional and financial pressures of his disease. The nurse, case manager, physician, and social worker meet to discuss the plan of care. The nurse knows this type of interdisciplinary interaction is best referred to as which of the following? 1. Case management 2. Collaboration 3. Cooperation 4. Collegiality
- This is correct. The interdisciplinary interaction between different healthcare professions such as nursing, medicine, and social work is known as collaboration.
Case management refers to the coordination of care to reduce fragmentation and improve quality and outcomes as well as to reduce costs
quiz questions
a pregnant woman at 15 weeks gestation is scheduled for a amniocentesis. As the client is being prepped for the procedure it becomes clear to the nurse that the client does not fully understand the risks and benefits associated with the procedure. Which of the following describes the nurse’s role in obtaining informed consent? Select all that apply
1. Explain the risks and benefits associated with the procedure
2. Describe alternatives to the procedure
3. Witness the client signature on the consent form
4. Advocate for the client by ensuring she is making an informed decision
3, 4. this is correct. One of the nurses roles in the informed consent process is to witness the signature on the consent form and to advocate for the client by ensuring she has been provided the necessary information to make an informed decision.
it is the physician’s duty to provide information on the other two answers
quiz questions the nurse noticed an increase in the prevalence of pressure ulcers among clients in an intensive care unit. She documented her findings and worked with her manager to develop and implement a new policy using a pressure ulcer risk assessment scale. Which of the following best describes the nurse's actions? 1. Quality improvement 2. Collaboration 2. Advocacy 4. Case management
- this is correct. Quality improvement includes activities such as identifying opportunities and developing policies for improving the quality of nursing practice. Identifying an increase in pressure ulcers and implementing a policy aimed at improving the assessment and prevention of pressure ulcers best fits the definition of quality improvement
quiz questions
the nurses working on a surgical unit which of the following tasks would be appropriate for the nurse to delegate to the unlicensed assistive personnel?
1. Assisting new postoperative client to the bathroom
2. Set up the client’s lunch trays
3. Change a central line dressing
4. Teach a client how to minister discharge medications
- this is correct setting up the client’s lunch trays is an appropriate task to delegate to the UAP.
Assisting a new postoperative client to the bathroom is a task the registered nurse or another licensed individual such as an LVN or LPN should perform
quiz questions the nurses been asked to administer a drug by IV push. She is uncertain whether or not this task also been her scope of practice. The nurse knows which of the following are the best sources to refer to point information related to her scope of practice in this situation? Select all that apply
- Hospital in unit policies and procedures
- Nurse practice act
- Ordering physician
- Hospital pharmacist
1, 2. this is correct. Hospital unit policies and procedures they outline specific information about who can determine which drugs by which route. The nurse practice acts (NPAs) are laws in which each state defines the scope of practice for nursing.
quiz questions in 20-year-old client with leukemia has consented to a blood transfusion against wishes of his family who were all Jehovah witnesses. The nurse knows that which of the following ethical principles best supports the decision?
- Autonomy
- Beneficence
- Nonmaleficence
- Justice
- this is correct. Autonomy refers to the right of individuals to make decisions for themselves
quiz questions
the nurse wants to delegate the task of showering an elderly client in a wheelchair to the UAP. Before delegating a task the UAP the nurse should first ensure which of the following is accomplished?
1. the UAP is supervised at all times
2. The UAP demonstrated competency for the task during orientation
3. The UAP has performed the task before
4. The UAP has received the assignment during report
- This is correct. Prior to delegating a task appropriate for the UAP, the nurse should first ensure that competency has been verified during the UAP’s orientation
quiz questions
a well-known actor has been admitted to the ambulatory surgical unit. The nurse notices a staff member who is not involved in the client’s care reading his medical record. The nurse knows she should first two which of the following
?1. Nothing. The staff member has a hospital ID badge and is authorized to read the medical record
2. Inform the staff member that without a legitimate need for the information, a staff should not be reading the medical record
3. Tell the client his medical records have been read by an unauthorized individual
4. page the physician and ask if it’s acceptable for the staff member to access the medical records
- This is correct. An individual not involved in the care of the client does not have a legitimate need to access the medical record. The nurse should protect the client’s right to privacy by ensuring that only authorized individuals access medical records
quiz questions
the nurse is learning how to use the hospital’s new electronic medication administration record. The nurse knows this tool has the potential to do which of the following? Select all that apply
1. Reduce medication administration errors
2. Improve access to information at the point of care
3. Eliminate the need for the nurse to document medication ministration
4. Eliminate the need for the nurse to verify dose calculations
1, 2. This is correct. Electronic medication administration records have the potential to reduce medication administration errors and the potential to improve access to client information at the point of care
