Lesson One: Chapters 1, 2, 3, 4, 16 & 32

Question 1

A nurse is discussing restorative health care with a newly licensed nurse. Which if the following examples should the nurse include in the teaching?

A. Home health care
B. Rehabilitation centers
C. Diagnostic Centers
D. Skilled Nursing Facilities
E. Oncology centers

Answer 1

A. Home health care:
restorative healthcare involves immediate follow -up care for restoring health and promoting self care. Home health care is a type of restorative care.

B. Rehabilitation centers
Restorative health involves immediate follow up care for restoring health and promoting self care. rehab is restorative care.

D. Skilled Nursing Facilities
Restorative health care involves intermediate f/u care for restoring health and promoting self care. skilled nursing facilities are a restorative care.

Incorrect: C&E

Diagnostic Centers…secondary health care includes the diagnosis and treatment of acute injury or illness.

Oncology centers: …Tertiary healthcare is specialized and highly technical care.

Question 2

Focuses on education and equipping clients to reduce and control risk factors for disease. Examples include programs that promotes immunization , stress management, occupational health and seat belt use.
Which level of health care is this?

A. Primary
B. Preventive
C. Secondary
D. Tertiary
E. Restorative
F. Contiunuing

Answer 2

Preventive health care

Question 3

Address long term or chronic health care needs over a period of time. Ex. End of life care, palliative care, hospice, adult day care, assisted living , and in home respite care.

Which level of healthcare is this?

A. Primary
B. Preventive
C. Secondary
D. Tertiary
E. Restorative
F. Contiunuing

Answer 3

Continuing

Question 4

Involves immediate follow up care for restoring health and promoting self care. Examples include home health care, rehabilitation centers, and skilled nursing facilities.

Which level of healthcare?
A. Primary
B. Preventive
C. Secondary
D. Tertiary
E. Restorative
F. Contiunuing

Answer 4

Restorative

Question 5

or acute care, involves the provision of specialized and highly technical care. examples include intensive care, oncology centers and burn centers.

Which level of healthcare?
A. Primary
B. Preventive
C. Secondary
D. Tertiary
E. Restorative
F. Contiunuing

Answer 5

Tertiary

Question 6

Involves the diagnosis and treatment acute illness and injury. Ex includes: hospital settings (impatient and ED), diagnostic centers, and urgent and emergent care centers.

Which level of healthcare?
A. Primary
B. Preventive
C. Secondary
D. Tertiary
E. Restorative
F. Contiunuing

Answer 6

Secondary

Question 7

Health promotion and includes prenatal prenatal and well-baby care, family planning, nutritional counseling and disease control. This level of care is a sustained partnership between clients and providers. Ex. office or clinic visits, community health centers, and scheduled school or work centered screenings (Vision, hearing, obesity)

Which level of healthcare?
A. Primary
B. Preventive
C. Secondary
D. Tertiary
E. Restorative
F. Contiunuing

Answer 7

Primary

Question 8

Nurse is explaining the various types of health care coverage clients may have to group of nurses. Which of the following health care financing mechanisms should the nurse include as federally funded? SATA

A. PPO
B. Medicare
C. Long term care insurance
D. Exclusive provider organization’
E. Medicaid

Answer 8

Medicare and Medicaid is both federally funded

LTC insurance is privately funded
Exclusive provider organization is privately funded

Question 9

Nurse manager is developing strategies to care for the increasing number of clients who have obesity. Which of the following actions should the nurse include as a primary healthcare strategy ?

A. Collaborating with providers to perform obesity screenings during routine office visits.
B. Ensuring the availability of specialized beds in rehab centers for clients who have obesity
C. Providing specialized intraoperative training in surgical treatments for obesity
D. Educating acute care nurses about postoperative complications related to obesity.

Answer 9

A. Collaborating with providers to perform obesity screenings during routine office visits.

Identify obesity screenings at office visits as an example of primary health care. Primary health care emphasizes health promotion and disease control, is often delivered during office visits and include screenings.

Incorrect choices:

B. Ensuring the availability of specialized beds in rehab centers for clients who have obesity- (Restorative Health)
C. Providing specialized intraoperative training in surgical treatments for obesity (Tertiary Healthcare)
D. Educating acute care nurses about postoperative complications related to obesity. (Secondary healthcare)

Question 10

Nurse is discussing the purpose of regulatory agencies during a staff meeting. Which of the following tasks should the nurse identify as the responsibility of the state licensed boards?

A. Monitoring evidence based practice for clients who have specific Diagnosis
B. Ensuring that hcp comply with regulations
C. Setting quality standards for accreditation of health care facilities
D. Determining whether meds are safe for admin to clients.

Answer 10

B. Ensuring that hcp comply with regulations

state licensing boards are responsible for ensuring that health care providers and agencies comply with state regulations.

Incorrect Answers:

A. Monitoring evidence based practice for clients who have specific Diagnosis
(Utilization review committees have the responsibility of monitoring for appropriate diagnosis and treatment according to evidenced based practice for Diagnosis and treatment of hospitalized clients)

C. Setting quality standards for accreditation of health care facilities ( Joint commission has the responsibility of setting quality quality standards)

D. Determining whether meds are safe for admin to clients. (U.S Food and Drug admin has the responsibility of determining whether meds are safe to admin to clients

Question 11

Nurse is explaining the various levels of healthcare services to a group of newly licensed nurses. Which of the following examples of care or care settings should the nurse classify as tertiary care? SATA

A. ICU
B. Oncology
C. Burn Center
D. Cardiac Rehab
E. Home health care

Answer 11

A. ICU
B. Oncology
C. Burn Center

Incorrect:

Cardiac Rehab-restorative care & also tertiary prevention but not tertiary care

home health care- is restorative care

Question 12

Nurse is caring for a group of clients on a med surge unit. For which of the following client care needs should the nurse initiate a referral for a social worker? SATA

A. A client who has terminal cancer requests hospice care in the home.
B. client asks about community resources avail for older adults
C. A client states “I would like to have my child baptized before surgery
D. Client requests an electric wheelchair for use after discharge
E. A client states “I dont understand how to use a nebulizer”

Answer 12

A. A client who has terminal cancer requests hospice care in the home.
B. client asks about community resources avail for older adults

D. Client requests an electric wheelchair for use after discharge

Question 13

A goal for a client who has difficulty with self feeding due to rheumatoid arthritis is to use adaptive devices. The nurse caring for the client should initiate a referral to which of the following members of the interprofessional team?

A. Social worker
B. Certified nursing assistant
C. Registered dietician
D. Occupational Therapist

Answer 13

D. Occupational Therapist

Question 14

A client who is post op following knee arthroplasty is concerned about the adverse effects of the med prescribed for pain management. Which of the following members of the interprofessional team can assist the client in understanding the med effects? SATA

A. Provider’
B. CNA
C. Pharmacist
D. RN
E. Respiratory Therapist

Answer 14

A. provider
C. Pharmacist
D. RN

Question 15

A client who had a CVA has persistent problems with dysphagia. The nurse caring for the client should initiate a referral with which of the following members of the interprofessional care team?

A. Social worker
B. CNA
C. OT
D. Speech language pathologist

Answer 15

D. Speech language pathologist
Can initiate specific therapy for a client who has difficulty with feeding due to swallowing difficulties

Question 16

Nurse is acquainting a group of newly licensed nurses with the roles of the various members of the healthcare team they will encounter on a med surge unit. When providing examples of the types of tasks CNAs can perform, which of the following client activities should the nurse include? SATA

A. Bathing
B. Ambulating
C. Toileting
D. Determining pain level
E. Measuring vital signs

Answer 16

A. Bathing
B. Ambulating
C. Toileting
E. Measuring vital signs

CNAS cant EAT: Evaluate, Assess , Teach

Question 17

The right to make one’s own personal decisions, even when those decisions might not be in the person’s own best interest?

A. Veracity
B. Nonmaleficence
C. Justice
D. Beneficence
E. Autonomy

Answer 17

Autonomy

Question 18

action that promotes good for others, without any self interest

A. Veracity
B. Nonmaleficence
C. Justice
D. Beneficence
E. Autonomy

Answer 18

Beneficence

Question 19

fulfillment of promises

A. Veracity
B. Nonmaleficence
C. Fidelity
D. Beneficence
E. Autonomy

Answer 19

fidelity

Question 20

Fairness in care delivery and use of resources

A. Veracity
B. Nonmaleficence
C. Justice
D. Beneficence
E. Autonomy

Answer 20

Justice

Question 21

Commitment to do no harm

A. Veracity
B. Nonmaleficence
C. Justice
D. Beneficence
E. Autonomy

Answer 21

nonmaleficence

Question 22

Commitment to tell the truth

A. Veracity
B. Nonmaleficence
C. Justice
D. Beneficence
E. Autonomy

Answer 22

Veracity

Question 23

Nurse is caring for a client who decides not to have surgery despite significant blockages of the coronary arteries. The nurse understands that this client’s choice is an example of which following principle?

A. Fidelity
B. Autonomy
C. Justice
D. Nonmaleficence

Answer 23

Autonomy

In this situation the client is exercising their right to make their own personal decision about surgery, regardless of other’s opinions of what is “best” for them.

Question 24

Nurse offers pain med to a client who is post op prior to ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principles?

A. Fidelity
B. Autonomy
C. Justice
D. Beneficence

Answer 24

Beneficence

promotes good for others, without any self interest. By administering pain med before the client attempts a potentially painful exercise like ambulation, the nurse is taking a specific and positive action to help the client.

Question 25

Nurse is instructing a group of newly licensed nurses about the responsibilities organ donation and procurement involve. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the newly licensed nurses should understand that this aspect of care delivery is an example of which of the following ethical principle?

A. Fidelity
B. Autonomy
C. Justice
D. Nonmaleficience

Answer 25

Justice

is fairness in care delivery and in the use of resources. By applying the same qualifications to all potential kidney transplant recipient

Question 26

Nurse questions a medication prescription as too extreme in light of the client’s advanced age and unstable status. The nurse understands that this action is an example of which of the following ethical principles?

A. Fidelity
B. Autonomy
C. Justice
D. Nonmaleficence

Answer 26

Nonmaleficence

is a commitment to do no harm. In this situation , administering the medication could hard the client. By questioning it, the nurse is demonstrating this ethical principle .

Question 27

Nurse is instructing a group of newly licensed nurses about how to know and what to expect when ethical dilemmas arise. Which of the following situations should the newly licensed nurses identify as an ethical dilemma?

A. A nurse on a medical surgical unit demonstrates signs of chemical impairment.

B. A nurse overhears another nurse telling an older adult client that if he doesn’t stay in bed, she will have to apply restraints

C. A family has conflicting feelings about the initiation of enternal tube feedings for their father, who is terminally ill.

D. A client who is terminally ill hesitates to name their partner on their durable power of attorney form.

Answer 27

C. A family has conflicting feelings about the initiation of enternal tube feedings for their father, who is terminally ill.

making the decision about initiating enternal tube feedings is an example of an ethical dilemma . a review of scientific data cannot resolve the issue, and it is not easy to resolve. The decision will have a profound effect on the situation and on the client..

Question 28

INFORMED CONSENT

Provider: Obtains informed consent. The provider must give to the client.

Client: Gives informed consent. Voluntarily, be competent and of legal age or be an emancipated minor. when the client is unable to give consent, another authorized person must give consent.

Nurse: Witness informed consent. Ensure provider gave the client the necessary info; ensure the client understood the information and is competent to give informed consent; have the client sign the informed consent; notify provider is client have more questions or appears to not understand any of the info; document questions the client has, notification of provider, reinforcement of teaching and use of interpreter.

Question 29

Refusal of Treatment

Competent adults have the right to refuse treatment, incl the right to leave a facility without a discharge prescription from the provider.

When a client decides to leave the facility against medical advice without discharge order , nurse notify provider and discusses with the client the risks to expect when leaving the facility prior to discharge.

Nurse asks the client to sign an AMA form and documents the incident.

Question 30

Legal document that expresses the client’s wishes regarding medical treatment in the event client becomes incapacitated and is facing end of life issues.

Answer 30

Living will

Question 31

document in which client designate a health care proxy to make healthcare decisions for them if they are unable to do so.

Answer 31

Durable power of attorney for heath care

Question 32

Unless a provider writes a DNR or allow natural death order in the client’s medical record the nurse initiates CPR when the client has no pulse or respirations. The provider consults the client and the family prior to administering a DNR or Allow natural death.

Question 33

Nurse observes an assistive personnel reprimanding a client for not using the urinal properly. The AP tells the client that diapers will be used next time the urinal is used improperly. Which the AP is committing?

A. assault
B. Battery
C. False imprisonment
D. Invasion of privacy

Answer 33

Assault

by threatening the client the AP is committing an assault.

Incorrect:

B. Battery- physical contact without the client’s consent
C. False imprisonment- restrains the client
D. Invasion of privacy- disclosing info about the client to unauthorized person.

Question 34

Nurse caring for a competent adult client who tells the nurse, “I am leaving the hospital this morning whether the doctor discharges me or not” The nurse believes that this is not in the client’s best interest and prepares to admin a PRN sedative med the client has not requested. Which of the following types of tort the nurse about to commit?

A. Assault
B. False imprisonment’
C. Negligence
D. Breach of confidentiality

Answer 34

False imprisonment

administering a med as a chemical restraint to keep the client from leaving the facility against medical advice is false imprisonment, because the client neither requested nor consented to receiving the sedative.

Incorrect :

Assault- an action that threatens harmful contact without the client’s consent. The nurse has made no threats in this situation.

Negligence- breach of duty that results in harm to client

Breach of confidentiality- disclosure of health information

Question 35

Nurse is caring for a client who is about to undergo a elective surgical procedure. The nurse should take which of the following actions regarding informed consent? SATA

A. Make sure the surgeon obtained the Client’s consent
B. witness the client’s signature on the consent form
C. Explain the risks and benefit of the procedure
D. Describe the consequences of choosing not to have the surgery
E. Tell the client about alternatives to having surgery

Answer 35

A. Make sure the surgeon obtained the Client’s consent
B. witness the client’s signature on the consent form

Question 36

Nurse has noticed several occasions in the past week when another nurse on the unit seemed drowsy and unable to focus on the issue at hand. Today, the nurse was found asleep in a chair in the break room not during a break time. Which of the following actions should the nurse take?

A. Alert the ANA
B. Fill out an incident report
C. Report the observations to the nurse manager on the unit
D. Leave the nurse alone to sleep

Answer 36

C. Report the observations to the nurse manager on the unit

Question 37

Nurse is caring for a young adult at a college health clinic . Which of the following actions should the nurse take first?

A. Give the client information about immunization about meningitis

B. Tell the client to have a TB skin test every 2 years

C. Determine the client’s health risk

D. Teach the client about exercise recommendations

Answer 37

C. Determine the client’s health risk

the first action should be taken using the nursing process is assessment. Talk with the client first to determine what risk factors the client might have before initiating the health promotion and disease prevention measures.

Question 38

Nurse in a clinic is planning health promotion and disease prevention strategies for a client who has multiple risk factors for cardiovascular disease. Which of the following interventions should the nurse include? SATA

A. Help the client see the benefits of their actions
B. Identify the client’s support system
C. Suggest and recommend community resources
D. Devise and set goals for the client
E. Teach stress management strategies

Answer 38

A. Help the client see the benefits of their actions
B. Identify the client’s support system
C. Suggest and recommend community resources
E. Teach stress management strategies

Incorrect:
Devise and set goals for the client

The nurse and the client should work together to devise and set mutually agreeable goals that are also realistic and achievable

Question 39

A nurse in a health clinic is caring for a 21 y/o client who tells the nurse that their last physical exam was in high school. which of the following health screenings should the nurse expect the provider to perform for this client?

A. Testicular exam
B Blood glucose
C. Fecal occult blood
D. Prostate -specific antigen

Answer 39

A. Testicular exam

starting at puberty the client should have exams for testicular cancer along with BP and BMI and cholesterol measurements. Testicular is most common in males 15-34 of age.

Incorrect:

B Blood glucose- begins at age 45
C. Fecal occult blood- typically begins at age 50
D. Prostate -specific antigen- begins at 50

Question 40

Nurse at a health department is planning strategies related to heart disease. Which of the following activities should the nurse include as part of primary prevention?

A. Providing cholesterol screening
B. Teaching about a healthy diet
C. Providing info about hypertensive meds
D . Developing a list of cardiac rehab programs

Answer 40

B. Teaching about a healthy diet
Primary prevention encompasses strategies that help prevent illness or injury. This level of prevention includes health information abut nutrition, exercise, stress management and protection from injuries and Illness

Incorrect:

A. Providing cholesterol screening- secondary prevention
C. Providing info about hypertensive meds- secondary prevention
D . Developing a list of cardiac rehab programs- tertiary prevention

Question 41

Nurse at a provider’s office is talking about routine screenings with a 45 y/o female client who has no specific family history of cancer or diabetes mellitus. Which of the following client statements indicates that the client understands how to proceed?

A. “So I dont need the colon cancer procedure for another 2-3 years”
B. “For now, I should continue to have a mammogram each year”
C. “because the doctor just did a Pap smear, I’ll come back next year for another one”
D. “I had my blood glucose test last year, so I won’t need it again for 4 years”

Answer 41

B. “For now, I should continue to have a mammogram each year”

Female client who is between ages 45-54 should have a mammogram done annually.

Question 42

Nurse is caring for a client who states “ I have to check with my partner and see if they think I am ready to go home”. The nurse replies, “How do you feel about going home today?” Which clarifying technique is the nurse using to enhance communication with the client?

A. Pacing
B. Reflecting
C. Paraphrasing
D. Restating

Answer 42

Reflecting
directs the focus of the conversation back to the client so that they can further explore their feelings

INCORRECT:

A. Pacing- verbal communication, not a clarifying technique

C. Paraphrasing - restates the client’s feelings for them to confirm what they have communicated. In this scenario, the client did not verbalize their feelings to the nurse.

D. Restating- uses the clients exact words. In this scenario, the nurse did not restate what the client started

Question 43

Which of the following actions should the nurse take when demonstrating an empathic presence to a client? SATA

A. Use an open posture
B. Write down what the client says to avoid forgetting details
C. Establish and maintain eye contact
D. Nod in agreement with the client throughout the conversation
E. Sit facing the client

Answer 43

A. Use an open posture- facing the client and leaning forward are ways that can demonstrate an empathic presence

C. Establish and maintain eye contact-

E. Sit facing the client- demonstrates empathic presence , it also helps clients who have a hearing loss understand verbal communication

INCORRECT
B. Write down what the client says to avoid forgetting details
D. Nod in agreement with the client throughout the conversation - the client could indicate that as an agreement with what the client is saying

Question 44

Nurse is caring for a client who is concerned about being discharged to home with a new colostomy because of being an avid swimmer. Which of the following statements should the nurse make? SATA

A. “You will do great! You just have to get used it”
B. “Why are you worried about going home?”
C. “Your daily routines will be different when you get home”
D. “Tell me about the support system you’ll have after your leave the hospital”
E. “It sounds like you are not sure how having a colostomy will affect swimming”

Answer 44

C. “Your daily routines will be different when you get home”
D. “Tell me about the support system you’ll have after your leave the hospital”
E. “It sounds like you are not sure how having a colostomy will affect swimming”

Incorrect
A. “You will do great! You just have to get used it”
Giving false reassurance and minimizing the client’s feelings are both barriers to effective communication.

B. “Why are you worried about going home?”
(Dont ask WHY questions)

Question 45

Which of the following strategies should a nurse use to establish a helping relationship with a client?

A. Make sure the communication is equally distributed between the nurse’s and client’s desires.

B. Encourage the client to communicate their thoughts and feelings

C. Give the nurse-client communication no limits

D. Allow communication to occur spontaneously throughout the nurse-client relationship

Answer 45

B. Encourage the client to communicate their thoughts and feelings- Therapeutic communication facilitates a helping relationship that maximizes the client’s ability to express their thoughts and feelings openly

Incorrect:

A. Make sure the communication is equally distributed between the nurse’s and client’s desires.-
the communication should not be reciprocal but client-focused

C. Give the nurse-client communication no limits-
Limit therapeutic communication to the boundaries of the therapeutic relationship, including time

D. Allow communication to occur spontaneously throughout the nurse-client relationship
-Plan therapeutic communication

Question 46

Nurse is caring for a school age child who is sitting in a chair. To facilitate effective communication which of the following actions should the nurse take?

A. Touch the child’s arm
B. Sit at eye level with the child
C. Stand facing the child
D. Stand with a relaxed posture

Answer 46

B. Sit at eye level with the child