Managing Multiple Patient's (Module 1)

Question 1

What are some elements included in the American Nurses Association (ANA) Code for Nurses? Select all that apply.

Answer 1

A. The nurses primary responsibility is the person requiring nursing care
B. The nurse is responsible for maintaining competence by continued learning
C. The nurse takes appropriate action to safeguard care when endangered by another
D. The nurse maintains personal health so care is not compromised

Question 2

Which statement by the RN reflects an understanding of personal liability when delivering patient care?

Answer 2

“The medication order was not clear so I contacted the physician/provider to clarify the order”

Question 3

The RN is witnessing the patient signing a consent for a procedure. The patient states “I really don’t know why I need this test.” What would be the next action by the RN?

Answer 3

Have the physician performing the procedure speak to the patient

Question 4

During patient centered rounds, the interdisciplinary health care team reviews best practice “bundles” for each patient. What is included in the term best practice “bundles?” Select all that apply.

Answer 4

A. Cost effective quality care
B. Result in improved outcome
C. Demonstrates quality patient care
D. Evidence based patient care

Question 5

One method of organizing data in a consistent and organized manner to enhance interdisciplinary communication is the situation, background, assessment and recommendation or SBAR system. Which of the following data would be included in the Situation (S) section?

Answer 5

The patient name and location

Question 6

A child with hearing impairment is hospitalized for an appendectomy. How does the RN accommodate the plan of care to better meet the needs of the child? Select all that apply

Answer 6

A. Assign consistent care givers for the child
B. Allow the child to see the care giver before the child is touched
C. Provide additional means of communication (drawing computer)
D. Plan extra time for support and communication

Question 7

A family member starts to pace and shout obscenities after hearing the physician say the patient will not recover after a traumatic brain injury. What is an appropriate response by the RN?

Answer 7

Try to maintain ongoing communication

Question 8

Which initial statement by the RN is most appropriate for a patient returning for follow up in the outpatient setting?

Answer 8

“It is good to see you again Mrs. Smith”

Question 9

A patient decides to refuse cardio-pulmonary resuscitation. This is an example of which basic ethical concept?

Answer 9

Self determination

Question 10

A patient is found sitting on the floor beside the bed by unlicensed assistive personnel (UAP), upon arrival, the RN finds the patient conscious with no bleeding, bruises or obvious fractures. The patient states “I’m fine. When I felt weak getting out of bed, I slid to the floor.” What information would the RN gather before notifying the physician/provider?

Answer 10

A. The v/s now and over the past hours
B. Mental status now and prior to event
C. Current medications and time that last one was administered

Question 11

The RN notices that there is inconsistent implementation of prevention measures by staff when a patient is identified for risk for falls. When reporting the observation to the unit manager, which suggestion made by the RN to the manager would best address the concern?

Answer 11

“I suggest a unit based quality improvement review”

Question 12

What are the advantages to bedside report during change of shift? Select all that apply

Answer 12

A. Maintains the focus of report on the patient
B. Helps to establish with the patient specific goals for the shift
C. Augments the computerized documentation
D. Allows outgoing and oncoming RN visualize the patient together

Question 13

A patient who was 36 weeks pregnant dies after developing pneumonia and sepsis. What is the purpose of the quality review for the sentinel event?

Answer 13

To identify the reason and possible prevention

Question 14

A family member notifies the RN and says” something is very wrong. My spouse is just not right.” The patient’s vital signs are similar to baseline. The patient states “I feel like something bad is going to happen. I just have indigestion and my arm aches.” What would the appropriate next step by the RN?

Answer 14

Request an immediate assessment by the interdisciplinary team

Question 15

According to the national hospital patient safety goals, what is included in the universal protocol?

Answer 15

A. Identify the procedure site by placing a mark on the patient
B. Document the process according to institutional policy
C. Designate a member of the team to initiate “time out” sequence
D. Involve all team members participating in the procedure

Question 16

Based on the national patient safety goals, what is included when the RN collects a patient specimen?

Answer 16

Label the specimen container in front of the patient

Question 17

What is the term used for guidelines developed by experts to prevent patient falls?

Answer 17

Evidence based practice

Question 18

The emergency operations plan has been activated by the hospital after a plane crashed. What action might the RN assign to perform? Select all that apply

Answer 18

A. Provide nursing care that is atypical of current level of clinical practice
B. Have family members provide non skilled interventions for patient
C. Help identify patients that could be transferred to a lower level of care
D. Assign comfort care to family for patients with fixed and dilated pupils

Question 19

Which situation has been associated with increased medication errors by the RN?

Answer 19

High nurse patient ratio

Question 20

What is the staff nurses role in the nursing research process?

Answer 20

Identify the clinical issue

Question 21

Identify five (5) properties within a health care organization that are important in the development and maintenance of a culture of safety.

Answer 21

A. Leadership
B. Teamwork
C. Evidence based practice
D. Communication
E. Patient centered care
F. Errors are viewed as opportunities to improve
G. Errors viewed as potential are system issues

Question 22

Which action by a nursing team member indicates the staff member needs additional instructions to complying with the current national patient safety goals?

Answer 22

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Question 23

An RN wishes to provide a brochure for family members which provides general information about the health care team. The brochure would be similar to one from a published nursing article that demonstrates improved patient/family satisfaction. What is the initial step taken by the RN?

Answer 23

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Question 24

As a member of the nursing quality improvement team, which data provides information about the quality of nursing care?

Answer 24

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Question 25

The Day RN thinks there is alcohol odor from the Night RNs breath during change of shift report. What is an appropriate response by the Day RN?

Answer 25

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Question 26

The RN has entered the patient’s room to administer the scheduled medications. The patient states “This does not look like the pill I take at home.” Which action should the RN initially take?

Answer 26

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Question 27

An RN is assisting a co-worker to transfer a patient with left sided weakness from bed to chair. The specialized lift equipment is not in the patient’s room. What should be the RNs response?

Answer 27

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Question 28

The student nurse asks the RN the reason that the patients peripherally inserted central line (PICC) line is being removed. “The PICC line seems like a great idea, the patient does not need to be stuck for blood samples.” What is the RNs response?

Answer 28

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Question 29

The RN assesses a patient as impulsive and at risk for falling. Which of the following statements by the nursing team members about the chair alarm requires follow up by the RN?

Answer 29

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Question 30

A neighbor asks an RN to recommend a physician that the RN knows has less than optimum patient care outcomes. What is the RNs response?

Answer 30

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Question 31

How should the RN communicate to the physician/provider about a patient with an ongoing bleed from an arterial site?

Answer 31

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Question 32

Which of the following nursing actions decreases a patient’s risk of developing a catheter associated urinary tract infection? Select all that apply

Answer 32

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Question 33

The physician/provider tells the RN to discontinue the oxygen on the patient in room 120. The RN knows the Mr. Jones in room 120 is receiving 6 liter of oxygen via nasal cannula. Mr. Jones current oxygen saturation is 90%. What is the most appropriate response by the RN?

Answer 33

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Question 34

The patient. During the pre-operative check the patient says “I don’t want to do this. I don’t want to have surgery.” What is the first thing the RN does?A patient is scheduled for a craniotomy within the hour. The informed consent was signed by
14. Which strategy by the RN helps evaluate and assess patient learning?

Answer 34

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Question 35

Which strategy by the RN helps evaluate and assess patient learning?

Answer 35

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Question 36

A teenager is being admitted to the nursing unit with acute heroin over dose. What nursing interventions are included in the patient’s plan of care? Select all that apply

Answer 36

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Question 37

A patient admitted to the cardiac nursing unit has an order for an anti-hypertensive medications. A co-worker offers to provide the medication from another patient’s supply. What would be an appropriate response by the RN?

Answer 37

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Question 38

Which of the following is considered a sentinel event by the Joint commission requiring immediate investigation by the health care organization?

Answer 38

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Question 39

What should the RN do with an unlabeled container left on a sterile field used for a central line placement?

Answer 39

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Question 40

A RN states during a “hand off report” to the team leader that one patient has a moderate amount of drainage on the dressing. What should be the team leader’s response?

Answer 40

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Question 41

A co-worker gave a patient an extra dose of Colace. How does the RN respond to the co-workers question, “Do I have to make a medication error report?”

Answer 41

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