Quiz 6 Timby 6,9,11 Concepts 4 Flashcards
When providing nutritional education for a Mexican-American patient with newly diagnosed hypertension, the nurse notes that the patient is nodding “yes” to everything that is being said. Which action by the nurse is appropriate?
Write everything down for the patient to refer to later.
Prompt the patient further to elicit additional questions or concerns.
Call the patient’s oldest male relative for help with decision making.
Call the recognized elder for this patient.
Prompt the patient further to elicit additional questions or concerns.
The nurse is caring for a Latin-Caribbean patient who is behaving hysterically in the emergency room. The patient is crying, has uncontrollable spasms, and is trembling and shouting. What cultural bound syndrome should the nurse recognize these behaviors demonstrate?
Shenjing shaijo
Loco de la cabeza
Neurasthenia
Ataque de nervios
Ataque de nervios
Why is it important for nurses to have a broad understanding of cultural influences on health care?
Requirements of the Health Insurance Portability and Accountability Act (HIPAA)
Increasing global diversity
Litigious society
Disability entitlements
Increasing global diversity
A patient who has recently moved to this country states he is frustrated about the pressure to give up his original identity and develop a new cultural identity. Which term best describes this type of cultural change?
Ethnicity identification
Acculturation
Assimilation
Biculturalism
Assimilation
The nurse is working with a patient who has undergone transgender transformation to become a male. Which are some Western cultural masculine attributes the nurse should emphasize to the patient?
Harmonious relationships, modesty, and caretaking
Achievement, material success, and recognition
Fitness, fidelity, and stamina
Generosity, sportsmanship, and leadership
Achievement, material success, and recognition
Which of the following is the best definition of culture?
A- a group of sharped beliefs and behaviors that occur among those who live in a defined geographical region
B- a pattern of sharped behaviors among a cohesive group of individuals who may or may not be blood related
C- the way in which a common group of individuals thinks, acts, and socializes
D- a pattern of shared attitudes, beliefs, self-definitions, norms, roles, and values particular language or live in a defined geographical region
D- a pattern of shared attitudes, beliefs, self-definitions, norms, roles, and values particular language or live in a defined geographical region
Which term best describes the process by which a person learns the norms, values, and behaviors of a culture? A- acculturation B- enculturation C- assimilation D- biculturalism
B- enculturation
Which term best describes when the dominant cultural group imposes their values on the minority group? A- acculturation B- enculturation C- assimilation D- biculturalism
C- assimilation
_________ refers to a common ancestry that leads to shared values and beliefs
Ethnicity
Individuals labeled “black” are genetically distinguishable from individuals labeled “white”
A- true
B- false
B- false
Cultural norms impact a variety of aspects in life. Which of the following are influenced by culture? Select all that apply A-dietary preferences B- perceptions of illness C- religious practices D- medication adherence E- family dynamics F- genetic traits
A B C D E
Western culture typically attribute illness to natural causes like bacteria, viruses, climate, environmental irritants, and negative social interactions.
A- true
B- false
B- false
Patients may deny socially stigmatized illnesses or behaviors. Which of the following would most likely not be reveled to a health care provider?
A- a history of sexually transmitted infections
B- a history of rheumatic heart disease
C- a history of having difficulty paying medical bills
D- a history of being introverted
A- a history of sexually transmitted infections
Which of the following concepts are closely related to the concept of culture? Select all that apply A- coping B- motivation C- family dynamics D- communication E- adherence
A
C
D
True or false
A groups culture is passed from one generation to the next
True
True or false
Generalization is a supposition that a person shares cultural characteristics with others of a similar background
True
True or false
There are six major subcultures in United States
False
True or false
Cultural shock is the bewilderment over behavior that is culturally atypical
True
True or false
Cultural groups tend to share biologic and physiologic similarities
True
_________ is a term used to categorize people with genetically shared physical characteristics
Race
_______ is the belief that ones own ethnicity is superior to all others
Ethnocentrism
U.S. culture can be described as ______ or English based.
Anglicized
People from Mexico are often known as _______
Chicano
____________ are people who trace their ethnic origin to Latin or South America
Latinos
Which of the following statements is true regarding culturally competent care?
A- by treating every patient with respect and understanding nurses demonstrates culturally competent care.
B- culturally competent care means conveying acceptance of the patients health beliefs while sharing information, encouraging self efficacy and strengthening the patients coping resources
C- culturally competent care is less important today because there are many internet resources available to assist nurses with appropriate communication for patients belonging to various cultures
D- there is a weak correlation between patient centered care and culturally competent care
B- culturally competent care means conveying acceptance of the patients health beliefs while sharing information, encouraging self efficacy and strengthening the patients coping resources
A nurse at a small, rural hospital that lacks professional interpreter services has admitted a client who does not speak the dominant language. How should the nurse best communicate with this client?
Ask a family member to remain with the client at all times.
Rely on written, rather than spoken, instructions and questions when interacting with the client.
Base the client’s care on the nurse’s preexisting knowledge of the client’s culture.
Utilize a telephone-based interpreting service in order to communicate clearly with the client.
Utilize a telephone-based interpreting service in order to communicate clearly with the client.
The nurse asks a client who has recently given birth to begin breastfeeding her baby. However, the client informs the nurse that she cannot breastfeed the baby for a day because she believes that the mother’s milk on the first day is not pure. What is the appropriate action for the nurse in this case?
calling the nurse supervisor and informing him or her about the client
educating the mother about the advantages of colostrum and breastfeeding
feeding the baby with artificial milk till the mother starts breastfeeding
telling the mother that her beliefs are mere superstitions and of little value
educating the mother about the advantages of colostrum and breastfeeding
A client who practices Islam dies at the hospital surrounded by family members. Which action by the nurse demonstrates cultural sensitivity related to the client’s death?
consulting the family member prior to performing post-mortem care
having the family members consult with the funeral home for transport
allowing the family to remain present when the nurse washes the client prior to shrouding
informing the family members they may say their goodbyes so that care can be provided
consulting the family member prior to performing post-mortem care
An 8-year-old client with stunted growth, pallor, and weakness is admitted to the health care facility. On interviewing the mother, the nurse finds that the client is from the Mediterranean region and the symptoms had aggravated when the boy participated in a sports activity. Being aware of the ethnic variations, what action is most appropriate for the nurse?
ensuring that the client does not overexert himself
ensuring that the client takes a well-balanced diet
ensuring that the client regularly takes hematinics
ensuring that the client is not prescribed fluoroquinolones
ensuring that the client is not prescribed fluoroquinolones
The cardiologist advises the client to undergo angioplasty, a procedure to clear blocked coronary arteries. The client refuses the procedure and the nurse later discovers that the client believes in naturopathy and is taking herbal extracts to clear the coronary arteries. Which action should the nurse take?
Warn the client that majority of the herbalists are unqualified.
Tell the client that herbal therapy has not proven to be ineffective.
Ask the client to opt for herbal therapy and also undergo the procedure.
Tell the client that herbal medicines could lead to other complications.
Ask the client to opt for herbal therapy and also undergo the procedure.
A client of Asian descent has recently given birth and notes the presence of a dark blue area on the back of the baby. What should be the nurse’s explanation to the mother?
“It may be due to any intrauterine abnormalities.”
“It is normal for a baby of Asian ethnicity.”
“It may be due to your food habits during pregnancy.”
“I have called the doctor to check the baby.”
“It is normal for a baby of Asian ethnicity.”
A group of nurses who provide care in a large, urban hospital have attended an education session on transcultural nursing. Transcultural nursing encompasses which nursing action(s)? Select all that apply.
The nurses ensure that members of all racial and ethnic groups receive the same care.
The nurses carry out an assessment of each client’s cultural identity.
The nurses educate clients on the importance of culture, race, and language.
Each nurse builds an extensive knowledge base about cultures that are present in the region served by the hospital.
The nurses create plans of care that fit within each individual client’s belief system.
The nurses carry out an assessment of each client’s cultural identity.,
Each nurse builds an extensive knowledge base about cultures that are present in the region served by the hospital.,
The nurses create plans of care that fit within each individual client’s belief system.
Which behaviors demonstrated by the client would the nurse consider reflections of the client’s pride in ethnicity? Select all that apply.
Crying when given a diagnosis of cancer
Asking to wear unique clothing
Requesting native cuisine
Requesting assistance when transferring from bed to chair
Listening to folk music and dance
Asking to wear unique clothing,
Requesting native cuisine,
Listening to folk music and dance
The nurse is admitting a client who practices the Jewish faith to the acute care unit and calls the dietary department to order a kosher dietary tray without consulting the client about food preferences. Which behavior is the nurse demonstrating when performing this action?
generalization
ethnocentrism
stereotyping
ageism
Generalization
The nurse is caring for a client whose language skills are very limited in the dominant language, and an interpreter has been obtained. The interpreter appears to be telling the client more than the nurse is saying and possibly providing an opinion or medical advice. Which action is appropriate for the nurse to take?
Continue with the method of communication because the nurse does not speak the language.
Use a computerized application to confirm what the interpreter is saying.
Document in the medical record that the client is not making his own decisions.
Speak privately with the interpreter and instruct them to only provide language interpretation.
Speak privately with the interpreter and instruct them to only provide language interpretation.
Which factors contribute to the concept of a culture? Select all that apply.
Styles used for communication
Art and music
Language
Type of disease contracted
Items and clothing worn
Beliefs about health practices
Styles used for communication, Art and music, Language, Items and clothing worn, Beliefs about health practices
The nurse is educating a client of Chinese descent regarding the reduction and elimination of lactose in the diet. Which statement(s) made by the client indicates that the education was effective? Select all that apply.
“When I drink coffee or tea, I should use a non-dairy creamer instead of milk or cream.”
“I can use foods that use milk solids since those are not milk products.”
“If I drink milk, I should drink one large glass a day and none at any other time.”
“I should replace 2% milk with lactose-free milk.”
“I can use kosher parve foods because they are prepared without milk.”
“When I drink coffee or tea, I should use a non-dairy creamer instead of milk or cream.”,
“I should replace 2% milk with lactose-free milk.”,
“I can use kosher parve foods because they are prepared without milk.”
An 8-year-old black child is admitted to the pediatric unit for a tonsillectomy. On physical examination, the nurse finds that the child has keloid scarring on the chest. What should be the nurse’s reaction?
Consider the keloid normal for the ethnic background.
Request biochemical investigations.
Apply a dressing on the keloid.
Inform the physician and request a visit.
Consider the keloid normal for the ethnic background.
The nurse is caring for an older adult client who has been hesitant to seek health care. Which action(s) by the nurse would develop a trusting nurse–client relationship? Select all that apply.
addressing the client by title and last name
touching the client’s arm when speaking directly
following through with requests by the client
asking direct questions and waiting for responses
respecting the client’s privacy
addressing the client by title and last name,
following through with requests by the client,
respecting the client’s privacy
A nurse needs to bathe a client at the health care facility. What is the most appropriate action of the nurse before washing the client’s hair?
Acquire a special shampoo to bathe the client.
Give an oil massage before washing the hair.
Seek permission from the client.
Arrange the articles required.
Seek permission from the client
The nurse overhears a colleague state, “All people from that client’s country are rude.” What is the appropriate nursing response?
Respond by saying, “Stereotypes keep us from accepting others as unique individuals.”
Say nothing and ignore the comment.
Report the colleague to the nurse manager.
Agree and state, “Yes, I’ve noticed the same thing.”
Respond by saying, “stereotypes keep us from accepting others as unique individuals.”
The nurse is assigned to care for an older adult client and states to the charge nurse, “I do not know why I am always assigned to the old people. This client is probably confused, disoriented, and incontinent because of age too!” Which behavior is most likely informing the nurse’s statement?
Stereotyping
Ageism
Ethnocentrism
Generalization
Ageism
A nurse at a long-term care facility has completed a comprehensive assessment of an 83-year-old woman who has just moved to the facility. The assessment reveals that the new resident has a lactase deficiency. How should the nurse integrate this knowledge into the resident’s care?
The resident should be provided with supplementary dietary enzymes for the digestion of fats prior to each meal.
The nurse should liaise with the resident’s health care provider to ensure that a B-vitamin is prescribed.
The nurse should ensure that the resident is not given dairy products.
The nurse should arrange for a vegetarian diet.
The nurse should ensure that the resident is not given dairy products.
Which stereotypical ideas about older adult clients does the nurse associate with the concept of ageism? Select all that apply.
Burdensome to family
Cognitively enhanced
Physically impaired
Uninterested in intimacy
Financially independent
Burdensome to family,
Physically impaired,
Uninterested in intimacy
A parent brings a newborn into the clinic for a 3-month wellness visit and when assessing the back, the nurse observes a dark blue area on the lower back resembling ecchymosis that does not elicit a pain response when pressure is applied. What action should the nurse take to address this finding?
notifying child protective services of the potential for abuse
questioning the parent as to the possibility of an injury to the lower back
documenting the finding as a “Mongolian spot”
asking the parent if the child has spina bifida
Documenting the finding as a “Mongolian spot”
The nurse works in an urban hospital and cares for a diverse population of clients. Which action(s) by the nurse demonstrates the delivery of culturally sensitive care to clients? Select all that apply.
asking the client questions regarding health care beliefs related to the client’s culture
allowing the client to keep a religious necklace on until going into the operating room
indicating that the cultural groups should adapt to the Anglo-American culture
integrating the client’s cultural practices when assisting with the creation of the plan of care
maintaining direct eye contact during conversations with all cultural groups
asking the client questions regarding health care beliefs related to the client’s culture,
allowing the client to keep a religious necklace on until going into the operating room,
integrating the client’s cultural practices when assisting with the creation of the plan of care
The nurse is conducting a health interview with an older adult client. Which action indicates the nurse is engaging stereotyping during the interview?
asking the client if he or she prefers to be call by first name
inferring the client’s religious practices from the cultural background
avoiding questions about history of sexually transmitted infections
ensuring the interview room is fitted with adequate light prior to starting
avoiding questions about history of sexually transmitted infections
A nurse is assessing the skin of a black client to observe the baseline skin coloring. Which body part of the client would be suitable for the performing of this assessment?
abdomen
arms
face
back
Abdomen
A nurse is assigned the care of a client who speaks a nondominant language. The nurse does not understand the client’s language. Which agency resource is best for the nurse to use in this case?
A family member
A hospital employee who speaks the client’s language
A professional interpreter.
The hospital social worker.
A professional interpreter
The nurse observes that an increasing number of clients who do not speak the dominant language are coming for inpatient treatment at the local hospital, making communication difficult. What proactive intervention would be most appropriate for the nurse to recommend to assist with the facilitation of communication?
Having a volunteer known for speaking the language interpret for the client
Having the client’s family members interpret for the client
Using a translation application on a cell phone
Training professional interpreters
Training professional interpreters
A nurse has been cautioned by a nursing educator to ensure that stereotyping does not influence the nurse’s beliefs, behaviors, and interactions with clients from other cultures. What action by the nurse would be considered stereotyping?
making adjustments to a client’s diet based on the client’s stated religion
allowing race and ethnicity to inform the nurse’s assessments and client education
arranging for an interpreter to assist with the admission assessment of a client who is a recent immigrant
ascribing attributes to members of a particular culture that are unsupported by facts
ascribing attributes to members of a particular culture that are unsupported by facts
An adolescent informs the nurse at the clinic, “I do not know what is happening to me, my skin is turning very white in spots all over my hands.” The nurse assesses hypopigmented areas on the hands and documents the finding. Following evaluation by the health care provider, what education will the nurse provide to the client?
There may be a slight stinging sensation when washing the hands.
Using a pigmented cream will help to even the skin tones.
This is due to sun exposure, so your pigmented areas should be covered in sunscreen.
The hypopigmented areas will be confined to the present location.
Using a pigmented cream will help to even the skin tones
True or false
Clients who are extremely unstable or in severe discomfort may bypass the admitting department and go directly to the nursing unit.
True
True or false
The term “rule out” is used to indicate that the medical diagnosis is confirmed
False
True or false
Discharge planning helps determine that a clients post discharge needs are met in a timely manner
True
True or false
A skilled nursing facility provides health related care and services to people who require institutional care but not 24 hour nursing
False
True or false
A basic care facility provides assistance with cooking and laundry services to clients
True
_______ is the process of helping a person become familiar with a new environment
Orientation
The primary responsibility for admission lies with a _____ nurse
Registered
_______ has been defined as a vague uneasy feeling of discomfort or dread accompanied by an autonomic response.
Anxiety
______ is the termination of care from a health care agency
Discharge
People who do not meet the criteria for hospitalization are often transferred to ________ care facilities
Extended
What do Hispanics and those from centeral America eat and drink?
Atole, piloncillo, cinnamon, vanilla, and sometimes chocolate or a fruit.
What is the diet of African America’s?
Greens, grits, cornbread, and beans cooked with a generous amount of fat or fatty meats
What are common Asian American diets?
Rice and rice noodles, mixtures containing beef, chicken, fish, and soybean products; bok Choy; and bean sprouts.
Flavors are enhanced with mono sodium glutamate; soy, oyster, bean, and fish sauce; peppers, resulting in food that is both spicy, and salty.
What is the Native American diet?
What is grown locally like fry bread made from corn; meat that is hunted in land or fished from nearby rivers; and chicken, pigs, and cattle that are raised within the community.
What do Muslims eat?
Buy halal meat from Muslim shop keepers who sell only to Muslims. Islam also includes rules about not eating at a table where alcohol is served.Pork and alcohol are forbidden
What do Jewish people eat?
Kosher rules for food, which must be certified as such by rabbi. Utensils that have come in contact with meat may not be used with dairy and vice versa. Utensils that have come in contact with non kosher food may not be used with kosher food.
What do we need to do in order to be culturally competent?
Assessments of cultural nature
Acceptance of each client as an individual
Knowledge of health problems that affect particular cultural groups
Planning of care within the clients health beliefs system to achieve the best health outcomes
Must become skilled at managing language differences, understanding biologic and physiologic variations, promoting health education that will reduce prevalent disease, and respecting alternative health beliefs or practices.
Know about eye contact and distance with different cultures…
Native Americans
Very private.
Believe that no person has the right to speak for another and may refuse to comment on a family members health.
They prefer oral rather than written communication.
Know about eye contact and distance with different cultures…
African Americans
Must be addressed by tittle and last name and introduce self.
Nurse should follow up throughly with request.
Ask open ended question rather than direct.
Know about eye contact and distance with different cultures…
Latinos
Comfortable sitting close to interviewers and letting interactions unfold slowly.
Ask questions carefully.
Know about eye contact and distance with different cultures…
Asian Americans
Respond with brief or more factual answers and little elaboration.
Value simplicity, medication, and introspection.
May not openly disagree with people.
Eye contact with different cultures
Anglo-Americans generally make and maintain eye contact, but it will offend Asian Americans or native Americans.
Arab Americans may misinterpret as sexually suggestive.
Space and distance with different cultures
Asian Americans- more than an arms length away.
Native Americans- handshake is offensive.
Southeast Asia-sacred part only family can touch and area between a females waist and knees is private.
Know about alternative medications people might take and what do we say when they try and refuse the medication we give them
Folk medicine
And you ask the patient why they don’t want that medication and see if their is an alternative medication.
Let them have the option of doing both
What are restrictions for Jehovah witnesses?
Blood transfusions are refused even in life threatening situations because they believe blood is the source of the soul.
Know about shamans
A herbalist
Native Americans use herbs and spiritual rituals performed by tribal leaders or medicine men or women.
Know about Ayurveda.
Alternative medicine for Indians.
Know about curanados
Latino practitioner who is thought to have spiritual and medicinal powers.
Folk medicine for Spain and Latin America
What is soap charting?
The documentation style more likely be used in a problem oriented record.
S- subjective data- info about client
O- objective data- observations made by the nurse
A- analysis of the data- problem identification
P- plan for care- proposed treatment
What is narrative charting?
The style of documentation generally used in source oriented records, involved writing information about the client and client care in chronologic order.
What is focus charting?
A modified form of SOAP charting, uses the word focus rather than problem because some believe that the word problem carries negative connotations. Can be on current or changed behavior
What is pie charting?
A method of recording the clients progress under the headings of problem, intervention, and evaluation. Promotes nurse to address specific content in a charted progress note.
What is charting by exception
A documentation method in which nurses chart only abnormal assessment findings or care that deviates from a standard norm.
More efficient. Quick access to normal findings.
What is documentation?
The process of entering information
What is an extended care facility?
A health care agency that provides long term care designed for people who do not meet the criteria for hospitalization. Associated with nursing homes.
What is a skilled nursing facility?
Provides 24 hour nursing care under the direction of an RN. Must be referred to by a physician and must require daily skilled nursing care. Must also provide rehabilitation services.
What is intermediate care facility?
Provides health related care and services to people who, because of their mental or physical condition, require institutional care but not 24 hour nursing care.
What is basic care facility?
An agency that provides extended custodial care. The emphasis is on providing shelter, food, and laundry services in a group setting.
Know about anxiety with new admissions
Anxiety. Fear. Decisional conflict. Situational low self esteem. Powerlessness. Social isolation. Ineffective self health management.
Uncomfortable feeling caused by insecurity. It can be defined as vague, uneasy feeling of dread or discomfort.
What is DAR?
Focus charting.
D- data
A- action
R- response
notations tend to reflect the steps in the nursing process
Know about nonadherence to medication regimens.
Non adherence to medication regimens accounts for more than 10% of older adult hospital admissions, nearly one fourth of nursing home admissions, and 20% of preventable adverse drug events among older persons in an ambulatory setting.
Know who to notify upon admission and discharge
Business department
Physician
Know all the components of a medical and health history.
Present illness
Personal history
Past health history
Family history
Know all the eligibility to get home care services
- Services must be ordered by primary Dr.
- Person must be home bound
- Person needs skilled nursing care or rehabilitative services
- Person requires intermittent but not full-time care
- Care must be provided by/under arrangements with a Medicare-certified provider
What is an admission?
Means entering a health care agency for nursing care, medicinal, or surgical treatment
What is the term for discharging a client from one unit or agency and admitting him or her to another without going home in the interim
Transfer
What is termination of care from a health care agency
Discharge
What refers to obtaining and verifying the medications a client is currently taking. The name, dosage, frequency, of administration, and route are necessary pieces of information to obtain
Medication reconciliation
What type of care provides short-term, temporary relief to full-time caregivers of home bound clients
Respite care
What type of assistance provides one or two hot meals per day delivered either at home or at a community meal site
Meals on wheels
What agency investigates and pursues accountability of individuals who are physically, socially, emotionally, or financially victimizing vulnerable adults
Adult protective services
What is a discussion between a nursing spokesperson from the shift that is ending and the arriving personnel.
the first part of change of shift report. It includes a summary of each client’s condition and current status of care.
Change of shift report
What comes from loss of identity, decreased privacy, powerlessness and fear
Anxiety
What is a term used that applies to situations when the client leaves before the physician authorizes the discharge
AMA- against medical advice
Which strategy would provide the most effective form of change of shift report?
Recording the report for the oncoming shift prior to leaving the unit.
Utilizing a reporting form and allowing time for any questions.
Providing the oncoming nurse the client’s clipboard prior to leaving the unit.
Discussing the client’s visitors and complaints during the prior shift.
Utilizing a reporting form and allowing time for any questions.
The nurse is caring for a client whose spouse wishes to see the electronic health record. What is the appropriate nursing response?
“Let me get that for you.”
“Only authorized persons are allowed to access client records.”
“I am sorry I can’t access that information.”
“The provider will need to give permission for you to review.”
“Only authorized persons are allowed to access client records.”
A nurse will be finishing work for the day at 1900. Besides using the health care records, which form of communication should the nurse use to provide client details to the health care team coming on duty at 1900?
Telephone calls
Client assignments
Team conferences
Change of shift reports
Change of shift reports
A nurse has responded to a client’s call light, and the client has asked for assistance in transferring from the bed to the bathroom. However, the nurse has not previously been involved in the client’s care and does not know the client’s current activity orders. Where could the nurse most easily access this information?
the client’s computerized health records
checklists from previous nurses’ shifts
the nursing Kardex
the client’s medical chart
The nursing kardex
A client with hemiplegia has been admitted to the health agency. The nurse who cares for the client has a fixed routine of cleaning, feeding, and administering medicines to the client. Which should the nurse use to record these details?
flow sheet
checklists
nursing Kardex
nursing care plan
Checklists
The nursing student is discussing the need for a care plan with the instructor. What is the most appropriate explanation by the instructor for nursing care plan development?
“The care plan is required for every client by The Joint Commission.”
“The care plan shows the medical diagnosis for the client.”
“The care plan provides additional documentation about the work of the nurse.”
“The care plan is the only way for nurses to document what they do.”
“The care plan is required for every client by The Joint Commission.”
The nurse is caring for a client on a medical unit that uses focused charting to document client care. Which written statement by the nurse demonstrates the use of focused charting to document the client assessment?
The client was received into care at 0730 hr.
The client is accompanied by family members.
The client rates abdominal pain at 8/10.
The client reports feeling well all morning.
The client rates abdominal pain 8/10
A client was admitted to the emergency department with a confirmed diagnosis of tuberculosis. To whom should the nurse report this diagnosis?
Health Canada
the public health department
the client’s family
the client’s employer
The public health department
The health records department of a hospital has received a request from an insurance provider for a client’s health records. The request has been authorized by the client and bears the client’s signature. What principle should guide the hospital’s release of the client’s records?
The hospital should release the minimum amount of data that is necessary for the purposes of the request.
The hospital should deny the request unless there is a notarized or court-ordered request.
The hospital should release the client’s entire health record in order to ensure thoroughness and accuracy.
The hospital should release the health record to the client, who may then forward it to the insurance provider.
The hospital should release the minimum amount of data that is necessary for the purposes of the request.
A health care provider suggests that the nurse use the computer terminal that is available at the point of care or at the client’s bedside. In what scenario is this most important?
The client is being discharged and the nurse is providing discharge education.
The client has enacted his or her rights and demanded to see all records and documentation as they occur.
The client has had a sudden change in status needing immediate attention.
The client is receiving ongoing medication therapy for a chronic disease.
The client has had a sudden change in status needing immediate attention.
The nurses on a hospital’s high-acuity unit have traditionally used walking rounds to provide change-of-shift report. This practice may violate the principles of HIPAA for what reason?
The interaction includes only nurses and is not interdisciplinary.
Nurses tend to provide inaccurate information because of the presence of clients.
It is not normally possible to maintain confidentiality when discussing clients.
The content of the conversation is not documented in the client’s health record.
It is not normally possible to maintain confidentiality when discussing clients.
A health care agency has been asked to compensate a client as per a lawsuit filed for not following the Health Insurance Portability and Accountability Act (HIPAA) regulations. Which situation is a HIPAA violation?
not informing the auditors of the reason for sharing client health details
not informing a client in writing of the purpose of sharing his or her personal details
not informing the physician before sharing client-specific information
not informing health authorities before sharing client-specific information
not informing a client in writing of the purpose of sharing his or her personal details
The nurse is preparing a SOAP note. Which assessment findings are consistent with objective client data?
describes wound as itchy
concerned with feeling tired
pain rating of 4 on a scale of 0-10
urine output 100 ml
urine output 100 ml
In the computer, the nurse needs to document the time the client took medication. However, the time is written in the military format, and the computer accepts only the traditional format. How should the nurse enter the time in the computer if the client took his medication at 1530 hours?
05: 30 a.m.
03: 30 p.m.
03: 30 a.m.
03: 00 p.m.
03:30 p.m
A laboratory assistant who is trying to view the electronic record of a client’s personal history gets an error message, “You are not authorized to view this information.” What is the reason for this message?
The laboratory assistant does not have the correct access number.
The laboratory assistant can only retrieve patient records but cannot view the details.
The laboratory assistant does not have the correct password.
The laboratory assistant is trying to view archived data.
The laboratory assistant can only retrieve patient records but cannot view the details.
A recent nursing graduate has begun working at a site where SOAP charting is used for nursing documentation. When completing this form of documentation, the nurse will:
record the relevant data and then identify the action and progress that will be undertaken.
begin each entry with the subject and object that will be addressed in the charting entry.
differentiate between subjective assessment data and objective assessment data.
complete each charting entry with a prognosis for resolution of the problem.
differentiate between subjective assessment data and objective assessment data.
What does the nurse recognize as purposes of the electronic health record? Select all that apply.
qualifying health care providers for government funds
defending health care personnel during practice lawsuits
facilitating health education and research
ensuring client safety
documenting continuity of care
qualifying health care providers for government funds,
facilitating health education and research,
ensuring client safety,
documenting continuity of care
A nurse, when documenting the health details of a client in an acute care agency, fills out all the details under assessment, diagnosis, planning, and implementation. What did the nurse miss as per The Joint Commission (TJC) standards?
physician’s feedback
client’s diet chart
evaluation of outcomes
client’s past medical history
Evaluation of outcomes
A nurse uses the computer to access health records of the clients. What care should the nurse take when using a computer to access health records?
The password and access number should be shared only with the auditors.
The password and access number should be shared only with the physician.
The password and access number should be kept secret and changed regularly.
The password and access number should be shared only with the client.
The password and access number should be kept secret and changed regularly.
A physician has asked a nurse to use written forms of communication to share the client’s health status with other medical personnel. Which is an example of a written form of communication?
notepad
checklist
SMS
Checklist
A nurse has administered 1 unit of glucose to the client as per order. What is the correct documentation of this information?
1 bottle of glucose
1 Unit of glucose
1U of glucose
One U of glucose
1 unit of glucose
A hospital client has expressed dissatisfaction with the quantity and quality of care that they have been receiving since admission. The client has told the nurse that they would like to read their medical record. How should the nurse best respond to the request?
Grant the client access to the health record in accordance with the hospital’s policies.
Give the health record to the client and ask the client to return it to the nurses’ station when they are done.
Present the client’s request to the hospital’s ethics committee.
Inform the client of the need to generate a request through a lawyer.
Grant the client access to the health record in accordance with the hospital’s policies.
A client was recently hospitalized. To process insurance payment, the insurance company requested access to the client’s payment information. What is the most appropriate response to maintain client privacy?
Use minimum disclosure policy to release the information.
Release the full medical record to expedite payment.
Do not release any information to the insurance company.
Refer the insurance agency directly to the client.
Use minimum disclosure policy to release the information.
A nurse has administered six units of insulin to the client as per order. What is the safest documentation of this information?
six U of insulin administered
6U of insulin administered
six u of insulin administered
6 units of insulin administered
6 units of insulin administered
A client injured in an accident at her place of work has to be admitted in the health care facility. The client was taken directly to the nursing unit, and the client’s colleague is asked to continue with the admission formalities. What of the following information must be entered on the form?
maiden name
bank details
Medicare details
mother’s name
Medicare details
An 84-year-old man has presented to the primary care provider accompanied by his daughter. The daughter tells the care provider that her father has recently stopped sleeping in his bedroom and bathing in his bathroom. The man denies this, stating that he has simply decided to change his routines around the house. A nurse should consider the possibility that:
the man is unaware of the importance of hygiene and a comfortable place to sleep.
the man may benefit from a consultation with a social worker.
the daughter is manipulating her father for her own benefit or that of other family members.
the man may be downplaying his lack of mobility out of fear of having to move out of his home.
the man may be downplaying his lack of mobility out of fear of having to move out of his home.
The nurse is completing an admission assessment on an older adult who lives alone. The client states, “I am worried about who is going to care for my dog Trixie.” What is the most appropriate action by the nurse?
Take care of the pet for the client.
Make arrangements for care of the pet.
Tell the client not to worry about the pet.
Let the client bring the pet to the hospital.
Make arrangements for care of the pet.
A nurse is discharging a surgical client to home. The client will need to be referred to a home health agency. Which action made by the nurse ensures the client receives appropriate follow-up care?
completing a summary of the client’s current condition for the agency
providing the home health agency with the client’s operatory report
sending the agency the client’s vital signs for the entire hospital stay
reporting to the agency the last time the client had pain medication
completing a summary of the client’s current condition for the agency
The nurse is preparing to do an admission assessment on an older adult who came from an extended care facility. The nurse notices ecchymosis along both of the client’s arms. What is the most appropriate action made by the nurse?
Report the findings to the local police.
Confirm the findings with the physician.
Confirm the findings with the nursing home administrator.
Report the findings to Adult Protective Services.
Report the findings to Adult Protective Services.
The nurse is performing a medication reconciliation for an older adult client newly admitted to the unit. What action should the nurse perform when finding two bottles of the same medication with different dosages?
Notify the health care provider of the discrepancy of medication.
Log the medications in the computer system as ordered.
Ask the client what the last dosage the health care provider prescribed
Determine that the client’s condition may warrant both medications.
Notify the health care provider of the discrepancy of medication.
An adult who lives alone is recovering after surgery for left knee replacement. Which agency will provide the most appropriate care for this client?
intermediate nursing facility
extended care facility
assisted living facility
skilled nursing facility
skilled nursing facility
A client with a fibroid in the uterus is required to undergo surgery. The physician and the client agree that the surgery can be held on a later date. What kind of care is being given to the client?
primary care
urgent care
emergency care
planned care
planned care
During admission, a client receives an identification bracelet, which the client has to wear on the wrist during the client’s stay at the health care facility. Apart from the client’s name, what other information will the identification bracelet contain?
the client’s main medications
bar code
room number
nurse’s name
Bar code
Which client at a health care facility requires immediate medical attention from a nurse?
client with a cataract
client with fever
client with tonsillitis
client with bleeding
Client with bleeding
A nurse has been asked to obtain a client’s blood sample from the client’s central venous catheter and send the sample to the laboratory. What must the nurse do to ensure that the blood sample is collected from the right client?
Check the client’s room number.
Confirm the client’s name by asking a relative.
Ask the client for their name if the client is alert.
Check the identification band on the wrist.
Check the identification band on the wrist.
A nurse has admitted a new client to the hospital unit and completed a comprehensive assessment. After the nurse has collected these data, what should the nurse do next?
Teach the client about the reasons for admission.
Ensure that necessary safety equipment is present at the bedside.
Determine the best course of medical treatment for the client.
Create a plan of nursing care.
Create a plan of nursing care.
The nurse is starting the transfer on an adult with a hearing deficit. What is the best nursing action at this time?
Allow social services to handle the discharge.
Allow additional time to do the discharge.
Send discharge information to the transfer agency.
Stop the process until family arrives.
Allow additional time to do the discharge.
A client has just been admitted to the medical/surgical unit. When is the best time for the nurse to begin discharge teaching?
at the time of discharge
at the time of admission
when the IV medications are finished
when the client starts feeling better
at the time of admission
After a period of initial recovery, a client who experienced a stroke is being transferred from the acute neurological unit to a rehabilitative unit of the same hospital. What are the neurological nurse’s responsibilities during the transfer? Select all that apply.
Liaise with a nurse on the rehabilitative unit to arrange a time for the transfer.
Ensure the client and the client’s family are made aware of the transfer.
Remain with the client on the rehabilitative unit for four to six hours after the transfer.
Complete a written summary of the client’s current health status.
Teach the client’s family how to transport the client to the new unit.
Liaise with a nurse on the rehabilitative unit to arrange a time for the transfer.,
Ensure the client and the client’s family are made aware of the transfer.,
Complete a written summary of the client’s current health status.
A nurse provides care in a hospital in which there are as many as four beds in each room. The nurse is responsible for the care of all four clients in a particular room, one of whom requires the insertion of a Foley (urinary) catheter. How can the nurse best protect this client’s privacy?
Perform the procedure silently and without explanation so that the other clients in the room are unaware of the procedure.
Ensure that the curtains around the client’s bed are secured so that the client cannot be seen by others.
Ensure that the door to the room is closed before beginning the procedure.
Arrange for the other clients in the room to be temporarily removed from the room.
Ensure that the curtains around the client’s bed are secured so that the client cannot be seen by others.
A client has been admitted to the nursing unit of a health care facility following a head injury. Which department will take care of the payment details?
nursing department
admitting department
outpatient department
diagnostic department
Admitting department
A nurse is caring for a client involved in an accident. The client informs the nurse about wanting to leave the facility immediately after first aid, although the health care provider has prescribed tests and not given permission for discharge. Which nursing action is the priority at this time?
completing all discharge procedures
providing written discharge instructions
preparing the client for discharge from the facility
obtaining the client’s signature on a dated release form
obtaining the client’s signature on a dated release form
A diabetic client who lives alone is to be discharged from the hospital with a large abdominal wound that requires comprehensive nursing care. Which agency will provide the most appropriate care for this client?
skilled nursing facility
assisted living facility
extended care facility
intermediate care facility
Skilled nursing facility
A client admitted to the health care facility for a surgery has lost his identification bracelet. What is the nurse’s responsibility in this case?
registering a complaint with the administration for loss of the bracelet
ensuring that an identification bracelet is received before client discharge
introducing the client to the health care personnel on the unit
arranging for replacement of the bracelet immediately
arranging for replacement of the bracelet immediately
The nurse enters the room to begin the admission assessment on a new client. The nurse gives an introduction and asks how the client is feeling. The client reports feeling anxious. Which response made by the nurse indicates proper attention and support of the client?
“Can you tell me more about your anxiety?”
“Can I get you something for that?”
“You look a little anxious.”
“It’s not being here that is making you anxious, is it?”
“Can you tell me more about your anxiety?”
A client who has completed all the admission formalities is escorted to the nursing unit. Meanwhile, the admission department also informs the nursing unit about the arrival of the client. Which nursing action is the priority at this time?
arranging for waste baskets near the bed
providing personal care items
placing oxygen administration equipment
arranging for denture containers
placing oxygen administration equipment
True or false
Source orientated records provide a documentation approach that is sometimes criticized for being fragmented or disjointed
True
True or false
HIPPA is responsible for accreditation of health agencies
False
True or false
Narrative charting is organized according to client problems rather than time
False
True or false
HIPPA regulations make it mandatory to have names of clients publicly visible on charts
False
True or false
Military time uses different four-digit numbers for each hour and minute of the day
True
Charting by ______ is a documentation method in which nurses chart only abnormal assessment findings or care that deviates from the standard
Exception
PIE charting is organized according to problem, intervention, and _______
Evaluation
Nurses use the _______ to obtain quick access to current information about a client
Kardex
__________ charting is used to document client information electronically
Computerized
Nurse use ______ to document the types of care that are regularly repeated briefly and efficiently
Checklist
